Search

Psychotropic medications, particularly antipsychotics, are known to elicit various adverse effects, with ocular complications being underreported yet significant. This case series presents three instances where atypical antipsychotics, namely Risperidone, Cariprazine, and Olanzapine, led to ocular dystonias and nystagmus. These adverse effects occurred at relatively low doses, highlighting the need for vigilant monitoring even with second-generation antipsychotics. Case descriptions delineate patients experiencing acute dystonic reactions and nystagmus following initiation or dose adjustment of atypical antipsychotics, leading to upward deviation of the eyes, involuntary movements, and nystagmus. Prompt recognition and management were crucial, with cessation of the offending medication resulting in symptom remission and subsequent stabilization with alternative treatments. Factors contributing to these adverse effects, such as dopamine receptor blockade and individual susceptibility, are explored, emphasizing the importance of comprehensive evaluation and open patient–physician communication. The present case series underscores the necessity of vigilant monitoring for ocular adverse effects, even with atypical antipsychotics, given their potential to induce acute dystonias and nystagmus. The presented cases advocate for heightened awareness among clinicians to promptly recognize and manage such rare complications, ensuring optimal patient care and treatment outcomes.

Background: Type 1 diabetes (DM-type 1), marked by early onset and an autoimmune origin resulting in minimal insulin production, necessitates insulin therapy. This study aims to assess the awareness of diabetic patients, minimize fasting-related complications by identifying the attitudes of Saudi individuals with diabetes, explore diabetes care and dietary patterns, and identify the most common symptoms during Ramadan and Eid-Al-Fitr. Methods: The study utilized a cross-sectional design involving individuals aged 18 and above with diabetes across Saudi Arabia. Over 3 months, 318 responses were collected through an online validated questionnaire, measuring the attitudes of Saudi individuals with diabetes during Eid-al-Fitr festivities and Ramadan fasting. The questionnaire included categories such as behavior, attitude, food consumption, health complications, medications, and test results. Logit regression analysis and other statistical procedures were performed using R language version 4.3.3, with statistical significance set at the 95% confidence level. Results: During religious fasting, statistically significant positive associations were observed with the type of diabetes mellitus (DM) for age (adjusted odds ratio [adjOR] = 1.30, 99% CI: 1.072-1.568), use of DM tablets (adjOR = 3.27, 99% CI: 1.774-6.103), use of hypolipidemic medication (adjOR = 2.14, 95% CI: 1.174-3.902), and glucose level (adjOR = 2.06, 99% CI: 1.414-3.039). Additionally, statistically negative associations were noted in blood sugar control (adjOR = 0.56, 95% CI: 0.357-0.871) and the use of insulin (adjOR = 0.41, 99% CI: 0.230-0.730). Conclusion: The study findings indicate significant associations with fasting during religious festivities, encompassing hypoglycemia observation, DM tablet use, insulin, hypolipidemic medications, vitamin B complex, eye complications, and elevated glucose levels. [ABSTRACT FROM AUTHOR]

This paper examines the impact of playing tennis on the visual system, providing an in-depth analysis of physiological, adaptive, and risk-related aspects associated with the sport. The dynamic nature of tennis necessitates intensive visual engagement to track a fast-moving ball, thereby enhancing dynamic vision, depth perception, and visuomotor coordination. On the other hand, the sport also poses risks such as eye strain and mechanical injuries, including corneal and retinal damage. The study underscores the importance of peripheral vision in the game and the need for the visual system to adapt to varying lighting conditions. The authors highlight the benefits of implementing vision exercises and protective measures, such as sunglasses and contact lenses. The significance of preventive measures, regular eye check-ups, and education for players, coaches, and parents is also emphasized. Although demanding, tennis offers opportunities to improve visual functions, contributing to athletic development and visual health.

