Past Issues - Vol. 17, No. 2, April – June 2021

Al-Shifa Journal of Ophthalmology

Editorial: Cataract Trends in Pakistan Over a Period of Years
Ume Sughra

Visual Outcomes and Complications of Phacoemulsification for Senile Cataract in a Tertiary Eye Care Hospital
Hafsa Maryam, Qandeel Tahir, Shama Khan

Purpose: Cataract is one of the main causes of preventable blindness in Pakistan, the purpose of this study was to evaluate the effect of phacoemulsification on visual acuity for senile cataract as well as to track record the types of complications associated with this procedure.
Study design: Cross-sectional study.
Place and duration of study: The study was conducted at General OPD of Tertiary Eye-care Hospital of Rawalpindi, Pakistan from October 2020 to March2021.
Materials and Methods: Participants coming for follow-up who have undergone phacoemulsification (one-week post-op) by same consultant surgeon. An interview based structured questionnaire was used with informed consent to collect the data.
Result: A total of 290 eyes of 250 participants suffering from senile cataract were included in the study. Mean age of participants was 59 ±7.10 years, 56% (140) of the participants were male, while 110 (44%) were female. All the surgeries were carried out by the same consultant surgeon. 60.4% (151) of the eyes were right while 55.6% (139) were left. Good final visual outcome was seen in 84.4% of the cases. Postoperative complications occurred in 5.2% of the participants.
Conclusion: The result of this study showed good final visual outcome (84.4%), which is close to the WHO recommendation of best corrected good visual outcome of 90%.

Visual Outcomes After Pediatric Cataract Surgery; A Retrospective Analysis
Anisa Irshad, Fareeha Ayyub, Ume Sughra, Sumaira Altaf, Saifullah

Purpose: The purpose of this study was to estimate the amount of improvement during the follow-ups and improvement before and after the cataract surgery.
Materials and Methods: A retrospective study was carried out in the pediatric department at Al-Shifa trust eye hospital Rawalpindi Pakistan from July 2018 to December 2018. In this study total of 100 patients were included having the age of 2 to 11 years with congenital cataracts. The clinical record of patients was found through the computer. There visual acuity of both eyes was observed before and after the surgery.
Results: Visual acuity of all the patients was assessed and was measured in log-MAR. The mean visual acuity of a right eye before surgery was 1.05(±0.155SD). While the mean visual acuity on the first follow-up of the right eye after surgery was found to be 0.60(±0.36SD) and the mean visual acuity on the second follow-up after surgery was 0.46(±0.43SD). The mean visual acuity of a left eye before surgery was 1.00(±0.155SD) while the mean visual acuity on first follow-up after surgery was found to be 0.61(±0.36SD). And the mean visual acuity on second follow-up after surgery was 0.44(±0.36SD).
Conclusion: Cataract surgery procedure results in a significant change of visual acuity. This has a positive impact on postoperative visual acuity as the visual acuity showed improvement.

Quality Of Life in Cataract Patients Visiting a Tertiary Care Eye Hospital
Maryam Bacha, Sadaf Qayyum, Ume Sughra, Nimra Gul, Shakeela Abbas

Background: Visual impairment caused by cataract is the major cause of treatable blindness. According to the WHO prevalence of cataract is 47.9% worldwide. Quality of life is greatly affected by cataract. Quality of life means the individuals’ perception of his place in life according to the contexts of culture and values, a concept often affected by individuals psychological and physical state and social relations.
Objectives: The main objectives of the study were to access the quality of life of individuals before and after cataract and to find the association of quality of life with their socioeconomic factors.
Materials and Methods: A cross-sectional study was carried out in Al-Shifa trust eye hospital Rawalpindi from October 2020 to February 2021. Technique used for the study was convenient sampling and sample size was 206. Structured questionnaire was used with verbal consent form to collect data. Results: 31.6% males shows poor general health as compared to females, p-value=0.000. Illiterate patients shows high difficulties with activities 31.7% p-value=0.000. People from urban areas have more difficulties in daily life activities 33.7% having p-value 0.0004. Non-working shows poor responses to vision 42.7% p-value=0.000. All these shows significant results while all other categories show insignificant result.
Conclusion: The results of this study indicate that cataract affects quality of life and cataract is still the major cause of blindness and many people are unaware of it. It should be treated on time before it causes blindness. Illiterates are more affected. Education is important and awareness about cataract.

