Opthalmologist

Non-contact tonometry (NCT) is a non-invasive ophthalmologic technique to measure intraocular pressure (IOP) using an air puff for routine glaucoma testing. Although IOP measurement using NCT has been perfected over many years, various phenomenological aspects of interfacial physics, fluid structure interaction, waves on corneal surface, and pathogen transmission routes to name a few are inherently unexplored. Research investigating the interdisciplinary physics of the ocular biointerface and of the NCT procedure is sparse and hence remains to be explored in sufficient depth...

BACKGROUND: Low/middle-income countries have the highest burden of blindeness and visual impairment, which directly affects the children and indirectly affects their community. Furthermore, the number of blind years suffered by children with low vision or blindness creates a self-perpetuating ripple effect on their development, health and the socio-economic development of their communities. This systematic review aims to interrogate the existing evidence on the prevalence and causes of blindness and visual impairment in Nigerian children to provide evidence to drive health policy...

INTRODUCTION: Clinicians enter the medical profession through a variety of routes. This paper explores how non-traditional routes into the medical profession can follow through into subsequent medical leadership practice, influencing issues of confidence, self-image and assumptions about leadership as a concept. METHOD: The first-person reflections of a doctor who entered the profession and the National Health Service from the German system and with a non-standard background are considered...

Importance: The hybrid ophthalmology telemedicine model asynchronously pairs an imaging appointment by a technician with a subsequent virtual appointment by a clinician. Although it has been mentioned in several studies as an alternative to standard in-person care during the COVID-19 pandemic, outcomes of this alternative clinical care model remain to be evaluated. Objective: To investigate the outcomes associated with the hybrid ophthalmology telemedicine model during the COVID-19 pandemic for nonurgent and nonprocedural ophthalmological care...

Diabetic retinopathy has seen tremendous progress in diagnostic tools and treatment in recent 15 years. Sight threatening stages like proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) can be treated much more effectively now. The recognition of vascular endothelial growth factor (VEGF) as a driver of proliferation and macular edema has led to the development of VEGF inhibiting drugs such as antibodies (Bevacizumab), fragments of an antibody (Ranibizumab), or a so called VEGF trap (Aflibercept)...

BACKGROUND: The WHO VISION 2020 global initiative against blindness, launched in 2000, prioritised childhood visual disability by aiming to end avoidable childhood blindness by 2020. However, progress has been hampered by the global paucity of epidemiological data concerning childhood visual disability. The British Childhood Visual Impairment and Blindness Study 2 (BCVIS2) was done to address this evidence gap. METHODS: BCVIS2 was a prospective UK-wide, cross-sectional, observational study to establish an inception cohort of children newly diagnosed with visual impairment...

Diabetic eye disease is a collection of ocular problems that affect patients with diabetes. Thus, timely screening enhances the chances of timely treatment and prevents permanent vision impairment. Retinal fundus images are a useful resource to diagnose retinal complications for ophthalmologists. However, manual detection can be laborious and time-consuming. Therefore, developing an automated diagnose system reduces the time and workload for ophthalmologists. Recently, the image classification using Deep Learning (DL) in between healthy or diseased retinal fundus image classification already achieved a state of the art performance...

Automatic grading of retinal blood vessels from fundus image can be a useful tool for diagnosis, planning and treatment of eye. Automatic diagnosis of retinal images for early detection of glaucoma, stroke, and blindness is emerging in intelligent health care system. The method primarily depends on various abnormal signs, such as area of hard exudates, area of blood vessels, bifurcation points, texture, and entropies. The development of an automated screening system based on vessel width, tortuosity, and vessel branching are also used for grading...

Diabetic Macular Edema (DME) is a severe eye disease that can lead to irreversible blindness if it is left untreated. DME diagnosis still relies on manual evaluation from opthalmologists, thus the process is time consuming and diagnosis may be subjective. This paper presents two novel DME detection frameworks: (1) combining features from three pre-trained Convolutional Neural Networks: AlexNet, VggNet and GoogleNet and performing feature space reduction using Principal Component Analysis and (2) a majority voting scheme based on a plurality rule between classifications from AlexNet, VggNet and GoogleNet...

The nasolacrimal drainage apparatus (NDA) is of interest to anatomists, radiologists, and ophthalmologists alike, owing to its intricate luminal contour, complex surrounding structural morphology, and its clinical relevance. Here, we review the history of anatomical descriptions of so-called luminal "valves" of the NDA, including the numerous historical figures whose eponyms adorn the NDA. By 1908, multiple false "valves" that are likely no more than mounds of mucosa along the NDA had been recorded. In the modern era, these have all been largely considered speculative in nature and function aside from the consistently described true valve of Hasner (plica lacrimalis)...

BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure. IIH causes significant morbidity marked by incapacitating headaches and visual disturbances. This study investigated the long-term outcomes of venous sinus stenting in a large group of patients with IIH. METHODS: We retrospectively reviewed all patients at our institution who underwent venous sinus stenting for IIH over 6 years (July 1, 2012-June 30, 2018)...

Diabetes mellitus (DM) is a complex and chronic metabolic disorder leading to many complications. One of the most common complications of DM is diabetic neuropathy. There are many studies exploring corneal sensitivity as a potential marker of diabetic neuropathy. This review aims to explore association between corneal sensitivity and diabetic neuropathy. In diabetic neuropathy, corneal sensitivity is impaired due to low level of corneal nerve trophic factors, impaired sensory nerve fibers, and lost communication of dendtritic cell...

BACKGROUND: Risk of developing thyroid-associated ophthalmopathy (TAO) in children and adolescents is similar or may be even slightly higher than in adults. The aim of this article is to review and summarize current knowledge regarding diagnostic and therapeutic measures in pediatric TAO. CONTENT: MEDLINE and EMBASE papers were searched using the terms 'pediatric Graves' ophthalmopathy' 'pediatric Graves' orbitopathy', 'thyroid-associated ophthalmopathy in childhood and adolescence' from the year 1970 to December 2015...

Penetrating Keratoplasty in high risk cases like paediatric patients, complicated cases of pseudophakic bullous keratopathy, or in patients with highly vascularized corneal opacities have been a challenge for opthalmologists because of the poor outcome. 101 patients with such high risk indications underwent penetrating keratoplasty. Some of them also underwent concurrent procedures like PC IOL implantation or vitrectomy. The patients' follow up period ranged from six months to four years. The results were evaluated...

Blindness from retinopathy of prematurity (ROP) in Australian and New Zealand is an uncommon event although 3% of <31 weeks gestation infants receive treatment for the disease. New world-wide estimates of the incidence of blindness from ROP are much higher than previously at 20 000 children annually. The impact of severe ROP can be reduced through good evidence-based care of very preterm infants and careful organisation of eye examinations and follow-up services. Recent oxygen saturation targeting trial results might mean the adoption of higher targets than formerly in very preterm infants and will require vigilance to ensure all eligible infants are examined appropriately...

BACKGROUND: Ochronosis/Alkaptonuria is a tyrosine metabolism disorder where accumulation of homogentisic acid, in eye, skin, cartilage and several other connective tissues leads to a black pigmentation of the affected tissues. It is autosomal-recessive inherited in men with a frequency of 1-9/1,000,000. While it is clear that pigment deposits lead to joint destruction, renal stone formation and cardiac valvulopathy respectively, the significance of ocular findings is still unclear. We therefore aim to evaluate the frequency and clinical significance of ocular findings in ochronosis and discuss possible therapeutic options...

We present an automated algorithm for the detection of blood vessels in 2-D choroidal scan images followed by a measurement of the area of the vessels. The objective is to identify vessel parameters in the choroidal stroma that are affected by various abnormalities. The algorithm is divided into five stages. In the first stage, the image is denoised to remove sensor noise and facilitate further processing. In the second stage, the image is segmented in order to find the region of interest. In the third stage, three different contour detection methods are applied to address different challenges in vessel contour...

Nitrous oxide is absolutely contraindicated after vitreoretinal surgery that uses intraocular gas, as the mixture of gas and nitrous oxide can cause catastrophic vision loss. Professional awareness and communication are vital to prevent this iatrogenic complication. This case report identifies a side effect of vitreoretinal surgery with a benign outcome--specifically, a referred pain or pressure from left eye surgery or an associated gas bubble to the upper left quadrant. Such cases underscore the need for a dentist and staff to inquire about all ocular procedures to avoid patient vision loss due to nitrous oxide...

Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous communications in the cavernous sinus. In many cases of CCF's the primary signs are ocular manifestations, which include: pulsatile proptosis, orbital bruit, chemosis and conjunctival injection, elevated intraocular pressure, venous stasis retinopathy, and cranial nerve pareses. Patients in whom the fistula causes arterial drainage into the cerebral veins and sinuses are at risk for intracranial hemorrhage. The most common treatment for CCF's is endovascular occlusion of the lesion...

The article is devoted to the problems of eye prosthetics that develops since ancient times till today. Indications for eye prosthesis and its role in rehabilitation of anophthalmic patients are determined. The process of glass prostheses production is described in details, technology is discussed and illustrated. This article is of great interest for opthalmologists and prosthetic technicians as it is proved that glass prostheses are more physiologic and have a number of advantages compared to plasticones.