Psychotropic medications, particularly antipsychotics, are known to elicit various adverse effects, with ocular complications being underreported yet significant. This case series presents three instances where atypical antipsychotics, namely Risperidone, Cariprazine, and Olanzapine, led to ocular dystonias and nystagmus. These adverse effects occurred at relatively low doses, highlighting the need for vigilant monitoring even with second-generation antipsychotics. Case descriptions delineate patients experiencing acute dystonic reactions and nystagmus following initiation or dose adjustment of atypical antipsychotics, leading to upward deviation of the eyes, involuntary movements, and nystagmus. Prompt recognition and management were crucial, with cessation of the offending medication resulting in symptom remission and subsequent stabilization with alternative treatments. Factors contributing to these adverse effects, such as dopamine receptor blockade and individual susceptibility, are explored, emphasizing the importance of comprehensive evaluation and open patient–physician communication. The present case series underscores the necessity of vigilant monitoring for ocular adverse effects, even with atypical antipsychotics, given their potential to induce acute dystonias and nystagmus. The presented cases advocate for heightened awareness among clinicians to promptly recognize and manage such rare complications, ensuring optimal patient care and treatment outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The Covid-19 pandemic and the increase in monkeypox (Mpox) infections that have been with us for the past two years have forced scientists and doctors to intensify their efforts to understand them. They mainly affect the respiratory, circulatory and immune systems and cause skin lesions. They can lead to death from lung disease, so complications such as ophthalmic ones are not often described in scientific studies, but doctors report that Covid-19 and Mpox patients not infrequently show symptoms such as inflammation, conjunctival congestion, corneal ulceration, swelling of the eye area and others. Aim of the study: The aim of this study was to review scientific articles with a view to presenting the problem of ocular complications following SARS-CoV-2 infection and ways to prevent them. Methods and materials: a literature review was conducted using the PubMed database, using the keywords: “ocular complications”, “ophthalmic complications” “ocular manifestations”, “eye complications”, “monkeypox”, “Mpox”, “Covid-19” “SARS-CoV-2”. Results: PCR studies from conjunctival swabs have confirmed the presence of SARS-COV-2 and MPXV genetic materials in ocular secretions, so they are a reservoir of viruses and pose a risk of further transmission. In the case of Covid-19, the eye can act as a host for infection. Humidification and preventive antibiotic therapy have been shown to prevent bacterial superinfection and avoid serious ocular complications, including loss of vision. Conclusions: Patients with Covid-19 and Mpox should be diagnosed ophthalmologically, as neglect can lead to deterioration and even loss of vision, reducing their quality of life. Eye care treatments and pharmacotherapy prevent future complications. It is also important to use personal protective equipment, take care of hygiene and disinfect equipment used for ophthalmic examinations to prevent the spread of infections to other patients as well as to medical staff.

Purpose: to describe a clinical case of ocular complications of gastric stromal tumor treatment with imatinib mesylate.Material and methods. A patient aged 78 was examined by general ophthalmologic and instrumental methods, including ultrasound and spectral optical coherence tomography (SOCT).Results. Ophthalmoscopy helped diagnose a blunted foveal reflex of the right eye. In the left eye, fuzzy boundaries of the optic disc edema and the macular reflex, the presence of gray-yellow foci of an irregular shape with even distinct boundaries in the paramacular zone were revealed. In the lower part of the left eye fundus, a weakly pigmented gray-yellow focus with uneven indistinct boundaries and an uneven surface was to be seen. SOCT showed in the right eye a retinal edema in the macula and paramacular zones and an epiretinal membrane. In the left eye, SOCT showed vitreoretinal tractions and retinal edema on the edges of the optic nerve; in the paramacular zone and in the inner parts of the fundus, vitreoretinal tractions, epiretinal fibrosis, retinal edema was observed whilst in the lower parts of the fundus complete destruction of all retinal layers due to the hyperreflective focus with a small-shaped inner contour, an even choroidal profile with thinning of the choroid, vitreoretinal tractions, and epiretinal membrane in the left eye could be seen.Conclusions. The clinical case of eye complications of imatinib mesylate in the treatment of gastric stromal tumor necessitates an interdisciplinary integrated approach (involving an oncologist and an ocular oncologist) in the diagnosis and treatment of eye tumors. A complex of instrumental methods of diagnostics of eye fundus diseases involving additional refinement methods (SOCT) ensures differential diagnosis of retinopathy during the chemotherapy, secondary metastatic involvement, and vitreoretinal pathology of a different pathogenetic etiology. Early diagnosis facilitates providing adequate treatment aimed at preserving the patient’s vision, the eye, and life.

