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Effects of Lipiflow treatment prior to cataract surgery: A prospective, randomized, controlled study 白内障手术前Lipiflow治疗的效果:一项前瞻性、随机、对照研究
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_30_22
K. Husna
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引用次数: 3
Role of teachers in screening of ocular disorders in school children: A multistage school screening program 教师在学龄儿童眼部疾病筛查中的作用:一项多阶段学校筛查计划
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_213_21
K. Aparna, Resmi Bhaskar, Unnikrishnan Nair
Purpose: The aim of the study was to find out whether teachers can be introduced as an effective tool in ocular screening of school children and to list out various causes of visual impairment and ocular abnormalities in school children and provide appropriate measures. Method: A multistage school screening program from August to December 2019 in Trivandrum included 33,990 students from 52 schools. Five stages of the study were training of selected teachers, screening by teachers in the school, comprehensive examination by the hospital team in schools, detailed evaluation of referred children in the hospital, and corrective measures by pediatric ophthalmologists in our hospital. A total of 1480 children were selected randomly from the children identified as normal by teachers to detect false negatives. The pattern of ocular disorders children was analyzed. Results: Out of 33,990 students, 6343 students who were detected to have ocular disorders by teachers (18.6%) were examined by our team. 74.2% (4707 students) of them were confirmed to have ocular problems. Thus teachers were able to identify the eye problems correctly (true positives) in 74.2% children, 25.8% being false positives. True positives include refractive errors (73.4%), allergic conjunctivitis (7.9%), strabismus (1.9%), amblyopia (0.098%), pediatric cataract (0.08%), etc. Out of 1480 randomly selected children, 8 (0.54%) children were false negatives (none had refractive errors). Spectacles were given to 2484 children free of cost. Conclusion: Simplicity of multistage screening, ease of its application, time and cost effectiveness, wider coverage, utility as a continuous process in coming years signifies that introducing teachers as primary vision screeners at their schools is an innovative community-based strategy to address the challenges of childhood blindness in resource-constrained settings.
目的:本研究的目的是了解教师是否可以作为学童眼部筛查的有效工具,列出学童视力障碍和眼部异常的各种原因,并提供适当的措施。方法:2019年8月至12月在特里凡得琅进行的一项多阶段学校筛查计划包括来自52所学校的33990名学生。研究的五个阶段是对选定教师的培训、学校教师的筛查、学校医院团队的全面检查、医院转诊儿童的详细评估以及我院儿科眼科医生的纠正措施。从教师认定为正常的儿童中随机抽取1480名儿童进行假阴性检测。分析了儿童眼部疾病的发病模式。结果:在33990名学生中,6343名被老师检测出患有眼部疾病的学生(18.6%)接受了我们团队的检查。74.2%(4707名学生)被证实有眼部问题。因此,教师能够正确识别74.2%的儿童的眼部问题(真阳性),25.8%为假阳性。真阳性包括屈光不正(73.4%)、过敏性结膜炎(7.9%)、斜视(1.9%)、弱视(0.098%)、儿童白内障(0.08%)等。在随机选择的1480名儿童中,8名(0.54%)儿童为假阴性(无屈光不正)。2484名儿童免费获得了眼镜。结论:多阶段筛查的简单性、应用的方便性、时间和成本效益、更广泛的覆盖范围、在未来几年作为一个持续的过程的实用性意味着,在学校引入教师作为初级视力筛查员是一种创新的基于社区的战略,可以在资源有限的环境中应对儿童失明的挑战。
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引用次数: 0
Supranuclear and internuclear ophthalmoplegia - Gaze palsy 核上和核间眼肌麻痹-凝视性麻痹
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_79_22
Cyril George, P. Krishnan, Ashwati Sankar
Gaze palsy is the loss of binocular control because of lesions of the pathways above the level of the nucleus.[1] To localize the lesion, an understanding of the supranuclear and internuclear pathways is necessary.
