BACKGROUND:Severe visual impairment and blindness are significant disabilities, impacting the lives of individuals and placing economic and psychosocial burden on society. Blind schools provide specialized education and rehabilitation services for individuals with visual impairment/blindness. Limited data exist on the causes of blindness in children in Jammu province, highlighting the need for this study to understand local trends and form targeted healthcare strategies. OBJECTIVES:This study aimed to evaluate the causes of blindness among residents of blind schools in Jammu province; categorize them into preventable, treatable, and unavoidable causes; and explore vocational interests of the residents to support societal integration. METHODS:This cross-sectional observational study was conducted in two blind schools (one for boys and one for girls) in Jammu province. A total of 82 residents underwent detailed ophthalmological examination by trained doctors using standardized protocols, including visual acuity assessment and anterior and posterior segment evaluations. The etiology of blindness was categorized into congenital, acquired, and undetermined causes. RESULTS:The study included 82 participants (mean age: 14.3 ± 3.9 years; 57.32% males). A positive family history of blindness was noted in 12.19%. The majority of cases (67%) were due to congenital causes, 27% were acquired, and 6% had undetermined etiology. Anatomically, the most affected sites were the whole globe (26.8%), retina (26.8%), and cornea (19.6%). Avoidable causes formed a significant proportion (35%), emphasizing the importance of public health interventions. CONCLUSION:The findings highlight congenital anomalies, retinal dystrophies, and corneal scarring as significant contributors to blindness in this population. These data can be helpful for the policy makers to take adequate action for reducing the burden of avoidable blindness.
PURPOSE:To evaluate the efficacy of secondary bony decompression following primary fat decompression. DESIGN:Retrospective interventional case series. METHODS:Setting: A tertiary university hospital. STUDY POPULATION:A total of 27 eyes from 17 patients who underwent secondary inferomedial orbital wall decompression following primary orbital fat decompression were included. Patients with a history of trauma, extraocular muscle surgery, prior orbital irradiation, or eyelid or orbital inflammation within 6 months prior to decompression were excluded. INTERVENTION PROCEDURE:Secondary inferomedial orbital wall decompression performed for recurrent proptosis or compressive optic neuropathy after primary fat decompression. MAIN OUTCOME MEASURE:Changes in Hertel value, and best corrected visual acuity (BCVA). RESULTS:Primary orbital fat decompression achieved an initial proptosis reduction of 3.4 ± 0.1 mm in 27 eyes. Secondary bony decompression was subsequently performed in 15 eyes from 9 patients with recurrent proptosis and in 12 eyes from 8 patients with dysthyroid optic neuropathy. Secondary bony decompression resulted in a reduction in Hertel measurement by 4.5 ± 2.1 mm, improving from 21.7 ± 2.8 mm to 17.3 ± 1.6 mm ( P < 0.001) at a follow-up period of 40.6 ± 28.7 months. BCVA in patients with dysthyroid optic neuropathy improved from 0.43 ± 0.3 to 0.12 ± 0.15 logMAR ( P = 0.005). Diplopia occurred in 12 of 17 patients (70%), including five with new-onset diplopia. Preoperative diplopia predicted postoperative diplopia in regression analysis. CONCLUSION:Secondary inferomedial orbital wall decompression following primary orbital fat decompression effectively reduces proptosis and improves vision.
Oculoplasty and orbital surgeries demand high precision due to confined anatomy and nearby critical structures. Recent innovations in orbital surgeries include augmented reality, robotic assistance, and computer-assisted navigation. These technologies are increasingly being explored to enhance surgical accuracy, improve outcomes, and reduce complications. Augmented reality provides real-time visualization of patient-specific anatomy, supporting preoperative planning and intraoperative guidance. Robotic systems offer tremor-free manipulation, enhanced dexterity in restrictive spaces, and minimally invasive reconstructions. Navigation enables accurate localization of deep orbital structures, thereby aiding orbital surgery. This review aims to provide current evidence on clinical practices, advantages, and limitations of newer technologies.
