Pakistan Journal of Ophthalmology

Commentary on “A Study of Visual Function Quality Along with Static and Dynamic Visual Acuity in Commercial Bus Drivers of Chandigarh, Mohali, and Panchkula”

2025-10-08T14:29:24+00:00

I read with great interest the article by Sharma et al, investigating static and dynamic visual acuity (SVA and DVA) among professional bus drivers in the Tricity region of India.¹ The study adds valuable insight into occupational vision health, yet some gaps and methodological limitations merit discussion.

First, while the cross-sectional design provides a snapshot of visual skills, it does not establish causal relationships between visual functions and driving performance. A longitudinal or interventional design could more effectively assess whether deficits in DVA or contrast sensitivity directly contribute to increased accident risk, as highlighted in previous systematic reviews linking vision impairment with crash likelihood

Determination and Comparison of Corneal Endothelial Cell Changes in Phakic and Pseudophakic Patients Undergoing Vitrectomy with Silicone Oil Tamponade

2025-09-25T08:05:49+00:00

Purpose: To determine and compare corneal endothelial cell changes between phakic and pseudophakic patients undergoing vitrectomy with silicone oil tamponade.

Study Design: Quasi experimental study.

Place and Duration of Study: Retina Eye Clinic, POB Eye Hospital,

Methods: Fifty-six patients aged 18 to 65 years undergoing pars plana vitrectomy (PPV) with silicone oil tamponade were included. They were divided into phakic and pseudophakic groups. Pars Plana Vitrectomy was done with 1000 centistoke silicone oil. Endothelial cell density (ECD) was measured using specular microscopy preoperatively and postoperatively on day 1, at 1 month, and at 3 months.

Results: The mean preoperative ECD was 2554.20 ± 127.36 cells/mm². On postoperative day 1, it decreased to 2495.25 ± 134.41 cells/mm², further declining to 2422.16 ± 141.22 cells/mm² at 1 month, and 2334.11 ± 152.09 cells/mm² at 3 months. Repeated measures ANOVA indicated a statistically significant effect of time on ECD (F (3,52) =1083.86, p<0.001), as well as a significant interaction between time and lens status (F (3,52) =61.23, p<0.001). Pseudophakic eyes exhibited a greater degree of endothelial cell loss compared to phakic eyes. Stratified analysis showed that age significantly influenced ECD loss, with older pseudophakic patients experiencing greater damage. Gender did not significantly modify the trend.

Conclusion: Pseudophakia is associated with greater endothelial damage. This highlights the importance of lens status in surgical planning and postoperative management, particularly in elderly patients.

Adjuvant Mitomycin C with an Alternative Cycle Strategy after surgical Excision in Conjunctival Melanoma: A Case Report

2025-10-14T13:59:21+00:00

Melanoma of conjunctiva is arare but aggressive malignancy that has a high probability of recurrence. Topical Mitomycin C (MMC) is being used more commonly as an adjuvant. Our report presents a female patient with a temporal, bulbar conjunctival pigmented mass. Malignant melanoma was confirmed by excision with amniotic membrane transplantation and adjunctive cryotherapy. Although there was initial recovery, recurrence occurred within three months. Adjuvant MMC 0.04% was started in four intermittent cycles and each cycle was four days with a weekly pause. The regimen was also tolerated and only mild ocular irritation was present. Six months follow-up showed that the lesion was partially regressed with visual acuity remaining normal. The present case demonstrates that adjuvant MMC using another cycle regimen is a possible and effective alternative to recurrent conjunctival melanoma.

