Clinical relevance: Swept-source optical coherence tomography may not provide reliable measurements of choroidal thickness for pigmented subjects.Background: The repeatability of choroidal thickness measurements in young healthy adults was investigated using swept source optical coherence tomography.Methods: Choroidal thickness was measured using swept source optical coherence tomography in 98 healthy subjects (49 South Asian and 49 Caucasian) aged between 19 and 28 years old. Repeated radial scan images centred on the fovea were obtained from the right eye with 5 min between measurements. Choroidal thickness values were obtained from the built-in automated segmentation algorithm for the 9 subfields defined by the Early Treatment Diabetic Retinopathy Study. Interclass correlation coefficients and Bland-Altman methods were used to assess test-retest repeatability.Results: The mean ± standard deviation sub-foveal choroidal thickness was 316.53 ± 63.36 µm for the Caucasian group and 292.70 ± 60.13 µm for the South Asian group. Bland-Altman analysis showed smaller test-retest variability for choroidal thickness measurements in the Caucasian group (mean difference ± SD = −0.01 ± 6.59 µm) compared to the South Asian group (mean difference ± SD = −2.38 ± 12.20 µm). No relationship was found between the mean choroidal thickness and mean spherical equivalent of refractive error for both subject groups.Conclusion: Swept source optical coherence tomography is capable of obtaining choroidal thickness measurements with good repeatability. However, test-retest limits of agreement are substantially greater in South Asian subjects, suggesting that successful identification of the choroidal scleral interface may be affected by the amount of pigmentation present in the retinal and choroidal tissues.

PURPOSE: The purpose of this study was to explore the side effects of using cycloplegic eye drops at ophthalmology clinics at King Saud Medical City (KSMC) in Riyadh, Saudi Arabia. Moreover, to have an insight into physicians’ attitude towards the management of these side effects. METHODS: A retrospective cross-sectional study where medical records of pediatric patients who attended ophthalmology clinics at KSMC. Subjects were selected after reviewing their files and based on their reaction to the ocular drops. In addition, the response of ophthalmologists was obtained through a questionnaire distributed through electronic channels. RESULTS: A total of 111 patients’ medical records were included in this study. The most reported cycloplegic agents that caused side effects were cyclopentolate 1%, tropicamide 1%, and phenylephrine 2.5%. Fifty-three percentage of physicians reported that changing their way of administering cycloplegic drops in practice plays a role in reducing some side effects. The most reported side effects of using cycloplegic eye drops were facial flushing 68%, followed by fever 46%, and irritability 38% of cases. Few children who experienced side effects needed medical intervention. CONCLUSION: Side effects caused by cycloplegic agents are usually mild and rarely severe. There are some systemic side effects such as hallucinations, psychosis, or seizures. Proper parental counseling before administering cycloplegic agents and proper clinical management in case of severe side effects is crucial. Prophylactic measures to reduce the incidence of these side effects are advisable.

PURPOSE: This study aimed to evaluate the long-term outcomes of primary pediatric cataract surgery and to identify determinants of success and recommendations to improve the care of patients with pediatric cataracts. METHODS: A cohort, retrospective study of cases who were operated as primary pediatric cataract surgery at King Khaled Eye Specialist Hospital. Patients who are 4 years old or younger and underwent primary cataract surgery with at least 3-year follow-up were enrolled in this study. Preoperative and postoperative evaluations were performed to determine the surgery outcomes. RESULTS: Two hundred and two eyes of 119 patients were enrolled in the study. Seventy percentage of the patients were diagnosed with bilateral cataracts and 30% with unilateral cataracts. Postoperative evaluation showed that 20% of the patients had best corrected visual acuity of 20/30 or better, 25% had 20/40–20/50, 20% had 20/60–20/80, and 29% had 20/100 or less, 6% as fixate and follow. In addition, the mean spherical equivalent was 1.50D. Amblyopia was present in 120 eyes. Fourteen percentage showed a significant myopic shift of more than −4.00D and it was more in eyes with primary intraocular lens (IOL) implantation. Glaucoma was reported in 19% of the patients. CONCLUSION: There was a significant postoperative myopic shift and it was more in eyes with primary IOL implantation. Glaucoma was the most common reported postoperative complication. The presence of strabismus and nystagmus may affect the visual outcomes. Early intervention might reduce the incidence of amblyopia.

Klebsiella pneumoniae is an opportunistic pathogen commonly found in the normal flora of the gastrointestinal tract. While it typically remains benign, it can lead to severe healthcare-associated infections, particularly among immunocompromised individuals and those in long-term care settings. This study aimed to investigate the epidemiology and antibiotic resistance patterns of K. pneumoniae infections among male patients in a long-term care hospital. A retrospective cross-sectional study was conducted, analyzing microbial culture data from 29 male patients admitted to the male ward of a long-term care hospital in Riyadh, Saudi Arabia. The study included patients with confirmed positive cultures for K. pneumoniae. Data were collected regarding demographic information, culture sites, and antibiotic susceptibility test results. Statistical analysis was performed to identify significant associations between patient characteristics and resistance patterns, with a particular focus on the prevalence of carbapenem-resistant Enterobacterales (CRE) and the production of extended-spectrum beta-lactamases (ESBL). Around 51.7% of the K. pneumoniae isolates were found to be resistant to carbapenems, while 24.1% were classified as producers of ESBL. Patients suffering from bedsores had a significantly higher prevalence of CRE infections at 37.9% compared to only 13.8% in patients without bedsores (p=0.034). The analysis also indicated that older patients (aged over 50 years) exhibited a higher prevalence of CRE infections (34.5%) compared to their younger counterparts (17.2%, p=0.069). Notably, resistance levels against antibiotics were high, with 75.9% of isolates resistant to cotrimoxazole, 65.5% to ciprofloxacin, and 62.1% to gentamicin. In contrast, imipenem and meropenem showed relatively higher susceptibility, with each antibiotic having a susceptibility rate of 34.5%. There is a significant prevalence of multidrug-resistant K. pneumoniae infections in long-term care environments, particularly affecting older male patients and those with bedsores. These findings underscore the need for targeted infection control measures and enhanced antibiotic stewardship programs. Future research should include both genders to investigate epidemiological differences and broader resistance trends.

The cornea is an integral part of the eye which is involved in the optical system that enables optimum visual acuity. Visual acuity relies not only on the cornea itself but also on other factors such as pathological state of the eye and refractive error...