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Journal Francais D'ophtalmologie Jan 2015An ophthalmology consultation was carried out at the Hôtel-Dieu to facilitate eye care in underprivileged patients referred by the general medicine PASS (socialized...
INTRODUCTION
An ophthalmology consultation was carried out at the Hôtel-Dieu to facilitate eye care in underprivileged patients referred by the general medicine PASS (socialized health care) of the same hospital.
MATERIALS AND METHODS
The files of 150 consecutive patients examined by a single ophthalmologist between January 2012 and June 2013 were reviewed. A standard examination was performed in these patients, sent with a consult sheet, to which a response was sent to PASS. As necessary, prescriptions were also written for the patients.
RESULTS
Most patients (89/150) were immigrants from sub-Saharan Africa. Additionally, there were 25 Europeans with only 5 French, and 17 Asians. The mean age was 41 years with 90 men (mean age 43) and 60 women (mean age 36). The most common systemic diseases observed were hypertension, (13), diabetes (6), and hepatitis (6). The mean best-corrected visual acuity (129 patients) was a slightly more than 8/10 (16/20) (measurable in 143 patients). Refractive state (measured in 129 patients) was myopia (46), hyperopia (41), presbyopia (isolated in 12 cases), astigmatism (26), and emmetropia (28). Optical correction was prescribed in 87 patients. The main pathological conditions included pingueculae (19), cataracts (19), trauma (13) of which 4 patients were monocular, and pterygia (9).
DISCUSSION AND CONCLUSION
Refractive errors were the main abnormality observed in these underprivileged patients. Apart from cataract as a pathologic condition observed in the general population, more characteristic of this sub-Saharan population were pinguecula, pterygium and trauma. This study highlights the more general question of access to eye care for all underprivileged patients.
Topics: Adolescent; Adult; Africa South of the Sahara; Aged; Aged, 80 and over; Cardiovascular Diseases; Catchment Area, Health; Chronic Disease; Communicable Diseases; Comorbidity; Diabetes Mellitus; Diagnosis-Related Groups; Emigrants and Immigrants; Europe; Eye Diseases; Female; General Practice; Humans; Male; Mental Disorders; Middle Aged; Nervous System Diseases; Paris; Poverty; Retrospective Studies; Urban Population; Vision Disorders; Vulnerable Populations; Young Adult
PubMed: 25577432
DOI: 10.1016/j.jfo.2014.07.009 -
Health Science Reports May 2024The elderly comprises the fastest-expanding age group globally, with the greatest increase occurring in developing countries. The elderly populace is prone to develop...
BACKGROUND
The elderly comprises the fastest-expanding age group globally, with the greatest increase occurring in developing countries. The elderly populace is prone to develop various ocular morbidities.
PURPOSE
To determine the distribution of ocular morbidities among the elderly population visiting a private eye care facility in Malawi.
METHODS
This was a retrospective cross-sectional study conducted at St. John's Hospital in Mzuzu, Malawi. We retrieved data from the hospital's ophthalmic outpatient registry from January, 2021 to December, 2021. A nonprobability census sampling technique was used to retrieve 52 elderly patients. Data analysis were done employing SPSS (v.26).
RESULTS
This study found according to gender a larger proportion were females 27 (51.9%) compared males, who accounted for 25 (48.1%). Refractive error 21 (40.4%) was the most prevalent ocular morbidity followed by cataract 13 (25.0%), pinguecula 6 (11.5%), and glaucoma 4 (7.7%). Although clear differences exist in the distribution of ocular morbidities according to sex ( = 0.529) and age ( = 0.328), the differences are not statistically significant.
CONCLUSION
The pattern of eye diseases is typical to the country. More resources should be targeting main causes of preventable blindness including refractive error and cataracts at the facility.
PubMed: 38784254
DOI: 10.1002/hsr2.2112 -
Mycologia 2018The anther smuts of the genus Microbotryum are known from host plant species belonging to the Caryophyllaceae, Dipsacaceae, Lamiaceae, Lentibulariaceae, Montiaceae, and...
