Pattern of Pediatric Ocular Trauma in Kashan

Background: Ocular trauma is a significant health problem in pediatric patients. Objectives: The aim of this study was to analyze the characteristics of ocular-trauma-related hospitalization of children in Kashan. Patients and Methods: This descriptive, cross-sectional study included 131 children aged less than 16 years with ocular trauma, who were admitted to the Matini Hospital at the Kashan University of Medical Sciences between April 2006 and March 2009. After admission, detailed ocular examination was performed, and their ocular trauma was classified according to the International Ocular Trauma Classification and Birmingham Eye Trauma Terminology systems. Results: The mean age of the patients was 7.8 ± 2.2 years (age range, 0–16 years), and the male to female ratio was 5:1. The most common cause of admission was hyphema (38.1%), followed by corneoscleral laceration (27.5%). Ocular trauma most commonly occurred at home (43%), and 69% of the patients presented to the emergency room within 24 h of injury. In 30% of the patients, initial visual acuity at the time of presentation was less than 20/200. Conclusions: Ocular trauma is a major cause of unilateral blindness, especially in young boys, and hence, preventive measures and education is required

Blood vessels extraction from fundus fluorescein angiogram in Curvelet domain

Abstract: This paper proposes a new method for blood vessel segmentation and extraction based on Curvelet domain and Hough transform. Diabetic retiopathy is an important human visual disease which leads blindness. Fluorescein angiography has become indispensable in the diagnosis and evaluation of many retinal conditions. Here, we introduced a novel and efficient algorithm for automated retinal blood vessels segmentation in fluorescein angiography images. The proposed method in this paper consists of three main steps that in the first step, the input image to create an image with high contrast and uniform background by becoming curvelet transform under processing. Then, in the next step Kirschs templates are used for edge detection in retinal images and arithmetic mean filter is applied to the image. Finally, Hough transform is applied to the image obtained from the previous step to remove non-information parts. Experimental results show the superiority of the proposed method against competing approaches. Keywords: Transforms,Diabetes,Image edge detection,Biomedical imaging,Retinopathy,Blood vessels,Retin

External Ocular Surface Bacterial Isolates and their Antimicrobial Susceptibility Patterns among Pre-operative Cataract Patients at Mulago National Hospital in Kampala, Uganda.

Endophthalmitis is a severe complication of cataract surgery which leads to high ocular morbidity and visual loss even with antibiotic treatment. Bacterial ocular floras are the implicated causative agents. This study was undertaken to evaluate the external ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital. This cross sectional study enrolled consecutively 131 patients scheduled for routine cataract surgery in the Department of Ophthalmology at Mulago National Hospital in Kampala, Uganda. Eyelid margin and conjunctival swabs were collected and processed using standard microbiological procedures to identify bacterial isolates and their respective antimicrobial susceptibility patterns. Of 131 patients involved (mean age 63.3 ± 14.5 years), 54.2% (71/131) were females. The eyelid margin and conjunctival samples were culture positive in 59.5% (78/138) and 45.8% (60/138) respectively. The most common organisms identified were Coagulase-negative Staphylococci (CoNS) [65.9% (91/138)] and Staphylococcus aureus [21.0% (29/138)]. CoNS showed the highest resistance to tetracycline (58.2%, 53/91) and erythromycin (38.5%, 35/91), whereas in S. aureus the resistance to tetracycline and erythromycin were 55.2% (16/29) and 31.0% (9/29) respectively. Methicillin resistant CoNS (MRS) and Methicillin resistance S. aureus (MRSA) were 31.9% (29/91) and 27.6% (8/29) respectively. There were low resistance rates for CoNS, S. aureus and other bacterial isolates to ciprofloxacin (11.1%-24.2%), gentamicin (5.6-31.0%), tobramycin (17.2% -25.3%) and vancomycin (0.0%). CoNS and S. aureus are the most common bacterial isolates found on the external ocular surface of the pre-operative cataract patients. Ciprofloxacin, gentamicin, tobramycin and vancomycin showed the lowest resistance rates to all bacterial isolates, therefore may be used to reduce bacteria load in the conjunctiva sac among cataract patients prior to surgery

Retinopathy surgery in patients with diabetic ophthalmoplegia in the City of Kashan

Diabetic ophthalmoplegia is a complication of diabetic mellitus. The purpose of this study was to examine the clinical characteristics and severity of retinopathy in diabetic patients with cranial nerve (CN) 3,4 and or 6 palsies involvement. This descriptive study included 96 patients with diabetic ophthalmoplegia who were treated in Matini hospital of Kashan, Iran during the years 2004-2012. Demographic and clinical data including type of DM, stage of diabetic retinopathy, involved cranial nerve, and duration of resolution were examined. Statistical analysis was performed by SPSS 16.0 Software. The result showed that 96 patients 54(56) were male and 42 (44) were female. The frequency of 6th nerve involvement was 50(52), 3rd nerve 41(43), and 4th nerve 5(5.2). There was no statistically significant association between the stage of diabetic retinopathy (DR) and diabetic ophthalmoplegia (P=0.92). Based on the result of this study, diabetic ophthalmoplegia more frequently involves 6th cranial nerve and rarely 4th nerve. Diabetic patients with cranial nerve palsies (3,4 or 6) may have mild retinopathy. This may imply a different pathophysiologic mechanism for these two microvascular complications of DM

