Ophthalmology Hospital Research Articles

Clinical profile and etiological spectrum of patients presenting with corneal hydrops over a 12-year period.

To describe the demographics, clinical characteristics, and management of corneal hydrops in patients presenting to a multi-tier ophthalmology hospital network in India. Cross-sectional hospital-based study. Of the total of 3,140,941 new patients presenting between October 2010 and March 2022, patients with a clinical diagnosis of corneal hydrops in at least one eye were included in the study. All the data was collected using an electronic medical record system. 1291 eyes of 1110 patients were diagnosed with corneal hydrops and included in the study and 961 patients (83.69%) had a unilateral affliction. Corneal hydrops was noted to be significantly more common in males (62.43%) and adults (62.7%). The most common age group at presentation was during the second decade of life with 472 (42.52%) patients. They were more commonly from the higher socio-economic status (77.3%) and from the urban geography (44.23%). In the 1291 eyes, 567 (43.92%) eyes had a visual impairment of blindness (> 20/400-20/1200) followed by moderate visual impairment (> 20/70-20/200) in 166 (12.86%) eyes. Overall, the most common etiology was keratoconus in 1,082 (83.81%) eyes followed by primary congenital glaucoma (PCG) in 91 (7.05%) eyes. Surgical intervention to hasten the recovery of hydrops was performed in 7.82% of eyes with ectasia and as a definite management in 7.05% eyes with PCG. Visual rehabilitation was with contact lenses in 29.1% eyes and keratoplasty in 13.94% eyes. Corneal hydrops is predominantly unilateral and is more common in males. Keratoconus was the commonest etiological condition; however, the risk of hydrops was highest in keratoglobus, followed by PMD. Most affected age was the second decade of life and visual impairment was severe in majority (60%). A surgical intervention was performed in a third of the cases.

Accuracy of 7 artificial intelligence based intraocular lens power calculation formulas in extremely long Caucasian eyes: Short title: AI-based IOL calculation in extra-long eyes

To compare 7 AI-based IOL power calculation formulas in extremely long eyes DESIGN: : Retrospective accuracy and validity analysis. SETTING: Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Ukraine STUDY POPULATION: : Patients with highly myopic eyes, who underwent uneventful phacoemulsification OBSERVATION PROCEDURES: Prior to cataract surgery IOL power was calculated. The power of the implanted IOL was randomly selected from the outcomes of SRK/T, Holladay 2 or Barrett Universal II. Three months after phacoemulsification, refraction was measured. Post-surgery IOL power calculations were performed utilizing the following formulas: Hill-RBF 3.0, Kane, PEARL-DGS, Ladas Super Formula AI (LSF AI), Hoffer QST, Karmona and Zhu-Lu. root mean square absolute error (RMSAE), median absolute error (MedAE) and percentage of eyes with prediction error (PE) within ±0.50 D RESULTS: : Forty eight eyes with axial length exceeding 30.00 mm were studied. Hill-RBF 3.0 yielded the lowest RMSAE (0.788) with statistical superiority only over Karmona (0.956, p=0.021). In terms of MedAE, outcomes obtained by Hoffer QST (0.442) and Hill-RBF (0.490) were statistically significant vs LSF AI (0.800, p=0.013, p=0.008, respectively). The highest percentage of eyes with PE within ±0.50 D was achieved by Hill-RBF 3.0, Kane and Hoffer QST (54.17% each) statistically significant as follows: both Hill-RBF and Kane vs LSF AI (27.08%) and Karmona (39.58%), and Hoffer QST vs LSF AI. All tested formulas demonstrated comparable trueness, with Hill-RBF 3.0 being more accurate than Karmona (RMSAE), and LSF AI being less accurate than Hoffer QST and Hill-RBF 3.0 (MedAE).

Comparative Analysis of AI Chatbots ChatGPT, Gemini, and Copilot’s Answers to Common Cataract Questions

