Indian Journal of Ophthalmology

ARTICLES
Year
: 1982  |  Volume : 30  |  Issue : 4  |  Page : 333--335

The pattern of corneal diseases in Punjab


Daljit Singh, Jaspal Singh Bhullar 
 Department of Ophthalmology, Medical College, Amritsar, India

Correspondence Address:
Daljit Singh
Department of Ophthalmology, Medical College, Amritsar
India




How to cite this article:
Singh D, Bhullar JS. The pattern of corneal diseases in Punjab.Indian J Ophthalmol 1982;30:333-335


How to cite this URL:
Singh D, Bhullar JS. The pattern of corneal diseases in Punjab. Indian J Ophthalmol [serial online] 1982 [cited 2020 Apr 2 ];30:333-335
Available from: http://www.ijo.in/text.asp?1982/30/4/333/29465


Full Text

This is a very brief report of 1000 consecu tive eyes suffering from corneal diseases, seer in the eye department of Medical college hospital between August 1979 and May 1980.

 HOSPITAL INCIDENCE



1000 eyes suffering from corneal disease, were detected in 680 patients out of 5682 that came to the hospital. The incidence of corneal diseases thus comes to 11.96%.

Varieties of corneal diseases are encounterec, [Table 1]

 OCCUPATION



31.9% of the eyes belonged to the farm workers, 30.6% to the housewives (mostly villagers), 9.9% to labourers (mostly rural), 6.3% to office workers, 3.5% to students, 4.1% to shopkeepers, 2.8% to industrial workers, 0.8% to others and 10.1% to those who were doing nothing.

 ECONOMIC STATUS



Only 5.6% of the patients came from well to do families, the rest came from poor or lower middle income groups.

 EFFECTS ON VISION



Out of 680 patients, 256 patients (37.6%) had vision 6/60 or less in both eyes. Of these 202 (78.9%) had corneal ulcers and opacities, 24 had corneal degenerations (9.4%). The other conditions had a smaller share. Corneal blinds accounted for 256 out of 5680 patients coming to the hospital, an incidence of 4.5%.

 BRIEF DESCRIPTION OF SOME OF THE OBSERVATIONS



Corneal Opacities

Total number of eyes affected : 558 (55.8%). 70.25% opacities were unilateral and the rest bilateral. The incidence of opacities increases with age. The sufferers belonged to the lower economic strata. Most victims belonged to the rural areas.

24.6% of the opacities were nebular, 50.7% were macular, 14.7% leucomatous, 7.7% adherant leucoma and 2.3% were anterior staphylomas. 68% of th opacities were central, 21% were peripheral and II% involved half or more of the cornea.

The aetiological factors responsible for corneal opacities were trachoma 30%, corneal ulcers 16%, injuries I I%, latrogenic 4%, small pox 5% and miscellaneous 33%.

Visual impairment was as follows : 36% of the patients had vision less than 6/60 in both the eyes, 5% had vision 6/24 to 6/36 in one ey.' and 6/60 or less in the other eye, 10% hi i vision upto 6/18 in one eye and 6/60 or less in the other eye, 10% had vision 6/24 to 6/36 in both eyes, 15% had vision upto 6/ 18 in one eye and 6/24 to 6/36 in the other eye, 23% patients had vision 6/18 or better in both the eyes.

Corneal ulcers

Eyes affected : 112 (11.2;0) 74% of the affected eyes belonged to the males and 26% to the females. 93 eyes (83%) belonged to the rural patients. 35 cases (31%) were due to trauma while in the others, the ulcers occurred spontaneously.

Herpetic Keratitis

Number of eyes : 73 (7.3%). It was more common in the males (75%) in their 2nd, 3rd and 4th decades. The condition was unilateral in 70% of cases. Most patients give a history of fever at the time of corneal involvement.

Corneal Injuries

Number of eyes : 46 (4.6%). Almost all the cases (96%) were males in their first four decades of life. In 65% cases the injury was caused by iron particles or saw dust, the rest were caused by straws of paddy and wheat etc. The corneal injuries were seen in industrial workers and farm workers.

Corneal degenerations, climatic keratopathy etc.

A small percentage of cases, usually from the older age groups were affected by many ill­understood degenerations. The visual loss in most of the cases was severe.

 COMMENTS



It is generally not realized that the inci­dence of corneal disease is very high in this country. The fact that 11.96% of the hospital attendance had corneal disease speaks for itself. In a large percentage of cases, the vision is irreversible. Most of the affected patients are rather on the younger side. Thus the total effect on the lives of the patients and the eco­nomy of the nation is incalculable. Most of the corneal diseases are preventable and should be a matter of great concern to the health authorities and the departments of community medicine.

The misery of the corneal blinds is com­pounded by the unsuitability of keratoplasty in most cases and by the lack of facilities for keratoplasty for the suitable cases.

The ophthalmologists, side by side working for the treatment of curable blinds, should actively disseminate knowledge about corneal diseases that cause incurable blindness.

There needs to be a national debate on the serious matter of corneal morbidity and corneal blindness.

The following preventive steps are suggested

Raising the general standard of living by rapid economic growth. Emphasis needs to be placed on the provision of balanced diet, clean water and environment free from diet, clean water and environment free from dirt and flies.

A total ban on the use of Burma and surma applicators in whole of the country. Similarly a ban should be placed on the advertisement and sale of eye medicines fielded by various quack-pathies.

It is a pity that inspite of vastly improved communications and a very large scale increase in medical education and medical services, first aid to the ill and injured are not yet available to a vast majority of the population. The eye in particular is sadly neglected.

Now that we have enough eye specialists i n the country, the general practitioners should concern themselves only with the preliminary treatment of the eyes and should refer the cases to the specialists immediately.

The eyes of the industrial workers and workers in the fields need to be protected by goggles and eyeshades etc.

We should work for a uniform workable law for the whole of the country for the donation of eyes after death. Creation of a large number of keratoplasty centres in different areas is a practical possibility at the moment.

Public education on the care of the eyes needs to be taken in hand earnestly. All the eye institutions should have a wing for eye education to the patients and their relatives that come to the hospitals.