Abstract Background One-third of adults with diabetes in the United States have chronic kidney disease (CKD), and 19% of them have eye complications (ECs). However, little is known about the Health-related Quality of Life (HRQoL) of adults with both of these diabetes-related complications. Therefore, the purpose of this study is to examine differences in the HRQoL, mental health, and healthcare utilization of adults with diabetes who have CKD, ECs, both or neither. Methods A cross-sectional study design was implemented using data from multiple panels (2009–2015) of the Medical Expenditure Panel Survey. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. The HRQoL, mental health, and healthcare utilization of four mutually exclusive groups: 1) diabetes with both CKD and ECs; 2) diabetes with CKD only; 3) diabetes with ECs only, and 4) diabetes with neither CKD nor ECs were compared. In all analyses, adults with neither CKD nor ECs were the reference group. Results There were 8415 adults with diabetes who met the inclusion criteria. Approximately, 75% of the study sample had neither CKD nor ECs, 13.3% had ECs only, 5.7% had CKD only, and 5.5% had both CKD and ECs. In the adjusted analyses, adults with both CKD and/or ECs complications exhibited significantly lower HRQoL compared to those with neither CKD nor ECs. Mental illness and psychological distress were higher among adults with both CKD and ECs compared to those with neither CKD nor ECs. Furthermore, adults with CKD and/or ECs had higher polypharmacy, inpatient and emergency services use compared to those with neither CKD nor ECs. Conclusions The results indicate that the presence of both CKD and/or ECs was negatively associated with poor HRQoL, poor mental health, higher psychological distress and healthcare utilization in adults with diabetes. The findings emphasize the need for routine assessment and treatment for diabetes-related CKD and/or ECs complications to improve the quality of care for individuals with diabetes.

Aims: To evaluate the prevalence and risk factors of diabetic eye complications among the United States (US) adults and examine the differences across racial and ethnic groups. Methods: Using the 2009–2018 Medical Expenditures Panel Survey (MEPS) data, this study included adults with diabetes conditions. Patients were grouped into African Americans, Hispanics, and Whites based on self-reported identity. The rate of diabetic eye complications was reported and compared across racial/ethnic groups. This study applied multivariable logistic regression models to examine dilated eye exam attendance, and the completion of American Diabetes Association (ADA) recommended guidelines for diabetes care across racial/ethnic groups. Results: This study identified 8,080 patients with diabetic eye complications, which represented a national estimation of 4.12 million US adults according to MEPS data. Among diabetic patients, Hispanics (18.78%) and African Americans (18.18%) had higher rates of eye complications than Whites (12.71%). After adjusting relevant demographic, socioeconomic, and clinical variables, the multivariable model found that Hispanics and African Americans had 1.63 and 1.61 times more likely to have diabetic eye complications compared to Whites. In addition, African Americans were 29% less likely to complete all of the ADA-recommended processes of diabetes care than White patients. Conclusions: Compared to White patients, Hispanics and African Americans were more likely to have diabetic eye complications and were less likely to manage diabetes appropriately. Healthcare providers and policymakers should promote interventions and education programs accordingly to prevent and reduce the development of eye complications among minorities.

