Mild Visual Impairment Research Articles

Deriving disability weights for the Netherlands: findings from the Dutch disability weights measurement study

BackgroundThe aims of this study were to establish national disability weights based on the health state preferences of a Dutch general population sample, examine the relation between results and respondent’s characteristics, and compare disability weights with those estimated in the European disability weights study.MethodsIn this cross-sectional study, a web-based survey was administered to a general population 18–75 years from the Netherlands. The survey included paired comparison questions. Paired comparison data were analysed using probit regression and located results onto the 0-to-1 disability weight scale using non-parametric regression. Bootstrapping was used to estimate 95% uncertainty intervals (95%UI). Spearman’s correlation was used to investigate the relation of probit regression coefficients between respondent’s characteristics.Results3994 respondents completed the questionnaire. The disability weights ranged from 0.007 (95%UI: 0.003–0.012) for mild distance vision impairment to 0.741 (95% UI: 0.498–0.924) for intensive care unit admission. Spearman’s correlation of probit coefficients between sub-groups based on respondent’s characteristics were all above 0.95 (p < 0.001). Comparison of disability weights of 140 health states that were included in the Dutch and European disability weights study showed a high correlation (Spearman’s correlation: 0.942; p < 0.001); however, for 76 (54.3%) health states the point estimate of the Dutch disability weight fell outside of the 95%UI of the European disability weights.ConclusionsRespondent’s characteristics had no influence on health state valuations with the paired comparison. However, comparison of the Dutch disability weights to the European disability weights indicates that health state preferences of the general population of the Netherlands differ from those of other European countries.

Vitrectomy for vitreous haemorrhage due to proliferative diabetic retinopathy in eyes with mild visual impairment.

Vitrectomy for vitreous haemorrhage due to proliferative diabetic retinopathy in eyes with mild visual impairment.

Prevalence, causes and factors associated with vision impairment in Limpopo province

Background: Epidemiological data on the prevalence, causes and risk factors associated with vision impairment (VI) is necessary to evaluate the effectiveness of eye care services.Aim: To determine the prevalence, causes and factors associated with VI among patients presenting to public hospitals of Limpopo province, South Africa.Setting: This study was conducted in public hospitals.Methods: A retrospective chart review of patients seen from April 2019 to March 2022 in 29 public hospitals was conducted. The following information was extracted: demographic information, medical history, visual acuity (VA), refractive and ophthalmoscopy findings.Results: Of the 1140 participants, 56.1% were women. Participants’ ages ranged from 5 to 94 years. The prevalence of VI was 61.5%. Most had moderate-severe VI (57.3%), followed by blindness (22.7%) and mild VI (20.0%). The leading causes of VI were uncorrected refractive error (URE) (28.1%), cataract (26.0%) and glaucoma (25.0%). The main causes of blindness were glaucoma (42.8%) and cataract (32.1%); while URE (7.5%), retinal anomalies (7.5%) and corneal anomalies (6.9%) accounted for almost equal proportions of blindness. Participants aged 50–64 years (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.2–2.6); 65 years and older (OR: 6.6; 95% CI: 4.3–10.2); and those diagnosed with systemic hypertension (OR: 2.5; 95% CI: 1.9–3.2) and diabetes mellitus (OR: 2.9; 95% CI: 1.9–4.4) had increased risk of VI.Conclusion: The prevalence of VI in this population is relatively high. The main causes of VI are correctable, suggesting the need for improved measures to prevent avoidable VI.Contribution: The study addresses the gap in the province’s current prevalence, causes and factors related to VI.

