Evaluation of chilhood ocular trauma: 5-year single-center experience

Amaç: Çocukluk çağı göz travmalarının epidemiyolojisinin ve prognostik faktörlerinin değerlendirilmesi. Gereç ve Yöntem: Bu retrospektif çalışmaya, Kasım 2008 ve Kasım 2013 yılları arasında hastanemiz göz kliniğine göz travması ile başvuran 0-16 yaş arasında 248 hastanın, 258 gözü dahil edildi. Hasta dosyaları taranarak yaş, cinsiyet, travmanın tipi ve oluşum yeri, travmanın oluşumundan hastaneye varışa kadar geçen süre, göz içi basınçları, ilk ve son görme keskinlikleri kayıt altına alındı. McNemar ve Ki-kare testi istatistiksel değerlendirilmede kullanıldı. Bulgular: Çalışmaya dahil edilen 258 gözde erkek/kız oranı 1,3/1 idi. En sık travma uğrama yaşı 7-12 yaş arasında idi. Ön segmentin nonperforan travması (%88,3) en sık rastlanılan tip idi. Tedavi sonrasında en iyi düzeltilmiş görmesi 0,5 ve üzerinde olan göz miktarı %70 (n=182) iken 0,05 ve altında kalan göz oranı %14 (n=36) idi. Takip süresi 1 gün ile 36 ay arasında olduğu tespit edildi. Endoftalmi tespit edilen olgu sayısı 4 (%1,55) iken göz içi yabancı cisim 4 olguda tespit edildi. 6 yaş altında travmaya en sık oyuncaklar neden olur iken 6 yaş sonrasında en sık etken taş ve sopa gibi cisimler idi. Tüm olguların tanıları, uygulanan tedavileri, oküler komplikasyonları ve tedavi sonuçları rapor edildi. Sonuç: Çocukluk çağında oküler travmalar nedeniyle ortaya çıkan tek taraflı körlük engellenebilen ve bu konuda bilgilendirme ve eğitimin önemi vurgulanılarak insidansı azaltabilinecek bir problemdir. Böylelikle daha fazla ebeveyn gözlemi, eğitimsel ve yasal düzenlemelerin oluşturulması, bu tip kazaların morbiditesini ve prevalansını azaltılmasında ciddi öneme haizdir.Aim: To assess the epidemiology and prognostic factors of pediatric ocular traumas. Materials and Methods: This retrospective study included 258 eyes of 248 patients between 0-16 years of age who were presented to ophthalmology clinic of our hospital between November 2008 and November 2013. Age, gender, type and cause of the trauma, time elapsed from the onset of the trauma to admission to the hospital, intraocular pressure, initial and final visual acuities were obtained from the medical records of patients. McNemar and Chi-square tests were used in statistical analyses. Results: In the 258 eyes included in the study, the male to female ratio was approximately 1.3:1, and most were 7 to 12 years old. Non-perforating trauma in the anterior segment was the most common type of injury (88.3%). After the treatment, best corrected visual acuity was 0.5 or better in 70% of the patients, while it was 0.05 or worse in 14%. Follow-up period was ranged from 1 day to 36 months. Endophthalmitis was detected in 4 patients (1.55%) and intraocular foreign body was detected in 4 patients. Toys were the most frequent cause of trauma in children under 6 years of age while it was stone and wood in those over 6 years of age. Diagnoses, therapies implemented, ocular complications, and outcomes were reported. Conclusion: Unilateral blindness in childhood due to ocular traumas is avoidable and its incidence could be markedly reduced by emphasizing an information strategy and education based on prevention of ocular trauma. Thus more adequate adult supervision and educational and legislative measures are necessary and useful in order to reduce prevalence and morbidity of these accidents

