Comprehensive Eye Examination Research Articles

Structure–function models for estimating retinal ganglion cell count using steady-state pattern electroretinography and optical coherence tomography in glaucoma suspects and preperimetric glaucoma: an electrophysiological pilot study

PurposeTo derive and validate structure–function models for estimating retinal ganglion cell (RGC) count using optical coherence tomography (OCT) and steady-state pattern electroretinography (ssPERG) parameters in glaucoma suspects (GS) and preperimetric glaucoma (PPG).MethodsIn this prospective cross-sectional study, 25 subjects (50 eyes) were recruited at the Manhattan Eye, Ear, and Throat Hospital. Subjects underwent comprehensive eye examinations, OCT, standard automated perimetry (SAP), and ssPERG testing. Eyes were divided into three groups based on the Global Glaucoma Staging System: healthy (N = 30), GS (N = 10), and PPG (N = 10) eyes. The combined structure–function index (CSFI), which estimates retinal ganglion cell count (eRGCCSFI) from SAP and OCT parameters, was calculated in each study subject. Two prediction formulas were derived using a generalized linear mixed model (GLMM) to predict eRGCCSFI from ssPERG parameters, age, and average retinal nerve fiber layer thickness (ARNFLT) in 30 eyes selected at random (training group). GLMM predicted values were cross-validated with the remaining 20 eyes (validation group).ResultsThe ARNFLT, ssPERG parameters magnitude (Mag) and magnitudeD (MagD), and eRGCCSFI were significantly different among study groups (ANOVA p ≤ 0.001). Pearson correlations demonstrated significant associations among ARNFLT, ssPERG parameters, and eRGCCSFI (r2 ≥ 0.31, p < 0.001). Two GLMMs predicted eRGCCSFI from Mag (eRGCMag) and MagD (eRGCMagD), respectively, with significant equations (F(3,18), F(3,19) ≥ 58.37, R2 = 0.90, p < 0.001). eRGCMag and eRGCMagD in the validation group (R2 = 0.89) correlated with eRGCCSFI similarly to the training group. Multivariate pairwise comparisons revealed that eRGCMag and eRGCMagD distinguished between healthy, GS, and PPG eyes (p ≤ 0.035), whereas independent Mag, MagD, and ARNFLT measures did not distinguish between GS and PPG eyes.ConclusionThis pilot study offers the first combined structure–function models for estimating RGC count using ssPERG parameters. RGC counts estimated with these models were generalizable, strongly associated with CSFI estimates, and performed better than individual ssPERG and OCT measures in distinguishing healthy, GS, and PPG eyes.

Impact of an intervention for avoidable vision loss on visual function in the elderly-The Hyderabad Ocular Morbidity in Elderly Study (HOMES).

To report the impact of interventions for avoidable vision impairment (VI) on the visual function of elderly residents in 'homes for the aged' in India. Participants aged ≥60 years were recruited. A comprehensive eye examination was conducted by trained examiners and interventions were provided. Trained social investigators administered the Indian Vision Function questionnaire (INDVFQ) to assess visual function before and after the intervention (spectacles, cataract surgery or laser capsulotomy). Lower scores on IVFQ imply better visual function. VI was defined as presenting visual acuity worse than 6/18 in the better eye. VI due to cataract, uncorrected refractive errors, and posterior capsular opacification after cataract surgery were considered avoidable VI. The mean age of the participants (n = 613) was 73.8 years (standard deviation: 8.1 years) and 378 (62.2%) were women. 64/103 (62.1%) participants who had avoidable VI at baseline were evaluated after the intervention. Significant gains were observed in all four domains of visual function. There was a 14.9% improvement in mobility scores (33.8 versus 28.8; p = 0.03), a 19.9% improvement in the activity limitations score (36.8 versus 29.5; p < 0.01), a 10.9% improvement in the psychosocial impact score (41.1 versus 36.6; p < 0.01) and a 13.6% improvement in the visual symptoms score (49.2 versus 42.5 p < 0.01). Overall, the mean IVFQ score improved by 16.4% (47.6 versus 39.8; p < 0.01). Elderly individuals in residential care with avoidable VI had a significant improvement in visual function after relatively low-cost interventionssuch as spectacles and cataract surgery. Strategies are needed to provide these interventionsfor theelderly in 'homes for the aged'in India.

