logMAR Chart Research Articles

Clinical outcomes after mix-and-match implantation of diffractive multifocal intraocular lenses with +\u20092.75 and\u2009+\u20094.00 diopter add powers

BackgroundTo evaluate the clinical outcomes of bilateral mix-and-match implantation of diffractive multifocal intraocular lenses (IOLs) with different add powers.MethodsWe retrospectively reviewed the medical records of 18 patients who underwent bilateral mix-and-match implantation of diffractive multifocal IOLs with different add powers. Multifocal IOLs with add powers of + 2.75 diopters (D) and + 4.00 D were implanted into the patients’ dominant and nondominant eyes, respectively. At 1 and 3-month postoperatively, monocular and binocular visual acuity was measured using logMAR charts and manifest refraction was performed. Specifically, logMAR charts were used to measure uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and corrected distance visual acuity (CDVA). Defocus curves, contrast sensitivity, and patient satisfaction were assessed at 3-month postoperatively.ResultsBinocular logMAR measurements (mean ± standard deviation) at 3-month postoperatively were 0.01 ± 0.04 (UDVA), 0.16 ± 0.05 (UIVA), and 0.11 ± 0.07 (UNVA). Postoperative spherical equivalent was − 0.43 ± 0.35 D and − 0.39 ± 0.21 D in the dominant and nondominant eyes, respectively. Defocus curves showed significant differences between − 1.50 and − 4.00 D among binocular, dominant, and nondominant eye measurements, except between − 2.50 and − 3.00 D. Eyes implanted with + 2.75 and + 4.00 D IOLs showed good contrast sensitivity under photopic and mesopic conditions. Over 80% of patients reported high satisfaction with their near vision.ConclusionsBilateral mix-and-match implantation of diffractive multifocal IOLs with add powers of + 2.75 D and + 4.00 D showed good near, intermediate, and far vision.

Clinical profile of retinal vasculitis in a tertiary eye care Centre in South Kerala

Objective is to study the clinical profile of retinal vasculitis in a tertiary eye care Centre in South Kerala. All consecutive patients diagnosed with retinal vasculitis in a tertiary eye care Centre over a period of one year were evaluated for ocular and systemic risk factors for developing the disease. Patients more than 10 years of age were included in the study. Patients with diabetic and hypertensive retinopathy were excluded from the study. Data was collected using a pretested proforma. Demographic variables, risk factors, symptoms, clinical signs and visual acuity at presentation were studied. Examination tools used were Log MAR chart, slit lamp, direct & indirect ophthalmoscope. 38 eyes of 28 patients were included in the study. Defective vision and floaters were the main symptoms whereas vitritis and vascular sheathing were the most common signs. Secondary retinal vasculitis (82.2%) was more common than primary retinal vasculitis (17.8%). Also infectious etiology was commoner than autoimmune diseases. Unilateral disease was common in secondary retinal vasculitis. Toxoplasma gondii was the most common agent associated with secondary retinal vasculitis in our hospital.

Effect of Stimulus Orientation on Visual Function in Children with Refractive Amblyopia.

PurposeWe investigated and characterized the patterns of meridional anisotropies in newly diagnosed refractive amblyopes using pattern onset–offset visual evoked potentials (POVEPs) and psychophysical grating acuity (GA).MethodsTwenty-five refractive amblyopes were recruited and compared with non-amblyopic controls from our previous study. Monocular POVEPs were recorded in response to sinewave 4 cycles per degree (cpd) grating stimuli oriented along each individual participants' principal astigmatic meridians, which were approximately horizontal (meridian 1) and vertical (meridian 2). Binocular POVEPs in response to the same stimuli, but oriented at 45°, 90°, 135°, and 180°, were recorded. Psychophysical GAs were assessed along the same meridians using a two-alternative non-forced-choice technique. The C3 amplitudes and peak latencies of the POVEPs and GAs were compared across meridians for both groups (refractive amblyopes and controls) using linear mixed models (monocular) and ANOVA (binocular), and post hoc analysis was conducted to determine if meridional anisotropies in this cohort of amblyopes were related to low (≤1.50 diopters [D]), moderate (1.75–2.75 D) and high (≥3.00 D) astigmatism.ResultsIn the newly diagnosed refractive amblyopes, there were no significant meridional anisotropies across all outcome measures, but the post hoc analysis demonstrated that C3 amplitude was significantly higher in those with low (P = 0.02) and moderate (P = 0.004) astigmatism compared to those with high astigmatism. Refractive amblyopes had poorer GA and C3 amplitudes compared to controls by approximately two lines on the logMAR chart (monocular: P = 0.013; binocular: P = 0.014) and approximately 6 µV (monocular: P = 0.009; binocular: P = 0.027), respectively.ConclusionsDeleterious effects of high astigmatism was evident in newly diagnosed refractive amblyopes, but the neural deficits do not seem to be orientation-specific for the stimulus parameters investigated.

