Current Spectacles Research Articles

Conceptualizing the Dangerous Rise of Ethnoreligious Nationalist Literacies in Education

Reluctance to embrace change leaves societies vulnerable to the rise of authoritarian political ideologies, particularly during times of socioeconomic and political crises. Public schools have seen an increase in incidents where fundamentalist groups with differing agendas have attempted to pressure them into adopting curricula whose literacy practices are rooted in a White, northern European Protestant worldview. This essay examines this contemporary phenomenon in public education discourse, which the authors identify as “ethnoreligious nationalism.” It does so by providing a snapshot of current spectacles of ethnoreligious nationalist activism worldwide, discussing how their affective literacy strategies have contributed to the demoralization of public education as a democratic institution. We conclude by proposing potential questions for critical comparative international research on the literacies deployed by ethnoreligious nationalist movements across educational settings.

Frequency of Eye Diseases in Residents of Nursing Homes - 1-Year Results of a Novel Telemedicine Service in Switzerland.

For the elderly in nursery homes, a visit to the ophthalmologist is a burden, which might lead to undertreatment. We have recently started offering a novel ophthalmological service combining onsite examination and telemedical interpretation for patients with limited access to ophthalmological care. This study summarises the frequency of findings of treatable eye diseases after the first year of operation in participants who dropped out from regular ophthalmological control. Participants' clinical characteristics, frequency of service utilisation, and findings were extracted from the system and analysed. Of 1946 residents approached, 540 (27.7%; 1080 eyes) signed up for the service. A complete examination was possible in 412 persons (813 eyes) and partially possible in the remaining 128. The mean age of the examined participants mean age was 83.9 years (SD 9.7), and they were predominantly female (69.8%). The majority had a diagnosis of dementia (54.5%) and 20.2% had diabetes mellitus requiring treatment. The median care level (ranging from 0 - 12) was 7(interquartile range 6 - 9), corresponding to a care need of 121 - 140 min/d. The mean best-corrected decimal visual acuity was 0.55 (SD 0.24). For 164 eyes (15.2%), the current spectacle correction was insufficient. An untreated cataract was present in 145 eyes (13.4%), 89 eyes (8.2%) were receiving glaucoma treatment, and 7 eyes had a decompensated glaucoma. Dry age-related macular degeneration (AMD) appeared in 276 eyes (25.6%), 12 eyes (1.1%) had wet AMD, and 24 eyes (11.0%) among patients with diabetes showed signs of diabetic retinopathy. Other pathologies were uncommon. Residents of nursery homes, who are unable to attend regular ophthalmological control, show various treatable ophthalmological conditions, including cataracts, glaucoma, and retinal pathologies. Screening with a novel telemedicine service allows for the identification of treatable conditions and careful planning and referral of patients to appropriate clinics having the necessary infrastructure for this particular population.

Factors affecting guardians' decision making on clinic-based purchase of children's spectacles in Nigeria.

This study aims to understand the key factors influencing guardians' decisions when purchasing spectacles for their children in semi-urban and urban areas of Cross River State, Nigeria, where a spectacle cross-subsidisation scheme will be implemented. This cross-sectional study was conducted among all consecutive guardians visiting the Calabar (urban), Ugep, Ikom and Ogoja (semi-urban) public eye clinics in Cross River State, southern Nigeria, from August 1 to October 31 2019, and whose children had significant refractive errors (myopia ≤-0.50D, hyperopia ≥1.50D, astigmatism >0.75D) and received spectacles. Guardians were interviewed using a questionnaire which included i) close-ended questions on reasons guardians choose to purchase spectacles for their children in eye clinics, ii) guardians' perceptions of the quality and design of children's current spectacle, iii) factors most heavily influencing their choice of spectacles for children, and iv) open-ended questions to seek guardians' suggestions on how to improve the current spectacle range. All 137 eligible guardians (67.2% women [n = 92]) who visited the selected eye clinics participated in the study (response rate = 100%), with 109 (79.6%) from semi-urban and 28 (20.4%) attending urban clinics. Guardians from both urban and semi-urban clinics prioritised frame design, quality, and material as the main factors affecting their decision when purchasing spectacles for their children. Female guardians and those with higher incomes were both 1.5 times more likely to emphasise frame quality when describing selection criteria for purchasing spectacles for their children than male guardians (p = 0.01) or guardians earning less (p = 0.03). Design, material, and frame quality are key factors influencing guardians when purchasing spectacles for their children in these setting and female guardians or those with higher income prioritise frame quality. This study could guide the planning and implementation of a novel cross-subsidisation scheme in Cross River State.

