The Impact of Non-Steroidal Anti-Inflammatory Agents after Phacoemulsification on Quality of Life: A Randomized Study.

INTRODUCTION: The purpose of our study was to investigate the impact of ketorolac addition to the well-established combination of antibiotic-steroid agent in terms of vision-related quality of life. METHODS: Patients were randomized to: (1) fixed combination of tobramycin 0.3%-dexamethasone 0.1%, one drop qid (n = 68) and (2) fixed combination of tobramycin 0.3%-dexamethasone 0.1%, one drop qid, plus ketorolac tromethamine 0.5%, one drop tid (n = 70). All patients completed the VFQ-25 questionnaire to assess their functional vision before cataract surgery and postoperatively on days 7, 28 and 42. The statistical analysis comprised the point-wise comparison between the two groups at the four time points for all sub-scales of the VFQ-25 questionnaire, as well as the composite score. RESULTS: No significant differences were noted regarding the composite score, as well as all subscales in all examined time points. CONCLUSIONS: The addition of ketorolac did not seem to offer any additional benefit in terms of vision-related quality of life.

Risk factors for poor vision-related quality of life among cataract patients. Evaluation of baseline data.

BACKGROUND: Our study aims to investigate the possible risk factors for poor vision-related quality of life in patients scheduled to undergo phacoemulsification. METHODS: Participants in our study were 220 patients who were eligible for phacoemulsification cataract surgery. All participants underwent a routine ophthalmological examination and completed the Visual Function Questionnaire-25 (VFQ-25), which encompasses 12 subscales and the composite score. Sociodemographic and lifestyle parameters were evaluated as potential risk factors for low VFQ-25 composite score, as well as subscale scores. Multivariate regression analysis was performed. RESULTS: Composite score did not exhibit any significant associations. General Health subscale score was positively associated with higher educational level. Patients who currently worked presented with lower Vision Specific Mental Health subscale score (OR: 0.33, 95 % CI: 0.18 to 0.63). Vision Specific Role Difficulties subscale score was positively associated with exercise (OR: 1.89, 95 % CI: 1.30 to 2.75). Vision Specific Dependency subscale score was independently positively associated with marital status (married vs single/widowed/divorced, OR: 1.83, 95 % CI: 1.08 to 3.12) but inversely with current working status (OR: 0.40, 95 % CI: 0.20 to 0.79). Males exhibited lower Peripheral Vision subscale score compared with females (OR: 0.19, 95 % CI: 0.04 to 0.91). CONCLUSIONS: Baseline vision-related quality of life in cataract patients presenting for surgery seems affected by inherent sociodemographic and lifestyle parameters, such as gender, educational level, marital status, current working status and exercise. Therefore, clinicians should be aware of the discrepancies that risk factors may confer, and should thus focus on the most vulnerable subgroups.

The value of fundoscopy in general practice.

BACKGROUND: Many of the common systemic diseases present characteristic changes in the fundus of the eye, but fundoscopy is often performed by an ophthalmologist. Our purpose was to assess the value of fundoscopy for the general practitioners (GPs) regarding the diagnosis and management of the cases which they face in daily practice. METHODS: 689 patients were referred by GPs to the outpatient ophthalmology department for fundoscopy during the year 2010. The causes of this referral, the results of ophthalmoscopy and its significance in the final diagnosis were recorded and analyzed. RESULTS: In 22 patients (3.1%), fundoscopy revealed optic disc edema. In 7 patients with head trauma (9.7%), fundoscopy revealed intravitreous haemorrhage and Berlin edema. From the patients with photopsias or floaters, 5 (10.2%) had retinal detachment. Finally, in cases with diabetes mellitus or hypertension, ophthalmoscopy was very important to detect the existence and grade the degree of diabetic or hypertensive retinopathy, if they appeared, and as a result to evaluate the prognosis of the disease. CONCLUSIONS: Fundoscopy is fundamental for the GP, as it may help to confirm or exclude the diagnosis of many common diseases. Nevertheless, there are clinical entities where ophthalmoscopy should be performed by an ophthalmologist, in order to be more specific and accurate, and GP should be able to recognise these cases.