IntroductionAny disturbance to the normal ouVlow of tears through the nasolacrimal passage causes overflow known as epiphora. The clinical symptoms of epiphora range from mild dribble to the continuous ouVlow of tears. Watering of eyes caused by the nasolacrimal drainage obstruction is managed by surgery. One of the many surgeries to treat this is external dacryocystorhinostomy.ObjectiveThe objective of this study was to evaluate the success rate of external dacryocystorhinostomy as well as factors affecting it.MethodologyThis is a retrospective cross-sectional study, conducted in the Department of Ophthalmology, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan with the approval of Institutional Review Committee, BPKIHS. The medical records of patients who underwent external Dacryocystorhinostomy surgery from April 2011 to April 2016 at BPKIHS were retrospectively reviewed. Statistical analysis was performed using SPSS for windows, version 11.5 (SPSS Inc., Chicago, IL). Binary logistic regression models were used to investigate the association of the surgical outcome with various predicting variables.ResultsThe success rate of the external dacryocystorhinostomy was 78.09%. Factors studied were: age, with a range of 2-81 years; duration of symptoms with a range of 1-84 months; and gender of the patients. The intra-operative factors studied were use of silastic tube, types of flap, and osteotomy size. Among these factors, the duration of symptoms and osteotomy size had significant association with the outcome of the surgery p<0.05.ConclusionOur study yielded high success rate in patients with shorter duration of watering of eyes and larger osteotomy size during surgery. Hence, a larger osteotomy size and early intervention is recommended for better surgical outcome. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 196-200
Background. Orbital lymphomas are primarily non-Hodgkin type and can originate from the eyelids, extraocular muscles, soft tissue orbital adnexa, conjunctiva, or lacrimal glands. Orbital malignancies often represent a diagnostic dilemma for clinicians given their varying and atypical presentations. Objective. To report a case of orbital lymphoma mimicking orbital cellulitis. Case. A 66-year-old male patient presented with sudden onset of painful proptosis with visual impairment in the left eye for 15 days. On ocular examination, best-corrected visual acuity was 6/12 in the right eye and 2/60 in the left eye, abaxial proptosis with hypertropia, swollen and erythematous eyelids, restricted extraocular movement in all cardinal position of gaze, conjunctival congestion with chemosis and tortuous vessels, sluggish pupillary reaction, and chorioretinal folds in the inferior quadrants. The case was diagnosed as left eye orbital cellulitis, and the patient was treated with broad-spectrum intravenous antibiotics and oral steroids. No clinically discernible response was noted despite 7 days of antibiotics and steroids. Contrast-enhanced computed tomography (CECT) orbit showed features suggestive of orbital lymphoma involving the ipsilateral maxillary and ethmoid sinuses. ENT consultation with diagnostic nasal endoscopy and biopsy was done. Histopathological reports showed features of non-Hodgkin lymphoma. Conclusion. Orbital malignancies masquerading as orbital cellulitis can pose a diagnostic dilemma. A multidisciplinary approach involving ENT consultation, radiological investigation, and pathological sampling can help achieve a timely diagnosis and appropriate management.
Purpose To report post typhoid fever neuroretinitis with Serous Retinal Detachment and choroidal involvement. Observation Patients with diminished vision post typhoid fever can present with neuroretinitis with serous retinal detachment. Conclusion and importance With help from noninvasive imaging such as optical coherence tomography angiography(OCTA) and Deep Range Imaging(DRI), we were able to conclude choroidal involvement – which has not been discussed in literatures yet.OCTA and choroidal thicknessboth served as agood indicators for monitoring the response of treatment in this case.
Background: Being an added high-risk group, ophthalmic HCP are actively providing emergency eye care services, also enthusiastically participating in prevention and control of the COVID-19 pandemic. Hence, this study aimed to assess the level of knowledge, attitude, and practice (KAP) among ophthalmic HCP towards COVID-19 pandemic. Methods: A web-based cross-sectional study was conducted during the period of lockdown among ophthalmic HCP including consultant ophthalmologist, resident, optometrist, ophthalmic assistant, nursing staff, and other paramedics of eye care centers in Nepal. The KAP questionnaire was designed and distributed online. Data were analyzed using the Chi-square test, Pearson correlation, and binary logistic regression. All tests were performed at 95% Confidence Interval (CI) and p-value <0.05 was considered statistically significant. Results: Of 694 participants, the majority were male (59.1%) from the age group 31-40 years (41.5%) and tertiary eye center (68.9%). Among ophthalmic HCP, there were 29.8% consultants ophthalmologist, 22.6% residents, 23.3% optometrist, 15% ophthalmic assistant, and 9.2% other ophthalmic paramedics, 11.7% working as front-liners in COVID-19 centers. Findings showed, 98.1% had good knowledge, 59.4% had a positive attitude and only 13.3% had good practice regarding COVID-19. Binary logistic regression analysis demonstrated the age of HCP to be a significant determinant of good knowledge (Crude Odds Ratio (COR)=0.72, 95%CI=0.62-0.82), positive attitude (COR=0.92, 95%CI=0.90-0.94) and good practice (COR=1.16, 95%CI=1.10-1.21). Lower odds of poor practice was seen among junior resident (COR=0.26, 95% CI=0.14-0.47) and higher odds of poor practice was seen among HCP with job experience of 5-10 years (COR=2.38, 95% CI=1.23-4.60) towards COVID-19 pandemic. Conclusion: The majority of ophthalmic HCP have good knowledge, insufficient positive attitude, and inadequate evidence-based practice towards the COVID-19 pandemic in Nepal. Hence, this study conclusively recommends to modify existing guidelines and formulate new policies to improve KAP among ophthalmic HCP to effectively control the spread of COVID-19.
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