Purpose: To compare the readability and quality of the answers given by artificial intelligence (AI) chatbots to the twenty-five most frequent searches about cataracts on Google. Study Design: Cross sectional comparative study. Place and Duration of study: Serdivan State Hospital's Ophthalmology Department from March 2024 to April 2024. Methods: The word 'Cataract' was entered into Google Trends, and 25 trending searches made worldwide since 2004 were identified. These 25 trending searches were entered separately into AI programs. The answers were examined for quality using the Ensuring Quality Information for Patients (EQIP) test, while the readability was evaluated using the Flesch-Kincaid Reading Ease (FKRE) and Flesch-Kincaid Grade Level (FKGL). Results: The keywords searched most frequently were ‘Cataract surgery,’‘Eye cataract and 'After Cataract’. The EQIP category of all three AI chatbots was found to be 'serious quality issues.' When EQIP scores were compared, ChatGPT had a lower median value than Gemini and Copilot (p:0.001, p:0.007, respectively), while there was no significant difference between Gemini and Copilot (p:0.098). When FKRE values were compared, ChatGPT had a lower median value than Gemini and Copilot (p:0.001, p:0.001, respectively), with no significant difference between Gemini and Copilot (p:0.557). When FKGL values were compared, ChatGPT had a higher median value than Gemini and Copilot (p:0.003, p:0.001, respectively), with no significant difference between Gemini and Copilot(p:0.245). Conclusion: All three AI chatbots had an EQIP category of 'serious issues with quality .'The readability of all three was not at the recommended level.

Comparison between surgical outcome of bilateral recession and unilateral recession-resection in intermittent exotropia

Purpose The aim of this study was to compare the postoperative drift after bilateral lateral rectus recession (BLR) compared to unilateral lateral rectus recession combined with medial rectus resection (R&R) in children with intermittent exotropia. Patients and methods This is a prospective comparative study that included 52 patients with intermittent exotropia [range=20–50 prism diopters (PD)] who were recruited from the Pediatric Ophthalmology Clinic of the Research Institute of Ophthalmology, Giza, and Beni-Suef University Hospital, Beni-Suef, Egypt between February and September 2020. The patients were randomly divided into two equal groups: BLR group and R&R group, each of 26 patients. The patients were subjected to complete ophthalmic examination including best corrected visual acuity and a full cycloplegic refraction. An alternate prism cover test with accommodative target was used to measure the deviations in the nine positions of gaze, both for distance and near. The cover test was used to examine the control of exodeviation. The ocular dominance was measured by hole in card test. Accommodative convergence/accommodation ratio was measured using the gradient method. The amblyopia cases were not included in this study. According to the postoperative results after 1 year, the patients were assigned to one of the following groups: success [esophoria or esotropia≤5 PD or exophoria or exotropia≤10 PD], overcorrection (esophoria or esotropia >5 PD), and undercorrection or recurrence (exophoria or exotropia >10 PD). Results There was a statistically significant improvement in the angle of deviation after surgery in both groups. In the BLR group, the mean angle of deviation significantly improved from 37.5±5.34 PD preoperatively to 0.58±1.39 PD at 6 months (P<0.00001) and to −2.73±5.95 PD at 12 months (P<0.00001), while in the R&R group, it significantly improved from 39.62±6.15 PD preoperatively to −1.38±2.06 PD at 6 months (P<0.00001) and to −4.42±7.5 PD at 12 months (P<0.00001). At 12 months, the surgical success rate was 92.3% in the BLR group and 84.62% in the R&R group, with no statistically significant difference (P>0.05). There were no serious intraoperative or postoperative complications in either group. Conclusion With long-term follow up, the BLR group appeared to have more stable results on ocular alignment compared to the R&R group.

Clinico-demographic profile and visual outcomes of pseudophakic bullous keratopathy in a multi-tier eyecare network in India

Abstract Purpose: The purpose of this study is to present the clinico-demographic characteristics of pseudophakic bullous keratopathy (PBK), its visual outcomes, factors associated with the choice of treatment, and poor visual outcomes of PBK. Methods: In this hospital-based retrospective study, electronic medical records data of new patients who presented to a multi-tier ophthalmology hospital network in India (November 2010–June 2022) were extracted. Patients with at least 4 weeks of follow-up were analyzed for visual outcome data. Bivariate analysis and multivariate logistic regression were used to determine the factors associated with the treatment choice and poor visual outcomes. Results: Of the 3,323,247 electronic records (with an average follow-up of 293 days) examined, 10,522 eyes of 10,158 patients (0.3%) had PBK. The majority were managed non-surgically (n = 7372; 70.1%), with increased odds of poor visual outcome by 3.46 times (AdjOR: 3.04–3.92, P < 0.001). Those belonging to the non-paying category had higher odds of poor visual outcome (AdjOR: 1.48, 95%CI: 1.29–1.69; P < 0.001). Surgical management improved vision by 0.72 logMAR (95%CI: 0.60–0.73; P < 0.001). A total of 41.2% (n = 113/274) of cases that underwent Descemet’s membrane endothelial keratoplasty and 18.4% (n = 285/1551) of Descemet’s stripping endothelial keratoplasty attained last follow-up visual acuity (LVA) of 6/18 or better. Conclusion: About three in every thousand patients had PBK. Surgical interventions improved visual acuity significantly. About four in ten patients who underwent DMEK attained a vision of 6/18 or better at the last follow-up visit. Markers of lower socioeconomic strata were independently associated with poor visual outcomes.

