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Middle East African Journal of... 2014To describe the limitations of Fourier-domain optical coherence tomography (OCT) in imaging common conjunctival and corneal pathology.
PURPOSE
To describe the limitations of Fourier-domain optical coherence tomography (OCT) in imaging common conjunctival and corneal pathology.
MATERIALS AND METHODS
Retrospective, single-center case series of 40 patients with conjunctival and cornea pathology.
RESULTS
Fourier-domain OCT imaged laser in situ keratomileusis (LASIK) flaps in detail, including its relation to other corneal structures and abnormalities. Similarly, in infectious or degenerative corneal disorders, Fourier-domain OCT successfully showed the extent of infiltration or material deposition, which appeared as hyper-reflective areas. In cases with pterygium, the underlying cornea could not be imaged. All cases of common conjunctival pathologies, such as nevus or pinguecula, were successfully imaged in detail. Nevi, scleritis, pterygium, pinguecula, and subconjunctival hemorrhage were hyper-reflective lesions, while cysts and lymphangiectasia were hyporeflective. The details of the underlying sclera were not uniformly imaged in conjunctival pathologies. Fourier-domain OCT imaged the trabeculectomy bleb in detail, whereas the details of structures of the anterior chamber angle were not routinely visualized in all cases.
CONCLUSIONS
Light scatter through vascularized, densely inflamed, or thick lesions limits the imaging capabilities of Fourier-domain anterior segment OCT.
Topics: Adult; Aged; Conjunctival Diseases; Corneal Diseases; Corneal Surgery, Laser; Diagnostic Techniques, Ophthalmological; Female; Fourier Analysis; Humans; Male; Middle Aged; Retrospective Studies; Tomography, Optical Coherence; Young Adult
PubMed: 25100905
DOI: 10.4103/0974-9233.134673 -
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 -
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 -
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 -
Scientific Reports Mar 2024Globally, there has been a dramatic increase in the geriatric population. Sadly, this populace is highly prone to develop various ocular morbidities putting pressure on...
Globally, there has been a dramatic increase in the geriatric population. Sadly, this populace is highly prone to develop various ocular morbidities putting pressure on the strained eye care delivery system especially in low-income countries. Hence, the aim of this study was to determine the distribution of ocular morbidities among elderly. The study was a retrospective cross-sectional study conducted at Mzuzu Central Hospital in Malawi. We retrieved data from the hospital's Ophthalmology out-patient registry from January 2021 to December 2021. We recruited all 970 elderly patients who visited the clinic during the period of study. Data entry and analysis was done employing SPSS (v.26). More males than females had ocular morbidities. Cataract 400 (41.2%) was the most prevalent ocular morbidity followed by glaucoma 189 (19.5%), pinguecula 48 (4.9%) and allergic conjunctivitis 43 (4.4%). Anterior segment eye diseases were common 714 (73.6%). The prevalence of cataract, glaucoma, refractive error and allergic conjunctivitis was significantly associated with sex (p < 0.05). Age association was found with the prevalence of cataract, glaucoma, pinguecula, allergic conjunctivitis and corneal scar (p < 0.05). The pattern of eye diseases is endemic to the country. More resources should be targeting cataract and glaucoma among the age group.
Topics: Male; Female; Humans; Aged; Conjunctivitis, Allergic; Tertiary Care Centers; Cross-Sectional Studies; Retrospective Studies; Malawi; Pinguecula; Eye Diseases; Glaucoma; Cataract; Prevalence; Outpatients
PubMed: 38509142
DOI: 10.1038/s41598-024-55538-z -
Health Science Reports Jun 2023The population of older adults is growing dramatically. Sadly, this populace is highly prone to develop various ocular morbidities, which if left unattended can lead to...
BACKGROUND
The population of older adults is growing dramatically. Sadly, this populace is highly prone to develop various ocular morbidities, which if left unattended can lead to blindness.
AIM
To determine the distribution of ocular morbidities among older adults at a secondary hospital in Malawi.
METHODS
This was a retrospective cross-sectional study conducted at Mzimba North District Hospital in Malawi. We retrieved 314 patient records from the hospital's ophthalmic outpatient registry from August 2020 to July 2022 using a nonprobability census sampling technique. Data entry and analysis were done employing SPSS (v.26).
