Ocular manifestations in children with cerebral palsy.

To evaluate the prevalence of ocular abnormalities among children with cerebral palsy, 140 patients with age between 6 months and 16 years were selected and the overall incidence of ocular abnormalities in this study was 42.1%. Two major ocular abnormalities identified in these cases were strabismus in 36.4%. Myopia was detected in 12.9% children while hypermetropia in 8.6% and astigmatism in 3.6% cases. Non-glaucomatous optic atrophy was present in 10.7% cases and nystagmus in 9.3% cases. Raised intra-ocular pressure was detected in 2.1% cases. Cortical visual impairment was seen in 20.7% children. Ocular abnormalities are frequent manifestations in cerebral palsy patients. Therefore, evaluation of all cerebral palsy cases emphasises the need for a full ophthalmological examination in order to detect ocular problems and to institute necessary therapy of the abnormalities for better livelihood of these physically challenged patients.

Ocular effects of long term use of topical steroids among children and adolescents with vernal keratoconjunctivitis: a prospective observational study.

Topical steroids were often irrationally used on long term basis for quick relief from ocular discomfort of inflammatory eye conditions like vernal keratoconjunctivitis in spite of their well known deleterious ocular effects. The present study was undertaken to determine the ocular effects of long term use of topical steroids among the patients with vernal keratoconjunctivitis and also to evaluate the ocular responses after withdrawal of steroids. The prospective observational study was carried out in a tertiary eye care centre of West Bengal. A total 150 referred patients of vernal keratoconjunctivitis, those used topical steroids for more than a month were included in the study. A complete set of ophthalmic examinations including measurement of intra-ocular pressure and visual acuity was carried out during registration. After withdrawal of steroids, the patients were followed-up periodically and finally evaluated after 8 weeks for any Improvement of Intra-ocular pressure and best corrected visual acuity. The data was analysed by SPSS 12.0.1 software package. Proportions were used for Interpretation. Paired t-test was used for comparison between two proportions (before and after withdrawal of steroids) and p-value <0.05 was considered as the level of significance. Though ropy mucus discharge with minimal conjunctival involvement was found the most common (74.7%) ocular manifestation, grave consequences like glaucoma was also evident among 8.7% of the study participants. Significant improvements (p<0.05) were observed for both reduction of intra-ocular pressure and visual acuity after 8 weeks of withdrawal of topical steroids. Topical steroids should be used cautiously with periodic ophthalmic examinations including intra-ocular pressure.

Rare association of retinitis pigmentosa and Marfan's syndrome--a case report.

A 25 years old male patient presented with long stature with disproportionately long limbs and digits (arachnodactyly). Examination of cardiovascular system showed mitral regurgitation and dilatation of aortic root. Slit lamp examination showed bilateral superotemporal dislocation of lens. Ophthalmoscopy revealed waxy pallor of optic disc, arteriolar attenuation and bone-spicule like pigments in the retina. The diagnosis of retinitis pigmentosa was confirmed by electroretinogram.

Changing trends of ocular anaesthesia in phaco-emulsification surgery.

This study was undertaken prospectively to assess the safety and effectiveness of topical anaeshthesia over sub-tenon and peribulbar anaesthesia during routine phaco-emulsification surgery. One hundred and fifty eyes undergoing clear corneal phaco-emulsification were randomly divided into 3 groups. Pain was assessed subjectively by the patients during introduction of anaesthetic agent, also intra-operatively and 2 hours postoperatively on a visual analogue scale of 0 to 4 by the visual descriptive method. Ocular akinesia at the beginning and during the surgery was recorded by the operating surgeon. Any intra-operative complication was also noted at the end of the surgery. This analysis showed that topical anaesthesia caused no pain at all in 98% and sub-tenon anaesthesia caused minimum or no pain in 92% during introduction of anaesthetic agent as opposed to peribulbar (42%) and two values were also statistically significant. Sub-tenon and peribulbar anaesthesia provided significantly more intra-operative akinesia as compared to topical, the rate of intra-operative complications was comparable in all the 3 groups. So the recent trend of topical anaesthesia in phacosurgery is a safe and efficient alternative to sub-tenon and peribulbar anaesthesia.