bluuebunny/crossref_metadata_2025_split huggingface dataset:
Referral to low vision services by ophthalmologists
Authors: Keeffe J E. , Lovie‐Kitchin J E. , Taylor H R. 
Published: November 2007

Abstract Purpose: People in need of low vision rehabilitation services often experience delays in referral to services. This study investigated referral criteria of Australian ophthalmologists, the frequency of referral of their patients with low vision and their perceptions of low vision services. Methods: A survey was sent to a representative, random sample of 200 ophthalmologists. They were asked about criteria used for the referral of their patients with low vision. The survey included questions on the frequency with which they prescribed low vision devices (LVD) and referral of their patients to low vision and rehabilitation services and peer support groups. Perceptions of the quality and availability of low vision services were also investigated. Results: The response rate was 82%. Approximately 11% of ophthalmologists' patients have low vision. It is uncommon for ophthalmologists to prescribe LVD but 67% refer most of their patients with low vision. It is less common for them to refer to rehabilitation services (29%) or peer support services (18%). The perceived local availability of services influences the rate of referral. Ophthalmologists who used the criteria of moderate low vision (<6/21 to <6/60) are more likely to refer more of their patients than those who use the criteria of severe low vision. Conclusions: Australian ophthalmologists refer most of their visually impaired patients to low vision services, but infrequently to rehabilitation services or peer support groups. Differences in perceived need for low vision services indicated by the criteria used for referral, and the perceived availability, influence the rate at which ophthalmologists refer their patients for services. Ophthalmologists are encouraged to refer patients with permanent visual loss to low vision services earlier.
Relation of hormone and menopausal status to outcomes following excimer laser photorefractive keratectomy in women
Authors: McCarty Cathy A. , Ng Irene , Waldron Ben , Garrett Sinead KM , Downie Julie A. , Aldred Geoff F. , Wolfe Rick JB , Taylor Hugh R. 
Published: November 2007

Abstract Purpose: To examine the effect of hormone use, pregnancy and menopausal status on clinical outcomes following excimer laser surgery for myopia and myopic astigmatism. Methods: Participants comprised all female patients of the Melbourne Excimer Laser Group (MELG). A standardised surgical protocol was followed by the 27 MELG members, using the VisX 20/20 excimer laser and included the prospective collection of the following information preoperatively and one, three, six and 12 months after the procedure: uncorrected and best corrected visual acuity with a LogMAR chart; best manifest refraction: and subjective assessment of corneal clarity. A survey that elicited information about oral contraceptive (OC) use, pregnancy history, surgical and natural menopause, and use of hormone replacement therapy (HRT) was mailed to all the women. Results: A 77% response to the mailed survey was achieved. Two women were pregnant at the time of surgery, one became pregnant during the first month after surgery, and all three women were excluded from further analyses, although a review of two of the case histories revealed suboptimal clinical outcomes. Women taking OC were included in the control group after OC use was shown not to be associated with outcome. Women were grouped accordingly: control, n=225; pre‐menopausal on HRT, n=7; post‐menopausal not on HRT, n=34; and post‐menopausal on HRT, n=21. The groups differed significantly with regard to age and preoperative spherical equivalent. After controlling for age and preoperative spherical equivalent, the mean number of uncorrected LogMAR letters read one year after surgery was significantly lower for the post‐menopausal women on HRT in comparison with the control group. Best corrected acuity and corneal clarity were not significantly different among the groups. Discussion: These preliminary results suggest that the interaction of menopausal and HRT status could decrease the effectiveness of PRK and PARK, but require confirmation with a further study in a prospective manner using objective measures of corneal epithelial healing and serum hormone levels.
A randomised prospective study of outpatient haemodilution for central retinal vein obstruction
Authors: Luckie Alan P. , Wroblewski John J. , Hamilton Peter , Bird Alan C. , Sanders Michael , Slater Nicolas , Green William 
Published: November 2007

