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1.
West Indian med. j ; 50(3): 20, July, 2001.
Artigo em Inglês | MedCarib | ID: med-235

RESUMO

Posterior uveitis which is an important cause of visual loss, needs careful work-up and aggressive management to minimize morbidity and reduce the incidence of blindness. Uveitis may be classified with regards to its presentation (acute or chronic) and also depending on its anatomic location. Patient symptoms are often helpful in determining the type of inflammation. It is important to carefully evaluate patients with posterior uveitis to determine the aetiology. Inflammation may be in the par plana (pars planitis), retina (retinitis) and the choroid (choroiditis). Some patients have inflammation in many layers (chorio-retinitis). In addition to specific agents to treat aetiologic factors (penicillin for syphilis), steroids are important agents for treating inflammation in these patients. Appropriate laboratory investigations help to determine systemic disorders. Chest X-rays are important to evaluate granulomatous diseases such as sarcoidosis and tuberculosis. Close follow-up is critical. (AU)


Assuntos
Humanos , Cegueira/etiologia , Uveíte Posterior/diagnóstico , Uveíte Posterior/terapia , Uveíte Posterior/etiologia , Coriorretinite/terapia , Corioidite/terapia , Pars Planite/terapia , Retinite/terapia
2.
West Indian med. j ; 47(Suppl. 3): 31, July 1998.
Artigo em Inglês | MedCarib | ID: med-1713

RESUMO

Sickle cell retinopathy is a well recognized cause of blindness. However, in Jamaica it is not a very common cause of blindness, and the incidence of blindness in sickle cell disease is not accurately known. Most of the published work on sickle cell disease comes out of special research units which differ from the experience of clinicians in general ophthalmic practice. The study was undertaken to determine the causes and prevalence of blindness among sickle cell patients attending a general ophthalmology practice. Patients with sickle cell disease who attend with ocular complaints are listed, and a record of their complaints and examination findings are recorded. These records were pulled and examined for visual acuity, presence and type of sickle cell retinopathy. 74 patients presenting with ocular complaints attributable to sickle cell disease were found. One patient with homozygous sickle cell (SS) disease was blind in one eye. 3 patients with sickle cell trait were blind in one eye from sickle cell retinopathy. 27 (81 percent) of 33 patients with sickle cell-HbC (SC) disease had proliferative retinopathy, including 21 (63.6 percent) who were blind in at least one eye at the time of presentation. Of patients with SC who had proliferative retinopathy 77.7 percent were blind at the time of initial presentation. Only 8 (24 percent) patients with SC had 20/20 vision in both eyes. The age range was 5 to 55 years at the time of presentation. Of the blind eyes, one spontaneously regained sight, and four had sight restored surgically. Two patients who were blind in one eye at the time of presentation went on to become blind in the other eye despite surgical intervention and became permanently and bilaterally blind. Sickle cell disease is a significant cause of blindness. Sickle cell patients, particularly those with SC disease, need careful monitoring for the early detection and treatment of eye disease. More public education is needed on this matter.(AU)


Assuntos
Adulto , Criança , Pré-Escolar , Pessoa de Meia-Idade , Humanos , Anemia Falciforme/complicações , Cegueira/etiologia , Jamaica
3.
West Indian med. j ; 47(Suppl. 3): 23, July 1998.
Artigo em Inglês | MedCarib | ID: med-1729

RESUMO

This study was designed to determine the frequency of central retinal vein occlusion as a cause of blindness in glaucoma. Glaucoma patients attending the author's practice over a four month period were examined specifically for evidence of central retinal vein occlusion (CRVO) and their visual acuity recorded. Evidence of CRVO was taken as the following: tortuous anastamotic vessels on the disc; scattered retinal haemorrhages; and telangiectatic retinal vessels or scattered cotton wool spots in the retina in the absence of other retinal disease, eg. diabetic retinopathy. Blindness was accepted as a best corrected visual acuity of 20/200 or worse. The cause of blindness was recorded. 74 blind eyes were recorded, with 44 (60 percent) blind from glaucoma, 22 (30 percent) blind from CRVO. All patients were predominantly Negro. Central retinal vein occlusion is a common cause of blindness in glaucoma patients who are black. This is an important and previously unrecognized fact. In this study approximately one-third of glaucoma patients were blind from CRVO and not glaucoma itself. Essential hypertension and glaucoma are associated factors in CRVO, and each of them has a high incidence in Negroes, and they may be acting synergistically to produce the high incidence of blindness due to CRVO found in this study. This also explains the increase severity of glaucoma in the Negro. Tissue under-perfusion in both diseases may be the underlying explanation.(AU)


