Positive vitreous pressure (PVP) is common during open anterior segment surgery and penetrating k... more Positive vitreous pressure (PVP) is common during open anterior segment surgery and penetrating keratoplasty (PKP) has a reported incidence rate of 40-50%. Despite adequate perioperative preventive precautions, positive pressure occurs during surgery and optimum management of PVP is required to avoid serious complications. Many pharmacological and mechanical approaches can be employed either preoperatively or intraoperatively to decrease vitreous pressure. Surgical techniques such as graft-over-host technique, the modified graft-over-host technique, techniques employed mattress sutures and needle, or Vitreous aspiration or vitrectomy can be effectively used to manage intraoperative PVP during PPK. This article reviews the incidence, risk factors, prevention, and different approaches to the management of positive vitreous pressure during PKP to analyze the available evidence in order to improve the safety profile of PKP and prevent sight-threatening complications.
Introduction: To investigate the 24-month efficacy and safety of iStent inject trabecular microby... more Introduction: To investigate the 24-month efficacy and safety of iStent inject trabecular microbypass system implantation combined with phacoemulsification in subjects with primary open-angle glaucoma (POAG) and concomitant cataract. Methods: This prospective, uncontrolled, interventional case series included 36 eyes (29 subjects) with POAG of mild to moderate severity and coexisting cataract that underwent combined phacoemulsification and implantation of a second-generation trabecular microbypass stent (iStent injectÒ). Main outcome measures involved mean intraocular pressure (IOP), number of antiglaucoma medications, and proportional analysis of eyes with IOP B 18 mmHg or B 15 mmHg, or with 0 or C 2 glaucoma medications. Secondary outcome measures involved the cup-to-disc ratio, corrected distance visual acuity (CDVA), and adverse issues.
Purpose To report the efficacy and safety of MicroPulse transscleral laser therapy (TLT) and Kaho... more Purpose To report the efficacy and safety of MicroPulse transscleral laser therapy (TLT) and Kahook Dual Blade excisional goniotomy and goniosynechialysis combined with phacoemulsification for chronic angle-closure glaucoma (ACG). Patients and Methods A 39-year-old hyperopic female with a known history of ACG presented with a 2-week history of blurry vision, headache, and photophobia in the right eye (RE) following surgical peripheral iridectomy at another hospital. On examination, her uncorrected visual acuity was 20/50 in the RE, and 20/25 in the left eye (LE). Goldman applanation tonometry revealed an intraocular pressure (IOP) of 51 mmHg in the RE and 12 mmHg in the LE. Ocular examination of the RE revealed conjunctival hyperemia, corneal edema, shallow anterior chamber, posterior synechia, mid-dilated non-reactive pupil, and early cataractous changes. Anterior segment examination findings in the LE were normal except for a shallow anterior chamber. Gonioscopy revealed a closed ...
Purpose: To evaluate the impact of the current pandemic on ophthalmology residency training in Sa... more Purpose: To evaluate the impact of the current pandemic on ophthalmology residency training in Saudi Arabia, focusing on its effects on clinical education, training, and the mental well-being of the trainees. Methods: An online self-administered questionnaire was distributed among residents in the Saudi ophthalmology training programs between July 7 and 14, 2020. In this study, we explored residents' opinions regarding training disruption and virtual education. The patient health questionnaire (PHQ-9) was used to assess the COVID-19 pandemic's impact on their mental health. We used descriptive statistics for data analysis. Results: Out of 183 registered ophthalmology residents, 142 participated in this study. Ninety-six participants (35.4%) were rotated at a specialized eye hospital during the COVID-19 pandemic, while 52 (19.2%) had rotations in the ophthalmology department at general hospitals. Those who rotated in both types of hospitals were 123 (45.4%). According to the participants, there was a significant decline in exposure to surgical and office-based procedures compared to emergency eye consultations (Friedman P <0.001). The COVID-19 pandemic's effect on mental health was reported by 100 (70.5%) participants. Eighty-five (55.4%) respondents were satisfied with the virtual method of education. Conclusion: COVID-19 pandemic has disrupted residents' clinical and surgical training in the Saudi ophthalmology training programs. Additionally, we believe that COVID-19 may have a negative impact on trainees' mental health. Fortunately, the current pandemic provided an innovative education method that will likely be used even after the pandemic.
