Background: Congenital Nasolacrimal duct obstruction (CNLDO) is one of the most common problems in the pediatric age group. It is the commonest cause of childhood epiphora. In most cases it is caused by incomplete canalisation of the nasolacrimal duct (NLD). Aim: The present study was conducted to determine the success rate of primary nasolacrimal duct probing in children older than two years of age. Methods: The present prospective study was conducted in the post graduate department of ophthalmology, Sher-i-Kashmir Institute of Medical Sciences and hospital Bemina. Fifty two eyes of forty two children underwent probing and syringing for nasolacrimal duct obstruction under general anaesthesia. Follow up was done at first week, fourth week and three months. Success was defined as complete absence of sign and symptoms. Statistical analysis was performed using SPSS version 17.0. P value of less then 0.05 was considered significant. Results: Success rate of S&P in our study was found to be 94.23 %. Simple obstruction was encountered in 44 (84.61 %) eyes and all resolved successfully post S&P. Complex obstruction was encountered in 8 (15.39%) eyes and only five resolved successfully post S&P giving a success rate of 62.5 % only. Conclusion: late probing should be performed as an initial surgical step in the management of every case of CNLDO presenting late in the course of the disease (> 2 years), before more invasive procedures are attempted.

Background: Pseudoexfoliation syndrome (PEX), is an age-related condition with generalized disorder of the extracellular matrix (ECM) characterized by a pathological accumulation of polymorphic fibrillar extracellular material in ocular tissue and various visceral organs. The search for the etiology of pseudoexfoliation syndrome has been directed towards both genetic and environmental factors. It is associated with many ocular and systemic complications.Methods: The study was a hospital based comparative clinical study with 100 consecutive patients with pseudoexfoliation and age and sex matched 100 patients as control without pseudoexfoliation. The patients were registered on a Pre-structured Proforma which included patients’ demographic detail, history and examination. Examination protocol including visual acuity with snellen’s chart for literate patients and E-Chart for illiterate patients, intraocular pressure (by Goldmann applanation tonometry), slit lamp examination and fundus examination.Results: The mean age of cases was 65.93± 7.82 years ranging from 49 to 85 years. The mean age of controls was 63.98± 7.06 years ranging from 50 to 80 years (p=0.139). 72% of cases were more than 60 years old. Male female ratio was 1.63:1. Most of the cases were from Budgam, Bandipora and Ganderbal areas. Spring water was proportionately more frequently used as water source in cases (χ2 =18.5, p=0.000), and tube well water in controls. The mean duration of smoking was 26.63±24.74 pack years for cases and 14.88±17.10 pack years for controls (p=0.000). Average duration of daytime exposure for cases was 6.68±2.13 hours and for controls it was 4.52±2.53 hours. Among cases 12 patients (12%) were on treatment for glaucoma whereas among controls, 1 patient (1%) was on treatment for glaucoma. With respect to dietary habits, there was no difference between cases and controls. Farmers comprised of 49% of cases, followed by House wives and government employees.Conclusions: The study concludes that PEX is very common in our region, increasing with age and more in men. Smoking, occupations involved with sunlight exposure, spring water as water source are possible risk factors for PEX. Glaucoma and cataract are common ocular complications of the syndrome.

Introduction: Phacoemulsification is considered the gold-standard procedure for cataract. However, MSICS being less expensive can be considered a better procedure for doing mass surgeries. The purpose of this comparative hospital-based study was to assess the visual outcome in the post-operative patients of MSICS and Phacoemulsification. Method: 160 consecutive patients who completed the post operative follow up of 6 weeks were included in our study with two groups of 80 patients each. One group of patients were operated by MSICS and another by Phacoemulsification. Proper ocular examination including visual acuity (aided and unaided), pupillary reaction, slit lamp examination and fundus was evaluated at week 1 and week 6. Results: Amongst the 80 cases of phacoemulsification 74 (92.5%) had unaided visual acuity of 6/18 or better at week 1. In case of MSICS unaided visual acuity of 6/18 or better was present in only 62 (77.5%) cases at week 1. The results were statistically significant (P <0.01) in favour of Phacoemulsification. At week 6 Visual Acuity of 6/18 or better was present in 76 (95%) and 67 (83.5%) patients in Phacoemulsification and MSICS methods respectively, though better in phacoemulsification group it was not statistically significant (P>0.01). Similar was case with Best Corrected Visual Acuity at week 6. Conclusion: Phacoemulsification gives better UCVA at 1st week than MSICS though both are equally safe and efficacious procedures with low complication rates and same visual outcome when compared at 6 weeks. MSICS can thus be an alternative wherever the requisite equipment and expertise for PHACO are not available. Keywords: Manual Small Incision Cataract Surgery, Phacoemulsification, Visual outcome, surgical induced astigmatism.

Diagnostic criteria are defined as group of features that can collectively be used to diagnose a condition. Diagnostic criteria are used for diagnosing those skin conditions that have heterogenous presentation and do not have a single specific clinical, laboratory or pathological feature. Keywords: Diagnostic criteria, Atopic Dermatitis, Sweets Syndrome, Pyoderma Gangrenosum

Aim: To study the pattern of keratoconus including age, sex, and risk factors such as eye rubbing, UV exposure. Material And Methods: Retrospective hospital based study including 437 diagnosed patients of keratoconus in the year 2022. Results: In our study the prevalence of keratoconus was 0.5%. The mean age of keratoconus patients in our study was 25.67 years. Males (54.7%) were affected more than females (45%). Maximum number of cases were from Srinagar followed by Pulwama and Budgam districts. Most of the patients gave itching and eye rubbing as a symptom and were associated with VKC. Conclusion: We believe that the prevalence of keratoconus in Kashmir is way beyond which is diagnosed. This is because of the lack of proper investigative tools. The number is just the tip of iceberg which we got in our hospital. Moreover, eye rubbing, VKC and UV exposure has been the most important risk factor. Keywords: Keratoconus, Corneal Topography, Prevalence, Distribution.