Introduction: Strabismus is a state of abnormal alignment of the two eyes. Current research was aimed at studying the profile of strabismus at a tertiary care hospital in Kashmir valley. Material and methods: Strabismus patients attending squint clinic of a tertiary care referral centre in Kashmir, between December, 2015 and December, 2017, across all age groups were included in this study. Patients operated previously for strabismus were excluded. Visual acuity, cycloplegic retinoscopy, stereopsis assessment were done in all patients. Strabismus was objectively measured using Prism Cover Test / Modified Krimsky method. Results: During the defined period a total of 911 patients were evaluated and included in this study. Out of these, 516 (56.6%) were females and 395(43.3%) were males. 37.1% of the study cohort were products of consanguineous marriages. History of prematurity and turbulent perinatal period was elicited in 4% and 18% of the patients respectively.As regards the pattern of strabismus in our study population 59.93% had esotropia, 36.6% had exotropia. Inferior oblique overaction and Dissociated vertical deviation were seen in 22.61% and 23.38% respectively. Duanes Retraction syndrome (0.98%), Superior oblique palsy (1.2%)Browns syndrome (0.21%), Third nerve Palsy (0.32%), LR palsy (0.65%) were the lesser common deviations noted. Conclusion: Esotropia is the most common motility disorder among patients attending a tertiary care hospital in Kashmir, in contrast to rest of India. Statistics from majority of colder regions of the world show the same inclination, further reinforcing the theory of association between sunlight and exodrift.
Background: Vernal Keratoconjunctivitis (VKC) is a seasonally recurring bilateral allergic condition of the cornea and conjunctiva characterized by symptoms like itching, watering, foreign body sensation and ropy discharge. Chronic epithelial trauma provoked by eye rubbing due to intense ocular itching has been postulated as an important risk factor in the pathogenesis of keratoconus in VKC patients. Objectives: To detect anterior corneal surface changes like astigmatism and keratoconus by topographic evaluation of cornea. Methodology: This was a cross sectional study carried out on 424 eyes of 212 patients between 5 to 20 years of age at
Background: Canalicular lacerations contribute to approximately 16% of the eye lid injuries. The torn medial end is to be identified, cut end sutured, and then the canaliculus intubated to restore patency. Silicone being inert, flexible, easily available, and cost effective is the material of choice for lacrimal stenting. Aims and Objectives: The aim of this study was to determine the surgical outcomes of the canalicular tear repair with the self-retaining Mini-Monoka stent in a tertiary care hospital in North India. Materials and Methods: Patients presenting to tertiary care hospital in Kashmir, North India with canalicular tear from August 2019 to December 2020 were included in this prospective study and repaired with self-retaining Mini-Monoka stent under microscope. All the patients were analyzed for demographic data, mode of injury, complications, and outcomes and followed up after a week, 6 weeks, and 3 months and stent removed after 6 weeks. Results: The study was conducted on 18 patients. The mean age of the patients was 37.5 years with male: female ratio of 5:1. The lower canaliculus was most commonly involved and road traffic accidents was the most common mode of injury (27.7%). The most common associated injury was lid injury (50%). The mean time of stent removal was 6 weeks±2 weeks. Syringing was done in all the patients except children. At last follow-up, 17 out of 18 patients had functional and anatomical success in terms of absence of epiphora and patent syringing and all the patients were cosmetically satisfied. Conclusion: Our study concludes that surgical repair of canalicular tear with Mini-Monoka stent is a safe and simple reliable technique, cosmetically satisfying with minimal manipulation giving high functional and anatomical success rate post repair.
Aim: To study clinical features and surgical outcomes of limbal dermoid excision in Kashmiri patients. Study Design :Interventional, Prospective Material and Methods: 20 patients with epibulbar limbal dermoid who attended the Out Patient department of Government Medical College ,Srinagar, from August 2019 to September 2020, across all age groups were included in the study. All the patients were examined for site, colour, presence of pigmentation and presence of ocular and systemic associations of the lesions and then surgically managed. Simple Excision was done with blade and scissors. Postoperative follow up was done upto 3 months Results: The age group included was 4 to 60 years with male to female ratio 3:2. All the patients had unilateral epibulbar dermoids located at infero-temporal quadrant of the limbus. Most lesions (13 cases - 65%) extended equally to cornea and sclera while a few extended more on the sclera (3 cases - 15%) or cornea (3 cases - 15%). Most (15 cases - 75%) were round. Two (10%) had Goldenhar Syndrome and both had preauricular tags and maxillary hypoplasia. Postoperatively one patient (5%) had corneal thinning and two(10%) patients had granulation tissue formation.Pigmentation of the lesion was seen in 18 cases (80%). Conclusion:Limbal dermoids in Kashmiri patients have clinical characteristics resembling those described in other parts of the world. Treatment with simple excision and supercial sclerokeratectomy gives satisfactory results.
