Effect of Uveitis on the Development of Keratopathy: A Population-Based Cohort Study.

Purpose: The purpose of this study was to evaluate the effect of uveitis on the development of various keratopathies via the use of the National Health Insurance Research Database (NHIRD) in Taiwan. Methods: Approximately 1 million patients were randomly sampled from the registry of the NHIRD. Patients diagnosed with uveitis by ophthalmologists were enrolled in the study group after exclusion. Each individual in the study group was age and sex matched to four non-uveitis individuals who serve as the control group. In addition to keratopathy, other possible risk factors and medications were included in the multivariate model, and the effects of different subtypes of uveitis for developing keratopathies were also analyzed. Results: A total of 4773 uveitis patients (2662 male and 2111 female) and 19,092 non-uveitis patients (10,648 male and 8444 female) were enrolled. There were 406 events of keratopathy in the study group, and another 764 events occurred in the control group. A higher incidence rate was found in the study group after adjustment (adjusted hazard ratio [aHR]: 1.772), with a greater cumulative probability (P < 0.0001). For the subgroup analysis, anterior uveitis (aHR = 1.765) and panuveitis (aHR = 3.386) increased the risk of developing keratopathies. Moreover, male sex was associated with a higher aHR than female sex for developing keratopathies in the study group. Conclusions: The presence of uveitis significantly elevates the risk for developing keratopathy.

Ophthalmologic findings in contact sport disciplines.

BACKGROUND: The aim of the study was to investigate the prevalence and the incidence of ocular complications in contact sport disciplines in a large population of professional and amateur athletes over a period of 3 years. METHODS: We performed a retrospective review of 694 medical records from athletes examinated from 2008 to 2011. The following data were collected during the routine visit for agonistic sports eligibility: medical history, age, weight, years of sport practice, approximate number of matches, head and eyes injuries during and beyond of the match and a through ocular history. All athletes underwent a detailed ophthalmological evaluation. The follow-up of each athlete was carried out during the following routine visit for agonistic sports eligibility. RESULTS: Most common disorders observed were: peripheral retinal degeneration, blepharitis, conjunctival and corneal diseases with a prevalence of 7%, 4%, 7% and 4% respectively. It was observed a positive correlation between peripheral retinal degeneration and age in amateur male boxers. Moreover, we noticed an incidence of 6% of laser therapeutic treatments as a result of retinal holes or degenerations, during the follow-up. CONCLUSIONS: Contact sport disciplines did not result in higher prevalence of severe ocular lesion. Both conjuntival diseases and peripheral retinal degenerations represented the ophthalmologic disorders with the higher prevalence in our sample. In particular, peripheral retinal degeneration is remarkable because of the increased risk of retinal detachment. Dyschromatopsie, even if quite rare, should be considered when analysing the reception of shots, since gloves in most cases are either red or blue.

Minimising corneal scarring from the use of harmful traditional eye remedies in developing countries.

Corneal scarring is the fourth largest cause of blindness globally, and a much more prominent factor in developing countries. Blindness from corneal scarring is largely a preventable phenomenon, and is capable of causing significant morbidity that can last for a lifetime. A significant proportion of these cases are caused by the use of harmful traditional eye medicines/remedies, and are used and prescribed by friends, relatives and traditional healers, with widespread use especially in developing countries. Use of traditional remedies can also cause harm indirectly by causing delays before seeking medical treatment. Reducing corneal scarring from the use of harmful traditional medicine is through a combination of approaches with the key strategies being community diagnosis, education, participation, and intervention, with provision of basic eye care integrated into the primary health care of the community. Collaboration with traditional healers in the community is also another approach that has been found to be useful.

Causes and temporal trends of childhood blindness in Indonesia: study at schools for the blind in Java.

AIMS: To ascertain the causes of blindness and severe visual impairment (BL/SVI) in schools for the blind in Java, to identify preventable and treatable causes and to evaluate temporal trends in the major causes. METHODS: From a total of 504 students, 479 were examined. Data was collected using a modified World Heath Organization Prevention of Blindness (WHO/PBL) eye examination record for children. RESULTS: The majority of the students (95%) were blind and 4.6% were severely visually impaired. The major anatomical site of BL/SVI was whole globe in 35.9%, retina in 18.9%, lens in 16.4% and cornea in 16.1%. The major underlying aetiology of BL/SVI was undetermined/unknown in 32.7% (mainly microphthalmia, anterior segment dysgenesis and cataract), hereditary factors 31.9% (mainly retinal dystrophies), and childhood disorders 28.5%. Avoidable causes of BL/SVI accounted for 59.9% of the total students, whereas measles blindness was the underlying condition for 23.1% of the preventable causes; cataract and glaucoma accounted for 15.5% and 8.2% of the treatable causes, respectively. Exploration on trends of SVI/BL among two different age groups <16 years and > or = 16 years suggested that childhood disorders and corneal factors have declined, while hereditary disorders have increased. Optic nerve disorder, although not counted as a major cause of blindness, seems to be on the increase. CONCLUSIONS: More than half of the BL/SVI causes are potentially avoidable. Cataract and corneal disorders related to measles or vitamin A deficiency were the major treatable and preventable causes. Declining proportions of childhood factors and corneal disorders over a period of 10-20 years could reflect improved vitamin A supplementation and measles vaccination coverage in Indonesia. This finding, and the increased proportion of hereditary disease causes, could suggest improving levels of socioeconomic development and health care services.

Changing patterns of corneal disease and associated vision loss at a rural African hospital following a training programme for traditional healers.

AIMS/BACKGROUND: Use of African traditional eye medicines (TEM) is associated with the presence of corneal disease, delay in presentation, and vision loss. An interactive training programme was conducted with traditional healers in Chikwawa District, Malawi and changes in the pattern of corneal disease assessed in patients presenting to the district hospital after the training. METHODS: All patients presenting to the district hospital with corneal disease for a 15 month period before intervention and a 12 month period after intervention were enrolled in the study. Interviews and examinations were carried out by the same person using a standardised, pretested form. RESULTS: Among the 175 pre-intervention and 97 post-intervention patients, delay in presentation improved only slightly. Blindness among patients reporting the use of TEM decreased from 44% to 21%; bilateral corneal disease in patients using TEM decreased from 31% to 10%. Multivariate analysis demonstrates that poor vision in corneal disease patients continues to be associated with TEM use and distance from the district hospital. CONCLUSION: As there were no other relevant eye health programmes in the district it is believed that this collaborative eye care programme with the traditional healers was likely to have been responsible for many of the changes in the pattern of corneal disease in the district. Although the changing patterns are encouraging and are likely to improve with additional collaboration, distance to a district hospital will continue to be a barrier to timely use of Western eye care services.