Vision therapy for children with autism spectrum disorder – A review and case report

A higher incidence of ocular morbidity including visual perceptual disorders has been noted in individuals with autism spectrum disorder (ASD). Individuals with ASD show a lack of eye contact, poorly developed eye-hand coordination, and decreased visual perceptual skills. The presence of such deficits may influence the development of cognitive, motor skills, perception, behaviour, social interactions, and communication of these children. A nine-year-old male child diagnosed with autism spectrum disorder presented with a lack of eye contact, challenges in gross and fine motor skills, and social interactions. A comprehensive eye examination was performed, followed by an assessment of visual-spatial abilities of the child. Developmental Test of Visual Perception - third edition, administered to understand visual-motor integration and motor-reduced visual perceptual skills, revealed perceptual deficits in all domains. The child completed 30 sessions of vision therapy resulting in significant improvement in visual-spatial skills, visual-motor integration, and motor-reduced visual perception. This case demonstrated that individuals with ASD can benefit from vision therapy. Significant changes in behaviour including improved attention span and increased understanding of instructions were evident from parental feedback. Visual perceptual skill training holds the promise of being an adjunct developmentally supportive intervention for some children with an autism spectrum disorder.

Steep increase in myopia among public school-going children in South India after COVID-19 home confinement

Novel coronavirus has brought huge changes in lifestyle, especially among children. Reports indicate that the prevalence of refractive errors among children has increased due to home confinement. Hence, this study was done to understand the current status of refractive errors among children from public schools in southern India. This cross-sectional study was conducted as part of school eye screening conducted between September and October 2021. Children between 14 and 17 years of age from public schools underwent a three-phased comprehensive eye examination. Children identified with refractive errors and an equal proportion of children without any refractive errors underwent a survey on outdoor activities. Prevalence estimates and 95% confidence interval were calculated. Chi-square tests and regression analysis were used to understand the association between refractive error and other variables. From the data of 3,850 (90.69%) children, the prevalence of vision impairment, refractive errors, and myopia in at least one eye was found to be 12.83% (n = 494), 21.51% (n = 828), and 19.53% (n = 752), respectively. The average myopic spherical equivalent error was found to be -2.17 ± 1.11D (range:-0.50 D to -14.00 D). Almost 96.82% of girls had less than 3 h of outdoor activities. Refractive errors were 7.42 and 2.77 times more (95% CI: 3.51-15.70), P < 0.001) among children who had outdoor activities less than 3 h per day and sleep less than 7 h per day. Comparing to previous studies from North Indian and South Indian public schools, this study reports a three- to six-fold rise in myopia post-home confinement among public school children from India.

Case Control Study to Evaluate Tear Film Function and Ocular Surface Disorder in Diabetic Patients

BACKGROUND&#x0D; Diabetic retinopathy and early development of cataracts are well-known ocular complications of long-standing diabetes. In recent years various researchers have reported ocular surface disorders, particularly dry eyes in diabetic patients which if left untreated may result in a variety of corneal complications. These ocular surface disorders can be clinically diagnosed by performing a detailed slit lamp examination, Schirmer's test and tear film break-up time. Our study intended at assessing tear film and ocular surface disorders in diabetic patients and study tear film function in them and compare it with non-diabetic patients.&#x0D; METHODS&#x0D; A comparative cross-sectional study was done on 100 diabetic and 100 non-diabetic patients &gt; 30 years of age visiting OPD of health centre of tertiary care hospital of Central India. Clinical data and detailed clinical history were obtained from all subjects through direct patient interviews and reviewing of their medical records followed by a comprehensive ocular examination that included best-corrected vision, slit lamp examination, and Tear Film break up time (TBUT) &amp; Schirmer test.&#x0D; RESULTS&#x0D; In our study, mean TBUT was found to be significantly reduced in diabetics (15.94 ± 3.8) as compared to non-diabetics (20.13 ± 6.6). No significant difference was found in the Schirmer test reading between diabetics (17.13 ± 3.20) and non-diabetics (19.20 ± 6.23). Diabetic male patients had significantly decreased mean TBUT &amp; mean Schirmer test readings as compared to diabetic females. Mean Schirmer reading &amp; Mean TBUT were lowest in a patients having &gt; 20 years of DM and highest in patients having &lt; 5 years of DM. No positive correlation was found between HbA1c (Glyosylated Haemoglobin) and diabetic retinopathy with TBUT/ Schirmer test readings.&#x0D; CONCLUSIONS&#x0D; Our study showed that the tear film stability was found to be affected in diabetic patients, as compared to non-diabetic subjects as evident by the lower level of TBUT in diabetic patients. Significantly reduced TBUT with no significant difference in Schirmer test reading in diabetic as compared to non-diabetic subjects might be due to a decrease in basal secretion with normal overall tear secretion. The absence of subjective symptoms of dryness in spite of decreased TBUT in the diabetic group might be due to a decrease in corneal sensitivity caused by diabetic peripheral neuropathy in diabetic patients. There was an increase in the prevalence of DES with an increasing duration of DM. Rheumatoid arthritis was found to be a risk factor for DES. Diabetic males were found to be at risk for developing dry eye syndrome. Hence it can be concluded from our study that every diabetic patient should undergo a comprehensive eye examination which should include various tests for dry eye assessing multiple tear parameters.

