Adaptación de lentes de contacto en 133 ojos con astigmatismo irregular / Contact lens fitting in 133 eyes with irregular astigmatism

Objetivos: Estudiar la adaptación de lentes de contacto en 133 ojos con astigmatismos irregulares. Material y métodos: Se realizó un estudio retrospectivo en 133 ojos con astigmatismos irregulares. El criterio de inclusión fue tener un astigmatismo irregular imposible de corregir con gafas o con lentes de contacto de diseño estandard. Se efectuó una exploración oftalmológica completa, incluyendo topografía con Eye-Sys 2000. Las variables que se tuvieron en cuenta fueron: refracción, agudeza visual antes y después de la adaptación, etiología y tipo de lente de contacto. Resultados: De la muestra 50% fueron mujeres y 50% hombres, 52% de los ojos fueron derechos y 46% izquierdos y con afectación bilateral un 67%. El 78,2% (110 casos) de los ojos tratados correspondieron a queratoconos, 4 traumatismos corneales, 9 infecciones corneales y 6 astigmatismos idiopáticos. De las 133 lentes de contacto que se adaptaron 103 fueron lentes híbridas (Softperm(R)),, 20 sistemas piggy-back, 5 hidrofílicas gruesas (Queratosoft(R)), 4 hidrofílicas y 3 rígidas gas permeables. La agudeza visual (AV) previa media fue de 0.28 (DE 0,24) (rango 0,1-0,8). Después de la adaptación de la lente de contacto la agudeza visual fue de 0,81 (DE 0,23) (rango 0,1-1). Se encontraron diferencias significativas entre la AV pre/postratamiento con una mejoría visual de 0,53 (DE 0,28). Conclusiones: Sólo a través del manejo de multitud de lentes de contacto por un oftalmólogo especializado se puede llegar a un buen resultado visual-confort en ojo con astigmatismo irregular

Purpose: To study the adaptation of contact lens in a sample of 133 eyes with irregular astigmatism. Methods: A retrospective study was made in 133 eyes with irregular astigmatism. The selection criterion was to obtain a sample population with irregular astigmatism that was unlikely to be corrected with spectacles or conventional contact lens. A complete ophthalmologic exploration which included a topography with the Eye-Sys 2000 corneal topographer was made was made. The variables analyzed in the study were: refraction, visual acuity before and after the correction, cause of the astigmatism and contact lens used. Results: An equal number of women and men were enrolled in the study. The right eye was studied in 52% of cases, and the left eye in 46%. Both eyes were affected in 67% of the subjects. The reason for the astigmatism was keratoconus in 110 eyes (78.2%), and there were 4 corneal injuries, 9 ocular infections, and 6 idiopathic astigmatisms. Among the contact lens used in the study: in 103 eyes a hybrid lens (Softperm(R)), was adapted, in 20 eyes a piggyback system, in 5 eyes a thick hydrophilic lens (Queratosoft (R)),, in 4 eyes a hydrophilic contact lens and in 3 cases a rigid gas permeable contact lens. The average visual acuity before the adaptation was 0.28 (SD 0.24) (range 0.1-0.8). After the use of the lens the average visual acuity was 0.81 (SD 0.23) (range 0.1- 1). Statistically significant differences between the visual acuity before and after treatment were found, with an improvement of 0.53 (SD 0.28) obtained. Conclusion: Only with experience using a large variety of non-conventional contact lens can a specialist contact lens ophthalmologist achieve a good result

[Contact lens fitting in 133 eyes with irregular astigmatism]. / Adaptación de lentes de contacto en 133 ojos con astigmatismo irregular.

PURPOSE: To study the adaptation of contact lens in a sample of 133 eyes with irregular astigmatism. METHODS: A retrospective study was made in 133 eyes with irregular astigmatism. The selection criterion was to obtain a sample population with irregular astigmatism that was unlikely to be corrected with spectacles or conventional contact lens. A complete ophthalmologic exploration which included a topography with the Eye-Sys 2000 corneal topographer was made was made. The variables analyzed in the study were: refraction, visual acuity before and after the correction, cause of the astigmatism and contact lens used. RESULTS: An equal number of women and men were enrolled in the study. The right eye was studied in 52% of cases, and the left eye in 46%. Both eyes were affected in 67% of the subjects. The reason for the astigmatism was keratoconus in 110 eyes (78.2%), and there were 4 corneal injuries, 9 ocular infections, and 6 idiopathic astigmatisms. Among the contact lens used in the study: in 103 eyes a hybrid lens (Softperm) was adapted, in 20 eyes a piggy-back system, in 5 eyes a thick hydrophilic lens (Queratosoft), in 4 eyes a hydrophilic contact lens and in 3 cases a rigid gas permeable contact lens. The average visual acuity before the adaptation was 0.28 (SD 0.24) (range 0.1-0.8). After the use of the lens the average visual acuity was 0.81 (SD 0.23) (range 0.1-1). Statistically significant differences between the visual acuity before and after treatment were found, with an improvement of 0.53 (SD 0.28) obtained. CONCLUSION: Only with experience using a large variety of non-conventional contact lens can a specialist contact lens ophthalmologist achieve a good result.

