Search

Purpose: To estimate the prevalence of diabetic retinopathy (DR), an emerging cause of sight threat and blindness from a large rural population in Pakistan.Methods: This was a population-based cross-sectional study. We selected a rural district of Matiari Sindh Province in Pakistan, where we selected all the health facilities and their attached Lady Health Workers (LHWs)/Lady Health Supervisors (LHSs). These female health workers were trained to identify high-risk diabetic individuals in their catchment areas using pre-defined criteria and to refer them to the nearest health facilities for screening and testing random blood sugar (BSR). Adults of 18 years or above, male or female, were included in the study for DM and DR screening. Ophthalmic examination was conducted by the optometrists on those who had BSR level >180 mg/dl for the evidence of DR. Identified DR patients were referred to a linked tertiary-level ophthalmology institute for their free DR treatment.Results: Of the identified and referred 24,463 participants, 23,999 were tested for BSR and 2,331 (9.74%) were found to be high-risk patients (BSR >180 mg/dl) and had ophthalmic examination conducted. Of these, 563 had clinically established DR, a prevalence of 24.2% (95% CI, 22-26%). Significantly more DR patients (228, 40.5%) were found in the age group >60 years, with more among female (327, 58.1%) with DR.Conclusion: DR is highly prevalent in the Pakistani rural population. The establishment of an integrated approach within the health care system could decrease the burden of DR in Pakistan. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effectiveness of lateral tarsal strip procedure (LTS) in treating different types of lid malposition. Study Design: Interventional case series. Place and Duration of Study: Sindh Institute of Ophthalmology and visual sciences from January 2019 to December 2019. Method: There were 49 eyelids on which LTS procedure was performed. A complete ophthalmic examination was done and patients were assessed for horizontal lid laxity by pinch test. Patients with severe and moderate to severe medial canthal laxity were excluded. Patients with medial ectropion and minimal medial canthal laxity were included in the study where LTS was combined with medial spindle. Results: Twenty three patients had involutional ectropion. Spindle procedure was performed in addition to LTS in 3 of these 23 patients. Six patients had involutional entropion. One patient had recurrent ectropion and LTS was combined with everting sutures in 3 of them. Five patients had facial palsy and two of them had combined spindle procedure. One patient had traumatic avulsion of lateral canthal tendon which was not repaired primarily. Two patients had previous cantholysis. In one patient LTS was performed to support the prosthesis in a previously eviscerated eye. All the patients underwent LTS with variation in length of lateral tarsal strip which was adjusted to horizontal lid laxity and presumed post-operative position of lower lids in relation to lower limbus and canthal angle. Conclusion: .Lateral tarsal strip is a simple and effective procedure for correction of different types of lower lid laxity and malposition. [ABSTRACT FROM AUTHOR]

Purpose: To determine the mean Post-operative corneal astigmatism in 3.2m.m versus 5.5m.m incision in patients with cataract undergoing Phaco-emulsification. Material & Method: Randomized controlled study was conducted at the Sindh Institute of ophthalmology & Visual Sciences, Hyderabad. Total of 190 subjects with 95 eyes in 3.2 mm incision group and another 95 eyes in the 5.5 mm incision group were included in the study. Inclusion criteria were 40-60 years of age, with symptoms of blurring of vision, visual acuity 6/24 to = 3/60 along with grade 2/3 cataract. Results: The mean surgical induced astigmatism in 3.2mm incision group was 0.20D +/- 0.40 (SD=0.38549) with a narrow range of surgical induced astigmatism from -0.50D to 0.75D. Whereas, in 5.5mm incision group the mean surgical induced astigmatism was 0.72D +/- 0.50 (SD= 0.55229)with a relative wider range of surgical induced astigmatism from -0.75D to 1.75D respectively. Compare both the groups by applying Independent t-Test, the p-value was is statistically significant. Conclusion: Patients with 3.2mm incision with Phaco-emulsification, surgical induced astigmatism is much lower and manageable as compared to 5.5mm incision with Phaco-emulsification. And, there was no significant correlation of age, sex and grade of cataract with surgical induced astigmatism. [ABSTRACT FROM AUTHOR]

