The THAI Journal of OPHTHALMOLOGY

Predisposing Factors and Timing of Orbital Implant Exposure/Extrusion Following Enucleation or Evisceration: An 11-year study

2023-09-06T14:17:37+07:00

Purpose

Enucleation and evisceration are surgical procedures to remove a diseased eye. An extrusion/exposure of the orbital implants is the most common post-operative orbital implant-related complication. This study aimed to identify the incidence, timing, and possible risk factors of orbital implant exposure/extrusion in patients who underwent enucleation or evisceration.

Methods

The medical records of patients diagnosed with “exposure/extrusion orbital implant” following enucleation or evisceration at Chiang Mai University Hospital between January 2007 and December 2017 were retrospectively reviewed. Multivariable regression analysis was performed to identify the possible predicting factors.

Results

Overall, 466 patients underwent either enucleation (313/466, 67.17%) or evisceration (153/466, 32.83%). Three hundred twelve patients (312/466, 67.16%) were male. The age ranged between 0 and 94 years. The incidence of exposure/extrusion was 12.14% (38/313) in the enucleation group and 17.65% (27/153) in the evisceration group. The most common indication for surgery was ocular infections (218/466, 46.78% patients). Using multivariable regression analysis, older age (p=0.008) and HIV infection (p<0.0001) were significantly associated with the occurrence of exposure/extrusion in patients who underwent enucleation but not the evisceration.

Conclusion

The incidence of extrusion/exposure of the orbital implants following enucleation or evisceration was not uncommon. We identified older age and HIV infection as possible risk factors of orbital implant exposure/extrusion in patients who underwent enucleation. In most cases, the complications occurred within a month following the enucleation (18/38, 47.37% patients) and during 1-12 months following the evisceration (16/27, 59.26% patients), suggesting the appropriate follow-up frequency and period.

“A Picture is Worth a Thousand Words” with Eye Diseases Identification

2024-01-22T14:09:54+07:00

“A picture is a thousand words” is a proverb that is used in many languages. This means that a single still image
can describe or express feelings and communicate as much as we can use words to describe thousands of words in
a short time. the doctor in the medical record The doctor will usually draw a picture of the abnormality detected or
the pathology of the patient coming for treatment on the examination record. to make it easy to see and understand
convenient and fast Reduce the time for writing detailed descriptions. in the examination of eye illnesses as well If we
bring pictures to describe eye disease In one picture the doctor draws at each treatment. May help disease coders to
understand and code the disease completely and accurately. Because most doctors may only diagnose one disease. due to
the complete and correct disease code It is important to the health system’s data. The World Health Organization therefore
has set guidelines for disease coding of all countries in the world in the same direction by creating The International
Classification of Diseases and Related Health Problems, 10th : ICD 10 to be useful in tracking data and disease statistics
in research. and public health, so the inspector must record all the information for accurate and complete disease coding
as well But the limitation in the examination time and the number of patients that exceed the examination service time.
May prevent the doctor from writing or describing as much detail as he wants Difficult to read medical handwriting
Or sometimes it’s an abbreviation that the coder doesn’t understand. The drawings recorded by the physician may be
a guide for coding eye diseases. This will benefit the foundation of the country’s public health system in the future.

Specimen submission in Ophthalmic pathology

2023-08-10T11:55:21+07:00

Pathological examination has an essential role in disease diagnosis and prognosis. However, pathological interpretation may be difficult or even impossible if cellular morphology or microstructures are distorted due to an artifact, an artificial structure or tissue alteration caused by the preparation process for a microscopic slide. Ophthalmologists who submit specimens for pathological examination should have knowledge of specimen collection for surgical pathology, cytology, and frozen sections starting from the proper surgical techniques for each organ collection, type and amount of fixative, and container. Importantly, precise communication between a surgeon and a pathologist should be made via an ophthalmic pathology consultation request form. Data should be completely provided for the right understanding of the submitted specimen. This leads to an accurate interpretation of pathological results, which helps guide further patient management.

Ocular Myasthenia Gravis

2023-09-06T14:38:02+07:00

Ocular myasthenia gravis (OMG) is a neuromuscular disease characterized by autoantibody production against post-synaptic proteins in the neuromuscular junction. The basis, therefore, seems to be special immunological, biochemical and pathophysiological mechanisms leading to specific local changes in the neuromuscular junction. The overall incidence of OMG based on a population study is 1.13 per 100,000 per year. The diagnosis of OMG relies mainly on clinical assessment, the use of clinical tests such as the ice test, pharmacological test and electrophysiologic tests, particularly single-fiber electromyography, have a valuable role in diagnosis. The serological antibody assays for acetylcholine receptors, muscle-specific tyrosine kinase, and low-density lipoprotein 4 can be demonstrated in less than 50% of OMG. More than 20-60% of OMG patients develop generalized symptoms in the course of the disease. The treatment of OMG is primarily through cholinesterase inhibitors (pyridostigmine), immunosuppressants are frequently required in cases of ophthalmoplegia. The biomarkers are required to assess disease severity and response to therapy to optimize the management of OMG. Thus, the aim of this review is to summarize the current diagnosis, investigations, and treatment of OMG.

Myopia control in children

2023-08-21T16:24:34+07:00

Myopia has become a significant national and global health concern, as it is a leading cause of visual impairment and blindness worldwide. According to projections, by 2050, nearly half of the global population (49.8%) may be affected by myopia. This condition can lead to various complications and, in severe cases, even permanent visual impairment. Therefore, it is crucial to focus on myopia control to prevent the progression of this condition and its related complications. Myopia control modalities can be broadly categorized into three groups: activities modification, optical correction, and medication. In this review, each of these modalities will be discussed in detail.