Aim of the Work:To evaluate the incidence and risk factors for development of retinopathy of prematurity (ROP) in the biggest neonatal intensive care unit (NICU) in Itay Elbaroud City, Behera province, Egypt. Methods: We studied data of 240 newly born infants with gestational age (GA) ≤34 weeks or birth weight (BW) ≤2000 g or infants with unstable course who were admitted to the biggest NICU in Itay Elbaroud City, Behera province, Egypt, between October 1, 2018 and October 31, 2020. There is no standard screening system in Egypt. Furthermore, we had screened babies more than 1500 g, more than 32 weeks and found signs of ROP, so we decided to expand our inclusion criteria to include babies up to 2000 g of birth weight and up to 34 weeks gestational age in addition to older and heavier babies with unstable course in NICUs. Clinical information about perinatal neonates was collected by reviewing medical charts. The main outcomes are the incidence and severity of ROP. The relationship of clinical risk factors and the development of ROP were analyzed. Results: The overall incidence of ROP was 34.1%, and the overall incidence of type 1 ROP was 26.3% of infants. ROP was significantly associated with GA (odds ratio; OR: 6.8; (3.7-12.3), BW (OR: 4.1; 2.3-7.3), apnea, supplementary oxygen administration, and thrombocytopenia. Conclusion:The incidence of ROP is high in Itay Elbaroud city, Behera Province, Egypt. Immaturity, low birth weight, low gestational age, oxygen administration, apnea, thrombocytopenia, and jaundice are important risk factors for development of ROP.

Background: Idiopathic intracranial hypertension (IIH) is a disorder of unidentified etiology characterized by raised intracranial pressure (ICP) without clinical, laboratory, or radiological evidence of intracranial pathology. The aim of this work was to determine the visual outcome in newly diagnosed IIH patients. Methods: The study included 68 IIH patients; 59 responded to medical treatment and nine needed lumboperitoneal shunting (LPS). Patients were submitted to papilledema grading using Frisén Scale, water CSF manometry, brain MRI/ MRV, mean deviation of visual field examination (MD-VFE), optic nerve sheath diameter (ONSD), average optic disc optical coherence tomography-retinal nerve fiber layer (OCT-RNFL) thickness, and pattern-reversal visual evoked potential (VEP). Results: Patients needed LPS showed statistically significant increase in baseline papilledema grade, MD-VFE, ONSD, average OCT-RNFL thickness, and P100 VEP latency. On the other hand, both studied groups showed statistically nonsignificant differences regarding the patients' ages and opening CSF pressure. Conclusion: Newly diagnosed IIH patients' evaluation must be based on multimodality neuro-ophthalmological assessment where papilledema grade, MD-VFE, and OCT-RNFL are valuable biomarkers of PVD while P100 VEP latency delay is a predictor of poor visual outcome and ONSD is an early indicator of elevated ICP regression after LPS surgery.

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Background: Traumatic cataract accounts for a large proportion of monocular visual disability and blindness in pediatric populations, especially in developing countries. This study aims to evaluate the axial length and other biometric data changes after penetrating corneal wound in pediatric eyes. Methods: This is a prospective comparative control study carried on thirty children with unilateral penetrating ocular trauma associated with cataract. Patients were classified into 3 groups: Group A (n= 15 eyes) underwent cataract extraction and IOL implantation in same session 6 weeks after trauma, Group B (n= 15 eyes) underwent cataract extraction, and IOL implantation in second session 3 months after trauma and the third one is the control group with 30 contralateral eyes of both groups Results: Regarding axial length, measures were reported to be was (22.882 ± 0.712) mm in group (A) after 6 weeks from the incidence of trauma, while in group (B) it was (22.568 ± 0.881) mm. P-value was insignificant (0.292). After 12 weeks, mean AL in group A was reported to be 23.199 ± 0.724) mm while in group B it was (22.903 ± 1.008) mm with insignificant p value as well (0.362). After 6 weeks, the mean K-readings for group A were found to be 41.184 ± 2.109 while group B were (42.928 ± 2.433). After 12 weeks, the mean K-readings for group A were 41.491 ± 1.729 while group B were (42.797 ± 2.518). Conclusion: Early I/A and anterior vitrectomy recommended for cases with free lens in AC for fear of reaction, while IOL implantation is recommended to wait after stitches removal.

