Current Issues - Vol. 21, No. 1, January – March 2025

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Al-Shifa Journal of Ophthalmology

Editorial: AI as a Weapon Against Blindness: A Game-Changer for Premature Infants
Muhammad Saad, Hassaan Ahmed Khan, Shafaq Najmi

Visual Acuity and Contrast Sensitivity among Subjects with Human Immunodeficiency Virus Infection Receiving Highly Active Anti-Retroviral Therapy
Azmat Jehan, Sadiqullah Khan, Siraj Khan Safi, Sami Uddin

Objective: To assess visual acuity and contrast sensitivity among subjects with Human Immunodeficiency Virus (HIV) infection receiving Highly Active Anti-Retro Viral Therapy (HAART) and compare with the duration of treatment.
Methods: A total of 85 participants with Human Immunodeficiency Virus infection receiving HAART therapy were assessed for both visual acuity (VA) and contrast (CS) sensitivity. VAwas taken for right eye and left eye separately with Log Mar chart. Refraction was done for refractive error. For Contrast Sensitivity, Pelli-Robson chart was used. Contrast Sensitivity was taken binocularly. Data was analyzed through (SPSS) software version 22.
Results: In this study, the total number of participants was 85, among which 82 were males and 03 were transgenders, who were receiving highly active antiretroviral therapy (HAART) for HIV infection. The mean age of the participants was 31.41 ± 5.19 years. The majority of subjects (84.7%) had VA of 0.00 log Mar (6/6) or better, while 15.3% had mild visual impairment. Normal contrast sensitivity was observed in 50.6% of subjects, while 45.9% had poor CS. The duration of HAART did not show any significant association with visual acuity (p=0.407); however, a significant association was observed between contrast sensitivity and duration of HAART (p=0.003).
Conclusion: People with HIV receiving HAART may experience changes in their visual function, specifically in contrast sensitivity. The duration of HAART treatment was found to be significantly associated with contrast sensitivity, while it has no effect on visual acuity.

Frequency of Types of Squint and Gender Distribution Presenting to a Tertiary Care Hospital in Islamabad
Nighat Anwer, Adila Anwer, Rabia Akhtar, Samra Ahmed

Objective: To determine the frequency of various types of squint with gender distribution presenting to a tertiary care hospital in Islamabad.
Methods: This cross sectional study was conducted from 07-01-2021 to 15-03-2022. 57 patients with strabismus were selected for this study. After obtaining consent baseline features including age, gender, and eye involved were documented on the predesigned proforma. The cover-uncover test was performed to determine the type of squint including “exotropia” and “esotropia”. The chi-square test was used as a test of significance.
Results: Among 57 patients 34 (59.65%) were males while 23 (40.35%) were females. The mean age was 21.51 ± 7.22 years. Squint was observed in the left eye only in 9 (15.79%), right eye only in 15 (26.32%), and in both eyes in 33 (57.89%) patients. The frequency of “Exotropia” was 50 (87.72%) while of “Esotropia” was 7 (12.28%). Among male patients (n = 34), “exotropia” was found in 29 (85.29%), and “esotropia” was found in 5 (14.71%) while in female patients (n = 23), “exotropia” was found in 21 (91.30%) and “esotropia” in 2 (8.70%) patients, (p = 0.498).
Conclusions: Exotropia is the more prevalent type of strabismus in our study population with higher frequency in the male population.

Effect of Duration of Type II Diabetes Mellitus on Intraocular Pressure and Central Corneal Thickness
Sehrish Aslam, Naila Obaid, Tehmina Nazir Hussain, Shumaila Obaid, Haseeb Ahmed Khan

Objective:To find out the effect of duration of type II diabetes mellitus on intraocular pressure and central corneal thickness.
Methods: A total of 100 diabetic patients were included in the study after taking approval from Ethical Review Committee. Patients were selected for the data collection process in the Eye outpatient department. Slit lamp and retinal examinations were performed on all individuals. The central corneal thickness (CCT) was determined with a Quantel clinical pachymeter, and the intraocular pressure (IOP) was assessed with a Goldman applanation tonometer. Patients were divided into two groups based on the duration of their disease: Group A (diabetes less than 10 years) and Group B (diabetes more than 10 years).
Results: The mean age of patients was 47.1±8.94 years in group A and 72.86±6.04 years in group B. Group A patients were found to have a mean CCT value of 532.400 ± 12.98 micrometer while Group B patients had a mean CCT of 553.120 ± 13.23 micrometer (p-value <0.05). Mean IOP in group A patients was 18.03 ± 0.749 mmHg and in group B patients was 19.58 ± 1.029 mmHg (p-value <0.05)
Conclusion: Prolonged duration of type 2 diabetes mellitus (disease duration >10 years) has been depicted to be significantly associated with increased Central Corneal Thickness (CCT) and raised Intraocular Pressure (IOP).

