ABSTRACT:This Population based Prospective interventional study was carried out in 120 eyes of 120 patients of outpatient department Detailed history was taken regarding onset, duration, preceding symptoms, ocular morbidity, data related to risk factors, past illness, systemic illness if any recorded and through clinical examination along regurgitation test, fluorescent dye disappearance test, jones dye test, probing, syringing. Epiphora is most common in the age group of 40-50 years (66 patients). Prevalence of epiphora is more in common in females (70%) than males (30%). The mean period of epiphora in our study was 1.5 years ranged from 0.5 years to 3.5 years. Syringing and probing are the main tests for the investigation of epiphora and level of block in Nasolacrimal system. Our study suggests that canalicular trephination and silicone stem intubation should be considered as an alternative treatment for distal canalicular obstructions. Highest success rates were seen in dist al lower canalicular obstructions followed by distal bicanalicular obstructions and common canalicular obstructions. Complication rates are low, particularly when compared with the DCR with Jones tube placement. No correlation was found between infectious and idiopathic causes of epiphora to the surgical outcome. Eye with proximal canalicular obstruction may have increased risk of recurrence. Factors significantly associated with recurrence of epiphora during follow up of patients after surgery included proximity of block and chronicity of disease. This study identifies punctoplasty is the surgery of choice for punctal occlusion. In unicanalicular obstruction trephination with mini monaka stent has better surgical outcome. In patients with distal common canalicular obstruction bicanalicular silicone tube intubation with external dacryocystorhinostomy is the procedure of choice. In patients with nasolacrimal duct obstruction external dacryocystorhinostomy has a good surgical outcome. Distal monocanalicular obstructions have the highest degree of symptomatic epiphora relief, followed by distal bicanalicular, common and proximal obstructions.
BACKGROUND:Ptosis is derived from the greek word for falling and is the medical terminology describing a drooping
or abnormal lowering of an anatomical area. Ptosis that obstruct the pupil may interfere with the normal development of
vision, resulting in amblyopia in children2 .In adult it may impair the field of vision and interfere with activities of daily
living Ptosis is broadly classified into congenital and acquired,based on age of onset of the ptosis.Ptosis that is present at
birth or within the first year of life is called congenital ptosis. Ptosis that presents after the age of one year is termed
acquired ptosis. The treatment of ptosis depends upon the underlaying etiology. Ptosis usually does not improve over
time and nearly always require corrective surgery. Depending upon the severity of congenital ptosis ,patients should be
monitored every 3-12 months for sign of amblyopia due to congenital ptosis. In mild cases of congenital ptosis
observation is sufficient ,if no sign of amblyopia, strabismus and abnormal head posture are present. METHODS:This
study was conducted in the Upgraded Department of Ophthalmology,LLRM Medical College,Meerut during 2018–2019.
Study design-A Population based Prospective interventional study was done on patients selected from OPD and camps
during 2018-2019. Plan & Work: All patients with ptosis who are attending ophthalmology OPD and admitted in eye
wards were included in the study provided they fulfill the inclusion criteria. RESULTS AND CONCLUSION: The
subjects in our study were more males 12(66.66%) than females(33.33%). In our study there were 12(66.66%) patients of
myogenic ptosis,out of them 11(61.11%) had frontalis sling surgery and 1(5.55%) had levator resection surgery. There
was 2(11.11%) cases of neurogenic ptosis which was congenital in nature and in which 1(5.55%) is operated with
frontalis sling &1(5.55%) with levator resection surgery. Most commonly performed surgery was frontalis sling
14(77.77%) followed by levator resection 2(11.11%) and 2(11.11%).
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