The results of 1000 intracapsular cataract extraction with the suture-fixated Medallion lens implant

One thousand intracapsular medallion implants, performed between August 1975 and July 1980, were analyzed for complications (minimum follow-up 6 months): cystoid macular edema, 6.5%; retinal detachment, 2.8%; corneal edema, 0.9%; aphakic glaucoma, 2.5%; suture failure, 9%; implant subluxation, 3.7%; implant dislocation, 2%; and implant removal, 0.6%. Visual acuity of 20/40 or better was achieved in 93.4% of the cases, excluding non-implant related causes of low visual acuity.

Eye lesions in Sprague-Dawley rats: type and incidence in relation to age

Ophthalmological examination of about 3000 rats up to 2 years old, untreated controls in toxicological studies, has provided information on the varying incidence with age of various spontaneous ophthalmic lesions of low frequency. Such information is of fundamental value in assessing the effect of administered compounds on ophthalmic changes.

High corneal astigmatism in Navajo school children and its effect on classroom performance

809 unselected Navajo school children from kindergarten to sixth grade received visual acuities and keratometry readings. The information obtained was directed at statistical analysis of the degree of corneal curvature of two diopters or more and the distribution of its ranges, grade distribution, sex distribution, unilateral percentage and eye dominancy, uncorrected visual acuities of the high uncorrected astigmat, the mean corneal astigmatism, and the relationship between uncorrected high astigmatism and classroom performance.

Incidence, prevalence, and scale of blinding malnutrition

4595 pre-school-age children in six villages of West Java were examined every 3 months. The incidence of active corneal xerophthalmia was 5 per 1000 per year (95% confidence limits, 2.6-7.5), and the average prevalence during each round of examinations was 12 per 10000. In a randomised, multistage cluster survey of 27084 rural children throughout Indonesia the population-weighted prevalence of active corneal disease among pre-school-age children was 6.4 per 10000 (95% confidence limits 3.2-9.6), 53% of that in the longitudinal study areas. At an adjusted incidence rate of 2.7 per 1000 per year, over 60000 Indonesian children become xerophthalmic every year. By extrapolation of these findings about 500000 new cases of xerophthalmia, half of which lead to blindness, occur each year in India, Bangladesh, the Philippines, and Indonesia combined.

Prevalence of map-dot-fingerprint changes in the cornea

Map-dot-fingerprint basement-membrane abnormalities of the cornea are common in the general population, affecting as many as 76% of persons over age 50 and 42% of persons of all ages. The prevalence of this condition in the general population is not significantly different from that found in families of patients with recurrent corneal erosions and map-dot-fingerprint corneal changes. Despite this extremely high prevalence of basement-membrane changes the incidence of recurrent erosive symptoms in total groups of patients with basement-membrane changes is quite rare, suggesting that these 2 entities are possibly not related. Although previous observers have suggested an autosomal dominant mode of inheritance of these basement-membrane changes, our data raise the possibility that map-dot-fingerprint basement-membrane changes represent an age-dependent, degenerative condition of the cornea. We were unable, however, to prove either hypothesis.

Aetiology of spheroidal degeneration of the cornea in Labrador

To determine the aetiology of spheroidal degeneration of the cornea (Labrador keratopathy), total population surveys were conducted in 5 communities in coastal Labrador and northern Newfoundland. For 4 years records were also kept on all clinic patients aged 40 or more throughout the region. Both methods gave a peak prevalence at latitudes 55 degrees--56 degrees north. The greatest severity and earliest age of onset occurred around the same latitudes. Of the proposed environmental causative agents only ultraviolet radiation, reflected from ice and snow, explains the distribution of the disease. The high cumulative UV dosage is due to the unique geographical and climatic features of the region.

West Indian punctate keratopathy in a Caucasian

We present a patient with the picture of corneal white spots, very similar in morphology to those described in native West Indians, occurring here in a Caucasian. Their aetiology remains obscure.

The prevalence of corneal disease and cataracts in Australian aborigines in Northwestern Australia

Fifty percent of the Aborigines over the age of 30, in two settlements, were examined and the presence of anterior ocular disease was recorded. A group of urban Europeans were also examined. All of the 82 Aborigines showed signs of trachoma, eight were bilaterally blind and 15 had monocular blindness. Corneal opacities were found in 60% of Aborigines, pterygium in 44%, cataract in 32%, climatic droplet keratopathy in 18% and pseudo-exfoliation of the lens in 11%. Only 4% of Europeans had corneal scarring and 4% had pterygium, 10% of Europeans had cataracts. Trachaoma, climatic droplet keratopathy and pseudoexfoliation were not seen in Europeans. It is postulated that much of the anterior segment disease seen in Australian Aborigines is due to environmental factors.

