Introduction: Pseudoexfoliation (PEX) is a systemic disease characterised by the accumulation of dandruff like fluffy deposits of fibrillar granular material. It is the most common cause of secondary open angle glaucoma. Pseudoexfoliation Glaucoma (PXG) is typically associated with rapid visual field loss, greater severity of optic neuropathy and pressure spikes. Aim: To evaluate the clinical characteristic of Pseudoexfoliation Syndrome (PXS) and PXG in the eastern part of Uttar Pradesh. Materials and Methods: This retrospective cross-sectional study was done at Sitapur Eye Hospital, Sitapur, Uttar Pradesh, India. The authors reviewed the medical records database to identify all patients aged 35 years or older with PXG or PXS who attended the outpatient clinic between January 1, 2020 and January 31, 2021. Ethical approval was obtained from the Institutional Review Board at Sitapur Eye Hospital, Sitapur. Continuous variables were calculated by Mann-whitney and student t-test and qualitative variables using the chi-square test. The p-value <0.05 was considered significant. Results: A total of 40 patients with 78 eyes were diagnosed as having PXG or PXS. The mean age of study patients was 66.12±11.63 years. The male to female ratio was 2.64:1. The average Intra Ocular Pressure (IOP), Cup:Disk ratio was more in the patients having PXG (p<0.001) as compared to PXS. The PEX at the pupillary margin and pupillary ruff atrophy was more in PXG. The bilateral involvement of disease was observed in most of the patients. Conclusions: The spectrum of PEX includes a detailed ocular and systemic examination. Dilated anterior segment examination should be emphasised in routine practice to prevent missed diagnosis of early PEX patients, thus resulting in decreased glaucomatous damage.
BACKGROUND:Cataract is the leading cause of avoidable blindness in India. Around 4 million people become blind each year because of cataract. AIM: To assess the visual outcome and complications associated with cataract surgery in camp patients operated at a Medical College tertiary hospital. MATERIALS AND METHODS: It was a retrospective study where 412 camp patients underwent posterior chamber intraocular lens implantation surgery over a period of one year. Data was compiled based on demographic characteristics, and post-operative complications. It was graded as per Oxford Cataract Treatment and Evaluation Team (OCTET) definitions on first post-operative day. After one month post-operative complications, best corrected visual acuity and refractive errors were also analyzed. RESULTS: 412 eyes underwent cataract surgery with posterior chamber intraocular lens implantation .The maximum patients were in the age group of 60-69 years, 180 (43.6%) patients., Among these patients 240 were males (58.2 %) and 172 were females (41.7 %). Small incision cataract surgery (SICS) with intraocular lens implant was the commonest surgical method (80%) used. 792 eyes of 412 patients had cataract, of which 596 had the cortical type (75.3 %) and 196 had the nuclear type (24.7 %). Of the cortical type, 428 were immature and 168 were mature cataracts Based on OCTET grading, the most common first post-operative day complication was mild iridocyclitis (26.2%) followed by transient corneal edema in 86 patients. The major postoperative complications after 4 weeks of cataract surgery were pigments on PCIOL in 18 (4.36%) cases and capsular flap in 12 cases. After 4 weeks post-operative best corrected visual acuity of eye 6/18 in 89.8% cases. The commonest refractive error was Myopia with against the rule astigmatism seen in 172 out of 300 patients. CONCLUSION: Acceptable results can be obtained from eye camp surgery patients with experienced ophthalmologists in the base hospitals and these camps help in reducing huge burden of cataract patients. Our aim remains to reach more blind and needy patient and to provide an improved standard of visual rehabilitation.
Background: Phacomorphic glaucoma is highly prevalent in developing countries. In India, the prevalence of phacomorphic glaucoma is 3.91%. The definitive treatment of phacomorphic glaucoma is surgery. The purpose of our study was to compare the surgical technique and outcomes of phacoemulsification and manual small incision cataract surgery (MSICS), in management of phacomorphic glaucoma and analysis of the risk factors for developing phacomorphic glaucoma. Methods: This was a hospital based retrospective study done at a tertiary eye care center, over a period of nineteen months. A rigorous protocol to diagnose phacomorphic glaucoma was followed. All patients were given IV mannitol 20%, before surgery. The study patients were divided in to phaco group and MSICS group. The data analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: Out of 99 phacomorphic glaucoma cases, 37 underwent phacoemulsification and 62 underwent MSICS. The total number of female patients was 66 (66.67%) and that of male was 33 (33.33%) with female to male ratio of 2:1. The mean age of presentation was 63.64±8.27 years. The overall mean IOP was 42.9±9.68 mmHg in both the groups. The mean axial length was 22.47±1.03 mm in study patients and 22.82±0.8 mm in control group, (p=0.0082). The mean AC depth was 2.54±0.53 mm for phacomorphic eyes and 2.69±0.5 mm for control groups, (p=0.04). Conclusions: MSICS is effective, safe and inexpensive in controlling IOP and achieving good visual acuity with minimal complications in the management of phacomorphic glaucoma as compared to phacoemulsification.
Background: Cataracts in children are rare, accounting 7.4-15.3% of pediatric blindness. Pediatric cataract is a treatable leading cause of childhood blindness. Rashtriya bal swasthya karyakram (RBSK) is an important initiative aiming at early identification and early intervention for children from birth to 18 years. The objective of our study was to know the impact of RBSK, in management of childhood cataract, at a tertiary eye care center.Methods: This was a hospital based retrospective study, done from December 2018 to December 2019. This study included all patients of congenital and developmental cataract during this study period. The patients aged less than or equal to 18 years were included. All statistical analyses were done at 5% (p<0.05) significance using Graph Pad instat version 3.0 and Microsoft excel 2019.Results: During a study period of thirteen months, 357 eyes of 210 patients with congenital or development cataract were included. There were 142 (67.61%) male patients and 68 (32.38%) were female. The maximum number of patients were seen in the age group of 4-6 years 52 (24.7%), followed by the age group of 7-9 years 48 (22.8%). Bilateral cataracts were seen in 148 (70.4%) patients and unilateral cataract in 61 (29.0%) patients. The most common type of cataract was lamellar cataract seen in 150 (42%) eyes.Conclusions: RBSK is changing the lives of children and their families by reducing the burden of childhood blindness due to cataract and improving the quality of the life, especially in financially underprivileged families.
Background: Cataract is the major cause of blindness in developing nations, in India it has been reported to be responsible for 50-80% of the bilaterally blindness in the country. Patients coming for community cataract surgery are being screened for retinal diseases which are third most blinding condition after cataract and glaucoma.Methods: This was a hospital based retrospective study. Patients included were of age between 40 to more than 80 years of age from 1st September to 31st December 2019. Comprehensive ocular and systemic examinations were done.Results: The age ranged from 40 to >80 years with a mean±SD age of 69.64±7.31 years. Mean±SD age of men was 69.98±7.37 years, and women were 69.36±7.26 years. Nearly half of the study subjects (48.5%) were between 60 and 69 years of age, whereas 3.9% were of 80 years and above. The prevalence of unilateral retinal disorders was 18.9% (95% CI: 17.2–20.8%), while bilateral retinal disorders was 33.5% (95% CI: 31.2–35.6%) The prevalence of retinal disorders was 45.47% between age 60–69 years, 54.48% between age 70–79 years, and 25% for age 80 years and above.Conclusions: Without screening programs, patients often fail to notice developing visual impairment until the disease progresses to advanced stage, especially in their nondominant eye. So community patients should also be screened for glaucoma and retinal diseases which are second and third most common blinding conditions in developing countries like India.
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