凝视性麻痹是由于核水平以上的神经通路受损而导致双目控制丧失为了定位病变,了解核上和核间通路是必要的。
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引用次数: 0
Comparative evaluation of the thickness of macula, ganglion cell layer, and retinal nerve fiber layer in emmetropes, myopes and myopes with lattice degeneration by using Cirrus high-definition optical coherence topography 利用Cirrus高清晰度光学相干地形图对比评价近视眼、近视和伴晶格变性近视的黄斑、神经节细胞层和视网膜神经纤维层厚度
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_138_21
Mamta Singh, B. Sinha, Pradeep Karak
Purpose: To know the quantitative thickness changes occurring in the macula, retinal nerve fiber layer (RNFL), and ganglion cell layer (GCL) of the retina in myopic eyes (ME) and in ME with lattice degeneration (ME-LD) in comparison to emmetropic eyes, with the help of Cirrus HD Optical coherence topography (OCT) 5000 (Carl Zeiss Meditec Inc.). Methods: Hospital-based, nonrandomized prospective study involving 90 eyes, divided into three groups – Group A comprising 30 eyes with − 3–−6D of myopia, Group B comprising 30 eyes with − 3–−6D of myopia with LD and Group C with 30 emmetropic eyes. The central macular thickness (CMT), RNFL, and GCL analysis was done with Cirrus HD OCT 5000 (Carl Zeiss Meditec). Results: The CMT was significantly higher in Group A and B than Group C. There was no significant difference in CMT between Group A and B. Any of the group did not reveal significant difference in parafoveal thickness in any quadrant. Average RNFL, average GCL + inner plexiform layer (IPL), minimum GCL + IPL was significantly thicker in Group C than Group A and B. There was no significant difference between in CMT, average RNFL thickness, average GCL + IPL between Group A and B. Conclusion: There is a significant change in thickness of macula, RNFL, and GCL between emmetropes as compared to myopes and ME-LD but not between myopes and ME-LD. This underscores the need of incorporating a myopic normative database in the present normative built-up of Cirrus OCT. Patients of ME-LD, when being evaluated on different OCT-based parameters, can be considered the same as the myopic population.
目的:利用Carl Zeiss Meditec公司的Cirrus HD光学相干地形图(OCT) 5000,了解近视眼(ME)和伴晶格变性ME (ME- ld)患者视网膜黄斑、视网膜神经纤维层(RNFL)和神经节细胞层(GCL)厚度与准视眼的定量变化。方法:基于医院的非随机前瞻性研究,纳入90只眼,分为三组:A组30只眼为−3 -−6D近视伴LD, B组30只眼为−3 -−6D近视伴LD, C组30只眼为远视。中央黄斑厚度(CMT)、RNFL和GCL分析使用Cirrus HD OCT 5000(卡尔蔡司Meditec)进行。结果:A、B组CMT明显高于c组,A、B组CMT无显著性差异。两组间各象限CMT均无显著性差异。C组的平均RNFL、平均GCL +内丛状层(IPL)、最小GCL + IPL均明显厚于A、b组。A、b组的CMT、平均RNFL厚度、平均GCL + IPL差异无统计学意义。结论:黄斑、RNFL、GCL厚度与近视组、ME-LD组比较差异有统计学意义,而近视组与ME-LD组比较差异无统计学意义。这强调了在目前建立的Cirrus oct规范中纳入近视规范数据库的必要性。当使用不同的基于oct的参数进行评估时,ME-LD患者可以被认为与近视人群相同。
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引用次数: 0
Ensuring patient safety in eye care 确保患者眼科护理安全
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_61_22
R. Ravindran
Due to the frequent and rapid development of new drugs, changes in treatment protocols and patient care delivery systems including technology, patient care in health care settings is becoming increasingly complex. However, there is a greater expectation from the patient and the community regarding the quality of patient care, outcomes, and timely delivery. These create stressful situations, making the care process prone to errors, resulting in unsafe incidents. Common errors in ophthalmology include incorrect procedures, identification errors, technical errors, medical or diagnostic errors, and documentation errors. Hence, there is a dire need to create comprehensive methods to support error-free patient care. These include standardization, developing safety protocols, safety checklists, training the staff, creating a platform for reporting, performing a root-cause analysis, monitoring, and periodical meetings to improve and continue the process. Providing a dignified, non-punitive approach with a well-defined system is paramount for ensuring patient safety in eye care.
