Eye Care Research Articles

Study of prevalence of non-strabismic binocular vision anomalies in a tertiary centre: An important but often forgotten cause of ophthalmic headache

To study the presence of non strabismic binocular vision anomalies in young patients presenting with headache. A prospective, non-interventional study of 110 patients was conducted for a period of one year in our tertiary eye care institute after obtaining informed consent and taking into consideration the inclusion and exclusion criteria. Patients presenting with asthenopic symptoms were subjected to thorough ophthalmic examination. After excluding refractive errors, patients were further subjected to detailed orthoptic evaluation (including accommodation and convergence assessment). Other non-ocular causes of headache were ruled out by appropriate referrals. Out of 110 patients, 33% were found to have accommodative insufficiency, 14% were having convergence insufficiency and 4% showed both accommodative and convergence insufficiency. 49% patients showed no extraocular muscle imbalance and were referred to relevant specialities for further evaluation. It is important to perform a thorough evaluation of patients presenting with headache for the presence of non strabismic binocular vision anomalies after ruling out other ophthalmic causes.

Assessment of Eye Care Apps for Children and Adolescents Based on the Mobile App Rating Scale: Content Analysis and Quality Assessment.

In China, the current situation of myopia among children and adolescents is very serious. Prevention and control of myopia are inhibited by the lack of medical resources and the low awareness about eye care. Nevertheless, mobile apps provide an effective means to solve these problems. Since the health app market in China is still immature, it has become particularly important to conduct a study to assess the quality of eye-care apps to facilitate the development of better eye-care service strategies. This study aimed to evaluate the quality, functionality, medical evidence, and professional background of eye-care apps targeting children and adolescents in the Chinese app stores. A systematic search on iOS and Android app stores was performed to identify eye-care apps for children and adolescents. The general characteristics, development context, and functional features of the apps were described. Quality assessment of the apps was completed by 2 independent researchers using the Mobile App Rating Scale. This study included 29 apps, of which 17 (59%) were developed by commercial organizations and 12 (41%) had a design with relevant scientific basis. The main built-in functions of these apps include self-testing (18/29, 62%), eye exercises (16/29, 55%), and eye-care education (16/29, 55%). The mean overall quality of eye-care apps was 3.49 (SD 0.33), with a score ranging from 2.89 to 4.39. The overall Mobile App Rating Scale score exhibited a significant positive correlation with the subscale scores (r=0.81-0.91; P<.001). In addition, although most apps provided basic eye-care features, there are some deficiencies. For example, only a few apps were developed with the participation of medical organizations or professional ophthalmologists, and most of the apps were updated infrequently, failing to provide the latest eye-care information and technology in a timely manner. In general, the quality of eye-care apps for children and teenagers in Chinese app stores is good. These apps fulfill users' needs for eye-care services to a certain extent, but they still suffer from insufficient medical background, low user engagement, and untimely updates. In order to further improve the effectiveness of eye-care apps, cooperation with medical institutions and professional ophthalmologists should be strengthened to enhance the scientific and authoritative nature of the apps. At the same time, interactive features and regular updates should be added to enhance user participation and the continuity of the apps. This study provides a reference for future development or improvement of eye-care apps, which can help promote myopia prevention and control.

