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1.
Br J Ophthalmol ; 102(7): 863-867, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29122822

RESUMO

Posterior keratoconus (PKC) is a rare, typically non-inflammatory condition that is characterised by an abnormal posterior corneal curvature, which may be accompanied by overlying stromal opacification. It is usually congenital and can be associated with other ocular and systemic abnormalities. PKC remains a clinical diagnosis, although imaging techniques including ultrasound biomicroscopy and anterior segment optical coherence tomography may be useful tools for confirmation and classification. Genetic studies should be considered, although no specific genetic defects have been identified thus far. As a potential cause of amblyopia, early diagnosis and management are crucial in maximising visual potential. Occasionally, management considerations may also include surgical intervention, such as corneal transplantation. Intraocular lens power calculation at the time of cataract surgery requires special consideration. Here, we review the present literature on PKC and consider future directions in the management of this rare entity.


Assuntos
Córnea/patologia , Ceratocone/diagnóstico , Topografia da Córnea , Humanos , Ceratocone/fisiopatologia , Ceratocone/prevenção & controle , Tomografia de Coerência Óptica , Acuidade Visual
2.
Ophthalmic Genet ; 39(1): 11-16, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28569566

RESUMO

BACKGROUND: The prevalence of myopia is increasing worldwide. Previous studies have found a positive association between myopia, education, and near activities, while others have noted a negative association with outdoor exposure. This study reports refractive error and biometry in a founder population of European ancestry, the Hutterites, and discusses risk factors contributing to myopia. METHODS: Cross-sectional study, including complete eye exams with retinoscopy and biometry. RESULTS: 939 study participants, ages 6 to 89, were examined. Females were significantly more myopic than males (SE -0.87 ± 2.07 and -0.40 ± 1.49 in females and males, respectively, p < 0.0001). Males had significantly longer axial lengths. Females had steeper corneas. This is the first epidemiological report of refractive error among the Hutterites. DISCUSSION: As a genetically isolated population with a communal lifestyle, the Hutterites present a unique opportunity to study risk factors for myopia. Hutterite females are more myopic than males, a finding which has only been reported in a few other populations. Hutterite children complete compulsory education through the 8th grade, after which women and men assume gender-specific occupational tasks. Men often work outside on the farm, while women engage in more domestic activities inside. These occupational differences likely contribute to the increased myopia comparing females to males, and their uniform lifestyle reduces the impact of potential confounding factors, such as education and income. CONCLUSIONS: The Hutterites are more myopic than most other North American and European populations. Greater time spent doing near work and less time spent outdoors likely explain the increased myopia comparing females to males.


Assuntos
Efeito Fundador , Miopia/epidemiologia , População Branca/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comprimento Axial do Olho/patologia , Biometria , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/genética , Retinoscopia , Fatores de Risco , South Dakota/epidemiologia , População Branca/genética
3.
J AAPOS ; 21(2): 163-165, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28007653

RESUMO

Posterior scleritis in children is very rare. In contrast to the adult form, pediatric posterior scleritis has not previously been associated with any systemic disorder. We describe a case of an 11-year-old girl who presented with left eye pain and redness and was found to have posterior scleritis on ultrasonography. Her laboratory work-up revealed a highly elevated antistreptolysin O titer; the rest of her serologic and radiologic evaluation was unremarkable. She was diagnosed with presumed poststreptococcal posterior scleritis and improved with a slow taper of oral steroids.


Assuntos
Esclera/diagnóstico por imagem , Esclerite/etiologia , Infecções Estreptocócicas/complicações , Segmento Anterior do Olho/diagnóstico por imagem , Criança , Diagnóstico Diferencial , Feminino , Humanos , Esclerite/diagnóstico , Infecções Estreptocócicas/diagnóstico , Síndrome , Tomografia de Coerência Óptica , Ultrassonografia
4.
Surv Ophthalmol ; 61(6): 791-798, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27134009

RESUMO

As the ophthalmology accreditation system undergoes major changes, training programs must evaluate residents in the 6 core competencies, including appropriately communicating bad news. Although the literature is replete with recommendations for breaking bad news across various non-ophthalmology specialties, no formal training programs exist for ophthalmology. There are many valuable lessons to be learned from our colleagues regarding this important skill. We examine the historic basis for breaking bad news, explore current recommendations among other specialties, and then evaluate a pilot study in breaking bad news for ophthalmology residents. The results of this study are limited by a small number of residents at a single academic center. Future studies from multiple training programs should be conducted to further evaluate the need and efficacy of formal communication skills training in this area, as well as the generalizability of our pilot training program. If validated, this work could serve as a template for future ophthalmology resident training and evaluation in this core competency.


Assuntos
Comunicação , Educação de Pós-Graduação em Medicina , Internato e Residência/métodos , Oftalmologia/educação , Relações Médico-Paciente , Médicos , Competência Clínica , Humanos
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