Clinicopathological profile, management and clinical outcomes in recurrent cases of ocular surface squamous neoplasia at a tertiary care centre.

This study was taken up to look into the various causes of recurrence, clinicopathological profile and final outcomes in recurrent cases of ocular surface squamous neoplasia (OSSN). A prospective cohort study was conducted and total 18 patients were recruited. All patients were subjected to detailed history, comprehensive eye examination and imaging studies. A treatment plan was formulated based on the size and extent of the lesion. The primary outcome measure was complete response to treatment with no evidence of recurrence after12months and secondary outcome measure was complication associated with each treatment modality. The common cause of recurrence in our study was misdiagnosis of the lesion as in 15 cases it was diagnosed as pterygium and in 03 cases it was actinic keratosis. Excision Biopsy with adjunctive cryotherapy was the preferred treatment modality followed by topical interferon-alpha 2b drop-in our study. We could achieve good outcomes in terms of complete response to the treatment in 16 cases. The complication associated with this treatment was minimal in our study as few patients complained redness and irritation which subsided after application of topical lubricants. There was no sign of recurrence even at 12months of follow-up in all 18 cases. The current study provided clinicopathological characteristics and treatment outcomes in recurrent cases of OSSN. In our study, adopting appropriate treatment strategy, regular follow-up to assess the response to treatment and change over to new treatment plan in cases with inadequate response helped in achieving good outcomes in recurrent cases of OSSN.

Access to eye care and prevalence of refractive error and eye conditions at a high school–based eye clinic in southeastern Michigan

To analyze clinical and demographic data from a twice monthly optometrist-run comprehensive eye program at a high school in a community with high rates of poverty. Students received comprehensive eye examinations. We collected demographic and ocular data on 429 initial visits from February 2015 to July 2019. Follow-up visits were excluded. The average student age was 14.2 ± 2.7 years. Of the total, 55.7% were female, 59.7% were Black, and 61.7% had Medicaid. Of the total, 70.2% had a previous eye examination, 60.8% had worn glasses previously, and 24.1% still wore glasses. Hispanic students were less likely than non-Hispanic students to have had a prior eye examination (59.1% vs 75.3% [P = 0.022]) or worn glasses (47.8% vs 63.8% [P= 0.035]). Black students had significantly worse presenting visual acuity in the better seeing eye than White students (logMAR 0.22 vs 0.13 [P = 0.0004]). Of the 256 Black students, 62.7% had improvement of two or more lines, compared with 42.9% of White students (P = 0.01). Of the students who participated, 74.0% received glasses following their examination, and 21 required referrals to ophthalmologists, of whom 13 attended the appointment. The high school-based clinic identified high rates of uncorrected refractive error, highlighting the benefit of a school-based eye clinic in a population with high rates of poverty. There were concerning racial and ethnic disparities in prior eye care.

Familial Primary Open Angle Glaucoma

Primary open-angle glaucoma (POAG), also known as chronic simple glaucoma, is usually an inherited disease. Inheritance is considered multifunctional and polygenic. Glaucoma is the second leading cause of irreversible blindness worldwide, of which POAG is the most common. First-degree relatives of POAG patients are at increased risk. A reasonable risk for siblings is four and twice the risk of the normal population for the offspring, although the number of surveys varies. This case series of eight family members with POAG illustrates the stealth nature of POAG and the devastating vision loss it can cause as it progresses; emphasizing regular and comprehensive eye examinations during its early stage.

