Eye Examination Findings Research Articles

Profile of Glaucoma Patients at a Tertiary Care Centre in Gokarneshwor, Kathmandu, Nepal

Glaucoma is a progressive optic neuropathy characterized by irreversible optic nerve damage and progressive visual field loss. It is the second leading cause of global irreversible blindness. The objective of this study was to find the prevalence, clinical profile and distribution of various types of glaucoma in patients attending a tertiary care center of Kathmandu. This was a retrospective, descriptive hospital based study conducted at glaucoma clinic at tertiary care center from March 2022 to February 2024 (24 months). Patients’ demographic profile along with comprehensive eye examination findings were reviewed from the records. Data analysis was done with SPSS version 18 and chi-square test was used for analysis. P value <0.05 was considered as statistically significant. Two hundred and four patients were diagnosed with glaucoma during 2 years period. The Mean age among glaucoma patients was 55.12 ± 16.7 years. Female was common 109 (53.4%) than male 95 (46.6%). Open angle was 185 (90.7%) and close angle was 19 (9.3%) on gonioscopy. Prevalence of glaucoma seen in this study was 0.72% of total outpatients (27,970). Among the glaucoma patients, primary open angle glaucoma (POAG) was more common 84 (41.2%) followed by glaucoma suspect 46 (22.5%), normal tension glaucoma (NTG) 26 (12.7%), primary angle closure disease 19 (9.4%), ocular hypertension (OHT) 12 (5.9%), secondary glaucoma 9 (4.4%) and juvenile open angle glaucoma (JOAG) 8 (3.9%). In primary angle closure disease, primary angle closure glaucoma (PACG) was 10 (4.9%), angle closure attack 5 (2.5%) and primary angle closure suspect (PACS) 4 (2%). The most common secondary glaucoma was pigmentary glaucoma 3 (1.5%) followed by steroid induced glaucoma 2 (1%), neovascular glaucoma 2 (1%) and inflammatory glaucoma 2 (1%). The most common type of glaucoma seen in a tertiary care center of Nepal was POAG. Glaucoma was more prevalent in female patients after forty years. The prevalence of glaucoma increases with increasing age. So, the patients above the age of 40 should be screened for glaucoma for early detection and prompt treatment. Awareness of glaucoma is needed as it is one of the leading causes of blindness.

Universal eye screening: perinatal risk factors and ocular abnormalities in 1795 newborns not meeting retinopathy of prematurity criteria.

This prospective cohort study aimed to investigate the ocular outcomes of universal eye screening in newborns and assess the relationship between different perinatal risk factors and various ocular abnormalities in infants who do not meet the criteria for retinopathy of prematurity (ROP) screening. An universal eye screening questionnaire was utilised to screen newborn babies who did not meet the ROP screening criteria within 72 h of birth at a public and private hospital between June 2016 and April 2018. The questionnaire covered demographic characteristics, neonatal history, and eye examination findings. A trained retina specialist conducted comprehensive anterior and posterior segment examinations utilising a binocular indirect ophthalmoscope. Out of the 1795 newborns screened, 55.2% were male, and 44.8% were female. The most prevalent ocular abnormality observed was retinal haemorrhage (RH), with a prevalence of 10.64% (95% CI: 9.25-12.16%). The prevalence of non-RH abnormality was 7.5% (95% CI: 6.34-8.84%). The retinal haemorrhages were associated with normal vaginal deliveries (OR: 9.91; 95% CI: 6.71-14.64, p-value < 0.001), while non-RH abnormalities were associated with pre-term babies (OR: 4.87; 95% CI: 3.03-7.83, p < 0.001), consanguinity (OR: 2.20; 95% CI: 1.28-3.8, p < 0.001), low birth weight (OR: 0.22; 95% CI: 0.14-0.34, p < 0.001) and systemic abnormalities (OR: 3.08; 95% CI: 1.94-4.91, p < 0.001). Sight-threatening ocular pathology in newborns may be linked to perinatal risk factors such as preterm birth, low birth weight, consanguinity, and systemic abnormalities. Accordingly, it may be prudent to consider specialized ocular screening protocols for neonates within this high-risk cohort in future prospective studies.

Detection of significant vision conditions in children using QuickSee wavefront autorefractor.

