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Showing 14 results for Subject: Ophthalmology

Mohammad Hossien Davari, Hoda Ghitasi, Esmat Davari,
Volume 3, Issue 1 (3-2015)

Pterygium is characterized by an elastic degeneration of the conjunctiva that extends across the limbos and invades the cornea. The recurrence rate is varied from 25-80% after primary closure to 6% with free conjunctival and Iimbal grafts. Several adjunctive therapies have been investigated for recurrent pte¬rygium. This article presents a 52-year-old athletic man who was seen for evaluation of a recurrent lesion in his right eye and treated with topical administration of IFN-α-2b (Intron A, Schering Plough, Kenilworth, NJ), 1 million units/mL 4 times a day as eye drops.  

Mohammad Hossein Davari, Behrouz Heydari, Atiyah Etebari,
Volume 3, Issue 3 (10-2015)

Introduction: Cataract is a common disease across the world and the most common cause of vision loss and blindness. Several factors contribute to the disease, the most important of which is aging. Other contributors include sex, smoking, sunlight, place of residence, family, job, and systemic disease. This study was aimed to enquire into the epidemiology of cataract cases referred to Noor Ophthalmology Clinic of Birjand from March 2015 to February 2016.

Methods: In this descriptive and cross-sectional study, the patients with cataract admitted to Noor Ophthalmology Clinic in Birjand from March 2015 to February 2016, who were available, were selected. A total of 386 patients were selected. Information was collected by a checklist concerning variables such as age, sex, smoking history, diabetes, location, separate left and right eye, family, job, and cataract diagnosis. Their records were collected, and the obtained data were analyzed by SPSS software (V: 16). The significant level was set at P<0.05.

Results: The majority of the 386 cases under study were women (56.5%). The mean age of patients was 67.4±2.9 years. Cataract was more commonly seen in the right eye, diabetes (13.50%), hypertension (21.1%), and urban (31.9%) and rural (68.1%) areas. The prevalent cataract types were respectively nuclear cataract, cortical cataract, and sub-capsular cataract.

Conclusions: As cataract is one of the common eye diseases which is of more prevalence in elderly age group (50-79) and housewives, special attention should be given to these groups of population in order to prevent and control cataract.

Behrooz Heydari, Saeed Reza Heydari, Gholamhossein Yaghoobi,
Volume 4, Issue 3 (7-2016)

Introduction: Intravitreal Avastin (bevacizumab) injection is reportedly accompanied by ocular and systemic side-effects. Our enquiry assesses whether there are any differences between intraocular pressure (IOP) in baseline and on the day after injection in patients treated for retinal disease.
Methods: In this experimental study, 82 eyes with retinal diseases that had indication for anti-VEGF and were treated with injections of intravitreal bevacizumab were taken as the case group, and 82 healthy eyes were considered as controls. The IOP was measured by non-contact tonometry in both the healthy eyes and the eyes with retinal diseases before and 24 hours after intervention. Data were analyzed by paired t test and independent t-test in SPSS 19.0 software. Significance level was set at P <0.05.
Results: Results of the study showed that the mean IOP before injection was not significantly different in either groups (p=0.51). However, it was significantly lower after injection than before it in both case and control eyes (p<0.01). The mean IOP changes before and after infusion in the case and control eyes did not differ significantly (p=0.30).
Conclusions: Our study did not find an increased IOP in bevacizumab-treated eyes when compared to fellow control eyes. Further studies with a greater sample size are needed to evaluate whether an increased number of ranibizumab injections is associated with IOP changes.
Seyyed Abbas Hosseinirad, Gholamhossein Yaghoubi, Behrouz Haidari,
Volume 5, Issue 1 (9-2017)

Leeches are segmented worms belonging to Phylum Annelida and make up the subclass Hirudinea. Leeches have been historically used in medicine to suck blood from patients. Ocular infestation with leech is rare, moreover it is often misdiagnosed. In this report, we describe 2 patients with continuous bright ocular bleeding after swimming in a pool, and pseudo iris prolapse in a child after trauma with a wooden piece who immediately washed his face in a stream. Ocular leech infestation must be ruled out in children with a history of contamination or swimming in rural pool or streams.

