Solani D. Mathebula

Amplitude of accommodation is reduced in pre-presbyopic diabetic patients

Introduction: The prevalence of diabetes mellitus is increasing exponentially often causing an enormous public health burden due to changing lifestyles. People with diabetes have accelerated age-related biometric ocular changes compared with people without diabetes. Aim: The purpose of this study was to determine the effect of diabetes on the amplitude of accommodation in pre-presbyopic diabetic patients, and compare the results with age-matched healthy individuals. Methods: The study population consisted of 84 diabetic patients (30–40 years of age, 36 ± 2.5 years and 81 (35 ± 2.7 years) age-matched healthy normal controls. Using the best correction for distance visual acuity, the amplitude of accommodation was measured using the subjective push-up technique. The influence of age and duration of diabetes on amplitude of accommodation were analysed using the regression analysis. Results: The mean amplitude of accommodation was lower in the diabetic group (6.34 ± 1.39 dioptre (D)) compared with the controls (8.60 ± 2.00 D), which was statistically significant (p = 0.000). There was a little negative correlation between the amplitude of accommodation and duration of diabetes (–0.20, p = 0.069). Conclusion: People with diabetes showed lower amplitude of accommodation when compared with age-matched controls. The results suggest that diabetic people will experience presbyopia earlier in life than people without diabetes. Early detection and rehabilitation of diabetic patients with corrective spectacle lenses is recommended.

Ophthalmoscopy for general practitioners

Cardiovascular disease (including ischaemic heart disease and stroke) remains the most common cause of death. 1 Traditional risk factors for cardiovascular disease (such as hypertension, hyperlipidaemia and cigarette smoking, among others) allow doctors to identify, monitor and treat high-risk patients. 2-7 However, a large proportion of cardiovascular morbidity and mortality is not explained by these risk factors. As a result, there is a possibility of finding additional variables for cardiovascular risk stratification.

Clinical management of hyphaema

Hyphaema is the presence of red blood cells in the anterior chamber. A minimal amount of tiny red blood cells suspended in the aqueous humour is termed a microhyphaema. Microhyphaema may be visible only with the slit lamp, in the form of eryth-rocytes floating and circulating in the aqueous humour. Slightly larger amounts of red blood cells settle as variously shaped masses on the surface of the iris, lens or vitreous. Still larger volume of red blood cells gravitates to the anterior aspect of the interior chamber, producing a grossly visible layered hyphaema, which may be partial or complete. The management of hyphaema can present a challenge to a clinician, because medical treatment is of little value for hyphaema itself but is useful for complications. South African Family Practice Vol. 48 (10) 2006: pp. 60-61