Subramanya K Giliyar

Abstract

Aim: To evaluate post operative visual outcome and complications of retro-pupillary iris fixated Intracoular lens (IOL) in aphakia. Materials and Methods: This is a prospective interventional case study conducted at our tertiary eye care centre from March 2018 to February 2019 All monocular aphakias secondary to any cause with no capsular support, good iris diaphragm support and BCVA of better than 6/60 were included. Patients who required combined procedures like trabeculectomy and retinal procedure were excluded. Patients with poor endothelial count/ corneal decompensation, any posterior segment pathologies, pre existing glaucoma and any form of uveitis were also excluded from the study. Pre operative visual acuity, slit lamp examination and fundus examination were carried out. Anterior vitrectomy and retropupillary fixation of iris claw lens were done. The primary outcome was to assess the post operative visual acuity and secondary outcome was to analyse post operative complications at various intervals up to 6 months after surgery. Results: Our study comprised of thirty eyes of 30 aphakic patients. RPIFIOL was inserted as primary intraocular lens in 18 patients (%) and secondary intraocular lens in 12 patients(%). Baseline best corrected visual acuity was 0.831±0.66 logMAR. Four patients had light perception at baseline. The mean best corrected visual acuity was 0.77±0.35 logMAR at month 1, 0.64±0.36logmAR at month 3 and 0.53±0.33logmAR at month 6 respectively. Mean intraocular pressure at baseline was 16mmHg. Mean intraocular pressure at month 1, 3 and 6 were 17mmHg, 16mmHg, and 16mmHg. Among the complications, twelve eyes (40%) had significant ovalisation of pupil at post operative month 1 which persisted at month 6, two eyes(6.66%) had transient ocular hypertension (OHT), and none of the eyes progressed to glaucoma. Choroidal detachment was noted in 2 eyes (6.66%), CME in 3 eyes (9.99%), 1 eye (3.33%) had retinal detachment and 2 eyes (6.66%) had one haptic disenclavation. Among the complications, ovalisation of pupil was the most common observed one. Conclusion: Retro-pupillary Iris fixated IOL is an effective, safe and simple procedure for management of aphakia in eyes with no posterior capsular support. Keywords: Aphakia, Anterior vitrectomy, Retro-pupillary iris fixated intraocular lens.

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Abstract

Aim: Strabismus is the common condition seen in children and adults in our society. Strabismus has variety of psychosocial impact that can affect the quality of life of the patients. Proper education and awareness regarding the condition can help to rule out the myths associated with strabismus and also building up the personality of the patients. This study was done to know the level of awareness, knowledge about the strabismus in our population and the social impact of strabismus in patients life. Material and Methods: Cross sectional study conducted on 196 patients with strabismus attending outpatient department of Minto Ophthalmic Hospital, regional institute of ophthalmology were included in the study. After taking informed consent, face to face interview conducted asking questions from structured questionnaire prepared. Data collected and analysed with descriptive statistics. Results: Out of 196 patients included in the patients, 128 were males and 68 females. About 9.6 % of patients, were unaware of the condition of strabismus, 56.3% were unaware that squint can cause visual disturbance, 63% were unaware of that strabismus can be treated, 37% of people felt like surgery is the only mode of treatment for strabismus. 60% of the study population expressed that they were rejected for being married due to strabismus because of cosmetic affect, 42.4% felt like squint can hinder the social leadership, 36 % had difficulty in getting job, 28% of the patients expressed being criticized by their friends that lowered their confidence, 75% of the patients felt that they look ugly because of strabismus. Conclusion: Strabismus apart from causing ocular problems, is associated with many psycho-social impact on life of patients. There is lack of awareness regarding the strabismus in our population. Attitude and perception of society towards patients with strabismus will affect the overall confidence, personality of the patients and hence affect quality of life. Hence awareness about the condition, treatment availability is necessary to build up the overall personality of the patients with strabismus, to have better life. Keywords: Awareness about strabismus, Social impact.

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Abstract

Aim: To assess vision in children with delayed development or cerebral palsy attending OPD at tertiary care hospital, for early assessment and accurate detection of visual disorder, which in turn helps their rehabilitation, locomotor and cognitive functions. Materials and Methods: Total of 24 (18 males and 6 females) children with delayed development and 12 (6 males and 6 females) with cerebral palsy were examined. Central steady maintenance method (CSM) was used for visual assessment as children were not co-operative for Teller’s acuity card. Thorough examination was done in children including dilated refraction & fundus examination. Clinical findings like nystagmus, squint, roving eye movements were noted and photographed. Selected children were given glasses and few were advised visual stimulation exercises. Results: Out of 36 children, about 24 were males and 12 were females. It was noted that about 16% in developmental delay children and about 17% in cerebral palsy children had abnormal birth history Among 24 children with developmental delay, 16% had squint,12.5% had horizontal nystagmus, among 12 children with cerebral palsy, 66% had fundus abnormalities, 50% had squint,16% had horizontal nystagmus, Central steady maintenance was good in 8% of developmental delayed children and 15% of cerebral palsy children. Conclusion: Above study showed that visual assessment in children with delayed development and cerebral Palsy provided relevant information for creating a rehabilitation program aimed at the individual as a whole. Visual impairment plays key role in locomotor and cognitive performance in CP and visual exploration seems to be crucial in rehabilitation of affected children, contributing to their motor improvement and to a better visual prognosis. Keywords: Cerebral palsy, Delayed development, Visual assessment, Tertiary care center.

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