ABSTRACT
PURPOSE: To describe the characteristics of keratoconus (KC) patients seen in a contact lens clinic of a children's hospital in Kenya. RESULTS: A total of 254 patients' records were analyzed. Mean age at presentation to the clinic was 20.97 ± 11.13 year (range, 6-84 years) with 75% between the ages of 6 and 25 years. There was a preponderance of males (59.8%). Most patients were referred by an ophthalmologist. All patients were Africans. The most common complaints were blurred vision (50%), poor visual acuity with spectacles (33.5%), contact lens intolerance (11.8%), and other (unspecified). Most cases were severe (71%) followed by moderate (22.9%) and mild (6.2%). Mean BCVA was 0.24 ± 0.23 (6/11). An optical correction was provided in 98% of cases; 34.6% with spectacles, 31.1% with gas permeable lenses and the remaining with both. Referral for keratoplasty was warranted in 16.5%. CONCLUSION: This is the first study of KC conducted in Kenya. KC presented at a very early age and tended to be severe. Ophthalmologists were the main source of referral. The main presenting symptom was reduced vision. Optical correction was the most common management and the percentage of patients referred for surgery concurred with other studies.
Subject(s)
Contact Lenses , Keratoconus/diagnosis , Vision Disorders/rehabilitation , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Kenya , Keratoconus/physiopathology , Keratoconus/therapy , Male , Middle Aged , Referral and Consultation , Retrospective Studies , Specialization , Vision Disorders/physiopathology , Visual Acuity/physiology , Young AdultABSTRACT
PURPOSE: This article aims to describe a case of asymptomatic branch retinal vein occlusion (BRVO) in a patient with cystic fibrosis (CF) and discuss the possible link between the two. CASE REPORT: A young adult (aged 35 years) with CF who presented for routine ocular examination was found to have a superior temporal BRVO in the left eye. Visual acuity was unaffected, measuring -0.06 LogMAR, and intraocular pressure was 10 mm Hg. Optical coherence tomography showed no macular involvement. Regarding the patient's general health, blood pressure was within the normal range, and there was no diabetes. Exploratory blood tests revealed elevated fibrinogen levels. CONCLUSIONS: It is hypothesized that BRVO occurred secondary to raised fibrinogen levels, a common feature in CF resulting from chronic pulmonary infection and inflammation. Practitioners should be aware of the possible link between BRVO and CF.
Subject(s)
Cystic Fibrosis/complications , Retinal Vein Occlusion/etiology , Adult , Blood Pressure , Cystic Fibrosis/diagnosis , Fibrinogen/metabolism , Humans , Intraocular Pressure , Male , Retinal Vein Occlusion/diagnosis , Thrombosis/etiology , Visual Acuity/physiologyABSTRACT
Tear ferning (TF) has shown good sensitivity and specificity in the diagnosis of dry eye, but is a relatively uncommon test, especially in contact lens wearers. The aim of this study was to investigate the relationship between TF, ocular comfort and tear film stability amongst contact lens (CL) wearers and non-contact lens (NCL) wearers. Subjects (36 NCL, 24 CL; mean age 23.2 +/- 4.8 years) underwent assessment of non-invasive tear break up time (NIBUT), fluorescein tear break up time (FBUT) and completed the Ocular Comfort Index (OCI) questionnaire. Non-stimulated tears were collected from the inferior tear meniscus with a glass capillary. Samples of 1.5 microL were air dried, observed by light microscopy and the TF pattern quantified according to Rolando's grading scale. Significantly higher grades of TF pattern and discomfort (higher OCI scores) were observed in CL wearers compared to NCL wearers (Mann-Whitney U-test; p < 0.005 and p < 0.05 respectively). Differences in tear film stability were not significant between groups. Even when asymptomatic (low OCI scores) CL and NCL subjects were compared, TF remained significantly different (p < 0.005). In both CL and NCL subjects, TF displayed poor correlation with tear film stability tests and OCI scores. Higher TF grades in CL wearers, even if asymptomatic, indicate an unfavourable ratio of salt to macromolecule concentration within the tear film of such subjects. The lack of significant difference in TF between symptomatic CL and NCL wearers could suggest similar aetiology (tear film hyperosmolarity) in each cohort. The TF technique demonstrates limited sensitivity and specificity for the prediction of ocular surface comfort in both CL and NCL wearers.