Optimizing the pterional approach in medial sphenoid wing meningioma: a detailed morphometric study on anterior clinoidectomy and its effect on operability score

BackgroundMedial sphenoid wing meningiomas are best treated through pterional craniotomy, as pterional craniotomy provides wide and multidirectional exposure of the anterior and middle cranial fossa. Anterior clinoidectomy can increase the exposure potential. To delineate the role of anterior clinoidectomy (AC) in the standard pterional craniotomy approach through the evaluation of operability score measures (manoeuvrability arc, depth of surgical field, and surgical angle of attack). All patients with inner sphenoidal wing meningioma who underwent microsurgical excision between February 2022 and October 2023 were enrolled in the study. Preoperative and postoperative imaging studies (MR contrast studies and 3D thin-slice CT scans of the brain) were performed to determine the tumour size, extent, and pattern of optic canal involvement by comparing pre- and postoperative operability score parameters.ResultsTwenty-five patients met our inclusion criteria: 2 males (8%) and 23 females (92%). The mean age (SD) was 49.08 ± 6.42 years, with an age range of 39–60 years. The preoperative visual manifestations were as follows: eight patients (32%) had mild visual impairment, five patients (20%) had moderate visual impairment, six patients (24%) had severe visual impairment, and five patients (20%) had blindness. There was a significant positive correlation between the operability score and extent of resection (gross total resection was correlated with a higher operability score) (r = 0.301, n = 25, p = 0.005).ConclusionsA well-planned manoeuvrable arc allows neurosurgeons to perform surgery with precision, ultimately impacting surgical outcomes and the potential for complete tumour removal with minimal patient morbidity.

Visual Impairment at Presentation in Pediatric Uveitis: A Multicentric Study in 477 Children Across Southern and Eastern India

ABSTRACT Objective To evaluate visual impairment (VI) at presentation in pediatric uveitis cases in southern and eastern India. Methods Retrospective analysis of 477 children across four tertiary centers (2015–2020). Best-documented visual acuity (ETDRS letters) in the better eye was used to categorize VI. Results Mean age at presentation was 11 ± 3.7 years; 43.8% were females, and 64.8% bilateral. Of 205 patients with complete investigations, 32.7% were undifferentiated uveitis, 31.7% infectious, 25.7% juvenile idiopathic arthritis-associated uveitis, and 10.2% other non-infectious uveitis. At presentation, 79.0% had none to mild VI, 12.6% moderate VI, and 8.4% severe VI to blindness. On generalized estimating equations analysis for individual eyes, prior oral steroids and older age were risk factors, while female gender, prior topical corticosteroids and immunosuppressive therapy were protective against moderate and/or severe VI. Conclusions Over a fifth of pediatric uveitis cases present with moderate/severe VI, especially in older age or with prior oral corticosteroid therapy.

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

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

Visual Impairment and Refractive Error Among Deaf and Hard of Hearing Learners in Ghana

Introduction This study aims to assess the prevalence of visual impairment and refractive error among learners who are deaf or hard of hearing in schools for Deaf students in Ghana. Methods A descriptive cross-sectional study design was used to assess the distance visual acuity with the logMAR “E” chart, and ocular health was assessed with an ophthalmoscope and handheld slit lamp with a 90 D lens. Results A total of 1,914 learners were examined in six schools for Deaf students in Ghana. Their ages ranged from 5 to 43 years ( M = 15.18 ± 4.53 years). There were more males (55.5%) than females (44.5%) in the study. Among the learners, 91.1% were deaf, followed by mild hard of hearing (4.0%) and profound hard of hearing (1.8%), among others. Also, 94.8% of the learners had typical vision, followed by moderate visual impairment (2.5%), mild visual impairment (1.4%), and blindness (1.3%) before the provision of spectacles. There was no association between visual impairment (i.e., blindness and visual impairment) and sex among the learners ( p &lt; .05). The leading causes of visual impairments were refractive error and cataracts, while the leading cause of ocular morbidity was allergic conjunctivitis. The prevalence of visual impairment was reduced by almost 2-fold after the provision of spectacles. Discussion The prevalence of deafblindness was low among the learners, with uncorrected refractive errors as the leading cause of mild and moderate visual impairment. If these learners had not been identified through this study, they would have continued to struggle to access the curriculum visually. Implications for Practitioners There is a need to assess hearing and visual functions among learners with disabilities in developing countries like Ghana.

