PREVALENCE AND CHARACTERISTICS OF MULTIFOCAL CHOROIDITIS/PUNCTATE INNER CHOROIDOPATHY IN PATHOLOGIC MYOPIA EYES WITH PATCHY ATROPHY.

PURPOSE: To determine the prevalence and characteristics of multifocal choroiditis/punctate inner choroidopathy (MFC/PIC) in eyes with patchy atrophy because of pathologic myopia. METHODS: Five hundred eyes of 253 patients with patchy atrophy were examined between 2014 and 2020 at the Advanced Clinical Center for Myopia. The main outcome measures included the prevalence and characteristics of active MFC/PIC lesions diagnosed by optical coherence tomography. RESULTS: Fifty-five of the 500 eyes (11%) diagnosed with patchy atrophy had optical coherence tomography features of active MFC/PIC lesions, such as focal elevations of the retinal pigment epithelium filled with medium hyperreflectivity material, curvilinear scars (Schlaegel lines), and/or areas of outer retinal atrophy. At the time when the MFC/PIC was diagnosed, the mean age was 57.3 ± 12.0 years, and the mean axial length was 29.2 ± 1.8 mm. Macular neovascularization was found in 45 of eyes (81.8%) with MFC/PIC versus 151 eyes without such findings (33.9%; P < 0.001). In 25 of the 55 eyes (45.5%), active MFC/PIC lesions were found before the development of the patchy atrophy. The Bruch membrane defects were colocated with these lesions. CONCLUSION: Active MFC/PIC lesions were identified in a minority of eyes with pathologic myopia, and a subset of these lesions were observed to progress to findings indistinguishable from myopic patchy atrophy. Evidence of MFC/PIC in eyes with pathologic myopia appeared to be a risk factor for the development of macular neovascularization.

Spectral domain optical coherence tomography study of pearl-like lesions in the anterior chamber.

AIM: To study the morphological pattern of pearl-like lesions in the anterior chambers of children before and after management using anterior segment spectral domain optical coherence tomography (SD-OCT). PATIENTS AND METHODS: This was a prospective, observational cross-sectional study of patients presenting with peculiar pearl-like lesions in the anterior chamber of their eyes. 1 mL of betamethasone sodium phosphate (2 mg/mL) and betamethasone dipropionate (5 mg/mL) was injected subconjunctivally. Follow-ups of all patients were conducted for a period of 6 weeks. Anterior segment imaging was done using SD-OCT and also photo slit lamp before and after management. RESULTS: Twelve eyes of 12 patients were included in this study. These patients presented with pearl-like lesions in the anterior chamber with signs of anterior uveitis. There was no history of ocular injury or tuberculosis in any patients. Six weeks after subconjunctival steroid injection, all patients achieved mean best-corrected visual acuity, which changed from 0.2 (range 0.1-0.4) to 0.5 (range 0.4-0.8), and the severity of iritis decreased. SD-OCT showed that the lesions at presentation appeared as a globular noncystic mass attached to the back of the cornea, encroaching on the angle of the eye, and attached to the anterior surface of the iris at some points. CONCLUSION: SD-OCT for imaging the anterior segment allowed us to exclude the cystic nature of this pearly lesion. Some similarities may exist between these pearly lesions and superficial phlyctenular keratitis, which may support the immunological and inflammatory origin of these lesions.

Patient satisfaction with cataract surgery.

INTRODUCTION: Measuring the patient satisfaction is a very important issue that will help very much in improving the service provided to patients and improve the level of satisfaction. AIM: To evaluate patient satisfaction with the cataract surgery service and identify any areas for improvement, determination of patient satisfaction with referral, out-patient consultation, pre-assessment clinic, surgery and post-operative care, also to report patients' comments relating to improvement in service provision. METHODOLOGY: A retrospective study was undertaken for 150 patients underwent cataract surgery at Barrow General Hospital, UK, the survey sample was by postal questionnaires. We collected our data from the theatre lists for a period of 4 month. RESULTS: This study included 150 patients; the response rate was (72%) 108 patients, Most patients were referred from their general practitioner 86.1%, 93 (86.1%) patients were happy with the time interval from seeing their GP to eye clinic. In the eye out patient department many factors significantly affected the level of patient satisfaction, in general the more information provided for the patient the more the satisfaction. CONCLUSION: Patient satisfaction is on important health outcome old understanding both the domains of satisfaction as well as their relative importance to patients is necessary to improve the overall quality of patient care. Meeting the doctor, presenting all relevant information and giving printed information are very important factors in improving the patient's satisfaction with cataract surgery.

Pattern of eye casualty clinic cases.

INTRODUCTION/BACKGROUND: The purpose of the eye casualty clinic (ECC) is to manage patients with ocular emergencies, however a large number of patients attended the eye casualty clinic did not have an acute problem and could have been treated by their General Practitioner (GP) or referred to the eye outpatient clinic. AIM: To identify the number of patients attending the ECC every day and their route of referral and to estimate the number of patients who could have be seen and managed by a competent ophthalmic nurse practitioner. METHODS: A retrospective analysis was conducted using the notes and history of all patients who attended the eye casualty clinic at the Princess Margaret Hospital in Swindon during two weeks in March 2006. RESULTS: The average daily attendance was 21 patients who were seen between morning and afternoon sessions in the Eye Casualty Clinic.112 (54%) patients were female. The median patient age was 50 years with an age range of 1 to 91 years. 68 (34.2%) patients attended as self referrals without GP letters as our eye casualty clinic is open to the general public from 9.00 a.m. to 5.00 p.m. A & E referred 28 (14.1%) patients of which only 3 had a General Practitioner (GP) letter and only 1 patient had a walk-in centre letter. There was insufficient information to assess whether 14 patients could have been managed by a nurse; of the remaining 195 visits, 50 (25.6%) patients could have been managed by an Ophthalmic Nurse Practitioner and 145 (74.4%) patients could not have been managed by an Ophthalmic Nurse Practitioner. CONCLUSION: The workload of the eye casualty doctors could be decreased by 38.6% if defined categories of patients were managed by the ophthalmic nurse practitioner, appropriate referrals were directed to the General Clinic and casualty patients were not followed up inappropriately.