Magnitude and Determinants of Awareness Regarding Refractive Surgeries Among Saudi Adults.

Objectives: This study aimed to present the magnitude and determinants of awareness about refractive surgery among the adult Saudi population and recommend knowledge improvement. Methods: This web-based cross-sectional study was conducted between June 2020 and May 2021 across various regions of Saudi Arabia on the adult Saudi population. A total of 11 close-ended questions regarding indication, contraindication, preparation and surgery procedures were asked. The awareness scores were grouped as 'good' (≥6) or 'poor' (≤5). Demographic and ocular parameters were associated with the outcomes. Results: Of the 6,746 participants, 6,580 (response rate = 97.5%) completed the survey. The participation of younger women and older men was greater than their proportions in the population, while older women participated less than their proportion. Good awareness about refractive surgery was noted in 1,165 (17.7%; 95% confidence interval: 16.2-18.0) participants. Women (P <0.001), the 18-29 age group (P <0.001), residents of the central region of Saudi Arabia (P <0.001), health professionals (P <0.001), health sector students (P = 0.0004), people with myopia (P <0.001) and history of refractive surgery (P <0.001) were associated with good awareness. Women (adjusted odds ratio [AOR] = 1.5; P <0.001), health sector students (AOR = 1.57; P <0.001), and residents in the central region (AOR = 1.27; P <0.001) were independent predictors of awareness. Knowledge about contraindications for surgery was good in more than one-third of the participants. Of the 535 participants who underwent surgery in the past, 452 (84.5%) were satisfied with their outcomes. Conclusion: Awareness of refractive surgeries is low in the adult Saudi population. Targeted counseling is recommended to improve the knowledge and acceptance of refractive surgery.

Knowledge, Attitudes, and Practices Toward Self-Medicating Eye Symptoms in Saudi Arabia.

Purpose: Self-medication is the selection and use of drugs by individuals to treat self-diagnosed diseases or symptoms. While some patients regard self-medicating as harmless, it is far from being a safe practice. The aim of this study was to evaluate the knowledge, attitudes, and practices toward self-medicating eye symptoms in Saudi Arabia. Patients and Methods: A cross-sectional study was conducted through an online questionnaire on a study population that consisted of Saudi nationals aged 18 and older who were using or had previously used ophthalmic medications. Results: Among the 524 responses obtained, 79.4% were female, and more than half were less than 40 years old. Participants admitting to practicing ophthalmic self-medication measured 62.4%. The most commonly self-prescribed ophthalmic medications were artificial tears (n=276), followed by antiallergic (n=57) and antibiotic medications (n=33). Many participants reported that the reason for self-treatment was for repeated and simple symptoms that did not require professional care. While approximately 51% showed high levels of knowledge about ophthalmic medications, no significant relationship was seen with their choice to self-medicate (P=0.153). Conclusion: Despite detecting a high level of knowledge and acceptable practices and attitudes among participants, a high incidence of self-medication was observed. This effect was mostly attributed to long hospital waiting times and patient self-diagnosis. Increasing the number of healthcare units and properly educating patients on ophthalmic medications may help decrease the incidence of self-medication.

Pilomatrixoma in a child mimicking a ruptured epidermal cyst clinically and histopathologically: Case report.

INTRODUCTION AND IMPORTANCE: Pilomatrixoma is a superficial benign skin tumor that originates from the matrix cells of the hair follicles. It presents more frequently during the first two decades of life and usually involves the head and neck, most often in the eyelid or eyebrow area. CASE PRESENTATION: We present a case of pilomatrixoma, which appeared at the age of 14 years with history of recurrent inflammation and discharge mimicking a ruptured epidermal cyst. DISCUSSION: Pilomatrixomas are often confused clinically with other benign masses, encountered in the clinical practice more frequently like dermoid cysts and epidermal inclusion cysts. The rate of accurate preoperative diagnosis ranges between 0%-30% and the correct diagnosis can be established only after excision and histopathological examination. Our case demonstrates an atypical presentation of pilomatrixoma as an epidermal inclusion cyst. CONCLUSION: Ophthalmologists and ocular pathologists should be aware of the atypical presentation of pilomatrixomas to ensure early accurate diagnosis and curative treatment.

Tungiasis infestation of dermis fat graft in an anophthalmic socket.

A patient with an anophthalmic socket with a dermis-fat graft (DFG) developed inflammation and a foul odour in the right socket. The DFG was surgically removed and Tungiasis infestation was detected. This is the first case to report Tungiasis infestation in a DFG in an anophthalmic socket.

Characteristics and management of congenital anophthalmos and microphthalmos at a tertiary eye hospital.

Purpose: The purpose of the study is to evaluate demographic data and outcomes of the management of congenital anophthalmia/microphthalmia. Methods: This retrospective, descriptive, cross-sectional study evaluated patients with congenital anophthalmia/microphthalmia managed from 2004 to 2014 at a tertiary hospital in Saudi Arabia. Data were collected on patient age, gender, cause, orbital status, laterality, systemic comorbidities, ocular evaluation, and management (type of surgery, type of orbital implant, and complications). The main outcome measure was the ability to hold the prosthesis. Results: The study sample was composed of 513 eyes/sockets of 365 patients. Two-hundred and seventeen (59.4%) patients were unilateral cases. Forty-one (8%) sockets were due to congenital anophthalmia and 471 (92%) were due to microphthalmia. There were 73.2% isolated cases and 28.5% with systemic involvement. Systemic involvement was more common in bilateral cases. The most commonly associated conditions were central nervous disorders. One-hundred and nineteen (46.7%) cases had parental consanguinity. Two hundred and eighteen eyes/sockets (163 patients) underwent surgery including conjunctival flap (38; 17.4%), evisceration (38; 17.4%), enucleation (16; 7.3%), or procedures to improve the anophthalmic socket volume (45; 20.6%). Volume enhancing procedures included polymethylmethacrylate orbital implants (26; 57.8%), expanders (11; 24.4%), integrated hydroxyapatite or polyethylene implants (2; 4.4%), and dermis-fat graft (6; 13.3%). In most cases, clinical or surgical management resulted in a successful outcome. Conclusion: Anophthalmia/Microphthalmia was detected in 36.5 patients/year. The majority had isolated microphthalmia. Good outcomes were achieved with clinical or surgical management in the majority of cases.

Eyelid molluscum contagiosum presenting as a giant solitary ulcerating mass.

Molluscum contagiosum is a benign viral cutaneous infection. It typically presents as an asymptomatic centrally umbilicated nodule 3-5 mm in diameter. Susceptible patients are children and adults receiving immunosuppressive therapy. We report a case of an eyelid molluscum contagiosum in a 5-year-old boy with no risk factors and a 2-week history of a large localized ulcerating mass of the left upper eyelid. The mass was totally excised, and diagnosis of molluscum contagiosum was confirmed in the histopathology study. Microscopic examination revealed enlarged keratinocytes, and acquired eosinophilic Henderson-Patterson inclusion bodies were also detected. Such ulcerating solitary lesions can be misdiagnosed as infected epidermal cysts, keratoacanthoma, or infected chalazions; therefore, molluscum contagiosum should be considered in the differential diagnosis. Complete excisional biopsy of the mass is diagnostic and curative.