Visual screening; government, private and community school going children in Faisalabad

Various eye diseases affect school going children. They do not complain of defective vision usually. Uncorrected visual problems are the basic reason for early visual impairment and blindness. An early diagnosis and treatment can reduce it to a great extent. To reduce the prevalence of avoidable blindness among urban children in Pakistan. It was an observational and interventional study conducted in various Government, Private and Community Schools. The children requiring detailed ophthalmic examination and surgeries were referred to Diagnostic and Research Centre, Department of Ophthalmology, Allied Hospital, Punjab Medical College, Faisalabad. January, 2013 - December, 2013. Age: 5 -16 years. Total 60,402 children were screened from 87 government, private and community schools. All the students were screened for eye disorders by testing visual acuity with Snellen's chart, anterior segment by torch light examination and fundus examination with ophthalmoscope. The study team included the school teachers, a clinical ophthalmologist, a refractionist, a community ophthalmologist, an optometrist, an ophthalmic technician, physiologist, PG trainees and a community social worker. The children identified with more complex visual problems were referred for detailed examination to Allied Hospital. Every government, private and community school of the target area was visited. All the data was collected, arranged and analyzed. During study period, total 60,402 children were screened from 87 government, private and community schools. The students having visual acuity >/= 6/12, with or without glasses, were considered as normal. Out of 60,402 screened children, 54966 [91.01%] were normal and 5436 [8.99%] were identified by the teachers with the eye problems. 2,028 [3.35%] students were provided spectacles. Among these, 364 were boys and 1664 were girls. This shows 18% refractive error in boys and 82% in girls. 120 children were treated by surgery; 63 for cataract [0.1%], 42 for squint [0.06%] and 15 [0.02%] for ptosis. Other identified ocular problems were chalazion 671[1.11%], blepheritis 696 [1.15%], corneal ulcer/ opacity 7 [0.01%], conjunctivitis 1133 [1.87%], non-cooperative 781 [1.29%]. In urban areas of Faisalabad district, 8.99% of school going children needed treatment for their ocular problems. School screening programs could play an essential role in the betterment of eye health and the avoidance of blindness among urban children in Pakistan

Comparison of three port and two port technique of silicone oil removal

Objective: this study was conducted to see whether the three port or two port technique is better to remove the silicone oil in patients who have undergone pars plana vitrectomy and silicone oil injection for the treatment of retinal detachment more than three months ago

Study Design: it was a prospective interventional study

Place and Period of study: conducted in Ophthalmology Departments of Mayo Hospital, KEMU Lahore and Allied Hospital, Punjab Medical College Faisalabad from July 2012 to July 2014

Materials and Methods: total fifty patients were included in this study, aging from 19 to 71 years with an average of 43.71 years. They had undergone pars plana vitrectomy with silicone oil endotamponade, more than three months ago. Prophylactic 360degree laser had been applied to all these cases. These patients were divided into two main groups, A and B, each group comprising of twenty five patients. In group A silicone oil was removed by using three port technique and in group B by two port technique. All patients were examined on the first postoperative day and then after one month. The final best corrected visual acuity was checked postoperatively by Snellen's chart one month after silicone oil removal

Results: on first postoperative day, in group A all patients had attached retina, no silicone oil bubble seen in vitreous cavity while there were few microdroplets of silicone oil. After one month best corrected visual acuity [BCVA] of operated side was on average 0.17, from minimum 0.03 to maximum 0.33. In group B all patients had attached retina, slightly more microdroplets of silicone oil in the vitreous cavity. Two patients [8%] had a part of silicone oil remaining behind in the vitreous cavity. So we had to operate again these patients to remove the last bubble of silicone oil. After one month BCVA of operated side was on average 0.12, from minimum 0.05 to maximum 0.25

Conclusion: the three port technique of silicone oil removal looks to be a better one. The ultimate best corrected visual acuity was slightly better with this technique and there were few microdroplets of silicone oil in vitreous cavity as compared with two port technique

Optical coherence tomography [OCT]; findings and visual acuity [V/A] in diabetic macular edema [DME] patients