Purpose: To study the effects of combined intravitreal injections of bevacizumab (IVB) and triamcinolone acetonide (IVTA) in patients with non-resolving macular edema (ME) secondary to Branch Retinal Vein Occlusion (BRVO). Methods: In a prospective observational study, 50 pseudophakic eyes of BRVO patients with non-resolving central macular edema who had received more than 3 doses of IVB previously were injected with combination therapy of 1.25 mg/0.05 ml IVB and 4 mg of IVTA and followed up for 6 months with best corrected visual acuity(BCVA), intraocular pressure(IOP) and central macular thickness(CMT) Results: The mean BCVA was logMAR 0.75±0.25 at baseline and 0.65±0.15, 0.48±0.20, and 0.22±0.25 at 6weeks, 3 months and 6 months respectively. Mean CMT at baseline was 668.32±254.66 and 434.43±99.55, 243.22±58.92, and 220.83±42.60 at 6 weeks, 3 months and 6 months respectively. Baseline IOP measured was 16.5±3.1 mmHg which progressed to 19.6±3.4mmHg and 21.4±2.8mmHg at 6 weeks and 3 months respectively and decreased to 17.3±2.2 at 6 months. The most common adverse effect seen was increase in IOP in 24(48%)patients, out of which 3(6%) patients needed to start anti-glaucoma medication (AGM). 3(6%) patients had sub-conjunctival hemorrhage(SCH). Conclusion: The prolonged therapeutic effects of combination therapy leads to outstanding anatomical and visual outcome in non resolving ME due to BRVO, with fewer doses and thus fewer adverse effects.
Case ReportA 25 year old man, smoker, non -diabetic, nonhypertensive, a driver by occupation presented with two days history of sudden diminution of vision in the left eye associated with mild pain on and off on the same side. On examination the visual acuity was 6/6 in the right eye and finger counting at half meter in left eye at presentation. He had RAPD and defective color vision in left eye. Fundus examination showed disc edema on left side without hemorrhages and a patch of pale retina along the distribution of cilioretinal artery. The physical examination was normal with pulse 72 bpm, was afebrile and BP recorded was 110/70 mmHg. All the baseline investigations were done on day 1 of admission and the results were:
Purpose: To detect the incidence of keratoconus by videokeratography in patients in Kashmir in North India and to describe the clinical characteristics associated with it. Design: Cross sectional study Methodology: This study was carried out on eyes of 212 patients between 5 to 20 years of age presenting to tertiary care hospital of Kashmir in north India over a period of two years. Best Corrected Visual Acuity (BCVA), slit lamp examination, pachymetry, refraction, fundus examination, and corneal topography was done in all the patients and clinical ndings recorded. To detect keratoconus, corneal topography maps were analysed using Rabinowitz-McDonnel criteria. Maps with central corneal power(Kmax) greater than 47.2 diopters and the inferosuperior asymmetry value greater than 1.4 were considered to have a keratoconus pattern. Results: Out of 212 patients, 145 were males and 67 were females. Majority were in the age group of 5- 10 years. Among the study eyes, Kmax> 47.2 D was seen in 10.1 %, Sim K astigmatism > 1.5D in 29%, I-S difference > 1.4 D in 11.79 % , SRAX > 21° in 20% and K max>47.2 D + I-S Difference >1.4 i.e keratoconus pattern was seen in 93 eyes i.e 21.9% Conclusion: Incidence of keratoconus in allergic patients is more when compared to general population of the same age group from previous studies. The videokeratographic examination of patients leads to early detection of mild keratoconus by interpretation of color-coded maps.
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