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History of cataract surgery from ancient times to today

Honorary Lecture at the 13th Conference of the Hungarian Medical Association of America – Hungary Chapter (HMAA-HC) at 30–31 August 2019, in Balatonfüred, Hungary

Developments in Health Sciences
Author:
Z. Z. Nagy

Abstract

Cataract surgery is the most frequently performed ophthalmic surgery worldwide. This year approximately 32 million surgeries will be performed. The journey to modern, quick, and safe cataract surgery has been quite long. This review covers topics from ancient couching to the most modern phacoemulsification and femtosecond laser-assisted cataract surgery. The gain in quality of life is the largest with cataract surgery compared to other implant surgeries (e.g. knee, hip replacement, etc.). Ophthalmology has made huge advancements in recent decades. New microsurgical tools and diagnostic equipment have been developed, together with new surgical methods and foldable intraocular lenses, made from biocompatible material. From monofocal lenses, through aspheric, toric, and multifocal lenses, to multifocal toric lenses, today almost all kinds of refractive error can be compensated, including presbyopia. Teamwork, precise preoperative assessment, and fine surgical technique should also be emphasized in order to achieve the best and most predictable postoperative results for both patient and surgeon.

Open access

Abstract

Preeclampsia is a severe, sometimes life-threatening complication of pathological pregnancies. The incidence of neonatal morbidity and mortality is usually increased. Besides general maternal symptoms like hemolysis, low platelet number, elevated liver enzyme level, proteinuria, cardiovascular problems, neurological and cerebral complications, serious ophthalmic symptoms might occur. These include focal or generalized narrowing of the arterioles, flame-shaped retinal haemorrhages, and cotton-wool spots. Rarely, disc swelling, exudative retinal detachment, cystoid macular edema, bilateral occipital lobe infarction, or cortical blindness might occur. In this article, I review the retinal and macular changes, retinal detachment, and the cause of blindness. Optical coherence tomography (OCT) allows ophthalmologists to diagnose early and late changes in choroid vasculature and circulation, and consequent retinal morphological changes. Spectral-domain OCT and enhanced depth imaging provide important insight and possible prognosis for the course of the disease. After termination of the pathological pregnancy, vision returns to normal in most cases; unfortunately, there are some exceptions.

Open access

Abstract

Coronavirus-19 infection caused a mysterious pandemic worldwide. Some people experienced flu-like symptoms, while others have died due to pulmonary complications. Besides droplet spread, other routes of infection started to be suspected, such as through eye contact. During the first phase of the pandemic, pulmonary symptoms were in focus, later other signs and symptoms were also published. Eyelid, anterior and posterior segment symptoms, neuro-ophthalmic complications, and orbital problems related to COVID-19 infections are discussed in this article. It is important to detect the serious signs and symptoms to prevent late, sight threatening complications of COVID-19 infection.

Open access

Abstract

Ageing is a common problem in modern societies. Due to sophisticated new methods in medicine, the average life expectancy significantly increased in recent years. 70 is the new 50. The new principles of food intake and processing, more exercise, and less smoking contributed to a health benefits and a longer life span of human kind. Nevertheless, there are the special problems of ageing. Numerous dysfunctions of the body may arise affecting a broad range of organs and the musculoskeletal system. The eye can also be severely affected by ageing. Vision gained more importance recently especially during the COVID-19 pandemic. Elderly people who never used computers before, had to learn computer technology in order to communicate with their family and to accomplish their everyday tasks or pay their bills. Therefore, good near vision has become crucial for elderly people. In this review article the most common ageing problems of the eye, therapies and pathophysiology of ageing processes will be reviewed and discussed. There are physiological problems of ageing and there are ocular pathologies which can be treated efficiently in time to preserve near and far visual acuity.

Open access

Abstract

Purpose

The aim of the study was to analyse the use of digital devices among children.

Materials/Methods

A specially designed questionnaire was distributed to 249 schoolchildren to assess their use of digital devices both in school and outside school. The questionnaire was used before the start of the COVID-19 pandemic. The children were asked about the extent of their use of digital devices, as well as about ophthalmic and general health complaints. Their responses were assessed statistically.

Results

Regarding age distribution, 145 children were between seven and 10 years old when they started to use digital devices. Most of the children used a digital device for between one and two hours a day. The majority preferred using smartphones. The second most popular devices were laptops and tablets, and the third most popular was the desktop computer. Fifty-six children wore glasses, 14 to correct hyperopia and 42 to correct myopia. 97 children spent between one and two hours a day outdoors; 99 children spent more than two hours outdoors; and 51 spent less than one hour outdoors. 71 children reported eye problems; 48 reported other general health problems (back and neck pain); and 43 mentioned blurred vision while using a digital device.

