Ocular abnormalities in patients with chronic renal failure on haemodial-ysis: A study from a rural tertiary care teaching institute.

Abstract

Background: Chronic Renal Failure (CRF) affects every organ system, including the eye. Potential vision-threatening ocular complications among patients with CRF can lead to irreversible visual impairment. Aims: We assess and report ocular abnormalities in patients with chronic renal failure on hemodialysis in a rural setup. Settings and Design: This is a cross-sectional hospital-based study conducted in a rural tertiary care institute. Methods and Material: One hundred twenty subjects undergoing dialysis in our institute for a period of 2 years were included in the study by convenient sampling. Statistical analysis used: Data were analyzed using Microsoft excel and represented using mean, standard deviation, ratio, and percentages. Results: Among the subjects, 16.7% of total eyes had vision <6/60, and 35% had < 6/24. The causes for visual impairment were maculopathy in 31 eyes, cataract in 20 eyes followed by proliferative diabetic retinopathy in 11 eyes. Lid edema was present in 22.5%, conjunctival pallor in 30.8%, and corneal calcification in 2.4% of total eyes. Retinopathy was the most important finding. Hypertensive retinopathy was present in 93 out of a total of 120 patients (98%). Diabetic retinopathy was present in 49 out of 85 diabetic subjects (72.3%). Seventeen out of 93 patients of hypertensive retinopathy and 11 out of 49 subjects of diabetic retinopathy were detected for the first time. Conclusions: This study highlights the importance of ocular examination in patients with metabolic disorders like Diabetes and Hypertension. Vision threatening complications in CRF patients were detected easily without any complicated procedures and any cost. And even screening was possible in bedridden patients. In this study, the patient was recognized to have the renal disease by looking at the ocular abnormalities and was referred to a physician in the same visit. This signifies easy accessibility of changes in the eye, to know disease in the other organs like kidney.