Article Review Paper: Corticosteroids and Open-Angle Glaucoma in the Elderly
Cristina Bui
San Diego City College
Article Review Paper: Corticosteroids and Open-Angle Glaucoma in the Elderly
The research article Corticosteroids and Open-Angle Glaucoma in the Elderly was authored by Micheal Marcus, Rogier Müskens, Wishal Ramdas, Rodger Wolfs, Paulus Jong, Johannes Vingerling, Hofman R, Bruno Albert, and Nomdo Jansonius and was published in 2012 in Switzerland. It is the original research article based on the Rotterdam study that examines the link between the use of corticosteroids and open-angle glaucoma (OAG) in the elderly population. This paper will summarize and review the article, discuss the articles accuracy and shortcomings,
…show more content…
The methods used for the study were study population, which consisted of 3,939 elderly who were 55 years and older, ophthalmic assessment which consisted of a baseline exam in 1991 to 1993 and two follow-up rounds in 1997 to 1999 and 2002 to 2006, incident open-angle glaucoma which defined incident OAG case as a participate that did not have glaucomatous visual field loss in both eyes at baseline and at least one eye at follow-up examinations, medication data that consisted of corticosteroid stratifying into five groups: inhaled steroids, steroid ointments, ophthalmic steroids, oral steroids, and nasal steroids which were prescribed for all participants from seven different pharmacies, other co-variables which included sex, age, diabetes mellitus, family history of glaucoma, rheumatoid arthritis myopia, IOP, and IOP-lowering treatment, and statistical analysis which compared differences in baseline characteristics between participants with and without incident …show more content…
The introduction provided a clear and concise explanation of the study and how it was performed; from subjects, to types of corticosteroids, to length, and methods of the study. The study had a large and adequate amount of participants who were all in an appropriate age range for this study. However, the study only collected participants from one region of the Netherlands which does not take environmental factors into consideration. The study also did not take into consideration the ratio of men to women, their current and past medical history, and their current medication use, which can all affect the results of the study. The study had a thorough screening method for the participants which included the baseline exam and two follow-ups. The amount of time that the study spanned for was also appropriate for this kind of study. The author also took into considerations different variables that might affect the outcome of the study. Rationales were also provided for the conclusion of the study and the charts were legible and provided sufficient evidence to back up their findings. Overall, the article was clear, concise, well organized, and easily to
Miguel, Maria Fernanda, ProfessorH. Kent Bowen. Ophthalmic Consultants of Boston and Dr. Bradford J. Shingleton. Harvard Business School. Rev. May 20, 1997.
Saxena, Rohit, Diguijay Singh, and Praveen Vashist. “Glaucoma: An Emerging Peril.” Indian Journal of Community Medicine 38.3 (2013): 135-7: Proquest. Web. 7 Jan 2014.
Glaucoma is a disease of the eye and it is fluid pressure within the eye rises and if the eye is left untreated the patient might lose vision or maybe even blind. But this disease is generally affects both eyes but although one of their eyes may have more severe signs or symptoms then the other eye. When you have glaucoma there are small spaces in the front of the eye and they are called anterior chamber. There is clear liquid that flows in and out of the anterior chamber and the fluid nourishes and bathes nearby the tissues. And if the patient has glaucoma the fluid dose not drain like it should drain but the fluid drains out of the eye. And this may lead to fluid build up and pressure inside the rises of the eye. Unless the pressure is brought down and controlled and the optic nerves and some of the other parts of the eye might become damaged leading to ...
Vision loss from glaucoma is permanent but can be prevented with early detection and treatment. Since the symptoms of the disease are usually unnoticeable, regular eye examination are important especially for persons over the age of 35 and those in high risk group.
With no treatment needed, glaucoma is a leading cause of blindness in the United States, while simultaneously being the number one leading cause in Africa (Glaucoma Research Foundation). According to the American Optometric Association, “Glaucoma is a group of eye diseases causing optic nerve damage. The optic nerve carries images from the retina, which is the specialized light sensing tissue, to the brain so we can see.” They go on to say that when dealing with glaucoma, one’s eye pressure plays a vital role in damaging the delicate nerve fibers of the optic nerve. “When a significant number of nerve fibers are damaged, blind spots develop in the field of vision. Once nerve damage and visual loss occur, it is permanent.” The National Institute of Health states that due to shallower anterior chamber depths, this defect hurts the lives of people mostly from East Asian descent. The Foundation continues to say that blacks are among the people who are three times more likely to have glaucoma while woman in general are two times more likely to developing angle closure glaucoma.
According to Baily and Hall, while visual impairment early in life is associated with inherited congenital disorders, abnormal fetal devepment, and problems associated with premature birth, most eye conditions are associated with aging. They claim that over 70% of the visually impaired population in the United States is over 65. Age related maculopathy, also called macular degeneration, or AMD, impairs the center of vision in older individuals. The macula is the region in the back of the retina that surrounds and includes the fovea (Goldstein 1999). It is important to understand that when this degeneration progresses enough, the condition constitutes blindness because the foveal area is what is used to focus on something. Most cases do not progress this far, but between five and 20% do. Allikments and Shroyer claim that 11 million people in the United States alone suffer some degree of this impairment, with 75% of those individuals being 75 or older. Seven percent of this older age group reportedly suffer advanced forms. Freidman reports the disease as most common in developed countries.
