Ocular Disturbances Research Articles

Microsurgical Lateral Orbital Approaches to Resect Tumors within the Cavernous Sinus, Middle Fossa, and Temporal Lobe: A Systematic Review

Abstract Introduction Common approaches to remove skull base tumors invading the orbital apex, cavernous sinus, middle fossa, or temporal lobe include orbitozygomatic or fronto-orbital craniotomies. Recently, different types of orbital approaches have been described as alternative minimally invasive techniques. Objective With this systematic review, we analyzed the typology of intracranial tumors treated through transorbital approaches, especially through the lateral orbital (LO) wall, and analyzing the complication rates and outcomes. Design A PubMed/Medline search was performed using the criteria: “orbitotomy,” “transorbital,” “transpalpebral,” and “lateral orbitotomy” in combination with “cavernous sinus,” “middle fossa,” and “temporal lobe.” Main Outcome Measures From these reports, we collected diagnoses, lesion sizes and locations, approaches, outcomes, aesthetic outcomes, postoperative ptosis, postoperative cranial nerve (CN) palsies, length of CN deficits postoperatively, overall complications, and follow-up length. Results A total of 13 papers and 3 of our own cases matched our inclusion criteria totaling 160 patients. Most patients were treated for meningiomas (135, 84.4%). The approaches included the LO approach (n = 54; 33.8%), deep transorbital (n = 5; 3.1%), mini-LO (n = 91; 56.9%), and modified LO (n = 10; 6.2%). While not all cases reported excision success, the various LO approaches achieved total (n = 42; 26.25%) resection margins. Postoperative ocular complications (including CN palsies, proptosis, or ocular disturbances) totaled 46 (28.8%) new CN palsies, 23 (14.4%) occurrences of vision loss, 1 (1.7%) with worsened proptosis, 5 (3.9%) with worsened enophthalmos, and 42 (26.3%) other complications. Conclusion Microsurgical LO approaches, especially in the era of radiosurgery, may become a suitable alternative to other more established craniotomies.

Detecting Abnormal Eye Movements in Patients with Neurodegenerative Diseases - Current Insights.

This review delineates the ocular motor disturbances across a spectrum of neurodegenerative disorders, including Alzheimer's Disease (AD) and related disorders (ADRD), Parkinson's Disease (PD), atypical parkinsonism, and others, leveraging advancements in eye-tracking technology for enhanced diagnostic precision. We delve into the different classes of eye movements, their clinical assessment, and specific abnormalities manifesting in these diseases, highlighting the nuanced differences and shared patterns. For instance, AD and ADRD are characterized by increased saccadic latencies and instability in fixation, while PD features saccadic hypometria and mild smooth pursuit impairments. Atypical parkinsonism, notably Progressive Supranuclear Palsy (PSP) and Corticobasal Syndrome (CBS), presents with distinct ocular motor signatures such as vertical supranuclear gaze palsy and saccadic apraxia, respectively. Our review underscores the diagnostic value of eye movement analysis in differentiating between these disorders and also posits the existence of underlying common pathological mechanisms. We discuss how eye movements have potential as biomarkers for neurodegenerative diseases but also some of the existing limitations.

Antioxidant insights of wild olive (acebuche) oil ophthalmic nanoemulsions against arterial hypertension

