Eye Disease

Background: Patients who suffer from ocular genetic diseases have special needs in terms of diagnosis and management of rare entities, low-vision needs, genetic counselling, and psychosocial adjustments that are usually not addressed by an ophthalmologist alone.The Ocular Genetics Program (OGP) at the Hospital for Sick Children,Toronto, was established in 1994 to provide comprehensive, multidisciplinary care of patients with inherited eye disorders.We now assess the benefits of such a program and of integrating research into the care of patients. Methods: We report our experience in developing a multidisciplinary ocular genetics program and the results of a pilot patient satisfaction survey that involved 61 patients. Results: The OGP multidisciplinary aspects are described. Of the 61 patients surveyed, 98% stated that they were satisfied with the OGP; 93%-96% of patients were content with "one day of appointments","understanding of eye problem", and "coordination of ancillary tests such as visual fields test, electrophysiology, and others"; and for 70%-86% of respondents "waiting time to get an appointment", "information received on current research", and "primary health care provider adequately informed" were satisfactory. Interpretation: The OGP is a unique service in Canada, which strives to provide the comprehensive care needed by ocular genetic patients. High patient satisfaction is an indicator of the success of this approach. Long waiting times for appointments and application of laboratory research in clinical care remain challenging. Contexte : Les patients qui souffrent d'une maladie oculaire d'ordre génétique ont des besoins particuliers en matière de diagnostic et de gestion d'entités rares, de déficience visuelle, de conseils génétiques et de rajustements psychosociaux que l'ophtalmologiste n'aborde ordinairement pas seul. Le programme de génétique oculaire (PGO) de l'Hospital for Sick Children, institution pédiatrique de Toronto, a été créé en 1994 pour prodiguer des soins compréhensifs et multidisciplinaires aux patients ayant une maladie oculaire héréditaire. Nous évaluons les bienfaits du programme et les avantages de l'intégration de la recherche aux soins des patients. Méthodes : Nous décrivons l'expérience que nous avons vécue lors de la création du programme de génétique oculaire ainsi que les résultats d'un sondage pilote sur la satisfaction des patients, effectué auprès de 61 personnes. Résultats : Les aspects multidisciplinaires du PGO sont décrits. Parmi les 61 patients interrogés, 98 % se sont dits satisfaits du PGO; 93 % à 96 % se sont dits contents des « rendez-vous d'une journée », de la « compréhension du problème oculaire » et de la « coordination des tests complémentaires, tels celui des champs visuels, l'électrophysiologie et autres »; 70 % à 86 % des répondants ont trouvé satisfaisants la « durée d'attente pour obtenir un rendez-vous », « l'information reçue sur la recherche en cours » et le « caractère adéquat de l'information transmise aux préposés aux soins primaires ». Interprétation : Le PGO, qui est unique en son genre au Canada, s'efforce de fournir toute la gamme des soins dont ont besoin les patients atteints d'une maladie oculaire d'ordre génétique. Le degré élevé de satisfaction des patients indique la réussite de cette approche. Le défi demeure quant au délai d'attente des rendez-vous et l'application de la recherche de laboratoire aux soins cliniques.

PURPOSE. The authors recently used topical endoscopy to image the mouse eye fundus. Here, they widened the field of application for this ophthalmologic tool, imaging both the posterior and the anterior eye segments in larger animals commonly encountered in research laboratories and veterinary clinics. METHODS. Pupils were dilated, and local anesthetic and gel were applied to the animal cornea. The endoscopic probe was placed in contact with the cornea of conscious rats, sedated cats and dogs, anesthetized sheep, and nonhuman primates. RESULTS. High-resolution digital images of the eye fundus were obtained in all investigated animals using the endoscopic probe along the eye axis. Arteriovenous filling time was monitored with fluorescein angiography in pigmented rats. The retinal periphery and ciliary bodies could be visualized with the probe placed at an oblique angle. The probe was inclined further to observe the iridocorneal angle such that the pectinate ligaments could be seen at high resolution in cats. The authors used the probe on eyes with retinal detachment, luxation of a cataractous lens, and pigment infiltration in the iridocorneal angle, demonstrating its potential use in eye diseases. CONCLUSIONS. This topical endoscopic technique provides a unique tool for single eye examinations. The authors obtained a circular view of the anterior (iridocorneal angle) and the posterior (fundus) eye segments from all animal species studied. This technique is inexpensive and easy to use. It can be easily moved to the eye of the patient who cannot move to stand in front of classic apparatus, offering new opportunities in ophthalmology. (Invest Ophthalmol Vis Sci. 2008;49: 5168 -5174)

Diabetic retinopathy (DR) is a condition where the retina is damaged due to fluid leaking from the blood vessels into the retina. In extreme cases, the patient will become blind. Therefore, early detection of diabetic retinopathy is crucial to prevent blindness. Various image processing techniques have been used to identify the different stages of diabetes retinopathy. The application of non-linear features of the higher-order spectra (HOS) was found to be efficient as it is more suitable for the detection of shapes. The aim of this work is to automatically identify the normal, mild DR, moderate DR, severe DR and prolific DR. The parameters are extracted from the raw images using the HOS techniques and fed to the support vector machine (SVM) classifier. This paper presents classification of five kinds of eye classes using SVM classifier. Our protocol uses, 300 subjects consisting of five different kinds of eye disease conditions. We demonstrate a sensitivity of 82% for the classifier with the specificity of 88%.

Senior-Loken syndrome is a rare entity that combines familial juvenile nephronophthisis with retinal dystrophy. The eye disease may be congenital amaurosis of Leber type or pigmentary retinal degeneration and electroretinogram (ERG) helps in the diagnosis of these varieties. The disease progresses inexorably to chronic renal failure. Here is a case of twins with Senior-Loken syndrome emphasizing the importance of ophthalmic examination in children with renal failure, for determining a correct diagnosis. [Indian J Pediatr 2006; 73 (11) : 1041-1043]

To examine the association between age-related eye disease (ARED), visual impairment, and health-related quality of life (HRQOL). We used data from the 2006 and 2008 Behavioral Risk Factor Surveillance System to examine self-reported visual impairment and two HRQOL domains-physical impairment (including poor general health, physical unhealthy days, activity-limitation days, and disability) and mental distress (including mental unhealthy days, life dissatisfaction, major depression, lifetime depression, and anxiety) for people aged 65 years or older, by ARED status. People with any ARED were more likely than those without to report visual impairment as well as physical impairment and mental distress. The prevalence of visual impairment (P trend <0.001) and physical impairment (P trend <0.001) increased with increasing number of eye diseases after controlling for all covariates. There was no significant linear trend, however, in mental distress among people with one or more eye diseases. ARED was found to be associated with visual impairment and poorer HRQOL. Increasing numbers of AREDs were associated with increased levels of visual impairment and physical impairment, but were not associated with levels of mental distress.