No abstract

Endoscopic drainage was applied in 14 patients with either external or internal (bile ascites) postoperative biliary fistulas. Endoscopic sphincterotomy and/or insertion of a nasobiliary tube or an endoprosthesis was found to be a safe and effective treatment, achieving closure of fistula in all patients.

A 22-year-old man complained of sudden, painless loss of vision (vague scotoma in central vision) in his right eye. The patient became symptomatic following a session of weight training at a gymnasium the previous day. There was no history trauma. Medical, ocular and familial history were unremarkable. The inferior and temporal aspect of the haemorrhage was darker due to gravitation, but the rest of the fundus was normal. The appearance of the right fundus, combined with an associated unequivocal history of physical exertion, was consistent with a diagnosis of Valsalva maculopathy (holding breath while bench pressing). Systemic examination and all relevant blood tests were normal. Fluorescein angiography (FFA) was done which confirmed the diagnosis. The patient recovered a vision of 6/6 in his right eye after 2 months. FFA was again done, which showed no sequelae of the problem.

Background: Congenital Nasolacrimal duct obstruction (CNLDO) is one of the most common problems in the pediatric age group. It is the commonest cause of childhood epiphora. In most cases it is caused by incomplete canalisation of the nasolacrimal duct (NLD). Aim: The present study was conducted to determine the success rate of primary nasolacrimal duct probing in children older than two years of age. Methods: The present prospective study was conducted in the post graduate department of ophthalmology, Sher-i-Kashmir Institute of Medical Sciences and hospital Bemina. Fifty two eyes of forty two children underwent probing and syringing for nasolacrimal duct obstruction under general anaesthesia. Follow up was done at first week, fourth week and three months. Success was defined as complete absence of sign and symptoms. Statistical analysis was performed using SPSS version 17.0. P value of less then 0.05 was considered significant. Results: Success rate of S&P in our study was found to be 94.23 %. Simple obstruction was encountered in 44 (84.61 %) eyes and all resolved successfully post S&P. Complex obstruction was encountered in 8 (15.39%) eyes and only five resolved successfully post S&P giving a success rate of 62.5 % only. Conclusion: late probing should be performed as an initial surgical step in the management of every case of CNLDO presenting late in the course of the disease (> 2 years), before more invasive procedures are attempted.

To study the type and severity of ocular injuries in gun pellet victims. METHODOLOGY: It was a retrospective case series. The study was conducted in the department of Ophthalmology, SKIMC Medical College Bemina Srinagar. The study included gun pellet victims admitted in our department between January 2010 to September 2013. RESULTS: Total number of patients were 20 with 19 males and 1 female. Mean age of the subjects was 21.45 years. Ocular injury was unilateral in 17 cases and bilateral in 3 cases. The most common type of injuries encountered were hyphaema in 82.60% of eyes, followed by corneoscleral tear in 78.26% and vitreous hemorrhage in 47.82% of eyes. Out of the 23 eyes, 18 eyes (78.26%) had an open globe injury, while only 3 eyes (13.04%) had closed globe injury at presentation in our hospital. The most commonly performed surgery was corneoscleral repair in 18 eyes. Final corrected visual acuity remained unchanged in 34.78% and improved in 65.22% of eyes. About 47.83% of eyes had final visual acuity < 6/60. CONCLUSION: Gun pellet related ocular injuries are becoming increasingly common in Kashmir valley. In severely injured eyes the visual prognosis remained poor despite development of advanced micro-surgical techniques. The best preventive measure for such injuries involve reducing the level of violence in our society.