Background: Retinopathy of prematurity (ROP) is a serious problem which affects the premature infants. It is becoming a public health issue in developing countries like Pakistan. Antenatal visits, delivery and NICU management plays an important role in prevention of ROP. Objective: The aim of this study was to find out the prevalence of retinopathy of prematurity in premature neonates visiting Sir Ganga Ram hospital Lahore. Study Design: observational study. Settings: Study was carried out in Out-patient of Ophthalmology Department, A public sector Sir Ganga Ram Hospital, Lahore Pakistan. Duration: The duration of the study was one year from September 2020 to August 2021. Methods: All the preterm babies referred from pediatric department were part of study. A total of 160 babies were examined in this study. The data was presented in the form of frequency and percentages using SPSS software. Results: In this study out of 160 patients 75(46.87%) were male and 85(53.12%) were females. The prevalence of retinopathy of prematurity was observed in 43(26.87%) babies. Weight of patients less than 1kg was 11(25.58%) between 1-1.5 kg was noted in 28(65.11%) patients and >2 kg weight was noted in 4(9.30%) patients. Babies with ROP, 23(53.48%) recovered without any intervention, 9(20.93%) required intervention and recovered after 3 months follow up, 6(13.95%) kept under observation and recovered after 4 months and 5(11.62%) babies lost follow up. Practical implication: this study will help in early diagnosis and prevention of disease and help to formulate and introduce newer guidelines for prevention, early identification and prompt treatment starting from basic levels to prevent development of ROP of any stage. Conclusion: The study concluded that the prevalence of retinopathy of prematurity in premature neonates visiting Sir Ganga Ram hospital Lahore is 27%. Keywords: Retinopathy of Prematurity(ROP), Neonates, Preterm, screening, blindness

The prospective study was conducted in the Ophthalmology department, Sir Ganga Ram Hospital, Lahore, from January 2022 to January 2023 to compare the efficacy and safety of intravitreal (IVT) Bevacizumab alone with the suprachoroidal injection of CLS-TA (an injectable form of triamcinolone) along with IVT Bevacizumab in patients with retinal vein occlusion (RVO) induced macular edema in treatment naïve patients. Participants were randomized 1:1 to the IVT Bevacizumab group, and suprachoroidal injection of CLS-TA combined with IVT Bevacizumab group. Participants in both groups were administered drugs and monitored for 30 minutes after the injections. The final evaluation was done after 3 months. Results showed that the Bevacizumab group required 22 re-treatments of the participants for 3 months follow-up, while the combination group required 8 re-treatments (P=0.013). Regarding safety, 1 patient had cataract progression unrelated to the study drug. Combining steroids with vascular endothelial growth factor (VEGF) suppression benefits RVO-induced macular edema. It improves vision, reduces injection frequency, and provides rapid resolution. It is also seen that suprachoroidal delivery of CLS-TA is associated with a reduced risk of increased IOP and cataract progression compared to typical intraocular steroids. Regarding safety, 1 patient had cataract progression unrelated to the study drug. Combining steroids with vascular endothelial growth factor (VEGF) suppression benefits RVO-induced macular edema. It improves vision, reduces injection frequency, and provides rapid resolution. It is also seen that suprachoroidal delivery of CLS-TA is associated with a reduced risk of increased IOP and cataract progression compared to typical intraocular steroids.

