International Journal of Current Medical And Applied Sciences, 2020, May, 26(3), 30--35.

ORIGINAL RESEARCH ARTICLE

A Study of Clinical Profile of the Patients Visiting

Ophthalmology Out- Patient Department in A
Teaching Hospital
Rajesh Gotekar1, Kamlesh N. Lanje2, Amit H. Pathak3 & Ajit K. Joshi4
1Associate Professor, 2Junior Resident, 3Assistant professor, 4Professor and HOD, Department of
Ophthalmology, Bharati vidyapeeth (Deemed to be University) Medical college and Hospital,
Sangli, Maharashtra, India : 416416.
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Abstract:
Purpose: To study the clinical profile of ocular diseases among the patients attending the Ophthalmology
outpatient department in a teaching hospital. Materials and Methods: A prospective cross-sectional study was
conducted in Ophthalmology department of Bharati Vidyapeeth (Deemed to be University) medical college and
th th
hospital, Sangli between 15 November 2019 to 14 February 2020.Total 719 patients were included in the study. A
thorough comprehensive ophthalmic examination of each walk in patient above 18 years of age was performed
pertaining to his/her ophthalmic complaint. Referred patients from other OPD, indoor and casualty consultations
were excluded from the study. After comprehensive checking and necessary investigations, patient’s diagnosis
was established and patients were categorized into sub-specialties. Results: Out of 719 patients 387 (54%)were
male and 332 (46%) were females, ratio of male to female being1.17:1 .Cataract 195 (27.12%) was found to be the
commonest ocular morbidity followed by refractive errors 188 (26.14%) conjunctival disorders 85 (11.82%), uveal
diseases 41 (5.7%)posterior segment disorders 52 (7.23%), lid disorders 44 (6.11%),corneal disorders 31 (4.31%),
glaucoma 25 (3.47%), squint (0.83%) and miscellaneous (0.69%) in order of frequency. Conclusion: The major
causes of ocular morbidity in order of frequency were cataract, refractive errors, conjunctival disorders, posterior
segment disorders and corneal disorders.
Keywords: Blindness, Cataract, Conjunctival disorder, uveal diseases, Ocular diseases, Refractive error.
Introduction:
India being a developing country is still facing a ocular diseases is essential as some of the ocular
challenge of cataract as a major cause of avoidable conditions if not treated in time may lead to blindness
blindness. Eighty percent of diseases responsible for [3]. The pattern of eye diseases varies among children,
blindness and eighty-five percent of diseases causing adults and elderly people. It also varies from country
moderate to severe visual impairment are avoidable to country and within different parts of the same
[1]. WHO model on economic and social impact of country. Considering the complicated epidemiology of
blindness has predicted the prevalence of blindness ocular morbidity, visual impairment and the wide
and low vision in India to be around 1.37% in the year variety of factors involved, region specific intervention
2020 which amounts to about 18 million people with strategies are required for every community [4].
blindness/low vision [2]. A study of the pattern of
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Address for correspondence:
Dr. Kamlesh N. Lanje, Access this Article Online
Junior Resident,
Department of Ophthalmology,
Bharati Vidyapeeth (Deemed to be University), Website:
Medical College & Hospital, Sangli [MS], India. www.ijcmaas.com
Email ID- lanjekamlesh@gmail.com
How to cite this article:
Rajesh Gotekar, Kamlesh N. Lanje, Amit H. Pathak & Ajit K. Joshi: A Subject:
Study of Clinical Profile of the Patients Visiting Ophthalmology Out- Medical Sciences
Patient Department in A Teaching Hospital: International Journal of Quick Response Code
Current Medical and Applied sciences; 2020, 26(3), 30-35.

