Ophthalmology Research: An International Journal

Surgical Outcomes and Prognostic Factors of Traumatic Retinal Detachment at a Tertiary Hospital in Northern Tanzania

Jesca Mkahumbya Theodory — 2025-09-06

Aim: To assess surgical outcomes and prognostic factors for traumatic retinal detachment following globe injuries among patients treated at a tertiary hospital in Northern Tanzania from December 2012 to November 2022.

Study Design: A hospital based retrospective cohort study.

Place and Duration of Study: Department of ophthalmology, Kilimanjaro Christian Medical Centre in Northern Tanzania between December 2012 to November 2022.

Methodology: Retrospective review of files of 80 patients who had undergone retinal detachment surgery following globe injury, and were monitored for a minimum of 3 months between December 2012 and November 2022. Collected data encompassed demographics, initial visual acuity (VA), type and cause of the injury, clinical observations, surgical procedures performed, postoperative retinal status, and final best corrected visual acuity (BCVA). Statistical analysis involved the use of generalized linear model with family Poisson distribution and log link function.

Results: Among 80 study participants, 68 (85%) were males, the median age 30 (17.5-38) years, with the largest group of participants being workers (34, 42.5%). Twenty-seven patients (33.75%) had an unrecorded cause of injury, while vegetative and metallic were 17 (21.25%) and 15 (18.75%), respectively. Fifty-five patients (68.8%) had close globe injury, with the median duration of injury and symptoms being 105 (48.5-365) days & 90 (30-240) days, respectively. Anatomical success and functional success were achieved in 62 (77.5%) and 34 (42.5%), respectively. The predictor for a poor anatomical outcome was the presence of pre-operative proliferative vitreoretinopathy (PVR), while an increase in age was associated with functional success, but macula involvement and the presence of pre-operative PVR were associated with a poor functional outcome.

Conclusion: Factors like advancing age, proliferative vitreoretinopathy, and macular status influence surgical outcomes. The proportion of visual success was lower than anatomical success, highlighting the challenge of restoring vision even after successful retinal reattachment.

Comparison of Outcomes and Postoperative Satisfaction Between Laser-Assisted and Conventional Open Dacryocystorhinostomy: A Prospective Comparative Study

Abir Bin Sajj — 2025-09-09

Purpose: To compare the outcomes, postoperative recovery, and patient satisfaction between transcanalicular diode laser-assisted dacryocystorhinostomy (laser DCR) and conventional external dacryocystorhinostomy (external DCR) in patients with primary acquired nasolacrimal duct obstruction (PANDO).

Methods: This prospective comparative study included 189 patients (103 laser DCR, 86 external DCR) with PANDO. Outcome measures included surgical success (anatomical patency and resolution of epiphora), operative time, intraoperative pain (VAS), time to return to work, cosmetic satisfaction, and overall patient satisfaction.

Results: Surgical success at 12 months was comparable between laser DCR (89.3%) and external DCR (91.8%) (p=0.55). Laser DCR demonstrated significantly lower intraoperative pain (VAS 3.2 vs 5.7, p<0.0001), shorter operative time (19.8 vs 26.7 minutes, p<0.0001), and earlier return to work (3.4 vs 8.6 days, p<0.0001). Patients reported higher cosmetic satisfaction following laser DCR. However, costs were higher for laser DCR due to equipment and maintenance.

Conclusion: Both external and laser DCR provide high success rates for PANDO. Laser DCR offers distinct advantages in terms of pain, cosmesis, and recovery, making it an attractive alternative where resources allow. External DCR remains the gold standard, particularly in revision or complex cases.

Clinical Profile of Acute Optic Neuritis in a Tertiary Eye Hospital in Bangladesh

Sanjida Naharin — 2025-09-18

Background: Optic neuritis (ON) is an inflammatory or demyelinating disorder of the optic nerve that presents with acute visual loss and periocular pain. Its clinical profile varies across regions due to genetic, environmental, and demographic influences.

Aim: This study aimed to determine the demographic and clinical characteristics of patients with ON at a tertiary eye hospital in Bangladesh.

Methods: A descriptive cross-sectional study was conducted at the Neuro-ophthalmology Department of the Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh, between July 2019 and June 2020. A total of 100 patients (139 affected eyes) diagnosed with ON were included in the study. Demographic data, complaints, visual acuity, color vision, pupillary responses, visual fields, and fundus findings were recorded. Statistical analysis was performed using SPSS v20.0.

