Nepalese Journal of Ophthalmology最新文献

{"title":"Bleb-related Infection following Trabeculectomy.","authors":"Madhu Thapa, Pragati Gautam, Sareena Pachai","doi":"10.3126/nepjoph.v17i1.69157","DOIUrl":"https://doi.org/10.3126/nepjoph.v17i1.69157","url":null,"abstract":"<p><strong>Introduction: </strong>Bleb-related endophthalmitis after trabeculectomy is a rare but sight threatening complication. Thin walled blebs, occurring after adjunctive use of antimetabolite like mitomycin C and 5-flurouracil, is an important risk factor for bleb-related infections.</p><p><strong>Case: </strong>Forty-five years old one-eyed male had undergone trabeculectomy in past, had presented with diminution of vision, pain, photophobia in his seeing eye.</p><p><strong>Observation: </strong>On examination, best corrected visual acuity was 5/60, thin walled avascular bleb with congested conjunctiva, minimal hypopyon, pupil had fibrinous exudate and vitreous reaction. He was diagnosed as bleb-related endophthalmitis. He improved after intra-vitreal and topical antibiotics Conclusion: Bleb-related infections can be controlled if diagnosed and treated on time.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"66-71"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Omega-3 Fatty Acid in Dry Eye Syndrome.","authors":"Leesha Shrestha Joshi, Raju Kaiti, Ranjila Shyangbo, Birkha Bogati, Sabina Nepal, Grishma Dahal","doi":"10.3126/nepjoph.v17i1.69713","DOIUrl":"https://doi.org/10.3126/nepjoph.v17i1.69713","url":null,"abstract":"<p><strong>Introduction: </strong>Dry eye syndrome (DES) is a multifactorial disease of the ocular surface. It is accompanied by increased osmolarity of tear film and inflammation of the ocular surface.</p><p><strong>Objective: </strong>To evaluate the impact of Omega-3 fatty acids in patients with DES and compare their effectiveness with topical lubricating agents in relieving subjective symptoms and improving clinical signs.</p><p><strong>Methodology: </strong>A prospective interventional study involving patients diagnosed as 'moderate' to 'severe' Dry Eye Syndrome were included by convenience sampling. The inclusion criteria were patients above 20 years who were diagnosed as dry eye in the Outpatient Department in Nepal Eye Hospital. All the samples underwent detailed comprehensive eye examination, followed by a detailed dry eye evaluation. The severity of the dry eye was assessed both objectively based on 'Schirmer's-II test' and 'Tear Film Break Up Time (TBUT)', and subjectively by Ocular Surface Disease Index (OSDI) questionnaire. Each patient was prescribed Omega-3 fatty acid for three months and were followed up after one month and three months.</p><p><strong>Result: </strong>The baseline Schirmers-II, TBUT and OSDI Score was 5.85 + 5.38 mm, 4.00 + 2.077 seconds, and 38.61 + 8.35 respectively. No significant change in the Schirmer's score was noted after the end of treatment period, but the TBUT and OSDI Score improved significantly.</p><p><strong>Conclusion: </strong>This study shows that omega-3 fatty acid has significant role in improving TBUT and subjective symptoms in patients with dry eye syndrome but has no effect on the Schirmer's test.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"30-38"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Primary Open-angle Glaucoma in a Nepali Population: Jiri Eye Study.","authors":"Archana Sharma, Manish Poudel, Pradeep Banjara, Mohan Krishna Shrestha, Suman Shumsher Thapa","doi":"10.3126/nepjoph.v17i1.67322","DOIUrl":"https://doi.org/10.3126/nepjoph.v17i1.67322","url":null,"abstract":"<p><strong>Introduction: </strong>Glaucoma is the second most common cause of blindness with primary open-angle glaucoma (POAG) as one of the leading causes.</p><p><strong>Objective: </strong>To study the ocular and systemic associated factors that lead to the development of primary open-angle glaucoma Methodology: This is population-based, analytical cross-sectional, oculo-genetic study conducted from 2015 to 2018. Among the total 2042 study participants ≥18 years of age, included using convenience sampling, 37 were diagnosed with POAG. For comparative analysis, age and gender matched controls without glaucoma were selected in a 1:4 ratio from the same population. A detailed systemic and ophthalmic history was recorded; systemic and ophthalmic examinations were carried out. Examinations also included measurement of blood pressure and body mass index. A comprehensive ophthalmic examination included measurement of visual acuity, refraction, slit lamp bio microscopy, recording of intraocular pressure, gonioscopy and dilated fundus examination. Keratometry, biometry, visual field assessment, anterior and posterior segment Optical Coherence Tomography were undertaken.