Refractive Defects Research Articles

Predicting intraocular pressure using neural networks: Incorporating image data and patient metadata from papila dataset

Aims/Purpose: This study aimed to explore the feasibility of predicting intraocular pressure (IOP) using a neural network model incorporating both image data and patient metadata. The objective was to evaluate the potential of this approach in improving the understanding and prediction of IOP levels in individuals, utilizing data from the PAPILA public database.Methods: We employed a dataset containing 331 images from the PAPILA database, with 298 images classified as normal and 33 diagnosed with glaucoma. Additionally, patient metadata such as glaucoma diagnosis status, age, sex, refractive defect, pachymetry, and axial length were incorporated. The dataset was divided into 70% for training the neural network model, 15% for validation, and 15% for testing.Results: The analysis of the neural network model's predictive performance produced the following metrics: Mean Absolute Error (MAE) of 2.515, Root Mean Square Error (RMSE) of 3.131, and Mean Absolute Percentage Error (MAPE) of 16.611%. These results indicate a moderate level of predictive capability for IOP based on the input data.Conclusions: In conclusion, our study demonstrates promising potential in utilizing artificial intelligence to predict intraocular pressure (IOP) using image data and patient metadata. While our model's predictive performance is moderate, it sets the stage for further advancements. With continued refinement and exploration of additional factors, AI‐driven approaches hold promise for revolutionizing glaucoma management.References Kovalyk O, Morales‐Sánchez J, Verdú‐Monedero R, Sellés‐Navarro I, Palazón‐Cabanes A, Sancho‐Gómez JL. PAPILA: Dataset with fundus images and clinical data of both eyes of the same patient for glaucoma assessment. Sci Data. 2022 Jun 9;9(1):291. doi: 10.1038/s41597‐022‐01388‐1. PMID: 35680965; PMCID: PMC9184612.

Adopting Machine Learning to Automatically Identify a Suitable Surgery Type for Refractive Error Patients

efractive error is a visual impairment that arises when the ocular anatomy hinders the proper focusing of light onto the retina, the light-sensitive tissue layer located at the posterior region of the eye. This condition poses difficulties in achieving clear vision. Refractive error stands as the prevailing kind of visual impairment. The objective of this study is to classify two surgical approaches utilized in the treatment of refractive defects. Two commonly performed refractive surgeries are Photo-Refractive Keratectomy (PRK) and Laser-Assisted In-Situ Keratomileusis (LASIK). Artificial Intelligence (AI) encompasses a specific branch known as Machine Learning (ML), which is the focal point of this investigation. ML is dedicated to the advancement and use of algorithms that possess the capacity to acquire knowledge from data and enhance their predictive capabilities without explicit programming. The present study employs sophisticated ML methods to classify different types of refractive defect surgeries using a dataset of 124 samples obtained from Al-Rabee Hospital in Iraq, specifically focusing on corneal topography data. Two ML approaches, namely K-Nearest Neighbor (KNN) and Artificial Neural Network (ANN), are employed to predict the kind of refractive defect surgery. The findings produced from the experiment demonstrated an accuracy rate of 90.32% for the KNN algorithm and a perfect accuracy rate of 100% for the ANN algorithm. Additionally, the KNN algorithm exhibited a sensitivity of 90% and a specificity of 90.54%. The study’s findings indicate that the ANN classifier outperforms the KNN classifier.

The Therapeutic Trip of Melatonin Eye Drops: From the Ocular Surface to the Retina.

Melatonin is a ubiquitous molecule found in living organisms, ranging from bacteria to plants and mammals. It possesses various properties, partly due to its robust antioxidant nature and partly owed to its specific interaction with melatonin receptors present in almost all tissues. Melatonin regulates different physiological functions and contributes to the homeostasis of the entire organism. In the human eye, a small amount of melatonin is also present, produced by cells in the anterior segment and the posterior pole, including the retina. In the eye, melatonin may provide antioxidant protection along with regulating physiological functions of ocular tissues, including intraocular pressure (IOP). Therefore, it is conceivable that the exogenous topical administration of sufficiently high amounts of melatonin to the eye could be beneficial in several instances: for the treatment of eye pathologies like glaucoma, due to the IOP-lowering and neuroprotection effects of melatonin; for the prevention of other dysfunctions, such as dry eye and refractive defects (cataract and myopia) mainly due to its antioxidant properties; for diabetic retinopathy due to its metabolic influence and neuroprotective effects; for macular degeneration due to the antioxidant and neuroprotective properties; and for uveitis, mostly owing to anti-inflammatory and immunomodulatory properties. This paper reviews the scientific evidence supporting the use of melatonin in different ocular districts. Moreover, it provides data suggesting that the topical administration of melatonin as eye drops is a real possibility, utilizing nanotechnological formulations that could improve its solubility and permeation through the eye. This way, its distribution and concentration in different ocular tissues may support its pleiotropic therapeutic effects.