Purpose: To report the surgical outcomes of combined gonioscopy-assisted transluminal trabeculoto... more Purpose: To report the surgical outcomes of combined gonioscopy-assisted transluminal trabeculotomy (GATT) with ab interno canaloplasty (ABiC) in conjunction with phacoemulsification for primary open-angle glaucoma (POAG). Patients and Methods: This prospective, interventional, non-comparative case series included POAG patients who underwent combined GATT and ABiC in conjunction with phacoemulsification performed between January 2018 and August 2018. Main outcome measures include surgical success rate, changes in intraocular pressure (IOP), number of antiglaucoma medications, corrected distance visual acuity (CDVA), and complications. Results: We enrolled twenty eyes of 19 patients in our study. The mean age was 61.2 ± 6 years, and all the patients completed a 12-month follow-up. The overall success rate was 100%. The mean baseline IOP was 19.75 ± 4.68 mmHg, and at 12 months, the mean IOP was 13.30 ± 1.30 mmHg (IOP reduction of 32.7%). The baseline number of antiglaucoma medications was 3.4 ± 0.6 (range: 2 to 4 medications), and after 12 months follow-up, the number was reduced to 1.1 ± 1.0 (range: 0 to 2 medications). The CDVA for all 20 eyes was 0.85±0.58 LogMAR at baseline, and 0.16±0.30 LogMAR at 12-month follow-up. Only six eyes developed hyphaema, which had cleared by the first postoperative month, and three eyes needed medical treatment for postoperative IOP spikes. Conclusion: The 12-month results of our study suggest that combined GATT with ABiC in conjunction with phacoemulsification is a safe and effective alternative in decreasing the IOP and number of antiglaucoma medications in POAG patients.
American Journal of Ophthalmology Case Reports, 2020
In this report, we describe a case of episcleritis that appeared to be the first sign of the nove... more In this report, we describe a case of episcleritis that appeared to be the first sign of the novel coronavirus disease (COVID-19). Observations: A 29-year-old man with no prior medical condition presented with a complaint of redness and foreign body sensation in his left eye, which started two days before his consultation. He had no history of decreased vision, pain, photophobia, discharge, ocular surgery, or trauma. He had no symptoms in his fellow eye nor did he have any systemic symptoms. External examination of his left eye revealed a sectoral nasal conjunctival and episcleral injection and a clear cornea. There was no scleral edema. A diagnosis of episcleritis was made based on clinical grounds and topical fluorometholone 0.1%. was started. Three days later, the patient presented with headache, shortness of breath, cough, and fever (39.2 • C). Real-time fluorescence polymerase chain reaction test of his nasopharyngeal swab returned a positive result for COVID-19. The patient was then admitted for observation and supportive therapy. After five days, fever, respiratory and ocular symptoms were markedly improved and the patient was discharged and advised to isolate at home for 14 days. Conclusions and importance: This is the first report that describes episcleritis as a possible presenting sign of COVID-19. Understanding the association between ocular signs/symptoms and COVID-19 can aid in the diagnosis of the viral infection and can help in limiting its transmission.
Purpose: To evaluate the safety and efficacy of MicroPulse ® transscleral cyclophotocoagulation (... more Purpose: To evaluate the safety and efficacy of MicroPulse ® transscleral cyclophotocoagulation (µP-TSCPC) up to 24-months follow-up using a standardized fixed protocol in patients with various types of glaucoma. Methods: Prospective, nonrandomized, non-comparative interventional case series of µP-TSCPC performed by a single glaucoma surgeon at tertiary hospitals between May 2017 and May 2019. Results: A total of 71 eyes of 68 patients (39 males, 29 females) aged 60.0 years (13-89 years) were treated with µP-TSCPC. The most common diagnosis was neovascular glaucoma. The safety index of corrected distance visual acuity (CDVA) was 1.0, i.e. there was no significant change in CDVA postoperatively compared to baseline CDVA. The median baseline IOP was 35.0 mmHg (21.0-70.0 mmHg), which was reduced to 16 mmHg (8-32 mmHg) at 12 months/ last follow-up postoperatively (p<0.001, Wilcoxon signed-rank test). The median reduction in IOP was 52% (0.0-89%) at 12 months/last follow-up postoperatively compared to baseline. The median number of medications was 5 (3-5) at baseline compared to 4 (2-4) at 12 months/last follow-up postoperatively (p<0.001, Wilcoxon signed-rank test). The percent of eyes treated with systemic glaucoma medication was 62% (44) at baseline compared to 0% (0) at 12 months/ last follow-up postoperatively. The postoperative surgical success of 90%, 91.4%, and 95.7% at 2 weeks, 3 months, and 6 months respectively then remains unchanged. No significant adverse events or complications were observed. Conclusion: µP-TSCPC demonstrated good efficacy and safety profiles with minimal vision-threatening complications in treating a variety of glaucoma types.
