Nepalese Journal of Ophthalmology最新文献

{"title":"Demographic and Aetiological Outline of Patients Requiring Low Vision Aids in a Tertiary Care Hospital in Rural Eastern India.","authors":"Indranil Saha, Anubhav Singh","doi":"10.3126/nepjoph.v16i2.63654","DOIUrl":"https://doi.org/10.3126/nepjoph.v16i2.63654","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with low vision and functional blindness have been increasing. Low vision aids (LVA) are devices or tools that help individuals with visual impairments to enhance their existing vision and maintain physical independence. Understanding demographic profile is crucial to tailor interventions and services to meet their specific needs.</p><p><strong>Objective: </strong>To assess demographic and aetiological profile of patients attending low vision clinic at a tertiary grade teaching eye hospital.</p><p><strong>Methodology: </strong>This retrospective, non-interventional study was conducted in a tertiary grade teaching eye hospital. All patients (census) attending LVA clinic between 2022 April 12 and 2023 April 12 were included. Patient data were collected through evaluation of registered patient records after institutional ethical committee approval.</p><p><strong>Result: </strong>Majority of LVA clinic patients were males (64.77%), with ages from 11-20 years (25.15%). Posterior segment pathologies (87.42%) were more common than anterior (12.57%). The overall common causes of low vision were: retinitis pigmentosa (10.06%), retinochoroidal coloboma (7.54%), macular scar (5.66%). In males, posterior segment involvement was 86.40%; retinal causes 82.02% and optic nerve: 17.97%; common vitreoretinal causes were retinochoroidal coloboma (20.54%), macular scar (12.32%), retinitis pigmentosa (12.32%); common optic nerve causes were primary optic atrophy (12.5%), secondary optic atrophy (87.5%); and common corneal causes: microphthalmos (42.85%), leucomatous corneal opacity (7.14%), anterior staphyloma (7.14%). In females, posterior segment involvement was seen in 83.92%, retinal causes 80.85%, optic nerve 19.14%; the common vitreoretinal causes were retinitis pigmentosa (26.31%), macular scar (13.15%), HMD (10.52%); common optic nerve causes were primary optic atrophy (33.33%), secondary optic atrophy (66.66%), and common corneal causes: Leucomatous corneal opacity (33.3%), microphthalmos (22.2%), microcornea (22.2%).</p><p><strong>Conclusion: </strong>The LVAs are essential tools to provide functional vision to those with severely compromised vision. Better awareness and understanding of this visual rehabilitation are vital to individualise treatment for such patients to help enhance quality of life.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 32","pages":"32-39"},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207971","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":"Schwannoma of the Caruncle.","authors":"Khushdeep Abhaypal, Manpreet Singh, Manu Saini, Kirti Gupta, Rajneesh Dhiman, Pankaj Gupta","doi":"10.3126/nepjoph.v16i2.59457","DOIUrl":"https://doi.org/10.3126/nepjoph.v16i2.59457","url":null,"abstract":"<p><strong>Introduction: </strong>Schwannomas, typically benign, encapsulated tumours arising from peripheral nerve sheaths, are commonly found in the orbit but are exceptionally rare in the caruncle. Here, a unique case of caruncular schwannoma is reported in an adolescent male who presented with gradual, painless swelling over a two-year period. This rarity emphasises the need to consider schwannomas in the differential diagnosis of caruncular masses.</p><p><strong>Case: </strong>An 18-year-old male presented with a two-year history of progressively enlarging swelling adjacent to the right lacrimal caruncle, without associated symptoms or trauma. The mass was completely excised under local anaesthesia.</p><p><strong>Observation: </strong>Histopathological analysis revealed a well-defined tumour consisting of spindle cells. Immunohistochemical staining for S-100 was strongly positive, confirming the diagnosis of schwannoma. This case is the first documented instance of caruncular schwannoma in a young individual, contributing to the limited understanding of this condition.</p><p><strong>Conclusion: </strong>This case highlights a rare presentation of caruncular schwannoma in an adolescent male, marked by a painless, progressively enlarging mass adjacent to the right lacrimal caruncle over a two-year period. Complete excision under local anaesthesia allowed for histopathological confirmation of schwannoma, with immunohistochemical positivity for S-100. Post-operative healing was uneventful, providing an excellent cosmetic result with no recurrence observed at the two-year follow-up.