Assuntos
Humanos , Oclusão da Veia Retiniana/diagnóstico , Cegueira/etiologia , Glaucoma/complicações , Veia Retiniana , Diabetes Mellitus/complicações , Hipertensão/complicações
4.
West Indian med. j ; 47(Suppl. 3): 23, July 1998.
Artigo em Inglês | MedCarib | ID: med-1730

RESUMO

This retrospective study reviewed data on all new patients in a general ophthalmological service between January and June 1997. Of 1,286 new patients 156 (12.6 percent) were diabetic. 75 percent of these presented for their first eye examination by an ophthalmologist, 25 percent had at least one previous examination and 10 percent were previously diagnosed with diabetic retinopathy. Over 75 percent were diabetic for more than 5 years. Only 23 percent sought consultation as a routine. 77 percent attended because of visual complaints. Most diabetics (58 percent) were East Indian, in keeping with previously reported studies. Blindness occurred in 19 to 21 percent of diabetics depending on the definition. Of 142 whose fundi could be examined, 74 or 52 percent had retinopathy. In spite of increasing knowledge from studies such as the Diabetic Retinopathy Study, the Early Treatment Diabetic Retinopathy Study and the Diabetes Control and Complication Trial, it seems that the message is not filtering through to the level of primary care and to patients. Our review demonstrates the most patient present for ophthalmological assessment only on experiencing visual symptoms. The majority are seen after they have been diabetic for over five years and most patients attend on self referral. Greater effort is required to promote the guidelines of the World Health Organization and the American Academy of the Ophthalmology for the ophthalmic management of diabetic patients in order to reduce the blindness rate due to this epidemic.(AU)


Assuntos
Humanos , Diabetes Mellitus/complicações , Retinopatia Diabética/prevenção & controle , Cegueira/etiologia , Retinopatia Diabética/terapia , Trinidad e Tobago , Estudos Retrospectivos
5.
West Indian med. j ; 47(Suppl. 3): 23, July 1998.
Artigo em Inglês | MedCarib | ID: med-1731

RESUMO

In melanoderms it is estimated that over 10 percent of the adult population is afflicted with open angle glaucoma. This disease is painless, chronic and gradually reduces vision leading eventually to blindness. There is no cure but with early diagnosis, patient education and treatment glaucoma is controllable. The anatomy, physiology, and pharmacology of the eye will be discussed. Surgical management will also be discussed as well as the social and economic effects of this disease in developing countries.(AU)


Assuntos
Adulto , Humanos , Glaucoma de Ângulo Aberto/complicações , Cegueira/diagnóstico , Cegueira/terapia , Olho/anatomia & histologia , Olho/fisiopatologia
6.
Postgrad Doc - Caribbean ; 14(2): 46-51, Mar./Apr. 1998.
Artigo em Inglês | MedCarib | ID: med-1590

RESUMO

Childhood blindness results in a lifetime of morbidity for the child and family involved, requiring special schooling with limited employment opportunities. The identification of the causes of blindness in children and their prevention, where possible, is of vital importance. We look at the causes of blindness in Jamaica. The leading preventable cause was congenital rubella syndrome, which often results in multiple handicap. This condition should be avoidable with a suitable immunisation programme. The leading treatable causes were congenital cataract and glucoma. These conditions may both be treatable if surgery is performed at an early age and specialist care is maintained.(AU)


Assuntos
Criança , Feminino , Humanos , Masculino , Cegueira , Síndrome da Rubéola Congênita/complicações , Catarata/complicações , Glaucoma/congênito , Cegueira/prevenção & controle , Jamaica
7.
West Indian med. j ; 44(Suppl. 2): 22, Apr. 1995.
Artigo em Inglês | MedCarib | ID: med-5790