Gholam Hossein Yaghoubi, Behrouz Heydari, Gholamreza Faal, Elahe Heydari, Mohammad Alipour,
Volume 5, Issue 3 (11-2017)

Introduction: The prevalence of retinopathy of prematurity is expected to increase along with the developing of premature infants’ care and better prognosis of these infants. The aim of this study was to evaluate the prevalence of retinopathy of prematurity in preterm infants.
Methods: According to this cross-sectional study, one same ophthalmologist examined the eyes of all the babies at 4 weeks postnatally or 32 weeks post-conceptional age, whichever was earlier, for all premature infants under 37 weeks and those who had ROP risk factor. These infants were referred to the ophthalmology clinic of Vali-asr Hospital by neonatologists and pediatricians. History and risk factor was assessed by the neonatologist on admission time. Data were analyzed with SPSS software (version 19) using Chi-square, and Fisher's Exact Test. The significance level was considered P < 0.05.
Results: A total of 209 patients were referred to the ophthalmologic clinic of Vali-asr hospital of whom 15 infants (7.2%) were diagnosed with retinopathy of prematurity. The prevalence of retinopathy of prematurity had a significant relationship with gestational age and birth weight. However, there were no significant associations with other risk factors (gender, oxygen, respiratory distress, sepsis, and phototherapy).
Conclusions: Overall, the prevalence of retinopathy of prematurity in our study was lower than that of other studies. Excellence in pre- and neonatal care, screening and early treatment of retinopathy of prematurity are keys to preventing vision loss induced by this disease. It is mandatory to ensure that these newborns have regular ophthalmologic support.
Mohammad Hossein Davari, Toba Kazemi, Masoumeh Saberhosseini,
Volume 6, Issue 1 (1-2018)

Introduction: Clinical education is one of most important medical education courses in Medicine. Medical education is in turn part of the higher education system that deals with human life, and thereby it is important to pay attention to its quantitative and qualitative aspects. In this study, we aimed to investigate the status of clinical education in ophthalmology ward of Vali-e-Asr Hospital in Birjand before and after an intervention.
Methods: This Descriptive-interventional study was conducted on students and interns in the ophthalmology department of Vali-e-Asr Hospital during one year. The number of participants was 30 (on average, 4-6 people per month). A questionnaire was first designed in 5 fields (Reviewing educational activities, studying the educational environment, reviewing patients' records, assessing the duties of trainees, and assessing the duties of interns). The questionnaires were later evaluated by 5 faculty members for validity, and after confirmation, the ophthalmology surgery ward was assessed in 3 months. Interventions were performed by the head and the deputy of the faculty of medicine. Eight months later, assessment was again carried out by the same researcher. The results were encoded and entered into SPSS 15 software and analyzed at the level of P ≤ 0.05 by independent t-test.
Results: After intervention in the field of educational activities, the score increased from 6 to 10 (P = 0.13). The educational environment score increased from 7 to 14 (P = 0.002). The mean score of assessments of interns before and after intervention was equal to 8. The mean scores for patients' records improved from 8.23 ± 1.98 to 8.92 ± 1.65 (P = 0.04).
Conclusions: The results of this study showed that physical changes in the educational spaces by the authorities can be easily accomplished and the educational environment can be improved by planning. It requires more action however to create changes in educational programs, improve the quality of clinical education, provide emergency training to students, and make plans by authorities.
Gholam Hossain Yaghoobi, Seyed Abbas Hosseinirad, Saeedreza Heydari,
Volume 6, Issue 4 (12-2018)

The aim of this study was to investigate the improvements of central serous chorioretinopathy (CSC) treated with topical dorzolamide. These observational case studies included nine eyes of the nine patients with CSC, treated by a physician with topical dorzolamide consecutively over a one-month period. The central macular thickness and best-corrected visual acuity (BCVA) were measured and compared with baseline values. All the eyes of nine patients demonstrated subretinal fluid (SRF) before or during the treatment course. The SRF was measured and compared with baseline values in this subgroup. Among the cases (n=9), the mean age was reported as 39±6, and BCVA improved in 77% (7 cases), 11.1% (1 case), and 11.1% (1 case) of the cases within two, four, and ten weeks of treatment after the follow-ups, respectively. Indeed, the mean value of central macular thickness showed improvement from 4.72±1.40 to 3.93±9.8 microns (P=0.211). The SRF decreased during follow-up treatment with the mean time of 0.7±0.6 months; however, central macular thickness, choroidal thickness, and BCVA revealed no significant change. Topical dorzolamide might improve BCVA and decrease SRF in patients with CSC. This case series study demonstrated that topical dorzolamide might be effective in the treatment of CSC.