Purpose: To assess the efficacy of per-operative 5% Povidone-iodine alone or in combination with post injection topical antibiotics for reducing vitreous activity in patients undergoing Intravitreal injection of anti-vascular endothelial growth factors.Methods: Total of 114 enrolled patients with retinal medical pathologies requiring Intravitreal anti vascular growth factors were randomized to study group A (5% Povidone-iodine per operative on conjunctiva for 3 minutes) and group B (5% Povidone-iodine per-operative on conjunctiva for 3 minutes and post injection topical antibiotics fluroquinolone four times a day for a week) with 57 patients in each group. All Intravitreal injections were performed in operating room in a sterile manner. Vitreous activity assessed using Sun's classification on slit lamp on first day and day 7 post Intravitreal injection of 1.25mg/0.05ml anti VEGF Bevacizumab. Collected data of group A and B was analyzed.Result: Out of 114 patients, 75 were males and 39 were females. Vitreous activity seen at day one post injection was same in both study groups while at day seven group A had increased vitreous cellular activity as compared to study group B. Both day one and day seven activity within the study groups were insignificant with p=0.244 and p=0.498 respectively. Conclusions:In both groups A and B, 5% Povidone-iodine (PI) solution shows effective prophylaxis against Endophthalmitis in Intravitreal anti VEGF injections. Post injection topical antibiotics should be avoided following Intravitreal injections of anti VEGF as it can increase microorganism resistance, virulence and add additional cost for the patients.

Background Ophthalmic trauma caused by intraocular foreign bodies (IOFBs) can impact visual prognosis by generating direct ocular structural damage. Factors bearing poor visual prognosis are related to size and velocity of IOFB, location in posterior segment with associated retinal detachment or endophthalmitis. Current study is aimed to evaluate size and location of IOFB and associated ocular structural damage. Methods In this retrospective study done at single tertiary center, patients injured by IOFBs were analyzed between January, 2010 to January, 2021 for ocular structural damage caused by size, velocity and location of impacted IOFB. All were assessed for corneal or scleral perforation and other structural damage due to IOFB. Location, route of retrieval and size of IOFB was measured. Results All 41 eyes were operated for removal of metallic IOFB. Corneal repair was done in 90.2% and scleral repair in 9.8% eyes. Hyphema cleared in 53.6% eyes. Traumatic cataract in 85.4% requiring phacoemulsification, preexisting aphakia (previous surgery) and siderosis was seen in 2.4% eyes. Retinal detachment was present in 14.6% and endophthalmitis in 4.9% eyes. Location of IOFB was on iris and lens in 2.4% each, with 19.5% impacted in retina and 75.6% were isolated in vitreous cavity. Small size IOFB was 58.3%, medium size was 29.3%, large size was 4.9% and very large size was 7.3%. No eye was deformed requiring evisceration of enucleation. Corneal or scleral repair, phacoemulsification, pars plana vitrectomy and intraocular foreign body removal as one stage procedure was done in each case. Intraocular lens implantation was done where sufficient anterior or posterior capsule was present. Conclusion Trauma caused by IOFB is commonly seen at workplace in young male laborers. It usually presents as corneal or scleral perforation, traumatic cataract, endophthalmitis and retinal detachment. Level of structural damage to ocular structures is dependent on the size, velocity and location of IOFB impaction. One stage surgical intervention for wound closure and IOFB should be considered for better surgical prognosis.

This study assessed the relationship between Retinopathy of Prematurity (ROP) and post-natal weight gain in premature infants admitted to the Neonatal Intensive Care Unit (NICU). The observational study was conducted in the Department of Ophthalmology in collaboration with the Department of Pediatrics, the neonatal intensive care unit (NICU) at Sir Ganga Ram hospital in Lahore from September 2020 to August 2022. Data including gender, Birth Weight (BW), Gestational Age (GA), and post-natal complications(hypotension, packed red cell transfusion, intraventricular hemorrhage, necrotizing enterocolitis, and respiratory distress syndrome) of all the premature infants with gestational age less than 35 weeks, admitted in NICU was collected. All these premature infants underwent eye examination for the presence or absence of ROP, and weight was measured. In the second, fourth, and sixth weeks, their relative weight gain(RWG) was calculated. Infants with ROP had lower BW (P <0.001) and GA (P<0.001). More infants with severe ROP had body weight <1000g and post-natal complications than those without ROP. Moreover, RWG at the 2nd and 4th weeks was lower in infants with ROP than with no ROP infants. Based on the result, it can be concluded that the ROP was associated with low postnatal weight gain, birth weight, and gestational age.