Ophthalmology Outpatient Department Research Articles

Malarial Retinopathy: Falci Not So Fan-See!

Malarial retinopathy is an established entity in cases of complicated falciparum malaria and cerebral malaria in children whereas, in adults it is rarely reported. Here we report a case of a 21-year-old male, with uncomplicated falciparum malaria, referred to the ophthalmology outpatient department with a chief complaint of sudden blurring of vision in both eyes. On examination, both eyes showed mild blurring of nasal optic disc margins with multiple intraretinal, preretinal haemorrhages, subhyaloid haemorrhage involving the macula and Roth spots, suggestive of malarial retinopathy. The patient was observed closely for spontaneous resolution and was treated systemically with anti-malarial drugs including injection artesunate and tablet doxycycline. On subsequent follow-up after 2 weeks, improvement in visual acuity with complete resolution of haemorrhages occurred. We aspire to bring to light a rare entity of malarial retinopathy and the need to not over-treat the condition.

A prospective observational study for the safety of Nd-YAG Laster posterior capsulotomy procedure in patients of Posterior Capsular Opacification (PCO) at the ophthalmology outpatient department of a tertiary care teaching hospital in western India

: Nd YAG laser is preferred method to manage thickened posterior capsule because it is an easy, non-invasive and an OPD basis procedure considering the comfort of the patients.: The present study was carried out with objectives to evaluate the safety profile of Nd-YAG Laser Capsulotomy mainly in terms of rise in intraocular pressure (IOP) and other intra as well as post-operative complications.This prospective observational study was carried out with prior Institutional Ethics Committee (IEC) approval and written informed consent from the participants at Ophthalmology Outpatients Department (OPD) of a tertiary care teaching hospital of western India, for the duration of two years from Oct’2015 to Sept’2017. A detailed ocular, systemic, family history was taken of all the enrolled patients with pre- and post-procedure evaluation of IOP by Goldman’s Applanation Tonometry, Slit lamp examination and Fundus examination by direct and indirect ophthalmoscopy. Capsulotomy was done using VISULAS YAG III laser of Zeiss company.The data was entered and tabulated in Microsoft Excel 2007 and analyzed. Data was analyzed by frequency distribution. The ‘p’ value was determined to finally evaluate and P <0.05 was considered as statistically significant.Acute transient rise of IOP up to 5mmHg or more (P value <0.001) was found in Nine cases which is highly significant compared with pre-procedural stage. Intraocular lens pitting was observed in Four cases. Cystoid macular edema was found in one case. Two patients developed mild iritis. Nd-YAG laser capsulotomy is an easy, practical modality to treat posterior capsular opacities, but is not a completely innocuous procedure. Nd-YAG laser capsulotomy is an easy, practical modality to treat posterior capsular opacities, but is not a completely innocuous procedure. Due precautions should be taken in pre- and post-procedural stages including medications, thorough counselling, proper focusing and steady fixation of the patients to minimise the complication.

Prevalence of Falls in Patients Presenting to an Ophthalmic Outpatients Department- A Surveillance Study.

Introduction:Approximately 1 in 3 adults aged 65 and over experience a fall each year. Poor vision is an identified risk factor. The aim of this cross-sectional public health surveillance audit was to determine the prevalence of falls experienced in the previous 12 months by adult patients presenting to an ophthalmology department.Methods:A short questionnaire was given to consecutive patients attending an ophthalmology department at two trusts in the North West to determine whether they had experienced a fall in the previous 12 months, whether they had suffered a fracture, their eye condition and the type of glasses worn.Results:Data was collected for 585 patients (mean age: 69 years, SD: 13.8). Falls in the previous 12 months were reported by 96 (16.4%) patients, and a significant proportion of these were aged 60 years and over (82%, p < 0.0001, one-sample binomial test). Half of the respondents were unaware of their eye health condition for which they were attending the department. Glaucoma was the most prevalent condition in those who had experienced a fall (43%). A significant proportion of the individuals who reported a fall wore single-vision glasses (43%, p < 0.0001, one-sample chi-square test).Conclusion:In an ophthalmology outpatient department, the proportion of older adults who experienced a fall in the previous 12 months was lower than the reported prevalence in the general population. There is a need for health literacy to educate patients about their eye condition, the potential effects on their visual function and, consequently, managing falls risk.

