Ocular Foreign Bodies: A Review

A foreign body is any abnormal substance or object that does not belong to the body (eye). The incidence of foreign body in the eye is high especially in the industrial towns. It can occur at any age and in both genders. It affects the eye by mechanical effects, by introduction of infection or by specific reaction. Introduction of a foreign body is a significant disturbance and can create health problem. The study of the foreign body presents unparalleled opportunities for reducing morbidity and for realizing significant savings in both financial and human terms.

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Ischaemic Optic Neuropathy Non Arteritic/NA-AION

Ischaemic optic neuropathy (ION) is the commonest adult optic nerve disorder encountered worldwide and can be expected to increase in incidence in our ageing population. In a recent review of 121 cases the mean age was 61 years. The condition has been classified as a) anterior (AION) affecting the optic nerve head and b) posterior (PION) involving that portion of the optic nerve behind its immediate retrolaminar portion.

The SCHEIE Visual Field Grading System

No method of grading visual field (VF) defects has been widely accepted throughout the glaucoma community. The SCHEIE (Systematic Classification of Humphrey visual fields-Easy Interpretation and Evaluation) grading system for glaucomatous visual fields was created to convey qualitative and quantitative information regarding visual field defects in an objective, reproducible, and easily applicable manner for research purposes.

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Cornelia de Lange Syndrome with Congenital Glaucoma

Cornelia De Lange syndrome (CDLS), also known as Brachmann de Lange syndrome is a rare syndrome. It is characterised by distinctive facial dysmorphism, growth retardation, developmental delay, upper limb reduction defects, gastroesophageal dysfunction, ophthalmologic and genitourinary anomalies, hirsutism, pyloric stenosis, congenital diaphragmatic hernias, cardiac septal defects, and hearing loss. The syndrome was first described by a Dutch paediatrician named Cornelia de Lange, in 1933.

Though the genetic basis of this syndrome is not clear, a majority of cases are due to spontaneous mutations. The defective gene can be inherited from either parent, making it autosomal dominant type of inheritance. Synophrys, long curled lashes, myopia, and hypertrichosis of the brows. These patients have also been found to have ptosis, epiphora, nasolacrimal duct obstruction, and microcornea, congenital glaucoma, corneal opacities, iris heterochromia and optic nerve head pallor/atrophy.

Impact of Amblyopia Treatment on Vision-Related Quality Of Life

Treatment of amblyopia during childhood can have both positive and negative impacts in later life. The treatment of amblyopia could influence Vision-related Quality of Life in adults and children, particularly social relationships and emotions. For example, children with a history of occlusion were 35% to 37% more likely than children without visual defects to have suffered from verbal or physical bullying at school. Many parents associate occlusion treatment with a decrease in children’s self-confidence because of poor vision during occlusion and report greater distress and more conflict at home.

Koklanis et al. conducted a study in Australia on the psychosocial impact of amblyopia and its treatment from both the children (aged 3 to 15 years) and parents’ perspectives. The investigators performed a semi-structured interview with both children with amblyopia and their parents. In addition, parents were asked to complete a psychological inventory, the Behaviour Assessment System for Children. The study showed that dealing with stigma and the perceptions and responses of peers were found to be of central significance in amblyopia therapy and that stigma and the perceptions of peers had adverse consequences for some children’s identity and psychosocial well being.

Comparison of Combined Bevacizumab plus Dexamethasone Vs. Ranibizumab Monotherapy as First-Line Therapy in Patients with Treatment Naive Neovascular Age-Related Macular Degeneration in Real-Life Clinical Practice: A Retrospective Case-Series Analysis

Age related macular degeneration (AMD) is a major cause of legal blindness in elderly individuals in the western world. It affects the macula, initially with characteristic retinal pigment epithelium (RPE) changes (mottling, hyper/hypopigmentation) and drusen deposition (dry AMD). Of note is the presence of a series of inflammatory factors between the RPE and Bruch's membrane. The progression of AMD leads either to late stage geographic atrophy of the macular RPE, or to neovascularization (neovascular AMD), due to vascular endothelial growth factor (VEGF) production.

Neovascular AMD is the most vision-threatening form of the disease. Visual impairment in neovascular AMD is caused by the formation of a choroidal neovascular membrane (CNV) beneath the macula with consequent subretinal leakage, hemorrhage and intraretinal fluid accumulation. Inflammatory factors and VEGF are the main contributing mediators involved in the progression of AMD, participating in a vicious cycle involving hypoxia, oxidative stress, inflammation, edema and neoangiogenesis.