Race, Social Determinants of Health, and the Quality of Diabetic Eye Care

Besides race, little is known about how other social determinants of health (SDOH) affect quality of diabetic eye care. To evaluate the association between multiple SDOH and monitoring for diabetic retinopathy (DR) in accordance with clinical practice guidelines (CPGs). This cohort study was conducted in 11 US medical centers and included adult patients (18-75 years old) with diabetes. Patients received care from 2012 to 2023 and had 18 months or more of follow-up. Multiple SDOH and associated factors, including ethnicity, urbanicity of residence, health insurance type, and diabetes type. Adjusted odds ratio (aOR) of receiving 1 or more eye-care visits and 1 or more dilated fundus examinations in accordance with CPGs. The study cohort included 37 397 adults with diabetes: 10 157 Black patients and 27 240 White patients. The mean (SD) age was 58 (11) years for Black patients and 59 (11) years for White patients. Of the Black patients, 6422 (63.2%) were female and 3735 (36.8%) male; of the White patients, 13 120 (48.1) were female and 14 120 (51.8) were male. Compared with those of the same race in urban communities, Black patients (aOR, 0.12; 95% CI, 0.04-0.31) and White patients (aOR, 0.75; 95% CI, 0.62-0.91) with diabetes living in rural communities had 88% and 25% lower odds of having eye-care visits, respectively. Sicker Black and White patients, defined by the Charlson Comorbidity Index, had 4% (aOR, 1.04; 95% CI, 1.02-1.06) and 5% (aOR, 1.05, CI 1.04-1.06) higher odds of having an eye-care visit, respectively. Black patients with preexisting DR had 15% lower odds of visits (aOR, 0.85, CI 0.73-0.99) compared with those without preexisting DR while White patients with preexisting DR had 16% higher odds of eye-care visits (aOR, 1.16; 95% CI, 1.05-1.28). White patients with Medicare (aOR, 0.85; 95% CI, 0.80-0.91) and Medicaid (aOR, 0.81; 95% CI, 0.68-0.96) had lower odds of eye-care visits vs patients with commercial health insurance. Hispanic White patients had 15% lower odds of eye-care visits (aOR, 0.85; 95% CI, 0.74-0.98) vs non-Hispanic White patients. White patients with type 1 diabetes had 17% lower odds of eye-care visits (aOR, 0.83; 95% CI, 0.76-0.90) vs those with type 2 diabetes. Among patients who had eye-care visits, those with preexisting DR (Black: aOR, 1.68; 95% CI, 1.11-2.53; White: aOR, 1.51; 95% CI, 1.16-1.96) were more likely to undergo dilated fundus examinations. This study found that certain SDOH affected monitoring for DR similarly for Black and White patients with diabetes while others affected them differently. Patients living in rural communities, Black patients with preexisting DR, and Hispanic White patients were not receiving eye care in accordance with CPGs, which may contribute to worse outcomes.

Biologics in ocular inflammatory diseases - Experience from a tertiary referral eye care center in South India.

To analyze the utility of biologics in noninfectious uveitis and other ocular inflammatory diseases in a South Indian patient population. This was a retrospective observational study conducted at the uveitis and ocular inflammatory diseases clinic of a tertiary eye care hospital in South India between 2016 and 2023. Records of 76 patients on biologics were retrieved from our databases. The mean age was 34.84 ± 17.383 years. In 75% of patients, the duration of follow-up was 52.75 months. Overall, anterior nongranulomatous uveitis was the most common anatomic type of uveitis (34.21%). HLA B27-associated uveitis was the most common etiology (34.21%) in whom biologics were used. Patients <18 years of age formed 23.7% with a mean age of 10.77 ± 2.75 years. Mean duration of follow-up in patients <18 years of age was 36 months. In this subgroup, panuveitis was the most common anatomic subtype (61.1%) and juvenile idiopathic arthritis was the most common etiology (27.7%). The most commonly used biologic in this study was adalimumab (36.84%). Additional conventional immunomodulators were used along with biologics in 50 patients (65.78%), of which methotrexate was the most common (50%). Adalimumab and rituximab were biosimilars, while tofacitinib was the generic version. There was a significant decrease in the mean number of flareups post-biologics (P = 0.001). Adverse effects were seen in 14 patients (18.42%). The success rate of biologics was low in the parsplanitis group <18 years (33.3%), Blau-associated uveitis (50%), and idiopathic uveitis (30%). In this study, we have analyzed the results of biologics in different anatomic types of ocular inflammation and etiologies. The success rate of biologics was low in parsplanitis, idiopathic uveitis, and Blau-associated uveitis and higher in other etiologies.

Visual outcomes with implantable Collamer lens versus small incision lenticule extraction in moderate-high myopia: A pilot study.