Introduction: Obstructive sleep apnea syndrome (OSA) is characterized by intermittent upper airway collapse during sleep in obese patients, being a severely underdiagnosed multiorgan disorder. Although the impact of OSA on cardiovascular morbidity is well documented, ocular complications remain an uncertain topic. Eye diseases, taking into account the important cause of the reduction of the quality of life and disability, are a current modern problem of the society. Case Report: OSA has been identified as a significant risk factor for various eye disorders, including glaucoma, non-arteritic anterior ischemic optic neuropathy (NAION), central serous chorioretinopathy (CSC), retinal vein occlusion, keratoconus, and diabetic retinopathy. The prevalence of these conditions among OSA patients is documented to be considerably higher than in the general population. While some studies indicate a link between OSA and these eye conditions, other research contradicts this association. Ocular diseases can develop in the presence of conditions that reduce ocular blood flow independently of OSA, such as obesity, diabetes, and hypertension. Nevertheless, positive outcomes have been observed with CPAP treatment in patients with glaucoma, NAION, CSC, and diabetic retinopathy. Discussions : The pathogenic mechanisms involved in the deterioration of the eye are uncertain, however, studies suggest that ophthalmological lesions may occur indirectly, secondary to systemic cardiovascular and metabolic damage, but also through direct pathways. The eyeball is heavily vascularized by the basin of the internal carotid artery. Imbalance of vasoactive substances, oxidative stress, inflammatory cytokine activity and disruption of the blood-retinal barrier will corrupt the integrity of the optic nerve and retinal layers. Intermittent hypoxia will induce hyperactivity of the sympathetic nervous system with the onset of vascular autonomic dysfunction. These phenomena can alter cerebral and ocular circulation, especially during the night, with deregulation of ocular perfusion and increased intraocular pressure. Conclusions: While the connection between OSAS and eye disease remains subject to debate, recognizing the potential for this association can assist clinicians in delivering holistic care to their patients. Encouraging increased vigilance for ocular symptoms in individuals with sleep apnea is crucial to prevent vision-related complications. Further research should delve into the underlying pathological mechanisms that predispose sleep apnea patients to ocular conditions. Advanced noninvasive technologies like optical coherence tomography and optical coherence tomography angiography hold promise in enhancing our understanding of retinal structures and elucidating the ophthalmic implications of OSA. [ABSTRACT FROM AUTHOR]

Background: One-third of adults with diabetes in the United States have chronic kidney disease (CKD), and 19% of them have eye complications (ECs). However, little is known about the Health-related Quality of Life (HRQoL) of adults with both of these diabetes-related complications. Therefore, the purpose of this study is to examine differences in the HRQoL, mental health, and healthcare utilization of adults with diabetes who have CKD, ECs, both or neither.Methods: A cross-sectional study design was implemented using data from multiple panels (2009-2015) of the Medical Expenditure Panel Survey. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. The HRQoL, mental health, and healthcare utilization of four mutually exclusive groups: 1) diabetes with both CKD and ECs; 2) diabetes with CKD only; 3) diabetes with ECs only, and 4) diabetes with neither CKD nor ECs were compared. In all analyses, adults with neither CKD nor ECs were the reference group.Results: There were 8415 adults with diabetes who met the inclusion criteria. Approximately, 75% of the study sample had neither CKD nor ECs, 13.3% had ECs only, 5.7% had CKD only, and 5.5% had both CKD and ECs. In the adjusted analyses, adults with both CKD and/or ECs complications exhibited significantly lower HRQoL compared to those with neither CKD nor ECs. Mental illness and psychological distress were higher among adults with both CKD and ECs compared to those with neither CKD nor ECs. Furthermore, adults with CKD and/or ECs had higher polypharmacy, inpatient and emergency services use compared to those with neither CKD nor ECs.Conclusions: The results indicate that the presence of both CKD and/or ECs was negatively associated with poor HRQoL, poor mental health, higher psychological distress and healthcare utilization in adults with diabetes. The findings emphasize the need for routine assessment and treatment for diabetes-related CKD and/or ECs complications to improve the quality of care for individuals with diabetes. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a multi-system chronic inflammatory skin disease targeting 2% to 3% of the general population. It is a prototype of immune dysregulation mediated by TH1 proinflammatory cytokines such as TNF-α, IFN-gamma, IL-6, and IL-12 with far reaching systemic effects. There is growing and emerging evidence that psoriasis patients have a higher prevalence of associated comorbid diseases, with severe skin disease portends a serious risk for development of these comorbidities and are found to have a higher association of extracutaneous disease manifestations. Aim: To look for eye involvement in psoriasis patients and to evaluate the risk and prognostic factors of disease association. Material and Methods: 200 Patients with psoriasis were screened for any eye involvement after few unusual case presentations with eye complications during the period from September 2013 - August 2014. Results: First case was a post cataract sudden loss of vision secondary to development of uveitis in a female patient aged 52 years, with past history of psoriasis with minimal skin lesions and no arthritis. Another 5 cases of psoriasis with eye involvement were detected during the screening employed in a series of 200 psoriasis cases. Conclusion: The present report highlights the importance of psoriasis and eye involvement, need for collaboration between dermatologists and ophthalmologists for thorough examination and evaluation prior to any surgical intervention and also further long term follow-up studies are warranted for confirmation of this causal relationship.

