Ocular diseases and blindness in elderly Thais.

The prevalence of ocular disease and blindness in 2,092 Thai subjects, aged 60 years and over, in 33 communities in the vicinity of Siriraj Hospital, Bangkok was studied. The subjects were examined by a team which consisted of 3-4 ophthalmologists, 6 nurses and a trainee health officer. The history, visual acuity and ocular tension were recorded. The anterior and posterior segments of the eye were assessed by using a portable slit lamp biomicroscope, and a direct and indirect ophthalmoscope. The examination revealed disease of the lens in 1656 cases (79.16%), cornea 852 cases (40.72%), lid 516 cases (24.67%), conjunctiva 462 cases (22.08%), retina 300 cases (14.34%), glaucoma 128 cases (6.12%) and of the optic nerve in 39 cases (1.86%) respectively. There were 66 cases of blindness (3.15%) and 743 cases of low vision (35.5%). The causes of blindness were cataract, glaucoma, late age-related maculopathy, optic atrophy and corneal opacity.

Normal intraocular pressure.

A study of the intraocular pressure on 1,000 apparently normal eyes, from 668 women (66.8%) and 332 men (33.2%) in whose ages ranged from 14 to 81 years (mean age = 50.16 years) revealed the mean intraocular pressure of 15.16 + 3.11 mmHg with the highest range at 21.38 mmHg. The maximum pressure among subjects in the 50-59 years age-group was 22.26 mmHg. In women the mean intraocular pressure was 15.04 + 3.07 mmHg, and in men 15.38 + 3.18 mmHg. The maximum intraocular pressure among women aged 40-49 years was 21.64 mmHg, while among men aged 50-59 years was 23.24 mmHg.

Acute angle-closure glaucoma.

The authors retrospectively studied patients with acute angle-closure glaucoma from the In-patient section, Department of Ophthalmology, Siriraj Hospital from January 1986 to 31 December 1986. There were a total of 33 cases There were 10 male (30.30%) 23 female (69.70%) with an age range of 30-84 years, average 55.55 years: 13 right eyes (39.39%). 20 left eyes (60.61%). Times from the onset of acute attack until admission were between 1 day to 20 days, average 4.09 days. Intraocular pressure was from 28-101.4 mmHg, average 58.74 mmHg. After per-operative medical treatment the intraocular pressure was reduced and averaged 36.16 mmHg. The type of operations performed were 26 filtering operation (78.79%), and 7 peripheral iridectomy (21.21%). Visual acuity before treatment was lass that 6/60, 19 cases (57.58%); 6/18-6/60, 14 cases (42.42%); 6/6-6/12, 0 case (0%). Visual acuity after treatment was less than 6/60, 5 cases (15.15%); 6/18-6/60, 22 cases (66.67%); 6/6-6/12, 6 cases (18.18%).

Probing in congenital nasolacrimal duct obstruction.

A four-year retrospective study of probing in congenital nasolacrimal obstruction was conducted in Department of Ophthalmology, Siriraj Hospital from January 1982 to 31 December 1985. There was a total of 57 cases, 27 boys (47.37%), 30 girls (52.63%). 23 right nasolacrimal ducts, 22 left nasolacrimal ducts and 12 bilateral, this a total of 69 nasolacrimal ducts were studied. The age group found with the highest incidence was from 7-12 months with obstruction in 26 eyes (37.68%), and 0-6 months in 12 eyes (17.39%). In the first year of life there were 38 eyes (55.07%) with the obstruction. The obstructions were relieved by the result of a first probing in 57 eyes (82.61%), and a second probing in 7 eyes (10.14%). There was failure of probing in 5 eyes (7.25%). The age group that respond best with probing was from 0-6 months for whom all obstructions (100%) were relived. Congential nasolacrimal ducts obstruction should require probing before 6 months.

Effect of pupillary dilation on intraocular pressure.

A prospective study of the effect of papillary dilation on intraocular pressure was carried out in the Outpatient Section, Department of Ophthalmology, Siriraj Hospital. There were a total 100 cases, 43 male (43%), 57 female (57%) with a total of 200 eyes. Ages ranged from 15-81 years, mean 56.13 years. The mean of the intraocular pressure before papillary dilation was equal to = 15.42 + 2.87 mm Hg, while the mean of the intraocular pressure after papillary dilation was = 16.07 + 2.94 mm Hg. There was no change in the intraocular pressure in 48 eyes (24%). In the increased intraocular pressure group, a range of 2.0-3.9 mm Hg was found in 43 eyes (53.09) and a range of 2.0-3.9 mm Hg, in 14 eyes (29.17%). The change in intraocular pressure after papillary dilation was statistically significant (p < 0.001).

Enucleation.

A five-year retrospective study of 410 cases of enucleation at the Department of Ophthlmology, Siriraj Hospital, from the 1st January 1982 to 31st December 1986 was conducted. The patients were male 253 (61.71%), female 157 (38.29%). The youngest patient was 3 months old and the oldest patient was 93 years old, mean age was 35.5 years. The indication found mostly was endophthlamitis, 121 cases (29.51%), the second was deformity of eyeball such as phthisis bulbi and anterior staphyloma, for cosmetic purpose, 101 cases (24.63%). The third was painful blind eye, 87 cases (21.22%). The fourth was extensive rupture eyeball or prevention of sympathetic ophthmities, 63 cases (15.37%). The fifth was intraocular tumour, 38 cases (9.27%). In endopthalmitis, the age group of 60 years or more was found predominant (39.67%). For cosmetic purpose, the age group of 20-29 years was found largest (39.6%). In painful blind eye, the age group of 60 years or more was found largest (33.33%). In traumatic rupture eyeball, age group of 20-29 years was found largest (30.16%). In intraocular tumour, age group of 0-9 years was found largest (81.58%).