Purpose:To investigate clinical features, causative organisms and their antibiotic sensitivity, management, and visual acuity outcomes of eyes with bleb-related endophthalmitis (BRE).Design:Retrospective, noncomparative, consecutive eye series.Methods:Clinical and microbiological records of patients with culture positive bleb-related endophthalmitis treated at a single institution between April 1995 and February 2002 were revised retrospectively.Main Outcome Measures:Final visual acuity, loss of eye and complications.Results:There were 34 cases with presenting visual acuities ranging from 20/200 to light perception. Decrease of visual acuity was the most frequent sign (94%) followed by pain (79%) and hypopyon (53%). Associated features included pseudophakia (79%), vitreous wick (29%), and wound leak (12%). The most frequent organisms isolated from vitreous specimens, were streptococcus species (55%) and gram positive coagulase negative staphylococci (20%). Polymicrobial growth was noted in 27% of cases. The cultured organisms were sensitive to antibiotics used in 94% of cases. Treatment modality used was vitreous tap with antibiotic injection without (65%) or with vitrectomy (35%). The most common intravitreal antibiotics combination was vancomycin with ceftazidime, Intravitreal dexamethsone was administered in 56% of cases. Final visual outcome of 20/400 or better was noticed in 50% of cases without and 33% with vitrectomy, but this was not statistically significant (p=0.45). The difference in final visual acuity of cases infected by gram-positive coagulase-negative staphylococci and streptococcus species were not statistically significant (p= 0.18). Overall, final visual outcome of 20/400 or better was noticed in 47% of cases, while no light perception was recorded in 8 (24%) cases. Of no light perception cases 7 underwent evisceration or enucleation. Overall, 32% of the cases experienced other complications like retinal detachment with dislocated intraocular lens, phthisis bulbi, and epiretinal membrane formation.Conclusion:BRE is associated with substantial visual morbidity. Prompt treatment of BRE with intravitreal vancomycin and broad spectrum antibiotics recommended while culture results are pending. Neither tap-injection with vitrectomy nor tap-injection without vitrectomy proved superior in the management of this condition.
PURPOSE:To report the causes of permanent severe visual impairment and blindness among Jordanian blind people.MATERIALS AND METHODS:This study was conducted on 1422 legally blind or worse vision people of all ages who attended the ophthalmic division of a medical committee for evaluation of disabled persons from July 2013 through November 2014. They were divided into two age groups: adult group (998 cases) and childhood group (<16 years, 424 cases). Patients presented reports from their ophthalmologists detailing their eye examination including best-corrected visual acuity, slit-lamp examinations, and if applicable, intraocular pressure, dilated ophthalmoscopy, and visual field and the primary cause of visual impairment. Blind defined as best-corrected visual acuity < 6/60 (20/200) and/or visual field of 20° or less.RESULTS:Retinitis pigmentosa was the most common cause of blindness among adult group (29.7%) followed by diabetic retinopathy (19.9%) and glaucoma (15.8%). Congenital whole-globe malformations were the most common cause of blindness among childhood cases (16.7%) followed by retinopathy of prematurity (ROP) (15.8%) and retinal dystrophies (13.9%). Overall, blindness related to genetic diseases, illnesses, and trauma was present at 56.5% (803), 41.7% (593), and 1.8% (26) of cases, respectively.CONCLUSIONS:Genetic diseases such as retinitis pigmentosa, diabetic retinopathy, and glaucoma were the dominant causes of blindness among adults, while whole-globe malformation, ROP, and retinal dystrophies were the dominant causes of childhood blindness. These major causes of blindness should be considered in future public health and nongovernmental organizations strategies for blindness prevention in Jordan.
Objectives: To review ocular and systemic manifestations, and efficacy of systemic treatment of Behcet's disease patients at King Hussein Medical Center. Methods: This retrospective study was conducted at the ophthalmology and rheumatology departments at king Hussein Medical Center. All patients who were diagnosed to have Behcet's disease according to the International Study Group criteria between January 2012 and April 2017 were included in the study. Patients with incomplete Behcet's disease or those who were recently diagnosed to have Behcet's disease (less than 6 months) were excluded from the study. Data regarding demographic features was initially collected then patient's files were reviewed regarding the possession of HLA-B51, systemic manifestations, and complications of the disease. Type of ocular involvement and ocular complications were studied, and the offered treatment options and their efficacy were evaluated. Results: One hundred and eleven patients were included. The mean age of cases was 30.2 years with male predominance (ratio 5:1). The most common clinical findings was genital ulcers (75.7%) followed by skin lesions (46.8%) and uveitis (32.4%). Arthralgia and arthritis was the most common systemic complication (14.4%). The most common eye involvement was vitritis (58.3%) followed by anterior uveitis (55.6%), retinal vasculitis (30.6%), retinitis (8.3%), pan uveitis (8.3%), and optic neuritis (3.8%). HLA-B51 and pathergy test were positive in 55.9% and 34.2% of cases, respectively. Colchicine and oral Prednisolone were the most used drugs and infliximab was the most effective single drug used in the treatment of Behcet's disease Conclusion: After oral ulcers, the most common clinical finding found in Behcet's disease patients was genital ulcers. Ocular involvement of Behcet's disease was relatively uncommon and vitritis was the most common manifestation. HLA-B51 was significantly associated with ocular involvement. Infliximab was the most effective drug in controlling the activity of Behcet's disease.
Purpose:The study has examined the problems encountered during management of cataract surgery during clinical practice within a developing country. Methods:A retrospective study was conducted by recruiting patients with the diagnosis of congenital cataract operated between 2011 and 2014. Intraocular lens was implanted, when the corneal diameter was 10 mm or more, which approximately corresponded to the capsular bag diameter, regardless of the patients' age. Results:The results showed that 13 were aphakic and none of them developed visual axis opacification. Eleven out of the 49 pseudophakic patients needed 2 or more surgeries to clear visual axis opacification; whereas, 25 out of 49 pseudophakic patients received hydrophobic intraocular lens. However, 3 of them (12%) developed visual axis opacification. The remaining 24 patients received hydrophilic intraocular lens, where 8 of them (33%) developed visual axis opacification. There was increased incidence of visual axis opacification as a result of pseudophakia that required a second surgery, which delayed their visual rehabilitation. Conclusion:Hydrophobic intraocular lenses are better used because of their lower risk to induce visual axis opacification.
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