Epidemiology of Common Eye Diseases in North Kordofan, Sudan

Introduction: Eye illness epidemiology is critical because it identifies the most dangerous diseases in the community and helps decision-makers make better management decisions. This study aims to explore the epidemiology of prevalent eye diseases in north Kordofan State. Methodology: This retrospective descriptive study was conducted at El-Obeid Teaching Hospital's Ophthalmology Department, North Kordofan State, Sudan, and Dr. Khalil's Ophthalmology Center. Out of almost 50000 patient files, we selected 1000 files for this study using a random systemic selection of 1 in 50. The data collection sheet was created, and all data were collected. Results: The corneal diseases made up 19.6% of the 1000 cases in this study, followed by conjunctival 17.7%, lens 15.3%, eye surface 9.8%, uveal tract 9.1%, refractive errors 6.4%, eye lids 5.4%, orbital 5.4%, glaucoma 4.3%, retinopathy 4.6%, anterior chamber diseases 2.1%, lacrimal drainage system disorders 1.8%, and nerve palsies 0.5%. Conclusion: The western Sudan is heavily affected by eye diseases, with corneal diseases being the most common, closely followed by conjunctival diseases. This report delves into the eye disease situation in western Sudan. With absence of such literature from Sudan, the findings of this study presenting baseline of future research in this context.

Analysis of corneal remodeling post-myopic photorefractive keratectomy with the WaveLight® EX500 excimer laser

Refractive error is becoming a significant public health issue. Photorefractive Keratectomy (PRK) is a corneal surface surgical technique that removes the corneal epithelium before stromal photoablation by ultraviolet radiation from the Excimer laser. We designed a retrospective study to characterize corneal remodeling after myopic Photorefractive Keratectomy and assess the accuracy of laser-predicted ablation depth (AD). This study took place in 15–20 National Ophthalmology Hospital, Paris, France. 150 eyes with preoperative manifest spherical equivalent between − 10.00D and − 0.25D and cylinder < 3D, treated with the WaveLight® EX500 laser between 01/2019 and 01/2023, were followed for at least three months. The main outcome measurements were postoperative changes in epithelial (ET) and stromal (ST) thicknesses measured with spectral domain optical coherence tomography and mean simulated keratometry (SimK) assessed with corneal topography. The central ET significantly decreased at M1, increased over the preoperative value from M1 to M6, and stabilized after M6. The increase in central ET after M1 was associated with an increase in mean SimK (r = 0.34). The achieved AD was 7.9 ± 8.0 µm greater than the laser-predicted AD. Stromal over-ablation was significantly and independently associated with myopia > 6D preoperative mean SimK > 44D and transepithelial procedures.

The Pattern of Corneal Diseases in North Kordofan State

Background: All corneal diseases cause ocular morbidity and decrease vision, or even blindness, so early management intervention is critical. This study sought to evaluate several corneal disorders, including corneal foreign bodies, corneal tears, and ruptured globes. Methodology: This retrospective descriptive study was undertaken in El-Obeid Teaching Hospital's Ophthalmology Emergency Department in North Kordofan State, Sudan, as well as Dr. Khalil's Ophthalmology Center. This study sample, which represents the entire corneal illness, was obtained from 1000 patient files for various eye conditions. Results: This study examines 205 patients with corneal disorders to assess the prevalence of corneal diseases in North Kordofan State. The study found that the disease is more common in males, with 48 out of 78 patients (62%) being male and 38% being female. The male-to-female ratio is 1.6:1. The age group that is most affected is the group of individuals younger than 9 years, accounting for 34% of the affected population. This is followed by the age groups of 10–20 years, 21–32 years, 33–53 years, and &gt;54 years, which account for 24%, 18%, 14%, and 9%, respectively. Regarding the classification of corneal disorders, the most prevalent form is foreign body corneal disease, accounting for 38% of cases. This is followed by corneal tear (16%), corneal opacity (15%), corneal tear with iris prolapses (10%), bacterial corneal ulcer (7%), and rupture globe (6%). The incidence rates of viral corneal ulcers, chemical trauma, burn trauma, and keratoconus are 3%, 3%, 1%, and 1%, respectively. Conclusion: Eye trauma is prevalent in north Kordofan, leading to an upsurge in corneal illnesses including foreign body cornea, corneal tear, and ruptured globe.