Abstract Purpose: Central retinal vein obstruction (CRVO) has significant visual morbidity. We prospectively evaluated an outpatient haemodilution (HD) regimen for CRVO. Methods: We recruited 59 patients with CRVO of less than three months' duration and visual acuity (VA) worse than or equal to 6/9.5. Thirty patients underwent HD (packed cell volume of <0.35, 12 weeks); there were 29 controls and follow‐up was for six months. Results: Incidence rates for VA improvement (P=0.708) and rubeosis iridis (P=0.619) between the two groups were not different. The incidence rate of VA deterioration was 5.315 times higher with HD (P=0.035, Cox Proportional analysis). Conclusion: This data does not support the previous studies on haemodilution.
Experimental corneal neovascularisation using sucralfate and basic fibroblast growth factor
Authors: Loughnan Michael S. , Chatzistefanou Klio , Gonzalez Evelyn M. , Flynn Evelyn , Adarnis Anthony P. , Shing Yuen , D'Amato Robert J. , Folkman Judah 
Published: November 2007

Abstract Purpose: To develop a non‐inflammatory model of both acute and chronic angiogenesis in the rabbit cornea using a known directly angiogenic cytokine. Methods: Pellets made of the slow‐release polymer Hydron (polyhydroxyethylmethacrylate) and containing sucralfate and/or basic fibroblast growth factor (basic‐FGF) were implanted into rabbit corneas. The neovascular response to the implantation of pellets containing basic‐FGF alone, sucralfate alone or a titration of basic‐FGF in the presence of a constant amount of sucralfate was measured. The role of inflammation in the neovascular response was also investigated. Results: The addition of sucralfate to the pellets led to the sustained release of basic‐FGF resulting in a predictable and aggressive neovascular response with a low dose of basic‐FGF that by itself was unable to elicit neovascularisation. At a dose of 500ng per pellet, approximately one‐third of the surface area of the cornea was vascularised within eight days of implantation. Minimal or no vascularisation occurred with the same dose of basic‐FGF without sucralfate. While this dose of basic‐FGF induced corneal oedema, only minimal inflammation was observed and the response was unaffected by ionising radiation. A less aggressive though still robust neovascular response with no or only minimal oedema was observed when the dose was lowered to 50ng of basic‐FGF per pellet. Some induced vessels persisted for more than three months. Conclusion: This is an inexpensive in vivo model of angiogenesis with the advantages of the neovascularisation being aggressive, predictable, persistent, unassociated with an obvious inflammatory response and induced by the sustained release of an agent known to have a direct stimulatory action on endothelial cells.
Cataract surgery in Australia 1985–94
Authors: Keeffe Jill E. , Taylor Hugh R. 
Published: November 2007

Abstract Background:Cataract surgery is the most common form of major ophthalmic surgery in Australia and a common surgical procedure among the elderly. The purpose of this report is to compile the numbers and rates of cataract extractions and implant of IOLs over the period 1985–94 for Australia. Methods:Data were obtained for public and private cataract extractions and IOL implants from state and territory ministries of health and from the Health Insurance Commission. The data relating to cataract surgery were compared with the growth in the proportion of elderly people in the population. Results:The number of cataract extractions has increased by 2.6 times over the ten‐year period to 67459 in 1994 and IOL implants have increased by 2.9 times over the same period to 70084. The increase in the elderly population for the period was 1.3 times so that there is a relative doubling in the rate of surgery. The proportion of public patients has risen from 19% to 28% from 1985 to 1994. Conclusions:The numbers of cataract extractions and IOL implants was increased at double the rate expected from the growth in the elderly population. Advances in microsurgery and IOL technology have resulted in improved outcomes and have created a greater patient demand. The improved outcomes have also lead to ophthalmologists recommending cataract surgery at better visual acuity levels than previously.
Merkel cell turnour occurring simultaneously in the upper and lower eyelids
Authors: Marshmann Wendy E. , McNab Alan A. 
Published: November 2007

Abstract Purpose:To highlight an unusual presentation of two Merkel cell turnours in the same patient. ResultWe report a case of two Merkel cell turnours occurring simultaneously in the upper and lower eyelids of an elderly woman, a unique occurrence. Wide local resection and reconstruction resulted in microscopic clearance of the tumours. Lymphatic spread was detected, a common feature. She had previously undergone excision of a similar lesion from the lower eyelid. Conclusion:Merkel cell tumour is a rare turnour of the elderly that often locally recurs and metastasises early. Treatment consists of wide local excision with or without adjuvant radiotherapy. Juxtaposing lesions on the eyelids have not been previously reported. We postulate that this patient showed local recurrence and a new tumour of the upper eyelid simultaneously.
Choroidal melanoma: A review of the experience of the Sydney Eye Hospital Professorial Unit 1979–1995
Authors: Reader S , Grigg J , Billson FA 
Published: November 2007

