https://www.theskygallerypattaya.com/hceo A Heighpubs Open Access Journal en-us 09/29/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1033.php <h2>Abstract</h2> <p><strong>Background:</strong> Ocular diseases affect every individual in this world, with the only difference being in the pattern of occurrence of disease depending on age, gender, region, and climatic conditions. In Ethiopia there is shortage of literatures stating pattern of ocular diseases which is very important for planning preventive, curative and rehabilitative health service concerning prevalence of eye problems.</p> <p><strong>Objective: </strong>This study is aimed to determine the pattern of eye diseases at Borumeda Hospital, Amhara region, Ethiopia from July 10 to December 15, 2018.</p> <p><strong>Method: </strong>Institutional based cross- sectional retrospective study was conducted among 384 patients attending in ophthalmic OPD of Borumeda primary hospital. Nine hundred three newly diagnosed patients who were registered on OPD registration book in the study period were study population. Systematic random sampling was conducted to select study participants from study population. The collected data were then analyzed using descriptive statistics (mean and frequency percentage).</p> <p><strong>Results: </strong>From all study participants who had ocular disorders 92(24%) of them were came by Allergic conjunctivitis, followed by cataract 16.9%, refractory disorders 13%, Glaucoma 7.1%, infective conjunctivitis 4.7%, Pterygium 3.1%, Blepharitis 3.1%, NLDO 2.6%, Pseudoaphekia 2.4% and Corneal opacity 2.1%.</p> <p><strong>Conclusion:</strong> Significant number of patients 182(47.5%) of them came for treatment of adnexa (lid, margin, conjunctiva, lacrymal system) disorders. So every health professional should be responsible to deliver preventive, curative and rehabilitative services to control the most prevalent ocular disorders.</p> <p><strong>Significance of study:</strong> This study will be very important for health managers to distribute medical resources and staffs according to the prevalence of ocular disorders. This study result will be useful for health care workers for planning preventive, curative and rehabilitative health services for those common eye disorders.</p> 05/25/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1032.php <h2>Abstract</h2> <p><strong>Background:</strong> Corneal abrasions are a common result of eye trauma. Corneal injuries are very common in both the adult and pediatric population and account for a significant proportion of the workload of most emergency departments. Although abrasion heals well with preservative treatment, it still causes pain and job lost. The abrasion result from the scrabble of the corneal epithelium. These injuries cause pain, tearing, lids spasm, light scare, foreign body sensation, decreased visual acuity/blurring, and a gritty feeling. The light, friction & wink was worse the condition. Most abrasion cure within 24-27 hours and seldom proceed to erosion or infection. The study aims to use bandage soft contact lens [BSCL] as a primary treatment for traumatic corneal abrasion [TCA] instead of traditionally use pressure patch [PP].</p> <p><strong>Patients and methods:</strong> The present prospective study has been conducted on 50 patients attending the out-patient department of ophthalmology in an Alyarmouk teaching hospital for six months after taking ethical permission. Before subjecting the patient to the treatment of bandage soft contact lens therapy, a detailed clinical history and thorough local examination have been done. A history indicating the occurrence of recent ocular trauma followed by severe pain, redness, lids spasm, photophobia, and tearing of the involved eye is suggestive of a corneal abrasion. Always we ask about contact lens wear as this can complicate the presence of an abrasion. To confirm the diagnosis of traumatic corneal abrasion we examine the cornea by slit-lamp under cobalt-blue filtered light after the application of tetracaine eye drops & fluorescein strips. The treatment of 50 consecutive patients presenting with traumatic corneal abrasion has been treated with anesthetic eye drop (tetracaine 0.5%)to relieve pain and lids spasm, antibiotic eye drop (ofloxacin 0.3%), therapeutic bandage soft contact lens was applied to provide pain relief and once again act as a splint to promote epithelial healing, then visual acuity was measured by Snellen chart, a cycloplegic eye drop (cyclopentolate1%) was applied to relieve ciliary spasm & then preservative-free lubricant eye drop were applied lastly. This criterion dramatically relieves most, if not all of the pain the patient may be experiencing (which is a big plus for the patient and earns instantaneous trust), but it also allows the patient to return to work/school or any other daily activities. Patients have been evaluated after 24hours, 72hours and after 1week regarding pain, visual acuity, and complications. Though pressure patch [PP] occasionally advice in abrasion therapy, it does not assist and may prevent recovery. Employ the protective eyewear can preclude the traumatic corneal abrasion.</p> <p><strong>Results:</strong> A total of 50 cases were enrolled in our study during the study period of 6 months. Out of 50 patients, there were 30males and 20 females and the male/female ratio was 3:2. The patient’s age was ranged from 5-35years. The commonest cause of injury was direct minor trauma (80% of cases), with cosmetic & optical contact lenses related problems accounting for 20% of presentations, visual acuity was documented correctly in 90% of adult and pediatric group and difficult to documented in children less than 6-year-old 10%. Traumatic corneal abrasion treated with bandage soft contact lens has an apparent advantage over the traditional pressure patch in terms of reduced pain, speedier healing, and an advantage of faster rehabilitation, facilitation epithelial healing, and proper surface hydration. Evaluation of pain revealed sufficient comfort with this regimen, allowing 45 patients (90%) to go back immediately to their occupations. Moreover, visual function is retained without any complication. Healing of the traumatic corneal abrasion occurred within 1 to 3 days in all patients, with minimal or no pain. The infection did not occur at the time of the follow up. We remove the bandage soft contact lens after 1 week to allow epithelial migration and attachment without the interference of the shearing forces of the upper lid.