Publications by staff affiliated to the Royal Victoria Eye and Ear Hospital, Dublin

Recent Submissions

  • Cross-sectional Analysis of the Standards of Consent Applied to Anaesthesia in Ireland: Are Anaesthetists Aware of their Legal and Ethical Obligations?

    Cafferkey A; Lyons, B (Irish Medical Journal, 2018-01)
    Consent to a medical intervention has legally and ethically evolved to a process prioritising autonomy and patient-led decision-making. This cross-sectional analysis investigated Irish anaesthetists’ practices of taking consent. Following ethical approval, trainees and fellows of the College of Anaesthetists of Ireland were invited to participate in a 33 question online survey. One hundred and sixty responses (11.8%) were received, an equal number coming from consultants and trainees. The majority (93.7%) worked in a teaching hospital. Fifteen percent said their department had guidelines on obtaining consent for anaesthesia, but only 4.5% said their department used a separate consent form. Most (63.8%) do not usually document consent. A significant number rarely (21.8%) or never (27.8%) explained risks to patients. Lack of time was identified as the most frequent barrier (77.6%), with just under half first meeting the patient in the theatre holding-bay or the anaesthetic room. Forty-one percent felt the ultimate decision regarding which anaesthetic technique is employed should usually lie with the anaesthetist alone. These results suggest a wide variation in the practice of obtaining consent for anaesthesia. Less than half deemed their practice to be adequate in this regard, while 50% were concerned about litigation stemming from inadequate consent.
  • A novel homozygous truncating GNAT1 mutation implicated in retinal degeneration.

    Carrigan, Matthew; Duignan, Emma; Humphries, Pete; Palfi, Arpad; Kenna, Paul F; Farrar, G Jane (2016-04)
    The GNAT1 gene encodes the α subunit of the rod transducin protein, a key element in the rod phototransduction cascade. Variants in GNAT1 have been implicated in stationary night-blindness in the past, but unlike other proteins in the same pathway, it has not previously been implicated in retinitis pigmentosa.
  • Royal Victoria Eye and Ear Hospital annual report and accounts,1996: celebrating 100 years.

    Royal Victoria Eye and Ear Hospital (Royal Victoria Eye and Ear Hosital, 1997)
    The Dublin Eye and Ear Hospital Act, 1897 came in to force on 15th July 1897. The Act provided for the amalgamation of the National Eye and Ear Hospital in Molesworth Street (founded in 1814) and St Mark's Ophthalmic Hospital in Lincoln Place founded in 1844 by Sir William R. Wilde) and established this Hospital. We are therefore celebrating this year the completion of one hundred year of service by the Hospital to the citizens of Dublin and indeed to people from all parts of Ireland.
  • Ophthalmic manifestations of vitamin A and D deficiency in two autistic teenagers: case reports and a review of the literature.

    Duignan, Emma; Kenna, Paul; Watson, Rosemarie; Fitzsimon, Susan; Brosnahan, Donal (Karger Publishing, 2015-01)
    We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, reports in developed societies are rare. Our patients presented over a 1-year period. The patients were 14 and 13 years old at the time of presentation and were both found to have marked features of vitamin A deficiency related to unusual dietary habits. Anterior segment signs of xerophthalmia were present in both patients. In addition, patient 1 showed evidence of a rod-predominant retinopathy, which resolved with vitamin A supplementation. Due to its rare occurrence, hypovitaminosis A must be highlighted and anticipated in this cohort.
  • Proteomics in uveal melanoma.

    Ramasamy, Pathma; Murphy, Conor C; Clynes, Martin; Horgan, Noel; Moriarty, Paul; Tiernan, Damien; Beatty, Stephen; Kennedy, Susan; Meleady, Paula; Royal College of Surgeons Ireland, Stephen's Green, Dublin 2, Ireland; National Institute for Cellular Biotechnology, Dublin City University, Collins Avenue, Glasnevin, Dublin 9, Ireland. Electronic address: Pathma.Ramasamy@dcu.ie. (2014-01)
    Uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence of 5-7 per million per year. It is associated with the development of metastasis in about 50% of cases, and 40% of patients with uveal melanoma die of metastatic disease despite successful treatment of the primary tumour. The survival rates at 5, 10 and 15 years are 65%, 50% and 45% respectively. Unlike progress made in many other areas of cancer, uveal melanoma is still poorly understood and survival rates have remained similar over the past 25 years. Recently, advances made in molecular genetics have improved our understanding of this disease and stratification of patients into low risk and high risk for developing metastasis. However, only a limited number of studies have been performed using proteomic methods. This review will give an overview of various proteomic technologies currently employed in life sciences research, and discuss proteomic studies of uveal melanoma.
  • Lemierres syndrome: the forgotten disease