To compare the visual outcomes of implantable Collamer lens (ICL) with small incision lenticule extraction (SMILE) in cases of moderate-high myopia. A prospective comparative study was conducted on 60 eyes of 30 patients with moderate-high myopia (-3D to -8D with astigmatism ≤1 D) at a tertiary eye care center. Patients underwent either SMILE or ICL in both eyes and had a postoperative follow-up of 1 year. The manifest refractive spherical equivalent was -5.22 ± 1.05 D and -5.4 ± 1.17 D in the SMILE and ICL groups, respectively (P = 0.53). The mean sphere and cylinder were comparable between the groups. The mean uncorrected visual acuity improved from 1.18 ± 0.19 logMAR to 0.03 ± 0.07 logMAR in SMILE and 1.14 ± 0.25 logMAR to 0.011 ± 0.04 logMAR in the ICL group. The efficacy for SMILE was 83.3% and that for ICL was 93.3%. Safety and predictability (±0.5D) for both was 100%. A significant increase was observed in ocular aberration with a decrease in modular transfer function in the eyes that underwent SMILE, whereas no significant change in the eyes that underwent ICL. A significant difference was observed in all parameters of ocular aberration except corneal trefoil, corneal astigmatism, and PSF between the two groups at the final follow-up. The contrast sensitivity at final follow-up was higher in ICL cases when compared to SMILE. The quality of vision (QoV) score suggested a better QoV with ICL; however, the difference was not statistically significant. Both SMILE and ICL are safe in patients with moderate-high myopia. The efficacy, contrast sensitivity, and postoperative ocular aberration profile are better in cases undergoing ICL.

Measuring utility values of eye conditions among children in India using the EQ-5D-Y instrument

BackgroundVision impairment and blindness are significant global public health challenges, particularly in low- and middle-income countries, where access to eye care services remains limited. India has significantly reduced the prevalence of Blindness and Vision Impairment (VI) over the last two decades. This was achieved with the help of greater investments towards blindness control programs. The use of utility values helps in conducting economic evaluations of various eye health programs and empirically justify investing in these programs. This study aimed to estimate utility values for various childhood eye conditions in central India using the EuroQol-Five-Dimension-Youth (EQ-5D-Y) instrument.MethodsThis is a before and after study with data collected at two time points for few participants and at only one time point for others. This study was undertaken at Shri Sadguru Netra Chikitsalaya (SNC) and included children representing central and north India. Participants were randomly sampled in the hospital. After comprehensive eye examination, participants completed the EuroQol-Five-Dimension-Youth (EQ-5D-Y) questionnaire along with EuroQol Visual Analogue Scale (EQ VAS) measurement to elicit their health state for their condition which was repeated after six months post-intervention to measure the change in utility value. We have used Indonesian value set to analyze the preference scores of each dimension of EQ-5D-Y.ResultsUtility values of 16 eye conditions were estimated at baseline and seven conditions were followed up for post-intervention utility value estimation. There is a statistically significant improvement in the utility values post-intervention amongst six conditions. Blindness and Pediatric cataract had the greatest change (0.23 and 0.2 respectively) in utility value whereas mild Vision Impairment (VI) showed the least change (0.02) in the utility value post-intervention. Blindness had the lowest baseline (0.62) and post-intervention (0.85) utility value.ConclusionThe utility values estimated in this study showed that generic measures such as EQ-5D-Y may be used to elicit health states for various eye conditions amongst children. These estimates are helpful in undertaking cost-utility analyses of eye health programs and interventions aimed at these eye conditions.

Epidemiology and Risk Factors of Dry Eye Disease: Considerations for Clinical Management.