This study evaluated the ability of QuickSee to detect children at risk for significant vision conditions (significant refractive error [RE], amblyopia and strabismus). Non-cycloplegic refraction (using QuickSee without and with +2 dioptre (D) fogging lenses) and unaided binocular near visual acuity (VA) were measured in 4- to 12-year-old children. Eye examination findings (VA, cover testing and cycloplegic retinoscopy) were used to determine the presence of vision conditions. QuickSee performance was summarised by area under the receiver operating characteristic curve (AUC), sensitivity and specificity for various levels of RE. QuickSee referral criteria for each vision condition were chosen to maximise sensitivity at a specificity of approximately 85%-90%. Sensitivity and specificity to detect vision conditions were calculated using multiple criteria. Logistic regression was used to evaluate the benefit of adding near VA (6/12 or worse) for detecting hyperopia. A paired t-test compared QuickSee without and with fogging lenses. The mean age was 8.2 (±2.5) years (n = 174). RE ranged up to 9.25 D myopia, 8 D hyperopia, 5.25 D astigmatism and 3.5 D anisometropia. The testability of the QuickSee was 94.3%. AUC was ≥0.92 (excellent) for each level of RE. For the detection of any RE, sensitivity and specificity were 84.2% and 87.3%, respectively, using modified Orinda criteria and 94.5% and 78.2%, respectively, using the American Academy for Pediatric Ophthalmology and Strabismus (AAPOS) guidelines. For the detection of any significant vision condition, the sensitivity and specificity of QuickSee were 81.1% and 87.9%, respectively, using modified Orinda criteria and 93% and 78.6%, respectively, using AAPOS criteria. There was no significant benefit of adding near VA to QuickSee for the detection of hyperopia ≥+2.00 (p = 0.34). There was no significant difference between QuickSee measurements of hyperopic refractive error with and without fogging lenses (difference = -0.09 D; p = 0.51). QuickSee had high discriminatory power for detecting children with hyperopia, myopia, astigmatism, anisometropia, any significant refractive error or any significant vision condition.

Intraocular sarcoid-like reaction in patients with chronic lymphocytic leukemia

ObjectifVérifier la fréquence de survenue et les caractéristiques cliniques de la réaction sarcoïdosique (SLR, pour sarcoid-like reaction) intraoculaire paranéoplasique dans la leucémie lymphoïde chronique (LLC). MéthodesExamen rétrospectif des dossiers de patients présentant une LLC entre le 1er janvier 1980 et le 31 décembre 2020. On a procédé à la recherche d'examens oculaires à l'aide de 22 mots clés évoquant une SLR, et les dossiers ont été vérifiés manuellement. RésultatsSur les 4209 patients uniques qui présentaient une LLC, 1021 (24 %) avaient subi au moins 1 examen oculaire selon les notes consignées à leur dossier, et au moins 1 mot clé figurait dans la description des résultats de l'examen oculaire de 324 (8 %) patients. Après vérification manuelle des dossiers, une SLR a été évoquée chez 12 patients (< 1 %) : 7 patients présentaient une SLR probable à caractéristiques typiques et 1 patient, une SLR possible sans caractéristique classique; chez les 4 autres, la SLR était soupçonnée, mais moins probable. Tous les patients qui ont eu une SLR probable ou possible (n = 8) étaient de race blanche, et la moitié (n = 4) étaient de sexe masculin. La SLR intraoculaire a été diagnostiquée en moyenne 49,7 mois après le diagnostic de LLC (n = 7) ou 1 mois avant le diagnostic de LLC (n = 1). Il s'agissait d'une atteinte bilatérale chez 5 patients. On comptait en tout 13 yeux touchés, et l'acuité visuelle moyenne au moment de l'examen initial était de 20/50 sur l’échelle de Snellen. À l'examen initial, les caractéristiques suivantes ont été fréquemment observées : cellules vitreuses (n = 13), cellules de la chambre antérieure (n = 10), précipités kératiques (n = 9), synéchies postérieures (n = 6), lésions choriorétiniennes (n = 5) et flou du vitré (n = 5). Le traitement a reposé sur les corticostéroïdes topiques seuls (n = 5), avec l'administration sous-ténonienne de corticostéroïdes (n = 1) ou d'immunosuppresseurs d’épargne cortisonique (n = 1), ou sur les corticostéroïdes oraux seuls (n = 1). Après un suivi moyen de 19,8 mois, l'acuité visuelle finale moyenne était de 20/30. ConclusionLa SLR intraoculaire touche moins de 1 % des patients atteints de LLC et doit figurer sur la liste des diagnostics différentiels des troubles oculaires en présence de LLC. L'administration de corticostéroïdes permet une prise en charge efficace de la plupart des patients.

