Ocular manifestations in patients with senile sensorineural deafness: experience at Prince Rashid Bin Al-Hussien hospital

Objectives: To screen patients having senile sensorineural hearing loss [presbycusis] for the presence of age- related changes in their eyes particularly age- related macular degeneration

Method: A prospective study conducted at prince Rashid Bin Al Hassan Military hospital, Irbid Jordan between March 2016 and May 2016. Three- hundred and forty-five patients diagnosed with senile sensorineural hearing loss [Presbycusis] at the ENT clinic were referred to the ophthalmology clinic to perform comprehensive eye examination including visual acuity [VA], anterior segment examination using slit lamp biomicroscope, applanation tonometry using Goldmann applanation tonometer and dilated fundus examination using non-contact 78 diopter lens

Results: Three- hundred and forty-five patients aged between 45 and 87 years [mean 64.4 +/- 12.5 years] were included in the study. One-hundred and fifty-seven [45.8%] were females with a mean age of 62 years. The mean visual acuity was [0.6]. Arcus senilis was present in [53.6%] of patients with slight male predominance. Cataract was found in [55.9%] of patients. Pseudoexfoliative material on the anterior capsule of the lens and/or pupillary margin was found in [8.3%] of patients. Glaucoma was found in [3.2%] of patient's eyes. Age-related macular degeneration was found in [20.1%] of patients

Conclusion: Age related macular degeneration and pseudo exfoliation syndrome were present at higher frequency among patients with presbycusis. There was no increase in the frequency of arcus senilis, cataract and glaucoma among those patients

Relationship between glaucoma, pseudoexfoliation and pseudoexfoliative glaucoma with sensorineural deafness

Objective: to study whether there is an increase in the frequency of sensorineural hearing loss among patients suffering from primary open angle glaucoma, pseudoexfoliation syndrome and pseudoexfoliative glaucoma

Methods: this is a cross-sectional study conducted at the ophthalmology and ENT clinic of prince Ali Bin Al-Hussein military hospital between Jan.2012 and Aug 2013. All patients who attended to the ophthalmology clinic and found to have primary open angle glaucoma, pseudoexfoliation syndrome or pseudoexfoliative glaucoma were referred to the ENT clinic for hearing assessment after performing detailed ophthalmological -examination. Those results were compared with that of a control group

Results: sensorineural hearing loss was found in 6% of patients in the control group and in 9.7% [p value > 0.05] of patients with primary open angle glaucoma. On the other hand it was found in 34.3 %[ p value < 0.05] and 30.3 %[ p value < 0.05] among patients with pseudoexfoliative glaucoma and pseudoexfoliation syndrome respectively

Conclusion: this study provides evidence regarding the effect of pseudoexfoliation of the eye and its severity on the frequency of sensorineural hearing loss which in turn suggests that pseudoexfoliation syndrome is a systemic disease which may have otological involvement manifested as sensorineural hearing loss

Phototherapeutic keratectomy for treatment of corneal diseases: our experience at king hussein medical center

To evaluate and present the results using phototherapeutic keratectomy for treatment of corneal diseases at King Hussein Medical Center. This was a retrospective study conducted at the Laser Refractive Unit in King Hussein Medical Center between October 2011 and May 2013. All patients who were scheduled for phototherapeutic keratectomy for various corneal conditions were included in the study. Patients with any systemic disease that would affect epithelial healing such as diabetes or systemic lupus were excluded from the study. Data was collected including patient's age, gender, visual acuity, primary diagnosis, refraction, corneal thickness using Pentacam [Oculus, Wetzlar, Germany] and presence of any systemic disease. All patients were followed after one week of treatment. Bandage contact lens was removed and the cornea checked for epithelial healing and the patients were followed up for at least 6 months after treatment. One hundred and forty-six eyes of 146 patients with a mean age of 57 years [range 7 to 74 years] were enrolled in the study, 87 of them were males. The most common type of corneal pathology found was band keratopathy [37%] followed by old superficial corneal scars [22%], other pathologies found included: Salzmann nodules [12%], bullous keratopathy [9%], spheroidal degeneration [6%], keratoconus with nebula [6%], granular dystrophy [3%], Reis Buckler dystrophy [3%] and recurrent corneal erosions syndrome [3%]. Ninety percent of patients experienced improvement in their vision. All patients showed satisfactory improvement in either visual acuity or symptoms of pain and discomfort in the immediate post operative period. Phototherapeutic keratectomy is a safe and very effective procedure to be used for treatment of various surface corneal lesions