Dry eye disease is a multifactorial condition characterised by tear film instability, hyperosmolarity and ocular surface inflammation. Understanding the epidemiology of dry eye disease and recognising both modifiable and non-modifiable risk factors can assist eye care practitioners in assessing, treating, and managing patients with the condition. This review considers current knowledge surrounding its incidence and prevalence, as well as associated demographic, systemic, ocular, and iatrogenic, and lifestyle-related modifiable risk factors. Population-based prevalence estimates vary according to the diagnostic criteria used to define dry eye disease, as well as severity and demographic characteristics of the population. Considering recent data and variable population demographics, conservative prevalence estimates suggest that 10-20% of the population over 40 years of age report moderate to severe symptoms and/or seek treatment for dry eye disease. Individuals with specific non-modifiable demographic risk factors may be at increased risk of developing dry eye disease. Advanced age, female sex and East Asian ethnicity have been identified as key non-modifiable demographic features predisposing individuals to dry eye disease. Systemic conditions that have been associated with an increased risk of dry eye disease include migraine, Sjögren syndrome, connective tissue disorders, mental health disorders, diabetes mellitus and androgen deficiency. Medications that may contribute to this risk include antidepressants, antihistamines, and hormone replacement therapy. Ocular and iatrogenic risk factors of dry eye disease include blepharitis, Demodex infestation, ocular surgery, blink completeness, contact lens wear, and topical ophthalmic medications. A range of modifiable lifestyle factors that can increase the risk of dry eye disease have also been identified, including low humidity environments, digital screen use, quality of sleep, diet, and eye cosmetic wear. Dry eye is a common disease affecting millions globally. Increasing knowledge regarding its associated risk factors can better prepare the eye care practitioner to successfully manage patients with this ocular surface disease.

Treatment of ocular surface squamous neoplasia in an Indian rural facility: a study of 38 eyes

PurposeTo report the demographic profile, clinical presentation, and management outcomes of ocular surface squamous neoplasia (OSSN) treated with primary topical chemotherapy in a limited resource secondary eye care facility in rural parts of South India.MethodsRetrospective interventional study of 38 eyes of 37 patients with OSSN treated with topical 1% 5-Fluorouracil (5FU), over a period of two years.ResultsThe median age at presentation with OSSN was 44 years (mean, 46 years; range 13 to 74 years). Majority (76%) were males. The most common morphological variant was placoid OSSN (18, 47%). Limbus was the most common epicenter (31, 82%). Corneal OSSN was the most initially misdiagnosed variant (n = 3). Of the 38 eyes receiving one week on and 3-weeks off cycles of 5FU regimen, complete tumor resolution was achieved in 36 (95%) eyes. The median number of topical 5FU cycles for tumor resolution was 2 (mean, 2; range, 1 to 4). Over a median follow-up period of 5 months (mean, 6 months; range, 1 to 27 months), tumor recurrence was noted in 3 eyes (8%), of which one case had xeroderma pigmentosum with bilateral multifocal recurrence. Complication rate was 5% (n = 2), which included transient conjunctival hyperemia (n = 1), and bacterial keratitis (n = 1) which resolved with fortified antibiotics.ConclusionPrimary chemotherapy with topical 1% 5FU is a safe and effective management modality for OSSN at limited resource settings in rural India.

Lubratex eye ointment with polyethylene cover significantly reduces corneal abrasion in ICU patients: a randomized controlled trial

Corneal abrasion is a frequent complication in critically ill, intubated patients, potentially leading to visual impairment. This study compares the efficacy of three ocular care methods in preventing corneal abrasion among this vulnerable population. We conducted a randomized controlled trial involving 156 intubated adult patients admitted to the ICU. Participants were randomly allocated to one of three intervention groups (n = 52 per group): (1) polyethylene cover only, (2) polyethylene cover with artificial tear drops, and (3) polyethylene cover with Lubratex eye ointment. One eye per patient was randomly assigned as the control, receiving standard ICU eye care. Daily assessments over five days included a standardized dryness and corneal abrasion checklist, graded strip evaluation of eye dryness, and documentation of corneal abrasion incidence. Data were analyzed using descriptive and inferential statistics (SPSS-18). The incidence of corneal abrasion was significantly lower in the group receiving polyethylene cover with Lubratex eye ointment (4%) compared to the polyethylene cover with artificial tears group (36%, p < 0.001) and the polyethylene cover only group (60%, p < 0.001). The combined application of a polyethylene cover with Lubratex eye ointment effectively prevents corneal abrasion in intubated ICU patients. This method demonstrates superior efficacy compared to polyethylene covers used alone or with artificial tears. We recommend its implementation as standard practice for corneal abrasion prophylaxis in this high-risk population.Trial Registration. This study is registered with the Iranian Registry of Clinical Trials (IRCT201506294736N8) and can be accessed at www.IRCT.ir.

