Objectives: To identify ocular trauma trends and to analyze how initial uncorrected visual acuity (VA) is associated with mechanism of injury (MOI) in a referral hospital in Indonesia. Methods: A five-year medical chart review at the Ophthalmology Emergency Department (OED) Dr. Soetomo General Academic Hospital (DSGAH). The information retrieved included sex, age, laterality involvement, initial uncorrected VA, MOI and management. Sex- and age- adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the relationship between poor initial uncorrected VA and MOI, using multivariate logistic regression analysis. Results: A total of 953 patients consisted of 80.3% males and 19.9% females. Ocular trauma predominantly occurred in 21–30 years age group (20.9%). May and November were found to have the highest average number of monthly patients. Closed globe injuries (80.3%) were more prevalent than open globe injuries (17.7%). The most frequent MOIs were sharp objects (311; 32.6%), followed by blunt objects (236; 24.8%). Most cases (89.2%) displayed unilateral involvement and 54.3% cases showed an initial uncorrected VA of better than 6/18. Compared to road dust, blunt object, sharp object and traffic accident were significantly associated with poor initial VA, with adjusted ORs (95% CIs) of 5.24 (2.27-12.10), 4.03 (1.76-9.25) and 8.17 (3.31-20.15), respectively. Conclusions: Initial uncorrected VA and MOI provide earlier information regarding the prognosis. Traffic accident showed a greater tendency to cause a poor initial uncorrected VA. Most ocular trauma is preventable by educating people at risk to avoid common MOIs and to use protection.
Condensing lens is a lens used as an auxiliary lens in indirect instruments to examines the fundus. This lens is used with binocular indirect ophthalmoscope and slit-lamp biomicroscope to reach a stereopsis image of fundus. Optical principle of condensing lens is to make the eye in myopic condition, so it can producesa real, aerial, inverted and reversed image. This lens was placed between the instruments and the eye of the patient which located closer to patient’s eye. Optimalized position of the lens can produce a good fundus image. Condensing lens have so many power of dioptre that each power produces different magnification and field of view. High powered lenses produces wider field of view than low powered ones. High powered lens can also used in patient with small dilated pupil and shorter distance of examination. Low powered lenses offer more magnification. Fundus examination with binocular indirect ophthalmoscope and slit-lamp biomicroscope have purpose to produces stereopsis image because of the binocularity system. These two instruments have each advantages and disadvantages. The advantages of binocular indirect ophthalmoscope are a portable instrument, relatively can be used in uncooperative patient and it can be used with scleral indentation to reach more peripheral view of the fundus. Meanwhile slit-lamp biomicroscope has the advantages to offer more magnification and flexible illumination system. With higher powered lens use in biomicroscope, it also give advantages in shorter distance of examination and wider field of view.
Introduction : Age Related Macular Degeneration (AMD) stills the leading cause of blindness in developing countries for age 50 and above, increasing along higher life expectations.Anti- VEGF is the mainstay management for exudative AMD and able to reduce the central retinal thickness (CRT) and to increase the visual outcome. The aim of this study is to correlate between CRT and visual outcome in exudative AMD post intravitreal ranibizumab injection loading doses in Soetomo general academic hospital, Surabaya Methods : This was a retrospective, cross sectional study. Fourty two eyes who met inclusion criterias were received monthly loading doses of 0.5 mg Ranibizumab intravitreal injection for three consequtives months. Baseline visual acuity (BCVA) was measured with Snellen Chart converted to LogMAR, CRT was measured by SD-OCT. Parameters was measured before the first injection and after completed three months injections. Result : Fourty two eyes were composed by 59.5% male and 40.5% female with higher incidence in 61-70 years old (47.6%). Mean BCVA were 0.831 before and 0.624 after injection of serial Ranibizumab. Mean CRT were 346.9 and 254.2 µm before and after injection respectively. There was significant comparison between CRT and BCVA (p=0.00) & no correlation between CRT and BCVA before and after injection of Ranibizumab loading doses (p=0.418 & p=0.275) Conclusion : There were no correlation statistically between CRT and BCVA before and after injection of loading doses Ranibizumab intravitreal in exudative AMD. Further studies may be needed to prove the etiology of this tendencies.
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