Amblyopia and refractive errors among school-aged children with low socioeconomic status in southeastern Turkey.

PURPOSE: To investigate the prevalence of refractive errors and other eye diseases, incidence and types of amblyopia in school-aged children, and their relation to gender, age, parental education, and socioeconomic factors. METHODS: A total of 21,062 children 6 to 14 years old were screened. The examination included visual acuity measurements and ocular motility evaluation. Autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus were performed. RESULTS: There were 11,118 females and 9,944 males. The average age was 10.56 ± 3.59 years. When all of the children were evaluated, 3.2% had myopia and 5.9% had hyperopia. Astigmatism 0.50 D or greater was present in 14.3% of children. Myopia was associated with older age, female gender, and higher parental education. Hyperopia was inversely proportional with older age. Spectacles were needed in 4,476 (22.7%) children with refractive errors, and 10.6% of children were unaware of their spectacle needs. Amblyopia was detected in 2.6% of all children. The most common causes of amblyopia were anisometropia (1.2%) and strabismus (0.9%). CONCLUSION: Visual impairment is a common disorder in school-aged children. Eye health screening programs are beneficial in early detection and proper treatment of refractive errors.

Effect of low molecular weight heparin (enoxaparin) on congenital cataract surgery.

AIM: To assess the efficacy of intracameral enoxaparin (a low-molecular-weight heparin) infusion, in variable doses on postoperative inflammatory response in congenital cataract surgery. METHODS: It is a prospective, randomized controlled trial. Eighty eyes of 53 children with congenital cataract were enrolled in this study. Every eye had primary posterior capsulorrhexis and intraocular lens (IOL) implantation after lens aspiration. The eyes were divided into 4 equal groups. In group 1 balanced salt solution (BSS) without enoxaparin was used as an irrigation solution. Whereas in group 2, 3 and 4, 40mg, 20mg and 10mg enoxaparin in 500mL BSS was used respectively. The inflammatory response in the anterior chamber was compared among the groups with slit-lamp biomicroscopy. RESULTS: The mean follow-up period was (17.75±3.95) months in group 1, (18.00±5.15) months in group 2, (19.20±5.47) months in group 3 and (18.65±5.16) months in group 4. Mean number of inflammatory cells in the anterior chamber in group 1 was significantly higher than that of group 2, 3, 4 (P<0.001). There was fibrin formation in the anterior chambers of 3 eyes in group 1 and one eye in group 4. There was synechiae formation in 3 eyes of group 1 and one eye of group 4. There was no significant difference among the groups by means of fibrin or synechiae formation (P>0.05). There were IOL precipitates in 4 eyes of group 1 and 2 eyes of group 4. IOL precipitate formation was significantly higher in group 1 than that of group 2 and 3 in which there was no IOL precipitate (P=0.048). There was IOL subluxation in only one eye of group 1, 3 and 4 while no subluxation was observed in group 2 (P>0.05). There was no statistically significant difference detected about IOL subluxation occurance in all 4 groups (P>0.05). CONCLUSION: Complications of cataract surgery in congenital cataract patients associated with postoperative inflammatory response found to be decreased with the use of enoxaparin in intraocular infusion solutions. Furthermore according to our results the anti-inflammatory effect of enoxaparin was dose dependant.

Anastomosis of both posterior and anterior flaps or only anterior flaps in external dacryocystorhinostomy.

PURPOSE: To evaluate the outcomes of external dacryocystorhinostomy (DCR) by using two different patterns of flap anastomosis; one only with anterior flap anastomosis and the other with both anterior and posterior flap anastomosis. METHODS: One hundred and sixty-four patients were enrolled in the study. Patients were then randomly divided into two groups as follows: those who underwent DCR with both anterior and posterior flap anastomosis (Group 1) and those who underwent DCR with only anterior flap anastomosis (Group 2). Surgical success was defined as patient satisfaction, disappearance of epiphora and lacrimal patency up to 12 months after surgery. RESULTS: After 12 months, the DCR with both anterior and posterior flap anastomosis had a success rate of 89.8% (71/79), while the DCR with only anterior flap anastomosis had a success rate of 89.4% (76/85). There was no statistically significant difference between the two groups (p < 0.05). CONCLUSION: Anastomosis of posterior flaps does not seem to affect success rate of external DCR. Creating only the anterior anastomosis is technically simpler and does not seem to negatively influence the outcome of DCR surgery.

