Lucy A Goold

University of Adelaide, Tarndarnya, South Australia, Australia

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Publications (9)15.86 Total impact

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    ABSTRACT: Introduction: To present a series of patients with bisphosphonate induced orbital inflammation, and to review the clinical presentation, radiological features, treatment options and outcomes. Methods: We present a multicentre, retrospective case series review of patients with a clinico-radiological diagnosis of bisphosphonate induced orbital inflammation and review all the reported cases of this complication in the literature. Results: Four new patients with bisphosphonate induced orbital inflammation were added to the 25 cases in the literature. Intravenous zoledronate was the commonest precipitant (22/29, 75.9%) and inflammation occurred 1-28 (mean 3) days post-infusion. Orbital imaging identified orbital inflammation in 22/29 cases and extra-ocular muscle enlargement in 8/29. Five patients presented with reduced vision of which one - with anterior ischaemic optic neuropathy - did not resolve. The vision resolved in all except one patient, with most requiring steroid treatment. Conclusions: Bisphosphonates have a pro-inflammatory effect, which can precipitate orbital inflammation. This rare, but potentially serious complication of bisphosphonate treatment should be considered by clinicians using bisphosphonate treatment and by ophthalmologists seeing patients with orbital inflammatory disease.
    No preview · Article · Nov 2015 · Orbit (Amsterdam, Netherlands)
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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.
    No preview · Article · Apr 2013 · The British journal of ophthalmology
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    ABSTRACT: Background Invasive fungal sinusitis is a rare condition that usually occurs in immunocompromised patients and often presents as an orbital apex syndrome. It is frequently misdiagnosed on presentation and is almost always lethal without early treatment. DesignRetrospective case series of 14 consecutive patients with biopsy-proven invasive fungal sinusitis from four tertiary hospitals. ParticipantsFourteen 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 MeasuresDemographic data, background medical history (including predisposing factors), symptoms, signs, radiological findings, histopathological findings, treatment approach and subsequent clinical course were recorded and analysed. ResultsOnly one patient was correctly diagnosed at presentation. Only two patients were not diabetic or immunocompromised. The tempo was acute in two patients, subacute in nine patients and chronic in three patients. In the subacute and chronic cases, there was about 1 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 two 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.
    Full-text · Article · Dec 2012 · Clinical and Experimental Ophthalmology
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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.
    No preview · Article · Jan 2012 · European Journal of Plastic Surgery
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    ABSTRACT: Aldose reductase (ALR) is involved in diabetic microvascular damage via the polyol pathway. A recent meta-analysis found genetic variation in the ALR gene (AKR1B1) to be significantly associated with diabetic retinopathy (DR). We investigated the genetic association of AKR1B1 with DR. The study enrolled 909 individuals with diabetes. Participants were genotyped for an AKR1B1 (CA)n microsatellite and 14 tag single nucleotide polymorphisms, and ophthalmological assessment was performed. A total of 514 individuals were found to have DR. rs9640883 was significantly associated with DR (P = 0.0005). However, AKR1B1 variation was not independently associated with DR development after adjusting for relevant clinical parameters. rs9640883 was associated with duration of diabetes (P = 0.002). Many previous reports have failed to account for known risk factors for DR. The commonly reported association of AKR1B1 with DR may be due to an association of the gene with younger age at onset of diabetes.
    Full-text · Article · Aug 2010 · Diabetes care
  • Lucy Goold · Shane Durkin · John Crompton
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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.
    No preview · Article · Oct 2009 · Australian family physician
  • Lucy Goold · Shane Durkin · John Crompton
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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.
    No preview · Article · Oct 2009 · Australian family physician

  • No preview · Article · Oct 2009 · Ophthalmology
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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.
    No preview · Article · Sep 2009 · The British journal of ophthalmology
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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.
    Full-text · Article · Feb 2009 · Clinical ophthalmology (Auckland, N.Z.)

Publication Stats

36 Citations
15.86 Total Impact Points

Institutions

  • 2009-2015
    • University of Adelaide
      • • Discipline of Ophthalmology
      • • South Australian Institute of Ophthalmology
      Tarndarnya, South Australia, Australia
    • Royal Adelaide Hospital
      Tarndarnya, South Australia, Australia
  • 2009-2013
    • South Australian Institute of Ophthalmology
      Tarndarnya, South Australia, Australia