Mm In Left Eye Research Articles

RIGID GAS PERMEABLE USAGE IN AMBLYOPIC PATIENTS: IS IT SECURE ENOUGH?

Introduction : Amblyopia and anisometropia are frequently diagnosed during preschool. Several treatments approaches are currently being prescribed to reduce myopia progression, such RGP.
 Case Illustration : A-17-years-old-patient came with blurry vision in both eyes since elementary school. Since Junior High School patient always felt un-comfort using spectacles and routinely check for 6 months. Initial visual acuity was 2/60 pinhole 5/30 and 4/60 pinhole 5/12 in the right and left eye. The previous spectacles were S-4.75 C-1.50 A0 become 5/20 and S-9.00 C-3.50 A0 become 5/6.5 in the right and left eye. After correction S-11.00 C-4.00 A180 become 5/6.5 and S-9.00 C-3.50 A0 become 5/6.5. Due to high myopia, RGP contact lenses were fitted. RGP contact lenses that are given to this patient were BC 8.10 mm/P -9.00D/ D 9.2mm in right eye, and BC 8.00 mm/ P -8.50D/ D 9.2mm in left eye, and visual acuity become 5/6.5 in both eyes.
 Discussion : Management of anisometropia can be accomplished through a variety techniques. In cases of severe anisometropia, contact lenses are frequently utilized for refractive correction such as RGP, that is produced in a larger variety of powers, can fit in a certain base curve or diameter, has high oxygen permeability, improved durability, increased contrast sensitivity, and correct higher corneal astigmatism and decreased amblyopia
 Conclusion : The risk-benefit and patients' low compliance haven't yet provided a definitive answer. RGP contact lens is secure and practical in the treatment of anisometropia and amblyopic patients. All of which are crucial for achieving the greatest vision and comfort possible following adaptation.

Evaluating Changes in Apparent Chord Mu after Pharmacological Pupil Dilatation

Introduction: Preoperative measurements of apparent chord mu length above 0.6 mm have been associated with higher risks for photic phenomena after cataract surgery with multifocal intraocular lenses (MFIOLs). Methods: This retrospective study evaluated patients scheduled for elective cataract surgery at a single tertiary medical center between 2021 and 2022. Pupil diameter and apparent chord mu length were analyzed for eyes with biometry measurements from IOLMaster 700 (Carl Zeiss Meditec, AG) under photopic light conditions, before and after pharmacological pupil dilatation. Exclusion criteria were visual acuity worse than 20/100, prior intraocular surgery, refractive surgery, iris-related procedures, or pupil abnormalities affecting dilatation. Apparent chord mu lengths before and after pupil dilatation were compared. In addition, multivariate linear regression analysis, using a stepwise method, was conducted to assess possible predictors of apparent chord values. Results: Included were 87 eyes of 87 patients. Mean chord mu length increased after pupillary dilatation from 0.32 ± 0.17 mm to 0.41 ± 0.17 mm for right eyes (p < 0.001) and from 0.29 ± 0.16 mm to 0.40 ± 0.22 mm for left eyes (p < 0.001). Seven eyes (8.0%) had an apparent chord mu of 0.6 mm and above pre-dilatation. Fourteen eyes (16.1%) with an apparent chord mu under 0.6 mm pre-dilatation had apparent chord mu of 0.6 mm or above post-dilatation. Conclusion: Apparent chord mu length significantly increases after pharmacological pupillary dilatation. Pupil size and dilatation status should always be considered during patient selection for a planned MFIOL using apparent chord mu length as a reference marker.

Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health Study.

Results 18,335 eyes of 9,559 participants aged 40 to 80 years were included in the analysis. Median pupil diameter was 4.19 mm in right eyes and 4.12 mm in left eyes. A smaller pupil was associated with older age, hyperopic refractive error, previous cataract surgery, diabetes, obesity, and ACE inhibitor intake, whereas wider pupil was associated with female gender, arterial hypertension, intake of tricyclic antidepressants, and intake of SNRI and tetracyclic antidepressants. Socioeconomic status and smoking were not associated with pupil size. Conclusion Individuals of older age, after cataract surgery, under therapy with ACE inhibitors and with diabetes have a smaller pupil. This should be taken into account when planning nonmydriatic fundus photography-based screening programs, for instance, for diabetic retinopathy.