Uncorrected refractive errors for distance among the residents in 'homes for the aged' in South India-The Hyderabad Ocular Morbidity in Elderly Study (HOMES).

PurposeTo investigate the prevalence and risk factors of Uncorrected Refractive Errors (URE) for distance in elderly residents in ‘homes for the aged’ in Hyderabad, India.MethodsIndividuals aged ≥60 years and residing in ‘homes for the aged’ in Hyderabad, India for a minimum of 1 month and providing consent for participation were recruited. All participants underwent visual acuity assessment, refraction, slit lamp biomicroscopy, intraocular pressure measurement, fundus examination, and retinal imaging. Monocular presenting visual acuity was recorded using a logMAR chart. Objective and subjective refraction were performed, and best‐corrected visual acuity was recorded. URE was defined as presenting visual acuity worse than 6/12 but improving to 6/12 or better with refraction. Univariable and multivariable logistic regression analyses were used to assess the risk factors associated with URE.ResultsIn total, 1 513 elderly participants were enumerated from 41 homes of which 1 182 participants (78.1%) were examined. The mean age of participants was 75.0 years (standard deviation 8.8 years; range: 60–108 years). 35.4% of those examined were men and 20.3% had no formal education. The prevalence of URE was 13.5% (95% CI: 11.5–15.5; n = 159). On applying multiple logistic regression analysis, compared to those living in private homes, the odds of URE were significantly higher among the elderly living in the aided homes (OR: 1.65; 95% CI: 1.11–2.43) and free homes (OR: 1.67; 95% CI: 1.00–2.80). As compared to those who reported having an eye examination in the last 3 years, the odds of URE were higher among those who never had an eye examination in the last three years (OR: 1.51; 95% CI: 1.07–2.14). Similarly, those who had unilateral cataract surgery (OR: 1.80; 95% CI: 1.10–2.93) or bilateral cataract surgery (1.69; 95% CI: 1.10–2.56) had higher odds of URE compared to those elderly who were not operated for cataract. Gender, self‐report of diabetes, and education were not associated with URE.ConclusionsA large burden of URE was found among the residents in the ‘homes for the aged’ in Hyderabad, India which could be addressed with a pair of glasses. Over 40% of the residents never had an eye examination in the last three years, which indicates poor utilisation of eye care services by the elderly. Regular eye examinations and provision of spectacles are needed to address needless URE for distance among the elderly in residential care in India.

Physical performance is associated with visual acuity in university students: results of a school-based study.

The aim of our study is to explore the relationship between physical performance and visual acuity in university students in China. tests of standing long jump, 50-meter dash and pull-ups sit-ups were conducted. The visual acuity was measured using a logarithm of the minimum angle of resolution (logMAR) chart. Pearson correlation was used to test the correlation of physical performance with visual acuity in university students. The number of pull-ups was negatively associated with visual acuity in the left eye for male students, while a negative correlation was found between the time of the 50-meter dash and visual acuity in the right eye for female students. Our study identified that physical exercise might help improve visual acuity. University students should practice strength exercises to improve physical performance.

