Objectives: To compare the effectiveness of topical and retobulbar anesthesiain term of pain relief in patients subjected to cataract surgery. Material and methods: Thiscomparative study was conducted at Department of Ophthalmology, Bahawal Victoria HospitalBahawalpur from 18th July, 2012 to 18th January, 2013. Total 100 patients with cataract wereincluded in this study. Results: Mean age of the patient was 64.14 ± 8.7 years. No. of patientsin RA group who reported the pain scores (0- 4) during cataract surgery, was 46 (effectivenesswas positive in 92% patients), while it was 33 (effectiveness was positive in 66% patients) in TAgroup. A significant difference between effectiveness of both anesthetic group was observed. (P= 0.001). Conclusion: It is observed that topical anesthesia in cataract surgery is a simple, safeand noninvasive technique but it cannot be proposed as a very good alternative to retrobulbaranesthesia in cataract surgery of all patients regarding its effectiveness interms of pain relief.
An 81 years old woman presented with sudden painless greying of her vision in the right eye. This resolved within l-2 hours without any residual visual loss. She experienced similar symptoms twice in 4 months. The attacks lasted forty to sixty minutes. She had no history of hypertension, diabetes mellitus, migraine, ischemic heart disease and atrial fibrillation. Further neurological and systemic enquiry was negative On ocular examination, best visual acuity was 6/9 right eye and 6/60 in left eye. Slit lamp biomicroscopy, tonometry and discs appearances were normal. Right macula showed multiple drusens and dry type of ARMD.There was left disciform macular degeneration. The vascular pattern of both fundi was normal and did not reveal any embolus. Extraocular movements were normal. Cardiovascular examination, Carotid artery palpation and auscultation were all normal. Serum cholesterol level was normal. Thrombophilic screen was negative. Magnetic Resonance Angiogram showed aneurysm of right ophthalmic artery near the junction of carotid-ophthalmic artery. After neurosurgical consultation, she was advised to take Tab. Aspirin 75mg daily.
A 90 years old man presented with outward deviated right eye with droopy lid. These symptoms were developed over a period of two weeks and there was no pain behind the eye. There was no previous history of Diabetes mellitus, hypertension etc. He had a treatment for adenocarcinoma of prostate six years ago. On examination his best-corrected visual acuity was 6/60 in each eye. There was right complete third nerve paralysis with pupil involvement. Anterior segment examination showed nucleosclerotic changes on both sides. Posterior segment examination showed ARMD (dry type) in both eyes. Intraocular pressure and discs were normal. Contrast enhanced MR scan brain revealed a destructive mass at the base of skull at petrous apex on the right side extending forward to orbital apex on the same side. Total body bone scan also showed multiple metastatic lesions. Patient was referred to oncology unit for further management
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