Alteration Ocular Motility in Retinitis Pigmentosa: Case-Control Study.

To evaluate ocular motility (OM) disorders and strabismus in a sample of patients with retinitis pigmentosa (RP) and a control sample. In this cross-sectional retrospective analysis, we studied a sample of RP patients with a mean age of 48.74 years and an average visual acuity of 7/10 based on Snellen optotype and a sample of control patients with similar mean age (49 years [men], 47 years [women]) and sex and an average visual acuity of 9.9/10, with the aim of assessing correlations between alteration of OM and strabismus in RP patients based on age, high refractive defect, or severely impaired binocular vision. The examination followed a protocol of testing for anamnesis and best-corrected visual acuity, as well as a complete eye examination, corneal reflex, cover test, OM, Hess screen, and Lang test. At the first orthoptic evaluation, 45.16% of patients showed strabismus, 41.93% exotropia (25% of cases intermittent), 3.22% esotropia, and 6.45% vertical deviation. Later evaluation showed strabismus in 25.80% of patients, exotropia in 19.35% (9.67% intermittent), esotropia in 3.22%, and vertical deviation in 3.22%. Assessment of eye motility study showed 51.6% overaction of the inferior oblique and hypofunction of the superior rectus, and 18% overaction of the lateral rectus and hypofunction of the medial rectus. According to our results, alterations in OM and strabismus in RP patients are not correlated with age or high refractive defect. Therefore, motility disorders and strabismus are attributed to a genetic factor to which men are more susceptible. The incidence of OM disorder was 77.42%, and strabismus was present in 45.16% of patients.

The Prevalence of Refractive Errors Among Middle-Class Kids in and Around Dehradun

Background: Children living in countries with moderate income levels, such as India, who are born with untreated refractive abnormalities continue to face significant challenges. Despite the availability of low-cost remedial techniques like eyeglasses, uncorrected refractive defects cause vision loss for many children in India. This persists even though glasses may correct the problem. Aim: The aim of the present study is to investigate whether children from middle-income families exhibit any refractive errors. Materials & methods: The researchers conducted the present study after receiving approval from the institution’s ethics board. The research was carried out at Gautam Budha Chikitsa Mahavidyalaya, Jhajra, Dehradun, India. The study enrolled children from middle-income groups in and around the Dehradun city area. Results & Conclusions: The study revealed that refractive errors are the leading cause of visual impairment among school-age children, particularly those from middle-income families. Given that most refractive defects can be corrected with glasses, there is a need for cost-effective strategies to safeguard children’s eyesight. Such disabilities might impede a child’s development and education. There is compelling evidence supporting this treatable cause of blindness.

Prevalence and Patterns of Refractive Error Among School-Age Children in Bisha, Saudi Arabia.

A widespread and serious eye condition is a refractive error (RE). Globally, uncorrected refractive defects affect numerous individuals, with some who are blind. Numerous studies in Saudi Arabia have been conducted to assess reflective error. However, there is a lack of knowledge regarding RE among school-agechildren in Bisha province, southwest Saudi Arabia. This study aimed to determine the prevalence and types of RE among school-age children in Bisha, Saudi Arabia. A cross-sectional study involved 360 schoolchildren from primary schools was carried out between December 2022 and November 2023 in Bisha. A validated questionnaire form was used to collect sociodemographic information and clinical data (history of the ocular problem, visual acuity test findings, and the refractor machine's result). A total of 360 schoolchildren aged from seven to 14 years, with a mean of 10.1 years (standard deviation (SD)=2.05). The prevalence of hyperopia was 21% in the right eyeand 23% in the left eye. In addition, the prevalence of myopia was 20% in the right eye and 22.5% in the left eye. A significant association between visual acuity and myopia (p=0.001). By contrast, there was no significant correlation between hyperopia and visual acuity (p=0.412). The current study summarized the prevalence of REs among school-age children in Bisha, Saudi Arabia.The study population included nearly half of those with at least some degree of RE. These results highlight the need for prompt and careful screening programs to detect and treat refractive disorders across this age range.