USABILITY AND VALIDATION OF EYE QUESTIONNAIREBASED VISION SCREENING (EYEQVS)

Eye: Questionnaire-based Vision Screening (EyeQVS) is a 21-item questionnaire designed to screen for reduced vision, visual field defects, binocular disorders, dry eye, postural ergonomic problems and computer vision syndrome. EyeQVS offer an online and equipment-free vision screening option. The purpose of this research is evaluating both usability and validity of EyeQVS. The testability was surveyed using grading scales and the experience was investigated using structured and open-ended questions. Each target ocular condition of EyeQVS was compared to the full eye examination. Method: In the usability investigation of EyeQVS, two modes were employed [selfadministration (fifty-two self-respondents cum patients) and proxy-administration (ten proxy-respondents for sixty-two patients) modes] in screening for vision problems. In the validation investigation, fifty-two subjects were recruited using convenient sampling to check the accuracy of EyeQVS. Each subject was screened with EyeQVS before undergoing a comprehensive eye examination. Results: All respondents indicated high confidence towards EyeQVS with an average of more than 8 points on the Likert scale score. The majority found it easy to use and navigate. Respondents also adored the short duration required to complete the vision screening. The Chi-square of the Independence Test revealed that the designated components of EyeQVS had a good relationship with respective clinical tests (p &lt; 0.05). Conclusion: EyeQVS exhibits workable user satisfaction and operative validation from the full eye examination findings. EyeQVS provides alternative online easy access to preventive eye care. EyeQVS is pragmatic for vision screening implementation in locations where equipment-based screening is not feasible. It is also suitable for vulnerable communities needing special care, support or protection because of age, disability, poverty or accessibility issues.

A Case of Adenoid Cystic Carcinoma Mimicking Orbital Pseudotumor

Introduction: Clinical approach to the case of dacryoadenitis. Case Report: A 41-year-old male patient was admitted to our clinic with complaints of decreased vision in the left eye, periorbital and headache for 2 days. On examination, his visual acuity was full on the right and counting fingers at 2 meters on the left. There was a slight swelling and dimness in the margins of the optic disc on the left, other eye examination findings were normal. The patient was treated with intravenous methylprednisolone at a dose of 1gr/day for three days with the prediagnosis of orbital pseudotumor. However, it was observed that the patient's complaints recurred after methylprednisolone was discontinued. In repeated orbital MRI, at the level of the orbital apex on the left, infiltrating the dural structures, indenting the cavernous sinus, affecting the soft tissue structures adjacent to the nasopharyngeal lumen on the left, are seen. The left optic nerve was found to be slightly thicker than normal, especially at the apex level. For histopathological diagnosis, endoscopic biopsy was performed from the tumor and surrounding tissue from the left maxillary sinus. The biopsy result was reported as adenoid cystic carcinoma. Discussion: The diagnosis of orbital pseudotumor is made in accordance with clinical, radiological and pathological data. Orbital pseudotumor is histopathologically characterized by polymorphous inflammatory cell infiltration accompanied by varying degrees of fibrosis. It is difficult to distinguish an orbital pseudotumor from a true neoplasm. Lymphomas constitute 20% of orbital mass lesions. Our case was initially treated with a preliminary diagnosis of orbital pseudotumor localized in the posterior orbit and responded to steroids. However, lack of complete recovery and recurrence after steroid discontinuation brought to mind other underlying pathologies and directed to further examination and biopsy. As a matter of fact, the patient, who was diagnosed with adenoid cystic carcinoma as a result of biopsy, was included in the oncological follow-up and treatment program. It is necessary to be vigilant in terms of malignancy in orbital pseudotumors and not to avoid biopsies in suspected cases.

