Tomislav Kuzman

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 Case of Lacrimal Gland Dirofilariasis

A patient with a diagnosis of chronic and idiopathic unilateral dacryoadenitis was submitted to our clinic for diagnostic reasons from a regional hospital. Within a period of 1 year, this was the second onset of a swelling in the region of the lacrimal gland which – unlike the first time – showed resistance to antibiotic treatment. The patient’s general and ophthalmic condition was good, and his only complaint was of cosmetic nature because of the disfiguring swelling in the lateral part of the left upper eyelid. Basic laboratory findings showed no abnormalities and radiographic imaging showed enlargement of the left lacrimal gland without bony destruction. Guided by epidemiological data for noninfectious dacryoadenitis we decided to perform excisional biopsy of the left lacrimal gland. To our surprise, the pathologist verified the presence of a worm of the genus Dirofilaria, which is, to the best of our knowledge, the second reported case of lacrimal gland dirofilariasis in the literature and the second reported case of such a disease in Croatia.

The Effect of Body Position on Intraocular and CSF Pressures in the Lateral Ventricle, and in Cortical and Lumbar Subarachnoid Spaces in Cats

BACKGROUND Correlation between cerebrospinal fluid (CSF) and intraocular pressure (IOP) is still unclear. We compared CSF pressure from different parts of the CSF system and IOP measured by the same invasive technique in a new experimental model in cats during changes of body position. METHODS Pressure changes were recorded on anesthetized cats (n = 7) in the lateral ventricle (LV), in the cortical (CSS) and lumbar (LSS) subarachnoid spaces, and in the anterior ocular chamber. Animals and measuring instruments were both fixed on a board at an adequate hydrostatic level. RESULTS In a horizontal position, IOP (18.5 ± 0.6 cm H(2)O) and CSF pressures (LV = 17.4 ± 0.9; CSS = 17.2 ± 0.7; LSS = 17.8 ± 1.2 cm H(2)O) were similar. In a vertical position, pressure in the LSS increased (33.5 ± 2.3 cm H(2)O), pressures inside the cranial cavity dropped (LV = -4.1 ± 0.9 cm H(2)O; CSS = -4.8 ± 0.5 cm H(2)O), while IOP slightly decreased (14.3 ± 0.1 cm H(2)O). CONCLUSION Change in body position from horizontal to upright causes drastic changes in CSF pressure and relatively small changes in IOP, which indicates that the IOP does not reflect CSF pressure. In an upright position, CSF pressures were equal at the same hydrostatic level in LV and CSS, which suggests that CSF pressure inside the cranium depends on its anatomical and biophysical features, and not on CSF secretion and absorption.

Comparison of Optic Nerve Head Morphology in Patients with Primary Open Angle Glaucoma and Non-Arteritic Anterior Ischemic Optic Neuropathy

The aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION). The study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual field defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual field and quadrant excesses. Topographic ONH alterations, examined by HRT II, showed the same number of sectors to be affected in the eyes with POAG and NAION. A larger number of sectors in the upper part of ONH were affected in the eyes with NAION. Optic disc morphology differed significantly between the eyes with POAG and NAION by a higher rate of neuroretinal rim thinning and higher mean cup depth in the POAG group.

Posterior Capsule Opacification and Nd:YAG Rates with Two Acrylic Intraocular Lenses after Age-Related Cataract Treatment: Three-year Results.

ABSTRACT Objective: To compare the incidence and intensity of posterior capsule opacification (PCO) between two intraocular lenses (IOLs) over three years. Methods: Eighty-three patients underwent cataract surgery with implantation of Acreos Adapt AO or Acrysof SA60AT. PCO values were assessed using a photographic image analysis system (EPCO 2000) and the amount of PCO at the slit lamp. Results: Mean PCO score was 2.78 ± 1.55 for the Acreos Adapt AO and 2.32 ± 1.20 for the Acrysof SA60AT (P=.229). There were no significant differences in the median EPCO values in the entire IOL optics area (0.60 ± 0.26 vs 0.58 ± 0.23; P=.745) and in the central 3-mm zone (0.28 ± 0.13 vs 0.27 ± 0.12; P=.638). Neodymium:YAG capsulotomy was performed in 28% of eyes with Acreos Adapt AO and 23.33% with Acrysof SA60AT (P=.692). Conclusion: Both IOLs had comparable PCO and Nd:YAG rates three years postoperatively.

The Effect of Body Position on Intraocular and Intracranial Pressure in Rabbits

BACKGROUND The correlation between cerebrospinal fluid (CSF) and intraocular pressure (IOP) is still unclear. We compared CSF and IOP measured by the same invasive technique using a new experimental model in rabbits during changes of body position. METHODS Pressure changes were recorded in the lateral ventricle (LV), the cortical subarachnoid space (CSS), and the anterior ocular chamber of anesthetized rabbits (n = 12). Animals and measuring instruments were both fixed on a board at an adequate hydrostatic level. RESULTS In a horizontal position, control IOP (15.1 ± 1.6 cmH2O) and CSF pressure in the LV (12.4 ± 0.6 cmH2O) and CSS (12.2 ± 0.9 cmH2O) were similar during the 60-min period. When changing the body position from horizontal to vertical (upright), CSF pressures decreased drastically (LV = -5.5 ± 2.6 cmH2O and CSS = -7.7 ± 2.3 cmH2O), while the IOP decreased moderately (IOP = 13.3 ± 0.5 cmH2O). CONCLUSION Change in body position from horizontal to vertical causes drastic changes in CSF pressure and moderate changes in IOP. Thus, IOP is not reflected by the CSF pressure. In an upright position, the values of CSF pressure were equal to the hydrostatic distance between measuring points and the foramen magnum, which suggests that CSF pressure inside the cranium depends on its anatomical and biophysical features, and not on CSF secretion and absorption.