Medical Hypothesis, Discovery & Innovation (MEHDI) Ophthalmology Journal
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Coronavirus disease pandemic and dry eye disease: A methodology concern on the causal relationship
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Causative link between coronavirus disease vaccination and central serous chorioretinopathy: Reality or illusion?
Get PDFBackground: Most COVID-19 vaccines were authorized for emergency use. Despite a large number of vaccines that have been administered, adverse ocular effects have been reported. This paper summarized the reports about central serous chorioretinopathy (CSCR) following coronavirus disease vaccination.
Methods: In this short communication, we have included relevant publications about CSCR after coronavirus disease vaccination from the beginning of the pandemic until January 2022.
Results: The CSCR occurrence after vaccination has been reported for many years. However, a few studies are available about CSCR after coronavirus disease vaccination. Most cases revealed the development of CSCR within one week of vaccination that subsequently resolved.
Conclusions: The timeline of the CSCR diagnosis developing a few days after vaccination suggests a causative link. However, in view of the millions of administered doses of vaccines along with boosters, the causative link between CSCR and vaccines remains uncertain. Additional studies are needed to confirm a causal claim
The role of primary eye health care in controlling the surge of monkeypox
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KEYWORDS: monkey pox, vaccinations, transmission, communicable disease, primary healthcare, conjunctivitides, blepharitide
Levator palpebrae superioris function and corneal astigmatism in university students with normal eyelid morphology
Get PDFBackground: Eyelids have been shown to influence corneal shape. The effects of eyelid pathologies on corneal astigmatism have been widely investigated. This study aimed to determine the correlation between levator palpebrae superioris (LPS) muscle function and with-the-rule (WTR) corneal astigmatism in university students with normal eyelid morphology.
Methods: This was a cross-sectional study with a sample of 58 university students of Chinese origin selected by simple random sampling at the University College Sedaya International (UCSI) University Optometry Clinic, Kuala Lumpur, Malaysia. We included participants aged 18 to 30 years, regardless of sex, with normal eyelid morphology, normal LPS function, and WTR corneal astigmatism. For LPS muscle function, the distance of the upper eyelid margin from the maximal downgaze to the upgaze was measured, while the frontalis function was negated by the thumb of the examiner. Corneal astigmatism was measured using a manual Keratometry (Topcon OM-4; Topcon Corporation, Tokyo, Japan).
Results: Of the 58 participants, 23 (39.7%) were men and 35 (60.3%) were women. The mean ± standard deviation (SD) age was 23.22 ± 1.77 years. For all participants, the means ± SDs for LPS muscle function and corneal astigmatism were 14.72 ± 1.74 mm and - 1.16 ± 0.47 D, respectively. Of the 58 participants, 25 and 33 had low and moderate WTR corneal astigmatism, respectively. The mean LPS muscle functions were not significantly different between the low and moderate WTR corneal astigmatism groups (P > 0.05). A positive but statistically insignificant correlation (r = + 0.14; P > 0.05) was found between LPS muscle function and WTR corneal astigmatism.
Conclusions: We found no significant difference in the mean LPS muscle function between low and moderate WTR corneal astigmatism groups in young university students of Chinese origin with normal eyelid morphology. Furthermore, no significant correlation was found between LPS muscle function and low-to-moderate WTR corneal astigmatism
Ocular biometry characteristics in cataract surgery candidates: A cross-sectional study
Get PDFBackground: This study was conducted to investigate ocular biometry parameters in cataract surgery candidates in northern Tehran, Iran using OA-2000 biometry device.
Methods: In this cross-sectional study, values of ocular biometry parameters, including axial length (AL), anterior chamber depth (ACD), mean corneal curvature (mean K), lens thickness (LT), corneal astigmatism (CA), and white-to-white (WTW) of 818 eyes with cataracts, were measured using the OA-2000 biometry device (Tomey, Nagoya, Japan). The participants were divided into six age subgroups, in 10-year intervals. Finally, the values of the biometry parameters were calculated, and the trend of changes was examined for both age and sex subgroups.
