Objective: To evaluate and compare surgical outcomes with respect to refractive errors in strabismus surgery for the treatment of intermittent exotropia. Methods: The medical records of 129 patients with intermittent exotropia who were treated with one surgeon from June, 2010 to January, 2015 were reviewed. The patients were divided into three groups according to preoperative refractive error: hyperopia (group A with 20 patients), emmetropia ( group B with 63 patients) and myopia (group C with 46 patients). The orthotropia rate and stereoscopic vision were compared among the three groups. Results: The orthotropia rate was higher in group A and C than in group B at postoperative 3 and 6 months and at the last follow-up（P＜0.05). Stereoscopic vision was significantly better in group B and C than in group A preoperatively（P＜0.05). The difference was not significant postoperatively. The surgical success rates according to orthotropia rate and stereoscopic vision were higher in group A and C than in B at postoperative 3 and 6 months and at the last follow-up（P＜0.05. Conclusion: Taking into consideration the age, follow-up period postoperatively, orthotropia rate and stereopsis improvement, hyperopia is a good prognostic factor. Key Words intermittent exotropia，refractive errors，surgery，orthotropia rate，stereoscopic vision
Dr. Chandni Nigam has graduated from Imperial College London and is pursuing Ophthalmology as a specialty in the UK. She has held the position of President of the Imperial College Ophthalmology Society, which was set up to enhance undergraduate ophthalmology education and promote the field to undergraduates as a career. She is a published author of peer-reviewed articles.
Infective conjunctivitis is a common self-limiting condition which constitutes around 35% of ocular presentation in general practice. A Cochrane systematic review investigating the effect of antibiotic treatment in the management of bacterial conjunctivitis concluded that the benefits from antibiotic use compared to placebo were marginal. UK National clinical guidelines further state that topical antibiotics should not be prescribed as first line treatment for conjunctivitis. The aim of this audit was to compare the frequency of antibiotic prescription at a busy general practice surgery against the standard set by national guidelines. A retrospective analysis of patients presenting with symptoms and signs of infective conjunctivitis over a period of fifteen months were collated using the System. One patient database. Ninety-seven percent of patients included in the study were prescribed topical antibiotics as first line treatment for conjunctivitis. Another 2% of consultations showing evidence of delayed prescribing. Doctor and patient education is important to manage expectations relating to the prescription of antibiotic to reduce unnecessary use. This has implications for reducing antibiotic resistance and improving cost-effectiveness of treatment. Changes implemented at the practice following the audit included updating general practitioners on the latest evidence and national guidelines on infective conjunctivitis management and creating an information leaflet for patients presenting with infective conjunctivitis containing advice on supportive measures to manage their symptoms.