Drug Utilization Study in Ophthalmology Outpatient Department of a Tertiary Care Teaching Hospital

Abstract: Background: World Health Organization (WHO) has defined drug utilization in 1977 as marketing, distribution, prescription and use of drugs in a society with special emphasis on the resultant medical and social consequences. It should be evaluated periodically to increase the therapeutic efficacy and decrease adverse effects. Objectives: The aim of study is obtain data on the current prescribing pattern and drug utilisation trend of ophthalmologist in a tertiary care teaching hospital with ultimate goal to promote appropriate use of drugs. Methods: This prospective interventional study was conducted in 272 patients of either sex visiting Ophthalmology outpatient department over a period of six months at NMCH and RC, Raichur, Karnataka. The data collected from data collection form was analysed with the help of WHO prescribing indicators and evaluated using descriptive statistics. Results: Prescription analysis showed that the average number of drugs per prescription was 2.45. Drugs were mostly prescribed by brand name (98.5%), Eye drops (69%) were most prescribed dosage form, Injections (0.75%) were least prescribed, drugs prescribed from Essential Drug List was 50.9%. Antibiotics were most prescribed class of drugs (49.62%). Dosage form, frequency and duration of therapy were recorded in 100%, 95.5% and 84% of prescriptions. Conclusion: Polypharmacy was slightly seen in prescriptions. Antibiotics were highly used. The most commonly prescribed dosage form was eye drops. Half of drugs were prescribed from Essential drug list (EDL). Physicians preferred branded drugs rather than generic drugs. Diagnosis of the patient was not recorded for most of the prescriptions. Key words: Drug utilization evaluation, WHO core drug prescribing indicators, Polypharmacy, Generic name, Ophthalmology.

A study of meibomian gland and tear film changes in patients with pterygium in a tertiary care centre

To find out the correlation of Meibomian gland and Tear film dysfunction with pterygium. Institution based prospective cross sectional study. 70 (seventy) patients with unilateral primary progressive nasal Pterygium and 70 healthy adults without any ocular pathology were selected as comparison group from the Ophthalmology outpatient department of Calcutta National Medical College and hospital, Kolkata for a duration of 6 months from January 2020 to June 2020. Meibomian gland dysfunction was measured by meibomian gland expression score and lid margin abnormality score. Tear film changes were measured by Ocular Surface Disease Index (OSDI) Score , Tear break up time (TBUT), Tear meniscus height(TMH), Schirmer’s test 1 (ST1) and Corneal flourescein staining in both pterygium and control group and comparisons were done to find out the significance in differences. The Categorical variables were analyzed with the help of Pearson Chi square test, Spearman rho Correlation, Man Whitney U Test and the continuous variables were analyzed with the help of Independent T test and Pearson Correlation coefficient. The level of significance was considered as 95% of confidence interval i.e. P value &amp;#60;0.05. OSDI score, TBUT, meibomian gland expression score, lid margin abnormality score and corneal fluoresce in staining were significantly higher in pterygium group than others (p&amp;#60;0.05) whereas TMH values although showed differences between the two groups but were not statistically significant. ST1 were normal in pterygium group though had significant difference with control. Meibomian gland function was altered in patient with Pterygium which is also associated with uncomfortable ocular symptoms due to tear film abnormalities.

English

BACKGROUND We wanted to compare lensectomy with anterior vitrectomy and conventional methods in the surgical management of congenital cataract. METHODS The present study is an interventional analytical study that entailed 30 patients (33 eyes) of bilateral or unilateral congenital cataract who attended the Ophthalmology outpatient department of LLRM Medical College, Meerut, during the period extending from March 2018 to March 2019. 19 of these patients (63.3 %) were males while 11 (36.7 %) were females. Age of the patients varied from 2 years to 12 years, with a mean age of 5 years 7 months. The maximum number of patients was in the age group of 4 - 8 years in either sex. RESULTS Being a comparative analysis, this study had 39.3 % cases treated by conventional methods and 60.7 % cases managed by lensectomy and anterior vitrectomy. The visual acuity was compared in the conventionally treated patients and lensectomy and anterior vitrectomy treated patients. Amongst the patients managed by conventional methods, 37.5 % had good vision, 12.5 % had fair vision and 50.0 % poor vision. In the lensectomy and anterior vitrectomy treated group, 61.1 % cases had good vision, 22.2 % had fair vision and only 16.7 % had poor vision. Comparing the occurrence of complications in both groups, the conventionally treated group showed an incidence of 32.4 % as compared to 4.4 % in lensectomy and anterior vitrectomy treated group. CONCLUSIONS The lensectomy and anterior vitrectomy treated groups had good vision and fewer complications as compared to the conventional methods. KEY WORDS Cataract, Visual Acuity, Lensectomy, Vitrectomy