Impact of contact lens hygiene risk factors on the prevalence of contact lens-related keratitis in Alexandria-Egypt

BackgroundThis study aimed at measuring the effect of contact lens hygiene risk factors on the prevalence of contact lens-related keratitis and identifying the specific risk factors to both microbial and non-microbial keratitis independently.MethodsA cross-sectional study was conducted at Alexandria Ophthalmology Hospital from May to October 2023. All contact lens wearers attending the outpatient clinic had undergone face-to-face interviews using a standardized validated questionnaire which included demographic data and contact lenses (CLs) hygiene risk factors. Participants were classified into two groups; normal group and keratitis group. Keratitis group was further subdivided into non-microbial and microbial group.ResultsThe study included 245 contact lens wearers; 149 normal cases, 50 (20.4%) contact lens-related non-microbial keratitis (CLNK) cases, and 46 (18.8%) contact lens-related microbial keratitis (CLMK) cases. Sharing contact lenses and eye trauma were significant risk factors for both CLNK (p=0.036), (p=0.001) and CLMK (p=0.003), (p=0.017). CLs wear duration for more than 12 hours was associated with an increased risk of CLNK by about 4 times (p=0.030) and overnight wear of contact lenses increased the risk of CLNK by 2.6 times (p=0.030). Showering or swimming in lenses was identified as a significant risk factor for CLMK (p=0.012), moreover washing lenses with tap water increased the risk of CLMK (p=0.030).ConclusionsPoor compliance with contact lenses hygiene rules results in a high prevalence of contact lens-related keratitis. Eye trauma and sharing contact lenses were significant hygiene risk factors for both contact lens-related non-microbial keratitis and contact lens-related microbial keratitis.

Fungal keratitis among inpatients with corneal ulcers in Thai Binh, Vietnam: A retrospective observational study

Background: Infectious keratitis can be caused by bacteria, fungi, and viruses. Fungi are a common pathogen, especially in developing countries like India, Nepal, and Bangladesh where the prevalence ranges from 20% to 60%. In Vietnam, fungal keratitis accounted for the highest number of keratitis cases in a study conducted at the central eye hospital over a 5-year period (57%). Therefore, it is necessary to collect specific background information connected to the types of fungal keratitis in corneal ulcer cases in this region. Aims and Objectives: The aim of this study was to investigate the prevalence of fungal keratitis and the epidemiological features in 216 cases of fungal keratitis out of a total of 240 cases of infectious keratitis. Materials and Methods: This retrospective study collected secondary data from medical records of 240 inpatients with infectious keratitis who were treated at the ophthalmology hospital in Thai Binh, Vietnam, from January 01st, 2021 to June 30th, 2022. Patients with a positive fungal-directed smear were analyzed in detail for the type of fungus isolated, sociodemographic data, predisposing risk factors, prior treatment modalities, and laboratory results for the distribution pattern of fungus species. Results: Among the 240 cases, 126 (52.5%) were diagnosed with fungal keratitis by direct microscopic examination. Culture results showed the highest rate of Fusarium spp. (43.3%). The age group of 41–60 years was most commonly involved (40.5%). Males were more affected by fungal keratitis than females, (53.2% compared to 46.8%), with farmers being the most common occupation correlated with fungal keratitis (55.6%). The rate of fungal keratitis patients due to agricultural injuries was the highest compared to other risks (47.6%) and most patients self-medicated before going to the hospital, with many not knowing or remembering what medications they had taken (52.4%). Conclusion: The study revealed a high rate of fungal keratitis among the total of infectious keratitis cases in Thai Binh, Vietnam. Fusarium spp. was the most commonly isolated fungi. The study also highlighted the impact of agricultural injuries on fungal keratitis, especially in regions like Thai Binh.

The carbon footprint of French hospital ophthalmology consultations.

