Outcomes and Baseline Predictors of Failure in Primary Standalone Xen45 Gel Stent versus Trabeculectomy for Glaucoma.

Purpose: To compare safety, effectiveness, and baseline predictors of failure in standalone primary Xen45 gel stent (Xen) versus trabeculectomy (Trab) in glaucoma.

Design: Retrospective study.

Subjects: Subjects that underwent primary Xen or Trab augmented by mitomycin-C with at least 12 months follow-up.

Glaucoma severity at first presentation to an ophthalmologist and risk factors for late presentation in rural Australia: the S1P study.

Clinical Relevance: Well-targeted referrals and timely commencement of treatment are essential to limiting vision loss in glaucoma. Optometrists, primary care providers, and public health policymakers can utilise predictors of late to identify and target at-risk populations.

Background: This study, which aimed to evaluate glaucoma severity at first presentation to an ophthalmologist in a rural Australian population, is the first of its kind in an Australian population.

Two-year outcomes of Xen 45 gel stent implantation in patients with open-angle glaucoma: real-world data from the Fight Glaucoma Blindness registry.

Objective: To evaluate efficacy and safety outcomes of the Xen 45 gel stent implant over 24 months of follow-up.

Methods: A retrospective analysis of prospectively collected data from the Fight Glaucoma Blindness observational registry. Complete success (CS) was defined as intraocular pressure (IOP) reduction ≥20% from preoperative and an IOP ≤18 mm Hg and ≥6 mm Hg with no secondary procedure at 2 years and without IOP-lowering medications.

Diabetic Retinopathy Screening at the Point of Care (DR SPOC): detecting undiagnosed and vision-threatening retinopathy by integrating portable technologies within existing services.

Introduction: The aim of this study was to determine the prevalence of diabetic retinopathy (DR) in a low socioeconomic region of a high-income country, as well as determine the diagnostic utility of point-of-care screening for high-risk populations in tertiary care settings.

Research Design And Methods: This was a cross-sectional study of patients with diabetes attending foot ulcer or integrated care diabetes clinics at two Western Sydney hospitals (n=273). DR was assessed using portable, two-field, non-mydriatic fundus photography and combined electroretinogram/ pupillometry (ERG).

A Systematic Review of Glaucoma Diagnosis in Prevalence Studies and Quality of Reporting.

Prcis: This systematic review has revealed that variable definitions of glaucoma continue to be used in prevalence studies, despite the introduction of the International Society of Geographic and Epidemiologic Ophthalmology (ISGEO) criteria.

Purpose: To systematically review diagnostic criteria and examinations performed in glaucoma prevalence studies over time and determine the quality of reporting. Accurate estimates of glaucoma prevalence are crucial to inform resource allocation.

Optimising fundoscopy practices across the medical spectrum: A focus group study.

Introduction: Fundoscopy can be of great clinical value, yet remains underutilised. Educational attempts to improve fundoscopy utilisation have had limited success. We aimed to explore the barriers and facilitators underlying the uptake of clinical direct ophthalmoscopy across a spectrum of medical specialties and training levels.

Surgical approach to repair of traumatic avulsion and external herniation of the levator palpebrae superioris aponeurosis.

This report describes the unusual case and surgical repair of avulsion and external herniation of the levator palpebrae superioris (LPS) aponeurosis and attached muscle fibres associated with superior tarsal plate fracture in an 8-year-old Indigenous girl. To the authors' knowledge, isolated and complete levator palpebrae superioris avulsion with external herniation in trauma is previously unreported. Open injury to LPS requires swift surgical repair, and an anterior ptosis repair approach may facilitate identification of anatomical structures to prevent upper eyelid ptosis.

Reactivation of Multifocal Choroiditis Associated with Treatment in Latent Tuberculosis.

Tuberculosis (TB) causes significant morbidity and mortality worldwide. Ocular manifestations of TB can lead to severe and sight-threatening complications. Initiating treatment in ocular TB with anti-tubercular therapy (ATT) may be necessary to prevent long-term visual complications.

Fundoscopy use in neurology departments and the utility of smartphone photography: a prospective prevalence and crossover diagnostic accuracy study amongst neurology inpatients.

Background And Purpose: Although fundoscopy is a crucial part of the neurological examination, it is challenging, under-utilized and unreliably performed. The aim was to determine the prevalence of fundus pathology amongst neurology inpatients and the diagnostic accuracy of current fundoscopy practice compared with systematic screening with smartphone fundoscopy (SF) and portable non-mydriatic fundus photography (NMFP).

Methods: This was a prospective cross-sectional surveillance and diagnostic accuracy study on adult patients admitted under neurology in an Australian hospital.

Nutritional supplementation in the prevention and treatment of glaucoma.

Glaucoma is a chronic optic neuropathy that creates a significant burden on public health. Oxidative stress is hypothesized to play a role to glaucoma progression, and its reduction is being analyzed as a therapeutic target. Dietary antioxidants play a crucial role in helping provide insight into this hypothesis.