Results: Among 100 patients (54 males, 46 females; mean age 30±12.95 years), most were aged 40–49 years (34%). All patients presented with acute dimness of vision, while 22% reported periocular pain and 12% fever. Nearly half (47.5%) had visual acuity <3/60, and 73.4% showed reduced color vision. Central scotoma (46.8%) was the most common visual-field defect. Relative afferent pupillary defects were noted in 46.8% of eyes. Papillitis, retrobulbar neuritis, and neuroretinitis accounted for 86 %, 10%, and 4% of the cases, respectively. Unilateral ON (61%) was more frequent than bilateral ON (39%).

Conclusion: Papillitis was the predominant type of ON in this cohort, with unilateral involvement being more common. Unilateral papillitis occurred more frequently in middle-aged men (40–49 years). These findings provide insights that may support the early diagnosis and improved management of ON in Bangladesh.

Nd: YAG Capsulotomy: Visual Outcomes & Its Associated Factors among Patients with Posterior Capsule Opacification

Camillius Mbaga — 2025-09-24

Background: Posterior Capsular Opacification (PCO) is a common post-cataract surgery complication, it is treated by Nd:YAG laser capsulotomy or surgical capsulotomy, nd; YAG laser is a safe, effective, and quick treatment, though it is associated with potential complications.

Aim: To assess the visual outcomes of nd; YAG lasers capsulotomy and its associated factors among patients with posterior capsular opacification who attended at KCMC Eye department from July 2023 to May 2024.

Methodology: A hospital-based prospective cohort study conducted at KCMC Eye Department, investigated factors affecting visual outcomes after Nd:YAG laser capsulotomy for PCO. Different variables were analyzed, including patient demographics; IOL characteristics, pre- and post- nd; YAG laser VA and IOP, and PCO grade, to determine their impact on best corrected visual acuity one-month post-treatment. Data were cleaned and analyzed using SPSS version 25.

Results: This study involved 87 eyes from 87 participants; the average age of the participants was 65 years, ranging from 24 to 90 years. No participant had VA of ≥ 6/12 pre-YAG laser; the majority (48.3%) had VA of 6/60 and below. Post-YAG laser capsulotomy there was a significant change in best corrected visual acuity with (82.7%) attaining good visual acuity from 0% pre Nd: YAG and 17.3% remained with poor visual acuity. There was also a significant change in several lines read on the Snellen chart with the majority 48.3% improving 2 lines post Nd: YAG, only one patient did not improve on the Snellen chart because of macula edema. The improvement in VA was noted among the study participants; however, the changes in VA before and after YAG laser capsulotomy was not statistically significant.

In this study, IOP spike, floaters, lens pitting, hyphema, burn IOL, and macular edema were the observed complications. And the presence of factors like, complicated cataracts, high energy setting during the procedure, high-grade PCO, and Sulcus-inserted IOL were associated with poor visual outcome post-procedure.

Conclusion: YAG laser capsulotomy is safe, effective and rewarding non-invasive procedure for visual improvement in PCO patients.

Impact of Excessive Screen Use on Strabismic Anomalies of Binocular Vision in Children and Young Adults

Eram Fatma — 2025-10-04

The pervasive use of digital devices for education and recreation is linked to a rising incidence of binocular vision anomalies, particularly heterophoria, in children and young adults. This retrospective cross-sectional study investigated the relationship between excessive screen use and heterophoria, specifically esophoria and exophoria, in 40 patients aged 5-30 years with best-corrected visual acuity of 6/9 or better. Participants were categorized into exophoria (n=30) and esophoria (n=10) groups and measurements included the magnitude of phoria (prism diopters, PD), near point of convergence (NPC), and near point of accommodation (NPA) along with daily screen time exposure data. The mean age was 18.2 ± 6.1 years, with a female predominance (62.5%) and average screen sreen time was 5.1 ± 2.3 hours/day. Females had higher odds of esophoria (OR=3.1, p=0.02), while screen time positively correlated with near phoria magnitude (r=0.32, p=0.04) and negatively with NPC (r= 0.41, p= 0.008).Esophoria was associated with shorter NPC (7.6 ± 1.1 cm vs. 9.8 ± 2.1 cm, p=0.003) and NPA (8.2 ± 1.3 cm vs. 10.3 ± 2.3 cm, p=0.02), and a higher prevalence of myopia (66.7% vs. 33.3%, p=0.04), while astigmatism was more prevalent in exophoria (66.7% vs. 33.3%, p=0.04). Regression analysis showed that each additional hour of screen time increased near phoria by 0.5 PD (p=0.01). these findings indicate that excessive screen exposure is significantly associated with heterophoria, reduced convergence, and specific refractive errors, particularly in females, underscoring the importance of early screening, visual hygiene education, and preventive measure to mitigate long term binocular vision complications.

