Differentiation of acanthamoeba keratitis from other non-acanthamoeba keratitis: Risk factors and clinical features.

INTRODUCTION: Infectious Keratitis is one of the most common ocular emergencies seen by ophthalmologists. Our aim is to identify the risk factors and clinical features of Acanthamoeba Keratitis (AK). METHODS: This retrospective chart review study was conducted at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, and included all the microbial keratitis cases, male and female patients of all ages. The main outcome is the differentiation between various microbial keratitis types. RESULTS: We included 134 consecutive eyes of 126 persons. We had 24 cases of acanthamoeba keratitis, 22 bacterial keratitis, 24 fungal keratitis, 32 herpetic keratitis, and 32 bacterial co-infection. Contact lens wear was found in 33 eyes (24.6%). Among acanthamoeba keratitis patients, 73% were ≤ 39 years of age, and 73% were females (P <0.001). Also, in AK cases, epithelial defect was found in all cases (100%), endothelial plaques were found in 18 eyes (69.2%), 12 cases had radial keratoneuritis (46.2%), and ring infiltrate was found in 53.8% of AK cases. CONCLUSIONS: We determined the factors that increase the risk of acanthamoeba infection and the clinical characteristics that help distinguish it from other types of microbial keratitis. Our findings suggest that younger females and patients who wear contact lenses are more likely to develop acanthamoeba keratitis. The occurrence of epitheliopathy, ring infiltrate, radial keratoneuritis, and endothelial plaques indicate the possibility of acanthamoeba infection. Promoting education on wearing contact lenses is essential to reduce the risk of acanthamoeba infection, as it is the most significant risk factor for this infection.

Anterior segment migration of intravitreal dexamethasone implant in a patient with scleral fixation intraocular lens implant: a case report.

Corticosteroids are crucial for treating inflammatory ocular conditions. The development of dexamethasone revolutionized targeted ocular therapy. Ozurdex, a dexamethasone implant, effectively treats various eye conditions but carries risks such as implant migration. This is a case of anterior segment migration of intravitreal dexamethasone implant, Ozurdex, in a patient with scleral fixation intraocular lens implant in whom conservative management with supine positioning and pharmacologic pupil dilation can help retain the implant back in the vitreous. Patients at high risk of Ozurdex migration should avoid its use. Educate patients on the risk of implant migration and signs of migration to present immediately to an ophthalmology emergency department to avoid corneal damage. It is essential to identify high-risk patients before considering Ozurdex migration. In some cases, conservative management can be initiated while preparing for surgical removal.

The Perception of Spectacles Use Among the General Population in Ha'il Region, Saudi Arabia: A Cross-Sectional Study.

Purpose: The study aims to assess the perception of optical spectacles use among the Ha'il region population in Saudi Arabia. Patients and Methods: A cross-sectional survey was distributed via various social media applications to the residents of the Ha'il region. An online questionnaire was designed and included informed consent and questions assessing the participants' perceptions about wearing eyeglasses, contact lenses, and general eye health. Results: 32.4% of the participants think that long-term eyeglasses wearing worsens vision, and 43% think eyeglasses wearing improves vision. 75.2% believe that long-term use of glasses could cause lifetime dependency on eyeglasses. Regarding contact lenses, 45.9% believe that long-term wearing worsens vision, and 24.1% think long-term wearing of contact lenses improves vision. 60% think long-term use of lenses causes lifetime dependency on those contact lenses. Conclusion: Our results highlighted the misconceptions among the study population regarding wearing prescribed eyeglasses and contact lenses. Thus, education programs and media are warranted to correct the misconceptions about spectacles and raise the awareness about refractive errors and treatment options.

Prevalence and Risk Factors for Symptomatic Dry Eye Disease Based on McMonnies Questionnaire Among Medical Students, Saudi Arabia; a Cross-Sectional Study.

Purpose: Dry eye disease (DED) is a common ocular problem that worsens patients' quality of life. This study aimed to assess DED prevalence and risk factors among medical students at the University of Tabuk. Patients and Methods: This is an analytical, cross-sectional, survey-based study. An online questionnaire was distributed by email to all medical students at the University of Tabuk. A self-administered McMonnies questionnaire was used in the assessment. Results: We included 247 medical students who completed the questionnaire. Most participants were females (71.3%) and were <25 years old (85.8%). DED prevalence rate was 18.2% (95% CI=13.61% to 23.61%). Furthermore, DED was found to be significantly associated with the presence of irritation of eyes when waking up from sleep (OR=19.315), sleeping with partially opened eyes (OR=19.105), redness and irritation of the eyes when swimming in chlorinated fresh water (OR=7.863), and having prescription eyedrops or other dry eye treatments (OR=3.083). Conclusion: Our study at the University of Tabuk found that 18.2% of medical students had dry eye disease and identified the associated risk factors. Early diagnosis and treatment are crucial to prevent complications due to the high prevalence of DED.

