Browsing by Author "Gurung, Reeta"
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Publication Outcome of Paediatric Microbial Keratitis in Tertiary Eye Center in Nepal(Nepal Paediatric Society (JNPS), 2023) Bajracharya, Leena; Gurung, ReetaAbstract: Introduction: Corneal diseases are important ocular morbidity in childhood in developing countries and microbial keratitis is a common cause for it. Methods: It is a retrospective study of 50 microbial keratitis occurring in children of < 18 years presenting in tertiary eye center in 18 months’ period. Results: Average age of the patients having non-viral infective keratitis was 10.25 years. Sixty-four percent were males. Ninety percent of cases were from rural regions. Patients visited tertiary center at average duration of symptoms of 13.2 days. Twenty-five (50%) cases had history of trauma, of which 16 had trauma while playing. Topical steroids, as risk factor was present in 12 (24%) cases. Six (12%) cases had history suggestive of herpetic keratitis as predisposing factor for microbial keratitis. Thirty-one cases underwent diagnostic corneal scraping. Seven cases showed bacterial growth and three cases fungal growth. Twenty percent of cases had infiltrate size > 25% of corneal surface. Eleven (22%) were with hypopyon. Two cases were perforated at presentation. In total, 37 (74%) of the ulcers healed after treatment, five (10%) underwent therapeutic keratoplasty and eight (16%) were lost to follow up. Out of those healed, 17 had vision of ≥ 6 / 18 and 7 had vision < 3 / 60. Conclusions: Awareness is important for care-takers to avoid trauma in eyes of children. Paediatric microbial cases present late in the tertiary center in our context. Timely referral is important to prevent complications and to avoid need of keratoplasty.Publication Recurrence of Avellino Corneal Dystrophy Following Penetrating Keratoplasty: A Case Report(Nepal Medical Association, 2021) Rana, Rachana Singh; Bajracharya, Leena; Gurung, ReetaAbstract: Granular – lattice (Avellino) corneal dystrophy is inherited in an autosomal dominant fashion which affects stroma of the cornea with recurrent erosions and decreased vision due to clouding of cornea in later stage. We reported a case of 53-year old woman presented with pain and blurring of vision of left eye for 10 days with history of right eye deep anterior lamellar dystrophy and Left eye penetrating keratoplasty 5years back for Avellino dystrophy. On examination right eye graft was clear and left eye showed circular edges of irregular epithelium with patchy stains and epithelial defect suggestive of recurrence of dystrophy. A patient with recurrent corneal erosions and opacity in cornea has to be examined carefully so as not to overlook Avellino corneal dystrophy. Being a rare disorder this case has been reported to draw the attention of ophthalmologists about its recurrence following keratoplasty.Publication Tectonic Graft for Persistent Leakage and Visual Outcome After Corneal Perforation Repair: A Case Series(Nepal Medical Association, 2020) Rana, Rachana; Bajracharya, Leena; Gurung, ReetaAbstract: Keratoplasty is a modality of treatment for large and leaking corneal perforation in a tertiary center. We report cases of 20and 30-years old men presented in an emergency with history of road traffic accident 1 and 3 days back. Best corrected visual acuity was hand movement in both injured eye. Slit lamp examination of both cases revealed full thickness corneal laceration with Siedel test positive. Both cases underwent corneal laceration repair with resuturing and corneal glue on consecutive days but couldn't seal the leaking wound. Then ultimately both were undergone for tectonic keratoplasty. The final best corrected visual activity of involved eye was 6/36 in case 1 and 6/24 in case 2. Most cases of traumatic corneal perforation undergone urgent corneal repair but sometimes very difficult to seal the wound. In such cases donor cornea tissue may have to be used to maintain integrity of globe and better visual potential.