Varied Ocular Manifestations of Wernicke Encephalopathy: A Case Report and Literature Review

2025-08-04T06:52:53+00:00

Wernicke encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine deficiency. Though the classical triad of confusion, ataxia, and ophthalmoplegia is well-known, ocular presentations may be subtle or atypical.We report the case of a 49-year-old male admitted to the intensive care unit following an intra-abdominal leak post-Whipple procedure. He received total parenteral nutrition (TPN) for prolonged fasting. After a month, he developed bilateral visual blurring without pain or redness. Examination revealed horizontal gaze-evoked nystagmus, bilateral optic disc swelling, and peripapillary haemorrhages. Brain CT was normal, but neurological signs including ataxia and confusion emerged, prompting a clinical diagnosis of Wernicke encephalopathy. He received high-dose intravenous thiamine with subsequent improvement in vision and resolution of optic disc findings.Blurred vision may be an early ocular manifestation of Wernicke encephalopathy. This case highlights the need for high clinical suspicion and prompt thiamine supplementation in at-risk patients, even without full-blown encephalopathy.

Multistage Surgical Correction of Monocular Elevation Deficit with Large Angle Exotropia in a Pediatric Patient: A Case Report

2025-10-14T13:56:00+00:00

Monocular elevation deficit (MED) is characterized by restricted upward gaze, often associated with hypotropia and horizontal deviation. We report the case of a young patient with right eye MED and large-angle exotropia. A negative forced duction test ruled out mechanical restriction. Surgical management was performed in three steps;partial Knapp operation combined with horizontal rectus recession and plication in the RE, followed by inferior rectus recession in the RE and horizontal rectus surgery in the contralateral eye, and finally ptosis correction. A multistage approach provided precise correction of ocular alignment and improved cosmesis. This case highlights the value of individualized, stepwise surgical planning for complex strabismus associated with MED and large horizontal deviations. Follow-up continued for 6 months after the final procedure, during which ocular alignment and eyelid position remained stable.

Sustained Visual Field Recovery Following Autologous Stem Cells and Exosomes Based Therapy in Recurrent Optic Neuritis – A Case Report

2025-11-21T11:41:25+00:00

A 40-year-old male had recurrent episodes of optic neuritis. Best-corrected visual acuity was evaluated and Humphrey Visual Field analysis was done before and after treatment. Treatment consisted of three weekly cycles of intravenous platelet-rich plasma combined with exosomes, followed one week later by bilateral posterior sub-tenon, retrobulbar, and intravenous injections of blood-derived mononuclear cells.At 3 months of follow-up, Humphrey visual fields showed significant improvement. The patient reported subjective improvement in visual acuity. No further relapses occurred, and no steroid or other systemic therapy was required during the follow-up period.The combined approach of using autologous PRP, exosomes, and hematopoietic stem cell therapy may cause sustained visual field recovery in recurrent optic neuritis refractory to corticosteroids.

The Evolving Landscape of Glaucoma: History, Fellowship Training, and National Priorities for Pakistan

2025-12-13T13:48:19+00:00

Glaucoma is a leading cause of irreversible blindness globally, hence aptly coined as the “black hole of blindness” by Parihar.¹ The origin of the word ‘glaucoma’ is from the Greek work ‘glaukos’ that signifies a greenish to grey discoloration of the pupillary area. In the Hippocratic age, ‘glaukos’ generally referred to a diseased eye with opacities in the media with no comprehension regarding the pathophysiological mechanisms.²

Omega-3 Supplementation Decreases Malondialdehyde, Vascular Endothelial Growth Factor Expression, Tumor Necrosis Factor Alpha, and Vascular Tuft in Oxygen-Induced Retinopathy

2025-11-10T06:34:21+00:00

Purpose: To determine whether omega-3 supplementation can reduce malondialdehyde (MDA) levels, vascular endothelial growth factor (VEGF) expression, tumor necrosis factor-alpha (TNF-α) expression, and vascular tuft formation in oxygen-induced retinopathy (OIR) mouse models.

Study Design: Controlled laboratory experimental study.

Place and Duration of Study: Animal Laboratory Unit (ALU), Faculty of Medicine, Udayana University, from

Methods: Thirty-six male Sprague Dawley rats, aged one week and weighing 10–12 g were included. Rats were exposed to 75 ± 5% oxygen from postnatal day 7 (P7) to P12 in a sealed oxygen chamber to induce vaso-obliteration. They were then returned to room air (20% oxygen) from P13 to P17 to allow hypoxia-driven pathological neovascularization. After that, rats were randomly assigned to either the treatment or control group. The treatment group received omega-3 fatty acids at a dose of 0.4 mg/g body weight, administered once daily via nasogastric tube from P13 to P17. Control animals did not receive supplementation and were maintained on standard laboratory diet.Retinas allocated for histological assessment were processed for immunohistochemical evaluation of VEGF, TNF-α, and vascular tuft formation.

