From: Place: Bellary

The Professor and Head of the Department, Date:

Department of Ophthalmology,

VIMS, Bellary.

To

The Registrar,

Rajiv Gandhi University of Health Sciences,

Bangalore.

THROUGH PROPER CHANNEL

Respected Sir,

As per the regulations of the University for registration of Dissertation topic, the following Post Graduate Student in MS-Ophthalmology has been allotted the dissertation topic as follows by the Official Registration Committee of all qualified and eligible guides of the Department of Ophthalmology.

NAME / TOPIC / GUIDE
DR. FARHEEN
MANIYAR
Post Graduate Student in M.D. Dept. of Ophthalmology,
VIMS, Bellary. / “ CLINICAL STUDY AND MANAGEMENT OF TRAUMATIC CATARACT DUE TO MECHANICAL INJURIES IN VIMS BELLARY” / DR.K.NAGARAJ,
Professor
Department of Ophthalmology,
VIMS, Bellary.

Therefore, I kindly request you to communicate the acceptance of the dissertation topic allotted to the PG student at an early date.

Thanking you,

Yours faithfully,

Signature of the guide: ( DR. G. PAWAN)

Professor and

Head of the Department

Department of Ophthalmology,

Dr.K.NAGARAJ, VIMS,Bellary

Professor ,

Department of Ophthalmology,

VIMS, Bellary.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,BANGALORE,

KARNATAKA

ANNEXURE II

SYNOPSIS FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / Name of the candidate And Address(in block letter) / DR FARHEEN MANIYAR POSTGRADUATE STUDENT IN
M.S. OPHTHALMOLOGY VIMS,BELLARY-583104
2. / Name of the institution / Vijayanagar institute of Medical Sciences,Bellary-583104
3. / Course of study and subject / Medical,M.S.in OPHTHALMOLOGY
4. / Date of admission to course / 17.03.2008
5. / Title of the topic: CLINICAL STUDY AND MANAGEMENT OF TRAUMATIC CATARACT DUE TO MECHANICAL INJURIES IN VIMS BELLARY”
6. / BRIEF RESUME OF THE INTENDED WORK
6.1 Need for the study:
Cataract remains the commonest cause of blindness in our country
accounting for nearly 51%1
Traumatic cataract is a special clinical type since it is commonly seen in
young individuals and in children. By causing severe visual impairment in
younger population it leads to reduced productivity due to loss of manpower
and in children it may lead to loss of binocular single vision if neglected.
Lens can be damaged by both blunt and penetrating trauma
Cataracts secondary to blunt trauma often have rosette shaped appearance
or are of posterior subcapsular variety2 .
Penetrating trauma that directly damages the lens capsule can lead to cortical
opacification at the site of injury or the entire lens can opacify.It can also
lead to a rosette shaped cataract.3
Considerable number of patients present with ocular trauma (both blunt
and penetrating) in this part of the country, many being engaged in manual
labour owing to the low literacy rate prevalent here, which increases
their risk of exposure to accidental ocular trauma.
Since traumatic cataract causes significant visual impairment
in younger population, It is necessary to evaluate the damages caused by it
and manage it with timely intervention to restore the vision at the earliest.
Thus this study has been undertaken to know the incidence of traumatic
cataract, modes of clinical presentation and their management.
7
8
/ 6.2 Review of literature:
Doutetien etal (2008) did a study on 54 patients of all ages who were
treated for traumatic cataract. They found that traumatic cataract accounted
for 6.9% of all cataracts, with males being predominantly affected.
Majority of the cases had total cataracts and most were unilateral .4
Jones W L(1991) studied the mechanism of traumatic cataract. He found
that concussive trauma to the eye produces shock wave that progresses and
causes insult to both anterior and posterior structures. Rosette cataract is
characteristic of concussive trauma . Luxation and Subluxation are
additional complications of traumatic cataract.5
Synder A, Kobielska D, Omulecki W (1999) in a study on 41 patients
of traumatic cataract aged 10 to 66 years found that 78.6% had a history
of penetrating injury and 21% had history of blunt trauma. Extra Capsular
cataract extraction was performed in all cases. posterior chamber IOLs were
implanted in 33 patients.71.4% patients achieved good visual acuity
post-operatively.patients with severe posterior segment damage do not
benefit functionally from cataract surgery.6
Kuldeep S,Srivastava K R, Vijayalakshmi P(2000) prospectively
Evaluated 60 children who underwent PCIOL implantation. >80% children
Recovered visual acuity >6/12. commonly encountered post operative
Complications were post operative inflammation, PCO, Irregular pupil and
pupillary capture of IOL.7
Moisseiev J, Seger V, Harizmann (2001) retrospectively studied 21
patients of traumatic cataract, with follow up of 20.4 months.95% achieved
final visual acuity of 20/60 or better. M ajor causes of limited visual acuity
