Average Acuity Research Articles

Risk Assessment on Visual Acuity among Elementary Pupils in the Heritage City of Vigan

Children's vision is linked with the Global Goals for Sustainable Development. The Comprehensive School Eye Health Program's mandate is to prevent, detect, and treat eye disorders in children to realize their rights and enhance their growth and development. The study examined the association between visual acuity and personal factors and the academic performance of 491 pupils of three elementary schools in Vigan City. It used the descriptive correlational research. Data were collected through observation, questionnaire- checklist, and records review and treated by Frequency count, percentage, and simple linear correlation analysis. Findings showed that the majority of the respondents belong to age 10 and 11, male, grade VI, without a family history of vision problems, grandmother commonly suffer vision problem, preferred fruits and vegetables, had 8-10 hours’ sleep, television, and cellphone exposure of 0-1 hour daily, and sits while reading. Most respondents have an average visual acuity of 20/20 – 20/25, based on a self-reported result of the Vision Development Quality of Life checklist. The study yielded a significant relationship between quality of Vision (COQV) and a family history of eye problems. Likewise, a significant relationship existed between visual acuity (Snellen's Chart measurement) on both eyes and gadgets used.

The effect of serifs and stroke contrast on low vision reading

PurposePatients with low vision are generally recommended to use the same fonts as individuals with normal vision. However, we are yet to fully understand whether stroke width and serifs (small ornamentations at stroke endings) can increase readability. This study's purpose was to characterize the interaction between two factors (end-of-stroke and stroke width) in a well-defined and homogenous group of patients with low vision. MethodsFont legibility was assessed by measuring word identification performance of 19 patients with low vision (autosomal dominant optic atrophy [ADOA] with a best-corrected average visual acuity 20/110) and a two-interval, forced-choice task was implemented. Word stimuli were presented with four different fonts designed to isolate the stylistic features of serif and stroke width. ResultsFont-size threshold and sensitivity data revealed that using a single measure (i.e., font-size threshold) is insufficient for detecting significant effects but triangulation is possible when combined with signal detection theory. Specifically, low stroke contrast (smaller variation in stroke width) yielded significantly lower thresholds and higher sensitivity when a font contained serifs (331 points; d’ = 1.47) relative to no serifs (345 points; d’ = 1.15), E(μsans, low − μserif, low) = −14 points, 95 % Cr. I. = [−24, −5], P(δ > 0) = 0.99 and E(μserif, low − μsans, low) = 0.32, 95 % Cr. I. = [0.16, 0.49], P(δ > 0) = 0.99. ConclusionIn people with low visual acuity caused by ADOA, the combination of serifs and a uniform stroke width resulted in better text legibility than other combinations of uniform/variable stroke widths and presence/absence of serifs.

En Bloc Keratolimbal Allograft and Central Penetrating Keratoplasty: A Novel Surgical Technique in Severe Limbal Stem Cell Deficiency.

The purpose of this study was to present a novel surgical technique combining 360-degree keratolimbal allograft (KLAL) and simultaneous central keratoplasty termed en bloc KLAL with the central penetrating keratoplasty (PKP) performed in those cases with total limbal stem cell deficiency (LSCD) and corneal scars. Nine eyes of 9 patients underwent en bloc KLAL and central PKP between 2014 and 2016. All patients had bilateral total LSCD with total corneal opacity due to different etiologies. The exclusion criteria were previous limbal stem cell transplantation and the presence of active and uncontrolled ocular surface inflammation. The same donor globe was used for harvesting 360-degree KLAL and central PKP. The 1-piece integrity of the KLAL and PKP graft was preserved during the described technique. All patients received modified immunosuppressive regimens compatible with the Cincinnati solid organ transplantation protocol. The average age of patients was 58.6 ± 18.6 years. The diagnosis was mustard gas keratopathy in 6, herpes simplex keratitis in 1, and severe acid chemical burn in 2 patients. Seven patients were male. An integrated ocular surface without epitheliopathy and a clear cornea was achieved in 8 patients (88.8%) with an average of 6.5 years in follow-up. The average best-corrected visual acuity was 1.89 ± 0.18 (20/1600) preoperatively which improved to 1.02 ± 0.64 (20/200) logMAR in the postoperative period. Endothelial immune rejection episodes were observed in 3 patients. KLAL rejection was not observed in any patient. One patient required repeat PKP due to corneal graft failure. En bloc 360-degree KLAL and central PKP could simultaneously be performed in patients with total LSCD and corneal opacification.