France carbon footprint, with 604 million tons of CO2 equivalent (CO2eq) annual emissions, far exceeds the worldwide scientific specifications to not exceed 2 °C of warming in 2100. The healthcare sector is one of the biggest contributors to greenhouse gas emissions. The aim of this study is to quantify and evaluate the carbon footprint of the consultation activity of an ophthalmology department at a single institution in France. The perimeter of the investigation included consultations and excluded the surgeries and the hospitalisation. We calculated the carbon footprint of a single day of practice in our scope of investigation. We included consumption of energy, patient travel, staff travel, pharmaceutics and medical devices purchases, computer hardware, biomedical equipment/exam materials, and waste. We used the official French public database of emission factors: Base Empreinte® of the Environmental and Energy Management Agency of France. The carbon footprint of a single day of our department was estimated at 1 688.65 kgCO2eq. It represents an average of 9.28 kgCO2eq per patient. Energy consumption contributed for 114.80 kgCO2eq (6.8%), travel for 1324.76 kgCO2eq (78.4%), pharmaceutics and medical devices for 208.33 kgCO2eq (12.3%), equipment for 14.38 kgCO2eq (0.9%) and waste for 26.38 kgCO2eq (1.6%). This study highlights the importance of patient travels, and possibly pharmaceutics, in the carbon footprint of hospital ophthalmology practice in France. More studies are needed to establish it at the national or international scale, as well as more carbon footprint analyses on products, especially those of high prices, to increase the accuracy of these studies.

Correlation of posterior segment lesions with anterior segment biometric parameters and FBN1 genotype in patients with Marfan syndrome

Objective: To investigate the characteristics of posterior segment lesions in Marfan syndrome (MFS) patients and their relationship with anterior segment biometric parameters and FBN1 genotype. Methods: A cross-sectional study was conducted. A total of 121 MFS patients, 76 males and 45 females, with an average age of (11.72±11.66) years, who visited the Department of Ophthalmology, Eye & ENT Hospital of Fudan University from January 2013 to March 2023 were included. The presence of posterior scleral staphyloma was observed using B-mode ultrasound, and macular lesions were identified and classified using the atrophy-traction-neovascularization system based on ultra-widefield fundus images, color fundus images, and optical coherence tomography scans. Anterior segment biometric parameters, including axial length of the eye, average corneal curvature, corneal astigmatism, horizontal corneal diameter, anterior chamber depth, and lens thickness, were collected, and the direction and extent of lens dislocation were observed. Molecular genetic analysis of FBN1 gene mutations in patients was performed using next-generation sequencing based on a panel of ocular genetic diseases, and the impact of the genotype and anterior segment biometric parameters on the posterior segment manifestations was analyzed. Results: Sixty patients exhibited posterior segment lesions, including retinal detachment (4 cases, 3.31%), macular lesions (47 cases, 38.84%), and posterior scleral staphyloma (54 cases, 44.63%). There was statistically significant difference in axial length of the eye between patients with and without posterior scleral staphyloma [23.09 (22.24, 24.43) and 27.04 (25.44, 28.88) mm], between patients with and without macular lesions [23.16 (22.24, 24.61) and 27.04 (25.74, 28.78) mm], and between patients with and without atrophic macular lesions [23.16 (22.24, 24.61) and 27.04 (25.74, 28.79) mm] (all P<0.001). There was statistically significant difference in anterior chamber depth between patients with and without macular lesions [3.11 (2.75, 3.30) and 3.34 (3.09, 3.60) mm] (P<0.05). There was also statistically significant difference in corneal astigmatism between patients with and without posterior scleral staphyloma [2.15 (1.20, 2.93) and 1.40 (1.00, 2.20) diopters] (P<0.05). The location and region of the FBN1 gene mutation not only showed statistically significant difference from the positive rates of posterior scleral staphyloma and macular lesions (all P<0.05), but also influenced the occurrence of atrophic macular lesions (both P<0.05). Patients with FBN1 mutations located in the transforming growth factor β regulatory sequence had the highest proportion of posterior scleral staphyloma and macular lesions (both 10/11). Conclusions: Posterior scleral staphyloma and macular lesions have a relatively high incidence in MFS patients and tend to progress to more severe grades. The age, axial length of the eye, anterior chamber depth, corneal astigmatism, and location and region of the FBN1 gene mutation are factors affecting the posterior segment lesions in MFS patients.

Eye care following pre-school vision screening: Data from the Growing Up in New Zealand study.

This study aimed to determine adherence with follow-up from the New Zealand pre-school vision screening programme. The study also examined associations between pre-school vision screening outcomes and cognitive measures assessed at the 54-month follow-up in the Growing Up in New Zealand study cohort. A cross-sectional retrospective record review of pre-school vision screening outcomes and hospital ophthalmology records with linkage to Growing Up in New Zealand cohort study data. Of 176 children referred from vision screening, 21.6% did not attend a referral appointment. Of 138 children who attended a referral appointment, 21.0% did not attend one or more follow-up appointments. Ethnic differences were observed in attendance at referral appointments (attended Māori 13%, Pacific 22.5%, European/Other 64.5%; not attended Māori 26.3%, Pacific 28.9%, European/Other 44.7%; P = 0.04) and follow-up appointments (attended Māori 11.9%, Pacific 15.6%, European/Other 72.5%; not attended Māori 17.2%, Pacific 48.3%, European/Other 34.5%; P = 0.001). Vision screening outcome was significantly associated with letter naming fluency scores (P = 0.01) but not name and numbers scores (P = 0.05). Non-attendance at referral and follow-up appointments limits the efficacy of vision screening, particularly for children of Māori and Pacific ethnicity. Children referred from vision screening achieve lower scores on letter naming fluency, a key predictor of reading ability in later childhood. Equity-based improvements are required to ensure that all children referred from vision screening receive appropriate follow-up eye care.