Accuracy of a commonly used mobile ophthalmology application's vision assessment tools in measuring five vision assessment parameters.

The use of mobile ophthalmology applications (MOA) is increasing, but many of these tools have not been validated. This study was performed to assess the accuracy of a popular MOA, Eye Handbook, in measuring five commonly-tested vision assessment parameters (distance visual acuity (DVA), near visual acuity (NVA), colour vision testing (CVT), contrast sensitivity (CS), and pupillary distance (PD)) was compared with traditional vision assessment methods (TVAM) [i.e. Snellen chart, Rosenbaum near card, Ishihara, Pelli Robson test, etc.] performed in the eye clinic setting. Prospective crossover clinical trial of 129 patients meeting inclusion criteria. Participants averaged significantly better DVA (p = 0.0008), NVA (p < 0.0001), and CVT (p = 0.0105) in the MOA than the TVAM, but all three MOA assessments were predictive of the TVAM values. CS was significantly better with the MOA (p < 0.0001). Linear regression and Spearman correlation tests were applied to assess the effect of CS on NVA, which showed no clear relationship between the difference in NVA and the difference in CS. PD using the two methods was in agreement with no significant difference (p = 0.2889). The studied MOA offers an effective means of measuring four common vision parameters: DVA, NVA, CVT, and PD. The MOA can potentially be used by eye care providers, health care providers, and patients, both as a screening tool with correction factor and to monitor ocular pathologies. Atypical MOA measurements should prompt testing in the clinic with formal TVAMs.

Myopic Shift over 5 Years after Pediatric Lensectomy with Primary Intraocular Lens Implantation

To report the change in refractive error over 5 years following primary intraocular lens (IOL) placement by age at surgery, and to identify factors associated with the change in refractive error after 5 years. Prospective observational study at 61 pediatric eye care practices. 186 eyes of 152 children undergoing primary IOL implantation before 13 years of age for non-traumatic cataract. Cataract surgery with primary IOL placement MAIN OUTCOME MEASURES: Five-year change in refractive error (spherical equivalent) by age at surgery (<1 year; 1 to <2.5 years; 2.5 to <4 years; 4 to <7 years; 7 to <13 years). Five-year myopic shift in children 4 to <13 years with immediate postoperative myopia vs emmetropia or hyperopia. Mean spherical equivalent myopic shift (95% confidence interval [CI]) was -5.99 D (-7.64 to -4.34) when surgery was performed at 0 to <1 year of age (n=13), -3.53 D (-4.57 to -2.48) at 1 to <2.5 years (n=28), -1.91 D (-2.55 to -1.26) at 2.5 to <4 years (n=36), -2.04 D (-2.60 to -1.49) at 4 to <7 years (n=60), and -0.83 D (-1.27 to -0.40) at 7 to <13 years (n=49) (P<.01 for each comparison with the oldest group). Variability of myopic shift also decreased with increasing age (P<.01). In eyes of children 4 to <13 years (small sample size precluded analysis of children <4 years), there was significantly less mean change [95% CI] in refractive error over 5 years in eyes with myopia immediately after surgery (-0.69, 95% CI -1.48 to +0.10) than eyes with emmetropia/hyperopia immediately after surgery (-1.70, 95% CI -2.10 to -1.31) (difference = -1.01 D, 95% CI -1.89 to -0.14 D, P=.03). In this large, prospective cohort study of children younger than 13 years of age undergoing cataract surgery with primary IOL placement, there was greater and more variable myopic shift in children undergoing surgery at a younger age. Our finding of less myopic shift over 5 years in eyes with unintended immediate postoperative myopia deserves further study to more accurately guide IOL power selection.