Aims/Purpose: Many systemic and ocular disturbances are closely related to oxidative stress, including hypertensive eye diseases. In this context, the oral administration of wild olive oil, also known as acebuche (ACE) oil (Olea europaea var. sylvestris), proved to modulate local production of reactive oxygen species (ROS) by the enzyme nicotinamide adenine dinucleotide phosphate (NADPH) oxidase1. Here we aimed to develop an ophthalmic formulation based on ACE oil as a localized therapy against oxidative damage associated with arterial hypertension (AH).Methods: Nanoemulsions (NEs) of ACE oil were successfully produced, characterized, and evaluated in vivo in terms of efficacy. The antioxidant properties of these NEs were tested in mice with AH induced via administration of Nω‐nitro‐L‐arginine‐methyl‐ester (L‐NAME), which underwent intravitreal or topical ophthalmic treatment with ACE oil NEs. At the end of the treatments, a histological analysis of the cornea and retina was performed together with an evaluation of the activity/expression of NADPH oxidase in these ocular tissues.Results: Adequate ophthalmic formulations were designed to present the features for ophthalmic administration, including a nanometre size (below 200 nm), moderate negative ZP, adequate osmolality and pH, among others. Histological analysis indicated that NEs reduced hypertension‐dependent morphological alterations in the cornea and retina. Furthermore, the evaluation of the activity and expression of NADPH oxidase suggest a noticeable antioxidant effect of NEs through downregulation of NOX1, NOX2 and NOX4 isoforms and counteracting excess ROS production in the hypertensive eye.Conclusions: Topical administration, via intravitreal or drop instillation, of an ophthalmic formulation based on ACE oil NEs might show promise against ocular pathologies related to AH. Interestingly, this therapeutical approach provided better outcomes compared to long‐term dietary administration of the oil, both in terms of cumulative dose and treatment time required.

Ocular surface disturbances after laser refractive surgery

Most patients undergoing laser refractive surgery demonstrate transient and mild symptoms of dry eye disease. The article presents the main mechanisms involved in dry eye disease after the most frequently performed laser vision correction methods. Differences in the occurrence of dry eye disease between flap, surface procedures and minimally invasive lenticule extraction were highlighted.

Solving the New Puzzle(s) 2014-2022: Flammer Syndrome Probably Represents a Mild Endophenotype of Raynaud’s Phenomenon Mainly Associated with Ocular Disturbances and Also Due to Latent T. gondii Infection

Solving the New Puzzle(s) 2014-2022: Flammer Syndrome Probably Represents a Mild Endophenotype of Raynaud’s Phenomenon Mainly Associated with Ocular Disturbances and Also Due to Latent T. gondii Infection

Diagnosis of vestibular schwannoma following an 11-year interval of head and neck manifestations: case report.

The vestibular schwannoma (VS) is a benign peripheral nerve sheath tumor involving the vestibulocochlear nerve. Affected patients typically experience a gradual emergence of episodic imbalance and unilateral hearing loss, tinnitus, and headache. Less often, VS may be associated with facial pain; ocular, otic and taste disturbance; paresthesia of the tongue and face; and temporomandibular disorder-like presentations. There is limited information in the dental literature relating the myriad of oral and maxillofacial manifestations of VS. The objective of this article is to underscore the importance for dental clinicians to seek clinicopathologic correlations with VS-related symptomatology, potentially resulting in a timelier diagnosis and improved patient outcomes. To convey this clinical challenge, a detailed narrative of a 45-yearold patient with a 11-year delay in diagnosis has been reported. In addition, the typical radiographic appearance of an implanted cranial device placed following VS resection has been provided.

Subclinical involvement of eye movements detected by video-based eye tracking in myasthenia gravis.

Ocular abnormalities in myasthenia gravis (MG) are characterized by severely limited movements and rapid saccades. Data about eye motility of MG patients whose ocular movements are apparently normal are lacking. Our study assessed the eye movement parameters in MG patients without clinical eye motility dysfunctions and investigated the effects of neostigmine administration on the eye motility in these patients. In this longitudinal study, we screened all patients diagnosed with MG referring to the Neurologic Clinic of the University of Catania between October 1, 2019, and June 30, 2021. Ten age- and sex-matched healthy controls were enrolled. Patients underwent eye movement recording using the EyeLink1000 Plus® eye tracker at baseline and after 90min from the intramuscular administration of neostigmine (0.5mg). A total of 14 MG patients with no clinical signs of ocular motor dysfunction (64.3% men, with a mean age of 50.4 ± 14.4years) were enrolled. At baseline, saccades in MG patients showed slower velocities and longer latencies compared to controls. Moreover, the fatigue test induced a reduction in saccadic velocity and an increase in latencies. After neostigmine administration, the ocular motility analysis showed shorter saccadic latencies and a significant improvement of velocities. Eye motility is impaired even in MG patients with no clinical evidence of ocular movement disturbance. Video-based eye tracking may detect subclinical involvement of eye movements in patients with MG.