Mohammad Hossein Davari, Seyed Hassan Golboie, Negar Shamsaki,
Volume 6, Issue 4 (12-2018)

Introduction: There is insufficient information about the correlation between hearing and visual impairments. Its importance arises when trainers should care about medical issues of their clients. Refractive errors of the eye are one of the main causes of visual loss in the society. The purpose of this study was to evaluate the relationship between refractive errors in the eye (by the type of refractive error) and hearing loss in patients referred to Vali-e-Asr Hospital in Birjand, Iran.
Methods: In this case-control study was conducted on 124 patients referring to Ear, Nose, and Throat Clinic with hearing loss (case) and 117 patients with normal hearing status (control). The participants were selected non-randomly and they were matched in terms of age and gender. All data were analyzed by SPSS (version 21) using the Chi-square test and t-test. P-value less than 0.05 was considered statistically significant.
Results: A total number of 241 patients (case=124, control=117) participated in this study. There were 51.6% and 54.7% of women in the case and control groups, respectively. The mean ages in the case and control groups were 36.03±17.13 and 35.95±18.22 years, respectively. The frequencies of refractive disorders were similar in both groups (i.e., 36.3% in case vs. 38.5% in control). The frequencies of myopia in the case and control groups were 85% versus 72.5% for the right eye and 88.4% versus 75.6% for the left eye. There was the higher prevalence of myopia in the case group; however, the relationship was not significant. The results showed that the difference in the prevalence of refractive errors in the hearing loss of patients was not statistically significant, compared to patients with normal hearing.
Conclusions: There was no significant difference between the hearing loss and refractive disorders. Individuals with hearing loss showed higher prevalence of myopia; however, the relationship was not statistically significant.
Gholam Hossain Yaghoobi, Malihe Nikandish,
Volume 7, Issue 1 (3-2019)

  • We reported the case of a 9-year-old boy with a complete right blue iris and left brown iris. Other Ophthalmic examinations were normal except for the homonymous symmetrical pattern of nasal retinal hypopigmentation. The case had no systemic finding or positive family history. The present case was unique because the presentation of iris heterochromia did not follow Mendelian law and was not associated with any diseases or syndromes.

Mohammad Reza Akhlaghi, Rezvan Ansari,
Volume 7, Issue 2 (6-2019)