Introduction: Twenty-first century is a period of equipment, and every now and then, more state-of-the-art electronic devices are brought into the market. The relative time spent on personal computer (PC) and diverse gadgets has extended rapidly consistently. Sweeping use of electronic gadgets causes many health and mental issues. The main aim of this study is to find the prevailing eye complication among children due to excessive usage of electronic gadgets. Materials and Methods: The survey was taken among 100 children by distributing questionnaires, and their daily habit of using electronic gadgets and the effects caused physically and mentally were observed. Results: It has been known for some time that exposure to blue light, which is emitted in abundant amounts by electronics such as televisions and smartphones, can tell your body to stop generating melatonin. Melatonin is the chemical that tells your body that it is time to sleep. Hence, less secretion of melatonin hormone leads to lack of sleep which is the main cause for dark circles in children at this early age. Conclusion: From our survey, we found that children are more prone to use mobile phone per day than any other electronic gadgets. Children who use smartphones for a longer period of time are exposed to eye damage. The blue light exposure may lead to macular degeneration and a point may come where the eye cannot see real colors properly. This condition can be treated and prevented with regular screen breaks and exercises. Children are advised to wear protective glasses, reduce brightness of the electronic devices, and avoid small screen phones. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a multi-system chronic inflammatory skin disease targeting 2% to 3% of the general population. It is a prototype of immune dysregulation mediated by TH1 proinflammatory cytokines such as TNF-α, IFN-gamma, IL-6, and IL-12 with far reaching systemic effects. There is growing and emerging evidence that psoriasis patients have a higher prevalence of associated comorbid diseases, with severe skin disease portends a serious risk for development of these comorbidities and are found to have a higher association of extracutaneous disease manifestations. Aim: To look for eye involvement in psoriasis patients and to evaluate the risk and prognostic factors of disease association. Material and Methods: 200 Patients with psoriasis were screened for any eye involvement after few unusual case presentations with eye complications during the period from September 2013 - August 2014. Results: First case was a post cataract sudden loss of vision secondary to development of uveitis in a female patient aged 52 years, with past history of psoriasis with minimal skin lesions and no arthritis. Another 5 cases of psoriasis with eye involvement were detected during the screening employed in a series of 200 psoriasis cases. Conclusion: The present report highlights the importance of psoriasis and eye involvement, need for collaboration between dermatologists and ophthalmologists for thorough examination and evaluation prior to any surgical intervention and also further long term follow-up studies are warranted for confirmation of this causal relationship. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a chronic disease affecting many people worldwide. It causes degenerative changes that result in many complications including eye diseases that may lead to blindness. However, these eye conditions could be prevented or minimized through regular eye examinations, correct treatment and self management if clients are made aware of these complications and taught how to manage themselves. Health professionals, therefore, have a major responsibility to assist patients to acquire essential knowledge and skills towards prevention of eye problems and self care. The study was conducted in the clinics under Thulamela Municipality. The purpose of the study was to assess the knowledge of diabetes mellitus patients regarding eye complications related to diabetes. The quantitative cross-sectional design was used. Data collection was through a self administered questionnaire. Data were collected from a sample of 156 diabetes patients and analysed using the Statistical Package for Social Sciences (SPSS). The findings of the study indicated that diabetes mellitus patients have inadequate knowledge about their disease and its effect on the eyes. Although many of them were experiencing eye problems they associated their eye problems with normal ageing changes. [ABSTRACT FROM AUTHOR]

