Eye Clinic Research Articles

Comparison of 3-month clinical outcomes between two enhanced monofocal intraocular lenses: A single-center prospective study.

This study aims to compare the 3-month clinical outcomes between two enhanced monofocal intraocular lenses (IOLs) following cataract surgery.Setting: Eye Clinic of Careggi University Hospital, Florence, Italy. Single-center prospective study. We included patients with cataract and corneal astigmatism less than 0.75 D, with no ocular comorbidities, who underwent unilateral cataract surgery with implantation of either the Tecnis Eyhance ICB00 (N = 25) or Evolux (N = 25) IOLs. Standard cataract procedures were performed without complications. The main outcome measures included uncorrected and corrected visual acuity at distance (4 m), intermediate (60 cm) and near (40 cm) at 3-month follow-up. Additionally, monocular defocus curves, aberrometric profiles, and perceptions of halo and glare were evaluated. The study involved 50 patients (26 male, 24 female) with a mean age of 68 ± 8 years. Preoperative characteristics were similar between the groups, and no intraoperative or postoperative complications were reported. Statistically significant differences were observed between the groups, with the Evolux IOL showing superior results (p < 0.05) in terms of uncorrected and corrected visual acuity at near, intermediate, and distance, as well as in aberrometric profiles (lower-order aberration root-mean-square [RMS], higher-order aberration RMS, spherical equivalent RMS, and point spread function) and defocus curves. Based on our experience, while both IOLs offer substantial visual performance for intermediate and distance vision, the Evolux IOL demonstrated superior mean visual outcomes and objective parameters at the 3-month follow-up compared to the Tecnis Eyhance IOL. This indicates a potential advantage of the Evolux IOL in providing better visual performance.

Correlation Between Axial Length and Amplitude of Accommodation in Myopia Patients

Background: Myopia is the most common refractive disorder and is a global concern because it can cause more serious eye problems. Excessive prolonged axial growth of the eyeball can lead to myopia. The amplitude of accommodation is the strength of the eye accommodation during the minimum and maximum accommodation conditions. Based on the above data, the researchers wanted to assess the relationship between eyeball length and accommodation amplitude in myopia patients. Method: The research was conducted at the Hospital of Prof CPL University of North Sumatra from November 2023 to March 2024. Data analysis was done analytically and presented in the form of data tabulation. Result: This study included 54 myopia patients, 27 males and 27 females, who visited the eye clinic. The mean age of the subjects was (52%). The mean age of the subjects was 23 years old with the youngest being 22 years old and the oldest being 24 years old. The mean of axial length for mild myopia, moderate myopia and severe myopia were 24.51 cm, 25.75 cm and 28.38 cm respectively. The lowest NPA value was found in severe myopia (27.33 cm) and the highest in mild myopia (43 cm). The lowest NPC value was found in mild myopia (36.61 cm) and the highest in severe myopia (38.56 cm). There was a significant relationship between eyeball length and accommodation amplitude with a Spearman correlation value of -0.685 as well as after cycloplegic administration with a Spearman correlation value of 0.438. NPA values showed an increase when receiving spherical correction, whether accompanied by cycloplegics or not, and a decrease when not receiving spherical correction. NPC values showed a decrease in all treatments. Conclusion: There is a correlation between axial length and amplitude of accomodation values (NPA and NPC) in patients with myopia.

Unravelling ChatGPT's potential in summarising qualitative in-depth interviews.

Qualitative research can be laborious and time consuming, presenting a challenge for practitioners and policymakers seeking rapid, actionable results. Data collection, transcription and analysis are the main contributors to the resource-intensive nature. OpenAI's Chat Generative Pre-trained Transformer (ChatGPT), have demonstrated potential to aid in data analysis. Our study aimed to compare themes generated by ChatGPT (3.5 and 4.0) with traditional human analysis from in-depth interviews. Three transcripts from an evaluation study to understand patients' experiences at a community eye clinic were used. Transcripts were first analysed by an independent researcher. Next, specific aims, instructions and de-identified transcripts were uploaded to ChatGPT 3.5 and ChatGPT 4.0. Concordance in the themes was calculated as the number of themes generated by ChatGPT divided by the number of themes generated by the researcher. The number of unrelated subthemes and time taken by both ChatGPT were also described. The average time taken per transcript was 11.5 min, 11.9 min and 240 min for ChatGPT 3.5, ChatGPT 4.0 and researcher respectively. Six themes were identified by the researcher: (i) clinic's accessibility, (ii) patients' awareness, (iii) trust and satisfaction, (iv) patients' expectations, (v) willingness to return and (vi) explanation of the clinic by referral source. Concordance for ChatGPT 3.5 and 4.0 ranged from 66 to 100%. Preliminary results showed that ChatGPT significantly reduced analysis time with moderate to good concordance compared with current practice. This highlighted the potential adoption of ChatGPT to facilitate rapid preliminary analysis. However, regrouping of subthemes will still need to be conducted by a researcher.

