Hospital-admitted eye injury in Victoria, Australia.

BACKGROUND: The public health concern represented by eye injury in Victoria, Australia has been known for a period now approaching 20 years. However, there has been no improvement observed in this public health concern since it was first identified in the 1990s. This study further investigates the epidemiology of eye injury in Victoria, specifically hospital-admitted eye injury. METHODS: The Victorian Admitted Episodes Dataset was surveyed for eye injury coded by the International Classification of Diseases 10th revision during the period spanning 2001-2005, retrieving all cases of hospital-admitted eye injury in Victoria during the surveyed period. RESULTS: During the period surveyed, the average incidence of eye injury requiring hospital admission in Victoria was 53.6 per 100 000 person-years. Sixty-four per cent of patients were male and 36% were female (P < 0.001). Male patients were most commonly middle-aged compared with female patients who were most commonly middle-aged to elderly (P < 0.001). Core patient groups included: elderly women sustaining eye injuries as a result of falls (particularly in residential homes); middle-aged men sustaining eye injuries as a result of assault and in transport-related accidents. CONCLUSION: The incidence of hospital-admitted eye injury in Victoria has increased since it was first identified as a concern in the 1990s. The design and implementation of an effective preventative strategy to reduce the rate of hospital-admitted eye injury in Victoria presents as a difficult task given that the most common causes are represented by falls, assault and transport-related accidents.

Eye injuries in rural Victoria, Australia.

BACKGROUND: Eye injury causes significant morbidity and is a leading cause of blindness worldwide. This study investigates the incidence, spectrum and patterns of eye injury presenting to a rural hospital in Victoria, Australia. METHODS: A retrospective review of the medical records of all patients presenting with eye injury to the emergency department of Mildura Base Hospital, Victoria, Australia in year 2004 was conducted. As the emergency department of Mildura Base Hospital also acts as the outpatient department for this hospital, the series included all patients treated for eye injury at Mildura Base Hospital in year 2004, including admissions. RESULTS: There were 435 patients present to Mildura Base Hospital emergency department for eye injury in 2004, which represented approximately 1% of the population of Mildura. The majority of eye injuries were superficial. Fifty-six (13%) patients required specialist attention. Most patients were male (83%) and were middle-aged. The most common locations where eye injuries took place were residential homes (47%) and workplaces (32%). The most common causes of eye injuries were trade tools and machinery (47%), followed by chemicals (12%) and branches/sticks/twigs (11%). Of particular concern for Mildura is that approximately one-quarter of the patients treated at Mildura Base Hospital for eye injury in 2004 had been treated at Mildura Base Hospital for a separate episode of eye injury in the past. CONCLUSION: Eye injuries represent a significant socioeconomic burden. This research contributes to the knowledge required for the design and implementation of effective preventative strategy.

Comparing ultrasound biometry with partial coherence interferometry for intraocular lens power calculations: a randomized study.

PURPOSE: To determine whether intraocular lens (IOL) power calculations for cataract surgery as measured by postoperative refractive error using partial coherence interferometry (PCI) are more accurate in improving postoperative outcomes than applanation ultrasound biometry (AUS). METHODS: A double-blind randomized controlled trial consisting of 205 patients was undertaken by the Southern Health Ophthalmology Unit, Victoria, Australia. Mean absolute postoperative refractive error (MAE) represented the dependent variable; the biometric technique (PCI; AUS) used to determine the IOL power to be implanted in the surgical eye represented the independent variable. An intention-to-treat analysis was used to prevent loss of randomization caused by the effects of crossover and drop-out. RESULTS: The MAE in patients with implanted PCI-calculated IOLs was 0.40 +/- 0.37 D (SD; 95% confidence interval [CI], 0.32-0.48 D) compared with 0.45 +/- 0.41 D (SD; 95% CI, 0.36-0.54 D) for patients with implanted AUS-calculated IOLs. There was no statistically significant difference between MAE in patients with implanted PCI-calculated IOLs and that in patients with AUS-calculated IOLs in analysis of best possible outcomes (t(167) = 1.0, P = 0.315). CONCLUSIONS: The results of this trial demonstrated that the calculation of IOL power based on ocular axial length measurement with PCI technology provided no clinical advantage over conventional applanation ultrasound, as measured by postoperative refractive outcome (anzctr.org.au number, ACTRN12608000077369).