Glaucoma is a common and important health problem. It is one of the leading causes of blindness in Western Society (Hoskins & Kass, 1989). It is responsible for ten percent of all blindness in the United States and continues to be the second or third most common cause of blindness in the world (Bunce, Fraser, & Wormald, 1999). It is estimated that two million people in the United States have been diagnosed as having glaucoma. Glaucoma is known to affect about two percent of Caucasians beginning at the age of 40 with an increasing risk for those over the age of 60. This risk is especially high if a member of the family has glaucoma or diabetes. Further, there is a higher risk of a glaucoma diagnosis for African Americans over the age of 40.
Therefore, low intakes of lutein may promote the progression of AMD. To determine the effect of lutein on the progression of AMD, Richer et al.4 conducted a 12-month prospective, randomized, double-blind, placebo-controlled study that consisted of 90 subjects who expressed symptoms of AMD in one or both eyes. The participants were randomly assigned to one of three experimental groups: 29 participants were assigned to Group 1(10 mg non-esterified lutein), 30 participants were assigned to Group 2(10 mg non-esterified lutein plus additional antioxidants and nutrients in the form of a multivitamin), and 31 participants were assigned to Group 3 and received the placebo. Ophthalmic testing measured MPOD, BCVA, and CS at baseline, 4 months, 8 months, and 12 months. The three groups were controlled for age, years diagnosed with AMD, smoking, caffeine/alcohol use, iris color, multivitamin use, as well as dietary intake of lutein and iron. The results indicated that between the time baseline measurements were conducted and the final study visit: MPOD increased approximately 36 percent (0.09 log units) in Group 1, 43 percent (0.08 log units) in Group 2, and decreased 0.03 log units in Group 3. BCVA increased 5.4 and 3.5 Snellen letters for Group 1 and 2 respectively as well a decrease of 0.2 Snellen letters for Group 3. The results indicated that over the course of the study CS increased
Imagine a researcher requesting you to copy a picture. It's a simple task. You move your instrument of illustration across a sheet of blank paper with ease, glancing from the given picture to your own sketch in progress. When you are finished you observe a satisfactory replica and feel a sense of accomplishment and proficiency with the similarity you have achieved between picture and sketch. Then the researcher queries whether you can tell him what you have drawn. You search the interconnected lines, the edges, and the shapes of your sketch but cannot answer what the picture represents. Finally, an explanation is given. You have just drawn a house- a simple triangle resting on top of a square. Your sense of accomplishment is quickly replaced with a feeling of despair.
I chose this study because it has a large cohort which eliminates sample bias. High quality data could be obtained from this longitudinal epidemiological ...
Glaucoma is an eye disorder that causes damage to the optic nerve, this nerve plays a very important part in the way we carry images from the retina to our brain, so we have vision. Glaucoma has a nickname “the sneak thief of sight,” because this disease gradually worsens over a period of time and the person cannot tell their vision is going until it is too far advanced. As a result, it is the second leading cause of blindness in the world, especially in older generations. This disorder is typically caused by an elevation of eye pressure, which damages the nerve fibers of the optic nerve. As this progresses a number of nerve fibers are damaged, blind spots occur, and glaucoma becomes permanent. In other cases poor blood circulation in the optic nerves can result to glaucoma. There are procedures to follow when in danger for glaucoma, this can happen to anyone, when in doubt people should go to their ophthalmologist and get treated for glaucoma right away in varies ways depending on the type of glaucoma.
Glaucoma is a group of eye disorders that cause blindness by hurting the optic nerve, which is the large nerve that is responsible for vision. In glaucoma, the optic nerve damage is related to a change in the fluid pressure that circulates around the eyeball. In many cases, Glaucoma occurs when the eye's fluid pressure is high, but it can also occur when the pressure is measured as normal.
The patient is a 43 year-old female insurance sale agent who came to the clinic for annual eye examination. She complained from symptoms of ocular irritation and burning when she wakes up in the morning. She felt ocular dryness in the afternoon and the eyes look red. She has also noted different height of her eyelids when putting make-up on. She denied significant problems with driving, TV watching, computer use or reading. She also denied flashes, floaters or diplopia. The patient was myopia with no prior eye surgeries, previous history of eye trauma, amblyopia or strabismus. She did not use any medication. The past ocular family history was negative. Social history was negative, too.
Studies have shown as of 2013 that older people are at an increased rate for falling if their Astigmatism is at an oblique axis of 180* or stronger. So extra care must be taken when new eyewear is given to these particular patients.
Optometry is unique when compared to a field such as general medicine; as a field, optometry is relatively new to many people. The importance of optometry has moved beyond simply helping patients see better, to maintaining the health of the eye and working to screen for many other health conditions. Because its importance is becoming more understood and well known to the general public, the number of patients seeking treatment is growing drastically. As stated above this drastic growth is not only increasing the number of patients but also the number of places optometry is being practiced as well as changing the demographics of the patients being see...