Purpose:  To perform pediatric cataract surgery audit at a tertiary care center in Karachi. Study Design:  Descriptive observational study. Place and Duration of Study:  From January, 2016 to July, 2018 at Ophthalmology Department of Jinnah Postgraduate Medical Center, Karachi. Material and Methods:  All patients with congenital cataract were included in study regardless of presence or absence of systemic association. Patients who were lost to follow up at three months were excluded from the study. Hospital records were reviewed retrospectively and data on patient demographics, preoperative presentations, intraoperative complications and postoperative visual outcomes was documented on predesigned proformas. All patients underwent lens aspiration, posterior capsulotomy and anterior vitrectomy. Surgeries were performed under general anesthesia. Preoperative and postoperative visual acuity was assessed with ability to fix and follow light/objects, Kay picture test and Snellen’s chart according to patient’s age. Results:  Three hundred and twenty six eyes underwent surgery for congenital cataract and sixty for traumatic cataract. Number of male patients was 54.93% and female was 45.07%. The average age of patients with congenital cataract was 5.01 years and that for traumatic cataract was 7.8 years. Amblyopia, nystagmus and strabismus were the commonest ocular comorbidities. Uncorrected visual acuity ranged from 6/18 to light perception preoperatively. Postoperatively 55% children with congenital cataract and 15% children with traumatic cataract had visual acuity better than 6/24. Conclusion:  Early surgery in congenital cataract gives good visual outcomes. In traumatic cataract extraction, the final visual outcome depends on other effects of trauma on ocular structures.

Purpose: To find out frequency of eyelid lesions at a tertiary care hospital. Study Design: Descriptive observational Place and Duration of Study: Jinnah Postgraduate Medical Centre Karachi, from March 2013 to December 2018. Methods: Records of patients operated for eyelid lesions were reviewed. Tumors arising from eyelids, may or may not be extending to other tissues were included in study. Data included age, gender, type of lesion, site of lesion, Histo-pathologic diagnosis, management and follow up. Result: A total of 150 patients with lid lesions were managed which included 50% benign and 50% malignant lesions. There were 77 (51.3%) males and 73 (48.7%) females. Age range was 3 to 85 years. The most commonly diagnosed lid lesion was squamous cell carcinoma (n=45, 30%), 60% among malignant lesions. It was followed by epidermal inclusion cyst (n=25, 16.7%), 33.33% of benign lesions. Patients with benign lesion were younger than 30 years while patients with malignant lesions were more than 50 years of age. Majority of the affected population was aged males, farmers and laborers, with history of prolong sunlight exposure. Among 150 lesions, 126 (84%) underwent excision biopsy and 24 (16%) underwent exenteration. Excision Biopsy was performed in all 75 (100%) benign lesions and 51 (68%) malignant lesions. Exenteration was performed in 24 (32%) malignant lesions. Conclusion: Owing to a large percentage of malignant eyelid lesions, population at risk should be educated about eyelid tumors, its early diagnosis, treatment and follow up.

Background: Paediatric traumatic cataract is one of leading treatable cause of childhood blindness. The purpose of this study is to analyse number of avoidable blindness in children and to access final visual outcomes, causative factors, strategies for the prevention and management. Methods: One hundred and twenty patients of ocular traumatic cataract age between 2 months to 14 years were treated in Department of Paediatric Ophthalmology from April 2019 till April 2020wasprospectivelyreviewed. Data included age, gender, time of presentation, type of injury, anterior segment with fundus examination, time and type of surgery, visual outcome at presentation and final visual outcome. Visual acuity was assessed by fixation and following, Snellen's chart according to patient's age. Some patients underwent for lens aspiration and rest underwent for lens aspiration, posterior capsulotomy and anterior vitrectomy followed by intraocular lens implantation under general anaesthesia. Patients who lost follow ups for two months were not included in study. Analysis of data was done using SPSS for window version 24.0. Results: One hundred and twenty eyes operated for traumatic cataract among which 64 (53.34%) patients were males and 56 (46.66%) were females. The average age of patients was 7.8 years with traumatic cataract. Initial Uncorrected visual out come at the time of presentation ranged from 6/60 to light perception. 15 %of children with traumatic cataract had post-operative final visual outcome of better than 6/18. Conclusion: The commonest cause of ocular injuries in our pediatric ophthalmology department was domestic, mostly in 5-9 years of age with greater number in males. In traumatic cataract extraction final visual outcome depends on initial visual outcome, source and type of injury, duration of presentation, duration of surgery and complications.