Background. A highly infectious RNA virus known as Severe Acute Respiratory Corona Virus 2 is known to be responsible for recent Corona pandemic (SARS - COV-2). The latest pandemic lockdown caused thousands of ophthalmic administrations to be cancelled, including hospital appointments and surgical procedures. Due to unpredictability of times, patient's fear of getting their cataract surgery during the facilitation of COVID-19 lockdown should not be overlooked. A study was conducted in order to ascertain the experience of patients while waiting for cataract surgery during the pandemic and their desire to have their operation after lockdown relaxation. Objective. To assess patient's perception while waiting for cataract surgery as well as to assess the time period of delay in surgery due to covid-19 lockdown. Methodology: It was a cross sectional study for three months at Ophthalmic unit III, Sindh Institute of Visual and Ophthalmic Sciences, after approval by ethical committee. Total 380 patients with cataract reported to ophthalmic OPD were included in this study. Informed consent was taken and proformas were explained to the patient in their mode of language, to assess the patients' knowledge as well as their possible perception in decision and willingness to delay in surgery during covid-19 duration, their visual condition during the delay. Results: The study included 162 (42.6%) male patients and 218 (57.3%) female patients in total. The majority of the male patients were between the ages of 45-68 were as females were between the ages of 40 -70. The results showed only 22 (5.78%) patients had co-morbidities (Diabetes & Hypertension). Vision related quality of life for patients before cataract surgery showed that most of the patients had slight difficulty in vision 335(88.15%) patients while 32 (8.42%) patients had severe difficulty and 13(3.42%) patients had moderate difficulty of vision. During COVID-19 pandemic only 115 (30.3%) patients showed their willingness to attend clinics while 265(69.7%) patients were not willing to attend, may be due to increased awareness regarding spread & preventive measures of COVID-19. Conclusion. In this study most of the patients were female with early cataract as compared to male patients while almost majority of the patients were financially from low socioeconomic income population. Even with this reasonable sample size most of the patients had no co-morbid conditions especially diabetes and hypertension which is quite prevalent in our society, the reason could be lack of liaison between general health care Government hospitals and eye care providing facilities like Sindh Institute of Ophthalmology & Visual Sciences in whole of Sindh province. Patients were astonishingly almost all of them aware of the COVID-19 preventive measures, this could have been due to frequent public messages on cell phones, radio and television media by the Government. Nevertheless the patients were mostly from remote areas and had difficulties in transport, limited outpatient services due to COVID-19 lockdowns but still most of them were willing to visit hospitals may be due to the social taboo that people who have cataract will go blind. Considering visual needs most of the patients had acceptable vision to carry out their routine work but still reasonable number of patients were very much concerned about the delay of their cataract surgery. Finally we would suggest that planning and delivering better services to the patients in need could only be achieved by constant evaluation and improvement and that can only be achieved by frequent research on basic problems faced by underprivileged section of population. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequencies & association of different risk factors of bacterial keratitis followed by healing in patients visiting ophthalmology department of Liaquat University of Medical & Health Sciences (LUMHS) Hyderabad. Study Design: Prospective case series. Place and Duration of Study: The study was carried out from May 2013 to October 2013 in the Department of Ophthalmology, Liaquat University of Medical & Health Sciences (LUMHS) Hyderabad. Material and Methods: During the study period of 6 months 152 patients with bacterial keratitis were purposively sampled keeping in view the eligibility criteria. Variables studied were age, gender, site of eye (right or left), risk factors of keratitis and healing. Frequencies of different variables were analyzed through SPSS version 20 and p-value of <0.05 was considered as significant. Results: The results showed that males were more prone to corneal ulcers than females. Trauma was the most common risk factor followed by contact lenses, topical steroids, ocular surface diseases and previous corneal surgeries. Complete healing of the corneal ulcer was recorded in 84% cases. There was statistically significant association of risk factors with trauma (p-value=0.04), contact lens (p-value=0.00001), ocular surface disease (p-value=0.031), topical steroids (p-value=0.05) and previous corneal surgery (p-value=0.01). Conclusion: The study concluded that trauma is the leading cause for the bacterial corneal infections. Males are more prone to have bacterial keratitis in the age group of 31-40 years mostly affected. There is statistically significant association of risk factors like trauma, contact lenses, topical steroids, ocular surface diseases and previous corneal surgery with healing. [ABSTRACT FROM AUTHOR]