Povezanost boje irisa i tipa glaukoma

Introduction: Glaucoma is a group of diseases, etiologically very different, which is characterized by typical damage to the optic nerve and visual field defects. The most common cause of this disease is higher intraocular pressure (IOP) than the vascular system of the optic nerve head can withstand. Aim: The aim of our study was to examine the correlation between iris color and glaucoma type through a cross-sectional study. Material and methods: Total of 117 patients with glaucoma that were treated at the Clinic for Ophthalmology of the University Clinical Center of Serbia, in the glaucoma clinic, relevant data was recorded, including iris color and the type of glaucoma that was diagnosed and under therapy. The correlation between iris color and sex of patients, age, type of glau-coma, values of IOP of both eyes (IOP OD/OS) and central corneal thickness of both eyes (CCT OD/OS) was examined. Results: The population of our patients consisted of 38.5% men and 61.5% women. Primary open angle glaucoma (POAG) was present in 34.2% and primary angle closure glaucoma (PCAG) in 28.2% of patients. Blue iris was found in 16.2%, green in 6.8%, light brown in 29.9% and dark brown in 47% of patients. The mean IOP is 17.6 ± 6.5mmHg for the right and 16.9 ± 6.1mmHg for the left eye, and for CCT 547.6 ± 69.3mm for the right and 546.6 ± 64.2mm for left eye. Statistically significant correlations were found between glaucoma type and sex (p = 0.001), glaucoma type and iris color (p = 0.031) and CCT and iris color (p = 0.027). Conclusion: A statistically significant correlation of iris color and glaucoma type was confirmed , indicating that people with darker irises develop glaucoma more often than people with lighter irises. The relationship between sex and IOP with iris color was not determined. Results show a higher incidence of glaucoma in females, as well as higher values of CCT in people with darker irises.

Evaluation of tear function tests and corneal thickness in patients with meibomian gland dysfunction

Objectives: To investigate whether central corneal thickness (CCT) and tear function test differ from healthy controls in the ones suffering meibomian gland dysfunction (MGD). Methods: This prospective study was carried out with 99 individuals in total (50 patients MGD, 49 healthy individuals). Schirmer-1, tear break-up time (TBUT), the Ocular Surface Disease Index (OSDI) questionnaire and CCT measurmentwas administered to all patients.Results: The average Schirmer 1 measurements were 16.6 ± 3.3 mm for right eyes, 16.4 ± 3.6 mm for left eyes in the MGD group and 17.1 ± 3.7 mm for right eyes, 17.0 ± 4.4 mm for left eyes in the control group. The mean TBUT values were 10.1 ± 3.6 seconds for right eyes, 10.2 ± 3.4 seconds for left eyes in the MGD group and 14.7±3.7 seconds for right eyes, 15.8 ± 4.1 seconds for left eyes in the control group (p = 0.001). The mean OSDI score values were 40.3 ± 23.7 in the MGD group and 19.4 ± 8.7 in the control group (p = 0.001). The average CCT in the MGD group was 539.4 ± 30.0 µm and 539.7 ± 33.0 µm (right and left, respectively). The average CCT in the control group was 551.6 ± 32.8 µm and 550.7 ± 32.2 µm (right and left, respectively). The mean CCT measurements in the MGD group were not statistically significant compared to the healthy control group (p = 0.059, and p = 0.097, right and left, respectively). Conclusions: The Schirmer test and CCT measurements are not significantly different in patients with MGD compared to healthy control subjects.

Schirmer test results: are they associated with topical or systemic medication?

