Eye
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Randomized Controlled Trial Clinical Trial
A comparison of amethocaine cream with lignocaine-prilocaine cream (EMLA) for reducing pain during retrobulbar injection.
A prospective, randomised, double-masked, placebo-controlled study was carried out on 169 patients undergoing cataract extraction to compare the topical anaesthetic cream amethocaine with EMLA (eutetic mixture of local anaesthetic, lignocaine and prilocaine) and placebo in reducing pain during retrobulbar injection. Fifty-eight patients received EMLA, 55 amethocaine and 56 the placebo. ⋯ Significantly lower pain scores were observed in those patients who had amethocaine (p < 0.001) or EMLA (p < 0.005) in comparison with those who had placebo, but there was no statistical difference between amethocaine and EMLA (p > 0.1; t-test). No systemic or local side-effects were encountered in any group.
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Case Reports
Detection of varicella-zoster virus DNA in ocular samples from patients with uveitis but no cutaneous eruption.
Herpes zoster ophthalmicus is a well-recognised cause of intraocular inflammation, which may become recurrent or chronic after the acute phase has elapsed. Although it commonly presents with the typical rash, cases of ocular zoster with no cutaneous eruption have been well documented. We present two patients with unilateral anterior uveitis complicated by cataract, in whom molecular techniques based on the polymerase chain reaction detected varicella-zoster virus DNA in intraocular material obtained during cataract surgery. Neither patient gave a history of cutaneous eruption.
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A scanning laser ophthalmoscope (SLO) was used to examine the fundi of 54 diabetic patients through undilated pupils and the results compared by an experienced ophthalmologist with clinical examination through dilated pupils to assess the effectiveness of the SLO in detecting diabetic retinopathy. Whilst the SLO was not as good at detecting cotton wool spots and subtle intraretinal microvascular abnormalities, it did not miss any active new vessel formation and all eyes needing treatment would have been referred.