Eye Care Research Articles

Compliance and Determinants of Spectacle Wear Among Moroccan Adults Residing Beni-Mellal Khénifra Region.

Ensuring a high level of adherence to wearing spectacles is essential to preserve eye health and achieve optimal vision correction. Comprehending the factors influencing adherence to wearing spectacles can inform strategies to improve eye care outcomes. This study aimed to assess the prevalence and factors influencing adherence to wearing spectacles among Moroccan adults residing the Beni-Mellal Khenifra region. A cross-sectional interview survey was conducted involving 389 adult spectacle wearers. Participants were recruited through a multilevel random sampling technique and interviewed using a structured questionnaire. This questionnaire collected data on demographics, spectacle prescription, usage patterns, and barriers to compliance. Compliance was assessed based on self-reported frequency and duration of spectacle wear according to the prescription. Possible factors influencing the wearing of spectacles were investigated using both univariate and multivariate regression models. This study revealed that 57.6% of participants adhered to the recommended use of spectacles. Factors associated with compliance were higher education level, longer duration of spectacle use, awareness about the importance of spectacle wear, absence of a family history, specific refractive error types, and increased severity of refractive errors. Participants reported various reasons for not adhering to the recommended use of spectacles, with the most common being forgetfulness, perceiving improved vision without spectacle, discomfort while wearing spectacle, difficulty adapting to spectacle, and loss of spectacle. Given the high prevalence of non-compliance to spectacle wear among adults in the Beni-Mellal Khenifra region, it is evident that additional efforts are required to improve understanding and education regarding the advantages of consistent spectacle usage. Targeted educational and awareness initiatives have the potential to substantially enhance adherence rates and consequently improve visual health outcomes in the region.

Parents' Knowledge and Attitudes Toward Pediatric Ophthalmic Disorders in Saudi Arabia: A Cross-Sectional Study.

Recognizing pediatric eye health issues at an early stage, along with ensuring that parents are well informed, is crucial. This study measures parents' knowledge and perspectives on pediatric ophthalmic disease. The study utilized a cross-sectional design, and participants included Saudi parents of children residing in Saudi Arabia. Data were collected using a pre-validated self-administered questionnaire with a scoring system. Sociodemographic characteristics and factors associated with knowledge/attitude were collected and analyzed. Initially, 425 respondents participated in this study. Excluding the participants whose work was related to healthcare and those with incomplete data yielded 370 responses on which the subsequent analyses were performed. The analysis revealed that only half of the parents recognized the need for annual eye examinations for children. Most of them showed gaps in knowledge regarding the frequency of routine eye exams and indicators of visual problems. Notably, parents with good/excellent knowledge were more proactive in their eye care practices, such as adherence to recommended eye examination schedules and accepting corrective measures like glasses for common conditions such as refractive errors and amblyopia. However, parental willingness to permit surgical interventions did not correlate significantly with their level of knowledge, signaling the influence of other factors. In conclusion, this study underscores the need for enhanced public health education to improve parental awareness of pediatric eye diseases in Saudi Arabia. Given the link between knowledge and proactive eye health practices, targeted interventions should distribute comprehensive, culturally sensitive information accessible to all demographics.

Web-based vs. conventional: a comprehensive analysis of visual acuity assessment using the PocDoc tool in a tertiary eye care centre.

Visual acuity (VA) represents a fundamental measure of visual function. The significant prevalence of underdiagnosed ocular disorders underscores the importance of effective VA assessment. This study evaluates the efficacy of a web-based VA assessment tool ("PocDoc") versus conventional VA testing. Prospective observational study including 353 participants recruited from various eye clinics in a tertiary referral centre. Age, diagnosis, and VA related information (i.e. VA measurements from PocDoc and conventional VA test [Snellen chart], test type, etc) were collected. Spearman's rank correlation, Intraclass Correlation, and Bland-Altman plot compared outcomes of both tests. One-way ANOVA and paired-T test were used to compare means. Most patients were males (59.2%) with a mean age of 52.2 ± 20.6 years. PocDoc had moderate positive correlation to conventional testing (rho = 0.50, p < 0.001). PocDoc led to higher logMAR scores compared to conventional testing (mean logMAR 0.19 and 0.13 respectively, p < 0.01). Moreover, PocDoc demonstrated a sensitivity of 82.8% and specificity of 79% for detecting visual impairment. The discrepancy between PocDoc and conventional VA testing increased with higher logMAR values, indicating greater inconsistency between the tests for patients with poorer VA. Age, test type, and disease type contributed to this variability. The concordance between PocDoc and conventional testing for VA measurement across various ages and conditions makes it a suitable screening tool. Future technological inventions should consider age, test type, and disease type as critical factors related to the level of agreement and correlation between digital and conventional VA testing methods.