Population-based assessment of prevalence of spectacle use and effective spectacle coverage for distance vision in Andhra Pradesh, India – Akividu Visual Impairment Study

ABSTRACT Clinical relevance Effective spectacle coverage is a useful indicator to assess the coverage of refraction services in a given region. We found a low coverage in the Akividu region suggesting a need to develop effective refraction services. Background To assess the prevalence of spectacle use and effective spectacle coverage for distance vision among people aged 40 years and older in the Indian state of Andhra Pradesh. Methods A population-based cross-sectional survey was carried out in the Akividu region in West Godavari and Krishna districts. The study teams visited selected households and conducted eye examinations in the selected clusters. A structured questionnaire was used to collect information on spectacle use. ‘Met Need’ was defined as unaided VA worse than 6/12 but improved to 6/12 or better with their current spectacles. ‘Unmet Need’ was defined as unaided VA worse than 6/12 but improved to 6/12 with pinhole, among those not using spectacles. The ‘Under-met Need’ was defined as aided VA worse than 6/12 but improving with pinhole to 6/12 or better. Based on these definitions, Effective Refractive Error Coverage (e-REC) is calculated as: e-REC (%) s = ((met need)/(met need + under-met need + unmet need)) X100. Results Of 3,000 enumerated from 60 clusters, 2,587 (86.2%) participants were examined. The prevalence of current spectacle use was 43.1% (95% CI:41.2–45.0). The e-REC was 37.4%. It was also lower in men compared to women and among those without any education. Participants who had cataract surgery in either eye had similar e-REC compared to those who were not operated. Conclusion Though spectacle use was found to be high, there is a still large unmet need for refractive correction for distance. Effective service delivery models to provide refraction and spectacle dispensing services are needed to achieve universal eye health coverage in the region.

Effects of aiming lines and visual function on the golf putting alignment

Background: In golf, a player hits a ball with a club, aiming to transfer the ball successively into a series of hole cups in a course consisting of 18 (or fewer) holes. This study aimed to compare the impact of visual function and the presence and number of aiming lines on golf putting alignment between beginner and expert golfers.
 Methods: In this prospective comparative study, 43 participants with a mean ± standard deviation (SD) of corrected distance binocular visual acuity of –0.07 ± 0.74 logarithm of the minimum angle of resolution, who knew their average golf scores, were divided into beginner and expert golfers. Six visual function tests were conducted to assess heterotropia, dominant eye, verification of current spectacles, static visual acuity, stereopsis, and fixation disparity. At the putting distances of 1.5 m and 3 m, alignment errors were measured five times each, using golf balls with 1 and 3 aiming line(s) and putters with 1 and 3 aiming line(s).
 Results: The mean ± SD of age was 48.33 ± 10.07 years for study participants overall. The accuracy of ball alignment was not affected by the career or number of aiming lines, but the putter alignment was higher for the 3-lines putter than for the 1-line putter (P < 0.05). When the number and shape of the aiming line were the same for both the ball and putter, the aiming accuracy was found to be higher. In both stereopsis and fixation disparity, the combination of putting distance and a 3-lines ball showed negative values; all other combinations showed positive values, but no statistically significant correlation was detected (all P > 0.05). 
 Conclusions: The accuracy of golf ball alignment did not depend on the number of aiming lines and the golfer’s career. However, the predicted putting success rate and subjective satisfaction were increased when three-line golf balls and putters were used, as compared to when one-line golf balls and putters were used.
 
 How to cite this article: Kim YJ, Jin YG, Koo BY, Jang JU, Mah KC. Effects of aiming lines and visual function on the golf putting alignment. Med Hypothesis Discov Innov Optom.2021 Spring; 2(1): 41-49. DOI: https://doi.org/10.51329/mehdioptometry124

Spectacle frames: Disposal practices, biodegradability and biocompatibility – A pilot study