</p><p><strong>Result: </strong>Prevalence of POAG among ≥30 years was 2.53%, (males 0.98%, female 0.83%). The mean IOP was 15.34 (±3.74) mmHg. Those ≥40 years had an increased risk of developing POAG. POAG was associated with increased intraocular pressure (p = 0.019), increased vertical cup disc ratio (p <0.001), retinal nerve fibre layer thinning (p <0.001), increased pattern standard deviation (p <0.001) and decreased mean deviation (p = 0.020). Other factors such as BMI, DM, HTN, family history of glaucoma, smoking, alcohol consumption, tobacco chewing, refractive error, CCT, CCR, ACD, AL, lens thickness, and iris thickness were not associated.</p><p><strong>Conclusion: </strong>Identifying the factors associated with POAG and adopting screening strategies for its early detection will prevent blindness in this population.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"11-21"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Intraocular Adipocytic Metaplasia in a Phthisical Eye.","authors":"Bidhan Chandra Das, Dipankar Das, Ganesh Chandra Kuri, Apurba Deka","doi":"10.3126/nepjoph.v7i2.14962","DOIUrl":"https://doi.org/10.3126/nepjoph.v7i2.14962","url":null,"abstract":"<p><strong>Introduction: </strong>Phthisis bulbi is an end stage ocular disease caused by injury, long term eye disease and infection. The adipocytic metaplasia within the ocular coat is a rare variety of metaplasia.</p><p><strong>Case: </strong>An 18 year-old female presented with complaints of severe dimness of vision in the right eye for last 11 years.</p><p><strong>Observation: </strong>Slit lamp examination showed total cataract, shallow anterior chamber and enophthalmos in the right eye. As the right eye was blind, enucleation with silicon ball implant was advised. Histopathological examination of the eyeball showed evidence of phthisical eye, exudative retinal detachment with extensive osseous and adipocytic metaplasia.</p><p><strong>Conclusion: </strong>Adipocytic metaplasia of retinal pigment epithelium is a very rare feature observed in intraocular pathology.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"78-81"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Following Primary Excision of Ocular Surface Squamous Neoplasia at a Tertiary Eye Care Centre in the Midwestern Region of Nepal.","authors":"Ipsa Bhandari, Jyoti Sapkota, Santosh Subedi, Arati Karakheti","doi":"10.3126/nepjoph.v17i1.81321","DOIUrl":"https://doi.org/10.3126/nepjoph.v17i1.81321","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular surface squamous neoplasia (OSSN) includes variety of tumours ranging from mild epithelial dysplasia to invasive squamous cell carcinoma. Squamous lesions of conjunctiva and cornea are important clinical entities due to potential risk of significant ocular and even systemic morbidity and mortality.</p><p><strong>Objective: </strong>To determine demographic profile, clinical presentation, histopathological features, and surgical outcomes of OSSN.</p><p><strong>Methodology: </strong>This hospital-based, retrospective, observational study was conducted from 2021 July to 2025 April after ethical approval among all consecutive patients diagnosed with biopsy-proven OSSN at Rapti Eye Hospital. Main outcomes examined included demographic profile, clinical presentation, histopathological features, and surgical results, including complications and recurrence.</p><p><strong>Result: </strong>A total of 36 eyes of 35 individuals with mean age 46.51±16.44 (range: 10-84) years were included. Male predilection (63%) was observed. Unilateral presentation was seen in 97% and bilateral involvement in one case with Xeroderma Pigmentosa. Nasal bulbar conjunctiva was involved in 25 out of 36 eyes (69.4%). All 36 eyes were treated with surgical excision followed by histopathological examination. All patients were followed up for two years. Conjunctival intraepithelial neoplasia (CIN) III was the most common finding histologically, with 11 (30.5%) patients, followed by benign lesions in 10 (27.8%) patients. Six patients had CIN II, with the lowest number of cases. Surgical margins were involved in 10 (27.8%) patients who underwent further adjuvant chemotherapy with topical Mitomycin-C (MMC). Only one (2.8%) out of 36 eyes had recurrence. Post-operative complications were seen in two (5.6%) cases. Thin sclera was observed in one case, and punctal stenosis occurred in one case that received MMC post-operatively.