Spectacle Wear Research Articles

CORRELATION BETWEEN COMPLIANCE OF SPECTACLE WEAR AND MYOPIA PROGRESSIVITY RATE IN MEDICAL STUDENTS OF DIPONEGORO UNIVERSITY

Introduction and Objective
 Myopia is a refractive error that causes images of distant objects to be focused in front of the retina by the non-accommodating eye. Myopia is one of the most common visual disturbances in the world. It is believed that the use of spectacle can reduce the progressivity rate of myopia. Spectacle can help light fall on the retina and prevent axial elongation of the eye. This theory needs to be investigated further so that it can be used as a reference. This study aimed to know the correlation between compliance of spectacle wear and myopia progressivity rate in medical students of Diponegoro University (UNDIP).
 Methods
 This research was an observational analytical study with cross-sectional design on 54 subjects ranging from 18 to 22 years old. Data are primary data obtained from questionnaires and objective eye examinations using an autorefractometer. The research was conducted from October to November 2021. Data were analyzed using Spearman Rank test which p<0,05 was considered significant.
 Results
 The mean of compliance of spectacle wear and myopia progressivity rate in medical students of UNDIP are (1,57±0,108) and (0,259±0,515) dioptres respectively. The correlation between compliance of spectacle wear and myopia progressivity rate are p=0,082 and r=0,239.
 Conclusion
 There are no correlation between compliance of spectacle wear and myopia progressivity rate in medical students of UNDIP.

Non-compliance of Spectacle Wear in School-Going Children With Refractive Errors.

Background Uncorrected refractive errors are the most common cause of avoidable visual impairment in children worldwide. The school screening of refractive errors is one of the most important initiatives outlined in WHO Vision 2020 targets for control of avoidable visual impairment in children. However, the benefit depends on the compliance of the spectacle worn by children. Objective To determine non-compliance of spectacle wear and its predisposing factors among school-going children in Lahore, Pakistan. Methods This cross-sectional analytical study was conducted among 200 school-going children (5-16 years), with spectacle prescription for at least the last six months studying in primary and secondary schools of Lahore, by using convenience sampling. We collected data with the help of a standardized, self-administered, close-ended questionnaire determining age, gender, class, and non-compliance and its reasons. Data were subjected to statistical evaluation using Statistical Product and Service Solutions (SPSS, version 26; IBM SPSS Statistics for Windows, Armonk, NY), and a chi-square test was applied to determine the statistical significance. p-value 0.05 was considered significant. Results Of the 200 children, 42 were boys, and 158 were girls, with a mean age of 12 years with a standard deviation of 2.6. The proportion of spectacle wear non-compliance was 19.5% (n=39). Children with non-compliance were more likely in the age group of 14-16 years (n=20{51.3%}; p=0.039). The main reasons for non-compliance were dislike to wear spectacles (28.2%), broken spectacles (23.1%), spectacles causing headache (20.5%), spectacles lost and parents' disapproval (20.5%), and peer pressure/teasing (15.4%). Significant difficulties faced while wearing spectacles were pressure on the nose due to worn-out nose pads (36.4%), pressure on ears causing pain in the temple and headache (34.1%), repeated cleaning of spectacles (29.5%), heavy spectacles (18.2%), excessive glare and pain in the eyes (12.5%), and improper fitting of spectacles (11.4%). Conclusions We found that non-compliance was more significant in school-going children aged 14-16 years and girls. The main reasons were unlikeness to wear, broken spectacles, headache, and spectacles lost. School children were not compliant because of many issues that should be addressed, and this information will be used for better eye care in school-going children with refractive errors.

Compliance with spectacle wear among learners with hearing impairment in Ghana.

