Retrospective review of visual outcome in operated lens subluxation

To describe the visual outcome of patients with lens subluxation [LS], including ectopia lentis [EL] due to genetic causes, who underwent surgical correction using standard selection criteria and surgical techniques in order to assess effectiveness of current LS therapy. This is a retrospective review of 17 sequential patients with LS who underwent lens aspiration between 2000 and 2012 through an anterior [limbal] or posterior [pars plana] approach at King Abdulaziz University Hospital, Riyadh, Saudi Arabia. Snellen visual acuity was converted to the logarithm of the Minimum Angle of Resolution [logMAR] equivalent for statistical analysis. All statistical comparisons were performed by t-test. This series consisted of 28 eyes with causes of LS including Marfan syndrome [12 eyes], familial EL [5 eyes], homocystinuria [4 eyes], sickle cell anemia [2 eyes], and trauma [6 eyes]. Mean visual acuity [VA] for the entire group increased from 20/200 before surgery to 20/70 after surgery [p >/= 0.01]. Post-operative VA was >/= 20/60 in all eyes that did not have complicating factors such as amblyopia, retinal detachment, and/or other ocular abnormalities. Visual outcome of limbal and pars plana approaches was statistically similar [p >/= 0.29]. Patients with genetic causes of EL had a significantly better visual outcome than other patients [p >/= 0.01]; out of these, patients with Marfan syndrome had a better visual outcome than other patients with genetic abnormalities [p >/= 0.02]. Accepted surgical criteria and techniques improved visual outcome in patients with LS. Patients with Marfan syndrome and others genetic abnormalities without ocular complications had best visual outcomes

Outcomes of 3 hours part-time occlusion treatment combined with near activities among children with unilateral amblyopia

To evaluate the outcome of part-time occlusion therapy with or without near activities in monocular amblyopic patients. One hundred and thirty patients who prescribed daily occlusion therapy [part-time occlusion] were followed-up for a 12-week period. The study was carried out in the Pediatric Ophthalmology and Orthoptics Clinics of King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia for the period from January to November 2010. Sixty-five patients were recommended to undertake the 3 hours of near visual activities [such as reading a book during patching] while the other 65 patients were not advised to do any near activity. Main outcome measures were best corrected visual acuity [VA] for both groups and line improvement. The total line of VA improved from baseline by an average of 6.7 +/- 2.37 line log MAR [logarithm of the minimum angle of resolution] units in the group of patching with near activities and by an average of 5.3 +/- 2.04 line log MAR units in the group of patching without near activities. All type of amblyopia [strabismic, anisometropic, and mixed types of amblyopia] improved significantly after patching with near activities. Both moderate and severe amblyopia improved significantly in the group of near activities compared with the group without near activities. Performing near activities while patching in the treatment of anisometropic, stabismic, or combined amblyopia improves the VA outcome more than patching alone

Unilateral amblyopia: optical coherence tomography findings

This study was performed to measure the macular and the retinal nerve fiber layer [RNFL] thicknesses using optical coherence tomography [OCT] in patients with unilateral amblyopia. Measurement of the Retinal nerve fiber layer and Macular Retinal Layer thickness for both amblyopic and normal fellow eyes by [OCT] was carried out at king Abdulaziz University Hospital, Riyadh, Saudi Arabia. Ninety-three patients with unilateral amblyopia between the ages of 5 years and 12 years were included. The macular retinal thickness and the RNFL thickness were measured using OCT. The mean macular retinal thickness was 259.3 microm and 255.6 microm, and the mean RNFL thickness was 112.16 microm and 106 microm, in the amblyopic eye and the normal eye, respectively. OCT assessment of RNFL thickness revealed a significantly thicker RNFL in amblyopic eye [P < 0.0001], but no statistically significant difference was found in macular retinal thickness [P = 0.195]. The amblyopic process may involve the RNFL, but not the macula. However, further evaluation is needed

One month outcome of ocular related emergencies in a tertiary hospital in Central Saudi Arabia

To investigate the number and characteristics of patients attending the Accident/Emergency [A/E] Department of a tertiary care hospital in Riyadh, and to determine their route of referral, and pattern of ocular emergency cases. A retrospective study was carried out using the records and history of all patients attending the A/E at King Abdulaziz University Hospital [KAUH] in Riyadh, Kingdom of Saudi Arabia in July 2010. Data collected included time of arrival, age, gender, source of referral, principal diagnosis, attending doctor, action taken, and discharge plan. A total of 1,412 patients were recruited in our study with an average daily attendance of 47 patients. A total of 863 [61%] patients were male, and their mean age was 28.2 years. The most frequent diagnosis in patients was trauma [382, 27%], followed by conjunctivitis [211, 14.9%], lids and lacrimal system [133, 9.4%], retina problems [51, 3.6%], glaucoma [30, 2.1%], neuro-ophthalmology [22, 1.6%], keratitis [20, 1.4%], uveitis [10, 0.7%], and episcleritis [5, 0.35%]. Most cases [77.5%] seen were self-referrals. Additionally, 712 [50.4%] of cases were considered as non-emergency, which are visiting the A/E for dry eye, chalazion, blepharitis, and allergy. Most cases seen at our ophthalmic A/E had non-urgent conditions that could be managed satisfactorily by trained ophthalmic assistants under supervision of an ophthalmologist