</p><p><strong>Conclusion: </strong>In current study, the demographic profile showed OSSN being more common in the middle age group with male predilection. The overall prognosis of surgical management of OSSN with margin clearance is fairly good, with a low recurrence rate and adverse effects.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"22-29"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Significant Milestone in Thyroid Eye Disease Research in Nepal.","authors":"Eliya Shrestha","doi":"10.3126/nepjoph.v17i1.75919","DOIUrl":"https://doi.org/10.3126/nepjoph.v17i1.75919","url":null,"abstract":"<p><p>We invite all ophthalmology centres and clinicians across Nepal to participate in this collaborative effort. Together, we can strengthen evidence-based care for TED and foster future research benefiting patients nationwide.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric Eye Care in Nepal.","authors":"Srijana Adhikari","doi":"10.3126/nepjoph.v17i1.86069","DOIUrl":"10.3126/nepjoph.v17i1.86069","url":null,"abstract":"<p><p>Visual development is an important aspect of infant and child development. Vision is a complex sensorineural process, the development of which begins soon after the birth. Healthy eyes and good vision are key components to achieve many important developmental milestones in children. Hence Paediatric eye care should be started as soon as the child is born and continue throughout childhood and adolescence. It is an important public health component as childhood blindness carries a lifetime of economical and psychosocial impact.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"1-3"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Evaluation of Corneal Endothelium and Central Corneal Thickness Before and After Cataract Surgery.","authors":"Poonam Shrestha, Neyaz Kausar Mikarani, Om Prakash Budhathoki, Santosh Paudel","doi":"10.3126/nepjoph.v17i1.67664","DOIUrl":"https://doi.org/10.3126/nepjoph.v17i1.67664","url":null,"abstract":"<p><strong>Introduction: </strong>Preservation of corneal endothelial function is a major goal in cataract surgery as it plays an important role in maintaining the corneal transparency and visual outcome. This study compared the morphological features of corneal endothelium and central corneal thickness (CCT) before and after cataract surgery.</p><p><strong>Objective: </strong>To compare the corneal endothelium morphology and central corneal thickness before and after cataract surgery.</p><p><strong>Methodology: </strong>This was hospital-based, prospective, observational study conducted at Nepal eye hospital within six months period from September 2022 to February 2023 considering inclusion and exclusion criteria before and after cataract surgery, that is Phacoemulsification. Consecutive sampling technique was utilised and ethical approval was taken. Corneal endothelial cell characteristics: endothelial cell density, coefficient of variability, percentage of hexagonality, and central corneal thickness were taken before the surgery and then first week and six weeks after cataract surgery.</p><p><strong>Result: </strong>Among the 63 patients were who underwent cataract surgery the mean age was 69.81±9.2 years with male:female ratio of 31:32. The mean CCT preoperatively, first week, and six weeks after surgery were 536.06±34.3, 536.46±41.9, and 523±37.9 respectively which suggest slight borderline statistical difference in CCT preoperatively and at six weeks. The endothelial loss at first week follow-up was 22.5% and the preoperative hexagonality was 64.83± 6.56, and at one week follow up the hexagonality decreased to 62.14± 6.99 which was statistically significant. The endothelial cell loss at six week follow up was 24.8%, polymegathism was increased and percentage of hexagonality had decreased.</p><p><strong>Conclusion: </strong>Endothelial cell alteration after surgery is important parameter for estimation the safety of surgical technique. The study concluded that there were changes in corneal endothelial morphology and central corneal thickness before and after cataract surgery.