Glaucoma knowledge and attitudes among diagnosed participants at a Vhembe clinic, South Africa

Background: Glaucoma remains a major public health concern worldwide. Most patients are dropping out of care, oblivious to the symptomless nature of glaucoma disease.Aim: This study aimed to investigate glaucoma knowledge and attitudes among those diagnosed with the condition in the Limpopo province (South Africa).Setting: The study was conducted at Elim Hospital in the Vhembe District of the Limpopo province, South Africa.Methods: The design of this study was cross-sectional and quantitative in approach. Those diagnosed with glaucoma and receiving eye care treatment at a district hospital in Limpopo province were purposively selected to participate in the study. Quantitative data on knowledge and attitudes towards glaucoma was collected and analysed using a self-administered questionnaire.Results: Eighty-nine purposively selected glaucoma patients, with an average age of 61.20 ± 14.77 years, participated in the study. Participants had an average knowledge score of 43 ± 20.87, with over 50% demonstrating an understanding of the importance of follow-up care, that treatment can slow the condition, and that the condition can progress rapidly if left untreated. The socio-demographic factors found to be statistically significant in relation to glaucoma knowledge were education and the duration of the condition, with p-values of 0.000 and 0.002, respectively. Concerns regarding the condition were expressed by the majority of participants, totalling 82% (n = 73).Conclusion: Awareness programmes need to be implemented to spread knowledge about the nature of glaucoma and the importance of adherence to treatment among those with low levels of education and newly diagnosed patients.Contribution: Awareness and knowledge regarding glaucoma can assist patients in treatment adherence, alleviation of the disease burden and concerns related to the eventuality of becoming blind.

Rasch analysis of quality of life in children with vernal keratoconjunctivitis (QUICK) questionnaire

ABSTRACT Clinical relevance A validated questionnaire measures the construct accurately, helps clinician to support decision making, facilitates assessment and monitoring of patients, guides clinical trial and promotes patient-centred care. Background To assess the psychometric properties of the Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) questionnaire among Indian children with Vernal Keratoconjuntivitis (VKC) using Rasch analysis. Methods This study used a questionnaire validation study design. The QUICK questionnaire for VKC was translated to two local languages using back translation process and administered to the Indian children (aged 5–15 years) diagnosed with VKC between June 2021 and March 2022. The study took place at a tertiary eye care hospital in Chennai, India. The psychometric properties were assessed based on six indicators namely rating scale behaviour, measurement precision, item fit, unidimensionality, targeting and Differential Item Functioning (DIF). Results Fifty six children with VKC (mean age 10.5 years and 77.8% males) filled the questionnaire. The analysis of overall QUICK questionnaire (16 items) revealed an ordered threshold for the rating scale, no noticeable DIF and excellent person-item targeting (0.15). However, the questionnaire showed inadequate person separation (PSI 1.82 and PSR 0.77), four misfit items and lack of unidimensionality (eigenvalue 2.80). Eliminating misfit items and contrasting items resolved multidimensionality, leaving nine items related to the symptoms domain in the questionnaire. However, the person separation (PSI 1.52 and PSR 0.70) remained below 2.0. Conclusion The resultant 9-item QUICK questionnaire discriminates only low and high performers among VKC patients. Thus, it may be used solely to assess the symptoms domain in Health Related Quality of Life (HRQoL). This questionnaire requires addition of items in other domains pertaining to HRQoL to make it holistic.

Exploring the Relation Between Peripapillary Retinal Vessel Caliber and Visual Field Defects in Primary Open-Angle Glaucoma.

