World Eye and Vision Congress December 09-10, 2019 Dubai, UAE

Biography:

Ghada Yousry Sayed has completed her Master’s degree from Ain Shams University, Egypt. She is a Member of International and European Strabismological Associations (ISA and ESA) and an active Member of the Egyptian Pediatric Eye Surgeons (EGPES). She is the Head of Pediatric Ophthalmology and Strabismus in Safeer Eye Center. She has assisted in scientific research including data gathering and writing in national and international papers.

Abstract:

A 4-year-old boy was presented to the clinic by acute onset bilateral ptosis. He was examined for mechanical causes (no abnormalities were detected in lids), definitely not congenital (acute onset is against us) and he was investigated for the systemic and local myogenic causes, nerogenic and neuromuscular junction causes (anticholinestrase antibodies negative, anti-musk antibodies negative) of ptosis and all revealed no abnormalities. The picture then converted to unilateral hypertropia which improved on its own and followed by huge exotropia. A full pediatric dose of Mestinon was given and side effects occurred, then a gradually increasing pediatric dose was started and clinical picture improved greatly.

Biography:

Salem has graduated as ophthalmologist from the School of Medicine, Cairo University, Egypt. He has started his specialized medical career as an Ophthalmology Resident in Cairo University, in addition to his experience at the military hospitals. He has participated in several medical exchange programs abroad including Austria, Hungary and Germany. He has obtained his Master in Ophthalmology from Cairo University, Egypt. Besides being an Assistant Lecturer of Ophthalmology, School of Medicine, New Giza University, he works as a Refractive Surgeon in Dar El Oyoun Hospital and Eye Subspecialty Center, Cairo, Egypt. Presently he is working on his Fellowship in the Royal College of Surgeons of Edinburgh, after being a Member of the International Council of Ophthalmology and the Royal College of Surgeons of Edinburgh.

Abstract:

Background: Corneal perforations after corneal ulcers are ocular emergencies with myriad causes, such as trauma, infection, autoimmune diseases and loss of corneal innervation. Knowledge of the cause of the perforation is essential for its proper management. Treating perforated corneal ulcer with a therapeutic PKP (Penetrating Keratoplasty) is the best option to eliminate active infection or to treat a perforation larger than 2 mm that involves tissue loss. 

Materials & Methods: Female patient 56 years old came presenting with corneal melting and perforation after long history of corneal abscess with multiple failure of healing. Patient came seeking medical advice in February 2018 in Eye Subspecialty Center, Cairo, Egypt. She has IDDM (Insulin-Dependent Diabetes Mellitus) for 10 years and no past ophthalmic surgeries. Vision was HM BP Hand Moment Blood Pressure. Slit lamp exam showed faint descemetocele with impending perforation. Surgical Procedure: (1) Under general anesthesia, sterilization of the eye lids was done and surrounding skin using povidone iodine 10%. (2) Centration of the pupil was done using specific surgical marker and then using corneal marker for the stitches was applied. (3) Opening a side port using a 1.2 mm MVR and injecting viscoelastic material to allow formation of the anterior chamber. (4) Trephining the host cornea was done using a 7.75 mm trephine and the donor graft was cut using 7.5 mm punch. (4) Trimming the edges of the host tissue with application of the donor graft and suturing using 10/0 nylon 16 stitches. Postoperative Assessment: Patient was prescribed topical and systemic antibiotics, topical and systemic steroids, topical antiglaucomatous drops and systemic analgesics. Post-operative visits were done one day, one week, 3 weeks. Patient showed improvement in graft edema with regressed signs of inflammation and rejections. Patient subsequently development complicated cataract that was scheduled for removal 6 months post-operatively. 

Results: Patient received a therapeutic corneal graft maintaining the integrity of the eye, preserving the anatomy of the globe and eliminating the source of infected tissue. 

Conclusion: Therapeutic penetrating keratoplasty is one of the vision preserving measures in cases of large perforated corneal ulcers not responding to other treatment options.

Biography:

Fatima Iqbal has her expertise in cornea, low vision and pediatric care. She is working as full time Faculty at School of Optometry, The University of Faisalabad and private practice at Abdullah Memorial Hospital. She is also a Global Ambassador of TFOS (Tear Film and Ocular Surface Society). Her interest in cornea and tear film led her to conduct this study to evaluate pre and post-cycloplegic effects on axial length and corneal curvatures. Her study also unveiled role of accommodation on described ocular structures. Her best academic skills and competency in research awarded her with Gold Medal twice in optometry conferences. Her passion is to travel and explore new aspects in optometry.

