Low-Grade Versus Medium-Grade Nuclear Sclerotic Cataract Density Produces Identical Surgical and Visual Outcomes: A Prospective Single-Surgeon Study

Purpose To determine whether the incidence of major complications and postoperative corrected distance visual acuity are comparable for surgery on low-grade versus medium-grade nuclear sclerotic cataracts. Design This was a prospective, consecutive, single-surgeon, no-exclusion study of 1025 cataract cases with one-month follow-up. Methods Patients were divided into two cohorts according to the nuclear sclerosis grade at presentation, as classified using the Lens Opacities Classification System (LOCS) III. Cohort A, representing low-grade nuclear sclerotic cataracts (grades 1-2), consisted of 739 eyes, while Cohort B, representing medium-grade nuclear sclerotic cataracts (grades 3-6), consisted of 286 eyes. Results There was no significant difference in major intraoperative or postoperative complications (p>0.999) between Cohorts A and B. The mean logMar preoperative corrected distance visual acuity (CDVA) in Cohort A was 0.245 as compared with 0.346 in Cohort B (p<0.001). There was no significant difference between cohorts for postoperative CDVA at one day (-0.168 versus -0.118; p=0.070), one week (-0.180 versus -0.147; p=0.405), or one month (-0.185 versus -0.161; p=0.569). Conclusions There was no significant difference in the incidence of operative complications or postoperative CDVA between the cohorts. These findings suggest that, in experienced hands, surgery for medium-grade nuclear sclerotic cataracts is equally effective and safe as compared with that for low-grade nuclear sclerotic cataracts

Intracranial Arterial Compression of the Anterior Visual Pathway

Intracranial blood vessels can compress adjacent cranial nerves, leading to disorders such as trigeminal and glossopharyngeal neuralgia, and hemifacial spasm. However, the occurrence of compressive damage by intracranial arteries of the Anterior Visual Pathway (AVP), consisting of the optic nerves, chiasm or optic tracts, is poorly recognized. This study aimed to determine whether vascular compression of the AVP could contribute to visual field defects, pupillary abnormalities affecting the AVP, and optic nerve head changes in patients without an identified cause of their visual dysfunction

Visualisation of nerve fibre orientation in the human optic chiasm using photomicrographic image analysis

"Compression of the optic chiasm typically gives rise to bitemporal hemianopia due to selective damage to the decussating nasal fibres. It is unclear why nasal fibres are particularly vulnerable to the extent of generating a sharp vertical cut-off in the visual fields. One theory suggests that this is due to the geometry of individual fibres within the chiasm.1 Unfortunately, detailed anatomical information about the precise arrangement and crossing of nerve fibres in the chiasm is limited. This study aimed to clarify the microscopic anatomy of the chiasm, looking particularly at nerve fibre distribution and the location of nerve fibre crossings.

Clinical Assessment of Biopsy-Proven Temporal Arteritis in an Australian Tertiary Referral Hospital

Patients with temporal arteritis may present initially not only to ophthalmologists and neurologists, but also to emergency departments and other physicians. All groups must be confident in assessing patients presenting with possible temporal arteritis, as delays in treatment may have devastating consequences. This study aimed to review and to compare the initial assessments of patients with biopsy-confirmed temporal arteritis by doctors at the eye clinic and the emergency department of a major Australian teaching hospital

Visualisation of nerve fibre orientation in the human optic chiasm using photomicrographic image analysis

"Compression of the optic chiasm typically gives rise to bitemporal hemianopia due to selective damage to the decussating nasal fibres. It is unclear why nasal fibres are particularly vulnerable to the extent of generating a sharp vertical cut-off in the visual fields. One theory suggests that this is due to the geometry of individual fibres within the chiasm.1 Unfortunately, detailed anatomical information about the precise arrangement and crossing of nerve fibres in the chiasm is limited. This study aimed to clarify the microscopic anatomy of the chiasm, looking particularly at nerve fibre distribution and the location of nerve fibre crossings.