Background:Use of suxamethonium is associated with an increase in intraocular pressure (IOP) and may be harmful for patients with penetrating eye injuries. The purpose of our study was to observe the efficacy of dexmedetomidine for prevention of rise in IOP associated with the administration of suxamethonium and endotracheal intubation.Methods:Sixty-six American Society of Anaesthesiologists I or II patients undergoing general anaesthesia for non-ophthalmic surgery were included in this randomized, prospective, clinical study. Patients were allocated into three groups to receive 0.4 μg/kg dexmedetomidine (group D4), 0.6 μg/kg dexmedetomidine (group D6) or normal saline (group C) over a period of 10 min before induction. IOP, heart rate and mean arterial pressure were recorded before and after the premedication, after induction, after suxamethonium injection and after endotracheal intubation.Results:Fall in IOP was observed following administration of dexmedetomidine. IOP increased in all three groups after suxamethonium injection and endotracheal intubation, but it never crossed the baseline value in group D4 as well as in group D6. Fall in mean arterial pressure was noticed after dexmedetomidine infusion, especially in the D6 group.Conclusion:Dexmedetomidine (0.6 μg/kg as well as 0.4 μg/kg body weight) effectively prevents rise of IOP associated with administration of suxamethonium and endotracheal intubation. However, dexmedetomidine 0.6 μg/kg may cause significant hypotension. Thus, dexmedetomidine 0.4 μg/kg may be preferred for prevention of rise in IOP.

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BACKGROUND Glaucoma is the second most leading cause of visual loss in the world. Different socio epidemiological parameters like gender, age, socio-economic status, educational status etc. has been directly linked to occurrence of glaucoma in previous studies. Review of the western literature showed that the risk factors associated with glaucoma were high intra ocular pressure (IOP), low blood pressure, low ocular perfusion pressure, narrow anterior chamber angles, thin corneas, pseudoexfoliation, a low body mass index (BMI), and myopia. We need to evaluate the clinical and epidemiological factors affecting primary open angle glaucoma. METHODS Records of patients with a diagnosis of primary open-angle glaucoma (POAG) were studied. All data, addressing demographics (gender, age and skin colour), socioeconomic status, educational status, emotional status and clinical information concerning risk factors for developing glaucoma (family history of glaucoma, hypertension and diabetes mellitus) and any treatment history (e.g., corticosteroid intake) were noted. Findings from visual acuity examination, refraction, detailed anterior segment examination by slit lamp, fundus examination with 90 D, gonioscopy, applanation tonometry, VF examination by automated perimetry and A-scan USG were also carefully taken into account. RESULTS A total 920 patients were enrolled of which 67.94 % were males and 57.6 % were from urban population. 18.7 % cases had positive family history. Most of the patients came from lower and middle-income group (43.48 % and 48.37 % respectively). Cup-disc ratio of majority of eyes was found to be more than 0.30 (97.29 %). Different grades of disc changes and field changes were noted. Cupdisc ratio asymmetry of more than 0.20 was found in 355 (38.59 %) eyes. Paracentral and / or arcuate scotoma was detected in 585 eyes (31.80 %). CONCLUSIONS Understanding the socio-demography and socio-economy helps in early diagnosis and better assessment of the disease severity in POAG. KEYWORDS Glaucoma, POAG, CDR, Visual Fields