Digital journal of ophthalmology : DJO最新文献

Topical medications such as prostaglandin analogues, beta-blockers, alpha-2 agonists, and carbonic anhydrase inhibitors are routinely used for the management of ocular hypertension and glaucoma. Many are associated with adverse effects. We present the case of a 72-year-old woman who developed bilateral periocular hypopigmentation in the setting of long-term use of latanoprost, timolol, and brinzolamide/brimonidine. A well-known side effect of prostaglandin analogues is skin hyperpigmentation, but a few cases of a paradoxical hypopigmentation have been reported. Timolol and brinzolamide/brimonidine have not been associated with changes in skin pigmentation in the ophthalmic literature. Our case most likely represents a rare instance of paradoxical skin depigmentation associated with latanoprost use and adds to the limited literature on this clinical entity.

Purpose: To evaluate a wet-lab session designed to teach temporal artery biopsy (TAB) using simulation.

Methods: The Welsh Institute for Minimal Access Therapy Team (WIMAT) developed two simulation models using pig ureter for the temporal artery. The session consisted of consultant-led teaching on TAB surgical approaches, mapping the temporal artery with a Doppler device, and practical demonstrations with videos. Trainees performed two biopsies using the models under consultant supervision. Participants completed questionnaires to evaluate their pre- and post-session knowledge, understanding, and learning experiences. Three key areas of comparison were mapping the temporal artery, using an ultrasound doppler device, and performing a TAB.

Results: Seven specialist trainees (ST1-5) and 3 staff grade surgeons, supervised by 3 consultants, participated. Paired t test sampling showed statistically significant improvements in mapping the temporal artery (P = 0.0076), using an ultrasound Doppler device (P = 0.0002), and performing a TAB (P = 0.0002). Identified barriers included lack of knowledge, limited prior procedures, concern about damaging the facial nerve, and lack of senior support/supervision, which contributed to trainees' apprehension about performing TAB.

Conclusions: This innovative teaching event offers a blueprint for medical training programs to improve TAB training. Modern surgical education benefits from wet labs with expert supervision.

Purpose: To assess the level and determinants of knowledge, attitude, and practice for eye and vision screening of preschool children among parents in Al-Qassim Province, Saudi Arabia.

Methods: Parents of kindergartners were surveyed in 2023. Questions relating to knowledge (10), attitude (5), and practice (5) of vision screening were asked. Answers were graded on a five-point Likert scale, where 1 indicates strong disagreement and 5 indicates strong agreement; results were analyzed with regard to family demographics and child refractive status.

Results: A total of 214 parents were surveyed, representing 214 households. Level of knowledge was good or very good in 66.2%, attitude was positive in 41%, and practice was acceptable in 72.2% of respondents. The median knowledge score was 4.0 (IQR, 3.5-4.0), median attitude score was 3.0 (IQR, 3.0-4.0), and median practice score was 4.0 (IQR, 3.0-4.0). Education and family income were associated with practice scores (P <0.001 [Kruskal-Wallis H test]). Refractive error status of the father was significantly associated with a positive attitude toward eye and vision screening of preschool children (P = 0.015 [Kruskal-Wallis]). Main sources of knowledge included ophthalmologists (49.5%), social media (16.4%), Google search (10.7%), and optometrists (10.7%); preferred sources of knowledge were ophthalmologists (60.3%) and optometrists (22.4%). Social media, computers, primary health care center staff, and opticians were less desired sources of information.

Conclusions: Parental knowledge on eye and vision screening for children in Al-Qassim Province has room to improve, and negative attitudes must be addressed. Practice for eye care in preschoolers was promising for adoption of universal preschool vision initiatives.

We report the case of a 33-year-old woman with a history of hypothyroidism and ocular history of mild myopia who presented with a spontaneous filtering bleb. Extensive systemic rheumatologic evaluation was unrevealing. The bleb was observed for many months, until the patient's vision declined secondary to the development of hypotony maculopathy. The filtering bleb was closed using an allogenic scleral patch graft, resulting in normotensive intraocular pressure and improved best-corrected visual acuity. A unilateral, spontaneous filtering bleb is a rare occurrence and is typically associated with systemic or ocular conditions. Complications such as hypotony can lead to visual impairment, and intervention is required. Early diagnosis and repair with donor scleral patch graft can prevent complications and provide an excellent cosmetic outcome.

We present the case of a 40-year-old woman with a history of high myopia and nyctalopia. Her best-corrected visual acuity was 20/80 in the right eye and 20/100 in the left eye. Fundus examination revealed generalized vascular attenuation, optic nerve pallor, and bone spicule pigmentation. Fundus autofluorescence in both eyes showed a Robson-Holder ring in the macula and multiple hypoautofluorescent lesions in the peripheral retina. Macular optical coherence tomography scans revealed a generalized thinning of retinal layers, with atrophy of the outer retinal layers. 10-2 visual fields revealed a small island of central vision in both eyes, and full field electroretinogram showed absence of scotopic and photopic responses. Genetic studies documented a rare variant in the RPGR gene (c.1991C>G p.(Ser664*)). Findings compatible with retinitis pigmentosa in our patient suggests that this mutation is pathogenic. Further study is required to confirm this hypothesis.

Melanocytomas are rare, benign tumors that occur most commonly on or adjacent to the optic disc, but they may be found in any part of the uveal tract. We report the case of a 68-year-old woman who presented with an asymptomatic melanocytic lesion on the iris of her right eye. Although it was initially observed and followed with serial imaging, the lesion was surgically removed via excisional biopsy after demonstrating interval growth. Subsequent pathological examination revealed the lesion to be a melanocytoma.

Spindle cell lipomas are slow-growing, benign tumors composed of bland spindle cells, adipocytes, and collagen bundles. They are typically found on the posterior neck, shoulder, or upper back. Spindle cell lipomas represent only a small percentage of reported lipomatous tumor types. We report the case of a 90-year-old white man who presented with a solid mobile lesion on his right upper eyelid. Histopathological and immunohistochemical analysis of the lesion led to a diagnosis of a "low-fat," intradermal, spindle cell lipoma. This case underscores the importance of considering spindle cell lipoma in the differential diagnosis for atypical eyelid lesions.

We report the case of a 60-year-old man diagnosed with unilateral, solitary, extramedullary plasmacytoma located in the right lacrimal sac fossa, with no systemic involvement. This rare plasma cell dyscrasia is usually found in the respiratory tract. Clinical and radiological features of the mass and histopathological results are described. The patient was successfully treated with complete surgical excision. There were no clinical or radiological indications of disease recurrence at 10 months' follow-up.