Two Cases of Ocular Manifestations in Patients with Microdeletion of the Chromosome 7 Long Arm

Purpose: We report ocular manifestations in two patients with 7q microdeletion. Case summary: (Case 1) A 62-day-old male infant was admitted to the ophthalmology outpatient department for ocular examination after being diagnosed with microdeletion of chromosome seven (7q36.2q36.3 deletion) in DNA microarray comparative genomic hybridization (DNA microarray CGH) and fluorescence in situ hybridization (FISH) tests. Fundus examination showed optic disc hypoplasia in both eyes and retinopathy of prematurity, accompanied by retinal hemorrhage in his right eye. Around the age of 24 months, the patient was diagnosed with intermittent exotropia with anisometropia and was prescribed spectacles. (Case 2) A 3-year-old male infant was referred to the ophthalmology clinic to evaluate poor fixation, which was found during rehabilitation therapy for cerebral palsy and developmental delay. Fundus examination showed an increased cup/disc ratio bilaterally. A flash visual evoked potential test indicated a decrease in amplitude in his right eye. Intermittent exotropia of forty prism diopters was observed. DNA microarray CGH and FISH tests performed at another hospital revealed microdeletion of chromosome seven (7q35 microdeletion) and CNTNAP2 gene loss. Conclusions: When genetic anomalies associated with ocular development are identified, it is necessary to detect the ophthalmic abnormalities early and provide the appropriate treatment to allow for the development of normal visual function.

A clinical study on dry eye

The purpose of this study is to evaluate prevalence risk factors, symptoms, signs, objective tests of dry eye diagnosis in patients attending to Out Patient Department of Mamata General Hospital, Khammam.All patients presenting with dry eye symptoms to ophthalmology outpatient department, Mamata Medical College over a period of one and half year. A prospective study was conducted for a period of 18 months from June 2018 to Jan 2021 among patients attending ophthalmology Out Patient Department unit with symptoms of dry eye. Among the 100 patients studied, prevalence of dry eye was found to be as high as 23%.The prevalence of dry eye increased with increase in age and was significantly higher among people more than 40 years of age. Prevalence was higher among females when compared to males. Conjunctival congestion was found to be reliable sign of dry eye with a strong positive association. Foreign body sensation was found to be the most common symptom associated with dry eye. People with refractive errors, with or without history of spectacle use, had a higher incidence of dry eye compared to emmetropes. OSDI was found to be reliable measure of dry eye symptoms. Higher, scores of OSDI, indicating severe dry eye, correlated well with diagnostic tests for dry eye. TBUT test showed a high sensitivity and specificity, followed by Schirmers test and impression cytology. Impression cytology was a reliable measure for detecting ocular surface changes. Many patients showed grade 2 or 3 changes. These changes were more among those with schirmer less than 5mm. Dry eye evaluation with an appropriate and standard questionnaire along with standard tests for dry eye helps in diagnosis and treatment. This will go a long way in the effective and successful management of patients with dry eye, specially so as the disease is chronic and needs long term treatment. Early and appropriate management will provideocular comfort and satisfaction with a better quality of life.

An unusual presentation of well-differentiated squamous cell carcinoma of left upper eyelid: Case report

Squamous cell carcinoma is mainly an invasive epithelial malignancy having keratinocyte differentiation. They are relatively rare and usually slow growing skin cancer. Well-differentiated squamous cell carcinoma closely resembles normal epithelial cell. We report a case of a sixty-five-year-old female who presented to the ophthalmology outpatient department with the chief complaint of a rapidly growing mass on her left upper eyelid for 6 months interfering with her vision. Physical examination revealed a firm mass of size 3.5 cm x 3 cm x 2.5 cm. RT-PCR for COVID-19 was done and found negative. Routine blood investigations, blood sugar levels, viral serology, chest X-ray were done. Excision and biopsy with wide margins at the base were performed under local anesthesia. Histopathological examination of the specimen showed well differentiated squamous cell carcinoma. The patient responded satisfactorily. Early diagnosis and treatment reduce the morbidity and mortality of the patient.