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 32","pages":"74-80"},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207928","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":"Knowledge and Attitude of Refractive Error Correction Methods in Patients Visiting Eye Hospital.","authors":"Anup Subedi, Gyan Bahadur Basnet, Nabin Baral, Anil Parajuli, Umesh Belbase","doi":"10.3126/nepjoph.v16i2.64632","DOIUrl":"https://doi.org/10.3126/nepjoph.v16i2.64632","url":null,"abstract":"<p><strong>Introduction: </strong>There are different types of refractive error correction methods that are either appropriate or appealing to all patients. Although spectacles appear to be the most common method of visual correction, there is no single method preferred for correction that is accepted by all patients. Knowledge and attitude towards methods of correction may influence the preferred method of correction.</p><p><strong>Objective: </strong>To determine the knowledge and attitude of patients towards refractive error correction methods.</p><p><strong>Methodology: </strong>This analytical cross-sectional study included 150 subjects aged ≥18 years who visited the refraction unit of Himalaya Eye Hospital. They were randomly interviewed using structured questionnaires which consisted of open- and closed-ended questions to gather information on demography, knowledge, and attitude towards different eye care practitioners as well as spectacles, contact lens, and refractive surgery for correcting refractive error and analysed using descriptive statistics for frequency and Chi-square test for analysing association between variables.</p><p><strong>Result: </strong>Out of 150 participants, Majority of the participants had history of ocular examination. Only 67 (44.7%) participants had history of using spectacles, whereas 33 (22%) participants knew about the contact lens and 21 (14%) participants were aware about the refractive surgery as a method of refractive correction. Lack of information and fear of side effects were the major reasons for not using contact lens and refractive surgery as a method of refractive error correction.</p><p><strong>Conclusion: </strong>The knowledge and perception about the refractive error correction methods, especially for contact lens and refractive surgery, was low among the participants.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 32","pages":"49-55"},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207965","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":"Chronic Post-operative Endophthalmitis caused by Acinetobacter Baumannii.","authors":"Punita Kumari Sodhi, Ayush Arya, Prabhav Aggarwal, Sonal Saxena","doi":"10.3126/nepjoph.v16i2.69137","DOIUrl":"https://doi.org/10.3126/nepjoph.v16i2.69137","url":null,"abstract":"<p><strong>Introduction: </strong>Endophthalmitis caused by Acinetobacter baumannii (A. baumannii) has been rarely reported in literature.</p><p><strong>Case: </strong>A case of chronic post-operative endophthalmitis (CPE) from A. baumannii is reported here. A 50-year-old hypertensive male did not gain good vision following implantation of a three-piece +20.0 diopter intraocular lens (IOL) in his left eye (LE). Five months later, he was referred to retina services with gross diminution of vision and whiteness of the cornea. An ultrasound B scan was done to assess the posterior segment. The pars plana vitrectomy could not be done due to corneal opacity. The specimen obtained from the anterior segment wash was sent for culture and sensitivity.</p><p><strong>Observation: </strong>The left eye (LE) had perception of light with an inaccurate projection of rays in all quadrants. On slit lamp examination, the cornea showed oedema, Descemet's membrane folds, peripheral vascularisation and a blood-stained endothelium. The intraocular pressure (IOP), keratometry and axial length were 12 mmHg, 41.5 x 45.75 and 22.25 mm respectively. The ultrasound B scan showed a well-defined vitreous opacity with moderate to high echoes in the posterior segment pointing towards vitritis with IOL and cortical lens matter drop. There was choroidal detachment (CD) in one quadrant. The anterior segment specimen grew colonies of A. baumannii sensitive to co-trimoxazole, minocycline, and levofloxacin. Oral levofloxacin 750 mg once a day for ten days was prescribed, but his ocular condition did not improve. The IOP reduced to 8 mmHg, and a repeat ultrasound showed serous CD in two quadrants. Even with systemic steroids, inflammation did not resolve fully and LE had only perception of light one month later.