Middle East African Journal of Ophthalmology, 2017
PURPOSE: The purpose of the study was to review the safety and stability of scleral-fixated intra... more PURPOSE: The purpose of the study was to review the safety and stability of scleral-fixated intraocular lens (IOL) 2 years after implantation in children with idiopathic ectopia lentis (EL). METHODS: This retrospective case series enrolled children with EL managed between 2011 and 2015 at a tertiary eye hospital in the eastern of Saudi Arabia. Data were collected on age, gender, vision, isolated or syndromic pathology, intraoperative and postoperative complications, spherical equivalent refraction, and final best-corrected visual acuity (BCVA). RESULTS: The series included 18 eyes of 11 children with EL (6 males and 5 females). There were 7 bilateral and 4 unilateral cases. The median age was 3.5 years (25% quartile 1 year; range: 1–8 years). Preoperatively, fixation was absent in 3 eyes, 8 eyes were fixating but vision could not be recorded. In the remaining seven eyes, median distant visual acuity was 0.1 (25% quartile: 0.08). The median postoperative follow-up was 24 months (25% quartile, 7 months). Complications included two eyes with iris capture and one eye with lens subluxation requiring re-implantation. Postoperative BCVA was better than 20/60 in 15 (83%) eyes. At last follow-up, 6 eyes required myopic correction, 1 eye was emmetropic, and 11 eyes were hypermetropic. One eye with glaucoma was managed medically. CONCLUSION: Scleral fixated IOL in eyes of young children with EL had good visual outcomes and high stability. However, there is a high incidence of residual refractive error.
A crucial role is played by personal biomedical data when it comes to maintaining proficient acce... more A crucial role is played by personal biomedical data when it comes to maintaining proficient access to health records by patients as well as health professionals. However, it is difficult to get a unified view pertaining to health data that have been scattered across various health centers/hospital sections. To be specific, health records are distributed across many places and cannot be integrated easily. In recent years, blockchain has arisen as a promising solution that helps to achieve the sharing of individual biomedical information in a secure way, whilst also having the benefit of privacy preservation because of its immutability. This research puts forward a blockchain-based managing scheme that helps to establish interpretation improvements pertaining to electronic biomedical systems. In this scheme, two blockchains were employed to construct the base, whereby the second blockchain algorithm was used to generate a secure sequence for the hash key that was generated in first b...
Blood perfusion quantification is important vital parameters in different diagnostic procedure, u... more Blood perfusion quantification is important vital parameters in different diagnostic procedure, using infrared thermography imaging; it is reliable to use this technique as non-contact, non-invasive blood flow measurement method. Therefore, we developed a measurement protocol for blood flow over the arm's anterior surface. By using the superficial brachial and radial veins to be monitored under the impact of cold-excitation of (2 °C to 5 °C), the blood perfusion signal was detected using thermal imager of long-wave infrared spectral range (LWIR, 7μm - 14 μm). The simulation of Penne's bioheat transfer equation was performed to be compared with results obtained from the infrared thermography. Furthermore, the proposed blood flow monitoring using external adjusting of the excitation temperature, by using (cold-compress, or cold air-stream) applied to the region under testing. The signal detected resembles to the hemodynamic pulse of the superficial veins, in the ...
The focal and non-focal epilepsy is seen to be a chronic neurological brain disorder, which has a... more The focal and non-focal epilepsy is seen to be a chronic neurological brain disorder, which has affected ≈ 60 million people in the world. Hence, an early detection of the focal epileptic seizures can be carried out using the EEG signals, which act as a helpful tool for early diagnosis of epilepsy. Several EEG-based approaches have been proposed and developed to understand the underlying characteristics of the epileptic seizures. Despite the fact that the early results were positive, the proposed techniques cannot generate reproducible results and lack a statistical validation, which has led to doubts regarding the presence of the pre-ictal state. Various methodical and algorithmic studies have indicated that the transition to an ictal state is not a random process, and the build-up can lead to epileptic seizures. This study reviews many recently-proposed algorithms for detecting the focal epileptic seizures. Generally, the techniques developed for detecting the epileptic seizures were based on tensors, entropy, empirical mode decomposition, wavelet transform and dynamic analysis. The existing algorithms were compared and the need for implementing a practical and reliable new algorithm is highlighted. The research regarding the epileptic seizure detection research is more focused on the development of precise and non-invasive techniques for rapid and reliable diagnosis. Finally, the researchers noted that all the methods that were developed for epileptic seizure detection lacks standardization, which hinders the homogeneous comparison of the detector performance. INDEX TERMS Focal epilepsy, non-focal epilepsy, time and frequency domain features, nonlinear features, machine learning algorithms, EEG signal analysis.
