Othman M. Al-Omar

Single-dose Azithromycin in the Treatment of Trachoma: A Randomized, Controlled Study

PURPOSE To compare the safety and efficacy of single oral-dose azithromycin with a 7-week topical tetracycline ointment course in the treatment of active trachoma. METHODS A total of 64 patients with active trachoma were selected randomly to receive azithromycin (20 mg/kg) in a single dose or topical tetracycline eye ointment for 6 weeks. Clinical assessments were made before and at 4, 8, 12, and 24 weeks after treatment. Conjunctival scrapings were obtained before and after 24 weeks after treatment and fixed for Giemsa and direct immunofluorescence staining. RESULTS Trachoma resolved in 17 (63.3%) patients who received azithromycin compared with 19 (65.4%) who were treated with tetracycline ointment. There were no significant differences in treatment effect or baseline characteristics between the treatment groups. Both treatments were well tolerated, and no adverse events were noted. CONCLUSION Single-dose azithromycin is as effective as a 6-week course of topical tetracycline ointment in the treatment of active trachoma. The findings may help establish high compliance in treating trachoma and could contribute to the control of trachoma worldwide.

Trachoma in Saudi Arabia

AIMS & BACKGROUND The main objectives of this study were to determine the prevalence and magnitude of trachoma in Saudi Arabia and to evaluate the factors that play a role in the transmission and severity of the disease. METHODS The samples consisted of a stratified multistage random cluster design that selected defined primary sampling units of 50-60 housing units in both metropolitan and non-metropolitan communities. RESULTS In 1984, evidence of trachoma (active and inactive) was found among 22.2% of the Saudi population and 6.2% of the Saudis had evidence of active trachoma. In addition, 17.4% had conjunctival scarring as a result of old trachoma, and 1.5% had entropion or trichiasis. In 1994, clinical evidence of trachoma (active and inactive) was found among 10.7% of the Saudi population while 2.6% had active trachoma. Conjunctival scarring as a result of healed trachoma was seen in 8.1% and 0.2% had entropion and trichiasis. The prevalence of trachoma in households was directly related to the presence and appearance rating of children in a household, the presence of flies, and the appearance rating of the household itself. An increase in individual risk was found among women who veil and men who use kohl. CONCLUSION This study has shown a remarkable decrease in the prevalence of active trachoma in Saudi Arabia over the past decade. The findings should serve as a basis for future plans for prevention and intervention.

PREVALENCE AND CAUSES OF VISUAL IMPAIRMENT AND BLINDNESS IN THE SOUTH WESTERN REGION OF SAUDI ARABIA

A population-based survey of the prevalence of major causes of blindness and visual impairment was conducted in Bisha region, Saudi Arabia. Overall, 2882 people were examined. The prevalence of blindness (visual acuity of < 3/60 in the better eye with best available correction) was 0.7% and the prevalence of visual impairment (visual acuity < 6/12 but ≥ 3/60 in the better eye with best available correction) was 10.9%. Cataracts were responsible for 52.6% of blindness and 20.6% of visual impairment. Refractive errors accounted for 67.9% of visual impairment. Proper management of cataracts and correction of refractive errors will cure 73.6% of blind subjects and 88.5% of visually handicap people in this part of the world.

Heparin surface-modified intraocular lenses in patients with inactive uveitis or diabetes.

OBJECTIVE This study aimed to determine whether heparin surface-modified (HSM) intraocular lenses (IOLs) with a hydrophilic surface would reduce cell adherence and other postoperative changes compared with the conventional polymethylmethacrylate (PMMA) IOLs in patients with either diabetes mellitus or inactive uveitis. DESIGN The study design was a randomized, double-masked, clinical trial. PARTICIPANTS Twenty-five patients with bilateral cataracts, 14 with inactive anterior uveitis and 11 with diabetes, with an age range of 11 to 81 years (mean, 52.8 years) participated. INTERVENTION Bilateral cataract extraction with posterior chamber IOL implantation was measured, each patient receiving an HSM lens in one eye and a PMMA lens in the other. Pharmacia one-piece HSM and PMMA IOLs were used. Postoperative ocular changes were evaluated at regular intervals for 24 months in patients with inactive uveitis and for 6 months in patients with diabetes. Patients and physicians alike were unaware of which eye contained which lens until postoperative results were compiled. Records were kept by a study coordinator. MAIN OUTCOME MEASURES Comparisons of posterior synechiae, IOL cellular deposits, and posterior capsular fibrosis between PMMA and HSM IOLs were measured. RESULTS Using the chi-square test, no statistically significant difference was found between the HSM and PMMA IOLs in the number of cellular deposits found on the anterior IOL surface, the number of adhesions between the iris and IOL, or the incidence of capsular opacification. CONCLUSION The HSM and PMMA IOLs showed similar postoperative results in patients with inactive uveitis or diabetes mellitus.

Eyelid Laceration Sustained in an Attack by a Rabid Desert Fox

PURPOSE/METHODS Two patients were bitten on the face by a rabid desert fox and sustained eyelid lacerations. The patients were examined and they received the same prophylactic treatment: human rabies immunoglobulin, intramuscularly and at the laceration site, and rabies human-diploid cell vaccine. RESULTS/CONCLUSIONS One patient survived; the other died. Eyelid laceration sustained by a bite of a rabid animal is a life-threatening condition; patients should receive prompt rabies prophylaxis.

The long term effects of unilateral corneal scars

The main purpose of this study was to evaluate the long term effects of unilateral dense central corneal scars on the axial length and development of lens opacities. We included 12 patients with unilateral dense central corneal scars of early onset before the age of seven years. This study served as naturally-controlled experiment and demonstrated a statistically significant increase in ocular axial length and decrease in the incidence of cataract in the eye with central corneal scar. Visual deprivation induced by unilateral central corneal scars occurring in early childhood leads to increase in the ocular axial length, and decrease in the incidence of cataract.