Prevalence of pinguecula in Greenland and in Copenhagen, and its relation to pterygium and spheroid degeneration

The prevalence of pinguecula has been studied by slit lamp examination of 659 Eskimos in South Greenland and 810 Caucasians in Copenhagen. The overall prevalence was found to be 56 per cent in Greenland against 41 per cent in Copenhagen (P less than 0.001) and to rise with increasing age, though with a fall after the age of 60 among Greenland women. Pingueculae (measured by their vertical height) are largest among Greenlanders, and larger in males than in females. They increase in size with increasing age. They are generally located nasally in Greenlanders and temporally in Copenhageners. The prevalence of pinguecula in almost 1 1/2 times higher among Greenlanders than among Copenhageners, while that of spheroid degeneration and that of pterygium are 3 times and slightly over 10 times higher respectively. The incidence of pinguecula and spheroid degeneration are correlated per site and per subject in the two geographically different series. Pterygium is not correlated with regard to site, this being always located nasally. Pterygium practically never harbours spheroid degeneration, neither in its body nor in its head (81 pterygia). Pinguecula and pterygium are therefore to be regarded as two different disorders, while spheroid degeneration is related to pinguecula.

Visual results and complications of 500 intraocular lens implantations

These statistics reported for the visual results and complications of 500 intraocular lenses suggest that better visual results are obtained following extracapsular surgery. After all nonoperative causes for vision less than 6/12 were eliminated, 85.2% of the intracapsular cataract extractions had 6/12 or better vision. A similar group of planned extracapsular cataract extractions and phacoemulsifications yielded vision of 6/12 or better in 95% and 91.2% respectively.

Affections of conjunctiva and cornea in Bendel State of Nigeria

A review of conjunctival, episcleral and corneal diseases seen in Bendel State in the South of Nigeria shows significant differences in the pattern of conjunctional and corneal diseases. Onchocerciasis and trachoma which cause much ocular morbidity and blindness in the savannah north have little place in the rain forest areas of southern Nigeria. The relative rarity of herpetic dendritic ulcers and corneal dystrophies are highlighted while the major indication for keratoplasty in southern Nigeria is leucoma associated with measles or trauma. The place of measles immunisation, improved nutrition and treatment for xerophthalmia is emphasized.

Frequency of eye complaints and rashes among patients receiving practolol and propranolol

Among 71 patients treated with practolol by general practitioners, eye complaints were recorded in the case-notes of 14 (20%) during treatment, compared with 4 (6%) during equal periods before the drug was prescribed. Half the patients with eye complaints also had a rash while receiving practolol. These findings, which were not due to greater numbers of attendances during treatment nor to awareness of the hazards of the drug, suggest that mild eye complaints were relatively common among patients treated with practolol. Among 246 patients treated with propranolol, the numbers with eye complaints before and during treatment were similar, although there was a significant excess of patients with both an eye complaint and a rash during treatment.

The microfilarial load in the anterior segment of the eye. A parameter of intensity of onchocerciasis

The presence of microfilariae of Onchocerca volvulus in the eye is associated with an increased risk of deterioration of existing eye lesions. An opthalmological and parasitological examination of 630 persons was carried out in a hyperendemic focus of onchocerciasis in northern Togo. The prevalence of microfilariae increased in the cornea as well as the anterior chamber up to the age of 40-50 years, then decreased. The prevalence of onchocercal punctate keratitis, on the other hand, showed a peak for the age group 10-20 years. In two-thirds of the cases microfilariae were present in the anterior chamber as well as in the cornea. The relative distribution of microfilariae between the anterior chamber and the cornea did not change with the development of severe anterior lesions but in cases with severe posterior lesions relatively more microfilariae were found in the anterior chamber than in the cornea. In all cases of severe ocular lesions the numbers of microfilariae both in the anterior chamber and in the cornea were increased. The average number of microfilariae in the eye can be used as a parameter to enumerate the severity of ocular onchocerciasis.

Xerophthalmia and anterior segment blindness

The prevalence of presumed vitamin A-related corneal scars among 5,589 preschool-age Haitian children ranged from 1.2 per 1,000 in the south, to almost 1% in the famine-afflicted north. These scars accounted for at least 45% of all corneal scars, and all bilateral corneal blindness encountered. Most lesions were acquired during the first three years of life. There was no variation by sex or ecology of the sample site. This country of 5.5 million inhabitants acquires 345 new surviving cases of vitamin A-related corneal destruction, over one fourth bilaterally blind, each year, although local ophthalmologists rarely encounter the disease and Bitot's spots were absent from our study population. Countrywide clinical prevalence surveys are the only unbiased means of determining the magnitude, severity, and geographic distribution of vitamin A-related corneal destruction, prerequisites for the design of public health prevention programs.