Results: The mean± standard deviation (SD) of age of the participants was 63.82 ± 13.25 years. Mean ± SD of biometry parameters were as follows: AL, 23.36 ± 1.55 mm; ACD, 3.09 ± 0.40 mm; LT, 4.45 ± 0.55 mm; mean K, 44.51 ± 1.72 D; CA, 1.06 ± 0.94 D; and WTW, 11.81 ± 0.45 mm. Most of the parameters showed significant age-related changes in the total population. There was an increase in LT (P < 0.001) and mean K (P = 0.001), as well as a decrease in AL (P < 0.001) and ACD (P < 0.001) with age. Moreover, AL had a negative negligible correlation with LT (r = -0.24, P < 0.001) and mean K (r = -026, P < 0.001), as well as a weak positive correlation with ACD (r = 0.44, P < 0.001).
Conclusions: Our study revealed that the mean values of most biometric parameters varied across age and sex subgroups. Moreover, most of the parameters showed significant age-related changes in the total population
Lacrimal stenting versus three-snip punctoplasty for treatment of punctal stenosis or occlusion: An open-label, randomized clinical trial
Get PDFBackground: To compare the short-term anatomical and functional outcomes of, as well as patient satisfaction with, lacrimal stenting and three-snip punctoplasty for the treatment of punctal stenosis or occlusion.
Methods: In this open-label, randomized clinical trial, we included 50 eyes of 30 patients diagnosed with punctal stenosis or occlusion. They were randomly allocated to two groups of 25 eyes each, using central telephone randomization. Group A underwent a lacrimal stenting procedure and was subdivided into two subgroups: Group A1 (13 eyes) received polyvinylpyrrolidone-coated perforated punctal plugs, and Group A2 (12 eyes) received closed intubation using a bicanalicular silicon tube. Group B included 25 eyes that underwent three-snip punctoplasty. All eyes were examined after 1 day, 1 week, 1 month, 3 months, and 6 months. Postoperative anatomical success assessing the punctum size, functional success using the fluorescein disappearance test, and patient satisfaction based on epiphora scoring were recorded.
Results: Both study groups were comparable in terms of sex and age distribution. Compared to Group B, Group A had a significantly larger punctum size at one, three, and 6-month postoperatively (P = 0.009, 0.01, and 0.02, respectively). The difference in FDT results was significant between the two groups at all follow-up visits (P = 0.008, 0.0001, 0.003, and 0.002, at postoperative one week, one-months, three-month, and six-month, respectively). Likewise, patient satisfaction was significantly different between both groups at all follow-up visits (P = 0.007, 0.001, 0.005, and 0.002, at postoperative one week, one-months, three-month, and six-month, respectively).
Conclusions: Lacrimal stenting is an effective method for the treatment of punctal stenosis or occlusion. Overall, the FDT results and patient satisfaction outcomes were significantly better
Modified capsulorhexis for fluid-filled mature cataracts
Get PDFBackground: The aim of this study was to develop a modified capsulorhexis technique featuring a new maneuver for the removal of subcortical fluid in fluid-filled mature cataracts to avoid high intralenticular pressure.
Methods: This prospective interventional study included 33 eyes with mature cataracts and evidence of subcapsular fluid spaces by slit lamp examination. For each patient, 20% mannitol was administered intravenously according to the bodyweight 1 h preoperatively. Under peribulbar anesthesia, a 2.2-mm main incision was made, and the anterior chamber was filled with a dispersive ophthalmic viscosurgical device. Using a bent-tip cystotome, a 2-mm curved incision was made in the center of the anterior capsule, which released subcortical fluid and was drained through compression of the posterior lip of the main incision using a spatula. Then, fine gentle milking in all quadrants around the puncture on the anterior lens capsule from the periphery toward the site of puncture using the blunt-edged spatula further assists drainage of subcortical fluid and breaks fine septa inside the lens to remove fluid from intralenticular fluid pocket collections.
Results: The study included 15 (45.5%) men and 18 (54.5%) women with a mean ± standard deviation (SD) of age of 63.2 ± 5.33 and 64.4 ± 6.21 years, respectively. The modified capsulorhexis technique was performed for 33 intumescent cataracts. Capsulorhexis was completed in all cases; capsulorhexis was easy in 31 (94%) eyes and difficult in 2 (6%) eyes. In the two difficult cases, radial extension occurred in one eye, and it was retrieved using the Little technique; the other case with radial tear was completed successfully using a retinal micro scissor from the other edge of the capsulorhexis until reaching an oval, continuous capsulorhexis.
