Ischemic optic neuropathy following craniotomy.

Ischemic optic neuropathy is one of the major causes of severe impairment of vision often leading to blindness. It has varied etiopathogenesis with limited management options and very often result in poor outcome. Perioperative ischemic optic neuropathy is rare and particularly seen in elderly patients with multiple comorbidities undergoing cardiac or spine surgery. We present a case of young patient who developed ischemic optic neuropathy following craniotomy for recurrent meningioma. Keywords: Ischemic optic neuropathy; optic nerve vasculature; painless vision loss; perioperative complications; perioperative optic nerve ischemia.

Physiological Ocular Changes in Various Trimesters of Pregnancy.

INTRODUCTION: A large number of hormonal, metabolic, immunologic and haematological changes occur in all organ system of female body during pregnancy. Human eye and its function are no exception to these changes. PURPOSE: To evaluate physiological ocular changes in various trimesters of pregnancy and to compare them amongst the three trimesters. PATIENTS AND METHODS: A hospital based cross sectional study, using judgmental convenient sampling method, was done in both eyes of 120 pregnant females (40 in each trimester), with known last menstrual period, attending antenatal clinic of BPKIHS, Dharan. Women with known systemic or ocular diseases like conjunctivitis, keratitis, iridocyclitis, glaucoma, refractive error, were excluded. Demographic details of all patients were recorded and detailed ocular examination, including best corrected visual acuity, slit lamp examination, vertical and horizontal keratometry, central corneal thickness and intraocular pressure were performed and recorded. A comparison of these parameters was made amongst three trimesters. RESULTS: Visual acuity of all the subjects was 0 logMAR. Corneal curvature, both vertical and horizontal, significantly increased towards third trimester. Central corneal thickness progressively increased from first to third trimester (p= 0.019 Right eye, 0.016 Left eye). In contrary to this, intraocular pressure significantly decreased during successive stages of pregnancy (P=0.000 both eye). CONCLUSION: Significant increase in corneal curvature and central corneal thickness along with, decrease in intraocular pressure occur during successive trimesters of pregnancy. All pregnant women should have routine ocular examination; changes noted, if any, should receive attention and period of gestation should be considered prior to making a diagnosis.

Factors affecting the visual outcome of pediatric cataract surgery: a hospital based prospective study in eastern Nepal.

The World Health Organization's (WHO) global initiative for the elimination of avoidable blindness by the year 2020 (Thylefors et al., 1995) has prioritized the control of childhood blindness. Currently cataract remains one of the most important causes of treatable blindness in children (Giles et al., 2016). In Nepal, as in other developing countries, cataract is believed to be a leading cause of blindness in children. According to The Nepal Blindness Survey from 1978 to 1980, congenital cataract accounted for 16.3% of blindness detected in children under the age of 15 years (Brilliant et al., 1985). Epidemiology of Blindness in Nepal 2012 survey has suggested that the prevalence of childhood blindness has reduced from 0.68% in 1981 to 0.4% in 2011 (Sapkota, 2012).