role of pretreatment microbiologic study in the management of suspended infectious keratitis

Sixty-five cases of suspected infectious keratitis not receiving treatment were studied. All patients were subjected to full ophthalmological examination and pretreatment microbiologic studies. All eyes were treated with topical fortified tobramycin and chloramphenicol eye drops. Comparisons of the results of gram stain and cultures were recorded. Fifty cases produced positive bacterial isolates [32 in single form and 18 were mixed]. Fungal isolates were positive in five cases [three in pure form and two mixed with bacteria]. Sixty cases had complete resolution with initial therapy. Modification of antibiotic therapy succeeded in treating another two eyes. Three cases with pure fungal infection improved on antifungal therapy. The two eyes with mixed fungal infection resolved on antibiotic therapy alone. It was concluded that for small, superficial, peripheral corneal ulcers without associated risk factors or suspected fungal infection, the treatment with carefully selected broad spectrum antibiotics at frequent intervals with close follow up is recommended. For otherwise cases complete pretreatment microbiologic examination is recommended followed by medical therapy guided by the microbiologic results

Evaluation of pseudophakos tilt effect upon postoperative astigmatism

Eighty eight [88] cases of extracapsular cataract extraction [ECCE] with posterior chamber lens implant [IOL] were studied. The implants were purposely inserted within the capsular bag. The placement of the upper haptic in the bag was not ascertained in each case. The pseudophakic astigmatism closely followed the changes in the corneal astigmatism proving that the IOL tilt did not induce any significant astigmatism provided that the IOL did not disturb either the iris or the posterior capsule

Adjustable sutures in glaucoma filtering surgery

Sixty eyes with uncontrolled glaucoma constituted the material of this work. The control group [20 eyes] was operated upon following the classic trabeculectomy operation. Trabeculectomy with two adjustable sutures was performed for the remaining 40 eyes. Their postoperative course was uneventful in 23 out of the 40 eyes. Five eyes suffered from uveitis which was mild in 4 but severe in fifth eye, ending in posterior synechiae and complicated cataract. Trace hyphema occurred in two eyes but disappeared in a few days. Progression of already present cataract was noticed in two eyes. Marked postoperative hypotony and very shallow anterior chamber were recorded in five eyes in addition to three eyes of the control group. Two eyes of the control group improved on medical treatment and third one required air reformation of the anterior chamber. Tightening of one adjustable suture succeeded in restoration of the intraocular pressure in 3 eyes. The other 2 eyes were successfully managed by tightening of the second suture. Two out of the 40 eyes and 2 of the control group developed postoperative rise of intraocular pressure. One of the control cases responded to medical therapy and the second one required anothor operation. Loosening of one adjustable suture cured one eye. The second eye required loosening of the other suture. In conclusion, adjustable sutures may be used in glaucoma fistering surgery for better management of excessive postoperative rise or drop of intraocular pressure

role of computerized perimetry in the detection of early glaucomatous field defects

This discusses the role of computerized threshold perimetry detection of early glaucomatous filed defects. A glaucoma program was used in which the size of the test target was 2mm and the area tested included the central 300 and nasal periphery. In early glaucoma suspects computerized perimetry helped in estabilishing or rejecting a diagnosis of glaucoma

importance of accurate anterior chamber depth measurement in intraocular lens power calculation

A prospective study was done on one-hundred [100] cases of extracapsular cataract surgery with posterior chamber intraocular senses. Two parameters were studied carefully in relation to intraocular lens [IOL] power selection: accuracy of postoperative anterior chamber depth [ACD] and changes in corneal power. Of these two parameters, changes in anterior chamber depth have far greater effect than changes in corneal power upon the accuracy intraocular lens power selection