Romatoid Artritte Göz Bulguları: Retrospektif Çalışma

Objective: The aim of this study is to determine the accompanying ocular findings, frequency and to examine the complications in Rheumatoid Arthritis (RA) patients.&#x0D; Method: Medical records of Rheumatoid Arthritis patients who were consulted with the eye clinic between 2017 and 2022, were retrospectively reviewed. Demographic features, eye examination findings, and detected eye diseases were noted.&#x0D; Results: The records of 23840 Rheumatoid Arthritis and related patients who were consulted with the Eye Clinic were reviewed. From these patient records, 2691 patients, who were especially diagnosed with seropositive Rheumatoid Arthritis, were evaluated in detail within the scope of the study. Ophthalmological examination findings obtained from the records were examined. In particular, anterior segment biomicroscopy, Schirmer test, tear break-up time (BUT) and fundus examination was evaluated. 2067 of the patients were female and 624 were male. And the mean age was examined. When the average age is examined; patients aged 41-65 years were the most common (1795 patients (1374 women, 421 men)). The most common sign of ocular involvement was a dry eye(%25.97). Less frequently, episcleritis was found in 4.57% of patients, and scleritis was found in 1.37%. There were no patients with posterior or necrotizing scleritis among the patients examined. In addition, posterior scleritis of the cornea, scleromalacia, or retinal vasculitis were not detected in our patients.&#x0D; Conclusion: Rheumatoid Arthritis is a disease that can progress with extra-articular findings and may even appear as the first finding. Ocular findings may accompany the disease at a considerable rate. It can also affect the prognosis of the disease with the right perspective.

Clinico-epidemiological Study of Patients with Glaucoma in a Tertiary Eye Center, Nepal.

Major cause of irreversible blindness is glaucoma which is increasing as a significant global health problem. Knowledge of glaucoma burden and its clinical characteristics in this region is essential. This was a cross-sectional hospital -based study conducted at Glaucoma unit in CHEERS Hospital, Bhaktapur from August 2015 to July 2019. Patients' demographic profile, along with comprehensive eye examination findings were reviewed from the records. Data analysis was done with IBM SPSS version 24 and was presented in mean (±SD), frequency and proportions and a chi- square test was applied. P value < 0.05 was considered statistically significant. Total of 310 glaucoma cases were included in this study. The mean age presentation was 61.89±14.4 years, and the majority of patients (52.9%) were in the age group 60-79 years. Most patients had primary open angle glaucoma (171, 55.2%) followed by primary angle closure glaucoma (92, 29.7%). Primary open angle glaucoma is the most common form of glaucoma. The proportion of glaucoma increased with increasing age (> 40 years). Provision of screening programs targeting persons with risk factors and opportunistic eye examinations would be beneficial in detection of glaucoma.

Term Infant with Bilateral Parenchymal Brain Hemorrhages.

Term Infant with Bilateral Parenchymal Brain Hemorrhages.

Fixation Stability and Preferred Retinal Locus in Advanced Age-Related Macular Degeneration

Objectives:To evaluate fixation stability and characteristics of the preferred retinal locus (PRL) in patients with advanced age-related macular degeneration (AMD).Materials and Methods:Sixty-three eyes of 63 patients with AMD who presented to the low vision unit were included in this prospective study. Sociodemographic characteristics, eye examination findings, and reading performance results with the Minnesota Low Vision Reading test were evaluated. Microperimetry was used to evaluate fixation stability and PRL characteristics.Results:There was unstable fixation in 68% of the eyes, relative stable fixation in 27%, and stable fixation in 5%. The mean PRL-foveal distance was 5.15°±3.31° (range 0.75°-14.2°). PRL-foveal distance was greater in cases with unstable fixation than cases with stable fixation (p=0.023). Distance of the PRL from the lesion margin was not associated with absolute scotoma size or fixation stability (p=0.315, p=0.095, respectively). PRLs were most frequently located in the nasal quadrant (31%), followed by the superior quadrant (26%) of the retina. There was no significant relationship between PRL location and fixation stability (p=0.088). Fixation stability was significantly associated with reading speed (p=0.003).Conclusion:In advanced AMD, PRL-foveal distance is an important factor in fixation stability. Knowing the factors that affect fixation stability may be important in determining low vision rehabilitation strategies for these patients because of the strong association between fixation stability and reading speed.

Multipiece posterior chamber intraocular lens as sutureless, glueless scleral fixated intraocular lens.