Background Primary open-angle glaucoma (POAG) is a progressive optic neuropathy characterized by loss of retinal ganglion cells, optic nerve head changes, and visual field defects. Vascular factors, alongside intraocular pressure, play a crucial role in POAG pathogenesis, and this study aims to explore the relationship between retinal vessel caliber and visual field defects in POAG patients. Purpose To evaluate the association between retinal vessel calibers in the peripapillary area with visual field defects in one or both hemifields. Materials and Methods This cross-sectional study was conducted at a tertiary eye care center in northern Karnataka for one year, enrolling 100 eyes from 50 primary open-angle glaucoma (POAG) patients with visual field abnormalities. Fundus color stereoscopic photographs were taken using a Canon digital camera, and diameters of the superior and inferior temporal arteries (STA and ITA) and veins (STV and ITV) in the peripapillary area were measured. Visual field defects were categorized, and statistical analyses were performed to correlate retinal vessel calibers with field defect locations. Results Participants had a mean age of 89.68 years, with 72% male. Visual field defects included superior arcuate scotoma (20%), inferior arcuate scotoma (32%), double arcuate scotoma (30%), and tubular vision (18%). Significant vessel caliber changes were observed: for superior hemifield defects, the mean STA: ITA ratio was 1.15 (p = 0.001), and for inferior defects, it was 0.94 (p = 0.04). STV: ITV ratios also showed significant changes corresponding to visual field defects. Eyes with defects in both hemifields showed pronounced narrowing, particularly in inferotemporal vessels. Conclusions Decreased retinal vessel caliber is significantly associated with visual field defects in primary open-angle glaucoma and can be a valuable diagnostic parameter tool for assessing glaucomatous damage and the progression and severity of POAG.

Parents' or Guardians' Knowledge, Attitudes and Practices in the Prevention and Management of Childhood Myopia.

The aim of this study was to assess the knowledge, attitude, and practices (KAP) of parents or guardians regarding the prevention and management of childhood myopia. This cross-sectional study was conducted at the Department of Ophthalmology in the First Affiliated Hospital of Soochow University (Suzhou, China) between August 2023 and November 2023. Parents or guardians who willingly volunteered to take part in the study were surveyed using a self-designed questionnaire. A total of 571 participants returned valid questionnaires, among whom 288 respondents (50.44%) fell within the 31- to 40-year age group and 474 respondents (83.01%) were identified as myopic. The mean KAP scores for the knowledge, attitude and practices dimensions were 23.34 ± 3.05 (possible range: 0-26), 46.47 ± 4.02 (possible range: 12-60), and 40.52 ± 7.07 (possible range: 11-54), respectively. Structural equation modeling analysis indicated that education had a direct effect on knowledge (estimate = 0.41, P = 0.038), while knowledge directly influenced both attitude (estimate = 0.40, P < 0.001) and practices (estimate = 0.36, P < 0.001). Also, attitude was found to have a direct impact on practices (estimate = 0.45, P < 0.001). Parents or guardians had adequate knowledge, a positive attitude, and proactive practices towards the prevention and management of childhood myopia, which might be affected by their educational level. This comprehensive understanding of parental perspectives highlights the potential for targeted interventions in clinical settings to further enhance pediatric eye care.

Providing Cataract Surgeries at a Rural Primary Health Centre through Non-governmental Organisation Collaboration: An 8-year Experience

Abstract The National Programme for Control of Blindness and Visual Impairment aims to reduce blindness and visual impairment in India. Despite these efforts, rural areas still have high numbers of cataract patients due to inadequate healthcare services. Leveraging non-governmental organisation (NGO) networks to provide rural eye care camps has been proposed to address these challenges. This article shares an 8-year collaboration with an NGO in rural Haryana, delivering cataract surgeries. Initially, surgeries were conducted in temporary locations; however, due to complications, they were shifted to hospitals, increasing travel difficulties. In 2016, collaboration with ICARE Eye Hospital began, involving screening camps and transporting patients for surgery. This reduced patient expenses and referral burdens, performing 1690 surgeries with high satisfaction. Authors recommend similar collaborations to achieve the national blindness reduction goal.

Comparison of Outcomes of Bell’s Palsy Patients Treated with Steroid and Steroid with Antiviral Drug in a Tertiary Care Hospital

