Purpose: To evaluate the reproducibility, and therefore the utility, of using traditional tonometry devices for measuring intraocular pressure (IOP), while a prosthetic replacement of the ocular surface ecosystem device (PD) or scleral lens is applied to the eye.
Patients and methods: Twenty subjects (40 eyes) with keratoconus were enrolled. With PD applied, the first 10 consecutive patients had IOP measured multiple times with a handheld tonometer (Tono-Pen AVIA, Reichert, Depew, NY) on the superotemporal sclera 1 mm posterior to the PD edge. This identical procedure was repeated for the next 10 consecutive patients with a pneumatonometer (Model 30, Reichert, Depew, NY). Once three reliable measurements, as defined by the study protocol, were obtained for an eye, the procedure was repeated with the same tonometer device on the fellow eye.
Results: The mean standard deviation for reliable IOP measurements was ±2.92 mmHg, median (IQR) of 2.62 (1.68 to 3.53) mmHg in the handheld tonometer group and ±1.98 mmHg in the pneumatonometer group. There was no statistically significant difference between the groups (p = 0.07). The mean IOP range for the reliable IOP measurements was 5.5 ± 3.80 mmHg, median (IQR) of 5 (3 to 7) mmHg for the handheld tonometer group and 3.71 ±1.12 mmHg in the pneumatonometer group. There was no statistically significant difference between the groups (p = 0.06).
Conclusion: Handheld tonometry and pneumatonometry have poor reproducibility when used to measure scleral IOP in keratoconus patients, while a PD is applied to the eye. An alternative research model and methodology should be investigated and confirmed to have precision prior to proceeding with further analysis of any relationship between scleral lens wear and IOP.
Purpose: To present a case of chronic progressive external ophthalmoplegia (CPEO) diagnosis in the setting of a busy glaucoma clinic.
Materials and methods: Case report.
Results: A 70-year-old-female presented to our glaucoma clinic concerned on her glaucoma status. She was previously followed-up elsewhere. Her past ophthalmic history included a diagnosis of normal tension glaucoma 10 years earlier for which she was on topical anti-glaucoma medication. On inspection, symmetrical ptosis was noted and when she was asked about her family history, she reported that 4 members of her family had "problems with moving their eyes" as she also had from a young age. Her best corrected visual acuity was 20/100 in her right eye (RE) and 20/80 in her left eye (LE). Optic discs had normal margins with peripapillary atrophy and cup/disc ratio was 0.7 RE and 0.8 LE. Intraocular pressure was 10mmHg bilaterally. Ocular motility examination revealed severe restriction in all directions of gaze. She had mild alternating exotropia but she did not report any diplopia. Based on her family history, bilateral ptosis, ophthalmoplegia and reported symptoms, the diagnosis of CPEO was made.
Conclusion: In the setting of a busy subspecialty clinic, it is common for clinicians to focus on a specific pathology and overlook additional signs and symptoms that represent a second often unrelated condition. Our case highlights the importance of a thorough assessment including history taking (general, ophthalmic and family), good documentation of symptoms and an adequate clinical examination.
[This corrects the article DOI: 10.2147/OPTO.S336361.].
Background: Traditional eye medicine is a form of biologically based therapies, practices, or partially processed organic or inorganic agents that can be applied to the eye and lead to a blinding complication. Attitude towards those medicines plays a pertinent role in the practice of those traditional eye medicines.
Objective: To determine attitude towards traditional eye medicine and associated factors among adult ophthalmic patients attending University of Gondar Comprehensive Specialized Hospital-Tertiary Eye Care and Training Center, Northwest Ethiopia, 2020.
Methods: A hospital-based cross-sectional study was conducted on 417 newly presenting adult ophthalmic patients who were selected by using a systematic random sampling method from June 22 to August 11, 2020. The data from the interview-based structured questionnaire were entered into Epi Info 7 and analyzed by SPSS 20. Frequency and cross-tabulations were used for descriptive analysis. Association between variables was analyzed using binary logistic regression through the enter method with a 95% confidence interval.
Results: A total of 417 subjects with a 98.8% response rate have participated in the study. Of the total study subjects, 60.7% (253) (95% CI: 19-26%) had a positive attitude towards traditional eye medicine. Residing in a rural area (AOR=6.46 (95% CI: 2.89-14.45)), positive family history of traditional eye medicine use (AOR=8.01 (95% CI: 4.17-15.37)) and availability of traditional healer (AOR=19.43 (95% CI: 12.06-31.64)) were significantly associated with a positive attitude towards traditional eye medicine.
Conclusion and recommendation: Most adult ophthalmic patients had a positive attitude towards traditional eye medicine. Residing in a rural, availability of a traditional healer, and positive family history of traditional eye medicine use had a significant positive association with a positive attitude. Educating the traditional healers on safe practices is crucial in reducing the burden.
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