Objectives: The present study undertaken to study the factors responsible for the development of lens-induced glaucomas (LIGs), factors, and various modes of presentation in LIGs. Methodology: A minimum of 50 cases of LIG were selected based on simple random sampling, who attended the Department of Narayana Medical College Hospital and were diagnosed with LIG. Based on the clinical findings, etiological diagnosis of LIG was made. Results: Out of the 50 cases, 34 cases (68%) were diagnosed as phacomorphic glaucoma, 12 cases (24%) were of phacolytic glaucoma, two each (4%) were lens-particle glaucoma and glaucoma secondary to subluxation/dislocation of lens. Conclusion: There was no influence of sex, religion, or occupation on the incidence or occurrence of LIGs. Majority of the patients had good vision in the other eye as a result of which they neglected the affected eye till they developed LIG leading to pain during the time of presentation. Hence, it is important to advice the patients regarding the early surgical treatment of cataract before they develop complications.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: The growing number of mobile phone users or video display terminals (VDTs) puts them at hazards of computer vision syndrome (CVS) resulting in ocular surface damage, eye strain, exhaustion, and muscular complaints as result of improper usage of VDTs. Objectives: To determine the prevalence of CVS and to get a baseline data about this syndrome among inhabitants of Al-Ahsa, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted for the duration of 1 month in Al Ahsa Saudi Arabia. Convenience sampling was used with a validated questionnaire to measure the CVS symptoms and to collect data. Consequently, Chi-square test was performed to observe the prevalence of CVS with its risk factors using SPSS version 22. Results: This study showed the prevalence of CVS among Al-Ahsa population to be 43.5% of the screened sample; this was significance results in the term of blurred vision (P = 0.002), dry eye (P = 0.011) and ocular discomfort (P = 0.013) among individuals suffer from CVS. Regarding extraocular complaint, there was a significant result seen in the presence of neck and shoulder pain (P = 0.008) and dizziness (P = 0.045) in individual developed CVS. Conclusion: The study found significant results in term of ocular and nonocular complaints among individuals who developed CVS from Al-Ahsa. Further longitudinal studies are required to study the effect of VDTs on ocular health.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Dry eye disease (DED) is the most common multifactorial annoying ocular surface disorder, of various ocular symptoms, ranging from eye discomfort, dryness, itching, irritation, and foreign body sensation up to noticeable visual disturbance. Eventually ends with reducing quality of life. Optical refractive quality might deteriorate in these DED individuals, especially in hot-dry-windy climates like in Sudan. Aim: This study aims to determine the influence of spherical refractive errors (REs) on the tear volume and DED. Materials and Methods: In a comparative cross-sectional hospital-based study 90 (n = 90) participants were included; all were free from any ocular or systemic diseases and not using contact lenses. They were of equal numbers of hypermetropes and myopes of mixed gender; males and females, with their ages range between (18-28) years. The mean ages in both groups of RE states were 21.97 ± 2.35 and 22.55 ± 3.29 hypermetropes and myopes, respectively. The study was performed at Makkah Eye complex (MEC), Khartoum, Sudan, from May to July 2015; where the participants were recruited from the general refraction clinics at MEC. All individuals were subjected to the full eye examination. The Schirmer's test was used for all the participants. SPSS statistical analysis program was used to analyze the data. Results: Dry eye was found in 26.6% on hypermetropic patients and 1.1% myopic patients. In this study, the spherical REs showed a significant difference between males (16.6%) and females (12%) P = 0.001. Conclusion: REs may be considered to be one of the risk factors to cause dry eye condition. Correcting RE may reduce the risk factor of dry eye, and that may reduce its prevalence.