Ocular Trauma in Pediatric Population

Pediatric ocular trauma is the main challenge for ophthalmologists. It is the most crucial cause of monocular blindness. Thus, it is the main problem in public health management. This study is aimed to determine the clinical characteristics and visual consequences of ocular trauma. The ocular trauma with further complications can result in blindness. An immediate evaluation of the potential damage may be impossible because of vitreous hemorrhage or may be ill-advised because of hyphema or damage to other ocular or orbital structures. Books like Comprehensive Ophthalmology by Dr. A K Khurana and various articles, WHO (World Health Organization) website, etcetera were referred for this review article. Trauma in pediatric age groups is more prevalent than that in adult age groups. The so, the male gender is more prone to such injuri females. This study concludes that trauma to eyes the is the leather dying cause of ocular morbidity, which can be avoided by simple measures. First aid and early treatment can cause a significant decrease in loss of vision due to ocular trauma. Thus, a little awareness in parents and guardians can help decrease loss and blindness in the pediatric population. Eye injury, if occurred in a closed eye, causes contusion or lamellar laceration, and if that happens in an open eye, then it can lead to rupture, perforation, or penetrating injury to the eyeball. Troma to the eyes is the leading cause of ocular morbidity, which simple measures can avoid. First aid and early treatment can cause significant decrease in loss of vision due to ocular trauma. Thus, a little awareness in parents and guardians can help decrease loss and blindness in the pediatric population.

Ocular Morbidity among Patients Visiting the Department of Ophthalmology during the Coronavirus Disease 2021 Pandemic at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: Due to the ongoing coronavirus disease 2021 pandemic and lockdown, eye care services have been compromised globally. The magnitude of ocular diseases across all populations in Nepal are few and far between and rare during this pandemic. This study was aimed to find out the prevalence of ocular morbidity among patients visiting the department of Ophthalmology of a tertiary care hospital during the pandemic. Methods: A descriptive cross-sectional study was conducted among the patients visiting thedepartment of Ophthalmology of a tertiary care hospital from 18 August 2021 to 30 September 2021. Ethical clearance was taken from the Institutional Review Committee (Reference: 078/079-023). Convenience sampling was done. Basic demographic data, clinical characteristics, visual status and prevalence of ocular morbidities were noted. Data entry was done using Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 650 study subjects examined, 454 (69.8%) (66-73.0 at 95% Confidence Interval) study subjects had at least one ocular morbidity in at least one eye. Refractive error 153 (33.7%) was the commonest ocular morbidity followed by headache 52 (11.5%), dry eyes 50 (11%), non-communicable diseases related ocular morbidity 41 (9%), and age related cataract 37 (8.1%). Conclusions: The prevalence of ocular morbidity in our study was higher than findings from other similar studies done at national and international levels, though the causes of ocular morbidity was similar.

Incidence of fungal keratitis in Libya: An epidemiological study

Objectives: The aim of this study was to assess the occurrence of eye fungal infection among patients attending the eye hospital in Tripoli city, Libya. Materials and Methods: Seventy-one patients with ocular fungal infections were subjected to clinical and microbiological investigations. They were selected from patients attending the Tripoli Eye Hospital. The specimens of the external ocular infections were collected using sterile swab and inoculated to different culture media. Data were presented as count and percentages. Results: The current findings showed that Aspergillus was the most common causative agent, being responsible for 91.54% of the all cases, followed by Candida albicans (8.46%). Conclusion: Occurrence of fungal keratitis gradually increased in the years after 2009, especially after 2013. Knowledge of the pathological course and clinical features of fungal keratitis will undoubtedly bead in early diagnosis and treatment, with reduction in ocular morbidity.

Anti-Inflammatory Effect of Tacrolimus/Hydroxypropyl-β-Cyclodextrin Eye Drops in an Endotoxin-Induced Uveitis Model

