Ophthalmology
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To determine the prevalence of glaucoma and risk factors for primary open-angle glaucoma in a rural population of southern India. ⋯ The prevalence of glaucoma in this population is not lower than that reported for white populations elsewhere. A large proportion of those with POAG had not been previously diagnosed. One fifth of those with POAG had blindness in one or both eyes from glaucoma. Early detection of glaucoma in this population will reduce the burden of blindness in India.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of lidocaine 2% gel versus amethocaine as the sole anesthetic agent for strabismus surgery.
To compare the efficacy of lidocaine 2% gel with amethocaine 1% eyedrops as the sole anesthetic agent for one-stage adjustable suture strabismus surgery. ⋯ In terms of pain control, lidocaine 2% gel alone is a superior topical anesthetic for one-stage adjustable suture strabismus surgery when compared with amethocaine 1% eyedrops.
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To determine long-term graft survival rates and causes of secondary graft failures for a large series of penetrating keratoplasties (PKPs). ⋯ The 5-year and 10-year survival rates in this series demonstrate that PKP is a safe and effective treatment for the corneal diseases commonly transplanted in the United States. However, endothelial failure and immunologic graft rejection were persistent risks over the long term, supporting the need for continued patient follow-up. Regrafts, aphakic eyes without intraocular lens placement at the time of transplant, and corneas with deep stromal vascularization had reduced graft survival rates. Pseudophakic bullous keratopathy grafts with a retained posterior chamber intraocular lens were at increased risk of endothelial failure compared with primary grafts done for other causes or compared with pseudophakic bullous keratopathy grafts done with intraocular lens exchange.
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To report a case of bilateral posterior ischemic optic neuropathy (PION) in a healthy young patient after lumbar spine surgery which was initially diagnosed as functional visual loss. ⋯ Young patients without vascular risk factors may develop bilateral PION after otherwise uncomplicated lumbar spine surgery. In subjects complaining of visual loss in the postoperative period who have a normal fundus and normal neuroimaging, a diagnosis of PION should be suspected, and close follow-up is warranted.
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Review Case Reports
Visual deterioration in giant cell arteritis patients while on high doses of corticosteroid therapy.
To report the incidence and extent of visual deterioration in patients with giant cell arteritis (GCA) on high doses of systemic corticosteroids during the early stages of treatment; the various factors that may influence the outcome; and whether intravenous megadose corticosteroid therapy is more effective than oral therapy. ⋯ Our study shows that although a few eyes can develop visual deterioration while on high doses of steroid therapy, early, adequate steroid therapy is effective in preventing further visual loss in most. When further visual deterioration occurred despite high doses of systemic corticosteroids, it almost invariably started within 5 days after the start of the high-dose steroid therapy. There was no evidence that intravenous megadose steroid therapy was more effective than oral therapy in preventing visual deterioration.