Habitual visual acuity and visual acuity threshold demands in Nigerian school classrooms

This study was designed to estimate the burden of blindness and vision impairment in school children, and to determine the proportion of students meeting the visual acuity (VA) demand for their classrooms. From 148 primary and secondary school classrooms in Edo State, Nigeria, the habitual distance and near VA of over 2000 students were measured. Values obtained were compared with the calculated distance VA demand and actual near VA demand for their classrooms. Measures used to calculate the VA demand were working distance and smallest text size on learning materials, at both distance and near. We also determined the relationship between age and calculated VA demand and the effect of factors such as school ownership and school type on the VA demand. Habitual distance vision impairment was found in 0.8% of pupils, including 2 (0.10%) who met the WHO criteria for blindness. The average VA demand at the furthest and nearest sitting position to the board was 0.21 ± 0.23 and 0.65 ± 0.33LogMAR, respectively. Near working distance of students ranged from 15.00 to 37.20 cm, and the near VA demand as well as actual near VA demand (using a 2.5 times acuity reserve) was 0.60 ± 0.17 and 0.20 ± 1.7LogMAR, respectively. LogMAR VA demand increased (size of print decreases) with increasing age, at both distance (r = − 0.549, p = 0.070) and near (r = − 0.921, p < 0.0001). The VA demand at maximum distance and the actual near VA demand differed significantly by school ownership and between primary and secondary schools. Most students had VA better, but up to 11% of students per class had VA poorer than their classroom demands. Although the majority of students had better VA than their classroom demands, for students with reduced vision, learning could be negatively impacted. It is important to continually screen students for vision impairment and ensure prompt referral and treatment. These findings have implications for managing vision problems in children, as well as enabling appropriate classroom arrangements for those with vision impairment.

Refractive outcomes and optical quality of PRESBYOND laser-blended vision for presbyopia correction.

To investigate the one-year refractive outcomes and optical quality following PRESBYOND laser-blended vision (LBV). This retrospective study included 20 patients who underwent PRESBYOND treatment between Jan 2019 and Aug 2020. The patients were asked to attend a follow-up outpatient visit one year after surgery. Distance and near visual acuity as well as subjective refraction were examined. Optical quality was assessed using wavefront-supported custom ablation. A questionnaire evaluating optical quality and satisfaction was completed at the last visit. The average patient age was 48.1±7.4y (range, 41 to 58y). The mean preoperative spherical equivalent was -7.59±2.39 D. At the one-year follow-up, two eyes (both dominant eyes) lost one line of corrected distance visual acuity (CDVA), while the remaining eyes (38/40) maintained or gained lines of CDVA. The average binocular uncorrected distance visual acuity improved from 0.15±0.03 to 0.90±0.26 (decimal vision; P<0.001). The average binocular uncorrected near visual acuity increased from 0.34±0.28 to 0.97±0.07 (P<0.001). The spherical aberration was 0.04±0.06 µm in the nondominant eye and 0.09±0.09 µm in the dominant eye (P=0.02). All patients were satisfied with or accepted the outcomes of the surgery. The primary complaints were related to disturbances in night vision and relatively inferior near vision. Over the one-year observation period, PRESBYOND is a safe and effective option for presbyopia correction. The optical quality and near vision deserve further investigation.

Опыт применения глюкокортикоидов у пациентов с макулярным отеком, связанным с саркоидозом

