Abstract:Background: Street or gully cricket, a stripped-down-version

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BACKGROUND Dacryocystitis is the most common pathology affecting lacrimal drainage system, representing 79 - 87 % of all lesions. This retrospective study was conducted to understand the clinical spectrum and management patterns of dacryocystitis in the past 5 years in a tertiary care hospital of coastal Karnataka. METHODS This is a five-year retrospective review of the case records of patients with dacryocystitis from the year 2015 to 2019. The records were retrieved from the electronic medical record system of the hospital using the International Statistical Classification (ICD) 10 codes. Data retrieved included, demographic profile, clinical history, presenting symptoms, past surgical interventions, examination findings, systemic comorbidities, pattern of management, medical or surgical management and complications if any. 45 cases that had completed medical records were included in the study. RESULTS The mean age of presentation was 49.37 (± 19.59). The condition was more common in females with a male to female ratio of 1:2.5. The condition was almost equal on both sides. 11 (24.44 %) had bilateral involvement. The patients were mostly from coastal areas or dry plains. Most common presentation was chronic dacryocystitis. Aggravated epiphora was the most common symptom (33) 73.3 %. Diabetes mellitus (15) and hypertension (10) were the most common systemic comorbidities. (22) 48.8 % had no comorbidities. The complications seen were (4) 8.9 % fistula, (1) 2.2 % lacrimal abscess, (2) 4.4 % conjunctivitis and (1) 2.2 % preseptal cellulitis. The patients who underwent nasal examination were (31) 68.9 % out of which, 26 had no abnormal finding in the nose. Surgical treatment was performed in 29 (64.4 %) mainly in the form of dacryocystectomy (DCT) 24 (53.3 %) while only 5 (11.1 %) underwent conventional dacryocystorhinostomy (DCR). CONCLUSIONS Chronic dacryocystitis is the most common form of presentation with higher incidence in the females in the fifth decade of life. Epiphora was the commonest symptom. Most patients who underwent a preoperative nasal examination did not have any pathology. DCT was the more commonly performed procedure. KEYWORDS Acute Dacryocystitis, Chronic Dacryocystitis, Dacryocystectomy, Dacryocystorhinostomy, Epiphora

A BS T R A C T BACKGROUNDPrimary angle-closure glaucoma affects 20 million people worldwide. There is a significantly high incidence of PACG in India, which forms almost half of all adult primary glaucoma seen in a hospital setting. The primary angle closure suspects (PACS) are defined as patients with narrow angles with no evidence of glaucoma or damage to the angle. Half of those blind from glaucoma are due to angleclosure disease. Not all PACS need LPI, as the incidence of acute angle closure in angle closure suspects is not very high according to a few studies. Some studies have shown that LPI may not necessarily widen the angle following iridotomy. We wanted to study the completeness of the pre-and post-procedure evaluation of PACS in terms of gonioscopy and tonometry and the prescription and treatment rate of Nd YAG LPI and its complications in a tertiary hospital. METHODSThis is a retrospective analysis of medical case records of patients with angle closure suspects. Data was retrieved from hospital EMR and also from the glaucoma speciality clinics registry. Only PACS were included where at least two quadrants of posterior trabecular meshwork were not visible with normal IOP and with no peripheral anterior synechiae. PAC, PACG, secondary angle closures and all open angle glaucomas were excluded. RESULTS61 records were included for analysis. 38 (62%) were females and 56 (92%) were bilateral. The pre-and post-procedure IOP performed were 82% and 90% respectively, and gonioscopy performed were 87% and 77% respectively. 53 (86%) were advised LPI and 25 (71.5%) underwent the same immediately. CONCLUSIONSThe pre-procedure tonometry and post procedure gonioscopy rates confirming the state of angle anatomy and patency of iridotomy were not satisfactory. The rate of LPI prescription was high. Majority of patients underwent LPI immediately on prescription. Hyphema was the only complication documented.