Utilisation of eye health services and compliance with spectacles wear among community school adolescents: a mixed-methods study from Bagmati province of Nepal

ObjectivesThis study aims to determine the factors influencing eye care service utilisation and compliance with spectacles wear among school students.DesignMixed-methods study.Setting27 community schools from 6 districts of Bagmati province of...

Pain management inequities by demographic and geriatric-related variables in older adult inpatients.

Pain is ubiquitous, yet understudied. The objective of this study was to analyze inequities in pain assessment and management for hospitalized older adults focusing on demographic and geriatric-related variables. This was a retrospective cohort study from January 2013 through September 2021 of all adults 65 years or older on the general medicine service at UCSF Medical Center. Primary exposures included (1) demographic variables including race/ethnicity and limited English proficiency (LEP) status and (2) geriatric-related variables including age, dementia or mild cognitive impairment diagnosis, hearing or visual impairment, end-of-life care, and geriatrics consult involvement. Primary outcomes included (1) adjusted odds of numeric pain assessment versus other assessments and (2) adjusted opioids administered, measured by morphine milligram equivalents (MME). A total of 15,809 patients were included across 27,857 hospitalizations with 1,378,215 pain assessments, with a mean age of 77.8 years old. Patients were 47.4% White, 26.3% with LEP, 49.6% male, and 50.4% female. Asian (OR 0.75, 95% CI 0.70-0.80), Latinx (OR 0.90, 95% CI 0.83-0.99), and Native Hawaiian or Pacific Islander (OR 0.77, 95% CI 0.64-0.93) patients had lower odds of a numeric assessment, compared with White patients. Patients with LEP (OR 0.70, 95% CI 0.66-0.74) had lower odds of a numeric assessment, compared with English-speaking patients. Patients with dementia, hearing impairment, patients 75+, and at end-of-life were all less likely to receive a numeric assessment. Compared with White patients (86 MME, 95% CI 77-96), Asian patients (55 MME, 95% CI 46-65) received fewer opioids. Patients with LEP, dementia, hearing impairment and those 75+ years old also received significantly fewer opioids. Older, hospitalized, general medicine patients from minoritized groups and with geriatric-related conditions are uniquely vulnerable to inequitable pain assessment and management. These findings raise concerns for pain underassessment and undertreatment.

Prevalence and Pattern of Ocular Diseases among Rural Dwellers in Affa, Enugu State

Background: The prevalence and pattern of different ocular diseases among rural dwellers vary in different parts of the world. It is usually influenced by a numerous factor, including but not limited to utilization of eye care services, socio-economic status, and level of education. Aim: To identify the most prevalent eye diseases and their pattern of occurrence, among rural dwellers in South East Nigeria, with a view to influence targeted health policies and subsequently, targeted interventions to improve eye health in the region. Methods: The study was a cross sectional study involving patients willing to participate in the study during a one-day free eye outreach organized by the Ophthalmology department, ESUTH Parklane at Affa Community in Udi Local Government Area of Enugu state. A preliminary visit was made one week prior to the health outreach, by some members of the outreach team to mobilize the community, seek their consent and fix a date through their leaders. On the day for the outreach, the objective of the eye screening was explained to the participants in both English and their local language. Subsequently, informed consent was obtained and each subject registered and the bio-data documented. Registered participant had their unaided and aided Visual Acuity (VA) of each eye determined. Then, the anterior and posterior segment was examined. Data collected were recorded using a proforma and later inputted into a computer, cleaned and analysed using SPSS version 21. Results were presented in tables and represented in frequencies percentages. Association between variables were done using t-test and p- value of &lt;0.05 was considered significant. Results: One hundred and sixty-eight participants were screened during the outreach programme/study with mean age of 40+0.5years. There were more females 116 (69.1%) than males 52 (30.9%), giving a female to male ratio of 2:1 and they are predominantly Christians and farmers. The common ocular problems among the participants include cataract 53 (22.6%), refractive error 37 (15.8%), Pterygium 35 (14.9%). Cataract was the most common eye disease among the outreach participants and responsible for 22.6% of all ocular problems. Normal visual acuity was found more in participants &lt; 50 years of age, mild visual impairment occurred more in participants 51-70 years while moderate visual impairment to blindness were seen more in patients &gt;70 years. Conclusion: In this study, the commonest ocular problems among the participants include Cataract, Refractive error, and Pterygium which are reversible causes of visual impairment and blindness. Therefore, health policies and advocacies should be directed towards reducing the burden of these reversible causes of visual impairment and blindness among the rural dwellers which constitute greater proportion of our population.

