Effective temporary analgesia for severe painful blind eye

There are various methods of providing pain relief for painful blind eyes. We wish to recommend this effective method of providing temporary analgesia in patients suffering from a severe painful blind eye before undergoing enucleation.

Attitudes of community optometrists to smoking cessation: an untapped opportunity overlooked?

AIM

To assess community optometrists' attitudes and current behaviour regarding provision of smoking cessation advice in their practice.

METHODS

A self-completion postal questionnaire was sent to community optometrists in north-west England identified from the General Optical Council's practice lists.

RESULTS

Of 709 optometrists identified, 71.8% (509/709) returned the completed questionnaire. Few community optometrists routinely asked about smoking habits: only 6.2% (95% CI: 4.1-8.3) (n = 31) at new patient consultations, and 2.2% (95% CI: 0.9-3.5) (n=11) at follow-up visits. Reasons for optometrists not routinely providing smoking cessation advice included: not their role (35.4%, n=180), lack of time (22.0%, n=112) and forgetting to ask (21.4%, n=109). Overall 67.6% (95% CI: 63.5-71.7) (n=344) of community optometrists wanted to improve their knowledge of smoking and visual impairment with 56.2% (95% CI: 51.9-60.5) (n=286) requesting further training.

CONCLUSION

Despite low levels of current involvement, many optometrists were keen to receive training on smoking cessation topics. We suggest that there are untapped opportunities to develop brief interventions to promote smoking cessation services in community optometry settings.

Bimedial hang-back recession— outcomes and surgical response

AIM

To report outcomes and identify factors affecting surgical response for constant esotropia using 'hang-back' bimedial rectus recession.

STUDY TYPE

Retrospective case series analysis.

METHODS

Patients managed by a single surgeon over a 4-year study period were categorized into esotropia types: infantile, partially accommodative, nonaccommodative and secondary esotropia. Postoperative alignment was compared between types, and regression modelling used to examine factors predicting surgical response.

RESULTS

In all, 95% (18/19) of children with partially accommodative esotropia achieved postoperative deviation <15 prism dioptres from orthotropia, compared to 56% (15/27) of children with infantile esotropia, 69% (11/16) of children with non-accommodative esotropia and all (2/2) of those with secondary esotropia. Surgical response (Delta/mm recession performed) increased with the magnitude of both preoperative deviation (P<0.001) and anisometropia (P<0.001); the effect of deviation on surgical response was reduced by amblyopia (P=0.02). Age at surgery was statistically associated (P=0.002) but had negligible clinical effect on response.

CONCLUSIONS

Surgical response to hang-back recession may be partially predicted by preoperative factors.