Prevalence of myopia and vision impairment in school students in Eastern China

BackgroundPrevention of myopia has become a public health priority in China. This study is to investigate the prevalence of myopia and vision impairment, and their associated factors in school students in eastern China.MethodIn this cross-sectional school-based study of 4801 students from 16 schools ranging from kindergarten to high school, students underwent refraction using non-cycloplegic autorefractor and visual acuity testing using logMAR chart with tumbling E. Myopia was defined as spherical equivalent (SPHE) ≤ − 0.5 diopter (D) and uncorrected visual acuity (UCVA) 20/25 or worse. High myopia was defined as SPHE ≤ − 6.0 D and UCVA 20/25 or worse. Vision impairment was defined as UCVA 20/40 or worse. Logistic regression models were used to determine factors associated with myopia and vision impairment.ResultsAmong 4801 children (55% male) with mean age (standard deviation) 12.3 (3.8) years, 3030 (63.1, 95% CI: 61.7–64.5%) had myopia, 452 (9.4, 95% CI: 8.6–10.3%) had high myopia, and 2644 (55.1, 95% CI, 53.7–56.5%) had vision impairment. The prevalence rate of myopia increased with grade in a non-linear manner, 12% in kindergarten, 32% in grade 2, 69% in grade 5, and approximately 90% by grade 10 or above. The prevalence rate of high myopia was relatively low in grade 4 or below (< 1.5%), 4–7% in grade 5 to 7, 13–15% in grade 8–9, and > 20% in grade 10 to 12. The prevalence rate of vision impairment was 4% in kindergarten, 37% in elementary school, 77% in middle school and 87% in high school students. Higher grade (p < 0.0001), female (p < 0.0001) and higher school workload (p = 0.007) were independently associated with higher prevalence rates of myopia and vision impairment, while higher grade (p < 0.0001) and higher school workload (p < 0.0001) were independently associated with higher prevalence of high myopia.ConclusionPrevalence of myopia and vision impairment was high among Chinese school students and increased with grade in a non-linear manner, reaching alarming high in high school students accompanied by high prevalence of high myopia. Increasing study burden on school students at younger age plays an important role on the higher prevalence rate of myopia and vision impairment.

Evaluation of Corneal Curvature and Astigmatism in Patients with Persistent Pupillary Membrane by Partial Coherence Interferometry Measurements

Purpose: To evaluate and compare the corneal curvature and astigmatism in patients with persistent pupillary membrane (PPM) and healthy controls by partial coherence interferometry. Methods: This study included 14 eyes (9 patients) with PPM and 16 eyes (16 subjects) without PPM or other ocular disease, which were age and gender matched. The horizontal corneal radius of curvature (hCRC), vertical CRC (vCRC), average CRC (aveCRC), corneal astigmatic vectors (CAV), and axis were recorded using partial coherence interferometry. Uncorrected visual acuity and best corrected visual acuity (BCVA) were also recorded using a logMAR chart. Results: In the PPM group, the vCRC (45.46 ± 0.52 D) was significantly larger than that in the control group (44.05 ± 0.24 D) (p = 0.009). The aveCRC in the PPM group (43.90 ± 0.46 D) was also significantly larger than that in the control group (43.34 ± 0.23 D) (p = 0.018). In the PPM group, the hCRC (42.35 ± 0.41 D) was significantly smaller than that in the control group (42.63 ± 0.24 D) (p = 0.049). The astigmatisms were with-the-rule in both groups. The absolute value of CAV in PPM group (3.17 ± 0.23 D) was significantly higher than that of control (1.36 ± 0.09 D) (p = 0.001). BCVA (0.42 ± 0.08) in PPM group was significantly worse than that in control (0.90 ± 0.03) (p = 0.009). Conclusions: The larger vertical and smaller horizontal corneal curvature resulted in higher corneal astigmatism with the rule, which is a characteristic feature in patients with PPM. More attention should be paid to astigmatism status and correction treatment for these patients.

