Frequency of different types of paediatric ocular trauma attending a tertiary care paediatric ophthalmology department

To assess the etiological factors and circumstances associated with the occurrence of eye injuries in children attending a tertiary care pediatric ophthalmology department. This study was conducted at the Department of Pediatric Ophthalmology, Civil Hospital, Karachi from August 2007 to July 2009. Personal information, clinical findings and management plan was recorded on a prescribed performa. Variables studied included: age, sex, date of injury, place of injury, involved eye, circumstance and mechanism of injury, initial visual acuity and immediate management. A total of 462 patients under the age of 16 years presented with ocular trauma. There were 297[64.3%] males and 165[35.7%] females. Mean age was 7.03 +/- 3.61 years. Most cases 198 [42.9%] belonged to the schoolgoing age group [6 to 11years]. The injuries occurred most frequently at home [215 patients, 46.5%].Blunt trauma occurred in 228[49.4%] cases followed by penetrating in 162[35.1%] cases. Injuries restricted to the eyelid occurred in 61 [13.2%] accidents, closed globe injury occurred in 338 [73.1%] and open globe injury in 63 [13.7%] accidents. Visual acuity was better than 6/12 in 245 [53.0%] children. Two hundred and fifteen children [46.5%] were prescribed only general measures like pressure patching, warm or cold compresses antibiotics or lubricant eye drops. Surgical management was required in 121[26.2%] patients. This study has shown frequencies of different type of ocular trauma which can be minimized by taking preventive measures as adopted in developed countries

Stargardt's disease: clinical presentation and fundus fluorescein angiographic findings

Objective: To document the clinical presentation and fundus fluorescein angiographic findings in Stargardt's disease

Methodology: This descriptive study was conducted at the Department of Ophthalmology Unit-I Civil Hospital Karachi and Unit III Lyari General Hospital Karachi of Dow University of Health Sciences from June 2004 to May 2008. Patients were selected from the out patient department of Sindh Govt. Lyari General Hospital and Civil Hospital Karachi fulfilling the inclusion criteria. Sociodemographic data and family history were obtained and patients subjected to complete ophthalmic examination of anterior and posterior segment and Fundus Fluorescein Angiography

Results: Thirty patient were found to have Stargardt's disease. Mean age was 18.4 +/- 6.9 years. Twenty two [73.4%] patients were found to be 20 years of age or below. Males [18 [60%]] outnumbered the females [12[40%]]. Visual acuity at presentation revealed a symmetric loss of vision in right and left eyes [P=0.410 at 99% CI]. Macula showed atrophic lesion in 12 cases [40%], beaten bronze in 13 [43.3%] cases and varnished appearance in 5 [16.7%] cases. Retinal flecks were found in 18 [60%] patients only. Fundus fluorescein angiography revealed dark choroids and elliptical hyperfluorescent lesion at the macula in all the patients. Tiny hyperfluorescent areas not corresponding to the area of flecks were found only in 18 [60%] patients

Conclusion: We conclude that Stargardt's disease has varied presentation and there is a familial and genetic predilection

Prevalence of diabetic retinopathy and influence factors among newly diagnosed diabetics in rural and urban areas of Pakistan: data analysis from the Pakistan national blindness and visual impairment surgery 2003

To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabetics from the data set of Pakistan National Blindness survey 2003. We analyzed the data collected from the Pakistan National Blindness Survey, a population based survey with regards to diabetic retinopathy and its risk factors. Descriptive information for each of the variable was derived and distribution was assessed by simple tabulation and cross tabulation. We used Odds Ratio [using Mantel-Haenszel technique] and 95% confidence interval to assess association between the variables. Among the 16507 subjects [95.3% response rate] 660 [4%] were found to be diabetic. Out of these, one hundred one [15.3%] had diabetic retinopathy. We found a low prevalence of diabetic retinopathy [0.6%] among the subjects aged 30 and above. The risk of diabetic retinopathy was higher in urban diabetic subjects [OR 2.7, with 95% CI 1.08-4.1] as compared to rural areas of Sindh. In addition it was higher in hypertensive [OR 2.77 with 95% CI 1.0-4.1] and in obese [OR 2.2 with 95% CI 1.7-4.2] as compared to subjects with normal body mass index [BMI]. The prevalence of blindness in diabetic subjects was 5.9%. There were three hundred forty four [52%] subjects with diabetes with normal vision, 149[22%] subjects were with moderate visual impairment, thirty six [5.9%] subjects were blind and twenty two [3.3%] subjects were with severe visual impairment. About 214 diabetics have hypertension [32.4%], one hundred forty one [21.3%] diabetics are obese. Our study data suggests lower prevalence of Diabetic Retinopathy as compared to other part of the region. There is great need to collect and monitor epidemiological data at district hospital level in order to develop a national annual retinal screening program for diabetic patients in Pakistan