由于新药的频繁快速开发、治疗方案和包括技术在内的患者护理提供系统的变化,医疗机构中的患者护理正变得越来越复杂。然而,患者和社区对患者护理的质量、结果和及时交付抱有更大的期望。这些会造成压力,使护理过程容易出错,从而导致不安全事件。眼科常见的错误包括不正确的程序、识别错误、技术错误、医疗或诊断错误以及文档错误。因此,迫切需要创建全面的方法来支持无错误的患者护理。其中包括标准化、制定安全协议、安全检查表、培训员工、创建报告平台、执行根本原因分析、监测和定期会议,以改进和继续该过程。提供一种有尊严的、非惩罚性的方法和一个明确的系统,对于确保患者在眼部护理中的安全至关重要。
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引用次数: 0
Comparative study of sutureless and glue-free versus conjunctival autograft with sutures in primary pterygium surgery 无缝合线、无胶自体结膜移植与缝合线自体结膜移植在原发性翼状胬肉手术中的比较研究
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_79_21
K. Jipina, N. Latha, Sikha Radhakrishnan, K. Praveena, A. Asha
Context: Sutureless glue-less surgery (SGF) is a newer alternative to the conventional conjunctival autograft with sutures (CAGS) techniques used for pterygium surgery. Aims and Objectives: To compare the safety, efficacy, and complications of SGF technique versus CAGS in the management of primary pterygium. Subjects and Methods: We performed a hospital based prospective study among 46 patients who underwent pterygium excision during an 18-month period from 2017 to 2018. Results: The duration of SGF procedure was <15 min with fewer incidences of overall symptoms postoperatively (P < 0.001) which were significantly higher in the CAGS group. The duration of symptoms was 4 days for SGF and 4 weeks for CAGS group. Although signs like graft edema and retraction were more in the SGF group in the immediate postoperative period, it resolved by 6 weeks. Three cases of recurrence were noted in the SGF group, but this was statistically insignificant. No graft loss occurred. Paired t-test showed that there is a significant reduction in astigmatism and improvement in keratometric values in both groups, with greater change in SGF group, however, this was not statistically significant. Conclusion: Sutureless and glue-free technique is a safe, effective, time-saving, and economical option for the management of pterygium with less postoperative symptoms. SGF has more postoperative signs which resolved in 6 months. The recurrence rate was higher in SGF but within the expected range reported in the literature.
背景:无缝合线无胶手术(SGF)是用于翼状胬肉手术的传统自体结膜带缝合线移植(CAGS)技术的新选择。目的和目的:比较SGF技术与CAGS技术治疗原发性翼状胬肉的安全性、有效性和并发症。研究对象和方法:我们对2017年至2018年18个月期间接受翼状胬肉切除术的46例患者进行了一项基于医院的前瞻性研究。结果:SGF手术持续时间<15 min,术后总症状发生率较低(P < 0.001), CAGS组明显高于CAGS组。症状持续时间SGF组为4天,CAGS组为4周。虽然SGF组术后立即出现移植物水肿、回缩等体征较多,但术后6周均消失。SGF组有3例复发,但差异无统计学意义。未发生移植物损失。配对t检验显示,两组患者散光明显减少,角膜度数明显改善,其中SGF组变化更大,但无统计学意义。结论:无缝合无胶技术是一种安全、有效、省时、经济的治疗翼状胬肉的方法,术后症状少。SGF术后体征较多,6个月消退。SGF的复发率较高,但在文献报道的预期范围内。
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引用次数: 0
Peripheral ulcerative keratitis with multiple punctate scleral abscess – A rare presentation of ocular tuberculosis 外周溃疡性角膜炎伴多点巩膜脓肿——一种罕见的眼结核表现
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_214_21
I. Karthiga, Charmaine Solomon, Sanaa Konnakkodan, V. Babitha, A. Kumar
This case report represents an unusual presentation of ocular tuberculosis (TB). Ocular TB is rare, but it can be the first clinical manifestation of the disease. Here, we report a case of a 67-year-old male, a chronic smoker who presented with pain, redness, and photophobia (BE), and slit-lamp examination showed multiple corneal infiltrate along the limbus with multiple scleral abscesses not responding to routine treatment. Investigations revealed high erythrocyte sedimentation rate value, positive Mantoux reaction, and changes on contrast-enhanced computed tomography of the thorax. Sputum CBNAAT was negative, and pus aspirate revealed no growth with negative staining for acid-fast bacillus. With high suspicion of TB, we started on Anti tuberculosis therapy, and there was rapid healing of lesions. In endemic areas, even when microbiological studies are not positive, ocular TB should be kept in mind in atypical cases so that early treatment can be instituted to prevent serious complications.