Anterior uveitis following eyebrow epilation with alexandrite laser

WOS: 000215307400037PubMed ID: 26379448Ocular tissues are known to be sensitive to damage from exposure to laser emissions. This study reports the case of a female patient with acute unilateral anterior uveitis caused by alexandrite laser-assisted hair removal of the eyebrows. We report a 38-year-old female who presented with unilateral eye pain, redness, and photophobia after receiving alexandrite (755 nm) laser epilation of both eyebrows. Best corrected visual acuity was 20/20 in both eyes. Right eye examination was normal. Left eye examination showed conjunctival injection and 2+/3+ cells in the anterior chamber. Intraocular pressure and fundus examination were normal. Topical steroids and cycloplegic drops were prescribed for 3 weeks. At the end of the 3-week follow-up, best corrected visual acuity was 20/20, and intraocular pressure and fundus examination were normal in both eyes. The left eye was white, and the anterior chamber was clear. The patient continues to be monitored. In conclusion, without adequate protective eyewear, laser hair removal of the eyebrows with alexandrite laser can lead to ocular damage

Clarifying the effect of refractive errors and stereopsis on traumatic dental injuries in childhood

Background/Aim Visual acuity and stereopsis both play an important role in developing posture and balance in children. The aim of this study was to investigate whether children with traumatic dental injuries (TDI) have abnormal stereopsis, due to a reduction in visual acuity, compared to children with good dental health. Material and Methods A total of 140 participants (75 with traumatic dental injuries resulting from falls and crashes, and 65 age-matched controls without dental trauma) were enrolled in this prospective, cross-sectional study. The participants underwent complete dental and ophthalmologic examinations. After the ophthalmologic examination, the stereo acuities were assessed by a Titmus stereo test at 40 cm. Results Titmus test scores were significantly worse in the TDI group (mean score 252.46 +/- 629.12 seconds of arc) compared to the control group (mean score 56 +/- 27.39 seconds of arc) (P < .05). The percentage of subjects with abnormal Titmus test scores was higher in the TDI group (28%) than in the control group (3.1%). The mean anisometropia value was 3.03 +/- 2.37 D and 0.55 +/- 0.41 D in the TDI group and the control group, respectively (P < .001). The severity of anisometropia correlated with the degree of stereopsis (r = .83,P < .01). Conclusions The presence of abnormal stereopsis may lead to postural instability which can lead to traumatic dental injuries. The prevalence of abnormal stereopsis in children with TDI was higher than in children with good binocular vision and stereopsis

Performance of the SRK/T formula using A-Scan ultrasound biometry after phacoemulsification in eyes with short and long axial lengths

Medical Technologies National Conference, TIPTEKNO 2015 -- 15 October 2015 through 18 October 2015 -- 118954Background: The SRK/T formula is one of the third generation IOL calculation formulas. The purpose of this study was to evaluate the performance of the SRK/T formula in predicting a target refraction ±1.0D in short and long eyes using ultrasound biometry after phacoemulsification. Methods: The present study was a retrospective analysis, which included 38 eyes with an AL < 22.0 mm (short AL), and 62 eyes ?24.6 mm (long AL) that underwent uncomplicated phacoemulsification. Preoperative AL was measured by ultrasound biometry and SRK/T formula was used for IOL calculation. Three different IOLs were implanted in the capsular bag. The prediction error was defined as the difference between the achieved postoperative refraction, and attempted predicted target refraction. Statistical analysis was performed with SPSS V21. Results: In short ALs, the mean age was 65.13 ± 9.49 year, the mean AL was 21.55 ± 0.45 mm, the mean K1 and K2 were 45.76 ± 1.77D and 46.09 ± 1.61D, the mean IOL power was 23.96 ± 1.92D, the mean attempted (predicted) value was 0.07 ± 0.26D, the mean achieved value was 0.07 ± 0.63 D, the mean PE was 0.01 ± 0.60D, and the MAE was 0.51 ± 0.31D. A significant positive relationship with AL and K1, K2, IOL power and a strong negative relationship with PE and achieved postoperative was found. In long ALs, the mean age was 64.05 ± 7.31 year, the mean AL was 25.77 ± 1.64 mm, the mean K1 and K2 were 42.20 ± 1.57D and 42.17 ± 1.68D, the mean IOL power was 15.79 ± 5.17D, the mean attempted value was -0.434 ± 0.315D, the mean achieved value was -0.42 ± 0.96D, the mean PE was -0.004 ± 0.93D, the MAE was 0.68 ± 0.62D. A significant positive relationship with AL and K1, K2 and a significant positive relationship with PE and achieved value, otherwise a negative relationship with AL and IOL power was found. There was a little tendency towards hyperopic for short ALs and myopic for long ALs. The majority of eyes (94.74 %) for short ALs and (70.97 %) for long ALs were within ±1 D of the predicted refractive error. No significant relationship with PE and IOL types, AL, K1, K2, IOL power, and attempted value, besides with MAE and AL, K1, K2, age, attempted, achieved value were found in both groups. Conclusion: The SRK/T formula performs well and shows good predictability in eyes with short and long axial lengths

