AimTo analyse long-term visual outcomes across different subtypes of primary congenital glaucoma (PCG).MethodsPatients with PCG with a minimum of 5-year follow-up post surgery were included in the study. Snellen visual acuity recordings taken at their last follow-up were analysed. We evaluated the results using Kaplan-Meier curves to predict the probability of maintaining good vision (as defined by a visual acuity of 6/18 or better) in our patients after 30-year follow-up. The results were also analysed to determine whether there were any differences in the long-term visual acuities with time between the neonatal and infantile PCG. We also analysed the reasons for poor visual outcomes.ResultsWe assessed a cohort of 140 patients with PCG (235 eyes) with an average follow-up of 127±62.8 months (range 60–400 months). Overall, the proportion of eyes with good visual acuity was 89 (37.9%), those with fair visual acuity between 6/60 and 6/18 was 41 (17.4%), and those with poor visual acuity (≤6/60) was 105 (44.7%). We found a significant difference (p=0.047) between neonatal and infantile patients with PCG whereby the neonatal cohort fared worse off in terms of visual morbidity. On Kaplan-Meier analysis, the cumulative probability of survival of a visual acuity of 6/18 or better was more among the infantile PCG in comparison to the neonatal PCG (p=0.039) eyes, and more among the bilateral than the unilateral affected eyes (p=0.029). Amblyopia was the most important cause for poor visual acuity as shown on a Cox proportional-hazards regression model .ConclusionsLong-term visual outcomes of infantile are better than neonatal PCG. Eyes with unilateral have worse visual outcomes compared with those with bilateral PCG because of the development of dense amblyopia.

The objective of this study was to observe the clinical features of patients with vernal keratoconjunctivitis attending the Outpatient Department of a mobile eye unit, Directorate of Health Services, Jammu and Kashmir over a period of 1 year. The greater prevalence of VKC is seen in the regions with hot, humid climate, and higher load of airborne allergens. The clinical profile of this disease seems to have geographical variation. The study was conducted in the mobile eye unit, Directorate of Health Services, Kashmir, a comparatively cooler area. All the patients with vernal keratoconjunctivitis who presented to the OPD during this period were examined. The diagnosis of vernal keratoconjunctivitis was based on typical history, clinical features, and examination. All the patients with the complaints of itching, watering, and photophobia were examined. After proper history, clinical features, and ocular examination under slit lamp, the data were recorded for patients who were diagnosed with vernal keratoconjunctivitis. Of all the patients who had allergic ocular disorders, a total of 212 patients were diagnosed as cases with vernal keratoconjunctivitis. This is a non-interventional study, and the ethical clearance was obtained from the regulatory board of the hospital. The study abides by the tenets laid down in the declaration of Helsinki. During this 1-year period, 212 vernal keratoconjunctivitis patients were examined, of whom 155 (73 %) were males and 57 (27 %) were females. As per the age group, 40 % (85) of patients were in the age group of 11-15 years. 93 % (197) of patients had bilateral disease, and 7 % (15) had unilateral. It was seen that 75 % (159) had seasonal attack. Different types of disease were observed: 77 % (163) had bulbar disease, 7 % (15) had palpebral, and 16 % (34) had mixed disease. During this period, we noticed that VKC led to complications also. It was seen that 3 % (6) of patients had steroid induced glaucoma, 5 % (11) had developed cataract, 6 % (13) of patients had keratoconus, and 6 % (13) of patients had corneal scarring. Other complications were also seen. VKC is a bilateral disease. Males are affected more than females. Ocular complications were seen in around 30 % of patients. Visual impairment ranging from severe visual impairment to blindness was observed in 2 % of patients. VKC patients should be instructed to use medication under the supervision of an ophthalmologist. There is a need to assess disease severity in order to develop standardized guidelines based on the stage of vernal keratoconjunctivitis.

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Background: Headache is one of the most common neurological symptom that we come across, but very few well-planned studies have been conducted to know its psychiatric aspects .The aim of the study was to investigate the socio demographic profile, clinical types and psychiatric comorbidity in patients with various types of headache. Methods: We conducted a cross-sectional study for a period of one and a half years in Shri Maharaja Hari Singh hospital of Government medical college. The study was conducted in patients attending the medical outpatient department (OPD) for headache. The diagnosis of various types of headache was established by adopting the International Headache Society criteria (2004). A total of 200 patients were screened. Psychopathology was measured using MINI International Neuropsychiatric Interview Schedule PLUS (MINI PLUS). Descriptive statistics was used to report the socio-demographic characteristics of the patients. Chi-square was used to assess association between categorical variables and a p-value of significance was set at p ≤ 0.05. Results: Among 200 patients, there were 83 (41.5%) males and 117 (58.5%) females. Their ages ranged between 18 years to 78.5 years, with mean (± SD) of 35.85 (± 9.45) years. Psychiatric morbidity in headache was 47%. The psychiatric morbidity was more in females (53%) than males (38.6%) (P-value=0.044). It was also more in urban (58.3%) than rural areas (42.1%) (p-value= 0.036). Tension-type headache (48%) was the most predominate type of headache. Conclusion: Patients with headache had higher psychiatric morbidity. Screening patients with headache for psychiatric disorders and timely psychiatric intervention can go a long way in improving the quality of life of headache with comorbid psychiatric disorders.

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