RESUMO

This study has been designed to provide information about the visual loss in the predominantly Afro-Caribbean population in Barbados. The prevalence, incidence and risk factors of eye disease were studied in a random population sample of 4,709 Barbadian-born people 40 - 84 years of age. Data collected included visual acuity, applanation tonometry, automated perimetry, lens grading, disc and macula photographs along with histories and other clinical measurements such as blood pressure. Data on visual acuity showed that 12 percent of subjects had impairment of vision worse than 6/12 whislt 3.4 percent had severe loss ( > 6/60). Open angle glaucoma (OAG) was diagnosed on the criteria of visual field loss and typical optic disc pathology in at least one eye. Six percent (309 persons) were diagnosed as having OAG, 3.6 percent as suspect OAG and 12 percent had intraocular pressure higher than 21 mm Hg. Prevalence of OAG increased with age, reaching 25 percent in men and 22 percent in women 80 years of age and over. Half of the cases found had been previously diagnosed. Analysis suggests that the risk factors for OAG are: older age, males, high intraocular pressures, a history of cataract and a lean body mass. Diabetes, hypertension, cardiovascular disease and obesity were not identified as risk factors in this study. Lens opacities were frequent (44 percent), and increased in frequency with age. Of those persons with visual acuity less than 6/12, 75 percent had cataracts. These findings should be helpful in implementing blindness prevention programmes (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Oftalmopatias/epidemiologia , Cegueira/epidemiologia , Barbados
9.
Eye ; 8(pt 3): 315-20, 1994.
Artigo em Inglês | MedCarib | ID: med-7145

RESUMO

The purpose of the study was to estimate the prevalence of and risk factors for chronic glaucoma in a sample of African Caribbean people over 35 years of age living in the London Borough of Haringey. A cross-sectional voluntary sample of persons were subjected to detailed ophthalmic assessment including automated tangent screen suprathreshold visual field testing, applanation tonometry and stereoscopic disc evaluation in 50 community-based survey clinics over an 8 month period. Cases and suspects were referred to Moorfields Eye Hospital for more detailed assessment and confirmation of the diagnosis. Of 873 eligible persons examined (out of a total of 1022), 32 definite cases of glaucoma were identified, a prevalence of 3.9 percent; 42 percent of these had been previously diagnosed. Approximately 10 percent of the sample required further assessment and follow-up when ocular hypertensives and glaucoma suspects were included. An age-standardised comparison with the findings of the Roscommon survey revealed a relative risk for glaucoma for Haringey blacks compared with Irish whites of 3.7. Significant risk factors for glaucoma included age, African birthplace and darker skin colour. Neither diabetes nor hypertension reached significance. Despite the lack of a population base, this study provides strong evidence that the 4 times greater risk of glaucoma estimated for American blacks compared with whites applies equally to the United Kingdom population. Community-based facilities are required to raise awareness of the risk among this ethnic minority in this country and case-finding resources should be provided to meet local needs (Summary)


Assuntos
Pessoa de Meia-Idade , Glaucoma/epidemiologia , África/etnologia , Cegueira/etiologia , Região do Caribe/etnologia , Diabetes Mellitus/complicações , Hipertensão/complicações , Londres/epidemiologia , Análise Multivariada , Prevalência , Fatores de Risco , Pigmentação da Pele , Campos Visuais
10.
West Indian med. j ; 42(suppl.3): 14, Nov. 1993.
Artigo em Inglês | MedCarib | ID: med-5495

RESUMO

It is estimated that there are almost 41 - 52 million people who are legally blind worldwide with vision of 6/60 (20/200) or less. Ninety percent of these patients live in developing countries. This leads to serious social and economic consequences and is associated with reduced life expectancy. Eighty percent of cases presented could be cured. The most common causes are: Cataracts, Trachoma, Glaucoma, Onchocerciasis, Xerophthalmia, Trauma. The geographic distribution is presented. Each cause is discussed in terms of aetiology, epidemiology, treatment, immunology and future research aimed at eliminating or reducing the incidence of blindness in the world (AU)


Assuntos
Cegueira
11.
West Indian med. j ; 40(suppl.1): 52, Apr. 1991.
Artigo em Inglês | MedCarib | ID: med-5553

