Ophthalmology and Allied Sciences

Introduction: Avoidable blindness which could be treated or prevented by known and cost effective means is cataract. Therefore majority of blindness due to cataract can be prevented by simple techniques called conventional ECCE, SICS and phacoemulsification. Around 62.6% of blindness is due to cataract and thereby it is burdening the country with major morbidity. To reduce this burden most easy technique and cost effective method employed in developing countries like India is small incision cataract surgery (SICS).

Aim & Objective: To find out the causes of subnormal vision post operatively in patients undergoing small incision cataract surgery at a tertiary care center.

Methods: The present study was a prospective study done on 100 patients who attended OPD during the study period between 2018-2020. Patients underwent detailed examination before cataract surgery and best corrected visual acuity was recorded at day 1, 1 week, 6 weeks post operatively. Complications were noted to determine the causes for subnormal vision at 6 weeks post-operatively.

Results: Out of the 100 patients severe visual loss (6%) was caused by iridocyclitis (65%) in majority of patients on 1st post op day. At 1st post op week residual lens matter (3%) and astigmatism (59%) contributed equally to moderate vision loss (55%). At 6 weeks astigmatism (88%) and Pigment Dispersion on IOL (16%) were the causes of moderate visual loss (55%). 

Conclusion: Astigmatism was the major cause of subnormal vision at 6 weeks causing mild moderate vision loss in majority of the patients.

Introduction: The Human race is supreme in hierarchy of animal kingdom by the acquisition of Binocular Single Vision 1 (BSV). It is important to have normal ocular muscle balance to have normal BSV. Any muscle balance disorder may lead to squint or amblyopia. Ocular muscle balance disorders shows an association with refractive error. Most of this research has focused on myopia. But hyperopia and astigmatism are also being examined in our study. 

Methodology: A Prospective study conducted over period of 1 year 300 subjects were included 150 were selected from OPD and rest 150 by screening 1875 students of various schools in Raichur District who had vision less than 6\6 or with 6\6 vision and as the no pic symptoms. Visual Acuity was measured. Fund us examination, Squint evaluation and Type of squint was noted. AC/A ratio was calculated. Binocular Vision was assessed. Those who needed treatment were treated by spectacles ororthoptic exercises. Correlation was made between ocular muscle imbalance and refraction.

Results: The prevalence of refractive errors was 8% with mallet of emaleratio 1.9:1. Highest were between 17-20 yrs. Heterophori as were the most common Type of ocular muscle balance disorders (80%) followed by heterotropias (20%). Exophoria was highest (52.8%) followed by esophoria (46.6%). Strong association was noted between myopia and exophoria 43 out of 60 (p=0.042). Cases of mixed astigmatism were observed having esophoria for near and exophoria for far. Significant association was noted between hypermetropia and convergent squint (67 out of 81).

Conclusion: Myopia is mainly associated with divergent squint, Hypermetropia with convergent squint. Mixed astigmatism associated with exophoria for far, esophoria fornear.

Purpose: To study the incidence of rhegmatogenous retinal detachment in phakic and pseudophakic myopic patients and also to study the course of posterior vitreous detachment causing retinal breaks in myopia patients.

Methods: 19 Patients presented with Rhegmatogenous retinal detachment (RRD) were examined and documented. Patients of different age groups presented with various complaints were examined. Retrospective study done, cases presented from June 2022 to December 2023 were collected from electronic data of the institute. Proper history, BCVA, Slit Lamp examination, fundus examination and documentation done. All myopia patients were examined, underwent peripheral fundus examination irrespective of degree of myopia, refractive status of patients was taken into account for screening the retina, both central and peripheral retina. Phakic as well as pseudophakic patients also underwent fundus examination if the refractive error was myopia. Posterior vitreous detachment (PVD) has major role in causing retinal pathology like retinal breaks in myopia patients during its course near sites of adhesions.

Results: Myopia is definitely a risk factor for rhegmatogenous retinal detachment, some percentage of myopia patients will escape from the retinal detachment and maintain good vision. All myopia patients have risk, but the outcome is good in mild to moderate degree of myopia compared to severe degree of myopia. Presentation of breaks is also different in different degrees of myopia. In paediatric cases, retinal detachment will remain unnoticed usually due to delayed presentation, risk of Proliferative Vitreo retinopathy (PVR) is severe, all these factors will cause irreversible blindness. RRD in myopia was commonly noted in middle age group, male gender and slightly in phakic patients more compared to pseudophakic patients.

Conclusions: Myopia is the major non traumatic cause of RRD, hence screening in myopia has important role to detect the retinal breaks as early as possible and treat to prevent the retinal detachment, which can cause severe blindness.