Microbiological study of resistant corneal ulcers

Nineteen cases [26 eyes] of resistant corneal ulcers were studied. They were all examined ophthalmologically, generally and microbiologically. The onset of corneal ulceration was variable [2 months to one year] but more than half of the cases were less than one year in duration. Recurrent ulcers were more requent [57.7%]. Central ulcers were the commonest [0.8%] followed by Para central ulcers [15.4%] while peripheral ulcers were the least frequent [3.8%]. 53.8% of ulcers were 3-5 mm in sioze, 30.8% were 1-2 mm and 15.4% were extensive. Rounded ulcers were found in 42.4%, dendritic in 15.4%, amoeboid or oval in 11.5 each, multiple linear or lattice in 7.7% each and creascentic in 3.8%. Deep ulcers with elevated edges were more frequent [57.7%] than the superficial ones. Herpes simplex virus was the commonest agent [61.5%]. Pathogenic bacteria came next [34.6%] while pathogenic fungi had the least role [11.5%]. Infection with one pathogen constituted 73.1% [viral in 57.8%, bacterial in 11.5% and fungal in 3.8%]. Combined infection was less frequent [26.9%: viral and bacterial in 19.2% while bacterial and fungal in 7.7%. However, 15.4% of eyes were negative for all organisms. 84.6% of eyes presented with the usual ulcer of the causative organisms. In the remaining 15.4% the picture does not match with the isolated pathogen. Generally, diabetes mellitus was the most frequent condition [15.4%] followed by bilharzias is, addiction and repeated not well-spaced pregnancies in 7.7% each, while typhoid fever and hepatic failure were the least frequent [3.8%]

Mycoflora of the human conjunctival sac

Eighty healthy eyes, 114 healthy eyes receiving systemic medications and 736 diseased eyes constituted the material of this work. They were all subjected to mycological examination of their conjunctival sacs. Direct microscopic examination showed fungal elements in 35% in the first group. 47.3% in the second and 20% in the third. The cultures gave higher incidence than the smears in all the groups [35%, 63.1% and 37.2% respectively]

Glaucoma and cataract: a modification for failed trabeculectomy cases

Eighteen eyes of failed trabeculectomy operation were reoperated upon following a modified procedure. Fifteen eyes were successfuly controlled for follow up period 6 months. Two eyes practiced secondary rise of tension. One of them could be controlled by local medications while the other one was reoperated upon following the modified procedure at another site. The remaining eye showed early shallow anterior chamber and hypotony, then the IOP became normal with reestablishement of filtration. The described technique can be considered as a good solution for the treatment of failed trabeculectomy cases

Congenital nasolacrimal duct obstruction

Fifty infants below 3 months of age with 62 eyes suffering from congenital nasolacrimal duct obstruction were divided at random into two groups each contained 31 eyes. The first group was treated with gentamycin eye ointment and massage under pressure for their lacrimal passages and the second group with gentamycin eye ointment onlyTwenty two of the first group and 14 of the second group were cured before the age of 6 months. The remaining 26 eyes and another 34 new cases of congenital nasolacrimal duct obstruction over 6 months of age were subjected to probing of their lacimal passages under general anesthesia

Conjunctiva and cornea

Three hundred mothers and their newborn infants [160 males and 140 females] were studied. Swabs from the infant's conjunctiva and their mother's vagina were cultured for bacteria. Susceptibility of the isolated pathogenic bacteria to the commonly used antibiotics was performed. All infants were followed up for 10 days for the development of ophthalmia neonatorum. Data obtained were fully discussed

summer meeting lid and lacrimal apparatus pathogenesis of chronic blepharitis

This study was conducted on 140 cases of chronic blepharitis, and 25 of age and sex matched normal controls. They were all evaluated ophthalmologically, bacteriologically and dermatologically. It was found that blepharitis can be classified into 5 groups: seborrheic, infective, mixed infective/seborrheic, meibomian and others. Pathogenesis of blepharitis includs various local and systemic factors. A significant role was found for external irritants, prolonged exposure to strong sun, unhyglenic surroundings, insufficient sleep and local ocular cosmetics. From this study, it was found that bacteria and fungi have no primary role in the pathogenesis of many of the cases of blehparitis even in some of the infective group

Comparative study on local injection therapy of chalazia

Ninety five chalazia were treated with local injections. Small cystic chalazia responded best to intralesional steroid. Acute infected lesions did better if an antibiotic was added to the steriod Injection. Hard, long-standing chalazia did not respond well either to intra. or paralesional steriod injection with or without an antibiotic. The control group injected with saline and followed for a similar period did not show any spontaneous resolution