Childhood blindness in Uzbekistan

PURPOSE

To elucidate the aetiology of childhood blindness in the Republic of Uzbekistan and to assess the needs for future provision of ophthalmic services for children.

METHODS

Six hundred and seventy-one children in seven schools for the blind and visually impaired throughout Uzbekistan were examined using the WHO/PBL (World Health Organization Prevention Of Blindness) childhood blindness proforma. The locations were chosen to give a representation of the major areas of population within the country.

RESULTS

Of the 671 children examined, 506 (75.4%) were blind or severely visually impaired (corrected visual acuity of less than 6/60 (20/200) in the better eye). Cataract-related blindness (35%), retinal dystrophies (24%) and microphthalmos (23%) formed the three largest diagnostic categories.

CONCLUSIONS

The commonest avoidable cause of blindness was found to be cataract; the cause of poor vision may be due to unoperated cataract, aphakia, amblyopia or post-operative capsular fibrosis. The high proportion of retinal dystrophies may be related to the common practice of consanguineous marriage. The frequent finding of microphthalmos is discussed and compared with findings from other surveys. Glaucoma accounted for approximately 5% of the avoidable blindness.

Nodular scleritis: case report involving immunosuppressive therapy

BACKGROUND

Scleritis is a chronic inflammation of the scleral coat of the eye. Although the clinical manifestations of scleritis can follow a benign clinical course, the more serious forms may lead to vision loss and even enucleation of the eye.

METHODS

A case is presented of a 57-year-old woman with a diagnosis of nodular scleritis and attendant ocular manifestations.

RESULTS

Scleritis affects females slightly more frequently than males, and is most commonly found in patients who are 40 to 60 years of age. Patients who are symptomatic in only one eye typically have bilateral involvement within 5 years. More importantly, 50% of patients with scleritis have an underlying systemic disorder, which makes a detailed medical history and complete physical examination a crucial part of the treatment regimen.

CONCLUSION

Recognizing the disease and determining the possible underlying systemic etiologies as early as possible will elucidate the appropriate treatment options and help suppress the potentially devastating effects of scleritis.

Rapid assay of lactoferrin in keratoconjunctivitis sicca

We compared measurement of lactoferrin concentration by the LactoCard solid phase ELISA assay with the LactoPlate radial immunodiffusion assay in tears of normal patients and those with keratoconjunctivitis sicca. The LactoCard, a new lactoferrin assay, allows rapid determination of tear lactoferrin concentration in 10-15 min, a notable improvement over the 3 days required of the LactoPlate. There was no statistically significant difference between the accuracy of the two assays in normal patients nor in those patients with a diagnosis of keratoconjunctivitis sicca. Both assays showed a significant decrease in tear lactoferrin concentration in patients with severe keratoconjunctivitis sicca when compared to normal patients. The LactoCard is a rapid and reliable means of measuring tear lactoferrin concentration in a clinical setting.

Surface kinetic test method for determining rate of kill by an antimicrobial solid

An antimicrobial-surface kinetic test which maximizes probability of cell-to-surface contact has been developed. The measurement of rate of kill by a nonleaching antimicrobial surface is based on the number of surviving bacterial cells at specific times of exposure to various amounts of total treated surface area of test substrate. This method gives information for direct comparison of rate of kill for a variety of antimicrobial surfaces in terms of rate of kill per square centimeter of surface area. Data obtained by this method can also give valuable dose response application information as an indication of the exponential efficiency of concentration in terms of treated surface area.