Introduction: Penetrating eye injury is an important cause of visual impairment in pediatric population.Aims and Objectives: To study the epidemiology and visual outcome of penetrating eye injuries in pediatric population presented to Lumbini Eye Institute, the tertiary eye hospital of western Nepal.Materials and Methods: This retrospective study was conducted at the Department of Pediatric Ophthalmology and Strabismus, Lumbini Eye Institute over a period of one year from June 2014 to May 2015. All patients of penetrating eye injuries up to the age of 15 years were included in the study. The demographics of the patient, cause and duration of injury were recorded. The presenting and final best corrected visual acuity, anterior and posterior segment findings were recorded in specially designed proforma.Results: A total number of 127 children (127 eyes) presented with penetrating eye injuries during a year. The incidence of penetrating eye injury in one year was 127 out of 12927 new patients. Minimum age was 11 months, while the maximum age was 15 years with mean of 7.29 years (SD= ±3.49). Male and female patients were 99 (78%) and 28 (22%) respectively. Involvement of right eye was seen in 69 cases (54.33%) and left eye 58 (45.67%). The most common cause of injury was wooden stick in 55 cases (43.31%) followed by iron wire 12 (9.45%) and the stone 11 (8.66%). Corneal laceration was found in 102 cases (80.31%), scleral laceration in 10 (7.87%) and corneo-scleral laceration in 15 (11.81%). Seventy three percent patients were blind at the time of presentation whereas at discharge 37.63% were blind and 11.43% of patients had visual acuity better than 6/18 at presentation whereas 35.48% had visual acuity better than 6/18 after treatment.Conclusion: Penetrating eye injury is one of the common causes attending Pediatric Ophthalmology Department. Penetrating eye injury is common in male and majority of trauma is caused by wooden stick. The awareness of ocular trauma and its consequences should be increased to reduce incidence of childhood blindness.Asian Journal of Medical Sciences Vol.7(4) 2016 84-87
Background: Influencing factors of conventional horizontal surgery for surgical outcome has not been assessed in Nepal. Aims and Objective: To assess the pre-operative factors that influences the surgical outcome of horizontal strabismus surgery. Materials and Methods: The medical records of 68 patients who underwent their first horizontal strabismus surgery at Lumbini Eye Institute from 1 st January to 30 th December 2015 were retrospectively reviewed. The collected clinical data included diagnosis, age group, visual acuity, binocular function, extraocular motility and pre and postoperative deviation. The success of surgery was defined by eye deviation less than 10 prism diopters (PD) at 6 weeks after operation. The influencing factors for surgical success (diagnosis, age group, visual acuity, binocular function, and angle deviations) were analyzed using chi square test and Mann-Whitney -U test, where ever appropriate. Results: Out of 113 patients who underwent strabismus surgery during the year, 68 patients were enrolled in the study. Majority of the patients (27, 39.7%) were >9 years of age and 52.9% were female. Thirty seven patients (54.4%) were esotropic whereas, 31 were exotropic. Preoperatively, angle of deviation ranged from 20 to 90 PD with binocular vision present in 57.4% cases. Overall, success was seen in 26 patients (38.2%). Pre-operative angle of deviation and binocular vision had statistical significance with surgical success (p = 0.012 and 0.026 respectively). Conclusion: Larger angle of deviation and poor binocular vision at presentation has higher failure rate for horizontal strabismus surgery.
Enterobius vermiculari which is often referred as pinworm, is an intestinal nematode which is transmitted through fecal-oral route. The extraintestinal presentation of the worm is rare. A live worm, Enterobius vermicularis in anterior chamber is a very rare case. To present an unusual case of Enterobius vermicularis in anterior chamber of right eye in a 3 years old girl. Visual acuity assessment, slit lamp examination and ultrasonography of the eye were performed. The worm was found in anterior chamber of right eye at 8-9 o' clock hour position, coiling at the presentation. The living, white worm was freely moving and changing position frequently. There was hypopyon with exudates inferiorly. The pupil was irregular, posterior synechiae was present with cataractous lens. The living worm was removed surgically under general anesthesia and sent for microbiological examination. Synecholysis with lens aspiration and Posterior chamber intraocular lens implantation was done in second surgery. An adult worm in anterior chamber is rare. Treatment is surgical removal. The visual prognosis is not good when the case present with severe form of anterior uveitis and complicated cataract.
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