PurposeTo test whether Schirmer test (ST) results are associated with topical or systemic medication and to evaluate the distribution of tear fluid quantity in a 3-min and 5-min ST. MethodsThe Gutenberg Health Study is a population-based, prospective, observational cohort study in Germany. ST was assessed in a sub-cohort of 1,999 participants. ST was performed under topical anesthesia for 5 min (ST-5) or of 3 min (ST-3). Anthropometric factors, systemic diseases, use of systemic and eye medications were recorded. We used multivariable quantile regression analysis to assess the influence on ST measurements. ResultsThe length of wetting of the Schirmer strips for ST-5 was 23.2 ± 9.31 mm for right and 22.9 ± 9.0 mm for left eyes. In ST-3, the measurements were 20.0 mm in right and 19.1 mm in left eyes. The clinical cut off of 10 mm for ST-5 corresponded with an 8 mm cut off for ST-3.There was an association of smaller ST-5 measures with male sex, higher age, socioeconomic status and season (all p < 0.001), but not with diabetes or smoking. The use of prostaglandin or beta-blocker eye drops or oral non-steroidal anti-inflammatory drugs, drugs for peptic ulcer and gastro-oesophageal reflux disease, thyroid hormones, progesterone and estrogen combination drugs, and hypnotics and sedatives showed an association with smaller ST-5. ConclusionsFor the first time we describe the distribution of tear fluid quantity by ST in a very large cohort of the general population. Furthermore, we found associations of ST measures with topical and systemic medication.

Artefact-free topography based scleral-asymmetry.

PurposeTo present a three-dimensional non-parametric method for detecting scleral asymmetry using corneoscleral topography data that are free of edge-effect artefacts.MethodsThe study included 88 participants aged 23 to 65 years (37.7±9.7), 47 women and 41 men. The eye topography data were exported from the Eye Surface Profiler software in MATLAB binary data container format then processed by custom built MATLAB codes entirely independent from the profiler software. Scleral asymmetry was determined initially from the unprocessed topography before being determined again after removing the edge-effect noise. Topography data were levelled around the limbus, then edge-effect was eliminated using a robust statistical moving median technique. In addition to comparing raw elevation data, scleral elevation was also compared through fitting a sphere to every single scleral surface and determining the relative elevation from the best-fit sphere reference surface.ResultsWhen considering the averaged raw topography elevation data in the scleral section of the eye at radius 8 mm, the average raw elevations of the right eyes’ sclera were -1.5±1.77, -1.87±2.12, -1.36±1.82 and -1.57±1.87 mm. In the left eyes at the same radius the average raw elevations were -1.62±1.78, -1.82±2.07, -1.28±1.76 and -1.68±1.93 mm. While, when considering the average raw elevation of the sclera after removing the edge effect, the average raw elevations of the right eyes were -3.71±0.25, -4.06±0.23, -3.95±0.19 and -3.95±0.23 mm. In the left eyes at the same radius the average raw elevations were -3.71±0.19, -3.97±0.22, -3.96±0.19 and -3.96±0.18 mm in the nasal, temporal, superior and inferior sides respectively. Maximum raw elevation asymmetry in the averaged scleral raw elevation was 1.6647±0.9015 mm in right eyes and 1.0358±0.6842 mm in left eyes, both detected at -38° to the nasal side. Best-fit sphere-based relative elevation showed that sclera is more elevated in three main meridians at angles -40°, 76°, and 170° in right eyes and -40°, 76°, and 170° in left eyes, all measured from the nasal meridian. Maximum recorded relative elevation asymmetries were 0.0844±0.0355 mm and 0.068±0.0607 mm at angular positions 76° and 63.5° for right and left eyes in turn.ConclusionsIt is not possible to use corneoscleral topography data to predict the scleral shape without considering a method of removing the edge-effect from the topography data. The nasal side of the sclera is higher than the temporal side, therefore, rotationally symmetric scleral contact lenses are more likely to be translated towards the temporal side. The scleral shape is best described by levelled raw elevation rather than relative elevation.

Three-dimensional non-parametric method for limbus detection.