Training in retinoscopy: learning curves using a standardized method

BackgroundRetinoscopy is one of the most effective objective techniques for evaluating refractive status, especially in non-cooperative patients. However, it presents a slow learning curve that often leads to student frustration. With the current Covid-19 pandemic and the need for social isolation, clinical education based on simulation has become more relevant. Therefore, we implemented retinoscopy laboratories and learning protocols to reduce student stress and learning time.MethodsWe conducted a study to evaluate the retinoscopy learning curve using a new training protocol proposal. One hundred trainees were assessed in four stages, corresponding to 08, 12, 16, and 20 hours of training. Six different refractive defects were used trying to reproduce frequent conditions of care. The time spent on the assessment was not considered as additional training time. To analyze the data, we used non-parametric statistics and linear regression to assess the variables associated with training time and performance rate.ResultsThe mean performance score at 08 hrs was 32.49% (±16.69 SD); at 12 hrs was 59.75% (±18.80 SD); at 16 hrs was 70.83% (±18.53 SD) and at 20 hrs was 84.26% (±13.18 SD). Performance at 12 hrs was significative higher than 08 hrs of training, but did not show significant differences with the performance rate at 16 and 20 hrs. We found a strong positive correlation between performance and training time in retinoscopy (R = 0.9773, CI: 0.2678 - 0.9995 p = 0.0227).ConclusionThis study showed that an increasing number of hours of practice positively correlates with performance in retinoscopy. The elaboration of a protocol and standardization of performance per hour also allowed us to estimate that a minimum of 13.4 hrs of practice is required to achieve 60% performance. Using the resulting formula, it is possible to determine the number of hours of retinoscopy practice are necessary to reach a certain level of performance.

Different Eye Exercises for Refraction Defects of the Eye

Işık ışınlarının, ortamlar arası yoğunluk farkı nedeni ile ortam değişikliğine uğrarken hızını ve açısını değiştirmesi refraksiyon (kırılma) olarak isimlendirilir. Gözde bulunan refraksiyon kusurları miyopi, astigmatizma, hipermetropi ve presbiyopi olarak sınıflandırılabilir. Çeşitli yayınlarda, göz refraksiyon kusurlarının görülme sıklığının değiştiği bildirilmiştir. Literatürde yer alan birçok çalışmaya göre, konverjans yetmezliği, akomodasyon disfonksiyonu, gözün hareket bozuklukları, dijital göz yorgunluğu ve göz kuruluğu gibi birçok durumda göz egzersizleri herhangi bir komplikasyon oluşturmaksızın önleyici ve tedavi edicidir. Göz egzersizleri ile oküler bölgede kan dolaşımı artmakta, hümör dolaşım uyarılmakta, ekstraoküler kasların gerilimi azalmakta, göz kasları arasındaki koordinasyon artmakta, göz yorgunluğu ve stres azalmaktadır. Bu etkilerin sonucuna bağlı olarak da görme problemleri üzerinde olumlu yönde değişiklikler görülmektedir. Çalışmalar incelendiğinde genel olarak yoga göz egzersizleri, göz egzersiz protokolü, konverjans göz egzersizleri, okülomotor egzersiz protokolü, kalem takip terapisinin uygulandığı tespit edilmiştir. Bu derlemede literatürde gözün refraksiyon kusurlarında farklı göz egzersizlerini içeren çalışmalar incelenmiş, bu egzersizlerin etkileri ve uygulama yöntemleri özetlenmiştir. Literatürde bu konuda sınırlı sayıda çalışma bulunmaktadır. Bu derlemenin, bu alanda yapılacak çalışmalara ışık tutarak, literatüre ve klinisyenlere katkı sağlayacağı düşünülmektedir.

A Numerical Study on the Effects of Laser Refractive Surgery: SMILE vs PRK

In the last two decades, corneal laser surgery has become a common procedure to correct medium-low refractive defects. It consists of reshaping the corneal geometry by means of a laser in order to correct the present refractive error. In this work, we compare the opto-mechanical performance of two laser surgery procedures: Photorefractive Keratectomy (PRK) and Small Incision Lenticule Extraction (SMILE).