Association of HbA1c and Duration of Diabetes with Refractive Errors in Type II Diabetic Patients
Aqsa Malik, Aqeel Rasheed, Anoosh Qayyum, Gulsanga Khan, Muhammad Farooq, Maher Mustansar Ali Qasim

Objective: To evaluate the association between HbA1C levels, duration of diabetes, and refractive errors in patients with type II diabetes mellitus.
Methods: A cross-sectional study involving 200 patients with type II diabetes (400 eyes) was conducted over 3 months at the federal government Polyclinic Hospital. Eye examinations and HbA1C assessments were analyzed using SPSS v21, employing chi-square and regressionanalyses.
Results: Astigmatism (56%) was the most prevalent refractive error, followed by myopia (29.5%) and hyperopia (14.5%) with higher prevalence in males (52%) and patients aged >50 years (35%). Prediabetic patients exhibited the highest prevalence of refractive errors (62%). The duration of diabetes was significantly associated with refractive error severity (χ2=30.21, p<0.001).
Conclusion: Refractive errors, particularly astigmatism, are prevalent in diabetic patients. Longer duration of diabetes and suboptimal HbA1C levels exacerbate these changes. Routine eye exams and glycemic control are essential to prevent visual impairment.

Comparative Analysis of Academic Performance of Medical Students with Eye Diseases and Healthy Eyes
Fatima Akbar Shah, Umair Tariq Mirza, Muhammad Usman Sadiq, Samar Fatima, Muhammad Shoaib, Sidrah Riaz

Objective: To examines the relationship between ocular diseases and academic performance among medical students.
Methods: Conducted as an observational comparative study at Mohiuddin Teaching Hospital, data were collected through questionnaires completed by a consultant ophthalmologist, alongside academic grades provided by the medical education department.
Results: A total of 418 medical students participated. The results show no statistically significant association between ocular disease and student grades, with a p-value of 0.267, indicating that any observed differences were likely due to chance.
Conclusion: The study suggests that factors other than eye health may play a more critical role in academic success for medical students. However, the study is limited to a single institution, and the findings should not be generalized without further research across diverse populations and settings.

Comparison of Aberrations in Corneal Topography Between Young Adults with More Than 1 Diopter Versus Less Than 1 Diopter Astigmatism
Saqib Abbass, Muhammad Moin, Muhammad Shaheer, Ummara Rasheed, Asima Rafique

Objective: To evaluate the impact of anterior segment parameters and high-order and Low-Order aberrations on visual quality in young adults with different astigmatism levels using corneal topography.
Methods: The research was approved by the Ethical Review Board of the College of Ophthalmology and Allied Vision Sciences, Mayo Hospital (Ref # 1620/2023). The study was conducted on patients visiting Mayo Hospital, Lahore, with a sampling size of 74 eyes (34 in each group). Patients with > ± 1D astigmatism (study group) and < ± 1D astigmatism (control group) were recruited. Corneal astigmatism, keratoconus indices, keratometry findings, anterior segment parameters, high-order aberrations, and low-order aberrations were assessed and compared between groups. These parameters were measured using Sirius corneal Topography. All dependent and independent variables were considered. Data were entered and analyzed using SPSS 27.0. A P value ≤ 0.05 was considered significant.
Results: Thirty-seven eyes of 37 young adults and 37 eyes of 37 children were analyzed. The mean astigmatism was -2.3776 ± 2.25034 and -0.3878 ± 0.29369, respectively. Total corneal astigmatism was -3.03 ± 1.73 and -0.44 ± 0.25 diopters. Significant differences were seen in keratoconus-indices, mean corneal-thickness, high-order-aberrations (HOAs) and low-orderaberrations (LOAs), and visual quality were observed between the groups between.
Conclusion: Young adults with ± 1D astigmatism showed higher corneal astigmatism, thinner mean CT, and increased keratoconus indices, with higher HOAs and LOAs.

Corneal Curvatures, Anterior Chamber Depth and Axial Lengths in Pakistani High Myopic Cases
Afia Matloob Rana, Fatima Sidra Tanveer, Saira Bano, Mustafa Abdul Hameed, Faizan Fazal

Objective: To determine correlations between the myopia and the Axial Length of the eye and the values of other ocular biometrics like corneal curvature and anterior chamber depth in high myopic patients of Pakistan.
Methods: Total 77 patients with refractive error of more than -5.00 D were included in this cross-sectional study. Ocular biometrics like axial length, keratometric readings and anterior chamber depth were documented. Axial lengths of eyes were measured by A-scan Ultrasonography. The mean value and ranges of ocular biometrics were calculated. Data was analyzed using SPSS version 22.
Results: Mean axial length of study participants was 26.3895±1.54274 mm, ranging from 21.56 mm to 29.21 mm. Mean keratometric values were (K1 of 44.41 D and K2 of 45.36 D). Our results showed no significant association between Axial Length (AL) and Anterior Chamber Depth (ACD), 2.998± 0.47680 with p > 0.05.
Conclusion: Myopia progression was directly associated with axial length. However, there is no statistically significant relationship of keratometric values and Anterior Chamber Depth (ACD) with severity of myopia.