Frequency and impact of individual symptoms on quality of life in dry eye disease in patients presenting to a tertiary care hospital.

OBJECTIVE: To assess the frequency of symptoms and impact on quality of life in individuals with dry eye disease. METHODS: The cross-sectional, study was conducted from December 2018 to June 2019 at the outpatient clinic of the Department of Ophthalmology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and comprised dry eye disease patients aged at least 13 years with ocular burning sensation, lacrimation, grittiness, photophobia, redness or itching. Tear Film Breakup time <10 sec and / or positive ocular surface staining >5 corneal spots, >9 conjunctival spots, lid margin staining ≥ 2mm in length were used to diagnose the disease. Data was collected using the Dry Eye Quality of Life Score questionnaire. Data was analysed using SPSS 25. RESULTS: of the 191 patients, 135(71%) were females and 56(29%) were males. The overall mean age was 39.8±16.6 years. Itching 155(81.2%), watering 151(79.1%) and burning 124(64.9%) were the most frequent symptoms, with watering (p<0.001) and photophobia (p=0.012) significantly impacting quality of life. CONCLUSIONS: The most common symptoms among patients of dry eye disease affecting their quality of life were itching, watering, burning, photophobia and low mood.

To assess the role of cataract extraction in glaucoma management by its intraocular pressure lowering effect.

OBJECTIVE: To measure the mean change of intraocular pressure in glaucoma patients with cataract after uncomplicated phacoemulsification surgery with intraocular lens implanted in capsular bag. METHODS: The quasi-experimental study was conducted at the Ophthalmology Department of Pakistan Institute of Medical Sciences Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan, from June 11 to December 10, 2018, and comprised patients who had uncomplicated cataract extraction by phacoemulsification with intraocular lens implant in the capsular bag in glaucomatous eyes of age 30-80 years. Visual acuity, intraocular pressure, slit lamp examination, fundoscopy, visual fields, details about topical medication and relevant history were recorded not more than 5 days before cataract extraction. Intraocular pressure was recorded using Goldman's applanation tonometer one day before surgery, and post-surgery 1 month and 3 months. Data was analysed using SPSS 20. RESULTS: Of the 40 patients, 19(47.50%) were males and 21(52.50%) were females. The overall mean age was 52.23±9.44 years. Mean pre-operation intraocular pressure was 20.42±1.69mmHg, while at 1 month post-surgery it was 18.55±0.90mmHg and at 3 months it was 17.03±1.19mmHg (p=0.0001). CONCLUSIONS: There was a significant change in intraocular pressure readings in glaucoma patients with cataract after uncomplicated phacoemulsification surgery with intraocular lens implanted in capsular bag.

The association between ethnicity, environmental and lifestyle factors and chronic disease in the development of pseudoexfoliation syndrome.

OBJECTIVES: To determine the association between ethnicity, environmental factors, lifestyle factors, chronic diseases and pseudoexfoliation syndrome (PEX). METHODS: A case control study conducted at four major hospitals in Pakistan from January to November 2019, with 241 cases and 294 controls, aged ≥ 40 years, who were administered a questionnaire assessing demographics, lifestyle factors, chronic diseases and ethnicity. Multivariate binary logistic regression was applied to calculate the odds ratio between cases and controls. RESULTS: PEX was found to be positively associated with ethnicity (p<0.001), time spent outdoors (p<0.001), educational status (p<0.001), asthma (p<0.001), mean age (p<0.001), daily tea intake (p=0.003), weighted maximum temperature (p<0.001) and weighted mean temperature (p=0.004). Poor association was found with weighted latitude (p=0.526) and weighted minimum temperature (p=0.079). Odds ratios for patients with asthma (OR=7.366, regression coefficient=1.993, p<0.001) Pathan ethnicity (OR=1.616, regression coefficient=0.48, p=0.016) and mean weighted temperature (OR=0.907, regression coefficient-0.097, p=0 .000) were significant in diagnosed cases of PEX. CONCLUSION: Individuals with Pathan ethnicity and asthmatics should be made aware of the risk of developing PEX and the importance of periodic screening. Limiting exposure to sunlight and cold and reducing the intake of tea may help in reducing in the chances of developing PEX.