PurposeTo present a novel non-parametric algorithm for detecting the position of the human eye limbus in three dimensions and a new dynamic method for measuring the full 360° visible iris boundary known as white-to-white distance along the eye horizontal line.MethodsThe study included 88 participants aged 23 to 65 years (37.7±9.7), 47 females and 41 males. Clinical characteristics, height data and the apex coordinates and 1024×1280 pixel digital images of the eyes were taken by an Eye Surface Profiler and processed by custom-built MATLAB codes. A dynamic light intensity frequency based white-to-white detection process and a novel three-dimensional method for limbus detection is presented.ResultsEvidence of significant differences (p<0.001) between nasal-temporal and superior-inferior white-to-white distances in both right and left eyes were found (nasal-temporal direction; 11.74±0.42 mm in right eyes and 11.82±0.47 mm in left eyes & superior-inferior direction; 11.52±0.45 mm in right eyes and 11.55±0.46 mm in left eyes). Average limbus nasal-temporal diameters were 13.64±0.55 mm for right eyes, and 13.74±0.40 mm for left eyes, however the superior-inferior diameters were 13.65±0.54 mm, 13.75±0.38 mm for right and left eyes, respectively. No significant difference in limbus contours has been observed either between the nasal-temporal direction (p = 0.91) and the superior-inferior direction (p = 0.83) or between the right (p = 0.18) and left eyes (p = 0.16). Evidence of tilt towards the nasal-temporal side in the three-dimensional shape of the limbus was found. The right eyes mean limbus contour tilt around the X-axis was -0.3±1.35° however, their mean limbus contour tilt around the Y-axis was 1.76±0.9°. Likewise, the left eyes mean limbus contour tilt around the X-axis was 0.77±1.25° and the mean limbus contour tilt around the Y-axis was -1.54±0.89°.ConclusionsThe white-to-white distance in the human eye is significantly larger in the nasal-temporal direction than in the superior-inferior direction. The human limbus diameter was found not to vary significantly in these directions. The 3D measures show that the limbus contour does not lay in one plane and tends to be higher on the nasal-inferior side of the eye.

Double elevator palsy with hypotropia, exotropia, and ptosis with dissociated vertical deviation in other eye managed with knapp's procedure

The aim of this study is to report a case of double elevator palsy (DEP) managed with Knapp's procedure. An 18-year-old female presented to us with a complaint of drooping of the right eyelid since childhood. Best-corrected visual acuity was 6/12 in right eye and 6/6 in left eye. Elevation in right eye was absent. Her right eye showed 14–16 prism diopter (PD) hypotropia with 10 PD exotropia, and the left eye showed dissociated vertical deviation (DVD). Her palpebral fissure height was 6 mm in right eye and 9 mm in left eye with marginal reflex distance-1, 1 and 4 mm, respectively. Levator palpebrae superioris action was 7 mm in right eye and 14 mm in left eye. Bell's phenomenon was absent in right eye. Diagnosis of right eye DEP with ptosis and exotropia on left eye DVD was made. Knapp procedure in right eye was performed with postoperative orthophoria in primary position. Knapp's procedure is the surgery of choice in a case of DEP.

Interocular differences in visual quality due to ocular aberrations and scattering in a patient with post-traumatic anisocoria: A case report

A 41-year-old patient with visual disturbances after an ocular trauma in right eye three years before was carefully analyzed and discussed. No corneal or intraocular sequelae were present. Only a significant anisocoria could be observed. Right eye (RE) achieved a best spectacle-corrected visual acuity (BSCVA) of 0.05 LogMAR with a refraction of +0.50 sphere and −1.25 cylinder. Left eye (LE) achieved a BSCVA of 0.0 LogMAR with a refraction of +0.75 sphere and −1.00 cylinder. In photopic conditions pupil diameter was 4.96mm for RE and 3.02mm for LE whereas in scotopic conditions, these values were 7.45mm and 6.71mm, respectively. More significant levels of higher-order corneal and ocular aberrations were found in RE for the same pupil size. In addition, the scattering index (OSI) was 3.8 in RE and 1.0 in LE (4-mm pupil). In conclusion, anisocoria can lead to relevant visual disturbances if significant interocular differences in ocular aberrations and scattering are present.