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Binocular single vision involves the simultaneous use of both eyes with bifoveal fixation, and this process helps individuals to use their both eyes for reading, writing, and other near activities; the stress on this system could lead to ocular complaints and affect the near task for the school-aged children. Aim: The aim of this study was to assess the effect of academic examination stress on binocular vision functions among secondary school-aged children in Khartoum State of Sudan. Materials and Methods: This is an experimental study of 148 secondary school-aged children, selected randomly from Alfath Secondary School, and their ages ranged from 13 to 17 years with a mean age of 14.6 ± 1.13 years. Investigation was performed before and after the academic examinations in 2017. The clinical examinations include visual acuity measurements using Snellen vision testing chart, refraction using autorefractometer, dissociated near phoria by Maddox Wing, associated near phoria by Mallet Fixation Disparity Test, amplitude of accommodation and near point of convergence (NPC) measured by R.A.F rule, and near positive fusional vergence (PFV) and near negative fusional vergence by prism bar. All these investigations were done before 15 days of academic examinations and on the day after the students finished their academic examinations. Results: The findings indicated that most of the students (62.8%) before the academic examinations reported that they were free from any ocular complaints, whereas 37.2% had ocular symptoms. After stress due to examinations, the percentage of students who had ocular complaints increased to 71.6, whereas those free of ocular complaints decreased to 28.4. The mean of amplitude of accommodation before taken the examinations was 9.81 ± 2.16, and after the examination, the mean of amplitude of accommodation decreased to 8.77 ± 1.97 (P < 0.001). Nearly 54.7% of the participants had normal NPC before the academic examinations, and after the examinations, those who had normal NPC decreased to 46.4% (P < 0.001). Only 29% of the students had associated heterophoria before the stress of examinations, and after the examinations, the percentage of students with associated heterophoria increased to 56.5 (P < 0.001). Almost 40.5% of the students presented with normal PFV at near fixation, and after the stress, only 29.1% had normal PFV at near fixation. However, more than half of the students (59.5%) had weak PFV for near fixation before the examinations, and after the examination, they increased to 70.9% (P < 0.001). Conclusion: The academic examination stress had a major effect on binocular vision functions, result in decompensated heterophoria, as well as decline in amplitude of accommodation, and NPC. Thus, comprehensive eye examination including binocular vision function assessment should be made annual for school-aged children.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Purpose: The aim of the study was to determine the frequency and pattern of eye diseases among patients attending the eye clinics of Makah Eye Hospital, Khartoum, Sudan. Methods: A retrospective study involved all the new cases presenting to the outpatient department of the hospital over a 22-month period from January 2012 to October 2013. Patients were examined by optometrists/ophthalmologists through routine examination using the Snellen's chart, refraction, tonometry, slit-lamp examination of the anterior segment, and fundus examination. Results: A total of 64,529 patients were seen during this period with a male to female ratio of 1:1.1. The most common eye diseases were cataract, allergic conjunctivitis, infective conjunctivitis, refractive disorders, and glaucoma. Conclusion: The pattern of eye diseases observed in Makah Eye Hospital was similar to other reports from developing world and such study will be helpful in planning, management, and prevention of blindness.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Objectives: To estimate the prevalence and causes of blindness and other degrees of vision impairment in people aged 50 years and older in North Kordofan state, Sudan, using the Rapid Assessment for Avoidable Blindness methodology. Design: Cross-sectional, population-based survey. Participants: Forty-three clusters of 50 people aged 50 years and older were selected by probability proportionate to size sampling of clusters. Households within clusters were selected through compact segment sampling. A total of 2167 eligible persons were selected, of whom 2032 (93.8%) persons were examined. Materials and Methods: Participants underwent a comprehensive ophthalmic examination in their houses by trained ophthalmic teams, including measurement of visual acuity (VA) with a tumbling-E chart and the diagnosis of the principal cause of visual impairment. Results: The prevalence of bilateral blindness (presenting VA < 3/60) was 8.37% (95% confidence interval [CI]: ±1.60), the prevalence of severe visual impairment (VA < 6/60–3/60) was 2.71% (95% CI: ±0.59) and the prevalence of bilateral visual impairment (VA < 6/18–6/60) was 9.06% (95% CI: ±1.76) in the sample. Definite avoidable causes of blindness (i.e., cataract, refractive error, trachoma and corneal scarring) were responsible for 76.5% of bilateral blindness. Cataract was the major cause of blindness (60.6%), followed by Glaucoma (20%). Conclusions: The prevalence of blindness in people aged 50 years and older in North Kordofan state was higher than that expected for Sudan. The main cause of blindness was Cataract, followed by Glaucoma. More than 75% of blindness was due to avoidable causes.