Background: Rise in intraocular pressure (IOP) is the commonest complication after YAG posterior capsulotomy. As there are different opinions regarding use of anti-glaucoma therapy before YAG, we compared post-YAG IOP between the patients who had Brimonidine eye drops and those who did not have any anti-glaucoma treatment. Material and methods: It was a prospective study that included patients who had undergone uneventful phacoemulsification with foldable intraocular lens implantation and YAG posterior capsulotomy. One hundred fifty patients were divided into two groups; (a group with prophylactic brimonidine 0.2% eye drops before laser and a group without any anti-glaucoma therapy). Intraocular pressure was checked pre-laser and one hour after laser procedure. Results: Out of 150 patients, 78 were in brimonidine group and 72 in the control group. The mean age of the patients was 60.39 ± 12.98 years. In the brimonidine group, IOP was 12.56 ± 2.38 mm Hg and 12.29 ± 3.64 mm Hg before and after YAG, respectively. In the control group, IOP was 12.24 ± 1.53 mm Hg and 13.38 ± 2.84 mm Hg before and after YAG. Brimonidine 0.2% caused a decrease in IOP, but the post-laser IOP difference between the two groups was not statistically significant. The change in IOP before and after using brimonidine 0.2% was also not statistically significant. Conclusion: Every patient undergoing YAG capsulotomy does not require prophylactic anti-glaucoma therapy. Only the patients prone to high IOP, glaucoma suspects, and diagnosed cases of glaucoma should be given prophylactic treatment.

Background: This study aimed to analyse the influence of location, pathology, and approach on the extent of resection of orbital tumours. Material and methods: We have conducted a retrospective analysis of the clinico-radiological features of all orbital tumours operated between January 2012 and December 2019. Frontotemporal craniotomy with orbitotomy was performed for almost all lesions, except those limited to the lateral compartment (lateral orbitotomy), superior compartment (mini-craniotomy), and inferior medial compartment (transconjunctival/endoscopy). Statistical Analysis System (SAS) version 9.4 was used for analysis, and a p-value < 0.05 was considered to be statistically significant. The study was approved by the Institutional Review Board (3/10/2020). Results: Our study group comprised forty patients with a mean age of 40.89 years ± 19 years. Of the forty tumours, 21 (52.5%) cases were primary tumours of the orbit, and 19 (47.5%) were secondary tumours. The majority, 27 (67.5%), of the tumours were extraconal in location. The two most common presenting symptoms were proptosis (36/40; 90%) and visual blurring (30/40; 75%). The majority of the patients could be successfully operated through a fronto-tempero-orbital approach with or without removal of zygoma (28/40; 70%). Meningioma was the most common histology (45%), followed by schwannoma and lacrimal gland tumours (10%). Primary orbital tumours (15/21; 71.6%) and intraconal tumours (9/13; 69.23%)were associated with greater rates of gross total removal (GTR). GTR in sphenoorbital meningiomas was poor (2/17; 11.8%). Conclusion: Intraconal primary benign orbital tumours have a better chance of total gross removal. A frontotempero- orbital approach with or without removal of zygoma provides adequate exposure for the majority of the tumours.

Background: Pseudo-melanomas are a group of pathologies that can mimic melanoma. A retinal hemorrhagic macrocyst is a rare condition that can mimic choroidal melanoma. Diagnosing it accurately is important because of the difference in prognosis and treatment. Ocular ultrasound can be used to help differentiate between these similar conditions. Case presentation: We present a patient with a choroidal pseudo-melanoma diagnosed accurately and on time with the aid of an ocular ultrasound.

Background: Globally the prevalence of myopia has increased alarmingly and is expected to affect an estimated 2.56 billion people in the world by the end of 2020. It is believed to be the leading cause of visual impairment in Kenya, contributing 59.5% of all causes of visual impairment. Still, agreement on the exact prevalence in Kenya and whether socio-demographic factors have an influence on myopia is unknown. This study was aimed at evaluating the prevalence of myopia and its socio-demographic distribution amongst randomly selected school-going adolescent. This study was conducted in Lurambi Sub-County in Kakamega, Kenya. Material and methods: The study adopted a school-based cross-sectional descriptive study design. Using a multi-stage sampling technique, 733 participants from a population of 7,400 secondary school students within Lurambi Sub-County were randomly selected. A standard optometric vision-assessment protocol was applied to those who met the inclusion criteria and cycloplegic refraction was conducted to elicit those who had myopia. Results: The prevalence of myopia was found to be 7.5% of which 29 (52.7%) were male while 26 (47.3%) were female and there was no association between gender and myopia (p = 0.572). Myopia was found to be more prevalent in urban 49 (87.3%) as compared to rural 7 (12.7%) areas and there was no association between place of residences and myopia (p = 0.381). Similarly, 15–18 years was the dominant age group 39 (70.9%) and there was no association between age and having myopia (p = 0.926). The study also found that there was no association (p = 0.207) between school class of the participants and having myopia, although most myopic cases were in the form four class 15 (27.3%). Conclusion: Myopia was found to be mostly prevalent in the urban setting and upper classes as compared to rural and lower classes. This may link myopia to other risk factors such as near work and outdoor activities, but more research needs to be done in these areas.