</p> <p><strong>Conclusion:</strong> The use of bandage soft contact lens as a primary treatment for a traumatic corneal abrasion is a safe and effective method with anesthetic eye drop (tetracaine 0.5%), antibiotic eye drop (ofloxacin 0. 3%), cycloplegic eye drop (cyclopentolate 1%), preservative-free lubricant drop instead of traditionally pressure patch. Bandage soft contact lens causes dramatic improvement from pain, lid spasm, tearing & visual function is retained without any complication, and patients can immediately resume their regular activities.</p> 05/22/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1031.php <h2>Abstract</h2> <p>Alzheimer’s Disease (AD) is a common dementia problem of the old population. The two main hallmarks of AD are tau protein and amyloid-beta protein. The relevant investigations on AD suggest that these proteins are also seen in the eye. There are many tests and imaging modalities are used for AD diagnosis. But these techniques are still unable to predict the disease effectively. In this regard, the lens of the eye may help in diagnosing AD. Therefore, a reliable technique for measuring the lens or retina must be selected. In this paper, we focus on the different types of retinal diseases occur in AD patients and the use of the Optical Coherence Tomography (OCT) technique is used for diagnosing AD.</p> 05/20/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1030.php <h2>Abstract</h2> <p><strong>A Statement of Significance:</strong> This study shows that the effect of transcorneal electrical stimulation (TES) therapy as a stimulator device in retinitis pigmentosa (RP)patients with have a significant increase in visual acuity and shortening of p100 latency in pattern visual evoked potential (pVEP) test during 3 months follow up.</p> <p><strong>Purpose:</strong> To assess the safety and efficacy of TES therapy with electrophysiological and structural tests in RP patients.</p> <p><strong>Methods:</strong> Thirty four eyes of 17 RP patients were included in the study. Initial examination included best corrected visual acuity (BCVA) and visual field (VF) test (Humphrey). Central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT) and choroidal thickness (CT) were measured with using swept-source optical coherence tomography (OCT). The patients were tested by Metrovision brand monpack model visual eletrophysiology device for pVEP and flash electroretinogram (fERG) tests. Patients were seen 12 times during 3 months: initial visit for screening and weekly visits for TES. All tests were repeated 3 times. The results of pre and post TES therapy were compared.</p> <p><strong>Results:</strong> Patients’ baseline BCVA was 0,34 ± 0,22. The increase in the last visit BCVA was significant (p : .001) and it was 0.50 ± 0.29. The difference between CMT, RNLF and CT pre and post TES therapy were not significant (p > .05). The mean latencies of the 120’ pattern p100 waves that patients could see were shortened and statistically significant (p = .04). The peaks amplitudes of the 120’ pattern p100 waves that patients could see were increased; but not statistically significant (p :. 19).</p> <p><strong>Conclusion:</strong> This study shows that the safety of TES as a stimulator device in our patient group and the effect on this group have a significant increase in visual acuity and shortening of p100 latency in pVEP test during 3 months follow up.</p> 05/20/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1029.php <h2>Abstract</h2> <p><strong>Background:</strong> The posterior capsule opacification (PCO) is also known as after cataract is a common complication after planned extra capsular cataract extraction (ECCE) with or without intraocular lens (IOL) implantation. The aim of this study was to evaluate the changes in intraocular pressure (IOP) after Nd-Yag laser posterior capsulotomy (LPC) for PCO. The Nd-Yag LPC is a safe and non- invasive procedure and can be performed as an outpatient procedure.</p> <p><strong>Patients & methods:</strong> A total of one hundred eyes with symptomatic intact posterior capsule opacification (PCO) at Glaucoma Department of Alyarmouk Teaching Hospital fulfilling the inclusion criteria were enrolled in the study over a period of 6 months, 64 eyes were aphakic and 36 eyes were pseudophakic, the fellow eye was used as control. The base line pre-laser IOP was measured with the help of Goldmann Applanation Tonometer (GAT) and slit lamp examination before procedure. The pupils were dilated by using 1% tropicamide eye drops. Proparacaine eye drops were used 1-2 times for topical anesthesia, using Nd: YAG laser (VISULAS YAG III Carl Zeiss Meditec AG Germany), an opening of 3-4 mm was made in the posterior lens capsule, ensuring use of least possible energy. IOP was again assessed 1 hours, 24 hour and one week after the procedure.</p> <p><strong>Results:</strong> IOP was checked before laser, at one hour, 24 hour and one week after laser. There was statistically significant (p < 0.001) rise in IOP at one hour in both aphakic and pseudophakic groups from a mean of 12.54 mmHg before laser to a mean of 20.79 mmHg at one hour with an average of 8.35 mmHg from baseline measurement. IOP at one hour rises from 2-5 mmHg in 30 eyes (30%), > 5 mmHg in 46 eyes (46%) and > 10 mmHg in 24 eyes (24%). Every patient had an IOP at one hour equal to or greater than 22 mmHg received anti-glaucoma drugs to control the rise in IOP. At 24 hours IOP decreased to a mean of 13.24 mmHg in both groups. No distinction was made between the aphakic and the pseudophakic groups with regard to IOP changes. In all treated eyes, best corrected visual acuity (VA) was recorded before and at one week after Nd-Yag laser application by Snellen’s chart. After performing a central capsulotomy VA increased in all patients. In no eye was the post-laser VA lower than before laser treatment.