Branimir Cerovski

Lens wearers non-compliance - is there an association with lens case contamination?

PURPOSE This study aims to investigate the association of compliance amongst lens wearers and lens case contamination as assessed by the microbial profile of lens cases. METHODS Fifty-two asymptomatic lens wearers filled out questionnaires seeking demographic data and several aspects of compliance to lens wear. Subsequently, contamination profiles of the inside bottom and rim of their lens cases was obtained for bacteria, fungi and Acanthamoeba. The association of the self-reported responses in the questionnaire with contamination profile of the lens case was then analyzed. RESULTS Based on compliance criteria, 21% of the participants were described as fully compliant lens wearers. Contamination of lens case was prevalent in 42% of the cases. Frequent non-compliant behaviours reported by study participants included, showering and sleeping with contact lenses, and irregular lens case replacement. In comparison to soft contact lens wearers prevalence of non-compliance and contamination amongst rigid gas permeable (RGP) lens wearers was significantly greater. There was a statistically significant correlation between bacterial contamination and current case age. CONCLUSION These results suggest that majority of lens wearers do not fully comply with recommendations for lens wear and case care. Crucially, none of the fully compliant patients had contaminated lens cases. However it would appear that several non-compliant behaviours significantly increase the risks of case contamination. These results suggest that greater efforts should be invested with lens wearers to ensure enhanced compliance as this is likely to reduce the possibility of case contamination.

A contribution to the surgery of the trachomatous entropion and trichiasis

Although the WHO document WHO/PBL/93.29 recommends the bilamellar tarsal rotation operation for trachomatous entropion, we will describe another operation that has proved to be very reliable. It is a combined method, consisting of the modified tarsal wedge resection and the eversion splinting–grey line incision. A possible additional correction of the grey line incision on the first postoperative day improves the results. A total of 708 eyes with moderate trachomatous entropion and major trichiasis underwent this surgery, but only 508 of these were followed up during a 6-month period. The rate of failed operations, which consisted of incomplete closure of the lids or more than two inverted lashes remaining, was 6.9%.

Early Detection of Inborn Dyschromatopsias in Preschoolers and Young Schoolchildren

Color vision is one of the most important factors of human vision. Early detection of color vision malfunction in children is of utmost importance, allowing parents and teachers to take appropriate and timely measures for childrens future professional orientation. A cohort of 300 children aged 4-6 years (49-86 months) were examined by color vision testing and divided into three age groups of 4-5, 5-6 and > 6 years. Their ability to name the fundamental spectral colors and read Ishiharas pseudoisochromatic plates were recorded. The results obtained are presented in tables and figures. Data analysis showed the youngest group of children to be unsuitable for such testing of color vision. Numerical data revealed considerable percentage deviations as compared to the older groups. In addition, a great difference between the girls and boys indicated psychomotor development to be much faster in girls of that age. Generally, data obtained by the distribution of the results for the two older age groups were consistent with those found in the literature; thus, the authors propose an early examination for the detection of inborn chromatopsia to be performed in preschool children, but not before the age of five. Ishiharas pseudoisochromatic test can be useful in differentiating between dyschromatic and other children, but it is very difficult to implement for singling out dyschromates according to the protan or deutan type.

Role of NMO-IgG in Distinguishing the Type of Optic Neuritis

Purpose. To emphasize the importance of neuromyelitis optica (NMO)-immunoglobulin G (IgG) antibodies testing in patients with typical optic neuritis (ON) refractory to steroid treatment. Methods. Two patients were evaluated with ON refractory to steroid therapy and poor visual acuity; they were tested for NMO-IgG antibodies. Results. Brain magnetic resonance imaging was normal in both patients. The serum and cerebrospinal fluid were positive for NMO-IgG antibodies. Magnetic resonance imaging of the cervical and thoracic spine revealed lesions longer than three vertebral segments and the diagnosis of NMO was confirmed. Treatment with plasma exchange and immunosuppressive therapy resulted in marked improvement of visual acuity. This improvement was sustained. Conclusions. The testing for NMO-IgG antibodies is important for distinguishing ON in NMO from multiple sclerosis in cases of ON refractory to steroid treatment. These cases suggest that testing for NMO-IgG antibodies should be performed in comparative trials on a larger series.