    Morariu, I; Curran, A; Killeen, RP (Irish Medical Journal, 2014-09)
    Lemierres syndrome is a rare and potentially fatal entity affecting otherwise healthy and young adults. The infection originates in the throat and spreads via a septic trombophlebitis of the internal jugular vein, with development of distant septic emboli. This clinical picture is characteristic but many clinicians are unaware of the condition and diagnosis is often delayed with potentially fatal consequences.
  • Adoption of intracameral antibiotic prophylaxis of endophthalmitis following cataract surgery: update on the ESCRS Endophthalmitis Study.

    Barry, Peter; Royal Victoria Eye and Ear Hospital and St Vincent's University Hospital, Dublin, Ireland. (2014-01)
    To determine the use of intracameral cefuroxime at the end of cataract surgery since the beneficial results were first reported by the European Society of Cataract and Refractive Surgeons Endophthalmitis Study Group in 2006, 250 ophthalmic surgeons affiliated with both public and private hospitals and clinics across Europe were surveyed. The questions regarded their awareness of the results of the ESCRS endophthalmitis study and their current use or non-use of intracameral antibiotics in their cataract procedures. Seventy-four percent of respondents said they always or usually use intracameral antibiotics in their cataract surgery procedures. The most frequently cited reasons for not using cefuroxime or other intracameral antibiotics was the lack of an approved commercial preparation and related anxieties regarding the risk of dilution errors and contamination. More than 90% of respondents said they would use cefuroxime if an approved single-unit dose product were commercially available.
  • "Tarantula keratitis": a case report.

    McAnena, L; Murphy, C; O'Connor, J; Royal Victoria Eye and Ear Hospital (RVEEH), Adelaide Road, Dublin 2, Ireland. lmcanena@yahoo.co.uk (2013-09)
    A case of an 11-year-old boy presenting with a two-week history of a red, irritated right eye after handling a Chilean Rose Tarantula at an exotic pet exhibition. Examination revealed innumerable microscopic hairs embedded at all levels of the cornea. He was commenced on steroid drops with subjective and objective improvement at follow up.
  • Systematic review and meta-analysis of wound drains after thyroid surgery.

    Woods, R S R; Woods, J F C; Duignan, E S; Timon, C; Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. (2014-04)
    Drainage after routine thyroid and parathyroid surgery remains controversial. However, there is increasing evidence from a number of randomized clinical trials (RCTs) suggesting no benefit from the use of drains.
  • A method for the prescription of inexpensive spectacles by non-specialist healthcare workers: S-Glasses.

    Treacy, M P; Treacy, M G; Dimitrov, B D; Seager, F E; Stamp, M A; Murphy, C C; Department of Ophthalmology, Royal College of Surgeons in Ireland, Royal Victoria Eye and Ear Hospital, Dublin 2, Republic of Ireland. Max@Treacy.ie (2013-04)
    Globally, 153 million people are visually impaired from uncorrected refractive error. The aim of this research was to verify a method whereby autorefractors could be used by non-specialist health-workers to prescribe spectacles, which used a small stock of preformed lenses that fit frames with standardised apertures. These spectacles were named S-Glasses (Smart Glasses).
  • Glomangiopericytoma (sinonasal-type haemangiopericytoma).

    Oosthuizen, J C; Kennedy, S; Timon, C; Department of Otorhinolaryngology, Head and Neck Surgery, The Royal Victoria Eye and Ear Hospital, Dublin, Republic of Ireland. C.Oosth@gmail.com (2012-10)
    Glomangiopericytoma is a rare sinonasal tumour of perivascular myoid phenotype, which accounts for less than 1 per cent of all sinonasal tumours.
  • The case for intraocular delivery of PPAR agonists in the treatment of diabetic retinopathy.

    Treacy, Maxwell P; Hurst, Tara P; Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Dublin, Ireland. max@treacy.ie (2012-09)
    Systemic therapeutics targeting the peroxisome proliferator-activated receptors have been found to be beneficial in the treatment of diabetic retinopathy. In this paper, we provide a rationale for the use of these therapeutics as intraocular agents. In addition, we introduce the peroxisome proliferator-activated receptors and describe their functions in response to the drugs.
  • Orbital exenteration in periorbital malignancies.

    Roche, Phoebe; Timon, Conrad; Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland. phoebe.roche@yahoo.co.uk (2012-08)
    Orbital exenteration is a disfiguring procedure most commonly performed for locally advanced or recurrent periorbital malignancies.
  • The changing face of informed surgical consent.

