JAMA ophthalmology
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The timing and indications for repair of orbital floor fractures have been controversial. Current practice dictates that fractures involving more than 50% of the orbital floor should be repaired. Early management is initiated in such situations to prevent long-term sequelae of enophthalmos and diplopia. Because fracture size as measured by computed tomography (CT) is one of the criteria to determine the need for surgical repair, there is a need to know the reliability of this parameter. ⋯ Although the literature has long held that a floor fracture seen radiographically to involve 50% of the orbital floor has a high likelihood of enophthalmia and should be repaired, this study shows how variable CT measurements of orbital floor fractures can be in a clinical setting, even in trained hands. We question the dependence on such a criterion and reemphasize the importance of making surgical decisions based on clinical findings rather than radiological interpretations.
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Multicenter Study
Baseline factors predictive of visual prognosis in acute postoperative bacterial endophthalmitis in patients undergoing cataract surgery.
Although rare, postoperative endophthalmitis in patients undergoing cataract surgery can lead to anatomical or functional loss of the eye. Therapeutic strategies such as antibiotic prophylaxis and microbiological diagnosis are more effective with a target patient population. New prospective data are needed to identify prognostic factors. ⋯ Most clinical outcome factors in acute postoperative endophthalmitis can be identified at presentation. The bacterial virulence level is the main factor predictive of the final visual prognosis.
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Follow-up at 30 months' corrected age reveals eye and visual problems in one-third of children born extremely prematurely (<27 weeks' gestation). ⋯ One-third of the extremely prematurely born children in this study had some kind of eye or visual problems, such as visual impairment, strabismus, or major refractive error. Despite being born extremely preterm, the present cohort has a similar prevalence of blindness and visual impairment as in previous Swedish cohorts of children born less prematurely.
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Telemedicine is a useful clinical method to extend health care to patients with limited access. Minimal information exists on the subsequent effect of telemedicine activities on eye care resources. ⋯ Although a teleretinal screening program can be accurate and sensitive for multiple visually significant diagnoses, measurable resource burdens should be anticipated to adequately prepare for the associated increase in clinical care.