The results of this randomized controlled study indicate that the first ophthalmic review after uneventful cataract surgery can be safely deferred until 2 weeks postoperatively in patients in whom a transient IOP spike would not be deemed clinically deleterious. Such a policy will enhance the efficiency of day-surgery units.
Physicians initiating long-term disulfiram therapy should be aware of these adverse effects. They should recommend annual ophthalmic reviews with visual field testing. Patients should be reassured with respect to the reversibility of these adverse effects.
Dear Sir:In the clinical laboratory, many workers spend prolonged periods at microscopy, but there is little appreciation of the range and severity of the work-related problems that may ensue. We administered a questionnaire to assess the magnitude of occupational problems associated with microscope use in the pathology laboratory.Laboratory personnel in Ireland were interviewed through an anonymized questionnaire. Ethical approval for the study was obtained from the St. James's and Federation of Dublin Voluntary Hospitals Ethics Committee. There were 62 respondents with equal numbers of males and females. The response rate was approximately 40%. Personnel were predominately histopathologists or cytopathologists working at consultant level. The majority were less than 50 years of age. Table 1 is a summary of the main results.This study reports a high incidence of visual and musculoskeletal problems (some serious) in the pathology laboratory associated with microscopy use. Three quarters reported episodic musculoskeletal problems involving predominately the neck, back, and shoulder and 20% noted repetitive strain injuries. More than half of those affected required some therapy and 5% had taken sick leave. Visual problems, predominately eye fatigue, were indicated by more than half the respondents. Interestingly quite a significant number of respondents who performed routine microscopy less than the median number of hours per week (20.5h) still reported quite a high incidence of either occupationally associated visual or musculoskeletal problems (39% and 26%, respectively). As expected, there was an increase in the reported visual and musculoskeletal problems once the median number of hours is exceeded (71% and 55%, respectively). Furthermore, the number of years working with a microscope did not have a major impact on the type of occupational injury sustained: Those respondents who worked less than the median number of years (14.5 years) reported a high incidence of either visual or musculoskeletal problems (65% and 32%, respectively) as did those who worked above the median number of years (45% and 42%, respectively).Microscopists should be aware for the potential for work-related illness. Previous studies, involving cytotechnologists and part-time microscopists, have reported similar high rates of neck, shoulder and back pain, eye strain, or headache as a result of working long hours with a conventional light microscope, and related these to the use of non-ergonomic workstations [1][2][3]. It is interesting that there is little fall in the number reporting occupational injuries compared with the older studies. Although specifics on microscope types was not assessed in the questionnaire, it is likely that newer generation microscopes were in use
We report a case involving a 75-year-old lady who presented to our department of ophthalmology complaining of a 1 day history of ocular pain and reduced vision in the right eye, associated with rigors and diarrhoea. This patient, who had undergone a right carotid endarterectomy (CEA) 4 days previously, was subsequently confirmed to have developed endogenous endophthalmitis. To our knowledge, endogenous endopthalmitis has not previously been described as a postoperative complication of CEA, and should be considered in patients presenting with ocular complaints after this type of surgery.
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