Clinical biomicroscopy versus fluorescein angiography: effectiveness and sensitivity in detecting diabetic retinopathy.

PURPOSE: To compare diagnostic effectiveness and sensitivity of the two methods of screening for diabetic retinopathy. METHODS: Prospective analytic study comparing diabetic retinopathy grading obtained from clinical slit lamp biomicroscopy and fundus fluorescein angiography (FFA). A total of 189 consecutive patients were examined in the ophthalmology department at Jordan University Hospital. RESULTS: A total of 376 eyes were reviewed by consultant ophthalmologist for diabetic retinopathy grading on FFA. The sensitivity of ophthalmoscopy in diagnosing diabetic retinopathy grading was 91.2%, with a specificity of 97.9%. The degree of agreement kappa was 0.87. CONCLUSIONS: Slit-lamp biomicroscopy is highly sensitive for screening diabetic retinopathy grading in diabetic patients and ophthalmologists do not need to confirm a suspected clinical diagnosis of proliferative diabetic retinopathy using FFA as ophthalmoscopy proved to be comparable to angiography.

Prevalence of blindness and visual impairment among Jordanian diabetics.

PURPOSE: To investigate the prevalence of blindness and visual impairment among a population of Jordanian diabetics. METHODS: A total of 986 diabetic patients were fully assessed, including complete history, examination, and laboratory tests. All patients underwent detailed eye examination, which included visual acuity, slit-lamp examination, tonometry, funduscopy, and fundus fluorescein angiography (FFA). RESULTS: Of all patients examined, 53.2% were male and 46.8% were female. The mean age and duration of diabetes were 55.3 and 11.9 years. Of all patients, 93.3% had type 2 while 6.7% had type 1 diabetes mellitus (DM). Over half (50.3%) were on oral hypoglycemic agents, 34% on insulin, and 14.5% on both types of treatment, whereas only 1.2% were on diet alone. The mean value for HbA1c was 7.7%. The prevalence of blindness among participants was found to be 7.4%, while 10.1% were visually impaired. Diabetic retinopathy (DR) was present in 64.1%, 37.8% had cataract, and 8.7% had undergone cataract surgery. Using multivariate logistic regression analysis, visual impairment was significantly associated with age, treatment of diabetes, and DR, while only age and retinopathy were significantly related to blindness. CONCLUSIONS: DM is a common disease in Jordan and DR is highly prevalent among Jordanian diabetics. National screening and educational programs are highly needed to reduce the risk of blindness and visual impairment among diabetic patients.

Causes of blindness among adult Jordanians: a hospital-based study.

PURPOSE: To assess the causes of blindness among adults aged 20 years and over who attended two big general ophthalmic clinics in Jordan. PATIENTS AND METHODS: This hospital-based study was undertaken at Jordan University Hospital in Amman (the capital of Jordan) and Princess Basma Teaching Hospital which is affiliated with Jordan University of Science and Technology in Irbid, the third largest city in the country. A total of 2732 patients seen consecutively over 26 months were examined and the ophthalmic findings were recorded. Using standard Snellen charts, subjects were placed in one of three categories according to their best corrected visual acuity: (1) unilateral blindness: less than 6/60 in the worst eye, 6/60 or more in the better eye; (2) moderate bilateral blindness: less than 6/60 in the worst eye, less than 6/60 to 3/60 or more the better eye; and (3) severe bilateral blindness: less than 3/60 in both eyes. RESULTS: Of the totalpatients seen, 373 were blind according to the selection criteria. Among 248 patients with unilateral blindness, diabetic retinopathy, cataract and trauma were the leading causes. Among the 81 patients with moderate bilateral blindness, diabetic retinopathy and cataract were the leading causes. Diabetic retinopathy and glaucoma were the leading causes in patients with severe bilateral blindness. CONCLUSIONS: These data could be used in planning blindness prevention and treatment programs while awaiting a national survey on the prevalence and causes of blindness in Jordan.

Myopia and level of education.

PURPOSE: To find out whether the development of myopia is related to the level of education. MATERIALS AND METHODS: From two big ophthalmic outpatient clinics in Jordan, 968 subjects (between the age of 24 and 45 years) were included in this study. A subject was considered myopic if at least one eye had a spherical equivalent refractive error of at least -0.75 diopter. The subjects were divided into two groups: the educated group was those who had finished at least 12 years of education and the non-educated which included those with maximum of six years of education. There were 468 men and 500 women. RESULTS: The frequency of myopia was higher in the educated group in both men and women. A significant relationship was found between the level of education and myopia in the whole study group (p<0.0001). CONCLUSIONS: This study had too few subjects to draw general conclusions, but within the study group there was a significant relationship between the level of education and the development of myopia.

Ankylosing spondylitis in north Jordan: descriptive and analytical study.

OBJECTIVE: A study of ankylosing spondylitis in Jordan, which has been under investigated in this region. METHODS: Twenty two patients were studied according to standard methodology during a period of four years. Information on HLA, the presence of uveitis, cardiac disease, and peripheral arthritis was recorded. Other variables such as age, sex, employment, and level of disability were also recorded. RESULTS: The results reflected the characteristics of the illness and the impact of the disease on the patients and their quality of life and were consistent with the findings of other workers in the region.

Childhood eye injuries in North Jordan.

AIMS: To provide epidemiological data on serious eye injuries among children that can be utilized in planning health education and safety strategies for preventing such injuries. MATERIALS AND METHODS: Records were reviewed of 116 children who sustained serious eye injuries which required admission to Princess Basma Teaching Hospital between October 1995 and November 1998. The material was analyzed retrospectively with respect to various epidemiological features. RESULTS: 71.5% of the injured children were male and 28.5% were female. There was a marked preponderance of injuries in the age group 6-10 years. The majority of injuries occurred during play and sport (74.1%). Stones and sharp objects were the most common causes accounting for 18.1% and 17.2% respectively. Most of the sharp objects were household instruments. Perforating injuries were more common than non-perforating injuries. 56% of injured eyes had a low vision with visual acuity between 6/24 and 3/60, and 13% had a blinding outcome with visual acuity less than 3/60. CONCLUSION: The major causes of serious eye injuries among these children were unnecessary risks during play, the use of dangerous objects and insufficient supervision by adults, especially at home. Health education should be directed towards prevention of such serious injuries.