[A new method to quantify subjective aniseikonia]. / Un nuevo método de diagnóstico y cuantificación de la aniseiconia subjetiva.

PURPOSE: To design subjective aniseikonia measuring criteria in order to quantify its value and to use it to the clinical practice. MATERIAL AND METHODS: In order to carry out the aniseikonia measurements, a sinoptophore (Clement Clark) was used and two tests (one per eye of each patient) were performed. A viewfinder capable of measuring the difference in size between subjective images in both eyes was used and a percentage scale of ratio between 0 and 30%, with an accuracy of 1% was developed. An observational descriptive study was performed on 358 patients, and a complete ophthalmological examination also performed. The patients were divided in 3 groups: emmetropic patients, ametropic patients with non-progressive spectacles, and ametropic patients with hydrophilic contact lenses. RESULTS: Of the 358 patients studied, 22.7% were men and 67.3% women. The average age was 38.3 (SD 17.3) years. 40.2% of the patients were emmetropic and 59.8% had some type of ametropia. When analyzing the refractive defect measured as the spherical equivalent we found a higher prevalence of myopia than hyperopia. The level of aniseikonia in the group of emmetropic patients was 1.6% (SD 3.11), in patients with glasses was 1.3% (SD 2.81), and in patients with contact lenses was 1.1% (SD 2.96). Comparing the results of aniseikonia in anisometropic and emmetropic patients, no statistically significant differences were found. CONCLUSION: A simple method to quantify subjective aniseikonia, useful in clinical diagnosis has been designed.

Un nuevo método de diagnóstico y cuantificación de la aniseiconia subjetiva / A new method to quantify subjective aniseikonia

Objetivo: Diseñar un sistema de medida de la aniseiconia subjetiva así como validar éste en una muestra de sujetos para poderlo proponer para su uso en práctica clínica. Material y métodos: Para la realización del estudio se utilizó un sinoptóforo Clement Clark 2051ltd y un par de test (uno para cada ojo del paciente) que se adaptan al portamiras. Las miras permiten la cuantificación de la diferencia de tamaño entre las imágenes subjetivas de los dos ojos, mediante una escala de proporcionalidad, en porcentaje de 0% a 30% con discriminación del 1%. Se realizó un estudio observacional descriptivo transversal en 358 sujetos. Se les cuantificó la aniseiconia subjetiva con el nuevo método y se realizó una exploración oftalmológica completa. La muestra estaba compuesta por 3 grupos: emétropes, amétropes corregidos con gafas no progresivas y amétropes con lentes de contacto hidrofílicas. Resultados: De los 358 sujetos un 32,7% eran hombres y 67,3% mujeres con edad media de 38,34 (DE 17,5). Del total de la muestra un 40,2% eran emétropes y 59,8% amétropes. Al analizar el defecto de refracción valorado como equivalente esférico se detectó una predominancia de miopes respecto de hipermétropes. El grado de aniseiconia en el grupo de emétropes fue de 1,6 %(DE 3,11), en los sujetos portadores de gafas fue de 1,3% (DE 2,81) y en portadores de lentilla de 1,1% (DE 2,96). Tras comparar las medias de aniseiconia en pacientes anisométropes y no anisométropes no se detectaron diferencias estadísticamente significativas. Conclusiones: Disponemos de un método sencillo, clínicamente útil para diagnosticar y cuantifificar la aniseiconia subjetiva