Different accelerated corneal collagen cross-linking treatment modalities in progressive keratoconus

WOS: 000469914500001PubMed ID: 31172016Background: To compare the outcomes of two different protocols of accelerated corneal crosslinking (CXL) on visual, corneal high order aberrations (HOA) and topographic parameters in patients with progressive keratoconus. Methods: In this prospective comparative study, sixty-six eyes of 66 patients with progressive keratoconus were divided into two groups; 37 eyes in Group 1 received 18 mWcm(2) for five minutes, and 29 eyes in Group 2 were treated with 9 mW/cm(2) for 10 min. The uncorrected distant visual acuity (UCVA), best-corrected distant visual acuity (BCVA), corneal HOAs and topography parameters were measured preoperatively and postoperatively at the end of 12 months. The data for the two groups were compared statistically. Results: The mean UCVA and BCVA were significantly improved at the postoperative 12 months compared with the preoperative values in both groups (P <0.05 for all). A significant improvement in corneal HOAs was observed in both groups (P <0.05 for all). The change in corneal coma value was significantly higher in Group 2 (P <0.05). The change in keratometric values K1, K2, AvgK and maximum keratometry (AKf) were significantly higher in Group 2 (P <0.05 for all). The regression model showed that the most important factor predicting the change in AKf was the type of CXL (beta =- 0.482, P= 0.005). Conclusions: Accelerated CXL using 10 min of UVA irradiance at 9 mWcm(2) showed better topographic improvements and coma values than five minutes of UVA irradiance at 18 mW/cm(2) independent of keratoconus severity

Evaluation of corneal thickness with spectral-domain optical coherence tomography following keraring implantation for keratoconus: Five year follow-up

To evaluate the change in the position of intrastromal corneal ring segments (ICRS) implanted in keratoconus patients within five years of implantation. Participants in this study included keratoconus patients who received Keraring 10 ICRS implantation and had a follow-up time of at least 5 years. The distances from apex to anterior corneal surface (AA), from outer basal corner to posterior corneal surface (BP), and from inner basal corner to posterior corneal surface (CP) were measured at every postoperative visit (6 months, 1 year, 3 years, and 5 years) and compared to each other. Thirty eyes of 22 patients were included. The CP showed a statistically significant decrease at all 15 time points (p .05 for all). Triangular ICRS implanted in keratoconus patients remained stable for five years without any complications, which is an extremely important aspect of ICRS surgery. The only difference was a slight posterior movement of the inner basal corner, although without anterior chamber perforation

Evaluation of ganglion cell complex and retinal nerve fiber layer thinning in epilepsy patients