Clinical and Molecular Characteristics of Diabetic Retinopathy and Its Severity Complications among Diabetic Patients: A Multicenter Cross-Sectional Study.

Background: Diabetic retinopathy (DR) is a complication associated with uncontrolled DM. It is a leading preventable cause of visual impairment in the world and a cause of blindness in those under 75 years old in developing countries. We aimed to explore the prevalence and associated risk factors of DR among diabetic patients in the West Bank. Materials and Methods:A quantitative multicenter cross-sectional study was conducted in all West Bank cities. Nearly, 385 patients underwent a comprehensive eye examination in addition to blood and urine tests. A previously validated questionnaire for ocular examination classification was used together with a socio-demographic and past medical history information sheet. Results: The prevalence of all DR in the West Bank was 41.8%. The prevalence of non-proliferative diabetic retinopathy (NPDR) was 50.3% (38.5% for mild NPDR, 10.6% for moderate NPDR and 1.2% for severe NPDR). The prevalence of proliferative diabetic retinopathy (PDR) was 9.9% and 39.7% for diabetic macular edema (DME) (17.4% for mild, 15.5% for moderate and 6.8% for severe DME). The prevalence of vision-threatening PDR and DME was 49.7% for both. In a univariate analysis, DR was significantly associated with body mass index; BMI (p = 0.035), DM duration (p = 0.002), Low-density lipoprotein (LDL) (p = 0.034), glutamic-oxaloacetic transaminase (GOT) level (p = 0.016) andblood urea (BU) (p = 0.044). A multivariate analysis showed a strong significant association between DR andpatients who had DM for 10-19years (adjusted odds ratio; AOR (95%CI); 1.843 (1.05–3.22)), abnormal levels of LDL (AOR (95%CI); 0.50 (0.30–0.83)), abnormal levels of GOT (AOR (95%CI); 0.49 (0.27–0.89)), and overweight (AOR (95%CI); 0.39 (0.19–0.80)). Conclusions: We found that the prevalence of DR in Palestine was higher than the global prevalence. Referral coordination between ophthalmologists and internal physicians is necessary to better follow up with DR patients. An interventional educational program by clinicians and public health professionals is recommended.

Identification of Retinal Diseases using blood vessel segmentation Based on Robinson Compass Mask and K-Means Clustering Algorithm

Abstract: In order to discover distinct infection circumstances within blood veins, medical professionals frequently examine tissue layer blood vessels using retinal images. The automatic recognition of retinal veins would make it easier to diagnose numerous diseases. As a result, the time required for comprehensive eye examinations by the optometric MD is reduced. This study's main purpose is to create attached tips for tracing blood veins in the tissue layer. To extract the retinal vas network from anatomical structure images, the proposed methodology was devised. Our method is divided into four stages: first, preprocessing in case you want to organize your dataset for segmentation; second, an image enhancement method that includes CLAHE with Sequential filter; third, a Robinson compass mask for feature extraction; and fourth, a K-means clustering approach agglomeration for higher segmentation. Lastly, a new process step that eliminates incorrectly divided remote regions was added.

Clinical Characteristics of Post-surgical Ptosis Patients at Dr. Mohammad Hoesin General Hospital Palembang

