Frequency and risk factors for myopiaamong children visiting ophthalmology outpatient department of Bahawal victoria hospital, Bahawalpur

Background: Myopia is one of the preventable cause of visual impairment

Objective: Objective of this study was to determine the frequency and risk factors for myopia among children [6-12 years] visiting Ophthalmology outpatient department of Bahawal Victoria Hospital, Bahawalpur

Patients and Methods: It was cross sectional study conducted in Ophthalmology outpatient, department of Bahawal Victoria Hospital, Bahawalpur from 1[st] July, 2012 to 30[th] June 2013. After taking ethical approval from hospital ethical committee, all the children aged 6-12 years visiting Ophthalmology outpatient department, whose parents had endorsed informed written consent, were included in the study. After collecting personal detail of each participant, and noting risk factors from their parents by using questionnaire, the visual acuity of each child was checked by using Snellen's chart. The children having visual acuity less than 6/6 in at least one eye underwent refraction by using retinoscopy after 1% cyclopentolate eye drops had been instilled at least half an hour previously. Data was entered and analyzed by using SPSS version 17. Spherical equivalents equal to or more than -0.50 D in either eye was taken as myopic. Chi square test was applied to see any statistical difference if existed and p-value

Results: Out of total 2936 children, 57.93% were myopic. 32.86% children were in the age group of 6-8 years, 54.67% in 9-11 years and 12.47% were >/= 12 years of age. 67.37% children were females. Family history of myopia was positive in 65.8% children. The reading hours of 17.3% children were 8 hours per day in 6.48%. The duration of TV watching was 4 hours in 2.02% children. 60.72% of the children were spending their time in playing video games or using computer for 4 hours

Conclusion: There is strong association of myopia with near work and parental myopia

Amniotic membrane transplantation for symptomatic bullous keratopathy

Objectives: To evaluate the efficacy of amniotic membrane in the management of painful bullous Keratopathy

Material and Method: Amniotic membrane transplantation was performed at Ophthalmology Department Bahawal Victoria Hospital, Bahawalpur. The study included 15 eyes [15 patients] with symptomatic bullous keratopathy and poor visual potential. The underlying causes of bullous keratopathy included aphakia [4 eyes], pseudophakia[9 eyes], and others [2 eyes]

Results: During the follow-up period of 6 weeks after amniotic membrane transplantation, 13 0f the 15 eyes with intolerable pain preoperatively became pain free postoperatively. Among the 2 eyes with residual pain, 1received repeated amniotic membrane transplantation and 1 had reduced pain. Epithelial defects in 13 of the 15 eyes created and covered by amniotic membrane healed rapidly within 2 weeks. Only 2 eyes showed recurrent surface breakdown. Epithelial edema or bullae recurred in a smaller area in only 1 eye and that was effectively controlled with medical treatment

Conclusion: Amniotic membrane transplantation is a good treatment option for alleviating pain, promoting epithelial healing, and preserving cosmetic appearance in patients with symptomatic bullous keratopathy and poor visual potential

Lower eye lid reconstruction using single stage Mustarde' cheek rotation flap

To determine the functional and cosmetic outcome of Mustarde' cheek rotation flaps performed for reconstruction of large lower eyelid defects. Bahawal Victoria Hospital, Bahawalpur from August 2003 to March 2006. All those patients in whom Mustarde 'cheek rotation flap was done for the reconstruction of large lower eyelid defects, were included. Follow up included assessment of position of eyelid, closure, presence of epiphora, aesthetic balance, and donor-site morbidity. Thirty patients, aged 2 year to 70 years, have been operated with this technique for total or sub total defects of the lower eyelid. Two patients received an auricular chondro-cutaneous graft. Rest of them received a nasal chondro-mucosal graft for inner lining. The flap remained viable in every patient, without total or partial necrosis. Mustarde cheek rotation flap is very reliable procedure that provides complete reconstruction and can be used with good functional and cosmetic results in patients with total and sub-total lower eyelid defects

Sub-tenon anaesthesia; an efficient and safe technique for cataract surgery

To describe a method that seeks to improve the administration of local anaesthesia for cataract surgery avoiding the risk of potential complications associated with other methods using sharp needles. Prospective study. Eye unit, Bahawal Victoria Hospital Bahawalpur. Twelve months. The safety and efficacy of this method was demonstrated in 100 consective cases. This technique consists of small, blunt dissection of the conjunctiva, tenon's capsule and intermuscular septum in the inferior nasal quadrant, followed by the insertion of the curved cannula that is guided to the retro bulbar space, where 2.0 to 2.5 ml of anaesthesia is injected. All of the patients [100%] felt that this procedure was comfortable and painless. The operative procedure was graded with a median of no pain or discomfort for both ECCE and phaco. Akinesia, analgesia and operating conditions were assessed on a point scale. Sub-Tenon Anaesthesia proved to be a safe and efficient technique that offers excellent anaesthesia and akinesia and avoids a sharp needle being passed into the orbit

Estrogen replacement therapy for depression in perimenopausal women

To determine the effect of a four-week course of oral estrogen therapy on depression in aging women. Quasi experimental. The OPD, Bahawal Victoria Hospital, Bahawalpur, from September 2000 to January 2004. Forty-two depressed women [aged 42-57] who were either perimenopausal [n=20] or postmenopausal [n=22] received open label treatment with oral estrogen tablets[1.25mg/day] for 4 weeks. The Montgomery-Asberg Depression Rating Scale and the Beck Depression Inventory were used to assess depressive symptoms, the Greene Climacteric Scale was used to assess menopause-related symptoms, and the Clinical Global Impression[CGI] was used to assess global clinical improvement in these women at baseline and after treatment. Remission of depression was defined as a score <10 on the Montgomery-Asberg Depression Rating Scale and a score < 2 on the CGI at week 4. The women who completed the study had a median Montgomery-Asberg Depression Rating Scale score of 20 [range= 15-32] at study entry and 11.50 [range= 10-31.0] at week 4 [z = -3.43, p<0.01]. This improvement was consistent with that reported by the women themselves on the Beck Depression Inventory [rs=0.86, n=20, p<0.01]. The improvement measured by CGI scores was also significant [p<0.01]. Remission of depression was noted in 5 of the 40 women [after 1 year] who completed the study. Anti-depressant response was not associated with severity or subtypes of depression at study entry or with concomitant improvement in menopause-related symptoms. Perimenopausal and postmenopausal women benefit from short-term use of estrogen therapy. Antidepressant effect of estrogen therapy is independent of improvement in menopause-related symptoms