PURPOSE:The purpose of the study is to report the outcomes of sutureless, glueless multipiece posterior chamber intraocular lens (PCIOL) as scleral fixated intraocular lens (SFIOL) implantation in patients with poor or no posterior capsular support.METHODS:Medical records of 45 eyes of 42 patients who underwent SFIOL implantation where no suture or glue was used to fixate intraocular lens (IOL) to the sclera from November 2016 to October 2017, with minimum 18 months of follow-up were retrospectively analyzed. The best-corrected visual acuity, indication of surgery, other significant eye examination findings, and complications were analyzed.RESULTS:Out of 42 patients, 62% were males and 38% were females. Mean age of subjects was 48.5 ± 16.5 years (range 13–79 years). Mean preoperative and postoperative visual acuity was 1.48 ± 0.6 Logarithm of the Minimum Angle of Resolution (logMAR) units and 0.6 ± 0.3 logMAR units, respectively. Most common complication was vitreous hemorrhage six eyes (13.3%) followed by postoperative hypotony in five eyes (11.11%). Other complications such as transient postoperative intraocular pressure rise, hyphema, tilted IOL, cystoid macular edema, retinal detachment were also noted.CONCLUSION:Multipiece PCIOL used as SFIOL without any sutures and glue is a viable, cost-effective method of IOL implantation in eyes with aphakia following surgical complication or trauma, with comparable outcome to other techniques of SFIOL implantation.

P-202: Characterization of ocular adverse events in patients receiving Belantamab Mafadotin for ≥12 months: post-hoc analysis of DREAMM-2 study in relapsed/refractory Multiple Myeloma

<h3>Background</h3> The B-cell maturation antigen–targeting antibody–drug conjugate belantamab mafodotin (belamaf; GSK2857916) is approved for the treatment of adult patients with heavily pretreated relapsed or refractory multiple myeloma (RRMM). Ocular symptoms (eg, dry eye, blurred vision), eye examination findings (including keratopathy; superficial punctate keratopathy and/or microcyst-like epithelial changes), and visual acuity changes are common with belamaf. This post-hoc analysis characterizes the safety profile of belamaf 2.5 mg/kg Q3W in patients treated for ≥12 months in the DREAMM-2 study. <h3>Methods</h3> Patients with RRMM who had ≥3 prior therapies, including an immunomodulatory agent and proteasome inhibitor, refractory and/or intolerant to an anti-CD38 monoclonal antibody, received single-agent belamaf. Eye examinations were conducted at baseline and prior to each dose. Dose modifications were based on the most severe Keratopathy and Visual Acuity scale grading, which considers corneal exam findings and best corrected visual acuity (BCVA) changes from baseline. Recovery was defined as Grade 1 exam finding/no exam finding, and ≤1-line decline in BCVA vs baseline. Patient-reported ocular symptoms were graded per Common Terminology Criteria for Adverse Events version 4.03. <h3>Results</h3> At 13-month follow-up, the clinical benefit rate (≥minimal response) in patients receiving belamaf 2.5 mg/kg (n=97) was 36%; 14 patients (15%) had received ≥12 months of treatment. All 14 patients experienced ≥1 ocular event (maximum grade: 2 [14%]; 3 [79%]; 4 [7%]), and required ≥2 dose delays, with dose reduction to 1.92 mg/kg in 12 patients (86%). Dose modifications permitted ocular event recovery, so belamaf was resumed in all 14 patients. Patients had a mean of 3.6 dose delays (median: 3.5; range: 2–6). Median duration of dose delays was 41 days (range: 4–212); 10 patients (71%) had dose delays ≥63 days. Long delays did not appear to negatively impact clinical response to belamaf: 12 (86%) had a clinical response (≥partial response; 11 [79%] for ≥6 months). All 14 patients had keratopathy. Ocular symptoms occurred in 13 patients (93%); blurred vision 57%, dry eye 36%, visual acuity reduced 21%, and photophobia 21%. No patients had permanent complete vision loss. <h3>Conclusions</h3> In this subset of patients receiving belamaf treatment for ≥12 months, dose modification was effective in managing ocular symptoms and decreasing findings at eye examination, and allowed patients the clinical benefit gained from continuing treatment with belamaf. The safety profile of belamaf will be further characterized in ongoing analyses and studies. <h3>Funding</h3> GlaxoSmithKline (Study 205678, NCT03525678). Drug linker technology licensed from Seagen Inc.; mAb produced using POTELLIGENT Technology licensed from BioWa. © 2021 European Hematology Association, Inc. Reused with permission. This abstract was accepted and previously presented at the 2021 EHA Annual Meeting. All rights reserved.

