Off the Cuff: Chinese Roulette

As COVID-19 occurs suddenly and is highly contagious, this will inevitably cause people anxiety, depression, etc. The study on the public psychological states and its related factors during the COVID-19 outbreak is of practical significance. A total of 600 valid questionnaires were received. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used.

Females' anxiety risk was 3.01 times compared with males (95% CI, 1.39 to 6.52). Compared with people below 40 years old, the anxiety risk of people above 40 years old was 0.40 times (95% CI, 0.16 to 0.99). SDS results indicated that the difference between education level and occupation was statistically significant (p=0.024, 0.005). Compared to people with a master's degree or above, those with a bachelor's degree group had a depression risk of 0.39 times (95% CI, 0.17 to 0.87). Compared with professionals, industrial service workers and other staff had a depression risk of 0.31 times (95% CI, 0.15 to 0.65) and 0.38 times (95% CI, 0.15-0.93).

Six hundred questionnaire participants were psychologically stable. Non-anxiety and non-depression rates were 93.67% and 82.83%, respectively. Anxiety was found in 6.33% and depression in 17.17%. Therefore, attention should be paid to the psychological states of the public.

Traveling has been growing in popularity over the last several decades. Eye diseases, e.g., decreased visual acuity, inflammatory or degenerative lesions, chronic diseases or eye trauma, affect all groups of travelers. The main risk factors contributing to the manifestation or exacerbation of common ocular diseases include exposure to dry air (inside the airplane cabin or in air-conditioned hotel rooms), exposure to chlorinated or salty water (swimming/bathing in swimming pools or in the sea) and sudden changes in the weather conditions.

In addition, travelers to tropical destinations are at risk of ocular diseases that are rarely seen in temperate climate, e.g., onchocerciasis, loiasis, gnatostomosis, African trypanosomosis or trachoma. The most common condition of the eye seen in travelers is conjunctivitis; it may be either of cosmopolitan (bacterial or viral infections, allergic inflammation) or tropical etiology, e.g., arboviral infections (zika, chikungunya).

Given the fact that a large proportion of the general population has decreased visual acuity and many individuals wear contact lenses rather than glasses, keratitis has become a common health problem among travelers as well; the major risk factors in such cases include sleeping in contact lenses, prolonged exposure to air-conditioning, working with a computer or swimming/bathing in microbiologically contaminated water (e.g., Acanthoamoeba protozoa). Conditions affecting the cornea, conjunctiva or lens may also occur due to excessive exposure to solar radiation, especially if travelers wear glasses without a UV protection.

An 18-year-old male presented with complaints of gradually decreasing vision in both eyes for six years. He was diagnosed with juvenile scleroderma at the age of 11 years by a pediatric rheumatologist.

Clinical slit-lamp examination showed features of ectasia, thinning, Vogt's striae and apical scarring in both eyes. Bulbar and tarsal conjunctiva was quiet and normal. Corneal tomography revealed mean keratometry 65.8 and 65.4 diopters, and thinnest pachymetry of 351 and 224 microns in the right and left eye, respectively. There was no history of itching and eye rubbing in the past. Patients of juvenile scleroderma may have associated keratoconus.

The management of advanced keratoconus presents challenges related to handling and insertion of contact lenses in this condition. Keratoplasty is an option in those patients when contact lenses are not acceptable.