A Cataract Surgery in A Camp Patient; A Study on Visual Outcomes

Cataract is the leading cause of blindness and visual impairment among cataract patient globally including in Libya. Phacoemulsification is a commonly performed procedure to improve visual outcome among senile cataract patients because of its advantages compared to other techniques. This study was aimed to determine visual outcome improvement after phacoemulsification among cataract patient. A descriptive study was carried out among cataract patients who underwent phacoemulsification procedure. A total number of 100 operated eyes were followed-up to obtain their postoperative visual acuity (VA) and complications. There were significant improvements of VA resulting in an increase in the number of patients with good vision (normal to mild visual impairment) to 86% after phacoemulsification procedure. There was also low rate of postoperative complications. High quality cataract surgery with a low rate of intra-operative complications and good visual outcome can be attained in camp patients operated in the base hospitals, thus justifying more similar screening camps to clear the vast cataract backlog.

Visual Outcome following Blunt Ocular Trauma among Patients attended Tobruk Medical Center

Visual Outcome following Blunt Ocular Trauma among Patients attended Tobruk Medical Center

Visual impairment and cognitive performance: A nationwide study of 1.4 million adolescents.

Previous research highlights the adverse effects of visual impairment (VI) on academic achievement in children, yet its impact on cognitive performance among adolescents and young adults remains under-studied. Therefore, this investigation aimed to analyse this association in a nationwide sample of Israeli adolescents. A retrospective population-based cross-sectional study was conducted among 1,410,616 Israeli-born adolescents aged 16-19 years, who were assessed before mandatory military service between 1993 and 2017. The definition of VI was based on best-corrected visual acuity (BCVA) measurements using a standard Snellen chart. Adolescents with BCVA worse than 6/9 in either or both eyes were classified as having unilateral or bilateral VI, respectively. Cognitive performance was measured using the General Intelligence Score (GIS), based on a validated four-domain test. Relationships were analysed using regression models yielding adjusted odds ratios (ORs) for low (<-1 standard deviation [SD]) and high (≥1 SD) cognitive Z-scores. Of 1,410,616 adolescents (56.1% men), 13,773 (1.0%) had unilateral and 3980 (0.3%) had bilateral VI. Unilateral VI was associated with adjusted ORs for low and high cognitive Z-scores of 1.24 (1.19-1.30) and 0.84 (0.80-0.89), respectively. ORs were accentuated for bilateral VI, reaching 1.62 (1.50-1.75) and 0.81 (0.74-0.90) for low and high cognitive Z-scores, respectively. Cognitive performance subscores mirrored these results, with the visual-spatial functioning subtest demonstrating the greatest effect size. These associations persisted in sub-analyses restricted to adolescents with amblyopia-related VI, mild VI and unimpaired health status. Visual impairment, including mild and unilateral cases, is associated with reduced cognitive performance scores assessed in late adolescence. Further research is required to gain a comprehensive understanding of the dynamics underlying this relationship.

