1 (06) 2017

Bacterial keratitis: epidemiological features, risk factors, etiology

Sakovych V.N.¹, Volok S.I.², Malik L.P.², Isaev A.A.¹

¹SE «Dnepropetrovsk Medical Academy, of Ministry Health of Ukraine», Dnipro, Ukraine
²CE «Dnepropetrovsk Regional Clinical Ophthalmologic Hospital», Dnipro, Ukraine

Summary. The article is devoted to the scope and severity of bacterial keratitis of the eye, depending on risk factors (improper use of contact lenses, injury, surgery on the cornea surface skin diseases and eye adnexa, etc.) and type of pathogens (staphylococcus, pneumococci, streptococci, gonococci and pseudomonas aeruginosa). The results show the incidence of the scale compared to the epidemiological characteristics, risk factors and etiologic aspects of bacterial keratitis in the world, the severity and incidence of complications. The results presented in the literature works show an increasing number of bacterial keratitis as compared with previous years. Also in recent years, the emergence of bacterial strains that are resistant to many used in medical practice, antibiotics significantly reduces the effectiveness of the therapy. And the problem of evolutionary change agents structures and their biological properties dictate the need for clinical and microbiological monitoring, able to provide an adequate range of therapeutic and preventive measures.

Keywords: bacterial keratitis, prevalence, risk factors, etiology. 

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Received: 27 Oct. 2016

Published: April 2017

Glaucoma of pseudophakic and aphakic eyes

Veselovskaya Z.F.^{1, 2}, Veselovskaya N.N.^{1, 2}

1Kyiv Medical University, Kyiv, Ukraine
2Kyiv City Ophthalmologic Center, Kyiv City Clinical Hospital 1, Kyiv, Ukraine

Summary. Glaucoma of aphakic and pseudophakic eyes refers to a type of secondary glaucoma. It is fairly common complication of early and late postoperative period in patients with cataract.

Purpose. To analyze an experience of follow up and the treatment of aphakic and pseudophakic glaucoma.

Materials and methods. Modern literature were learned and summarized.

Results and discussion. The paper presents the current view on the problem of secondary glaucoma on pseudophakia and aphakia or so-called pseudophakic and aphakic glaucoma. Analysis of modern data allowed the authors to demonstrate the basic mechanisms of the development of these types of glaucoma, presenting a rather detailed description of them. The paper outlines the basic approaches to the prevention before and during the operation, the treatment of the possible intraoperative complications.

Keywords: glaucoma, pseudophakia, aphakia, pathogenesis, prevention, treatment.

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Received: 13 June 2016

Published: April 2017

Cost-effectiveness of screening for open angle glaucoma in developed countries

Tuulonen A.

University of Oulu, Oulu, Finland

Summary. As all developed countries are struggling with health care costs growing too large and too fast, the current performance and overburden of glaucoma services demand a reappraisal of current management strategies. The performance of the glaucoma care in western countries offers several opportunities to improve the simultaneous under- and over-diagnosis and treatment. Since available resources are finite, they should be targeted to produce the best eye health. There is an obvious need for prioritization of all interventions, including improving case finding. The limited evidence to date indicates that we do not have enough evidence to decide whether systematic population screening could be cost-effective in the developed world. This article gives an overview of the methods of economic evaluation and the evidence on cost-effectiveness of systematic screening for glaucoma in the developed world, need for future research and challenges related to evaluation of increasing economic literature as well as need to change behaviors on the basis of evidence.

Keywords: cost-effectiveness, glaucoma, screening.

INTRODUCTION

Glaucoma is the second most common cause of visual disability in the elderly in the developed world. The performance of its current care in western countries is far from optimal and offers many opportunities to improve, e.g. all health care systems suffer from unequal access to care, large variations in the distribution of services both between and within the countries as well as problems with simultaneous under- and over-diagnosis and treatment [1]. More than half of glaucoma patients are undiagnosed [2], half of the patients treated for glaucoma do not have the disease [3], about 50 % of glaucoma patients do not use their drops regularly (ranging from 5 to 80 %) [4] and half of newly diagnosed patients found through screening studies have seen an ophthalmologist or an optometrist, but their disease was not diagnosed [5, 6].

Read more: Cost-effectiveness of screening for open angle glaucoma in developed countries