Glaucoma after open globe injury at a tertiary care university hospital in central Saudi Arabia; cumulative incidence and risk factors

Objectives: To investigate the incidence and risk factors of glaucoma after open globe injury [OGI]

Methods: The medical records of all patients admitted with the diagnosis of OGI at the Department of Ophthalmology, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia and had undergone primary repair from January 1996 to December 2011 were retrospectively reviewed

Results: For the 15-year study period, 775 patients who underwent repair of an OGI were identified. The overall risk of post-traumatic glaucoma was 5.3% [41/775] with a mean +/- SD follow-up period of 12+/-6.5 months. Univariate analysis revealed that Zone II injury [p=0.027], penetrating ocular injury [p=0.0008], lens injury [p=0.011], vitreous hemorrhage [p=0.002], and presence of intraocular foreign body [p<0.0001] were significantly associated with glaucoma. Age of more than 18 years was critical [p=0.054]. Following logistic regression, penetrating ocular injury [p=0.019], lens injury [p=0.002], and vitreous hemorrhage were significant [p=0.037]

Conclusion: Glaucoma after OGI is not uncommon. Zone II injury, penetrating ocular injury, lens injury, presence of vitreous hemorrhage, and presence of an intraocular foreign body were significant risk factors for developing post-traumatic glaucoma

Management of recurrent pterygium

To evaluate the outcome following surgical excision of recurrent pterygium, the efficacy of adjunctive therapy utilized in conjunction with excision of recurrent pterygium, and the complications of surgical intervention. A retrospective study of 77 eyes of 77 patients at the King Khaled Eye Specialist Hospital in Riyadh who had surgical excision of recurrent pterygium between January 1991 and December 2000, and were followed up for more than three months. Fifty-one patients had simple excision with conjunctival autograft, 12 patients had simple excision, 7 had simple excision with application of mitomycin C, 4 had simple excision with conjunctival autograft and mitomycin C, 2 had excision of pterygium with amniotic membrane transplant [AMT], and 1 had excision with cryotherapy of the pterygium bed. The rate of recurrence was 27, 17, 1.4, 0.0, 0.0, and 100 percent respectively; no serious complication was encountered for any of these procedures. As the recurrent rate in secondary pterygium is high, simple excision cannot be considered as the only option. Simple excision and AMT showed impressive and promising results, and could be considered as a first procedure for recurrent pterygium

Changes in intraocular pressure during simulated Moslem Prayers

We evaluated the changes in intraocular pressure [IOP] in normal eyes of 30 male volunteers performing simulated Moslem prayer in which two characteristic head-down positions are assumed during 'Rukoo' and 'Sujood'. Ten seconds after assuming such positions, the intraocular pressure increased significantly from a mean value of 17.61 mmHg +/- 3.17 in the standing position to 21 .22 mmHg +/- 3.26 in Rukoo and to 26.72 mmHg +/- 2.88 in Sujood. The intraocular pressure rise in these Moslem prayer positions might be hazardous in the immediate postoperative period following anterior segment surgery. The possible long-term effects of such repeated episodes of IPO rise on the optic nerve of normal individuals and glaucoma patients are discussed

Spectrum of bacterial keratitis in a major eye hospital in Riyadh, Saudi Arabia

Bacterial keratitis is a major cause of ocular morbidity and an important cause of blindness from corneal scars in our region of the world. This review of the medical records of 100 consecutive patients with bacterial keratitis was carried out in order to determine the predisposing factors, and the causative organisms. All patients that had presented over the period of January 1986 to December 1987 to the emergency department of the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, were surveyed; 68 were male and 32 female. Among the cases where only a single organism was isolated, Staphylococcus epidermidis predominated [28 cases and%], Streptococcus pneumoniae was found in 18, and Pseudomonas aeruginosa in 18 patients [18% each]. Nineteen patients had mixed infections. The most common predisposing factor was antecedent ocular trauma, predominantly surgical: 56 patients had preceding surgery. In 38 of these, this had included corneal grafting. Fifteen% of the patients suffered from diabetes mellitus