Purpose. To evaluate the results of treatment of patients with sarcoidosis with chronic non-infectious uveitis complicated by macular edema by intravitreal injection of a glucocorticosteroid implant with previously used methods. Material and methods. The study performed a comparative analysis of data from patients with cystic macular edema against the background of chronic non-infectious uveitis associated with sarcoidosis, with corrected visual acuity of more than 0.05 (according to the Golovin-Sivtsev table). Group 1 (prospective analysis) included the results of treatment of patients with sarcoidosis with corticosteroid implants (4 eyes, 4 patients). In the 2nd group (retrospective analysis of the medical history), patients underwent peribulbar administration of betamethasone (9 eyes, 7 patients). The parameters were analyzed after 2.0±0.5, 4.0±0.5 and 6.0±0.5 months with assessment of maximally corrected visual acuity (BCVA), OCT, color photography, and IOP control. The risk of recurrence of macular edema when comparing groups was assessed over a 6-month follow-up period. Results. During the observed period in both groups, no complications were detected in any case. According to visometry and OCT, the best functional results were obtained in group 1. Average visual acuity after 6 months. was 0.7±0.1, the thickness of the retina in the central zone was 331±15µm. Conclusion. According to the results of the study, it was found that intravitreal injection of dexamethasone implant in its effectiveness surpasses the previously used peribulbar injections of betamethasone in terms of the quality of restoration of visual functions, the effectiveness of reducing macular edema and the duration of remission of the chronic inflammatory process. Key words: sarcoidosis, chronic uveitis, macular edema, dexamethasone implant, surgical treatment

Quantifying visual acuity of Terrapene carolina triunguis utilizing optokinetic response.

Quantify visual acuity of a semi-aquatic turtle species, Terrapene carolina triunguis (three-toed box turtles), utilizing optokinetic response/reflex/nystagmus. Ten turtles were placed on a custom platform and an image of white and black gratings of varying sized widths was projected onto a white screen in front of the turtles. Optokinetic response (OKR) was observed through a web camera as well as physically by an observer. The grating sizes were decreased until OKR could not be elicited. The size of grating was recorded and was used to calculate visual acuity. The average visual acuity was 0.26 cycle per degree (cpd) with the highest recorded value being 0.43 cpd and lowest being 0.15 cpd. Neither sex nor weight were significantly associated with visual acuity (p=.24 and .98, respectively). Visual acuity of these semi-aquatic turtles was much lower than previously reported visual acuities of aquatic turtles. This could be due to differences in refractive indices between water and air, behavioral adaptations for the different species and/or method of obtaining visual acuity.

Visual recovery after unilateral optic nerve sheath fenestration for pseudotumor cerebri syndrome

ABSTRACT Purpose To evaluate the effect of optic nerve sheath fenestration (ONSF) on the rate of visual function improvement in patients with pseudotumor cerebri syndrome (PTCS). Methods Retrospective chart review of patients with PTCS who underwent ONSF between 1998 and 2017. Visual function was evaluated by evaluating visual field (VF), mean deviation (MD), retinal nerve fiber layer (RNFL) thickness, papilledema grade, and visual acuity (VA) prior to and after ONSF. Results Seventeen female patients aged 17 to 36 years underwent unilateral ONSF. Follow-up averaged 40.1 months. VF MD improved steadily in both eyes up to 12 months. Average RNFL thickness improved in the operated eye from 347 ± 166 mm to 92 ± 27 mm (p < .001) and the non-operated eyes from 306 ± 165 mm to 109 ± 46 mm (p < .001). The grade of papilledema improved in the operated eye from 3.3 ± 1.3 to 0.3 ± 0.7 and the non-operated eye from 3.0 ± 1.6 to 0.18 ± 0.4. There was an exponential rate of improvement in papilledema and RNFL thickness, with the greatest improvement occurring within the first 30 days. Average visual acuity remained intact in both eyes before and after surgery. Conclusions ONSF in appropriately selected patients leads to rapid improvement in papilledema and a steady recovery in VF.

The Relationship Between Diabetic Retinopathy Degree With Visual Acuity And Retinal Nerve Fiber Layer Thickness In Type 2 Diabetes Mellitus Patients

