PURPOSE: To determine the prevalence of refractive errors among Saudi adults in Riyadh, Saudi Arabia. METHODS: A cross-sectional study was conducted targeting healthy Saudi adults (20–40 years old) at two major gatherings in Riyadh, Saudi Arabia from December 2018 to January 2019. Refractive errors were measured, and data pertaining to age, sex, region of origin, and spectacle use was collected. Clinically significant myopia was defined as SE ≥ -0.50 D, hyperopia as SE ≥ 0.50D, and astigmatism as cylindrical error ≥ 0.50D. Refractive error measurements were assessed using Topcon's Auto-Kerato-Refractometer, KR-800. RESULTS: A total of 660 adult individuals (1,319 eyes) were included in this study, of which 321 participants (48.7%) were found to be myopes, 167 subjects (25.2%) were hyperopes, and 438 individuals (66.3%) had astigmatism. With regards to correlations, myopia was highly correlated with being male ( P -value = 0.036), belonging to age group 20–25 years ( P -value = 0.033), originating from the northern regions of Saudi Arabia ( P -value <0.001). Similarly, hyperopia was significantly correlated with being male ( P -value = 0.048), age groups 20–25 years ( P -value = 0.04), and 31–35 years ( P -value = 0.011) and was higher in people from northern region ( P -value = 0.011). In contrast, astigmatism was only found to be correlated with age group 36–40 years ( P -value = 0.002). Additionally, 71.7% of myopic participants and 76.1% of astigmatic individuals opted not to wear spectacles ( P -value <0.001). CONCLUSION: In this study, the refractive error with the highest prevalence among Saudis was astigmatism, followed by myopia and hyperopia. Gender, region of origin, and spectacle wear were all observed to be highly correlated with higher rates of refractive error.

Background Goiter is a common presenting sign of various thyroid diseases in children. Thyroid nodules are clinically and/or radiologically significant findings due to their high malignancy rate. The ultrasound (US) characteristics of pediatric patients with goiter are rarely reported in literature; thus, the purpose of this study is to assess the characteristics of thyroid US and the prevalence of thyroid nodules in pediatric patients with goiter. Methods A retrospective review of children and adolescents under the age of 18 (2015–2020) referred for neck ultrasound due to goiter in clinical examination. Results A total of 262 patients were included with a mean age of 13.77 ± 3.7 years. Thyroid antibodies were positive in 119/262 (45.4%) patients. Thyroid US reported to be abnormal in 210/262 (80%) patients. Thyroid nodule were found in 33.6% (n = 88/262) of patients with goiter and in 41.9% (n = 88/210) of patients with abnormal thyroid US result. Patients with positive antibodies had more of heterogeneity and hypervascularity of the gland on thyroid US (P < 0.001). On the other hand, thyroid nodules were more likely to be presented in patients with negative thyroid antibodies (P = 0.025). The heterogeneity within the thyroid positive group was significantly correlated with increasing TPOAb (P < 0.001) and TSH levels (P < 0.028). Heterogeneity on US had a positive predictive value (P = 0.041), while hypervascularity had low prediction for thyroid nodules (P = 0.022). Age, gender, family history of thyroid diseases, antibodies status and echogenicity in US did not show any significant associations with thyroid nodules. Papillary thyroid carcinoma was diagnosed in six patients and one of these patients was positive for thyroid antibodies. Conclusion Thyroid nodules are quite common in our population. Thyroid nodules were significantly associated with heterogeneity in US. Although, no clinical or biochemical factors could predict the presence of thyroid nodules on thyroid US in our cohort, the absence of thyroid antibodies should lower the threshold for performing thyroid US.

IntroductionTo evaluate the outcomes of the superior oblique split tendon lengthening (SOSL) procedure for Brown syndrome (BS).MethodsAt a single institution, all patients who underwent SOSL surgery for BS from 2013 to 2019 were reviewed retrospectively. We looked at the surgical outcomes and complications in a total of 20 eyes of 18 patients. The superior oblique (SO) muscle was isolated and then extended. The tendon was then split centrally into equal halves. Two 6–0 polyglactin sutures were then placed on each end of the split tendon 6–10 mm apart. To complete the Z-cut, the split tendon was cut distal to the preplaced sutures. The sutures were then tied to produce the split Z-tendon lengthening.ResultsEleven (55%) out of 20 eyes were female patients. The mean age was 6.6 years (range 2–17 years). The mean follow-up was 26.8 months (range 5–72 months). The mean degree of preoperative limitation of elevation on adduction was −3.6±0.58 preoperatively and −0.75±1.25 postoperatively (p=0.0001). Preoperatively, the mean degree of vertical deviation at near was 3.5±7.62 and at distance was 3.10±7.84 prism diopters (PD), respectively. Postoperatively, the mean vertical deviation was 2.77±4.75 and 2.10±4.08 PD at near and distance, respectively. Postoperative complications included haematoma in one patient (5%), overcorrection in two patients (10%) and one patient required reoperation (5%).ConclusionSOSL is a safe procedure that surgeons can consider in managing patients with BS.

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