The long term effects of unilateral corneal scars.

The main purpose of this study was to evaluate the long term effects of unilateral dense central corneal scars on the axial length and development of lens opacities. We included 12 patients with unilateral dense central corneal scars of early onset before the age of seven years. This study served as naturally-controlled experiment and demonstrated a statistically significant increase in ocular axial length and decrease in the incidence of cataract in the eye with central corneal scar. Visual deprivation induced by unilateral central corneal scars occurring in early childhood leads to increase in the ocular axial length, and decrease in the incidence of cataract.

Toxoplasmosis in Saudi Arabia.

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Ocular levels of azithromycin.

OBJECTIVE: To assess azithromycin levels in human serum, aqueous humor, tear fluid, and conjunctival tissue specimens after administration of a single 1-g oral dose of azithromycin. METHODS: Sixty patients undergoing cataract surgery were included in this analysis. Serum, aqueous, and tear specimens were collected 3, 6, and 12 hours and 1, 2, 3, and 4 days after azithromycin administration. Conjunctival tissue biopsy specimens were collected 1, 2, 3, 4, 6, 8, 10, 12, and 14 days after azithromycin administration. All specimens were subjected to analysis by high-performance liquid chromatography-mass spectrometry. RESULTS: Azithromycin concentration ranges during the specified sampling times were as follows: serum, 21 to 974 ng/mL; tear, 82 to 2892 ng/mL; aqueous, 10 to 69 ng/mL; and conjunctival, 0.7 to 32 micrograms/g. Levels above the 90% minimal inhibitory concentration (MIC90) for Chlamydia trachomatis were detected after 4 days in all tear samples and after 14 days in all conjunctival tissue specimens following oral azithromycin administration. CONCLUSION: We demonstrated prolonged high levels of azithromycin in drug-targeted ocular tissue. Prolonged high concentrations of azithromycin in conjunctival tissue make this drug suitable for treatment of conjunctivitis caused by chlamydiae and other susceptible organisms.

Heparin surface-modified intraocular lenses in patients with inactive uveitis or diabetes.

OBJECTIVE: This study aimed to determine whether heparin surface-modified (HSM) intraocular lenses (IOLs) with a hydrophilic surface would reduce cell adherence and other postoperative changes compared with the conventional polymethylmethacrylate (PMMA) IOLs in patients with either diabetes mellitus or inactive uveitis. DESIGN: The study design was a randomized, double-masked, clinical trial. PARTICIPANTS: Twenty-five patients with bilateral cataracts, 14 with inactive anterior uveitis and 11 with diabetes, with an age range of 11 to 81 years (mean, 52.8 years) participated. INTERVENTION: Bilateral cataract extraction with posterior chamber IOL implantation was measured, each patient receiving an HSM lens in one eye and a PMMA lens in the other. Pharmacia one-piece HSM and PMMA IOLs were used. Postoperative ocular changes were evaluated at regular intervals for 24 months in patients with inactive uveitis and for 6 months in patients with diabetes. Patients and physicians alike were unaware of which eye contained which lens until postoperative results were compiled. Records were kept by a study coordinator. MAIN OUTCOME MEASURES: Comparisons of posterior synechiae, IOL cellular deposits, and posterior capsular fibrosis between PMMA and HSM IOLs were measured. RESULTS: Using the chi-square test, no statistically significant difference was found between the HSM and PMMA IOLs in the number of cellular deposits found on the anterior IOL surface, the number of adhesions between the iris and IOL, or the incidence of capsular opacification. CONCLUSION: The HSM and PMMA IOLs showed similar postoperative results in patients with inactive uveitis or diabetes mellitus.

Trachoma in Saudi Arabia.

AIMS & BACKGROUND: The main objectives of this study were to determine the prevalence and magnitude of trachoma in Saudi Arabia and to evaluate the factors that play a role in the transmission and severity of the disease. METHODS: The samples consisted of a stratified multistage random cluster design that selected defined primary sampling units of 50-60 housing units in both metropolitan and non-metropolitan communities. RESULTS: In 1984, evidence of trachoma (active and inactive) was found among 22.2% of the Saudi population and 6.2% of the Saudis had evidence of active trachoma. In addition, 17.4% had conjunctival scarring as a result of old trachoma, and 1.5% had entropion or trichiasis. In 1994, clinical evidence of trachoma (active and inactive) was found among 10.7% of the Saudi population while 2.6% had active trachoma. Conjunctival scarring as a result of healed trachoma was seen in 8.1% and 0.2% had entropion and trichiasis. The prevalence of trachoma in households was directly related to the presence and appearance rating of children in a household, the presence of flies, and the appearance rating of the household itself. An increase in individual risk was found among women who veil and men who use kohl. CONCLUSION: This study has shown a remarkable decrease in the prevalence of active trachoma in Saudi Arabia over the past decade. The findings should serve as a basis for future plans for prevention and intervention.

Prevalence and causes of visual impairment and blindness in the south western region of Saudi Arabia.

A population-based survey of the prevalence of major causes of blindness and visual impairment was conducted in Bisha region, Saudi Arabia. Overall, 2882 people were examined. The prevalence of blindness (visual acuity of < 3/60 in the better eye with best available correction) was 0.7% and the prevalence of visual impairment (visual acuity < 6/12 but > or = 3/60 in the better eye with best available correction) was 10.9%. Cataracts were responsible for 52.6% of blindness and 20.6% of visual impairment. Refractive errors accounted for 67.9% of visual impairment. Proper management of cataracts and correction of refractive errors will cure 73.6% of blind subjects and 88.5% of visually handicap people in this part of the world.

Retrobulbar alcohol injection in blind painful eyes.

We studied 39 blind painful eyes in 39 patients who were treated with retrobulbar injection of absolute (96%) alcohol for their severe ocular pain at the King Khaled Eye Specialist Hospital from January 1984 to January 1987. There were 21 (54%) male and 18 (46%) female patients; all were followed for at least three months. The protracted ocular pain was mainly due to: end-stage (absolute) glaucoma in 31 (80%) eyes, uveitis or endophthalmitis in four (10%) eyes, or corneal ulcer in two (5%) eyes. One eye had painful phthisis bulbi, and one eye had infraorbital neuralgia. The complications encountered were transient and included blepharoptosis in eight (21%) eyes, external ophthalmoplegia, and corneal epithelial defect. The effective time of the injection to relieve pain ranged from two weeks to two years (mean, 29 weeks). The authors believe that there is still a place for retrobulbar alcohol injection for blind painful eyes when enucleation or evisceration is not possible.