Abstract:

Statement of the Problem: Assessment of corneal curvature and axial length has prime importance in performing various ocular procedures such as planning corneal and refractive surgery, cataract surgery and overall corneal health evaluation. Cycloplegics paralyze the ciliary muscle and pupillary sphincters thus suspend the accommodation and induce pupil dilatation. These agents also cause some changes in corneal curvature and axial length of the eye. Purpose of the study is to observe the effect of cycloplegia on Corneal Curvature (CC) and Axial Length (AL) and to compare this effect in myopes, emmetropes and hypermetropes.

Methodology: Study was conducted in Ophthalmology Department of Madina Teaching Hospital, Faisalabad. Changes in both meridians of CC and AL were analyzed using NIDEK Auto Ref-Keratometer and Alcon A-Scan respectively. Both eyes of 150 subjects of either sex with ages ranging from 15 years to 30 years were included in study. The subjects were categorized according to refractive status into three groups as myopes, emmetropes and hypermetropes.

Results: A significant association was observed between pre- and post-cycloplegia AL (r=0.00, p<0.005). There is also a statistically significant association between pre- and post-cycloplegia horizontal meridian of CC (r=0.22, p<0.005). However, there is no significant change in vertical meridian of corneal curvature post-cycloplegically (r=0.441, p<0.005). These variations are more obvious in myopes than emmetropes and hypermetropes.

Conclusion & Significance: Cycloplegia induced decrease in axial length and increase in horizontal meridian of corneal curvature. Eye care professional must be aware of this cycloplegia-induced change in order to optimize better surgical plans and thus attaining better refractive status.

Biography:

Vanchalearm Banchasakjaroen has the expectation to improve vision of the people in the world as he can. In the training program he was interested in the retinal specialist and he had the experience in treatment of central serous chorioretinopathy (CSC) in patients. He had done the research in the optimal dose of verteporfin and it is not reported. This research is to compare the efficacy of half-dose PDT and one-third-dose PDT in treatment of chronic, or recurrence CSC. He hopes this research will be making the decision of treatment in the patients with CSC.

Abstract:

Objective: To compare the efficacy of half-dose photodynamic Therapy (PDT) and one-third-dose PDT in treatment in chronic or recurrence Central Serous Chorioretinopathy (CSC).

Methods: A retrospective review of chronic or recurrence CSC patients, who were treated with half-dose or one-third dose PDT for 12 months follow-up. Best-Corrected Visual Acuity (BCVA), Central Retinal Thickness (CRT) and resolution of Subretinal Fluid (SRF) at baseline, 1, 3, 6, and 12 months post PDT were assessed.

Results: 46 eyes and 20 eyes received half-dose and one-third dose PDT, respectively. The study shows non-inferiority of the one-third-dose PDT compared with half-dose PDT in BCVA improvement (0.10±0.04 vs. 0.17±0.04 LogMar, P=0.293) and CRT improvement (125.6±24.6 vs. 139.1±16.54 µm, P=0.652) at 12 months follow-up. The recurrence rates of SRF was significant higher in one-third-dose of PDT compared with half-dose PDT (40.0% vs. 15.2%, P=0.027) at 12 months follow-up.

Conclusion: One-third-dose PDT was non inferiority in BCVA and CRT improvement when compared with half-dose PDT. This study showed one-third-dose PDT was higher recurrence rate of disease.

Biography:

Qurat Ul Ain Asghar is currently pursuing her Optometry from the University of Faisalabad, Pakistan.

Abstract:

Introduction & Objective:  Now a day many people complain of eye irritation, dryness and itching especially those who have dandruff in their head. This dandruff can be the cause of dry eye. In the skin diseases like seborrheic dermatitis and seborrheic blepharitis there are chances of dry eye whose symptoms cannot be relieved until we treat these disease because the cause of this dry eye is dry skin. If these skin diseases are left untreated they can cause further damages to eye such as corneal erosions. The objective of this study is to find out the frequency of frequency of dry eye in 30 people (male and female) who were suffering from the seborrheic dermatitis and seborrheic blepharitis.

Method: We diagnosed the dry eye by the tear break-up time testing using the cobalt-blue filter of slit lamp. We took the patients of seborrheic dermatitis and seborrheic blepharitis which are diagnosed by consultant doctors and performed the method to check dry eye. Fluorescein was instilled in the patient’s eye and asked the patient to do a complete blink once and then stop blinking and then we noted the time with stop watch when the first dry spot appeared in tear film (normal: 10-40 seconds).

Results: We took 30 patients of SB and adult SD. Most of these patients were between the ages 20-25. Out of these 30 patients 23.3% were male and 76.7% were female. In case of SB, 83.3% females had dry eye and all males 100% had dry eye. While in case of SD, 91% females and 100% males had dry eye and the results showed that dry eye was more marked in right eye as compared to left eye. 19 out of 30 patients had symptoms more prominent in their right eye.

