Myopia progression in school children with prolonged screen time during the coronavirus disease confinement.

Background: Myopia, the most common refractive error, is a global public health problem with substantial visual impairment if left untreated. Several studies have investigated the association between increased near-work and restricted outdoor activities in children with myopia; however, such studies in children without myopia are scarce. We aimed to monitor the effect of the coronavirus disease-2019 (COVID-19) home confinement and mandatory virtual learning on myopic progression among myopic and non-myopic school-aged children. Methods: We conducted a retrospective chart review of children aged 6 - 12 years attending regular visits to the pediatric ophthalmology clinic in a tertiary eye hospital in Eastern Province, Saudi Arabia. Cycloplegic refraction was determined from three visits at least six months apart: two visits before the start of the COVID-19 pandemic and one during the COVID-19 home confinement. Parents were asked about the time spent in near-work and outdoor activities, the devices used during virtual learning, and the demographic characteristics of the children. Statistical analyses were conducted to compare myopia progression before and during the COVID-19 home confinement. Results: A total of 160 eyes of 80 children were analyzed. The boy (n = 46) to girl (n = 34) ratio was 1.4:1. The hyperopia (n = 131 eyes) to myopia (n = 29 eyes) ratio was 4.5:1. Most eyes exhibited a hyperopic shift before the confinement; however, all eyes displayed a myopic shift during the confinement. When comparing both eyes of the same individual, the more myopic or less hyperopic eye in the same child had a significantly greater myopic shift than the fellow eye (both P < 0.05). Children who used tablets showed a significant myopic shift (P < 0.05). Likewise, children in both age categories ( ≤ 8 and > 8 years), boys, those living in an apartment, and those having parents with bachelor's degrees experienced a significant myopic shift during COVID-19 home confinement compared to before (all P < 0.05). The mean myopic shift was greater in children aged > 8 years than in those aged ≤ 8 years. Children with and without a family history of myopia had a myopic shift in the mean spherical equivalent during COVID-19 home confinement; however, that of children with no family history was statistically significant (P < 0.05). Conclusions: Progression of myopia accelerated in children during the COVID-19 pandemic. Excessive time spent on digital screen devices at near distances is considered a substantial environmental contributor to myopic shift in children. Further multicenter studies with extended follow-up periods are needed to assess the factors contributing to myopic progression in our population.

A Review of the Different Intraoperative Findings of Revision Endoscopic Frontal Surgery.

A revision endoscopic sinus surgery (rESS) is considered when the primary surgery fails to improve the symptoms or causes problems. The rESS is still a difficult surgical procedure, despite the use of imaging-guided surgical navigation systems, because the anatomical landmarks are removed or scarred. To determine the causes and indications of rESS observed radiologically or endoscopically in patients with frontal rhinosinusitis. This retrospective clinical study was conducted between 2010 and 2019 in the Ear, Nose, and Throat Department of King Fahad Specialist Hospital, Saudi Arabia. Sixty cases were indicated for revision endoscopic surgery, and all had distorted or lost anatomical landmarks. Most landmark losses were caused by undissected uncinate processes and residual agger nasi with/without ethmoid disease. The rESS surgical procedure remains difficult, despite the use of imaging-guided surgical navigation systems, because most of the anatomical landmarks are removed or scarred. An undissected uncinate process, residual agger nasi with/without ethmoid disease, extensive mucosal disease with polyps obstructing the frontal recess, and lateralized middle turbinates are the most common conditions requiring rESS.

Bilateral proptosis-an unusual presentation of extensive allergic fungal sinusitis.

Allergic fungal rhinosinusitis (AFRS) is counted as the most common form of fungal sinusitis. It is mainly due to the hypersensitivity reaction to fungal infection. Usually, the patients are atopic or immunocompetent. These patients are usually suffering from signs and symptoms of rhinosinusitis. The expanding mass in the disease leads to bony remodeling and the involvement of adjacent structures. When allergic mucin involves the orbit, many complications may occur. This includes diplopia, telecanthus, unilateral proptosis, malar flattening, epiphora, Asthenopia and even visual loss. The diagnosing of AFRS initially requires radiographic imaging, but to confirm the diagnosis, histopathological examination is needed. The treatment of AFRS should be combined with surgical and medical therapy. This case report demonstrates a unique and rare presentation of the non-invasive AFRS with bilateral proptosis which had dramatic improvement and resolution after we managed it with endoscopic sinus surgery, steroids and nasal saline irrigation.

The Association of Smell and Taste Dysfunction with COVID19, And Their Functional Impacts.

The novel coronavirus disease 2019 (COVID-19), which caused Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was appeared at the end of 2019 in wuhan city in china. Covid-19 has high ability of transmission from human to another human, and due to its fast spread globally, the World Health Organization (WHO) announced that Covid-19 is pandemic disease on March 11, 2020. Several articles have reported many common ENT-related symptoms as an early sign of COVID19. To measure the prevalence of insomnia and dysgeusia in COVID19 patients in Saudi Arabia and investigate their functional and psychological effects on patients. This study evaluated the impact of insomnia and dysgeusia on COVID-19 patients' quality of life using the short version of the Olfactory Disorders-Negative Statements (sQODNS) Questionnaire. It was done from 5 June to 30 July 2020, in the Eastern region of Saudi Arabia. A total of 274 laboratory-confirmed COVID-19 patients were participated. The most common ENT-related symptoms were headache 69%, insomnia 65.3%, and dysgeusia 64.6%. Interestingly, insomnia can greatly affect patients' daily life, as around 37.6% of our patients had problems with taking part in daily activities, 42% felt isolated, 68.1% had changes in appetite, 51.4% had more stress, and 28.2% had increased anger secondary to loss of smell. In Addition, 62% (110) of patients who lost their taste declared that their daily activities were affected. ENT-related symptoms are one of the most COVID19 manifestations. The duration of both insomnia and dysgeusia is an important contributing factor on the patients' functional & psychological state as it may prolong their isolation period. Therefore, Otolaryngologists considered the first-line physicians for many of Covid-19 patients, which makes us at higher risk to be infected with Covid-19 too. It is also particularly important for Otolaryngologists to develop a management guideline to reduce the duration and severity of all ENT-related features.

The endonasal endoscopic management of pediatric lateral frontal mucocele.

OBJECTIVES: The aim of this report is to show the usefulness of endoscopic sinus surgery in management of lateral frontal mucocele in pediatric patient. CASE PRESENTATION: A 14 years old girl presented with right frontal bone depression and headache. CT and MRI showed lateral mucocele occupying the right frontal sinus. The patient was managed successfully by image-guided endoscopic sinus surgery and she was well after two years follow up. DISCUSSION & CONCLUSION: Frontal mucoceles in children are rare. We report a rare case of a child with lateral frontal mucocele with no known etiology, treated successfully by image-guided endoscopic sinus surgery with no recurrence after two years follow-up. This case shows the usefulness of image-guided endoscopic sinus surgery in treatment of lateral frontal mucocele in children.