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At least 919 records · Page 51Linked to original sources
PubMed1999

Ocular complications with high-dose interferon alpha in chronic active hepatitis.

PURPOSE: Interferon alpha, which is used to treat various systemic disorders, has many reversible side-effects involving various organ systems. In this study, chronic active hepatitis patients undergoing interferon alpha therapy were followed with regard to the ocular side-effects. METHODS: Thirty-six patients with chronic active hepatitis undergoing subcutaneous interferon alpha therapy for 1 year were enrolled. Complete ocular examination and photographic documentation were performed at baseline of the therapy and monthly thereafter. Fisher's exact chi-squared test and Mann-Whitney U-test were employed in the statistical evaluation of the results. RESULTS: Trichomegaly was noted in 2 (6%) patients. Fifteen patients (42%) were found to have retinopathy with cotton wool spot formation and splinter haemorrhages. CONCLUSIONS: These findings emphasise the need to monitor these retinal complications, which may result in loss of vision in patients receiving interferon alpha therapy.

Adolescent↗
PubMed1997

Incidence estimates of late stages of trachoma among women in a hyperendemic area of central Tanzania.

The purpose of this study is to estimate 5-year incidences of conjunctival scarring and trichiasis, and 10-year incidence of corneal opacities due to trachoma, using prevalence data from a population sample of 6038 women living in a trachoma-hyperendemic area of central Tanzania. Previous surveys have documented the age-specific prevalence of scarring, trichiasis, and corneal opacities in women in hyperendemic areas. Using the age-stratified prevalences of these different clinical signs, corresponding incidence rates were estimated. Transition rates from one sign to the next were also obtained by restricting the risk group to only women with a specific trachoma sign. Thus, the 5-year incidence of trichiasis among women with conjunctival scarring, and the 10-year incidence of corneal opacities among women with trichiasis were estimated. Incidences of all the signs markedly increased with age. For scarring, 5-year incidence rates increased from 3.1% in the 15-19 age category to 14.3% for women between 55 and 59 years. The 5-year incidence of trichiasis ranged from 0.3% in the 15-19 age category to 7.5% in the age group 55-59. Corneal opacities due to trachoma were highest in the age group 45-54; the 10-year incidence increased to 2.8%. The 5-year incidence of trichiasis among only women with scars increased from 3.2% in the 15-19 age group to 15.1% in women in the 55-59 age group. Once trichiasis is present, almost one-third of the women below 35 and more than 40% of the women older than 45 will develop corneal opacities in a 10-year interval. These estimates are important in understanding the dynamics of progression of trachoma from conjunctival scarring to the potentially blinding signs of trichiasis and corneal opacities. They provide important information for planning adequate services in areas where trachoma is endemic and surgery for trichiasis is a key factor to avoid blindness from trachoma. They also provide clues to the pathogenesis that may be useful in the development of new methods of control.

Adolescent↗
PubMed2000

Should trichiasis surgery be offered in the village? A community randomised trial of village vs. health centre-based surgery.

INTRODUCTION: Surgery for trachomatous trichiasis prevents blindness and is advocated by the WHO as part of the SAFE strategy for the global elimination of trachoma. We conducted a randomised community trial to investigate the effect of providing surgery in villages on surgical uptake in The Gambia. METHODS: 56 villages from two divisions were assigned to eight pairs of clusters matched by geographical division and proximity. One cluster from each pair was randomly assigned to receive village-based surgery and the other cluster health centre-based surgery. Outcome measures were uptake rates and surgical results after 1 week and 3 months. The paired t-test was used to analyse the results. RESULTS: Overall uptake was 66% in the village-based clusters and 44% in the health centre-based clusters. Subjects in the village-based surgery arm had significantly shorter journey times (P = 0.01) and lower costs (P = 0.002). The mean difference in absolute acceptance rates of surgery was 20% better in village-based clusters (95% CI -9 to + 49%, P = 0.15), which would equate to an improvement of 45% (95% CI -20% to 120%) on the average acceptance rates of 44% in the health centre-based group. CONCLUSION: These results strongly suggest better surgical uptake when surgery is provided in patients' villages due to lower cost to the patient, time saved and less fear of the operation.