We describe the case of a healthy 28-year-old woman who underwent implantation of a posterior cha... more We describe the case of a healthy 28-year-old woman who underwent implantation of a posterior chamber, phakic, toric, implantable Collamer lens (ICL) in both eyes for correction of bilateral high myopia with astigmatism. On the first postoperative day the patient developed increased intraocular pressure (IOP) and a fixed, mid-dilated pupil in her left eye. The elevated IOP was corrected within 3 days by medical treatment. However, the pupil remained mid-dilated and nonreactive to both light and accommodative effort during 2 months of follow-up; there was no reaction to pilocarpine (0.125% or 4%) eyedrops. The patient was diagnosed with Urrets-Zavalia syndrome (UZS), which has been reported in association with ICL implantation only once previously.
Purpose To evaluate the safety and efficacy of implantation of the Visian Implantable Collamer Le... more Purpose To evaluate the safety and efficacy of implantation of the Visian Implantable Collamer Lens phakic intraocular lens (pIOL) (spherical and toric models) for management of amblyopia due to anisometropic hyperopia and myopia in children. Design Retrospective case series. Setting Tertiary care eye specialty hospital, Dhahran, Saudi Arabia. Methods Eyes of patients who underwent the implantation of the pIOL for refractory anisometropic amblyopia were identified. None of the patients were compliant with spectacle/contact lens correction. Preoperative and postoperative clinical evaluation included visual acuity, cycloplegic refraction, slitlamp microscopy, intraocular pressure, orthoptic evaluation, anterior chamber depth, and ICL vault. Results A total of 11 eyes (9 myopic, 2 hyperopic) of 11 patients aged 5 to 15 years were identified. Of the 9 myopic eyes, 6 eyes received spherical ICLs and 3 received toric ICLs. Both hyperopic eyes received spherical ICLs. Preoperatively, the mean cycloplegic refractive spherical equivalent (CRSE) was −11.07 D (range −7.75 to −21.88 D) in myopic eyes, and +8.75 D (range +8.63 to +8.87 D) in hyperopic eyes. The mean corrected distance visual acuity (CDVA) was 20/171 (range 20/40 to 20/400) in myopic eyes, and 20/130 (range 20/60 to 20/200) in hyperopic eyes. At a mean follow‐up of 16.8 months (in myopic eyes), the mean CRSE was −1.40 D (range 0 to −2.25 D), and mean CDVA was 20/51 (range 20/20 to 20/100). In hyperopic eyes, at a mean follow‐up of 15 months, the mean CRSE was +1.82 D (range +1.75 to +1.88 D) and the CDVA had improved to 20/25 in both eyes. Although complications occurred in the 2 hyperopic eyes, the complications were either temporary or visually insignificant and did not necessitate reoperation or ICL explantation. Conclusion ICL implantation may be considered a safe and effective treatment option for refractory amblyopia due to anisometropic hyperopia or myopia in children who are noncompliant with conventional therapy. Financial Disclosure The authors have no financial or proprietary interest in a product, method, or material described herein.
We report the first case of secondary implantation of implantable collamer lens (ICL) for correct... more We report the first case of secondary implantation of implantable collamer lens (ICL) for correction of anisometropic hyperopia in a 3-year-old pseudophakic child. The ICL implantation was considered in our patient due to parental noncompliance for contact lens and spectacles use for one year. In terms of efficacy, the preoperative refractive error of +7.00-1.75 diopter (D) reduced to +1.00-1.75 D. The uncorrected distance visual acuity (UDVA) significantly improved from 20/400 (preoperatively) to 20/50 (postoperatively). In terms of safety, after an uneventful implantation surgery, the ICL was well tolerated, and remained well centered, with no serious postoperative complications encountered over a 22-month follow-up.
Middle East African Journal of Ophthalmology, 2015
Tuberculous (TB) conjunctivitis was not an uncommon condition before the early 20(th) century but... more Tuberculous (TB) conjunctivitis was not an uncommon condition before the early 20(th) century but is currently a rare occurrence, especially in the developed countries. We report a 27-year-old Saudi female who underwent enucleation of the right eye at the age of 20 following a penetrating eye injury. She had a history of miliary TB that was treated at the age of 22. She was presented with chronic purulent discharge from her right an anophthalmic socket for 2 months. Cultures for bacteria and fungi were sterile. There was no response to empirical topical antibiotics and steroids. Direct microscopic examination of conjunctival scrapings with the Ziehl-Neelsen staining revealed no microorganisms. Histopathological examination revealed epithelioid granulomas. Polymerase chain reaction was negative for Mycobacterium tuberculosis DNA. TB conjunctivitis was suspected from the history of miliary TB and presence of epithelioid granulomas. The definitive diagnosis was made after prompt resolution of the ocular signs with no recurrence only after systemic anti-TB therapy.
