ABSTRACT
Cornea plana (CP) is a rare ocular condition existing in two distinct clinical and hereditary forms: a milder, autosomal dominant type I and a more severe, autosomal recessive type II. The condition is more commonly found in Finnish, Saudi, and Czech families. We report three brothers from a consanguineous marriage that presented with complaints of decreased vision of varying degrees. All three of them have blue, thick, and hazy corneas with shallow anterior chamber depths. The additional features of CP type II were seen in the older two brothers including arcus lipoids, ill-demarcated limbus, and an accommodative squint. They were managed by the correction of refractive errors through spectacles and detailed counseling with follow-up visits to look for progressive complications. The management is mainly centered around optically or surgically correcting the developmental anomalies. This is complimented with proper genetic counseling and regular follow-up visits to look for and manage complications. There are, however, novel therapies that can be considered in these patients including corneal transplants or corneal stromal stem cellular therapies.
ABSTRACT
Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant condition characterized by the dysgenesis of the anterior segment along with some systemic abnormalities such as dental and facial bone defects. Its incidence is thought to be 1 in 200,000. Treatment is predominantly the management of glaucoma and is mostly medical but can be surgical in refractory cases. Here, we describe the case of a 35-year-old female patient who presented with co-existing vernal keratoconjunctivitis and ARS. The treatment was more challenging as we had to manage two conditions simultaneously.
ABSTRACT
OBJECTIVE: To evaluate the success rate of Transcanalicular Diode laser assisted Dacryocystorhinostomy (TC-DCR) in cases of acquired nasolacrimal duct obstruction (NLDO). METHODS: This Quasi-Experimental study was conducted in Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi, from July 2018 to April 2019. In this study, 73 patients of chronic dacryocystitis secondary to acquired NLDO were treated by TC-DCR under general anaesthesia. Follow up examination was done after one day, one week and three months. Silicone tubes were removed three months after surgery and syringing of lacrimal system done to confirm patency of lacrimal passages. Success of the procedure was documented as absence of epiphora and patent nasolacrimal duct on syringing. RESULTS: Seventy three patients (males 27; females 46) were included in this study. Mean age of these patients was 51.6+21 years. On completion of this study which was three months after surgery, we found subjective improvement (absence of epiphora) in 86.3% patients and objective improvement (successful irrigation of lacrimal passages) in 93.2% patients. CONCLUSION: TC- DCR is a minimally invasive technique of doing Dacryocystorhinostomy and imparts more than 90% success rate. It has additional advantages of good cosmetic results, low complication rate and short surgery and convalescence time.
ABSTRACT
BACKGROUND: A steroid 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