Results: There was a statistically significant reduction in MDA levels, VEGF expression and TNF-α in the treatment group receiving omega-3 supplementation. The number of vascular tufts was notably lower following omega-3 administration, implying its potential to inhibit pathological angiogenesis.

Conclusion: Omega-3 unsaturated fatty acids exhibit antioxidant, anti-inflammatory, and anti-angiogenic properties that help suppress pathological neovascularization in oxygen-induced retinopathy (OIR).

Effectiveness of Simulator-Based Training for Cataract Surgery in Postgraduate Ophthalmology Residents

2025-09-20T08:16:16+00:00

Purpose: To compare the impact of virtual reality–based cataract surgery training versus conventional patient-based training on surgical performance, confidence, and self-efficacy among postgraduate residents.

Study Design: Quasi experimental study.

Place and Duration of Study: A multicentered study conducted from October 2023 to March 2024.

Methods: Thirty-two second-year FCPS trainees were enrolled and divided equally into two groups. The simulator-trained group practiced cataract surgical steps on a virtual reality simulator and progressed to real patients only after achieving ≥60% accuracy in each step. The conventional group received traditional training through the master-apprenticeship model, starting surgical steps on cataract patientsunder supervision. Both groups were later assessed while performing cataract surgery under consultant supervision using a structured proforma.

Results: Simulator-trained trainees performed significantly better in basic steps such as incision and paracentesis, viscoelastic injection, and initiation of Capsulorhexis (p = 0.028, 0.042, and 0.050, respectively). No statistically significant difference was observed in more advanced steps, including Capsulorhexis completion
(p = 0.11), hydro-dissection (p = 0.60), phacoemulsification (p= 0.57–0.72), nucleus manipulation (p = 0.68), cortex removal (p = 0.81), intraocular lens placement (p = 0.48), and wound closure (p = 0.27). Simulator-based trainees outperformed in 3 of 13 steps, while differences in the remaining steps were not significant.

Conclusion: Simulator training improves basic cataract skills but not advanced maneuvers; it is a useful adjunct for early skill acquisition.

Astigmatism in Iraqi Clinical Setting: Distribution and Axis Patterns

2025-09-11T06:29:49+00:00

Purpose: To investigate the astigmatism distribution and axis patterns among Iraqi patients and explore its associations with age and gender.

Study Design: Cross-sectional observational study.

Place and Duration of Study: College of Medicine, University of Fallujah, Iraqfrom January to March 2024.

Methods: A total of 112 patients (224 eyes) with astigmatism were included. Data included visual acuity, auto refraction, and astigmatism axis. Astigmatism was classified by magnitude and axis orientation. Statistical analysis was done using Chi-square test and Pearson's correlation test was used to assess association with age and gender.

Results: Mild astigmatism was the most common (87.5%), followed by moderate (8.5%) and severe astigmatism(4%). With-the-rule (WTR) astigmatism was the predominant axis pattern (54.9%), with against-the-rule (ATR) and oblique astigmatism accounting for 39.3% and 5.8%, respectively. WTR astigmatism occurred more frequently in younger individuals, whereas ATR predominated in older patients (p < 0.001). There was no significant association between axis type and gender (p = 0.992). Visual acuity improved in most cases after refractive correction,with 87.9% achieving normal vision.

Conclusion: WTR astigmatism is more common in younger individuals, whereas ATR astigmatism becomes more prevalent with age. These findings highlight age-related changes in astigmatism patterns and provide valuable local data to guide refractive correction in Iraq.

