A role for optometrists in emergency departments?

Optometrists display a good ability to correctly identify and manage patients in busy accident and emergency (A&E) departments, according to a report published in the April issue of the British Journal of Ophthalmology.

A total of 150 subjects were assessed and the agreement in primary diagnosis and management between the two groups were 89.3% and 79.3%, respectively. A high level of agreement in management outcomes was found and no sight-threatening conditions were misdiagnosed by the optometrist.

Myopia could be mistaken for glaucoma in some

A study published in the March issue of Ophthalmology, has found that many young and middle-aged people of Chinese ancestry who are told they have glaucoma may actually be misdiagnosed. These patients who do not show disease progression may, in fact, have glaucoma-like symptoms caused by myopia.

Amish Doshi, MD and colleagues from Stanford University, USA, observed more than 100 cases and fully reviewed the medical records of 16 Chinese men (average age 38.9 years) who had ocular symptoms suggestive of glaucoma. Average intraocular pressures (IOPs) ranged from 13.5 mmHg to 17.9 mmHg and 56.3% of subjects were using IOP-lowering medications.

Over a seven-year follow-up period, none of the subjects showed either progressive optic nerve cupping or visual field loss, regardless of whether they used anti-glaucoma medications.

Researchers discovered that 43.8% of eyes had myopia greater than 6 D, 75% of eyes had tilted discs and 81.3% of optic nerves had peripapillary atrophy. Cup-to-disc ratios averaged 0.56. The most common visual field defect was an arcuate defect, found in 31.3% of subjects.

The researchers believe that progressive myopia may have caused a strain gradient that affected susceptible axons in the preliminary optic nerve head tissue, leading to vision loss. The condition is now being studied in a larger population sample.

Statin use reduces cataract & AMD risk

Statins may have protective effects on the development of both cataract and age-related macular degeneration (AMD), according to a report published in the April issue of the American Journal of Ophthalmology.

Jennifer Tan and colleagues from the Centre for Vision Research, University of Sydney, Australia examined the relationship between statin use and long-term incidence of cataract and AMD using participants from the Blue Mountains Eye Study.

A total of 2,335 participants were re-examined at five years and 1,952 at 10 years. After controlling for age and gender, compared with non-users, statin users had a reduced risk of developing indistinct soft drusen, the principal late AMD precursor lesion (hazard ratio, 0.33; 95% confidence interval, 0.13 to 0.84).

The authors also discovered that statin use can reduce the risk of cataract development by up to 50%.

Digital technology could drastically improve diabetic retinopathy screening

Digital imaging technology, used during primary care visits, can significantly improve screening rates for diabetic retinopathy, according to a report published in the March issue of Diabetes Care.