Causes of visual impairment and blindness among elderly patients attending ophthalmology clinic at King Hussein Medical Center

Objectives: To investigate the causes of visual impairment and blindness among elderly patients attending ophthalmology clinic at King Hussein Medical Center

Methods: A prospective study that was conducted at King Hussein Medical Center of the Royal Medical Services during the period between January 2010 and January 2012. Inclusion criteria were patients older than 60 years of age attending ophthalmology clinic for any complaint with best corrected visual acuity of less than 6/18 in the better eye. Patients were classified into two groups: first group for patients with visual impairment defined by best corrected visual acuity of less than 6/18 and better than 3/60 in the better eye, and second group for blind patients with best corrected visual acuity of less than 3/60 in the better eye. Ophthalmologic examination included best corrected visual acuity, anterior segment examination via slit lamp, intraocular pressure assessment by applanation tonometry and posterior segment examination via +78 lens. Causes of visual impairment and blindness were investigated for all patients

Results: One thousand and two hundred and forty patients were enrolled in the study. Nine hundreds and eighty nine patients [79.8%] had visual impairment and 251 patients [20.2%] were blind. The most common cause of visual impairment was cataract followed by diabetic retinopathy, glaucoma and age related macular degeneration. For patients with blindness, cataract was the commonest cause followed by age related macular degeneration. Other causes included corneal and myopic degenerations, optic nerve disease and retinal and vascular pathologies

Conclusions: The most common causes of visual impairment and blindness in elderly patients attending ophthalmology clinic at King Hussein Medical Center are treatable with good potential of visual recovery

Ahmed glaucoma valve implantation experience at King Hussein Medical Centre

To evaluate Ahmed Glaucoma Valve Implantation at King Hussein Medical Center. Indications, outcomes, and complications were investigated. The medical records of all patients who had Ahmed Glaucoma Valve Implant surgery at King Hussein Medical Center during the period between August 2006 and January 2009 were retrospectively reviewed. A total of 50 cases were enrolled in this study. A specially designed medical record abstract form was used to collect the following data: type of glaucoma, visual acuity, intraocular pressure, number of medications, and postoperative complications. Simple descriptive statistics [frequency, mean, percentage] were used to describe the study variables. The mean age of patients was 54.3 +/- 2.1 years [range 1.3 to 79.9 years]. Types of glaucoma included uveitic glaucoma, paediatric glaucoma, aphakic/ pseudophakic glaucoma, neo-vascular glaucoma, traumatic glaucoma and previous failed trabeculectomy. The mean follow-up duration was 16.6 +/- 1.7 months [range 9.8 months to 26.1 months]. The mean intraocular pressure before surgery was 28.6 mm and 14.2 mmHg after surgery. The mean number of eye drops used by patient was 3.8 +/- 0.4 [range 1 to 4] and 1.1 +/- 0.2 [range 0 to 3] before and after surgery respectively. Transient postoperative hypotony with shallow anterior chamber occurred in 8 patients. Encapsulated bleb occurred in 5 patients. Revision of the procedure was performed in 3 cases. Endophthalmitis was not encountered in our series. Results of Ahmed Glaucoma Valve Implantation surgery at King Hussein Medical Center showed that it is safe and effective procedure for treating refractory glaucomas

Gold weight implantation for facial palsy at King Hussein Medical Center

To evaluate the outcome of upper eyelid loading with gold weight implant in patients with lagophthalmos due to facial palsy. The indications, results and complications were investigated. A retrospective observational study that was conducted at King Hussein Medical Center between January 2005 and June 2008 on 16 patients with facial palsy of different etiologies. Inclusion criteria included lagophthalmous of more than 5mm, and facial palsy of more than 6 months duration. Degrees of lagophthalmos and corneal coverage were assessed pre- and post- operatively. Follow-up period ranged between six months and three years. The mean age of patients was 57.2 years. The main cause of facial palsy was post cerebellopontine angle tumor surgery [10 patients]. Other causes were Bell's palsy [5 patients], trauma [one patient]. The degree of lagophthalmos improved from 5.8 mm to 0.8 mm on average. Corneal coverage improved from 69% to 99%. No serious complications occurred. Upper lid gold weight loading is an effective and safe procedure in patients with facial palsy lagophthalmos with minimal complications

Ocular manifestations among Jordanians with inflammatory bowel disease. hospital-based study in asymptomatic patients

To study the ocular manifestations of inflammatory bowel disease and to investigate whether they are related to disease activity, site of occurrence, and presence of arthritis. A randomized controlled prospective study that was conducted at King Hussein Medical Center during the period between June 2008 and December 2008. One hundred and thirty patients attending inflammatory bowel disease clinic were enrolled in the study. First five patients attending the clinic were selected each week to ensure randomization. Data collected included type of disease, duration, treatment, presence of active disease, site of involvement and presence of arthritis. The randomly selected patients were referred to ophthalmology clinic where they had anterior and posterior segment examination by the same senior ophthalmologist. We investigated the relationship between ocular involvement and type of disease, site of involvement, presence of disease activity and presence of arthritis. Data was collected and compared with a control group of 130 normal subjects. Relatives of patients attending ophthalmology clinic for various reasons were randomly selected as a control group. P-value was calculated to see statistical significance. A total of 130 patients were studied. Mean age of patients was 46.8 years [range 16.2 to 82.2 years] with a male to female ratio of 1.1:1. Seventy patients had ulcerative colitis and 60 patients had crohn's disease. Episcleritis was seen in 12 patients, dry eyes in 9 patients and iritis in 8 patients. One patient was found to have uveitic glaucoma. None of the patients had corneal involvement, scleritis, or retinal vascular involvement. Fifty patients had active disease and 80 were in remission. All patients with episcleritis and iritis had active bowel disease. Tortuous episcleral vessels were seen in 16 patients; the majority of them had inactive disease. Patients with history of arthritis or colonic involvement had more risk of ocular involvemt. The results of our study showed that ocular manifestations of inflammatory bowel disease are related to disease activity, site of involvement and presence of arthritis