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Refractive Errors among Administrative Staff of Senior High Schools in the Kumasi Metropolis

Refractive error is a condition in which the eye in its relaxed state is unable to sharply see images due to failure of the optical system to bring parallel rays of light reflected off objects) of regard to a sharp focus on the retina. As a result, there is relatively poor vision as images of objects are seen to be blurred. There are different types of refractive errors and they include hyperopia, myopia, and astigmatism, with overlapping forms. Myopia and hyperopia are said to occur when the optical system of the eye brings parallel rays of light into focus in front and at the back of the fovea, respectively. Astigmatism on the other hand occurs when rays of light from different planes do not come to the same point on the fovea.

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Cornelia de Lange Syndrome with Congenital Glaucoma

Cornelia De Lange syndrome (CDLS), also known as Brachmann de Lange syndrome is a rare syndrome. It is characterised by distinctive facial dysmorphism, growth retardation, developmental delay, upper limb reduction defects, gastroesophageal dysfunction, ophthalmologic and genitourinary anomalies, hirsutism, pyloric stenosis, congenital diaphragmatic hernias, cardiac septal defects, and hearing loss. The syndrome was first described by a Dutch paediatrician named Cornelia de Lange, in 1933.

Though the genetic basis of this syndrome is not clear, a majority of cases are due to spontaneous mutations. The defective gene can be inherited from either parent, making it autosomal dominant type of inheritance.

Synophrys, long curled lashes, myopia, and hypertrichosis of the brows. These patients have also been found to have ptosis, epiphora, nasolacrimal duct obstruction, and microcornea, congenital glaucoma, corneal opacities, iris heterochromia and optic nerve head pallor/atrophy.

Periorbital Cellulitis that Developed after Alternative Medication of Hirudo Medicinalis Application

We aimed to present a case of periorbital (preseptal) cellulitis that developed after Hirudo medicinalis alternative medicine application for glaucoma treatment which can be rarely seen in routine ophthalmology practice. A 36 year old woman with a glaucoma was admitted to our outpatient clinic because of redness, pain and swelling around the right eye for three days and gave a history of leech application 1 week ago, that recommended by her relatives as a remedy for glaucoma.

Orbital cellulitis was excluded and cure was achieved with oral ciprofloxacin and flurbiprofen treatment. Patients with chronic diseases such as glaucoma, they are abandoning the treatment over time, will seek solutions from alternative medicine. These inappropriate treatments without scientific evidence can cause various complications. Physicians should maintain proper communication with the patients inform them about their chronic diseases (e.g. glaucoma) to make them the part of the solution and treatments.

Moving Toward Consensus Terminology in Ophthalmic Practice

The dual purposes of this review are to point out inherent problems in communication due to lack of consensus terminology, and to review preferred ophthalmic terms or to suggest others in order to improve eye care. With advances in informatics and the ongoing evolution of modern health care delivery, a common lexicon will also improve basic research and clinical outcomes. It is hoped that this paper will raise awareness of these issues and open profession-wide discussion with the ultimate goal of improving medical communication for ophthalmic patient care.

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Combined Hamartoma of RPE and Retina

A 10 year old male patient presented with diminished vision in his right eye since 6 years. He had not taken any treatment for the same. On examination visual acuity in the right eye was 20/720 and left eye was 20/20. Anterior segment was normal in both eyes. Fundus examination of the right eye showed an ill-defined pigmented lesion measuring 14 mm × 10 mm in its greatest dimensions.

Un-doing All that Good Work! Glaucoma After Vitrectomy and Silicone Oil Injection for the Treatment of Complicated Retinal Detachment

A fifty-two year old bilaterally pseudophakic Caucasian gentleman having a retinal detachment secondary to two retinal breaks superotemporally in his right eye underwent twenty-three gauge pars plana vitrectomy (PPV), endophotocoagulation and perfluoroethane (C2F6) gas insertion.

He presented five weeks later with a total retinal detachment in the same eye presumed consequent to a retinal break inferotemporally thought to represent temporal extension of the initial retinal tear beyond the margin of the aforementioned retinopexy. Twenty gauge PPV was performed, cryotherapy was applied to the retinal break, indirect retinal photocoagulation carried out and 16% perfluoropropane (C3F8) inserted into the vitreous cavity.

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Corneal Toxicity after Self-Application of Calotropis procera (Ushaar) Latex: Case Report and Analysis of the Active Components

Calotropis procera (ushaar) produces a copious amount of latex, which has both inflammatory and anti-inflammatory pharmacological properties. Local application produces an intense inflammatory response and causes significant ocular morbidity.

We report corneal toxicity following self-application of latex from C. procera in a 74-year-old man. He reported painless decreased vision in the affected eye with diffuse corneal edema, and specular microscopy revealed a reduced endothelial cell count. After he was treated with topical corticosteroids, his visual acuity improved from HM to 20/80. The composition of the active compounds in the latex was analyzed. When topically administered, the latex may cause severe ocular injuries and a loss of endothelial cells over a period of time. Public education, early recognition of such injuries, and timely intervention may prevent permanent ocular damage.