AbstractPurpose:This study examines 90 patients presenting with choroidal or ciliochoroidal melanoma to the Professorial Unit at the Sydney Eye Hospital. The indications for treatment, and the outcome for the eye and vision are presented together with an account of mortality and the incidence of metastases.Methods:A retrospective analysis of 90 choroidal melanoma patients managed by one surgeon over a 16‐year period was undertaken. Initial findings, investigations performed, incidence of metastatic disease, treatment received and complication rates and mortality, where applicable, were recorded.Results:The group was followed for an average of 64 months (range, 5–172 months). Primary treatment was with either Iodine125(1251) brachytherapy, local excision or enucleation. Radiation retinopathy was prominent in1251 cases resulting in poor visual acuity when the tumour resided in the posterior pole. Local excision even of large tumours was effective particularly if peripheral. Overall metastatic disease was seen in 11% with 5‐year survival rates for the metastatic group being 10%. Prognosis after diagnosis of metastases was poor.Conclusions:Specific therapy for choroidal melanoma must relate to the size and location of the tumour at the time of diagnosis. Visual outcome relates directly to the proximity of the tumour to the optic nerve and fovea. Metastatic disease latency can be prolonged; therefore caution about prognosis is required long after therapy is given. The 5‐year survival is encouraging with all forms of therapy. However, as the natural history of ocular melanoma is variable and not fully delineated it is important to monitor the effects of conservative therapy. Further long‐term survival data is required to distinguish whether one form of treatment is advantageous over the others, although case‐control studies are difficult for ethical and practical reasons. In this regard the Collaborative Ocular Melanoma Study (COMS) will provide further evidence for the safety and efficacy of conservative therapy with brachytherapy compared to enucleation.
Orbital decompression for thyroid orbitopathy
Authors: McNab AA 
Published: November 2007

AbstractBackground:Severe thyroid orbitopathy may result in optic neuropathy, corneal exposure and disfiguring proptosis, Orbital decompression has most commonly been performed for optic neuropathy, but with improved techniques, more patients are undergoing decompression for other indications. Purpose: This report evaluates the results and morbidity of orbital decompression for thyroid orbitopathy performed by one surgeon. Methods: The records of 33 patients (53 orbits) undergoing orbital decompression for thyroid orbitopathy were analysed for changes in visual acuity and colour vision (where the indication was optic neuropathy) and reduction in proptosis. Complications were also analysed. Results: Visual acuity and colour vision improved in all 33 eyes with optic neuropathy in the short term postoperative period (4 weeks), but later deteriorated in five eyes (6.6%) of 4 patients (19%). Proptosis decreased by a mean 5.3 mm (range, 1–10). Diplopia developed or worsened overall in 10 of 33 patients (30%), but only in one of 12 (8%) where the indication was cosmesis or corneal exposure. Diplopia improved in 2 of 33 (6%). All patients with symptomatic diplopia achieved binocular single vision in a useful range after one and sometimes two squint procedures. No patient lost vision as a result of surgery. Conclusions: Orbital decompression is effective in improving vision in most patients with thyroid optic neuropathy, but induces or worsens diplopia in a high proportion of these patients. Proptosis can be effectively and dramatically improved.
Congenital optic pits and central serous chorioretinopathy
Authors: Chen M‐S , Tsai W‐F 
Published: November 2007

Abstract Purpose: The reporting of the occurrence of central serous chorioretinopathy in a patient with congenital optic pits. Methods: A 31‐year‐old man complained of blurred vision in the right eye for 1 week. He had a visual acuity of 20/25 in the right eye. He underwent ophthalmoscopy and fluorescein angiography. Results: Ophthalmoscopy revealed serous detachment of macula with its margin not adjacent to the margin of optic disc. Fluorescein angiography showed a typical ink blot appearance of dye leakage. Conclusions: Central serous chorioretinoapthy can occur in the patient with congenital optic pits. Detailed ophthalmoscopic and fluorescein angiographic studies are necessary to establish the diagnosis of optic pits associated with macular detachment. Various mechanisms have been reported to explain the serous macular detachment in patients with optic pits including vitreous and cerebrospinal fluid leakage through the optic pit and from there into the subretinal space. The present case further denotes that central serous chorioretinopathy in the presence of optic pits can be due to leakage from the retinal pigment epithelium.
Nanophthalmos with longstanding choroidal effusion and serous retinal detachment
Authors: Han Lirong , Cairns JD 
Published: November 2007

