Aims: To determine the coverage, outcome, and barriers to uptake of cataract s urgery in leprosy villages of north eastern Nigeria. Methods: People 30 years an d above resident in eight leprosy villages were examined....Aims: To determine the coverage, outcome, and barriers to uptake of cataract s urgery in leprosy villages of north eastern Nigeria. Methods: People 30 years an d above resident in eight leprosy villages were examined. Cataract blind people were questioned about the reasons they had not been treated. Subjects who had re ceived an operation for cataract were examined to determine the outcome and, whe re applicable, the causes of poor outcome. Results: 480 people were examined. Ca taract was the commonest cause of blindness. The cataract surgical coverage (peo ple) was 39.2%for orthodox surgery and 29.7%for couching. After surgery, visua l acuity ≥3/60 had been restored to 82.1%of eyes that had had orthodox surgery , but only 58.6%of eyes that had been couched. Cost was the commonest reason gi ven for not seeking treatment for cataract. Conclusions: Cataract is the major c ause of blindness in this population but cataract surgical needs are currently n ot being met. There is a need for better collaboration between leprosy control a nd ophthalmic services, improved education of people affected by leprosy, a comm itment to improving orthodox cataract surgery outcomes, and consideration of a p ossible role for traditional healers as sources of referral for orthodox surgica l services.展开更多
AIM:To describe the referral patterns of children with primary childhood glaucoma(PCG)or secondary childhood glaucoma(SCG)and their presenting symptoms in Northern Tanzania.METHODS:A retrospective observational study ...AIM:To describe the referral patterns of children with primary childhood glaucoma(PCG)or secondary childhood glaucoma(SCG)and their presenting symptoms in Northern Tanzania.METHODS:A retrospective observational study of children<17 y with PCG or SCG who were referred to Kilimanjaro Christian Medical Centre(KCMC)Eye Department between 2000 and 2013 was conducted.Presenting symptoms,age at presentation,place of origin,distance to hospital,type of glaucoma,visual acuity,optic disc appearance(vertical cupto-disc ratio)and type of referral were described.RESULTS:Seventy patients with PCG and 27 patients with SCG were included in the study.Median age at first presentation was 1 y in the PCG group(range 0-16 y)and 9 y in the SCG group(range 1-15 y).In both groups around 87%of the children presented already with low vision(logM AR>0.48,better eye).Most of the children(60%)and their caretakers presented on their own initiative,while 24%were sent by different general health cadres and 16%by eye care professionals.Buphthalmos was the main symptom mentioned as a trigger for presentation.CONCLUSION:The study shows that most of the children presented late resulting in advanced stages of glaucoma at the time of initiation of treatment.The majority attended the referral eye department on their own initiative with buphthalmos being the most commonly 452described symptom.Awareness creation among caretakers of children,general health and eye care providers,ideally embedded in general child health promotion activities,is needed to increase and accelerate referrals.展开更多
Background/aim: Haag-Streit recommends that for the most accurate anterior chamber depth (ACD) results, the corneal thickness, as determined with attachment No I, should be deducted from a measurement from corneal epi...Background/aim: Haag-Streit recommends that for the most accurate anterior chamber depth (ACD) results, the corneal thickness, as determined with attachment No I, should be deducted from a measurement from corneal epithelium to the anterior lens surface, made with attachment No II (method A). Often ophthalmologists use the measurement made from the corneal endothelium to the anterior lens surface, using only attachment No II (method B), which is a simpler and faster method. This study examined agreement between methods A and B. Methods: Two studies were conducted independently by each author. PHA measured 127 (27 men, 100 women; mean age, 66.9 years) consecutive Danish patients referred for evaluation because of possible angle closure. RRB measured 109 subjects (30 men, 79 women; mean age, 61.3 years) consecutively from a population based glaucoma survey in Rom Klao, Thailand. Results: Using method A, mean ACD was 1.97 mm (SD 0.29) in the Danish study and 2.59 mm (SD 0.27) in the Thai study. ACD measured with method B was significantly (p< 0.001 ) deeper than method A in both studies (Danes: difference =0.118 (95%CI: 0.109 to 0.127); Thais: difference=0.166 mm (95%CI: 0.158 to 0.174)). With an increase in ACD of 1 mm, the methodological difference increased by 0.052 mm (regression formula: difference (B-A)=0.0667 ×mean ACD -0.0148; R2=0.31). This positive correlation did not differ significantly between the two studies. Conclusions: The relevance and importance of estimating ACD as a risk factor in primary angle closure glaucoma suspects and patients has been repeatedly emphasised. This is the first empirical study to quantify the difference in ACD using these two methods in two samples, one clinic based (angle closure suspects) and the other population based. The size of the methodological difference has a level that corresponds to the age reduction of ACD per decade, or to about 6%of ACD in a given eye. These findings highlight the importance of clinicians recognising that these two methods will give different results and recommend that one should standardise ACD measurements using the Haag-Streit optical pachymeter.展开更多