MM-078: Characterization of Ocular Adverse Events in Patients Receiving Belantamab Mafodotin (Belamaf) for ≥12 Months: Post Hoc Analysis of DREAMM-2 Study in Relapsed/Refractory Multiple Myeloma (RRMM)

Context Belamaf is approved for the treatment of adult patients with RRMM. Ocular symptoms (e.g., dry eye, blurred vision), eye examination findings including keratopathy (superficial punctate keratopathy and/or microcyst-like epithelial changes), and visual acuity changes are common with belamaf. Objective To study the safety profile of belamaf 2.5 mg/kg Q3W in patients treated for ≥12 months in the DREAMM-2 study. Methods Patients with RRMM who had ≥3 prior therapies and were refractory to an immunomodulatory agent and proteasome inhibitor and refractory and/or intolerant to an anti-CD38 monoclonal antibody received single-agent belamaf. Eye examinations were conducted at baseline and prior to each dose. Dose modifications were based on the most severe Keratopathy and Visual Acuity Scale grading. Recovery was defined as grade 1 exam findings/no exam findings and ≤1-line decline in BCVA vs baseline; patient-reported ocular symptoms were graded per the Common Terminology Criteria for Adverse Events v4.03. Results At 13-month follow-up, 14 patients (15%) received ≥12 months of treatment. All experienced ≥1 ocular event (maximum grade: 2 [14%]; 3 [79%]; 4 [7%]) and required ≥2 dose delays, with dose reduction to 1.92 mg/kg in 12 patients (86%). Dose modifications permitted ocular event recovery; belamaf was resumed in all 14 patients. Patients had a mean of 3.6 dose delays (median: 3.5; range: 2–6) with a median duration of 41 days (range: 4–212); 10 patients (71%) had dose delays >63 days. Long delays did not appear to negatively impact clinical response to belamaf: 12 patients (86%) had a clinical response (≥partial response; 11 patients [79%] ≥6 months). All 14 patients had keratopathy. Ocular symptoms occurred in 13 patients (93%); blurred vision, 57%; dry eye, 36%; visual acuity reduced, 21%; and photophobia, 21%. No patients had permanent complete vision loss. Conclusions Dose modification managed ocular symptoms, decreased eye examination findings, and allowed patients the clinical benefit gained from continuing belamaf treatment. Funding GSK (Study 205678, NCT03525678). Drug linker technology licensed from Seagen Inc.; mAb produced using POTELLIGENT Technology licensed from BioWa. Presented at 26th Congress of the European Hematology Association (Lonial et al., 2021); submitted with permission of original authors.

Management of belantamab mafodotin-associated corneal events in patients with relapsed or refractory multiple myeloma (RRMM)

Belantamab mafodotin (belamaf) demonstrated deep and durable responses in patients with heavily pretreated relapsed or refractory multiple myeloma (RRMM) in DREAMM-2 (NCT03525678). Corneal events, specifically keratopathy (including superficial punctate keratopathy and/or microcyst-like epithelial changes (MECs), eye examination findings with/without symptoms), were common, consistent with reports from other antibody–drug conjugates. Given the novel nature of corneal events in RRMM management, guidelines are required for their prompt identification and appropriate management. Eye examination findings from DREAMM-2 and insights from hematology/oncology investigators and ophthalmologists, including corneal specialists, were collated and used to develop corneal event management guidelines. The following recommendations were formulated: close collaboration among hematologist/oncologists and eye care professionals is needed, in part, to provide optimal care in relation to the belamaf benefit–risk profile. Patients receiving belamaf should undergo eye examinations before and during every treatment cycle and promptly upon worsening of symptoms. Severity of corneal events should be determined based on corneal examination findings and changes in best-corrected visual acuity. Treatment decisions, including dose modifications, should be based on the most severe finding present. These guidelines are recommended for the assessment and management of belamaf-associated ocular events to help mitigate ocular risk and enable patients to continue to experience a clinical benefit with belamaf.Video Summary8tfusA9hgR4WGduPotvDZf