The anther smuts of the genus Microbotryum are known from host plant species belonging to the Caryophyllaceae, Dipsacaceae, Lamiaceae, Lentibulariaceae, Montiaceae, and Primulaceae. Of these, the anther smuts on Caryophyllaceae, in particular on Silene spp., are best known because they include model organisms studied in many disciplines of fungal biology. For Microbotryum species parasitic on Caryophyllaceae, a high degree of host specificity was revealed and several cryptic species were described. In contrast, the host specificity within Microbotryum pinguiculae occurring in anthers of different Pinguicula species (Lentibulariaceae) has not been investigated in detail until now. The anther smuts on Pinguicula alpina, P. villosa, and P. vulgaris, on which M. pinguiculae was described, were analyzed using nuc rDNA ITS1-5.8S-ITS2 and nuc rDNA 28S D1-D2 sequences and morphology to determine if they belong to one polyphagous species or rather represent three host-specific species. The results of the morphological investigations revealed no decisive differences between the anther smuts on different Pinguicula species. However, genetic divergence and molecular phylogenetic analyses, which split the specimens according to host plant species, supported host specificity of the anther smuts on different Pinguicula species. Accordingly, in addition to Microbotryum pinguiculae s. str. on Pinguicula vulgaris, M. alpinum sp. nov. on P. alpina from Europe and M. liroi sp. nov. on P. villosa from Asia are described and illustrated.
Topics: Asia; Basidiomycota; Cluster Analysis; DNA, Fungal; DNA, Ribosomal; DNA, Ribosomal Spacer; Europe; Flowers; Genetic Variation; Microscopy; Microscopy, Electron, Scanning; Phylogeny; Pinguecula; RNA, Ribosomal, 28S; RNA, Ribosomal, 5.8S; Sequence Analysis, DNA; Spores, Fungal
PubMed: 29792777
DOI: 10.1080/00275514.2018.1451697 -
Clinical & Experimental Optometry Mar 2020It was the author's (LWH) observation that pterygium was frequently misdiagnosed by general practitioners that led to this study. The aim was to identify the rate of...
BACKGROUND
It was the author's (LWH) observation that pterygium was frequently misdiagnosed by general practitioners that led to this study. The aim was to identify the rate of misdiagnosis of pterygium by optometrists and general practitioners based upon assessing referral accuracy to a single ophthalmologist (LWH).
METHODS
This study involved a prospective case series from 25 March 2015 to 18 December 2018 in a tertiary referral practice specialising in pterygium. The accuracy of diagnosis of pterygium, based upon the content of the clinical referral, was undertaken for optometrists and general practitioners. The benchmark for diagnostic accuracy was the diagnosis made by the author (LWH) during a consultation in person by the author (LWH) using a hand-light examination and confirmed by slitlamp examination.
RESULTS
A total of 1,511 consecutive patients were included in the study with 90/549 incorrectly diagnosed (16 per cent) by general practitioners and 14/962 (1.4 per cent) by optometrists. General practitioners were 13.28 times more likely to incorrectly diagnose a pterygium than optometrists (95% CI 7.48-23.57). Almost exclusively, the incorrect diagnosis made by general practitioners was naming a pinguecula, a pterygium. The same misdiagnosis was made by optometrists but far less frequently.
CONCLUSION
General practitioners misdiagnosed pterygium far more often than optometrists which may reflect a reduction in training in eye health.
Topics: Australia; Clinical Competence; Follow-Up Studies; General Practitioners; Humans; Optometrists; Prospective Studies; Pterygium; Reproducibility of Results
PubMed: 31060100
DOI: 10.1111/cxo.12916 -
Eye and Vision (London, England) 2019A number of risk factors have been evaluated in ocular surface squamous neoplasia, but few studies have assessed risk factors specific to the armed forces veteran...