Clinical effectiveness and safety of razumab (a biosimilar of ranibizumab)

Context: This study was done to evaluate the effectiveness and safety of biosimilar Razumab for the treatment of diabetic macular edema (DME), neovascular age related macular degeneration (ARMD), and cystoid macular edema (CME) due to retinal vein occlusions (RVOs) and to assess the central foveal thickness (CFT) and LogMAR best corrected visual acuity(BCVA) post Intravitreal Anti- VEGF Razumab at the end of 1 month from the baseline values. Aims: The purpose of this study was to evaluate the safety and efficacy of intravitreal biosimilar Razumab© in the treatment of wet ARMD, DME, and RVOs. Settings and Design: This was a retrospective, observational study which was conducted in a tertiary eye care institute in Tamil Nadu. Subjects and Methods: Three hundred and nine patients having active or previously treated retinal vascular conditions including neovascular ARMD, DME, and CME due to RVO were subjected to best-corrected visual acuity (BCVA) using LogMAR charts, Goldmann applanation tonometry to measure intraocular pressures, slit-lamp biomicroscopy, indirect ophthalmoscopy, color fundus photography, and spectral-domain optical coherence tomography at baseline and 1 month postintravitreal injection Razumab©, respectively. Statistical Analysis Used: Microsoft Excel was used to enter the data of the findings, and the analysis was done using SPSS 22 version software (IBM, SPSS Inc.,Chicago,IL). Frequencies and proportions were used to enter the categorical data. Chi-square was used as a test of significance. Continuous data were represented as mean and standard deviation. BCVA and CFT data were analyzed using two-tailed paired t-test. Paired t-test is the test of significance for paired data such as before and after injection. P

Pre-operative predicting factor in visual outcome after macular hole surgery.

Objective:To determine the effectiveness of macular hole index (MHI) as a predicting factor of visual outcome after full thickness macular hole surgery.Methods:This quasi-experimental study was conducted at LRBT Free Base Eye Hospital, Karachi from January 2018 to March 2019. Total 45 eyes of 45 patients with full thickness macular hole (FTMH) underwent preoperative Best Corrected Visual Acuity (BCVA) assessment with logMar chart and Optical Coherence Tomography (OCT) scanning, with measurement of base diameter and macular hole height. Values were calculated for the macular hole index (MHI), which was taken as the predictive factor. All patients had undergone 25+G trans-conjunctival three ports pars plana vitrectomy, internal limiting membrane peeling, and endo-tamponade of C3F8(14%). The final visual outcome of all the patients was noted.Results:Forty-five patients were included for the study, out of which 10 (22.2%) were male and 35 (77.7%) were female. Age ranged from 45-70 years (mean age 57.20±6.47 years). The mean pre-operative visual acuity was 2.46±1.15 logMar and was 3.88±2.00 logMar, post-operatively. Moreover, 27(60.0%) out of 45 patients achieved BCVA (gain of 2 lines of the logMar chart). The average macular hole index was 1.55±0.50 and out of 45, 25 patients had MHI ≥0.5. It was found that patients with macular hole index ≥0.50 showed clinically significant improvement in BCVA in comparison to those who have macular hole index <0.50.Conclusion:Macular hole index can be used to predict functional success in macular hole surgery.

A Multicenter, Retrospective Study (RE-ENACT 2) on the Use of Razumab™ (World’s First Biosimilar Ranibizumab) in Wet Age-Related Macular Degeneration

