Sigamani Veni Priya

Abstract

Convergence insufficiency (CI) is a common dysfunction of binocular vision. The prevalence of Convergence Insufficiency varies widely ranging from 2% to 27%. The role of CI as a cause of headache is neglected often. In this study, the association between Convergence insufficiency and Headache was being evaluated. Aim: To assess the prevalence of Convergence Insufficiency in headache patients. Materials and Methods: A prospective descriptive study included 84 patients in the age group 5 - 36 years with complaints of headache. After taking detailed history about headache pattern and asthenopic symptoms, complete ocular evaluation of both anterior and posterior segment examination, Refraction and Binocular vision assessment was done. Data was analysed by Percentage and Chi square test. Results: In this study, the prevalence of Convergence Insufficiency was 26.2% among headache patients CI was more common in female patients (63.6%) than in male patients (36.4%). 72.8% of CI was seen in young patients in the age group 10 – 29 years. Frontal headache (78.7%) and Astigmatism (45.5%) was frequently associated with CI. Increase in the Near Point of Convergence (NPC) value and decrease in the value of Base out Prism was associated with asthenopic symptoms in CI patients. Conclusion: Convergence Insufficiency is frequently associated with headache especially in younger patients. In this electronic era, the demand for near work has increased. Apart from thorough refractive evaluation, binocular vision assessment is also important in younger patients presenting with headache. Keywords: Asthenopia, Convergence, Astigmatism, Headache.

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Abstract

Aim: To evaluate the prevalence of Ocular manifestations in HIV/AIDS patients and its correlation with CD4 counts Materials and Methods: The ophthalmology OPD records of 100 HIV positive patients who attended Ophthalmology OPD(referred from ART centre in the Institute) for screening to rule out ocular manifestations in the period of Jan 2009 to Dec 2009 were evaluated retrospectively. Results: Out of 100 patients evaluated, ocular manifestations were seen in 54%. The percentage of patients with Anterior segment manifestations, Posterior segment manifestations and Adnexal manifestations were 12.96 %, 31.48 % and 79.62% respectively. Conjunctivalmicrovasculopathy was the most common Ocular manifestations seen in 36% of the patients. HIV microangiopathy was seen in 10 % of the patients and was the most common Posterior segment manifestations. Sight threatening complications like CMV retinitis was seen in 4 % of the patients. 60.8% of patients with ocular manifestations had CD4 count less than 100 cells/cu.mm. With the decrease in the CD4 count, the prevalence of Ocular manifestations increased. Most common systemic association was Tuberculosis. Conclusion: Though the prevalence of ocular manifestations is low when compared with the previous studies, Sight threatening ocular manifestations are seen frequently in HIV patients due to increased longevity of the patients with HAART therapy and also due to increased duration for the immune system to mature to act against the opportunistic infections. So frequent Ophthalmic examination should be made mandatory for all HIV patients with CD 4 count < 400> therapy. Keywords: HIV/AIDS, HIVmicroangiopathy, CD+4 cells, OSSN, Conjunctivalmicrovasculopathy.

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