Comparison of Corneal and Anterior Chamber Parameters between Myopic Eyes and the LASIK – Treated Eyes Using Pentacam

2025-09-03T09:52:48+00:00

Purpose: To compare the Corneal and Anterior Chamber Parameters between Myopic Eyes and the LASIK-treated eyes Using Pentacam

Study Design: Cross sectional observational study

Place and duration of study: Department of Optometry, College of Applied Medical Sciences, Qassim University from January 2024 to May 2024.

Methods: The study included 173 patients, 83 individuals with low to moderate myopia and 90 post-LASIK patients. Corneal and anterior chamber measurements were taken using Pentacam, including central corneal thickness, anterior and posterior corneal surface power, anterior chamber depth, angle, and volume.

Results: The mean spherical equivalent was -2.01 ± 1.02 D in myopic eyes and -0.51 ± 0.41 D in post-LASIK eyes (P = 0.000). Central and thinnest corneal thicknesses were significantly reduced in the post-LASIK group (P = 0.000). Uncorrected visual acuity in post-LASIK eyes (mean 1.03 ± 0.15) was comparable to the best-corrected visual acuity in myopic eyes (P = 0.098). A significant decrease in anterior corneal surface power was noted post-LASIK, while posterior corneal power remained stable. Anterior chamber depth and volume showed modest but significant reductions, with no significant difference in anterior chamber angle between the groups.

Conclusion: LASIK leads to significant thinning of the cornea and reduction in anterior corneal power, while posterior corneal curvature remains stable. Minor decreases in anterior chamber depth and volume occur without affecting the chamber angle or visual outcomes.

Accuracy of Refractive Outcomes in Pediatric Cataract Surgery: A Comparison of Targeted Versus Achieved Hyperopia

2025-12-20T15:00:46+00:00

Purpose: To compare target hyperopic refraction with achieved postoperative refractive outcomes in pediatric cataract surgery and to identify factors influencing absolute prediction error.

Study Design: longitudinal cohort study.

Place and Duration of Study: Mughal Eye Hospital, July 2024 to December 2024.

Methods: This study included 26 eyes of children aged 1–6 years undergoing cataract surgery with intraocular lens implantation. Preoperative biometric parameters and target refraction were recorded, and postoperative achieved refraction was measured. Statistical analysis included paired t-test, Pearson correlation, and multiple linear regression to evaluate refractive prediction error (p < 0.05).

Results: The mean age of the patients was 3.69 ± 1.81 years. Mean axial length was 22.56 ± 1.78 mm, and mean IOL power was 23.33 ± 5.94 D. The mean achieved postoperative refraction was 4.47 ± 1.46 D compared to target refraction of 3.76 ± 1.11 D, resulting in a mean hyperopic prediction error of +0.71 D (95% CI: 0.55–0.86; p < 0.001). Absolute prediction error was negatively correlated with age (r = −0.987, p = 0.001) and axial length (r = −0.956,
p = 0.001), and positively correlated with keratometry (r = 0.986, p = 0.001) and IOL power (r = 0.982, p = 0.001).

Conclusion: A consistent hyperopic overshoot relative to target refraction was observed after pediatric cataract surgery. Age and axial length were the most significant contributors to refractive prediction error, highlighting the need for individualized IOL calculations in younger children with shorter axial lengths.

Evaluating the Effect of Surgical Face Mask on Choroidal Thickness

2025-10-14T14:14:17+00:00

Purpose: To evaluate the choroidal thickness in healthcare professionals using a surgical face mask.

Study Design: Cross sectional study.

Place and Duration of Study: Ittefaq Hospital, Lahore, and Sohail’s Oculab from June 2023 to July 2024.

Method: Sixty healthcare professionals aged 25–45 years with best corrected visual acuity of 6/6 or 6/9 and normal intraocular pressure (12–21 mmHg) were included. Participants with any systemic or ocular pathology were excluded. The instruments used in this study included a distance Snellen chart, an air-puff tonometer (Topcon), and a swept-source OCT device (Topcon DRI OCT Triton 3D). A self-structured proforma was used for data collection. Choroidal thickness was measured after wearing a surgical face mask for at least 4 hours and again 30 minutes after mask removal using swept-source OCT.