Genetic background of high myopia in children.

High myopia is a significant risk factor for irreversible vision loss and can occur in isolation or as a component of various syndromes. However, the genetic basis of early-onset high myopia remains poorly understood. We aimed to identify the causative genetic variants for high myopia in a cohort of Slovenian children. The study included children referred to a tertiary paediatric ophthalmology centre at the University Eye Clinic in Ljubljana between 2010 and 2022. The participants met the following inclusion criteria: age ≤ 15 years and high myopia ≤-5.0 D before the age of 10 years. Genetic analysis included exome sequencing and/or molecular karyotyping. Participants were categorized based on clinical presentation: high myopia with systemic involvement, high myopia with ocular involvement, and isolated high myopia. Genetic analysis of 36 probands revealed a genetic cause of high myopia in 22 (61.1%) children. Among those with systemic involvement (50.0%), genetic causes were identified in 13 out of 18 children, with Stickler's and Pitt-Hopkins being the most common syndromes. Among cases of high myopia with ocular involvement (38.9%), a genetic cause was found in 8 out of 14 probands, including (likely) pathogenic variants in genes related to retinal dystrophies (CACNA1F, RPGR, RP2, NDP). The non-syndromic ARR3- associated high myopia was identified in the isolated high myopia group. A genetic cause of high myopia was identified in 61.1% of children tested, demonstrating the value of genetic testing in this population for diagnosis and proactive counseling.

Effect of Belin-Ambrósio deviation index on 2-year refractive outcomes of PRK.

To assess the effect of preoperative Belin-Ambrósio deviation (BAD-D) index on 2-year visual, refractive, and tomographic outcomes, as well as the efficacy and safety of photorefractive keratectomy (PRK) surgery. Eye clinic, Mashhad, Iran. Prospective cohort study. This study included 66 patients (66 eyes) who underwent PRK surgery, with a minimum follow-up period of 2 years. Participants were divided into 2 groups: preoperative BAD-D ≥1.60 (high BAD-D) and preoperative BAD-D <1.60 (low BAD-D). Preoperative and postoperative visual, refractive, and tomographic parameters were evaluated, and the efficacy and safety of the procedure were compared between groups. 66 patients with a mean age of 35.50 ± 8.21 years (range 22 to 55 years) were included. Postoperatively, the mean spherical equivalent (SE) of refractive error was +0.32 ± 0.65 diopters (D) in the high BAD-D group and +0.18 ± 0.66 D in the low BAD-D group ( P = .40). In addition, at 2 years of follow-up, the mean uncorrected distance visual acuity was 0.98 ± 0.07 in the high BAD-D group and 0.97 ± 0.08 in the low BAD-D group ( P = .905). Among the postoperative tomographic parameters, front elevation thickness, maximum Ambrósio relational thickness, astigmatism, and central corneal thickness were significantly different between the 2 groups (all, P < .05). At the 2-year follow-up, the mean Safety Index was 1.02 ± 0.04, and 1.01 ± 0.04 in high and low BAD-D groups, respectively ( P = .37), and the mean Efficacy Index was 0.99 ± 0.07 and 0.98 ± 0.06 in high and low BAD-D groups, respectively ( P = .40). The preoperative BAD-D index does not predict postoperative visual, refractive, and tomographic outcomes in patients with low-to-moderate myopia. However, in patients with normal preoperative BAD-D values, higher agreement was expected between the attempted and achieved SE.

