(1) Background: Glaucoma is a leading cause of irreversible blindness worldwide. Unfortunately, no noticeable symptoms exist until mid- to late-stage glaucoma, leading to substantial costs to the patient and the healthcare system. (2) Methods: The Student Sight Savers Program, an initiative started at Johns Hopkins University, was designed to meet the needs of community screening for glaucoma. Several medical students at the Rocky Vista University in Saint George, Utah, were trained, and screened patients at local fairs and gathering places using a modified version of this program. Patients found to have elevated pressure (>21 mmHg) or other ocular abnormalities were referred for an ophthalmological examination. (3) Results: Individuals from medically underserved areas/populations (MUA/Ps) were nearly three times as likely to have elevated intraocular pressure as individuals not in underserved areas (p = 0.0141). A further analysis demonstrates that medical students can help reduce medical costs for patients and the healthcare system by providing referrals to ophthalmologists and reaching populations that are not usually screened for glaucoma. (4) Conclusions: Allowing medical students to perform community-based glaucoma screening events in MUA/Ps using handheld tonometers may decrease the cost burden associated with late diagnosis, and raise awareness about glaucoma, especially in underserved populations.
ment and a methylprednisolone tapered dose pack. At 1-month follow-up, she had no pain, evidence of infection, or motility disturbance.Many household and store devices pose unintended ocular and periorbital damage risks. One report describes ocular trauma from merchandise display hooks, bringing awareness of this danger to shoppers and advocating modifying display hook design. 2 Cakes with wooden dowels pose a similar potentially underrecognized danger to the uninformed public. The hidden dowels, intended to provide stability to a multilayer cake, represent possible hazards especially in the setting of pranks or cultural traditions, such as in this patient. One similar anecdotal report was shared on social media, in which a woman sustained a periorbital injury when her face was pushed into a cake with a wooden dowel as a prank. 3 Additionally, a Mexican birthday tradition is la mordida, in which the guest of honor's face is shoved into their cake for the first bite for good luck. 4 While this tradition is intended to occur humorously and festively, there is inherent risk for ocular or orbital injury from hidden dowels, including retained intraorbital wooden foreign body that may be a nidus for infection. 5,6 Orbital computed tomography should be performed in periocular trauma to assess for these intraorbital foreign bodies and the extent of the injury. 1,5 Fortunately, this patient did not sustain severe ocular or orbital injury, as vital structures were missed due to the direction of the dowel penetration.To our knowledge, this case is the first in the medical literature to document and raise awareness of this hazard. We propose that the bakery industry consider warning labels for cakes with wooden dowels, as there are no regulations or requirements to provide this information to consumers. Additionally, we recommend celebrants of la mordida eliminate wooden dowels from cake assemblies or avoid forcefully planting the face on the cake. We hope knowledge of this hazard will modify consumer behavior to prevent ocular and orbital injury.
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