Interaction of neutral and protonated Tamoxifen with the DPPC lipid bilayer using molecular dynamics simulation

Tamoxifen as an antiestrogen is successfully applied for the clinical treatment of breast cancer in pre- and post-menopausal women. Due to the side effects related to the oral administration of Tamoxifen (such as deep vein thrombosis, pulmonary embolism, hot flushes, ocular disturbances and some types of cancer), liposomal drug delivery is recommended for taking this drug. Drug encapsulation in a liposomal or lipid drug delivery system improves the pharmacokinetic and pharmacodynamic properties. In this regard, we carried out 200-ns molecular dynamics (MD) simulations for three systems (pure DPPC and neutral and protonated Tamoxifen-loaded DPPC). Here, DPPC is a model lipid bilayer to provide us with conditions like liposomal drug delivery systems to investigate the interactions between Tamoxifen and DPPC lipid bilayers and to estimate the preferred location and orientation of the drug molecule inside the bilayer membrane.Properties such as area per lipid, membrane thickness, lateral diffusion coefficient, order parameters and mass density, were surveyed. With insertion of neutral and protonated Tamoxifen inside the DPPC lipid bilayers, area per lipid and membrane thickness increased slightly. Also, Tamoxifen induce ordering of the hydrocarbon chains in DPPC bilayer. Analysis of MD trajectories shows that neutral Tamoxifen is predominantly found in the hydrophobic tail region, whereas protonated Tamoxifen is located at the lipid–water interface (polar region of DPPC lipid bilayers).

The effects of facial mask use on ocular surface parameters and tear film cytokine profile in prolonged use.

To compare tear fluid levels of matrix metalloproteinase 9 (MMP-9) and IL-1ß cytokines between healthcare workers wearing facial masks and controls with correlations in clinical findings. In a prospective, controlled clinical trial tear fluid was analyzed for MMP-9 and IL-1ß levels using a commercially available test (Invitrogen; Thermo Fisher Scientific Inc. Waltham, Massachusetts, USA). Symptoms and signs of dry eye disease (DED) were evaluated using the ocular surface disease index (OSDI), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), Oxford corneal staining, meibomiography, and clinical findings of meibomian gland dysfunction (MGD). In the 38 eyes of healthcare workers and 30 eyes of controls, there was no statistically significant difference between the groups in terms of age and sex (p > 0.05). The mean OSDI score, daily mask wear time, meibomiography degree, and rate of positive clinical findings of MGD were higher in group 1 than in group 2, and the mean NIBUT was higher in group 2. (p > 0.05). The mean values of IL-1ß and MMP-9 were higher in group 1 (p = 0.036 and p = 0.001, respectively). The TMH and Oxford score percentages were similar between the two groups (p > 0.05). Elevated levels of IL-1ß and MMP-9 in the basal tear fluid reveal increased ocular inflammation in healthcare professionals. Lower NIBUT values with higher OSDI and meibomian gland loss scores support ocular surface disturbance depending on regular mask use.

