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Myopic Patients (myopic + patient)
Selected AbstractsThe content of optometric eye examinations for a young myope with headachesOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 5 2008Rakhee Shah Abstract Background:, A recent review found standardised patient (SP) methodology to be the gold standard methodology for evaluating clinical care. We used this to investigate the content of optometric eye care for a young myopic patient with headaches suggestive of migraine. Methods:, We recruited 100 community optometrists who consented to be visited by an unannounced actor for an eye examination and to have that eye examination recorded. The actor received extensive training to enable accurate reporting of the content of the eye examinations, via an audio recording and a checklist completed for each clinical encounter. The actor presented as a 20-year-old student seeking a private eye examination and complaining of symptoms suggestive of migraine headaches. The results of each clinical encounter were recorded on a pre-designed checklist based on evidence-based reviews on headaches, clinical guidelines and the views of an expert panel of optometrists. Results:, The presence of headache was detected in 98% of cases. Eight standard headache questions were considered to be the gold standard for primary care headache investigation. Although none of the optometrists asked all of these questions, 22% asked at least four of the eight questions. Sixty-nine per cent of practitioners asked the patient to seek a medical opinion regarding the headaches. The proportion of the tests recommended by the expert panel that was carried out varied from 33% to 89% and the durations of the eye examination varied from 5 to 50 min. Conclusion:, SP encounters are an effective way of measuring clinical care within optometry and should be considered for further comparative measurements of quality of care. As in research using SPs in other healthcare disciplines, our study has highlighted substantial differences between different practitioners in the duration and depth of their clinical investigations. This highlights the fact that not all eye examinations are the same and that there is no such thing as a ,standard sight test'. We recommend that future optometric continuing education could usefully focus on migraine diagnosis and assessment. [source] Long-term biomechanical properties after collagen crosslinking of sclera using glyceraldehydeACTA OPHTHALMOLOGICA, Issue 8 2008Gregor Wollensak Abstract. Purpose:, Chemical crosslinking by glyceraldehyde has been shown to increase significantly the biomechanical rigidity of sclera. It might therefore become an option for a sclera-based treatment of progressive myopia. The present pilot study was designed to test the long-term biomechanical efficiency of the new crosslinking method. Methods:, Six Chinchilla rabbits were treated with sequential sub-Tenon's injections of 0.15 ml 0.5 m glyceraldehyde, which were given in the supero-nasal quadrant of the right eye (OD) five times over 14 days. The rabbits were killed 4 months and 8 months after crosslinking treatment, respectively. Biomechanical stress,strain measurements of scleral strips from the treatment area were performed and compared to non-treated contralateral control sclera using a microcomputer-controlled biomaterial testing device. In addition, the eyes were examined histologically by light microscopy to evaluate possible side-effects. Results:, Following the crosslinking treatment, the ultimate stress was 10.2 ± 2.3 MPa after 4 months and 8.5 ± 2.2 MPa after 8 months versus 2.4 ± 0.3 MPa in the controls (increases of 325% and 254.17%, respectively); Young's modulus was 104.6 ± 13.7 MPa after 4 months and 53.2 ± 5.2 MPa after 8 months versus 9.6 ± 1.3 MPa in the controls (increases of 989.6% and 554.17%, respectively); and ultimate strain was 15.8 ± 1.5% after 4 months and 24.1 ± 0.7% after 8 months versus 38.4 ± 4.6% in the controls (decreases of 58.84% and 37.24%, respectively). Histologically, no side-effects were found. Conclusion:, Our new method of scleral collagen crosslinking proved very efficient in increasing scleral biomechanical strength over a period of up to 8 months. Glyceraldehyde can be applied easily by sequential parabulbar injections. Before clinical application in myopic patients, a study in an animal myopia model is recommended. [source] Longterm findings in peripapillary crescent formation in eyes with mild or moderate myopiaACTA OPHTHALMOLOGICA, Issue 6 2008Mitsuru Nakazawa Abstract. Purpose:, To describe early changes of optic disc deviation and peripapillary crescent