An Unknown Pregnancy Presenting as Vision Loss: A case report

Hypertensive retinopathy (HTR) secondary to preeclampsia can present similarly to non-pregnancy related HTR. Here, we report a case of a patient who presented to our eye clinic for decreased vision bilaterally. Ocular exam and imaging revealed large serous retinal detachments affecting the central macula along with massive intraretinal edema. Due to concern for systemic pathology, the patient was referred to the emergency department (ED), where her blood pressure was found to be 200/110 mmHg. The patient was discovered to be pregnant and diagnosed with preeclampsia with severe features in the third trimester. After delivery of the fetus, the patient had complete resolution of visual symptoms. Since pregnancy-related ophthalmic manifestations are generally mild and reversible, ophthalmologists do not usually consider pregnancy-related disease in patients who are not known to be pregnant. However, it is important to keep these complications on the differential with women of child-bearing age.

Discriminant prediction equation using an optical biometer for identifying postmyopic laser vision correction eyes.

To create an equation for identifying postmyopic laser vision correction (M-LVC) eyes by using corneal shape parameters in a swept-source optical coherence tomography (SS-OCT) biometer and verify its accuracy. Nagoya Eye Clinic, Nagoya, Japan. Retrospective evaluation of a screening approach. Control participants were selected retrospectively from patients who visited the clinic for cataract surgery or refractive surgery. M-LVC patients were selected retrospectively from patients who visited the clinic for cataract surgery or M-LVC postoperative checkups. The control and post-M-LVC patients with keratometric values between 39 diopters (D) and 43 D were included in the final analysis. Patients were randomly assigned to equation-creation and validation groups in a 2:1 ratio. To discriminate post-M-LVC patients from control participants, multiple logistic regression analysis was performed with the corneal shape parameters from the optical biometer as independent variables. The M-LVC and control groups consisted of 90 eyes from 90 patients and 97 eyes from 97 patients, respectively. The average keratometry (Ave-K) values did not differ significantly between the control and M-LVC groups ( P = .187). The multiple logistic analysis identified the asymmetry component (regression coefficient, 5.357; odds ratio, 212.158) and corneal eccentricity index (regression coefficient, -5.088; odds ratio, 0.006) as explanatory variables. The area under the receiver operating characteristic curve in the predictive equation-creation group was 0.946. The sensitivity and specificity in the validation group were 93.3% and 87.5%, respectively. The M-LVC discriminant prediction equation with the topography-equipped SS-OCT biometer was effective in detecting post-M-LVC eyes with high accuracy.

Visual Outcomes After Cataract Surgery With the Light Adjustable Lens in Japanese Patients With and Without Prior Corneal Refractive Surgery.

To describe Light Adjustable Lens (RxSight, Inc) (LAL) visual and refractive outcomes in a Japanese patient population with and without prior refractive surgery. In this retrospective chart review of patients with cataract in a private eye clinic, 34 eyes from 21 patients underwent cataract surgery with LAL implantation. Eyes underwent light treatment to adjust the patients' refraction after implantation to meet individual visual goals. Standard visual and refractive outcomes were collected. Contrast sensitivity (to assess quality of vision), clinical defocus and vergence curves (to assess range of vision), and patient satisfaction were also collected. The mean prediction error of the light adjustment was -0.04 ± -0.48. Thirty-one eyes (91%) and 33 eyes (97%) were within ±0.25 and ±0.50 diopters (D) of manifest spherical equivalent target, respectively. Thirty-two eyes (94%) had residual refractive cylinder of 0.50 D or less. The full depth of focus was 3.68 D. Monocular contrast sensitivity shows frequencies equivalent to a normal population aged 50 to 60 years. The mean satisfaction score was 8.8 (scale: 1 to 10). There were no adverse events and no eyes lost corrected distance visual acuity from the light treatment. LALs in cataract refractive surgery hold great promise, including for the Japanese population, which have unique ocular biometrics. By providing a safe procedure and the ability for postoperative adjustments, the LAL provided a tailored approach to vision correction, ultimately improving patient outcomes and satisfaction. [J Refract Surg. 2024;40(11):e854-e862.].

Modified pro re nata regimen of brolucizumab in treatment-naive neovascular age-related macular degeneration.