Scleral Buckling with 3600 Encirclement Using 3x5 mm Sponge in Rhegmatogenous Retinal Detachments
Muhammad Kamran Khalid, Farhana Ramzan

Objectives: To determine the efficacy of a modified scleral buckling technique.
Design, Duration & Settings: This qausi experimental post-test study was conducted at the department of Ophthalmology, Gomal Medical College, Dera Ismail Khan (D I Khan), Pakistan from January 2015 to December 2015.
Materials & Methods: The sample was collected from Eye Unit, DHQ Teaching Hospital D.I.Khan, Pakistan. Proper approval from the ethical committee of Gomal Medical College, D I Khan was taken before starting the study. All the patients were operated by the same surgeon under local anesthesia and GA was used when indicated.
Results: Retinal detachment surgery with 3600 encirclement using 3x5 mm sponge for SB for the repair of RRD is a highly effective procedure as the retina was flat in almost all the cases using this technique. Out of a sample of 25 patients of RRD, males were more than female and older (>40 years) more than younger (<40 years) patients. (Table-1). The prevalence of phakic patients was higher than pseudophakic and aphakic patients, the prevalence of sub-total RD was higher than half and total RD and the prevalence of very small breaks (Not visible) was higher than relatively larger breaks (Visible) (Table-2).
Conclusion: The retina was found flat in a very high percentage (96%) of patients as compared to patients (4%) with detached retina (p<0.0001) both at a follow up one week and three months.

Assessment of Stereopsis with TNO Stereoacuity Test Among Refractive Error Patients
Sumaira Arif, Maryam Firdous, Ayesha Babar Kawish, Sohail Ahmad, Saifullah

Purpose: To evaluate stereopsis in refractive error patients with TNO stereo acuity test and to compare Stereopsis values in patients with glasses and without glasses.
Materials and Methods: This Cross-sectional study were conducted among three sixty patients who have refractive error. Auto-refraction, best corrected visual acuity and stereopsis were measured. Convenient nonrandom Sampling technique is used for collecting sample. The level of stereopsis was divided into no stereopsis, abnormal, equivocal and normal for refractive error patients. Data was collected from general OPD of Al-Shifa Trust Eye Hospital and analyzed by SPSS version 17. Paired simple t test was used to evaluate stereopsis before and after glasses.
Results: A total of 360 subjects participated in this study. Majority of the participants were female N= 218 (60.6%) while remaining were male N=142 (39.4%). The mean and standard deviation (SD) of these ages ranging from 18 to 30years were 23.9 and ±3.8. All participants in the study Presented with mean refractive error was 2.3 (SD±1.7) with range of ±1 to ±6.00 Dioptric Sphere (DS) and ±0.75 to ± 4.00Dioptric Cylinder (DC).
Conclusion: It was concluded that refractive error greatly reduced the stereo acuity and after the correction of Refractive error the stereo acuity on TNO test was improved statistically significant (p<0.05).

Comparison Of Knowledge and Practices Between Urban and Rural Primary School Teachers Regarding Refractive Errors in Children
Mehwish Saleem, Nadeem Qureshi, Khizar Nabeel Ali, Maryam Firdous

A child’s eyes are always in use in classroom and 80% of the learning takes place through vision. Therefore, it is necessary to guide teachers on their role in simple eye care delivery.

Objective: Primary aim of this study was to determine the level of knowledge and to assess the practices regarding refractive error in children among primary school teachers, and to evaluate the associated factors affecting the level of knowledge regarding refractive error.
Methods: A cross-sectional study was carried out among primary school teachers of urban and rural areas of Rawalpindi for the duration of three months. All the government and private primary school teachers willing to participate in the study were included. An adopted questionnaire was used and all the responses from self-administered questionnaires were analyzed using SPSS version 21.
Results: A total 95 respondents were included in this study. Equal number of participants were taken from urban and rural areas of Rawalpindi; Pakistan. Out of these almost half (54.5%) of urban and rural primary school teachers had good knowledge and practice regarding refractive error in their children.
Conclusion: The study demonstrates that there is huge gap of knowledge and practices among primary school regarding refractive error, which needs to be addressed immediately, in order to decrease the burden of childhood visual problems in Pakistan.

Retinoschisis-An Optometric Approach
Nisma Sehar, Farman Ullah

Retinoschisis is a rare condition that can have serious visual consequences if not managed properly. Retinoschisis is described as a separation of the neurosensory components of the retina. This case report discusses asymptomatic acquires retinoschisis as it presented within a routine diabetic examination. The patient presented in OPD for regular check-ups she only had complaints of intermittent migraines without diplopia her visual acuity was normal with refraction. On fundus examination, there was a bubble-like appearance of the retina in the inferior temporal quadrants of the left eye bubble-like appearance of the retina with white dots in the lesion in the inferior temporal region of the right eye. This case report explores important clinical findings, treatment options, differential diagnoses, and the optometrist’s role in managing this condition.