Is Jain

Ocular hazards during birth.

In a study of over 2,000 consecutive live births, 243 newborns (12%) suffered birth trauma to the eye and its adnexa. Two hundred twenty-one cases (11%) had multiple retinal hemorrhages. Severe ocular accidents by forceps delivery were seen in the form of hyphema, Purtschers retinopathy, corneal edema, facial palsy, and corneal abscess. Purtschers retinopathy and corneal abscess are rare birth injuries that have not been reported so far in newborn babies.

Congenital Cataract: Etiology and Morphology

In a study of congenital cataract in northern India, 76 patients (146 eyes) were evaluated for morphological patterns and etiology. Partial cataracts were found to be three times more common than total cataracts, the lamellar types being the most common among the partial cataracts. Hereditary cataracts had a 19.7% incidence. The majority (46.05%) of cases of congenital cataract were of idiopathic origin. A few cases were associated with metabolic disorders (Marfans and Marchands). Strabismus and nystagmus were the most common associated ocular abnormalities (28.94% and 15.79%), and mental retardation was the most commonly associated systemic abnormality. Rubella cataract was seen far less frequently than expected.

Unilateral traumatic aphakia in children: role of corneal contact lenses.

Twenty-eight children below ten years of age with unilateral traumatic aphakia were fitted with hard corneal contact lenses. Visual acuity of 6/12 or better was achieved in 68% of the cases. Patients who were above seven years of age at the time of injury, and those fitted with contact lenses within eight months of trauma, were found to have better chances of recovering normal binocular functions.

Congenital Cataract: Management and Results

The visual outcome in cases of congenital cataract, managed both surgically and conservatively, is outlined. Final vision was better in cases with partial cataract, about 40% of whom attained 6/24 or better vision. With total cataracts, none could achieve this level of vision, with the majority (84%) attaining only 6/60 or less acuity. Visual results were also better in patients without nystagmus, 34% of whom attained 6/24 or better vision, while in cases with nystagmus, only 15% could come up to this level. Cataracts necessitating early surgery had a worse prognosis than cataracts necessitating late surgery. Visual results were best in cases with bilateral cataracts, partial cataracts, absence of associated ocular anomalies, the absence of nystagmus and in patients requiring later surgery. The important causes of nonimprovement of vision were amblyopia and after-cataract. Retinal detachment, retinopathy, and degenerative myopia were some of the less frequent causes of poor vision, while mental retardation was another important factor. Full cooperation from the parents is absolutely essential in the proper visual rehabilitation of the handicapped child.

Early onset of presbyopia.

Of the 800 presbyopes studied, 286 (35.75%) entered presbyopia at or before the age of 38 years. About 63% of these patients lived in rural areas and 37% in urban areas. Environmental conditions including high average temperature, much ultraviolet radiation, chronic deficiency of essential amino acids, and exposure to toxic factors, particularly hair dye, may play a significant role in precipitating the early onset of presbyopia.

Congenital Ocular Abnormalities of the New Born

No information is available in the literature about the true incidence of congenital ocular abnormalities and associated systemic abnormalities in an Indian population. Initial results based on the first year of this study are presented. Out of 2,153 children born from January 1978 to December 1978, 2,016 were examined for any congenital ocular or systemic abnormality. The incidence of congenital ocular and systemic abnormalities was 10.5/1000 and 20/1000 live births respectively. Four out of 21 congenital ocular abnormalities were associated with congenital systemic abnormalities. Individual abnormalities are discussed in brief.

Steroid addction: a complication of use and abuse of steroids in herpes simplex keratitis.

Herpes simplex virus (HSV) is said to be the most frequent cause of corneal blindness in western countries.(Duke-Elder S, 1965). In our country not much attention has been paid to HSV keratitis due to widely prevalent malnutrition, trachoma and other external ocular diseases. With the changing socioeconomic conditions, a change in the pattern of corneal blindness is emerging in our part of the country. HSV keratitis now accounts for more than 50% of all corneal affections (un-published data) and 0.57% of all ophthalmic out patients. (Chakraborty, G.S. et al., 1979). Many of these patients are first seen by general practitioners and exposed to topical or systemic steroids. It is well established that unjudicious use of steroids in HSV keratitis may lead to severe ocular complications. (Thygeson,1977). In this study we have outlined various indications and complications of use and abuse of steroids in HSV keratitis.