Eye care project in Gaur, Nepal.

PURPOSE: The aim of the eye care project is to clear the backlog of cataract blindness for the people of Gaur and its surrounding districts in southeast Nepal. The purpose of this study is to analyze the progress of this eye care project. METHODS: In mid 1997, the Nepal Netra Jyoti Sangh (NNJS), the national society for comprehensive eye care in Nepal, with financial support from the Association for Ophthalmic Cooperation to Asia (AOCA) and the 24 Hour Television (24HTV) Charity Committee established an eye hospital in the district headquarters of Gaur under the name of Narayani Eye Care Project (NECP). The hospital provides surgery, an outpatient department (OPD) and emergency services. We analyzed the number of patients, the number of surgeries and the profile of patients. RESULTS: The hospital was found to be providing services with modern equipment and instruments and the number of patients frequenting it had increased in accordance with the improved services. From mid 1997 until the end of 2002, the hospital provided services to a total of 122,093 patients and performed 6,143 major surgeries and 541 minor surgeries. CONCLUSIONS: It has been possible to conduct sight restorations of poor and blind individuals in this region at the Gaur eye hospital with the support of the NECP.

Renal failure caused by eyedrops containing phenylephrine in a case of retinopathy of prematurity.

The patient was a low birth weight infant with a history of renal failure. She was referred to our department 29 days after birth to undergo fundus examination. She experienced renal failure after undergoing a mydriatic test and needed medical treatment. Eyedrops containing phenylephrine were instilled several times and additional drops were also instilled during the fundal examination using an eyelid retractor, therefore the blood concentration of the drug was elevated sufficiently to contract the renal vessels, ultimately inducing renal failure. The present case suggests that since the use of mydriatic eyedrops in low birth weight infants could induce renal failure, the following points should be considered: 1) Mydriatic eyedrops should be used with caution by monitoring mydriasis and avoiding excessive instillation; 2) After instillation, the lacrimal region should be compressed to prevent the flow of mydriatic drops to the nasolacrimal canal; and 3) Vital signs should be monitored to check the onset of any adverse reactions for 12 hours after fundal examination.

Visualization of uveal perfusion by contrast-enhanced harmonic ultrasonography at a low mechanical index: a pilot animal study.

OBJECTIVE: To evaluate contrast-enhanced harmonic ultrasonography at a low mechanical index for its usefulness in visualizing uveal perfusion. METHODS: The study was performed with 9 rabbits, 6 intact and 3 with focal impaired blood flow in the uvea. Ultrasonography was performed by harmonic imaging (transmit, 5 MHz; receive, 10 MHz) with a contrast agent. The agent was administered at a dose of 50 microL/kg. Transmission power was at a mechanical index of 0.2, which is below the US Food and Drug Administration guideline. The images were compared between the impaired and intact eyes. For uveal measurements, video signal intensity-versus-time plots were generated in all cases. The plots were analyzed to obtain the rate of signal intensity increase and peak signal intensity. RESULTS: A clear increase of signal intensity was observed after contrast agent administration. The signal intensity of the uvea was lower in the impaired eye than in the intact eye. In the impaired eye, the intensity was lower on the side with impaired flow than on the other side. The differences were significant. CONCLUSIONS: Our findings suggest that uveal perfusion can be visualized by contrast-enhanced harmonic ultrasonography in the harmonic imaging mode at a low mechanical index.