Eye Mobile Units and Their Effect on Access to Pediatric Eye Care

Eye Mobile Units and Their Effect on Access to Pediatric Eye Care

Beyond human perception: Revolutionizing ophthalmology with artificial intelligence and deep learning

The purpose of the study was to provide a comprehensive overview of the transformative applications of artificial intelligence (AI) in ophthalmology, with a focus on its impact on screening, diagnosis, and treatment planning. A comprehensive literature search was conducted to identify relevant studies on the applications of AI in ophthalmology. PubMed, Embase, and Scopus were searched using appropriate keywords, with inclusion criteria focusing on studies related to image analysis, diagnostic algorithms, predictive models, and treatment planning. Limited to English-language articles, both original research and review articles were considered, while studies emphasizing nonophthalmic applications of AI or lacking sufficient detail were excluded. AI algorithms, powered by deep learning models, have demonstrated remarkable accuracy in the automated screening and detection of various ocular diseases. The potential implications of AI include revolutionizing screening programs for early identification of individuals at risk, facilitating timely interventions, and improving patient outcomes. The integration of AI with teleophthalmology and remote monitoring systems has the potential to alleviate the burden on health-care systems, particularly in underserved areas. The applications of AI in ophthalmology hold significant potential for transforming the field by enhancing diagnostic accuracy, optimizing treatment strategies, and increasing access to eye care. However, successful implementation requires addressing challenges such as diverse and representative datasets, ensuring interpretability and explainability of AI models, and addressing ethical considerations related to patient privacy and data security. Collaborative efforts between ophthalmologists, data scientists, and regulatory bodies are deemed crucial to fully leverage the potential of AI in ophthalmology.

International trends in prescribing silicone hydrogel contact lenses for daily wear (2000–2023): An update

PurposeIntroduced around the turn of the 21st century, silicone hydrogel contact lenses alleviated hypoxic anterior eye complications due to their high oxygen transmissibility. The purpose of this work is to update earlier surveys by describing international trends in silicone hydrogel daily wear contact lens fitting between 2000 and 2023. MethodAn annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023. Data relating to 260,144 daily wear soft contact lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of silicone hydrogel daily wear contact lens fitting. ResultsThere has been a dramatic increase in silicone hydrogel daily wear lens fits (p < 0.0001), increasing from 2.8 % of all daily wear soft lens fits in 2000 to 73.7 % in 2023. Of all daily wear soft contact lenses prescribed to males, 44.6 % were silicone hydrogel lenses, compared with 43.5 % for females (p = 0.0146). The mean age of those wearing silicone hydrogel daily wear lenses was 32.0 ± 14.5 years, compared to 30.4 ± 13.6 years for those wearing daily wear hydrogel lenses (p < 0.0001). Between 2019–2023, the average percentage of fits was – (a) material type: silicone hydrogel – 73 %; mid-water content hydrogels – 13 %; high water content hydrogels – 9 %; and low water content hydrogels – 5 %, and (b) lens design: spherical – 44 %, toric – 32 %, multifocal – 17 %, monovision – 4 %, and ‘other’ – 3 %. ConclusionThe dramatic increase in silicone hydrogel contact lens prescribing for daily wear has been commensurate with the introduction of multiple lens brands and an ongoing expansion of lens designs, parameters and replacement frequency options. The balance between silicone hydrogel and hydrogel lens prescribing is perhaps starting to approach an equilibrium.