Evaluation and comparison of quality of life in different, categories of low vision

Background: Low vision is problem in which it makes hard for the people to do everyday activities and this problem can’t be fixed with glasses, contact lenses, medicines or surgery. Aim: This study was conducted to assess the quality of life in patients with low vision. Materials & Methods: In present study, there were 2 categories of 90 patients each who were joined in the outpatient department of Ophthalmology, Gandhi Medical College, Hyderabad, Telangana State. Category 1 consisted of 90 patients of low vision (Moderate visual impairment). Category 2 consisted of 90 patients of low vision (Severe visual impairment). Results: The mean age was 60.22±10.52 and 60.66±8.96 years respectively. 36% were males and 64% were females in category 1 and 57% were males and 43% were females in category 2. Mean comparision of various questionnaires were found to be statistically significant between two categories. Category 2 people have more difficulty in reading ordinary newspaper, small print on telephone book, medicine bottle while wearing glasses and they need help from others due to their poor eye sight. Category 2 people recognise people with more difficulty even though they know the people across the room. Conclusion: In patients of both categories, low vision affects quality of life. This study concluded that Category 2 people have poor quality of life in comparison to Category 1.

Microbial profile of corneal ulcer in a tertiary eye care hospital at Tamil Nadu

Purpose: To identify the most common etiological agent in corneal ulceration in a tertiary care eye hospital.Materials and Methods: A total of 50 patients with suspected infectious corneal ulcers presenting to ophthalmology out-patient department in Rajah Muthiah Medical College and Hospital were evaluated. Sociodemographic data and information pertaining to risk factors were recorded. All patients were examined and corneal cultures and scrapings were performed.Results: Of 50 patients microbiological etiology was established in 39 cases (78%). Of these 36(72%) were male. Of 39 positive cases 42% were fungi and 36% were bacterial and 22% showed no growth. The most common isolated fungus was fusarium (67%) followed by aspergillus (33%). Streptococci was the most common isolated bacteria.Conclusion: Routine microbiological examination of patients with corneal ulcer is necessary to analyze the changing trends of the etiology.

Comparison of Intraocular Pressure among Individuals with Systemic Hypertension and those with Normal Blood Pressure

Introduction: Systemic blood pressure, by far, is one of the most important factors that can have an effect on intraocular pressure. We have compared the intraocular pressure (IOP) among patients with systemic hypertension and those with normal blood pressure. Materials and methods: A hospital based case control study was conducted from March 2017 to March 2018 in the Ophthalmology outpatient department at Dhulikhel Hospital. A total of 100 patients with hypertension were included in the case group (hypertensive group) and 100 cases with no systemic or ocular disease were included in the control group (normotensive group). Mean intraocular pressures were calculated and compared between the two groups. Results: Mean age of patients was 49.03 years in hypertensive group and 47.53 years in normotensive group. Mean IOP of the right eye in those with hypertension was 16.10 mmHg and in the left eye was 15.8 mmHg. Similarly mean IOP of the right eye in the normotensive group was 15.8 mmHg and the left eye was 16.2 mmHg. The difference between mean IOP of hypertensive and normotensive individuals was not statistically significant (p &gt; 0.05). The prevalence of ocular hypertension was found to be 7.5%. Conclusion: There was no statistically significant difference in IOP between hypertensive and normotensive individuals. However, a statistically significant difference in IOP was noted between ‘hypertensive with controlled blood pressure’ and ‘hypertensive with uncontrolled BP’ indicating that high blood pressure may be associated with high IOP.