Results: The study included the right eyes of 60 participants in which there were 34 males (58.3%) and 26 females (41.7%). The mean age was 30.35 ± 4.90 years. A paired-sample t-test showed a statistically significant change in choroidal thickness between 4 hours of mask wearing and 30 minutes after mask removal (p < 0.001).

Conclusion: The findings showed a significant difference in choroidal thickness when wearing a surgical face mask compared with not wearing one. Prolonged mask use may cause hypercapnia, which can increase retinal vessel diameter and blood flow, leading to increased choroidal thickness.

Intralesional Bleomycin for Orbital Vascular Malformations at A Tertiary Care Centre

2025-10-16T05:52:55+00:00

Purpose: To report the outcomes of intralesional bleomycin injections for orbital venous malformations (OVMs) in a tertiary care setting.

Study Design: Interventional case series.

Place and Duration of Study: Jinnah postgraduate medical Centre Karachi from January 2020to April 2022.

Methods: This case included 24 consecutive cases presenting with orbital vascular malformations, including orbital capillary hemangiomas, lymphangiomas, and orbital varices. The location, dimensions, extent of involvement, signal characteristics, and enhancement pattern following contrast administration of the lesion were determined. Intralesional bleomycin injections were given at a dose of 0.5 mg/kg body weight diluted in lidocaine. Retreatment if needed was done at an interval of 4 weeks. Follow up included measurement of proptosis and radiological measurements of tumor volume.

Results: Proptosis and lid swelling were the most common presentations. An average of 2.27±1.3 injections of bleomycin were given. The mean pretreatment volume was 3.61±1.14 cm³and the post-treatment volume was1.41±1.06 cm³ with a mean reduction in tumor volume of 2.20±1.13 cm³(t=9.52, p<0.001). There was marked improvement in clinical symptoms and the proptosis reduction averaged 7.22±2.80 mm (t= 10.95, p<0.001). Side effects included conjunctival swelling, skin hyperpigmentation around the lesion, and madarosis.

Conclusion: Intralesional bleomycin injection proved to be an effective and minimally invasive treatment modality for orbital venous malformations, resulting in significant reduction in lesion volume and proptosis, along with marked symptomatic improvement. It is a valuable therapeutic option for orbital vascular malformations, particularly in cases where surgical excision is challenging.

Visual Outcomes and Pattern of Injuries among Patients presented with Ocular Trauma: a Multicenter Analysis across Urban and Peri-Urban Karachi

2025-09-14T15:45:33+00:00

Purpose: To determine visual outcomes and pattern of injuries among patients presented with Ocular Trauma in three major tertiary care centers of Karachi.

Study Design: Cross sectional study.

Place and Duration of Study: Mross-sectional study conducted at three tertiary care centers of Karachi, over a 3-month period.

Methods: Patients with history and signs of recent ocular and adnexal trauma were included in the study and those with any other ocular or systemic disease were excluded from the study. Data was collected on a self-designed proforma for history and the relevant ocular and adnexal examination details. Majority of the patients presented to the Accident and Emergency department and referred to Eye clinics. Ocular Trauma Scores (OTS) were calculated with the help of OTS chart.

Results: In a sample of 343 patients, 44% were presented at Jinnah Postgraduate Medical Centre (JPMC), 45% at Isra Postgraduate Institute of Ophthalmology (IPIO), and 11% at Dow International Medical College (DIMC). Most injuries occurred in males (76.7%). Accidental injuries were the commonest injuries found in DIMC, (52.63%) and IPIO, (64.52%)(n=100). Whereas in JPMC, assault was the most common (31.75%). Commonest sign of ocular trauma was lid swelling (26.23%) found in DIMC and lid tear (16.76%) in JPMC.

Conclusion: Ocular trauma patterns in Karachi are closely linked to the nature of surrounding environments, including traffic density, occupational hazards, and access to emergency services. Public education, protective gear enforcement, and workplace safety policies are needed to reduce the burden of preventable vision loss.

Congenital and Acquired Malposition of Inferior Oblique

2025-09-04T12:34:19+00:00

Purpose: o report and characterize malposition of the inferior oblique (IO) muscle observed during orbital surgeries for congenital and acquired pathologies.

