OphthaTherapy. Therapies in Ophthalmology

Military aviation and vision. The impact of aerodynamic force on vision

Mon, 30 Sep 2024 00:00:00 +0200

The state of health and vision plays a crucial role in the effective and safe performance of duties by military pilots. Working in the air and exposure to aerodynamic stress can lead to various vision problems, which can be both temporary and permanent. Symptoms of dry eye syndrome, susceptibility to cataracts, and macular degeneration are more common among pilots than in the general population. Additionally, flights in hyperbaric chambers and significant aerodynamic stress can induce various ocular symptoms, such as corneal swelling, flashes in the eyes, or visual field disturbances, which can temporarily affect vision. Although most of these symptoms are reversible, there is a need for more scientific research on ophthalmic issues related to the work of military pilots to better understand these issues and develop appropriate prevention strategies. In the context of military operations, maintaining healthy vision is a key factor in the success of missions.

Corneal Imaging and Densitometry Measurements in Patients with Fuchs' Dystrophy Undergoing Penetrating Keratoplasty and Descemet's Striping Automated Endothelial Keratoplasty

Tue, 31 Dec 2024 00:00:00 +0100

Aims: In the present study, we used the densitometry software from the Oculus Pentacam to compare postoperative corneal clarity between penetrating keratoplasty (PK) and Descemet’s stripping endothelial keratoplasty (DSAEK) in patients with Fuchs’ dystrophy.

Methods: A retrospective comparative study was carried out at Manchester Royal Eye Hospital. In 28 patients with Fuchs’ dystrophy, corneal densitometry measurements were performed 12–18 months after corneal transplantation. The correlations of the densitometry measurements with the best corrected visual acuity (BCVA) and central corneal thickness (CCT) were analysed and compared between eyes that underwent PK and those that underwent DSAEK.

Results: Corneal densitometry measurements in the 33 eyes showed no significant differences between the PK and DSAEK post-surgery groups. There was no significant correlation between CCT and corneal densitometry measurements in either group (P >0.05 in both cases). After DSAEK, corneal densitometry measurements were significantly correlated with BCVA in the central (P = 0.01), posterior (P = 0.007), and full-depth (P = 0.008) 0–2 mm zones of the cornea but not in PK group. The postoperative CCT was significantly different between the two groups (P <0.01).

Conclusion: The 2 types of corneal transplantation resulted in different outcomes in terms of corneal densitometry measurements. Improved visual acuity after DSAEK was found to positively correlate with improvements in corneal clarity. Oculus Pentacam provides an objective evaluation tool to monitor corneal status after surgery.

Treatments of Herpes zoster ophthalmicus: an overview of current therapeutic and prophylactic strategies

Wed, 14 Aug 2024 00:00:00 +0200

Shingles and its complications are a significant issue in medicine, primarily affecting the elderly. The condition is caused by the reactivation of infection by a virus, whose primary clinical manifestation is chickenpox. A particular form of shingles is the ocular type, where changes occur along the branches of the trigeminal nerve. During the course of the disease, numerous symptoms concerning the eyeball may occur, and the patient is exposed to many dangerous and troublesome complications. In the following article, we will present available therapeutic and preventive options aimed at treating and preventing Herpes zoster ophthalmicus.

Long-term effects of epithelium-off corneal cross-linking in keratoconus therapy

Magdalena Maleszka-Kurpiel, Aleksandra Jackowiak, Marta Robak — Tue, 31 Dec 2024 00:00:00 +0100

Background: We report a well-documented cases of progressive corneal flattening and visual improvement after epithelium-off corneal cross-linking (epioff CXL) for keratoconus with long-term follow-up.
Case report: Two young men reported with deterioration of vision and diagnosed keratoconus few months earlier. Corneal tomography confirmed the previous diagnosis. Considering the age of the patients it was decided to perform epi-off CXL in both eyes. Based on several years of observation, no progression of the disease has been observed. In both cases, good visual acuity is maintained, what is unexpected the reduction in the maximum keratometry reading is still flattening also corneal thickness is reduced.
Conclusion: Continuous long-term flattening and corneal thinning after corneal cross-linking seems to be unpredictability in some cases. Our report highlights the importance of long-term evaluation of crosslinking techniques.

Scleritis in systemic diseases

Thu, 28 Nov 2024 00:00:00 +0100

This paper discusses scleritis in the course of systemic autoimmune diseases such as rheumatoid arthritis, nodular arteritis and granulomatosis with vasculitis. In addition, treatment suggestions based on the available literature are presented. Patients with scleritis resulting from an underlying disease should be twardiagnosed as soon as possible and given appropriate and effective treatment. Untreated or poorly treated scleritis or underlying disease can lead to severe damage to ocular tissues, loss of vision and eventually even blindness. A meticulous medical history, detailed ophthalmic examination and a series of targeted investigations as part of a multidisciplinary approach to detect any systemic disease are important in the management of scleritis. Rheumatoid arthritis remains the most common systemic rheumatic disease and the most common systemic condition associated with scleritis.