Background: Only limited information is available on the disposal methods for spectacle frames, and their interaction with the environment once such disposal occurs.Aim: This study investigates the disposal of spectacle frames and provides a preliminary report on their biodegradability and biocompatibility.Setting: The study was conducted at a university in the south eastern part of South Africa.Methods: The study was conducted in two parts: Part A consisted of an explorative, quantitative design using a closed-ended questionnaire investigating the current disposal methods of 375 spectacle wearers for their old spectacles; and Part B consisted of a descriptive, cross-sectional design involving chemical analyses of metal and plastic spectacle frames.Results: Almost 55% of the participants reported either keeping or reusing their spectacles. Only 5% had used a recycling method when disposing their previous spectacles. Inductively coupled plasma optical emission spectroscopy results showed that metal frames do not degrade easily unless they are oxidised in an acidic environment. Lead was detected in two metal frames. Results of thermogravimetric analysis revealed that plastic frames only begin to degrade at temperatures over 250 °C. Gas chromatography-mass spectrometry results suggest that plastic frames, except three dimensional (3-D) polarisers, are biocompatible as they are stable, not chlorinated and do not possess heavy metals. The results suggested that eco-friendly frames may be the most biocompatible.Conclusion: It appears that few spectacle wearers use recycling for disposing their frames. Current metal and plastic spectacle frames appear to have poor biodegradability but good biocompatibility.

Prevalence of Uncorrected Refractive Error and Its Risk Factors; Tehran Geriatric Eye Study (TGES)

ABSTRACT Purpose: To determine the age-sex-standardized prevalence of uncorrected refractive error and its determinants Methods: This population-based cross-sectional study was conducted on 3310 people aged≥ 60 years in Tehran, Iran in 2019. Need for spectacles was defined as uncorrected visual acuity worse than 20/40 in better eye that could be corrected to more than 20/40 with suitable spectacles. Met need was defined as proportion of individuals with need for spectacles whose visual acuity was 20/40 or better with current spectacles. Unmet need was defined as proportion of individuals with need for spectacles who needed but did not have spectacles or their visual acuity was worse than 20/40 with current spectacles while suitable spectacles improved their visual acuity to 20/40 or better. Results: The age-sex-standardized prevalence of need for spectacles, met need, and unmet need was 16.67% (95% CI: 15.33–18.09), 7.81% (95% CI: 6.95–8.78), and 8.85% (95% CI: 7.77–10.07), respectively. Myopic subjects had the highest prevalence of need for spectacles (24.06%, 95% CI: 21.47–26.87). The odds ratio of met and unmet need in subjects≥ 80 years versus those aged 60–65 years was 0.36 (p-value: 0.009) and 2.34 (p-value: <0.001), respectively. The odds ratio of met and unmet need in subjects with a university education versus illiterate subjects was 1.72 (p-value: 0.045) and 0.42 (p-value: 0.007), respectively. Conclusion: The prevalence of uncorrected refractive error was lower in this study compared to previous studies. The met need rate was lower in subjects with older age and lower education levels.

Low Vision Management in A 5-Years-Old Due to Retinopathy of Prematurity for Life Quality Improvement

Introduction: Management of low vision in pediatric patients with greater result can affect their quality of life than in adult low vision patients.. Retinopathy of Prematurity is the main cause of blindness in children. A case study highlights the tertiary prevention (low vision examination and management) in a 5 year old boy with ROP related blindness to optimize his remaining visual capacity by using optical and non optical aids that support daily activity and educational learning.Case Report: A 5 year old boy with ROP related blindness visited to the low vision clinic after receiving the several treatments for ROP before. His visual acuities were light perception in the right eye and hand movement in the left eye using his current spectacle correction. He had anti VEGF bevacizumab intravitreal injection, vitrectomy and complicated cataract extraction history on the left eye. He wasdifficult to learn and read numbers and alphabets caused by visual impairment.Discussion : Upon evaluation by assessment low vision method, his distance visual acuity in the left eye was improved significantly up to 3/40 on LEA Acuity chart with +14.00D. His near vision became 10 M at 30 cm of reading distance (without near correction) and 4 M at 13 cm improved with +3.00 D by spectacle. The non optical aid devices as reading task were also suggested to improove continuous reading text without difficulty.Conclusion: ROP blindness can be preventable if appropriate, adequate and accessible screening programmes are available. Unfortunately, even with the current screening guidelines and recommended treatment of ROP, many babies suffer from blindness by this disease each year. Low vision assessment and management in pediatric patient with visual impairmentaccording to children’s need can optimize the recent visual capability of low vision patient and give self care daily activity and educational learning.

Visual Examination Standard for Forklift and Crane Operators: A Report for 66 Operators of a Factory in Mumbai.