Hearing-impaired learners with refractive problems require correction because poor vision hinders their development and educational pursuits. To determine the level of compliance with spectacle wear in learners with hearing impairment in Ghana. A descriptive cross-sectional study design was used to investigate the level of compliance with spectacle wear in hearing-impaired learners with uncorrected refractive errors (URE). The participants were from six schools for the hearing impaired, comprising three schools from each sector (Northern and Southern) of Ghana. Of the 1914 learners screened, 69 (3.61% CI: 2.82-4.54%) had URE. Sixty-two (89.9%) learners with URE had myopia (-0.50 Dioptre Sphere (DS) to -2.00DS), and 7 (10.1%) had hyperopia (+2.00DS to +10.00DS). There were more females (53.6%) with URE than males, and their ages ranged from 8 to 35 years, with a mean of 17.35 ± 5.19 years. Many (56.5%) learners complied with spectacle wear after 3 months of reassessment, with females being more compliant than males, but the difference was not significant (p = 0.544). Learners who complied well with the spectacle wear were those with moderate visual impairment (VI), followed by mild VI, while those with no VI were the least compliant. A significant difference was observed between spectacle compliance and presenting VI (p = 0.023). The spectacle wear compliance level was high compared to a previous study (33.7%) in Ghana. This study highlights the importance of addressing URE among learners with hearing impairment in Ghana and Africa.

Effect of correction of refractive error and threshold estimation in ocular headache patients in a tertiary eye care center

Purpose: Headache is one of the most common symptoms in patients with refractive error. Our study aimed to find the effect of refractive error correction and estimate the threshold of refractive error in patients with ocular headaches in a tertiary eye care center. Methods: We enrolled patients who came with complaints of headaches. It was a prospective, interventional study. All the patients underwent comprehensive ocular examination that included a detailed headache history, objective and subjective refraction, cycloplegic refraction, Humphrey visual fields test (30-2), cover test, and dilated fundus examination. We excluded uveitis, glaucoma, optic atrophy, papilledema, sinusitis, migraine, dental cavities, and neuropathy patients. We prescribed glasses after the post-mydriatic test. We surveyed via phone call regarding the compliance of spectacle wear and relief of headaches. Results: Out of the 98 enrolled patients, 67 were female and 31 were male in the age group of 16 to 35. The patients had simple astigmatism (57.14%), simple myopia (15.30%), simple myopic astigmatism (23.46%), and hyperopia (9.18%). The threshold value of dioptric power was −1.25 D, −1.00 D, −0.75 DS/−0.75 DC, and +1.00 D for simple astigmatism, simple myopia, simple myopic astigmatism, and hyperopia, respectively. 86.73% recovered with glasses. Simple astigmatism had the highest recovery rate. Headaches frequently occurred in the frontal (44.89%), followed by temporal (32.65%), parietal (16.32%), occipital, and parietal (11.22%). Conclusion: Lower degrees of refractive error caused the headache. We reported the threshold values of the refractive error that caused the ocular headache. Correcting the refractive error relieved the headache

What choices of visual correction do people make for recreational running?

Recreational runners who need refractive visual correction will need to choose the type of visual correction (spectacles, contact lenses, or no correction) to wear when running. The prevalence of correction choices and distinguishing demographic features associated with these choices of correction were investigated. A 26-item online questionnaire covering demographics, running habits, and visual corrections used was answered by 941 people. Participants were aged 18 years or older, considered themselves a recreational runner and reported needing refractive correction for everyday life. Bivariate analyses and binary logistic regression were used to determine the variables independently associated with including or avoiding types of correction for running. Participants ran an average of 3.8times, 3.6hours, and 33.4km per week. Running habits were not associated with type of visual correction, suggesting that visual correction does not present a barrier to participating in recreational running. Solely using spectacles for running was the most common choice (38.8%) and they were worn for running at least sometimes by 65.8%. Fewer people wore spectacles for running than for general purposes (98.9%), suggesting spectacles have limitations for running. Spectacle wear for running was significantly associated with not having contact lenses available and longer duration of wearing visual correction. Running without correction was a common choice, with 15.5% of the sample only running without correction, and 26.2% running at least sometimes without their visual correction. Not wearing correction was significantly associated with not having contact lenses, a shorter duration of wearing visual correction, and a lower myopic refractive error. Contact lenses were the sole correction for running for 15.6% and were worn for running at least sometimes by 40.5%. Contact lenses were significantly more likely to be used by women and younger runners. Signposting runners to contact lenses if this has not previously been considered is recommended.

