Ocular trauma in patients presenting to Dhulikhel Hospital.

BACKGROUND: Ocular trauma is an important cause of blindness and ocular morbidity throughout the world. Prevalence studies help to define the target group, plan strategies and thereby lessen trauma related blindness in the country. OBJECTIVE: To identify the risk factors for ocular trauma, those at risk, describe the visual acuity at time of clinical presentation, and assess the nature and severity of ocular trauma in patients presenting to Dhulikhel Hospital emergency department and eye OPD with ocular trauma. METHODS: It is a descriptive and prospective study of all the patients with ocular trauma presenting to Dhulikhel Hospital from December 2009 to December 2010. A complete history and detailed ophthalmologic evaluation was done and noted down. RESULTS: There were 112 subjects with ocular trauma. Mean age was 28.43+/-16.36 years with a range of one year to 74 years. Males predominated with 72.3% frequency (p less than 0.001). Incidence peaked in third decade of life (p less than 0.01). Ocular trauma peaked in months of September and October. Presenting visual acuity better than 6/12 was noted in 83.9% of cases whereas 2.7% of cases had visual acuity of less than 3/60. Household (56.3%, p less than 0.001) was the commonest place of injury with wooden objects (19.6%) being the commonest object of injury. Most of the injuries were mechanical (85.7%, p>0.001). CONCLUSION: Blunt injuries were more common in young males. Household and workplace were common location of ocular injuries. Public awareness and strict legislation to use personal protective devices can help to reduce the occurrence of ocular injury.

Bacterial conjunctivitis and of antibiotics in Dhulikhel Hospital-Kathmandu University Hospital.

BACKGROUND: Acute Infective Conjunctivitis may be due to viral or bacterial infection; though it is usually self limiting, topical antibiotics are often prescribed for rapid recovery. OBJECTIVES: This study aims to find out prevalence of bacterial infection among cases of acute infective conjunctivitis and to determine their in-vitro antibacterial susceptibilities to commonly used antibacterial agents and to find out whether the rampant use of topical antibiotics are at all necessary or justified. METHODS: A prospective analytical study conducted over a period of two years on clinically diagnosed cases of Acute Infective Conjunctivitis. Isolation and identification of microorganisms by culture and antimicrobial susceptibility test were done on conjunctival swabs from 65 patients. RESULTS: A total of 65 patients were included where children (one month to 10 years old) accounted for the commonest age group (35.4%).On Gram Stain, 90.8% were negative for pus cells or micro organisms. Gram positive cocci were found in 6.2% of cases. On culture, bacterial growth was seen in 11 cases (18.9%) among which Streptococcus pneumonia was seen in seven cases (10.8%).The analysis on in-vitro susceptibility testing showed that Chloramphenicol and Gentamicin were the most sensitive (78.6% of samples) drugs for conjunctivitis. CONCLUSION: Ophthalmic antibiotics should be prescribed judiciously in acute infective conjunctivitis even for suspected bacterial cases; since it is found to resolve spontaneously without any serious complications. Chloramphenicol and Gentamicin are drugs of choice if at all required.