To see the consequences of diabetic macular edema as assessed by optical coherence tomography [OCT] and visual acuity [V/A]. A prospective observational study. Patients were selected by simple random technique. Jan 2012 - Dec 2013. A total of one hundred patients [200 eyes] of ages forty two to sixty three years with an average age of 51.04 +/- 6.26 years of either sex were included. All these patients were examined in the outpatient department and were diagnosed as diabetic with macular edema and no opacity in refractive media. Their V/A was checked. OCT was performed in the Diagnostic and Research Centre, Department of Ophthalmology, Allied Hospital, Faisalabad. Out of 200 eyes on OCT our findings were Diffuse Retinal Thickening in 199 eyes [99.5%], Cystoid Macular Edema in 119 eyes [59.5%], Subretinal Fluid in 48 eyes [24%], Epiretinal Membrane in 15 eyes[7.5%], Vitreomacular Traction in 11 eyes [5.5%] and Taut Posterior Hyaloid Membrane in 4 eyes[2%]. The visual acuity on the right side was 0.29+/-0.19 and on left side it was 0.38+/-0.11. The macular thickness was 437.10+/-82.57 microns on the right side and 414.01+/-69.35 microns on the left side. The best-corrected visual acuity was significantly correlated with central foveal thickness. Our results showed, on the right side, a significant negative correlation [correlation coefficient: -0.355, p<0.01] between them. On the left side, a significant negative correlation [correlation coefficient: -0.362, p<0.01] was recorded

Cataract; evaluation of density and its relation with axial length

Among all ophthalmic diseases, cataract is the most commonest disorder not only in Pakistan but also worldwide. There are a number of causes for cataract development. The present study was carried out to evaluate the density of cataract and its relation with axial length of the eye. In this observational study, the patients with cataract in both eyes were selected by simple random technique. From June to December 2012. Place: This study was conducted in Diagnostic and Research Centre, Department of Ophthalmology, Allied Hospital, Punjab Medical College, Faisalabad. In present study 200 eyes of 100 patients were included having cataract in both eyes. Only those patients were selected who had no pathology other than cataract affecting visual acuity. The density of the cataract was assessed by measuring visual acuity. The axial lengths of both eyes were measured at the time of examination to see the relation between the axial length and density of cataract. The comparison of the two eyes regarding the evaluation of the density of cataract and its relation with axial length was performed. Out of 100 patients 74 [74%] had a denser cataract or lesser visual acuity in the eye with a longer axial length [DCLAL] and 26 [26%] had a denser cataract or a lesser visual acuity in the eye with shorter axial length [DCSAL]. On right side the axial length was 24.84 +/- 1.73 and on left side, it was 21.62 +/- 1.63. Our results showed that on right side, the visual acuity was 0.19 +/- 0.09 and on left side, it was 0.23 +/- 0.08. The axial length and visual acuity were statistically analyzed. The correlation was significant at the 0.01 level [2-tailed].The correlation coefficient was -0.04 on right side and on left, it was -0.12 showing inverse correlation between the two variables. There is a strong correlation between density of cataract and the axial length of the eyeball

Derangements of pulmonary function tests; arterial blood gases in asthmatics after exercise

Asthma is one of the commonest diseases not only in Pakistan but also worldwide. This is cross-sectional analytical study. The study was carried out at Chest Department Civil Hospital Faisalabad. [Six months] Sep 2011 to Feb 2012. The effects of exercise in asthmatic patients as revealed by their pulmonary function tests [PFT's] and arterial blood gas [ABG] analysis. Total sixty male subjects having age from thirty to forty years were included. They were divided into experimental and control groups, each consisting of thirty cases. In experimental group all asthmatic patients were included who have been diagnosed six months earlier. The results of PFT's and ABG were recorded and compared, during pre and post exercise periods. At rest there was non-significant difference of PFT's and ABG in two groups. After six minutes exercise on bicycle-ergometer, there was a significant decrease in Forced Expiratory Volume during first second [FEV, P=0.026], Forced vital 1 capacity [FVC, P=0.036], Partial Pressure of Oxygen [PaO[2], P=0.036] and Partial Pressure of Carbondiaoxide [PaCO[2], P=0.020] in asthmatics. We concluded that in response to exercise challenge in asthmatics, PFT's have more precision for assessment than ABG