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"4-10"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Nepal Ophthalmic Society as a Professional Association.","authors":"Tejsu Malla, Sabin Sahu","doi":"10.3126/nepjoph.v17i1.82357","DOIUrl":"https://doi.org/10.3126/nepjoph.v17i1.82357","url":null,"abstract":"<p><strong>Introduction: </strong>Role of professional organisations is to set and promote standard, ultimately creating professional and personal excellence in supportive environment. Nepal Ophthalmic Society (NOS) plays crucial role in advancing ophthalmology in Nepal through education, research, and advocacy. Established in 1985 AD to promote professional development and enhance health care delivery, NOS has grown from handful of ophthalmologists, to 504 members and 50 associate members (2024 November 20).</p><p><strong>Objective: </strong>To assess perspectives of ophthalmologists on impact, activities, and role of NOS. To prepare framework for future to strengthen its organisation with happy members.</p><p><strong>Methodology: </strong>A cross-sectional survey was conducted among ophthalmologists in Nepal from 2024 May to 2024 July using structured questionnaire. The survey assessed their perspectives on NOS's impact, activities, and role in advancing ophthalmology. Data were collected through online surveys, ensuring a representative sample of practising ophthalmologists across Nepal.</p><p><strong>Result: </strong>The study included 309 ophthalmologists and residents. Majority were young (60.1% aged ≤40 years) and female (54%). Most participants (49.52%) believed primary function of NOS was professional development, followed by advocacy, and public awareness (34.73%). The mean satisfaction rating for NOS's role was 5.6 ± 1.85 out of 10. The major challenges faced by ophthalmologists in Nepal included low salary and financial difficulties (25.72%) as well as poor residency training and lack of surgical exposure (22.51%); 75.56% of respondents considered misuse of 'Doctor\" title by non-ophthalmologists a significant issue, with most suggested solutions being press releases and public awareness campaigns (63.43%), followed by notifying regulatory bodies (39.62%) Conclusion: The NOS has been significantly contributing to professional development, advocacy, and skill enhancement in Nepal. Key challenges include low salaries, inadequate surgical training, and misuse of 'Doctor\" title. Strengthening membership outreach, advocating professional rights, and addressing concerns will enhance NOS's impact and ensure its long-term sustainability in shaping Nepal's ophthalmology landscape.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"50-60"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Externalised Haptic of a Tilted Scleral-fixated Intraocular Lens: A Case Report.","authors":"Priyadarshini Parthiban, T N Ezhilvathani","doi":"10.3126/nepjoph.v17i1.69777","DOIUrl":"https://doi.org/10.3126/nepjoph.v17i1.69777","url":null,"abstract":"<p><strong>Introduction: </strong>Implantation of scleral-fixated intraocular lens (SFIOL) has become a common technique done in the recent times when there is inadequate support of the posterior capsular bag. As this technique of SFIOL implantation needs good expertise when performed, if not done properly it may result in several post-operative complications which may require a re-surgery that delays the patient's visual recovery. One such post-operative complication is haptic exposure in the post-operative period which is reported in this case report. This case report stresses on the importance of correct surgical technique and frequent post-operative follow up when SFIOL is implanted.</p><p><strong>Case: </strong>A 66-year-old female presented to OPD with complaints of diminution of vision in both eyes for the past six months following cataract surgery which was done elsewhere in some other hospital a year ago.</p><p><strong>Observation: </strong>On slit lamp examination, an externalised haptic of a tilted SFIOL was noted in the subconjunctival space of patient's left eye.</p><p><strong>Conclusion: </strong>Continuous professional development and adherence to best practice guidelines are imperative for optimising the success of SFIOL procedures.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"17 33","pages":"72-77"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}