IntroductionThe REal life assessmENt of safety And effeCTiveness of Razumab (RE-ENACT) and long-term RE-ENACT 2 retrospective studies have evaluated the use of Razumab™ (world’s first biosimilar ranibizumab) in retinal disorders in Indian patients. This report presents the subgroup analysis from the RE-ENACT 2 study in patients with wet age-related macular degeneration (wet AMD).MethodsMedical charts of patients administered biosimilar ranibizumab injections as PRN treatment regimen between September 2015 and June 2018, at 17 centers across India, were reviewed. Changes from baseline in best-corrected visual acuity (BCVA, based on Snellen’s or logMAR chart), central subfield thickness (CSFT), intraocular pressure (IOP), and proportions of patients having intraretinal fluid (IRF) and subretinal fluid (SRF) at weeks 4, 8, 12, 16, 20, 24, 30, 36, and 48 were evaluated.ResultsOf 103 patients with wet AMD, 62.1% were men and the majority (74.8%) were treatment naïve. The majority (57.9%) of the patients had received 3 (range 1–5) injections. Significant improvements were observed from baseline to all timepoints for BCVA (baseline, 0.92 ± 0.6 [n = 94]; week 48, 0.51 ± 0.4 [n = 14]; P = 0.0014) and CSFT (baseline, 430.83 ± 14.4 [n = 85]; week 48, 301.26 ± 11.6 [n = 15]; P < 0.0001). Changes in IOP from baseline to 48 weeks were minimal and not significant (14.92 ± 3.2 [n = 94] vs. 14.50 ± 2.1 [n = 18]; P = 0.9068). A decrease in proportions of patients having IRF (baseline, 63.6% [n = 99] vs. week 48, 15% [n = 20]) and SRF (baseline, 82.3% [n = 96] vs. week 48, 5% [n = 20]) were also observed. Similar results were observed for occult and classic subgroups. There were no new safety concerns.ConclusionRazumab (biosimilar ranibizumab) demonstrated improvements in visual acuity and disease outcomes in patients with wet age-related macular degeneration without new safety issues.Electronic supplementary materialThe online version of this article (10.1007/s40123-019-00228-7) contains supplementary material, which is available to authorized users.

Diagnostic Accuracy of Rapid Assessment of Avoidable Blindness: A Population-based Assessment

To evaluate the diagnostic accuracy of rapid assessment of avoidable blindness (RAAB). Population-based diagnostic accuracy study. A total of 2145 (95.3%, 2145/2250) subjects aged 50 years and older who participated in the RAAB survey were included. All the recruited participants underwent ophthalmic examination according to the RAAB protocol and then were reexamined with instruments in a mobile eye clinic set up in a village center on the same day. Examination in the mobile clinic included standardized visual acuity (VA) tests using logMAR charts, refraction, slit-lamp biomicroscopy, and dilated fundal examination with a binocular indirect ophthalmoscope. Blindness and economic blindness were defined as VA in the better-seeing eye <3/60 and <6/60, respectively. Visual impairment (VI) was defined as VA <6/18 in the better eye. The primary cause of blindness and VI was defined according to the cause of VI in the participant's better eye. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the curve (AUC) of receiver operating characteristics of RAAB for detection of blindness and the principal causes of VI. A total of 1816 subjects (84.7%), including 686 men (37.8%) and 1130 women (62.2%), underwent ophthalmic examination in the mobile eye clinic. The mean (±standard deviation) age was 64.4 ± 9.6 years. The sensitivities, specificities, AUC, PLR, and NLR of RAAB were 90.3%, 99.3%, 0.948, 124.0, and 0.10, respectively, for detection of blindness (presenting visual acuity, PVA <3/60); 89.5%, 98.7%, 0.940, 69.2, and 0.11, respectively, for detection of economic blindness (PVA <6/60); and 90.3%, 97.7%, 0.940, 38.7, and 0.10, respectively, for detection of VI (PVA <6/18). The sensitivities, specificities, AUC, PLR, and NLR were 90.5%, 98.1%, 0.943, 48.1, and 0.10; and 60.4%, 98.7%, 0.796, 46.4, and 0.40 for detection of VI (PVA <6/18) owing to cataract and refractive error, respectively. The diagnostic performances of RAAB were high for detecting the prevalence of blindness, VI, and VI owing to cataract.

Total Protein Concentration and Tumor Necrosis Factor α in Tears of Nonproliferative Diabetic Retinopathy.

