Introduction: The frequency of eye diseases has been suggested to start increasing around 40 years of age, with an even steeper increase beginning around 60 years of age. Health promotions and curative and rehabilitative services for the visually impaired elderly population should therefore be a priority in the coming years especially in low and middle income countries. Aim:To examine the changing pattern of ocular morbidity in the elderly population of Northern India and to determine the socioeconomic status in relation to ocular morbidities. Materials and Methods:A team from the Department of Ophth almology and Department of Community Medicine, conducted house visits and did a complete eye examination of 450 elderly subjects. They were selected by systematic random sampling from the data base available in the Department of Community Medicine.Results: A total of 900 eyes were examined. Visual impairment and blindness was seen in 135 (30%) and 36 (8%) individuals respectively. The most common cause of blindness was cataract, followed by corneal opacity, glaucoma, refractive error, diabetic retinopathy, macular scar, age related macular degeneration, retinal detachment, retinitis pigmentosa. Visual impairment was more in individuals with low socioeconomic status. Conclusion:The results of this study suggest that though cataract remains the main cause of blindness, there is an increase in blindness and visual impairment due to corneal diseases and glaucoma which was not seen earlier. The availability and accessibility to eye care facilities particularly for corneal diseases and glaucoma should be increased to reduce blindness in Northern India.

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BACKGROUND Posterior capsular opacification (PCO) is the most common long term complication of modern extra capsular cataract surgery techniques including phacoemulsification. The treatment of choice for clinically significant posterior capsule opacification is Neodymium: Yttrium-Aluminium-Garnet (Nd:YAG) laser posterior capsulotomy. Increased IOP is a well-known complication of Nd:YAG laser posterior capsulotomy Effective prophylaxis could prevent the possible optic nerve damage or visual field loss in susceptible patients. MATERIALS AND METHODS This prospective randomized study was conducted for one year in the Department of Ophthalmology Christian Medical College and Hospital, Ludhiana. All patients undergoing laser capsulotomy during this period were randomly distributed into two groups-A or B. Group A received 1 drop of Brimonidine 0.15%, Group B received 1 drop of 0.5% Timolol, one hour prior to presentation. Nd:YAG laser Capsulotomy was done. IOP was measured using an applanation tonometer after 1 hr, 2 hrs, 3 hrs and 4 hrs. after completion of procedure. The data was collected as per protocol and statistically analysed using t-test, Chisquare test and Z test. RESULTS There were 30 patients in each group. The baseline IOP was 15.10 ± 2.66 mmHg for group A and 16 ± 2.18 mmHg for group B (p = 0.11) (t test). There was no statistically significant reduction between the two groups in the mean IOP changes at 1, 2 or 3 hrs after Nd:YAG capsulotomy. The mean reduction in IOP after 4 hrs. for group was-1.83 mmHg and for group B was-1.53 mmHg. The difference was statistically significant (p <0.05). CONCLUSION Brimonidine 0.15% was found to have an efficacy comparable to that of Timolol 0.5% in preventing post Nd:YAG capsulotomy IOP spikes.

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