Amtul Aziz, Mahmood Ali.
Spectrum of ocular diseases in senior citizens at Al Shifa Trust Eye Hospital Rawalpindi.
Al-Shifa J Ophthalmol Jan ;2(1):11-8.

Purpose: To calculate the frequency of various ocular diseases and provide information regarding causes of visual impairment in the patients aged 70 years and above presenting at Senior Citizens Clinic (SCC) of Al Shifa Trust Eye Hospital, Rawalpindi. Design of study: A retrospective analysis of patient record. Participants: Randomly selected 1,000 newly registered patients aged 70 years and above who presented at the SCC of Al Shifa Trust Eye Hospital, Rawalpindi from January 2005 to April 2006. Methods: After a brief history, a detailed ocular examination of all the patients was performed, including visual acuity assessment, external inspection, biomicroscopy, applanation tonometry and fundus examination. Further investigations in some cases were advised to establish the diagnosis. Various management options were medical, surgical, prescription of glasses or referral to other clinics. All this record was maintained on specially designed Performa and analyzed using SPSS 10.0. Results: The most common complaint was decreased vision in 89% of patients. The most frequent disease was cataract in 44.3% patients. Visual impairment (Visual acuity equal to or <6/60 in the better eye) was recorded in 21.1% patients and the major causes of visual impairment were cataract in 45%, glaucoma in 15.38% and retinal diseases in 14.61%. Intra ocular pressure >22 mm of Hg in both eyes was found in 5.8% patients while 6.9% had >22 mm of Hg in one eye at the time of presentation. Regarding the management, 46.3% patients were advised surgery, 12.9% were treated medically, 24.7% were refracted, and 14.9% were referred to specialized clinics. Majority of the patients (48.31%) were from Rawalpindi / Islamabad. Conclusion: Cataract, glaucoma, retinal and corneal diseases are a major challenge to ophthalmologists in Pakistan because these diseases remain main causes of visual impairment in our elderly patients, thus affecting their quality of life. The elderly should be encouraged to come for annual ocular examination so that early detection of visual impairment is done and permanent visual loss is prevented.

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