BACKGROUND Head injury causes hospitalisation of 200-300 persons per 10000 population per year. Ocular manifestations are known to occur in patients with head injury, because of the proximity of the eye to head and its neural connections with brain. Clinical correlation of the ophthalmic findings is important in early localisation, ongoing assessment, better management, prognosis of the patient with head injury. METHODS A total of 180 patients with closed head injury were examined in the casualty of KIMS Hospital, Hubli. Glasgow coma scale of all the patients was noted. Ophthalmological examination was conducted. This included, orbital margins, periorbital region, eyelids, conjunctiva, cornea, anterior chamber, iris, pupil examination and lens details. Bedside vision up to 3 meters was evaluated. Digital tension, extra ocular movements and direct ophthalmoscope examination were done. Patient was managed accordingly. The results obtained were analysed. RESULTS In this study, 153 cases (85%) were male and 27 cases (15%) were females. Age of the patients ranged from 18 to 75 years. Road traffic accident was the most common cause of head injury in 108 cases (60%), followed by assault 44 cases (24.44%). 28 cases (15.55%) had other causes like falls etc. Types of ocular injury in this included-lacerations in 16 patients(8.89%), black eye in 12 patients (6.66%), palsies in 6 patients (3.33%), sub conjunctival haemorrhage in 5 patients (2.77%), optic neuropathy, globe rupture, vitreous haemorrhage with lens dislocation in 4 patients each (2.22% each) and most frequently combined injuries occurred in 124 patients (68.89%). Cranial nerve palsies occurred in a total of 8 patients. In our study most of the patients had good vision of counting finger >3 mt. (73.33%). 3.89% had CF <3 mt and 1.67% had no perception of light. 21.11% vision was not assessable. Most of the patients with ocular findings had mild GCS. Neurological manifestations were more common with reduced GCS. Ocular manifestations are quite common in patients with head injury. CONCLUSIONS Ophthalmological examination is quite often neglected in situations of busy casualties. Ophthalmic assessment in patients with head injury might help in diagnosing visual conditions earlier. This assessment might help in early treatment as well thus preventing the patient to live a morbid life even after surviving head injury. This highlights the importance of integrated ophthalmological assessment while evaluating a case of head trauma.

To compare the success rate and complications of external dacryocystorhinostomy (ExDCR) and transcanalicular laser assisted dacryocysto-rhinostomy (TCL-DCR) surgeries performed in patients with primary acquired nasolacrimal duct obstruction. METHODS: Sixty four patients with the diagnosis of primary acquired nasolacrimal duct obstruction were studied. Study period was 18 months. 30 patients in group A underwent Ex DCR, 34 patients in group B underwent TCL-DCR. Cases were followed up periodically for 6 months to note any complications and failure of the procedure. RESULTS: The patients in both the groups belonged to the age group of 18-65 years. In group A, failure was seen in 2 cases (6.6%) and complications were seen in 7 cases (23.33%). In group B, failure was seen in 3 patients (8.8%) and complications were seen in 2 patients (5.8%). The success rate of Ex DCR and TCL-DCR was found to be 93.4% and 92.2% respectively. CONCLUSIONS: The success rate of Ex DCR was comparable to that of TCL-DCR; however, complications were more in the former. TCL-DCR avoids post-operative morbidity and excessive tissue injury. Hence, we conclude that TCL-DCR was less traumatic, less time consuming, and had better cosmetic outcome.