</p> <p><strong>Conclusion:</strong> Photo-disruption with Nd-Yag laser is a safe and an effective method in management of PCO. However, there are several complications known to follow capsulotomy as significant rise in IOP and only if we can minimize their frequency or, better still, avoid them altogether, can we accept Nd-Yag LPC as a safe procedure in our effort to restore vision in cases of PCO.</p> 03/12/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1028.php <h2>Abstract</h2> <p><strong>Purpose:</strong> We have studied in 18-month 21 patients showing kerato-conjunctivitis and/or dermato-blefaritis, where we will find a constant presence of mycoplasma in SEM optical cytology samples. The 21 patients were divided as follows: 7 allergic, 7 alleged allergic and 7 not-allergic, this division it makes between a clinical approach considering clinical history and symptoms. At the first examination, 16 of the 21 patients had a single or multiple infection in which the main pathogenic element was found to be Mycoplasma; the remaining 7, 4 of them were suspected allergic patients, 2 of it, were allergic subjects with the presence of eosinophils or mast cells.</p> <p><strong>Material and methods:</strong> All the study is constructed on citological optical microscopy and citological electron scanning microscopy (SEM) images for demonstrate the efficacy of the SEM in clinical approach at allergic, not allergic and suspected allergic patients.</p> <p><strong>Therapeutic treatment and Results:</strong> Treatment of the allergic and false allergic patients has made with local somministration of galenic composition with ialuronic acid 3 ml and Tetracycline hydrochloride 30 mg and with low level of cortisone and antisthaminic therapy. This treatment is necessary to eradicate the Mycoplasma infection and counteract toxic action of this pathogen on mucosa.</p> <p><strong>Discussion:</strong> After appropriate therapy we note that allergic patients have a greater predisposition to redundancy in infections in the short period (minimum 20 days), while alleged allergic patients have more prolonged infection periods (between 3 and 5 months), with constant presence at low levels of persistent Mycoplasma. The latter continue to show signs and symptoms similar to allergic patients, but with a negative test for tear IgE and absence of eosinophils and/or mast cells, in the optical and SEM samples displayed.</p> 02/25/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1027.php <h2>Introduction</h2> <p>Visual impairment is a global health problem. Cataract is responsible for 50% of blindness worldwide [1].</p> <p>Posterior capsular opacification is the most common late complication of cataract surgery as a result of proliferation of residual lens epithelial cells overall 25% of patients undergoing extra-capsular cataract surgery develops visually significant PCO within 5 years of the operation [2].</p> 02/19/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1026.php <h2>Introduction</h2> <p>Retinopathy of prematurity (ROP) is a consequence of an arrest in normal retinal neural and vascular development, which determines the aberrant retinal regeneration [1,2].</p> <p>ROP is a disease process mostly reported in preterm neonates ranging from mild, transient changes in the retina with regression to severe progressive vasoproliferation, scarring, detachment of retina and blindness and it is common blinding disease in children and a major cause of vision loss among preterm infants [3]. Today it is well known that oxygen therapy is not the single causative factor, but many other risk factors play a causative role in the pathogenesis of ROP [4,5].</p> 01/29/2020 https://www.theskygallerypattaya.com/hceo/ijceo-aid1025.php <h2>Abstract</h2> <p><strong>Background/Aim:</strong> In spite of global initiatives to provide sight for all by the year 2020, many middle-aged to elderly people in the Niger Delta still have significant visual impairment due to uncorrected refractive errors. The aim of this study is to assess the types of refractive anomalies that occur among presbyopic patients in Port Harcourt and determine the demographic pattern of these anomalies based on age and gender characteristics.</p> <p><strong>Methodology:</strong> This is a hospital-based descriptive cross-sectional study in which sixty consecutive adult patients for refraction were seen. Every adult patient that came to get glasses during the study period was included in the study except where ocular or systemic contraindications were present. In addition to visual acuity, all patients had a detailed ocular examination and then refraction. The collected data was subsequently analysed using SPSS version 20.</p> <p><strong>Results:</strong> The mean age of the patients was 54.4 ± 9.4 years with a range of 35 to 80 years. A total of 60 patients were seen, comprising 30 males and 30 females. The commonest refractive error was presbyopia with hyperopic astigmatism and this accounted for 80% of all cases. Hyperopic presbyopia and presbyopia alone were the least common.</p> <p><strong>Conclusion:</strong> There is a high level of cylindrical and spherical errors in Port Harcourt. The full optical correction should always be prescribed to presbyopic patients to fully correct the associated visual impairment and improve the patients’ well-being.