Background: Bell’s palsy is the most common acute mononeuropathy associated with idiopathic unilateral facial weakness, characterized by facial asymmetry. Though steroids have effectiveness in managing Bell’s palsy, the use of antiviral is still debatable. Objective: To compare the outcome of Bell’s palsy with treatment by steroid versus combination of steroid and antiviral drugs. Methodology: A prospective analytical study was performed on 84 patients with acute Bell’s palsy attending at Neurology outpatient department of Mymensingh Medical College Hospital from July 2014 to June 2016. The patients were divided into two groups purposively after initial assessment as per House-Brackmann grading system (HBS). Group-I patients were treated with oral prednisolone and oral valacyclovir and Group-II patients were treated with oral prednisolone only. Both groups received facial exercises as per demonstration and proper eye care throughout the study period. Follow-up was done after 2 weeks, 4 weeks and 3 months for collection of data about recovery according to reassessment. Results: The analysis revealed that recovery rates at all 3 follow-ups were higher in the combination group than that of the prednisolone-only group [29(67.44%) versus 18 (43.90%) at 2nd week follow-up, 35(81.39%) versus 25(60.97%) at 4th week follow up and 40 (93.02%) versus 30(73.17%) at 3rd month follow-up]. Moreover, the expected recovery rate was higher in severe Bell’s palsy patients in the combination group than in steroid-alone group (22, 88.0% complete recovery versus 13, 54.17% complete recovery at the end of 3 months of treatment) [p=0.034]. haemorrhagic shock, spinal cord damage, septic shock and crush syndrome. Conclusion: The study showed antiviral (valacyclovir) plus steroid (prednisolone) to be more effective than steroid (prednisolone) alone in the treatment of Bell’s palsy. Moreover, outcome was more favorable in combination groups presenting with severe disease. Lessen their severity. Journal of Monno Medical College December, 2023; 9 (2):58-62

Comparison and analysis of ophthalmic resources and service ability in Shanxi Province in 2014 and 2021

Objective: To compare and analyze the ophthalmic resources and service ability in Shanxi Province in 2014 and 2021, and to provide reference for the development planning of ophthalmology and eye care. Methods: In this cross-sectional study, a questionnaire survey was conducted among all ophthalmic institutions registered in the health administrative department in 11 cities of Shanxi Province by the end of 2014 and 2021 by using the National Ophthalmology Competency Resource Questionnaire (compiled by the Medical Administration and Hospital Authority of the National Health and Wellness Commission). The basic situations of ophthalmic institutions in 2014 and 2021, as well as the human resources, ophthalmic equipment configuration, technology and medical service capabilities, were recorded and compared. The chi-square test was used for statistical analysis. Results: A total of 270 questionnaires for 2014 were collected from 270 ophthalmic institutions, and 292 questionnaires for 2021 from 292 ophthalmic institutions. The institution categories in 2014 (197 general hospitals, 31 eye hospitals and 42 others) were statistically different from those in 2021 (182 general hospitals, 45 eye hospitals and 65 others) (P<0.05). The proportion of doctors with senior titles in ophthalmic institutions increased from 25.5% (346/1 358) in 2014 to 41.7% (580/1 391) in 2021, the proportion of senior technicians increased from 9.4% (14/148) to 25.3% (110/435), the proportion of doctors with junior titles decreased from 42.1% (572/1 358) to 26.5% (369/1 391), and the proportion of junior technicians decreased from 45.3% (67/148) to 39.1% (170/435). There was a significant difference in the distribution of professional titles between doctors and technicians in ophthalmic institutions (P<0.05). The number of doctors (130 to 28), nurses (152 to 50), technicians (33 to 11) and full-time optometrists (44 to 12) in the first-class ophthalmic institutions decreased, the increase of equipment with the ophthalmic A-ultrasound scan system, fundus camera and coherent optical tomography system (35.1%, 28.9% and 25.4%; P<0.05) ranked the top three, and the increase of performing the phacoemulsification procedure, intraocular lens implantation, intravitreal injection and iris surgery (30.2%, 24.7% and 20.7%; P<0.05) ranked the top three in 2021 as compared to 2014. Conclusions: The resources and service ability of ophthalmology in Shanxi Province developed in 2021 in comparison with 2014. However, there were some problems, such as changes in the type and structure of eye institutions, unreasonable proportions of professional titles, insufficient human resources in primary ophthalmic institutions, and slow improvement in the allocation of ophthalmology equipment and technical capabilities.

Community Education and Diabetic Retinopathy: Effects on ERG Responses and Visual Acuity

The study investigates the impact of a community education program on diabetic retinopathy by analyzing changes in Electroretinogram (ERG) responses and visual indices. A purposive sampling method was used to target adults aged 20 to 50 at eye care centers, ensuring a demographically diverse group, including individuals without diabetes. The final sample included 195 participants, equally divided into healthy controls, diabetic patients, and high-risk individuals. Significant differences were found in ERG parameters and visual indices across healthy, diabetic, and high-risk groups, indicating that education programs may positively affect retinal function. Additionally, the study explores the correlation between ERG responses and visual indices, revealing significant positive relationships. Statistical analyses, including ANOVA and regression, were performed using SPSS (version 29), which confirmed improvements in retinal health, supporting the study's hypotheses. The findings suggest that educational programs can have a meaningful impact on visual health outcomes for diabetic patients.

