Vision screening of preschool children in Riyadh

A total of 860 children attending preschools and nurseries in Riyadh and aged between 3 and 6 years were screened for various visual parameters relating to strabismus and amblyopia. Saudi nationals constituted 69% of the subjects, the other 31% originating mainly from the surrounding Middle Eastern countries. Of the total 860 children examined, 59 were referred to a hospital for further evaluation, representing a referral rate of 6.86%. Of these 59 children, 51 were actually examined at the hospital; 23 were found, upon detailed examination, to be within normal limits. The remaining 28 had positive ocular findings, including amblyopia [in 22 children, representing a prevalence of 2.6% in the total sample], refractive error [16 children = 1.9%], and strabismus [10 children = 1.2%]. The prevalence of strabismus and amblyopia in the tested children is essentially similar to that reported in the literature; that of refractive error does not reflect real levels in the population since refraction was only performed on those children who were seen at the hospital. There was an unusually high prevalence of ptosis in the examined sample [0.6%]

Epikeratophakia for monocular aphakia in the amblyopic age group

The charts of 46 consecutive children who had undergone epikeratophakia below 8 years of age at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia were reviewed. The monocular cataract which had preceded the aphakia had been congenital in 15.2%, known traumatic in 80.4%, and suspected traumatic in 4.3%. Most of the children had undergone and failed a trial with contact lenses for their monocular aphakia; an average delay of 15.3 months occurred between lensectomy and epikeratophakia. Follow-up ranged from 1 month to > 4 years [mean 18.6 months]. Complications were seen in 10 of the 44 cases [22.7%] for which records were available. Of the 26 children in whom both pre - and postoperative Snellen visual actuity testing was done, vision had significantly improved in 3, significantly deteriorated in 4, and remained largely unchanged [most deteriorating slightly] in the other 19. Significant postoperative refractive errors were seen in 27 children [range: - 3.75 to + 5.5D sphere and up to 7.0D cylinder]. Despite these poor results, because of local patients' poor compliance with more conservative methods of correction, epikeratophakia may be a reasonable alternative in a higher proportion of pediatric patients in our region than in other parts of the world

Clostridium perfringens endophthalmitis and orbital cellulitis

Endogenous endophthalmitis in healthy adults is extremely uncommon. Moreover, endogenous Clostridium perfringens infection of the intraocular structures is rare. We report a healthy adult male who developed sudden loss of vision. Eye examination revealed evidence of endophthalmitis. The clinical course was complicated by orbital cellulitis. Blood cultures grew C. perfringens. This case confirms the fact that endogenous endophthalmitis may rarely occur in healthy adults. Prompt diagnosis and early treatment may prevent loss of vision and other serious complications