Role of Optical Coherence Tomography (OCT), Fundus Photography, and Amsler Grid in Detection of Macular Disorders Associated with High Myopia

Abstract Background High myopia refers to ametropia characterized by elongation of optic axis and retinal and choroidal degeneration in the fundus, and high myopic patients present with various degrees of structural and functional retinal changes and thinning of the retinal thickness. Active screening for high myopic patients with imaging techniques by OCT, Fundus photography and amsler grid and providing patients with corresponding treatment on this basis may effectively reduce the risk of irreversible visual function damage. Objective To point to the importance of combining OCT, fundus photography with amsler grid testing in patients with high myopia. Methods This study was conducted on 40 eyes from EI-Demerdash Hospital outpatient clinic and ophthalmology department investigations unit in the period from June 2021 till May 2022; the patients were 24 females (60.0%) and 16 males (40.0%) with age ranged from 16 to 50 years. Results Our investigations gave us an idea about the macular diseases associated with high myopia and the importance of combining use of OCT, fundus imaging and amsler grid with patients with high myopia. These findings consist of chorioretinal atrophy, foveoschisis, choroidal neovascularization, dehiscence of retinal layers known as retinoschisis (foveoschisis or extre foveoschisis), macular holes (lamellar and full thickness), posterior retinal detachment. We can early detect theses changes in macula of highly myopic patients by Amsler grid testing as daily self monitoring and this can be useful in directing the patient to more sophisticated investigation tool like OCT and fundus photography and therefore give the patient the optimal chance to save the vision. Conclusion OCT combined with fundus photography and amsler grid testing are helpful tools that allow detailed evaluation of the macula in eyes with pathological myopia and easily anticipate, diagnose and follow up diseases associated with high myopia.

Accessibility of United States ophthalmology hospital webpages to people with visual disabilities

PurposeEnhancing the accessibility of ophthalmology webpages can help individuals with vision access needs obtain essential appointment information, educational resources, and available ophthalmic services. This study evaluated the accessibility of these webpages for patients with visual impairment and color vision deficiencies. DesignRetrospective cross-sectional study. MethodsIn February 2024, the Web Content Accessibility Guidelines 2.0 (WCAG 2.0) were used to assess the accessibility of the web homepages of the top-ranked ophthalmology institutes in the United States using three evaluation tools: AChecker, ARC Toolkit, and WAVE. The webpages of the 38 top-ranked hospitals for ophthalmology in the 2023 US News & World Report were evaluated. ResultsAll assessed ophthalmology hospital and institute webpages had accessibility issues. The issues identified by each tool significantly impeded webpage navigation, with the mean number of issues as follows: AChecker (13.08, SD = 14.51), ARC Toolkit (16.21, SD = 17.68), and WAVE (6.47, SD = 7.14). The mean number of color contrast issues per website was 10.18 (SD = 15.84), present in 87 % (33/38) of the websites assessed. Most issues made information and interface components difficult to perceive (297/497, 59.76 %), and websites difficult to navigate or operate (145/497, 29.18 %). Common issues affecting people who are blind or have low vision and rely on screen readers included the absence of alternative text for images, hyperlinks without destination information, and missing instructions for user data input (e.g., search bars). ConclusionsOphthalmology webpages should be revised to comply with WCAG guidelines to improve accessibility for people with vision access needs. Addressing these issues can reduce information inequities for patients with visual disabilities and enhance their understanding of clinical processes, treatment, care plans, and available services such as transportation and online support groups.