Purpose- To study the efficacy and safety of pro re nata regimen of brolucizumab, without loading dose, in treatment-naive patients with neovascular age-related macular degeneration (nAMD). Case series- Retrospective, observational study. We included all consecutive patients diagnosed with treatment- naïve nAMD undergoing Brolucizumab in Humanitas eye clinic, Turin, Italy between April 2022 and May 2023. Treatment was performed following pro re nata regimen without loading phase. Injection intervals (time between two injections), adverse events, changes in best corrected visual acuity (BCVA), central macular thickness (CMT), maximal retinal thickness (MRT), intraretinal and subretinal fluid (IRF, SRF) were evaluated descriptively up to one year after the first injection. Twenty-one eyes of 21 patients were included in the study. The mean number of injections was 2.4±0.7 at 3 month, 3.0±2.0 at 6 month, 3.1±2.4 at 9 month and 3.8±2.8 at 12 month, respectively. BCVA significantly improved from 20/80 Snellen (0.6±0.3 LogMar) to 20/50 Snellen (0.4±0.3 LogMar) at month 12 (p = 0.044). CMT and MRT significantly reduced from 426 μm and 606 μm at baseline, to 248 μm and 356 μm at one-year follow-up (p=0.00067 and p=0.02, respectively). SRF and IRF also progressively resolved. On the other hand, intraocular inflammation (IOI) events occurred in 9.5% of cases during follow-up. IOI resolved in all cases with prompt treatment without visual sequelae. Conclusions- In our study, pro re nata regimen of brolucizumab without loading phase appears to be an effective treatment option in treatment-naive nAMD patients, with IOI rate similar to the one reported in trials and lower number of injections.

EFEKTIVITAS PROGRAM JAMINAN KESEHATAN NASIONAL (JKN) BPJS KESEHATAN DALAM MENINGKATKAN KUNJUNGAN PASIEN DAN PELAYANAN KESEHATAN DI KLINIK MATA PANDAAN

This study aims to analyze the effectiveness of the National Health Insurance (JKN) BPJS Kesehatan program in increasing patient visits and health services at Pandan Eye Clinic. The research method used is quantitative with a descriptive and analytical approach. Data was collected through documentation studies, interviews, and observations. The results of the study show that the JKN BPJS Kesehatan program has increased patient visits and the types of health services at Pandaan Eye Clinic. JKN BPJS Kesehatan patients are also satisfied with the health services they receive. In conclusion, the JKN BPJS Kesehatan program has been proven effective in increasing access to and quality of health services at Pandan Eye Clinic.

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.

Nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae among diabetes patients in western Kenya

AimsTo compare nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae among patients with and without diabetes at Moi Teaching and Referral Hospital (MTRH) in western Kenya. MethodsA cross-sectional study was conducted at MTRH diabetes and eye clinics. Participants were selected using systematic random sampling. Sociodemographic data and risk factors were collected through interviewer-administered questionnaires. Blood samples were taken to measure random blood sugar and HbA1c levels. Nasopharyngeal swabs were cultured and tested for antibiotic susceptibility within 24 h. Data analysis was performed using STATA version 13. Associations were assessed using Pearson’s chi-square, Fisher’s exact test, unpaired t-test, and Wilcoxon test. ResultsA total of 124 participants with diabetes and 121 without diabetes were enrolled. Overall, 7.4 % (95 % CI: 4.4, 11.4) of participants carried S. pneumoniae. Carriage was higher in diabetes (12.1 % [95 % CI: 7.0, 19.0]) than non-diabetes participants (2.48 % [95 % CI: 1.0, 7.0]), with a statistically significant difference (p = 0.004). Diabetes was associated with higher odds of carriage (adjusted OR 6.2, p = 0.012). No association was found with age, sex, cooking fuel, presence of children under 5, or prior antibiotic use. Among participants with diabetes, carriage of Streptococcus Pneumoniae was only associated with insulin use. Antibiotic resistance was highest for cotrimoxazole (94.44 %), followed by amoxicillin (16.7 %) and cefuroxime (11.1 %). No resistance to macrolides was observed. ConclusionNasopharyngeal carriage of S. pneumoniae is higher in patients with diabetes, with significant resistance to common antibiotics, though macrolides remain effective.

