Comparison of levobunolol and brimonidine in prophylaxis of intraocular pressure [IOP] rise following ndryag laser capsulotomy

To compare the efficacy of topical 0.5% Levobunolol and 0.2% Brimonidine in preventing intraocular pressure rise after Nd: YAG laser posterior capsulotomy. Randomized controlled trial [RCT]. Ophthalmology Department Combined Military Hospital Multan, from September 2010 to March 2011. A total of 82 patients fulfilling the inclusion criteria were selected from out-patient department and randomly divided into two equal groups. Topical 0.5% levobunolol was instilled in group A while 0.2% brimonidine was instilled in group B one hour before and immediately after doing Nd:YAG laser capsulotomy. The intraocular pressure [IOP] was measured using Goldmann applanation tonometer 1, 3 and 24 hours later. Data was analyzed using SPSS version 15.0. There was no statistically significant difference in mean IOP between 0.5% Levobunolol group [Group A] and 0.2% Brimonidine group [Group B] at 1 hour, 3 hours and 24 hours after Nd:YAG laser capsulotomy. The mean intraocular pressure [IOP] one hour after Nd:YAG laser and topical treatment in group A was 16.10 +/- 1.60 mmHg while in group B was 15.65 +/- 3.01 mmHg [P=0.401]. Mean IOP after three hours in group A was 15.80 +/- 1.35 mm Hg and in group B was 15.05 +/- 2.15 mmHg [p=0.062]. Mean IOP after 24 hours in group A was 15.13 +/- 2.05 mmHg while in group B was 14.32 +/- 1.62 mmHg [p=0.058]. Both 0.5% Levobunolol and 0.2% Brimonidine are equally effective in controlling the IOP spike after Nd: yAG laser capsulotomy. Either of these medicines can be used as a prophylaxis to prevent rise in IOP after NdrYAG laser capsulotomy

Welding associated ocular injuries

To determine the types of eye injuries during welding and to suggest measures for its prevention. This study was carried out at CMH Sialkot from October 2005 to March 2007. An observational study was conducted at [18 months]. Welders included in this study were from military setups i.e. Electrical and Mechanical Engineering [EME] workshops, battalion workshops, Military Engineering Services [MES] and civil workshops. They attended eye OPD for their ocular injuries, sustained during welding and grinding. Their knowledge of welding induced ocular injuries and level of safety measures awareness was assessed. Patients were thoroughly examined with special emphasis on anterior segment. Orbital x-ray and B-scan ultrasound were carried out where intraocular foreign body [IOFB] was suspected. Total 110 patients were studied during a period of 18 months. The commonest ocular injury that we encountered was metallic foreign body followed by photokeratitis and conjunctivitis. Majority workers were between 25 and 35 years of age. Their knowledge of safety measures was satisfactory but few were aware of ocular hazards of welding. Eye injuries due to welding are preventable. Workers performing welding tasks or working nearby welders must be trained, to reco gnize the potential hazards of welding and in proper use of safety equipments to prevent ocular damage

Diabetic macular oedema and role of intra viteral triamcinolone acetonide

The aim of this study was to determine efficiency of intravitreal injection of triamcinolone [IVT] in diffuse macular edema secondary to diabetes mellitus. Twenty eight eyes of 28 patients who fulfilled the inclusion criteria were selected for the study. Patients had a full ophthalmic examination carried out. Injection triamcinolone acetonide [Kenalog] was given intravitreally with full aseptic measures patients were followed up at selected intervals of time. At one month post injection interval 54% patients showed improvement in visual acuity. Three months post injection 43% patients maintained improvement in visual acuity. At six months post injections 18% maintained improvement while 43% showed no change and 14% showed deterioration of vision. We conclude that IVT has a favorable outcome in significant number of patients and may be an alternative to laser photocoagulation in diffuse macular edema secondary to diabetes mellitus

Frequency of diabetics in asteroid hyalosis patients.

Asteroid hyalosis is a benign condition characterized by small white or yellow-white spherical opacities throughout the vitreous. The aetiology of this disorder is not clearly understood. Association of asteroid hyalosis with diabetes mellitus has been a debatable issue in ophthalmology. This study was carried out to determine the relationship between asteroid hyalosis and diabetes. The study was carried out in the Department of Ophthalmology, Military Hospital, Rawalpindi. Cases were picked up during routine eye examination that showed evidence of asteroid hyalosis. All patients of diabetes scheduled for routine follow-ups were also checked for active signs of diabetes. Fasting and two-hour postprandial blood glucose were checked and the frequency of diabetes mellitus in patients with asteroid hyalosis was determined. Ninety-six cases of asteroid hyalosis were included. The median age of presentation was 55.68 years [range 40'71]. It was bilateral in thirty-six cases. Twenty-eight cases were positive for diabetes. The association between asteroid hyalosis and diabetes appears to be significant. Patients found to be having the findings of asteroid hyalosis should be screened for diabetes