Knowledge and barriers associated with contact lens use among spectacle wearers

Knowledge and barriers associated with contact lens use among spectacle wearers

Prevalence of mask associated dry eye disease symptoms among health care workers during COVID-19 pandemic in Puducherry, India

The aim of this cross-sectional study is to measure symptoms of mask-associated dry eye disease symptoms among health workers during the COVID-19 pandemic. This was a cross-sectional study which included Health care workers willing to participate in the Questionnaire based study from March 2022 to May 2022. After initial consent participants completed the questionnaire on the duration of mask wear, type of mask, presence and the severity of Dry Eye Disease (DED) symptoms.A total of 930 completed data had been analyzed. Out of them 651(70%) had reported to have DED symptoms either sometimes or often. About two-third 65% (605) health care workers were in the age group of 18 to 29 years, 55% (465) had been using face mask between 4 to 8 hours per day. Less than a quarter 20% had reported to be having previous dry eye symptoms. Among them 68% (126) reported worsening symptoms. Almost half 45% wore spectacles, among them 72% reported fogging of their glasses while wearing mask. Age group 18 to 29 years were reported to have significant association with DED symptoms along with usage of N95 mask and male gender using Chi square test (P <0.001).Our study reported ocular discomfort in majority of Health care workers who are in the fore front in this Covid-19 pandemic for long hours, hence counseling of proper wearing of face mask and ocular treatment as and when needed to maintain their ocular surface health by consulting ophthalmologist is recommended.

Status of Vision and Eye Care Among Patients in Rehabilitation Hospital Units: A Cross-Sectional Study

ObjectivesThe prevalence of vision disorders is high among geriatric and hospital inpatient populations, yet they often go undetected, resulting in consequences such as falls or prolonged recovery time. A needs assessment study was conducted to investigate levels of vision and the potential prevalence of unmanaged/undiagnosed ocular disorders among adult inpatients in a hospital-based rehabilitation unit. DesignCross-sectional study. Setting & ParticipantsInpatient rehabilitation units of an acute care hospital system in Ontario, Canada. Adults (n = 112) in a hospital inpatient rehabilitation unit participated from October 2018 to February 2019. MethodsParticipants were surveyed regarding their demographic, ocular, and medical data and spectacle wear. Visual acuity, contrast sensitivity, visual fields, and stereoacuity plus the spectacle condition were directly assessed. ResultsThe majority (75%) were found to have reduced habitual vision while in hospital. Nearly 60% of participants reported at least some difficulty reading a newspaper or distinguishing a face or were “not happy with their vision.” This was despite 80% of participants reporting that they had an eye care practitioner and 70% that they had an eye examination within the last 2 years. More than half (51.8%) of the participants received the recommendation to follow up with their eye care practitioner on discharge from the hospital. Conclusions and ImplicationsReduced vision and vision disorders has a high prevalence among hospital patients in rehabilitation units and should be evaluated at or soon after hospital intake. By incorporating vision screening tools, necessary precautions may be taken to avoid possible falls and promote recovery.

Spectacles Under Utilization and Associated Factors Among Adults in Hawassa, South Ethiopia, June, 2022.

The commonest and cheapest treatment modality for correcting refractive error is spectacles or eyeglasses. In Ethiopia, the rate of spectacles under utilization and its impact on visual impairment was not known. To assess spectacles under utilization and associated factors among adults in Hawassa, Ethiopia, 2022. Community-based cross-sectional study design was conducted from Jan 2021 to May 2022 with a final sample size of 664. Multi-stage random sampling technique was used during the sampling process. Using an interviewer-based questionnaire, the selected individuals were asked about demographic characteristics, spectacles use, and satisfaction with spectacles, knowledge, and attitude about spectacles. An odds ratio with a 95% CI was used to display the results. A P-value less than 0.05 in multivariate logistic regressions is used to show statistical significance. The prevalence of spectacles under utilization was 307 (48.7%). The spectacles under utilization was more prevalent in individuals with unaided visual acuity of 6/6 -6/12 (46.1%), no eye checkup (38.4%), no surgery on the eye (46.6%), willingness to accept spectacles (35.9%), good knowledge about spectacles (32.6%) and poor attitude about spectacles (35%). The most common reasons for not utilizing spectacles were believed not necessary (14.9%), expensive cost (13.1%), and discomfort (11.4%). Among the spectacles users (33.64%) who wore spectacles for 2 years, 31.17% procured the spectacles without physician orders and 46.6% purchased the spectacles in the optical workshop. The most common purpose to use spectacles was for protection (41.4%). The spectacles under utilization in Hawassa town was high. Rural residency, occupation, eye check, eye surgery, no willingness to wear spectacles, and attitude towards spectacles were significantly associated with spectacles under utilization. It is necessary to provide health education to improve the poor attitude regarding spectacles and eye checks.