Тромбоз кавернозного синуса, ассоциированный с COVID-19

This paper describes a case of cavernous sinus thrombosis The condition developed in a patient who had been treated for confirmed COVID-19 Left eye examination findings were as follows: amaurosis;absence of periorbital skin sensation;signs of orbital cellulitis;ptosis;chemosis;total ophthalmoplegia;exophthalmos;decreased corneal sensation;widened pupil;and absence of pupil light reflex In addition, ophthalmoscopy showed diffused retinal and optic disc edema The patient had an atypical clinical course which could not be clearly identified as septic or aseptic, and his elevated D-dimer level could indicate a potential relationship between this condition and COVID-19 © Oripov O I , Bilalov E N , 2021

Visual and Ocular Conditions among a Homeless Adult Population of Boston.

The eye care needs of the homeless population in the United States are not well known. This study elucidates those needs for health care for the homeless programs and eye care practitioners. This information could result in an increase in the provision of necessary eye care services. The purpose of this study was to assess the extent of visual and ocular conditions, the frequency of eyeglass orders and receipt of eyeglasses, and the frequency of ophthalmology referrals and receipt of ophthalmological care in an adult homeless population in Boston. A cross-sectional retrospective chart review was conducted for patients of the Boston Health Care for the Homeless Program's Pine Street Inn eye clinic from September 26, 2016, to December 31, 2017. Data on sociodemographics, medical history, comprehensive eye examination findings, glasses orders and receipt, and ophthalmology referrals and receipt of care were collected and analyzed. A total of 424 patients were included in the study. The mean age of the study population was 52.7 (interquartile range, 46 to 60), and the majority were male (74%). The most common systemic conditions were hypertension (40.6%) and diabetes (23.8%). The most common refractive error was presbyopia (67.7%), followed by astigmatism (38.9%), hyperopia (34.0%), and myopia (30.7%). The most common ocular conditions were dry eye (28.6%), visually or clinically significant cataract (20%), and glaucoma/glaucoma suspicion (13.9%). Refractive correction was indicated for 356 patients (84%), but 82 (29%) did not receive ordered eyeglasses. Ophthalmology referrals were placed for 61 patients (14.4%), yet only 20 (32.8%) of those referrals were completed. A significant need for refractive correction and a large gap for ophthalmological care were found among the study population. Health care for the homeless programs and eye care practitioners should be aware of the visual and ocular needs of this patient population so as to better meet their needs.

How Much Do Clinical and Microperimetric Findings Affect Reading Speed in Low Vision Patients with Age-related Macular Degeneration?

ABSTRACT Purpose: To investigate the factors affecting the reading speed of patients with central scotoma due to age-related macular degeneration (AMD). Materials and Methods: We included 63 eyes of 63 patients with AMD who applied to our low vision clinic between August 2018 and September 2019 in this prospective study. We evaluated socio-demographic characteristics, eye examination findings and Minnesota Low Vision Reading Test (MNREAD) results. We used the MAIA microperimeter device to evaluate the properties of the preferred retinal locus for fixation (PRL) of the patients. Evaluations included the assessment of the effects of all parameters on reading speed. Results: The PRL was most commonly in the nasal (31%) and superior (26%) quadrants. Twenty-nine percent of the cases preferred the left visual field. PRL localization had no effect on reading speed, whereas, fixation stability, educational status, presence of foveal absolute scotoma, reading acuity and duration of reading interruption were found to have the most significant effects. Multiple regression analysis showed that reading speed decreased by 67 units in the presence of unstable fixation, by 17 units in the presence of foveal absolute scotoma, by 3 units with every 0.1 increase in logMAR value, and by 1.7 units with every 1-year increase in reading interruption. Additionally, being a university graduate was associated with an increased reading speed (by 18 units) Conclusion: Increased reading performance is one of the factors that can improve quality of life. The factors found to affect the reading speed in the current study may guide the rehabilitation process in low vision patients.

Anterior Acute Uveitis Report in a SARS-CoV-2 Patient Managed with Adjunctive Topical Antiseptic Prophylaxis Preventing 2019-nCoV Spread Through the Ocular Surface Route.

