Eye
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A retrospective study of the visual outcome of 425 in-patients with traumatic hyphaema has been conducted. A multivariate analysis demonstrated that after adjusting for age, sex and pre-existing poor vision, the size of hyphaema on presentation and the presence of retinal damage were significant predictors of a worse final visual outcome (p = 0.00003 and 0.00001 respectively). Topical steroid and/or cycloplegic medication, and the occurrence of secondary haemorrhage did not influence the final visual outcome after adjustment for the other variables. These data illustrate, in an unselected sequential population of patients, the role of these factors in terms of final visual outcome following hyphaema from blunt ocular trauma.
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In a retrospective study of 462 in-patients with traumatic hyphema, secondary haemorrhage occurred in 8.7% of patients. A multivariate analysis demonstrated that the size of hyphaema on presentation and the presence of retinal damage did not affect the probability of secondary haemorrhage. The incidence of secondary haemorrhage was found to decrease by approximately half with the use of topical steroid (p = 0.005), but did not appear to be influenced by the use of cycloplegics. These data indicate in an unselected sequential population of patients, the therapeutic importance of topical steroid in the treatment of blunt ocular trauma.
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to report on trends in ophthalmology workload using linked statistical data; ⋯ Age-specific admission rates in ophthalmology are much higher in the very young and old than in other age groups. Patterns of work in the specialty are therefore particularly affected by variation in the age distribution of the population. The increase in cataract surgery reflected both the increase in numbers of old people in the population and an increase in age-specific operation rates for cataract. Attempts to alter attitudes and behaviour of the elderly regarding eye diseases, disability, and facilities for treatment may have had a positive impact on the use of services. The decrease in admissions for children probably reflects the impact made by child health surveillance programmes. As the child screening programme has expanded, the admission rates for strabismus have decreased.
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Fifty-four cases of peripheral nerve sheath tumours within the orbit are reviewed. Benign neurilemmomas or neurofibromas occurred in 93% of patients and had an equal incidence. There was a family history or other signs of systemic neurofibromatosis in one-quarter of those with solitary neurofibromas, but in none of the patients with neurilemmoma. ⋯ Within the orbit, most peripheral nerve sheath tumours affect the first division of the trigeminal nerve and extension of some tumours through the superior orbital fissure limits their surgical resection. Despite incomplete resection of some tumours, with up to 23 years follow-up there have been no recurrences requiring further surgery. A postoperative sensory deficit occurred in only 32% of patients with benign neurilemmomas and 72% with neurofibromas.
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Thirty-one Cystic Fibrosis patients were investigated for clinical and biochemical evidence of Vitamin A deficiency. All had been prescribed oral pancreatic enzyme replacements and twice the recommended daily requirement of Vitamin A (5000IU). ⋯ There was no correlation between the above findings and abnormal liver function or clinical disease severity. All patients with cystic fibrosis should have regular Vitamin A estimations with ophthalmological assessment if serum levels fall below 30 microgram/dl.