Systemic co-morbidities in patients undergoing cataract surgery

Cataract is most common cause of blindness in the world. As it is an age related change, it is usually associated with other systemic illness. To assess the presence of systemic co morbidities found during routine preoperative evaluation in the patients undergoing cataract surgery at tertiary care hospital. Interventional study included patients attending the ophthalmology outpatient department who were operated for cataract surgery between Jun. 2019 and May. 2020 at tertiary health care centre. Out of 412 patients 147 (35.68%) had systemic co-morbidity and 66 had a presence of both systemic and ocular co-morbidity. Out of 147 patients with systemic co-morbidity hypertension was found in 79 (53.74%) patients while 47 (31.97%) presented with Diabetes Mellitus. Bronchial asthma and Ischemic heart disease was observed in 19 (12.93%) patients followed by stroke in 8 (5.44%) patients. Presence of systemic comorbidity increase the number of investigations needed for fitness of the patient for cataract surgery. Also it can cause intra operative complication and may affect surgical outcome.

English

BACKGROUND Retinopathy and nephropathy are chronic vascular complications of type 2 diabetes mellitus, this eventually leads to end stage renal disease and blindness. Diabetic retinopathy is an important cause of legal blindness in 20 - 70 years. The purpose of the study was to establish association between severity of diabetic retinopathy with systemic levels of glycosylated haemoglobin and renal function test. METHODS This is a cross sectional study conducted among 75 patients with type 2 diabetes mellitus attending the ophthalmology out-patient department (OPD) of Acharya Vinoba Bhave Hospital, Wardha and patients referred from the hospital. Detailed fundus examination and staging of diabetic retinopathy (DR) was done. Glycosylated haemoglobin levels, serum creatinine and blood urea nitrogen were measured. RESULTS Majority of patients were in the age range of 61 to 70 years. Mean ± SD of 3 parameters in patients with no DR, mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR) were as follows: Serum creatinine 1.12 ± 0.41, 1.21 ± 0.53, 1.35 ± 0.49, 1.55 ± 0.22 and 1.70 ± 0.23 respectively. P = 0.007. Blood urea nitrogen (BUN) 28.62 ± 4.20, 31.83 ± 7.20, 37.31 ± 12.57, 44.21 ± 7.53 and 48.76 ± 5.08 respectively. P = 0.0001. HbA1c l, 6.72 ± 0.60, 8.14 ± 0.98, 8.52 ± 2.67, 9.96 ± 1.22 and 12.14 ± 1.96 respectively. P = 0.0001. All the 3 parameters were statistically significant. 40 % of cases had clinically significant macular oedema. CONCLUSIONS Poor glycaemic control as seen by higher levels of glycosylated haemoglobin and deranged renal function is associated with severe form of DR. KEY WORDS Diabetes Mellitus, Diabetic Retinopathy, Serum Creatinine HbA1c and BUN

A Hospital Based Study of Prevalence of Dry Eye in Tertiary Care Hospital of Nepal

Background Dry eye is a common disorder of the tear film that results from decreased tear production, excessive tear evaporation, or abnormality in mucin or lipid components of the tear film associated with symptoms of ocular discomfort.&#x0D; Objective To determine the prevalence of dry eye among patients above 40 years attending out-patient department in a Tertiary Care Hospital of Nepal.&#x0D; Method This was a prospective hospital-based study done at the Department of Ophthalmology in Dhulikhel Hospital, Kathmandu University Hospital for a period of six months from September 2016 to February 2017. All the patients above 40 years of age, attending out patients department were screened by ophthalmologist using the Ocular Surface Disease Index (OSDI). Those patients who were diagnosed of dry eye by OSDI were further evaluated by Schirmer’s test and Tear film breakup time (TBUT).&#x0D; Result Out of 4470 patients attending Ophthalmology outpatient department 1599 patients were of age above 40 years. The overall prevalence of dry eye according to OSDI questionnaire was 25% (400). The mean age of patient with dry eye was 54 yrs. 169 were males (42.2%) and 231 were females (57.7%). Among them Schirmer’s test was positive in 16.7% (67) and TBUT was positive in 85.7% (343) of the patients with dry eye.&#x0D; Conclusion Dry eye is a common condition among patients attending ophthalmology outpatient department in tertiary care center and is leading cause of ocular discomfort. The prevalence of dry eye was higher among indoor workers than in outdoor workers. Further studies are needed to establish association and risk factor of dry eye.