Impact on patient management of non-mydriatic fundus photography compared to direct ophthalmoscopy in a regional Australian emergency department.

Objective: To investigate the management impact of non-mydriatic fundus photography (NMFP) implementation for appropriate ED patients; compare the diagnostic accuracy of direct ophthalmoscopy (DO) and NMFP, and determine the prevalence of fundus pathology in a regional Australian ED.

Methods: This before/after crossover study prospectively enrolled patients presenting with headache, neurological deficit, visual disturbance and/or hypertensive urgency. Patients received DO examination, then separate NMFP examination.

Asymptomatic occlusive retinal vasculitis in newly diagnosed active tuberculosis.

Introduction: Worldwide, tuberculosis is the leading cause of death from an infectious disease. Ocular involvement can cause significant and permanent vision loss. Ocular manifestations of tuberculosis often present with visual symptoms.

eFOCUS 2: A randomised crossover trial of smartphone fundoscopy and direct ophthalmoscopy aiming to improve optic disc interpretation by medical students with e-learning support.

Background: Ophthalmoscopy and its interpretation are complex. We aimed to compare the diagnostic accuracy of smartphone fundoscopy with traditional direct ophthalmoscopy for optic disc interpretation, with e-learning support.

Methods: We conducted a randomised, crossover study of 102 medical students.

Using non-mydriatic fundus photography to detect fundus pathology in Australian metropolitan emergency departments: A prospective prevalence and diagnostic accuracy study.

Objective: To determine the prevalence of fundus pathology in metropolitan Australian EDs utilising a non-mydriatic fundus photography screening programme. Secondary objectives include diagnostic accuracy among emergency physicians compared to telehealth ophthalmologist review.

Methods: Prospective cross-sectional study investigating non-mydriatic fundus photography as a new diagnostic test in two tertiary Australian EDs.

Role of Optic Nerve Sheath Fenestration in Inflammatory Pachymeningitis Causing Visual Impairment.

Eye disease due to pachymeningitis caused by immunoglobulin G4-related disease (IgG4-RD) is a rare occurrence. Here, the authors report a unique case of a patient presenting with visual loss from raised intracerebral pressure from pachymeningitis most likely related to IgG4-RD. The patient was treated with acetazolamide and steroids, and an optic nerve sheath fenestration was performed to successfully save the patients vision.

Ophthalmic findings in neonates receiving sildenafil.

Aim: To determine the risk of ocular complications of sildenafil therapy in neonates.

Methods: Retrospective case review of neonates with persistent pulmonary hypertension of the newborn who received sildenafil therapy between 2010 and 2015 in a single, tertiary surgical neonatal intensive care unit in Australia. Ophthalmic examination findings in the neonatal intensive care unit and follow-up were examined.

Journey to glaucoma care - trusting but uncertain and uninformed: a qualitative study.

Background: This study aims to explore patient perspectives regarding their journey to glaucoma care and sought to understand the determinants that guide their access to tertiary glaucoma care.

Methods: Twenty-nine patients who are glaucoma suspects or had definitive diagnosis of glaucoma were recruited from a large public glaucoma clinic and a private ophthalmology clinic in Sydney. Face-to-face, in-depth semi-structured interviews were conducted between April and December 2017.

Determining patient preferences in a glaucoma service: A discrete choice experiment.

Importance: Patient perspectives are crucial in informing design of acceptable services.

Background: This study determined patient preferences in glaucoma care.

Design: A discrete choice experiment was used to evaluate the relative importance of out-of-pocket costs, waiting time, continuity of care, service location and expertise.

Complete Inferior Rectus Transection Following Blunt Trauma: A Case Report and Novel Approach to Surgical Repair.

Inferior rectus avulsion following blunt trauma is rare, with even fewer reported cases of complete transection. The authors report a case of orbital floor fracture and inferior rectus muscle transection without herniation following blunt orbital trauma. This case first highlights the difficulty in diagnosing complete inferior rectus muscle transection clinically and with imaging and second that an acceptable functional outcome can be achieved by a novel surgical repair approach utilizing contiguous orbital anatomical relations of the inferior oblique and inferior rectus muscles.

Orbital Cellulitis and Secondary Angle Closure: A Rare Presentation of Choroidal Melanoma.

We describe a case of choroidal melanoma initially presenting with orbital cellulitis, fulminant conjunctival swelling, and secondary angle closure. Despite treatment with intravenous antibiotics, the patient's condition did not improve. With further investigations including ultrasound scan and magnetic resonance imaging, a high-density lesion was found within the globe.

Orbital Apex Syndrome in Pseudomonas Sinusitis After Functional Endoscopic Sinus Surgery.

Sinusitis complicated by orbital apex syndrome is rare. The majority of cases are due to mucormycosis in immunocompromised patients. The authors report a case of orbital apex syndrome secondary to Pseudomonas sinusitis.