Artificial intelligence: An innovation shaping modern eye care

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Laser L ight I nduced R etinopathy in a Young Boy: A Case Report from Eye Care Hospital, Karachi

A case report of a 14 year-old-boy who came with a history of direct gazing to laser pointer at Khairun'nisa Eye Hospital, Karachi. A comprehensive eye examination including Slit lamp biomicroscopy, Fundoscopy, optical coherence tomography and Fundus photography was done. Main outcome measure were right eye foveal scarring with normal periphery. Fundoscopy showed right Eye old scar at fovea, exactly like solar retinopathy. Solar retinopathy is a type of retinopathy which is caused by directly looking at sunlight. In this report we are presenting the classical case of retinopathy exactly like solar retinopathy due to gazing directly at laser light for a long period of time.

Convolutional Neural Networks (CNNs) for detection of Eye Diseases in an Effective Manner

Introduction: This thesis concentrates on advancing a deep learning system for the precise classification of eye illnesses. Employing the Convolutional Neural Network (CNN) algorithm and Tkinter for GUI, the interface safeguards an intuitive and user-friendly experience. The system effectively identifies various eye conditions, including glaucoma, cataracts, diabetic retinopathy, among others. Objectives: The main goal of this thesis is to offer a reliable and efficient solution for classifying eye diseases through deep learning techniques by addressing the critical need for timely and accurate diagnosis. The significant contributions of this thesis include: Publication of new datasets beneficial to researchers in the field. Enhancement of a robust segmentation approach, applicable to various retinal conditions, including diabetic retinopathy. Methods: A supervised learning approach adopted to train the CNN algorithm with an extensive dataset of eye images. The system achieved an impressive accuracy in classifying eye diseases, underscoring its effectiveness in identification and diagnosis. Development of a hybrid characteristic extraction method from segmented objects, utilized by the classifier for detecting glaucoma and other eye diseases. Results: This system will be able to detect and diagnose the diseases which are related with Eys which will help patients to take care of eyes from further complications. Furthermore, with advancements in portable retinal cameras, integrating the proposed method can facilitate the diagnosis of glaucoma and other eye diseases, thereby enhancing the detection rate, especially in growing nations. Conclusions: The developed system significantly enhances the accuracy and efficiency of eye disease diagnosis, enabling early detection and treatment. The integration of Tkinter for GUI and the color-blind test feature improves the user experience, making the system more accessible to a broader audience. This thesis underscores the potential of deep learning techniques in medical diagnosis, presenting a valuable tool for healthcare professionals and patients alike.

Progression of corneal thinning and melting after collagen cross-linking for keratoconus.

To study the aetiology, diverse clinical manifestations, therapeutic interventions, and prognoses in patients with corneal thinning after collagen cross-linking (CXL) treatment. a retrospective observational study of all patients presenting with corneal thinning after collagen cross-linking, in a tertiary eye care hospital in south India from 2011 to 2017. Preoperative details were noted. Patients who presented with corneal thinning were subjected to investigative measures to assess thinning, received appropriate management, and underwent follow-up evaluations. Among the 12 patients, 8 were female and 4 were male, all of whom had undergone standard classical CXL. The duration between CXL and corneal melting/thinning onset varied from 5 to 12 years. Notably, among female patients, 2 were pregnant, 2 were lactating mothers, 1 was undergoing in vitro fertilization (IVF) treatment, and 1 had comorbid diabetes mellitus and hyperthyroidism. Clinical examination revealed corneal thinning accompanied by hypopyon in 1 patient, corneal perforation with shallow anterior chamber in 1 patient, and epithelial defect with crystalline deposit in another patient, the remaining patients exhibited corneal thinning. Corneal thinnest corneal thickness measurements ranged from 212 to 351 µm. Treatment approaches included penetrating keratoplasty (PKP) in 2 patients, deep anterior lamellar keratoplasty (DALK) in 1 patient, cyanoacrylate glue application in 1 patient, and awaiting DALK/PKP in three patients, 4 patients showing no signs of increased thinning. The incidence of corneal thinning after collagen cross-linking is less but fulminant, requiring timely and appropriate management to prevent visual complications.