PurposeTo report the clinical-epidemiological association between acute anterior uveitis and acute bilateral follicular conjunctivitis in a 30-year-old female patient who had tested positive for the SARS-CoV-2 RT-PCR.MethodsA 30-year-old female visited emergency ophthalmology care at the Siena Crosslinking Centre, Italy, for a bilateral eye redness lasting two weeks, associated with unilateral photophobia and blurred vision in her right eye. She visited on the 23rd of March 2020 in the full pandemic period and presented chills and fever with a temperature of 39.0°C, associated with complete loss of taste. Since eye examination findings, systemic symptoms and epidemiological criteria correlated with SARS-CoV-2 infection, she was referred to Siena University Hospital, Italy, for the SARS-CoV-2 nasopharyngeal buffer and haematological examinations for uveitis.ResultsEye examination revealed bilateral conjunctival hyperaemia with acute follicular conjunctivitis associated with right eye acute anterior uveitis characterized by diffuse pigmentary and whitish immune precipitates over the anterior capsule of the crystalline lens and initial anterior lens opacity explaining the blurred vision. Adjunctive prophylactic eye topical treatment, included in the acronym SHYPIO (0.02% sodium hypochlorite solution, 0.6% povidone iodine eye-drops and 10.50% ozonized oil eye-drops), was associated with conventional uveitis therapy to prevent the virus spread through the ocular surface route.ConclusionOur report demonstrates that complicated acute anterior uveitis (iridocyclitis) with blurred vision could be associated with SARS-CoV-2 infection, being potentially sight-threatening for early complicated lens opacity. Ophthalmologists examining suspected or asymptomatic patients should be aware of the risk of 2019-nCoV infection.

Lens and Intraocular Lens-Induced Uveitis; Clinic, Diagnosis, and Treatment

Lens-induced uveitis is a rare form of uveitis. It is an autoimmune phenomenon secondary to lens proteins that go out of the lens capsule due to exogenous or iatrogenic (surgical) trauma. The classic history and eye examination findings are typical for diagnosis. For the treatment, surgery is usually chosen in the forefront. Intraocular lens-induced uveitis is a rare form of uveitis that can be seen as a result of micro-and macro trauma of intraocular lens implants to intraocular tissues (iris, ciliary body, iridocorneal angle, etc.). Although this entity can be regressed by medical treatment, the definitive treatment is the removal or repositioning of the intraocular lens according to the etiological event. With the development of minimal traumatic surgical techniques and the use of new intraocular lens implants, its frequency decreases. The aim of this review is to summarize the general features, diagnosis, and treatment of uveitis due to lenses and intraocular lenses.

Comparative Analysis of Ocular Morbidity in Riverine and Upland Communities in Rivers State, Nigeria

Aims/Objective: A community- based cross-section all comparative study was carried out to compare the pattern of ocular morbidity between residents in upland and riverine communities in Rivers State.&#x0D; Methods: The sample size was calculated using the formula for comparative studies, based on alpha of 0.05, beta of 0.20, the proportion of eye disorder of 40.4% from a community-based study in Rivers State.&#x0D; A minimum sample size of 84 per group was attained.&#x0D; Data on age, sex, visual acuity, cup-disc ratio, intra-ocular diagnosis were obtained using an interviewer-based pro forma. Collected data were entered into Microsoft Excel and exported to the United States Centers for Disease Control and Prevention (CDC) Epi Info version 7 software for statistical analysis. The Pearson's Chi square/Fisher's exact tests were used as appropriate to determine significant differences in demographic and eye examination findings between the two groups (riverine versus upland) while Chi-square homogeneity was performed to determine significant differences in the individual ocular diagnosis across the groups. Statistical significance was set at P ≤ 0.05.&#x0D; Results: A total of eighty-six (86) participants per group were involved in the study, making a total of one hundred and seventy-two participants. The mean age was 37.9 (±18.1) and age range of 1-90 years. Males comprised 30.2% of the sample population while females were 69.8%. The commonest causes of ocular morbidity in both communities were Refractive error. Allergic conjunctivitis and cataract were more common in the Riverine community compared to the upland one.&#x0D; Conclusion: Our study shows that the pattern of ocular morbidity may differ based on land surfaces. Ocular morbidity appears to be more prevalent in Riverine areas than upland.&#x0D; Government interventions and eye care service providers should take cognizance of this while planning intervention programs at the State and National levels.