Objective: To compare the frequency of Pseudo-Exfoliation Syndrome (PXS) in patients undergoing cataract surgery in different regional hospitals in Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Three Tertiary Care Hospitals of Karachi, Rawalakot and Skardu Pakistan, from Sep 2017 to May 2020. Methodology: Patients aged 45 years and more undergoing age-related cataract surgery were evaluated for Pseudo-Exfoliation Syndrome. Initially, each patient underwent a complete outpatient ophthalmological workup. Demographic details like age and gender were noted. All the patients were screened for hypertension and diabetes mellitus. In addition, patients were screened for pseudo-exfoliation syndrome. Congenital, developmental, secondary and traumatic cataracts were excluded. Results: A total of 1882 patients were included in the study. Pseudo-exfoliation was carried out in 249(13.23%) patients. In Hospital-A, 23(3.23%); in Hospital-B, 145(14.92%) and Hospital-C, 81(40.70%) of the patients had pseudo-exfoliation. The frequency of pseudo-exfoliation syndrome was significantly more in Hospital-C and then in Hospital-B and least in HospitalA (p<0.01). Conclusion: Pseudo-exfoliation syndrome was significantly more common in Skardu and then in Rawalakot and least in Malir, which in the same order have more latitude away from the equator, have less average annual temperature and are situated at higher altitudes.

Objective: To assess the frequency of dry eye among children during the COVID-19 pandemic. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Naval Ship Hafeez Hospital, Islamabad Pakistan, from Mar to Aug 2021. Methodology: Children aged 7-15 years reporting to the PNS Hafeez Hospital, OPD were included in the study. A proforma was used to record the demographics and screen time of the children. In addition, an ophthalmic examination was conducted to assess the dry eye status of the children using the Schirmer-II test. Results: Seventy-three children participated in the study. Their mean age was 11.08±2.42 years. There were 40(54.8%) boys and 33 (45.2%) girls. These children had a mean daily screen time of 7.23±2.77hours. Children with dry eye had a greater amount of screen time (8.75±2.11hours) as compared to those with normal tear function (6.05±2.66 hours; p<0.001). In addition,the screen time of children with dry eyes was significantly greater than those with normal tear functions (p=0.001). Conclusion: Children with dry eyes were reported to have more screen time and more online classes than their counterparts with normal tear functions. Authorities should consider resuming face-to-face sessions for all school children.

Objective: To compare the frequency of depression in low vision and normal vision patients. Study Design: Comparative cross-sectional study. Place and Duration of Study: Eye Department, Combined Military Hospital, Malir Cantt, Karachi Pakistan, from Dec 2017 to May 2019. Methodology: Patients with low vision and normal vision were evaluated for depression. Initially, each patient underwent a complete Outpatient ophthalmological workup. Then, the patients were assigned to the low vision and normal vision groups,and after informed consent, each patient was to complete Patient Health Questionnaire-9 (PHQ-9). Result: Two hundred and sixty-nine patients with low vision and 275 patients with normal vision were included in the study.One hundred and eighty-two (67.66%) patients with low vision and 71(25.82%) patients with normal vision were found to have significant depression (PHQ-9 score≥5). Depression was significantly more prevalent in the Low Vision-Group (p=<0.01). Conclusion: Significantly high level of depression in the Low Vision-Group needs to be taken care of in ophthalmology departments. The ophthalmologist should not look into the eyes but treat the patients as human beings.

Objective: To compare the success rate of nasal endoscopic assisted probing and simple probing in congenital nasolacrimal duct obstruction. Study Design: Quasi-experimental study. Place and Duration of Study: Eye department, Combined Military Hospital, Malir Cantt, Karachi, from Feb 2018 to Jun 2019. Methodology: A total of 100 children were randomly divided into two groups. Each child in both groups underwent probing of the nasolacrimal duct. In one group, simple probing was performed, and patency was confirmed with metal on metal touch. In the second group, a nasal endoscope was employed to visualize probe passage through the opening of the nasolacrimal duct in the inferior meatus. In fracture of the inferior turbinate was performed in every case when a nasal endoscope was utilized. In the simple probing group, in fracture was performed if the inferior meatus was narrow. The rate of epiphora resolution was recorded in both groups at 1-month postoperatively. Results: The success rate of epiphora resolution was 96% (48 out of 50) in the nasal endoscopic assisted probing-group and 82% (41 out of 50) in the simple probing-group (p=0.02). The simple probing-group had a 40% (20 out of 50) significant nasal bleed, and in the nasal endoscopic-group, the significant nasal bleed was 20% (10 out of 50) (p=0.02). Conclusion: Nasal endoscopic assisted probing of the nasolacrimal duct has a higher success rate than simple probing in congenital nasolacrimal duct obstruction.