Conclusions

The use of digital devices can be regarded as general among schoolchildren, and most children use a digital device for longer than the recommended time. Excessive use of digital devices may contribute to an increase in the prevalence of myopia and other general eye and back problems.

Open access

Abstract

Purpose

The aim of this study was to assess longitudinal changes in retinal vessel density in diabetic patients using optical coherence tomography angiography (OCTA) to identify the most sensitive parameter for detecting retinopathy progression.

Methods

Patients with diabetes mellitus were enrolled in this study. Each study subject underwent two imaging sessions, during which three OCTA images of the macular area and three images of the optic nerve head were obtained. The two sessions took place one year apart. The OCTA imaging was performed using an AngioVue device. Superficial vessel density was evaluated in the central 3 mm and parafoveal area, and the nonflow area was measured using the built-in automated AngioAnalytics software of the Optovue system.

Results

This study included 78 eyes of 39 diabetic patients (age: 55.16 ± 13.73 years) with a mean of 7.70 ± 1.07 mmol L−1 HgA1c level at baseline. At the one-year visit, the eyes of the diabetic subjects had significantly lower superficial vessel density in the parafoveal macula compared to corresponding values at baseline (p < 0.05). There was no statistically significant difference between the baseline and one-year results for the other vascular density parameters and the foveal avascular zone (p > 0.05).

Conclusion

At the one-year follow-up, we found that vessel density had decreased in the parafoveal ring in these patients, while there was no significant change in other vascular parameters. This result suggests that superficial parafoveal capillary density is the most sensitive OCTA parameter that can be used as a biomarker for diabetic retinopathy progression. None of the other vascular density parameters nor the foveal avascular zone were able to indicate the subtle changes in retinal microcirculation due to the progression of diabetic microvasculopathy.

Open access

Abstract

Epidemics and pandemics have happened throughout the history of mankind. Before the end of the 20th century, scientific progress successfully eradicated several of the pathogens. While no one has to be afraid of smallpox anymore, there are some new pathogens that have never caused human disease before. Coronaviruses are a family of enveloped RNA viruses. In the 21st century, three of them have caused serious pandemics, including severe acute respiratory syndrome in 2002 and Middle East Respiratory Syndrome in 2012. In 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease-19 (COVID-19) pandemic, which has destroyed hundreds of thousands of lives and continues to rage.

Open access

The performance of a semisynthetic bisexual lure (SBL, containing isoamyl alcohol, acetic acid and red wine) previously found attractive for a number of noctuids was compared with that of the respective synthetic sex attractants of Orthosia cerasi (=stabilis), O. cruda, O. gothica, O. incerta, Anorthoa munda and Conistra vaccini. The respective sex attractants performed significantly better in the Orthosia spp. than the SBL lure, which, although regularly catching low numbers of both females and males, did not differ significantly from zero catch in unbaited control traps. On the other hand, the SBL lure performed as well as the sex attractant in C. vaccini. Sizeable catches of C. rubiginea, C. rubiginosa and C. erythrocephala were also recorded in traps with the SBL lure. The SBL lure can prove to be a useful tool in ecological and faunistical studies of Conistra and related hibernating Xylenini species.

Open access

Abstract

Purpose

This paper provides a detailed presentation of the estimated number of people in Hungary with eye disease and refractive errors by both sex and age.

Materials/methods

In the past 12 years, 168,522 people (54.1% women and 45.9% men) have been screened under Hungary's Comprehensive Health Protection Screening Programme (MÁESZ).

Results

The total number of people with eye disease in the adult Hungarian population (about 8 million people) is estimated to be 1,684,818, with women (1,078,026) outnumbering men (606,792). Eye diseases were found to be more common in older age groups, and more common in women than men in each age group. The estimated number of people with refractive errors in the Hungarian adult population is 5,005,095. The overall number of people with myopia in the adult Hungarian population is estimated to be 3,058,536, with roughly equal numbers of men and women. The majority of people with myopia (63.3%) are between 18 and 45 years of age.

Conclusions

The huge number of people in the Hungarian population affected by eye disease or refractive errors underscores the need to develop and implement an effective national strategy and specific programmes to prevent visual impairments.

Open access