Comparison of Ectasia versus Pseudoectasia using the Ectasia Risk Factor Score System

Objectives@#To evaluate and compare ectasia and pseudoectasia in post-myopic LASIK patients presenting with corneal topographic changes indicative of ectasia using the Ectasia Risk Factor Score System (ERFSS).@*Methods@#Single-center retrospective comparative case series of a consecutive chart review of cases in 18 years who underwent bilateral myopic-LASIK and showed topographic changes indicative of ectasia.@*Results@#Four patients were included. Group 1: pseudoectasia eyes, consisting of two patients with bilateral pseudoectasia, and Group 2: ectasia eyes, consisting of two patients with unilateral ectasia. The clinical course of the cases was discussed and compared based on the ERFSS parameters: topography pattern, residual stromal bed thickness, age, preop thinnest cornea, and pre-operative spherical equivalent (SE) manifest refraction (MR). Group 1 scored zero to low risk for developing ectasia while Group 2-eyes with ectasia scored moderate risk. The predictive value of the ERFSS was 1 in this study.@*Conclusion@#The ERFSS is a good measure in deciding the suited treatment plan for patient undergoing refractive procedure. Knowing the clinical course of ectasia and pseudoectasia is helpful in the therapeutic approach since pseudoectasia is reversible when identified and managed early as seen in this study.

Refractive errors in Filipino eyes in a single-center study population

Objective We determined the frequency of refractive errors among Filipino patients undergoing refractive or cataract screening at an ambulatory eye-care center, correlated them with demographic and ophthalmic variables, and compared refractive and keratometric astigmatism. Methods Clinical records of 666 consecutive patients who had optical interferometry were reviewed and the demographic and clinical parameters obtained were subjected to statistical analyses. Results The mean axial length (AL) was 24.43 ± 1.56 mm, significantly shorter among females (p < 0.001). Axial length (AL) was also inversely correlated with age (r = –0.50). Mean sphere was –1.3 ± 3.4D, and correlated with age (r = 0.57); younger age groups had higher negative values. Myopia was the major refractive-error type (90 to 100%) in the 17- to 30-year-old age bracket. Hyperopia was the predominant refractive error (50 to 75%) among the elderly. The mean keratometry reading was 44 ± 1.5D. Females had steeper K readings than males (p = 0.000). Refractive astigmatism was observed in 47.88% and keratometric astigmatism in 71.7%. Against-the-rule (ATR) was the prevalent type (46.1%) in refractive astigmatism and with-the-rule (WTR) (59.1%) in keratometric astigmatism. Conclusion In the older population, AL was shorter and hyperopia was more prevalent; in the younger population, myopia was more prevalent. Astigmatism did not differ between gender groups but differed among age groups. WTR astigmatism was more prevalent in the younger age group and ATR in the elderly.

A week in neuro-ophthalmology: The Singapore experience

Objective@#To report the frequency of neuro-ophthalmologic cases seen over one working week by a senior neuro-ophthalmologist in Singapore and to determine a pattern in the incidence of neuro-ophthalmic diseases.@*Methods@#A retrospective review of 57 consecutive neuro-ophthalmologic cases seen by one senior neuro-ophthalmologist from June 14 to 18, 2010 was done. All patients underwent a complete neuro-ophthalmologic examination. Demographic data and clinical diagnoses were gathered.@*Results@#A total of 57 patients were seen. Thirty-one percent (18) of these patients were new consultations while the remaining 61% (39) were follow-up visits. Fifty-two percent were females (30) with a mean age of 53 years while 47% were males (27) with a mean age of 49 years. Nineteen cases involved disorders of the optic nerve followed by disorders of ocular motility (11), optic chiasm, visual pathways, and/or visual cortex (14). Among the cases involving the optic nerve, 5 were ischemic optic neuropathy. In respect to disorders of ocular motility, ocular myasthenia gravis (n=5) was the most common condition seen. Pituitary adenomas comprised the bulk of the disorders of the optic chiasm (4). The remaining neuro-ophthalmic cases were almost evenly distributed. A very rare case of Froin’s syndrome was also seen.@*Conclusion@#Overall, during the five-day neuro-ophthalmologic clinic, majority of cases were ischemic in nature, reminding readers that systemic diseases, such as hypertension, diabetes mellitus, hyperlipidemia, commonly manifest in the eye. Hence, better systemic control of these diseases is necessary.

Refractive errors in Filipino eyes in a single-center study population

Objective@#We determined the frequency of refractive errors among Filipino patients undergoing refractive or cataract screening at an ambulatory eye-care center, correlated them with demographic and ophthalmic variables, and compared refractive and keratometric astigmatism.@*Methods@#Clinical records of 666 consecutive patients who had optical interferometry were reviewed and the demographic and clinical parameters obtained were subjected to statistical analyses.