    Oosthuizen, J C; Burns, P; Timon, C; Department of Otorhinolaryngology, Head and Neck Surgery, The Royal Victoria Eye and Ear Hospital, Dublin, Ireland. C.Oosth@gmail.com (2012-03)
    To determine whether procedure-specific brochures improve patients' pre-operative knowledge, to determine the amount of information expected by patients during the consenting process, and to determine whether the recently proposed 'Request for Treatment' consenting process is viable on a large scale.
  • A rare angiosarcoma: retiform haemangioendothelioma.

    O'Duffy, F; Timon, C; Toner, M; Department of Otorhinolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. fergaloduffy@hotmail.com (2012-02)
    We report the case of a rare angiosarcoma, retiform haemangioendothelioma, in an 18-year-old young man, which presented as a recurrent ulcerating lesion of the left pinna.
  • Changing trends in Thyroidectomy

    Chukudebelu, Obinna; Dias, Andrew; Timon, Conrad (Irish Medical Journal, 2012-06)
  • Patients' quality of life post thyroidectomy.

    Cashman, E C; Bresnihan, M; Timon, C; Royal Victoria Eye & Ear Hospital, Adelaide rd, Dublin 2, Ireland. emmacashman@gmail.com (2011)
    This study was designed to evaluate health related quality of life post thyroidectomy for hyperthyroidism with respect to clinical benefit and patient satisfaction. This is one of the first such studies in the literature evaluating quality of life post thyroidectomy for hyperthyroidism.
  • Clinical observations associated with proven and unproven cases in the ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery.

    Barry, Peter; Gardner, Susanne; Seal, David; Gettinby, George; Lees, Fiona; Peterson, Magnus; Revie, Crawford; Royal Victoria Eye and Ear Hospital, Dublin, Ireland. peterbarryfrcs@eircom.net (2012-02-01)
    PURPOSE: To describe cases of postoperative endophthalmitis in the European Society of Cataract & Refractive Surgeons (ESCRS) study of the prophylaxis of endophthalmitis, compare characteristics of unproven cases and cases proven by culture or polymerase chain reaction, and compare the characteristics with those in other reported series. SETTING: Twenty-four ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey, and the United Kingdom. METHODS: Univariable and multivariable logistic regression models were used to analyze data for statistical association of signs and symptoms in cases with proven or unproven endophthalmitis. Specific data describing characteristics of the cases were compared between the 2 types of cases. RESULTS: Data from 29 endophthalmitis cases were analyzed. Swollen lids and pain were statistically associated with proven cases of endophthalmitis on univariable regression analysis. Multivariable analysis indicated that swollen lids and an opaque vitreous were associated with proven cases. Five cases of endophthalmitis occurred in the cefuroxime-treated groups. No case of streptococcal infection occurred in the cefuroxime-treated groups. However, cases of infection due to streptococci showed striking differences in visual acuity and were associated with earlier onset. Characteristics in the 29 cases parallel results in previous studies, such as the Endophthalmitis Vitrectomy Study, although the addition of a control group in the ESCRS study elicited additional findings. CONCLUSION: Swollen lids, pain, and an opaque vitreous were statistically associated with proven endophthalmitis cases in the ESCRS study.
  • Classification and treatment of radiation maculopathy.

    Horgan, Noel; Shields, Carol L; Mashayekhi, Arman; Shields, Jerry A; Royal Victoria Eye and Ear Hospital, Dublin, Ireland. Noel.Horgan@rveeh.ie (2012-02-01)
    PURPOSE OF REVIEW: Radiation maculopathy is a sight-limiting consequence of radiotherapy in the management of uveal melanoma and other intraocular tumors. In this review, we consider clinical, fluorescein angiographic and optical coherence tomographic findings, propose a classification for radiation maculopathy and discuss the management of this condition. RECENT FINDINGS: Radiation macular edema (RME) can be classified by optical coherence tomography into noncystoid or cystoid edema, with foveolar or extrafoveolar involvement. Optical coherence tomographic grading of RME has been found to correlate with visual acuity. Focal argon laser might have some limited benefit in the treatment of RME. Intravitreal triamcinolone and intravitreal antivascular endothelial growth factor agents can be of short-term benefit in the treatment of RME. In a randomized controlled trial, periocular triamcinolone significantly reduced rates of RME and vision loss up to 18 months following plaque radiotherapy for uveal melanoma. SUMMARY: Currently, there is no proven treatment for established RME, though periocular triamcinolone has been shown to have a preventive benefit. An accepted classification system for radiation maculopathy would be of benefit in planning and comparing future treatment trials.

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