Introduction: Diabetic retinopathy is an ocular complication of diabetes mellitus (DM), and is one of the leading causes of visual impairment and blindness worldwide.. More than one third of people with diabetes have signs of diabetic retinopathy.&#x0D; &#x0D; Methods: This was an analytic observational study with cross-sectional design. The sample was type 2 diabetes mellitus patients with diabetic retinopathy who visited the eye clinic at the University of Sumatera Utara General Hospital from September 2021-December 2021. The sample were then analyzed with the Mann-Whitney and Kruskal Wallis test to find the relationship between diabetic retinopathy degree with visual acuity and retinal nerve fiber layer thickness in type 2 diabetes mellitus patients.&#x0D; &#x0D; Results: The sample of this study were 20 subjects with diabetic retinopathy and 20 subjects without diabetic retinopathy as the control group. The mean visual acuity in subjects with mild diabetic retinopathy was 0.65+0.48. Average visual acuity in subjects with the degree of moderate diabetic retinopathy was 0.83+0.46. The mean visual acuity in subjects with a proliferative degrees diabetic retinopathy was 0.77+0.64. Mann Whitney test revealed no statistically significant relationship between the degree of diabetic retinopathy and visual acuity (p=0.734). Using the Kruskal Wallis test revealed that there was no significant relationship between the degree of retinopathy diabetic with Avg RNFL (p=0.495), superior RNFL (p=0.385), inferior RNFL (p=0.111), temporal RNFL (p=0.064), nasal RNFL (p=0.535).&#x0D; &#x0D; Discussion: Controlling blood glucose levels becomes more important than the duration of diabetes in preventing the development of retinopathy. Most patients are advised to have an HbA1c of 7% or lower, and for certain patients it is recommended to be lower than6.5%. Diabetic retinopathy slowly damages the retinal blood vessels or the optic nerve layer, leading to leakage, thus resulting in accumulation of fluid containing lipid and blood in the retina which will gradually lead to visual impairment, and even blindness.&#x0D; &#x0D; Conclusion: There is no significant relationship between diabetic retinopathy degree with visual acuity and retinal nerve fiber layer thickness in type 2 diabetes mellitus patients.

Foveolar thickness as potential standardized structural outcome measurement in studies of Bietti crystalline dystrophy

Bietti crystalline dystrophy (BCD) is an ultra-rare orphan disorder that can lead to blindness. Because of the variable rates of progression of the disease, it is necessary to identify suitable outcome measurements for tracking progression in BCD. A retrospective analysis of patients with a clinical and genetic diagnosis of BCD was conducted. Four measurements of spectral domain-optical coherence tomography were compared to patients’ best corrected visual acuity. We observed that patients with higher measurements of foveolar thickness, choroidal thickness in the foveolar region, ellipsoid zone band length and the outer nuclear layer + area, had on average better visual acuity. Future studies are needed to validate the structural–functional correlations we observed in BCD and to propose a sensitive and clinically meaningful outcome measurement for tracking this rare, variable disease.

Long-term follow-up and health-related quality of life among cancer survivors with stage IEA orbital-type lymphoma after external photon-beam radiotherapy: Results from a longitudinal study.

We assessed the long-term outcomes and treatment-related adverse effects of patients with Stage I, "orbital-type" lymphomas that were uniformly treated with photons. All consecutive patients diagnosed with low-grade, Ann Arbor Stage IEA orbital lymphoma treated between 1999 and 2020 at our department were retrospectively reviewed. We excluded patients with exclusive conjunctival involvement, typically treated with en face electrons. In order to quantify radiotherapy related side effects we applied the CTCAE criteria, analyzed changes in visual acuity, quantified dry eye symptoms by use of the Ocular Surface Disease Index (OSDI) score and applied the EORTC QLQ-C30 questionnaire for quality of life (QoL) assessment. In total 66 eyes of 62 patients were irradiated with a median dose of 30.6Gy. The median follow-up was 43.5months. The predominant histological subtype were MALT lymphomas. No local failure occurred in this cohort. Of nine outfield relapses, six solely occurred in the contralateral eye. The 5- and 10- years distant progression free survival rates (PFS) were 81.4% and 63.5%. The 5- and 10-years overall survival rates were 85.1% and 71.9% without any tumor related death. Of the acute toxicities none was higher than CTCAE grade 1. The predominant late toxicities were dry eyes (21.2%) of CTCAE Grade <2 and radiation induced cataracts (19.7%). During long-term follow up the average visual acuity did not deteriorate. The global QoL was worst before treatment and improved significantly after 24months (p=0.007). External beam radiotherapy of "orbital-type" lymphomas with photons is an effective and gentle treatment option with excellent local control rates. From the high control rates the trend to use slightly lower total doses of 24-27Gy with conventional fractionation is supported. As non-coplanar radiotherapy techniques improved and total doses can slightly be reduced, the current status of radiotherapy as first line therapy is provided.

Comparison of Time-to-Surgery and Outcomes in Transferred Vs Non-Transferred Open Globe Injuries.