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 32","pages":"94-99"},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207974","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":"One Hundred Eighty-Three Days in Office.","authors":"Tejsu Singh Malla","doi":"10.3126/nepjoph.v16i2.82358","DOIUrl":"https://doi.org/10.3126/nepjoph.v16i2.82358","url":null,"abstract":"<p><p>During the one hundred eighty-three days in office (From 30th November 2024 to 31st May 2025), NOS has remained committed to advancing eye health, professional development, and institutional collaboration. Key activities undertaken during this period include: Institutional development Policy and advocacy Academic and Continuing Medical Education. Public health initiatives Professional collaboration Recognition Future activities.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 32","pages":"100-104"},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208055","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 Spectrum of Anterior Scleritis at a Tertiary Eye Care Centre of Western India.","authors":"Pradnya Krishnakant Bhole, Kshiti Gandhi, Dipali Parmar, Resham Khatri","doi":"10.3126/nepjoph.v16i2.66361","DOIUrl":"https://doi.org/10.3126/nepjoph.v16i2.66361","url":null,"abstract":"<p><strong>Introduction: </strong>Anterior scleritis can be the first sign of an underlying life-threatening systemic disease, can be lethally blinding and its management can be challenging. Thus, it is important to study the clinical spectrum of the disease to aid in early diagnosis and timely management.</p><p><strong>Objective: </strong>To evaluate the clinical spectrum of anterior scleritis (AS) at a tertiary care centre of Western India and to study the importance of its systemic association.</p><p><strong>Methodology: </strong>This analytical cross-sectional (prospective) study was carried out at a tertiary eye care centre of Western India between 2021 February to 2023 January after institutional ethical clearance. A total of 45 eyes of 37 patients were included in the study using convenience sampling.</p><p><strong>Result: </strong>The mean age of presentation was 43.41 ± 14.20 years. The mean follow-up duration was 6.00 ± 5.92 months. Bilateral AS occurred in 21.6% patients and was found to be more common in females (75%). The most common subtype of AS was non-necrotising AS in 35/37 (94.6%) patients. Non-necrotising diffuse AS was more common in females (p=0.047). Systemic association was present in 11/37 (29.73%) patients and rheumatoid arthritis (RA) was the most common systemic condition. Methotrexate was the most common immunosuppressive used in 18.91% patients. The mean time period for recurrence of AS was 3.53 ± 1.35 months. Recurrence was seen in 40.5% patients and was more common in patients with diffuse AS and patients with RA.</p><p><strong>Conclusion: </strong>The RA is an important cause of AS in India and knowledge of the systemic association of AS may enable early diagnosis and timely management of the condition to decrease morbidity and mortality.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 32","pages":"22-31"},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208058","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":"Barriers of Retinopathy of Prematurity Care in Nepal.","authors":"Eli Pradhan, Priya Bajgain, Manisha Shrestha, Aeesha Nj Mallik","doi":"10.3126/nepjoph.v16i1.76994","DOIUrl":"10.3126/nepjoph.v16i1.76994","url":null,"abstract":"","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 31","pages":"1-4"},"PeriodicalIF":0.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718875","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":"Scleral Necrosis in a Case of Seasonal Hyperacute Panuveitis Successfully Treated with Amniotic Membrane Graft: A Case Report.","authors":"Eliya Shrestha, Hara Maya Gurung, Babita Gurung, Hari Bikram Adhikari, Krishna Gurung, Anju Gurung","doi":"10.3126/nepjoph.v16i1.59410","DOIUrl":"10.3126/nepjoph.v16i1.59410","url":null,"abstract":"<p><strong>Introduction: </strong>Seasonal hyperacute panuveitis (SHAPU) is still a dilemma in the field of ophthalmology. Every alternate odd year from September until January, children usually present with unilateral painless red eyes if not treated in a timely manner, rapidly progressing to phthisis bulbi.</p><p><strong>Case: </strong>Case was also diagnosed as a case of seasonal hyperacute panuveitis.</p><p><strong>Observations: </strong>However, during the treatment, the patient developed spontaneous scleral necrosis, which has not been reported to date.</p><p><strong>Conclusion: </strong>Seasonal hyperacute panuveitis may have different clinical presentation, therefore cases of seasonal hyperacute panuveitis should be monitored and evaluated properly before initiating treatment.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 31","pages":"94-97"},"PeriodicalIF":0.