A Study on Refractive Outcome Following Manual Small Incision Cataract Surgery with Rigid PCIOL

Introduction: Cataract is a significant and increasing global problem with vast economic and social implications[1]. It is the principal cause of blindness in India accounting for 62.6% (92). The prevalence of blinding cataract will only increase as people live longer, so cataract will continue to be, by far, the most important treatable cause of blindness. It is estimated that the present number of 20 million of cataract blind will double by year 2030.[2] . Materials and Methods: Study design: Cross sectional observational study Source of data: All the patients admitted with small incision cataract surgery (SICS) with PCIOL implant, in the department of Ophthalmology Rajarajeshwari Medical College and Hospital, Bangalore Study period: 18 months (Jan 2021- June 2022) Sample size: 200 patients. Results and Observations: In our study, at 1st post operative week, most patients had visual acuity score of better than 6/9 and least had less than 6/60 score. A follow up of patients at 2nd week, 6th week and end of 6th week showed that visual acuity improved at 2nd and 6th post-operative weeks.. Most patients were in the refraction range of &lt; -0.50. Conclusion: From our study we conclude that the uncorrected visual acuity of cataract patients improved in the early and late post-operative weeks, after undergoing Manual Small Incision Cataract Surgery with Rigid PCIOL (MSICS) to a great extent. MSICS can be accepted as an alternative to phacoemulsification in developing countries like India. Keywords: Cataract, Small incision, Astigmatic, Visual outcome

Quantitative evaluation of metamorphopsia with M-CHARTS™ and evaluation of retinal morphologic changes by optical coherence tomography before and after pars plana vitrectomy in patients with idiopathic epiretinal membrane

Purpose: We aimed to quantitatively evaluate metamorphopsia pre- and postoperatively in patients with idiopathic epiretinal membrane(iERM) using M-CHARTS™ and to evaluate the relationship between morphological changes in retinal layers on optical coherence tomography (OCT) and metamorphopsia scores.Materials and Methods: This prospective study included 42 patients followed in Akdeniz University Hospital Ophthalmology Clinic diagnosed with iERM by fundus examination and OCT between 2020-2022. Detailed ophthalmologic findings, visual acuities, metamorphopsia scores, and OCT parameters of all patients were recorded. The relationship between pre- and postoperative visual acuity, metamorphopsia scores and OCT parameters was investigated. Changes in OCT parameters were compared by evaluating patients with stable or increasing metamorphopsia scores as one group (Group1) and patients with decreasing metamorphopsia scores as the other group (Group 2).Results: In “Group 2,” preoperative Ganglion Cell Layer+Inner Plexiform Layer (Central) (GCL+IPL (C)) was significantly (p:0.028) higher than in “Group 1.”Conclusion: A statistically significant preoperative thickness difference in the OCT parameters of the GCL+IPL (C) layer was associated with the quantitative metamorphopsia complaints of the patients. The thickness of the preoperative GCL+IPL (C) layer can be considered an important indicator of symptoms of metamorphopsia determining functional success after surgery.

An Analysis of ChatGPT4 to Respond to Glaucoma-Related Questions.

In recent years, ChatGPT has been widely used as a source of information. In our study, it was revealed that ChatGPT gives accurate information about glaucoma. We examined the knowledge of ChatGPT about glaucoma. Frequently asked questions about glaucoma found on websites of ophthalmology associations and hospitals, and social media applications were assessed. Evidence-Based Recommendations in the European Glaucoma Society Terminology and Guidelines for Glaucoma, Fifth Edition were evaluated. Using the ChatGPT-4, each question was asked twice on different computers to assess the reproducibility of answers. The answers provided were recorded and 2 specialist ophthalmologists evaluated them independently, assigning scores ranging from 1 to 4. The answers to all questions about glaucoma resulted in 88.7% completely correct, 7.5% correct but insufficient, and 3.8% misleading information and correct information. No question was answered completely incorrectly. While 85.8% of the general knowledge questions were answered correctly, 91.7%, 86.6%, and 91.7% of questions about diagnosis, treatment, and prevention were answered correctly, respectively. The number of questions prepared based on the European Glaucoma Society Terminology and Guidelines for Glaucoma was 16. The rate of completely correct answers to these questions was 75.0% (12). While 3 (18.8%) answers were correct but insufficient, 1 response (6.3%) contained false information and correct information. Our study revealed that ChatGPT answered 9 out of 10 questions about general information, diagnosis, treatment, and preventive and follow-up about glaucoma with acceptable and satisfactory accuracy rates. In addition, 3 of 4 answers given by ChatGPT were completely correct according to Terminology and Guidelines for Glaucoma.