Background:The clinical diagnosis of infective keratitis does not give an unequivocal indication of the causative organisms because a wide range of organisms can produce a similar clinical picture. The causative agents of infective keratitis frequently isolated are: bacteria, fungi, viruses and Parasites. Aim and Objectives: The purpose of this study was to identify the correlation between clinical and culture laboratory finding in resistant keratitis at the Ophthalmology Department of Tanta University Hospitals. Subjects and Methods: This study was a prospective interventional selectively randomized clinical study which extended for 12 months at Tanta university hospitals and included fifty eyes of fifty patients clinically diagnosed resistant keratitis and presenting to The Ophthalmology Department of Tanta University Hospitals. The study started in January 2021. Results: there was statistically significant deference between groups regarding to Medical history, Trauma, Ulcer characteristics, Satellite lesions and corneal sensation. There was no statistically significant deference between groups regarding to age, gender, Contact wearing, foreign body, Ulcer size and gutter and immune ring. Conclusion: Clinical diagnosis is more important for treatment and follows up while culture is performed for documentation of the clinical findings. Incidence of fungal keratitis is significantly high in our region. The therapeutic approach can initially be based on clinical impression and evidence of the microbiologic trends of infectious keratitis and sensitivity/resistance patterns in our locality.

Background: Phacoemulsification surgery is performed in a limited space, therefore, anatomy and procedural parameters, such as sufficient anterior chamber depth (ACD), are essential for protecting endothelial cells during surgery from mechanical and heat damage. Specular microscope is a useful non-contact investigational technique that photographs the human corneal endothelium. Methods: This a prospective comparative cohort non-randomized study included sixty eyes of phacoemulsification cataract surgery were collected from the outpatient clinics of Tanta University Hospitals and were admitted to Ophthalmology Department. Cases were divided into three groups according to ACD. All cases were subjected to: history taking, examination [visual acuity (VA), slit lamp examination, ACD measurement using IOL master, and Specular microscopy. Results: The percentage of endothelial cell loss was much increased in the group A than in the group There was statistically significant increase in the mean CCT in the three groups post-operatively at 1week and 1month compared to pre-operative mean CCT. However, there was no notable differences in CCT among the three groups. There was no notable differences in Coefficient of variation (CV) among the three ACD groups over the entire study period. Conclusions: taking in consideration the ACD as a very important prognostic factor to be considered before phacoemulsification cataract surgery. Eyes with shallow ACs can be vulnerable to more corneal endothelial cell loss during phacoemulsification surgery.

Background: To describe technique and evaluate outcomes of using amniotic membrane onlay strip for repair of corneal lacerations.Methods: Retrospective case series included eight eyes with traumatic corneal lacerations. A strip of amniotic membrane was applied to the corneal surface to cover the wound. Wound was then sutured with nylon 10/0 sutures involving the membrane. Sutures were well-spaced and suturing was avoided in the visual axis. Average keratometric reading (average K), keratometric astigmatism (KA), manifest refractive astigmatism (RA) in diopters (D) and spectacle or soft contact lens best corrected visual acuity (BCVA) were assessed 2 months after suture removal. Results: Transient postoperative hypotony was encountered in five cases (62.5%). Average K was 44.61 ± 2.81 D (mean± SD). KA was 2.20±0.71 D (mean± SD). RA was 1.78 ± 0.73 D (mean± SD) and ranged from 1 to 3 D. Log MAR BCVA was 0.39±0.18 (mean± SD) ranged from 0.22 to 0.70.Conclusions: The application of amniotic membrane onlay strip during repair of corneal lacerations was associated with good visual outcome possibly due to reduction of wound and suture related corneal astigmatism.

Purpose To investigate the safety and efficacy of green thermal laser as an adjunctive therapy for the treatment of resistant infectious keratitis (IK) in the Delta region of Egypt. Methods A retrospective case series of 150 patients, within a 4 year duration, with resistant IK, who failed to respond to specific medical treatment alone for 7 days, were included. They all received green thermal laser photocoagulation treatment to the cornea as an adjunctive to medical treatment. Results Forty-eight women and 102 men were included in this study with a mean age of 46.2 ± 7.7 years. Common risk factors associated with IK included trauma by material of plant origin and contact lens wear. The mean duration of healing was 2.87 ± 0.7 weeks. A single session of green thermal laser application was adequate in 138 IK cases (92%), while 12 cases (8%) required an additional session a week later. Supplementary amniotic membrane transplantation (AMT) was required in 26 cases (17.3%). Two patients (1.3%) required tectonic keratoplasty for corneal perforation. The final corrected distance visual acuity (CDVA) was counting fingers (CF) or better in 78 patients (52%). No decrease of CDVA was reported throughout the study. Conclusion Green thermal laser is a safe and effective adjunctive therapy for the treatment of resistant infectious keratitis.