Vision Correction Habits After COVID-19 Onset in Spectacle and Contact Lens Wearers.

To determine how vision correction habits changed after the 2019 coronavirus disease (COVID-19) pandemic onset. Participants reported vision correction habits, refractive error, screen time, mask wearing time, and dry eye symptoms since the COVID-19 pandemic onset through email survey. A total of 133 participants completed the survey. Worsening dry eye symptoms were associated with increased screen time ( P =0.04). Hours per day of spectacle wear increased by approximately 1 hr ( P =0.001) and was associated with increased screen time ( P =0.002). Worsening dry eye symptoms were associated with increased days per week of spectacle wear ( P =0.02). Participants wore contact lenses about one day per week less than before the pandemic ( P =0.0001). Increased mask wearing time was associated with increased days per week of contact lens wear ( P =0.03). After pandemic onset, hours per day of spectacle wear increased, and days per week of contact lens wear decreased. Increases in hourly spectacle wear were associated with increased screen time, whereas increased daily contact lens wear was associated with increased mask wear time, suggesting that spectacles may be preferred for screen time activities and contact lenses for mask wear.

Time Spent Outdoors Partly Accounts for the Effect of Education on Myopia.

The purpose of this study was to investigate if education contributes to the risk of myopia because educational activities typically occur indoors or because of other factors, such as prolonged near viewing. This was a two-sample Mendelian randomization study. Participants were from the UK Biobank, Avon Longitudinal Study of Parents and Children, and Generation R. Genetic variants associated with years spent in education or time spent outdoors were used as instrumental variables. The main outcome measures were: (1) spherical equivalent refractive error attained by adulthood, and (2) risk of an early age-of-onset of spectacle wear (EAOSW), defined as an age-of-onset of 15 years or below. Time spent outdoors was found to have a small genetic component (heritability 9.8%) that tracked from childhood to adulthood. A polygenic score for time outdoors was associated with children's time outdoors; a polygenic score for years spent in education was inversely associated with children's time outdoors. Accounting for the relationship between time spent outdoors and myopia in a multivariable Mendelian randomization analysis reduced the size of the causal effect of more years in education on myopia to -0.17 diopters (D) per additional year of formal education (95% confidence interval [CI] = -0.32 to -0.01) compared with the estimate from a univariable Mendelian randomization analysis of -0.27 D per year (95% CI = -0.41 to -0.13). Comparable results were obtained for the outcome EAOSW. Accounting for the effects of time outdoors reduced the estimated causal effect of education on myopia by 40%. These results suggest about half of the relationship between education and myopia may be mediated by children not being outdoors during schooling.

Eyeglasses and risk of COVID-19 transmission—analysis of the Virus Watch Community Cohort study

ObjectivesThe importance of SARS-CoV-2 transmission via the eyes is unknown, with previous studies mainly focusing on protective eyewear in healthcare settings. This study aimed to test the hypothesis that wearing eyeglasses is associated with a lower risk of COVID-19. MethodsParticipants from the Virus Watch prospective community cohort study responded to a questionnaire on the use of eyeglasses and contact lenses. Infection was confirmed through data linkage, self-reported positive results, and, for a subgroup, monthly capillary antibody testing. Multivariable logistic regression models, controlling for age, sex, income, and occupation, were used to identify the odds of infection depending on frequency and purpose of eyeglasses or contact lenses use. ResultsA total of 19,166 participants responded to the questionnaire, with 13,681 (71.3%, CI 70.7-72.0) reporting they wore eyeglasses. Multivariable logistic regression model showed a 15% lower odds of infection for those who reported using eyeglasses always for general use (odds ratio [OR] 0.85, 95% 0.77-0.95, P = 0.002) compared to those who never wore eyeglasses. The protective effect was reduced for those who said wearing eyeglasses interfered with mask-wearing and was absent for contact lens wearers. ConclusionsPeople who wear eyeglasses have a moderate reduction in risk of COVID-19 infection, highlighting that eye protection may make a valuable contribution to the reduction of transmission in community and healthcare settings.