文摘Aims: To determine the coverage, outcome, and barriers to uptake of cataract s urgery in leprosy villages of north eastern Nigeria. Methods: People 30 years an d above resident in eight leprosy villages were examined. Cataract blind people were questioned about the reasons they had not been treated. Subjects who had re ceived an operation for cataract were examined to determine the outcome and, whe re applicable, the causes of poor outcome. Results: 480 people were examined. Ca taract was the commonest cause of blindness. The cataract surgical coverage (peo ple) was 39.2%for orthodox surgery and 29.7%for couching. After surgery, visua l acuity ≥3/60 had been restored to 82.1%of eyes that had had orthodox surgery , but only 58.6%of eyes that had been couched. Cost was the commonest reason gi ven for not seeking treatment for cataract. Conclusions: Cataract is the major c ause of blindness in this population but cataract surgical needs are currently n ot being met. There is a need for better collaboration between leprosy control a nd ophthalmic services, improved education of people affected by leprosy, a comm itment to improving orthodox cataract surgery outcomes, and consideration of a p ossible role for traditional healers as sources of referral for orthodox surgica l services.
文摘AIM:To describe the referral patterns of children with primary childhood glaucoma(PCG)or secondary childhood glaucoma(SCG)and their presenting symptoms in Northern Tanzania.METHODS:A retrospective observational study of children<17 y with PCG or SCG who were referred to Kilimanjaro Christian Medical Centre(KCMC)Eye Department between 2000 and 2013 was conducted.Presenting symptoms,age at presentation,place of origin,distance to hospital,type of glaucoma,visual acuity,optic disc appearance(vertical cupto-disc ratio)and type of referral were described.RESULTS:Seventy patients with PCG and 27 patients with SCG were included in the study.Median age at first presentation was 1 y in the PCG group(range 0-16 y)and 9 y in the SCG group(range 1-15 y).In both groups around 87%of the children presented already with low vision(logM AR>0.48,better eye).Most of the children(60%)and their caretakers presented on their own initiative,while 24%were sent by different general health cadres and 16%by eye care professionals.Buphthalmos was the main symptom mentioned as a trigger for presentation.CONCLUSION:The study shows that most of the children presented late resulting in advanced stages of glaucoma at the time of initiation of treatment.The majority attended the referral eye department on their own initiative with buphthalmos being the most commonly 452described symptom.Awareness creation among caretakers of children,general health and eye care providers,ideally embedded in general child health promotion activities,is needed to increase and accelerate referrals.
文摘Background/aim: Haag-Streit recommends that for the most accurate anterior chamber depth (ACD) results, the corneal thickness, as determined with attachment No I, should be deducted from a measurement from corneal epithelium to the anterior lens surface, made with attachment No II (method A). Often ophthalmologists use the measurement made from the corneal endothelium to the anterior lens surface, using only attachment No II (method B), which is a simpler and faster method. This study examined agreement between methods A and B. Methods: Two studies were conducted independently by each author. PHA measured 127 (27 men, 100 women; mean age, 66.9 years) consecutive Danish patients referred for evaluation because of possible angle closure. RRB measured 109 subjects (30 men, 79 women; mean age, 61.3 years) consecutively from a population based glaucoma survey in Rom Klao, Thailand. Results: Using method A, mean ACD was 1.97 mm (SD 0.29) in the Danish study and 2.59 mm (SD 0.27) in the Thai study. ACD measured with method B was significantly (p< 0.001 ) deeper than method A in both studies (Danes: difference =0.118 (95%CI: 0.109 to 0.127); Thais: difference=0.166 mm (95%CI: 0.158 to 0.174)). With an increase in ACD of 1 mm, the methodological difference increased by 0.052 mm (regression formula: difference (B-A)=0.0667 ×mean ACD -0.0148; R2=0.31). This positive correlation did not differ significantly between the two studies. Conclusions: The relevance and importance of estimating ACD as a risk factor in primary angle closure glaucoma suspects and patients has been repeatedly emphasised. This is the first empirical study to quantify the difference in ACD using these two methods in two samples, one clinic based (angle closure suspects) and the other population based. The size of the methodological difference has a level that corresponds to the age reduction of ACD per decade, or to about 6%of ACD in a given eye. These findings highlight the importance of clinicians recognising that these two methods will give different results and recommend that one should standardise ACD measurements using the Haag-Streit optical pachymeter.