A study on the distribution characteristics of peripheral retinal defocus in children and adolescents

Objective: To explore the distribution characteristics of peripheral retinal defocus in children and adolescents. Methods: This cross-sectional study included 500 individuals aged 3 to 18 years, who visited the People's Hospital of Lincang, the First Affiliated Hospital of Dali University and Dali Ophthalmology Hospital between January and December 2021. Data of the right eye of each participant was analyzed. There were 226 males (45.20%) and 274 females (54.80%), with an average age of (10.79±3.79) years. All participants underwent post-cycloplegic refraction, optical biometry, and intraocular pressure measurement to obtain spherical equivalent, average corneal curvature, axial length, and intraocular pressure. Multispectral refraction topography was performed to obtain topographic maps and values at various field angles and orientations of peripheral retinal defocus. Based on multispectral refraction topography, peripheral retinal defocus values were categorized as crater type, hemilateral upturn type, saddle type, and relatively flat type. The distribution of different refractive states was analyzed. Results: The spherical equivalent of the 500 participants was(-1.51±2.61) D, axial length was (24.10±1.28) mm, and average corneal curvature was (43.20±1.22) D. Among the 500 eyes, 382 exhibited hyperopic peripheral retinal defocus values, with 316 eyes (82.72%) being myopic. Myopic peripheral retinal defocus values were observed in 118 eyes, with 15 eyes (12.72%) being myopic. Among different types of peripheral retinal defocus values, 112 eyes (22.4%) exhibited a crater type, 153 eyes (30.6%) exhibited a hemilateral upturn type, 107 eyes (21.4%) exhibited a saddle type, and 128 eyes (25.6%) exhibited a flat type. The proportion of myopia was 82.14% (92 eyes), 69.28% (106 eyes), 60.75% (65 eyes), and 3.90% (5 eyes), respectively. The peripheral retinal defocus values at 15°, 30°, and 45° were (0.01±0.08) D, (0.06±0.21) D, and (0.20±0.37) D, respectively. The peripheral retinal defocus values at temporal, inferior, nasal, and superior locations were (0.58±0.69) D, (0.52±0.63) D, (0.21±0.64) D, and (-0.26±0.67) D, respectively. Notably, the superior primarily manifested as myopic, while the others were predominantly hyperopic. Conclusions: Approximately three-fourths of children and adolescents exhibit hyperopic peripheral retinal defocus values, with a higher prevalence of myopia in this subgroup. The hyperopia peripheral retinal defocus value increases with the distance from the retina to the macula. The peripheral retinal defocus values between superior and inferior, nasal and temporal locations are asymmetrical, with the temporal hyperopic peripheral retinal defocus value being most prominent and the superior myopic peripheral retinal defocus value being most evident.

Mono-canalicular Lacrimal Stent Intubation for Congenital Nasolacrimal Duct Obstruction Treatment

Background Epiphora, marked by tear overflow at the eyelid margin, is a prevalent condition in ophthalmology, affecting over 20% of infants. The causes involve hypersecretion due to anterior segment diseases or compromised lacrimal drainage systems. While congenital nasolacrimal duct obstruction (CNLDO) in children often resolves spontaneously, persistent cases may necessitate surgical intervention. The management, which includes probing, stent insertion, and dacryocystorhinostomy, remains challenging due to the miniaturized and variable anatomy of the lacrimal pathways. Objective and Aims This study aims to investigate the efficacy of mono-canalicular Lacrijet stent insertion in managing congenital nasolacrimal duct obstruction (CNLDO) in pediatric patients, particularly those aged over 24 months. It focuses on assessing success rates in cases with prior probing or no previous probing. The study aims to contribute valuable insights to the existing literature on the effectiveness of Lacrijet intubation as a management option for CNLDO. Patients and Methods A prospective observational study following 25 pediatric patients diagnosed with epiphora in an ophthalmology hospital. The procedure included using mono-canalicular Lacrijet intubation. Patients were followed for 180 days post-operatively via subjective and objective measures. Independent and paired t-tests were used for numerical variables. Chi-square was applied to check the significant association of variables with outcome. A p-value less than or equal to 5% is considered significant. Results More than half of the sample was 3-6 years of age (56%), males (52%), and had previous probing attempts (56%). Seven (28%) patients were relieved from symptoms within less than 5 days, 12 (48%) recovered within 5-9 days, and 2 (8%) patients were symptom-free after 10 days. The success rate was 84%. Only 4 patients (16%) had unsuccessful outcomes. There was no significant difference in outcome regarding patients’ age, gender, affected eye, previous probing, and site of intubation. Conclusions and Recommendations Mono-canalicular Lacrijet stent insertion appears as a simple, safe, and reliable outpatient procedure for treating CNLDO in children. Age and prior failed probing did not significantly impact success rates. Early and detailed assessments are recommended for children with epiphora, with consideration for mono-canalicular stenting. Future research could compare outcomes between probing and intubation as initial treatments for pediatric epiphora.