Vision related quality of life among Nepalese patients with keratoconus

Introduction: Keratoconus (KC) is a bilateral progressive noninflammatory disorder characterized by irregular astigmatism and corneal thinning. KC results in a disproportionate impact on major aspects of quality of life (QoL) of a person due to its early onset and chronic nature. This study aims to evaluate vision-related QoL in Nepalese patients with KC. Method: A cross-sectional hospital-based study was carried out for 1 year. A sample of 35 KC subjects and 38 control subjects who met the eligibility criteria were enrolled. All subjects underwent corneal topography and abberometry along with a comprehensive eye examination. Both cases and controls completed the NEI VFQ 25 questionnaire. Visual acuity (high contrast visual acuity and LCVA), CS, color vision, refraction, and scores of all subscales of QoL were measured. The QoL scores were correlated with each of the visual function parameters in KC subjects. Result: The mean scores of all of the subscales of QoL were found significantly less in the KC group than in age and sex matched control group with P<0.001 The mean composite score was found to reduce significantly as the grade of KC increased. The mean composite score for grade 1 KC was 70.79±7.96, grade 2 KC was 60.56±6.49 and for grade 3 KC was 55.99±0.67 with P=0.001 about better eye. There was a highly significant difference in the mean composite score of QoL between these contact lens wearers and spectacle wearers. The mean composite score for spectacle wearer was 67.86±07.99 and that of contact lens wearer was 58.63±04.26 with P=0.004. Conclusion: This study concluded that the QoL of keratoconic individuals was found to reduce gradually as the severity of the disease increased. QoL score in contact lens-wearing Nepalese KC patients is worse than spectacle wearers. By stopping the progression of disease we can maintain functional vision as well as a vision-related QoL. Our study findings suggested that vision and visual function parameters in the better eye is the most important parameter affecting VR-QOL of patients with KC. KC patients should maintain the best vision that they can have.

Spectacle Wear Compliance in Primary School Children with Refractive Error in Addis Ababa

Purpose: Refractive error is a leading cause of visual impairment globally. Spectacle is the most cost-effective intervention used for correcting refractive error. Different factors affect spectacle wear compliance. This study assessed the spectacle wear compliance and determinant factors among school children with refractive error in Addis Ababa, Ethiopia. Methods: This study was a cross sectional study with 318 study participants in primary school children of Addis Ababa. Multistage sampling was used. The students were examined by a team of optometrists. A structured questionnaire used to collect demographic and clinical data, spectacle use, and reasons for not wearing spectacle. Ethical clearance obtained from IRB. Results: The compliance of spectacle wear among primary school children in Addis Ababa was 35.2% (95% CI 30.0, 40.5). Factors associated with poor-compliance were being male (p < 0.001), having low power refractive error (< 5D) (p < 0.001), having negative attitude towards spectacle (p = 0.007) and prolonged spectacle use (>12 months) (p = 0.037). Non-compliance was not associated with age, type of refractive error and parental use of spectacle. The main reason for not-wearing spectacle were parental disapproval (20.2%) (95%CI 15.8, 24.6). Conclusion: Spectacle wear compliance is very poor among children with refractive error. Health care intervention and school health programs need to address factors affecting compliance.

Refractive Error and Axial Length and Their Related Factors in 8-Year-Old Japanese Children: The Yamanashi Adjunct Study of the Japan Environment and Children's Study (JECS).

To investigate the distribution of visual acuity, refractive error, and axial length in 8-year-old children who participated in an additional survey in Yamanashi Prefecture of the Japan Environmental Children's Study (hereafter referred to as JECS-Y) conducted from 2019 to 2021. Eight-year-old children who participated in the JECS-Y study were subjected to noncycloplegic measurements of refractive error and axial length. If the uncorrected visual acuity was less than 20/20, the best corrected visual acuity was evaluated in accordance with the autorefraction data. A questionnaire was administered regarding the parent's history of eyeglass wear or contact lens use. Among the 400 participating children, the rate of uncorrected visual acuity of 20/20 or better in both eyes was 70.4%. The mean equivalent spherical equivalent error for both eyes was -0.366 ± 1.016 D. The mean axial length was 23.08 ± 0.225 mm in all patients. The males showed significantly longer axial length than the females despite no differences in body height. There was a significant correlation between axial length, spherical refractive, and uncorrected visual acuity. The children of parents with a history of wearing eyeglasses or contact lenses showed a significantly more myopic equivalent refractive error than those without a history. This study clarified the current state of refractive error in 8-year-old children and the association of inheritance with refractive error. In addition, the axials were significantly longer in male patients.