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: The axial length is one of the essential ocular biometric parameters which is to be done prior to any cataract surgery based on ultrasound. These ocular axial length (OAL) values can be influenced by sex, age, race, ethnicity, genetics, and refractive errors. Objectives: The aim of this study is to determine the normal ranges values of OAL in adult Sudanese population and to define the effects of age, gender, and tribal ethnicity on axial length. Materials and Methods: This is descriptive multi-center hospital-based study, carried out over a period of 6 months from January 2015 to June 2015. The study takes place in five study areas: Three in Khartoum and two in Omdorman. These centers are Khartoum Eye Hospital, Makkah Eye Complex, Alwalidain Eye Hospital, and Omdurman Military Hospital and Sudan Eye Center. The study population was recruited from patients presenting to the mentioned five Hospitals Biometric Departments or volunteers who accepted to be enrolled in the study. One thousand Sudanese adults participants (n = 1000), 507 female and 493 male, with ages ranging from 18 to 105 years were included. Patients with vitreoretinal diseases, intraocular surgery, recent trauma and staphyloma were excluded. All participants underwent systematic OAL measurements by A-scan ultrasonography. Effect of age, gender, and tribal ethnicity on OAL was analyzed. Results: The study showed that the average axial length was 23.09 mm ranging from 18.13 mm to 29.09 mm. It was longer in males (average 23.29), ranging from 20.31 mm to 28.48 mm and shorter in females (average 22.81), ranging from 18.31 mm to 29.09 mm. In the four main Sudanese tribes, the Nubian group had the longest axial length (23.23 mm), followed by the African group (23.15 mm), and then the Arab group (23.09 mm). Bejja group had the shortest axial length (22.85 mm). Conclusion: OAL in Sudanese adults was within the international standard but with a wider range (18.13–29.09 mm). Males' OAL was longer than the OAL of females. No significant age OAL variations, but the tribal ethnicity factor was clear, so tribal ethnicity had a major influence on Sudanese OAL.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

The aim of this study is to report a case of pleomorphic adenoma of palpebral part of lacrimal gland. A 38-year-old female was admitted with the complaints of swelling in the left upper eyelid which was gradual in onset and progressive in nature for 4 years. A firm nodular mass was seen protruding from left superior temporal region of orbit causing mild ptosis. Blood examination showed raised erythrocyte sedimentation rate. Ultrasound was typically hypoechoic well-capsulated mass. Under general anesthesia, the tumor was totally excised with anterolateral orbitotomy. Histopathological examination revealed a pleomorphic adenoma of the lacrimal gland with no evidence of malignancy. Postoperatively, mild ptosis was present and the patient was advised to use lubricating eye drops. Follow-up showed no recurrence. Pleomorphic adenoma (benign mixed tumor) of the lacrimal gland accounts for approximately 12–25% of all lacrimal tumors. Among these, 90% are orbital and only 10% are palpebral part of lacrimal gland tumor. It should be excised completely with a margin of normal tissue as incomplete resection may lead to recurrence. Incisional biopsy is believed to increase the risk of recurrence due to disruption of the pseudocapsule and tumor spillage.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Aim: This study aims to evaluate the contrast sensitivity, color vision, and stereoacuity in amblyopic eyes. Materials and Methods: A prospective, cross-sectional, hospital-based study includes 64 amblyopic patients (79 eyes), with age between 10 and 30 years, which represents the study sample. Thirty-six normal individuals of same age group were taken as a control group. The history of the patients was taken; vision, objective, and subjective refraction were performed. Pinhole was used to determine the amblyopia. Color vision, contrast sensitivity, and stereoacuity tests were done for both groups. Results: Anisometropic amblyopia represents 51.5% of cases. Significant decrease in contrast sensitivity was detected compared with the control group (P = 0.000). Color vision defect was found in 39.2% of amblyopic patients; 27.8% were tritanopes. Amblyopia affected stereoscopic vision in 48.5% of patients with mean 43.44 ± 95.17. Conclusion: Early detection of causes of amblyopia may prevent the bad Consequences.