Past Issues - Vol. 19, No. 2, April – June 2023

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Al-Shifa Journal of Ophthalmology

Editorial: Epidemiology of Ocular Trauma
Tayyab Afghani

Prognostic Factors For Visual Outcome Following Intraocular Foreign Body Removal
Hussain Ahmad Khaqan, Laraib Hassan, Raheela Naz, Atia Nawaz, Hasnain Muhammad Bukhsh, Muhammad Ali Haider, Aamna Jabran

Objective: To determine the influence of prognostic factors on the visual outcome in patients who underwent vitrectomy for intraocular foreign body.
Methods: A retrospective study was conducted at the Ophthalmology Department, Lahore General Hospital Lahore, between 2017 and 2021. A sample size of 60 patients is estimated by using a 95% confidence level, 7% absolute precision with an expected percentage of 8.4 %. The data of 62 patients who aged between 25 to 55 years and presented with open-globe injuries and retained IOFBs was collected by non probability purposive sampling technique.
Results: All the patients underwent 23-gauge pars plana vitrectomy with removal of IOFB. The final BCVA was improved by 02 letters or more on Snellen’s acuity chart in 38 (61.29%) patients and remained the same in 21 (33.87%) eyes while in 03 (4.84%) cases it decreased. Despite the systemic antibiotics, 03 (4.83%) eyes ended up with endophthalmitis. None of the eyes were enucleated.
Conclusion: The prognosis of an IOFB injury is mostly uncertain due to a complex combination of parameters. The main prognostic factors related to better visual outcomes were initial BCVA, time to surgery (first week), initially attached retina and the scleral entry site. Prognostic factors for poor final VA related to IOFBs included poor initial VA, large IOFB size, posterior segment location, and preoperative retinal detachment. The main complication was endophthalmitis.

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Spectrum of Work-related Musculoskeletal Disorders among Ophthalmologists in Pakistan
Shehr Bano Abbas, Arslan Sajjad, Fuad Ahmad Khan Niazi, Ambreen Gull, Mishaal Abbas, Muhammad Abbas

Objective: To assess the prevalence of work-related musculoskeletal disorders (MSD), associated symptoms, and contributing risk factors among ophthalmologists in Pakistan.
Methods: web-based questionnaire (Google Form) was developed and circulated via a social media application (WhatsApp) to ophthalmologist members of the Ophthalmological Society of Pakistan across the country. The questionnaire consisted of 21 questions on respondent demographics, practice characteristics, pain, and effects of musculoskeletal disorders on their practice patterns and social life.
Results: The survey was completed by 121 ophthalmologists with a response rate of 60.5%. Out of 121 participants, 96 (79.3%) reported work-related musculoskeletal disorders. Lower back pain was the most common symptom 57 (59.4%). The primary causes of MSD symptoms were abnormal postures during surgical procedures 67 (69.8%) and slit lamp examination 55 (57.3%). MSD attributed loss of productivity was claimed by 46.9% of the respondents.
Conclusions: Musculoskeletal pain is widespread among Pakistani ophthalmologists, significantly affecting their work and well-being. Urgent workplace adjustments, and prioritizing ergonomics in ophthalmic settings are essential. Moreover, integrating ergonomics into resident trainees curriculum is crucial for raising awareness of risks and promoting proactive prevention strategies.

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Frequency of Eye Diseases among medical students of Mohi-ud-din Islamic Medical College
Fatima Akbar Shah, Umair Tariq Mirza, Muhammad Usman Sadiq, Sidrah Riaz, Amjad Akram, Porus Ahmed

