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ObjectivesTo report central corneal thickness (CCT) measurements on patients requesting refractive surgery and to search for possible associations between CCT and patient's origin, age, sex, and preoperative data.SettingDepartment of Ophthalmology, Soroka University Medical Center, and Enaim Refractive Center, Beer-Sheva, Israel.MethodsSubjects were patients undergoing preoperative examination at our refractive centre during 2003. Patient's age, sex, preoperative CCT, refractive status, keratometry, and intraocular pressure (IOP) were obtained together with country of origin of the patients and their parents. Main outcome measures were CCT measurements and relationship between CCT and patient's origin and preoperative data.ResultsA total of 204 patients were included in the study. Patients of North African origin had statistically significantly thinner corneas than patients of other origins (518.9±31.5 vs. 545.4±30.4 μm in the right eye and 518.4±32.1 vs. 546.3±29.7 μm in the left eye; P<0.00001). Patients of North African origin were significantly older than patients of other origins (P=0.028). No differences were found when comparing for sex, intraocular pressure, refractive status, and keratometry. When multivariate analysis was performed patient's origin was the only independently associated factor associated with CCT.ConclusionsThis is the first work in reporting lower CCT in people of North African origin examined in a refractive surgery centre. Studies from similar populations are needed to confirm our results.Eye (2006) 20, 460–465. doi:10.1038/sj.eye.6701911; published online 6 May 2005 [ABSTRACT FROM AUTHOR]

PurposeTo elucidate whether BACTEC Peds Plus F broth, usually used for culturing body fluids in paediatric departments, can be used for corneal cultures from cases with clinically suspected infectious keratitis, and to compare yields between this method and traditional methods (blood agar, chocolate agar, a fungal media, and swab transport media).MethodsAll cases with newly diagnosed, nonviral, clinically suspected infectious keratitis with no prior antibiotic therapy, were cultured both in the BACTEC Peds Plus F broth and the traditional method. McNemar's test was used for pairwise comparisons of the rates of positive growth between the two groups.ResultsIn total, 30 eyes were included in this study. The growth rates for the traditional method and the BACTEC broth were similar (50.0 and 53.33%, respectively, P=1.0). The overall growth rate for the two methods combined was 73.33%, which is 45.29% higher than the reported yield in the literature (average of 50.47%).ConclusionsOur results show that BACTEC Peds Plus F broth can be used successfully in the work-up of clinically suspected infectious keratitis. The method has, apparently, several advantages over the ‘Traditional method:’ time-savings, as only one medium needs to be inoculated, transportation to the laboratory is simpler as there is no need for immediate incubation, and there is no need to keep and maintain a supply of fresh agar media. This method is especially suitable for office settings and remote clinics, but also can be used in hospital setting, as an adjunct, when available, to increase the growth yield.Eye (2006) 20, 215–220. doi:10.1038/sj.eye.6701858; published online 18 March 2005 [ABSTRACT FROM AUTHOR]

ObjectivesAlthough several works in the past have examined the effect of haemodialysis (HD) on intraocular pressure (IOP), reported findings, theories, and conclusions are very different. The objectives of this article are to resume the reported evidence of IOP changes during HD, to review the proposed hypothesis of HD influence on IOP, and to determine if ophthalmic examination is imperative in HD patients.MethodsWe analysed the peer-reviewed English literature and selected all possible relevant articles.ResultsThe influence of HD on IOP is not clear, and even in recent studies opposite findings can be found.ConclusionsFuture studies are needed to clarify the effects of HD on IOP. In patients with glaucoma or with predisposed narrow angles, or eyes with impaired aqueous outflow, the possibility of acute IOP rise during HD could be much more frequent than in normal patients. So in these patients, a more strict ophthalmic scheduled examination seems to be feasible.Eye (2005) 19, 1249–1256. doi:10.1038/sj.eye.6701755; published online 5 November 2004 [ABSTRACT FROM AUTHOR]

Vision impairment can be a debilitating condition, affecting not only the social, emotional, mental and physical functioning of an individual, but also the individual's ability to perform basic and instrumental activities of daily living. Scant knowledge exists about visual impairment among people with mental retardation. The results of this prospective study were based on interviews and eye ophthalmologic screening of 106 adults with a moderate level of mental retardation, ranging in ages from 19 to 62 years. Findings show that only 3% of those interviewed recalled having had an eye examination, yet 24% reported that they had visual problems. In spite of the high probability of visual problems for this group, only 13% reported having glasses and 20% said they needed glasses; 92% reported watching television but 22% stated they had difficulty seeing the TV; 62% of the respondents reported that they cook for themselves but 17% reported that visual problems affected their ability to perform this activity. Medical eye screening of the participants found that 79% had ocular problems - 42% were in need of eyeglasses, 12% had a cataract problem requiring surgery and 25% needed outpatient care at the local hospital. The study findings are discussed in terms of policy implications and service provision, and recommendations are made for additional research. [ABSTRACT FROM AUTHOR]