Retinal light damage: structural and functional effects of the antioxidant glutathione peroxidase-1.

PURPOSE: The role of the antioxidant enzyme glutathione peroxidase-1 (GPx1) in protecting the retina against photo-oxidative damage was investigated in GPx1-deficient and wild-type mice. METHOD: Albino GPx1-deficient and age-matched wild-type mice were examined. Baseline electroretinograms (ERGs) were recorded. Thereafter, mice were exposed to intense light for 12 hours. After a 24-hour recovery in darkness, post-light-insult ERGs were recorded and compared with baseline. Structural effects of light insult were evaluated by retinal histology. Antioxidant expression was investigated by quantitative reverse transcription-PCR (qRT-PCR). RESULTS: Light insult significantly affected ERG responses, with reduced a- and b-wave amplitudes. Structurally, photoreceptor layers were predominantly affected. As expected, GPx1 expression was negligible in GPx1-deficient mice but was upregulated in wild-type mice in response to light insult. Similarly, hemeoxygenase-1 and thioredoxin-1 expression increased significantly in wild-type retinas after light exposure. Catalase, GPx isoforms (GPx2 to -4), peroxiredoxin-6, glutaredoxin-1, and thioredoxin-2 expression was unaffected by GPx1 deficiency and light insult, whereas significant increases in glutaredoxin-2 occurred in non-light-exposed (baseline) GPx1-deficient retinas. Compared with baseline wild-type retinas, lipid peroxidation (TBARS assay), an indicator of oxidative stress, was elevated in baseline GPx1-deficient retinas. Unexpectedly, the light insult induced diminution of retinal function, in terms of ERG amplitude, and structural damage was significantly greater in wild-type than in with GPx1-deficient retinas. CONCLUSIONS: The data showing increased oxidative damage in baseline GPx-deficient retina give rise to the hypothesis that increased oxidative stress provides a "preconditioning" environment in which protective mechanisms paradoxically render GPx1-deficient retinas less vulnerable to light-induced oxidative damage. This study identified glutaredoxin-2 as a potential candidate.

Anterior uveitis in a child with Takayasu's arteritis.

Takayasu's arteritis is a rare idiopathic arteriopathy that produces narrowing and eventually closure of affected blood vessels. Ocular symptoms typically occur late in the disease process in those individuals who have severe involvement of the aortic arch and the carotid arteries. Visual loss typically occurs as a result of either systemic hypertension or concomitant ocular hypo-perfusion. We describe an unusual case of Takayasu's arteritis presenting in a child who complained of painful blurred vision. In this individual, no carotid artery disease was identified on vascular imaging and no evidence of impairment of ocular perfusion was demonstrable. Vision loss in this instance was due to anterior uveitis and cystoid maculopathy. These are atypical and rarely described features of Takayasu's arteritis. The patient responded well to anti-inflammatory treatment and his symptoms resolved. The clinical significance of these findings are discussed and the relevant literature reviewed.

The location of insulin receptors in bovine retina and isolated retinal cells.

PURPOSE: The binding of insulin to its cell-surface receptor is the sole means by which the hormone influences cellular activity. The location of insulin receptors in bovine retina and on isolated retinal cells was investigated to determine the specific cells sensitive to insulin. METHODS: Insulin receptors were located in frozen retinal sections prepared from enucleated bovine eyes, with polyclonal anti-insulin receptor antibodies using an immuno-peroxidase method. Isolated cells were obtained by enzymatic and physical dispersion of bovine retinal tissue. Insulin receptors on isolated cells were located by a monoclonal anti-insulin receptor antibody using an immunogold silver staining technique. RESULTS: Insulin receptors demonstrated a widespread distribution throughout the bovine retina, being present in all retinal layers. A particular association with the plexiform layers and Müller cells was identified in the frozen sections. Consistent with these findings, insulin receptors were predominantly located on dendritic processes of isolated retinal neurones and on Müller cells. CONCLUSIONS: The widespread distribution of retinal insulin receptors in the bovine retina supports the hypothesis that insulin has a role in regulating retinal activity. Insulin receptors associated with plexiform regions suggests that insulin may influence neural activity, while receptors on Müller cells indicate that insulin may have a role in metabolic or functional mechanisms in bovine retina.