Conclusions: This modified capsulorhexis technique with compression on the posterior lip of the main incision and capsule milking allowed for a safe, continuous curvilinear capsulorhexis. Further comparative studies are necessary to confirm our preliminary results
Vision screening among hearing-impaired school children in Biratnagar, Nepal
Get PDFBackground: The prevalence of hearing impairment in Nepal is 16.5%, affecting approximately 2.71 million people. Deaf children are visually dependent, and even a mild refractive error may cause visual discomfort. The goal of this study was to determine the need for vision screenings in schools for the hearing impaired in Biratnagar, Nepal.
Methods: A cross-sectional study was conducted with permission from Birat Deaf Secondary School, Biratnagar, Nepal. A total of 130 hearing-impaired students were examined. Non-invasive, comprehensive optometric examinations were performed to detect visual disorders. When a more detailed evaluation was needed, the students were referred to the Pediatric Ophthalmology Department, Biratnagar Eye Hospital Biratnagar, Nepal.
Results: Of the 130 hearing-impaired students, 58 (44.6%) were male and 72 (55.4%) were female. The mean ± standard deviation of age was 16.03 ± 3.8 years (range 6–25 years). Twenty-one (16.1%) students had refractive errors: 13 (10%) had myopia, 7 (5.4%) had hyperopia, and 1 (0.8%) had anisometropia. In the cover test, 88 (67.7%) had orthophoria, 19 (14.6%) had exophoria, 11 (8.5%) had esophoria, 5 (3.85%) had exotropia, and 3 (2.3%) had esotropia. Cover tests were not performed in 4 (3.1%) students, as they were unable to fixate due to nystagmus or decreased vision. On ocular examination, 20 (15.3%) students had anterior segment abnormalities, including lid abnormality, conjunctivitis, Bitot’s spots, pterygium, corneal opacity, and lenticular opacity. Posterior segment or retinal abnormalities were found in four students with one having Usher syndrome. Color vision defects, nystagmus, and amblyopia were found in 8 (6.1%), 2 (1.5 %), and 1 (0.8%), respectively.
Conclusions: The findings of the present study reflect the need of periodic vision screenings in schools for the hearing impaired in Nepal. These children are at a high risk of vision impairment.
 
Short-term effect of non-preserved cationic oil in-water ophthalmic emulsion on tear meniscus parameters of healthy individuals in a prospective, controlled pilot study
Get PDFBackground: This study investigated the effect of instilling a single drop of non-preserved cationic oil-in-water ophthalmic emulsion (Cationorm®) on the lower (LTM) and upper tear meniscus (UTM) parameters of normal eyes.
Methods: In this prospective, single-center, non-randomized, controlled pilot study, optical coherence tomography was used to estimate the UTM and LTM height, depth, and cross-sectional area in participants without a history of dry eye disease. In the right eye (study eye), we instilled one drop of Cationorm® in the lower conjunctival sac. Scans of the tear menisci were acquired at baseline, before the instillation, and at 5, 15, and 30 min thereafter. Control scans of the left eye (control eye) were obtained at the same timepoints. The tear meniscus parameters of the study eye were compared with the control eye at each timepoint.
Results: Twenty subjects (11 male and 9 female; mean ± standard deviation of age: 37.8 ± 10.9 years) were included in the study. Compared to the control eye, instillation of a single drop of Cationorm® resulted in significantly higher LTM parameter values and a higher UTM cross-sectional area up to 30 min after instillation (all P < 0.05). The UTM height and depth were significantly greater in the study eye than in the control eye up to 5 min (P < 0.001 and 0.007, respectively) and 15-min (P = 0.045, and 0.002, respectively) after Cationorm® instillation. In the study eye, Cationorm® resulted in a significant increase in LTM parameter values up to 30 min post-instillation (all P < 0.001). The UTM height was significantly greater up to 15 min post-instillation than at baseline. The UTM depth and area increased significantly from baseline to 5 min after instillation (P = 0.043, and 0.002, respectively).
Conclusions: Cationorm® seems to have a prolonged residence time on the ocular surface of healthy subjects as indicated by LTM parameters and to a lesser extent by UTM parameters