Quality of Refractive Error Care in Cambodia: An Unannounced Standardized Patient Study

ABSTRACT Purpose Quality-of-care in refractive error services is essential, as it directly affects vision outcomes, wellbeing, educational attainment, and workforce participation. In Cambodia, uncorrected refractive error is a leading cause of mild and moderate vision impairment in adults. We evaluated the quality of refractive error care in Cambodia by estimating the proportion of prescribed and dispensed spectacles appropriate for people’s refractive error needs and factors associated with spectacle quality. Methods A cross-sectional protocol was employed with 18 Khmer-speaking adult participants observing testing procedures in 156 optical services across six provinces in 2022. A total of 496 dispensed spectacles were assessed against spectacle quality indicators. Results The analysis revealed that 35.1% of dispensed spectacles were of optimal quality. The most common error observed in sub-optimal spectacles was the presence of horizontal prism outside of tolerance limits. The study also found that 44.0% of emmetrope visits involved unnecessary prescription spectacle recommendations, and 18.3% of written prescriptions did not correspond with dispensed spectacles. Sex differences were observed, with men predominantly providing refractive error care and women more likely to be unnecessarily recommended prescription spectacles. Conclusion The findings highlight the importance of prioritizing quality-of-care in refractive error services. A key recommendation is to consider regulatory mechanisms to ensure optical services employ appropriately qualified staff. Additionally, efforts should be made to eliminate unnecessary prescriptions –– especially for emmetropes and females –– standardize written prescriptions, ensure consistent pupil distance measurements, reduce reliance on autorefraction, and address the gender imbalance in the refractive error workforce.

Genetics, Clinical Characteristics, and Natural History of PDE6B-Associated Retinal Dystrophy

To analyze the clinical characteristics, natural history, and genetics of PDE6B-associated retinal dystrophy. Retrospective, observational cohort study. Review of medical records and retinal imaging, including fundus autofluorescence (FAF) imaging and spectral-domain optical coherence tomography (SD-OCT) of patients with molecularly confirmed PDE6B-associated retinal dystrophy in a single tertiary referral center. Genetic results were reviewed, and the detected variants were assessed. Forty patients (80 eyes) were identified and evaluated longitudinally. The mean age (±SD, range) was 42.1 years (± 19.0, 10-86) at baseline, with a mean follow-up time of 5.2 years. Twenty-nine (72.5%) and 27 (67.5%) patients had no or mild visual acuity impairment at baseline and last visit, respectively. Best-corrected visual acuity (BCVA) was 0.56 ± 0.72 LogMAR (range -0.12 to 2.80) at baseline and 0.63 ± 0.73 LogMAR (range 0.0-2.80) at the last visit. BCVA was symmetrical in 87.5% of patients. A hyperautofluorescent ring was observed on FAF in 48 and 46 eyes at baseline and follow-up visit, respectively, with a mean area of 7.11 ± 4.13 mm2 at baseline and mean of 6.13 ± 3.62 mm2 at the follow-up visit. Mean horizontal ellipsoid zone width at baseline was 1946.1 ± 917.2 µm, which decreased to 1763.9 ± 827.9 µm at follow-up. Forty-four eyes had cystoid macular edema at baseline (55%), and 41 eyes (51.3%) at follow-up. There were statistically significant changes during the follow-up period in terms of BCVA and the ellipsoid zone width. Genetic analysis identified 43 variants in the PDE6B gene, including 16 novel variants. This study details the natural history of PDE6B-retinopathy in the largest cohort to date. Most patients had mild to no BCVA loss, with slowly progressive disease, based on FAF and OCT metrics. There is a high degree of disease symmetry and a wide window for intervention.