Positive vitreous pressure (PVP) is common during open anterior segment surgery and penetrating k... more Positive vitreous pressure (PVP) is common during open anterior segment surgery and penetrating keratoplasty (PKP) has a reported incidence rate of 40-50%. Despite adequate perioperative preventive precautions, positive pressure occurs during surgery and optimum management of PVP is required to avoid serious complications. Many pharmacological and mechanical approaches can be employed either preoperatively or intraoperatively to decrease vitreous pressure. Surgical techniques such as graft-over-host technique, the modified graft-over-host technique, techniques employed mattress sutures and needle, or Vitreous aspiration or vitrectomy can be effectively used to manage intraoperative PVP during PPK. This article reviews the incidence, risk factors, prevention, and different approaches to the management of positive vitreous pressure during PKP to analyze the available evidence in order to improve the safety profile of PKP and prevent sight-threatening complications.
Introduction: To investigate the 24-month efficacy and safety of iStent inject trabecular microby... more Introduction: To investigate the 24-month efficacy and safety of iStent inject trabecular microbypass system implantation combined with phacoemulsification in subjects with primary open-angle glaucoma (POAG) and concomitant cataract. Methods: This prospective, uncontrolled, interventional case series included 36 eyes (29 subjects) with POAG of mild to moderate severity and coexisting cataract that underwent combined phacoemulsification and implantation of a second-generation trabecular microbypass stent (iStent injectÒ). Main outcome measures involved mean intraocular pressure (IOP), number of antiglaucoma medications, and proportional analysis of eyes with IOP B 18 mmHg or B 15 mmHg, or with 0 or C 2 glaucoma medications. Secondary outcome measures involved the cup-to-disc ratio, corrected distance visual acuity (CDVA), and adverse issues.
Purpose To report the efficacy and safety of MicroPulse transscleral laser therapy (TLT) and Kaho... more Purpose To report the efficacy and safety of MicroPulse transscleral laser therapy (TLT) and Kahook Dual Blade excisional goniotomy and goniosynechialysis combined with phacoemulsification for chronic angle-closure glaucoma (ACG). Patients and Methods A 39-year-old hyperopic female with a known history of ACG presented with a 2-week history of blurry vision, headache, and photophobia in the right eye (RE) following surgical peripheral iridectomy at another hospital. On examination, her uncorrected visual acuity was 20/50 in the RE, and 20/25 in the left eye (LE). Goldman applanation tonometry revealed an intraocular pressure (IOP) of 51 mmHg in the RE and 12 mmHg in the LE. Ocular examination of the RE revealed conjunctival hyperemia, corneal edema, shallow anterior chamber, posterior synechia, mid-dilated non-reactive pupil, and early cataractous changes. Anterior segment examination findings in the LE were normal except for a shallow anterior chamber. Gonioscopy revealed a closed ...
Purpose: To evaluate the impact of the current pandemic on ophthalmology residency training in Sa... more Purpose: To evaluate the impact of the current pandemic on ophthalmology residency training in Saudi Arabia, focusing on its effects on clinical education, training, and the mental well-being of the trainees. Methods: An online self-administered questionnaire was distributed among residents in the Saudi ophthalmology training programs between July 7 and 14, 2020. In this study, we explored residents' opinions regarding training disruption and virtual education. The patient health questionnaire (PHQ-9) was used to assess the COVID-19 pandemic's impact on their mental health. We used descriptive statistics for data analysis. Results: Out of 183 registered ophthalmology residents, 142 participated in this study. Ninety-six participants (35.4%) were rotated at a specialized eye hospital during the COVID-19 pandemic, while 52 (19.2%) had rotations in the ophthalmology department at general hospitals. Those who rotated in both types of hospitals were 123 (45.4%). According to the participants, there was a significant decline in exposure to surgical and office-based procedures compared to emergency eye consultations (Friedman P <0.001). The COVID-19 pandemic's effect on mental health was reported by 100 (70.5%) participants. Eighty-five (55.4%) respondents were satisfied with the virtual method of education. Conclusion: COVID-19 pandemic has disrupted residents' clinical and surgical training in the Saudi ophthalmology training programs. Additionally, we believe that COVID-19 may have a negative impact on trainees' mental health. Fortunately, the current pandemic provided an innovative education method that will likely be used even after the pandemic.