Pattern of ocular trauma among the elderly in Kashan, Iran

Objective: Ocular trauma is a common cause of visual impairment and accounts for 38 to 52 of all patients presenting as ophthalmic accident and emergency cases to the hospital. The purpose of this study is to describe the pattern of ocular injuries that leads to hospitalization in the elderly in Kashan, Iran. Methods: In the retrospective consecutive case series, a total of 94 geriatric patients (� 65 years) who admitted and underwent management for ocular trauma from April 2001 to March 2011 at Matini Hospital of Kashan, the only center of eye surgery in the region of Kashan, were reviewed. The items include age, sex, injury mechanism, site and extent of damage, presenting and final best corrected visual acuity at least 3 months after trauma, which were reviewed and analyzed with SPSS software. Results: During the 10 years, 94 eyes of 94 patients with ocular trauma were included. Mean age of patients was (77.5±5.1) years (range 65 to 102 years). Male to female ratio was 2.76. The mechanism of ocular injury included sharp trauma in 56 patients (59.6) and blunt in 38 patients (40.4). Trauma occurred mostly in males (69 patients, 73.4) and at the work place (38 patients, 40.4). On admission the visual acuity in 50 patients (53.2) with damaged eyes was light perception to hand motion. While the final best corrected visual acuity in 36 patients (38.3) was better than hand motion. Conclusion: Ocular trauma is a serious cause of visual impairment in the elderly. Appropriate and timely management may improve their visual prognosis

Visual acuity following cataract surgery in monocular patients referred to Matini hospital in Kashan, 2006-2011

Background: This study was carried out to determine the visual acuity and complications following cataract surgery in a consecutive case series of functionally (<20.200) versus completely (no light perception) monocular patients. Materials and Methods: This prospective study was performed on all monocular patients with cataract and best corrected visual acuity (BCVA) of less than 20/200. Snellian visual acuity, preoperative and 3 months postoperative visual acuity, intraoperative complications and cause of decreased vision in the fellow eye were recorded. All patients were followed up at least 3 months after the surgery. Results: Mean age of patients was 52±13 years. Fifty-eight percent of the patients were female. The most common cause for decreased vision in group I were diabetic retinopathy (32.4%) and trauma (31%), but in group II were diabetic retinopathy (41.7%), age-related macular degeneration (18.6%) and trauma (14.2%). Visual acuity three months after operation was ≥20/40 in 58% and 42% of the operated eyes in groups I and II, respectively. Results showed no significant difference in visual acuity between the two groups after three months. Conclusion: Phacoemulsification with intraocular lens implantation is safe in monocular patients and can improve visual acuity

EVALUATION OF EXCESSIVE BLINKING IN CHILDHOOD

Abnormalities of blinking in childhood are not uncommon. To determine the characteristics and causes of excessive blinking, this prospective, non–comparative consecutive case series study was carried out. In outpatient clinics of ophthalmology and neurology of our hospital, 60 children aging 2-16 years old with excessive blinking were examined. Detailed ophthalmologic and neurologic evaluation (history and physical examination) was done and etiology of excessive blinking and demographic characteristics of patients were determined. Of 60 children, 39 (65%) were male and 21 (35%) female. The most common causes were habitual tic in 25 (41.7%), uncorrected refractive error in 20 (33.3%), ocular surface abnormalities such as blepharitis in 6 (10%), psychogenic in 6 (10%) and central nervous system diseases in 3 (5%) cases. Excessive blinking in pediatric age group may occur because of a large number of potential problems. Most cases are caused by benign and self–limiting conditions. The causes can usually be determined after careful history and clinical examination. Neuroimaging techniques are not necessary to be done routinely

Prevalence and Risk Factors for Diabetic Retinopathy in Diabetic Patients of Kashan Diabetic Center in 2002-2003

Background: Diabetes mellitus has a high prevalence in our country. It is usually complicated with diabetic retinopathy. The aim of the present study was to determine the prevalence and risk factors of diabetic retinopathy in patients referring to Kashan Diabetic Center in 2002-2003.Materials and Methods: In this descriptive study, a thorough ocular examination was performed on 200 randomly selected patients from Kashan Diabetic Center. Stage of retinopathy was determined in patients. The risk factors such as age, sex, duration of disease and type of diabetes were considered.Results: Diabetic retinopathy was found in 72 patients (36). Sixty-two patients (31 of examined patients) were in non-proliferative phase. There was a significant association between diabetic retinopathy and duration of disease (P=0.00006), creatinin level (P=0.002), blood urea (P=0.002), fasting glucose (P=0.05) and sex (P=0.044). Other risk factors such as blood cholesterol and triglyceride level, hypertension, type of diabetes, and ischemic heart disease did not show a significant association with diabetic retinopathy.Conclusion: With respect to the high prevalence of diabetic retinopathy, controlling the blood sugar, urea, creatinin, blood pressure, and fat level can influence the occurrence of diabetic retinopathy

Glucocorticosteroids

Glucocorticosteroids are mainly used for inflammatory and non-inflammatory diseases as well as cancers. Unawareness of their function, indications and side effects may lead to patient's hazard. Thus, medical staff should be completely familiar with these drugs.Objectives: Promoting medical staff knowledge about glucocorticoids' side effects, function and indications. Promoting their knowledge about the signs and symptoms of withdrawal and approaches to drug tapering