Background: Uveitis is an infrequent disease which constitutes a major cause of ocular morbidity. Correct management is essential, being corticosteroids its cornerstone. In case of contraindication to corticosteroids or treatment failure, the use of topical tacrolimus (TAC) could be an alternative which has already demonstrated safety and effectiveness in other ocular pathologies. However, TAC eye drops are not marketed, thus their elaboration must be carried out in Hospital Pharmacy Departments (HPDs). Methods: 32 Sprague-Dawley rats were divided into 4 groups of 8 rats each: a) untreated healthy rats (Healthy); b) untreated Endotoxin-Induced Uveitis model-rats (EIU); c) EIU-rats treated with standard treatment of dexamethasone ophthalmic drops (DXM) and d) EIU-rats treated with TAC-hydroxypropyl-β-cyclodextrin eye drops previously developed by our group (TAC-HPβCD). The mRNA expression levels of IL-6, IL-8, MIP-1α and TNF-α, quantitative analysis of leucocytes in aqueous humor and histological evaluation were performed. Results: TAC-HPβCD eye drops demonstrated to reduce ocular inflammation, expression of IL-6, TNF-α, MIP-1α and leukocyte infiltration in aqueous humor. Conclusions: TAC-HPβCD eye drops showed beneficial effect in EIU model in rats, positioning as an alternative for uveitis treatment in case of corticosteroids resistance or intolerance.

Microbiological spectrum of ocular infections in patients of tertiary care eye hospital of Punjab

Eye is a complex and sensitive organ and is therefore more vulnerable to trauma and various infections ocular infections are one of the most commonly encountered infections. Any part of the eye can be infected by bacteria, fungi, parasites or viruses. In order to minimize the ocular morbidity and mortality, timely antimicrobial treatment must be initiated on the basis of clinical and microbial evaluation. For specific antibacterial treatment, isolation and identification of bacterial pathogens along with antibiotic susceptibility spectrum is essential. Hence, this study was undertaken to isolate and identify the bacterial and fungal pathogens responsible for the development of ocular infections and to determine their in vitro susceptibilities to commonly used antibiotics. A total of 203 samples of suspected ocular infections comprising 117 conjunctival swabs, 34 corneal specimens, 24 lacrimal pus samples and 28 vitreous specimens were analysed. Out of them 102(50.1%) showed growth. 82(40%) were bacterial and 21(10.3%) were fungal isolates. Due to the emergence of drug resistance it is imperative that all ophthalmological samples must be tested for antibiotic resistance as far as possible. Indiscriminate use of over the counter antibiotic eye formulations should be avoided and also it is important to know the changing pattern of pathogens.

Frequency of Different Ocular Conditions Leading to Ocular Morbidity in Pediatric Age Group at Dow University Hospital

Purpose: To determine the frequency of different ocular conditions leading to ocular morbidity in a tertiary care hospital. Study Design: Descriptive cross sectional study. Place and Duration of Study: Study was done in Dow University of medical sciences, from May 2018 to October 2018. Methods: A total of 278 patients presenting in the eye out-patient department were included. Patients with unaided visual acuity of 6/6 in both eye and no ocular abnormality were excluded from the study. Children with congenital syndromes like Down’s syndrome, etc. leading to eye diseases were also excluded. All children underwent complete ocular examination. Data was analyzed by using SPSS version 22. Frequency and percentages were computed for gender and different ocular diseases e.g., myopia, hypermetropia, strabismus, Vernal Kerato-conjunctivitis, astigmatism, red eye, subconjunctival hemorrhage etc. Post-stratification chi-square test was applied with p-value ? 0.05. Results: Out of 278 participants of the study, there were 154 (55.4%) males and 124 (44.6%) females. Average age of the patients was 11.15 ± 3.44 years. Myopia and red eyes were the major causes of pediatric ocular morbidity i.e. 33.81% and 26.6% respectively. Comparison between two age groups showed that Myopia was higher in children with 11 to 15 years. Myopia and astigmatism were more common in females while sub-conjunctival hemorrhage was more in males. Conclusion: Refractive errors are the commonest cause of childhood visual impairment in our setup. Correcting these preventable diseases can have a positive impact on the performance of children at school. Key Words: Visual acuity, Pediatric, Myopia, Hypermetropia, Kerato-conjunctivitis.

A retrospective study to analyse the ocular morbidity in the slum-dwelling population of central India.