Context:Forklift and crane industry in India is progressing at a rapid pace and the visual integrity of the operators is crucial for occupational safety. Hence, we performed a vision screening at a factory based in Mumbai.Aims:To evaluate the current visual status of forklift and crane operators working at a factory in Mumbai.Settings and Design:Prospective observational cross-sectional.Methods and Materials:All forklift and crane operators were invited to undertake visual examination that included visual acuity (VA) assessment, refraction, slit-lamp examination, color vision assessment, visual field assessment, and stereopsis. Referrals were made for participants who needed further assessment.Statistical analysis used:Mean and standard deviation were calculated and presented.Results:A total of 66 forklift operators with an average age of 48 years that ranged from 26–60 years completed the study. The average distance VA in LogMAR with current spectacles was 0.1 ± 0.14. The near VA with usual spectacles averaged at 0.63 M ± 0.2 M. The best-corrected VA (BCVA) of 0 LogMAR was not achieved by 12% subjects; however, all participants except one met the 0.3 LogMAR visual acuity criteria. The average stereopsis was 55.8 ± 47.8 with 8% operators had lower than acceptable levels of stereopsis while 7% could not meet the set criteria. One operator had 400 s of an arc and 4 had 100 s of arc stereopsis.Conclusions:The study demonstrates an urgent need to set up standards for vision assessment at the time of employment and frequency of eye examination for forklift and other powered industrial vehicles.

Case Report: Low Vision Management in A 5-Years-Old Due to Retinopathy of Prematurity for Life Quality Improvement

Management of low vision in pediatric patients with greater result can affect their quality of life than in adult low vision patients. Retinopathy of prematurity is the main cause of blindness in children. A case study highlights the tertiary prevention (low vision examination and management) in a 5 year old boy with ROP related blindness to optimize his remaining visual capacity by using optical and non-optical aids that support daily activity and educational learning. A 5-year-old boy with ROP related blindness visited to the low vision clinic after receiving the several treatments for ROP before. His visual acuities were light perception in the right eye and hand movement in the left eye using his current spectacle correction. He had anti VEGF bevacizumab intravitreal injection, vitrectomy and complicated cataract extraction history on the left eye. He was difficult to learn and read numbers and alphabets caused by visual impairment. Upon evaluation by assessment low vision method, his distance visual acuity in the left eye was improved significantly up to 3/40 on LEA Acuity chart with +14.00D. His near vision became 10 M at 30 cm of reading distance (without near correction) and 4 M at 13 cm improved with +3.00 D by spectacle. The non-optical aid devices as reading task were also suggested to improve continuous reading text without difficulty. ROP blindness can be preventable if appropriate, adequate and accessible screening programmes are available. Unfortunately, even with the current screening guidelines and recommended treatment of ROP, many babies suffer from blindness by this disease each year. Low vision assessment and management in pediatric patient with visual impairment according to children need can optimize the recent visual capability of low vision patient and give selfcare daily activity and educational learning.

Temporal trends in the prevalence of spectacle use and spectacle coverage in India

BackgroundThis study aims to assess the temporal trends in the prevalence of spectacle use and spectacle coverage for refractive errors in population‐based studies conducted during 2011–2012 and 2017 among those aged ≥ 40-years in the state of Telangana, India. An intervention in the form of 10 vision centres and a secondary centre was established in one district (Khammam) after the 2011–2012 study and another district (Warangal) was left to secular trends.MethodsIn both the studies, multi‐stage cluster random sampling methodology was used to select the participants. In addition to a clinical examination, a questionnaire was used for collecting information on current and previous use of spectacles, type of spectacles and details of the spectacle providers. The same questionnaire was used in both the studies.ResultsIn total, 2,485 participants were examined in the 2011–2012 study and 2,711 participants were examined in the 2017 study in Khammam. Similarly, 2,438 and 2,646 participants were examined in Warangal in the two studies, respectively. In Khammam, the age and gender‐adjusted prevalence of current spectacle use increased from 30.0 per cent (95% CI 28.2–31.9) to 34.8 per cent (95% CI 33.0–36.6) in the 2011–2012 and 2017 studies, respectively (p < 0.01). However, in the Warangal district, the age and gender‐adjusted prevalence of current spectacle use declined from 32.8 per cent (95% CI 31.0–34.7) to 27.6 per cent (95% CI 25.9–29.3) during the 2011–2012 and 2017 studies, respectively (p < 0.01). In Khammam, the spectacle coverage increased from 26.9 per cent to 35.6 per cent, but it declined from 43.8 per cent to 35.7 per cent in Warangal between the studies in 2011–2012 and 2017.ConclusionsAn increase in spectacle use and coverage was observed in Khammam where the secondary centre and vision centres were established, compared to Warangal where there was no such intervention. The results suggest a positive impact of the intervention in the Khammam district and suggest replication of the model to address the burden of uncorrected refractive errors.

