Fundus autofluorescence imaging in an ocular screening program.

Purpose. To describe integration of fundus autofluorescence (FAF) imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters) images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA), intraocular pressure (IOP), and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18%) individuals with diabetic retinopathy or macular edema (n = 4), focal RPE defects (n = 2), age-related macular degeneration (n = 1), central serous retinopathy (n = 1), and ocular trauma (n = 1). Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted.

Low-cost high-volume ECCE with PC I0L.

The following two letters address an article that appeared in the October 1999 issue of the Journal: Ruit S, Tabin GC, et al. Low-cost high-volume extracapsular cataract extraction with posterior chamber intraocular lens implantation in Nepal. (Ophthalmology 1999;106:1887-92)

Ocular sequelae of pneumatic drills.

PURPOSE: To determine the ocular sequelae of rock-drilling. METHODS: Nineteen rock-drillers and 20 age-, sex- and race-matched control subjects underwent ocular examination in a prospective manner. RESULTS: Subepithelial corneal opacities were found in 12 drillers (63%) and none of the controls; pigmented trabecular meshwork was noted in 13 drillers (68%) and 1 control (5%); low-tension glaucoma was diagnosed in 1 driller (5%); vitreous liquefaction was present in 17 of 17 drillers (100%) examined by a retina specialist and 9 of 20 controls (45%). CONCLUSIONS: The sequelae of drilling include corneal scars from projectile pieces of drilled stone as well as vibration-induced pigment deposition in the trabecular meshwork and vitreous liquefaction. Wearing of safety glasses is recommended.

Screening and referral patterns for glaucoma in family practice.

The purpose of this study was to determine whether family physicians in Louisiana were (1) aware of risk factors for glaucoma; and (2) complying with USPSTF recommendations. A brief, confidential survey was mailed to family physicians. Knowledge of glaucoma and its risk factors was assessed, as were physicians' decisions to refer high-risk patients for ophthalmologic evaluation. Questions addressed awareness of treatment guidelines and screening of glaucoma, as well as select demographic data. A total of 533 surveys were distributed. Sixty-three surveys were returned by the post office, which left a usable sample size of 470. The overall response rate was 40.22% (N = 189). Seventy percent of respondents considered diabetes and hypertension risk factors. Roughly 25% routinely screened high-risk patients for glaucoma; 75% did not. Sixty percent showed correct clinical judgment in referring patients to ophthalmologists based on history and physical examination. Sixty-five percent of respondents were unaware of any guidelines or consensus statements for the treatment of glaucoma. While most family physicians can identify risk factors for glaucoma, they do not routinely screen for patients with high-risk factors.

Anterior uveitis associated with latanoprost.

PURPOSE: To report the association of anterior uveitis with the use of latanoprost. METHODS: We studied four patients with complicated open-angle glaucoma who had anterior uveitis associated with the use of latanoprost. The uveitis was unilateral and occurred only in the eye receiving latanoprost in three patients. In one patient, latanoprost was used in both eyes, and the uveitis was bilateral. Four of five eyes had a history of prior inflammation and/or prior incisional surgery. All patients were rechallenged with the drug. RESULTS: The uveitis improved after cessation of latanoprost with or without topical corticosteroids. It recurred after rechallenging with latanoprost in all eyes. CONCLUSION: There is a possible association between latanoprost and anterior uveitis. Topical prostaglandin analogs may be relatively contraindicated in patients with a history of uveitis or prior ocular surgery. This association may also be possible in eyes that have not had previous uveitis or incisional surgery.