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718858","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":"Pituitary Macroadenoma with Apoplexy, a Mimicker of Normal Tension Glaucoma (NTG): A Case Report.","authors":"Thinley, Keepa Vaidya, Sandip Tamang","doi":"10.3126/nepjoph.v16i1.60134","DOIUrl":"10.3126/nepjoph.v16i1.60134","url":null,"abstract":"<p><strong>Background: </strong>Asymmetric visual field defects with a high cup-to-disc ratio resembling glaucomatous damage can be the only clinical features of a pituitary macroadenoma with apoplexy, posing diagnostic challenges.</p><p><strong>Case: </strong>A 39-year-old man presented with a history of gradual onset, progressive visual obscuration in the right visual field for one month without any other accompanying neurological symptoms. On examination, his intraocular pressure (IOP) was 16 mmHg in both eyes. Posterior segment examination revealed a cup to-disc ratio (CDR) of 0.8 in the right and 0.7 in the left eye, with concentric neuroretinal rim thinning and mild temporal disc pallor. These findings led to the diagnosis and treatment of normal tension glaucoma (NTG) elsewhere. Visual field examination showed field defects featuring a junctional scotoma. The MRI scan of the brain revealed a well-defined mass lesion situated in the sella suggestive of pituitary macroadenoma with possible apoplexy confirmed later through histopathological examination. The neurosurgery team successfully removed the tumor through the endoscopic endonasal trans-sphenoidal approach and the patient reported significant improvement in vision and visual field defects.</p><p><strong>Observations: </strong>In our case, visual signs and symptoms were the only presenting features, caused by pituitary macroadenoma with apoplexy, which can be a potentially life-threatening condition. Although pituitary apoplexy is an acute condition with numerous neurological signs and symptoms, visual symptoms with high CDR and neuroretinal rim thinning with mild temporal disc pallor were the only features seen in our case, posing a diagnostic challenge. There were no associated systemic manifestations. However, the patient had a favorable outcome because of prompt diagnosis and multidisciplinary management.</p><p><strong>Conclusion: </strong>The spectrum of clinical manifestations of pituitary macroadenoma with apoplexy should encompass a gradual onset, progressive asymmetric visual field defect with temporal disc pallor to facilitate timely diagnosis and effective management.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 31","pages":"80-86"},"PeriodicalIF":0.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718856","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":"Recurrence and Satisfaction in Patients after Pterygium Surgery in Tertiary Eye Hospital in Bhaktapur, Nepal.","authors":"Samata Sharma, Deepak Khadka, Arjun Shrestha, Nirsara Shrestha, Barsha Suwal, Bijay Khatri","doi":"10.3126/nepjoph.v16i1.59388","DOIUrl":"10.3126/nepjoph.v16i1.59388","url":null,"abstract":"<p><strong>Introduction: </strong>Pterygium is a common and benign condition that warrants surgical removal for ocular and cosmetic reasons. Pterygium excision with conjunctival autograft is frequently performed surgery in Nepal.</p><p><strong>Objective: </strong>This study is aimed to find out the recurrence and satisfaction following surgery.</p><p><strong>Methodology: </strong>This was a descriptive cross-sectional study conducted from August to October 2021 at a tertiary hospital in Bhaktapur. All the patients who had undergone pterygium surgery with conjunctival autograft surgery for primary pterygium from January 2018 to December 2019 and completed at least 6 months of follow-up were included. We reviewed records for surgery, complications, and recurrence from Medical Records. We also interviewed patients by phone for satisfaction related to symptomatic and cosmetic relief. The descriptive statistics were reported as frequency, mean, and standard deviation. The satisfaction score was measured on a 5-point Likert scale.</p><p><strong>Result: </strong>Among 142 patients, the mean age was 46.70±11.25 years, and 28.17% were males. 7.74% had complications and graft edema was the most common. The recurrence rate after surgery was 5.63%. The recurrence was higher among males and under 40 years patients. More than one-third of the patients reported they had surgery for symptomatic relief. The study showed high satisfaction scores for both symptomatic relief and cosmetic appearance, with scores of 3.62±0.93 and 3.87±0.96, respectively, on a 5-point Likert scale.</p><p><strong>Conclusion: </strong>Pterygium surgery with conjunctival autograft is safe surgery with minimal complications. Along with symptomatic relief, cosmetic satisfaction can be considered a measure of successful surgical outcome in pterygium surgery.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"16 31","pages":"53-61"},"PeriodicalIF":0.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718857","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}