Middle East African Journal of Ophthalmology最新文献

Cocaine abuse has been reported to cause devastating systemic and ocular side effects. Retinal vascular occlusion following cocaine abuse has been scarcely reported in the literature. Herein, we are describing a rare case of branch retinal artery occlusion (BRAO) following intranasal cocaine use in a young female. She presented to the emergency department 1 month after having blurred vision in the left eye, which started 1 day after cocaine nasal inhalation. Fundus examination of the left eye showed an inferotemporal BRAO. In conclusion, cocaine should be considered in the differential diagnosis of retinal arterial occlusion in young healthy patients.

Purpose: The purpose of the study is to compare the surgical outcomes and success rates of external dacryocystorhinostomy (EX-DCR) versus endoscopic endonasal DCR (EN-DCR) for the treatment of primary acquired nasolacrimal duct obstruction (PANDO).

Methods: This retrospective nonrandomized study was conducted at Farabi Eye Hospital and Noor Eye Hospital, Iran. A review of electronic medical records of all patients with PANDO who underwent EX-DCR or EN-DCR between January 2016 and 2018 was carried out.

Results: A total of 803 patients underwent surgery, of which 618 patients (77%) were managed by EX-DCR and 185 patients (23%) by EN-DCR. The majority of cases (62%) were female. The mean age of the patients in EX-DCR and EN-DCR groups was 40.8 ± 14.2 and 34.3 ± 9.2 years, respectively. EX-DCR resulted in significantly less amount of pain compared to EN-DCR (P < 0.05). The success rate of surgery among EX-DCR and EN-DCR groups was 92.4% and 91.1%, respectively, and did not show statistically significant difference. A higher incidence of intraoperative hemorrhage requiring intervention was noted in the EN-DCR group (16.7% vs. 4.5%). Postoperative patient's satisfaction with EN-DCR and EX-DCR was 73% and 82%, respectively.

Conclusion: Both EX-DXR and endoscopic DCR surgeries have high success rates and low incidence of failure. The choice of DCR technique should be based on the experience of the surgeon and patient's lacrimal and nasal anatomy and preferences.

Purpose: The purpose of this study is to evaluate the use of and beliefs toward social media (SM) among Saudi ophthalmologists.

Methods: This was a cross-sectional descriptive study. A web-based, self-administered questionnaire was e-mailed to ophthalmologists within Saudi Arabia.

Results: Out of 392 recipients, 293 completed the survey (74.7% response rate). The vast majority (90.1%) used at least one platform for personal and professional purposes or either. The three most commonly used applications were Twitter (72.3%), Snapchat (65.9%), and Instagram (51.9%). The opinions of respondents with regard to the different aspects of SM varied widely. Around half (56.7%) believed that it was permissible for ophthalmologists to promote themselves on SM and 70.6% agreed that SM usage by health-care professionals should be regulated. Participants believe that SM had both a positive and a negative impact on their daily life and clinical practice. For example, 94 (32.1%) respondents stated that it improved their ability to educate patients, on the other hand, 80 (27.3%) reported that SM wastes quality time that can be spent on something more productive.

Conclusion: Our results demonstrate an increased utilization of SM among Saudi ophthalmologists. The ethical aspects of SM usage were a matter of controversy among our respondents. This necessitates the establishment of guidelines by regulatory bodies and/or individual health-care organizations.

Metastatic tumors to the choroid are the most common intraocular malignancies. Choroidal metastasis from lung cancer is uncommon. Visual affection or other ocular manifestations as the initial clinical presentation of lung cancer primarily are rare. We report a case of a 71-year-old female patient presented with eye floaters in her right eye. Examination of the right eye visual acuity of 20/30 and fundoscopy revealed a pale choroidal mass superior to optic disc. Ocular coherent tomography showed subretinal fluid at the site of choroidal lesion. The patient is currently treated with radiotherapy and chemotherapy for secondary metastasizes in liver. In spite of floaters is very common nonserious symptoms in ophthalmology practice, but it should be taken seriously to rule out lifesaving condition.

Purpose: The purpose of this study was to analyze the outcomes of two frequently used surgical valves in treating refractory glaucoma.

Methods: This was a retrospective and nonrandomized study comparing patients aged 18 years or older who underwent implantation using standardized surgical techniques.

Results: A total of 86 patients were included in the study, 48 in the Ahmed group and 38 in the Baerveldt group. The overall success rate was 63.1% in both the groups. At the 3-year follow-up, the Ahmed group had a mean intraocular pressure (IOP) of 14.0 ± 4.8 mmHg (60% reduction) compared with 15.8 ± 6.2 mmHg (53.3% reduction) in the Baerveldt group (0.536). The Ahmed group required an average of 1.6 ± 1.3 medications (59% reduction) compared with 2.1 ± 1.7 (40% reduction) in the Baerveldt group (P < 0.001).

Conclusion: Despite a high failure rate, both devices were effective in lowering IOP and the need for medications. Lower IOP and medications were needed in the Ahmed group.

Purpose: The purpose of the study was to evaluate the accuracy of teleexamination of red eye by a trained general practitioner (GP) compared to the gold standard (in-office consultation by an ophthalmologist).

Methods: This was a study of diagnostic accuracy. We included consecutive male or female patients aged ≥6 months who presented to a primary care clinic in Riyadh, Saudi Arabia, with red eye. All the patients were initially evaluated by a trained GP using a standardized checklist and consulted virtually with an ophthalmologist. This was followed by an in-office eye examination conducted at a well-equipped ophthalmology clinic by a well-trained ophthalmologist. Data were analyzed using STATA 17.0 (StataCorp LLC, College Station, TX, USA).