Introduction: Sickle cell disease (SCD) is a heritable blood disorder resulting in deformed, rigid red blood cells, rendering them more prone to vaso-occlusion. Ocular complications are known to affect multiple organs through the body's vasculature. Here, we evaluated the incidence of eye complications in patients with SCD at King Abdulaziz Medical City in Jeddah, Saudi Arabia., Materials and Methods: We used a cross-sectional approach and collected relevant medical data from nine patients with SCD. Ophthalmic assessment included visual acuity and an in-clinic dilated fundus examination. All patients were asked to attend the ophthalmology clinic to undergo optical coherence tomography (OCT) angiography, macular OCT scan, and fundus photography. The results of the imaging tests were interpreted by a certified ophthalmology consultant specializing in retinal diseases. Descriptive analyses of the results were also performed., Results: The mean age of the nine patients was 24.78 ± 10.9 years. All patients were non-hypertensive, one had type 1 diabetes, and another had type 2 diabetes. Five patients had normal visual acuity, two had slight impairments in at least one eye, and two had moderate impairment in at least one eye. One of the nine patients exhibited retinal ischemia in the right eye despite normal macular thickness (visual acuity, OD, 6/30; OS, 6/21). The remaining eight patients showed no ocular abnormalities., Conclusion: Of the nine patients with SCD, five showed no symptoms of ocular complications. One patient showed retinal ischemia in the right eye, despite a normal macular thickness. This study's results suggest routine ophthalmologic examination may not be able to detect or monitor macular or retinal abnormalities unless augmented with detailed imaging techniques., Competing Interests: There are no conflicts of interest to declare., (© 2022 The Authors.)

Using a mobile ambulance the quality of diabetes care was evaluated, according to the recommendations of the St. Vincent Declaration, in 95 % of all known diabetic patients ( n = 395) in a geographically defined rural area of Austria with 7871 inhabitants. Fourteen of the 395 patients had Type 1 (insulin-dependent) diabetes with age at onset of diabetes below 30 years. Of the 375 patients examined (women 61%, age 66 ± 13 years, median diabetes duration 6 years) 16 % were treated with insulin and 47 % with oral agents; HbA levels were 7.3 ± 1.7 %. Prevalence of known hypertension was 54%; 68% of these patients had their blood pressure uncontrolled (systolic ≥ 160 and/or diastolic ≥ 95 mmHg); a further 15% of patients with previously unknown hypertension had blood pressure values of ≥ 160 and/or ≥ 95 mmHg. Urinary albumin concentrations of > 200 mg/l were found in 15% of patients, 2% had a serum creatinine level of > 177 μmol/l, no patient had renal replacement therapy. Six patients (1.5%) were blind. Screening for retinopathy identified six patients (out of 317 in whom the retina could be evaluated) for whom consultation with an ophthalmologist as soon as possible was recommended. Of the total patient group ( n = 395) 20 patients (5%) had foot complications (amputations and/or ulcers): 14 patients had a total of 21 lower limb amputations (eight above knee, six below knee, seven below ankle); eight of these 14 patients lived in a nursing home; 11 patients had a total of 13 foot ulcers. In conclusion, in this diabetic population quality of diabetes care was satisfactory with respect to glycaemic control, whereas the high rates of uncontrolled hypertension and above ankle amputations appear amenable to improvement. This study shows that through systematic assessment of the quality of diabetes care specific local needs and deficiencies can be identified in order to propose respective interventions in health care practices. [ABSTRACT FROM AUTHOR]

In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients' severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care. The study was conducted in the ICU of a university hospital. Methods for estimating and analyzing medical records were used. The patient's evaluation sheet covering 12 categories of risk factors for eye complications was worked out. The study group included 76 patients (34 patients with injuries and 42 without injuries). The Shapiro-Wilk test, the Spearman's rank correlation test, the Mann-Whitney U test and the Friedman's ANOVA test were used. The level of significance was set at α = 0.05. The most important risk factors for eye complications in the study group were: lagophthalmos ( p < 0.001), sedation ( p < 0.01), use of some cardiological drugs and antibiotics ( p < 0.01), mechanical ventilation ( p < 0.05), use of an open suctioning system ( p < 0.01), presence of injuries ( p < 0.01) including craniofacial trauma ( p < 0.001), high level of care intensity ( p < 0.01), failure to follow eye care protocol ( p < 0.001), length of hospitalization at the ICU ( p < 0.001), and the frequency of ophthalmological consultations ( p < 0.001). There was no correlation between the incidence of these complications and the age and gender of the patients. The exposure of critically ill patients to eye complications was high. It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk factors.