Cyclosporine: effective treatment for patients with inflammation of the ocular surface

Radosław Różycki, Piotr Nesterowicz, Małgorzata Różycka — Tue, 31 Dec 2024 00:00:00 +0100

Dry eye syndrome is a multifactorial and multisymptomatic disease affecting millions of people worldwide. Statistics show that depending on geographic location, 15% to 30% of a country’s population suffers from dry eye syndrome. Chronic inflammation leads to structural changes on the surface of the eye, causing pain and a range of other distressing symptoms. If left untreated, these symptoms can eventually result in reduced visual acuity and difficulties performing typical daily activities. The decline in quality of life strongly correlates with a deterioration in mental health. Recent studies indicate that one in three dry eye syndrome patients may struggle with depression. Chronic dry eye syndrome triggers the development of neurogenic inflammation. The aim of this study is to present the indications for and mechanism of action of cyclosporine A in the treatment of this condition.

Diseases of the cornea and ocular surface – an optimal management

Monika Udziela — Tue, 31 Dec 2024 00:00:00 +0100

The ocular surface diseases including dry eye disease are still increasing issue worldwide. Mild disorders are not sight threatening, but in advanced stages they may lead to serious complications. In some cases the treatment itself is the main cause for developing or aggravation of the dry eye disease, especially in patients with risk factors. The exact examination allows to avoid the misdiagnosis and to choose the optimal management.

Wide spectrum of retinal detachments – an insight into pathogenesis, medical examination and treatment

Nina Piłka, Mateusz Drabczyk, Sebastian Sirek, Dorota Wyględowska-Promieńska — Tue, 31 Dec 2024 00:00:00 +0100

Retinal detachment is a serious condition requiring prompt treatment to prevent vision loss. This review covers diagnosis, treatment options, and factors influencing clinical decisions. Despite its rarity, untreated detachment often leads to blindness. Early detection and intervention are crucial. Advances in imaging enhance diagnosis accuracy. Treatment ranges from conservative to surgical interventions like pneumoretinopexy, scleral buckling and vitrectomy. The review emphasizes the importance of timely diagnosis and treatment, highlighting the impact of early intervention on disease progression and vision preservation.

Evaluation of the efficacy of upper eyelid gold implant surgery in the treatment of lagophthalmos

Fri, 25 Oct 2024 00:00:00 +0200

Material and method: The study included 12 eyes of 12 patients, comprising 5 men and 7 women, with an average age of 55 years. Surgeries were performed on 6 right upper eyelids and 6 left upper eyelids affected by lagophthalmos due to various causes. The average duration of symptoms before surgery was 3 years and 6 months. Patients were eligible for surgery at least 6 months after the onset of paralysis. During the qualification examination, the weight of the implant was estimated using steel trial weights attached to the skin of the upper eyelid, and 0.2 g was added to this measured weight to determine the final implant weight. All patients underwent gold implant insertion into the upper eyelid, with the implants fixed to the tarsal plate using absorbable sutures to prevent prosthesis migration. Special attention was paid to precise layered tissue suturing. Subsequent ophthalmological examinations were conducted at various intervals post-surgery to evaluate the outcomes.

Results: Complete eyelid closure was achieved in 50% of the cases, while 100% of the patients reported subjective satisfaction with the surgical outcomes. The patients’ quality of life improved by an average of 85%. The average frequency of using moisturizing eye drops decreased from 7 times daily to 2 times daily. Improvement in the ocular surface condition was noted in all patients.

Conclusions: Gold implant insertion into the upper eyelid facilitates improvement in eyelid function and ocular surface condition, significantly enhancing the quality of life for patients with paralytic lagophthalmos.

Vitrectomy (25G) in a 77-year old patient with asteroid hyalosis – case report

Tomasz Maciejczyk, Antoni Sieńko, Małgorzata Łabuś, Sebastian Sirek — Tue, 31 Dec 2024 00:00:00 +0100

Introduction: Asteroid hyalosis, marked by calcified phospholipids in the vitreous body, is usually unilateral and becomes more common with age. It is often asymptomatic but may affect visual comfort.
Materials and methods: A 77-year-old woman with asteroid hyalosis, macular degeneration, and pseudophakia underwent 25G vitrectomy due to significant visual deterioration. Preoperative visual acuity in the right eye was 4/50.
Results: Postoperative visual acuity improved to 5/25 with no complications.
Conclusions: This case highlights the importance of personalized vitrectomy decisions based on symptom severity and comorbidities, even when visual acuity in asteroid hyalosis typically does not worsen.