Abstract Purpose: To report a typical case of nanophthalmos with uveal effusion and local serous retinal detachment followed for 1 year. Methods: Clinical ocular examinations included vision, refraction, corneal diameter; anterior chamber depth, intraocular pressure, fundoscopy, A/B scan ultrasonography and gonioscopy. Results: Both eyes were hypermetropic with small corneas and shallow anterior chambers. Decreased axial length and thickened sclera were also found. There were peripheral choroidal effusions and local serous retinal detachments as well. The patient declined any surgery that was offered. No significant change in either eye was found after I year follow‐up. Conclusion: This case illustrates that the progress of choroidal effusion and retinal detachment in nanophthalmos may be very slow and even non‐progressive for at least 1 year. In these cases sclerectomy and or sclerotomy may be delayed without undue immediate risk to the vision.
Smooth pursuit development in infants
Authors: Jacobs Mark , Harris Christopher M. , Shawkat Fatima , Taylor David 
Published: November 2007

Abstract Purpose: We set out to assess the development of pursuit eye movements in normal infants in an objective, longitudinal fashion. We asked whether smooth pursuit (SP) was present under 2 months of age and how the saccade ratio changed with increasing infant age. Methods: Smooth pursuit was recorded longitudinally from 25 infants aged 1–7 months, using DC electro‐oculography, in a clinically practical manner. Four uninstructed adults acted as controls. Results: Smooth pursuit was present under 2 months of age. The gain of SP increased with increasing infant age. However, it had still not reached adult levels by 6 months of age. Latency decreased with increasing infant age. Monocular SP asymmetry was present in the younger infants. Conclusions: Smooth pursuit is present under 2 months of age, but at 6 months SP has still not reached adult levels. The traditional model of SP development is questionable.
Traumatic retinopathy resembling acute macular neuroretinopathy
Authors: Gillies M , Sarks J , Dunlop C , Mitchell P 
Published: November 2007

Abstract Background: Acute macular neuroretinopathy (AMNR) is an uncommon disease of uncertain aetiology. We report on four males who developed unilateral changes following trauma which closely resembled acute macular retinopathy. Methods: Retrospective review of selected cases. Results: Four male patients developed a central or paracentral scotoma immediately or soon after an accident in which they suffered moderately severe bodily injury without direct ocular trauma. Vision was reduced in three patients. All four patients had characteristic well‐circumscribed, dark macular lesions best seen using red‐free light. The lesions cleared slowly in the two cases who returned for review. Conclusions: A picture that closely resembles AMNR may be seen after trauma. The mechanism may involve a sudden rise in ocular venous pressure. This may be an unrecognized cause of visual loss after non‐ocular trauma which may be regarded as functional. The subtle retinal lesions may be overlooked unless the fundi are examined in red‐free light and the macular dark areas are compared.
Magnocellular and parvocellular visual pathways are both affected in a macaque monkey model of glaucoma
Authors: Vickers JC , Hof PR , Schumer RA , Wang RF , Podos SM , Morrison JH 
Published: November 2007

Abstract Purpose: Neurochemical changes in nerve cells were investigated in the lateral geniculate nucleus (LGN) and primary visual cortex of macaque monkeys with experimentally induced glaucoma. Methods: Glaucomatous damage was induced in one eye of experimental animals by elevation of intraocular pressure following laser burns to the trabecular meshwork. Staining for the metabolic marker cytochrome oxidase, as well as immunolabelling for the neuronal markers synaptophysin and neurofilament proteins, was conducted on sections of the LGN and primary visual cortex. Results: In the LGN, staining for cytochrome oxidase and immunolabelling for synaptophysin were reduced in the parvocellular and magnocellular layers that received input from the glaucomatous eye and neurofilament protein labelling was reduced in the parvocellular layers. Cytochrome oxidase staining demonstrated the presence of denervated ocular dominance columns in layer IVC of the primary visual cortex of experimental animals. Conclusions: Pre‐ and post‐synaptic neurochemical alterations in the magnocellular and parvocellular visual pathways of the brain are associated with experimentally induced glaucoma in macaque monkeys.
Knowledge and beliefs about common eye diseases
Authors: Attebo Karin , Mitchell Paul , Cumming Robert , BMath Wayne Smith 
Published: November 2007