Central Retinal Artery Occlusion in a Young Patient With a Hidden Unusual Sickle Cell Trait.

Sickle cell trait is considered a benign condition. Ophthalmic manifestations are infrequent but can result in significant visual deterioration. We present a case of a 33-year-old male, not known to have any medical illnesses, who presented to the ophthalmological emergency room complaining of a sudden onset of painless and profound left eye vision loss for 12 hours. The patient denied any medication use, past eye trauma, or surgery. On detailed ophthalmologic examination, the best-corrected visual acuity (BCVA) was 20/20 in the right eye and hand movement in the left eye. Dilated fundus examination of the left eye showed a central retinal artery occlusion (CRAO) with pale, white retinal swelling and a macular cherry-red spot. Fundus fluorescein angiography showed delayed arterial filling with persistently reduced macular perfusion. CRAO was diagnosed in an otherwise healthy young male. Systemic workup was negative except for protein electrophoresis, which showed sickle cell trait, and HbA1C was 7.8%. Later, atrophic macular changes with a pale optic disc were observed, and BCVA was reduced to light perception. CRAO in young patients amounts to diverse causes, which require extensive systemic workup. In addition, the concurrence of the sickle cell trait with diabetes mellitus might have a role in CRAO development.

Retinopathy of Prematurity as Multidisciplinary Approach, a Pediatricians Standpoint, and Practice.

PURPOSE: This study aims to measure the knowledge levels toward retinopathy of prematurity (ROP) among pediatricians covering neonatal intensive care units (NICUs) in the major hospitals in Tabuk, Saudi Arabia. To our knowledge, this is the first report to assess the awareness level of ROP in the NICU pediatricians in the region. PATIENTS AND METHODS: This is a quantitative, non-experimental, cross-sectional, descriptive study using self-administered electronic questionnaires to assess the knowledge level among NICU pediatricians at the main hospitals of Tabuk city. We used a self-administer online validated knowledge, attitude, and practice (KAP) questionnaire. A scoring system was implemented in the data analysis, depending on the correct chosen answers on the KAP questionnaire, to present the ROP knowledge level in the participants. RESULTS: The study included 41 NICU pediatricians. Most of the participants' age exceeded 40 years (51.2%). The majority were recruited from either King Salman Military hospital (34.1%) or King Khalid hospital (31.7%). The average frequency of preterm infants seen per month exceeded 15 infants among 41.4% of the respondents. Most pediatricians recognized the important treatment modalities available for ROP (92.7%); however, only 24.4% of them could recognize that 32 weeks or less is the gestational age of the screening criteria for ROP. The overall knowledge score ranged between 4 and 10, out of a possible maximum of 12 with a mean ± SD of (6.68±1.47). The majority (75.6%) believe that the ROP treatment can successfully prevent blindness. CONCLUSION: Our study demonstrated that the NICU pediatricians have good knowledge about the treatment modalities of ROP. However, their knowledge about the inclusion criteria of ROP screening was insufficient. Thus, we highlighted the necessity of raising the awareness level and the strict application of the clinical guidelines among NICU pediatricians and healthcare workers involved in managing ROP.

Amblyopia and Routine Eye Exam in Children: Parent's Perspective.

Amblyopia is a reduced best-corrected visual acuity of one or both eyes that cannot be attributed to a structural abnormality; it is a functional reduction in the vision of an eye caused by disuse during a critical period of visual development. It is considered the leading cause of visual defects in children. With early diagnosis and treatment, children with amblyopia can significantly improve their vision. However, if it is neglected and not treated during childhood, unfortunately, it permanently decreases vision. Therefore, prevention, detection, and treatment largely depend on parents. This article explores parents' perspectives on amblyopia and routine examination of their children's eyes. A cross-sectional study used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents. As a result, a total of 325 participants were included in our analysis. 209 (64.3%) were mothers, and 116 (35/7%) were fathers. The age groups were 35-50 years of age (61.5%), 20-34 years (23.4%), and older than 50 years (15%). Participants with a history of amblyopia numbered 23 (7.1%), and 39 had an amblyopic child (12%). A good awareness level of amblyopia among parents was found in only 10 (3%) participants, a fair awareness level in 202 (62%), and 113 (35%) participants were classified as having a poor awareness level of amblyopia. Only 13.8% of the parents took their children for yearly routine eye exams, while the majority (72%) took their children only if they had a complaint, and 14.2% took them for eye checkups only before school entry. In conclusion, parents' awareness of amblyopia in Tabuk City, KSA, was low. In addition, a limited proportion of parents reported consistently taking their children for routine eye exams. Therefore, raising awareness should be considered in public education regarding the disease.