Ophthalmology Pakistan

To assess the Quality of life in Glaucomatous Patients who Underwent Trabeculectomy versus Medical treatment patients using the Glaucoma Quality of life-15 (GQOL-15) Questionnaire.

Muhammad Asif — 2025-06-02

Objective: To assess the Quality of life in Glaucomatous Patients who Underwent Trabeculectomy versus Medical treatment patients using the Glaucoma Quality of life-15 (GQOL-15) Questionnaire.

Study Design: cross sectional observational Study

Place and duration: The study was carried out at Hayatabad medical complex Peshawar from March (2019) to June (2019).

Methods and material: Ethical approval of the study was taken from the Ethical Committee of Hayatabad Medical Complex Hospital Peshawar. Patients with an established diagnosis of Primary Open-angle glaucoma with a minimum of one or more anti-glaucoma medications or a documented history of Trabeculectomy of the previous six months with no family history of glaucoma were selected for the study. The total number of patients in each group was 32. Complete eye examination was done in each patient. Then after examination, the fifteen quisenaries were asked from each patient and was documented. The data was then organized and analyzed using SPSS version 20.

Results : out of 64 patients, 32 patients were enrolled in each group. In both the groups male patients were more then femle patients and most of the participants in both groups were aged 20-40 years. The Medicine User group had a higher prevalence of diabetes and hypertension, and a greater percentage of right-eye involvement compared to the Trabeculectomy group.The IOP (Intraocular Pressure) range of 16-27 mmHg and C/D (Cup-to-Disc) Ratio range of 0.8-1.0. There was also significant differences (P < 0.001) in visual function scores by glaucoma severity (mild, moderate, severe). As severity increased, visual impairment worsened across all variables, with peripheral vision and total scores increasing from mild to severe cases.Similar trends were also found in the Trabeculectomy group, with worsening scores for peripheral vision, glare adaptation, and total scores as severity increased (P < 0.001). Severe cases had the highest scores across all variables. While compareing the visual function between groups, the Trabeculectomy group had significantly fewer impairments in all activities, including walking, judging foot distance, and adjusting to lighting, indicating better visual function compared to the Medicine User group (P < 0.001

Conclusion: Trabeculectomy may provide better functional vision outcomes in everyday activities compared to medication alone.

The Impact of Uncorrected Presbyopia on quality of life among individuals of urban slums of Lahore

Muhammad Iqbal Javed — 2025-06-02

Purpose: To assess the impact on quality of life after presbyopia correction among the general population, and draw attention to a huge public health issue.

Methods: This cross-sectional study was conducted among people with presbyopia in the general population in 06 months. A total of 329 participants were examined and data was obtained with a simple convenient sampling technique, and the record was maintained and analyzed using SPSS Software version 21, expressed in the form of tables, graphs, and figures.

Results: This study includes of total 329 participants, 182 (55.32%) females and 147 (44.68%) males. The majority of participants were of the age of 46 -55 years old. Regarding occupation, 100(30%) housewife, 64(19%) teachers, 28(9%) tailors, 24(7%) drivers, 33(10%) workers, 24(7%) computer operators, 14(4%) retired persons, 11(3%) beauticians 22(7%), shopkeepers and 9(3%) goldsmiths. Presbyopia reported being dissatisfied with their near-vision and required assistance for near-vision impairments. Reading, writing, threading needles, and identifying small objects were the most challenging presbyopia activities. Every one of them was statistically significant (each with p ≤ 0.005).

Conclusion: Uncorrected presbyopia has a detrimental influence on patients' vision-related quality of life as it makes it harder to do near-vision-related tasks. Uncorrected presbyopia became a major influential factor of socio-economic loss among the working-age group of the population. There was a significant difference between impaired near vision and its impact on quality of life in terms of people’s occupation. It was determined that different age groups (35-45, 46-55, 56-56 and above showed different attitudes varied significantly depending on their age range: 35-45 years, 46-55 years, 56-65 years, and above.

Early Intraocular Pressure Elevation After Cataract Surgery in Healthy Eyes

Farhana Ramzan — 2025-06-02

Objective:

To determine the frequency of IOP elevation following cataract extraction in early postoperative period and its association with age and type of surgery.

Methods:

This was an observational study conducted at department of ophthalmology, MTI-Hayatabad Medical Complex, Peshawar from October 2022 to April 2024. Patients undergoing cataract surgery, age 50-80 years of either gender with no other ocular comorbidity were recruited. The frequency of elevated intraocular pressure (IOP) of > 30 mmHg within 24 hours after surgery was determined. The IOP spike was stratified according to gender, age and type of cataract surgery.