Background: In this study, we aimed to measure neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) levels in primary acquired nasolacrimal duct obstruction (PANDO) patients and to determine whether there it could be used as a marker for PANDO. Material and methods: This retrospective study included 61 patients with PANDO and 65 healthy controls. Data were excluded from the file records of patients who underwent external dacryocystorhinostomy (DCR). Blood samples were obtained from venous blood and serum neutrophil, lymphocyte, and platelet data of all patients were recorded and also, NLR-PLR values were calculated. Results: There was no significant difference between PANDOs and controls in terms of gender and age (p > 0.05). Neutrophil-to-lymphocyte was significantly increased in PANDOs compared to the controls (p 0.05). The average MPV in the PANDOs was found to be significantly lower than controls (p < 0.05). Conclusion: Neutrophil-to-lymphocyte ratio and MPV counts were associated with PANDO.

Orbital myositis (OM) is a benign inflammatory disease of the orbit characterised by a polymorphous lymphoid infiltrate with varying degrees of fibrosis, without a known local or systemic cause. In this paper, we present a case of a young boy who sustained a trauma to his eyes a few days prior to admission, after which he developed bilateral orbital pain and ocular motility limitation. He underwent the appropriate investigations including orbital imaging and blood laboratory workup, which were all consistent with a diagnosis of posttraumatic bilateral orbital myositis. He was treated with steroids for few weeks, and when the dose of steroids was tapered, he had a relapse of the same disease with a different presentation, which was later controlled with a higher dose of steroids, after which the patient went into remission.

Background: Optic disc pit (ODP) is a congenital anomaly characterized by indented area of the optic nerve head most likely originating from the incomplete closure of the superior edge of the embryonic fissure. Maculopathy can occasionally complicate this anomaly as intra-retinal and sub-retinal fluid at the macula. In result, maculopathy is associated with a poor visual prognosis due to a serous macular detachment, formation of macular hole, or atrophy of the retinal pigmented epithelium. In this case series, we report of three patients with unilateral ODP. Case report: We attempted to analyze the morphologic changes seen in the ODP and evaluate patients with a complete ophthalmologic evaluation, fundus color photography, spectral-domain optical coherence tomography (SD-OCT) scanning, and magnetic resonance imaging (MRI) of globe and orbit. Magnetic resonance imaging scan was done for optic disc diameter (ODD) and optic nerve sheath diameter (ONSD). Conclusion: We noticed that in the patient who presented with neurosensory detachment in the macula, the ONSD is larger than in the fellow eye and is larger than the remaining two patients with ODP and without neurosensory detachment of the retina.

Background: The aim of the study was to compare the visual acuity (VA) score obtained in both normal subjects and patients with different eye diseases by using TOPCON CP-22 electronic ETDRS charts (i.e. E-ETDRS) and standard ETDRS charts (S-ETDRS). Material and methods: The primary outcome of this observational prospective study was the difference in median VA score (in letters) recorded in 60 patients by using both E-ETDRS and S-ETDRS. There were 60 subjects enrolled in the study: 20 normal, 20 with diabetic retinopathy and 20 with age-related macular degeneration. Results: Median number of letters read was 72.5 S-ETDR and 77 for E-ETDR (p &lt; 0.01). A subgroup analysis disclosed that the difference in VA score between the 2 devices was more pronounced (p &lt; 0.01) when considering healthy subjects compared to patients affected by diabetic retinopathy (p = 0.02) or age-related macular degeneration (p = 0.04). Conclusions: Small but significant discrepancies between the 2 devices have been detected, especially when recording high VA values.

Background: Post-traumatic endophthalmitis with retained intraocular foreign body is a severe complication of open globe injuries. It is generally associated with poor visual outcome and requires prompt and adapted management. Case report: A 39-year-old male patient presented with open globe injury of the right eye due to a metallic foreign body projection. He was a victim of a neglected work accident 10 days ago when hammering a metallic bar. Visual acuity on admission was LP (+) in the right eye. The Slit-lamp examination revealed perikeratic injection, edematous cornea and severe inflammation of the anterior chamber with hypopyon. Ocular ultrasound showed a heterogeneous vitreous organization compatible with a vitreous abscess. Orbito-cerebral CT scan revealed a retained intraocular metallic foreign body located in the posterior segment, within the vitreous humor. The patient received local and general antibiotherapy associated with intravitreal injections of vancomycin and ceftazidime followed by a vitrectomy to remove the intraocular foreign body. The visual outcome was poor with an evolution towards phtysis bulbi. The aim of this case report is to study the risk factors of post-traumatic endophthalmitis with retained intraocular foreign body and to examine treatment principles and visual outcome of this severe complication.

The classical rule was so far to observe idiopathic macular holes of stage 1a and 1b because of the high probability of spontaneous closure of the hole, while in higher stages surgical treatment was recommended. However, a growing number of case reports are available nowadays that suggest that even a more advanced stage macular hole may occasionally close spontaneously. In this article, we present a case of a 71-year-old female patient who presented with gradual bilateral decrease of vision, which was attributed to a combination of cataract and macular holes in both eyes. The macular hole in one eye was stage 1A and the other eye was stage 2. Follow up over a period of 6 months revealed conversion of the stage 1A hole to lamellar hole and spontaneous closure of the stage 2 hole.