Purpose: To report the surgical outcomes of combined gonioscopy-assisted transluminal trabeculoto... more Purpose: To report the surgical outcomes of combined gonioscopy-assisted transluminal trabeculotomy (GATT) with ab interno canaloplasty (ABiC) in conjunction with phacoemulsification for primary open-angle glaucoma (POAG). Patients and Methods: This prospective, interventional, non-comparative case series included POAG patients who underwent combined GATT and ABiC in conjunction with phacoemulsification performed between January 2018 and August 2018. Main outcome measures include surgical success rate, changes in intraocular pressure (IOP), number of antiglaucoma medications, corrected distance visual acuity (CDVA), and complications. Results: We enrolled twenty eyes of 19 patients in our study. The mean age was 61.2 ± 6 years, and all the patients completed a 12-month follow-up. The overall success rate was 100%. The mean baseline IOP was 19.75 ± 4.68 mmHg, and at 12 months, the mean IOP was 13.30 ± 1.30 mmHg (IOP reduction of 32.7%). The baseline number of antiglaucoma medications was 3.4 ± 0.6 (range: 2 to 4 medications), and after 12 months follow-up, the number was reduced to 1.1 ± 1.0 (range: 0 to 2 medications). The CDVA for all 20 eyes was 0.85±0.58 LogMAR at baseline, and 0.16±0.30 LogMAR at 12-month follow-up. Only six eyes developed hyphaema, which had cleared by the first postoperative month, and three eyes needed medical treatment for postoperative IOP spikes. Conclusion: The 12-month results of our study suggest that combined GATT with ABiC in conjunction with phacoemulsification is a safe and effective alternative in decreasing the IOP and number of antiglaucoma medications in POAG patients.
American Journal of Ophthalmology Case Reports, 2020
In this report, we describe a case of episcleritis that appeared to be the first sign of the nove... more In this report, we describe a case of episcleritis that appeared to be the first sign of the novel coronavirus disease (COVID-19). Observations: A 29-year-old man with no prior medical condition presented with a complaint of redness and foreign body sensation in his left eye, which started two days before his consultation. He had no history of decreased vision, pain, photophobia, discharge, ocular surgery, or trauma. He had no symptoms in his fellow eye nor did he have any systemic symptoms. External examination of his left eye revealed a sectoral nasal conjunctival and episcleral injection and a clear cornea. There was no scleral edema. A diagnosis of episcleritis was made based on clinical grounds and topical fluorometholone 0.1%. was started. Three days later, the patient presented with headache, shortness of breath, cough, and fever (39.2 • C). Real-time fluorescence polymerase chain reaction test of his nasopharyngeal swab returned a positive result for COVID-19. The patient was then admitted for observation and supportive therapy. After five days, fever, respiratory and ocular symptoms were markedly improved and the patient was discharged and advised to isolate at home for 14 days. Conclusions and importance: This is the first report that describes episcleritis as a possible presenting sign of COVID-19. Understanding the association between ocular signs/symptoms and COVID-19 can aid in the diagnosis of the viral infection and can help in limiting its transmission.
Purpose: To evaluate the safety and efficacy of MicroPulse ® transscleral cyclophotocoagulation (... more Purpose: To evaluate the safety and efficacy of MicroPulse ® transscleral cyclophotocoagulation (µP-TSCPC) up to 24-months follow-up using a standardized fixed protocol in patients with various types of glaucoma. Methods: Prospective, nonrandomized, non-comparative interventional case series of µP-TSCPC performed by a single glaucoma surgeon at tertiary hospitals between May 2017 and May 2019. Results: A total of 71 eyes of 68 patients (39 males, 29 females) aged 60.0 years (13-89 years) were treated with µP-TSCPC. The most common diagnosis was neovascular glaucoma. The safety index of corrected distance visual acuity (CDVA) was 1.0, i.e. there was no significant change in CDVA postoperatively compared to baseline CDVA. The median baseline IOP was 35.0 mmHg (21.0-70.0 mmHg), which was reduced to 16 mmHg (8-32 mmHg) at 12 months/ last follow-up postoperatively (p<0.001, Wilcoxon signed-rank test). The median reduction in IOP was 52% (0.0-89%) at 12 months/last follow-up postoperatively compared to baseline. The median number of medications was 5 (3-5) at baseline compared to 4 (2-4) at 12 months/last follow-up postoperatively (p<0.001, Wilcoxon signed-rank test). The percent of eyes treated with systemic glaucoma medication was 62% (44) at baseline compared to 0% (0) at 12 months/ last follow-up postoperatively. The postoperative surgical success of 90%, 91.4%, and 95.7% at 2 weeks, 3 months, and 6 months respectively then remains unchanged. No significant adverse events or complications were observed. Conclusion: µP-TSCPC demonstrated good efficacy and safety profiles with minimal vision-threatening complications in treating a variety of glaucoma types.
