Ophthalmology

Comparison of goldmann applanation tonometry measurements with and without fluorescein among adult sudanese glaucomatous and nonglaucomatous population 2018 Islam Elzein, Mahgoub Saleem Al-Basar International Journal of Ophthalmology 2017 4(4):93-98 Background: Goldman applanation tonometry (GAT) is still the most accurate for measuring intraocular pressure (IOP). Usually, fluorescein eye drops are used in additional to topical anesthesia to gain the best visualization result. Objective: The main objective of the study is to compare the GAT values with and without fluorescein in adult Sudanese glaucomatous and nonglaucomatous population. Materials and Methods: In a cross-sectional hospital-based study, 400 patients were recruited from out patient's and glaucoma clinics at Makkah Eye Complex, Khartoum, in the period from December 2017 to January 2018. Different ages were classified into three groups, patients also classified into glaucoma (n = 200) and nonglaucoma (n = 200) patients, another classification according to gender. Then, IOP measurements with and without topical fluorescein were done by GAT. Results: Two hundred and sixteen (n = 216; 54%) were male and 184 (46%) were female, with an average age of 54.76 ± 24.5 years. Two hundred (50%) were glaucomatous, and the other 200 (50%) were nonglaucomatous. The average IOP with fluorescein was higher than without fluorescein by 13.1% (2.08 mmHg) and still was higher in comparison between non-Glaucomatous and glaucomatous with and without fluorescein up to 3. 41 mmHg (17.86%). Both results ± fluorescein and ± glaucoma were statistically significant (P = 0.000). There was a significant correlation between age and IOP values with fluorescein and between having glaucoma and IOP with fluorescein (P = 0.000), while there was nonsignificant correlation between sex and IOP measurements with fluorescein. Conclusion: There are statistically significant differences in IOP values by GAT either ± fluorescein or ± glaucoma. A significant correlation between age and IOP values either ± fluorescein or ± glaucoma were detected, but not to sex.

Computer vision syndrome among mobile phone users in Al-Ahsa, Kingdom of Saudi Arabia Majed Al Subaie, Saif Al-Dossari, Mohamed Iheb Bougmiza Al-Basar International Journal of Ophthalmology 2017 4(4):99-103 Background: The growing number of mobile phone users or video display terminals (VDTs) puts them at hazards of computer vision syndrome (CVS) resulting in ocular surface damage, eye strain, exhaustion, and muscular complaints as result of improper usage of VDTs. Objectives: To determine the prevalence of CVS and to get a baseline data about this syndrome among inhabitants of Al-Ahsa, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted for the duration of 1 month in Al Ahsa Saudi Arabia. Convenience sampling was used with a validated questionnaire to measure the CVS symptoms and to collect data. Consequently, Chi-square test was performed to observe the prevalence of CVS with its risk factors using SPSS version 22. Results: This study showed the prevalence of CVS among Al-Ahsa population to be 43.5% of the screened sample; this was significance results in the term of blurred vision (P = 0.002), dry eye (P = 0.011) and ocular discomfort (P = 0.013) among individuals suffer from CVS. Regarding extraocular complaint, there was a significant result seen in the presence of neck and shoulder pain (P = 0.008) and dizziness (P = 0.045) in individual developed CVS. Conclusion: The study found significant results in term of ocular and nonocular complaints among individuals who developed CVS from Al-Ahsa. Further longitudinal studies are required to study the effect of VDTs on ocular health.

The effect of spherical refractive error on tear volume Reem Hassan Abd Almajeed, Mohammed Elhassan Elawad Al-Basar International Journal of Ophthalmology 2017 4(4):104-108 Background: Dry eye disease (DED) is the most common multifactorial annoying ocular surface disorder, of various ocular symptoms, ranging from eye discomfort, dryness, itching, irritation, and foreign body sensation up to noticeable visual disturbance. Eventually ends with reducing quality of life. Optical refractive quality might deteriorate in these DED individuals, especially in hot-dry-windy climates like in Sudan. Aim: This study aims to determine the influence of spherical refractive errors (REs) on the tear volume and DED. Materials and Methods: In a comparative cross-sectional hospital-based study 90 (n = 90) participants were included; all were free from any ocular or systemic diseases and not using contact lenses. They were of equal numbers of hypermetropes and myopes of mixed gender; males and females, with their ages range between (18-28) years. The mean ages in both groups of RE states were 21.97 ± 2.35 and 22.55 ± 3.29 hypermetropes and myopes, respectively. The study was performed at Makkah Eye complex (MEC), Khartoum, Sudan, from May to July 2015; where the participants were recruited from the general refraction clinics at MEC. All individuals were subjected to the full eye examination. The Schirmer's test was used for all the participants. SPSS statistical analysis program was used to analyze the data. Results: Dry eye was found in 26.6% on hypermetropic patients and 1.1% myopic patients. In this study, the spherical REs showed a significant difference between males (16.6%) and females (12%) P = 0.001. Conclusion: REs may be considered to be one of the risk factors to cause dry eye condition. Correcting RE may reduce the risk factor of dry eye, and that may reduce its prevalence.

