Optic nerve head disorders in a hilly state of india: a retro/prospective study

Abstract

Aim: To study the pattern/distribution of optic nerve head disorders in the hilly terrain of Himachal Pradesh (altitude ranging from 500 to 4500 m above sea level). Subjects and Methods: It is a retro/prospective study of patients with retinal diseases attending the general ophthalmology clinic of a tertiary care facility at Shimla from August 2008 to April 2013. Out of 5600 patients, 4323 were taken as a sample. The data were taken from the hospital records and thereafter analyzed to determine their age, sex distribution, and diagnosis. All patients underwent visual acuity, refraction, slit lamp examination, and fundus evaluation. The diagnosis was confirmed from fundus clinic records and evaluation of fundus photographic records retroprospectively. The photographs were taken on the fundus camera (KOWA'S FUNDUS CAMERA VX-10) and fundus fluorescein angiography done where ever indicated. Using the inbuilt software in KOWA VX 10 FUNDUS CAMERA, cup-disc ratio calculation was done. Results: Among the 139 (3.24%) patients of congenital optic nerve head disorders, the most common entity was optic nerve head hypoplasia. Out of 248 (5.73%) cases of acquired optic nerve head disorders-nonglaucomatous (NG), optic atrophy-NG was the most common. There were 532 (12.31%) cases of glaucoma suspects. Conclusion: Optic nerve head disorders appear to be a major public health problem in India as well as Shimla hills. The present study shall help us in planning the management of such disorders in the hilly state of Himachal Pradesh to reduce the visual morbidity arising out of such disorders.