Use of spectacles for distance vision: coverage, unmet needs and barriers in a rural area of North India

BackgroundUncorrected refractive errors contribute enormously to the burden of avoidable visual impairment worldwide. There is a huge disparity in different parts of the globe in context to spectacle coverage for distance vision. This study was undertaken with objectives of determining prevalence of spectacle coverage, unmet needs and associated factors among adults in a rural community of north India.MethodsA community-based cross-sectional study was carried out within selected clusters of Jhajjar district of Haryana. All participants aged > 15 years underwent visual acuity assessment by LogMAR “E” screening chart. Participants with presenting visual acuity < 6/12 in any eye and all current spectacle users underwent detailed ophthalmic examination and refraction. Additional details about spectacles, barriers for their use and willingness to pay for them were collected. Participants with met and unmet need for spectacle use at visual acuity > 6/12 was computed. These are reported as proportions with 95% confidence intervals. Associated factors with unmet need were determined using bivariable and multivariable logistic regression analysis.ResultsA total of 6910 participants were examined. The current spectacle use was 7.5% (95% Confidence Interval CI: 6.5, 8.7). The spectacle coverage was found in 33.3% (95% CI: 30.0, 36.7) participants among those in need. The unmet need was found in 10.8% of participants (95% CI: 10.1, 11.6). On multivariable analysis, odds of unmet need was associated with age, gender, level of education and marriage status. The most common barrier for refractive correction was lack of perceived need for refraction and its correction.ConclusionThere is substantial unmet need for distance vision spectacles in this population. It is imperative that multi-component intervention be implemented to improve spectacle coverage in this rural north Indian setting.

Corneoscleral contact lenses fitting on irregular corneas after laser-assisted in situ keratomileusis.

We aimed to describe the outcomes of corneoscleral contact lens fitting with multi-aspherical geometry designs in patients with irregular corneas after laser-assisted in situ keratomileusis (LASIK). This was a retrospective series of 18 patients (age, 26-38 years) selected from an eye clinic database. Participants were required to have unsatisfactory visual acuity with their current contact lenses or spectacles after LASIK for myopia correction. All patients were fitted with corneoscleral contact lenses designed to correct corneal surface irregularities. A diagnostic trial set was used for fitting, and assessments were performed according to a standardized methodology. Subjective comfort, visual acuity, central corneal thickness, endothelial cell count, and corneal-compensated intraocular pressure were evaluated. The follow-up period was one year. Contact lens use was discontinued in 3 patients, thus leaving 24 eyes from 8 females and 7 males for analysis. The fitting characteristics were optimal in terms of lens position and movement. Statistically significant improvements were found in the best spectacle-corrected vision from before fitting to the visual acuity after fitting (p<0.001). Moreover, the patients reported high subjective comfort ratings and usage times (12.98 ± 2.3 hours/day). After one year of wear, visual acuity, subjective comfort, and usage time were maintained. No statistically significant adverse changes developed in the corneas over this period. Corneoscleral contact lenses with a multi-aspherical geometry design provide optimal visual acuity, improved comfort, and prolonged usage times in patients with irregular corneas after LASIK.

The prevalence of uncorrected refractive errors in underserved rural areas

PurposeTo determine the prevalence of uncorrected refractive errors, need for spectacles, and the determinants of unmet need in underserved rural areas of Iran. MethodsIn a cross-sectional study, multistage cluster sampling was done in 2 underserved rural areas of Iran. Then, all subjects underwent vision testing and ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA), best corrected visual acuity, visual acuity with current spectacles, auto-refraction, retinoscopy, and subjective refraction. Need for spectacles was defined as UCVA worse than 20/40 in the better eye that could be corrected to better than 20/40 with suitable spectacles. ResultsOf the 3851 selected individuals, 3314 participated in the study. Among participants, 18.94% [95% confidence intervals (CI): 13.48–24.39] needed spectacles and 11.23% (95% CI: 7.57–14.89) had an unmet need. The prevalence of need for spectacles was 46.8% and 23.8% in myopic and hyperopic participants, respectively. The prevalence of unmet need was 27% in myopic, 15.8% in hyperopic, and 25.46% in astigmatic participants. Multiple logistic regression showed that education and type of refractive errors were associated with uncorrected refractive errors; the odds of uncorrected refractive errors were highest in illiterate participants, and the odds of unmet need were 12.13, 5.1, and 4.92 times higher in myopic, hyperopic and astigmatic participants as compared with emmetropic individuals. ConclusionThe prevalence of uncorrected refractive errors was rather high in our study. Since rural areas have less access to health care facilities, special attention to the correction of refractive errors in these areas, especially with inexpensive methods like spectacles, can prevent a major proportion of visual impairment.