The effect of pterygium on corneal thickness, corneal curvature, tear volume, and intraocular pressure in a Sudanese Population Rawia Tagelsir Eias Ali, Atif Babiker Mohamed Ali Al-Basar International Journal of Ophthalmology 2017 4(4):109-113 Background: Pterygium is a triangular fold of bulbar conjunctiva usually found in the nasal side of the interpalpebral fissure. It consists from apex and base. Its apex advancing progressively toward the cornea. The exact cause of pterygium is not well understood, but long-term exposure to sunlight, especially ultraviolet rays, wind, and chronic eye irritation from dry and dusty conditions seems to play an important causal role. It looks like scar, but it is not. The growth might spread slowly during a life or stop after a certain point. In extreme cases, pterygium can cover pupil and cause vision problems. Aim: The aim of this study is to reveal the effect of pterygium on corneal thickness, corneal curvature, tear volume, and intraocular pressure (IOP). Materials and Methods: A total of 100 patients have primary pterygium in one eye (unilateral) compared to their healthy (control) eye. The study was conducted in Makkah Eye Complex in Alkalakla branch between April 2016 and November 2017. The criteria of admission included individuals who have no history of systemic/chronic or other eye diseases. The patients whose pterygium enters the cornea within 2.0–3.0 mm and visual acuity at least 0.50 decimal (6/12) were selected. The data included age and gender, while the clinical procedures included testing vision and visual acuity (Snellen's type), autorefraction and autokeratometry, ultrasound pachymetry, applanation tonometry, and break-up time tear assessment. Frequency distribution tables and t-test were used to present the data. Results: The results showed that the pterygium was more apparent among male (53%) than female (47%). Significant decrease on visual acuity (77%) and tear volume (86%) of the pterygium eye (P < 0.0001) was observed as compared to healthy eye (HE). The primary pterygium caused meridional steepness in corneal curvature (98%). With-the-rule corneal astigmatism was dominant (61%) among other types. Statistically, there were little decrease on central corneal thickness and nonsignificant effect in IOP between the two eyes. Conclusions: Pterygium can cause significant change in ocular functions compared to HEs according to study parameters. Ocular dryness complications and vision impairment due to corneal astigmatism should be considered to make correct diagnoses for eye symptomatology.

Assessment of the effect of academic examination stress on binocular vision functions among secondary school-aged children Amani Ahmed Elsiddig, Saif Hassan Alrasheed Al-Basar International Journal of Ophthalmology 2017 4(4):114-119 Background: Binocular single vision involves the simultaneous use of both eyes with bifoveal fixation, and this process helps individuals to use their both eyes for reading, writing, and other near activities; the stress on this system could lead to ocular complaints and affect the near task for the school-aged children. Aim: The aim of this study was to assess the effect of academic examination stress on binocular vision functions among secondary school-aged children in Khartoum State of Sudan. Materials and Methods: This is an experimental study of 148 secondary school-aged children, selected randomly from Alfath Secondary School, and their ages ranged from 13 to 17 years with a mean age of 14.6 ± 1.13 years. Investigation was performed before and after the academic examinations in 2017. The clinical examinations include visual acuity measurements using Snellen vision testing chart, refraction using autorefractometer, dissociated near phoria by Maddox Wing, associated near phoria by Mallet Fixation Disparity Test, amplitude of accommodation and near point of convergence (NPC) measured by R.A.F rule, and near positive fusional vergence (PFV) and near negative fusional vergence by prism bar. All these investigations were done before 15 days of academic examinations and on the day after the students finished their academic examinations. Results: The findings indicated that most of the students (62.8%) before the academic examinations reported that they were free from any ocular complaints, whereas 37.2% had ocular symptoms. After stress due to examinations, the percentage of students who had ocular complaints increased to 71.6, whereas those free of ocular complaints decreased to 28.4. The mean of amplitude of accommodation before taken the examinations was 9.81 ± 2.16, and after the examination, the mean of amplitude of accommodation decreased to 8.77 ± 1.97 (P < 0.001). Nearly 54.7% of the participants had normal NPC before the academic examinations, and after the examinations, those who had normal NPC decreased to 46.4% (P < 0.001). Only 29% of the students had associated heterophoria before the stress of examinations, and after the examinations, the percentage of students with associated heterophoria increased to 56.5 (P < 0.001). Almost 40.5% of the students presented with normal PFV at near fixation, and after the stress, only 29.1% had normal PFV at near fixation. However, more than half of the students (59.5%) had weak PFV for near fixation before the examinations, and after the examination, they increased to 70.9% (P < 0.001). Conclusion: The academic examination stress had a major effect on binocular vision functions, result in decompensated heterophoria, as well as decline in amplitude of accommodation, and NPC. Thus, comprehensive eye examination including binocular vision function assessment should be made annual for school-aged children.

Alexandros Sfakianakis
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