Binocular, accommodative and oculomotor alterations in multiple sclerosis

AbstractMultiple sclerosis (MS) is an acquired demyelinating and inflammatory neurodegenerative disease affecting the central nervous system (CNS). Clinical and subclinical ocular disturbances occur in almost all patients with MS. Among them, oculomotor, accommodative and binocular alterations have been reported in MS. Our research group has conducted a complete analysis of the visual and oculomotor function in several researches with MS patients conducted in the last 4 years, obtaining a characterization of some visual aspects of the patient with MS. Concerning the binocular function, several alterations have been detected in MS patients, with divergence at near distance and stereopsis the most affected parameters. Likewise, MS patients with previous optic neuritis present worse binocular vision. Symptomatology compatible with convergence insufficiency measured with the CISS (Convergence Insufficiency Symptom Survey) is frequently reported by MS patients, but not supported by signs that show clear trend to esophoria at near. This discrepancy between the signs and symptoms could be due to the peculiarities of the CISS questionnaire, including items that are also related to the cognitive function and other ocular abnormalities.Oculomotor alterations have been reported also in patients with multiple sclerosis (MS), especially saccadic dysfunctions. The indirect analysis of horizontal saccades with the Developmental Eye Movement (DEM) and King‐Devick tests shows that are affected by MS, with more level of alteration if there has been a previous episode of optic neuritis. Similar findings have been also reported by other authors using objective eye tracking or video‐oculographic systems. Specifically, the most reported saccadic alterations in advanced MS and clinically isolated syndrome (CIS) are saccadic dysmetry (41.7%) and impaired smooth pursuit (42.3%), which relates to prolonged saccadic latency, no matter if they have suffered or not optic neuritis or internuclear ophthalmoplegia (INO). An increase in saccadic latency has been even found in children with MS. Saccadic initiation time (SI time) and average inter‐saccadic intervals (ISI) are also higher in patients with MS. Furthermore, the first cause of acquired pendular nystagmus is MS.Finally, macular sensitivity measured by microperimetry has been found to be altered in MS patients, especially in eyes with previous optic neuritis. Likewise, a fixational instability characterized also my microperimetry is present in MS patients with optic neuritis, with more increase of the vertical axis of the fixation area than of the horizontal. The ratio of the disease also affects the patient fixation pattern.

Isolated Ectopia Lentis in Suspect of Weill-Marchesani Syndrome (WMS)

Introduction: The prevalence of Weill-Marchesani syndrome (WMS) is estimated to be 1:100.000 proportion of the population. Knowledge of the clinical and therapy of WMS is expected to improve the ability to diagnose this disease. In this case report, we will present a case of WMS in a tertiary hospital because our findings are rare and essential concerning the symptomatic treatment and visual rehabilitation. Case Presentation: A 7-year-old child presented with blurred vision in the left eye. The patient showed an abnormal facial appearance with short stature and brachydactyly on both hands. The patient had a history of Intracapsular cataract extraction (ICCE) surgery on the right eye with an indication of anterior lens subluxation. The patient then suffered aphakic glaucoma in the right eye after surgery. Anterior segment examination of the right eye found an aphakic lens, conjunctival sclerectasia, atrophic iris, and mid-dilation pupil. Anterior segment of the left eye found an atrophic iris and lens subluxation. From the clinical appearance and the ocular disturbance, such as brachydactyly and short stature, the patient was diagnosed with suspected WMS. The patient was treated with ICCE surgery on the left eye and micropulse transscleral cyclophotocoagulation (MP-TSCPC) surgery on the right eye. Conclusion: WMS is a rare disease. It is essential to make an early diagnosis of glaucoma and ectopia lentis in WMS patients because it will affect their vision.

Hypertension secondary to nitric oxide depletion produces oxidative imbalance and inflammatory/fibrotic outcomes in the cornea of C57BL/6 mice

Arterial hypertension (AH) leads to oxidative and inflammatory imbalance that contribute to fibrosis development in many target organs. Here, we aimed to highlight the harmful effects of severe AH in the cornea. Our experimental model was established by administration of NG-nitro-L-arginine-methyl-ester (L-NAME) to C57BL/6 mice, which were monitored weekly for arterial blood pressure and intraocular pressure (IOP). Morphological studies of ocular tissues were accompanied by analyses of reactive oxygen species generation, and localization/expression of NAPDH oxidase isoforms (NOX1, NOX2, NOX4) and inflammatory biomarkers (PPARα, PPARγ, IL-1β, IL-6, IL-10, TNF-α, and COX-2). Masson’s trichrome and Sirius Red staining were used to explore the fibrotic status of the cornea. The expression of collagen isoforms (COL1α1, COL1α2, COL3α1, COL4α1, COL4α2) and relevant metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) were also quantified to evaluate the participation of collagen metabolism in AH-related corneal damage. Hypertensive animals showed an increase in IOP values, and a thinner cornea compared with normotensive controls. Moreover, AH increased NADPH oxidase activity and reactive oxygen species generation in the cornea, which was accompanied by transcriptional upregulation of NOX isoforms and inflammatory biomarkers, while reducing PPAR expression. L-NAME-treated animals also developed corneal fibrosis with overexpression of collagen isoforms and reduction of factors responsible for collagen degradation. This is the first study reporting structural changes in the cornea and elevated IOP in L-NAME-treated mice. Overexpression of the NADPH oxidase system and collagen deposition might play a substantial role in the pathogenic mechanisms contributing to ocular disturbances in a context of severe hypertension.