Middle East African Journal of Ophthalmology, 2017
PURPOSE: The purpose of the study was to review the safety and stability of scleral-fixated intra... more PURPOSE: The purpose of the study was to review the safety and stability of scleral-fixated intraocular lens (IOL) 2 years after implantation in children with idiopathic ectopia lentis (EL). METHODS: This retrospective case series enrolled children with EL managed between 2011 and 2015 at a tertiary eye hospital in the eastern of Saudi Arabia. Data were collected on age, gender, vision, isolated or syndromic pathology, intraoperative and postoperative complications, spherical equivalent refraction, and final best-corrected visual acuity (BCVA). RESULTS: The series included 18 eyes of 11 children with EL (6 males and 5 females). There were 7 bilateral and 4 unilateral cases. The median age was 3.5 years (25% quartile 1 year; range: 1–8 years). Preoperatively, fixation was absent in 3 eyes, 8 eyes were fixating but vision could not be recorded. In the remaining seven eyes, median distant visual acuity was 0.1 (25% quartile: 0.08). The median postoperative follow-up was 24 months (25% quartile, 7 months). Complications included two eyes with iris capture and one eye with lens subluxation requiring re-implantation. Postoperative BCVA was better than 20/60 in 15 (83%) eyes. At last follow-up, 6 eyes required myopic correction, 1 eye was emmetropic, and 11 eyes were hypermetropic. One eye with glaucoma was managed medically. CONCLUSION: Scleral fixated IOL in eyes of young children with EL had good visual outcomes and high stability. However, there is a high incidence of residual refractive error.
A crucial role is played by personal biomedical data when it comes to maintaining proficient acce... more A crucial role is played by personal biomedical data when it comes to maintaining proficient access to health records by patients as well as health professionals. However, it is difficult to get a unified view pertaining to health data that have been scattered across various health centers/hospital sections. To be specific, health records are distributed across many places and cannot be integrated easily. In recent years, blockchain has arisen as a promising solution that helps to achieve the sharing of individual biomedical information in a secure way, whilst also having the benefit of privacy preservation because of its immutability. This research puts forward a blockchain-based managing scheme that helps to establish interpretation improvements pertaining to electronic biomedical systems. In this scheme, two blockchains were employed to construct the base, whereby the second blockchain algorithm was used to generate a secure sequence for the hash key that was generated in first b...
Blood perfusion quantification is important vital parameters in different diagnostic procedure, u... more Blood perfusion quantification is important vital parameters in different diagnostic procedure, using infrared thermography imaging; it is reliable to use this technique as non-contact, non-invasive blood flow measurement method. Therefore, we developed a measurement protocol for blood flow over the arm's anterior surface. By using the superficial brachial and radial veins to be monitored under the impact of cold-excitation of (2 °C to 5 °C), the blood perfusion signal was detected using thermal imager of long-wave infrared spectral range (LWIR, 7μm - 14 μm). The simulation of Penne's bioheat transfer equation was performed to be compared with results obtained from the infrared thermography. Furthermore, the proposed blood flow monitoring using external adjusting of the excitation temperature, by using (cold-compress, or cold air-stream) applied to the region under testing. The signal detected resembles to the hemodynamic pulse of the superficial veins, in the ...
The focal and non-focal epilepsy is seen to be a chronic neurological brain disorder, which has a... more The focal and non-focal epilepsy is seen to be a chronic neurological brain disorder, which has affected ≈ 60 million people in the world. Hence, an early detection of the focal epileptic seizures can be carried out using the EEG signals, which act as a helpful tool for early diagnosis of epilepsy. Several EEG-based approaches have been proposed and developed to understand the underlying characteristics of the epileptic seizures. Despite the fact that the early results were positive, the proposed techniques cannot generate reproducible results and lack a statistical validation, which has led to doubts regarding the presence of the pre-ictal state. Various methodical and algorithmic studies have indicated that the transition to an ictal state is not a random process, and the build-up can lead to epileptic seizures. This study reviews many recently-proposed algorithms for detecting the focal epileptic seizures. Generally, the techniques developed for detecting the epileptic seizures were based on tensors, entropy, empirical mode decomposition, wavelet transform and dynamic analysis. The existing algorithms were compared and the need for implementing a practical and reliable new algorithm is highlighted. The research regarding the epileptic seizure detection research is more focused on the development of precise and non-invasive techniques for rapid and reliable diagnosis. Finally, the researchers noted that all the methods that were developed for epileptic seizure detection lacks standardization, which hinders the homogeneous comparison of the detector performance. INDEX TERMS Focal epilepsy, non-focal epilepsy, time and frequency domain features, nonlinear features, machine learning algorithms, EEG signal analysis.