were central corneal scar and central retinal injury.8
Loncar VL, Ivanka Petric (2004) n a study on 24 patient found that most
patients were young men who had associated ocular injuries in the form of
corneal scar, sphincter damage ,anterior synechiae etc.70.8% recovered good
vision post operatively following cataract extraction and IOL implantation.
Thus majority of eyes with traumatic cataract can be safely rehabilitated
with IOL implantation.9
6.3 Objectives of Study:
1. To know the incidence of traumatic cataract in patients attending VIMS,
Bellary.
2. To know the modes of presentation and types of injury causing it.
3. To know the intra operative and post operative complications and
difficulties encountered during the management.
4. To study associated injuries to other ocular structures.
5. To assess the visual outcome following management.
MATERIALS AND METHODS
7.1 Source of data:
It is a study conducted on patients with traumatic cataract diagnosed in
the ophthalmology department, VIMS, Bellary during a period of
Jan 2009 to Jun 2010 applying following inclusion and exclusion criteria.
Inclusion Criteria
All patients who present to the Ophthalmology Department
with traumatic cataract due to mechanical injuries.
Exclusion Criteria
1.All other types of cataract other than traumatic cataract due to
mechanical Injuries such as:
-Cataracts due to injuries other than mechanical like radiation cataract,
electric cataract.
-Complicated cataract.
-Congenital or developmental cataract.
-Age related cataract.
2. Ocular injuries without cataract.
3.Traumatic cataract associated with pre-existing ocular diseases.
7.2  Method of collection of data:( including the sampling procedure if any)
The study will be conducted in the Department of Ophthalmology, VIMS,
Bellary for a period of one and half years from Jan 2009 to Jun 2010.
Patients will be subjected to detailed ophthalmic evaluation and data will
be recorded in a specially designed proforma which will be transferred to
master sheet. The data will be subjected to statistical analysis by the
biostatistician of our institution.
7.3  Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.
Yes, the study requires the following investigations like testing for visual acuity and refraction, biomicroscopy, tonometry, lacrimal sac syringing,
Gonioscopy, fundus evaluation under slit lamp with 90 D lens,indirect ophthalmoscopy, binocular vision testing where required, in addition ‘B’ scan will be done to rule out posterior segment involvement.
All investigations will be done in the dept of Ophthalmology VIMS-
Bellary under the direct guidance and supervision of our guide. Before
starting the study all patients included in our study will be supplied with
patient information sheet and written/informed consent will be obtained
from each patient in local vernaculam.
7.4  Has the ethical clearance been obtained from your instituition in case
Of 7.3?
Yes, ethical clearance has been obtained from The VIMS Institutional
Ethical Committee(IEC),VIMS,Bellary.
LIST OF REFERENCES:
1. World Health Organisations, Global initiative for the elimination of
avoidable blindness,WHO/PBL/97.61, Geneva:WHO:1997.
2.Duanes “ Cataract –Clinical Types” chapter 73 clinical ophthalmology
revised edn 1996 Vol 1, edt. Manuel B, Datilers,Benjamin V,13
3..Albert Jakobiec. “ Anterior Segment Trauma”. Chapter 374 Principles
and practice of ophthalmology,3rd edn.,vol 4 edt. Bruce M, Zagelbaum, Peter
S, Hersh, Bradford J, Shingleton and Kenneth R. London :W.B.Saunders
Company 2008:5101-5105.
4.Doutetien C,Tchabi S, Sounouvou I, Deguenon j, Bassabi SK.”Traumatic
cataract: Epidemiological clinical and therapeutic considerations”. J
Fr.Ophthalmol 2008 May ;31(5): 522-6.
5.Jones W L.”Traumatic injury to the lens” Opth Clinics of North America”
1991; 1(2);125-142
6.Synder A,Kobielska D,Omulecki “Intraocular lens implantation in
traumatic cataract” Klin Oczna 1999; 101 (5) :343-346
7. Kuldeep S, Srivastava K R, Vijayalakshmi P. “ Posterior chamber IOL for
traumatic cataract in children. AIOC proceedings 2000; 399-401.
8.Moisseiev J, Seger V, Harizmann. “Primary Cataract extraction and IOL
implantation in penetrating ocular trauma”. Ophthalmology 2001; 108(6):
1099-1103.
9. Loncar VL, Petric I. “Surgical Treatment, Clinical outcome, and
complications of Traumatic Cataract”.Croatian Medical Journal 2004;
45(3):310-313.
9. / Signature of candidate:
10. / Remarks of guide: Recommended and forwarded
11. / Name & Designation : (in block letters)
11.1 Guide Prof.Dr.K.NAGARAJ,
Professor,
Department of ophthalmology
VIMS,Bellary.
11.2 Signature of guide
11.3 Co-guide if any
11.4 Signature
11.5 Head of the department Dr.G.PAWAN
Professor and
Head of the Department ,
Department of ophthalmology,
VIMS, Bellary.
11.6 Signature
12. /
12.1 Remarks of chairman & Principal
12.2 Signature