Purpose: The research was aimed to know the incidence of various eye diseases to get an insight into the incidence and subsequently probe into their causes so that students could be guided about lifestyle modifications.
Methods: A descriptive, cross-sectional study was carried out on MBBS students of both genders whose age group ranged from 18-24 years. The duration of the study was one month. A sample size of 427 was employed by non probability consecutive sampling. Data was collected by a researcher with a questionnaire after approval from the ethical review committee. A general eye examination was carried out and readings were noted on the questionnaire by the researchers.
Results: It was found that 257 students had healthy eyes. Myopia was prevalent among students with a total of 120 (28.2%) affected. Hypermetropia (0.5 %), astigmatism (3.3%), convergence insufficiency (2.1%), dry eyes (1.6%), blepharitis (1.2%), allergic conjunctivitis (2.8%) and color blindness (0.5%) were other disease entities discovered among the students.
Conclusion: Refractive error in general is the most common eye disease among medical students in which myopia was the leading cause, followed by hypermetropia and astigmatism. Dry eye, blepharitis, and allergic conjunctivitis were a few other eye disease entities found among students.

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Frequency Of Patients With Different Stages Of Diabetic Retinopathy Presenting To A Tertiary Care Eye Hospital In Rawalpindi, Pakistan
Waleed Ahmad, Muhammad Afaq Shah, Hafiz Muhammad Ahmad, Mehwish Ameer, Saad Bin Yasir, Yasir Ahmad

Objective: To determine the frequency of patients with different stages of diabetic retinopathy presenting to a tertiary care eye hospital in Rawalpindi.
Methods: A descriptive cross-sectional study was carried out in the general ophthalmology department. Consultant ophthalmologists identified 366 individuals, 66 (18.0%) with type I and 300 (82.0%) with type II diabetes mellitus based on patient history. A consultant ophthalmologist performed clinical evaluation; diabetic retinopathy was diagnosed and graded according to the 2017 ICO classification.
Results: The mean age of patients with Type I Diabetes Mellitus and Type II Diabetes Mellitus was 24.64+7.74 and 54.76+3.60 respectively. Mean visual acuity in patients with Type I DM and Type II DM was 0.36+0.26 and 0.37+0.27 decimal respectively. The mean duration of disease in patients with Type I DM and Type II DM was 7.61+2.79 and 7.59+2.87 years respectively. Similarly, 16 (16.0%) patients with Type I DM had proliferative diabetic retinopathy as compared to 84 (84.0%) patients having Type II DM.
Conclusion: The present study demonstrated a huge burden of proliferative diabetic retinopathy amongst Type II diabetic patients, thus warrants large multicentered studies to generalize its results to the overall population of the province and to contribute to the establishment of the national screening program for catering diabetic retinopathy.

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Incidence of Retinopathy of Prematurity in Infants with Low Gestational Age and Low Birth Weight
Bilal Humayun Mirza, Kanwal Zareen Abbasi, Muhammad Rizwan Khan, Munib Ur Rehman, Maria Zubair, Fuad Ahmad Khan Niazi

Objective: To determine the incidence of retinopathy of prematurity in infants with low gestational age and low birth weight.
Methods: An institution based cross-sectional study was conducted in the department of Ophthalmology, Holy Family Hospital, Rawalpindi in collaboration with department of Paediatrics, Holy Family Hospital for a duration of 12 months. Sample of 85 was collected using non probability consecutive sampling technique. 85 babies born before 34 weeks of gestation and babies with birth weight ranging from 0.9 kg to 2.5 kg were included in this study. These were the babies who were admitted in the neonatal intensive care unit and were on high concentration oxygen therapy. The fundi of the babies were examined under sterile conditions using an indirect ophthalmoscope, 20D and 28D lens. Data was analyzed through SPSS version 17.
Results: The mean gestational age of the babies was 30.48±1.517 weeks plus mean birth weight 1.56±0.30 kg. Out of 85 babies 54.1% were males while 45.9% were females. 20 (23.5%) of these babies were found to be suffering from retinopathy of prematurity. Among ROP positive infants, mostly belong to gestational age group 30 weeks and birth weight 1.1 to 1.5 kg group.
Conclusion: Retinopathy of prematurity is a disease of the premature infants. Lower gestational age at birth (less than 34 weeks) and low birth weight (less than 2 kg) have a strong association with development of retinopathy of prematurity.

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