Total protein concentration (TPC) and tumor necrosis factor α (TNF-α) concentration in tears are correlated with severity of retinopathy. However, minimal data are available in the literature for investigating tear TPC and TNF-α concentrations in Asian individuals with different severity of nonproliferative diabetic retinopathy (NPDR). This study evaluated differences of TPC and TNF-α concentrations in tears at different severity of NPDR among participants with diabetes in comparison with normal participants. A total of 75 participants were categorized based on Early Treatment for Diabetic Retinopathy Study scale, with 15 participants representing each group, namely, normal, diabetes without retinopathy, mild NPDR, moderate NPDR, and severe NPDR. All participants were screened using McMonnies questionnaire. Refraction was conducted subjectively. Visual acuity was measured using a LogMAR chart. Twenty-five microliters of basal tears was collected using glass capillary tubes. Total protein concentration and TNF-α concentrations were determined using Bradford assay and enzyme-linked immunosorbent assay, respectively. Mean ± SD age of participants (n = 75) was 57.88 ± 4.71 years, and participants scored equally in McMonnies questionnaire (P = .90). Mean visual acuity was significantly different in severe NPDR (P = .003). Mean tear TPC was significantly lower, and mean tear TNF-α concentration was significantly higher in moderate and severe NPDR (P < .001). Mean ± SD tear TPC and TNF-α concentrations for normal were 7.10 ± 1.53 and 1.39 ± 0.24 pg/mL; for diabetes without retinopathy, 6.37 ± 1.65 and 1.53 ± 0.27 pg/mL; for mild NPDR, 6.32 ± 2.05 and 1.60 ± 0.21 pg/mL; for moderate NPDR, 3.88 ± 1.38 and 1.99 ± 0.05 pg/mL; and for severe NPDR, 3.64 ± 1.26 and 2.21 ± 0.04 pg/mL, respectively. Tear TPC and TNF-α concentrations were significantly correlated (r = -0.50, P < .0001). Visual acuity was significantly correlated with tear TPC (r = -0.236, P = .04) and TNF-α concentrations (r = 0.432, P < .0001). This cross-sectional study identified differences in tear TPC and TNF-α concentrations with increasing severity of NPDR.

Visual acuity and structure‐function relationships in acute and chronic LHON patients treated with idebenone

AbstractPurposeLeber's hereditary optic neuropathy (LHON) is a mitochondrial disease characterised by a subacute and progressive impairment and subsequent degeneration of macular retinal ganglion cells and their nerve fibres causing permanently reduced visual acuity (VA) in most cases. Idebenone is currently the only approved treatment for LHON. This study aims to evaluate the course of VA and its correlations with inner retinal layer morphology in LHON patients treated with idebenone.Methods42 eyes of 21 genetically confirmed LHON patients treated with idebenone were examined in regular intervals. VA was measured using logMAR charts. Macular ganglion cell layer volume (GCLV) and peripapillary retinal nerve fibre layer thickness (pRNFLT) were measured by spectral domain OCT. Patients were divided into three groups according to their time from LHON onset until treatment start including acute patients (&lt;1 year, 12 eyes), chronic group 1 (1 to 5 years, 14 eyes) and chronic group 2 (&gt;5 years, 16 eyes).ResultsA significant increase of VA compared to minimum VA was observed in all groups (acute: ‐0.25 logMAR, chronic 1: −0.29 logMAR, chronic 2: −0.31 logMAR; p &lt; 0.001 all groups). VA at baseline was similar between groups, but 6 eyes of 4 acute patients showed a marked decline during the first year reaching a minimum after 9 months. Minimum VA of all patients was significantly correlated with final pRNFLT (r = 0.48, p = 0.002) and GCLV (r = 0.40, p = 0.008), but OCT and maximum VA during continued treatment showed stronger correlations (pRNFLT: r = 0.50, p = 0.001; GCLV: r = 0.43, p = 0.004). VA gain was not associated with OCT and not different between all groups.ConclusionsVA in LHON patients with recent disease onset can decrease during the first months of treatment with idebenone. The increase of VA after this nadir is comparable to the treatment effects observed in chronic patients and may be the result of a reactivated signal transduction in surviving dysfunctional ganglion cells.