Computed Tomography Dimensions of the Lacrimal Gland in Normal Caucasian Orbits

CT is frequently used to assess the lacrimal gland, yet no published reports exist of normal dimensions using this modality. We retrospectively evaluated CT data from normal orbits and measured the lacrimal gland dimensions. Two-hundred ninety-three consecutive orbital CT scans (586 orbits) of 282 patients were identified. Caucasian patients aged 18 years and older without known orbital disease were included. Traumatized orbits were excluded. All repeated scans were excluded. Length and width of the lacrimal gland were measured in axial and coronal sections with GE Centricity Software. The primary outcome was a descriptive analysis of the distribution of dimensions in normal orbits. A random subset of patient scans was measured independently by observers at different levels of training, and intraclass correlation coefficients (ICCs) were established. Three hundred orbits (150 right orbits and 150 left orbits) of 282 patients were included. Normal distributions occurred with axial and coronal length measurements. Mean (10th and 90th percentiles) lacrimal gland axial length in right orbits was 14.7 mm (10.9 mm and 18.3 mm) and 14.5 mm in left orbits (10.3 mm and 18.3 mm). Coronal length averaged 17.7 mm in right eyes (13.9 mm and 21.8 mm) and 16.9 mm in left eyes (12.8 mm and 20.8 mm). Axial and coronal width showed non-normal distributions. No statistically significant difference in dimensions was found between genders, and a significant inverse linear relation occurred between gland size and age. Agreement was significant among the observers (ICC >0.7). This study presents a normal range of Caucasian lacrimal gland dimensions seen on CT. Lacrimal gland size decreases with age, and no gender difference exists. This range can aid in differentiating diseased and nondiseased lacrimal glands, especially when correlated with physical examination. This may be useful in clinical trials that involve lacrimal gland size.

Normal standards of eye projection in Turkish children 6 to 17 years of age

There are a few international and Turkish reports on children's eye projection references. This is a cross-sectional study. Data were obtained from the second study of the Determination of Anthropometric Measurements of Turkish Children and Adolescents study group (DAMTCA II).The study population was 4,533 primary and secondary school students aged 6 to 18 years (2,512 girls, 2,021 boys). A Hertel exophthalmometer was used; age- and gender-specific means and standard deviations and percentiles were calculated for eye projection. The 3rd, 5th, 10th, 25th, 50th, 75th, 80th, 85th, 90th, 95th, and 97th percentiles of right and left eye projection, and the mean and standard deviation for each age and gender were calculated. In 6-year-old children, the smoothed eye projection of the 3rd-97th percentiles for the right and left eye in boys were detected as 11.2 mm-17.0 mm for right eye and 11.1 mm-17.0 mm for left eye. In 17-year-old male adolescents, the 3rd-97th percentiles were detected as 11.9 mm-19.5 mm for the right eye and 11.8 mm-19.2 mm for the left eye. The 3rd-97th percentiles in 6-year-old girls were detected as 11.1 mm-17.1 mm for the right eye and 10.9 mm-17.1 mm for the left eye. In 17-year-old girls, the 3rd-97th percentiles were detected as 11.7 mm-19.4 mm for the right eye and 11.8-19.2 mm for the left eye. Age- and gender-specific references for exophthalmos provide important information both for the clinical decision-making process, and screening in the diagnosis of abnormal or pathological conditions which result in exophthalmos.

Repeatability of Central Corneal Thickness Measures by Orbscan Pachymetry for Right and Left Eyes

To assess the repeatability of Orbscan measures on right versus left eyes. Three Orbscan measures were taken from the right eye and then the left eye by the same operator on 50 healthy myopic subjects (average right eye = -4.3 DS) aged 19 to 58 years, half of whom were successful long-term soft contact lens (SCL) wearers. The central point thickness measurement was compared for the 3 scans for each eye, the variability calculated based on the coefficient of variation (COV) and also paired comparisons with limits of agreement. No acoustic factor was applied. Single central point thickness values ranged from 0.483 to 0.663 mm, with mean values of 0.579 mm for both eyes, with no statistically significant difference between spectacle wearers and SCL wearers (P>or=0.387). From 3 repeat scans, the net difference was -0.001 mm between third and first scans of right eyes and +0.001 mm for left eyes (P>or=0.5). Overall, the COV was close to 1%, being marginally higher (0.955% and 1.176%) in spectacle wearers than SCL wearers (0.922% and 0.836%; P, NS). However, an overall assessment of the COV data indicates that the values were inversely related to absolute thickness values, being slightly higher for thinner versus thicker corneas (P<or=0.01). The limits of agreement (95% confidence interval) between repeat sets of measures were 0.018 mm for third versus first scans of either eye or 0.023 mm for first scans of right versus left eyes. The results confirm excellent repeatability of Orbscan pachymetry measures in both spectacle and contact lens wearers. For the adult subjects assessed, there was no evidence of a right/left eye difference and/or a progressive change in measured thickness with time. The high similarity between right and left eye measures should be taken into account if data from both eyes are being used either in contralateral eye comparisons or in comparative studies of different pachymeters.