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Stereoscopic Memory When Stimuli No Longer Persist: Void and Binocular Intervals in Alternating Monocular Presentations

It was early realized by Exner in 1875 that stereopsis could occur when both eyes together receive the two images of a stereo pair one after the other. Stereopsis occurs even when a void interval is inserted between the presentations of each image.

For instance, Ogle found that stereopsis occurred when two 18 ms presentations were separated by a void interval of 100 ms. Stereopsis has also been studied with protocols in which the two images of a stereo pair were presented cyclically, in alternation to the two eyes. Guilloz - who was motivated by a practical interest in 3d X-ray radioscopy - produced cyclical presentations to the two eyes using a disk rotating in front of a stereoscope lenses. He also described how natural scenes are perceived through his apparatus.

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Hypotony as a Hazard of Trabeculectomy with Mitomycin C

An eighty two year old Caucasian lady with primary open angle glaucoma attended eye clinic. She was using guttate latanoprost 50 g/ml, Brimonidine 2 mg/ml and combined Dorzolamide 20 g/ml and Timolol 5 mg/ml.

This lady was myopic with right eye manifest refraction spherical equivalent of -2.00 and left eye manifest refraction spherical equivalent of -8.00 dioptres. The left eye was amblyopic as a result of this anisometropia. This lady had had bilateral uncomplicated cataract extractions by phacoemulsification with intraocular lens implantation and subsequently bilateral neodymium yttrium aluminium garnet or Nd: YAG laser posterior capsulotomies.

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Aberrometric Outcomes of Intrastromal Corneal Ring Segment (KeraRing 355) Implantation Using Pocket Maker Microkeratome in Patients with Keratoconus

Keratoconus, the most common primary corneal ectasia, is a bilateral asymmetric corneal degeneration which accompanies with local corneal thinning and occurs mostly in inferior and central part of the cornea. Initiating in puberty, Keratoconus (KCN) often progresses until fourth decade of life.

Affecting all ethnic groups equally, KCN usually causes high myopia and irregular astigmatism which results in poor quality of vision. Based on disease severity, many treatment modalities exist including glasses and contact lenses for mild to moderate disease while corneal graft preserved for more advanced disease. High costs, need to long follow-ups, long periods for visual rehabilitation, risks of graft rejection or infection, wound dehiscence and suture-related problems make corneal grafts preserved for the last therapeutic choice by many ophthalmologists.

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Ocular Foreign Bodies: A Review

A foreign body is any abnormal substance or object that does not belong to the body (eye). The incidence of foreign body in the eye is high especially in the industrial towns. It can occur at any age and in both genders. It affects the eye by mechanical effects, by introduction of infection or by specific reaction. Introduction of a foreign body is a significant disturbance and can create health problem. The study of the foreign body presents unparalleled opportunities for reducing morbidity and for realizing significant savings in both financial and human terms.

Interpupillary Distance Measurements among Students in the Kumasi Metropolis

The aim was to obtain interpupillary distance (IPD) measurements of students in the Kumasi Metropolis. The study will provide a database for manufacturers of spectacle frames and optical equipment with Ghana as the target population. The IPD is a crucial measure that needs to be considered before frames can be selected for patients who have been prescribed with spectacle corrections. IPD data from other populations are unsuitable due to variations with age, sex and race.

A cross-sectional study involving 500 students, aged 10 to 20 years and selected from Junior and Senior High Schools in the Kumasi Metropolis, was carried out. Interpupillary distances were measured using the pupillometer and the PD rule.

Results: Out of the 500 students, 290 (58%) were males. The study revealed that the distance and near IPD measured with pupillometer in students was 65.53 ± 3.348 mm and 61.60 ± 3.054 mm respectively. Furthermore, the IPD was 64.48 ± 3.429 mm and 62.01 ± 3.464 mm for distance and near, respectively, when measured with a PD rule.

Surgical Management of Glaucoma in Sturge-Weber Syndrome

Sturge-Weber syndrome (SWS) or encephalo-trigeminal hemangiomatosis is a sporadic, mesodermal phakomatosis characterised by hemangiomas involving many parts of the body, particularly ocular, intracranial and facial cutaneous structures.

Glaucoma is a common feature, with an incidence of 30%-71% in patients with Sturge-Weber syndrome. Many mechanisms of raised intraocular pressure have been described in the past, the most consistent being congenital trabeculodysgenesis, increased episcleral venous pressure and hypersecretion due to ciliary body angioma.

An increased risk of intra and post-operative complications has been noted with glaucoma filtering procedures in these patients, predominantly due to rupture of the fragile vasculature in the choroidal hemangiomas, leading to expulsive choroidal haemorrhage or exudative choroidal detachment (CD) caused by sudden decompression during or after filtering procedures. Prohylactic sclerotomies have been advocated, to be performed prior to ocular decompression, during filtering procedures in order to avoid these complications.