Spectacles use in a rural population in the state of Telangana in South India.

Context:Uncorrected refractive errors are the leading cause of visual impairment.Aims:To assess the prevalence and patterns of spectacles use among those aged ≥40 years in the South Indian state of Telangana.Settings and Design:This was a population-based, cross-sectional study, in which 6150 people were enumerated from 123 clusters in the two districts of Telangana state (Adilabad and Mahbubnagar) using a two-stage cluster random sampling methodology.Materials and Methods:Participants were visited in their households and presenting visual acuity (VA) was assessed in all cases followed by pinhole VA if presenting VA was worse than 6/12. A questionnaire was used to collect information on the current and previous spectacles use, type of spectacles, and details of the spectacles provider.Statistical Analysis Used:Stata statistical software version 12.Results:Among 5881 participants examined, 53.7% were women, and 82% had no formal education. The prevalence of current spectacles use was 28.8% (95% confidence interval: 27.6–30.0). On applying multiple logistic regression analysis, spectacles use was significantly associated with older age groups, female gender, higher levels of education, and residing in Adilabad district. Bifocals were the most commonly used type of spectacles (56.3%), and private eye clinics (70.3%) were the leading service providers. The spectacles coverage was 53.6%.Conclusions:We reported on prevalence and patterns of spectacles use using a large representative sample and a high response rate. More than half of those who may benefit from spectacles were using them, suggestive of a reasonable primary eye care coverage in the two districts studied.

Effect of uncorrection versus full correction on myopia progression in 12-year-old children.

To investigate the effects of no correction versus full correction on myopia progression in Chinese children over a period of 2years. Myopia was defined as cycloplegic spherical equivalent (SE) of ≤ -0.50 D. Uncorrection was defined as no spectacles worn, and full correction was defined as when the value of SE subtracted from the dioptric power of the child's current spectacles was less than 0.5 D. Ocular examinations included visual acuity, cycloplegic autorefraction, axial length and vertometer measurements. Questionnaires were completed by parents on behalf of the children. A total of 121 myopic children, with a median age of 12.7years, were screened from the Anyang Childhood Eye Study, with 65 in the uncorrected group and 56 in the full correction group. At 2-year follow-up, children with no correction had slower myopia progression (-0.75 ± 0.49 D vs. -1.04 ± 0.49 D, P < 0.01) and less axial elongation (0.45 ± 0.18mm vs. 0.53 ± 0.17mm, P = 0.02) than children with full correction. In multivariate modeling, adjusting for baseline SE or axial length, age, gender, height, number of myopic parents, age at myopia onset, and time spent in near work and outdoors, children with no correction still had slower myopia progression (-0.76 ± 0.07 vs. -1.03 ± 0.08 D, P < 0.01) and less axial elongation (0.47 ± 0.03mm vs. 0.51 ± 0.03mm, P < 0.01). Myopia progression decreased significantly with an increasing amount of undercorrection in all children (r = 0.22, b = 0.16, P = 0.01). Our findings suggest that myopic defocus slows the progression of myopia in already myopic children, supporting previous findings from animal studies.

Assessment of a Prototype Apache Flight Eyewear.

Apache pilots needing refractive correction are issued modified HGU-4/P aviator spectacles. However, a recently published survey found field of view (FOV) dissatisfaction with the current spectacles when sighting in with a Helmet Display Unit (HDU). A current Air Force flight frame was modified in-lab and the purpose of this study was to evaluate the FOV with the current Apache flight frame vs. the modified flight frame. Recruited were 21 Apache pilots to assess FOV under three conditions: 1) wearing the current Apache frame; 2) wearing the modified Apache frame; and 3) wearing no frame. The main outcome measure was total FOV of four quadrants tested: superior left (45°); superior right (135°); inferior right (225°); and inferior left (315°). No significant differences in FOV were seen between the two frames tested while wearing the current Apache helmet (P = 0.33) and the new Apache helmet (P = 0.64). However, there were significant differences in FOV between the no frame condition and the two frame conditions tested with both helmets (P < 0.001). No significant differences in FOV were seen between the two frames tested while wearing either Apache helmet. However, with both helmets there were significant differences in FOV between the no frame condition and the two frame conditions tested. This suggests that wearing no eyewear is still optimal in integrating the HDU device. With advances in contact lens technology, future research can study the viability of the latest generation of multifocal contact lenses with Apache aviators. Walsh DV, Jurek GM, McLean WE, Statz JK, Allen RL, Riggs DW. Assessment of a prototype Apache flight eyewear. Aerosp Med Hum Perform. 2016; 87(9):800-805.