Dear Editor:
The process of launching a wet lab for cataract surgery on the goat's eye for publication and use of the respectable colleague surgeons of the ophthalmology department is presented as follows.
In order to design an effective and beneficial wet lab, we followed and implemented five main steps as follows:
Step 1: Preparing an appropriate physical space
To have a proper wet lab space, a room in Feiz Educational-Therapeutic Ophthalmology Center, affiliated to Isfahan University of Medical Sciences, was considered and prepared. Therefore, after cabinets, plumbing, cooling and heating equipment, and electricity, and telephone system were set up in the room, the required facilities including surgical microscope, the phaco machine, microwave, Trypan blue, extracapsular surgery set, phaco surgery set, safety box, refrigerator, desk, and chair were transferred.
Step 2: Obtaining finance to launch the wet lab
After coordination was made, we received and packed surgery sets using the old equipment from the operating room. Since modern equipment was purchased for the hospital operating room, we were able to transfer the phaco machine and microscopes that were no longer in use. Consumables and goat's eyes were not expensive, and a total of 30 goat's eyes were used.
In this physical space, a senior assistant performed the procedure step-by-step on a goat's eye, and the sophomore assistant followed the instruction as an observer and subsequently exercised it on a goat's eye. Other exercises in the wet lab comprised of scrub, introduction to ophthalmology surgery devices and microscope set-up, and stitching.
Step 3: Providinggoat's eye
To provide the eyes, the slaughterhouse (60 km to Isfahan) was reminded to extract the eyes from the animal's eye orbit in perfect form along with the surrounding fat without the eye surface being touched. The eyes were transferred to the wet lab in cold box at -2 °C inside the dextrose-saline solution. The temperature of the refrigerator was set at -2 °C to keep the eyes. Nevertheless, the cornea should not be dried or frozen. Notably, as the time between the displacement of the eyes from the slaughterhouse and their use in the wet lap and cataract surgery was long, the eyes were kept and transferred in 2/3 and 1/3 serums and a temperature of -2°C in order to prevent corneal opacity.
Goat’s eye was selected given its resemblance to the human eye and accessibility(1). The similarity helps us train the procedures to the assistants and to enable them to practice on their own.
Step 4: Stabilizing the eye
In keeping with the need for eye fixation, researchers used magnetic clip dispensers, as an innovative technique, to stabilize the eye. Bottom of the dispenser was filled with compressed cotton, and the eye was placed on it. We placed the head of the dispenser on the animal's eye so that the eye was accessible from the empty circular space of the dispenser head.
Step5: Preparing the eye for cataract surgery
Given the fact the goat's eye is deprived of vital nerves at the time of slaughter, that the pupil gets dilated, and that the eye was transferred under moist conditions inside 1/3 and 2/3 serums at -2 °Cin order to prevent from the cornea’s dryness and opacity, it was necessary to take certain measures on the goat's eye, because the goat’s eye lenses are made up of a loose, transparent tissue. Therefore, to make it more solid and darker, we induced cataract in the microwave according to our previous studies. It is necessary to explain that cataract induction on the goat's eye is performed for the first time worldwide, and what was observed in articles(2-3)concerned with the porcine eye, which was carried out at a power of 700 w in the microwave for 5-13 seconds. In this study, we evaluated that the goat's eye is different from that of the pig's, and that it has a tissue more susceptible to microwave conditions that the porcine eye such that it transforms in a faster time.
Thus, cataract induction of the goat's eye in the microwave was the first experience. Hence, as we did not have a reference in this regard, we checked the eye in the microwave every 3 seconds, observing that within 9 to 13 seconds at a temperature of 100 °C, total induction was accomplished and the cornea was still transparent for practicing rhexis and phaco in the wet lab. In this way, the goat eye lenses were prepared for cataract procedures including the anterior capsule, rhexis, phaco, irrigation and aspiration, IOL(Inter Ocular Lens), and stromal hydration. We found that the eye cataract could be used for surgical purposes for up to 24 hours after surgery in case they were stored inside a container with a lid under refrigerated conditions or in water. At these intervals, the necessary condition is for the cornea to remain transparent, which was considered by us in the operational plan.

Malihe Nikandish, Atefeh Gholami,
Volume 7, Issue 3 (9-2019)

  • Introduction: Ultrasound biometric measurements have long been the gold standard in cataract surgery. In the course of time, optical biometry replaced ultrasonography as the standard technique for axial length measurements of the eyes. However, optical biometry is not accessible in some centers; therefore, the present study was carried out to evaluate the predictability of refractive outcomes following phacoemulsification using applanation ultrasound biometry.
  • Methods: In this prospective study, ocular biometry was performed using an applanation ultrasound. Thereafter, mean absolute error (MAE) and the percentage of eyes achieving postoperative refraction within 0.5, 1.0, 1.5, and 2.0 D of the predicted spherical equivalent were calculated for SRK/T IOL formulas through a temporal clear corneal incision 1 month after phacoemulsification.
  • Results: A number of 299 adult cataract patients (323 eyes in total) were enrolled. Absolute refractive mean error was obtained as 0.51±29 D 1 month after the surgery. In addition, 59.4% of the eyes achieved postoperative refraction of ±.5 D of the predicted value. Furthermore, 95.7 % of the eyes were found to be within ± 1.00 D.
  • Conclusions: Based on the results of the present study, refractive outcomes after phacoemulsification using applanation ultrasound biometry are comparable with international standards for good practice and outcomes. It is worthy to note that this method offers considerable advantages, such as a few measurement limitations, cost-effectiveness, and accessibility.

Seyyed Mohammad Hosseinirad, Seyyed Abbas Hosseinirad, Mohammad Hossein Davari, Ghazal Taheri, Bita Bijari,
Volume 9, Issue 4 (12-2021)