IJCMAAS, E-ISSN: 2321-9335,P-ISSN:2321-9327 Page | 30

 Rajesh Gotekar, Kamlesh N. Lanje, Amit H. Pathak & Ajit K. Joshi

This type of study can provide vital clinical data for
the policy making, resource allocations and for the
recruitment of qualified staff as per the need of the
hospital [5].
Segregation of patients based on anatomical site of
the disease and its correlation with the functional
disability will be helpful in the eye care management.
We have speciality clinic services in the form of
cornea clinic, paediatric ophthalmology clinic,
oculoplasty clinic and vitreo-retinal clinic once in a
week at the hospital. The ophthalmologists having 2
years fellowships in that concerned speciality, heads
the speciality clinic. The post graduate residents are
posted with them on speciality clinic day to get
acquainted with the examination technique,
diagnosis and management of the cases
.Establishment of an eye care service delivery system
for the treatment of eye diseases and prevention of
blindness is linked to the existing medical services,
surgical services and available resources.[6] The
study was undertaken to determine the clinical
profile of ocular diseases for each sub- specialty, to
have a clinical data to be used for future upgradation
of the existing eye care facilities and to establish
global protocols of management for each sub-
speciality. This will improve quality eye care services
and will help in reducing the ocular morbidity.
Material & Methods:
Setting: Walk in patients in ophthalmology out-
patient department willing to participate in the study
Duration of Study:6 months (15thNovember 2019
to 14thFebruary 2020)
(3 months for data collection followed by 3 month
data analysis)
Type of Study: Descriptive Study
Sampling Method: By Convenience
Sample size: All patients visiting Ophthalmology
OPD and willing to participate in the study in the
stipulated time period.
Inclusion Criteria: Patients above 18 years of age.
Exclusion Criteria: 1. Patients referred to
ophthalmology OPD from other clinical
Departments for consultations and from casualty
2 . Follow up patients.
Data collection Procedure: This prospective study
was conducted at ophthalmology out-patient services
of Bharati Vidyapeeth (Deemed to be University)
Medical College & Hospital Sangli, from 15th
November 2019 to 14th February 2020. The patients
were seen in ophthalmology OPD by consultant
ophthalmologist. A detailed history regarding their
ocular complaints was recorded for each patient. The
examination protocol included a thorough
ophthalmic examination including visual acuity
testing, external eye examination, slit lamp bio-
microscopic examination of the anterior segment,
examination of the pupil and ocular motility,
refraction, tonometry with applanation tonometer
and fundus examination. All patients were examined
for undilated fundoscopy using direct
ophthalmoscope and patients having BCVA (Best
corrected visual acuity) less than 6/6 were subjected
to dilated fundoscopy using slit-lamp bio-microscopic
examination with +90 D lens. After assessment the
patients were examined by auto-refractometer and
subjective refraction was done. Slit-lamp examination
was helpful in confirming the type of cataract.
Glaucoma suspects were further subjected to AS-
OCT(angle), Gonioscopy, field testing and OCT of
optic nerve head for confirmation of the type of
glaucoma. Indirect ophthalmoscopy, fundus
photography and retina OCT, FFA, B-Scan was used to
establish the diagnosis of retinal diseases. Patients
needing further investigations and opinion of super-
specialist were advised accordingly. Data including
the registration number, name of the patient, age, sex
and diagnosis were recorded in OPD register. Data
collected and changed to percentages using the
Microsoft excel.
Ethical consideration and permission: Ethical
permission from institutional ethics committee of
Bharati Vidyapeeth Deemed to be University medical
college and hospital, Sangli, with approval letter
BV(DU) MC&H Sangli/ IEC/371.

Observations and Results:

Table 1: Age distribution of patients coming for ophthalmology Services (n=719)
Age of patients in years No. of patients Percentage (%)
18-30 120 16.5
31-40 90 12.5
41-50 137 19
51-60 131 18.5
61-70 165 23
>70 76 10.5
The age distribution of the patients is shown in [Table1]. Majority of patients 358 (50 %) found in the age
group 31-60 years, 241 (33.50%) found to be of age more than 61 years. Mean age of patient was 49.52 years.
Table 2: Sex distribution (n=719)
Sex No. of patients Percentage ( %)
Male 387 54.0
Female 332 46.0
Total 719 100
The study included 719 patients of which 54 % (387) were males and 46% (332) were females [Table 2].