The Effects of Face Mask Types, Athletic Levels, and Caffeine Intake on Employee Performance, Productivity, and Perception

Since the COVID-19 pandemic, face masks have been a standard part of our daily lives. Many continue to wear face masks to this day, and some even double up on their face masks. This research is a continuation of a previous investigation of the effect of face mask types, athletic levels, and caffeine intake on retail employees' performance, productivity, and perception. Findings showed that face mask types significantly affected the feeling of unfit and odor. In addition, the kind of face mask had a significant effect on the body temperature ratings. Also, employees who considered themselves to be athletic gave lower ratings of overall discomfort than other employees. The interaction of different types of face masks with the wearing of eyeglasses has been demonstrated to have a significant effect on the stress levels of workers and the amount of time it takes for them to comprehend others.

The Prevalence of Astigmatism and Spectacle Wear in Polish Schoolchildren

ABSTRACT Introduction Unilateral or asymmetric astigmatism is considered a principal refractive error leading to amblyopia and regular eye examinations should be carried out during childhood to prevent visual impairment. The aim of this study was to evaluate the prevalence of astigmatism and spectacle wear among Polish schoolchildren. Methods A cross sectional study was carried out in children aged 6 to 14 years old from 50 schools in Poland. The presence of astigmatism was assessed by non-cycloplegic autorefraction, and defined as a cylinder equal or greater than 0.75 D. Children were classified as living in urban or rural areas according to the school location. Spectacle wear was defined as having spectacles at school. Results The study included 1041 children and 52.3% were girls (n = 544). The mean age was 8.62 ± 2.04 years. The prevalence of astigmatism was 7.3% (95% confidence interval [CI]: 5.8–9.1%). Only 21.7% of children with astigmatism wore spectacles at school. Astigmatism was diagnosed in 8.2% of boys (95% CI: 6.0–11.0%) and 6.4% of girls (95% CI: 4.5–8.8%; p = .13); cylindrical anisometropia was present in 19/76 (25.0%) of children with astigmatism (95% CI: 15.8%–36.3%). Against-the-rule astigmatism was the most common; it was observed in 48.7% of children with astigmatism, followed by with-the-rule astigmatism (44.7%) and oblique astigmatism (6.6%). The prevalence of astigmatism was not linearly correlated with age (r = 0.24; p = .53). Gender, age and place of living were not significantly associated with the presence of astigmatism. Conclusions This study reports a low prevalence of astigmatism in Polish school children. However, the majority of children with astigmatism were uncorrected. Further longitudinal studies are warranted.

Influence of prismatic effect due to decentration of optical center in ophthalmic lens.

Induced prismatic effects due to poor fitting spectacle frames is a common problem, seen in most of the spectacle wearers and this improper fitting is often due to optical center demarcation on lenses and this error causes asthenopic symptoms and diplopia. However, these errors are most common in developing countries due to lack of awareness, hence a standardized regulation is required. The current study aimed to estimate the amount of prismatic effect that is induced due to the decentration of an optical center in ophthalmic lens. A quantitative cross-sectional study was conducted in single vision spectacle wearers (N = 120) with a mean age of 25 ± 5 years. The pupillometric evaluation was performed to mark the pupil center on the spectacle lens. A lensometry evaluation was done to mark the optic center of the spectacle lens. A comparison was made to note whether the optic center is aligned with pupillary center. Objective assessment was performed through Prentice's rule (P = cF) and subjective symptoms were assessed through a validated visual comfort questionnaire. In this sample, around 57% of the individual with single vision glasses were not looking through the optic center and experiencing induced prismatic effect of -0.7 to 0.6 prism diopter, with mean decentration of 3.5 mm. Forty percent of the individuals with misaligned optic center showed asthenopic symptoms and visual discomfort. Optometrist should check quality of dispensing and visual performance before handing over the newly dispensed glasses to the patients.

