حبیب اجاقی

Amblyopia as one of the most important social and visual problems is common in the world including Iran. It plays a major role in visual dimness. The aim of this study was to determine prevalence and causes of amblyopia in middle school students in Ardabil city, Iran in 2004. In this descriptive cross-sectional study 4548 middle school students were included. The subjects primarily were screened by optometrists and an ophthalmologist by using of Snelen chart. The doubtful cases were referred to eye clinic for further checking and re-examined by ophthalmologist. The data were collected by questionnaire and the results were analyzed by descriptive and analytical statistics using SPSS software. The results cleared that 11.4% of subjects (520) had refractive errors, 2.63% (120) showed the amblyopia and 0.9% (43) experienced strabismus. The most common cause of amblyopia was anisometropia (59% of all cases) and for strabismus was isotropia (69.5% of all cases). These findings showed that there is a significant correlation between type and rate of refractive defects with amblyopia. The highest rate for refractive amblyopia was over 3 Diopter hyperopia (29.5% of refractive amblyopia). Hyperopia revealed to occur in males more than females and vice versa for astigmatism It seems that the prevalence of amplyopia in Ardabil is similar to other cities in Iran and other countries. But the refractive amblyopia in Ardabil shows more prevalent than other areas. Its reason may be due to less knowledge to use glass and low socio-economic conditions as well as low quality of treatment.

Anesthesia for ophthalmic surgery requires management of intraocular pressure (IOP) during preoperative period. Any degree of IOP increasing could reduce visual acuity. Administration of narcotics concomitant with anesthetics has the ability to reduce this increase of IOP. This clinical trial aims to compare the efficacy of Remifentanil and Alfentanil in preventing an increase in IOP after administration of succinylcholine, intubation and during anesthesia. This double blind clinical trial was intended to 50 patients undergoing elective general surgery for cataracts. Patients were randomly divided to two groups; Alfentanil (20µg/Kg in 30 second) for group 1 and Remifentanil (1µg/kg in 30 second) for group 2 were injected before induction of anesthesia and 0.5µg/kg/min Alfentanil for group 1 and 0.1µg/kg/min Remifentanil for group 2 were infused during the anesthesia. Systolic and diastolic blood pressure, heart rate and IOP from normal eye were measured before the induction, after administration of thiopental and succinylcholine, after tracheal intubation and 2 minutes later and were repeated in 2-minute intervals until the end of operation. IOP decreased after injection of anesthetics and remitted lower all through the operation in both groups, but IOP decreased after injection of succinylcholine in Remifentanil group while it increased in Alfentanil group (P<0.05). Results of this study indicate benefits of both Remifentanil and Alfentanil for managing IOP after induction and during anesthesia. It seems that Remifentanil is better than Alfentanil in controlling the IOP after injection of succinylcholine.

one of the most common causes of Epiphora or lacrimation or recurrent infection is Dacryocystitis. The Dacryocystorhinostomy operation, which involves fistulization of the lacrimal sac into the nasal cavity may alleviate the symptoms. Since the routine usage of silicon tube in DCR operation for reducing the replapse has been a controversial issue, This study was done to investigate the rate of success of DCR operationwith silicone tube. This study was a cross-sectional descriptive study in which all of the patients (189) who had history of DCR at Sina and Alavi hospitals were asked to continue the treatment after the operation through contact or follow up from home. So the results of their records were analyzed statistically. 102 out of 189 patients had history of operation who had referred for follow up, in terms of most prevalent symptoms, epiphora and purulent discharge was the highest 55.6% and the second one was epiphora alone 29.1%. The operation prevalence was more in women 74.1%. than in men 25.9% and unilateral involvement 97.3% was more than bilateral one. The highest age prevalence in DCR operation was 30-60 years. The surgery was successful in 82.3%. It was a little more successful in men (85.7%) than in women and the mean age of patients with successful DCR surgery was more than that of patients with unsuccessful DCR surgery. The results showed that the rate of recovery in unilateral involvement is more than that of bilateral involvement. Also, success after the operation in patients whose primary complain was only purulent discharge was significantly more than those whose primary complain was epiphora and purulent discharge, It also seems that routine application of silicon tuby in DCR surgery has no effect in the increase of recovery and decrease of diseaserecurrency which of course more prospective studies are required to prove this.

Considering the high prevalance of congenital obstruction of nasolacrimal ducts in infants and the importance of timely intervention and due to the lack of previous similar researches in Ardebil province, and regarding the discrepancies in the reports about the degree of successful accomplishment of the first probing, the researchers set out to design and perform the present research among the patients referring to ophthalmology ward. This descriptive and cross-sectional study was conducted on 84 children suffering from congenital nasolacrimal duct obstruction who had undergone pobing surgery in Alavi hospitaly between 2000 and 2002. 70 eyes of 50 patients were examined. 27 (54%) were male and 23 (46%) were female. 20 of them (40%) had bilateral involvement and 30 (60%) had unilateral one. Involvement of right eye (60%) was more than left eye (40%) and was expected in first child (56%) more than subsequent offsprings. Clinical manifestation was epiphora in 44%, prulent discharge in 12% and epiphora with prulent discharge in 44%. 90% of the subjects were operated for the first time while 10% had had 2-3 operations before complete recovery was observed in 48% of the patients 46% of them had relative improvement and no recovery was witnessed in 6% of them. This study showed that the male infants were affected more than females, and the rate of involvement in right eye as well as in first children was relarively high. Also the rate of recovery among unilateral groups and infants under 1 year of age was considerably high, so it is recommended that the patients of this age group undertake a therapy with topical antibiotic and lacrimal sac massage and because of the low success of the surgery above 2 years of age, probing is recommended from 6 month to 18 months of age if medical treatment was unsuccessful.

The nationwide amblyopia prevention program is performed by prevention deputy of welfare organization every year. In this analytic report practical results of screening program in 1998-2001 were presented and compared with similar findings in other countries. The results were also compared with the findings of previous similar researches in Iran. The amblyopia screening program was performed on all 3-65 year-old children in day-care centers as well as those referring to the visual acuity measuring centers. The first examination was accomplished by trainers. In the second step doubtful cases were referred to optometrist by trainers and amblyopia was diagnosed by an optometrist and confirmed by an eye specialist after excluding organic causes. 608 out of 8427(7.21%) children examined by trainers in 2001 were referred to an optometrist because of suspected visual disorders. The prevalence of amblyopia in different cities of Ardabil province was 2%-15%. The figures in 2000-2001 were 10% (Rangs=1%-13%), respectively. In 1998 it was 11% (Range =5%-13%). In the second phase of amblyopia plan the prevalence of visual problems was estimated about 21%, 45%, 47%, and 74% in 1998-2001, respectively. In the third phase of the plan the amblyopia prevalence for children examined by eye-specialist in 1999-2001 were 1.6%, 1.41% and 1.25% respectively. In this research the prevalence of amblyopia was found to be 1.42% which has a conformity with the findings of other countries. Moreover, the higher variation in the estimation of the prevalence of visual disorders in this province requires further comparative researches.