Conclusion: This study was conducted to determine whether there is any association between dry eye and adult SD and SB and the study concluded that there is a strong association between dry eye, SD and SB. We took 30 patients and assessed the TBUT of both eyes. TBUT was seen to be low in right eye as compared to left eye. Out of 30 patients, 23 patients had dry eye and the results showed that dry eye was more marked in the patients of SD than SB.

Biography:

Kadhim Alabady is a Fellow of the Royal College of Physicians and Surgeons of Glasgow and Fellow of the Faculty of Public Health, UK. He holds a Doctorate degree in Public Health and Epidemiology, Master’s degree in Clinical Epidemiology (MSc), Master’s degree in Public Health (MPH), all from The Netherlands universities with broad experience driving Research and Development (R&D) strategies and operations. He has worked in Public Health since 1999 at different levels such as: Academic (Erasmus University, Rotterdam, The Netherlands; Queen Marry University, London, UK); and University of East Anglia (UEA), Norwich; International (United Nations); National Health Authority (Qatar); National Health Service.; Dubai Health Authority; and others. He is registered as an Epidemiologist Grade A with The Netherlands Epidemiological Society.

Abstract:

Background: The prevalence of sight loss increases with age and the Dubai population is ageing. In addition, there is a growing incidence in key underlying causes of sight loss such as obesity and diabetes. This means, that without action, the number of people with sight problems in the Dubai is likely to increase dramatically over the next 25 years.

Purpose: The purpose of the eye health needs assessment is to build a picture of current eye health services, i.e. a baseline and to gather information in order to plan and change services for the betterment of eye health.

Method: In order to carry out eye health assessment we applied qualitative (focus groups with 20 ophthalmology experts) and quantitative methodology (analyzing hospital, population health related surveys). Prevalence or incidence estimates based on research from national and international documents. It is intended to help stakeholders discuss the scale of the issue locally.

Findings:  A number of studies have shown that that rate of reported cataracts is around 2% on average. If these estimated prevalence rates (2%) are applied to the population of Dubai (without adjustment), there may have been 47,716 people with cataract across Dubai in 2015 of which: 33,145 would be males and 14,571 females. It was estimated around 9,144 residents in Dubai aged 40 years or more in 2015 had glaucoma (of which 8,149 were OAG and 995 were ACG). It was estimated there would be approximately 12,128 (95% confidence interval 9,639-15,001) adults aged 18+ years in 2015 suffering from diabetic retinopathy at some stage. Age-Related Macular Degeneration (AMD) seem to be a rare condition in Dubai and patients with AMD are not often seen at private healthcare sectors, as it is most common among the older white population.

Biography:

Laura Fanea has her expertise in Magnetic Resonance Imaging (MRI) of the central nervous system developed through professional collaborations with many medical specialists worldwide during the last 18 years. Her future plans focus on implementation of AI in routine clinical imaging through her most recent results’ generalization and standardization.

Abstract:

Statement of the Problem: Appropriate program implementation in ophthalmology is recommended to avoid, prevent or treat the socio-economic issues caused by blindness and visual impairment. Artificial Intelligence (AI) will help medical specialists evaluate at the highest possible standards any medical condition offering the most complex and accurate medical information in the most rapid way. The complex geometric-physicochemical quantitative information offered by Magnetic Resonance Imaging (MRI) on the qualitative anatomical biophysiology and/or pathophysiology of the eye covers the main eye structures: Cornea, aqueous humor, ciliary body, lens, vitreous humor, sclera, optic nerve and three retinal layers. Implementation of AI-based MRI techniques in ophthalmology could, therefore, play a crucial role in reducing the present socio-economic burden caused by eye disease.

Methodology & Theoretical Orientation: A Control/Normal (CN) database consisting of the already published qualitative and quantitative human ocular MRI information at 1, 1.5, and 3 T was used. Disease-Affected (DA) human eye regions were assessed by Relative-to-Normal (RN) values of each MRI parameter, calculated using the equation below: RN Parameter (%) = 100*(ParameterDA- ParameterCN)/(ParameterCN). Significance was considered for RN values >50%.

Findings: Detailed MRI physio-anatomical characteristics were defined based on the analyses of the MRI parameters evaluated. The complex disease staging scale was built using the relative-to-normal values calculated for the normal subjects and the MRI physio-anatomy defined. A scenario for AI-based ocular MRI is also presented.

Conclusion & Significance: The template for AI-based ocular MRI developed in this study can be immediately implemented in diagnostic ophthalmology and/or radiology. Future possible studies can extrapolate results in this study for AI-based medical diagnosis of any other organ in the human body, but also for AI-based medical prognosis, treatment and/or surgery.

