Prevalence of allergic conjunctivitis in school children of Karachi.

OBJECTIVE: To determine the prevalence of allergic conjunctivitis in children in selected schools in Karachi, Pakistan. METHODS: This cross-sectional study was conducted in September and October 2008 as part of the School Eye Health Initiative launched by the Aga Khan University, Karachi and the Adamjee Eye Hospital, Karachi. Children in the selected schools underwent vision assessment and a slit lamp examination by an ophthalmologist. The main objective was to detect allergic conjunctivitis which was ascertained by the presence of papillae in the upper tarsal conjunctiva, redness of the eyes, and presence or history of itching and burning. RESULT: A total of 818 children aged 5-19 years were examined. Of these, 19.2% (95% CI 16.5% to 21.9%) had allergic conjunctivitis. There was a significant association between increasing age and allergic conjunctivitis (Odds ratio: 1.19, 95% CI: 1.12, 1.26; P < 0.001). Boys had a higher burden of allergic conjunctivitis than girls; however this difference was not statistically significant (Odds ratio: 1.31, 95% CI: 0.90, 1.91, p = 0.153). CONCLUSION: There is a very high prevalence of allergic conjunctivitis in children in the selected schools in Karachi. Further research is needed to identify factors that contribute to such a high burden of this condition and to assess whether a similar pattern is also observed elsewhere.

Central corneal thickness of Pakistani adults.

OBJECTIVE: To determine the average central corneal thickness (CCT) of healthy adults in the ophthalmology clinic of a tertiary care hospital of Pakistan. METHODS: This was a cross-sectional study conducted in the ophthalmology clinics of Aga Khan University Hospital, Karachi Pakistan. One hundred normal subjects (200 eyes) were studied. An ultrasound pachymeter was used to measure CCT. RESULTS: The mean (+/- SD) age of the study population was 44.29 +/- 15.18 years with a median of 47 years (range: 16-73). Twenty three percent of the subjects had diabetes mellitus, 29% hypertension and 6% had history of ischaemic heart disease. The mean (SD) CCT measurements were 531.08 +/- 33.37) and 531.29 +/- 33.33 micrometers in the right and left eyes respectively and were not significantly different from each other. There was no statistically significant correlation between CCT and IOP (r = 0.158, p = 0.12). We did not find a significant association between CCT and other independent variables like age, sex, presence of co-morbidity i.e. Diabetes Mellitus (DM), Hypertension (HTN), Ischaemic Heart Disease (IHD), myopia, hypermetropia, systemic and eye medication use. CONCLUSIONS: The average CCT values obtained in the hospital-based study closely match those of the African Americans. A population-based study would be needed to provide unbiased CCT estimate in Pakistani population.

Glaucoma admissions and surgery in public sector tertiary care hospitals in pakistan: results of a national study.

PURPOSE: To assess the annual number of glaucoma operations and admissions in the public sector tertiary care hospitals in Pakistan. METHODS: Eye departments in all 18 public tertiary care centers in the country were requested to provide data on the number of glaucoma operations and admissions during 1998. Of these, 13 hospitals agreed to participate. Eye departments' log books or patients' records were used to collect data retrospectively on the total number of eye admissions, the total number of glaucoma admissions, the type of glaucoma, and the total number and type of glaucoma operations. RESULTS: Glaucoma accounted for 8.1% (1,942/23,931) of all eye admissions. Open-angle glaucoma was responsible for 37.6% or 731 glaucoma admissions followed by secondary glaucoma (35.0%) and angle-closure glaucoma (18.2%). During 1998, 1,407 glaucoma-related operations were performed in the selected hospitals. The mean (+/-SD) and the median number of operations performed were 108.2 (+/-59.6) and 112 (range: 17-206), respectively. Trabeculectomies accounted for 1,043 (74.1 %) of all procedures. Their number ranged from 16 to 170 (median: 84) in the selected hospitals. CONCLUSIONS: We believe that the annual number of glaucoma operations performed in the public tertiary care hospitals in Pakistan is far less than required. In-depth research is therefore needed to explain if this is because of gaps in service provision or a genuine shift to medical management of glaucoma on an outpatient basis.