Aims: Eye injury causes significant morbidity and is a leading cause of blindness worldwide. The current report assesses whether there has been any improvement (or, change in general) in respect of the burden of eye injury in Australia since it was first identified as a concern in the 1990s. The report focuses on the state of Victoria, Australia, but positions the information and findings within the context of broad global consideration.
Study Design: The study design comprises an epidemiological assessment of experiential and observational evidence globally.
Place and Duration of Study: The research was conducted at Melbourne University (Rank of No. 1 in Australia and No. 33 in the world) during years 2007 – 2009 and as a private consultant, 2016.
Methodology: During 2007 – 2009, the VAED Dataset was surveyed for eye injury during the period spanning 2001-2005. Specific focus on a rural location, Mildura Rural City, was performed through review of patient medical files. Review of the global medical database ENTREZ PMD was also performed, spanning 1990 – 2016. Three separate sources were utilized as a means of data triangulation and validation.
Results: The key finding of the report is that no improvement appears to have been observed in respect of the burden represented by eye injury in approximately twenty five years despite significant public health funding including campaigns directed toward raising awareness.
Conclusion: Given the burden represented by eye injury appears to be irretractable, it may be worth considering re-direction of the finances previously directed toward eye injury prevention toward another area, by way of formal cost-benefit analysis (such as decision tree analysis), based on measures including estimated cost per quality-adjusted life year (QALY) gained.
Aims: The pathway of subarachnoid hemorrhaged blood into the eye in Terson’s syndrome has not been definitively determined. We present our findings in a patient with Terson’s syndrome that provided clues on how the subarachnoid hemorrhaged blood entered the eye.
Presentation of Case: A 47-year-old man visited our department three months after a subarachnoid hemorrhage. His visual acuity was hand motion in the right eye and light perception in the left eye. B-scan ultrasonography showed dense vitreous opacities in both eyes and a total retinal detachment in the left eye. Vitrectomies were performed on both eyes. An old subretinal hemorrhage was found in the right eye. A circular opacity firmly attached to the posterior capsule of the lens was found during the vitrectomy on the left eye. His final visual acuity was 20/20 in the right eye and 20/400 in the left eye.
Discussion and Conclusions: The subretinal hemorrhage in the right eye suggests the blood spread along the choroid. The localized circular sublenticular opacity in the left eye suggests that the blood reached the posterior capsule of the lens through the hyaloid canal. A review of the development of the eye suggests that the blood can flow into the eye through the subarachnoid space in the choroid fissure and the choroid in eyes with Terson’s syndrome.
Aim: To provide the data differences in normal eyes with positive and negative family history of glaucoma.
Methodology: 152 eyes from healthy subjects aged 40 years and above with no ocular pathologies were examined using standard protocols by a single examiner. Two groups were made based on the positive and negative family history of glaucoma. There were 76 eyes in negative family history group and 76 eyes in positive family history group. Subjects with history of diabetic or hypertensive retinopathy, raised intraocular pressure (> 21 mmHg), any neurological diseases e.g. Parkinson’s disease and previous intraocular or laser surgery were excluded from the study. The mean retinal nerve fiber layer thickness was calculated in each quadrant separately.
Results: The mean global retinal nerve fiber layer thickness was found to be 102.57 ± 7.27 μm in those having negative family history of glaucoma. It was 90.46 ± 7.06 μm in those having positive family history of glaucoma (p = < 0.001).
Conclusions: Keeping in mind the variations in RNFL thickness with positive family history of glaucoma, this study provides the normal values of RNFL thickness according positive and negative family history of glaucoma. It is concluded that RNFL thickness is found to be significantly decreased in those having positive family history of glaucoma.
Purpose: Reliability and validity of ICareTM tonometer was evaluated for its accuracy on IOP measurements in diabetic patients and controls. Central and peripheral corneal pressures, within and between groups were compared.
Methods: This is a prospective study conducted from March 2015 to June 2015 in a tertiary hospital. Group 1 included central and peripheral IOP measurements in diabetics, Group 2 included central and peripheral IOP measurements in controls, Group 3 composed of central IOP measurements in diabetics and controls, and Group 4 was peripheral IOP measurements in diabetics and controls. Statistical analysis was performed by MedCalc software.
Results: Sixty eyes of 60 participants constituting 30 diabetics and 30 controls were recruited. Mean age in diabetics and controls was 52.63 (+/- 11.87) and 41.7 (+/- 16.53) years. Male to female ratio was 18 (60%) and 12 (40%) in diabetic group while 12 (40%) and 18 (60%) in control group. Mean central and peripheral IOP in diabetics was 15.20 (+/- 3.15) and 14.10 (+/- 3.95) mm of Hg. Mean central and peripheral IOP In controls was 13.97 (+/-2.70) and 13.73 (+/- 3.16) mm of Hg. Pearson coefficient (r) of -0.28, -0.19, 0.12 and 0.22 was found respectively for groups. Paired sample t test showed t values of 1.74, 0.45, -1.06 and -0.28 obtained respectively. Statistical significance was considered when p <0.05. Reliability of ICareTM tonometer was performed by calculating Cronbach’s alpha and intraclass correlation coefficient. Calculated Cronbach’s alpha was 0.44, 0.32, 0.22 and 0.37 respectively. Intraclass correlation coefficient of -0.27, -0.19, 0.12 and 0.22 as single measures were found respectively. ICareTM tonometer validity was determined by ROC curve and accuracy was calculated by AUC difference that revealed 0.23, 0.06, 0.14 and 0.35 respectively. Limits of agreement were evaluated by Bland-Altman difference plots.
Conclusion: ICareTM tonometry reliably measured ocular pressures in all groups with comparable values. Diabetic central pressures were negatively correlated with controls. Central and peripheral pressures showed slightly higher values in diabetics compared to controls.
Aim: To determine the pattern of central cornea thickness (CCT) in an indigenous African population attending the glaucoma clinic at University College Hospital (UCH), Ibadan, Nigeria and identify its relationship to specific open angle glaucoma (OAG) entities in order to administer appropriate treatments.
Study Design: This is a hospital based case control study.
Methods: 340 eyes of 170 consecutive glaucoma patients attending the eye clinic and 340 eyes of 170 consecutive non-glaucoma patients attending the general outpatient department (GOPD) clinic of the UCH, Ibadan, Nigeria between August 2009 and June 2010 who met the inclusion criteria were recruited into the study.
Detailed ocular examination was performed on all participants.
Results: The mean age of glaucoma group was 55.7 ± 9.9 years compared to 53.3 years ± 8.4 years in non-glaucoma group. The mean CCT of all eyes was 530µm. The mean CCT was found to decrease with age in both groups.
Conclusion: The study confirms there was no significant relationship between central cornea thickness and specific open angle glaucoma.