• 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.
    • 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).
    • Nd:YAG laser hyaloidotomy for valsalva pre-macular haemorrhage.

      Kirwan, R P; Cahill, M T; Department of Ophthalmic Surgery, The Royal Victoria Eye and Ear Hospital,, Adelaide Road, Dublin 2, Ireland. ruaidhri.kirwan@ucd.ie (2012-02-01)
      AIM: To report a case of successful drainage of a large pre-macular haemorrhage using laser photo-disruption of the posterior hyaloid membrane. MATERIALS AND METHODS: A case report. RESULTS: A 47-year-old man presented acutely to our emergency department complaining of a 24-h history of sudden onset, painless and persistent loss of vision in his left eye. Immediately before noticing this loss of vision, he had been vomiting violently from excessive alcohol intake. The left visual acuity was counting fingers. Dilated fundoscopy of the left eye revealed a large pre-macular haemorrhage which was 14 disc diametres in size. Clotting investigations were normal. A diagnosis of valsalva retinopathy was made and the patient elected to receive a prompt neodymium-doped yttrium aluminium garnet (Nd:YAG) laser posterior hyaloidotomy as an outpatient. At 1 week follow-up, the haemorrhage had drained completely into the vitreous space revealing a healthy macula and the visual acuity had improved to 6/12 unaided. At 6-month follow-up the left visual acuity stabilised at 6/9 unaided. CONCLUSION: Nd:YAG laser posterior hyaloidotomy is a useful outpatient procedure for successful clearance of large pre-macular haemorrhages that offers patients rapid recovery of visual acuity and the avoidance of more invasive intraocular surgery.