PurposeIt is widely accepted in the field of ophthalmology that closure of open globes within 24 hours of the injury results in the best visual outcomes. This study investigates the time-to-surgery and visual outcomes of open globe injury patients in North Carolina that were transferred to our institution before receiving surgical intervention as compared to those that were not transferred.Patients and methodsThis is a retrospective cohort study using data from UNC Hospitals trauma registry. Demographics, time of injury, final clinical outcomes, time to surgical intervention, and transfer history were extracted and analyzed. The study population includes open globe injury patients of all ages that were seen and treated at our institution from 2005 to 2020. Patients were divided based on transfer history. The transfer group consisted of patients who were transferred from an outside hospital to our tertiary care facility for surgical treatment. The non-transfer group consisted of patients who arrived at our tertiary care facility directly after injury.ResultsIn total, 238 open globe injuries were evaluated. Of those, 197 were transferred and 41 were not transferred. Compared to non-transfer patients, transfer patients had longer delays between injury and surgery, between presentation at the initial ED and surgery, and between injury and arrival at the tertiary care center. On average, the delay between injury and surgical intervention was 3 hours and 51 minutes longer for transfer patients compared to non-transfer patients. Eight patients in the transfer group were delayed >24 hours due to inter-hospital transfer. Additionally, transfer patients on average suffered from poorer final visual acuities, with an average final visual acuity of 1.84 logMAR in the transfer group and 1.35 logMAR in the non-transfer group.ConclusionOur study found that inter-hospital transfer leads to significant delays in primary closure of open globe injuries. Injuries that were transferred to a tertiary care center before receiving surgical intervention on average resulted in worse final visual acuities.

Pediatric ED Utilization in a Destination City: Demographic, Clinical, and Temporal Trends.

Seasonal variation in emergency department (ED) visits has been shown for a variety of pediatric conditions, but previous studies have not considered how geographic location may also influence when and why these patients present to the ED. Our study examined the demographic and clinical characteristics as well as the seasonal variation among 3 patient populations (locals, in-state nonlocals, and out-of-state visitors) presenting to our pediatric ED (PED), which is located in a coastal, destination city. This was a retrospective chart review of PED visits from June 2014 to June 2019 at the Medical University of South Carolina Children's Hospital, a tertiary care facility located in Charleston, SC. Pediatric ED encounters were divided into 3 groups, depending on the patient's home address: local patients residing in the 3 surrounding metro counties, in-state but nonlocal patients, and out-of-state patients. Demographic and clinical information was abstracted for each visit and compared among the 3 patient groups. Seasonal variation among PED visits was determined by recording the week of the year during which each visit occurred. Local patients accounted for more than 90% of PED visits with increases in visits from October to April. In-state nonlocal patients presented at consistent rates throughout the year, whereas out-of-state ED utilization peaked significantly during the summer months, Spring Break, Thanksgiving, and Christmas. Our local patient population was majority African American; our in-state nonlocal patients roughly matched our state's racial demographics, and our out-of-state population was predominantly White. Compared with in-state nonlocal patients, our local patients were more likely to present with an infection-related complaint and be diagnosed with lower-acuity conditions such as viral infection, otitis media, upper respiratory infection, cough, fever, and gastroenteritis. In-state nonlocal patients had the highest average triage acuity, more frequently had laboratory tests and imaging ordered, and were more than 4.5 times as likely to be admitted to the hospital compared with our local patients. In-state nonlocal patients were also more likely to present with a psychiatric chief complaint compared with our local patients. Out-of-state patients had a similar overall acuity to local patients but were more likely to have imaging ordered and be diagnosed with injuries such as fractures. At our institution, local patients, in-state nonlocal patients, and out-of-state patients exhibited 3 distinct patterns of PED utilization. Knowledge of these trends can be used to optimize resource allocation and follow-up planning, particularly for our out-of-state patient population.

Брахитерапия в лечении вазопролиферативной опухоли сетчатки

Purpose. To analyze the effectiveness of Ru106 brachytherapy in the treatment of the vasoproliferative tumor (VPT) – a neoplasm of the retina with a pronounced vascular component. Material and methods. The observation group consisted of 17 patients (17 eyes), the average lesion height according to B-scan data was 3.34 mm. Results. After treatment, the average visual acuity was 0.2, in most cases there was a decrease in the height of the VPT focus, on average by 1.4 mm. Conclusion. Brachytherapy Ru106 has shown its effectiveness as a method of treating VPT. Key words: vasoproliferative retinal tumor, brachytherapy, retinal detachment, uveitis, epiretinal fibrosis

Treatment History as a Predictor for Change in Visual Acuity After Surgical Correction of Diabetic Retinal Traction Detachment.

