Aim The aim of this study was to evaluate trends in visual impairment certification due to age-related macular degeneration (ARMD) in the Leeds metropolitan area between 2005 and 2010. Methods In this retrospective study, the primary causes of visual impairment certification in the Leeds metropolitan area between 2005 and 2010 were reviewed. ARMD was considered to be the cause of certification when recorded as the primary factor contributing to visual impairment in one or both eyes. The incidence of visual impairment certification due to ARMD was calculated using population estimates from the Office of National Statistics. Results ARMD was the primary cause of visual impairment certification in all study years, accounting for 58.7 and 50.8% of certifications in 2005 and 2010, respectively. For the same period, the incidence of certification due to ARMD fell from 364 to 248 per million population per year. This was largely the result of a fall in the incidence of visual impairment certification due to neovascular ARMD from 225 to 137 per million population per year, beginning in 2008 after the introduction of a local commissioning policy on the use of intra-vitreal ranibizumab. Conclusion The incidence of visual impairment certification due to ARMD in the Leeds metropolitan area appears to be falling. This is largely the result of a decrease in certification secondary to neovascular ARMD. This represents a change in the previously described trend for ARMD visual impairment certification.
SummaryA 63-year-old woman was referred to the eye clinic with a 2-year history of unresolving right eye discomfort, irritation and recurrent conjunctivitis, managed by her general practitioner, where frequent use of topical antibiotics and ocular lubricants provided little and transient relief. The right eye was blind following a complicated retinal detachment surgery 30 years ago. Examination revealed an extruding silicone sponge scleral buckle from a previous retinal detachment surgery in the superior conjunctival fornix, under the right upper lid. This was subsequently surgically removed and her symptoms resolved.
BACKGROUND
Patients with learning disabilities have a higher level of visual impairment compared with the general population. Cataract is a reversible cause of such impairment, but many barriers to surgery exist for patients with learning disabilities. The Equality Act 2010 requires organisations to make ‘reasonable adjustments’ in order for people with disabilities to access services. However, there is a distinct lack of literature on surgical outcomes and surgical planning strategies for this patient group. In this article, the authors discuss a multidisciplinary structured approach to caring for patients with learning disabilities who have visual problems relating to cataract and suggest reasonable adjustments that may help to develop pathways for enabling access to cataract surgery and reducing inequalities.
Introduction: This study was undertaken with an aim to identify any common factors or trends among patients of orbital cellulitis that developed neurological complications. Methods: A 24-month retrospective review of patients was undertaken to include those showing clinical deterioration and neurological complications on radiological imaging, after being treated for orbital cellulitis at Manchester Royal Eye Hospital. The study specifically looked at the site of orbital collection, sinus involvement, types of neurological complications and whether these were detected at initial presentation, surgical input and microbiology findings. Results: Nine patients (9/26) developed associated neurological complications during the study period. (February 2018 and January 2020) This included subdural empyema in six patients; leptomeningeal enhancement in two and septic emboli in one patient. All the patients had associated significant pan-sinusitis at initial presentation. Neurological complications were detected in three patients at the time of admission and after clinical deterioration and further investigations in the rest. Conclusion: A superior orbital abscess and Streptococcus mileri infection had higher risk of neurological complications. It is worth debating whether patients with chronic sinusitis who develop orbital cellulitis need earlier surgical input rather than a conservative treatment. Patients who fail to improve clinically need to be re-imaged to look for possible neurological complications.
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