PurposeThe aim of the study reported here was to compare the improvement of visual acuity (VA) of diabetic and nondiabetic patients after neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy.MethodsIn this prospective cohort study, 50 age- and sex-matched patients, comprising 25 nondiabetics and 25 diabetics (referred to as Group A and B, respectively), with posterior chamber poly(methyl methacrylate) non-foldable intraocular lens implants attending our clinic at Karachi for capsulotomy had pre- and postoperative measures of VA, posterior pole visibility, and grading of posterior capsular opacity as seen on slit-lamp examination. VA was recorded before and after performing standard capsulotomy.ResultsThe postoperative (mean) VA in nondiabetics was 0.25, 0.23, and 0.21 logMAR as compared with 0.25, 0.25, and 0.24 logMAR in diabetics at 1 week, 1 month, and 6 months, respectively. P-values of 0.47, 0.47, and 0.24, respectively, were determined, which were not significant. Preoperative VA improvement was recorded in 92% of diabetics in Group B and 96% of nondiabetics in Group A. Two (8%) diabetic patients developed glaucoma and did not participate in the study further.ConclusionRemarkable improvement in VA was achieved in both Group A and B, but the Group A nondiabetics showed more improvement in best-corrected VA after Nd:YAG laser capsulotomy.

Objective: This study was conducted to quantify the normal indices of anthropometric measures related to ophthalmology including Interpupillary distance (IPD), Inner canthal distance (ICD), Outer canthal distance (OCD) in a normal, healthy Pakistani population. Methods: This is a cross sectional study. Total 500 patients were chosen randomly but 499 were included in this study. Patients were selected randomly in an outpatient department of Jinnah Post Graduate Medical Centre Karachi, over the period of five months. IPD, ICD & OCD all measurements were taken with the help of plastic rule by only one researcher to minimize chances of error as much as possible. IPD was reconfirmed from auto refractometer while ICD and OCD readings were taken twice by occluding one eye of researcher to reduce error. Participants were divided into four categories on basis of: Age, Gender, ethnicity and geographical location. Patients were further categorized on basis of Ethnicity to Urdu Speaking, Sindhi, Punjabi, Pathan, and others. Moreover, four age groups were drawn ranging from 15-24 years, 25-44 years, 45-64 years and 65 years and greater. Results: Our study comprised a total of 499 patents of which 272(54.5%) were males, and 227(45.5%) were females. The mean age of the participants was 39.3 ± 14.5 years. The mean values for the IPD, ICD and OCD in mm were 61.8 ± 6.2, 30.9 ± 2.9 and 85.2 ± 6.6 respectively. A statistically significant difference was observed between IPD, ICD and OCD Indices among male and female study participants (p<0.001, p=0.043, p<0.001). While comparing the IPD, ICD and OCD indices amongst the different ethnic groups, we found no statistically significant difference (p=0.09. p=0.28, p=0.06). Overall, there was no correlation between the age and other variables i.e. IPD, ICD, OCD, (r = 0.07, p = 0.085), (r = 0.005, p = 0.906), (r = -0.08, p = 0.058). Conclusion: This work has recommended normative values of IPD, ICD and OCD in Pakistani population on the basis different variables including gender, age, and ethnicity. How to cite this:Hayat N, Alkhairy S, Cheema A, Ehsan M, Khan MA. Normal interpupillary, inner canthal distance and outer canthal distance in a normal population of Pakistan. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.288 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.

A 14-year-old boy presented with a right orbital lid mass, which had slowly grown over the last 4.5 years, as well as some impaired visual acuity in the affected (right) eye. We assessed the patient by taking a detailed history and physical examination. A Snellen chart was used to assess visual acuity, which revealed decreased acuity in the right eye as compared to the left eye. Pupillary reactions, including relative afferent pupillary reflexes, were unremarkable; anterior and posterior chamber assessment was normal including that of the optic disc and macula. Additionally, the intraocular pressure was within acceptable limits. The mass was excised surgically as it had caused significant disfigurement and posed risk to the patient in terms of the possibility for the lesion to increase in severity. It was an approach utilizing a blepharoplasty incision, horizontal wedge resection, and a frontalis sling done under general anesthesia. A biopsy of the mass identified it as a plexiform lesion of the orbit such as that attributed to neurofibromatosis type 1.

To present a case report of a 15 year old girl presenting with a slow growing mass in the orbit with normal visual acuity. We followed the patient for a year and closely observed the increase in the size of the mass for over a year both clinically and radiologically. The mass grew gradually with no effect on her visual acuity which was 6/6 in both eyes using Snellen chart; pupillary reactions were normal with no afferent papillary defect and her extraocular movements were full. Her anterior segment and posterior segment of the eye including the optic disc and macula and the intra ocular pressure remained within normal limits. We then had to intervene surgically on request of the patient  as the mass had caused significant cosmetic disfigurement .It was a combined effort by an ENT and an eye surgeon for the effective and complete removal of the lesion.We did a frontal orbitotomy under general anesthesia and the mass recovered was sent for biopsy. The biopsy report concluded the mass to be juvenile psammomatoid ossifying fibroma.   Key words: Orbit,psammomatoid ossifying fibroma,frontal orbitotomy

Purpose:To assess the prevalence of ocular, adnexal and orbital trauma resulting from various inciting agents presenting at three large centers located in different areas of Karachi, Pakistan.Method:Patients with ocular trauma were recruited at three centers over three months. Proforma was filled for every patient, and the inciting agents and prevalence of the different types of ocular damage were identified. Trauma scoring was performed according to the Ocular Trauma Score.Results:A total of 343 patients with trauma presenting at different tertiary centers, including Dow International Medical College (DIMC) 38 (11%), Jinnah Postgraduate Medical Center (JPMC) 150 (44%) and Al Ibrahim Eye Hospital/Isra Postgraduate Institute of Ophthalmology (IPIO) 155 (45%), were included. Commonest causes at IPIO were vegetative trauma, road traffic accidents at JPMC and metallic foreign bodies at DIMC (Table 5). Most of the patients fell at grade 5 of the Ocular Trauma Score. Patients with lid, conjunctival, paracentral corneal or lenticular damage retained V/A > 6/18 after medical and/or surgical treatment. However, it remained < 6/60 in those with central corneal, vitreal or retinal damage.Conclusion:This study showed that different inciting agents topped at the three centers with respect to their location, surrounding workplaces and dealing with medicolegal cases.