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 Logic Publications @ 2020, IJCMAAS, E-ISSN: 2321-9335,P-ISSN:2321-9327.

Table 3: Pattern of eye diseases in relation to the anatomical site of the disease
Anatomical site of No. of Percentage Males Females
the disease patients (%)
No. Percentage No. Percentage
Eyelid 44 6.11 15 34.10 29 65.90
Conjunctiva 85 11.82 49 57.65 36 42.35
Cornea 31 4.31 17 54.84 14 45.16
Lens 205 28.51 79 38.54 126 61.46
Retina and optic 57 7.92 34 59.64 23 40.36
nerve
Ocular motility 6 0.83 4 66.66 2 33.34
disorder
Lacrimal Apparatus 3 0.41 2 66.66 1 33.34
Uvea 41 5.7 29 12
Miscellaneous 5 0.69 3 60.00 2 40.00
Normal Ophthalmic 19 2.64 13 68.42 6 31.58
examination
Pattern of eye diseases in relation to the anatomical site of the disease is depicted in [Table 3] where diseases
of the crystalline lens attributed for 28.50% of the morbidity of the total ocular morbidity, while retina and
optic nerve diseases attributed for 7.92%.

Table 4: Clinical diagnosis of patients coming for ophthalmology services

Males Females
Etiology No. of Percentage
patients No. Percentage No. Percentage
Refractive Errors 188 26.14 126 67.02 62 32.98
Lid Abnormalities 44 6.11 15 34.10 29 65.90
Conjunctiva
Allergic 47 6.53 26 55.32 21 44.68
Conjunctivitis
Infective 33 4.58 20 60.60 13 39.40
Conjunctivitis
Pterygium 5 0.69 3 60.00 2 40.00
Cornea
Corneal Ulcer 12 1.66 7 58.33 5 41.67
Corneal Opacity 19 2.64 10 52.63 9 47.37
Uveitis 41 5.70 29 70.73 12 29.27
Lens
Cataract 195 27.12 69 35.38 126 64.62
Sx aphakia 14 1.94 7 50.00 7 50.00
Lens dislocation 06 3.75 3 50.00 3 50.00
Retina
Diabetic Retinopathy 27 3.75 17 62.96 10 37.04
Retinal vascular 05 0.69 3 60.00 2 40.00
Occlusion
Macular edema 10 1.39 7 70.0 3 30.0
Retinal detachment 10 1.39 4 40.0 6 60.0
Optic Neuropathy 05 0.69 3 60.0 2 40.0
Glaucoma 25 3.47 16 640 9 36.0
Dacrocystitis 03 0.41 2 66.66 1 33.34
Ocular motility 06 0.83 4 66.66 2 33.34
disorders
Miscellaneous 05 0.69 3 60.0 2 20.0
Normal Ophthalmic 19 2.64 13 68.42 6 31.58
examination

Etiology of patients coming for ophthalmology services is shown in [Table 4] cataract (27.12%)was found to
be the commonest ocular morbidity followed by refractive error (26.14%), conjunctival disorders (11.82%),
Posterior segment disorders were seen in 52 (7.23%). Lid disorders (6.11%), glaucoma (3.4%), and squint
(0.83%), miscellaneous (0.69%) patients (out of 719).