Prescribing Trends of Medications Ophthalmological Outpatient Department in a Public Hospital in Alkharj

Aim: The present study was undertaken to describe the prescribing pattern of medications in the ophthalmology department in a public hospital in Alkharj.&#x0D; Methodology: This is a cross sectional study included collecting data from outpatient pharmacy prescriptions in a public hospital in Alkharj. All of the outpatients who received prescriptions from the ophthalmology department between the beginning of July till the end of December 2018 were included in the study.&#x0D; Results: During the study period, 324 patients received outpatient prescriptions that were written by ophthalmology department. Artificial tears eye drops were the most commonly prescribed drug (29.32%) followed by olopatadine (12.96%), fusidic acid (11.42%) and fluorometholone (10.19%). Most of the prescribers who wrote the prescriptions were residents (98.15%). Eye drop was the most commonly prescribed dosage form (73.77%) followed by ointment (18.21%).&#x0D; Conclusion: The present study showed that the most commonly prescribed drugs in outpatient ophthalmology department were artificial tears, olopatadine, fusidic acid and fluorometholone. It is also important to increase the awareness of healthcare providers and patients about the appropriate use of these drugs.

Ocular morbidity during nationwide lockdown among patients attending ophthalmic department in a tertiary care center

During this pandemic times majority of the people with ocular complaints were either scared to approach health facility, fearing the chances of contracting the disease, COVID -19 or due to lack of regular functioning of ophthalmic clinics. Hence it is important to understand about the pattern of ocular morbidity during this phased relaxation of lock down. This cross sectional hospital based study was conducted in the outpatient department of Ophthalmology at Sri Muthukumaran Medical College Hospital and Research Institute, Chennai, from September 2019 to November 2019. A total of 234 patients were included in the study. Data analysis was done using SPSS version 18. Common ocular morbidity reported was refractive errors (35.9%) followed by cataract (20.1%), pseudophakia (11.1%), conjunctivitis (9%), age related macular degeneration (7.3%), blepheritis (5.6%), foreign body (5.6%), retinopathies (4.7%), glaucoma (3%) and corneal opacity (2.6%). Also 17.5% of cases reported that they had ocular complaints during the complete lock down. Pattern of ocular morbidity during the lock down was found to be similar to the pattern prevailed before the pandemic COVID 19. Considerable proportion of cases reported ophthalmic complaints during the nationwide lockdown and hence policies should be made in such a way that during these unexpected circumstances also, the essential ophthalmic care centers should be functional with easy access to the population.

Awareness and Knowledge about glaucoma among the cases attending Ophthalmology outpatient department in a Tertiary care center

Awareness and knowledge about glaucoma plays a major role is changing the people’s health seeking behavior for regular eye checkups which in turn leads to early detection and treatment of glaucoma and other ophthalmic disorders also and thus this study was planned. This cross sectional hospital based study was conducted in the outpatient department of Ophthalmology at Sri Muthukumaran Medical College Hospital and Research Institute, Chennai, from September 2019 to November 2019. A total of 220 patients were included in the study. Data analysis was done using SPSS version 18. Awareness about glaucoma was reported among 21.4% of participants and among them only 40.4% had knowledge that increased intraocular pressure (IOP) is the cause for glaucoma. Also 31.9%, 40.4%, 44.7%, 2.1%, 14.9% and 34% of participants reported that obesity, diabetes mellitus, hypertension, steroids, alcohol and smoking and family history of glaucoma were the risk factors of glaucoma. Degree holders and employed participants were found to be significantly associated with better awareness of glaucoma. Awareness about glaucoma in this study was poor and knowledge is still worse. This shows that we are in high time to health educate the people especially the target population about glaucoma, which causes preventable blindness.

