Holmes-Adie syndrome

Holmes-Adie syndrome (HAS) is a rare neuro-ophthalmological disorder, which mostly presents in young femalesas a unilateral dilated pupil. We present a case of a 12-year-old girl with bilateral tonic pupils. She had vermiformmovement of the iris with segmental palsy, as well as loss of ankle jerks. The diagnosis was confirmed with pilocarpine0.125% test, and she was symptomatically treated with the same drops

Dry eye symptoms among diabetics: an exploratory study on knowledge, attitude, and practice

Background: The objective of the study was to explore the awareness of dry eye symptoms among diabetics attending a tertiary care hospital in Karachi. Material and methods: Twenty-five diabetic patients aged ≥ 40 years were selected from the diabetic clinic of theAga Khan University Hospital Karachi using convenience sampling. Our primary focus was to determine whether diabetics knew that they were at high risk of developing dry eye symptoms. Participants were also asked both openand closed-ended questions to explore their attitude and practices in relation to dry eye symptoms such as burning, stinging, grittiness, and discomfort. Results: None of the 25 diabetics we interviewed knew that diabetics as compared to their non-diabetic counterparts were at higher risk of developing dry eye syndrome. They did not know about the signs, symptoms, and complications of dry eyes. Twelve participants had symptoms of dry eyes. Among these, five reported washing their eyes with cold water, four reported using no remedy, and one reported using surma. No one reported having consulted an eye doctor. Conclusion: Our study concludes that diabetics did not know that they had an increased risk of developing dry eye symptoms compared with their non-diabetic counterparts. Population-based research is needed to assess dry eye related risk awareness and control measures among diabetics

A case of an intraocular glass piece that has remained quiescent for four years

An intraocular foreign body (IOFB) is mainly acquired via a penetrating globe injury. Some foreign bodies like glass have an inert nature, and the timing of intervention can be delayed, but foreign bodies like metals have a toxic effect on the eye and require urgent removal. We present a case of a young male with a penetrating globe injury following a road traffic accident. He acquired a foreign body glass piece in his left eye, which was initially missed. Upon thorough examination, it was found at the inferotemporal quadrant of the retina. Considering the inert nature of IOFB and the risks of bleeding and damage to the surrounding intraocular structures, we decided not to remove it. The patient has been stable for four years with good vision in the same eye

Types of refractive errors in northern Pakistan: a hospital-based survey

Background: The World Health Organisation (WHO) reports that about 314 million people are visually impaired worldwide, and in 153 million of them the impairment is due to uncorrected refractive errors. Hence, uncorrected refractive error is one of the leading causes of blindness around the globe. The aim of this study is to assess the prevalence and patterns of different types of refractive errors among the people attending the eye clinic in Northern Pakistan. Material and methods: A hospital-based retrospective audit was done on patients who presented to the Ophthalmology Outpatients Department of Ayub Medical Complex Abbottabad between 1st June 2017 and 31st July 2017. The data of 662 patients were analysed using IBM SPSS Statistics v. 22.0. Results: Refractive errors were found in 487 (73.5%) of the total participants. The crude prevalence of myopia, hyperopia, and astigmatism was found to be 33.5%, 21.9%, and 18.1%, respectively. The refractive error status was found to be independent of gender (p = 0.075), but it varied among different age groups (p = 0.000). Conclusion: Myopia seems to be the most common refractive error in northern Pakistan, followed by hyperopia. The results of our study can be useful for the planning of eye care services in our country so that we can achieve the goal of VISION 2020 with proper care and planning

A 10-year review of indications for penetrating keratoplasty in a tertiary care setting in Karachi Pakistan

Abstract The retrospective study was conducted to determine the indications and outomes of penetrating keratoplasty(PKP) in a tertiary caresetting in Pakistan. All eyes that had undergone PKP between January 2005 and December 2014 at the Aga Khan University Hospital, Karachi, were included.Data were collected on the indications of PKP, graft survival (graft clarity at final follow-up), andbest corrected visual acuity (BCVA).Kaplan-Meier\\u27s method was usedto analyse graft survival.Out of 437 eyes, 383(87%) were for visual purpose. Trauma-related corneal scarring 113(26.2%) was the leading cause of PKP, followed by keratoconus 74(17.1%), redo graft 56(13%), infection-related corneal opacity 46(10.6%), corneal dystrophy 44(10.2%) and bullous keratopathy 36(8.3%). The probability of graft survival at 30 months was 90% for keratoconusversus 75% for the non-keratoconus grafts. Most of the PKPs in this case series were due to preventable causes. Our long-term PKP results were favourable, with a graft survival ratecomparable to those of other centres