Posterior chamber lens implantation with scleral fixation in children with traumatic cataract.

PURPOSE: To evaluate the outcomes of posterior chamber lens implantation with scleral fixation (SF-PCIOL) in children with traumatic cataract. METHODS: Twenty-four eyes of 24 cases were included. All patients had corneal or corneoscleral lacerations that were primarily repaired. Traumatic cataract subsequently developed and SF-PCIOL was performed due to insufficient posterior capsule support. RESULTS: The average age of the patients was 5.8 years (range: 4 to 10 years). All cases had SF-PCIOL implanted via internal route using triangular double scleral flaps made of 9-0 polypropylene after a complete anterior vitrectomy. Average follow-up was 14.6 ± 4.3 months (range: 11 to 18 months). Visual acuity was increased at the last visit in 23 (96%) patients. Common postoperative complications were fibrinous reaction in 6 (25%) patients, transient intraocular pressure increase in 4 (17%) patients, membrane formation requiring removal in 1 (4%) patient, transient intraocular hemorrhage as vitreous hemorrhage in 1 (4%) patient, and retinal detachment in 1 (4%) patient after the postoperative second month. CONCLUSION: SF-PCIOL is an effective and reliable method in patients with pediatric traumatic cataract who had insufficient posterior capsule support.

Is it necessary to accompany probing with endoscopy in cases of congenital nasolacrimal canal obstruction?

OBJECTIVE: To compare the results of probing with and without endoscopy in cases of congenital nasolacrimal duct obstruction who had previously not undergone probing. METHODS: Fifty-one children with congenital nasolacrimal duct obstruction who underwent surgical intervention between June 2007 and April 2009 in our hospital were included in the study. Patients who had had previous probings were excluded from the study. Conventional probing was performed in 37 eyes of 25 patients, and probing with intranasal endoscopic visualization in 36 eyes of 26 patients. Diagnosis was based on history of epiphora since birth or shortly after, and fluorescein dye disappearance test. RESULTS: Thirty-two of 37 eyes (86.48%) were cured by probing. Of the 5 cases with complaints, 1 had lacrimal sac fistula. Thirty-four of 36 eyes (94.44%) were cured by probing guided by endoscope observation. Thirty-two cases had stenosis at the lower end of the nasolacrimal duct which required probing. In two cases the probe passed submucosally to the floor of the nose. In two cases a false passage was made at the upper end of the inferior meatus. In these cases, the operation was continued by repeating the process until the distal end of the nasolacrimal canal was seen to have been passed. CONCLUSION: Probing with endoscopy may be excessive in primary cases but in cases which have undergone unsuccessful probing, it is useful for visualization of anomalies in the lower nasolacrimal canal and to obtain the correct anatomic position for the probe.

Apert's syndrome: ophthalmic importance and clinical findings.

Apert's syndrome is a rare form of craniosynostosis that exhibits with many ocular manifestations. We present two cases of Apert's syndrome. Our first case is a 10-year-old girl admitted with exotropia, V pattern and proptosis on examination. Investigations revealed coronal craniosynostosis, cleft palate, vaginal atresia and syndactyly of the hands and feet. The second case is a 5-year-old boy presented with hypertelorism, exotropia, dissociated vertical deviation and proptosis. Investigations revealed coronal craniosynostosis, bifid uvula and syndactyly of the hands and feet.

Bilateral cataract extraction with posterior chamber intraocular lens implantation simultaneous in pediatric cataracts.

We evaluated the results of simultaneous bilateral cataract extraction with intraocular lens (IOL) inplantation 32 pediatric cataract patients. Simultaneous cataract extraction and posterior capsulotomy with anterior vitrectomy and IOL implantation is an effective and safe procedure in bilateral pediatric cataracts treatment.

Congenital isolate and total optic disc coloboma: case report and review of the literature.

Isolated and total optic disc coloboma is a markedly rare congenital anomaly of the eye. Congenital eye colobomas frequently present with eye anomalies and systemic signal findings. We present a case of isolated total optic disc coloboma without systemic involvement, which has been rarely reported in the literature.