Background: The study aimed to evaluate the prevalence of different ocular pathologies in theslum-dwelling population of central India and to find its correlations with socio-demographic factors.Methodology: The study was conducted as a cross-sectional study in 84 slum areas across Bhopal,Jabalpur and areas in the vicinity using a camp-based approach during the study period of 3 years.A total of 15478 participants attended the camp, and of them, 6177 patients had variousophthalmological conditions. A detailed history was obtained, and participants were subjected to acomplete ophthalmological examination. Based upon their diagnosis, they were prescribedtreatment. Referral to the tertiary care centre was done when needed. Results: The prevalence ofocular morbidities was 39.9%. The most common ocular morbidity documented in our study wasrefractive errors (22.7%). Proportions of lid pathologies were significantly higher in patientsbelonging to less than ten years of age (36.4%). In contrast, refractive errors were observed inhigher proportions of patients belonging to more than ten years of age (p<0.05). Pterygium ratiowas significantly higher in males, whereas ocular malignancies were higher in females (p<0.05).Proportions of almost all the ocular morbidities were substantially higher in patients with lowsocioeconomic status (p<0.05). Conclusion: The overall prevalence of ocular morbidities in theslum population is high. The most common ocular morbidity includes refractive error and allergicconjunctivitis. These morbidities correlated with age, gender and socioeconomic status. Werecommend periodic screening of the slum population across all age range to prevent long termcomplications and disabilities.

Ocular Findings among Filipino Patients with Leprosy in a Tertiary Hospital: A Cross-sectional Survey

Background. Leprosy, a chronic granulomatous disease affecting mainly the skin and peripheral nerves, has widely recognized ocular complications. It is a significant cause of visual impairment in countries where it is still prevalent, including the Philippines. Methods. This was a cross-sectional study that determined the clinical profile and distribution of ocular pathology among Filipino patients with leprosy seen at a tertiary institution in the Philippines. Results. A total of 67 patients consented to be included in the study and were evaluated by an ophthalmologist. Thirty-seven out of the 67 patients diagnosed with leprosy had reported ocular findings. The average age was 41.2 ± 13.1 years and the majority of patients were men (78%). Thirty-six patients were multibacillary cases, 10 (27%) had a lepra reaction, and 24 (65%) were undergoing multi-drug therapy. Three patients had varying degrees of visual acuity impairment (one was visually impaired with visual acuity [VA] 6/24-6/60, one with VA 3/60-5/60, and one with VA <3/60). Steroid-induced cataracts occurred in four patients (6%) with concurrent or previous systemic corticosteroid treatment for lepra reactions. Univariate logistic regression and Fisher’s exact test of patient-, disease-, and treatment-related variables on ocular morbidity revealed non-significant values for all variables except for age with an odds ratio of 1.1 (95% CI, 1.04, 1.16) (p = 0.001). Conclusions. No ocular morbidities directly caused by leprosy were seen, and treatment-related ocular findings (steroid-induced cataracts) were the only morbidities documented. There is an age-related risk for developing ocular morbidity in patients with leprosy.

Visual Morbidity in Diabetic Retinopathy Associated with Diabetic Nephropathy - Our Experience in a Multispecialty Tertiary Hospital in Chennai, India

BACKGROUND The increased prevalence of diabetes mellitus (DM) worldwide has resulted in worsening diabetic retinopathy (DR) and nephropathy. The pathophysiological changes that occur at a cellular and anatomical level are similar in DR and DN. The risk factors for DR and DN are common hence investigating both is paramount to reduce morbidity. We wanted to study the association of diabetic retinopathy and diabetic nephropathy, their ophthalmic features, patterns of vision loss and extent of ocular morbidity. METHODS This is a retrospective observational study performed on 100 diabetic patients over 2 years. Patients with a confirmed diagnosis of DN based on clinical evaluation and laboratory tests were included. Ophthalmic evaluation and investigations were done and DR was classified based on early treatment diabetic retinopathy study (ETDRS). RESULTS Mild non-proliferative diabetic retinopathy (NPDR) occurred in 60 %, moderate to severe NPDR in 9 %, proliferative diabetic retinopathy (PDR) in 4 % and no diabetic retinopathy in 27 %. Macula was involved in 48 % with clinically significant macular edema (CSME) in 33 % and ischemic maculopathy in 5 %. Retinopathy occurred in 3 % after 5 years and in 40 % after 20 years of DM. The incidence of DN +DR was 65 % and statistical significance was noted with longer duration of diabetes, higher serum creatinine, proteinuria, lower haemoglobin, decreased GFR, higher age and higher lipid levels (P = 0.04). Improvement in vision was seen in 63 % after blood sugar control with laser photocoagulation, 27 % with laser alone and 7 % of patients with intravitreal anti-VEGF CONCLUSIONS DR and DN have an overlapping significant association and all patients have to be screened for both to prevent ocular morbidity. KEY WORDS Diabetic Retinopathy, Diabetic Nephropathy, Vision, Glomerular Filtration Rate, Macular Edema.