Spectacle Coverage Rate After Cataract Surgery in an Urban Area in Indonesia.

Uncorrected refractive errors after cataract surgery contribute to visual impairments. The aim of this study was to investigate the spectacle coverage rate (SCR) following cataract surgery and its relationship with socioeconomic factors in an urban city in Indonesia. This population-based cross-sectional study was conducted in 2015 in Jakarta. The former participants of the Rapid Assessment of Avoidable Blindness (RAAB) survey had a history of cataract surgery and met either of the following criteria: (1) wore spectacles with presenting visual acuity (PVA) 6/12 or (2) had PVA less than 6/12 regardless of spectacle use but achieved the best visual acuity (BVA) 6/12 with pinhole correction. Of the 2998 participants of the RAAB survey, 173 (5.6%) (252 eyes) had a history of cataract surgery, among whom 53 (86 eyes) met our inclusion criteria. The SCR was 69.8% and was associated with age group, household income level, education level, and physicians' recommendation of spectacle wear. Participants who were of nonproductive age (80%), had the highest household income level (88.2%), the highest level of education (87.5%), and had been recommended for spectacle use by their physicians (80.9%) demonstrated higher SCR. Participants with the highest household income had the highest SCR. Patients who had received a physician's recommendation showed a higher SCR and were 26 times more likely to wear spectacles (odds ratio [OR] 25.99, 95% CI 2.59-260.10). There is an unmet need for refractive errors after cataract surgery. Factors such as household income levels and physician recommendations were predictive of spectacle wear.

Green Light-Based Analgesia – Novel Nonpharmacological Approach to Fibromyalgia Pain: A Pilot Study

BACKGROUND: There continues to be significant reliance on pharmacological modalities for the management of chronic pain, with a particular focus on opioid analgesics as a singular option for pain management. Fibromyalgia is a prototypical central pain disorder, which is often used as a model to study chronic pain disorders. It has an estimated prevalence of approximately 1.1% to 5.4% in the general population. The widespread use of opioids in patients with fibromyalgia has been well demonstrated in several health claims database studies, with rates of use ranging from 11.3% to 69%. Minimizing opioid exposures reduces misuse risk, but requires adequate opioid-sparing multimodal analgesic strategies, particularly nonopioid analgesic adjuncts, to ensure effective treatment of pain, particularly high-impact pain. We chose fibromyalgia as our study population. Given that it is a disordered sensory processing condition, it may be particularly amenable to the beneficial effects of green-light therapy. OBJECTIVES: Most studies have evaluated exposure to light-emitting diode lights as a mode of green-light delivery; our study used green-light filtering eyeglasses, which would allow the wearer to move about with minimal interference. STUDY DESIGN: We conducted a randomized controlled trial to test the feasibility of green-light filtering eyeglasses in the treatment of chronic pain. SETTING: This study was conducted at Duke University Health System. METHODS: We recruited and randomized adult patients with a known diagnosis of fibromyalgia patients and excluded patients who were unable to wear eyeglasses for at least 4 hours per day or were colorblind according to the Ishihara Colorblindness Test. Patients were assigned to 1 of 3 arms: clear eyeglasses (control), green eyeglasses, or blue eyeglasses. We initially recruited 45 patients and randomly assigned 15 patients per group. RESULTS: To evaluate clinical significance, we determined the rate of >= 10% decline in oral morphine equivalents and found that 33%, 11%, and 8% of the green, blue, and clear eyeglass groups, respectively, achieved this clinically meaningful outcome. LIMITATIONS: This study was powered to detect feasibility of the intervention, rather than conclusive analgesic effects. CONCLUSIONS: Our study demonstrated the feasibility of this treatment approach and study design and supports a future study to determine the efficacy of green light-based analgesia on opioid use, pain, and anxiety. While the reduction of opioid use was not of statistical significance, we believe it to be of clinical significance as there was no increase of patient-reported pain. This warrants further investigation in a large-scale trial of the use of green-light filtration of ambient light to mitigate opioid use and possible mediation of psychological impacts of pain with the use of green-lensed eyeglasses. KEY WORDS: Chronic pain, fibromyalgia, pain, pain management, green light, green-light filtering eyeglasses, green-light analgesia, chronic pain management