Abstract Purpose: To ascertain the level of knowledge of common causes of blindness in an adult Australian population and to relate this to use of eye care services. Methods: A population‐based study of common eye diseases in an urban population aged 49 years or older was conducted. The questions were concerned with the awareness and knowledge of and the ability to describe three common eye diseases, namely cataract, glaucoma and agerelated macular degeneration (AMD). Results: Awareness of cataract (98%) and glaucoma (93%) were high in this population, but awareness of AMD was low (20%). Among people who were aware of the target eye disease, only 29% showed some knowledge of glaucoma, 26% showed some knowledge of AMD and 20% showed some knowledge of cataract; this was also low in people who had previous eye treatment, such as cataract surgery. Knowledge was related to education level, occupational prestige and knowledge of other eye diseases. After excluding people with a previous eye disease diagnosis, those people who were aware and had some knowledge of eye disease accessed eyecare services more frequently. Conclusions: Knowledge of common eye diseases is generally lacking. Age‐related macular degeneration is the leading cause of blindness in Australia, yet only 20% of the present study population had heard of it. As there are often no early symptoms for glaucoma, community awareness of this disease and the need for screening of people at risk may allow timely diagnosis and more effective therapy before advanced visual field loss has occurred. An informed public is more likely to present earlier with visual symptoms before irreversible visual loss has occurred and is more likely to comply better with recommended therapy.
Aeromonas sobria endophthalmitis
Authors: Lee Lawrence R , O'Hagan Stephen , Pra Mark Dal 
Published: November 2007

Abstract Background:
Aeromonas sobria causes a rare Gram‐negative bacterial water‐borne infection. It has been found in waters of North Queensland and South‐east Asia. Of all Aeromonas species, A. sobria is the most virulent and invasive and has been reported to cause soft tissue infection and corneal ulcer. Methods: A 14‐year‐old Caucasian male from North Queensland presented following a penetrating eye injury in which a water bird (cormorant species) had pecked his eye while he was fishing. A fulminant endophthalmitis developed despite treatment with intravenous, intravitreal and topical antibiotics and initial wound repair. Enucleation was performed. Results:
Aeromonas sobria was isolated from the vitreous aspirate. Conclusion:
Aeromonas sobria infection should be suspected in water‐contaminated penetrating eye injuries. The prognosis in this case was poor.
Growth of Gram‐negative bacteria in a simulated ocular environment
Authors: Cowell BA , Willcox MDP , Schneider RP 
Published: November 2007

ABSTRACTPurpose:Gram‐negative bacteria are major pathogens in the ocular environment, especially when contact lenses are worn. The source of many of these organisms, including Pseudomonas aeruginosa, is thought to be environmental.Methods:A defined medium is described here that resembles both tear fluid and the environment they are derived from.Results:Gram‐negative ocular bacteria were found to grow successfully in this medium. Bactericidal tear proteins were added to this medium and pathogenic strains were not only able to resist their effects but were able to use them for growth.Conclusion:Utilizaton of tear proteins for growth may be an important virulence factor of pathogenic bacteria in the ocular environment.
Role of tear fluid in the growth of Gram‐negative bacteria on contact lenses
Authors: Williams TJ , Willcox MDP , Schneider RP 
Published: November 2007

ABSTRACTIncidents of CLARE (contact lens induced acute red eye) are associated with high numbers of Gram‐negative bacteria on the lens surface. This study found that most strains of bacteria implicated in CLARE adhere poorly to the lens surface regardless of whether the lens surface was clean or had been worn in the eye. The high numbers of bacteria on the lens surface result from bacterial growth on the lens surface after adhesion has occurred. Using an artificial tear formulation and real tears, this study demonstrated that the tear fluid provides the necessary nutrients required for bacterial growth.