Clinical outcomes and epidemiology of intraocular foreign body injuries in Cork University Hospital, Ireland: an 11-year review.

BACKGROUND/AIMS: To describe the epidemiology, outcomes, and prognostic factors of intraocular foreign body (IOFB) injuries at a tertiary ophthalmic referral centre in Cork University Hospital, Ireland. METHODS: A retrospective review of 23 eyes with IOFB that presented to Cork University Hospital (CUH) from January 2009 to December 2019 was performed. The mechanism and characteristics of IOFB injury were all noted. This data was collated and analysed to ascertain the epidemiology of IOFB injury in CUH and to describe the prognostic factors affecting visual outcome following IOFB injury. RESULTS: There was a 100% male prevalence. The mean age was 37.4 years. The majority of IOFBs were metal in nature and were acquired by hammering, often while working and frequently in the absence of personal protective equipment (PPE). The route of entry for the IOFB was via the cornea in 70% of cases. Fifty-two percent of cases were clinically detectable and 43% of cases were only identifiable on CT (computed tomography) imaging. Eighty-seven percent of cases underwent surgery on the same day as presentation. There was no incidence (0%) of endophthalmitis. Seventeen percent of cases developed post-operative retinal detachment (RD). The mean pre-operative VA was 0.79 LogMAR (6/38 Snellen equivalent-SE) compared to a mean VA of 0.58 LogMAR (6/24 SE) following surgery. CONCLUSIONS: This review provides important epidemiological data for IOFB injuries in Ireland. It also adds some useful information to the literature in relation to prognostic factors and lens status post IOFB injury.

Ophthalmic outcomes following neonatal hypoxic ischaemic encephalopathy; oculomotor, biometric and refractive data in early childhood.

OBJECTIVES: To investigate the functional and structural impact of neonatal hypoxic ischaemic encephalopathy (HIE) on childhood visual development. METHODS: In a prospective study, the neurocognitive outcomes of 42 children with a history of neonatal HIE were assessed serially up to 5 years. For the ophthalmic component of the study, visual, refractive, orthoptic and ocular biometry measurements were obtained in 32 children, with axial length measurements estimated using the IOLMaster. RESULTS: For the 32 children who completed the ophthalmic component of the study, severity of HIE grade was determined to be mild, moderate, or severe in 18 (56.3%), 13 (40.6%), and 1 (3.1%) cases, respectively. One (3.1%) child was classed as visually impaired. Twelve (37.5%) were found to have ametropia. Mean (±SD) axial length was 22.09 (±0.81) mm, within the normal range for the age of this cohort. Seven of the 42 (16.7%) children who were involved in the larger neurodevelopmental arm of the study had clinical evidence of a squint. There was no correlation between the severity of HIE grade at birth and axial length or occurrence of squint. CONCLUSIONS: Neonatal HIE is associated with a higher incidence of squint compared with the general paediatric population. This occurred irrespective of severity of HIE grade. The ocular biometry measurements were consistent with published normative data, and no significant difference in ocular biometry was demonstrated between HIE severity groups.

Recent trends in chlamydial and gonococcal conjunctivitis among neonates and adults in an Irish hospital.

BACKGROUND: Chlamydia trachomatis and Neisseria gonorrhoeae are two important and frequently overlooked causes of neonatal and adult conjunctivitis. OBJECTIVES AND METHODS: In order to improve primary treatment, prevention, and control of infection caused by these organisms, an analysis of all cases presenting from July 2002 to December 2006 at a major Irish regional teaching hospital was performed. RESULTS: There were 51 cases of conjunctivitis in total. Among neonates and adults, C. trachomatis was the most common cause of conjunctivitis. Of the adult patients, 75% were men. The annual incidence of adult chlamydial conjunctivitis increased yearly from 2002 and correlated with an overall increase in genital chlamydia infection in the region. Neonatal chlamydial conjunctivitis has an overall incidence of 0.65/1000 live births and is continuing to rise annually. In 2006, gonococcal conjunctivitis accounted for 20% of all cases of conjunctivitis caused by sexually transmitted bacteria presenting to our hospital. CONCLUSIONS: The recent increase in the incidence of gonococcal keratitis serves to remind us that this important infection should be borne in mind when treating cases of purulent conjunctivitis. The diagnosis of chlamydial and gonococcal conjunctivitis requires a high index of suspicion and prompt treatment with systemic antibiotics.

Effects of autologous platelet concentrate and serum on retinal wound healing in an animal model.

BACKGROUND: The beneficial effects of adjuvant treatment with agents such as autologous platelet concentrate (APC) or autologous serum (AS) in the surgical management of macular holes remain uncertain. The purpose of this study was to determine the histological changes induced by these agents compared with control on retinal wound healing in an animal model. METHODS: The right eyes of 51 pigmented rabbits were used. Under anaesthesia, full-thickness sensory retinal incisions 2 mm in length were made into avascular retina down to the level of the retinal pigment epithelium using a 23-gauge needle via a superotemporal sclerotomy. APC, AS or sterilised balanced salt solution was placed directly over the wound site. Animals were killed at 3, 7 or 14 days and the wounds examined immunohistologically. Proliferating cell nuclear antigen (PCNA) was used to detect proliferating cells. RESULTS: No difference was observed between serum-treated eyes and control eyes. A greater displacement or migration of cells toward the retinal surface was consistently found in the APC-treated wounds than in control wounds. These cells were of mixed origin but appeared to arise predominantly from the outer nuclear layer. A significantly greater number of PCNA-staining cells was found in the platelet-treated group than in controls at 3 days (P=0.038), 7 days (P=0.039) and 14 days (P=0.038). CONCLUSION: We have demonstrated a significantly greater proliferative cellular response in the healing of retinal wounds with the use of platelet concentrate than in control wounds. We consider that this model may be used in further studies on the effects of other agents on retinal wound healing.