formation in eyes with mild or moderate myopia. Methods:, We carried out a retrospective review of medical records and fundus photographs. We evaluated serial fundus photographs taken in 10 patients with mild or moderate myopia. We observed longterm changes in optic disc areas by creating video files using these photographs and Photoshop® and Windows Movie Maker® software. The distance between the fovea and the temporal edge of the optic disc was measured in each photograph and any gradual changes in distance between these in the same patient were regarded as representative of optic disc deviation. Correlations between optic disc deviation (0,34.5% disc diameter) and either progression of myopia (, 0.75 D to 6.25 D) or length of follow-up (21,98 months) were statistically examined. Results:, On video files, the optic disc appeared to gradually deviate towards the nasal side and the myopic crescent developed gradually in the temporal side of the optic disc in most myopic patients. A significant correlation was found between optic disc deviation and progression of myopia (r2 = 0.61, p < 0.0001), but no correlation was detected between disc deviation and follow-up period (r2 = 0.055, p = 0.33). As optic disc deviation progressed, the peripapillary crescent became larger. Conclusions:, The optic disc appears to deviate mostly nasally as myopia progresses and the peripapillary crescent forms as a result of optic disc deviation in eyes with mild or moderate myopia. [source] Computer-assisted dosage calculation for strabismus therapy in myopic patientsACTA OPHTHALMOLOGICA, Issue 1 2008Martina Koch Abstract. Purpose:, The published dosage recommendations for the surgical correction of horizontal strabismus in non-myopic patients show large, unexplained differences. For patients with high myopia, the situation becomes even more complex because the increase in the size of the bulb also affects the geometry of the oculomotor muscles. In this study, we wanted to investigate whether computer simulations of the oculomotor plant can be used to find accurate surgical parameters. Methods:, In a retrospective study, we investigated pre- and postoperative strabismus patterns in 13 patients affected by convergent (seven patients) or divergent (six patients) strabismus and high myopia. Postoperative checks were made 1 day, 1 week, 3 months and 1,6 years after the operation. For each patient, we simulated the presurgical strabismus pattern with SEE++ (see ,Further Information' for manufacturer details), a biomechanical simulation program of the oculomotor plant. The individual results of the simulations were then compared to the measured postoperative strabismus patterns. Results:, We found a trend of under-correction in the postoperative situation, resulting in four patients having a large remaining strabismus angle of more than 5 degrees. The computer simulations were able to reproduce this under-correction, and suggested an increase in dosage. Conclusion:, We conclude that realistic biomechanical simulations of the oculomotor plant can predict the postoperative result for myopic patients accurately. The results of the computer simulation correlate well with the postoperative outcome of the patient. [source] LASIK after retinal detachment surgeryACTA OPHTHALMOLOGICA, Issue 3 2006Mohsen Farvardin Abstract. Purpose:,To compare, in the same individuals, the safety and efficacy of laser in situ keratomileusis (LASIK) in eyes with and without previous retinal detachment surgery. Methods:,In a prospective clinical trial, seven myopic patients who had previously undergone scleral buckling surgery in one eye underwent conventional LASIK surgery in both eyes. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, Orbscan topography and pachymetry were recorded before and 1, 3, 6 and 12 months after surgery. The eyes were divided into two groups: group 1 consisted of eyes that had undergone previous surgery for retinal detachment, and group 2 consisted of the fellow eyes of the same patients, which had not undergone any previous ocular surgery. Student's t -test for match-paired data was used to evaluate the significance of differences. Results:,LASIK was performed successfully in all patients. The UCVA improved in all eyes in both groups. The mean change in the spherical equivalent between 1 and 12 months after LASIK surgery was 1.7 ± 1.1 and 0.6 ± 0.5 diopter in groups 1 and 2, respectively (p = 0.019). Conclusion:,LASIK may be considered for treatment of myopia in eyes that have had previous surgery for retinal detachment. However, the risk of regression may be higher in such eyes than in eyes with no previous scleral buckling surgery. [source] | ||||||||||