RESULTS
More females 164 (52.2%) than males 150 (47.8%) had ocular morbidities. Cataract 108 (34.4%) was the most common ocular morbidity followed by allergic conjunctivitis 104 (33.1%), then pingueculae 44 (14%), and glaucoma 8 (2.5%) Cataract showed a statistically significant difference between males and females ( < 0.05). And Glaucoma portrayed a statistically significant variation according to age groups ( < 0.05). According to the time of the year, most cases were attended to in March compared to August.
CONCLUSION
The majority of blinding conditions among the elderly in Malawi are preventable similar to other geographical settings. Therefore, it is feasible to enhance the quality of life for senior Malawians and lessen the impact of blindness on individuals, families, and communities by addressing preventable causes of blindness through focused interventions.
PubMed: 37275671
DOI: 10.1002/hsr2.1304 -
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 -
International Journal of Surgery Case... Mar 2024Ocular surface squamous neoplasia (OSSN) may have atypical or unusual presentations and may attain large sizes especially in cases of delayed presentation resulting in...
Variable presentations of six conjunctival/limbal ocular surface squamous neoplasia (OSSN) cases: How good is our clinical judgment evidenced by the correlation to the histopathological findings and diagnosis?
INTRODUCTION
Ocular surface squamous neoplasia (OSSN) may have atypical or unusual presentations and may attain large sizes especially in cases of delayed presentation resulting in late diagnosis, treatment, and eventual guarded visual prognosis. We are reporting an interesting cases series of OSSN with variable clinical presentations to highlight the importance of the pre-operative clinical judgment and tissue diagnosis.
PRESENTATION OF CASES
Six patients (4 females and 2 males; mean age 59 years; range 42-79 years) were included with suspicious conjunctival lesions. The maximum dimension of the lesions was 17 mm. The initial suspected pre-operative clinical diagnosis -other than OSSN- included pterygium/pinguecula (n = 2), benign squamous papilloma (n = 1), cyst versus pyogenic granuloma (n = 1), and lymphoma (n = 1). This work has been reported in line with the PROCESS criteria.
DISCUSSION
The final histopathological diagnosis was unexpectedly invasive squamous cell carcinoma (SCC) in 4, one SCC in-situ, and squamous dysplasia in one. The primary treatment included MMC 0.02 % for 2 cycles for chemo-reduction in one of the cases where OSSN was suspected. Excisional biopsy was performed eventually for all lesions with application of one or more of the following modalities: MMC 0.02 %, absolute alcohol 99 %, and cryotherapy to the conjunctival margin. No tumor recurrence was noted in any of the patients after an average period of follow-up of 26 months. Even though the outcome was good, tumor-related morbidity and delay in the referral by general ophthalmologists are to be considered.
CONCLUSION
Conjunctival OSSN has wide presentation clinically and can be challenging in terms of diagnosis. Histopathological evaluation is essential for a definitive diagnosis and treatment. Accurate clinical diagnosis might affect the management plan with consideration for topical therapeutic modalities, however, these cases are best managed by wide excision using the no-touch technique and double-freeze-thaw cryotherapy to the conjunctiva with consideration of topical chemotherapy.
PubMed: 38330700
DOI: 10.1016/j.ijscr.2024.109359 -
Turkish Journal of Ophthalmology Jun 2018A 21-year-old male patient with no history of systemic disease or drug use presented to our clinic with redness and pain in the right eye. Best corrected visual acuity...
A 21-year-old male patient with no history of systemic disease or drug use presented to our clinic with redness and pain in the right eye. Best corrected visual acuity was 20/20 in both eyes. Inflamed pinguecula was observed on slit-lamp examination and the patient was prescribed ophthalmic nepafenac eye drops. After instilling the drops that day and the next day, the patient presented again due to pruritus and rash. Upon consultation with the dermatology department, the patient was diagnosed with drug-induced allergic urticaria and the nepafenac drops were discontinued. Although urticaria has been reported as a side effect after systemic non-steroidal anti-inflammatory drug (NSAID) use, such a reaction has not been reported with an ophthalmic NSAID and ours is the first reported case of urticaria following ophthalmic nepafenac use. This unique case highlights the fact that ophthalmologists must also keep urticaria in mind as a potential side effect when prescribing this drug.
PubMed: 29988879
DOI: 10.4274/tjo.78614