International Journal of Current Medical And Applied Sciences [IJCMAAS], Volume: 26, Issue: 3 Page | 32
 Rajesh Gotekar, Kamlesh N. Lanje, Amit H. Pathak & Ajit K. Joshi
Table5: Age wise and gender wise distribution of cataract cases (n=195)
Age Male Female
group
No. Percentage No.
< 40 05 83.33 01
41-50 05 38.46 08
51-60 11 44 14
61-70 28 31.81 60
>70 20 29.42 48
Total 69 35.38 126
Age wise distribution of cataract is 51-60 years 25 (12.82%) 61-70 years as 88 (45.12%) and more than >70
years 68 (35.38 %) shown in [Table 5].
Discussions:
The present study shows marginal preponderance
of male patients. M:F ratio was 1.17 : 1 in the
present study compared to 1.38:1 by Bhoi R [7].
In the present study, 358 (49.79.% ) patients were
between 31 to 60 years of age and 241 (33.51 %)
were above 61 years of age, compared with the
study by Bhoi R in which 44.67% were between
31 to 60 years of age and 14% were above 61
years of age [7].
In the study by T Jarina, M Lipa 304 (50.67%)
were between 31 to 60 years of age and 46 (7.67
%) were above 61 years of age.[8]
In the present study diseases of the crystalline lens
attributed for 28.51 % of the total ocular morbidity
out of which cataract (mature and immature) was
the most common (27.12%) ocular morbidity. This
is in correlation with studies conducted by Puri D S
et al, (22.48%) by Sehgal RK et al, (16.1 %)
Kanodia P.[9,10,11].
As per gender distribution cataract was seen in 69
(35.38%) male patients and 126 (64.62%) of
female patients. Cataract was more common in
females, which is in accordance with the study
conducted by Vashist P et al [12].
The age group for senile cataract patients in our
study was found as 51-60 years 25 (12.82%) 61-70
years as 88 (45.12%) and more than >70 years 68
(35.38 %) compared with the study by M M Kini,
prevalence of cataract was found to range from
4.6% for those between the ages of 52 to 64 years
to 46% for those 75 to 85 years of age.[13]
In the present study Surgical aphakia was seen in
14(1.94%) compared to the study conducted in
Makah Eye Hospital, Sudan in which it was 1.39%
[16].
Refractive error:
Uncorrected refractive errors constitute an
important ocular problem worldwide and had an
impact on quality of life and leads to poor
educational and socioeconomic outcomes[8].
In the present study the second most common
ocular morbidity found was refractive error
(26.14%). This is comparable to the Study done by
Haq et al in that refractive error was present in
25% [14]. Study by Singh M M et al in rural setting
reported that prevalence of refractive error to be
40.8% [15]. Another large study conducted in
Logic Publications @ 2020, IJCMAAS, E-ISSN: 2321-9335,P-ISSN:2321-9327.
Total
Percentage No. Percentage
16.66 06 3
61.53 13 6.66
56 25 12.82
68.19 88 45.12
70.58 68 35.38
64.61 195 100
Makah Eye Hospital, Sudan in 2015 on 64,529
patients revealed most common eye disorder was
refractive error (33%), followed by cataract
(26.66%) [16]. Another study in Uttarakhand in
Feb 2017, reported refractive error (20.97%) as
the commonest ocular morbidity [17].
In the present study, considering the gender
difference we found uncorrected refractive error
in 126 (67.02%) male and 62(32.92%) female
patients out of 188 refractive errors.
In the present study presbyopia 79 (42%) was the
most common ocular morbidity followed by
myopia 27(14.30%) and 23 (12.23%)
hypermetropia compared with study conducted in
Makah Eye Hospital, Sudan, the distribution was
presbyopia (34.22%), myopia (22.82%),
hypermetropia (22.81%)[16]. This is also in
correlation with studies conducted by Balarabe et
al [18].
Out of 79 presbyopia patients 47 (59.49 %) were
male and 32 (40.50%) were female. Age group of
61- 70 comprises 28 (35.44 %) presbyopic
patients.
Conjunctivitis:
In the present study we found allergic
conjunctivitis in 47(6.53 %),eyelid diseases 44
(6.11%), bacterial conjunctivitis in33(4.5%),
keratitis in 12(1.66%) lacrimal apparatus diseases
in 3 (0.4%), Uveitis in 41(5.7%) patients
compared with a cross sectional study on 600
patient conducted at the Eye OPD at GMCH,
Udaipur, Rajasthan has prevalence of ocular
diseases reported was allergic conjunctivitis
(43.33%), eyelid diseases 119 (20%),acute