Biography:

Fatima Iqbal has her expertise in cornea, low vision and pediatric care. She is working as full time Faculty at School of Optometry, The University of Faisalabad and private practice at Abdullah Memorial Hospital. She is also Global Ambassador of TFOS (Tear Film and Ocular Surface Society). Her interest in cornea and her study also unveiled role of accommodation on described ocular structures.

Abstract:

Background: Eyes are the windows to one’s soul. Through these windows optometrists can peep into the souls of their patients. We can tell them what they know what they do not, not only about their eyes but the systemic health also. Sometimes an ophthalmic finding may be the earliest manifestation of a systemic disorder or may precede the classical clinical signs and symptoms. Eye care doctors, by identifying such findings, may not only save the vision and eye but also the lives of their patients.

Aim: To present a series of cases with ophthalmic findings associated with systemic disorders.

Cases: Two real life cases of multisystem disorders with initial ocular presentation are discussed. Case-1: was a 16 years old girl with complaint of transient visual blur. Comprehensive ocular examination raised the suspicion of underlying hematopoietic disorder. Multispecialty workup confirmed the diagnosis of chronic myeloid leukemia. Case-2 was a 23 year, only eyed female. She had received a cryotherapy and anti-VEGF for a presumed Coats disease OD ending up in phthisis bulbi. Optometric exam suggested multisystem cancer disorder. Investigations further confirmed the diagnosis of Von-Hipple Lindau disease. 

Results & Discussion: Optometrists can identify potentially dangerous systemic disorders before the development of specific systemic symptoms/signs.

Conclusion: The earlier detection and timely referral to the appropriate specialties, thus, improve the prognosis, life expectancy and help avoiding complications associated with late diagnosis. Also enhancing scope of practice of optometrists and finding professional identity.

Biography:

Mohammed Mahdy was born in Egypt 1982, He accomplished his education basic and postgraduate in Egypt, and he is a graduate from Zagazig University that was established in 1974, He finished his master degree in neuropsychiatry 2010, and MD in neurology 2016, He is working as neurology Lecturer in faculty of medicine, Zagazig University, and a member of the American Academy of Neurology, and now He works as a neurology consultant in Saudi airlines medical services.

Abstract:

Introduction: Idiopathic Intracranial Hypertension (IIH), also referred to as benign intracranial hypertension, is a disorder generally affecting overweight women of childbearing age. Idiopathic intracranial hypertension has often been considered a diagnosis of exclusion, especially if no cranial neuropathies or papilloedema have been detected. Measurement of the Optic Nerve Sheath Diameter (ONSD) using CT scan can provide a solution for this situation, as it has been used as a non-invasive method of ICP monitoring since the mid-1990s. Another rapid non-invasive method for evaluation of patients with IIH is Optical Coherence Tomography (OCT). Spectral-domain OCT provides reliable thickness and volume measurements of the optic nerve head and retina and can reliably demonstrate structural changes due to papilloedema. This study included 40 patients (aged ≥18 years) presented with headache and fulfilled modified Dandy criteria for IIH.

Method: We collected and analyzed data on the following variables: ONSD in the middle third of the intraorbital path (the point where the ophthalmic artery crosses the optic nerve served as an anatomical landmark); Our patients underwent spectral domain OCT (SD-OCT) scanning dual beam Spectralis laser tracking tomography Spectralis®, using a commercially available device (3D OCT-1000; Topcon Corp., Tokyo, Japan). The scanning protocol involved the acquisition of a 6×6 mm cube scan of the Optic Nerve Head (ONH) and macula with a scan density of 512×128 pixels.

Results: Our study included 40 female patients with clinico-radiological diagnosis of IIH with their age range from 22 to 42 years, their main complaints were visual complaints as blurred vision and transient visual obscurations in 16 patients (40%), and headache in 15 patients (37.5%), while 9 patients (22.5%) had both complaints (table 1). None of our patients developed side effects or allergic reaction with the used contrast agent in orbital CT with contrast. The ONSD was nearly in the same range in both eyes (4-10 mm for right and 4-11 mm for left) when measured by CT with contrast at the crossing point of ophthalmic artery (table2). More than 82% (33) of patients diagnosed by OCT to have papilloedema while in 17% (7) of patients not (table 3). There was a statistical significant relation between the ONSD by OCT in both right and left sides with the diagnosis of IIH (P =0.003 for right, P= 0.001 for left) while there was no significant relation between PTC and patient's age (P= 0.921) (table 4). The estimated statistical cutoff value of ONSD was 5.5 mm with sensitivity of 84.4% and a specificity to diagnose optic nerve thickening by 100% in the left side and 85.7% in the right side (table 5, 6)

Conclusion: The addition of OCT to ONSD by CT+C can increase its diagnostic ability for the cases with IIH, which may reduce the need for invasive diagnostic techniques like LP.