Objective: To assess the frequency of symptoms and impact on quality of life in individuals with dry eye disease. Methods: The cross-sectional, study was conducted from December 2018 to June 2019 at the outpatient clinic of the Department of Ophthalmology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and comprised dry eye disease patients aged at least 13 years with ocular burning sensation, lacrimation, grittiness, photophobia, redness or itching. Tear Film Breakup time <10 sec and / or positive ocular surface staining >5 corneal spots, >9 conjunctival spots, lid margin staining ?2mm in length were used to diagnose the disease. Data was collected using the Dry Eye Quality of Life Score questionnaire. Data was analysed using SPSS 25. Results: of the 191 patients, 135(71%) were females and 56(29%) were males. The overall mean age was 39.8±16.6 years. Itching 155(81.2%), watering 151(79.1%) and burning 124(64.9%) were the most frequent symptoms, with watering (p<0.001) and photophobia (p=0.012) significantly impacting quality of life. Conclusions: The most common symptoms among patients of dry eye disease affecting their quality of life were itching, watering, burning, photophobia and low mood. Key Words: Quality of life in dry eye disease, Dry eye disease, Lacrimation, Photophobia, Continuous...

Objectives: To determine the association between ethnicity, environmental factors, lifestyle factors, chronic diseases and pseudoexfoliation syndrome (PEX). Methods: A case control study conducted at four major hospitals in Pakistan from January to November 2019, with 241 cases and 294 controls, aged ≥ 40 years, who were administered a questionnaire assessing demographics, lifestyle factors, chronic diseases and ethnicity. Multivariate binary logistic regression was applied to calculate the odds ratio between cases and controls. Results: PEX was found to be positively associated with ethnicity (p<0.001), time spent outdoors (p<0.001), educational status (p<0.001), asthma (p<0.001), mean age (p<0.001), daily tea intake (p=0.003), weighted maximum temperature (p<0.001) and weighted mean temperature (p=0.004). Poor association was found with weighted latitude (p=0.526) and weighted minimum temperature (p=0.079). Odds ratios for patients with asthma (OR=7.366, regression coefficient=1.993, p<0.001) Pathan ethnicity (OR=1.616, regression coefficient=0.48, p=0.016) and mean weighted temperature (OR=0.907, regression coefficient-0.097, p=0 0.000) were significant in diagnosed cases of PEX. Conclusion: Individuals with Pathan ethnicity and asthmatics should be made aware of the risk of developing PEX and the importance of periodic screening. Limiting exposure to sunlight and cold and reducing the intake of tea may help in reducing in the chances of developing PEX. doi: https://doi.org/10.12669/pjms.37.2.2216 How to cite this:Arif SA, Khan MI, Nauman F, Arif MA. The association between ethnicity, environmental and lifestyle factors and chronic disease in the development of pseudoexfoliation syndrome. Pak J Med Sci. 2021;37(2):---------.   doi: https://doi.org/10.12669/pjms.37.2.2216 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose:  To use clinical audit in improving the outcomes of manual small incision cataract surgery technique Study Design:  Clinical audit. Place and Duration:  Layton Rehmatullah Benevolent Trust Eye hospital Karachi, from September 2019 to December 2019. Methods:  Two hundred patients who had undergone Manual Small Incision Cataract surgery were selected. Cases with traumatic cataract, weak zonules, pseudoexfoliation, and more than 1 diopter difference in keratometric readings, corneal and retinal pathologies were excluded. Surgical complications and visual outcomes were recorded on the 7th postoperative day. Refractive data was recorded from subjective refraction. Data was analyzed by University Hospital Bristol formula. Standards were set using international literature. Deficiencies were noted and technique was modified to improve the outcome. The audit was repeated after 2 months to see whether modifications had improved the outcome. Results:  In the first audit, posterior capsular rupture rate was 1%, corrected visual acuity of 6/12 or better was achieved in 85.36% and surgically induced cylinder of less than 2 DC was achieved in 75.60% of the patients. In the second audit all standards were achieved. Posterior capsular rupture did not occur. Corrected visual acuity of 6/12 or better was achieved in 90.50% and induced cylinder of less than 2 DC was achieved in 87.05% of the patients. Conclusion:  Clinical audit of the surgical procedures is a good technique in improving the outcomes of manual small incision cataract surgery. Key Words:  Cataract extraction, clinical audit, posterior capsular rupture, astigmatism, visual acuity.

Objective: To measure the mean change of intraocular pressure (IOP) in glaucoma patients with cataract after uncomplicated phacoemulsification surgery with intraocular lens (IOL) implanted in capsular bag. Methods: A total of 40 patients who had uncomplicated cataract extraction by phacoemulsification with IOL implant in the capsular bag in glaucomatous eyes of age 30-80 years were included. Patients with corneal pathologies or had corneal refractive procedure, history of ocular trauma, uveitis, retinal pathologies or other ocular comorbids were excluded. Visual acuity, IOP, slit lamp examination, fundoscopy, visual fields, details about topical medication and relevant history was recorded not more than 5 days before cataract extraction. IOP was recorded (first individually, then average of all) by Goldman’s applanation tonometer one day before surgery, 1 month and 3 months post op. Results: Age range in this study was from 30 to 80 years with mean age of 52.23 ± 9.44 years. Majority of the patients i.e. 28 (70.0%) were between 30 to 55 years of age. Out of these 40 patients, 19 (47.50%) were male and 21 (52.50%) were females with male to female ratio of 1:1.1. Mean pre-operative IOP was 20.42 ± 1.69 mmHg, after 1 month of surgery was 18.55 ± 0.90 mmHg and after 3 months was 17.03 ± 1.19 mmHg (p-value = 0.0001). Conclusion: This study concluded that there is significant change of intraocular pressure in glaucoma patients with cataract after uncomplicated phacoemulsification surgery with IOL implanted in capsular bag. Keywords: Glaucoma, phacoemulsification, intraocular pressure Continuous...