Background: About 40 to 50 percent of all instances of microbial keratitis are caused by fungal keratitis (FK). Untreated FK can lead to corneal damage and endophthalmitis, both of which can lead to irreversible vision loss. Since long-term consequences, including blindness, can be prevented by timely diagnoses and treatment of microbial keratitis, there is no laboratory support for this type of diagnosis. Some experts in the field of ophthalmology have long held that it is possible to discriminate between fungal and bacterial infections of the cornea using clinical indicators. The aim of the study: It was assessment of the efficacy and safety of topical and systemic and sub-conjunctival fluconazole treatment for refractory fungal keratitis. Patients and Methods: Eleven people with refractory fungal keratitis took part in this investigation. All cases were managed with topical fluconazole 2% hourly for 2 days, then tapered 5 times/day for one week, sub-conjunctival fluconazole 2mg/ml once for 14 days and oral fluconazole 150mg per week daily. The diagnosis was based on KOH wet mount and clinical signs of fungal keratitis. Result: The result was eight of patient successfully treated with visual acuity improvement and local nor systemic side effect were observed. Conclusion:Severe fungal keratitis can be treated with topical and systemic, sub-conjunctival fluconazole, which may reduce the need for surgical intervention.
Aim: The aim of this study was to evaluate the efficacy and outcome of sutureless and glue-free conjunctival autograft for the management of primary pterygium in terms of complications such as loss of graft, graft dehiscence, and recurrence rate. Materials and Methods: A case series study was carried out in March 2015 at Nastaein private sanatorium, Zlitin, Libya. Twenty-seven eyes of 23 patients with primary pterygium were included in this study. Pterygium excision with conjunctival autografting without using sutures or glue was done to all patients. The patients were followed up postoperatively after 1 h, 1st day postoperatively, and then 1 week, 4 weeks, 3 months, 6 months, and 12 months. Results: The mean age of the patients was 55.9 ± 8.55 years (range: 43–71 years); 65% were male. Mean follow-up time was 10.2 ± 2 months. Changes of visual acuity were not noticed in any of these patients. Only one patient (3.7%) developed edge recession of the graft on the 1st postoperative day due to a wrong measurement of the size of the graft, and no other complications were noted. Cosmesis was excellent in all cases and no recurrence was noted. Conclusions: Sutureless and glue-free conjunctival autograft for primary pterygium surgery is a safe and effective way for the management of primary pterygium.
Macular thickness is key to the treatment and follow-up of patients with various ocular diseases. [1] Nussenblatt et al. claimed that the thickness of macula and not the occurrence of macular edema is correlated with changes in visual acuity. [2] Optical coherence tomography (OCT) is a valuable technique that measures retinal thickness quantitatively and provides information helping in the diagnosis, management, and follow-up of patients with retinal diseases. [3][4][5] Many studies reported an association between macular thickness and demographic variations such as different races, gender, and age, which should be taken into consideration when diagnosing macular diseases. [6][7][8][9] However, there is no data for normal macular thickness for the Libyan population. Our report is the first for the measurement of macular thickness in healthy Libyans' eyes. subjECts and mEtHodsThe study was conducted at the Ophthalmology Outpatient Department at Alkeish polyclinic, Benghazi, Libya, between January 1 and December 31, 2018. During the study period, the clinic was serving patients from all around Benghazi city as well as the population from the east and some parts of the south of Libya.This study included 243 healthy eyes of 131 Libyan adults of both genders. The chosen adults were Arab Libyans attending the clinic complaining of dry eye, headache, reading problems, and some volunteering 4 th -year medical students. All the participants underwent complete medical and ophthalmic Objectives: Management of various macular diseases depends on macular thickness which is measured quantitatively by optical coherence tomography. Studies have reported variations in the macular thickness by race and gender. The aim of this study was to determine the normal macular thickness measurements in healthy eyes of Libyans. Subjects and Methods: This study was conducted at the Ophthalmology Outpatient Department at Alkeish polyclinic in the period between January and December 2018. This study included 243 healthy eyes of 131 Libyan adults of both genders who underwent a complete ophthalmic examination including spectral domain optical coherence tomography to measure the macular thickness at the nine areas corresponding to Early Treatment Diabetes Retinopathy Study map (ETDRS). Results:The mean age of the study population was 48.3 ± 16.6 years (ranged between 21 and 79 years), the thickness in the foveola/center point of macula (CPT) was 192 ± 22.4 μm, the central foveal thickness was 230.3 ± 18.3 μm, and the average thickness was 270.1 ± 9.4 μm. Males were having more thickness than females. Conclusions: Foveola's thickness (CPT) in Libyan adults measured by spectral domain optical coherence tomography is thinner than that of previously published studies. Moreover, the central foveal thickness is less than that of many other studies and males have more thickness than females in all the areas of ETDRS map, which indicates that gender must be taken into consideration while interpreting macular retinal thickness data.
Dry eye disease (DED) is a common clinical condition that challenges ophthalmologists. Topical Cyclosporine A is an anti-inflammatory therapy being approved by the Food and Drug Administration (FDA) for the therapy for DED. This study aimed to evaluate the efficacy and pa- tient tolerability of topical Cyclosporine A 0.05% for the treatment of DED. A total of 87 patients diagnosed with DED were included in this study. Dry eye symptoms (foreign body sensation, burn- ing, and pain) were scored. As a baseline measurement, the tear break-up time test (TBUT) and the Schirmer’s test were performed for all the patients. Cyclosporine A 0.05% was given topically twice daily to all the patients for four months. They were followed up every month for a period of four months. The clinical signs (Schirmer’s test, the TBUT), and the symptoms scores, were record- ed for each visit. The mean age of the patients was 57.25±9.70 years (Range 32 - 80 years); 25 males (28.7%) and 62 females (71.3%). Out of them, 23 (26.4%) cases had Sjögren’s syndrome, and 12 (13.7%) cases had previous LASIK (laser in-situ keratomileusis). The symptoms score of the cases improved from (4.95±1.73) pretreatment to (0.40±.70) four months after treatment (P <0.001). The Schirmer’s test results improved from (4.10 ±1.089) pretreatment to (10.80±2.40) four months post-treatment (P <0.0001), and the TBUT test results improved from (5.54±1.77 s) pre- treatment to (12.95±3.12 s) four months post-treatment (P <0.0001). Only seven patients (8%) de- veloped ocular side effects in the form of redness, pain, and systemic side effects in the form of headache. In conclusion, Cyclosporine A 0.05% eye drops is an effective treatment for DED, im- proving both signs and symptoms of DED with few ocular side effects.
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