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Diabetic retinopathy (DR) is one of the major complications of diabetes mellitus (DM) and is the leading cause of blindness among working people. It constitutes 5% of the global causes of blindness. Knowledge, attitudes, and practices (KAPs) on DR among medical residents (MRs) and general practitioners (GPs) should be well assessed to insure a very good level of DR care. These groups are the most important primary health provider of the diabetic care network. Objectives: The aim is to assess the KAPs on DR among MRs and GPs in Sudan. Materials and Methods: Two hundred and twenty-five doctors, as the study population, were chosen from Khartoum state nonconsultant nonprivate working doctors, who are working in 22 general hospitals distributed across Khartoum state, between August and September 2016. All the selected study Personale were working in these hospitals, and they were exposed to diabetic patient's care which is available within the facilities of these hospitals. Specialist, consultants, and private doctors were excluded from the study. Data were collected through a well-designed self-administered questionnaire. The questionnaire was mainly included closed-ended questions with a few open-ended ones. It contains questions on demographic data, knowledge and awareness levels, practices toward screening DR, and questions on attitudes toward DR. At the end of the survey, the entire data were coded and entered into a Microsoft Excel spreadsheet in a personal computer. The responses were analyzed using Statistical Program for Social Sciences (SPSS) version 20 (Manufactured by IBM SPSS Inc., PASW Statistics for Windows, Version 20.0; 2009. Chicago: SPSS Inc., IL, USA). Results: Two hundred and twenty-five doctors; (GPs and MRs); were included in the current study. One hundred and thirty-seven (61%) of the responded participants were female and 88 (39%) were male. The mean age of the study group was 27.7 ± 8.0 years (range: 20–36 years). Two hundred and twenty-five questionnaires were distributed to all members, only 180 (93.75%) members completed the questionnaires. Fifty-eight (32%) has MBBS and 123 (68%) has MBBS + part one in medicine. Their years of medical practice was ranged from <1 year to >2 years. One hundred and sixty-one (92.5%) and 155 (89.0%) mentioned eye and kidney, respectively, as the organs affected by DM. One hundred and fifty-eight (90.8%) mentioned retina as the part of the eye that can be affected. One hundred and eighteen (68.0%) mentioned poor glucose control as the factor that influences the presence or severity of DR. Fifty-nine (34.0%) mentioned duration of DM. Fifty-six (32.4%) high blood pressure high and 13 (7.5%) lipid level is important for DR degree. One hundred and sixty-four (95.0%) respondents, mentioned retina as the part of the eye that should be examined first for changes for DR. Ninety-one percent noted that DM can cause eye complications; new vessel formations. Hemorrhages, retinal detachment… etc. Seventy-five percent have the attitude to examine the diabetics when only the vision is affected. Fifty-one percent strongly agreed to do eye examination in diabetic pregnant and to do fundoscopy for any diabetic patient. Thirty-seven percent strongly agree to check eyes when lipid is high. Most of the respondents, i.e., 99 (59%) strongly disagree that ophthalmology training in medical school was enough to detect patients with DR. Seventy-two (42%) do visual acuity for their diabetic patients and 50 (30%) examine the fundus (retina). One hundred and twenty-six (75%) disagree that eye examination is only required in diabetic patients when vision is affected. Conclusion: Participants generally had a poor knowledge on DR although they had good knowledge about relationship between DR and others end organs which can be affected by microvascular complication of diabetes mellitus and good practice in referral of diabetic patients 136(81%). Undergraduate ophthalmology training in medical school is not adequate.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Goldman applanation tonometry (GAT) is still the most accurate for measuring intraocular pressure (IOP). Usually, fluorescein eye drops are used in additional to topical anesthesia to gain the best visualization result. Objective: The main objective of the study is to compare the GAT values with and without fluorescein in adult Sudanese glaucomatous and nonglaucomatous population. Materials and Methods: In a cross-sectional hospital-based study, 400 patients were recruited from out patient's and glaucoma clinics at Makkah Eye Complex, Khartoum, in the period from December 2017 to January 2018. Different ages were classified into three groups, patients also classified into glaucoma (n = 200) and nonglaucoma (n = 200) patients, another classification according to gender. Then, IOP measurements with and without topical fluorescein were done by GAT. Results: Two hundred and sixteen (n = 216; 54%) were male and 184 (46%) were female, with an average age of 54.76 ± 24.5 years. Two hundred (50%) were glaucomatous, and the other 200 (50%) were nonglaucomatous. The average IOP with fluorescein was higher than without fluorescein by 13.1% (2.08 mmHg) and still was higher in comparison between non-Glaucomatous and glaucomatous with and without fluorescein up to 3. 