Weight patterns and perceptions among female university students of Karachi: A cross sectional study

Background: Body weight and its perception play an important role in the physical and mental well-being of a person. Weight perception is found to be a better predictor of weight management behaviour as compared to actual weight. In Pakistan, studies have been done on the prevalence of weight status but weight perception is still unexplored. The study was done to examine relationships between body weight perception, actual weight status, and weight control behaviour among the female university students of Karachi.Methods: A cross sectional study was carried out during Sep-Nov 2009 on female students in four universities of Karachi, Pakistan. Our final sample size included 338 female university students. Height and weight were measured on calibrated scales. A modified BMI criterion for Asian populations was used.Results: Based on measured BMI; the prevalence of underweight, normal weight and overweight females was 27.2%, 51.5% and 21.3% respectively. As a whole, just over one third (33.73%) of the sample misclassified their weight status. Among underweight (n=92), 45.70% thought they were of normal weight. No one who was truly underweight perceived them self as overweight. Among the normal weight (n= 174), 9.8% thought they were underweight and 23.6% considered themselves overweight. Among the overweight (n=72); 18.3% considered themselves normal. Only one female student thought she was underweight despite being truly overweight.Conclusions: Our study shows that among female university students in Karachi, the prevalence of being underweight is comparatively high. There is a significant misperception of weight, with one third of students misclassifying themselves. Underweight females are likely to perceive themselves as normal and be most satisfied with their weight. Health policy makers should implement these findings in future development of health interventions and prevention of depression, social anxiety and eating disorders associated with incorrect weight perception among young females. Studies that employ a longitudinal approach are needed to validate our findings

Outcomes of Epi-on collagen cross-linkage procedure assessed in progressive keratoconus patients

Introduction: Keratoconus is a corneal ectasia that causes astigmatism and reduced vision. Conventional treatment to stop the progression of ectasia involves debridement of corneal epithelium, followed by ultraviolet light and riboflavin drops to reinforce the collagen covalent bonds, called collagen cross-linkage (CXL). Epi-on (epithelium-on) is a modified technique without epithelial debridement and associated complications of pain, infection, and damage to the cornea. However, despite a good safety index and efficacy, Epi-on has not completely replaced the conventional Epi-off (epithelium-off) CXL. We aim to report our five-year experience and outcomes with Epi-on CXL.Methods: In this five-year retrospective clinical audit, we included all patients who underwent Epi-on CXL from December 2014 to June 2020 at the Aga Khan University Hospital. Outcomes were based on best-corrected visual acuity (BCVA) and topographic indicators such as keratometry-max (K-max), keratometry mean (K-mean), pachymetry apex (Pachapex), and pachymetry thinnest (Pachthin) performed during pre-CXL clinical visit within one month of the procedure and were compared with the most remote follow up within three years post-CXL. A p-value of \u3c0.05 was considered statistically significant.Results: A total of 223 eyes of 134 patients had undergone CXL of which 32 eyes of 18 patients were included in the study based on the inclusion criteria. The mean age was 26.8 (+/- 6.137) years; nine were males and 16 were right eyes. Mean BCVA was 0.383 logMAR (logarithm of the minimum angle of resolution) units which improved to 0.292 units post CXL (p=0.02) and K-max decreased from 57.4 to 56.60 diopters (p=0.048), both outcomes were statistically significant. Pachapex decreased slightly from 471 to 460 micrometers (p=0.099), K-mean was almost stable from 48.8 to 48.7 diopters (p=0.9), and Pachthin also decreased slightly from 455 to 445 micrometers (p=0.117), however, these outcomes were not statistically significant. Other studies reported similar improvements in K-max and visual acuity.Conclusion: Epi-on CXL is an effective treatment for halting the progression of keratoconus. Our results showed significant improvement in visual acuity and K-max readings indicating a halting of the progression of keratoconus in our patients. Long-term follow-up is required for all patients to assess detailed outcomes. Further studies comparing Epi-on CXL with other methods may be carried out