Abstract

 Objective: To observe incidence, recovery rate and extent of recovery in ocular manifestation of viral encephalitis. Method: All the patient with symptoms of encephalitis in the age group of 6 months to 14 years; Attending the Paediatric OPD with admission and eye OPD of B.R.D. Medical College will be included in this study. The details in infant include weight, age of presentation, gender significant neonatal problem and ocular findings up to a period of 6 months. All the children underwent a detailed paediatric examination by a paediatrician. Result: The findings of the study are based on 118 patients of Acute Encephalitis Syndrome. Maximum number of children were 6-10 year of age group , 47 children which covers 38.97 % cases. 58.47 %( 69 children) of total cases being male and 41.53 %( 49 children) of cases being female .In our study number of children showing any ocular finding were 44 i.e. 37.29% of total cases and the remaining 74 children i.e. 62.71 % cases does not show any ocular finding. Ocular findings include conjunctivitis, seen in 18 children, Subconjunctival hemorrhage in 6 children , corneal ulcer in 4 children, exposure keratitis in 16 children, iritis / Iridocyclitis seen in 3 children , Papilloedma in 12 children and CN Palsy in 2 children .Patients of conjunctivitis , Subconjunctival hemorrhage , exposure keratitis and iritis / Iridocyclitis recover completely without leaving any ocular deformity. Corneal ulcer is seen in 4 patients. These are all unconscious patient having GCS < 9 and malnutrition grade III &IV. These patients treated conservatively and in a follow up period of 1 month all patient recovered leaving nebular / macular grade corneal opacity in 2 patients. At time of admission 12 children had Papilloedma. In a follow up period of 6 months it resolved in 10 children without leaving any ocular deformity but in 2 children Papilloedma resolved with leaving post oedema optic atrophy. 2 children had 6th Cranial Nerve palsy without recovery in a follow up period of 6 month. Ocular manifestation of Vitamin A deficiency is seen in 13 children (6 male, 7 female). So total of 8.7 % male population of AES show vitamin A deficiency while 14.29 % of female population show the deficiency. Children showing untreatable blindness in our study were 18 (10 male, 8 female). Causes of untreatable blindness are post oedema optic atrophy in 2 children (1 male, 1 female) and retro bulbar neuritis / higher cortical lesion in 16 children ( 9 male , 7 female). 4pts of treated population suffer visual disability. Conclusion: Various observations in our study have clearly indicated that AES is more common in young males in rural area. Children showing ocular finding were 44 i.e. 37.29% of total population and the remaining 74 children i.e. 62.71% population does not show any ocular finding. Ocular manifestation of Vitamin A deficiency is seen in 13 children ( 6 male , 7 female ). Children showing untreatable blindness in our study were 18 ( 10 male, 8 female). Causes of untreatable blindness are post oedema optic atrophy in 2 children (1 male, 1 female) and retro bulbar neuritis / higher cortical lesion in 16 children (9 male, 7 female). So 15.25 % treated population suffer visual disability. 2 children show 6th Cranial Nerve palsy without recovery in a follow up period of 6 month. 2 children show nebular /macular grade corneal opacity. So ocular damage and blindness is quiet common in AES. All children should undergo a thorough ophthalmological examination and follow up.

Keywords: Acute Encephalitis Syndrome (AES); Blindness; Optic Atrophy; Eastern UP

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