Anterior Segment Changes during Accommodation in Accommodative Esotropia

PURPOSE: To evaluate the anterior segment biometric parameters of non-accommodative and accommodative refractive accommodative esotropia (RAE). METHODS: Eighty-one eyes of 81 patients were included in this prospective, case-control study. The patients were divided into three groups as follows: the RAE group (n = 31), the hypermetropia group (n = 25), and the emmetropia group (n = 25). Measurements were obtained in the non-accommodative (0.0 diopters) and accommodative status (-5.0 diopters) using a Pentacam HR. The anterior chamber depth (ACD), anterior chamber volume (ACV), pupil diameter (PD), and anterior chamber angle (ACA) were evaluated at all four quadrants. RESULTS: The ACD, ACV and PD values in the RAE group were lower than those of the other groups in both states (p < 0.05). The ACD values were lower in the hypermetropia group than in the emmetropia group for the non-accommodative status (p = 0.024) but were similar for the accommodative status (p = 0.225). PD and ACV values were lower in the hypermetropia group than in the emmetropia group in both states (non-accommodative status, p = 0.011 and p = 0.022; accommodative status, p = 0.026 and p = 0.034, respectively). Changes in ACD, ACV and PD during accommodation (Δ) were not significant in the RAE group but were significant for the other groups (hypermetropia: ΔACD, p = 0.001; ΔACV, p = 0.001; ΔPD, p = 0.002; emmetropia: ΔACD, p < 0.001; ΔACV, p = 0.001; ΔPD, p < 0.001). These changes were significantly lower in the hypermetropia group than in the emmetropia group (ΔACD, p = 0.012; ΔACV, p = 0.031; ΔPD, p = 0.034). CONCLUSIONS: The anterior chamber in RAE patients was shallower and the increase in convexity of the anterior surface or forward movement of the crystalline lens was more limited during accommodation in RAE.

knowledge and attitudes of the primary care physicis on developmental dysplasia of the hip

For the prevention and early diagnosis of developmental dysplasia of the hip [DDH], a detailed clinical screening of the newborn performed by a primary care [PC] physician is recommended as a standard practice throughout the most western countries. We aimed to determine the knowledge and attitudes of the PC physicians towards DDH, and to develop further educational and training programs, according to the results obtained from the study. The study was a pre- and post-test with a cross-sectional design. In winter of 2005, the participants included 102 PC physicians from 20 primary health care centers in Kahramanmaras, Turkey. A structured questionnaire was prepared consisting of 28 statements on medical, practical, and traditional knowledge and attitudes concerning DDH. There was a significant difference between the pretest [71.47 +/- 9.92] and post-test scores [78.85 +/- 12.86] of participants [P=0.000]. Of the participants, 83 [81.4%] before, and 93 [91.2%] after the lecture, thought that DDH is a preventable disease. Prior to the lecture, only 27.5% of the physicians were aware of the wrong traditional attitudes that are considered as risk factors for DDH. The knowledge and attitudes of PC physicians on DDH needs to be improved by providing continuous education programmes