BACKGROUND:The information about dry eye epidemiology in Saudi Arabia is few in literature.PURPOSE:To estimate the prevalence and identify determinants of dry eye symptoms (DES) in Al-Ahsa, Saudi Arabia.METHODS:Using a multi-stage proportionate sampling technique, Saudis of both genders from 6 urban and 4 rural Primary Health Care centers in Al-Ahsa were enrolled. They were interviewed to gather data on sociodemography, symptoms of dry eye, factors potentially related to dry eye, and chronic comorbidities. If one or more of DESs present often or constantly, we labeled the person with DES.RESULTS:We examined 1858 Saudi adults with mean age of 39.3 ± 14.1 years. The age-adjusted prevalence of DES was 32.1% (95% confidence interval [CI] = 30.0–34.3). Multivariate logistic regression analysis showed that female gender (adjusted odds ratio [aOR] = 2.1, 95% CI = 1.7–2.6), older age (>56 years; aOR = 1.5, 95% CI = 1.0–2.1), current smoking (aOR = 1.4, 95% CI = 1.1–1.8) and history of diabetes mellitus (aOR = 1.5, 95% CI = 1.2–2.0) were significantly associated with DES. Nonsignificant variables included residence (urban/rural); work status; wearing contact lenses; multivitamin use; caffeine use; history of trachoma, hypertension, bronchial asthma, coronary artery disease, thyroid disease, arthritis, hemolytic blood diseases (sickle cell-thalassemia), gout, and osteoporosis.CONCLUSION:DES are highly prevalent among the adult population of Al-Ahsa. Females, persons more than 55 years of age, smokers and diabetics were associated to DES.

Background The recommended weight of schoolbags is less than 10-15% of the body weight. Heavy schoolbags may result in musculoskeletal and psychological problems among primary school children. This study was conducted to assess the weight of school bags in relation to primary school children weight, and to look for the prevalence of back pain among them in Al-Ahsa, Saudi Arabia. Methods A total of 2567 school children were included in this study both from rural and urban areas of Al-Ahsa, Saudi Arabia. A cross sectional survey was conducted in which a pre-tested questionnaire was used to ask about demographic profile, and symptoms of back pain. The weight of the school bags and the school children was measured. Results 1860 school children (72.46%) out of 2567 were carrying bags of weight more than 15% of their body weight. The prevalence of heavy school bags was higher among the female children as compared with the male children. Back pain was reported by 42% of the school children. Conclusions The weight of schoolbags of Al-Ahsa primary school children were higher than the internationally acceptable standards and as a result back pain was reported by 42% of school children. The school authorities and ministry of health should further evaluate and take the necessary steps to rectify the situation.

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Précis: Glaucoma drainage devices (GDDs) are effective for the management of silicone oil-induced glaucoma. Although cyclophotocoagulation (CPC) has the advantage of shorter operative time and repeatability, it carries a higher risk of failure, blindness, and phthisis. Background/Aims: To compare the surgical outcome of GDD implantation and diode laser CPC in the management of refractory glaucoma following vitrectomy with silicone oil (SO) injection. Materials and Methods: In total, 56 eyes with refractory glaucoma after SO tamponade that underwent either CPC or GDD implantation were retrospectively evaluated. All patients underwent a complete ophthalmic examination and intraocular pressure (IOP) measurement at baseline and 1 day, 1 week, 1, 3, 6, and 12 months postoperatively. The rates of complete success and qualified success (for IOP between ≥5 and ≤21 mm Hg) were analyzed. Results: A total of 17 eyes underwent GDD implantation and 39 eyes underwent CPC. The preoperative IOP was 35.7±7.9 mm Hg and 27.8±8.4 mm Hg for the CPC and GDD groups, respectively (P=0.001), with a worse baseline visual acuity (P=0.01) and a higher proportion of SO-filled eyes in the CPC group (P<0.01). The IOP at 1 year postoperatively was 23.5±11.5 mm Hg and 15.3±5.9 mm Hg for the CPC and GDD group, respectively (P=0.01). Both groups achieved a reduction in IOP and number of medications at 1 year (P<0.001). The success rate in the GDD group was 94.1% (16/17), and 53.8% (21/39) in the CPC group at 12 months (P<0.005). Five eyes and 1 eye lost light perception vision in the CPC and GDD groups, respectively. Conclusions: GDD implantation may carry a higher surgical success rate than CPC. However, CPC retains the advantage of being technically easier and repeatable.

Genetic testing was performed in 5 patients, and one patient declined testing. Samples of peripheral blood were obtained and DNA was extracted from leukocytes of the five individuals and were used to build a Polymerase Chain Reaction (PCR). After PCR amplification, a targeted next generation sequencing (NGS) was performed using a panel for recessive retinal dystrophies by Bioscientia (Ingelheim, Germany) for 4 patients and by the molecular diagnostic laboratory of King Faisal Specialist Hospital and Research Center (Riyadh, Saudi Arabia) for 1 patient. The panel of genes tested include ABCA4, ABHD12,

Purpose: To compare the visual and anatomic outcomes of aflibercept versus ranibizumab as a second line treatment for persistent diabetic macular edema (DME) after initial bevacizumab injections. Methods: In this retrospective cohort study, patients with center-involved DME of ≥ 300 μm thickness after bevacizumab intravitreal injections in 2015-2019 were included. Those treated with ranibizumab (R) and aflibercept (A) were grouped as group R and group A, respectively. The change in central macular thickness (CMT) measured by optical coherence tomography (OCT) and the best corrected distance visual acuity (BCVA) before and after three-monthly anti-VEGF injections (anti-VEGF) in group R and group A were compared and reviewed. Results: There were 80 eyes of 75 patients in group R and 80 eyes of 72 patients in group A. The initial bevacizumab injections in group R and group A varied significantly (p = 0.01). The median change of the CMT after the three injections was not significantly different in group R (80 μm) and group A (81.5μm) (p = 0.7). The improvement of BCVA in group R and group A was not significant (p = 0.5). Dry macula was noted in 1 vs 14 eyes in group R vs group A. Conclusion:After treating refractory DME with initial bevacizumab injections, 3 injections of either aflibercept or ranibizumab had similar anatomic and functional outcomes. Aflibercept achieved dry macula in more eyes with refractory DME compared to ranibizumab.

Despite long axial lengths, shallow anterior chambers with occluded angles are possible in Crouzon syndrome and are most likely caused by FGFR2-related anterior segment dysgenesis. To the best of our knowledge, this is the first report that describes closed angles and anterior segment dysgenesis as a secondary cause of congenital glaucoma in Crouzon syndrome.

Corneal deposits have been reported with numerous topical medications including fluoroquinolones. However, they have not been documented as a side effect of topical moxifloxacin. In this report, we describe the first case of corneal deposits following the use of preservative-free topical moxifloxacin 0.5% eye drops in a 26-year-old male with keratoconus who underwent a unilateral corneal cross-linking. Increased frequency and prolonged instillation of moxifloxacin eye drops led to corneal precipitation in this patient. Complete resolution of corneal deposits occurred four months after drug discontinuation without sequelae.