Introduction: Nepal is a developing country where most of the population does not have access to proper health care services and on top of that eye care services do not reach the entire population. This study aimed to determine the pattern of ocular morbidity in patients attending the ophthalmic OPD of Rapti Academy of Health Sciences. Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Ophthalmology of Rapti Academy of Health Science, Dang. The study period was Poush 2077 to Chaitra 2077.  All the patients visiting the OPD of the Ophthalmology department with an ocular problem were included in the study. Results: A total of 1000 patients were examined during the study period. The patient's ages below 1 year were excluded so a total of 970 samples was selected. In which 625 (64.4%) were female and 345 (35.6%) were male. Most patients 92.9% were from Dang followed by Rolpa 4.1%, Rukum 1.4%, Pyuthan 0.9%, and Salyan 0.6%. Patients were examined from all age groups except for 1 year which was excluded. Out of the total patients, a maximum number of patients were female and the maximum number of patients were in the age group of 21- 30 years and followed by more than or equal to 60 years age group. Conclusions:  This study will help in obtaining epidemiology of Ocular disease for proper planning and management in the hospital.

Acanthamoeba keratitis is a sight-threatening corneal infection and is a growing clinical problem in the world. Though Acanthamoeba keratitis is considered uncommon and rarely reported in Nepal, we encountered six cases in 2019. All patients had redness, photophobia, decreased vision, and pain with ring infiltrate. Ten percent potassium hydroxide mount revealed Acanthamoeba cyst in all cases. Non-nutrient agar overladen with Escherichia coli revealed feeding tracks and Polymerase Chain Reaction revealed T4 genotype Acanthamoeba in four cases. Amoebicidal treatment was started with chlorhexidine 0.02% eye drop half-hourly and supplementary treatment included moxifloxacin eye drop, a combination of polymyxin B sulfate, neomycin sulfate, and bacitracin eye ointment. After treatment, one patient had the best-corrected visual acuity of 6/9 while others had a visual outcome of hand movement. A high level of clinical suspicion and wet mount examination of specimen from infected corneal tissue are essential to aid in rapid diagnosis.

Background Acanthamoeba keratitis is a sight threatening corneal infection and is a growing clinical problem in developing countries as well as developed countries. Acanthamoeba keratitis is a local infection of the eye and does not produce systemic illness. Proper diagnostic techniques and appropriate medical management are necessary for good prognosis. Findings We report a series of six cases of acanthamoeba keratitis diagnosed and managed at Biratnagar Eye Hospital in the year 2019. The patients age ranges from 28-58 years, with four males and two females. The mean duration of presentation to hospital was 19 days. Four patients had trauma with vegetative matter. All patients had redness, photophobia, decreased vision, pain among which only two had pain out of proportion. One patient had visual acquity of 2/60 whereas the rest had hand movement to perception of light at time of presentation. Ring infiltrate was noted in all the cases. Five patients had ulcer in central and paracentral regions, four had ulcer larger than 6mm and three showed presence of hypopyon. KOH stained smears revealed acanthamoeba cyst in all cases while Gram stain was positive in only one case. Non-nutrient agar overladen with Escherichia coli revealed feeding tracks in four cases and polymerase chain reaction revealed T4 genotype acanthamoeba in four cases. Amoebicidal treatment was started with Chlorhexidine 0.02% eye drop half hourly. Other drugs Natamicin 5% eye drop half hourly, Fluconazole 0.3% eye drop half hourly and antibiotic Moxifloxacin 0.5% eye drop half hourly were also used simultaneously. Pain was reduced in all patients. After treatment, only one patient had BCVA of 6/9 while others had visual outcome of hand movement. Conclusions Acanthamoeba keratitis can be severe and vision-threatening. Centrally located ulcer, size of the ulcer > 6mm and visual acuity Hand Movement/Perception of light at the time of presentation were associated with poor outcome. Clinically suspected lesions associated with microbiological assessment help in early diagnosis and prompt treatment.