The risk factors for getting glaucoma will channel into the resultant level of IOP and disc damage. The probability was calculated by the equation Y1 = Y0 + A1e X/T1 using the IOP and cup disc ratio. Accordingly people are classified into: Normal, Ocular hypertension, Possible, Probable, Highly probable and Definite glaucoma. In this way the clinical entities of normal, ocular hypertension, and glaucoma suspect, low tension glaucoma and definite glaucoma cases are precisely digitized and diagnosed. The target IOP is calculated according to the cup disc ratio. The details of combined probability of IOP, C/D ratio and the target IOP will be presented in details.

Pterygia are progressive unilateral or bilateral ocular surface growths that develop within palpebral aperture area that leads to contour disruption with symptoms ranging from foreign body sensation to cosmetic blemish. Commonly, they appear during the active period of human life, generally between third and fourth decade. Fate of pterygium spans from progressive growth in its earlier stages that undergo diversity of changes such as inflammation, infection, and degeneration ultimately ending in regressive stage during the sixth to eighth decade of life. Pterygium recurrence is the main complication encountered by surgically treating it with or without adjuvant. Not uncommonly pterygium occurrence had been described during childhood that resolved by conservative treatment. Untreated pterygia might grow exuberantly with the invasion of corneal layers, which might result in significant visual loss due to visual axis obstruction and high astigmatism. Therefore, it is justifiable to treat pterygia at any clinical stage of presentation to prevent ocular morbidity and recurrences. Common misbelief in letting the pterygia until corneal encroachment develops should be made understandable to public by conducting awareness programs. Primary objectives of the present review article are to search for the most successful method in terms of nil to low recurrence rates by various modality of treatment and to arrive at promising surgical technique that provided maximum relief in terms of survival rates on the basis of follow-up duration. Secondary objectives are related to intra- and post-operative complications, which have an effect on the ocular surface and final visual gain or loss.

Background: The anterior chamber angle (ACA) is the anatomical angle bounded by the iris root and the peripheral corneal vault that comprises the aqueous outflow drains, namely the trabecular meshwork (TM) and the Schlemm's canal. The assessment of the ACA is used to classify glaucoma into open or narrow angle glaucoma's. Objective: The aim of this study is to determine the normal range values of the gonioscopic character of the ACA in adult Sudanese population and to define the effects of age, gender, and tribal ethnicity on these values. Materials and Methods: Three hundred ninety-eight eyes (n = 396); of 198 adults volunteers Sudanese healthy workers, from two factories in Khartoum, North district, were enrolled in this study; over a period of 3 months from January 1, 2009 to March 30, 2009. One hundred and sixty males 38 were females; aged ranged from 18 to 50 years. All participants underwent systematic static and dynamic gonioscopy by Posner Gonio lens in conjunction with Haag- Streit slit lamp. Then, the ACAs were graded according to Shaffer grading and classification system. The effect of age, gender and tribal ethnicity on ACA was analyzed. Then, the overall grading and TM Pigmentation analysis were done with special grading criteria specifically designed for this study (Manal–Saleem ACA Overall Grading System and Saleem-Manal TM Pigmentation Grading System). Results: In total, 198 (n = 198) Sudanese adults were recruited for the study with the mean age of the study group was 43 ± 16 years (range: 18–50 years). About 80.8% of males and 19.2% of females. 77.8% have open ACA and 19.2% narrow ACA, 0.5% closed ACA, and 2.5% with Creeping ACA. Open ACA is more in males (81.3%) than female (63.2%) while narrow ACA is more in female (34.2%) than male (15.6%). Closed and creeping ACA are similar in the two sexes. The effects of tribal ethnicity was not so profound as both the Arabs (84.1%) and Africans (87.5%) origin groups were showing minor differences in the high rate of open-angle (3.4% more in the African's) and narrow ACA (2.9% more in Arab's) apart from the Bejja groups, who recorded 100% narrow ACA while the Nubian groups of Far North recorded a lower percentage of the open ACA (78.6%) and higher of narrow ACA (17.9%). Narrow ACA was proved to be more with older age (25% as compared 10–12.5%). The TM Pigmentation in the younger age groups was found to be of lightly pigmented in 66.7% and heavily pigmented in 33.3%. A result which was affected by tribal ethnicity; 54.9% of Arab origin groups have lightly pigmented TM while 92.0% of African origin groups presented with heavily pigmented TM. In general, pigmentation was shown to be more heavily in the inferior quadrant rather than superior and horizontal quadrants. Conclusion: There is a higher rate of open ACA (77.8%) in Sudanese Adults with low rate (19.2%) of narrow ACA, followed by an even more lower rate of creeping ACA 2.5% and scarcely closed ACAs (0.5%). The average Sudanese ACA TM pigmentation is 35.4% being of light pigmentation and 64.6% of heavy pigmentation with highly significant tribal, age, and Quadrantic variations (P = 0.000).