Beyond the Spicules: Atypical Retinitis Pigmentosa in Bardet-Biedl Syndrome

Ruchi Shukla — 2025-08-21

Bardet-Biedl Syndrome (BBS) is a rare autosomal recessive ciliopathy with multisystem involvement. We present the case of a 7-year-old boy who presented with photophobia and difficulty seeing in dim light. Examination revealed central obesity, bilateral post-axial polydactyly of the feet, crowded teeth, and micropenis. His best-corrected visual acuity was 6/9 in both eyes. Fundus examination showed pale optic discs and attenuated arterioles without classical bone spicule pigmentation, suggestive of retinitis pigmentosa sine pigmento. A clinical diagnosis of BBS was established based on the presence of multiple primary diagnostic features. The presence of dental and genital anomalies highlights the need for a multidisciplinary approach to diagnosis and care. This report contributes to the limited literature on BBS from India and reinforces the significance of recognizing atypical phenotypes, especially in resource-limited settings.

Vogt-Koyanagi-Harada Diseases Diagnosis by Means of Ocular Multimodal Imaging: A Case Report

Lotfi Chaabani — 2025-08-30

Aims: Vogt-Koyanagi-Harada (VKH) disease is a rare autoimmune uveo-meningeal disorder with variable clinical presentations. The aim of this report, prepared in accordance with the CARE case report checklist, is to describe a case of purely ocular VKH disease and highlight the role of multimodal imaging and early corticosteroid therapy in its management.

Presentation of Case: We report the case of a 37-year-old woman with no history of systemic illness, ocular trauma, or surgery, who presented with acute bilateral visual loss of 15 days’ duration. Ophthalmic examination revealed light perception in both eyes, with normal anterior segment and intraocular pressure. Fundus examination showed multiple bilateral serous retinal detachments. Fluorescein angiography demonstrated delayed choroidal filling, diffuse pinpoint hyperfluorescent leaks, pooling into multifocal serous retinal detachments, and bilateral optic disc edema. Optical coherence tomography confirmed multilobular serous retinal detachments with intraretinal septa. No extraocular manifestations were present, and laboratory and immunologic work-up were unremarkable. The diagnosis of possible VKH disease (purely ocular form) was made. The patient received three consecutive daily intravenous pulses of methylprednisolone (1 g/day), followed by oral prednisone (1 mg/kg/day) with gradual tapering. Functional recovery was rapid, with visual acuity improving to 10/10 in the right eye and 9/10 in the left eye after two months.

Discussion: Diagnostic criteria for VKH disease have evolved from the early description of Sugiura to the 2001 First International Workshop classification, which recognizes complete, incomplete, and possible forms. Our case illustrates the importance of considering VKH even in the absence of systemic involvement and demonstrates the diagnostic value of multimodal imaging, especially fluorescein angiography and OCT. Early and aggressive corticosteroid therapy remains the cornerstone of management, with immunosuppressive agents reserved for resistant or recurrent forms.

Conclusion: Purely ocular VKH disease is rare and diagnostically challenging in the absence of extraocular signs. However, a high index of suspicion, supported by multimodal imaging, enables early recognition. Prompt initiation of systemic corticosteroid therapy is associated with favorable functional and anatomical outcomes.Koyanagi Harada (VKH) disease is a rare autoimmune uveo-meningeal disorder with variable clinical presentations.

Relapsing Acute Lymphoblastic Leukemia Presenting as Unilateral Hypopyon in an Adult: A Case Report

A.Arazzakou — 2025-09-03

Leukemias may have ophthalmic presentations due to infiltration of central nervous system leukemia and bone marrow relapse.

Hypopyon uveitis as a presentation of relapse acute lymphoblastic leukemia (ALL) is very rare.

In our case, a young men with acute lymphoblastic leukemia after remission present a Unilateral hypopyon as a signe of relapse.

The paracentesis of anterior chamber was not performed. The lumber puncture confirmed the relapse

The purpose of our case is to aware about unilateral hypopion as indication or relapsing ALL when the relapse is typically bilateral hypopyon.

Trauma to Transplant: Pediatric Pythium Keratitis Advancing to Anterior Staphyloma

Ravi Solanki — 2025-10-13

Pythium keratitis, an aggressive vision-threatening infection that rarely affects children. We present the case of an 11-year-old boy who, three years after ocular trauma with a cow horn, experienced progressive corneal opacity and protrusion with vision loss in the right eye. He had a clinical diagnosis of Pythium keratitis, which progressed to anterior staphyloma after healing with scarring and ectasia. Histopathology confirmed the patient's healed Pythium keratitis sequelae after therapeutic penetrating keratoplasty. With better vision and cosmesis after surgery, the graft remained clear. This instance emphasises the importance of prompt keratoplasty in visual and cosmetic rehabilitation by highlighting an uncommon consequence of paediatric Pythium keratitis that progresses to anterior staphyloma.