Author(s): Shobha Ponmudy1, Savithiri Visvanathan2, Suresh Kaliamurthy3, Manupriya Murali
Chronic kidney disease affects every organ system including the eye. The aim of the study is to conduct a thorough ocular examination and to study the occurrence of various ocular manifestations exhibited by patients with chronic kidney disease and to analyse the findings.
MATERIALS AND METHODS
100 patients from Department of Nephrology, Stanley Medical College diagnosed with chronic kidney disease were examined for ocular manifestations at the Department of Ophthalmology, Stanley Medical College. This is a cross-sectional, descriptive, non-interventional, hospital-based study. The period of study was from August 2010 to October 2011.
The commonest cause of CKD was hypertension in 47 pts. (52.2%) followed by both diabetes and hypertension in 30 patients. Patients with only diabetes were 6 patients (6.7%) and with other causes were 7 patients (7.8%).10% of patients were legally blind with visual acuity <6/60. In this study, 65 patients belonged to less than 50 years. 49.3% of the presenile patients had cataract. A reduced Schirmer’s value was noted in 54 eyes of the 200 eyes. The incidence of ocular surface disease in the study was 27%. 92 eyes out of 200 eyes studied showed hypertensive retinopathy. Higher grades of hypertensive retinopathy was more in advanced stages of CKD, i.e. 24 eyes in stage IV and 23 eyes in stage V. 51 eyes out of 40 diabetics showed diabetic retinopathy changes of which a majority of 25 eyes belonged to stage V disease. Prevalence of diabetic retinopathy in CKD patients is significantly more when compared to diabetic patients without CKD.
Study demonstrates that routine ocular evaluation is necessary in all patients with chronic kidney disease irrespective of the presence of ocular symptoms. It also highlights the occurrence of a variety of treatable ocular manifestations, which can become vision threatening if not taken care of at the earliest.