Comp arison of c yclop legic refraction in ch i ldren w i th different iris c olou r cat eg ories: A cross- sec tio na l survey.

To compare the cycloplegic refraction in children with different iris colour categories and age groups. The cross -sectional study was conducted from December 2 022 to June 2023 at the Eye Clinic of Sehat Medical Complex, Hanjarwal, Lahore, and Khizar Eye Centre, Lahore, Pakistan, and comprised hyperopic children aged 5-12 years of either gender. Data regarding age, gender, iris colour, auto -refraction and retinoscopy before and after cycloplegic refraction was collected using a structured proforma. Data was analysed using SPSS 21. Of the 139 subjects, 73(52.5%) were males and 60(47.5%) were females. There were 79(56.8%) subjects aged 5-8 ye ars and 60(43.2%) aged 9 -12 years. The iris colour dis tribution was 23(16.5%) light, 80(57.6%) med ium and 36(25 . 9%) da r k, w ith a mean visual acuity of 0.7 ±0.6. There wa s a signi ficant differe nce in non - cyclopleg ic and cycloplegic refraction for different iris colours and age groups (p<0.05). Children with light iris colour accommodated more and needed a low concentration of cyclopentolate compared to those with m edi u m and dark ir is col ours. More accomm odation was noted among child ren ag ed 9-12 years.

Rheumatic fever and long-term use of benzathine penicillin as possible risk factors for extensive macular atrophy with pseudodrusen in a Brazilian cohort

BackgroundAlthough there has been a large increase in the number of extensive macular atrophy with pseudodrusen (EMAP) cases, the basic aspects of this disease remain unknown. Brazilian patients have a common past history of rheumatic fever (RF) and/or benzathine penicillin (BP) treatment possibly related to the disease. We analyzed how RF and BP might be correlated with EMAP in Brazilian patients.DesignObservational, retrospective, case-control study.MethodsThe databases of three private eye clinics in Brazil were searched for patients with an EMAP-like appearance. Each patient was asked about a previous history of RF and/or long-term use of BP. Patients underwent best-corrected visual acuity (BCVA) measurement, color fundus imaging, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT) imaging, and electroretinography (ERG). The following characteristics were analyzed: subretinal drusenoid deposits (SDD), pigment mottling, retinal pigment epithelial/basement membrane (RPE/BM) separation, outer retinal or RPE atrophy, and identification of a paving stone-like appearance. The choroidal thickness was measured using enhanced depth imaging OCT. The central atrophic area was measured manually on ultra-wide-field FAF.ResultsA total of 154 eyes of 77 patients (women, 66.2%; mean age, 58.6 years) with EMAP were included; 90.9% of patients were diagnosed with RF; 94.8% had been treated with BP and treatment was started at an average age of 7.3 years (mean duration, 11.8 years). The treatment duration was significant for the area of atrophy (P = 0.027) in which each 1-year increase in treatment duration led to an average reduction of 6.91 mm2 in area. The age at diagnosis of RF was significant (P = 0.026) for SDD. The increase of 1 year in the diagnosis of RF (late disease) led to a reduction of 24% in the chance of central SDD being present. On OCT, 65.5% eyes had SDD and more than 70% had a split RPE/BM and outer retinal or RPE atrophy. The choroidal thickness in patients with EMAP was significantly (P < 0.001) thinner than the control group. The ERG was abnormal in all eyes.ConclusionThese findings may suggest a relation between RF and EMAP in Brazilian patients. Patients with EMAP should be questioned about a history of RF.

The scanning CONfoCal Ophthalmoscopy foR DIAbetic eye screening (CONCORDIA) study paper 2.

