Introduction: Blindness is one of the most tragic yet often avoidable disabilities in the developing world. The pattern of ocular diseases varies in different parts of Nepal due to differences in socioeconomic and geographic factors. This retrospective study likely reflects the pattern of ocular diseases in Kathmandu Valley. Aim: To assess the patterns of ocular disease in the patients attending the outpatient department of Ophthalmology from 14th April 2009 to 13th April 2010 at the Army Hospital. Methods: This is a retrospective study and all the new cases which attended the department of Ophthalmology of Shree Birendra Hospital in the year 2066 were included. The diseases were divided into 11 groups i.e. lid & adenexal disorder, disease of conjunctiva & sclera, corneal diseases, lens associated disorders, diseases of uveal tract, refractive error, glaucoma & its associations, posterior segment diseases, ocular & systemic neoplastic disorders, Nekebadi (annual medical check up) and others. Result: The total number of patients recorded in the department of Ophthalmology is 16709. Among them 4473 were regular serving army personnel and 12236 were ex-army and army families. Conclusion: The pattern of eye disease varies in different age groups. In younger age group conjunctival, scleral disease and refractive error were commonly seen whereas in elder age group lens disorder was frequently seen. The number of blind patients was more in females than in male patients. Key words: Conjunctivitis; Cataract; Blindness. DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5023 Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 30-37

Introducti on: Visual impairment (VI) in children accounts for great challenge in the life of children that leads to greater medical, psychological, social and economic problems since the child has to live up with handicap for many years to come. Identi fying the main causes of visual degradati on and their patt ern will help in preventi ve measures, early diagnosis, treatment and rehabilitati on of vulnerable populati on. The aim of this study was to fi nd out the patt ern of visual impairment in children att ending low vision clinic of Nepal Eye Hospital.Methods: A retrospecti ve cross--secti onal review of hospital records of all VI children att ending the low vision clinic from 1 st May 2010 to 31 st April 2011 with age less than 16 years was done.Results: Overall, 65 children were included in this study with mean age 11.58±3.83 years. Among them 55.4% were male. More than one third (34%) of the total children were in the category of blindness. More than two thirds (72.30%) pati ents had refracti ve error. Majority of the pati ents (66.15%) had multi ple causes of visual impairment. Major causes of visual impairment were nystagmus (58.46%), high refracti ve error (26.15%) and amblyopia (24.61%). Low vision devices were prescribed for only 18.46% of the total pati ents. Telescope was the most frequently prescribed low vision opti cal device. Conclusion:Nystagmus, high refracti ve error and amblyopia were the main causes of VI. Most of the cases had multi ple causes. Low vision devices were prescribed for very few of the visual impaired pati ents and telescope was the most frequently prescribed among them.

Introduction: Cataract is a common ailment of the old age hindering daily activities leading to poor quality of life due to poor vision. It is the commonest cause of treatable blindness. In practice, extracapsular cataract excision and small incision cataract surgery are the two-common surgery for cataract these days in developing part like in Nepal. Between these two cataract surgeries, ECCE and SICS; SICS gives the better visual outcome. Methods: This retrospective cohort study was carried out including 286 eyes which were operated either by conventional extracapsular cataract extraction or small-incision cataract surgery. The patient’s demographics, preoperative vision, postoperative parameters/variables were studied from the patient’s record keeping. The postoperative visual outcome and complications were compared in both groups at the immediate post-operative period and at 8 weeks follow up period. Result: Among the total 286 cases, 138 underwent ECCE and 148 underwent SICS. 145 (50.6%) were right eye, 141 (49.3%) were left eye. Among total operated cases, 123 (43%) were mature cataract, 97 (33.9%) immature cataract, 66 (23.1%) hyper-mature cataract. In 172 cases (60.1%) there was a good vision, in 104 cases (36.4%) it was borderline while in rest 10 (3.5%) cases it was poor on the 60th postoperative day. There was the better visual outcome (≥6/18) with SICS (78.3%) than ECCE (40.5%) (p<0.001) on the 60th post-operative day. Among cases undergoing SICS the complications were less than ECCE. (p<0.001, OR=5.72 (2.10-15.51)). Conclusion: This study supports that SICS is safer than ECCE with less complication rate and better visual outcome in short term observation.

Introduction: Inflammation of the optic nerve is a common cause of visual loss due to optic nerve pathology. This study was conducted to report the clinical features, demographic pattern and response to pulse steroid therapy in patients with idiopathic optic neuritis in a tertiary care teaching institute in Kathmandu, Nepal. Methods: The hospital data of patients with idiopathic optic neuritis admitted to the Department of Ophthalmology of Shree Birendra Hospital, Chhauni, Kathmandu, Nepal between Jan 2015 to Dec 2018 were retrospectively analysed. The parameters studied were demographic pattern, clinical features, and visual acuity.    Results: Eighteen eyes of 15 patients were found to have optic neuritis (papillits in eight and retrobulbar optic neuritis in 10 eyes). The male to female ratio was 1.4:1. The mean age of the patients was 38.07 ± 11.37 years (95% CI = 31.77- 42.37). The most common modes of presentation were loss of visual acuity, painful ocular movement and colour vision defect. One patient had features suggestive of multiple sclerosis. Response to pulse methylprednisolone therapy was good in most (16 eyes) of the cases except for the patients having recurrent episode and started oral steroid elsewhere before presenting to our hospital.  Conclusions: Response to pulse methylprednisolone therapy was good in patients with initial visual acuity of at least perception of light. Demographic and clinical features of our patients were different from those reported from the western world.

Introduction: Uveitis is an inflammatory condition of uvea of eye. It is a sight threatening condition, so accurate and timely diagnosis and treatment is required. Acute anterior uveitis is characterised by eye pain or photophobia, circumlimbal redness and anterior chamber cells and flare. Methods: This is a cross-sectional descriptive hospital record-based study based on data record in eye department of a tertiary care level centre in Kathmandu, Nepal.  All cases of anterior uveitis presented to our OPD over one-year duration (December 2017- November 2018) were enrolled. Age, sex, co-morbidities and profile of uveitis like slit lamp findings were recorded. Results: Total 52 cases of acute uveitis were observed during the study period. There were total 34 males and 18 females with eye involvement. Age group of the patients ranged from 19 to 79 years with median age of 36 years. Forty eight cases (92.3%) had unilateral involvement whereas only four cases (7.7%) had bilateral involvement. Keratic precipitates were seen in 44 patients. Majority of the patients had good vision; 65.4% in right eye and 69.2% in left eye. Conclusions: Most of the anterior uveitis occur in male in third and fourth decade. The most common complaints of the patient were decreased vision, eye pain and red eye.