Objective: To assess the rate of positivity of Toxoplasma gondii, Rubella, Cytomegalovirus, Herpes simplex (TORCH) pathogens in patients suffering from congenital cataract in Pakistan. Study Design: Cross sectional comparative study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jun 2017 to Mar 2018. Methodology: Cataract group included sixty children already diagnosed with congenital cataract and control group included 60 children not suffering from congenital cataract. Serum samples of all children were collected to test against IgG and IgM antibodies of Toxoplasma gondii, Rubella, Cytomegalo, Herpes simplex pathogens using enzyme linked immune essay (ELISA) technique. Data were analyzed observe in difference between unilateral and bilateral cataract and between cataract and control group. Results: Out of 60 children in cataract group, 29 were tested positive for Toxoplasma gondii, Rubella, Cytomegalo (CMV), Herpes simplex infections. CMV IgG antibodies were identified in 21 (35%) children followed by Rubella IgG 13 (21.7%), Toxoplasmosis IgG 8 (13.3%), CMV IgM 7 (11.7%), HSV I IgG 5 (8.3%), HSV II IgG 2 (3.3%) and HSV I IgM 1 (1.7%) antibodies. None of the children was positive for Toxoplasmosis, Rubella and HSV II IgM antibodies. There was no statistical difference in rate of positivity of Toxoplasma gondii, Rubella, Cytomegalovirus, Herpes simplex pathogens between unilateral and bilateral cataract and between cataract and control group. Conclusion: Toxoplasma gondii, Rubella, Cytomegalovirus, Herpes simplex pathogens are an important cause of congenital cataract with Cytomegalovirus and Rubella virus being most common respectively. In order to prevent paediatric complications, we need........

Objective: To see the frequency and compare the type of refractive error and strabismus in amblyopic versus non amblyopic children. Study Design: Comparative cross sectional study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan to Jul 2019. Methodology: The sample population comprised of 250 patients of new or previously diagnosed children with refractive error and strabismus presenting at children eye outdoor patient department of armed forces institute of ophthalmology. Strabismus was diagnosed by the consultant eye specialist on the basis of heterotropia at near or distance fixation. Amblyopia and refracttive error was assessed by a trained optometrist. Patients were classified into amblyopia and non- amblyopia groups. The type of squint and refractive error was noted down along with demographic details. Chi square test was used to assess thesignificance of association between various categorical variables. Results: A total of 250 participants were included with a mean age of 5.00 ± 1.07 years. Out of total, 132 (52.8%) were males while 118 (47.2%) were females. One hundred and fifty (59.5%) patients were suffering from amblyopia while 100 (39.5%) patients were normal with comparable vision in both the eyes. Out of 150 amblyopic patients 134 (89.3%) were suffering from unilateral amblyopia while 16 (10.6%) patients had amblyopia in both the eyes. Out of refractive errors astigmatism was present in 83 (55.3 %) of amblyopia patients while hypermetropia was present in 54 (36%) of the patients. Out of total patients of strabismus, 95 (63.3%) of non-alternating esotropic patients..........

Objective: To determine the difference between target and postoperative refraction in children with congenital cataract. Study design:    Prospective interventional study Place and Duration of Study: This study was conducted at Armed Forces Institute of Ophthalmology from May 2017 to May 2018. Methods: This study was conducted on 38 eyes suffering from congenital cataract. Age at the time of surgery, axial length, average keratometry reading, estimated refraction, and the power of IOL implanted were recorded. Spherical equivalent of post-op refraction at 3 months after surgery was noted. The difference between the estimated and actual postoperative refraction was termed as prediction error. Age, keratometry, and axial length were then assessed for its effects on prediction error. Results:  Overall the mean prediction error was 1.43±1.98 D. The mean prediction errors in eyes with axial lengths ⩾20 mm were 0.96± 1.03 D and in eyes <20 mm were 5.50± 3.49 D. The mean prediction errors in eyes in children aged ⩾4 years were 0.14± 0.61 D) and in children aged < 4 years was 2.60± 2.07 D. The differences between the prediction errors for both axial length and age were statistically significant (p<0.05). Conclusion:       IOL power calculations in eyes with axial length less than 20 mm and children less than 4 years of age are prone to postoperative refractive errors. This study has reflected that adult based formulas are not reliable in pediatric age group.

Objective: To determine the effect of amblyopia patching therapy on visual outcome in young and adults at 6th and 12th week. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi, Pakistan, from Sep 2018 to Jan 2020. Methodology: Out of 110, follow up was successfully completed by 91 eyes. Subjects were divided into young and adult based on age. Age ranging from 5-12 years included in the young group and adult group included those ranging from 13-20 years. Anisometropic amblyopia was considered. Amblyopia due to any other disease were excluded. Subjects were advised patching therapy daily for 4 hours in the affected eye. Follow up was 3 weekly for 12 weeks and the effect of patching therapy was assessed by visual improvement. Statistical analysis was done with SPSS version 21. Result: Out of 91 eyes with amblyopia, 51 (56.6%) were included in the young group while 40 (43.4%) were included in the adult group. In the young group, visual improvement was seen in 40 (78.4%) while in the adult group 24 (60%) showed improvement in vision. Mean visual improvement in young was 1.66 ± 1.099 while 1.03 ± 0.944 in the adult group. Maximum visual improvement in both groups was seen till the 6th week of patching. Conclusion: Patching therapy is effective even at later ages too. However, continuing patching for more than 6 weeks doesn’t show much improvement in vision.