Effect of tropicamide and homatropine eye drops on a-scan parameters of the phakic normal eyes

A prospective study to evaluate the changes in A-Scan axial parameters of phakic normal eyes before and after instillation of 1% topical Tropicamide and 2% Homatropine eye drops. Anterior chamber depth, lens thickness, vitreous chamber length, and ocular axial length were measured in 76 eyes before and after cycloplegia induced by 1% topical Tropicamide, and in 28 eyes with 2% Homatropine eye drops. Anterior chamber depth demonstrated increase from baseline readings with Tropicamide and Homatropine eye drops, while lens thickness showed decrease from the baseline readings with both eye drops. Effect of both the eye drops on over all axial length and vitreous chamber length is statistically seen, but is clinically negligible and not significant. Cycloplegia induced by 1% Tropicamide eye drops and 2% Homatropine eye drops has a significant measurable influence on anterior chamber depth and lens thickness, while vitreous chamber length and overall axial length demonstrated negligible statistical difference on A-Scan parameters of the normal phakic eyes

Effect of 10 percent phenylephrine eye drops on systemic blood pressure in normotensive and hypertensive patients

A prospective study to evaluate the effect of 10% Phenylephrine eye drops on systemic blood pressure in normotensive and hypertensive patients. The sample comprised of 55 normotensive patients and 34 hypertensive patients were subjected to 10% Phenylephrine eye drops during routine eye examination. No statistically and clinically significant increase in blood pressure after the instillation of 10% Phenylephrine eye drops was seen in 87% of normotensive patients and 76% of hypertensive patients. Mild rise of blood pressure was seen in 11% of normotensive patients and in 15% of the hypertensive patients. Only one patient [3%] had severe rise of blood pressure in the hypertensive group. This study shows that pupillary dilatation with 10% Phenylephrine eye drops did not significantly increase systemic blood pressure in normotensive and hypertensive patients. Although precautions should be taken when used in hypertensive patients

Treatment of primary pterygium: Role of limbal stem cells and conjunctival autograft transplantation

The limbus and its stem cells are very important in the pathogenesis of pterygium. In this study, the efficacy of limbal stem cells and conjunctival autograft transplantation for the treatment of primary pterygium will be assessed. Prospective noncomparative cohort study. Forty-two eyes of 42 patients with grade I-III primary pterygium were included in the study. Pterygium excision was performed followed by superotemporal limbal stem cells and conjunctival autograft transplantation in all cases. Recurrence of pterygium and complications within a mean follow-up period of 18.26 months [10-28 months] was studied. Recurrence of pterygium occurred in two eyes [2/42; 4.75%]. No significant complications were noted. Apart from re-operation in the two recurrent cases, no further surgical interventions were needed in any case. Conclusions: Limbal stem cells and conjunctival autograft transplantation is a safe and effective technique for the treatment of different grades of pterygium. It is very useful in preventing pterygium recurrence, which is a major problem in pterygium surgery

Use of supero-temporal free conjunctivo-limbal autograft in the surgical management of pterygium: our technique and results

A pterygium is a fibro-vascular, wing shaped encroachment of the conjunctiva on to the cornea. The prevalence rates ranges from 0.7 to 31% among different populations and also influenced by age, race, and exposure to solar radiations. Ultraviolet light-induced damage to the limbal stem cell barrier with subsequent conjunctivalisation of the cornea is the currently accepted aetiology of this condition. Indication of surgery include visual impairment, cosmetic disfigurement, motility restriction, recurrent inflammation and interference with contact lens wear. This Study was conducted to know the safety, efficacy and success with supero-temporal free conjunctivo-limbal auto graft transplantation in the surgical management of pterygium. Prospective case series where supero temporal free conjunctivo-limbal auto grafting was performed on 72 eyes of 72 patients with vascular progressive pterygia. Pterygium recurrence was considered a surgical failure. Recurrence was defined as fibro vascular tissue crossing the corneo-scleral limbus on to the clear cornea in the area of previous pterygium excision before 6 months. Recurrence of pterygium was noted in three out of 72 eyes [4.16%], after a minimum follow up of 12 months to maximum of 25 months [Mean 14.6 months]. No major intra-operative or postoperative complications were encountered. Supero temporal free conjunctivo-limbal auto graft appears to be a safe and effective technique in the surgical management of pterygium. The inclusion of limbal tissue in the conjunctival auto graft following pterygium excision appears to be essential to ensure low recurrence rate

unusual presentation of intraorbital foreign bodies in an eye injury at work place