[Corneal astigmatism after penetrating keratoplasty with direct and indirect sutures (author's transl)]

After a full thickness optic keratoplasty the corneal astigmatism of 116 eyes was checked. 72 cases had been operated on with indirect, 44 with direct sutures. Up to the sixth month after the operation the astigmatism was found to be equally distributed between 0.75 and 12 dpt and until the end of the second year between 0.75 and 8 dpt. Neither the way of suturing nor the diameter of the graft nor the kind of corneal lesion had any influence on the postoperative astigmatism. After six months, the height and the axis of the astigmatism remained approximately constant; however, in four cases of keratokonus followed up for nineteen years the astigmatism gradually increased.

The refractive status of Zuni Indian children

American Indians show a high incidence of various ocular abnormalities. In the present study, refractive error and corneal curvature were measured in 420 Zuni school children. The mean spherical refractive error varied from +0.87 D in the lower grades to -0.62 D in the upper grades. The mean corneal astigmatism was 2.21 D was varied as function of grade. corneal and refractive astigmatism were highly correlated.

Recurrent erosion of the cornea

Altogether, 80 patients aged between 24 and 73 years with recurrent erosion of the cornea have been studied and compared with a control group of 200. The patients' erosions were divisible into macroform and microform types. The macroform occurred in 10%, the microform in 56%, and both types in the same patients in 31%. The macroform was more commonly related to trauma than the microform. However, many (40%) were spontaneous in origin. The most common cause of the initial trauma was a finger nail. The recurrences occurred at around the time of waking, either just before or just after. Difficulty in opening the eye occurred in 10%. There was little evidence of precipitating factors, but eye rubbing was admitted by 10% and barbiturates were implicated in 3%. The corneae were examined in the healed state, when a high incidence (59%) were found to have superficial corneal dystrophies of the fingerprint lines, bleb, and Bietti's lacunar (map-like) types. These are considered individually, particular attention being paid to the distinction between the various types of line resembling the fingerprint line. Epithelial microcysts were also a common finding (59%) and were sometimes of the Cogan type. In only 11% of patients were there no corneal signs in the healed state. The need for careful examination of the cornea by retroillumination, using both the iris and the fundus, is stressed. The control group, in contrast, showed a very low incidence of dystrophies and cysts. Treatment was given initially with either drops or ointment and no differences in healing were found. Debridement was performed in 12 eyes as an initial treatment and also in four eyes which were not healing on medical treatment. Debridement assisted healing, but did not prevent recurrence. One eye was treated with debridement and scarification and seven with carbolization. These procedures appeared to reduce the recurrence rate. Sodium chloride ointment 5% was found useful as a prophylactic taken at bedtime, and the recurrence rate increased when it was withdrawn.

Acute eye disease secondary to contact-lens wear

In a three-month survey of some hospital consultant ophthalmic services, 82 instances of complications of contact-lens wearing were reported. Some of the complications gave rise to discomfort, but in only 5 cases was vision impaired.

A vision profile of American Indian children

In an unselected study, Modified Clinical Technique screening plus keratometry was done on 398 American Indian grade school children. The results are compared to screening results for Caucasin grade school children.

Mass distribution of vitamin A and the prevention of keratomalacia

A retrospective review of 3,490 adminissions to the major pediatric facility in El Salvador was undertaken to determine whether biannual administration of massive doses of vitamin A (200,000 international units) to all availabel 1- to 4-year-old children was effective in preventing keratomalacia. During the 12 months preceding and following initiation of the program, the number of children admitted with presumed vitamin-A-related corneal destruction (33 vs. 31) and proportion of all malnourished admissions with such destruction (26 vs. 25 per 1,000) were similar. The seasonal distribution of these cases remained unchanged, the usual summer peak closely following the first distribution. Unexpectedly, 48% of the children had been ineligible for participation in the program, the vast majority being under 1 year of age. Only 80% of eligible children had actually received the vitamin. Corneal destruction was invariably accompanied by severe, generalized malnutition. Mortality among girls with corneal destruction (28 per 1,000) was almost three times that of boys, or malnourished patients as a whole.

Xerophthalmia and anterior-segment blindness among preschool-age children in El Salvador

A countrywide prevalence survey of 9,508 children was conducted in El Salvador to determine the prevalence of anterior-segment abnormalities and magnitude of clinical vitamin A deficiency. Thirty-six children had corneal opacities, 56% of them secondary to trauma. Such traumatic corneal opacities were 19 times more frequent among urban than rural children, 57.6 vs. 3.1 per 1,000. Keratomalacia accounted for only 8% of all corneal opacities, and for one (and possibly two) of the five cases of bilateral anterior-segment blindness encountered. The prevalance of Bitot spots and vitamin-A-related corneal opacities was 5.3 and 3.2 per 10,000, respectively. There are an estimated 43 new surviving cases of vitamin-A-related corneal opacities in the country each year, one third of which result in bilateral blindness. Fifteen percent of all children examined had grossly purulent conjunctivitis.