Purpose: To design subjective aniseikonia measuring criteria in order to quantify its value and to use it to the clinical practice. Material and Methods: In order to carry out the aniseikonia measurements, a sinoptophore (Clement Clark) was used and two tests (one per eye of each patient) were performed. A viewfinder capable of measuring the difference in size between subjective images in both eyes was used and a percentage scale of ratio between 0 and 30%, with an accuracy of 1% was developed. An observational descriptive study was performed on 358 patients, and a complete ophthalmological examination also performed. The patients were divided in 3 groups: emmetropic patients, ametropic patients with non-progressive spectacles, and ametropic patients with hydrophilic contact lenses. Results: Of the 358 patients studied, 22.7% were men and 67.3% women. The average age was 38.3 (SD 17.3) years. 40.2% of the patients were emmetropic and 59.8% had some type of ametropia. When analyzing the refractive defect measured as the spherical equivalent we found a higher prevalence of myopia than hyperopia. The level of aniseikonia in the group of emmetropic patients was 1.6% (SD 3.11), in patients with glasses was 1.3% (SD 2.81), and in patients with contact lenses was 1.1% (SD 2.96). Comparing the results of aniseikonia in anisometropic and emmetropic patients, no statistically significant differences were found. Conclusion: A simple method to quantify subjective aniseikonia, useful in clinical diagnosis has been designed

[Epidemiologic study of ocular emergencies in a general hospital]. / Estudio epidemiológico de las urgencias oftalmológicas en un hospital general.

PURPOSE: To provide epidemiological data about patients attending an ophthalmic emergencies center of a general hospital. METHODS: A retrospective analysis of all patients attending the emergency department (ED) of Rio Hortega Hospital during a 9-month period was carried out. Pathology was identified by International Classification of Diseases ((ICD9-CM) codes. RESULTS: A total of 2914 visits have been examined: 6% of patients were under 20 years of age, 35.4% between 21-50, 29% between 51-70, and 23.3% over 71 years. Thirteen per cent of visits were due to injuries, 50.7% of which occurred in patients 21 to 50 years old. Almost half of visits were due to inflammatory conditions of the cornea, conjunctiva and eyelids. CONCLUSIONS: ED plays a major role in the ophthalmology departments in a hospital. Certainly a considerable proportion of these patients had conditions which could have been dealt with in an ophthalmic outpatient clinic or by general practitioners. Ocular trauma is a common cause of visits to the ED.

[Granuloma annulare of the eyelid: an unusual presentation]. / Granuloma anular del párpado: una localización poco frecuente.

CASE REPORT: Granuloma annulare is a benign dermatosis, relatively common during childhood, usually self-limited and of unknown etiology. Localized ocular involvement is rare. We report a case of granuloma annulare involving the eyelid of a child. A biopsy taken from a similar lesion presented later on the back of a thumb confirmed the diagnosis. Treatment with topical corticosteroids was introduced. DISCUSSION: The literature on periocular granuloma annulare is reviewed. This diagnosis should be considered for any acquired papular of the periorbital area, especially if there is a history of antecedent trauma. Unnecessary surgical excision can then be avoided.

First Report of Verticillium dahliae Causing Wilt on Solanum cardiophyllum and Solanum ehrenbergii.

Solanum cardiophyllum Lindl and Solanum ehrenbergii (Bitt) Rydb are wild edible potato plants found throughout central Mexico (2). These plants are not cultivated, but farmers collect tubers for their own consumption and to sell at local markets (2). Wilted plants were observed in experimental plots of these wild potatoes established near Chapingo, Mexico, during spring 1983. Initial symptoms included wilting and dark yellowing of lower leaves. As the disease advanced, all of the foliage became chlorotic and the plants wilted and eventually died. Disease incidence was 13.4% for S. ehrenbergii and 0.2% for S. cardiophyllum. Verticillium dahliae Kleb. was consistently isolated from the roots and lower stems of diseased plants of both Solanum species. The isolating procedure consisted of thoroughly rinsing roots and lower stems with tap water and cutting roots and stems into 3- to 6-cm sections that were placed in 10% bleach for 3 to 5 min. Bleach excess was removed with sterile paper, and the tissue sections were cut into smaller pieces (0.5 cm) and placed on potato dextrose agar (PDA) plates. Cultures of Verticillium produced numerous dark microsclerotia of various shapes and sizes (0.05 to 0.1 mm); erect, slender, hyaline, and branched conidiophores; and elliptical and hyaline, single-celled conidia characteristic of V. dahliae (1). Pathogenicity studies were conducted in a greenhouse on 2-month-old S. cardiophyllum and S. ehrenbergii plants grown from tubers. Inoculum was obtained from colonies growing on PDA for 10 days producing abundant conidia. Conidial suspensions were obtained by flooding the plate cultures with sterile distilled water, filtering the suspension with two layers of cheesecloth, and adjusting the inoculum to 1.0 × 106 conidia/ml (3). Ten ml of the conidial suspension were applied to each of four holes 5 cm deep and 3 to 5 cm next to the crown of each plant. Symptoms similar to those observed on field-grown plants were observed 15 days after inoculation, and V. dahliae was re-isolated from lower stems and roots. All inoculated plants were dead 4 weeks after inoculation. Water-inoculated plants remained healthy throughout the experiments. This is the first report of V. dahliae on S. cardiophyllum and S. ehrenbergii. References: (1) G. R. Dixon. Vegetable Crop Diseases. Avi Publishing, Westport, Connecticut. 1981. (2) J. Galindo. Naturaleza 13:175, 1982. (3) H. A. Melouk and C. E. Horner. Phytopathology 65:767, 1975.