Study Design: Descriptive case series.

Place and Duration of Study: Al- Shifa Trust Eye Hospital, Rawalpindi from June 2004 to June 2024.

Methods: In this study, all the patients who underwent orbital surgery during the 20 years, by one experienced orbital surgeon, were reviewed. Out of 1200 cases of orbital surgeries four cases were identified for the study. In all four cases, IO mal position was directly observed during orbital surgery. Pre-operative orbital imaging studies could not find the malposition. All surgeries were performed by the same surgeon under general anesthesia. In addition to the planned surgical procedure, an attempt was also made to re-position the abnormal-origin IO.

Results: Out of the four patients with IO malposition, there were two females and two males. Two patients presenting with congenital dermoid cysts had a normal birth history with no history of any surgery or trauma. The other two patients with acquired malposition had a history of trauma and previous surgery.

Conclusion: IO malposition is a rare entity. It is difficult to predict pre-operatively so while performing orbitalor strabismus surgeries, one should be very careful and watchful to prevent damage to ectopic muscles.

Intra-Ocular Pressure after Injection of Intra-Vitreal Triamcinolone Acetonide in Patients with Diabetic Macular Edema

2025-09-20T13:33:02+00:00

Purpose: To determine the frequency of raised intraocular pressure and the pattern of intraocular pressure changes following intravitreal triamcinolone acetonide (IVTA) injection in patients with diabetic macular edema(DME) for three months follow up.

Study Design: Quasi experimental study.

Place and Duration of Study: Jinnah Postgraduate Medical Center, Karachi from January 2024 to June 2024.

Methods: A total of 150 patients, scheduled for IVTA injection for DME with central subfield thickness of ≥ 250 µm were included. Patients with history any other intraocular diseases and previous retinal surgery or anti-VEGF injections were excluded. After IVTA injection, patients were followed up at week 1, month 1 and month. Pre-injection and post-injection intraocular pressure (IOP) were measured at each visit. Data analysis was performed using SPSS version 22.

Results: The median (IQR) age of participants was 36.0 (34-42) years. There were 70.0% males. The median duration since diagnosis of DME was 5.0 (3-5) months, and median HbA1c was 10.3 (9.6-11.2)%. The median baseline IOP was 17 (16-18) mmHg. Following IVTA injection, the median IOP was 18.0 (17-19) mmHg at 1 week, 19(17-20) mmHg at 1 month, and 18(18-22) mmHg at 3 months (p < 0.001). The frequency of raised IOP at 3 months post-injection was 41 patients (27.3%).

Conclusion: IVTA injection in patients with DME was associated with a significant rise in IOP, with 27.3% of patients developing raised IOP at 3 months. Careful monitoring of IOP is mandatory following IVTA therapy.

Intraocular Pressure Changes Following Pars Plana Vitrectomy with 1000 CST and 5000 CST Silicone Oil in Superior Rhegmatogenous Retinal Detachment: A Comparative Study

2025-09-19T10:02:03+00:00

Purpose: To compare mean IOP changes following PPV using 1000 CST and 5000 CST silicone oil in patients with superior Rhegmatogenous Retinal Detachment (RRD).

Study Design: Quasi experimental study.

Place and Duration of Study: Layton Rahmatullah Benevolent Trust (LRBT) from January 2024 to June 2024.

Methods: A total of 150 patients with age range of 21 to 70 years, diagnosed with superior rhegmatogenous retinal detachment (RRD) and proliferative vitreoretinopathy (PVR) of grade B or C, were recruited. They were divided into two groups; Group A underwent vitrectomy with 1000 centistokes (cSt) and Group B had 5000 cSt silicone oil as tamponade. Intraocular pressure (IOP) was measured before and at 6, 12, 24, and 48 hours after surgery. Independent sample t-test was used to compare the results with p-value of ≤0.05 as significant.