RESUMO

The Barbados Eye Study is determining the prevalence and risk factors of major causes of visual loss in a random sample of the population between ages 40 and 84 years. All participants have visual acuity (VA) measurements, applanation tonometry, computerized perimetry, lens gradings, fundus photography, glycosylated haemoglobin, interview, blood pressure and anthropometry. Persons with positive test results and a 10 percent sample of all participants also have an opthalmologic examination, additional threshold perimetry and tonometry. The study also has a longitudinal component, the glaucoma follow-up study, which provides continuing care and evaluation for newly detected cases of glaucoma and suspect glaucoma. Recruitment of the intended sample size of 4,000 persons is expected to end in 1991. By November 1990, 3,095 persons had completed data collection with a participation of 87 percent of those eligible. Preliminary findings show a prevalence of visual impairment (VA < 20/40 in the better eye) of 11.5 percent, age-related cataract, age-related maculopathy, open-angle glaucoma and diabetic retinopathy were main causes of decreased VA. Blindness prevalence (VA < 20/200 in the better eye) was 3.2 percent; open-angle glaucoma and age-related cataract were the major causes of blindness. Results suggest a high prevalence of open-angle glaucoma as found in an earlier pilot project. Hypertension and diabetes mellitus were also very frequent in this population (AU)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Oftalmopatias/epidemiologia , Transtornos da Visão , Cegueira/epidemiologia , Barbados
12.
Int Ophthalmol ; 13(5): 301-3, Sept. 1989.
Artigo em Inglês | MedCarib | ID: med-12422

RESUMO

Maculopathy is the commonest cause of severe visual loss diabetic retinopathy in Jamaica [5]. Ophthalmic assessment of 158 black Jamaican maturity onset diabetics referred randomly from the primary and secondary health centres, demonstrated maculopathy in 48 percent of patients. Duration of diabetes was a strong risk factor for maculopathy (p less than 0.0010). Poor compliance with diabetic and hypertensive therapy may infleunce the prevalence of maculopathy (AU)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Retinopatia Diabética/epidemiologia , Macula Lutea , Doenças Retinianas/epidemiologia , Fatores Etários , Idoso de 80 Anos ou mais , Cegueira/etiologia , Pressão Arterial , Retinopatia Diabética/complicações , Jamaica/epidemiologia , Prevalência , Distribuição Aleatória , Análise de Regressão , Doenças Retinianas/etiologia , Fatores de Risco , Fatores Sexuais , Acuidade Visual
14.
Br J Ophthalmol ; 72(1): 65-7, Jan. 1988.
Artigo em Inglês | MedCarib | ID: med-12473

RESUMO

Examinations were performed on the 108 blind Jamaican children (VA less than 6/60 in the better eye) in residential care. The congenital rubella syndrome (CRS) was the leading preventable cause of childhood blindness, accounting for 22 percent of children examined. Improvement of the surgical procedures constitute recent attempts to combat childhood blindness. (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Masculino , Feminino , Cegueira/epidemiologia , Cegueira/etiologia , Cegueira/prevenção & controle , Catarata/congênito , Glaucoma/congênito , Imunização , Jamaica , Atrofia Óptica/congênito , Rubéola (Sarampo Alemão)/prevenção & controle , Síndrome da Rubéola Congênita/complicações
15.
Br J Ophthalmol ; 69(9): 700-6, Sept. 1985.
Artigo em Inglês | MedCarib | ID: med-9375

RESUMO

In sickle cell retinopathy vascular involvement is most frequently recognised at the retinal periphery but obstruction of perimacular arterioles and of major retinal vessels may also occur. This report describes a patient with homozygous sickle cell (SS) disease with recurrent occlusion of major retinal vessels associated with recurring transient impairment of visual function. (Summary)


Assuntos
Humanos , Adulto , Masculino , Anemia Falciforme/complicações , Cegueira/complicações , Angiofluoresceinografia , Recidiva , Doenças Retinianas/complicações , Vasos Retinianos , Acuidade Visual
16.
West Indian med. j ; 34(suppl): 54, 1985.
Artigo em Inglês | MedCarib | ID: med-6660

