Both LD and SD burns during cyclophotocoagulation effectively lowered IOP at 1 year. Neither treatment resulted in a greater reduction of IOP. LD treatment appeared to result in a decrease in VA and greater postoperative inflammation.

Purpose:The aim was to determine the frequency and describe the main histopathologic features of corneal stromal dystrophy in Saudi Arabia.Methods:A single-center, retrospective analysis of 193 corneal specimens diagnosed with stromal dystrophy. All samples were retrieved from the Histopathology Department at King Khaled Eye Specialist Hospital over a 10-year period (2002 to December 31, 2011). Cases of stromal dystrophy undergoing keratoplasty were included in the study. Routine histopathologic stains and specific stains were used to determine a diagnosis. The corresponding demographic data and basic clinical/surgical information were collected via chart review.Results:The study sample was comprised of 193 eyes. The final diagnoses were macular corneal dystrophy (MCD) in 180 (93.26%) eyes, granular corneal dystrophy (GCD) in 9 (4.66%) and lattice corneal dystrophy (LCD) in 4 (2.07%) eyes. The mean age at presentation was 27.03 years for MCD, 26.33 years for GCD and 53.75 years for LCD. The interval between diagnosis and surgical intervention was not statistically different between the macular and granular groups (P = 0.141). There was a positive family history for the MCD (37.22%) and GCD (44.44%) groups. All eyes underwent penetrating keratoplasty (PKP) except 10 MCD cases that underwent lamellar keratoplasty. Diffuse stromal deposits were present in 87.2% of MCD corneas and 66.67% of GCD corneas. Seventeen eyes with MCD were misdiagnosed as GCD. None of the LCD cases were clinically identified since all of these cases were diagnosed as corneal scarring. In eyes with MCD that underwent PKP, there was diffuse stromal involvement (in 87.22% eyes) and changes in Descemet's membrane (in 53.5% eyes).Conclusion:This pathological study suggested that MCD was the most common corneal stromal dystrophy that required keratoplasty in Saudi Arabia. Patient with MCD and GCD presented at a significantly younger age than LCD. The clinical diagnosis of MCD is not achieved in all cases likely due to a more severe phenotype in the Saudi population or the presence of corneal scarring that is associated with previous trachoma, which obscures the classical appearance of LCD. We believe that PKP is first-line surgical treatment, especially for MCD because it involves all corneal layers. However, deep stromal involvement and changes in Descemet's membrane in MCD should be considered when selecting the surgical procedure.

Background: For early detection and timely management of strabismus in children, parent’s cooperation is essential. It depends upon their level of awareness. The objective was to describe the determinants and the level of knowledge and attitude towards strabismus among parents of children with strabismus in Saudi Arabia.Methods: This cross-sectional study was conducted in 2018 at a hospital in Qaseem, Saudi Arabia. Consented parents of children with strabismus presenting to Qaseem University eye clinic were interviewed. Data were anonymously collected on participant demographics and the child’s strabismus. The survey interview consisted of 8 questions related to signs, symptoms, and management of strabismus. Three questions related to the attitude towards strabismus among parents/caregivers. Two separate questions queried the source of knowledge and possible barriers, respectively.Results: Each parent of 81 children was interviewed. An excellent level of knowledge of strabismus was noted for 41 participants (50.6% at 95%CI 39.7-61.5). A positive attitude towards strabismus was noted in 57 participants (70.4% at 95% CI 60.4-80.3). No history of surgery was statistically associated to an excellent level of knowledge (P<0.001). Gender (P=0.7), age (P=0.7), father’s education (P=0.3), mother’s education (P=0.5), type of strabismus (P=0.8) were not associated with the level of knowledge. High cost (43.2%) and false beliefs (53.1%) were the main barriers to medical consultations.Conclusions: Parents of children with strabismus presenting to a tertiary care eye hospital had good knowledge about the signs, symptoms and management of strabismus. Addressing barriers perceived by parents may improve early presentation rates of children with strabismus allowing timely management.

CYP1B1 mutation related congenital glaucoma can present with an extreme form of anterior segment dysgenesis that includes recalcitrant glaucoma, corneal opacification and aniridia.

A 34-year-old female with Usher syndrome, but no family history of similar illness, presented with complaints of vision reduction, redness, and photophobia. Biomicroscopic examination showed mildly injected conjunctivae bilateral, small, round keratic precipitates; bilateral +2 cells with no flare reaction in the anterior chamber; and bilateral posterior subcapsular cataracts. No associated posterior synechiae, angle neovascularization, or iris changes were detected; normal intraocular pressures were obtained. Fundus examination demonstrated waxy pallor of both optic nerves, marked vasoconstriction in retinal vessels, and retinal bone spicule pigment formation, with a normal macula. Electroretinography confirmed the diagnosis of retinitis pigmentosa, optical coherent tomography was normal and otolaryngology consultation was conducted. To our knowledge, an association between Usher syndrome and bilateral nongranulomatous anterior uveitis has not been previously reported, and our purpose is to report this association.