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

BackgroundThe prevalence of visual impairment (VI) and dementia increases with age and these conditions may coexist, but few UK data exist on VI among people with dementia.ObjectivesTo measure the prevalence of eye conditions causing VI in people with dementia and to identify/describe reasons for underdetection or inappropriate management.DesignStage 1 – cross-sectional prevalence study. Stage 2 – qualitative research exploring participant, carer and professional perspectives of eye care.SettingStage 1 – 20 NHS sites in six English regions. Stage 2 – six English regions.ParticipantsStage 1 – 708 participants with dementia (aged 60–89 years): 389 lived in the community (group 1) and 319 lived in care homes (group 2). Stage 2 – 119 participants.InterventionsStage 1 gathered eye examination data following domiciliary sight tests complying with General Ophthalmic Services requirements and professional guidelines. Cognitive impairment was assessed using the Standardised Mini-Mental State Examination (sMMSE) test, and functional ability and behaviour were assessed using the Bristol Activities of Daily Living Scale and Cambridge Behavioural Inventory – Revised. Stage 2 involved individual interviews (36 people with dementia and 11 care workers); and separate focus groups (34 optometrists; 38 family and professional carers).Main outcome measures.VI defined by visual acuity (VA) worse than 6/12 or worse than 6/18 measured before and after refraction.ResultsStage 1 – when participants wore their current spectacles, VI prevalence was 32.5% [95% confidence interval (CI) 28.7% to 36.5%] and 16.3% (95% CI 13.5% to 19.6%) for commonly used criteria for VI of VA worse than 6/12 and 6/18, respectively. Of those with VI, 44% (VA &lt; 6/12) and 47% (VA &lt; 6/18) were correctable with new spectacles. Almost 50% of remaining uncorrectable VI (VA &lt; 6/12) was associated with cataract, and was, therefore, potentially remediable, and one-third was associated with macular degeneration. Uncorrected/undercorrected VI prevalence (VA &lt; 6/12) was significantly higher in participants in care homes (odds ratio 2.19, 95% CI 1.30 to 3.73;p &lt; 0.01) when adjusted for age, sex and sMMSE score. VA could not be measured in 2.6% of group 1 and 34.2% of group 2 participants (p &lt; 0.01). The main eye examination elements (excluding visual fields) could be performed in &gt; 80% of participants. There was no evidence that the management of VI in people with dementia differed from that in older people in general. Exploratory analysis suggested significant deficits in some vision-related aspects of function and behaviour in participants with VI. Stage 2 key messages – carers and care workers underestimated how much can be achieved in an eye examination. People with dementia and carers were unaware of domiciliary sight test availability. Improved communication is needed between optometrists and carers; optometrists should be informed of the person’s dementia. Tailoring eye examinations to individual needs includes allowing extra time. Optometrists wanted training and guidance about dementia. Correcting VI may improve the quality of life of people with dementia but should be weighed against the risks and burdens of undergoing examinations and cataract surgery on an individual basis.LimitationsSampling bias is possible owing to quota-sampling and response bias.ConclusionsThe prevalence of VI is disproportionately higher in people with dementia living in care homes. Almost 50% of presenting VI is correctable with spectacles, and more with cataract surgery. Areas for future research are the development of an eye-care pathway for people with dementia; assessment of the benefits of early cataract surgery; and research into the feasibility of specialist optometrists for older people.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Uncorrected refractive errors, presbyopia and spectacle coverage in Kamuli District, Uganda