Blindness↗
PubMed2001

Trichiasis in Aboriginal people of the Kimberley region of Western Australia.

BACKGROUND: Trachoma is a significant public health problem in the Kimberley region of Western Australia. The prevalence of follicular trachoma in the region has been well documented and control of active trachoma is well established. In contrast, trichiasis prevalence in recent years is less well documented. This study aimed to determine trichiasis prevalence in the Kimberley population and to document an appropriate intervention. METHODS: A collaborative programme was established involving the Kimberley Public Health Unit, Kimberley Aged Care Services and the visiting ophthalmology service. After training, medical students screened the aged-care population for trichiasis and the aged-care services staff were educated about identification and referral procedures for patients with trichiasis. The Kimberley Public Health Unit was responsible for ensuring specialist assessment, and correction, of trichiasis and appropriate post-treatment follow up. RESULTS: A total of 597 Kimberley Aboriginal people aged 50 years or more were screened for trichiasis, representing 42% of that age group. Trichiasis was suspected in 40 people. Of the 28 people with suspected trichiasis who underwent ophthalmological assessment, 17 were found to have trachomatous trichiasis. The observed prevalence of trachomatous trichiasis was 2.8%. The trichiasis screening programme has been adopted by most aged-care organizations in the Kimberley. CONCLUSIONS: The results show that trichiasis continues to affect elderly Aboriginal people, especially those from Halls Creek Shire. Health professionals and aged-care workers should be alert to the possibility of this preventable cause of blindness and work collaboratively to ensure that patients receive timely and appropriate treatment.

Aged↗
PubMed1991

[Vitrectomy in secondary complications caused by intraocular foreign body].

Endophthalmitis and reduced vision as late complications of penetrating ocular injuries cause specific diagnostic problems. A persisting endopthalmitis may be caused by unnoticed organic foreign bodies (f.b.) like lashes or a splinter of glas. Endophthalmitis recurring months or years after a perforating injury indicates the possibility of a spontaneous mobilization of a f.b. Vitrectomy and removal of the f.b. is the therapy of choice in either situation. Five typical cases are presented: lashes encapsulated in the ciliary body following a limbal perforation; an intraretinal incarceration of a lash of unknown history; spontaneous dislocation of a glas splinter from the ciliary body into the anterior chamber; delayed spontaneous translocation of a 10 x 11 mm metallic f.b. from tenon's space transsclerally into the subretinal space leading to endophthalmitis one year after a severe perforating injury; secondary mobilization of an intraretinal piece of stone during a posterior hyaloid detachment. In each case, vitrectomy was performed and the f.b. removed via pars plana. Secondary surgery for retinal detachment or PVR was necessary in 2 cases. The final visual acuity was 20/20 in 3 cases and 10/20 or better in 2 cases.

Adult↗
PubMed1990

[Technic and long-term results of cryogenic epilation in trichiasis and distichiasis].

The present paper communicates the technique and results of cryoepilation in 1,690 cases (94% trichiasis and 6% distichiasis). Only nitrogen cryotherapy devices are totally suitable for this, and the spray freezing method is to be preferred. The IKG unit developed by the authors, which has proved successful in particular for tumor therapy, is also ideal for cryoepilation. It generates a very tightly bundled nitrogen spray jet, thus permitting isolated freezing of the lid margin. In about 95% of the cases permanent epilation is achieved without undue trauma. In 5% the condition described by Fraunfelder as "secondary trichiasis" develops. Ocular pemphigoid is not a contraindication to cryotherapy.

Cryosurgery↗
PubMed1990

[Surgery of the eyelid edge--references for general practice].

a) Punctum plasty (eversion of the lacrimal point): This simple method results in a permanently enlarged punctum. A 4-0 silk suture is passed through the vertical part of the canaliculus and the conjunctiva, drawing them together very tightly. The thread falls out after 4-6 weeks. b) Management of trichiasis: Electrolysis of misdirected lashes leads to contraction and renewed misdirection. This disadvantage is avoided by excising the lashes with a 1 mm trephine. The trephine must follow the direction of the lash exactly, so that a complete cylinder including the hair and root can be removed. The resulting small defect heals quickly without contraction.

Dacryocystorhinostomy↗