Lucy A Goold

University of Adelaide, Tarndarnya, South Australia, Australia

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Publications (8)14.77 Total impact

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    ABSTRACT: BACKGROUND: We present a series of patients with acute suppurative bacterial dacryoadenitis and review the clinical presentation, microbiology, treatment options and outcome. METHODS: A multicentre, retrospective, case series review of patients with a clinical diagnosis of acute bacterial suppurative dacryoadenitis (ASBD). Records were examined to obtain information regarding patient demographics, presenting symptoms and signs, radiology, microbiology, management, outcomes and follow-up. RESULTS: 11 patients (9 men, 2 women; mean age 43.9 years, range: 6-82 years) were included. Average time to presentation was 2.8 days, and predisposing conditions were found in 45% of cases. Common presenting symptoms were eyelid swelling, pain, redness and diplopia, and common signs were ptosis, discharge and restriction of eye movements. The most common causative bacteria were Staphylococcus aureus and skin flora. Lacrimal gland swelling was universally seen on CT, with globe indentation of displacement in 27% of cases. Intravenous antibiotics were used in 91% of cases, which subsequently resolved over an average period of 9.7 days. Those with abscess formation (n=2) required incision and drainage. CONCLUSIONS: ASBD is a rare condition that resolves quickly if managed appropriately. Underlying anatomical, infectious or inflammatory conditions should be investigated, and skin commensals should be covered with the instigation of antibiotic therapy.
    The British journal of ophthalmology 04/2013; · 2.92 Impact Factor
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    ABSTRACT: BACKGROUND: Invasive fungal sinusitis is a rare condition that usually occurs in immuno-compromised patients and often presents as an orbital apex syndrome. It is frequently misdiagnosed on presentation and is almost always lethal without early treatment. DESIGN: Retrospective case series of 14 consecutive patients with biopsy-proven invasive fungal sinusitis from 4 tertiary hospitals. PARTICIPANTS: 14 patients (10 men and 4 women; age range 46-82 years). METHODS: Retrospective chart review of all patients presenting with invasive fungal sinusitis between 1994 and 2010 at each hospital, with a close analysis of the tempo of the disease to identify any potential window of opportunity for treatment. MAIN OUTCOME MEASURES: Demographic data, background medical history (including predisposing factors), symptoms, signs, radiologic findings, histopathologic findings, treatment approach, and subsequent clinical course were recorded and analyzed. RESULTS: Only one patient was correctly diagnosed at presentation. Only 2 patients were not diabetic or immuno-compromised. The tempo was acute in 2 patients, subacute in 9 patients, and chronic in 3 patients. In the subacute and chronic cases, there was about one week of opportunity for treatment, from the time there was a complete orbital apex syndrome, and still a chance for saving the patient, to the time there was central nervous system invasion, which was invariably fatal. Only 2 patients survived - both had orbital exenteration, as well as antifungal drug treatment. CONCLUSIONS: Invasive fungal sinusitis can, rarely, occur in healthy individuals and should be suspected as a possible cause of a progressive orbital apex syndrome.
    Clinical and Experimental Ophthalmology 12/2012; · 1.96 Impact Factor
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    ABSTRACT: A technique for reconstruction of a traumatic upper-eyelid marginal defect utilizing a local tarsoconjunctival advancement flap with a skin graft is presented. A 22-year-old woman was bitten by a dog, resulting in a full-thickness loss of approximately the central half of her left upper eyelid. Debridement was performed under topical anaesthesia followed by one-stage upper eyelid reconstruction. The residual tarsal plate was used as a tarsoconjunctival advancement flap to reconstruct the posterior lamella of the defect. Skin from the posterior aspect of the left ear was grafted onto the reconstructed posterior lamella with two setting tarsorrhaphy sutures. One month postoperatively, the patient had an excellent cosmetic result with appropriate upper eyelid height and curvature, although cilia were not transplanted. The technique described offers a one-stage procedure with a simple surgical method providing on appropriate cosmetic and functional result.