Results:

A total of 171 eyes of 171 participants were recruited in this study. Mean age of the participants was 62.92±7.78 years and 107 (62.6%) were males. The mean preoperative IOP was 14.05±4.26mmHg while the mean postoperative IOP was 15.94±5.19mmHg. Five (2.9%) participants had IOP elevation of more than 30mmHg within 24 hours of surgery. Type of surgeries performed were extracapsular cataract extraction (ECCE) in 23 (13.4%), manual small incision cataract surgery (MSICS) in 58 (33.9%) and phacoemulsification in 90 (52.6%) participants. The early postoperative IOP was significantly less in phacoemulsification 0 (0%) group as compared to MSICS (n=4, 80%) and ECCE (n=1, 20%) group (p=0.047).

Conclusion:

The frequency of IOP elevation within 24 hours of cataract surgery with IOL implantation in healthy Asian eyes was low. Older age and MSICS have more risk of postoperative IOP spikes.

Conjunctival impression cytology used as a gold standard test in evaluating the cases of Computer Vision Syndrome among young university students

Muhammad Saeed Zafar Khan — 2025-06-02

Objective: To find the correlation between clinical dry eye tests and conjunctival impression cytology examination for the assessment of computer vision syndrome in university students in Lahore.

Methodology: An analytical cross-sectional study was conducted on 225 students at the University of the Punjab. A questionnaire-based data was collected, followed by measurement of tear-film breakup time (TBUT), the number of corneal dry spots& Schirmer’s test, and conjunctival impression cytology (CIC) under topical anesthesia. Pearson correlation analysis was done on CIC score versus TBUT, Schirmer’s test, and Goblet Cell Density (GCD). Analysis of variance (ANOVA) was used to compare visual acuity, TBUT, cornea spots, and Schirmer’s test to see the significance of the results. A p-value ≤0.05 was considered statistically significant.

Results: Out of the 225 students, 63 % were females compared to 37% male students. The mean age of the students was 19 ± 3.8 years. There was a statistically significant mean difference found between the CIC score and TBUT (F=208.45p=<0.001), cornea spot (F=39.31, p=<0.001), and Schirmer’s test (F=5.83, p=0.001).

Conclusion: In addition to applying the validated questionnaire and clinical dry eye tests, Conjunctival impression cytology should be tested on larger populations for the early diagnosis and management of CVS to be proven as a gold-standard test.

Assessing Additional Spectacle Need for Intermediate Distance in Presbyopic Computer Users.

Uzma Sattar — 2025-06-02

Introduction: Evaluate intermediate add necessity and unaddressed visual issues in presbyopic computer users using bifocals.

Methods: It was an institutional based study using structured Proforma containing questions to evaluate the need of intermediate correction (add). 50 presbyopic computer users using bifocal glasses were included in this study. They were asked to fill the proforma / questionnaire to document the problems experienced during computer work with bifocals.

Results: Out of 50 presbyopic computer users with bifocals, 90% were males and 10% were females. 76% had computer vision syndrome ². About 64% had complaint of blurred vision, 56% had complaint of headache, 76% had eyestrain, 70% had neck, shoulder, back pain, 44% were complaining of dry, tired and sore eyes, 36% complained of blurry distance vision after computer work. 58% get help through squinting, 8% had diplopia, 20% experienced problem in driving and night vision after computer work, 26% had complaint of overlapping of letters on screen and 70% interrupt their work for eye rest. 70% presbyopic computer users had hypermetropia, 10% were suffering in myopia and 20% were astigmatic. 94% presbyopic computer users used near correction for their computer work and 6% used distance correction. Most of them were using near correction to monitor the vision between 21-25 inches (near) and 31-35 (intermediate) inches.

60% computer users had illumination of room same as computer screen, 8% had brighter than screen, 32% had dimmer than screen. 20% patients had knowledge about intermediate correction (add) and 80% were unaware of it.

Conclusion: The results showed that 76% of the presbyopic computer users wearing bifocal glasses were experiencing computer vision syndrome type 2 and needed adjustments for intermediate distances.

Research practices among undergraduate and postgraduate students in Pakistan

Ammara Rasheed — 2025-06-02

In the dynamic field of ophthalmology, research is the lifeline that propels innovation, as seen in the case of cataract surgery. It was Sir Harold Ridley, who in 1949 in London first put an intraocular 1implant with a large corneal incision. Advanced research refined the techniques from pioneering minimally invasive surgeries like phacoemulsification with foldable intraocular implants to developing sight-saving therapies. In third-world countries, like Pakistan, despite the increasing complexity of ophthalmic care, research engagement among undergraduate and post graduate medical students remain sunder-focused.

Among undergraduates, exposure to ophthalmic research is often superficial, restricted to data collection and writing case reports to fulfill the university criteria for examination. For postgraduate ophthalmology trainees, though mandated to undertake a dissertation, frequently approach research as a bureaucratic requirement rather than a true scholarly pursuit. Recently, the College of Physicians and Surgeons, in a circular, had allowed the PG trainees to write an original research paper inascientific journal dually recognized by CPSP and PMDC. This trend has opened new opportunities for the future pipeline of clinician-scientists in our specialty.