RESUMO

The relative importance of different causes of blindness show a wide geographical variation. This retrospective study was undertaken to provide information on the comparative aetiology of blindness in Trinidad. All blind patients (visual acuity 6/60 or less) seen from Aug. 1982 to Oct. 1984 were reviewed. Where blindness was influenced by more than one pathology a judgment was made, on clinical grounds, as to the predominant cause, and the eyes categorised accordingly. Of the 111 patients with cataract, 32 had surgery with restoration of vision (6/12) in 25. Cataracts, diabetes mellitus and glaucoma together accounted for 68 percent of blindness. Onchocerciasis, trachoma and xerophthalmia, major causes of blindness in other parts of the developing world, were not diagnosed. Senile macular degeneration, which accounts for 30 percent of blindness in the elderly, was uncommon. It is probable that much of the blindness is preventable. Early referral, surveillance and photocoagulation have been shown to reduce diabetic blindness by 60 percent. Drug compliance was a major problem with glaucoma. Six of the eight hypertensive patients were out of therapeutic control when their retinal vascular accidents occurred (AU)


Assuntos
Humanos , Cegueira/epidemiologia , Cegueira/etiologia , Trinidad e Tobago
17.
Br J Ophthalmol ; 64(6): 404-11, June 1980.
Artigo em Inglês | MedCarib | ID: med-12167

RESUMO

The development of ocular lesions in 313 patients with sickle cell disease followed up for periods of 1-8 years is described. Proliferative sickle retinopathy (PSR) was present on initial examination in 68 (12 percent) of 567 eyes and developed in a further 46 (8 percent) eyes during the study period. Spontaneous regression (autoinfarction) was present on initial examination in 33 (49 percent) eyes with PSR initially and developed in a further 45 (39 percent) eyes during the study. Development of PSR was common in sickle cell-hemoglobin C (SC) disease, and autoinfarction appeared to occur more commonly in homozygous sickle cell (SS) disease. The two processes were delicately balanced, and some PSR lesions lasted less than a year before undergoing autoinfarction. Although the high prevalence of autoinfartion diminishes the clinical sequelae of PSR, blindness related to PSR occurred in 14/119 (12 percent) eyes. Autoinfarction closes the feeding vessels of PSR lesions more elegantly than, and without the complications associated with, photocoagulation. A greater understanding of factors involved in the progression and regression of PSR is relevant to defining the role of photocoagulation in this condition. (Summary)


Assuntos
Humanos , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Anemia Falciforme/complicações , Doenças Retinianas/complicações , Cegueira/etiologia , Angiofluoresceinografia , Seguimentos , Genótipo , Fotocoagulação , Remissão Espontânea , Doenças Retinianas/cirurgia
18.
West Indian med. j;19(1): 14-8, Mar. 1970.
em Inglês | MedCarib | ID: med-10932

RESUMO

A report of the types of blindness which have been recorded in St. Lucia from one hundred patients is presented. It was found that glaucoma was the most common cause (33 percent), optic nerve disease was the second commonest cause of blindness (23 percent). Half of the patients with optic nerve disease proabably were suffering from the condition known as tropical amblyopia. Corneal opacities were presented in 14 percent of these blind patients, but only a minority (3) were thought to be suitable for keratoplasty. Degenerative disease of the retina and choroid was recorded as the cause of blindness in nine patients. Cataracts were the registered cause of blindness in eight patients but it was pointed out that cataract is the commonest cause of blindness in St. Lucia at any time. Other causes of blindness in St. Lucia were found to be due to uveitis, congenital microphthalmos, retinitis pigmentosa, diabetic retinopathy, contusion injuries, congenital phthisis bulbi and arterial occlusion. The author feels that if greater effort could be devoted to treating the two large groups of glaucomatous and tropical amblyopic patients, it would go far towards reducing the numbers of blind people in this island (AU)


Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cegueira/epidemiologia , Cegueira/etiologia , Santa Lúcia
19.
West Indian med. j ; 13(3): 154-7, Sept. 1964.
Artigo em Inglês | MedCarib | ID: med-11012

RESUMO

Neurological complications following whooping cough are rare. A case report involving a seven year old girl in which blindness and recurrent bilateral paralysis of the limbs occurres with slow recovery after treatment with steroids. It is postulated that these neurological complications were due to haemorrhage associated with edema and possibly anoxia. (AU)


Assuntos
Humanos , Criança , Feminino , Cegueira/etiologia , Paralisia/etiologia , Coqueluche/complicações , Edema , Hipóxia/complicações , Hemorragia/complicações
20.
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