Results: A total of 54 patients with red eye presented to the primary care clinic during September-November 2021 and were initially examined virtually and then in-office. The mean age of the patients was 39.72 ± 21.70 years (range 5-90 years). Thirty-three patients (61.1%) were males. The most common cause of red eye was conjunctivitis (46.3%) followed by dry eye (31.5%). There was a significant association between viral conjunctivitis and age (P < 0.001), and between dry eye and age (P = 0.002). Tele eye examination accurately identified the etiology of red eye in all 54 patients.

Conclusion: Telemedicine has the potential to correctly diagnose patients with red eye and can result in a substantial decrease in the number of people visiting the health-care centers.

Purpose: Botulinum toxin (Botox) therapy is a well-known option for strabismus management and is often used in managing esotropia. Exotropia is also a common type of strabismus; however, the effectiveness of Botox in improving exotropia is still ambiguous. In this study, we report our experience in using Botox to manage the various types of exotropia.

Methods: A retrospective cohort study was conducted at King Khaled Eye Specialist Hospital Riyadh, Saudi Arabia. Medical records of patients with exotropia who received Botox from 2014 to March 2020 were reviewed. The main success indicator was a remaining angle of less than 10 prism diopters (PD).

Results: A total of 97 cases were reviewed, with 57 (58.8%) males and 40 (41.2%) females. The age ranged from 2 months to 40 years. The most prevalent diagnosis was sensory exotropia. Overall, 28 patients (28.9 %) and 49 patients (50.5%) achieved an angle of deviation within 10 PD and within 20 PD, respectively. Female patients had a better response to Botox than males, with 32.5% of them achieving an angle of deviation within 10 PD and 60% achieving an angle of deviation within 20 PD. We found that the change in the angle of deviation increased as the Botox dose was increased.

Conclusion: Botox represents a possible safe alternative to surgery in the management of some exotropia types. The success rate differs by type, with basic exotropia scoring the highest. The presence of poor vision and amblyopia leads to a significantly lower success rate.

Purpose: Color blindness is one of the potential disabilities affecting the ability of color perception by the eye. The aim of the present study was to evaluate the prevalence of color blindness among dental professionals.

Methods: For the present study, a total of 198 dental professionals were randomly selected as subjects who were asked to fill the required questionnaire followed by which their color vision status was evaluated using the Ishihara test. The results obtained were subjected to statistical analysis. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA). The prevalence of color blindness, age specificity, and the ratio of the occurrence of color blindness in relation to gender were assessed using Chi-square test for independence and Chi-square test with Yates's correction for independence when the expected frequency was <5. P < 0.05 was considered statistically significant.

Results: The present study reported 3.54% prevalence of color blindness among the study population. A higher number of cases were reported from males (9.26%) than females (1.39%). (P < 0.05) Furthermore, the prevalence of color blindness was found to be more in faculty members (5.88%) than in students with a reported prevalence of 3.31%.

Conclusion: The present study reported high prevalence of color blindness in dental professionals while they were totally unaware of it.

Coronavirus disease (COVID-19) has been declared by the World Health Organization as a pandemic on March 11, 2020. COVID-19 predispose patients to multisystem thromboembolic events, including pulmonary emboli and deep vein thrombosis. We report a 33-year-old previously healthy man, with previous history of COVID-19 infection presented with left eye central retinal vein occlusion (CRVO) with secondary macular edema. All possible risk factors for thromboembolic events were excluded. After a single dose of intravitreal injection of aflibercept (2 mg in 0.05 ml), gradual improvement in the clinical manifestation of CRVO with complete resolution of macular edema in the left eye was observed. To the best of our knowledge, this is the first report of CRVO post-COVID-19 in Oman.

Deep anterior lamellar keratoplasty (DALK) is a surgical intervention for corneal diseases that do not affect the endothelium. The creation of an interface between the donor graft and recipient bed is a typical feature of DALK. Interface infectious keratitis (IIK) is an uncommon complication that originates at this point of contact. The onset of IIK following lamellar keratoplasty can cause delayed visual loss and subsequent endophthalmitis, with primarily fungal etiology (e.g., Candida spp.) and occasionally bacterial etiology. Infection of the lamellar interface may be attributed to contamination of the donor material or to precipitating factors such as loose sutures, persistent epithelial defects, and prolonged topical steroid use; fungal IIK is frequently resistant to medical treatment. Here, we describe the previously unreported occurrence of corneal perforation as a complication of fungal IIK after DALK. A 26-year-old otherwise healthy woman underwent uneventful DALK for advanced keratoconus in the left eye. She was discharged with instructions to apply topical prednisolone acetate and topical moxifloxacin. Culture of the donor corneoscleral rim showed growth of Candida glabrata, although the patient exhibited no clinical signs of infection. Approximately 3 months later, the patient exhibited mild blurring of vision in her left eye. Therefore, treatment was modified to topical amphotericin B and oral voriconazole. One week later, the patient developed multiple, sheath-like whitish creamy infiltrates, primarily in the lamellar interface; a positive Seidel test result indicated the presence of corneal perforation. As treatment for IIK, excisional penetrating keratoplasty (PK) was performed, followed by topical amphotericin B and topical prednisolone acetate treatment. During 12 months of follow-up after PK, the corneal graft was clear and there was no clinical evidence of recurrent keratitis. Prompt excisional PK prevented the progression of IIK to endophthalmitis in our patient. Early intervention with excisional PK should be considered when a diagnosis of fungal IIK is suspected in a patient with a positive donor rim culture, and in whom the condition does not respond to medical treatment. This early intervention is essential to prevent delayed treatment, which could result in corneal perforation and endophthalmitis, with ultimately poor visual outcomes.