The purpose of this study was to evaluate the ophthalmic causes of headache among patients attend... more The purpose of this study was to evaluate the ophthalmic causes of headache among patients attending tertiary care hospital. This was a descriptive, cross sectional hospital-based study. One hundred and thirty-two patients with ocular cause of headache excluding primary headache and pediatrics patients during one year were included. Detail ocular examination was done including visual acuity, refraction, binocular vision assessment like convergence insufficiency and fusional insufficiency, anterior and posterior segment examination. Among headache patients, female was 106 (80.3%) and male was 26 (19.7%). The prevalence of headache in female was 6.9% and in male was 2%. Headache was more common in age group 18-29 (59.8%). The mean age of presentation was 29.9 ± 10.2 years (range 18-61 years). Out of 132 patients with headache, 104 (78.8%) had refractive error, 15 (11.4%) had fusional insufficiency, 6 (4.5%) had convergence insufficiency, 10 (7.6%) had anterior segment diseases and 5 (...
Glaucoma is the second leading ocular disease of irreversible blindness. Glaucoma is a progressiv... more Glaucoma is the second leading ocular disease of irreversible blindness. Glaucoma is a progressive disorder and requires serial evaluation in order to monitor disease progression and optimize therapy. The objective of this study was to determine the correlation between disc damage likelihood scale (DDLS) and vertical cup disc ratio (VCDR) with the results of Humphrey field analyzer (HFA) parameters. This study was a descriptive, cross-sectional and observational study. A total of 104 eyes of 52 patients diagnosed with primary open angle glaucoma or normal tension glaucoma were examined. DDLS staging, VCDR and HFA 24-2 visual fields were obtained from the patients. The correlation of DDLS and VCDR with Mean deviation (MD), Pattern standard deviation (PSD) and Glaucoma hemi field test (GHT) of HFA was calculated by Pearson correlation coefficient (r). DDLS showed a coefficient correlation value of r = -.628, r = .391 and r = .395 (p = <0.000) when correlated against HFA MD, PSD and...
The purpose of this study was to evaluate the location and pattern of visual field defects as mea... more The purpose of this study was to evaluate the location and pattern of visual field defects as measured by Humphrey Field Analyzer (HFA 24-2) in newly diagnosed primary open angle glaucoma (POAG) attending tertiary care hospital. This was a cross sectional, descriptive study. One hundred and four eyes of 52 patients who fulfilled the inclusion criteria during one year were included. They were classified as mild, moderate and severe glaucoma according to severity. Paracentral scotoma in superotemporal and superonasal region was the most frequent visual field defect observed in mild glaucoma. Superior arcuate defect and double arcuate defect was commonly seen among moderate and severe stages of POAG respectively. There was a significant association between severity of glaucoma and pattern of visual field defect (p=0.000). The superior hemifield was affected twice more than the inferior hemifield in newly diagnosed cases of POAG.
Amblyopia is a common cause of visual impairment in children. The aim of this study was to assess... more Amblyopia is a common cause of visual impairment in children. The aim of this study was to assess the profile of amblyopia and the outcome of occlusion therapy in amblyopic children attending the eye department of a tertiary care hospital. This was a hospital based prospective interventional study. Sixty-five eyes of 47 patients fulfilling the inclusion criteria were included in the study. Occlusion therapy was started for the diagnosed amblyopic cases after refractive adaptation of 4 weeks. The mean age of presentation was 8.8 ±3.2 years. 29(61.7%) cases had unilateral amblyopia, 18(38.3%) cases had bilateral amblyopia. Ametropic amblyopia (52.3%) was the most common type of amblyopia followed by Anisometropia (23.1%). Refractive error was the most common cause of amblyopia with compound myopic astigmatism seen among 30.8% and hypermetropia among 29.2% of patients. There was no significant association between initial visual acuity with age of presentation and types of amblyopia res...
