Management of diabetic Retinopathy in (Caribbean Eye Institute (CEI) [abstract]

This retrospective study will assess all the diabetic patients seen in all the CEI's office from January 1999 until the present. Note will be made of the mode of referral, cause of referral and the ocular pathology found on first presentation. The forms of management done will be discussed as well as the outcome of treatment. The Early Treatment Diabetic Retinopathy Study (ETDRS) study will be used as a model for discussion of management. Though there seems to be a better referral both from our colleagues and optometrists, many patients are still self referred or sent by other patient. With the trend of earlier assessment, the future should be brighter for ocular management of diabetics. (AU)

Glaucoma in a general ophthalmic practice in Trinidad and Tobago

This study is a retrospective look at the records of all patients seen over a three-year period at two locations in Trinidad. There were more males (59 percent) than females; East Indians comprised 33 percent and Negroes 29 percent. 69 percent were self-referrals, optometrists referred 11 percent and general practitioners, 13 percent. Chronic open angle glaucoma was the most common diagnosis (55 percent) among patients presenting for the first time; glaucoma was suspected in 24 percent, narrow angle glaucoma in 10 percent.(AU)

Corneal grafts in North Trinidad

A review of 42 patients who had penetrating keratoplasty between 1990 and 1997 in North Trinidad revealed that the two main indications for surgery were keratoconous and aphakic or pseudophakic corneal decompensation. There were 47 grafts with visual outcome showing improvement in 30 (63.8 percent), being unchanging in 8 (17.0 percent), and worse in 5 (10.6 percent). Records of 4 were inadequate. 34 (72.3 percent) had associated complications; i.e., raised intraocular pressure in 20 (42.6 percent), rejection in 12 (25.5 percent), and keratitis (one case); and retinal detachment (one case). Control of intraocular pressure was achieved in 17 cases. There were 8 graft failures, 6 of which were due to rejection. The 60 percent visual acuity of 6/18 (20/60) or better in this study compares well with results from Australia and Israel. The complications and graft failure rates are both acceptable at international levels. This study reflects measured success to corneal grafting locally. A major positive introduction would be the establishment of a corneal graft bank.(AU)

Diabetic eye disease: is the message reaching the flock?

This retrospective study reviewed data on all new patients in a general ophthalmological service between January and June 1997. Of 1,286 new patients 156 (12.6 percent) were diabetic. 75 percent of these presented for their first eye examination by an ophthalmologist, 25 percent had at least one previous examination and 10 percent were previously diagnosed with diabetic retinopathy. Over 75 percent were diabetic for more than 5 years. Only 23 percent sought consultation as a routine. 77 percent attended because of visual complaints. Most diabetics (58 percent) were East Indian, in keeping with previously reported studies. Blindness occurred in 19 to 21 percent of diabetics depending on the definition. Of 142 whose fundi could be examined, 74 or 52 percent had retinopathy. In spite of increasing knowledge from studies such as the Diabetic Retinopathy Study, the Early Treatment Diabetic Retinopathy Study and the Diabetes Control and Complication Trial, it seems that the message is not filtering through to the level of primary care and to patients. Our review demonstrates the most patient present for ophthalmological assessment only on experiencing visual symptoms. The majority are seen after they have been diabetic for over five years and most patients attend on self referral. Greater effort is required to promote the guidelines of the World Health Organization and the American Academy of the Ophthalmology for the ophthalmic management of diabetic patients in order to reduce the blindness rate due to this epidemic.(AU)

An assessment of the nutritional status of children 0 - 4 years in the parish of St. James

The study aimed to assess the nutritional status of children in the 0 - 4 year age group in the Parish of St. James, Jamaica W. I. The data presented covers information on nutritional practices , socio-economic status and nutritional status of the mothers and children under study. Information is given on the number of admissions and deaths for children in the age group under study as obtained from local hospital records. The number of deaths caused by malnutrition in the same age group is also presented. (AU)