BACKGROUND
A number of risk factors have been evaluated in ocular surface squamous neoplasia, but few studies have assessed risk factors specific to the armed forces veteran population.
METHODS
We conducted a retrospective case-control study on 55 patients and 55 age-matched controls with biopsy-proven ocular surface squamous neoplasia from the Miami Veterans Administration Hospital Eye Clinic to investigate potential risk factors encountered by veterans, including service-specific exposures. Veteran-specific risk factors included ionizing radiation exposure, Agent Orange exposure, deployment to Southwest Asia, and exposure to the series of biochemical warfare tests known as Project Shipboard Hazard and Defense. Data was analyzed with SPSS (SPSS Inc., Chicago, IL) using t-tests, chi-squared, and logistic regression analysis, with a -value of < 0.05 considered statistically significant.
RESULTS
The strongest risk factor for ocular surface squamous neoplasia was lifetime sun exposure both directly assessed via historical quantification of exposure by dermatology practitioners (Odds Ratio (OR) 5.4, 95% Confidence Interval (CI) 2.27-12.847, < 0.005), and using the surrogate markers of basal cell carcinoma (OR 3.157, 95% CI 1.286-7.748, = 0.010) and pingueculae (OR 5.267, 95% CI 2.104-13.186, < 0.005). Of the veteran-specific risk factors, Agent Orange exposure and Southwest Asia deployment were not associated with an increased risk of ocular surface squamous neoplasia. Exposure to ionizing radiation and involvement in Project Shipboard Hazard and Defense were not documented among any cases or controls.
CONCLUSIONS
The results of our study are consistent with prior established risk factors, namely highlighting the important role of sun exposure in ocular surface squamous neoplasia among veterans.
PubMed: 31131286
DOI: 10.1186/s40662-019-0138-1 -
Ophthalmic Plastic and Reconstructive...To document a case of actinic granuloma (AG) of the conjunctiva, provide an extensive histopathologic and immunohistochemical description, review previously reported... (Review)
Review
PURPOSE
To document a case of actinic granuloma (AG) of the conjunctiva, provide an extensive histopathologic and immunohistochemical description, review previously reported cases, and supply a differential diagnosis.
METHODS
Both a retrospective chart review and comprehensive literature review were performed. The distinctive histopathologic pattern of the current case was defined with histochemical and immunohistochemical stains (CD163, p63, and a Verhoeff-Van Gieson elastic stain). Clinical follow up was obtained.
RESULTS
A granulomatous process composed of CD163-positive mononuclear epithelioid cells and multinucleated giant cells was characterized by displaced extracellular actinic-related elastic fibers to the base of the lesion. Small elastic fibers were phagocytosed in epithelioid cells. Pseudoepitheliomatous hyperplasia of the overlying squamous epithelium was present; p63 assisted in defining the squamous proliferation and highlighted its noninvasive nature. Conjunctival AGs, according to the literature review, occur almost exclusively in young females, clinically manifest as nodular foci with painless injection over the course of weeks, and histologically featured granulomatous inflammation and elastophagocytosis. The etiology of this entity is likely multifactorial, but its genesis revolves around actinic injury.
CONCLUSION
AGs of the conjunctiva have likely been an underreported entity in the past. The authors' review underscores the importance of including conjunctival AGs in the differential diagnosis of painless, subacute injected masses of the perilimbal conjunctiva. While it is benign, histopathologically separating AGs from neoplasia and other mimickers such pinguecula, foreign body granulomas, allergic, or rheumatoid nodules is essential for optimal management.
Topics: Conjunctiva; Conjunctival Diseases; Diagnosis, Differential; Female; Granuloma, Foreign-Body; Humans; Retrospective Studies
PubMed: 33587421
DOI: 10.1097/IOP.0000000000001950 -
Vestnik Oftalmologii 2022Investigation of the capabilities of anterior segment (AS) optical coherence tomography angiography (OCTA) in evaluation of conjunctival vascular architecture in healthy...