Bilateral acute angle closure attack is a rare ocular emergency. Early diagnosis and immediate in... more Bilateral acute angle closure attack is a rare ocular emergency. Early diagnosis and immediate intervention can have a profound effect on patient’s visual outcome and ocular morbidity. A 70 year old female presented with vomiting about 7 to 8 episodes along with sudden diminution of vision in both eyes for last 3 days. Initially she was examined by physician where all the routine blood tests and upper GI endoscopy was advised which failed to reveal the cause. She was then referred to our department for ophthalmic evaluation. On ocular examination she was diagnosed as a case of bilateral acute angle closure attack with some unusual clinical features. After treatment with hyperosmotic agent, anti glaucoma drugs and Nd: Yag peripheral laser iridotomy, intraocular pressure came down to normal limits and the patient regained good vision.
A Prospective hospital based study to note the efficacy of Nd Yag Peripheral Iridotomy (PI) in th... more A Prospective hospital based study to note the efficacy of Nd Yag Peripheral Iridotomy (PI) in the treatment of acute primary angle closure glaucoma was carried out in Nepal Eye Hospital from Jan 2007 to Jan 2008. All the Patients (n=50) with acute primary angle closure glaucoma admitted to our hospital were selected for the study. Patients with secondary angle closure glaucoma were excluded. It is more common in age of 56-65 years (20%), in females (70%), and in tibetoburman ethnic group (56%). Mean duration of presentation to hospital was 5 days (22%) (Range 4-7 days). Grade 1 Angle closure was present in 74%. All 50 patients (100%) with AACG had undergone Yag PI. Out of 50 patients, 11 patients (22%) were surgically operated i.e. trabeculectomy. Among 11, 1 patient (9%) who had undergone trabeculectomy had presented with acute on chronic angle closure glaucoma. Majority of cases (66%) presented with visual acuity (VA) 1/60-PL at the time of presentation and the Intraocular pressu...
In ophthalmic zoster, involvement of the optic nerve is very rare, and most of the published case... more In ophthalmic zoster, involvement of the optic nerve is very rare, and most of the published cases have resulted in optic atrophy. This case report presents a woman who developed a severe visual loss in her right eye 4 weeks after the primary attack. Computer tomography and ultrasonic B‐scan showed a spindle‐shaped thickening of the optic nerve. Eight months later the visual acuity was 2/60 and the optic nerve showed atrophy. The computer tomography was normal, and the Visual Evoked Potential had reduced amplitudes. Earlier reports and pathogenesis are discussed.
The purpose of this study was to evaluate the ophthalmic causes of headache among patients attend... more The purpose of this study was to evaluate the ophthalmic causes of headache among patients attending tertiary care hospital. This was a descriptive, cross sectional hospital-based study. One hundred and thirty-two patients with ocular cause of headache excluding primary headache and pediatrics patients during one year were included. Detail ocular examination was done including visual acuity, refraction, binocular vision assessment like convergence insufficiency and fusional insufficiency, anterior and posterior segment examination. Among headache patients, female was 106 (80.3%) and male was 26 (19.7%). The prevalence of headache in female was 6.9% and in male was 2%. Headache was more common in age group 18-29 (59.8%). The mean age of presentation was 29.9 ± 10.2 years (range 18-61 years). Out of 132 patients with headache, 104 (78.8%) had refractive error, 15 (11.4%) had fusional insufficiency, 6 (4.5%) had convergence insufficiency, 10 (7.6%) had anterior segment diseases and 5 (...
Glaucoma is the second leading ocular disease of irreversible blindness. Glaucoma is a progressiv... more Glaucoma is the second leading ocular disease of irreversible blindness. Glaucoma is a progressive disorder and requires serial evaluation in order to monitor disease progression and optimize therapy. The objective of this study was to determine the correlation between disc damage likelihood scale (DDLS) and vertical cup disc ratio (VCDR) with the results of Humphrey field analyzer (HFA) parameters. This study was a descriptive, cross-sectional and observational study. A total of 104 eyes of 52 patients diagnosed with primary open angle glaucoma or normal tension glaucoma were examined. DDLS staging, VCDR and HFA 24-2 visual fields were obtained from the patients. The correlation of DDLS and VCDR with Mean deviation (MD), Pattern standard deviation (PSD) and Glaucoma hemi field test (GHT) of HFA was calculated by Pearson correlation coefficient (r). DDLS showed a coefficient correlation value of r = -.628, r = .391 and r = .395 (p = <0.000) when correlated against HFA MD, PSD and...