Acetyl-dl-leucine in cerebellar ataxia ([18F]-FDG-PET study): how does a cerebellar disorder influence cortical sensorimotor networks?

ObjectiveThe aim of the study was to deepen our insights into central compensatory processes of brain networks in patients with cerebellar ataxia (CA) before and with treatment with acetyl-dl-leucine (AL) by means of resting-state [18F]-FDG-PET brain imaging.MethodsRetrospective analyses of [18F]-FDG-PET data in 22 patients with CA (with vestibular and ocular motor disturbances) of different etiologies who were scanned before (PET A) and on AL treatment (PET B). Group subtraction analyses, e.g., for responders and non-responders, comparisons with healthy controls and correlation analyses of regional cerebral glucose metabolism (rCGM) with symptom duration, ataxia (SARA) and quality of life (QoL) scores were calculated.ResultsPrior to treatment rCGM was consistently downregulated at the cerebellar level and increased in multisensory cortical areas, e.g., somatosensory, primary and secondary visual (including V5, precuneus), secondary vestibular (temporal gyrus, anterior insula), and premotor/supplementary motor areas. With AL (PET B vs. A) cerebellar hypometabolism was deepened and sensorimotor hypermetabolism increased only in responders with clinical benefit, but not for the non-responders and the whole CA group. A positive correlation of ataxia improvement with rCGM was found in visual and vestibular cortices, a negative correlation in cerebellar and brainstem areas. QoL showed a positive correlation with rCGM in the cerebellum and symptom duration in premotor and somatosensory areas.ConclusionsCentral compensatory processes in CA mainly involve multisensory visual, vestibular, and somatosensory networks as well as premotor/primary motor areas at the cortical level. The enhanced divergence of cortical sensorimotor up- and cerebellar downregulation with AL in responders could reflect amplification of inhibitory cerebellar mechanisms.

Sleep disorders, mental health, and dry eye disease in South Korea

Dry eye disease (DED) is a multifactorial disease of the ocular surface causing severe discomfort, mild ocular irritation, fatigue, pain, visual disturbance, and foreign body sensation. Stress, depression, and sleep disorders are risk factors for DED. We aimed to investigate the association between DED symptoms and composite factors related to mental health (combined sleep duration, psychological stress perception, and history of depressed mood) in Korean adults aged ≥ 20 years in a population-based study using the 2010–2012 Korea National Health and Nutrition Examination Survey data. Symptoms of DED and data on mental health were obtained using questionnaires. Multiple logistic regression analysis was conducted to examine the association between mental health and DED, and adjusted for possible covariates. Subjects with symptoms of DED were more likely to experience short sleep duration, psychological stress perception, and a history of depressed mood [odds ratio (OR) = 1.42, 95% confidence interval (CI) 1.06–1.90; OR = 1.71, 95% CI 1.37–2.14; and OR = 1.37, 95% CI 1.06–1.77, respectively] even after correcting for demographic factors, lifestyle factors, and medical factors. Additionally, participants with symptoms of DED were more likely to experience composite factors related to mental health (OR = 1.91, 95% CI 1.07–3.39). Therefore, ophthalmologists may report difficulties in both sleep and mental health in patients with DED.