Aim: The aim is to assess color vision in Sudanese elderly patients' pre- and post-cataract surgery. Materials and Methods: Descriptive, cross-sectional, hospital-based study was conducted in in Makkah Eye Complex (a voluntary organization; a Tertiary Eye Care Center) in Khartoum Alryad. Elderly patients (200); their age varies from 60 to 95 (mean 67.91 and standard deviation ± 6.779) years with senile cataract were asked to participate in the study. Participation was entirely voluntary. Information was collected by means of interviews, questionnaire, and clinical examination. The data were analyzed using Predictive Analytic Software Statistics Version 18 (2010), a modified version of IBM SPSS Inc. PASW Statistics for Windows, Version 18.0; 2009. Chicago: SPSS Inc. All tests are of two sides (confidence interval of 99% level). Therefore, a P≤ 0.05 was taken to indicate the statistical significance for all analysis and spearman correlation (r) was used to identify association between variables. Results: In the presence of cataract, the results showed significant declines in visual acuity (>85% visually impaired). Failure to discriminate colors were recorded in right eye (RE) (56%) and left eye (LE) (60%). Improved visual functions as a result of cataract surgery included the following: Better optically corrected vision (71%) achieved satisfactory visual outcomes (logarithm of the minimum angle of resolution [LogMAR] >0.48) with average distance visual acuity (VA) of (0.36–0.46 Log MAR) and in increased ability to discriminate colors (90%) and 89% for RE and LE, respectively. Both pre- and post-operative results showed positive correlation for RE and LE and (P < 0.001) for Pearson Chi-square value were recorded for showing statistical significance for VA and color vision in the patients studied. Conclusions: VA and other retinal functions like color vision are restored by cataract extraction.

Background: The face is the most distinctive part of the human body. Of all areas on the face, the bilateral orbital regions which are located in the upper half of the face act as a strong influence in the perception of facial attractiveness, esthetic criteria, and “ideal” features of any certain nation. This fact increases the needs for interorbital anthropometry or interocular distances (IODs) which refers to the measurements of the human far interpupillary distance (FIPD), near interpupillary distance (NIPD), outer canthal distance (OCD), and inner canthal distance (ICD) among individuals of different age, sex, and ethnicity. Objective: To assess the normal ranges of interorbital anthropometric values among adult healthy Sudanese population and to define the effects of age, gender, and tribal ethnicity on interorbital anthropometry. Materials and Methods: Systematic interorbital anthropometric measurements were done in 920 Sudanese adults aged 20–85 years. Parameters included were FIPD, NIPD, OCD, and ICD across age, sex, and tribal ethnic perspective of the study subjects. Comparisons were made between their gender, age, and tribal ethnicity using the Chi-square test. Results: The study included 565 female (61.4%) and 355 male (38.6%) subjects with mean age of 48 ± 20 (range 20–85) years. Significant age, gender, and ethnical dimorphism were noted in the following parameters. OCD (male: 92.23 mm; female: 90.79 mm), FIPD (male: 63.20 mm; female: 61.57 mm), NIPD (male: 59.34 mm; female: 57.73 mm), and ICD (male: 34.30 mm; female: 33.00 mm). Conclusion: Significant interorbital measurement differences were found between Sudanese males and females in different age and ethnic groups. The present study suggests that age, gender, and ethnicity should be considered in Sudanese esthetic criteria and “ideal” features in any cosmetic or reconstructive orbital surgery. To individualize the treatment planning and diagnosis, it is important for the surgeons to have knowledge of these local Sudanese interorbital norms.