Results: The mean age was comparable between the two groups (Group A: 44.64 ± 14.71 years; Group B: 44.76 ± 14.09 years). A postoperative increase in IOP was observed in both groups. However, at 24 and 48 hours, Group B demonstrated significantly higher IOP compared to Group A, with mean values of 19.34 ± 0.86 vs. 18.64 ± 0.61 mmHg (p = 0.001) and 19.70 ± 1.09 vs. 19.22 ± 0.92 mmHg (p = 0.004), respectively.

Conclusion: Both 1000 cSt and 5000 cSt silicone oil lead to IOP elevation after PPV, but the increase is more significant and sustained in the 5000 cSt group. Careful IOP monitoring is recommended, especially in patients receiving high-viscosity silicone oil.

Visual Outcomes and Complications in Pediatric Traumatic Cataract Surgery at a Tertiary Care Hospital

2025-08-03T13:49:58+00:00

Purpose: To evaluate visual outcomes of traumatic cataract surgery in pediatric patients and identify preoperative, per operative and postoperative complicationsof management.

Study Design: Quasi experimental study.

Place and Duration of Study: Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi from April 2024 to September 2024.

Methods: This study included 61 children (≤16 years) who underwent surgery for traumatic cataract. Patients with any pre-existing ocular pathology or follow-up <6 months were excluded. Demographic data, type of trauma, timing of surgery, Itype of intraocular lens (IOL), and complications were recorded. Visual acuity (VA) was measured at baseline and at one week, three months, and six months, converted to logMAR for analysis. Statistical tests included repeated measures ANOVA and Spearman correlation.

Results: Mean age was 8.37 ± 3.62 years; 70.4% were male. Blunt and penetrating injuries were equally distributed. Foldable in-the-bag IOLs were most common (35.4%). Preoperative complications of trauma were present in 88.5%, most frequently visual axis opacification (39.3%). Postoperatively, 52.5% had no complications; others developed astigmatism (29.5%), anterior uveitis (18.0%), or IOL dislocation (9.9%). Mean LogMAR VA improved from 2.09 to 0.80 in 6 months (p < 0.001). Better outcomes were observed in older children and those without complications. Timing of surgery and trauma type did not significantly affect final VA.

Conclusion: Pediatric traumatic cataract surgery offers favorable visual outcomes. Age and complication profile significantly affects prognosis. Timely intervention, individualized rehabilitation, and vigilant postoperative monitoring are essential for optimizing results and minimizing long-term sequelae.

Guarding Sight: Traumatic Cataract Following Reflexive Self-Defense in a Teenager

2025-08-31T10:28:15+00:00

Traumatic cataract typically results from blunt or penetrating ocular injuries. However, cataract formation due to reflexive act of self-defense is exceptionally rare. We present the case of a 16-year-old boy who sustained trauma to his left eye while shielding himself during an altercation. The injury led to rupture of the anterior lens capsule and dense cataract formation. His best corrected visual acuity (BCVA) was counting fingers in the affected eye. Examination revealed circumciliary congestion, a corneal laceration, a Grade 4 anterior chamber reaction, a ruptured anterior lens capsule, and a white, opacified lens. Lens aspiration with in-the-bag intraocular lens (IOL) implantation was performed. Postoperatively, the patient regained 6/6 visual acuity, which remained stable over monthly follow-ups. This case underscores the importance of prompt diagnosis, timely surgical intervention, and patient education in preventing vision loss due to trauma.

Troubleshooting Scleral Contact Lens Deposits: A Case Study

2025-10-15T12:01:10+00:00

Scleral contact lenses are extensively used in clinical practices; however, deposits on scleral lenses are still a prevalent problem among wearers.The current case presents an innovative method of troubleshooting scleral lens deposit.A 31-year-old Asian male,using scleral lens from past six years, presented with complaints of irritation and decreased vision due to heavy lens deposits. A novel in-office deep cleaning procedure was carried out using a specially created manual technique with a specific cleaning solution to break up the surface deposits without damaging lens. After cleaning, the patient demonstrated better visual acuity, less discomfort, and long wearing time.A low-cost innovative cleaning technique can effectively increase life of scleral lens and improve patient comfort.