The Ergonomic Evaluation of Attendings and Trainees Across the Vitreoretinal Service as Measured by a Wearable Device

Background and Objective: A cross-sectional prospective study to examine ergonomic differences in vitreoretinal settings: surgery, clinic, and dedicated procedure clinic. Patients and Methods: Three vitreoretinal surgeons, three fellows, and one resident at a tertiary eye care facility. Participants wore an Upright Go 2 posture device and posture was recorded in each setting between July 1 to August 31, 2023. Results: Time in upright and poor postures was tracked. Significant differences were found in postural score for attendings between work settings ( P &lt; 0.01). Trainees showed no significant difference between settings. Poor posture in surgery was linked to microscope use and scleral buckle placement; in the clinic, it was associated with pan-retinal photocoagulation and injection minutes; in procedure clinic, it was ophthalmologist-dependent and those performing injections. Conclusions: Ergonomic considerations are crucial in vitreoretinal practice. Attendings and trainees should focus on posture in surgery and clinic settings to enhance career longevity. [ Ophthalmic Surg Lasers Imaging Retina 2024;55:XX–XX.]

Disparities in Amblyopia Treatment Outcomes: The Impact of Sociodemographic Factors, Treatment Compliance, and Age of Diagnosis

ObjectiveTo identify clinical and sociodemographic factors associated with disparities in amblyopia treatment outcomes. DesignRetrospective chart review. SubjectsChildren ≤8 years old diagnosed and treated for unilateral refractive or strabismic amblyopia at our institution from 2012-2022. MethodsChildren with amblyopia were categorized by outcome: resolved amblyopia (<0.2 logMAR interocular difference [IOD] in visual acuity, or no fixation preference in non-verbal patients) or persistent amblyopia. Demographic and clinical data were recorded from the medical record. Zip codes were used to calculate Childhood Opportunity Index (COI) scores, estimated annual household income, and distance to hospital. Main Outcome MeasuresSociodemographic and clinical factors were compared between children with resolved and persistent amblyopia. Factors significant at p<0.10 on univariate analysis were included in a multivariable regression model. Results168 patients met inclusion criteria, and 131 (78%) had resolved amblyopia. Demographic factors associated with resolution of amblyopia were younger age at diagnosis (3.3±1.7 vs. 4.5±1.9 years, p=0.0009), English as the primary language (79.4% vs. 62.2%, p=0.04), higher estimated annual income ($83,315.93±29,276.64 vs. $71,623.00±26,842.56, p=0.03), higher COI scores (50.9±27.3 vs. 40.0±26.4, p=0.03), and living further from our institution (28.6±37.6 vs. 14.9±12.7 miles, p=0.003). Patients with resolved amblyopia also had higher rates of treatment compliance (83.2±25.0% vs. 75.6±24.4%, p=0.009) and shorter delays in follow-up (40.1±76.8 vs. 61.1±90.4 days, p=0.02). Amblyopia persistence was borderline associated with governmental insurance and higher presenting IOD in visual acuity (both p=0.06). On multivariate analysis, only younger age at amblyopia diagnosis (p=0.0010) remained significantly associated with amblyopia resolution. ConclusionsOur findings suggest that disparities in amblyopia outcomes are related to differences in age at diagnosis. Interventions to lower the age at which amblyopia is diagnosed, such as programs to improve vision screening rates and access to pediatric eye care in at-risk groups, may directly address inequities in rates of amblyopia resolution.

Effect of Implementing Nurse-led Eye Care Protocol on the Control of of Eye Complications among Mechanically Ventilated Patients.

Effect of Implementing Nurse-led Eye Care Protocol on the Control of of Eye Complications among Mechanically Ventilated Patients.

Sub-Tenon versus peribulbar anesthesia in vitreoretinal surgery: A retrospective analysis in a tertiary eye care center