The magnitude of eye related disorders among people of African origin is considerable, especially those from countries which have experienced the ravages of war, drought, severe food shortages, malnutrition, poor sanitation and other related conditions. One such country that stands out among the rest is Ethiopia. During the last decade, thousands of Ethiopian Jewish people left the destitution of that country for Israel. The transition process for many has not been an easy one, especially for the elderly who for many reasons have found themselves struggling to adjust. This article describes a coordinated response by community, hospital and university-based medical and social work professionals and volunteers to address the problem of eye disorders among Ethiopian elderly. The model of intervention, while at the initial stages of development, appears to have a positive impact on the quality of life of Ethiopian elderly and their community. [ABSTRACT FROM AUTHOR]

We have begun a randomized study of tele-ophthalmology. General practitioners in two participating health centres in the Negev region of Israel, serving a local population of 40,000, were invited to participate. The study group consisted of 50 consecutive patients attending the general eye outpatient clinic and 50 consecutive patients suffering from various retinal diseases attending a hospital outpatient clinic. The initial assessment was carried out via the tele-ophthalmology system. There was then a face-to-face re-examination of the same patients, in randomized order, by the same ophthalmologist on the same day, at an outpatient ophthalmology clinic. [ABSTRACT FROM AUTHOR]

Purpose: To compare the outcomes of accelerated photoactivated chromophore for keratitis corneal cross-linking (PACK-CXL) as an adjunct treatment for bacterial keratitis (PACK-CXL plus standard antibiotic therapy) for patients receiving only standard antibiotic therapy., Methods: Retrospective cohort study of outcomes of patients with moderate infectious presumed bacterial keratitis (ulcer diameter 2 to 7 mm and stromal depth < 300 µm) were compared before and after initiation of a new treatment protocol of PACK-CXL in addition to standard antibiotic treatment., Results: A total of 70 eyes of 70 patients were included: 39 eyes in the PACK-CXL plus antibiotic (PACK-ABX) group and 31 eyes in the antibiotic only (ABX) control group. The PACK-ABX group showed shorter times to complete reepithelialization (9.3 ± 6.0 vs 16.0 ± 12.7 days, P = .01) and did not require tectonic emergency keratoplasty (0% versus 19.4%, P = .006). The PACK-ABX group also showed a higher percentage of eyes with complete reepithelialization in 6 days or less (46.2% vs 6.5%, P < .001) and a trend for shorter hospitalizations (6.3 ± 5.0 vs 8.5 ± 4.5 days, P = .06). A multivariate analysis controlling for age showed that PACK-ABX treatment remained significantly associated with early ulcer reepithelialization (odds ratio = 0.09, 95% confidence interval = 0.02 to 0.48, P = .005)., Conclusions: This study validates previous findings regarding the use of accelerated PACK-CXL in the treatment of bacterial keratitis. Adding PACK-CXL improved clinical outcomes (reducing healing time) when compared to antibiotics alone. [J Refract Surg. 2020;36(4):258-264.]., (Copyright 2020, SLACK Incorporated.)

Background: Systemic complications of intravitreal anti-vascular endothelial growth factor agents are relatively uncommon but highly significant., Objectives: Primary objective : To assess the risk for thromboembolic events following intravitreal bevacizumab injection in neovascular age-related macular degeneration patients by a large population-based study. Secondary objective : To analyze the association between injection frequency and the risk for thromboembolic events, the time interval between the injection and the thromboembolic events, and the influence of chronic diseases on complications rate., Design: A retrospective cohort study., Methods: Consecutive neovascular age-related macular degeneration patients receiving intravitreal bevacizumab at Soroka University Medical Center from December 2005 to December 2013 were included. Thromboembolic events analyzed included acute coronary syndrome, acute myocardial infarction, stroke, deep vein thrombosis, and pulmonary embolism. The thromboembolic event rate was compared 2 years prior and 2 years after the initial intravitreal bevacizumab injection., Results: A total of 2102 patients were included. Acute coronary syndrome and stroke rate were higher 2 years after intravitreal bevacizumab (p = 0.03 and p = 0.01, respectively). No statistical significant difference was found for the rest of thromboembolic events. Patients older than 80 years and patients receiving less than six intravitreal bevacizumab injections were more likely to experience stroke. Patients with known cardiovascular risk factors before starting injections did not develop significant more thromboembolic events., Conclusion: In our study population, patients treated with intravitreal bevacizumab were significantly more likely to experience stroke during 2 years after first injection.

