Ishita Anand1, Sandhya Gupta2

Purpose: To evaluate ocular changes in patients with Chronic Kidney Disease (CKD) undergoing haemodialysis (HD) and to analyze reasons for poor visual acuity in these patients.

Methods: 100 patients with CKD underwent a complete ocular examination including uncorrected and best corrected visual acuity, anterior and posterior segment examination, colour fundus photography and fundus fluorescein angiography. The examination was repeated at 1, 3 and 6 months after the commencement of HD.

Results: The commonest cause of CKD was Hypertension (65%), followed by Diabetes Mellitus (61%), Glomerulonephritis (5%), Idiopathic (2%) and Obstructive uropathy (1%). 65% of all eyes had a good visual acuity (VA) (>6/18), 24.5% had a fairly good VA (6/18-6/60) and 10.5% had a poor VA (<6/60).

The ocular manifestations seen were cataract (71.05%), diabetic retinopathy (48%), conjunctival inflammation (24%), hypertensive retinopathy (16%), clinically significant macular edema (10.5%), retinal haemorrhage (8%), subconjunctival haemorrhage (5.5%), disc pallor (5%), retinal pigment epithelium defects (5%), cystoid macular edema (4%).

Conclusions: The common sight-threatening complications in patients with CKD were diabetic maculopathy, macular edema, vitreous haemorrhage and tractional retinal detachment due to proliferative diabetic retinopathy, cataract, retinal venous occlusions, optic neuropathy and macular scarring.  Patients with CKD are at an increased risk of vision threatening complications and awareness is needed of the ocular complications of the disease process. An early detection of ocular changes can help to prevent and treat visual loss in these patients.