</p> 12/12/2019 https://www.theskygallerypattaya.com/hceo/ijceo-aid1023.php <h2>Abstract</h2> <p><strong>Introduction:</strong> Intense Pulsed Light (IPL) is the therapeutic tool implemented in the treatment of dry eye, characterized by the emission of waves of 500-1200nm in the region of the upper and lower eyelids. Dry eye is a recurring complaint in ophthalmology offices and has an impact on the patient’s quality of life. It results from dysfunction of the meibomian glands, duct obstruction, and quantitative and qualitative changes in glandular secretion. It is manifested by dryness and irritation, foreign body sensation, burning, tearing, and eye fatigue. The available treatments are short term palliative with unsatisfactory results.</p> <p><strong>Objective:</strong> To determine through a literature review, the benefit of using intense pulsed light for dry eye treatment. Methodology: We searched the Cochrane database, PubMed, Embase, Scopus, Web of Science, and Google Scholar (gray literature) using the keywords for an independent, blinded, peer-reviewed selection of articles to be met following pre-established criteria.</p> <p><strong>Results and discussion: </strong>Studies evaluated the use of IPL in patients with dry eye, despite the benefit found, focus on the objective and subjective assessment of the eye more frequently.</p> <p><strong>Conclusion:</strong> Evidence-based clinical guidelines are required for the use of intense pulsed light in the treatment of Meibomian Gland Dysfunction (MGD), as well as a device and algorithm for indications of therapeutic use.</p> 09/09/2019 https://www.theskygallerypattaya.com/hceo/ijceo-aid1022.php <h2>Abstract</h2> <p><strong>Background:</strong> Corneal injuries are significant contributors to blindness. Cornea being the most anterior structure of eye is exposed to various hazards like airborne debris and blunt trauma. By understanding different types of injuries to which cornea is exposed, the practitioner maybe more capable in managing injuries to minimise structural and visual sequelae.</p> <p><strong>Objectives:</strong> To study various patterns of corneal injuries and its visual outcome among patients of ocular trauma in a tertiary care hospital. <strong>Methods:</strong> Study of 100 cases of corneal injuries wherein patients were treated according to injury type and followed up for 4 months.</p> <p><strong>Results:</strong> Majority of patients belonged to working population between age groups 21-65 years. Most patients suffered from corneal abrasions while the least common were perforating and lacerating injuries. Alkali injuries were more common than acid injuries. Most patient presented within 24 hours and had only epithelial defects. Therefore, the number of patients receiving conservative management was higher than those receiving surgical intervention.</p> <p><strong>Conclusion: </strong>Most common causes of blindness and low vision in our study was full thickness corneal laceration and corneal abrasions, foreign body injuries affecting the pupillary area and involving anterior or mid stroma causing nebular or macular grade opacities hampering vision.</p> 08/22/2019 https://www.theskygallerypattaya.com/hceo/ijceo-aid1021.php <h2>Abstract</h2> <p><strong>Significance:</strong> Due to the limited number of reported cases little is known about the characteristics of unilateral retinitis pigmentosa. Information from additional case reports can aid in learning more about the condition. We report a case of retinitis pigmentosa that has remained unilateral for 28 years and review the available literature.</p> <p><strong>Case Report:</strong> A 40-year-old Caucasian female presented for an opinion as to the cause of her vision loss. Fundus autofluorescence demonstrated hypoautofluorescence in the midperipheral retina and a hyperautofluorescent ring surrounding the area of preserved photoreceptors in the macula. Optical coherence tomography showed disruption of the ellipsoid zone and the external limiting membrane. Electroretinography (ERG) showed severely reduced rod and cone function monocularly.</p> <p><strong>Discussion:</strong> Retinitis pigmentosa is typically bilateral and symmetric. Unilateral retinitis pigmentosa is a rare condition that manifests with only one eye having changes typical of retinitis pigmentosa. The unaffected eye can have no signs of retinitis pigmentosa and must have a normal ERG after long-term follow up. It is critical to rule out inflammatory, traumatic, toxic, and cancer associated retinopathy that can present with retinal pigmentary changes. Unilateral retinitis pigmentosa generally remains unilateral, but long-term follow up with ERG is important. There is currently no treatment that can stop the process of retinitis pigmentosa, but gene therapy shows promise.</p> 08/12/2019 https://www.theskygallerypattaya.com/hceo/ijceo-aid1020.php <h2>Abstract</h2> <p><strong>Purpose:</strong> Analyze Microincision Cataract surgery wound using Fourier-Domain optical coherence tomography.</p> <p><strong>Setting: </strong>Medical School of Medicine, Catholic University of Brasilia, Brasília, Brazil.</p> <p><strong>Design: </strong>Prospective comparative observational study.</p> <p><strong>Methods:</strong> Forty eyes were included in this prospective study divided in two groups: with contact lens (CL) and without contact lens (WCL). A line scan pattern of the corneal incisions were acquired using a Spectral domain OCT system immediately after the surgery, and at postoperative days 1, 7 and 30. Incisions were analyzed regarding length, location, angle, architecture, and anatomic imperfections.</p> <p><strong>Results:</strong> All incisions were located temporal or nasal superiorly. The average wound length was 1.28 + 0.18mm and the mean incision angle was 49 + 9 degrees. The average wound length of the WCL group mean was 1.24 + 0.17 mm and the mean incision angle was 51 + 8 degrees. Comparing groups for the length and the angle, the incisions measurements were not statistically significant. Anatomic imperfections were observed at the first day postoperative in 12 eyes for CL group and in 13 eyes for the WCL group. No patient presented endophthalmitis during the follow-up.