We report a case of a 27 year old male who presented to us with a badly lacerated upper lid in left eye with proptosis, chemosis and decreased vision associated with traumatic cataract, iridodialysis, vitreous and retrobulbar haemorrhage following a work place injury with paper grinding machine. The diagnosis of an intraorbital foreign body initially evaded us, as clinical examination, plain x-ray and ultrasound of orbit failed to show it

Management of refractory vernal keratoconjunctivitis with supra tarsal triamcinolone injection: our results

Vernal keratoconjunctivitis [VKC] cases are sometimes resistant to conventional treatments. We aimed to assess the efficacy, safety and longevity of the effect of supratarsal injection of intermediate acting steroid triamcinolone acetonide in the management of recalcitrant vernal keratoconjunctivitis. A prospective study comprising of Forty five patients [90 eyes] with severe VKC, and resistant to conventional method of treatments were selected and underwent injection of 0.6 ml triamcinolone acetonide in supratarsal area [in conjunctival side of upper lid] and were followed up for 12 months. Dramatic relief of symptoms [burning, itching, lacrimation and photophobia, tenacious discharge] was seen in all patients, in first few days after the supratarsal injection. Size of the cobble stone papillary hypertrophy in tarsal conjunctiva, gelatinous thickening of conjunctiva at limbus decreased significantly in the first month, but never disappeared completely. The mean period of recurrence of symptoms was 156.6 days [range 13-359 days]. No complication was noticed during the follow up period. All patients tolerated the treatment well. Supra tarsal injection of triamcinolone acetonide is a cheap, effective and safe modality for temporary suppression of clinical signs and symptoms of eyes with recalcitrant vernal keratoconjunctivitis. Rapid and dramatic symptomatic and clinical response and lack of complications suggest that supratarsal injection of triamcinolone acetonide could be a therapeutic approach for refractory vernal keratoconjunctivitis

Intra ocular pressure measurement with Goldmann applanation tonometer without using fluorescein: our results

The purpose of this prospective, double blind study was to evaluate a modified technique of Goldmann applanation tonometry without the use of fluorescein and compare these results when Goldmann applanation tonometry was done with fluorescein in same patients. The intraocular pressure in 86 eyes of 43 patients was measured with and without fluorescein by Goldmann applanation tonometry. Goldmann applanation tonometry without fluorescein underestimated IOP levels by 1 mm Hg. The modified technique of Goldmann applanation tonometry without fluorescein reflects standard Goldmann tonometry with fluorescein after a correction factor of + 1 mm Hg

Outcome of trabeculectomy surgery in primary open angle glaucoma

Retrospective study to evaluate the short term outcome and contributing prognostic factors of trabeculectomy in terms of intraocular pressure in Omani patients of South Batinah region with primary open-angle glaucoma. This study involved retrospective evaluation of 18 patients [22 eyes] with primary open angle glaucoma who underwent primary trabeculectomy between February 2005 and February 2008. All patients were aged over 40 years and were Omani. Follow-up for all subjects lasted at least 6 months or more [Average follow up 388 days with standard deviation of 182]. Successful control of Intraocular pressure [IOP] was defined as achieving IOP of 21 mmHg or less without medication [complete success]. The results are presented with particular emphasis being placed only on intraocular pressure [IOP] control. The tonometric success rate of trabeculectomy in controlling the IOP at 21mmHg or less without any medication was 46% [complete successes], 18% had qualified success [Post operative IOP 21 mm Hg or less with one topical medication], while 36% trabeculectomies failed to show desired results. The results of this retrospective study underline that the procedure of trabeculectomy has moderate success in controlling the intra ocular pressure in the study population. The procedure failed to show the desired result in almost one third of the patients [36%] and topical medical treatment was reinstated in these patients with either two or three drugs. However these results lead to the following question: Should trabeculectomy be the therapy of first choice in the early stage of glaucoma?

Safety and efficacy of supra- tarsal injection of triamcinolone in the management of refractory vernal keratoconjunctivitis

We aimed to assess the efficacy, safety and longevity of the effect of supratarsal injection of intermediate acting steroid triamcinolone acetonide in the management of recalcitrant vernal catarrh. In this prospective study 45 patients [90 eyes] with severe Vernal Keratoconjunctivitis [VKC], resistant to conventional method of treatments underwent injection of 0.6 ml triamcinolone acetonide in supratarsal area [in conjunctival side of upper lid]. The effects were monitored and cases were followed for 12 months. Dramatic relief of symptoms [burning, itching, lacrimation and photophobia, ropy discharge] was seen in all patients in first few days after the supratarsal injection. Size of the cobble stone papillary hypertrophy in tarsal conjunctiva and gelatinous thickening of conjunctiva at limbus decreased significantly in the first month but never disappeared completely. Mean period of recurrence of symptoms was 156.6 days [range13-359 days]. All patients tolerated the treatment well and no complication was noticed. Rapid and dramatic symptomatic and clinical response and lack of complications shows that supratarsal injection of triamcinolone acetonide is safe and effective therapeutic approach for refractory VKC