Introduction: Blepharoptosis is drooping of the upper eyelid in a primary position, causing the narrowing of the palpebral fissure. This condition can partially or completely cover the visual axis. Establishing the diagnosis of ptosis requires a comprehensive eye examination, including history taking, physical examination, and examination of the eyelids in ptosis patients. The majority of patients with ptosis require surgery, and clinical characteristics play an important role in classifying the type of ptosis and then formulating a detailed treatment plan strategy so that a better outcome is obtained.&#x0D; Methods: A descriptive retrospective study was conducted from medical records of post-surgical ptosis patients at Dr. Mohammad Hoesin Hospital Palembang from January 2016 to December 2021. The data taken included age, gender, the onset of occurrence, laterality, type of ptosis based on the onset, vertical palpebral fissure (FPV), horizontal palpebral fissure (FPH), margin-reflex distance (MRD), margin limbal distance (MLD), lid lag, bell's phenomenon levator muscle function, type of ptosis surgery and postoperative condition. This study aims to determine the clinical characteristics of patients with ptosis at Dr. Mohammad Hoesin Hospital Palembang.&#x0D; Results: Of the 57 ptosis patients in this study, the majority of patients were male, as many as 32 patients (56.1%) with the age category &gt;40 years, as many as 24 patients (42.1%) with unilateral lateral ptosis as many as 50 patients (87.7%) with the more frequent comparison was the left eye in 29 patients (58%). Acquired ptosis was the most common cause in this study in as many as 46 patients (80.7%), and the most common mechanism of acquired ptosis was neurogenic (33.3%). The majority of patients had no previous surgical history of 41 patients (71.9%), moderate levator function of as many as 42 (73.7%), and frontal suspension surgery technique with synthetic materials as many as 17 (34%) patients. the mean FPV was 5.08±2.627 with a median of 5.00 (0-11), FPH 25.94±1.726 with a median of 26.00 (20-29), MRD 0.246±1.78 with a median of 0.00 (-4 -5), MLD 4.789±2.801 with a median of 5.00 (-4-11) and LA 7.16±4.083 with a median of 7.00 (0-14). Ptosis patients had negative lid lag in 47 patients (82.5%) and positive bell's phenomenon in 49 patients (86%). The postoperative condition of ptosis patients was satisfactory where there was no recurrence and reoperation of ptosis, postoperative complications as many as 1 (1.8%) patients experienced overcorrection, 6 (10.5%) patients experienced lagophthalmos, and 2 (3.5%) patients had an outcome. asymmetric.&#x0D; Conclusion: Clinical characteristics of ptosis patients can determine the diagnosis and treatment that will be given to the patient.

Clinico-epidemiological Study of Patients with Glaucoma in a Tertiary Eye Center, Nepal.

Major cause of irreversible blindness is glaucoma which is increasing as a significant global health problem. Knowledge of glaucoma burden and its clinical characteristics in this region is essential. This was a cross-sectional hospital -based study conducted at Glaucoma unit in CHEERS Hospital, Bhaktapur from August 2015 to July 2019. Patients' demographic profile, along with comprehensive eye examination findings were reviewed from the records. Data analysis was done with IBM SPSS version 24 and was presented in mean (±SD), frequency and proportions and a chi- square test was applied. P value < 0.05 was considered statistically significant. Total of 310 glaucoma cases were included in this study. The mean age presentation was 61.89±14.4 years, and the majority of patients (52.9%) were in the age group 60-79 years. Most patients had primary open angle glaucoma (171, 55.2%) followed by primary angle closure glaucoma (92, 29.7%). Primary open angle glaucoma is the most common form of glaucoma. The proportion of glaucoma increased with increasing age (> 40 years). Provision of screening programs targeting persons with risk factors and opportunistic eye examinations would be beneficial in detection of glaucoma.

Comparison of the Effects of Latanoprostene Bunod and Timolol on Retinal Blood Vessel Density: A Randomized Clinical Trial

To compare the differences in retinal vessel density (VD) between topical administration of latanoprostene bunod (LBN) ophthalmic solution 0.024% and timolol maleate 0.5% in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) and normal subjects. Randomized, single center, crossover clinical trial. Eligible subjects were examined during 6 study visits over 12 weeks. All subjects were randomized in a 1:1 ratio to LBN dosed once daily or timolol dosed twice daily in both eyes (OU) for a duration of 4 weeks each, separated by a 2-week washout period. A comprehensive eye examination OU was performed at each visit. Testing was performed with optical coherence tomography and optical coherence tomography angiography (optic nerve and macula), as well as visual field examination, on the study eye at baseline and before and after each treatment. One eye from each of 50 patients was enrolled (10 healthy patients, 26 patients with OHT, and 14 patients with OAG). After administration of LBN there was significantly increased macular VD (0.76% [0.20%-1.33%], P=0.009) and a trend in increasing peripapillary VD in patients with OAG and patients with OHT. In contrast, after administration of timolol, there were no differences in macular VD, and a decrease in peripapillary VD only was observed in the nasal inferior sector (-0.56% [-1.08% to -0.03%], P=.04) in patients with OAG and patients with OHT. No change in peripapillary or macular VD was observed in the normal subjects (P > .05 for all). Topical administration of LBN enhanced macular VD in patients with OAG or patients with OHT. In contrast, timolol administration did not have any effect on VD.