conjunctivitis (14%), keratitis (4%) acute
dacryocystitis in 4 (00.67%), uveitis 11(1.83
%)[8].
The prevalence of pterygiumin the present study is
(0.69%) compared to study by Shrote V K (2.92%)
[19].
Corneal pathologies:
Diseases of cornea are increasingly becoming a
common cause of visual morbidity. As the study
population is in western Maharashtra, the main
occupation of people working is farming, we
thought to get number of corneal injuries in the
patient as an occupational hazard while working in
fields. But as the sugarcane factories’ working is
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 Logic Publications @ 2020, IJCMAAS, E-ISSN: 2321-9335,P-ISSN:2321-9327.
seasonal we have not got too much corneal injury
patients. We found corneal diseases in 31 (4.1 %)
patients in that, corneal opacity in (2.6 %) and
corneal ulcers in (1.66%) fungal corneal ulcers
found in 9 (75 %) bacterial corneal ulcers 3 (25%).
This is comparable to a study done by Haq I et al.,
the prevalence of corneal opacity was 4.2%[14]. In
another study by Dandona L et al., visual
impairment caused by corneal diseases accounted
for 11.5% [20].
Glaucoma:
Glaucoma accounted for 25 (3.47%) in the present
study compared to (11.1%) in the study by Baldev
VF et al [21], acute congestive glaucoma 3 (12%),
primary open angle glaucoma 19(76 %),
Neovascular glaucoma 2 (8%), phacomorrphic
glaucoma 1(4 %).
Retinal diseases:
Among retinal diseases, diabetic retinopathy,
retinal vascular occlusion and maculopathies were
the leading causes of ocular morbidity. In the
present study diabetic retinopathy was found in
(3.75 %) patients and retinal detachment in (1.39
%) patients compared to study by Agarwal RK who
found it in (20.21%) & (8.30 %) respectively.[22].
Present study compared with study by Sharifi
NAD, Samadi ALN [23].
Ocular Morbidity In present Sharifi NAD,
study Samadi ALN
study [23]
Cataract 195 (27%) 104 (20.8%)
Refractive errors 188 (26%) 96 (19.2%)
Conjunctivitis 80 (11%) 50 (10%)
Eyelid disease 44 (6 %) 46 (9.2%)
Pterygium 05 (0.69%) 28 (5.6%)
glaucoma 25 (3.4%) 13 (2.6%)
cornea disease 31 (4.1%) 12 (2.4%)
strabismus 06 (0.7%) 2 (0.4%)
In the present study we found cataract in195
(27.12%) refractive errors 188 (26.14%)
conjunctivitis 80 (11.11%) eyelid disease 44 (6.11
%) pterygium 05(0.69%) glaucoma 25(3.47%)
cornea disease 31 (4.1%), strabismus 06 (0.83%)
compared with study by Sharifi NAD, Samadi ALN
Cataract 104 (20.8%), refractive errors 96 cases
(19.2%), Conjunctivitis 50 cases (10%),Eyelid
disease 46 cases (9.2%), Pterygium 28 cases
(5.6%), glaucoma 13 cases (2.6%), cornea
disease12 cases (2.4%) strabismus 2 cases
(0.4%).[23]Information on the epidemiology of eye
diseases in a particular area helps in planning and
management of eye care facility, thereby
decreasing the burden of blindness.[24]In the
present study, the prevalence of major eye
diseases encountered was comparable to various
other studies done elsewhere.
International Journal of Current Medical And Applied Sciences [IJCMAAS], Volume: 26, Issue: 3
Limitation of the study:
Prevalence of eye diseases according to age group
is not done.
Prevalence of eye diseases according to occupation
and prevalence of eye diseases according to gender
is not done.
Recommendation:
Further analysis with collection of large volume
data about eye diseases pattern at a teaching
hospital is recommended. Future studies of such
nature will help in studying the relationship of the
different eye diseases in relation to the age, gender
and also regional preponderances.
Conclusion:
The finding of this study shows the wide range of
different eye conditions presented to a tertiary
care hospital. Also it throws light on the different
age groups getting affected by different eye
conditions. The analysis based on anatomical site
of pathology of eye disease/s emphasizes the need
of relevant investigations urgently to confirm the
diagnosis.
Acknowledgement:
We would like to express our gratitude to the
patients who joined in this study willingly.
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Conflict of interest: None declared
Source of funding: None declared
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