Cornea

Development and Validation of a Model to Predict Anterior Segment Vision-Threatening Eye Disease Using Primary Care Clinical Notes

imagePurpose:

The purpose of this study was to develop a decision-support tool to predict anterior segment vision-threatening disease (asVTD) to aid primary care physicians (PCPs) with patient triage and referral.

Methods:

The University of Michigan electronic health record data between January 1, 2016, and May 31, 2019, were obtained from patients presenting to a PCP with anterior eye symptoms and then saw an ophthalmologist within 30 days. asVTD included diagnosis of corneal ulcer, iridocyclitis, hyphema, anterior scleritis, or scleritis with corneal involvement by an ophthalmologist. Elastic net logistic regression with 10-fold cross-validation was used for prediction modeling of asVTD. Predictors evaluated included patient demographics and PCP notes processed using clinical natural language processing software (clinspacy).

Results:

Two thousand nine hundred forty-two patients met the inclusion criteria, of which 133 patients (4.5%) had asVTD. The age was significantly lower among those with asVTD versus those without (median = 42 vs. 53 yrs, P

By , ago

Preoperative Predictors for Acute Pain After Photorefractive Keratectomy

imagePurpose:

The aim of this study was to identify preoperative predictors for the occurrence of early severe postoperative pain in patients undergoing photorefractive keratectomy (PRK). The implementation of preoperative screening methods may facilitate more specific or aggressive pain therapies specifically targeted to individuals at a high risk of experiencing severe postoperative pain.

Methods:

This was exploratory research that included patients who underwent PRK. Before PRK, patients were administered a sociodemographic questionnaire, the Pain Catastrophizing Scale, and the State-Trait Anxiety Inventory and underwent corneal sensitivity and conditioned pain modulation (CPM) tests. Post-PRK pain was assessed using a pain intensity visual analog scale (VAS), and the short-form McGill Pain Questionnaire (SF-MPQ) was completed 21 days before PRK and 1, 24, 48, and 72 hours after PRK. Spearman correlations were calculated for pain scores and preoperative predictors.

Results:

This research included 34 eyes of 34 patients. Preoperative corneal sensitivity was positively correlated with post-PRK pain scores as assessed by VAS and SF-MPQ (rho = 0.39 and rho = 0.41, respectively, P 0.05).

Conclusions:

Abnormal presurgical corneal sensitivity was a protective marker for severe pain after PRK, while scores as assessed by VAS and SF-MPQ and CPM were not related to postoperative pain.

By , ago

What Hundreds of Millions of Patients With Dry Eye Will Find on YouTube: A Quality and Reliability Research of the YouTube Videos

imagePurpose:

The aim of this study was to evaluate the demographic features, quality, and reliability of YouTube videos addressing dry eye disease (DED).

Methods:

The term “dry eye disease” has been searched on YouTube. The first 500 videos that emerged using the defined search term were evaluated. Duplicated-split videos, videos shorter than 60 seconds, videos with a language other than English or videos with an unintelligible English accent, and videos unrelated to DED were excluded. Video uploaders, types, origins, durations, and viewer interactions of the videos were noted. DISCERN, the Global Quality Score, and the Video Quality Score (created by the authors) were used to evaluate the video quality.

Results:

Of the 500 videos, 262 videos were excluded, and the remaining 238 videos were evaluated. Videos were of moderate quality on all 3 scoring systems. The medical institute and academic society videos had the highest quality (P

By Sakallioğlu, Ahmet Kürşad; Garip, Rüveyde, ago

Topical Insulin—Utility and Results in Refractory Neurotrophic Keratopathy in Stages 2 and 3

imagePurpose:

The purpose of this study was to evaluate the clinical outcome of patients with refractory neurotrophic keratopathy (NK) in stages 2 and 3 treated with topical insulin.

Methods:

Retrospective analysis of eyes with NK in stages 2 and 3 refractory to standard medical and/or surgical treatment which were treated with topical insulin (1 unit per mL). This treatment was applied 4 times per day and was continued until the persistent epithelial defect (PED) or ulcer resolved. The primary outcome of the study was the complete reepithelialization of the PED or persistent ulcer. “Best-corrected visual acuity” pretreatment and posttreatment, “days until complete reepithelialization” data, and anterior segment photographs were obtained. Outcome measures were compared before and after treatment in both groups using paired and independent samples t tests.

Results:

Twenty-one eyes were included in this study, and 90% achieved complete reepithelialization of the PED and/or persistent ulcer within 7 to 45 days of follow-up. The mean number of days until complete reepithelialization was significantly lower in NK stage 2 (18 ± 9 days) when compared with NK stage 3 (29 ± 11 days) (P = 0.025). The best-corrected visual acuity improved significantly in both NK stage 2 (P

By , ago

Assessing the Quality, Reliability, and Readability of Online Information on Dry Eye Disease

imagePurpose:

The purpose of this study was to assess the quality, reliability, readability, and technical quality of web sites relating to dry eye disease.

Methods:

A cross-sectional study was conducted that evaluated the first 75 web sites on a Google Search by using the keyword “dry eyes.” Each web site was evaluated by 2 independent reviewers using the DISCERN, HONcode, and JAMA criteria to assess quality and reliability. Interrater reliability was also analyzed. Readability was assessed using the Flesch–Kincaid readability tests and the Gunning fog, Simple Measure of Gobbledygook, Coleman–Liau, and automated readability indices. Technical quality was determined by the presence of 10 specific features. Web sites were further categorized into institutional (academic centers, medical associations, and government institutions) and private (private practices) categories.

Results:

There was no significant difference in scoring observed between the 2 reviewers. The overall mean DISCERN score ± standard error (SE) was 3.2 ± 0.1, the mean HONcode score (±SE) was 9.3 ± 0.3, and the mean JAMA score (±SE) was 1.9 ± 0.1. Institutional web sites had a higher DISCERN score (3.4 ± 0.1 vs. 3.1 ± 0.1; P

By Oydanich, Marko; Kuklinski, Eric; Asbell, Penny A., ago