Eye examinations in school children with autism spectrum disorder: a case series to assess strategies and assistive devices

Purpose. To present a case series of how five Autism Spectrum Disorder (ASD) patients completed a comprehensive eye ex- amination when visual, sensory, and communication supports and tests and techniques minimizing tactile defensiveness were employed. Methods. Patients, between 9 and 17 years, with a confirmed diagnosis of ASD completed an eye examination using a protocol designed to accommodate communication, sensory processing, and motor challenges. Parents provided informa- tion regarding verbal communication level (nonverbal, uses short words, verbal). Results. 5 patients (2 females, 3 males) completed the protocol. Two were verbal and three were nonverbal or minimally verbal. Of these, 1 patient used a communication device to response Yes/No, 1 reviewed a social story in advance of the examination, 2 used a Lea acuity response card, 1 used the palm of a hand in place of an occlude, 1 utilized a sensory fidget. Conclusion. ASD patients, including those who are nonverbal or limited verbal language as reported by their parents, vary in their needs and responses, but can complete many vision and eye tests in a comprehensive eye examination when supports are provided. Keywords Autism Spectrum Disorder, eye examination, sensory pro- cessing, communication Keywords Autism Spectrum Disorder, eye examination, sensory pro- cessing, communication

Vision centre helps reduce blindness and vision impairment. Proof of concept in a four-year longitudinal study in an urban area in India.

Purpose:To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door-to-door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact.Methods:Four trained community health workers measured the visual acuity and performed an external ocular examination in patients’ homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years.Results:In the study, 44,535 people in 2015–16 and 98.14% (n = 43,708) of them in 2018–19 were examined. Blindness (vision < 3/60 in better eye), and moderate-to-severe visual impairment (MSVI, vision 6/18–6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort (P < 0.001). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 (P < 0.001). Females (P < 0.001) and older individuals (P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years.Conclusion:The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.

Incidence, causes and risk factors of vision loss in rural Southern China: 6-year follow-up of the Yangxi Eye Study

PurposeTo report the 6-year incidence, causes and risk factors for vision loss (visual impairment (VI) and blindness), among elderly adults in rural southern China.MethodsPopulation-based, cohort study. Initiated in 2014, the...

PREVALENCE OF GLAUCOMA IN PATIENTS AGED ≥ 40 YEARS ATTENDING A TERTIARY CARE CENTRE

AIM:To estimate the prevalence of glaucoma in patients aged ≥ 40 years attending a tertiary care centre. BACKGROUND: Glaucoma is the second leading cause of irreversible blindness worldwide. Glaucoma is a chronic progressive optic neuropathy characterized by retinal ganglion cell death and optic nerve head damage with associated visual field loss. MATERIALS AND METHODS: A prospective cross-sectional study was conducted on 170 patients aged ≥ 40 years attending ophthalmology outpatient department at a tertiary care hospital from 06.03.2022 to 12.03.2022. All patients underwent a comprehensive eye examination including brief history, anterior and posterior segment evaluation, IOP measurement.Perimetry,gonioscopy,pachymetry was done.OCT RNFL was done for glaucoma diagnosed patients. RESULTS: Glaucoma cases were diagnosed in 6 individuals among the total 170 study participants.In this study,prevalence of glaucoma was found to be 3.52%. CONCLUSION: People aged ≥ 40 years should be educated about the disease and its visual impact. Routine glaucoma screening should be emphasized in aged individuals for early diagnosis, prompt initiation of treatment and prevention of visual morbidity.

Long-term visual outcomes of children screened for retinopathy of prematurity with telemedicine in New Zealand