41 mmHg (17.86%). Both results ± fluorescein and ± glaucoma were statistically significant (P = 0.000). There was a significant correlation between age and IOP values with fluorescein and between having glaucoma and IOP with fluorescein (P = 0.000), while there was nonsignificant correlation between sex and IOP measurements with fluorescein. Conclusion: There are statistically significant differences in IOP values by GAT either ± fluorescein or ± glaucoma. A significant correlation between age and IOP values either ± fluorescein or ± glaucoma were detected, but not to sex.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Pterygium is a triangular fold of bulbar conjunctiva usually found in the nasal side of the interpalpebral fissure. It consists from apex and base. Its apex advancing progressively toward the cornea. The exact cause of pterygium is not well understood, but long-term exposure to sunlight, especially ultraviolet rays, wind, and chronic eye irritation from dry and dusty conditions seems to play an important causal role. It looks like scar, but it is not. The growth might spread slowly during a life or stop after a certain point. In extreme cases, pterygium can cover pupil and cause vision problems. Aim: The aim of this study is to reveal the effect of pterygium on corneal thickness, corneal curvature, tear volume, and intraocular pressure (IOP). Materials and Methods: A total of 100 patients have primary pterygium in one eye (unilateral) compared to their healthy (control) eye. The study was conducted in Makkah Eye Complex in Alkalakla branch between April 2016 and November 2017. The criteria of admission included individuals who have no history of systemic/chronic or other eye diseases. The patients whose pterygium enters the cornea within 2.0–3.0 mm and visual acuity at least 0.50 decimal (6/12) were selected. The data included age and gender, while the clinical procedures included testing vision and visual acuity (Snellen's type), autorefraction and autokeratometry, ultrasound pachymetry, applanation tonometry, and break-up time tear assessment. Frequency distribution tables and t-test were used to present the data. Results: The results showed that the pterygium was more apparent among male (53%) than female (47%). Significant decrease on visual acuity (77%) and tear volume (86%) of the pterygium eye (P < 0.0001) was observed as compared to healthy eye (HE). The primary pterygium caused meridional steepness in corneal curvature (98%). With-the-rule corneal astigmatism was dominant (61%) among other types. Statistically, there were little decrease on central corneal thickness and nonsignificant effect in IOP between the two eyes. Conclusions: Pterygium can cause significant change in ocular functions compared to HEs according to study parameters. Ocular dryness complications and vision impairment due to corneal astigmatism should be considered to make correct diagnoses for eye symptomatology.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: The term blindness is used for complete or nearly complete vision loss. The number of people estimated to be visually impaired worldwide is 285 million; 39 million are blind and 246 have low vision. About 90% of the world visually impaired lives in low-income settings. The overall objective of this study was to identify the social determinants of blindness in Sudan, aiming for prevention and control. Methodology: This was an outreached service cross-sectional study conducted among 858 participants selected using multistage cluster sampling and drawn proportionate to size among four cities in Sudan using probability sampling technique. The data were collected using closed-ended administered questionnaires, and data were analyzed using the Statistical Package for the Social Sciences version 21. The analysis included uni-variate for all determinants and bi-variate cross-tabulation using Chi-square test to reveal associations between variables of interest. The study was estimated at 95% confidence level. Results: The overall socioeconomic profile of the study group was low. The mean monthly income of the blind participants was only 1991 sustainable development goal. The majority of the blind participants were unemployed, where they represented >70% and there was a significant association between occupation and blindness (P = 0.000). More than half of the blind participants (58%) were living in rural areas, and the study revealed a significant association between blindness and living are (P = 0.000). Conclusion: The socioeconomic status in terms of income, occupation, and living area and is significantly associated with blindness. A majority of the blind participants are living in rural areas, unemployed, and earn low monthly income.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Fungal keratitis is a very serious and potentially sight-threatening corneal infection that most commonly develops in patients after trauma or in those with a compromised corneal surface. Although it is relatively rare but due the extensive use of topical antibiotics and Steroids there have been a noticeable increase in fungal keratitis.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]