Purpose: I. To determine the causes of low vision by age and sex. II. To assess the need of spectacles and low-vision devices (LVDs) in low-vision patients attending the clinic at the Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex Peshawar. III. To determine the proportion of patients with low vision whose distance visual acuity (VA) can be enhanced to 6/18 or better in the better eye and who have the potential to discern 1 M (newspaper print) after appropriate refraction and application of low-vision devices (LVDs). Design: Hospital-based, cross-sectional study. Methods: A total of 504 individuals attending the low-vision clinic between June 2000 and June 2002 were included in the study. Of this cohort, 372 (73.8%) were male and 132 (26.2%) were female. The inclusion criterion was that the individual had VA < 6/18 in the better eye after medical or surgical treatment and/or best available correction. Results: The leading cause of low vision in age group 16 years was nystagmus 28 (16.97%). While the leading cause amongst all patients was myopic degeneration (14.48%, 95% CI). The percentages of visually impaired, severe visually impaired, and blind (using the WHO low-vision criteria) were 41% (95%CI), 22.4% (95%CI), and 36.5% (95%CI), respectively. After appropriate refraction, 19% of the patients achieved a VA of 6/18 or better. With LVDs, 86% (95%CI) achieved a VA of 6/18 or better and 90% (95%CI) achieved essentially normal near visual acuity. Spectacles were the most common devices. Conclusions: Low-vision clinics have now become an integral part of comprehensive eye-care services. Any patient with some residual vision must be referred to a low-vision clinic for the possibility of exploiting his/her visual potential through LVDs or other means. With appropriate training in their use, counsel- Causes of low vision in Pakistan89

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Background Many cases of post-operative and posttraumatic endophthalmitis are being managed at the Khyber Institute of Ophthalmic Medical Sciences, Peshawar in Pakistan but no study has been done to ascertain the magnitude of the disease and to also evaluate the visual outcome after management. Methods The case notes of 39 patients diagnosed with posttraumatic and postoperative endophthalmitis between May 2006 and April 2007 were analyzed and clinical characteristics obtained were documented and tabulated Results During the study period, 2474 patients were admitted in both the male and female wards. Of these, 39 (1.6%) had endophthalmitis due to surgical and traumatic complications. In all, 6 (12.4%) patients had evisceration, while 21 (53.8%) patients who had topical antibiotics consisting of ofloxacin, 0.1% corticosteroids, fortified cetazoline and 1% atropine along with intravitreal antibiotics, a combination of 0.1mg vancomycin and 0.4mg amikacin, were discharged home with a visual acuity of counting fingers to light perception. Conclusion Endophthalmitis is a serious ocular complication of open globe injury and intraocular surgery. The frequency in this center has been noted to be very high as compared to other places. Its management is very challenging and often leads to devastating structural and functional damage to the eye; causing severe frustration to both the patient and the attending physician. Efforts must be made to prevent the condition.