Visual function assessment of diagnostic radiography students

IntroductionDeterioration of visual acuity (VA) and visual impairment has been linked to age-related subtle changes, gender, and a correlation to socioeconomic status. This study aimed to assess first-year diagnostic radiography students’ visual functional abilities by applying the International Classification of Impairments, Disabilities and Handicaps (ICIDH) recommendations of functional VA screening and health-related quality of life questionnaire (HRQOL). MethodsThe design followed the World Health Organisation (WHO) electronic VA testing of monocular sight using LogMAR charts and binocular vision using Snellen charts, and an HRQOL questionnaire assessing for reduced ability of visual-based tasks in activities of daily living (ADL). The data was evaluated in correlation to the participant's visual correction, age, gender, and socioeconomic background. ResultsSeventy students were recruited, all meeting the WHO standard level for visual ability, with 100% (n = 70/70) met or achieved above normal binocular vision, correlating to expected normal population results from published studies for age. The monocular vision demonstrated 74% (n = 52/70) for the right eye, and 80% (n = 56/70) for the left eye for normal vision levels. The results did not differ significantly between each eye (p = 0.21), gender variations between the left eye (p = 0.27) and the right eye (p = 0.10) results were affected by sample ratio of females (80%; n = 56/70) to males (20%; n = 14/70), the visual correction did not impair binocular VA. The HRQOL assessment indicated no significant functional VA issues in the study sample. The study demonstrated no association between the participant's socioeconomic background that may influence their VA ability. ConclusionThe results provided normative binocular and monocular data on visual function in a sample of student radiographers and indicated that their thresholds align to normal (or near-normal) VA standards. Implications for practiceThe visual health data was reviewed for subgroup comparison and trend analysis, and did not identify risk factors within this sample group that their VA and visual functioning would impact upon radiography clinical placement tasks and activities. The sample is not generalisable to the wider population; further studies are recommended.

Prevalence, associations and characteristics of severe uncorrected refractive error in the Australian National Eye Health Survey.

In Australia, nationally representative data of the burden and associations of severe uncorrected refractive error are scarce. To report the prevalence and characteristics of severe uncorrected refractive error in Indigenous and non-Indigenous Australians. Population-based cross-sectional study. A total of 3098 non-Indigenous Australians aged 50 to 98 and 1738 Indigenous Australians aged 40 to 92 living in 30 randomly selected Australian sites were examined. Severe uncorrected refractive error was defined as an improvement of ≥2 lines on the logMAR chart in one or both eyes in participants with a presenting visual acuity <6/12. Severe uncorrected refractive error RESULTS: Prevalence of severe uncorrected refractive error was 11.0% (95% confidence interval 9.3-13.0) in non-Indigenous and 14.5% (12.5-16.7) in Indigenous Australians. Eighty-two percent of non-Indigenous and 77% of Indigenous participants had a spherical equivalent refraction between -2.00D and +2.00D. Indigenous Australians who were older (odds ratio [OR] for 70-79 years vs 40-49 years = 3.59), resided in outer regional areas (OR = 1.78) and did not have an eye examination in the previous 2-years (OR = 1.50) were associated with higher odds of severe uncorrected refractive error. Geographical remoteness (OR = .68 for inner regional), male gender (OR = 1.30), older age (OR for 70-79 years vs 50-59 years = 1.51) and failure to have an eye examination in the previous 2-years (OR = 2.06) were associated with severe uncorrected refractive error among non-Indigenous participants. Increased public awareness of the importance of regular optometric examinations may be required in groups at high risk of severe uncorrected refractive error.

Validation of electronic visual acuity (EVA) measurement against standardised ETDRS charts in patients with visual field loss from inherited retinal degenerations

BackgroundWith the increase in clinical trials testing therapy for retinal disease, there is a need to ensure that outcome measures are both accurate and standardised. The US Food and Drug...

Visual Outcomes of Pars Plana Vitrectomy Alone or with Intravitreal Bevacizumab in Patients of Diabetic Vitreous Haemorrhage.