'Whatever the GP says, is what I'll do'-A qualitative study of patient perspectives in accessing primary eye care for type 2 diabetes.

To investigate the perspectives of people accessing a general medical practitioner (GP)-optometry model of collaborative care that was established to increase access to diabetes eye care. Qualitative study of patient barriers and facilitators to accessing primary diabetes eye care located in a metropolitan area in Australia. One-on-one interviews were recorded, transcribed and thematically analysed using a determinant framework on patient-centred access to health care. Twenty-four people with type 2 diabetes, including 15 males and 9 females, who accessed the service between September 2021 and June 2022 agreed to participate. Mean (SD) age of the participants was 52 (12) years and 50% had been diagnosed with diabetes for <2 years. Facilitators to accessing diabetes eye care included a referral from a GP or GP nurse, fee-free consultations, availability of after-hours appointments and short waiting times. Barriers to access included perceived out-of-pocket costs, competing responsibilities and lack of awareness of diabetic retinopathy screening recommendations. Considering diabetic retinopathy may present asymptomatically, primary health practitioners (optometrists and GPs) are well positioned to raise patient awareness of the importance of routine eye examinations. In Australia, access to routine screening could be facilitated by fee-free eye checks and personalised text message reminders implemented at a health system level.

Assessing Private Equity Involvement in Ophthalmology: Parallels with the Past, Concerns for the Future

PurposeTo discuss the history and current state of private equity in ophthalmology and explore potential implications for ophthalmology practices, physicians, and patients. DesignPerspective. MethodsReview of selected articles in ophthalmology and non-ophthalmology medical literature and commentary based on the authors’ experiences. ResultsInvestment in ophthalmology appeals to private equity firms because of high procedural volumes, fragmented private practices, opportunities for real estate ownership, and an aging population in need of eye care. As a result, acquisition of private practices by large private equity companies has swelled since 2015. Metropolitan areas and practices that possess ambulatory surgical centers or a high proportion of retina surgeons receive the greatest investment. However, little objective data exists regarding the benefits of this trend. Initial research suggests that private equity ownership may negatively impact patient care through greater costs, shorter appointments, and fewer Medicare/Medicaid patients seen. Skeptics of private equity also highlight concerns that include financial risk falling primarily on the acquired practice itself, a short-term business approach that rewards profit maximization, and the erosion of physician autonomy. Furthermore, young ophthalmologists express reservations about working for private equity firms. 78% of trainees indicated they would not consider employment by a private equity owned practice and 81.4% of vitreoretinal fellows voiced concerns about autonomy and job security. Proposed legislation aimed at limiting private equity acquisitions is currently under review at the statewide level, adding additional uncertainty to the future of private equity involvement in ophthalmology. ConclusionAlthough investment by private equity offers potential financial rewards and operational improvements for practices, it also raises significant concerns reminiscent of those experienced by physician practice management companies in the 1990s. Nonanecdotal data is needed to assess the benefits and future of private equity involvement in ophthalmology.

National Experience of Technology-based Eye Care Services (TECS): A Comprehensive Ophthalmology Telemedicine Initiative

Technology-Based Eye Care Services (TECS) is a tele-ophthalmology program operating in the Veterans' Administration since 2015. This study explores characteristics of the national TECS population, evaluates implementation and sustainability of TECS, and analyzes possible associations and effects of demographic characteristics and social determinants of health (SDOH) on being diagnosed with a vision threatening (VT) disease. Implementation and sustainability of TECS from 2015-2022 was examined along with the sociodemographic characteristics of Veterans served through TECS in 2021. Veteran patients seen in TECS nationwide. Characteristics, disease prevalence and diagnoses, implementation success rate, sustainability rate, preliminary analysis of outcomes and disparity. Per quarter from 2015-2022, TECS sites were classified as implementing, active, or sustained. Standard Query Language (SQL) was used to determine sociodemographic data and logistic regression models were used to identify risk factors associated with VT eye diagnosis. 21,712 Veterans, 52.1% rural or highly rural, were served by TECS in 2021. The average age was 64.7 years, with females comprising 10.9% of the population served. From 2015-2022, of the 67 TECS sites initiated, 6 were implementing with 51 of 61 initiated sites still operational in the first quarter (Q1) of 2022 (83.6% success rate).Macular degeneration (AMD) and cataracts were more prevalent in rural and highly rural populations (7.6% and 11.3%, and 48.8% and 55.0%, respectively) vs. urban populations; glaucoma and diabetic retinopathy (DR) had the opposite association. The prevalence of any type of VT eye disease was lowest in the Mountains/Central region (0.54%) and highest in the Southeast region (3.2%) of the US. Rural and highly rural residents were 1.3 and 2.5 times as likely, respectively, to be diagnosed with a VT eye disease than urban residents. Implementation and sustainability of TECS has been promising. The data provides key information that can be utilized to improve the deployment of TECS and similar programs, along with the possible future direction of TECS services. Moreover, experience from one national ocular telehealth program clearly illustrates that telemedicine can address eye care disparities in the Veteran population and may be utilized for other vulnerable groups as well.