PURPOSE
Investigation of the capabilities of anterior segment (AS) optical coherence tomography angiography (OCTA) in evaluation of conjunctival vascular architecture in healthy individuals and in various pathological conditions.
MATERIAL AND METHODS
The study included 17 healthy volunteers (34 eyes; the control group) and 62 patients (68 eyes) with conjunctival lesions of various nature. All participants underwent AS-OCT and AS-OCTA with assessment of qualitative (vessels pattern, lumen, pathologic tortuosity) and quantitative parameters (vessel density (VD, %) in the lesion area). Mean VD (MVD) and local VD (LVD) were determined, as well as VD in perifocal tissues (PVD).
RESULTS
OCTA scans in 8 conjunctival sectors showed mostly radial pattern of the vascular architecture, with vessel lumen remaining the same over their entire visible length. Larger-sized vessels in deeper conjunctival layers were discovered in most cases. The lowest VD value (33.3%) was registered in the superotemporal quadrant, and the highest (38.9%) - in the nasal. Tortuosity of the vessels with course disruption, uneven lumen over the length of the vessels and increase in VD were observed in the area of conjunctival lesions in all cases excluding congenital abnormalities, pingueculae and conjunctival melanocytic intraepithelial neoplasia. The malignant nature of the tumors was indicated by dense vessel distribution and difficulties for visualization of intravascular space, and confirmed by pathohistological analysis. An increase in the number of areas with a lace-like pattern was characteristic for melanomas, with mean VD of more than 50% in the most vascularized areas.
CONCLUSION
AS-OCTA is an informative method for the visualization of vessels in healthy conjunctiva and in conjunctival pathology. Local VD in the lesion area should be measured when the vessels are unevenly distributed.
Topics: Humans; Fluorescein Angiography; Retinal Vessels; Tomography, Optical Coherence; Conjunctiva; Melanoma
PubMed: 36573946
DOI: 10.17116/oftalma202213806132 -
The British Journal of Ophthalmology May 2017To investigate the role of high-resolution anterior segment optical coherence tomography (HR-ASOCT) in the assessment of pterygia.
AIMS
To investigate the role of high-resolution anterior segment optical coherence tomography (HR-ASOCT) in the assessment of pterygia.
METHODS
Single centre cross-sectional study. Patients with primary pterygium and/or pingueculae were included. Clinical assessment included HR-ASOCT, colour photography, keratometry followed by histology. Associations were tested between HR-ASOCT features of the pterygium and the degree of corneal scarring and elastotic degeneration, astigmatism and best-corrected visual acuity.
RESULTS
29 eyes of 26 patients with pterygium and 6 patients with pinguecula were included. Apical anterior stromal scarring was found in 23 cases (79.3%) reaching a mean depth of 68.8±21.7 µm (minimum: 33 µm, maximum: 126 µm). Increased stromal scarring and subepithelial elastotic degenerative tissue was significantly associated with HR-ASOCT features of flat bridging of the corneoscleral transition zone (p<0.01) reduced thickness of the pterygium head (p=0.01), and a greater degree of corneal astigmatism (p=0.04).
CONCLUSIONS
HR-ASOCT is a useful tool for the assessment and monitoring of pterygia in clinical practice. Features associated with increased stromal scarring and astigmatism are reduced thickness of the head of the pterygium and flat bridging of the corneoscleral transition zone.
Topics: Adult; Aged; Aged, 80 and over; Anterior Eye Segment; Cicatrix; Corneal Stroma; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Pterygium; Tomography, Optical Coherence; Visual Acuity
PubMed: 27488179
DOI: 10.1136/bjophthalmol-2016-308685 -
International Ophthalmology Feb 2024To examine the ophthalmic data from a large database of people attending a general medical survey institute, and to investigate ophthalmic findings of the eye and its...
PURPOSE
To examine the ophthalmic data from a large database of people attending a general medical survey institute, and to investigate ophthalmic findings of the eye and its adnexa, including differences in age and sex.