    European Journal of Plastic Surgery 01/2012;
  • Ophthalmology 10/2009; 116(9):1831-1831.e2. · 5.56 Impact Factor
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    ABSTRACT: Sudden vision loss usually requires urgent ophthalmic assessment. Diagnosis and management requires the judicious use of a wide range of serological and imaging investigations to guide appropriate treatment and referral. This article follows on from the previous discussion of the role of history and examination to discuss the appropriate investigation and management of common causes of sudden visual loss. The key historical and examination findings have now been extracted and synthesised and these inform the next step. The general practitioner must now decide upon the most appropriate and timely investigation pathway or the need for, and urgency of, referral.
    Australian family physician 10/2009; 38(10):770-2. · 0.71 Impact Factor
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    ABSTRACT: Sudden loss of vision requires careful history and examination to identify the underlying cause. This article discusses the various causes of sudden loss of vision and provides the general practitioner with a guide to examination. Rapidity of onset, duration and associated symptoms provide vital clues to the nature of the disease process. Simple examination techniques such as visual acuity measurement, confrontational visual field testing, pupil assessment and fundoscopy are integral to the appropriate assessment, treatment and referral of patients presenting with sudden loss of vision.
    Australian family physician 10/2009; 38(10):764-7. · 0.71 Impact Factor
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    ABSTRACT: To determine the prevalence, associations and risk factors for age-related macular degeneration (ARMD) in central Sri Lanka. The study was a population-based, cross-sectional survey of residents aged > or = 40 years in rural Sri Lanka. ARMD was assessed on dilated fundoscopy using the International Age-Related Maculopathy Epidemiology Study Group classification system. Of the 1721 subjects identified, 1375 participated (79.9%). Of the participants, 1013 were aged > or = 50 years (73.6%). The prevalence of any ARMD (adjusted for study design) was 4.72 (95% CI 2.22 to 7.20)% with 3.82 (95% CI 1.60 to 6.04)% early ARMD and 1.70 (95% CI 0.14 to 3.27)% late ARMD. Age (p<0.001) and Sinhalese ethnicity (p = 0.016) were significantly associated with ARMD. Men had a tendency toward a higher prevalence of ARMD than women, although this was not statistically significant (p = 0.081). Ocular risk factors such as cortical cataract (p = 0.024) and pseudophakia (p = 0.003) were associated with ARMD on the univariate but not multivariate analyses. Illiteracy and the identification of social supports were significantly associated with ARMD on univariate analyses. However, only social support was statistically significant after multivariate analysis (p = 0.024). Although the prevalence of ARMD is slightly lower in Sri Lanka than surrounding regions, it contributes to a higher proportion of visual impairment, including blindness. Risk factors include age and Sinhalese ethnicity.
    The British journal of ophthalmology 09/2009; 94(2):150-3. · 2.92 Impact Factor
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    ABSTRACT: Classical anatomical teaching reports the presence of the lateral palpebral raphe formed at the union in the preseptal and orbital parts of the orbicularis oculi muscle, or by the tendon adhering these to the underlying zygomatic bone. The lateral palpebral raphe has been shown to be absent in Asian cadavers. The current study uses both evidence from the anatomical dissection of five eyelids from three Caucasian cadavers, and histological assessment of the lateral canthus of 13 eyelids from seven Caucasian cadavers to illustrate the absence of the lateral palpebral raphe in Caucasian population.
    Clinical ophthalmology (Auckland, N.Z.) 02/2009; 3:391-3.

Publication Stats

8 Citations
14.77 Total Impact Points

Institutions

  • 2009–2012
    • University of Adelaide
      • South Australian Institute of Ophthalmology
      Tarndarnya, South Australia, Australia
    • Royal Adelaide Hospital
      Tarndarnya, South Australia, Australia
    • South Australian Institute of Ophthalmology
      Tarndarnya, South Australia, Australia