  • Introduction: Considering the increasing prevalence of myopia and the subsequent complications, and due to the dearth of studies on the correlation between myopia and gender with corneal thickness in Iran, this study aimed to determine this relationship in patients admitted to the ophthalmic clinic of Vali-e-Asr Hospital, Birjand, Iran.
  • Methods: This descriptive-analytic epidemiologic study was conducted on 100 patients admitted to Vali-e-Asr ophthalmic clinic in Birjand, Iran, for one year since January 2017. According to the degree of myopia, the patients were divided into three groups of low (0-3 D), moderate (3-6 D), and high myopia (6≤D). Corneal thickness was measured using Orbscan and Pentacam. The data were analyzed in SPSS software (Version 19) through ANOVA and T-test to determine the possible relationship between myopia and central corneal thickness. A p-value equal to and less than (P≤0.05) was considered statistically significant.
  • Results: Overall, 100 patients (49 males and 51 females) were enrolled in this study. Moderate myopia had the highest frequency in both eyes. The results of the T-test revealed that no significant difference was observed in the mean corneal thickness measured by Pentacam between the two genders (P=0.18 in the right eye and P=0.32 in the left eye). Based on the ANOVA findings, the mean corneal thickness measured by Pentacam was not significantly different among the myopia categories (P=0.05 in the right eye and P=0.51 in the left eye)
  • Conclusions: The study results revealed that there was no significant relationship between myopia and gender with corneal thickness.

Ebrahim Shirzadeh, Fademeh Mahjubfar, Maryam Tatari, Rahim Rahim Golmohammadi, Somayyeh Nayyeri,
Volume 9, Issue 4 (12-2021)

  • Introduction: Lacrimal drainage system disorders are among the most common ocular disorders faced by physicians. The prevalence of congenital nasolacrimal duct obstruction (CNLDO) is different in various studies, and the role of such factors as maternal and neonatal demographic characteristics have not been completely investigated in CNLDO. The present study aimed to assess the prevalence of CNLDO and its related factors in newborns in Sabzevar.
  • Methods: This cross-sectional study was conducted on 541 newborns in Shahidan Mobini hospital, Sabzevar, Iran from January to February 2015 after obtaining informed consent from their parents. Data were collected by interviewing mothers, filling out checklists, and physical examination of the newborns. Data analysis was carried out in Stata software using a logistic regression test at a 95% confidence interval.
  • Results: The prevalence of CNLDO was 22.6%. Purulent ocular discharge was the most common symptom (16.82%). There was a significant relationship between the neonate’s head circumference and the incidence of CNLDO (P= 0.01); nonetheless, CNLDO in the newborns showed no significant association with weight, height, and Apgar score (P>0.05).
  • Conclusion: Considering the significant prevalence of CNLDO in preterm and term neonates, as well as its variable prevalence rates reported in different studies and the absence of overlapping of various risk factors of such disorder, it is recommended to carry out more thorough studies from birth to 1 year of age.

Seyed Abbas Hosseinirad, Malihe Nikandish, Armin Forghani,
Volume 10, Issue 4 (12-2022)

  • Introduction: Blepharitis, chronic inflammation of the eyelid, is one of the most common eye diseases that involve eyelashes, parotid glands, and apocrine. The most important symptoms of blepharitis are burning and irritation of the eyes, which are more severe in the morning. Azithromycin 1% solution is a new therapeutic method for treating blepharitis, which has recently entered Iran. The purpose of this study was to compare the treatment of 1% azithromycin eye drops and erythromycin topical ointment on the symptoms and signs of blepharitis.
  • Method: In this clinical trial study, 98 patients with posterior blepharitis referred to the ophthalmology clinic of Razi Hospital in Birjand in 2020 and 2021 were studied based on inclusion and exclusion criteria. Patients were randomly divided into two groups receiving erythromycin and 1% azithromycin by the blocking method. A two-part questionnaire was completed for the patients before and after the intervention. In the first part of the questionnaire, the demographic information of the patients and the signs and symptoms of the disease, including the degree of dry eyes, redness and swelling of the eyes, itchy eyes, and in the second part, the standard Ocular Surface Disease Index questionnaire was completed by self-declaration. The SMTube test was also performed by the project manager for the patients. The intensity of color sensitivity was checked and recorded by an eye specialist. After collecting the data, they were entered into SPSS software )Version 18) and analyzed by independent T, Mann-Whitney, paired t, Chi-Square and Fisher's exact test at the significance level less than 5%.
  • Results: Out of a total of 98 patients, 52 patients (53.1%) were female. At the beginning of the study, there was no significant difference between the average OSDI index, staining intensity and SMTube, and at the end of the study, there was no significant difference between the two groups (P>0.05).
  • Conclusion: Based on the results of the present study, the efficacy of azithromycin eye drops in the patients was the same as the efficacy of topical erythromycin ointment in patients with posterior blepharitis.

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