本病例报告为一罕见的眼结核(TB)表现。眼结核是罕见的,但它可以是该病的第一个临床表现。在此,我们报告一例67岁男性慢性吸烟者,表现为疼痛、发红和畏光(BE),裂隙灯检查显示沿角膜缘有多个角膜浸润,并有多个巩膜脓肿,常规治疗无效。检查显示高红细胞沉降值,阳性曼图反应,胸部增强计算机断层扫描改变。痰CBNAAT阴性,抽脓液无生长,抗酸杆菌染色阴性。由于对结核病的高度怀疑,我们开始了抗结核治疗,病灶很快愈合。在流行地区,即使微生物学研究结果不呈阳性,在非典型病例中也应注意眼结核,以便及早进行治疗,防止严重并发症。
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引用次数: 0
Vision “wipe-out” phenomena following a nonincisional laser procedure in the management of narrow-angle glaucoma 非精确激光手术治疗窄角型青光眼后的视力“消失”现象
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_171_21
Irshad A Subhan, Ismail Bantan, W. Alkhuraimi, Taha Alaidaroos, A. Abdelaal
The “Wipe-out” or “Snuff-out” phenomenon refers to a permanent and severe loss of vision without an identifiable cause and is considered a rare but dreaded consequence of incisional ocular surgery. It is believed to occur in patients with advanced glaucoma who demonstrate a residual central island of vision. A 42-year-old female patient presented to the general ophthalmology clinic with complaints of painless blurring of vision of the left eye for 8 months. Best-corrected visual acuity (BCVA) was 20/30 and 20/40 and intraocular pressure (IOP) was 26 mmHg and 28 mmHg in the right and left eyes, respectively. Relative afferent pupillary defect was noted in the left eye. Anterior segment examination showed peripherally shallow anterior chamber and gonioscopy revealed appositionally closed angles (Shaffer-<20 Deg) in both eyes. Fundus examination showed advanced glaucomatous optic neuropathy of the left eye. Generalized depression in the right eye and inferior arcuate scotoma with a superior nasal step, and split fixation in the left eye was seen on Humphreys 30-2 visual fields. A diagnosis of chronic primary angle closure glaucoma was made and the patient was offered Nd: Yag Laser Peripheral Iridotomy (LPI). LPI was completed for the right eye and Argon Laser Iridoplasty was performed in the left eye as Iridotomy was not possible due to the proximity of the iris to the cornea as the pupil was mid-dilated. After the procedure, the patient was prescribed topical antiglaucoma medications with topical steroids at 1 week follow-up, the patient had BCVA of 20/30 in the right eye and hand motion in the left eye, IOPs were well controlled on topical anti-glaucoma medication. A thorough examination including a dilated fundus examination, B-Scan ultrasound, and fundus fluorescein angiography were unremarkable. Magnetic resonance imaging scan of the brain and orbits was normal. “Wipeout” phenomenon is a rare but notorious complication associated with incisional surgeries in patients with advanced glaucoma. It is also reported to occur following cataract and retinal incisional surgeries. There are no reports of a wipe-out after a commonly performed laser procedure.
“抹掉”或“鼻塞”现象是指在没有可识别原因的情况下永久性严重视力丧失,被认为是眼部切口手术的一种罕见但可怕的后果。据信,它发生在晚期青光眼患者中,他们表现出残余的中央视力岛。一名42岁的女性患者在普通眼科诊所就诊,主诉左眼无痛性视力模糊8个月。右眼和左眼的最佳矫正视力(BCVA)分别为20/30和20/40,眼压(IOP)分别为26mmHg和28mmHg。左眼可见相对传入性瞳孔缺损。眼前节检查显示外周浅前房,角度镜检查显示双眼同位闭合角(Shaffer-<20°)。眼底检查显示左眼有晚期青光眼性视神经病变。Humphreys 30-2视野显示右眼广泛性凹陷,下弓形暗点伴上鼻阶,左眼分裂固定。诊断为慢性原发性闭角型青光眼,并对患者进行Nd:Yag激光周边虹膜切除术(LPI)。右眼完成了LPI,左眼进行了氩激光虹膜成形术,因为瞳孔中期扩张,虹膜靠近角膜,无法进行虹膜切开术。手术后,患者在1周的随访中接受了局部抗青光眼药物和局部类固醇的治疗,患者右眼的BCVA为20/30,左眼的手部运动,局部抗青光眼药可很好地控制眼压。包括扩张型眼底检查、B超和眼底荧光素血管造影术在内的全面检查均不明显。大脑和眼眶的磁共振成像扫描正常。“刮除”现象是一种罕见但臭名昭著的并发症,与晚期青光眼患者的切口手术有关。据报道,它也发生在白内障和视网膜切口手术之后。没有关于在通常执行的激光程序后擦除的报告。
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引用次数: 0
Effect of cataract surgery on wet age-related macular degeneration activity 白内障手术对湿性年龄相关性黄斑变性活动的影响
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_31_22
K. Husna
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引用次数: 0
Atypical presentation of multiple sclerosis – A few points to ponder 多发性硬化症的非典型表现-值得思考的几点
Pub Date : 2022-05-01 DOI: 10.4103/kjo.kjo_85_22
A. Augustin
{"title":"Atypical presentation of multiple sclerosis – A few points to ponder","authors":"A. Augustin","doi":"10.4103/kjo.kjo_85_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_85_22","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"191 - 191"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46512092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Kerala Journal of Ophthalmology
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