The relationship between visual health and influencing factors among primary and secondary school students: a survey based in the Ningxia Hui Autonomous Region of China.

The myopia rate of young people around the world, especially in China, has continued to rise, and the vision health of primary and secondary school students has gradually become a global concern. It was to explore the current characteristics of vision status and their intrinsic links to influencing factors of the Ningxia Hui Autonomous Region primary and secondary school students under regional characteristics. 1,670 primary and secondary school students in Ningxia Hui Autonomous Region were surveyed using Vision examination, International Physical Activity Scale, Lifestyle Behavior Scale. The data were analyzed using SPSS 25.0 and AMOS 23.0. The prevalence of myopia among primary and secondary school students in the Ningxia Hui Autonomous Region was 27.3%, with rates of 31.5% for girls and 23.4% for boys. There was a significant negative correlation between lifestyle behaviors (r = -0.36, p < 0.01) and physical activity level (r = -0.06, p < 0.05) with vision status. The physical activity level played a significant masking effect between lifestyle behaviors and vision status (a*b = 0.002, c' = -0.044). Gender moderated the effects of lifestyle behaviors on physical activity level and vision status, as well as the effects of physical activity level on vision status. These factors constituted a mixed model with mediating and moderation. The model fitted well (RMSEA = 0.028, CFI = 0.951, NFI = 0.918). The prevalence of myopia among primary and secondary school students in this region is lower than the national average in China, and it is associated with lifestyle behaviors, physical activity level, and gender. When effectively controlled, the physical activity level significantly will reduce the prevalence of myopia as a masking variable. Gender, as a moderating variable, provides theoretical support for the classification and prevention of myopia. Regional surveys enriched the global database on adolescent myopia research, revealing the characteristics and common factors of visual problems in adolescents. Relevant departments and schools should integrate eye care into the national health security system, implement policies related to myopia prevention and control and safeguard the visual health of primary and secondary school students.

Analysis of clinical features and outcomes in patients with ocular myasthenia gravis according to anti-acetylcholine receptor antibody-seropositivity.

To comparatively analyze the clinical characteristics of patients with ocular myasthenia gravis (OMG) referred to an ophthalmology clinic, according to anti-acetylcholine receptor antibody (AchR Ab)-seropositivity. Retrospective Cohort Study. Medical records of patients with OMG who presented to a tertiary eye care center between 2003 and 2020 were retrospectively reviewed. Demographics, ophthalmologic characteristics, response to medical treatment, presence of autoimmune thyroid disease and thyroid autoantibody were compared between the AchR Ab seropositive and seronegative groups. A total of 130 patients with OMG were identified; among them, 46 patients (35.4%) had autoantibody against acetylcholine receptors. The mean age at symptom onset was 42.4 ± 18.9 years. There were no differences in mean age at symptom onset, gender ratio, and mean follow-up period between patients with seropositive and seronegative OMG. Graves ophthalmopathy was significantly more frequent in seronegative patients (p = 0.04), while thymic disease (p < 0.01) was more frequent in seropositive patients (p < 0.01). Among patients with seropositive OMG, 52.3% showed a good response to medical treatment, while only 31.4% of the seronegative patients were classified as good responders (p = 0.01). Thyroid dysfunction was found in 27.4% patients with OMG and the proportion of thyroid dysfunction was not different according to anti-acetylcholine receptor antibody-seropositivity. Seropositivity to acetylcholine receptor antibody is associated with a better response to medical treatment and lower risk of concomitant autoimmune thyroid disease in patients with OMG.