Ophthalmic complications in the lung transplant population are a little-known entity. It includes a spectrum of diseases ranging from infections such as cytomegalovirus (CMV) retinitis, herpetic keratitis, Pseudallescheria boydii to non-infectious complications such as posterior subcapsular cataracts (PSCs), cyclosporine retinopathy, and post-transplant lymphoproliferative disorder (PTLD). These diseases can be attributed to high levels of immunosuppression, advanced age, and drug-specific side effects. Underlying comorbidities such as diabetes mellitus may also play a role in the pathogenesis. Patients can present with varied symptoms such as blurry vision, floaters or eye pain. Prompt diagnosis often requires a high index of suspicion. With increasing numbers of transplants being performed worldwide, it is imperative for the pulmonologist and transplant physician to recognize these often subtle symptoms. Any visual symptom should trigger an ophthalmological evaluation in order to manage these complications; some of which pose the risk of systemic dissemination and significant morbidity. The following article provides an in-depth review of the common presenting symptoms, treatments and recent advances related to common ophthalmic complications following lung transplantation. While this article focuses on the lung transplant sub-population, the authors would like to point out that some of these complications are shared by other solid-organ transplants as well, by virtue of their shared immunosuppressive therapies., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Introduction: Systemic sclerosis (scleroderma, SSc) is a severe chronic connective tissue disease caused by immune system disorders and changes in the structure and functions of blood vessels, which consequently leads to enhanced tissue fibrosis. The aim of the study was to evaluate changes in the organ of vision in systemic sclerosis patients., Material and Methods: Overall the study involved 27 patients with systemic sclerosis. The control group comprised 27 age- and gender-matched healthy individuals. All the study subjects underwent complete ophthalmological examination that in systemic sclerosis patients additionally involved fluorescein angiography., Results: OPHTHALMOLOGICAL EXAMINATION REVEALED HIGHER INCIDENCE OF THE FOLLOWING ABNORMALITIES IN THE STUDY GROUP, COMPARED TO THE CONTROL: symptoms of dry eye syndrome (19 eyes, p < 0.02), astigmatism(in 30 eyes, p < 0.01), posterior subcapsular cataract (10 eyes, p < 0.05), increased intraocular pressure (> 21 mm Hg were observed in 11 eyes, p < 0.002) and vascular abnormalities within fundus in fluorescein angiography (20 eyes)., Conclusions: In patients with systemic sclerosis numerous abnormalities within the vision of organ may be found. Regular ophthalmological examinations are essential among the mentioned group. The examination should be particularly focused on the presence of retinal vascular abnormalities.

Aim: To assess the awareness of eye complications and the prevalence of retinopathy, in the first visit to eye clinic, among type 2 diabetic patients attending a tertiary medical centre in Kuala Lumpur, Malaysia., Methods: An investigator-administered questionnaire was given to 137 patients with diabetes undergoing first time eye screening in the eye clinic. This was followed by a detailed fundus examination by a senior ophthalmologist to assess for presence of retinopathy., Results: Almost 86% of respondents were aware of diabetic eye complications, especially in patients who had achieved tertiary educational level (96.3%). The majority of the patients (78.8%) were referred by their physicians and only 20.4% came on their own initiative. Many of the patients (43.8%) did not know how frequent they should go for an eye check-up and 72.3% did not know what treatments were available. Lack of understanding on diabetic eye diseases (68.6%) was the main barrier for most patients for not coming for eye screening earlier. Despite a high level of awareness, only 21.9% had recorded HbA1c level of <6.5% while 31.4% were under the erroneous assumption of having a good blood sugar control. A total of 29.2% had diabetic retinopathy in their first visit eye testing., Conclusion: In the present study, 29.2% of type 2 diabetic patients had retinopathy in their first time eye testing. Although the awareness of diabetic eye complications was high among first time eye screening patients, the appropriate eye care-seeking behavior was comparatively less and should be rectified to prevent the rise of this sight threatening eye disease.