To determine if the Eidon white light 60-degree field Scanning Confocal Ophthalmoscope (SCO) camera was safe to use with staged mydriasis in a Diabetic Eye Screening Programme (DESP). The trial participants were recruited from people with diabetes attending appointments in DESP or Virtual Eye clinics for post-Covid delayed hospital appointments. Using staged mydriasis, the SCO images were taken before the pupils were dilated and compared to two-field 45 degrees mydriatic digital photography (the reference standard). Mydriatic SCO images were only compared to the reference standard if the non-mydriatic SCO images were unassessable. 1050 patients were recruited, 35 individuals were withdrawn, the majority (18) due to an imaging protocol deviation leaving 1015 individuals (2029 eyes). Using staged mydriasis, the sensitivity and specificity for any retinopathy was 97.5% (95% CI: 96.4-98.4%) and 82.3% (95% CI: 79.6-84.7%) respectively. The sensitivity and specificity for referable retinopathy was 92.7% (95% CI: 89.9-94.9%) and 85.4% (95% CI: 83.6-87.2%) respectively. The total number of eyes that were unassessable with the Eidon without mydriasis was 85/2029 (4.2%), and after mydriasis was 34/2029 (1.7%) and, with the reference standard, 34/2029 (1.7% - not always the same images) were unassessable. This study provides promising early results of the performance of the Eidon camera using staged mydriasis in a DESP which needs further evidence from a non-Caucasian population and from cost-effectiveness analyses.

The relationship between contact lens ultraviolet light transmittance and myopia progression: a large-scale retrospective cohort study.

The prevalence of myopia is increasing dramatically around the world, and many studies have suggested the possibility that ultraviolet (UV) light is effective to prevent the onset and progression of myopia. However, UV is a risk factor for diseases that cause refractive errors such as cataract and pterygium. In this study, we evaluated the relationship between UV exposure and myopia progression. The dataset consisted of a total of 337 396 eyes of patients in the 12-to-29-year age range, who were prescribed soft contact lenses (SCL) for refractive error at Okada Eye Clinic in Japan between 2002 and 2011. They were tracked over a five-year period and did not change the type of SCL. In this retrospective cohort study based on medical records, we divided patients into two groups, one prescribed SCL with UV protection (UV-SCL), and another prescribed SCL without UV protection (UV+SCL). Change in refractive power over five years was measured and results compared. It was -0.413 diopter (D) in the UV-SCL group and -0.462 D in the UV+SCL group. Thus, the progression of myopia was slower in the UV-SCL group. The results were also analyzed separately by gender and degree of myopia at the time of initial prescription, which all showed significant differences (P<0.001). Results suggest that UV exposure may advance myopia. Further research is needed to investigate the underlying mechanisms that could explain this.

Comparison of Visual Acuity Outcomes of Phacoemulsification and Small Incision Cataract Surgery

Background. The visual outcomes of phacoemulsification (Phaco) and manual small incision cataract surgery (MSICS) have been extensively studied, with research indicating that both methods are highly effective in restoring vision. Purpose. This study was aimed at comparing the visual acuity outcomes of the two surgical techniques. Methods. A total of 90 participants were scheduled for cataract surgery at Adetula Opticals &amp; Eye Clinic, Oshodi-Isolo, Lagos State, Nigeria, from June to August 2023. The participants were divided into two groups of 45, a group was scheduled for Phaco (0.92 ± 0.65; 6/60-6/36) and SICS (1.32 ± 0.81; 3/60) logMAR. Visual acuities (VAs) were measured pre- and postoperatively. Results. The difference in mean VA pre-op of -0.40 (95% confidence interval (CI): -0.096, -0.71) between the two techniques was statistically significant (p = 0.000). There was no significant difference in the logMAR VAs between the techniques post-operatively (p = 0.06), although the visual outcome with the two methods showed the tendency of a better VA (0.11± 0.17 [6/9 - 6/6]) as opposed to that of the other two techniques (0.22 ± 0.32; [6/12 - 6/9]). Conclusion. Both techniques have been refined to a point where they provide comparable long-term visual outcomes, making the choice of method dependent on specific patient needs, surgeon expertise, and available resources.

The Scanning CONfoCal Ophthalmoscopy foR DIAbetic eye screening (CONCORDIA) study paper 1.