Unilateral retinitis pigmentosa with hypoplastic tilted disc in other eye

A case of a 32-year-old woman showing pigmentary degeneration of the retina in one eye associated with a hypoplastic tilted disc in fellow eye is presented. Clinical examinations of the patient were performed in order to rule out the various causes which are known to produce fundoscopic features that mimic retinitis pigmentosa. Since these investigations were all negative, the fundus changes were interpreted as a unilateral retinitis pigmentosa. Four years later, the patient was re-examined and the findings were reconfirmed. An association of unilateral retinitis pigmentosa and hypoplastic tilted disc in the other eye can be regarded as exceptional. The possibility of a correlation of the pathogenetic mechanism involved in the development of both conditions is discussed

case of eye lid trauma with retained glass pieces in road traffic accident

We present a case of 33-year-old expatriate woman who presented to us for simple suture removal from her left upper eyelid. She was a front seat passenger and met with a road traffic accident. Primary lid repair was done in nearby poly-clinic. The presence of foreign bodies in her left eyelid was not suspected at the time of primary repair probably due to inadequate history and paucity of clinical findings or lack of imaging studies. The significance of eyelid lacerations in relation to minor initial clinical signs and possible late complications is discussed and suggestions are made for management of all such injuries

Gyrate retinal atrophy of choroid and retina: a case report of 3 members in one family

Hyperornithinemia associated with gyrate atrophy of the choroid and retina is a rare, autosomal recessive disorder resulting from a deficiency of the mitochondrial matrix enzyme, ornithine d-aminotransferase [OAT]. Highest rate of gyrate atrophy is reported in Finland. We report for the first time 3 cases [siblings] in one Omani family in the Gulf, presenting with the classical clinical features and biochemical abnormality of this condition. The available forms of treatments which include treatment with pyridoxine, dietary restriction of arginine and supplementation with creatinine andproline, are known to slow the progress of disease process and help to delay the patient s morbidity, but no form of therapy is found to be unequivocally effective

Safety, efficacy and success with supero-temporal free conjunctivo-limbal autograft in the surgical management of pterygium: Our technique and results

The objective was to study the safety, efficacy and success with supero-temporal free conjunctivo-limbal autograft transplantation in the surgical management of pterygium. Prospective case series where superotemporal free conjunctivo-limbal auto grafting was performed on 24 eyes of 24 patients with vascular progressive pterygium. Pterygium recurrence was considered a surgical failure. Recurrence was defined as fibrovascular tissue crossing the corneoscleral limbus on to the clear cornea in the area of previous pterygium excision. recurrence of pterygium was noted in one out of 24 eyes [4.16%], after a minimum follow up of 6 months to maximum of 25 months [mean 14.6 months]. No major intraoperative or postoperative complications were encountered. In conclusion, superotemporal free conjunctivo-limbal autograft appears to be a safe and effective technique in the surgical management pterygium. The inclusion of limbal tissue in the conjunctival autograft following pterygium excision appears to be essential to ensure low recurrence rate

Bilateral pseudo-papilloedema due to optic nerve head drusen in a young patient

We report a case of 15 year old boy, who was found to have raised bilateral optic nerve heads on routine eye examination. After an initial dilemma of diagnosis, detailed eye examination supported by imaging studies confirmed the diagnosis of bilateral pseudo-papilloedema due to optic nerve head drusen. Parents of the patient were reassured and patient was discharged from eye clinic with the advice of follow up every 6 to 12 months

Pre and post operative assessment of astigmatism in pterygium cases

A significant degree of corneal astigmatism can be induced by the encroachment of a pterygium on to the cornea, which can have a significant impact on vision. There is a significant correlation between the extension of the pterygium on to the cornea and the amount of induced astigmatism. The pterygium generally causes With the Rule astigmatism that is hemi-meridional on the side of pterygium. This study was undertaken to evaluate the effect of successful pterygium surgery on existing refractive astigmatism. Four eyes with primary pterygium with astigmatism were analysed before and after pterygium excision. Astigmatism increased with the increase in the grade of pterygium, and subsequent excision of the pterygium brought a significant decrease in With the Rule astigmatism