Sooraj Singh Kubrey

Abstract

Background: The debilitating vasoproliferative retinal disorder retinopathy of prematurity (ROP), a prequel to neonatal blindness is known to be increasing in recent years with improved advances in neonatal care and survival. Aim of this study was to study the incidence of ROP, risk factors, and response to the gold standard treatment of laser has been explored in this study. Materials and Methods: In this prospective observational study of all neonates referred to the retina clinic of a tertiary care centre, from both in-house referrals and peripheral centres. Demographic data, both maternal and neonatal data were recorded. Neonates complying to inclusion and exclusion criteria were examined under 28 diopter lens and all ROP were documented using RetCam. Laser photocoagulation was performed and later followed up according to ETROP schedule. Results: 699 neonates were screened in the study and ROP was detected in 13.73% (182/1398) of this population, with mean gestational age 31.82±2.44 weeks and mean birth weight 1425.36±287.73 grams. Neonatal risk factors of gestational age Conclusion: Better premature neonates survival rates has shown an increased incidence of ROP over the past decades. Red flag signs like low gestational age, low birth weight, RDS, oxygen supplementation, sepsis, blood transfusion, AGA and twin pregnancy are confirmed to have significant association with the development of ROP. Laser therapy still remains effective in controlling progression of the disease. Keywords: Retinopathy of prematurity, Incidence, Risk factors, Laser therapy

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Abstract

Background: In vision 2020, amblyopia is a major preventable and treatable cause of low vision in paediatric age group. If not treated at appropriate time, paediatric amblyopia can result into monocular and binocular low vision with associated deterioration in Quality of Life indices in adulthood. This should be the hallmark of the blindness control programme in India. So this study was carried out to assess the magnitude of amblyopia and its associated risk factors in school going children and to correct the amblyopia by whatever treatment modality possible depending upon the type of amblyopia and to follow up the patient for any improvement in it. Materials and Methods: This was a prospective, observational study on 1200 school going children between 5-16 years of age. All the children were subjected to visual acuity examination. Those children with refractive error were further screened at Hospital. Results: Out of 1200 cases, 30 cases had amblyopia. Prevalence of amblyopia was 2.5%. Anisometropia was the most predominant risk factor associated with amblyopia (53.33%). Anisometropic amblyopia (53.33%) was most common. Amblyopia was more common in children with lower socio-economic background (40%). Maximum patients had unilateral (80%) and moderate amblyopia (46.7%). Association between duration of occlusion therapy and visual improvement in children with amblyopia was statistically insignificant (p=0.19). Conclusion: Amblyopia is one of the major hidden visual problem in the society which can be prevented by early identification and proper management in appropriate time. Early diagnosis and treatment can prevent and minimize risk of permanent deficit of vision in amblyopia if detected earlier especially before 10 years of age. Screening programs in school going children can detect amblyogenic factors earlier to prevent major permanent deficit in vision by amblyopia so screening of children should be done through school surveys, awareness should be spread through various campaigns among the teachers and parents of the children about amblyopia and its adverse consequences not only on visual impairment part but also functional, psychological, social, economic impact. Keywords: Amblyopia, Bhopal, Children, Occlusion therapy, Prevalence, Risk factors.

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