</p> <p><strong>Conclusion:</strong> Epithelial imperfection was observed in two patients in the WCL group with spontaneous resolution. The CL group had the highest length and lowest angle of corneal incision. Using contact lens to prevent wound construction imperfection appears not to be a good option. Further studies using a greater number of patients with an architectural analysis of clear corneal incisions are needed to confirm these preliminary results.</p> 01/03/2019 https://www.theskygallerypattaya.com/hceo/ijceo-aid1019.php <h2>Abstract</h2> <p>Cystoid macular edema is a common cause for unexplained painless vision loss after cataract surgery. Even the pathogenesis of pseudophakic cystoid macular edema (PCME) still remains undefined, it can most frequently occur in eyes with high vasoactive profile, had complicated cataract surgery such as posterior capsule rupture and risk of inflammation. Increased inflammation, ultimately leading to the breakdown of the blood-retinal barrier and cystic accumulation of extracellular intraretinal fluid. The natural history of PCME is spontaneous resolution without any treatment in most of patient, but it may take weeks or months, in addition permanent visual morbidity may occur in some cases. Therefore there is lack of consensus regarding treatment approach for this common ocular condition.</p> <p>In this review treatment alternatives of PCME and its relation with underlying patho-physiologic mechanism are evaluated.</p> 12/19/2018 https://www.theskygallerypattaya.com/hceo/ijceo-aid1018.php <h2>Abstract</h2> <p><strong>Aim:</strong> To evaluate the outcome of Trabeculectomy in advanced glaucoma in a hospital in Rivers State, Nigeria.</p> <p><strong>Methods:</strong> This was a non-randomized interventional study in which each patient served as its own control. Patients with advanced glaucoma and demonstrable field defects and Mean defect ≥-12 were included. The intervention employed was Trabeculectomy and IOP and visual acuity pre operative, as well as post op were collected and compared at pre- op, post -op day 1, one week, one month, 6 months. Data was analyzed using SPSS version 20.</p> <p><strong>Results:</strong> Thirteen (13) eyes from ten (10) patients with advanced glaucoma were involved in the study. Mean age of study population was 53±19.62 years. Mean of mean defect was -19.05±5.23dB while mean of vertical cup disc ratio (VCDR) was 0.88±0.04.</p> <p>Mean of Pre- op Visual acuity (log MAR) was 0.46 and dropped to 0.72 first day post-op but improved over 6 months to 0.42. The mean of IOP pre-op was 24.15mmHg and dropped to 11.23mmHg (58.24%) over 6 months (p=0.001).</p> <p><strong>Conclusion:</strong> Trabeculectomy still remains the gold standard surgical treatment for glaucoma. In our study it resulted in a 58.24% drop in IOP over 6 months with mean visual acuity maintained at pre-op levels after 6 months follow up. It therefore is effective and safe surgical intervention in advanced glaucoma.</p> 11/12/2018 https://www.theskygallerypattaya.com/hceo/ijceo-aid1017.php <h2>Abstract</h2> <p>To determine the proportion of participants with elevated intraocular pressure and abnormal vertical cup disc ratio in a glaucoma screening event in a rural community in Nigeria.</p> <p><strong>Methods: </strong>242 eyes of 121 participants at a one-day screening programme were examined. Visual acuity was accessed using Snellen literate and illiterate charts, followed by a pen torch examination of the anterior segment. The posterior segment was accessed using a direct ophthalmoscope (Welch Allyn, USA). All participants had intraocular accessed using Keeler non contact tonometer and those with significant media opacity preventing view of the posterior pole had cycloplegic examination after dilatation with 1%Tropicamide drops. Data generated was expressed as percentages and means.</p> <p><strong>Results:</strong> 121 participants (242 eyes) were examined. There were 42 males and 79 females giving a M:F ratio of 1:1.86. Age range of participants was 0-90years with a peak in the 5th decade. Mean age was 32 years. 79.3% of participants had normal visual acuity of 6/4 -6/18, while 9.5% had visual acuity worse than 6/60.</p> <p>83% of eyes had intraocular pressure within normal level, <21mmHg, 12.4% within 21-30mmHg and 4.6% >30mmHg.</p> <p>73.1% of eyes had Vertical Cup disc ratio (VCDR) <0.5, 10.7% had 0.5-0.7 and 6.6%>0.7. 9.6% of eyes could not be accessed due to media opacities.</p> <p><strong>Conclusion:</strong> 6.6% of participants had suspicious discs and 4.6% participants had intraocular pressures above 30mmHg. Opportunistic screening for glaucoma remains one of the important modes of case detection for glaucoma in the developing climes and should be encouraged as a way to address the scourge of this blinding disease.</p> 07/31/2018 https://www.theskygallerypattaya.com/hceo/ijceo-aid1016.php <h2>Clinical Image</h2> <p>A case of recurrent tuberculosis-related uveitis in a young female patient of North African origin.</p> <p>Right eye: Slit-lamp photograph of broad-based posterior synechiae (formed by macrophage-laden iris tissue when brushing against and then adhering to, the anterior lens capsule) rendering the pupils irregular, clover- or, here, “Mickey Mouse”©-shaped. Cycloplegic agents can increase the pupillary circumference, displacing iris tissue further away from the crystalline lens to help reduce adhesions from forming that beget lens opacities as well as block aqueous humor flow.