The aim of this study is to report a case of pleomorphic adenoma of palpebral part of lacrimal gland. A 38-year-old female was admitted with the complaints of swelling in the left upper eyelid which was gradual in onset and progressive in nature for 4 years. A firm nodular mass was seen protruding from left superior temporal region of orbit causing mild ptosis. Blood examination showed raised erythrocyte sedimentation rate. Ultrasound was typically hypoechoic well-capsulated mass. Under general anesthesia, the tumor was totally excised with anterolateral orbitotomy. Histopathological examination revealed a pleomorphic adenoma of the lacrimal gland with no evidence of malignancy. Postoperatively, mild ptosis was present and the patient was advised to use lubricating eye drops. Follow-up showed no recurrence. Pleomorphic adenoma (benign mixed tumor) of the lacrimal gland accounts for approximately 12–25% of all lacrimal tumors. Among these, 90% are orbital and only 10% are palpebral part of lacrimal gland tumor. It should be excised completely with a margin of normal tissue as incomplete resection may lead to recurrence. Incisional biopsy is believed to increase the risk of recurrence due to disruption of the pseudocapsule and tumor spillage.

Eye injuries continue to increase in frequency and are commonly accompanied maxillofacial and head multiple injuries, secondary to road traffic accidents (RTAs). Their management is normally requiring multidisciplinary team management including ophthalmic, maxillofacial, and neurosurgeons, an opportunity which cannot be achieved unless in multidisciplinary facilities. The purpose of this study is to report multidisciplinary management of devastating mid-facial and orbital direct trauma from a shattered car window glass in RTA. A 2-year-old girl was rushed to the Emergency Department of the Royal Care International Hospital in Khartoum, with a mid-facial massive injury involving the orbit, following RTA; her parents were seeking for a second opinion after that the left eye enucleation was planned in another general hospital. The case discussion reviewed the initial examination, resultant management decisions, and final excellent visual outcome.

The aim of this study is to report a case of double elevator palsy (DEP) managed with Knapp's procedure. An 18-year-old female presented to us with a complaint of drooping of the right eyelid since childhood. Best-corrected visual acuity was 6/12 in right eye and 6/6 in left eye. Elevation in right eye was absent. Her right eye showed 14–16 prism diopter (PD) hypotropia with 10 PD exotropia, and the left eye showed dissociated vertical deviation (DVD). Her palpebral fissure height was 6 mm in right eye and 9 mm in left eye with marginal reflex distance-1, 1 and 4 mm, respectively. Levator palpebrae superioris action was 7 mm in right eye and 14 mm in left eye. Bell's phenomenon was absent in right eye. Diagnosis of right eye DEP with ptosis and exotropia on left eye DVD was made. Knapp procedure in right eye was performed with postoperative orthophoria in primary position. Knapp's procedure is the surgery of choice in a case of DEP.

This report is a case of blepharophimosis syndrome in a 21-year-old male patient who presented to the outpatient department for handicapped certificate on account of poor vision. There was no history of similar occurrence in the family of the patient. The patient's vision was 6/18 in both eyes. The patient had refraction which revealed hyperopic astigmatism, but the vision did not improve due to amblyopia that the patient had. In view of cosmetic reasons, the patient was encouraged to have ptosis surgery.