IntroductionTractional retinal detachment remains a leading cause of severe, persistent vision loss in those with diabetic retinopathy. The purpose of this study was to investigate factors in treatment history associated with outcomes of surgical repair for diabetic tractional retinal detachments.MethodsA retrospective, cohort study design was used. Data on 64 eyes that underwent surgical correction for diabetic tractional retinal detachment were analyzed. For eyes that received any treatment within three months of surgery, the entire treatment history was recorded and analyzed. Eyes with no recorded treatment or only remote treatment outside of three months prior to surgery were considered treatment naïve.ResultsOf all eyes, 56% (n = 36) had received treatment for proliferative diabetic retinopathy in the three months prior to surgery. Among those treated, 50% (n = 18) of eyes had both laser and bevacizumab treatments and 44% (n = 16) had only bevacizumab injections. Average best corrected visual acuity (BCVA) for all eyes improved from 1.68 LogMAR (20/1,000) pre-operatively to 1.34 (20/400) post-operatively, p = 0.0017. Average BCVA in eyes with pre-operative treatment history improved from 1.73 (20/1,000) pre-operatively to 1.09 (20/250) post-operatively, p = 0.0006. Average BCVA in treatment-naïve eyes was 1.60 (20/800) pre-operatively and 1.66 (20/1,000) post-operatively, p = 0.638. Eyes treated only with intravitreal injections had an improvement in BCVA from 1.81 (20/1,200) pre-operatively to 0.91 (20/160) post-operatively, p = 0.006. There was no difference between tamponade agents when comparing mean change in BCVA, p = 0.944.ConclusionsThere was a relationship between intravitreal injection treatment history and a large improvement in BCVA, and a similar association between combined laser and injection treatment history and improvement in BCVA. These relationships, however, were not present when controlling for confounders in multivariate analysis. There were likely other factors in the patient’s treatment history such as timing, quantity, and order of treatments that played a role in the bivariate association observed in this study.

Safety and efficacy of 27-gauge transconjunctival vitrectomy for the diagnosis of posterior uveitis or pan uveitis of unknown origin

BackgroundDiagnostic vitrectomy is an important method for evaluating uveitis, and its diagnostic utility is high regardless of whether the uveitis is infectious or non-infectious. The course of diagnostic vitreous surgery with 27-gauge pars plana vitrectomy and perioperative complications is reported.MethodsAn observational retrospective study of patients who underwent 27-gauge diagnostic vitrectomy due to atypical intraocular inflammation was conducted. The final diagnosis rate, complications due to surgery, preoperative visual acuity, and postoperative visual acuity (1 month and 6 months after surgery) were examined retrospectively.ResultsDiagnostic vitreous surgery was performed in 32 patients and 35 eyes (14 males and 18 females, age 14–85 years, median 67 years) during the study period. The average operation time was 52 min for 19 eyes with cataract surgery and 35 min for 16 eyes without cataract surgery. Preoperative log(minimum angle of resolution [MAR]) visual acuity was 0.84 ± 0.87, 1-month postoperative logMAR visual acuity was 0.41 ± 0.55 (p = 0.004, n = 28), and 6-month postoperative average logMAR visual acuity was 0.45 ± 0.73 (p = 0.012, n = 15). The diagnosis was made by diagnostic vitrectomy in 19 cases (54%). Postoperative complications were observed in 2 of 35 postoperative patients (5%); one involved increased intraocular pressure, and the other case involved vitreous hemorrhage of the eye, necessitating reoperation.ConclusionDiagnostic 27-gauge vitrectomy could be effective for evaluating intraocular inflammation.

Preoperative dry eyes disease in cataract patients with deficient tear break up time: evaluation of OSDI questionnaire, its subcategories and Keratograph 5M device results.