The purpose of this study was to evaluate the location and pattern of visual field defects as mea... more The purpose of this study was to evaluate the location and pattern of visual field defects as measured by Humphrey Field Analyzer (HFA 24-2) in newly diagnosed primary open angle glaucoma (POAG) attending tertiary care hospital. This was a cross sectional, descriptive study. One hundred and four eyes of 52 patients who fulfilled the inclusion criteria during one year were included. They were classified as mild, moderate and severe glaucoma according to severity. Paracentral scotoma in superotemporal and superonasal region was the most frequent visual field defect observed in mild glaucoma. Superior arcuate defect and double arcuate defect was commonly seen among moderate and severe stages of POAG respectively. There was a significant association between severity of glaucoma and pattern of visual field defect (p=0.000). The superior hemifield was affected twice more than the inferior hemifield in newly diagnosed cases of POAG.
Amblyopia is a common cause of visual impairment in children. The aim of this study was to assess... more Amblyopia is a common cause of visual impairment in children. The aim of this study was to assess the profile of amblyopia and the outcome of occlusion therapy in amblyopic children attending the eye department of a tertiary care hospital. This was a hospital based prospective interventional study. Sixty-five eyes of 47 patients fulfilling the inclusion criteria were included in the study. Occlusion therapy was started for the diagnosed amblyopic cases after refractive adaptation of 4 weeks. The mean age of presentation was 8.8 ±3.2 years. 29(61.7%) cases had unilateral amblyopia, 18(38.3%) cases had bilateral amblyopia. Ametropic amblyopia (52.3%) was the most common type of amblyopia followed by Anisometropia (23.1%). Refractive error was the most common cause of amblyopia with compound myopic astigmatism seen among 30.8% and hypermetropia among 29.2% of patients. There was no significant association between initial visual acuity with age of presentation and types of amblyopia res...
Bilateral acute angle closure attack is a rare ocular emergency. Early diagnosis and immediate in... more Bilateral acute angle closure attack is a rare ocular emergency. Early diagnosis and immediate intervention can have a profound effect on patient’s visual outcome and ocular morbidity. A 70 year old female presented with vomiting about 7 to 8 episodes along with sudden diminution of vision in both eyes for last 3 days. Initially she was examined by physician where all the routine blood tests and upper GI endoscopy was advised which failed to reveal the cause. She was then referred to our department for ophthalmic evaluation. On ocular examination she was diagnosed as a case of bilateral acute angle closure attack with some unusual clinical features. After treatment with hyperosmotic agent, anti glaucoma drugs and Nd: Yag peripheral laser iridotomy, intraocular pressure came down to normal limits and the patient regained good vision.
A Prospective hospital based study to note the efficacy of Nd Yag Peripheral Iridotomy (PI) in th... more A Prospective hospital based study to note the efficacy of Nd Yag Peripheral Iridotomy (PI) in the treatment of acute primary angle closure glaucoma was carried out in Nepal Eye Hospital from Jan 2007 to Jan 2008. All the Patients (n=50) with acute primary angle closure glaucoma admitted to our hospital were selected for the study. Patients with secondary angle closure glaucoma were excluded. It is more common in age of 56-65 years (20%), in females (70%), and in tibetoburman ethnic group (56%). Mean duration of presentation to hospital was 5 days (22%) (Range 4-7 days). Grade 1 Angle closure was present in 74%. All 50 patients (100%) with AACG had undergone Yag PI. Out of 50 patients, 11 patients (22%) were surgically operated i.e. trabeculectomy. Among 11, 1 patient (9%) who had undergone trabeculectomy had presented with acute on chronic angle closure glaucoma. Majority of cases (66%) presented with visual acuity (VA) 1/60-PL at the time of presentation and the Intraocular pressu...
In ophthalmic zoster, involvement of the optic nerve is very rare, and most of the published case... more In ophthalmic zoster, involvement of the optic nerve is very rare, and most of the published cases have resulted in optic atrophy. This case report presents a woman who developed a severe visual loss in her right eye 4 weeks after the primary attack. Computer tomography and ultrasonic B‐scan showed a spindle‐shaped thickening of the optic nerve. Eight months later the visual acuity was 2/60 and the optic nerve showed atrophy. The computer tomography was normal, and the Visual Evoked Potential had reduced amplitudes. Earlier reports and pathogenesis are discussed.
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