Aim: The aim of this study was to compare the efficacy of sub-Tenon and peribulbar anesthesia in vitreoretinal surgeries. Methods: This was a retrospective study where patients who received peribulbar or sub-Tenon anesthesia during vitreoretinal surgeries between July 2023 and September 2023 were included. Lid movements, subconjunctival hemorrhage, chemosis, and akinesia were evaluated after anesthesia was injected in the two groups. Pain score was evaluated at the time of anesthesia, intraoperatively, and postoperatively after 1 h. Results: We included 108 patients, of which 58 were given peribulbar and 50 had sub-Tenon anesthesia and had mean ± standard deviation age of 56.8 ± 12.6 years and 57.90 ± 13.0 years, respectively (P = 0.67). Baseline, intraoperative, and postoperative (at 1 h after surgery) systolic blood pressure (BP), diastolic BP, and pulse rate were similar in both groups. None of the patients had any systemic complications in both the peribulbar and sub-Tenon groups. The mean pain score at postoperative 1 h was similar in both groups (P = 0.58). At postoperative 1 day, two patients had ecchymosis in the peribulbar group. Eighteen cases had lid edema in the peribulbar group compared to no lid edema in the sub-Tenon group (P &lt; 0.001). Conclusion: Sub-Tenon anesthesia is a simple, safe, and less traumatic technique that is as good as peribulbar in terms of providing analgesia. Although sub-Tenon could not produce total akinesia in most of the cases, the surgeon was able to operate comfortably with negligible chance of anesthesia-related complications. However, the anesthetist also plays an important role in a multidisciplinary approach in the management of vitreoretinal surgeries.

Public Awareness Regarding the Differences Between Ophthalmologists and Optometrists Among Adults Living in Makkah Province, Saudi Arabia.

Background Patients' knowledge of the differences between ophthalmologists and optometrists has been identified as a crucial factor influencing the choice of eye care services. This study aimed to assess the level of understanding of the differences between ophthalmologists and optometrists among the population in the Makkah province. Methods This cross-sectional study utilized an online questionnaire distributed to adults via social media platforms in the Makkah province, Saudi Arabia, from January to April 2023. The total number of respondents was 1,404. Results This study revealed that 464 (33.3%), 690 (49.5%), and 241 (17.3%) of the participants demonstrated a low, fair, and good understanding, respectively of the distinction between an optometrist and an ophthalmologist. Overall, 936 (66.7%) exhibited good knowledge. The high level of knowledge is directly correlated with a history of previous eye examinations and the use of eyeglasses. The variables of age (specifically the 18-30-year cohort) and higher educational attainment (at or above university level) emerged as statistically independent predictors of sufficient knowledge acquisition. The odds ratios for younger age and a higher educational level were (confidence interval of 95%) 1.45 (1.11-1.88) and 1.42 (1.19-1.68), respectively. Conclusion This study revealed a fair public knowledge of the distinctions between optometrists and ophthalmologists. Additionally, we recommend the Ministry of Healthencourage and sustain ongoing initiatives to enhance public awareness.

Comparing the Ability of Google and ChatGPT to Accurately Respond to Oculoplastics-Related Patient Questions and Generate Customized Oculoplastics Patient Education Materials.

To compare the accuracy and readability of responses to oculoplastics patient questions provided by Google and ChatGPT. Additionally, to assess the ability of ChatGPT to create customized patient education materials. We executed a Google search to identify the 3 most frequently asked patient questions (FAQs) related to 10 oculoplastics conditions. FAQs were entered into both the Google search engine and the ChatGPT tool and responses were recorded. Responses were graded for readability using five validated readability indices and for accuracy by six oculoplastics surgeons. ChatGPT was instructed to create patient education materials at various reading levels for 8 oculoplastics procedures. The accuracy and readability of ChatGPT-generated procedural explanations were assessed. ChatGPT responses to patient FAQs were written at a significantly higher average grade level than Google responses (grade 15.6 vs 10.0, p < 0.001). ChatGPT responses (93% accuracy) were significantly more accurate (p < 0.001) than Google responses (78% accuracy) and were preferred by expert panelists (79%). ChatGPT accurately explained oculoplastics procedures at an above average reading level. When instructed to rewrite patient education materials at a lower reading level, grade level was reduced by approximately 4 (15.7 vs 11.7, respectively, p < 0.001) without sacrificing accuracy. ChatGPT has the potential to provide patients with accurate information regarding their oculoplastics conditions. ChatGPT may also be utilized by oculoplastic surgeons as an accurate tool to provide customizable patient education for patients with varying health literacy. A better understanding of oculoplastics conditions and procedures amongst patients can lead to informed eye care decisions.