Purpose: To evaluate the safety and efficacy of accelerated contact lens-assisted cross-linking (A-CACXL) for patients with keratoconus and thin corneas., Methods: This retrospective study included consecutive patients undergoing A-CACXL for progressive keratoconus from 2015 to 2017. Patients with a minimum corneal thickness of 400 µm or less after epithelium removal who underwent A-CACXL (9 mW/cm 2 for 10 minutes, using iso-osmolar 0.1% riboflavin solution and a 90-µm thick, daily disposable bandage soft contact lens) with a follow-up time of 12 months or more were included. The main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuity and minimum corneal thickness at the last visit. Progression (increase) and flattening (decrease) were defined as a change of 1.00 diopters (D) or greater in maximum keratometry or 1.50 D or greater in mean keratometry., Results: Overall, 24 eyes of 24 patients were included with a follow-up time of 18.2 ± 6.3 months and a mean minimum corneal thickness, after epithelial debridement, of 353.13 µm. There was a significant improvement in UDVA (P = .009), maximum keratometry (P = .03), anterior steep keratometry (P = .04), anterior astigmatism (P = .02), and posterior astigmatism (P = .04) with no significant change in minimum corneal thickness (P = .11). There was a significant improvement in UDVA (0.90 ± 0.63 to 0.64 ± 0.47 logMAR, P = .009), maximum keratometry (61.20 ± 6.30 to 59.90 ± 5.70 D, P = .03), anterior steep keratometry (55.10 ± 3.90 to 54.50 ± 4.10 D, P = .04), anterior astigmatism (5.50 ± 2.40 to 4.60 ± 2.10 D, P = .02), and posterior astigmatism (0.90 ± 0.40 to 0.80 ± 0.40 D, P = .04) with no significant change in minimum corneal thickness (from 399.8 ± 30.7 to 391.0 ± 43.8 μm, P = .11). Flattening occurred in 45.8% (n = 11) and progression in 20.8% (n = 5). There were no serious adverse events. Persistent clinically significant stromal haze occurred in one case and completely resolved by 6 months. There was no significant change in endothelial cell density (P = .10)., Conclusions: In patients with keratoconus and thin corneas, A-CACXL halted keratoconus progression in 80%, led to flattening in 45%, and significantly improved UDVA and keratometry values without any evidence of damage to the corneal endothelium or permanent adverse events. [J Refract Surg. 2019;35(10):642-648.]., (Copyright 2019, SLACK Incorporated.)

Objective: To evaluate the effect of intraocular lens (IOL) implantation on the development of secondary glaucoma after cataract surgery in pediatric patients., Design: Retrospective case series study., Methods: This study reviewed the medical records of children under 16 years of age who had undergone cataract surgery from 1996 to 2016 for congenital or developmental cataract. In every child an IOL was implanted in the primary surgery. Data collected included demographic information, age at cataract diagnosis and at surgery, surgical procedure, and postoperative follow-up of refraction, cup-to-disc ratio (C/D), intraocular pressure (IOP), and associated systemic and ocular anomalies. Patients with risk factors for glaucoma were excluded from the study., Results: Of the 255 children below age 16 years who underwent cataract extraction surgery with primary IOL implantation, 73 (124 eyes) met the inclusion criteria. Follow-up ranged from 4 to 18 years. Only 1 patient (0.8% of the 124 eyes) developed glaucoma in 1 of his 2 operated eyes; the surgeries were performed at 10 months, 1 week apart, and glaucoma was diagnosed 4 months later. One patient had suspected glaucoma in both eyes (incidence of 1.6%). Both these children were of Bedouin origin., Conclusion: IOL implantation, by itself, is not a risk factor for development of secondary glaucoma after cataract surgery in a population below 16 years of age., (Copyright © 2019 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)

Purpose: To describe a previously unreported phenomenon of idiopathic edematous punctal stenosis (IEPS) with chronic epiphora, presenting almost exclusively in young female patients., Methods: A review of patients who presented with chronic epiphora and edematous punctal stenosis of unknown cause (IEPS) at the outpatient clinic of Soroka Medical Center between August 2011 and August 2015. Associated findings from clinical examination were recorded., Results: A total of 32 patients with IEPS were documented. There were 30 female and 2 male patients. Average age at diagnosis was 37.6 ± 13.4 years, range 19-63 years, median 35 years. Temporary alleviation of symptoms was reported in subjects treated with topical steroids (43.8%), tacrolimus ointment (15.6%), and matrix metalloproteinase inhibitors (3.1%). No improvement in symptoms was reported in 37.5% of patients. Symptoms were bilateral in 78.1% of the patients. Spontaneous resolution was achieved in only 6.3% (2/32)., Conclusions: IEPS accompanied by chronic epiphora has not been characterized to date. Our data show a clear predominance of females, most of them in their fertile years.