ABSTRACT Clinical Relevance Children with a history of regressed retinopathy of prematurity (ROP) are at increased risk of peripheral avascular retina. Wide-field digital retinal imaging and telemedicine is an effective tool for ROP screening. Ophthalmologists and Optometrists should have a high level of clinical suspicion for peripheral retinal changes in children screened for ROP. Background Retinopathy of prematurity, a vaso-proliferative disorder of the pre-term retina, is a preventable cause of childhood visual impairment. The Auckland Regional Telemedicine ROP (ART-ROP) network, established in 2006, utilises wide-field digital imaging and telemedicine to screen at-risk infants for ROP. This prospective observational study reports the long-term ocular outcomes of ART-ROP network infants. Methods A comprehensive paediatric eye examination including cycloplegic autorefraction and wide-field retinal imaging was completed on all participants. Participants had been screened for ROP by the ART-ROP network between May 2008 and October 2011. Results A total of 69 children, with a mean age of 5 to 8 years old were assessed and divided into two groups: those with or without a history of ROP, 44 and 25 children, respectively. Infants with a history of ROP had significantly lower gestational age (26.6 ± 1.9 vs. 29.1 ± 1.6 weeks, p < 0.001) and birth weight (937 ± 237 vs. 1177 ± 311 grams, p = 0.001). No significant differences were detected between the two groups for visual acuity (p = 0.596), stereopsis (p = 0.219), refractive error (p = 0.472), or strabismus. Clinically significant refractive error was noted in 10 participants; none with moderate or high myopia. Retinal imaging exposed asymptomatic, persistent, peripheral avascular retina in four children, all of whom had a history of regressed ROP. Conclusion Visual and ocular outcomes did not vary based on history of ROP, with no participant having reduced vision as a result of undetected or untreated ROP. Further research is required into the long-term implication of persistent avascular retina in regressed ROP.

Effect of glycaemic control on corneal parameters among type 2 diabetes mellitus

Purpose: To study the effect of glycaemic control as demonstrated by the change in HbA1c on corneal parameters among patients with type 2 diabetes mellitus (T2DM). Study design: Prospective study analysing corneal parameters among patients with T2DM along with fluctuations in HbA1c.Methods: A prospective, single-centre, cohort study was carried out on T2DM patients with HbA1c &gt; 6.5% from Kasturba Hospital, Manipal, India. The subjects underwent a comprehensive eye examination. One-hundred and twenty-two subjects who fulfilled the inclusion criteria were analysed using the Huvitz 9000A to measure anterior corneal curvature followed by ultrasound pachymetry to measure central corneal thickness (CCT) at baseline and after 3 months. A simple linear regression was used to compare the mean corneal parameters, CCT and anterior corneal curvature, for each group with the mean HbA1c. The mean difference was considered statistically significant only if the value was p &lt; 0.05.Results: We observed a significant difference between baseline and follow-up levels of HbA1c (t = 2.487; df = 53; p &lt; 0.05). Simple linear regression analysis showed a positive correlation and revealed a mean increase in CCT of 1.893 μm (p &lt; 0.001) and a mean increase in anterior corneal curvature of 0.069 D (p &lt; 0.005) for every unit increase in HbA1c.Conclusions: The present study showed that changes in CCT and anterior corneal curvature occur with respect to changes in HbA1c level. Thus, careful attention is required in considering HbA1c status when performing comprehensive eye examinations in diabetic patients.

Tribal Odisha Eye Disease Study # 11 - Particularly vulnerable tribal group eye health program. Program protocol and validation.

Purpose:To describe and validate the eye health program protocol of Dongria tribal community, a particularly vulnerable tribal group (PVTG) in Rayagada district, Odisha, India.Methods:The program would consist of three segments. At people’s residences, trained community health workers (CHWs) will measure the vision and collect demographic data. In addition, vision technicians (VTs) will refract using a hand-held device and prescribe spectacles to people who improve to >6/12, N8. Others would be referred to the vision center (VC). At VC, the VT will perform a slit-lamp examination and re-refract. They would refer people with vision ≤6/12 to the secondary center (SC). At SC, referred people will receive a comprehensive eye examination and treatment. The ophthalmologist will assign the cause of blindness and visual impairment for people with visual acuity <6/12. The entire process was rehearsed in a pilot study.Results:The target population is approximately 10,000 people residing in 101 hutments on the hills of Rayagada district. The pilot study included 126 people. The mean age was 44 ± 18 years; 70% of the people were illiterate, and in this cohort, 97.6% (n = 123) had never worn spectacles. In the pilot study, 41% of the people had cataract, and 12% had pterygium. The agreements between optometrist versus VTs and between optometrist versus CHWs were good (k = ~0.8–1.0) in all eye conditions except for strabismus (k = ~0.56–0.65)Conclusion:The pilot study confirms the program modality, and when completed, it would help in the planning and resource allocation of Odisha PVTG eye care.