Background: Successful refractive error programmes arise from evidence that can be collected cost effectively and timely.Aim: To investigate the prevalence of uncorrected refractive error (URE), presbyopia and spectacle coverage in the Kamuli district, Uganda.Setting: The study was conducted in the Kamuli district in Uganda.Methods: The Rapid Assessment of Refractive Error (RARE) study design is a communitybased cross-sectional study using multistage cluster random sampling to gather information on refractive errors and presbyopia. Subjects aged 15 years and older were selected from the population in Kamuli district in Uganda. Vision impairment due to URE at distance and near and barriers to uptake of refractive error services were investigated.Results: Participants, N = 3281 (57.6% male), with an age range of 15–92 years were enumerated and the response rate was 100%. The prevalence of refractive errors was 4.6% (95% confidence interval [CI]: 3.7 – 5.5) and the spectacle coverage was 5.96% (95% CI 1.74% – 10.18%). The prevalence of uncorrected presbyopia was 50.3% (95% CI 47.6% – 53.0%) and the spectacle coverage was 0%. Thirty-three (or 1%) respondents were current spectacle users. One-hundred fourteen people (3.5%) had previously used spectacles; however, 50.9% of them discontinued spectacle use a year before the study because the spectacles were broken or scratched. The major barriers to spectacle uptake were accessibility of services and affordability of spectacles.Conclusion: The prevalence of URE and the barriers to uptake of refractive services will inform the implementation of refractive services in the study area. Key words: Uncorrected refractive errors; presbyopia and spectacle coverage

Policing and the “War on Black Bodies”

Policing and the “War on Black Bodies” Chenjerai Kumanyika (bio) I hope it is not controversial to say that any discussion of policing in the United States must proceed from the acknowledgment that there has never been an ethical and effective system of policing in this country. To suggest otherwise is to argue that the lives of those who have been unjustly denied human, civil, political, and cultural rights as a result of policing do not matter. To continue to state the obvious, it is only during the very short period between the passage of the Voting Rights Act in 1965 and now that the question of ethical policing has been entertained at a national level with any pretense of sincerity. In all the years before this period, policing extended from the legally encoded and broadly embraced preservation of an explicit caste hierarchy. It is only during this recent period that ethical and effective policing even enters the legal imagination as a possibility and confronts the modern United States as a problem. A colleague recently asked me if I thought that the language of war accurately applied to the current spectacle of policing in the United States.1 He asked this in response to a scholarly presentation that I had just given on a panel about media production in the context of Ferguson and other Black-Lives-Matter-related protests. Even before the many protests that I have attended since August 9, 2014, the analysis of policing as part of a broader “war on black bodies” has been commonly accepted and frequently articulated among politicized Black folk and social justice advocates. [End Page 252] Public institutions have also caught on to this war metaphor: “American Policing: The War on Black Bodies” was the title of a September 2014 panel organized by the New York Public Library at the Schomburg Center for Research on Black Culture. Although the interpersonal violence and militarization of policing in the United States is increasingly visible and disturbing, I have worried that using the term “war” as a primary analytical framework lacks precision and sufficient explanatory power. I have wondered if “war” should be reserved to describe the conditions in places such as the Central African Republic, Yemen, or Syria, where the scale and urgency of everyday danger feel qualitatively different. But my mind also flashed back to the feeling that I had upon arriving in Ferguson, Missouri on the evening of November 26, 2014, the night after the decision not to indict Darren Wilson for the murder of Michael Brown was made. On the way to protests in front of the police station, my wife and I passed a Target parking lot that looked similar to how one might imagine central command in Iraq. It was completely filled with news tents and vehicles that looked and felt like tanks but were probably bomb-proof 600 MRAP armored personnel carriers. At the edge of the parking lot, both police and National Guard soldiers blocked off the intersection of West Florissant, making it impossible to enter the street by car and intimidating to enter the street on foot. When we approached that intersection soldiers abruptly advanced on our cars and gestured at us, waving large automatic weapons and ordering us to turn around. After navigating various road blocks and a neighborhood that seemed drenched in a haze of blue and red lights, the piercing sound of sirens, and the rumbling of large military vehicles, we arrived at 222 South Florissant in front of the Ferguson Police Department. Facing the police station, protesters faced off against a long line of officers dressed in the combination of military-style clothing and weaponry that we have come to call “riot gear.” Helicopters flew ominously overhead and a shrill voice from a bullhorn barked out orders for everyone to evacuate the area because, the voice announced, this was no longer a peaceful protest. Two different kinds of large black armored personnel vehicles passed slowly back and forth in front of the line of Special Units and Tactics (SWAT) officers. Five police officers on top of the vehicle trained their automatic weapons outward towards us, the protesters. Sandbags stood in piles between...