Microinvasive Glaucoma Surgery using Goniotomy as A Potential Surgical Treatment Modality in Indonesia: A Descriptive Study and Literature Review

Introduction &amp; ObjectivesMicro-invasive glaucoma surgery with goniotomy is a recent surgical treatment modality that targetsthe trabecular outflow to maintain intraocular pressure. This study aims to describe the clinicaloutcomes of excisional goniotomy using KDB and to review the published literature regarding amodified goniotomy technique as a potential surgical treatment modality in Indonesia.&#x0D; MethodsA cross-sectional descriptive study was conducted in patients that underwent goniotomy stand-aloneor combined with cataract surgery. Main outcome parameters consist of visual acuity, intraocularpressure (IOP), number of glaucoma medications, and complications during post-operative follow-up.&#x0D; ResultsA total of 7 patients (8 eyes) were included in the study, consisting of 5 (71,4%) males and 2 (28,6%)females. The mean age of the subjects was 47.7 years. Subjects consisted of primary,pseudoexfoliative, steroid-induced, and angle-recess glaucoma. Mean pre-operative IOPmeasurements showed 20.74 mmHg with visual acuity consisting of 1 (14.3%) mild visualimpairment and 7 (85.7%) severe visual impairment. Postoperatively there was progressiveimprovement in the mean IOP to 13.81 and 11.31 mmHg on first-day and one-week follow-up,respectively. Visual improvement was observed in 2 (28.5%) with mild visual impairment, 3 (42.6%)with severe visual impairment, and 2 (28.5%) with hand movement due to complications of cornealedema following phacoemulsification. A week later, visual acuity improved to 4 (57.1%) with mildvisual impairment and 3 (42.9%) with moderate visual impairment.&#x0D; ConclusionGoniotomy is a simple surgical method that may be applied in Indonesia as a novel technique toprovide an effective intraocular pressure-lowering effect.

THE METHODS OF ASSESSING VISUAL ACUITY IN CHILDREN IN COMMUNITY SETTING IN MALANG

Introduction &amp; ObjectivesEarly visual acuity assessment in children is crucial for conducting early intervention to improvetheir literation quality. The examination in children often experiences difficulties, thus appropriateapproach and method are needed. The objective of this examination is to measure visual acuity inchildren using four different methods.&#x0D; MethodsThis observational-descriptive study with cross-sectional design was established based on secondarydata collected through community service setting in two orphanages in Malang. This study includedchildren with an age range from 0.5 year-old to 12 year-old. All children underwent visual acuityexamination using Lea numbers, Lea symbols, Ivory Ball, and Mounted Ball.&#x0D; ResultsA total of 57 children underwent visual acuity examination. The mean age of subjects was 5.9 (SD3.05) year-old. The caretaker of the orphanage had been informed and consented about theexamination and data analysis. Among those children, 26 (45.6%) were examined with Lea numbers,19 (33.3%) children with Lea symbols, 6 (10.5%) children with Ivory Ball, and 6 (10.5%) childrenwith Mounted Ball. The examination results were 33 (57.9%) children who had normal visual acuity,14 (24.6%) children with mild visual impairment, 7 (12.3%) children with moderate visualimpairment, 1 (1.8%) child with severe visual impairment, and 1 (1.8%) child considered blind.&#x0D; ConclusionLea numbers, Lea symbols, Ivory Ball, and Mounted Ball could be used effectively to measurechildren visual acuity in community setting.

CLINICAL PROFILE OF CHILDREN REFRACTIVE ERRORS IN A SECONDARY HEALTH CARE HOSPITAL OF BEKASI WEST JAVA

Abstract&#x0D; Introduction &amp; Objectives : The aim of this study was to study the pattern of refractive errors and its association among children visited Hermina Hospital Bekasi.&#x0D; Methods : A hospital based retrospective review was conducted on children visiting Ophthalmology Outpatient Clinic of Hermina Hospital Bekasi from October 2022 to February 2023.&#x0D; Results : A total of 104 children (208 eyes) aged 5-18 years were diagnosed with refractive errors. Mean age of presentation was 11.13±3.38 years with male to female ratio of 1:1.6. At the time of presentation, 50% children suffered from mild moderate visual impairment. Most of the children have mild (≤3.00D) refractive error (70.2%) with spherical equivalents ranged from +4.50 D to -10.00 D. Astigmatism was found in 166 eyes (79.8.%) followed by myopia (39;18.8%) and hypermetropia (3; 11.78%). Compound myopic astigmatism was the commonest type of astigmatism (131;79.4%). With regards to the age categories, 23.9% of the children aged 10-14 years had myopic spherical equivalents, compared with 13.1% of children between 5 and 9 years old.&#x0D; Conclusion : Refractive errors was a common diagnosis among children seen in our secondary health care hospital. Most of the children with refractive errors present with mild to moderate decrease in visual acuity and had benefited from an optical correction by glasses.