</p> 07/27/2018 https://www.theskygallerypattaya.com/hceo/ijceo-aid1015.php <h2>Editorial</h2> <p>Obesity is a chronic and metabolic disease with a high increasing prevalence worldwide. It has multifactorial pathogenesis including genetic and behavioral factors [1-5]. Overweight and obesity have been defined and classified by the World Health Organization (WHO) and the National Institutes of Health (NIH) [2,3].A person with a normal weight has Body Mass Index (BMI) of 18.5-24.9. A person with a BMI under 18.5 is called underweight. An adult having a BMI of 25-29.9 is overweight and pre-obese. Class 1 obesity is defined as a BMI between 30.00-34.99. Class 2 (Severe) Obesity is to have a BMI between 35.00-39.99. Morbid (Extreme, Class 3) obesity is to have a BMI over 40 [1-5]. Obesity is significantly associated with enhanced morbidity and mortality rates. It has also various economic, medical and psychological effects and causes health problems including many systemic diseases, economic costs and burdens, social and occupational stigmatization and discrimination and productivity loss [4-6]. Obesity carries the increased risk of development of many systemic and chronic diseases, including sleep apnea, depression, insulin resistance, Type 2 (adult-onset) diabetes, Gout and related arthritis, degenerative arthritis, hypertension, dyslipidemia, heart disease such as myocardial infarction, congestive heart failure, or coronary artery disease, polycystic ovary syndrome and reproductive disorders, Pickwickian syndrome (obesity, red face and hypoventilation), metabolic syndrome, non-alcoholic fatty liver disease, cholecystitis, cerebrovascular accident, colonic and renal cancer, rectal and prostatic cancer in males, and gallbladder, uterus and breast cancer in females [6-12].</p> 06/26/2018 https://www.theskygallerypattaya.com/hceo/ijceo-aid1014.php <h2>Abstract</h2> <p>The Cloquet’s canal (CC) is the remnant of the primary vitreous and it disappears in the intrauterine developmental period of an eye. Rarely it can persist in mature eyes and cause low visual acuity. We detected a persistent CC and low visual acuity in a 36 year-old patient. Fundus fluorescein angiography and optical coherence tomography examinations were completely normal in our case and low visual acuity was directly associated with opacification of the fibrovascular persistent CC tissue. Persistent CC can cause low visual acuity due to directly media opacity effect of fibrovascular tissue without any complication.</p> 03/23/2018 https://www.theskygallerypattaya.com/hceo/ijceo-aid1013.php <h2>Abstract</h2> <p>Anatomical separation of the retinal pigment epithelium from the Bruch membrane is defined as retinal pigment epithelial detachment (PED) andit is classified as drusenoid, serous, and vascularized. Vascularized PED is mostly associated with choroidal neovascularmembrane due to age-related macular degeneration and the risk of vision loss is high in this situation. Studies show that all of baseline values including BCVA, PED height, subretinal fluid, central macular thickness, PED volume, vertical dimension, presence of coincident macular pathology, reflectivity and morphology on optical coherence tomography have prognostic importance. Current treatment protocols mainly based on intravitreal injection of anti-vascular endothelial growth factor (VEGF).Even the bevacizumab was the first anti-VEGF that was used for treatment in PED, there are several reports show the insufficiency of bevacizumab. In treatment-naïve eyes, both of ranibizumab and aflibercepthave similar effect in vascularized PED. In treatment-resistant eyes, high dose bevacizumab or switching therapy of anti-VEGF procedures can be effective when considering of all cases, aflibercept seems more effective than other options.We aimed in this manuscript, to give a general information about different characteristics of PEDs and to investigate the treatment strategies in the light of current literature.</p> 02/09/2018 https://www.theskygallerypattaya.com/hceo/ijceo-aid1012.php <h2>Abstract</h2> <p>Among eye diseases, cataract is the most commonly encountered lens disease and the leading cause of reduced vision. Cataract caused by radiation develops due to neck & head, central nervous system tumors, eye localized tumors and total body irradiation. Today, the only treatment of cataract is surgery.</p> <p>Beta radiation is seen to have an important place both in the etiology and treatment of cataract. Beta-radiation creates cataract in the lens as an adverse effect. However, beta radiation implementation is used for delay or prevention of cataract in glaucoma surgery. Effects of beta-radiation on the etiology and treatment should be supported by further prospective clinical studies.</p> 02/07/2018 https://www.theskygallerypattaya.com/hceo/ijceo-aid1011.php <h2>Abstract</h2> <p>Irvine-Gass syndrome, is one of the most common causes of painless decrease in vision following even uneventful cataract surgery. It usually responds well to medical therapy, but, there are no widely acceptedconsensus on the efficacy of various therapeutic options for the treatment of Irvine-Gass syndrome. The patient presenting in this case report, has systemic hypertension and chronic obstructive pulmonary disease and he use oral anti-hypertension medication and inhaler steroid. He diagnosed as Irvine-Gass syndrome due to presence of decrease in visual acuity and macular edema with hyporeflective cystic intraretinal spaces in optical coherence tomography (OCT) since4th weekcontrol visitfollowing uneventful cataract surgery. After the responsiveness of several medications including topical steroid and non-steroidal anti-inflammatory drugs and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF), intravitreal sustained-release dexamethasone implant was applied. The visual acuity improved to 0.00 logMAR at 1st month after intravitreal dexamethasone therapy and consecutive OCT images showed complete resolution of macular edema with a normalization of the foveal profile.The visual acuity and foveal architecture remained stable in 2-year follow-up period and additional treatment was not needed. To the best of our knowledge, this is the first reportthatmentions the increment of visual acuity after a single dexamethasone implant, even though it did not response anti-VEGF combined with topical steroid and non-steroidal anti-inflammatory drugs. </p> 12/29/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1010.php <h2>Abstract</h2> <p><strong>Objective:</strong> To study the epidemiology of xerophthalmia in children 2-6 years of age in North India.