BackgroundPseudoexfoliation syndrome (PXS) is the most common identifiable cause of secondary glaucoma, the prevalence of which varies considerably among different ethnicities. The aim of this study was to assess the prevalence of pseudoexfoliation syndrome in Pakistan.MethodsA prospective study conducted in the period from January 2003 to June 2004 in a teaching hospital serving a population of about 7.6 million. 1860 patients aged 45 or above attending the general ophthalmic clinics were recruited for this study. A detailed evaluation including ophthalmic and general history, slit lamp biomicroscopy, intraocular pressure measurement, gonioscopy and dilated eye examination was performed on all patients.Results120(6.45%) subjects were found to have PXS with a male to female ratio of 1.5:1. All 120 (100%) cases were bilateral and 48(40%) patients had high intraocular pressure.ConclusionTo the best of our knowledge, this is the first study conducted in a Pakistani population to determine the prevalence of PXS. The prevalence rate of 6.45% is similar to other studies conducted in south Asia, however all cases were bilateral and quite a high percentage of patients had high intra-ocular pressure.
Objective: The objective of this study was to determine the frequency of ocular trauma among gender and different age groups. And to determine various causative factors and the impact of trauma on ocular structures and visual acuity. Methods: This cross-sectional study was carried out in Ophthalmology department of Nishtar Medical University and Hospital, Multan, Pakistan from May 2021 to August 2021. Data were collected from 142 patients. A questionnaire was devised. Data were analyzed using SPSS V26. Results: Out of 142 patients that were admitted in Ophthalmology ward, 36 (25.40%) were female patients and 106 (74.60%) were male patients with mean age of 15.9 years with standard deviation of 14.5. There was no statistically significant difference between male and female patients (p value=0.2). Cornea was most commonly injured structure and mechanical factors were the most common cause of ocular trauma. Out of 142 patients, 4 (2.80%) got just medical management and 138 (97.20%) patients required surgical intervention while they were also given topical and oral antibiotics and anti-inflammatory drugs. Conclusion: Ocular Trauma is most prevalent among children. Males were affected more than females. The cornea was the most commonly affected structure. Ocular Trauma is one of the leading causes of monocular blindness. Most of the ocular traumas were due to some mechanical factors. Keywords: Ocular Trauma, Multan, Nishtar Hospital, South Punjab
Objectives: Glaucoma is the most common blinding condition in South Punjab of Pakistan and its management is a challenge due to illiteracy and lack of financial resources. Study Design: Randomized Clinical Trial. Setting: Department of Ophthalmology Nishtar Hospital Multan. Period: June 2016 - June 2018. Material & Methods: We have randomly selected patients on the basis of Cup to Disc ratio and applied randomized clinical trial of both medical and surgical modalities of glaucoma management to observe the visual outcomes in terms of Intraocular pressure and Cup to disc ratio. We have also linked the effects of our management with lenticular status of the patients which has shown significant results. Results: The vision survival of trabeculectomy in pseudophakics was 88.77% while only 9.8% was the survival rate of trabeculectomy in phakics. 90% of 31 phakic patients who underwent trabeculectomy failed. Similarly patients on 3 IOP lowering drugs had 70% vision survival rate out of 260 patients treated. Patients with C-D ratio 0.8 had maximum failure rate of 69% out of 78 patients in which medical treatment failed. Conclusion: Trabeculectomy significantly reduced the intraocular pressure in patients in which pharmacological treatment failed.The success rate of trabeculectomy among pseudophakics is high. In Phakics, when only Trabeculectomy is done, success rate is low. When trabeculectomy and clear lens extraction is done simultaneously, the success rate is slightly higher. When trabeculectomy is done after clear lens extraction, the success rate is highest. In case of Cataract, cataract extraction and trabeculectomy when done simultaneously, show low success rate. When trabeculectomy was done after cataract extraction, shows highest success rate.
Objective: To study the efficacy of pars plana vitrectomy (PPV) for visually significant vitreous opacities in improving visual function and quality of life. Study Design: Interventional study. Setting: Department of Vitreoretinal Clinic of Ophthalmology, Nishtar University Hospital Multan. Period: May 2017 to August 2019. Material & Methods: A total of 50 patients of both genders, aged 35 to 65 years having lenticular status (Phakic or pseudophakic patients) and planned for PPV were enrolled for this study. All patients were examined on slit lamp bio microscope. Dilated fundus examination was performed with indirect ophthalmoscope using scleral indentation. Intraocular pressure was measured pre and postoperatively with Goldmann’s applanation tonometer under topical anaesthesia. Diagnosis was made on through clinical examination. All patients underwent 23 gauge PPV with or without silicon oil with endo laser. Best spectacle corrected visual acuity was recorded with help of Snellen chart. Results: There were 50 eyes of 50 patients in two groups, 40 phakic eyes (80%) and 10 pseudophakic eyes (20%) that underwent 3 PPV for visually significant opacities. There were 38 (76.0%) male and 12 (24.0%) female patients. Thirty four (68.0%) out of 50 patients showed improved best spectacle corrected visual acuity (BSCVA) and visual function while 18% had BCVA 6/24 – 6/18. Forty three (86.0%) patients reported quality of life and psychological feel improvement. Conclusion: Pars plana vitrectomy is a safe, effective and viable option for annoying vitreous floaters. There are risks of retinal breaks, rhegmatogenous retinal detachment and cataract. Surgeon must be ready for prompt handling of patient.
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