To evaluate preoperatively dry eye disease (DED) in patients with pathological Tear Break Up Time (TBUT), utilising subjective Ocular Surface Disease Index (OSDI) with its subcategories and objective Keratograph 5M characteristics. Fifty-four cataract patients were included in this prospective study having a screening slit lamp TBUT of less than 10s and more or equal to 5s. Subjective evaluation of DED was performed with OSDI questionnaire and objective evaluation with Keratograph 5M. Tear Meniscus Height (TMH), bulbar and limbal redness and meibography grade were evaluated. Further analysis of OSDI subcategories, Visual Function Related (VFR), Ocular Symptoms related (OS) and Environmental Triggered (ET), was performed with linear and logistic multivariate regression models. Age, gender and logMAR visual acuity (VA) were also included in our models. Following the initial TBUT screening we identified 27(50%) normal and 27(50%) dry eye patients, using OSDI questionnaire. There was no statistical difference in TMH (p = 0.64), bulbar redness (p = 0.54), limbal redness (p = 0.72) and meibography grade (p = 0.25), between normal and dry eye OSDI group. In our regression analysis, average logMAR VA was highly associated with a higher total OSDI score (p < 0.001) and with a higher OSDI-VFR score (p < 0.001).Female gender was associated with a higher OSDI-ET score (p = 0.03).Multivariate logistic regression models were performed by sorting patients into 2 categories of normal and dry eye group according to their total OSDI,OSDI-VRF,OSDI-OS and OSDI-ET score. An increase in logMAR VA increased the odds of having abnormal total OSDI score (p = 0.007) and OSDI-VFR score (p = 0.006).Females had increased odds of having abnormal OSDI-ET score (p = 0.044). Clinicians should be aware of OSDI limitations when screening cataract patients for dry eyes, as there is high correlation with VA. Female patients were more susceptible to environmental factors. Keratograph results should be interpreted with caution when they are evaluated in conjunction with OSDI during preoperative assessment of DED in cataract patients.

Assessment of level of care recommendations and nursing acuity scores following an appropriateness of care intervention

BackgroundAs part of a multiprong intervention to eliminate waste in cost of hospital accommodations, the InterQual Level of Care (LOC) criteria was deployed by our institution to assign patients to...

Low prevalence of spectacle use in the Hungarian Roma population indicates unmet health needs

The Roma population is the largest transnational ethnic minority group in Europe, often facing socioeconomic inequalities and various health problems. In the present study, we investigated visual acuity and its influencing factors along with spectacle use of the Roma population in comparison with the general population in Hungary. A cross-sectional survey was carried out including 832 participants aged 20–64 years. We recorded the uncorrected visual acuity along with anthropometric, demographic, socioeconomic and health-related data of each individual. Although the average uncorrected visual acuity was somewhat higher, the use of a visual aid was significantly less frequent in the Roma population, especially in the group with a visual acuity below 0.5 in both eyes (14.3% vs. 77.1%, p < 0.001). Age, abdominal obesity and disturbances of carbohydrate metabolism had a negative impact on visual acuity in both populations; however, the latter was a much stronger risk factor in the Roma population (OR 5.789, 95% CI 2.239–14.964, p < 0.001) than in the general population (OR 2.075, 95% CI 1.097–3.926, p = 0.025). Our results show serious unmet health needs within the Roma population, which calls for public health programs to improve poor primary care indicators on regular eye examination and much more rigorous diabetes control.

RESULTS OF POSTERIOR LAMELLAR KERATOPLASTIES IN PHAKIC EYES.

To evaluate the results of posterior lamellar keratoplasties (DMEK and PDEK) in phakic eyes. Retrospective analysis of surgeries performed in our department between June 2016 and December 2019. The main focus was put on postoperative visual acuity, corneal endothelial cell density and possible peroperative and postoperative complications including cataract formation. We performed 12 surgeries on 11 eyes of 7 patients. The most prevalent primary diagnosis was Fuchs endothelial dystrophy (7 eyes), followed by bullous keratopathy after phakic anterior chamber IOL implantation (2 eyes) and ICE syndrome (2 eyes). The average length of follow-up was 12.5 months. Clinically significant complicated cataract had developed and was removed in 3 eyes, one eye required rebubbling due to graft detachment and one eye required rePDEK due to graft failure. At the end of follow-up, the average visual acuity was 0.87, while 82% of eyes achieved VA 0.8 or better, and the average endothelial cell density was 1589 cells/mm2. Posterior lamellar keratoplasties (DMEK and PDEK) can be performed on phakic eyes. When performed by an experienced surgeon, these are safe procedures with good postoperative results and significant advantage in preserving younger patients accommodation.