SELECTED NEUROLOGIC AND PSYCHIATRIC OUTCOMES IN PATIENTS TREATED WITH CLOZAPIN (Review Article)

Clozapine is a second-generation antipsychotic mostly used for treatment-resistant schizophrenia and acute suicidality. Although clozapine’s efficacy is well-documented, it has various side effects which need to be promptly addressed. In this article, we focus on neurological and psychiatric side effects. Among these side effects, seizure is a well-known complication of clozapine therapy. The articles that we reviewed concerning seizures and EEG changes in association with clozapine plasma levels and doses, found significant relations in some but not all cases. In addition to seizures, extrapyramidal side effects are common adverse effects of clozapine which can be an acute or chronic condition. Clozapine is also associated with ocular disturbances such as retinal pigmentation. It has also been shown to cause cataplexy. Moreover, clozapine can cause significant sedation. Effects of clozapine on sleep is still a controversial subject. The studies demonstrate inconsistent results. Cholinergic rebound syndrome is a rare complication of longterm clozapine use, which itself can be the inducer of insomnia. Apart from this, hypersalivation is one of the most frequent side effects with a paradoxical pathophysiology. Finally, clozapine is associated with severe psychiatric side effects, some of which need prompt intervention.

Ocular Adverse Events after Inactivated COVID-19 Vaccination in Xiamen.

Aims: To report potential vaccine-induced ocular adverse events following inactivated COVID-19 vaccination (Sinopharm and Sinovac). Methods: This case series took place at a tertiary referral center in the southeast of China (Xiamen Eye Center in Fujian Province) from February 2021 to July 2021. Patients who received the first dose of inactivated COVID-19 vaccine and developed vaccine-related ocular adverse events within 10 days were included. The diagnosis of vaccine-related ocular adverse events was guided by the World Health Organization causality assessment and the Naranjo criteria. Results: Ten eyes of seven patients (two male individuals) presenting with ocular complaints following COVID-19 vaccine were included in the study. The mean (SD) age was 41.4 (9.3) years (range, 30–55 years). The mean time of ocular adverse event manifestations was 4.9 days (range, 1–10 days). Three patients were diagnosed with Vogt–Koyanagi–Harada (VKH)-like uveitis, one with multifocal choroiditis, one with episcleritis, one with iritis, and one with acute idiopathic maculopathy. Two patients received the second dose of vaccine. One patient had exacerbation of VKH, and one patient had no symptoms. An aqueous humor analysis in three patients revealed elevated proinflammatory cytokines and negative virus copy. All the patients had transient ocular disturbance and responded well to steroids. No recurrence was noted during 6 months of follow-up. Conclusions: Potential ocular adverse events should be reported to increase the awareness of the health community for timely detection and proper treatment.

Ocular surface disturbance in patients after acute COVID-19.

BackgroundWe investigated the ocular surface disturbances in COVID‐19 patients discharged from the hospital.MethodsOne hundred and seventy‐nine eyes of 109 healthy participants and 456 eyes of 228 post‐COVID‐19 patients received comprehensive eye examinations; the latter were interviewed with questionnaires on ocular symptoms before and after COVID‐19 diagnosis. Associations of ocular surface manifestations with virological and ophthalmic parameters were evaluated by multivariable mixed linear or logistic regression models.ResultsMean interval between COVID‐19 diagnosis and ophthalmic evaluation was 52.23 ± 16.12 days. The severity of meibomian gland dysfunction (MGD) based on clinical staging was higher in post‐COVID‐19 than healthy eyes (1.14 ± 0.67 vs. 0.92 ± 0.68, p = 0.002) and so was ocular surface staining score (0.60 ± 0.69 vs. 0.49 ± 0.68, p = 0.044). Patients requiring supplementary oxygen during hospitalisation had shorter tear break‐up time (β −1.63, 95% CI ‐2.61 to −0.65). Cycle threshold (Ct) value from upper respiratory samples (inversely correlated with viral load) at diagnosis had an OR = 0.91 (95% CI 0.84–0.98) with new ocular surface symptoms 4 weeks after diagnosis. The presence of ocular surface symptoms 1 week prior to COVID‐19 diagnosis showed an OR of 20.89 (95% CI 6.35–68.66) of persistent or new ocular symptoms 4 weeks afterward.ConclusionsMGD and ocular surface staining are more common and severe in post‐COVID‐19 patients. Patients with higher viral loads have greater risks of ocular surface symptoms. Patients requiring supplementary oxygen are more likely to show tear film instability. Ocular surface evaluation should be considered 1–3 months following hospital discharge for any COVID‐19 patient.