METHODS
Retrospective analysis including medical data of all consecutive individuals whose ophthalmic data and the prevalences of ocular pathologies were extracted from a very large database of subjects examined at a single general medical survey institute.
RESULTS
Data were derived from 184,589 visits of 3676 patients (mean age 52 years, 68% males). The prevalence of the following eye pathologies were extracted. Eyelids: blepharitis (n = 4885, 13.3%), dermatochalasis (n = 4666, 12.7%), ptosis (n = 677, 1.8%), ectropion (n = 73, 0.2%), and xanthelasma (n = 160, 0.4%). Anterior segment: pinguecula (n = 3368, 9.2%), pterygium (n = 852, 2.3%), and cataract or pseudophakia (n = 9381, 27.1%). Cataract type (percentage of all phakic patients): nuclear sclerosis (n = 8908, 24.2%), posterior subcapsular (n = 846, 2.3%), and capsular anterior (n = 781, 2.1%). Pseudophakia was recorded for 697 patients (4.6%), and posterior subcapsular opacification for 229 (0.6%) patients. Optic nerve head (ONH): peripapillary atrophy (n = 4947, 13.5%), tilted disc (n = 3344, 9.1%), temporal slope (n = 410, 1.1%), ONH notch (n = 61, 0.2%), myelinated nerve fiber layer (n = 94, 0.3%), ONH drusen (n = 37, 0.1%), optic pit (n = 3, 0.0%), and ON coloboma (n = 4, 0.0%). Most pathologies were more common in males except for ONH, and most pathologies demonstrated a higher prevalence with increasing age.
CONCLUSIONS
Normal ophthalmic data and the prevalences of ocular pathologies were extracted from a very large database of subjects seen at a single medical survey institute.
Topics: Adult; Male; Humans; Middle Aged; Female; Prevalence; Retrospective Studies; Pseudophakia; Optic Nerve; Cataract
PubMed: 38334834
DOI: 10.1007/s10792-024-03026-8 -
La Medicina Del Lavoro Oct 2022Workplaces play a critical role in developing ocular diseases, owing to the risk of accidents. This study aimed to evaluate the ocular health of industrial workers by...
BACKGROUND
Workplaces play a critical role in developing ocular diseases, owing to the risk of accidents. This study aimed to evaluate the ocular health of industrial workers by determining the prevalence of foreign body injury, refractive error, dry eye, and pterygium/pingueculae, as well as the factors influencing these diseases.
METHODS
This study involved on-site examinations of workers from an industrial area hosting marble processing factories and metal sectors. Data such as refractive error, foreign body injury-related corneal nephelium, pterygium/pingueculae presence, and Schirmer test-assisted dry eye evaluation were all collected.
RESULTS
The average age of workers was 35.78±10.05 years, with a female-to-male ratio of 20:220. The majority of workers had completed primary school (56.3%), smoked >1 cigarette/day (57.6%), and did not use any assistive devices for bodily functions (88.3%). On average, working hours/week were 55.07±8.79, and working years were 5.99±7.00. Dry eyes were found in 31 (22%), and 35 (34%) marble and metal workers, respectively (p=0.042). 11 (7.9%) marble workers and 29 (28%) metal workers had foreign body ocular injury-related corneal nephelium (p=0.0001). Furthermore, pterygium/pingueculae were revealed in 17 marble workers (12.3%) and three metal workers (3%) (p=0.009).
CONCLUSIONS
Ocular health is essential, and routine ocular health screening in industrial workers, as well as workplace safety measures, should be implemented to prevent potential occupational accidents.
Topics: Male; Female; Humans; Adult; Middle Aged; Pterygium; Cross-Sectional Studies; Dry Eye Syndromes; Refractive Errors; Foreign Bodies; Calcium Carbonate
PubMed: 36282033
DOI: 10.23749/mdl.v113i5.13350