The edition · Ophthalmology
Carbide-gun eye burns: all 20 eyes re-epithelialised after early amniotic membrane grafts
An Indian tertiary series of 20 burned eyes reports outcomes after immediate irrigation and overlay grafting. Also: digital binocular therapy against patching, rural gaps in glaucoma OCT, and how rarely tamoxifen users see an eye doctor.
The edition in brief
A tertiary Indian centre treated 20 eyes of 18 young men burned by carbide guns during Diwali, mostly Dua grade III, with immediate irrigation, medical therapy and overlay amniotic membrane transplantation. All eyes re-epithelialised, at a mean of about 23 days; mean vision improved from logMAR 1.77 to 0.77 at three months, 21% needed a repeat graft, and one late-presenting eye was lost to phthisis. A meta-analysis of five trials in 225 treatment-naive children with amblyopia found digital binocular therapies gave the same visual acuity gain as patching (mean difference 0.00 logMAR), with moderate certainty. In 48,196 US glaucoma patients, rural residence was associated with less frequent nerve fibre layer OCT but not visual field testing, while Medicaid coverage was linked to much lower monitoring with both. Among 2,327 people starting tamoxifen, only 7.0% saw an eye doctor within a year and 1.7% had retinal imaging, no more than those on aromatase inhibitors.
Carbide-gun burns: immediate irrigation and early amniotic membrane grafts
Irrigate carbide-gun eye burns immediately and refer moderate to severe injuries urgently for early amniotic membrane grafting.
Rural glaucoma patients had fewer nerve fibre layer scans
Make sure glaucoma patients who travel far or have limited means still get regular OCT as well as visual fields.
Few people starting tamoxifen saw an eye doctor in the first year
Ask patients on tamoxifen to report new visual symptoms; routine eye review was rare in this cohort.
In a chemical eye injury, check the pH and keep irrigating
In a chemical eye injury, irrigate at once and continue until the conjunctival pH is neutral.
Digital binocular therapy matched patching in untreated amblyopia
Where a child will not patch, consider digital binocular therapy, which gave similar acuity gains in treatment-naive amblyopia.
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