Vogt-Koyanagi-Harada Disease: The Clinical Spectrum and Management of Case Series in a Tertiary Eye Centre in Northern Part Of Malaysia.

We present the clinical spectrum, the initial clinical presentation with management trends in treating 14 Vogt-Koyanagi-Harada (VKH) disease cases in a tertiary center in the Northern part of Malaysia. There were 14 cases of Vogt-Koyanagi-Harada (VKH) disease retrospectively reviewed over five years (from 2015 to 2020). The mean age at presentation was 37.7 years (range 21-64 years), with female predominance (85.7%). All cases presented with acute uveitic stage and bilateral eye involvement. Of them, 11 (78.6%) were probable VKH, and three (21.4%) were incomplete VKH. All patients attended with acute panuveitis at first presentation. The main posterior segment involvement was disc edema in 57.1% (16 out of 28 eyes) and exudative retinal detachment (ERD) in 35.7% (10 out of 28 eyes). Most of them presented with blindness (3/60 and worse) and moderate visual impair- ment (6/18-6/60); 35.71% each, followed by mild visual impairment (6/12-6/18), and severe visual impairment (6/60-3/60); 7.1% each. Ten patients (71.4%) required combination second-line immunomodulatory treatment during subsequent visits, and only four patients (28.6%) responded well to corticosteroid therapy. Most of the cases achieved no visual impairment (64.3%), followed by mild visual impairment (21.4%) and moderate visual impairment (14.3%), and none were severe or blind at the end of follow-up. VKH is a potentially blinding illness if there is inadequate control of the disease in the acute stage. Most of our patients achievedgood visual outcomes with early immunomodulatory treatment and systemic corticosteroids.

Hemi-retinal vein occlusion: Characterizing a rare retinal vasculopathy.

To characterize hemi-retinal vein occlusion (HRVO) in patients presenting to a multi-tier ophthalmology hospital network. This retrospective, hospital-based study analyzed 2,834,616 new patients between August 2010 and June 2021. Patients with a clinical diagnosis of HRVO in at least one eye were included as cases. Data were collected using an electronic medical record system. Data were compared to the findings noted in branch RVO (BRVO) and central RVO (CRVO) patients. HRVO constituted 0.9% ( n = 191) of all the retinal vein occlusions (RVOs), with the mean age being 60.55 ± 10.14 years. Most patients were male (125, 65.45%) with unilateral (92.67%) affliction. Majority presented during the sixth (31.41%) or seventh (32.46%) decade of life. Most patients reported mild (37.07%) or moderate (27.32%) visual impairment, with vision < 20/200 being less common in HRVO (25.8%) and BRVO (17.2%) compared to CRVO (44.1%) ( P < 0.00001). Glaucoma was diagnosed and treated in 49 (23.90%) eyes, which was much higher than CRVO (11.45%) and BRVO (5.04%) ( P < 0.001), though neovascular glaucoma was much less than CRVO (2.9% vs. 9.2%) ( P = 0.0037). On follow-up, HRVO eyes (12.2%) had lesser vision loss compared to CRVO eyes (13.7%) (this difference does not look very significant to me), though BRVO had the least (9.1%) vision loss. HRVO is a rare RVO, presenting more in males. It causes less-severe visual impairment compared to CRVO. Large majority of patients with HRVO do not have identifiable systemic risk factors other than age. Preexisting glaucoma was more associated with HRVO compared to other RVOs.