To evaluate the visual outcomes of pars plana vitrectomy (PPV) alone or with intravitreal bevacizumab in patients of diabetic vitreous haemorrhage. A quasi-experimental study. Al-Ibrahim Eye Hospital, Malir, Karachi, from March to November 2018. Patients between 40-70 years of age, irrespective of gender with non-resolving dense diabetic vitreous haemorrhage were divided into two groups. Group A received injection bevacizumab 7 days before PPV surgery. Group B received no preoperative injection. Log Mar chart was used for documenting postoperative vision. All patients completed their 6 months follow-up. SPSS was used to analyse the data. Best corrected visual acuity (BCVA) was documented as improved, same, or worse. In Group A, 21 (70%) patients had improved VA; whereas, in Group B, 17 (56.6%) patients showed improved visual acuity postoperatively. Patients were examined at four weeks, three months, and six months, respectively for recurrent vitreous haemorrhage. In Group A, 25 (83.3%) patients had no vitreous haemorrhage up to six months, whereas, in Group B, 13 (43.3%) patients had no vitreous haemorrhage up to six months with p-value of 0.021. Anti VEGF injection bevacizumab before PPV in patients with non-resolving diabetic vitreous haemorrhage is good to get better results in terms of BCVA, as well as reduce the incidence of recurrent vitreous haemorrhage.

Visual function is reduced in young adults formerly born prematurely: a population-based study

AimsTo assess visual function in young adults born preterm and compare with full-term individuals of the same age.MethodsYoung adults, born preterm (birth weight ≤1500 g) in 1988–1990, previously included in...

Non-Orthogonal Refractive Lenses for Non-Orthogonal Astigmatic Eyes

ABSTRACTPurpose: To present a novel design method for non-orthogonal lenses to reduce the problem of residual astigmatism in non-orthogonal, astigmatic eyesMethods: A method to create spectacle trial lenses with non-orthogonal power axes was developed based on a novel optimised light ray-tracing algorithm rather than conventional lens design methods which could not fully eliminate spherical aberration. Using this method, three sets of refraction trial lenses were made with the angles between power axes of each set controlled at 80°, 70° and 60°, respectively. Within each set, the cylindrical power varied from −1.00 D to −6.00 D in 1.00 D steps in addition to a −0.50 D lens. Computer-based numerical simulation of the lenses optical performance was carried out to apply orthogonal and non-orthogonal lenses on simulated astigmatic eyes. Subsequently, three clinical trial cases were investigated.Results: Computer-simulated optical performance of non-orthogonal lenses showed the ability to achieve high performance in correcting non-orthogonal astigmatism. Subsequently, three patients with irregular astigmatism were refracted with the non-orthogonal lens sets, and clinically observed improvement at least two lines in the LogMAR chart was achieved in all three cases, compared with correction with orthogonal lenses, along with subjective improvement in image quality.Conclusions: Non-orthogonal astigmatism, which is commonly ignored by current eye prescription systems, is taken into account in this study in the design of spectacle and soft contact lenses. The new approach considers the possible non-orthogonal positions of the eye’s two optical power meridians and appears to be better able to correct the vision of irregular astigmatic eyes and significantly reduce residual astigmatism.

Prevalence and types of refractive errors, and spectacle coverage in Sri Lankan adults: The Sri Lanka National survey of blindness and visual impairment

Introduction Uncorrected refractive errors are the commonest cause of visual impairment globally. Despite this, the proportion of affected individuals who wear spectacles can be low, particularly in low and middle- income countries. No data were available for Sri Lanka. Objectives To estimate the prevalence of refractive errors and investigate their risk factors among adults aged 40 years and above. Another purpose was to calculate spectacle coverage and identify subgroups with low coverage. Methods Cluster random sampling was used to obtain a nationally representative sample. Presenting distance visual acuity was measured using a logMAR chart, with distance spectacle correction if usually worn. All underwent autorefraction and an optician measured best-corrected visual acuity after subjective refraction. Participants who had undergone cataract surgery were excluded. Spectacle coverage was assessed amongst participants with a visual acuity of Results 5,779/6,713 (86.1%) enumerated adults were examined; 5,179 had refraction data. 67% had a refractive error: hyperopia 49.6%; myopia 17.4%. Refractive errors increased with age. Being aged 60 years and above and Sinhala ethnic group were independent risk factors. Spectacle coverage was 17.7% overall, being lower in females and the non-literate. Based on the findings, 1.66 million adults require spectacles for distance correction. Conclusions Refractive errors are very common in Sri Lankan adults, and there is a large unmet need for spectacles. Affordable services for refractive errors need to be scaled up, focusing on the most underserved subgroups in the population.