Mexican papita viroid: putative ancestor of crop viroids.

The potato spindle tuber disease was first observed early in the 20th century in the northeastern United States and shown, in 1971, to be incited by a viroid, potato spindle tuber viroid (PSTVd). No wild-plant PSTVd reservoirs have been identified; thus, the initial source of PSTVd infecting potatoes has remained a mystery. Several variants of a novel viroid, designated Mexican papita viroid (MPVd), have now been isolated from Solanum cardiophyllum Lindl. (papita güera, cimantli) plants growing wild in the Mexican state of Aguascalientes. MPVd's nucleotide sequence is most closely related to those of the tomato planta macho viroid (TPMVd) and PSTVd. From TPMVd, MPVd may be distinguished on the basis of biological properties, such as replication and symptom formation in certain differential hosts. Phylogenetic and ecological data indicate that MPVd and certain viroids now affecting crop plants, such as TPMVd, PSTVd, and possibly others, have a common ancestor. We hypothesize that commercial potatoes grown in the United States have become viroid-infected by chance transfer of MPVd or a similar viroid from endemically infected wild solanaceous plants imported from Mexico as germplasm, conceivably from plants known to have been introduced from Mexico to the United States late in the 19th century in efforts to identify genetic resistance to the potato late blight fungus, Phytophthora infestans.

Reliability diagnosis of FAST in allergic rhinitis. Correlation with RAST, nasal provocation and prick test.

Not much data is available on the reliability diagnosis of IgE FAST, in comparison with other "in vitro" and "in vivo" techniques. The motive of this study was to evaluate FAST sensitivity in patients with rhinitic allergies, comparing it with RAST and the prick test. Thirty-four patients, monosensitized in 11 cases for pollen, in 16 for mites and in 7 for moulds were studied. Ten patients with negative nasal provocation were used for the control group. In a total of 133 sera, there was class concordance between FAST and prick test in 59.39% of the cases, with a r = +0.41 and p less than 0.001 correlation coefficient. Corcordance of FAST and RAST for a total of 135 sera was 65.18%. Concordance in those who had nasal positive provocation was 87.65% for FAST, 75.04% for RAST and 92.85% for prick. From our experience with FAST, in patients with allergic rhinitis for the pneumoallergens evaluated, we conclude that this test constitutes an alternative "in vitro" diagnosis in the cases indicated. We found that its advantages were its low cost in the way of human and economical resources, its greater reliability in comparison with RAST, its simple administration and it being harmiess.

[Possible existence of retinal vascular disease in relatives of diabetic patients and its metabolic correlation]. / Estudio de la posible existencia de vasculopatía retiniana en familiares de diabéticos, y su correlación metabólica

The authors studied the possible presence of retinal vasculopathy in 31 patients with a diabetic father or mother. In 12 of them (38.7 per cent of the total number of patients) some degree of alteration in the glycemia curve and increased insulinemia were observed. Neither of these anomalies were related to sex of patients. Opthalmologic examination revealed diabetic retinopathy in 6.45 per cent of the patients, and the disease was only present in female patients. Among the 8 patients with diabetic glycemia curve (25.8 per cent of the total), only one (12.5 per cent of the diabetic patients, and 0.31 of the total) hand diabetic retinopathy. Diabetic retinopathy was not observed in any of the 4 non-diabetic patients with glucose load intolerance. I phase diabetic retinopathy was found in one subject (0.31 per cent of the total) with normal glucose and insulin tolerance.