Dry Eye Disease Terkait Penggunaan Video Display Terminals Pada Pekerja Era Pandemi Covid-19

Dry eye disease (DED) is a multifactorial progressive disease of ocular surface characterized by tear film instability and hyperosmolarity of the precorneal tear film. Patients with DED may experience range of ocular disturbances that may negatively impact their quality of life. The prevalence of DED is increasing among people who work with video display terminals (VDT), especially during the COVID-19 era. Studies have shown the association between DED symptoms and VDT usage. Complete blinking reduction, lacrimal gland hypofunction, Meibomian gland dysfunction, oxidative stress and local inflammation, and blue light phototoxicity are commonly accepted hypothesis. Several approaches are exist to treat and prevent DED among VDT workers.

The contact lens dry eyes questionnaire (CLDEQ-8) validation and ocular surface dysfunction among soft contact lens wearers.

To translate and validate the Contact Lens Dry Eyes Questionnaire (CLDEQ-8) to Portuguese language and to describe the impact of soft contact lenses on the ocular surface. We conducted a descriptive transversal study with the aim to: (1) translate and validate the CLDEQ-8 questionnaire to Portuguese language and (2) apply the CLDEQ-8 to a group of contact lens wearers along with a broad evaluation of the impact of soft contact lens on the ocular surface. The evaluation of the impact of soft contact lens was performed for a study population of 81 subjects, categorized in two groups: Group A: 61 contact lens wearers and Group B (control): 20 noncontact lens wearers. The study exclusion criteria were rigid contact lens wear, systemic or ocular diseases, the use of medications predisposing to ocular surface damage, and previous ocular surgeries. For the CLDEQ-8 questionnaire translation and validation, Kappa agreement values were ³0.7 in all questions, implying a good agreement between the Portuguese and English language versions. Considering the ocular surface evaluation of the subjects, all parameters differed in Soft contact lens wearers when compared with the controls (p<0.05), except in those related to tear volume, such as the tear meniscus height and Schirmer test. This study provided a translated and validated Portuguese version of CLDEQ-8 questionnaire, which represents an important tool for the evolution of contact lens wearers. The broad evaluation of the ocular surface revealed an association between soft contact lens wearing and ocular surface disturbances.

Prevalence of ocular findings regardless of visual acuity status in older adults from the Brazilian Amazon Region

Recently, it has been recommended that population-based studies report not only frequencies of vision impairment and blindness but also any ocular abnormalities that might lead an individual to seek for eyecare services. The current study aimed to determine prevalence of ocular findings regardless of visual acuity (VA) status in older adults from the Brazilian Amazon Region. Disturbances were grouped into: Eyelids; Anterior Segment; Posterior Segment; Increased intraocular pressure; and Overall Globe. The presence of an ocular finding was considered positive when any abnormality was noted, regardless of VA. Refractive errors were not considered. A total 2384 eligible persons were enumerated and 2041 (85.6%) examined. The prevalence of ocular disturbances in either eye was 87.0% and was associated with male gender, older age, lower education, and rural residence. Overall, main findings were pterygium, cataract, and pinguecula, occurring in 58.8%, 45.4% and 17.4%, respectively. Among individuals with 20/20 VA in both eyes, the most frequent findings were pterygium, pinguecula, and glaucoma cupping, occurring in 47.4%, 31.2% and 6.5%, respectively. The high prevalence of ocular findings observed in this population reinforces that different conditions might not immediately decrease VA but can indicate risk and/or discomfort symptoms and should be considered when planning public health ophthalmic services.