</p> <p><strong>Methods:</strong> A prospective clinical study was done at two tertiary care centers of North India between 2010 to 2016, Cases were selected from routine OPD and children less than 6 years of age were examined by an ophthalmologist. Diagnosis and classification of Xerophthalmia was done according to WHO classification. All the data recording demographic profile, socioeconomic status, other health problems etc were recorded in a fixed proforma. Data was analyzed by SPSS version 16.</p> <p><strong>Findings:</strong> Two thousand nine hundred forty six cases were included in the study after satisfying inclusion and exclusion criteria. The prevalence of night blindness was estimated to be 2.93% (95% Confidence Interval [CI]: 2.53-3.33) among children between 2 and 6 years of age. Xerophthalmia prevalence was 4.43% (95% CI: 4.19-4.67). Prevalence was more in girls than boys and higher in low socioeconomic status.</p> <p><strong>Conclusion:</strong> Vitamin A deficiency is recognized to be a severe public health problem leading to corneal opacity and childhood blindness in most of the areas of North India.</p> 12/27/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1009.php <h2>Abstract</h2> <p>Neuro-ophthalmological emergency disorders usually occur with symptoms of visual loss, diplopia, ocular motility impairment and anisocoria. In this mini-review, we aim to take look the common neuro-ophthalmological emergency disorders. The delayed diagnosis of the neuro-ophthalmological emergencies puts the patient at risk of death or blindness. If these are well-known, the discrimination and management of these emergency conditions will be easier. </p> 12/22/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1008.php <h2>Review</h2> <p>One of every four visits to eye care professionals is for dry eye disease which affects an estimated 7-34% of Americans [1].Knowledge regarding etiology and treatments has advanced exponentially in the last 20 years. As recently as 1997, in the mega textbook Cornea, it was stated “The mechanism for lacrimal gland dysfunction in this condition is unclear” [2]. A recent study entitled “The Dry Eye Workshop ll Report”, defines dry eye as “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms in which tear film instability and hyperosmolarity, ocular surface inflammation, and damage and neurosensory abnormalities play etiological roles” [3]. A 2003 study regarding the morbidity ratings of dry eye showed utility assessments for moderate and severe dry eye were parallel to historical reports for more severe (class lll/ lV) angina [4]. The tear film is responsible for the greatest optical power of any ocular surface, since the greatest change in the index of refraction occurs between the air and the tear film [5]. Double pass retinal imaging shows increased light scatter in dry eye patients which can decrease retinal image quality 20-40% [5]. Ophthalmologists now understand the critical necessity to normalize the ocular surface prior to cataract surgery; otherwise, they risk an unhappy patient with a less than ideal visual result. Increased use of electronic devices, such as smart phones, tablets, and computers, by youth in the last ten years has resulted in a broader age range of dry eye patients, to now include adolescents and teens. A study of urban school age children showed that 8.2% had dry eye (vs 2.8% in a rural group), presumably due to high incidence of smart phone use.6 In fact, with cessation of phone use for four weeks, dry eye resolved completely in 100% of subjects [6]. Only two FDA approved dry eye medications are available: cyclosporine ophthalmic emulsion, 0.05%, (approved in 2003) and lifitegrast, 5%, (approved in 2016), both of which require chronic treatment. The focus of this discussion involves an emerging paradigm in treating ocular surface disease: a nutraceutical containing omega-3 essential fatty acids.</p> 11/24/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1007.php <h2>Abstract</h2> <p><strong>Purpose:</strong> To evaluate the efficacy of ranibizumab in hastening the recovery of acute CSCR when given immediately at time of diagnosis.</p> <p><strong>Methods:</strong> In This retrospective case series, a total of 72 patients diagnosed with acute CSCR where reviewed, of which 63 received Ranibizumab at presentation. The patients were evaluated using Best corrected visual acuity, Ophthalmic examination, Optical coherence tomography (OCT) and fluorescein angiography, in addition to indocyanine green angiography and OCT angiography in some cases, at presentation, one week, one month and two months’ post injection.</p> <p><strong>Results:</strong> From the total 72 patients diagnosed with acute CSCR, 63 of them received intravitreal ranibizumab and the remaining 9 patients preferred to go for observation. The mean age of patients was 41.2 year old. The ratio of male to female was 8:1. The mean BCVA at presentation was 6/15 on Snellen chart. All patients who received ranibizumab injection showed an improvement after 1 week, with a mean improvement in BCVA of two lines. Of them, 43 patients were back to BCVA of 6/6 after 2 months and showed complete resolution of sub retinal fluid. The remaining 20 patients showed an additional mean of improvement of one line (over the previous two lines) after the 2 months.</p> <p><strong>Conclusion:</strong> Intravitreal ranibizumab hasten the recovery of both the BCVA and central macular thickness on OCT in acute CSCR when given immediately at presentation.</p> 10/24/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1006.php <h2>Abstract</h2> <p><strong>Background:</strong> Glaucoma is a multi-factorial optic neuropathy characterized by a loss of retinal ganglion cells with subsequent loss of the retinal nerve fibers ultimately resulting in visual impairment. The macula region has a high density of retinal ganglion cells thereby being a likely region to detect early cell loss .Since glaucoma affects mainly the inner layers of the retina, Ganglion Cell Complex (GCC) mapping can help to detect glaucomatous damage early as compared to the total retinal thickness.