Ocular evaluation in patients with chronic renal failure--a hospital based study

Chronic renal failure affects every organ system including eye. The aim of this study is to conduct thorough ocular examination in the patients of chronic renal failure and to analyze the findings. 119 cases were collected from Nephrology unit of Tribhuvan University Teaching Hospital between 1st June 2002 to 15th December 2003. This was a cross sectional, descriptive type of study. Sampling technique was consecutive and stratified. Severity of renal disease was classified as mild, moderate, severe and end stage renal disease. Twenty-three percent of total 238 eyes had vision < 6/18. The causes for visual impairment were maculopathy 23 eyes, cataract 14 eyes followed by proliferative diabetic retinopathy, 9 eyes. Twelve percent of total eyes had vision < 6/60. Lid edema was present in 63.0%, conjunctival pallor in 75.6% and corneal calcification in 1.6%. Retinopathy was the most important finding. Hypertensive retinopathy was present in 56 out of total 119 cases (47.1%). It was more prevalent and tended to be more severe as renal disease progressed. This was statistically significant. Diabetic retinopathy was present in 38 out of 43 diabetic cases (88.3%). Although statistically not proven, more severe grades of diabetic retinopathy were detected with increasing severity of the renal disease. There was one case of bilateral serous detachment of the retina relating to chronic renal failure. In this study, 47 out of 56 cases of hypertensive retinopathy and 19 out of 38 cases of diabetic retinopathy were detected for the first time, thus showing the importance of ocular evaluation of the patients of renal insufficiency.