This project was to determine the performance of the Zeiss Clarus 700 (Clarus) and the Optos California (Optos) with staged mydriasis in a Diabetic Eye Screening Programme (DESP). Trial participants were recruited from people attending appointments in DESP or Virtual Eye clinics for delayed hospital appointments. Non-mydriatic photographs from the Clarus and Optos cameras were compared to 2-field 45 degrees mydriatic digital photography (the reference standard) and mydriatic photographs compared if the non-mydriatic photos were unassessable (staged mydriasis). 1573 patients were recruited. 76 individuals were withdrawn, leaving 1497 individuals (2993 eyes). For the Clarus and the Optos, the sensitivity for any retinopathy were 94.2% (95% CI: 92.9-95.3%) and 91.9% (95% CI: 90.5-93.2%) with specificities of 87.3% (95% CI: 85.4-89.0%) and 78.1% (95% CI: 75.7-80.3%) respectively. For referable DR the sensitivities for the Clarus and Optos were 86.0% (95% CI: 82.9-88.8%) and 77.6% (95% CI: 73.9-80.9%) with specificities of 92.8% (95% CI: 91.7-93.8%) and 95.4% (95% CI: 94.5-96.2%) respectively. The Clarus and Optos without mydriasis produced 100 (3.3%) and 152 (5.1%) unassessable eyes respectively, and after staged mydriasis 51 (1.7%) and 102 (3.4%) respectively with 52 (1.7%) reference standard images unassessable. This study reports the performance of the Clarus and the Optos using staged mydriasis in DR screening with wider fields detecting more referable retinopathy peripherally with some reduction in sensitivity centrally for macular lesions.

Ugandan optometry students’ experiences of their clinical training: a qualitative study

BackgroundThere is a gradual increase in the number of optometry education programs in Africa yet there is limited knowledge on optometry students’ experiences of their clinical training. Therefore, the purpose of this study was to explore the optometry students’ experiences of their clinical learning environment at a national referral and teaching hospital in Uganda.MethodsBetween April 2023 and May 2023, face to face in-depth interviews were conducted to explore the experiences of the participants. All 16 optometry students in fourth-year at university were purposefully recruited into the study. Data was collected at the end of the students’ clinical training at the eye clinic of a national referral and teaching hospital. Interviews were audio recorded and transcribed for analysis using an inductive thematic approach.ResultsTwo themes, learning at the eye clinic and organization of the eye clinic, were identified to represent participants’ experiences. Each theme had three sub themes.ConclusionTraining optometry students at an eye clinic enhances their clinical skills and knowledge of diagnosing and managing various eye conditions. Future studies should compare optometry students’ experiences in lower-level health units to those in national referral hospitals.

7824 Orbital Lymphoma masquerading as Thyroid Eye Disease

Abstract Disclosure: S. Ganawa: None. S. Joseph: None. C. Anshuman: None. D. Luciane L: None. A. Sajid: None. C. Anne: None. S. Dhage: None. Thyroid eye disease (TED) is the most common extrathyroidal manifestation in Graves’ disease (GD). In this case report, we present a case of a 64 years old lady, who was initially diagnosed with thyroid eye disease about 9 years ago. However, she was clinically and biochemically euthyroid. She was offered an orbital decompression surgery by local ophthalmology team. Patient wasn’t keen on the surgery at this stage.Recently she experienced increased swelling of her eyes, with conjunctival redness, oedema, and diplopia bilaterally, more evident on the left side. She was initiated on intravenous methylprednisolone (IVMP) weekly, by local ophthalmology team and was referred to our specialist thyroid eye clinic for further management.On presentation to us, her clinical activity score (CAS) was 5/7, but she was euthyroid clinically and biochemically. She was continued on weekly IVMP and oral mycophenolate mofetil (MMF) was added on as per the latest EUGOGO guidelines published in 2021. Her treatment was reviewed after the anti thyroperoxidase (TPO) and anti-Thyroid Stimulating Hormone receptor (TSH) antibodies were reported as negative and her eyes worsened despite the treatment with IVMP and MMF.Her repeat MR orbit at this stage showed possible orbital lymphoma. Her immunosuppressive medications were discontinued at this stage. After further discussions at regional thyroid eye MDT and radiology MDT, an orbital biopsy was arranged for, which confirmed Extra nodal Marginal Zone lymphoma, with no high-grade component. She has been referred to the oncology unit for further assessment and management.This case highlights the importance of considering alternative differential diagnosis in certain patients with atypical features or those who are non-responders to the first line immunosuppressive therapies for thyroid eye disease. Details of this case and relevant literature will be reviewed in this report. Presentation: 6/3/2024