Refraction, axial length and age‐related maculopathy

To study the relationship between age-related maculopathy (ARM)/age-related macular degeneration (AMD) and phakic refraction and between ARM/AMD and axial length. The study was a point prevalence study that included 663 randomly selected persons aged over 65 years. We measured axial length and refraction. Fundus images were graded for ARM according to a modified Wisconsin Age-related Maculopathy Grading System standard. Data from both eyes were available from most participants. We analysed the results for both individual eyes and pairs. The mean axial length was 23.22 mm for right eyes and 23.21 mm for left eyes. Women had a 0.57-mm shorter mean axial length than men. The mean refraction was +1.0 dioptres (D) for right eyes and +0.9 D for left eyes. At 70 years of age women were more hypermetropic than men by 0.66 D. There was no significant difference in refraction or axial length among the groups with different ARM stages. We found no statistically significant relationship between axial length/refraction and AMD/ARM. There was a statistically significant sex difference in axial length and refraction, where women had shorter axial lengths and were more hypermetropic than men.

Refraction, axial length and age‐related maculopathy

To study the relationship between age-related maculopathy (ARM)/age-related macular degeneration (AMD) and phakic refraction and between ARM/AMD and axial length. The study was a point prevalence study that included 663 randomly selected persons aged over 65 years. We measured axial length and refraction. Fundus images were graded for ARM according to a modified Wisconsin Age-related Maculopathy Grading System standard. Data from both eyes were available from most participants. We analysed the results for both individual eyes and pairs. The mean axial length was 23.22 mm for right eyes and 23.21 mm for left eyes. Women had a 0.57-mm shorter mean axial length than men. The mean refraction was +1.0 dioptres (D) for right eyes and +0.9 D for left eyes. At 70 years of age women were more hypermetropic than men by 0.66 D. There was no significant difference in refraction or axial length among the groups with different ARM stages. We found no statistically significant relationship between axial length/refraction and AMD/ARM. There was a statistically significant sex difference in axial length and refraction, where women had shorter axial lengths and were more hypermetropic than men.

Association of visual field, cup-disc ratio, and magnetic resonance imaging of optic chiasm.

To assess the association of visual field, vertical cup-disc (VC/D) ratio, and vertical height of optic chiasm. Case series. Outpatient eye clinic. Eighteen patients with low, normal, or elevated intraocular pressure, with or without visual field defects. Measurement of visual field, VC/D ratio, and vertical height of optic chiasm. Association between VC/D ratio and visual field defects compared with association between vertical height of optic chiasm and visual field defects. Visual field defects were graded as 0, 1 to 10, and 11 to 20 (from least to most severe). Group mean VC/D ratios were 0.47 (0), 0.55 (1-10), and 0.69 (11-20) for right eyes and 0.48 (0), 0.57 (1-10), and 0.75 (11-20) for left eyes. The significance level for trend was P = .02 for right eyes and P = .006 for left eyes. Group mean chiasm heights were 3.5 (0), 2.9 (1-10), and 2.2 (11-20) mm for right eyes and 3.5 (0), 2.8 (1-10), and 2.2 (11-20) mm for left eyes. The significance level for trend was P < .001 for right eyes and P = .002 for left eyes. To assess the simultaneous effects of VC/D ratio and chiasm height on the visual field defects groups, we used ordinal logistic regression models. Models with both variables implied that chiasm height was a stronger predictor of visual field defects group than VC/D ratio (for right eyes, P = .04 [VC/D ratio], P = .001 [chiasm height]; for left eyes, P = .11 [VC/D ratio], P = .005 [chiasm height]). When chiasm and VC/D ratio were analyzed in the same model, chiasm height was a stronger predictor of visual field defects. In advanced visual field defects, the optic chiasm is atrophic.