Corneal metallic foreign bodies among Jordanian soldiers

To review the spectrum of metallic foreign bodies among Jordanian soldiers and the efficacy of treatment. A retrospective review was conducted at Prince Rashid Bin Al-Hassan Hospital between August 2011 and March 2012. File and photographs review of 55 patients who attended the ophthalmology clinic and found to have corneal metallic foreign body were included in this study. The following data were extracted and analyzed: age, gender, past ocular history, mechanism and time of injury and whether any eye protective measures were taken for those who were exposed to trauma during work, time to receive treatment, method of corneal foreign body removal, number of foreign bodies, location, depth of foreign body in the cornea, whether the eye was patched or not after removal of corneal foreign body, associated ocular injury, presence of Bell's phenomenon, complications, and duration of absence from work. All patients were males and the age ranged between 17 and 55 years [mean 31.3 years]. Eighty- two percent of eye trauma occurred during work and all of them did not use any protective measure during their work activity. The mid third of the cornea was involved in 39% of patients followed by the paracentral zone in 27%. Corneal foreign bodies were removed by 27 gauge needle in 68% of patients. Eye patch was not used in 48% of patients after removal of foreign body. The most common associated finding was corneal rust in 63% of cases. Absence from work ranged between two to nine days. Corneal foreign bodies are potentially sight threatening that occurs mostly as a result of occupational accidents in male workers who do not comply with the use of eye protection. Educational and safety programs and patient counselling on proper eye protection are essential and must be implemented in the work places to prevent serious eye injuries and work loss.

Ophthalmic findings among Jordanian patients with chronic renal failure on haemodialysis at Prince Ali Military Hospital in the south of Jordan

To characterize the ocular and peri-ocular findings in patients with chronic renal failure undergoing haemodialysis at Prince Ali Bin Al- Hussein Military Hospital. This is a descriptive study. Data were collected from patients with chronic renal failure undergoing haemodialysis from June 2012 till January 2013. The medical files were reviewed to report medical, surgical and ophthalmic history of all candidate patients. All patients underwent full ophthalmic examination on day one of recruitment. Forty-four patients [87 eyes] were reported. Mean age was 56.9 years [56.9 +/- 12.5]. Male to female ratio was 2:1. Aetiologies of chronic renal failure were: Hypertension [n=17, 39%], glomerulonephritis [n=13, 30%], and diabetes mellitus [n=10, 23%]. Some other aetiologies were also found like: Small kidney [n=4, 9%], renal stones [n=2, 5%], polycystic kidney [n=2, 5%], familial [n=2, 5%] and analgesic nephropathy [n=1, 2%]. Ocular findings were seen in 75 eyes [86%], including lid edema [n=66, 76%] conjunctival congestion [n=54, 62%], cataract [n=47, 54%], and dry eye [n=44, 51%]. Ocular and peri-ocular findings were frequent in chronic renal failure patients who were undergoing hemodialysis, which urges regular ophthalmic examination to detect and treat sight threatening complications early.

Retinal manifestations of diabetes on the first visit of Jordanian diabetics to the ophthalmology clinic

To assess retinal complications of diabetes mellitus among Jordanian diabetic patients during their first visit to the ophthalmology clinic. This study was conducted at Ophthalmology outpatient clinics in three major Royal Medical Services hospitals between 1[st] June 2009 and 1[st] October 2010. Sixty-seven diabetic patients who attended these clinics for the first time for complete ophthalmological examination were enrolled in the study regardless of the type and duration of diabetes. Pregnant women, patients with systemic lupus erythematosus, sickle cell disease or previous retinal and chronic ocular diseases were excluded from the study. A detailed history was obtained from every patient. Ocular examination included best corrected visual acuity, ocular adnexal and ocular motility, and slit-lamp examination of the anterior and posterior segments. The mean age of patients and duration of diabetes was 53.6 and 6.2 years respectively. Diabetic retinopathy was present in 29 [43.2%] patients; seven of them had Type I diabetes mellitus and 22 [32.8%] patients had Type II diabetes. The frequency of non-proliferative diabetic retinopathy, proliferative diabetic retinopathy, and maculopathy was 20.8%, 6.0% and 16.4% respectively; none of the patients had anterior segment or adnexal diabetic complication at the time of presentation. Diabetic retinopathy has a high frequency among a clinic sample of Jordanian patients with diabetes. Retinopathy screening remains inadequate. Effort is needed to improve health education and diabetes awareness in the general population. This will allow early detection and treatment of diabetic retinopathy and reduce the burden of visual impairment in the Jordanian population

Valsalva retinopathy during Labour: a case report

Rise of intra-abdominal pressure during labor may result in Valsalva retinopathy. This can cause visual loss in one or both eyes. Conservative treatment consisting of observation is offered in most cases. We report a case of a dense pre-macular sub-hyaloid hemorrhage in a pregnant woman. This complication arose during the early uterine contractions of labor at Prince Rashid Bin Al-Hassan military hospital. The management options available in such a case are discussed