Purpose: This study aimed to compare the perimacular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thickness measurements of epileptic and healthy individuals. Methods: The right eyes of 38 epileptic and 38 healthy individuals who had been using antiepileptic drugs (AEDs) for at least 1 year were included in the study. Central macular thickness, perimacular GCC thickness and volume, and peripapillary retinal nerve fiber layers were measured by optical coherence tomography (OCT) device. Perimacular 1, 3, and 6 mm circle diameters of Early Treatment of Diabetic Retinopathy Study (ETDRS) were selected for GCC measurements. Results: In epilepsy patients, GCC was significantly lower in the 3 mm superior quadrant and 6 mm in all quadrants compared to the control group (P 0.05). Conclusion: We found that epilepsy patients had significant thinning in the GCC layers and temporal-inferior quadrant of RNFL compared to the control group. Our findings from the study show that early retinal changes in epilepsy patients, especially perimacular GCC layers, can be followed up with OCT

The relationship between metabolic syndrome, its components, and dry eye: A cross-sectional study

WOS: 000407080800005PubMed ID: 28328296Purpose: The aim of this study was to evaluate tear osmolarity and tear film function and ocular surface changes in patients with metabolic syndrome.Methods: 108 eyes of 64 patients with metabolic syndrome (group 1) and 110 eyes of 55 healthy individuals (group 2) were included in this cross-sectional study. All participants were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), and tear osmolarity. Main outcome measures were Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), and tear osmolarity values.Results: Tear osmolarity values and OSDI scores were significantly higher in group 1 (314.4 19.1 mOsm and 38.9 +/- 1.1, respectively) compared with group 2 (295 +/- 14.3 mOsm and 18.69 +/- 17.2, respectively) (p = 0.01 for both). The Schirmer test values and TBUT in group 1 (10 +/- 3.7 mm and 14.8 +/- 3.6 sec, respectively) were significantly lower compared with group 2 (16.8 +/- 2.6 mm and 18.1 +/- 0.5 sec, respectively) (p < 0.001 for both). There was significant correlation between tear osmolarity versus waist circumference and fasting blood glucose in the study group (r = 0.364, p = 0.04; and r = 0.542, p 0.001, respectively).Conclusions: This study showed that metabolic syndrome can influence tear osmolarity and tear film function. Patients with metabolic syndrome showed tear hyperosmolarity and tear film dysfunction

Anterior segment optical coherence tomography measurement after neodymium-yttrium-aluminum-garnet laser capsulotomy

Purpose: To evaluate changes in anterior chamber depth (ACD) and angle width after neodymium- yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy.Design: Prospective interventional case series.Methods: In a single institution, 43 eyes of 43 consecutive pseudophakic patients with symptomatic posterior capsule opacification (PCO) underwent Nd:YAG laser capsulotomy. Anterior chamber depth and angle width in pseudophakic eyes with posterior capsule opacification were measured with anterior segment optical coherence tomography (AS-OCT) before and 3 days after Nd:YAG laser capsulotomy. Preoperative and postoperative measurements of anterior chamber depth and angle width included the angle opening distance, measured as the perpendicular distance from the trabecular meshwork at 500 mm and 750 mm anterior to the scleral spur to the anterior iris surface (AOD500 and AOD750, respectively), and anterior chamber angle (ACA) in the nasal and temporal quadrants. Main outcome measures were the changes in ACD and angle width parameters.Results: The mean patient age was 63.4 ± 3.6 years. Before Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurementswere 3.71 ± 0.11mm, 0.61 ± 0.054mm, 0.67 ± 0.063 mm, and 34.5 ± 1.67 degrees and 34.8 ± 1.55 degrees, respectively. Three days after Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.77 ± 0.1 mm, 0.69 ± 0.06 mm, 0.73 ± 0.06 mm, and 35.51 ± 1.64 degrees and 36.17 ± 1.51 degrees, respectively (P <.01 for all).Conclusion: The depth and width of the ACA in pseudophakic eyes with PCO increased significantly after Nd:YAG laser capsulotomy, as shown by AS-OCT, a reliable and noncontact method for measuring anterior ocular structures. Our study shows that the different angle parameters such as ACD, AOD500, AOD750, and ACA measurements seem highly correlated