We describe the case of a healthy 28-year-old woman who underwent implantation of a posterior cha... more We describe the case of a healthy 28-year-old woman who underwent implantation of a posterior chamber, phakic, toric, implantable Collamer lens (ICL) in both eyes for correction of bilateral high myopia with astigmatism. On the first postoperative day the patient developed increased intraocular pressure (IOP) and a fixed, mid-dilated pupil in her left eye. The elevated IOP was corrected within 3 days by medical treatment. However, the pupil remained mid-dilated and nonreactive to both light and accommodative effort during 2 months of follow-up; there was no reaction to pilocarpine (0.125% or 4%) eyedrops. The patient was diagnosed with Urrets-Zavalia syndrome (UZS), which has been reported in association with ICL implantation only once previously.
Purpose To evaluate the safety and efficacy of implantation of the Visian Implantable Collamer Le... more Purpose To evaluate the safety and efficacy of implantation of the Visian Implantable Collamer Lens phakic intraocular lens (pIOL) (spherical and toric models) for management of amblyopia due to anisometropic hyperopia and myopia in children. Design Retrospective case series. Setting Tertiary care eye specialty hospital, Dhahran, Saudi Arabia. Methods Eyes of patients who underwent the implantation of the pIOL for refractory anisometropic amblyopia were identified. None of the patients were compliant with spectacle/contact lens correction. Preoperative and postoperative clinical evaluation included visual acuity, cycloplegic refraction, slitlamp microscopy, intraocular pressure, orthoptic evaluation, anterior chamber depth, and ICL vault. Results A total of 11 eyes (9 myopic, 2 hyperopic) of 11 patients aged 5 to 15 years were identified. Of the 9 myopic eyes, 6 eyes received spherical ICLs and 3 received toric ICLs. Both hyperopic eyes received spherical ICLs. Preoperatively, the mean cycloplegic refractive spherical equivalent (CRSE) was −11.07 D (range −7.75 to −21.88 D) in myopic eyes, and +8.75 D (range +8.63 to +8.87 D) in hyperopic eyes. The mean corrected distance visual acuity (CDVA) was 20/171 (range 20/40 to 20/400) in myopic eyes, and 20/130 (range 20/60 to 20/200) in hyperopic eyes. At a mean follow‐up of 16.8 months (in myopic eyes), the mean CRSE was −1.40 D (range 0 to −2.25 D), and mean CDVA was 20/51 (range 20/20 to 20/100). In hyperopic eyes, at a mean follow‐up of 15 months, the mean CRSE was +1.82 D (range +1.75 to +1.88 D) and the CDVA had improved to 20/25 in both eyes. Although complications occurred in the 2 hyperopic eyes, the complications were either temporary or visually insignificant and did not necessitate reoperation or ICL explantation. Conclusion ICL implantation may be considered a safe and effective treatment option for refractory amblyopia due to anisometropic hyperopia or myopia in children who are noncompliant with conventional therapy. Financial Disclosure The authors have no financial or proprietary interest in a product, method, or material described herein.
We report the first case of secondary implantation of implantable collamer lens (ICL) for correct... more We report the first case of secondary implantation of implantable collamer lens (ICL) for correction of anisometropic hyperopia in a 3-year-old pseudophakic child. The ICL implantation was considered in our patient due to parental noncompliance for contact lens and spectacles use for one year. In terms of efficacy, the preoperative refractive error of +7.00-1.75 diopter (D) reduced to +1.00-1.75 D. The uncorrected distance visual acuity (UDVA) significantly improved from 20/400 (preoperatively) to 20/50 (postoperatively). In terms of safety, after an uneventful implantation surgery, the ICL was well tolerated, and remained well centered, with no serious postoperative complications encountered over a 22-month follow-up.
Middle East African Journal of Ophthalmology, 2015
Tuberculous (TB) conjunctivitis was not an uncommon condition before the early 20(th) century but... more Tuberculous (TB) conjunctivitis was not an uncommon condition before the early 20(th) century but is currently a rare occurrence, especially in the developed countries. We report a 27-year-old Saudi female who underwent enucleation of the right eye at the age of 20 following a penetrating eye injury. She had a history of miliary TB that was treated at the age of 22. She was presented with chronic purulent discharge from her right an anophthalmic socket for 2 months. Cultures for bacteria and fungi were sterile. There was no response to empirical topical antibiotics and steroids. Direct microscopic examination of conjunctival scrapings with the Ziehl-Neelsen staining revealed no microorganisms. Histopathological examination revealed epithelioid granulomas. Polymerase chain reaction was negative for Mycobacterium tuberculosis DNA. TB conjunctivitis was suspected from the history of miliary TB and presence of epithelioid granulomas. The definitive diagnosis was made after prompt resolution of the ocular signs with no recurrence only after systemic anti-TB therapy.
Uploads
Papers by Ahmed Habash