</p> <p><strong>Purpose:</strong> To map GCC thickness and average Macular Retinal (MR) thickness with high-speed Fourier-Domain Optical Coherence Tomography (FD-OCT) and correlate it with the Retinal Nerve fiber layer (RNFL) thickness in preperimetric glaucoma.</p> <p><strong>Design:</strong> Observational cross-sectional study.</p> <p><strong>Methods:</strong> Forty four eyes diagnosed as preperimetric glaucoma were studied. GCC, MR thickness and RNFL thickness was mapped using the RTVue FD-OCT system. The GCC thickness map, the deviation map and the significance map were obtained in all cases. Average GCC thickness and MR thickness were correlated with the RNFL thickness.</p> <p><strong>Results:</strong> Average GCC of patients was 85.99±6.9 µm. There was GCC loss in 35 (87.5%) eyes which correlated well with areas of RNFL loss (r=0.408, p<0.001). Nine (22.5%) eyes were seen to have decreased MR thickness. GCC loss correlated well with the loss of average RNFL thickness and MR thickness. Further GCC loss was also seen in 23 (74.19 %) eyes with a normal MR thickness.</p> <p><strong>Conclusion:</strong> GCC analysis may prove to be a robust diagnostic parameter and is complementary to RNFL analysis in preperimetric glaucoma.</p> 09/20/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1005.php <h2>Abstract</h2> <p><strong><small>Purpose</small></strong></p> <p>• To assess the short term effects of intravitreal Lucentis (IVTL) on intraocular pressure in patients with ocular hypertension and glaucoma.</p> <p>• To determine rate of anterior chamber paracentesis (ACP) required post-injection according to departmental protocol.</p> <p><strong>Methods</strong></p> <p>This was a prospective, observational study carried out between August 2011 and February 2012 in the Department of Ophthalmology, Maidstone Hospital. 24 participants (13 female, 11 male) with established ocular hypertension (OHT) or glaucoma were chosen from a cohort of patients receiving intravitreal (IVTL) Ranibizumab (Lucentis) treatment for wet age related macular degeneration (wARMD). Apraclonidine 1% was given pre-injection, and baseline IOP was measured 30 min. after this, just before IVTL. IOP was measured at baseline, within 1 min of injection, 5 min, 15 min, 30 min up to 60min following a single IVTL treatment.</p> <p>Anterior paracentesis was performed if:</p> <p>• Immediate post injection IOP > 50mm Hg and OHT.</p> <p>• Immediate post injection IOP > 40 mm Hg and there was evidence of disc damage only.</p> <p>• Immediate post injection IOP > 30mm Hg with evidence of disc damage and visual field loss.</p> <p>• Immediate post injection IOP > 30mm Hg with evidence of disc damage and visual field loss</p> 06/28/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1004.php <h2>INTRODUCTION</h2> <p>Mitomycin-C, First found its way into ophthalmic use in 1969, in Japan, where recurrent pterygia were successfully treated with the drug which is an antineoplastic / antibiotic agent isolated from the soil bacterium Streptomyces caespitosus [1]. It is an anti-metabolite with anti-proliferative effect on cells showing the highest rate of mitosis by inhibiting DNA synthesis and interferes with RNA transcription and protein synthesis [2].</p> 06/20/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1003.php <h2>Abstract</h2> <p>A 60-year-old woman had central retinal artery occlusion (CRAO) presented to the ophthalmology department with a sudden, painless loss of vision. Her initial visual acuity was light perception and she treated with hyperbaric oxygen therapy (HBOT) 4 hours after the development of visual symptoms. Systemic risk factors were not found so she was diagnosed as having idiopathic CRAO. Her vision improved from light perception to 20/50 after the HBOT. Any complications such as neovascularization were not developed until the last follow up visit of 8th months.</p> 02/20/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1002.php Basic control theory equations are developed showing conventional exponential system response of refraction vs. time R (t) with a characteristic system time constant, in response to a step change of near work environmental conditions. Details from preliminary experimental design using reading glasses at the U.S. Naval Academy at Annapolis are discussed. The conclusion is that (+) add lenses, used as reading glasses during study, can prevent the development of myopia for college students in pilot training. 02/17/2017 https://www.theskygallerypattaya.com/hceo/ijceo-aid1001.php <h2>Summary</h2> <p><strong>Aim:</strong> To compare the anatomical and functional outcomes of cataract surgery with manual small incision cataract surgery (MSICS) to those of extracapsular cataract extraction (ECCE) in Lome.</p> <p><strong>Patients and Methods:</strong> A prospective study involved two groups of patients who underwent ECCE (group 1) and MSICS (group 2) by the same surgeon in the same conditions in different periods. Complications and visual results to the 45th postoperative day were compared.</p> <p><strong>Results:</strong> At the 45th postoperative day, 60% of operated eyes of the ECCE group (G1) and 83.9% in the group of MSICS (G2) had uncorrected visual acuity greater than or equal to 3/10. Through the pinhole, these proportions increased to 73.3% for G1 and 92.2% for G2. Visual acuity was less than 1/10 in 4.4% for G1 and 1.1% for G2. The vitreous loss was observed in proportions of 3.8% for G1 and 3.3% for G2. During follow-up, the three main early postoperative complications were inflammation (13.9%), corneal edema (13.3%), and the pigment dispersion (7.2%) in G1 and corneal edema (9.4%), pigment dispersion (8.3%) and hypertonia (6.6%) in G 2.</p> <p><strong>Conclusion:</strong> Two cataract extraction techniques offer the same level of safety in intraoperative period. However, MSICS has certain advantages over the ECCE and would be an alternative technique in developing countries.</p>