The clinical and risk profile of presenile cataract in a semi-urban population of South India

Background: The aim of this study was to assess the morphological characteristics of presenile cataract and analyze its risk profile in a semi-urban population in a South Indian state. Subjects and Methods: This cross-sectional, observational, and descriptive study was conducted in the Outpatient Department of Ophthalmology at a University Teaching Hospital, Chennai, from June 2018 to May 2019. Eighty-two consecutive study participants underwent detailed medical history, ocular examination, and blood investigations such as fasting blood sugar, fasting lipid profile, post prandial blood sugar, hemoglobin, blood urea, serum creatinine, serum calcium, thyroid function tests (TFT) and Electrocardiogram (ECG). Data analysis was done using International Business Machines, United States of America, Statistical Package for the Social Science, (IBM, US, SPSS), version 20. Results: A female predominance of 69.5% was noted. The mean age was 43.8 ± 7 years. Presenile cataract was higher in the age group of 41–49 years (odds ratio = 6.55). Posterior subcapsular cataract (PSC) was found in 65 eyes (39.6%), grade 2 nuclear sclerosis in 42 eyes (25.06%), and cuneiform cataract in 22 eyes (13.4%). The risk profile in presenile cataract was hypocalcemia (54.9%), diabetes mellitus (50%), and hypertension (17.07%). Hypertriglyceridemia was found in 22% of diabetics (P = 0.026). 25.6% was idiopathic. Conclusion: PSC was the predominant type of presenile cataract in this semi-urban population group. Patients with hypocalcemia and diabetes are significantly at risk in developing presenile cataract. Diabetics with hypertriglyceridemia have a higher risk.

Correlation between Second and Fourth Digit Length Ratio with Height, Body Mass Index and Axial Length of Eyeball in Adult Population of Burdwan, West Bengal, India

Introduction: Studies are being conducted to correlate second (2D) to fourth digit (4D) length ratio as an anthropometric marker of prenatal sex steroid exposure with human body. As 2nd digit: 4th digit(2D:4D)ratio is an anthropometric window into the interplay of sex hormones in-utero, this tool may be tested to note if there is any correlation between the sexual dimorphism of axial length and the Digit length ratio. Aim: To find a correlation between digit length ratio (2D:4D) with physical parameters like height, BMI and axial length of eyeball in the adult population of South Bengal presenting in a tertiary care hospital, in Burdwan, West Bengal, India. Materials and Methods: A cross-sectional study with simple random sampling was conducted on 500 patients (age ≥20 years) from March 2016 to February 2017 in the Departments of Anatomy and Ophthalmology Out Patients Department (OPD) of a tertiary care Hospital and Medical College in West Bengal, India. Height, weight, axial length of eyeball were measured and the BMI was computed for the study population. Statistical analysis was done with Statistical Package for Social Sciences(SPSS) version 16.0. Unpaired t-test was used for determining possible group differences in 2D:4D length ratios. Pearson’s correlation coefficients were used to find a correlation between second and fourth digit length ratio (2D:4D) with height, BMI and axial length of eyeball in the study population. The p-value &lt;0.05 was considered significant. Results: The study included 280 males and 220 females with a minimum age above 20 years and most of the patients belonged to the age group of 50-69 years. A 2D:4D length ratio was significantly lower in males compared to females (For Right hand t=34.91, p&lt;0.001, and for left hand t=14.30, p&lt;0.001). Correlation analysis of 2D:4D length ratio of right and left hands with height of males revealed significant negative correlation (Right hand: r=-0.679, p&lt;0.001; Left hand: r=-0.0463, p&lt;0.001). In females, the result was positively significant for both hands (Right hand: r=0.313, p&lt;0.05; left hand: r=0.21, p&lt;0.05). A 2D:4D length ratio and BMI of males showed significant positive correlation for both Right hand (r=0.18, p&lt;0.05) as well as for the left hand (r=0.137 p&lt;0.05). In case of females, however 2D:4D ratio and BMI showed weakly negative correlation for both hands but the values were not significant. Correlation of 2D:4D length ratio of right and left hands on axial length of eyeball in males revealed significant negative correlation (right hand: r=-0.706, p&lt;0.001; left hand: r=-0.25, p&lt;0.05) but in females, there was significant positive correlation for the right hand (r=0.145, p &lt;0.05*) and positive but non-significant correlation for the left hand at 95% CI (r=0.087, p&gt;0.05) Conclusion: In this study, we have tried to establish that 2D:4D ratio (which is significantly higher in females) can be used as a putative non-invasive anthropometric marker to differentiate between males and females, which presumably is prenatally determined by in-utero sex steroid hormone exposure. By correlation studies, we have also tried to prove that this parameter correlates well with other anthropometric measurements like height, BMI and ocular axial length which are already known to be significantly different in males and females