EFFECT OF AKSHI TARPANA IN TIMIRA W.S.R TO MYOPIA: CASE REPORT

Ocular conditions are now more prevalent than ever due to an increase in dependence on digital devices brought on by technological advancement. Of those, myopia is the most prevalent. Excessive screen usage is one of the primary risk factors for refractive problems. The majority of refractive problems are easily treated in primary care using eyeglasses. Spectacles are merely a temporary fix. Refractive defects are now treated with eyeglasses, contact lenses, radial keratotomy, photorefractive keratectomy, and laser in-situ keratomileusis (LASIK). So, taking a look at the traditional Ayurvedic text A method of treatment used to treat Timira is called Akshi Tarpana. This article sheds light on the impact of Akshi Tarpana in Timira through a single case study.

Functional results in children with retinopathy of prematurity treated with intravitreal bevacizumab

Background/aimThe aim of the study is to describe the efficacy and to determine the functional outcome in terms of visual acuity and refractive defect of a single dose of intravitreal bevacizumab in patients with high-risk ROP type 1. MethodsIn this retrospective clinical study patients diagnosed between December 2013 and January 2018 with high-risk pre-threshold ROP type 1 and treated with intravitreal bevacizumab were selected. All patients were treated following the established protocol at our centre. Those patients with less than three-year follow-up were excluded. Visual acuity and cycloplegic refraction in the last visit were registered. Treatment efficacy was defined as the absence of retreatment with intravitreal anti-VEGF or laser during follow-up. ResultsA total of 38 infants (76 eyes) were included in the analysis. Twenty infants (40 eyes) completed visual acuity testing. Mean age was 6 years (IQR: 4–9). Median visual acuity was 0.8 (IQR: 0.5–1). Thirty-four eyes (85%) had good visual acuity (greater than or equal to 0.5). Thirty-seven patients (74 eyes) had cycloplegic refraction measured. Median spherical equivalent at the last visit was +0.94 (IQR: –0.25; 1.88). Treatment success rate was 96.05%. ConclusionIntravitreal bevacizumab treatment showed good functional outcome in patients with high-risk ROP type 1. In our study, good response to treatment was observed with a success rate over 95%.

The Magnitude of Refractive Error and Its Associated Factors Among Patients Visiting Ophthalmology Clinics in Southern Ethiopia, 2022.

Refractive error is a vision-impairing condition due to light rays not being able to focus on the retina, resulting in the visual outcome of a cloudy image. It is one of the main causes of central vision impairment globally and in Africa, including Ethiopia. This study was conducted to assess the magnitude of refractive error and its associated factors among patients attending ophthalmic clinics. An institutional-based cross-sectional study design was utilized. A systematic random sampling technique was applied to select 356 participants. The data were gathered using an interview-structured questionnaire and check list. Then, the data were entered into Epi-data version 4.6 and transferred to SPSS version 25 for further clean up and analysis. Descriptive and analytical statistics were conducted. A binary logistic regression analysis was done, and variables with a p-value of less than 0.25 in univariate analysis were taken for bivariate analysis. Statistically significant was declared at a p-value of less than 0.05 with an adjusted odds ratio and 95% confidence interval. Among 356 participants, 96 (27.5%), with 95% CI (22.8, 32.1) had a refractive error, of which nearsighted is the most common type (15.8%). Regular use of electronic devices, near working distance (<33cm), less or lack of outdoor activities, history of diabetes mellitus and family history of refractive error were factors significantly associated with refractive error. The magnitude of refractive error was 27.5%, which is relatively elevated than the previous studies. Clients need to get screened regularly so that refractive defects can be detected and corrected early. Eye care professionals shall make a big concern for patients with a history of diabetes and other medical illnesses since they are related to ocular refractive defects.

Resultados funcionales de tratamiento con bevacizumab intravítreo en pacientes con retinopatía del prematuro

Background/aimThe aim of the study is to describe the efficacy and to determine the functional outcome in terms of visual acuity and refractive defect of a single dose of intravitreal bevacizumab in patients with high-risk ROP type1. MethodsIn this retrospective clinical study patients diagnosed between December 2013 and January 2018 with high-risk pre-threshold ROP type1 and treated with intravitreal bevacizumab were selected. All patients were treated following the established protocol at our centre. Those patients with less than three-year follow-up were excluded. Visual acuity and cycloplegic refraction in the last visit were registered. Treatment efficacy was defined as the absence of retreatment with intravitreal anti-VEGF or laser during follow-up. ResultsA total of 38 infants (76eyes) were included in the analysis. Twenty infants (40eyes) completed visual acuity testing. Mean age was 6years (IQR: 4-9). Median visual acuity was 0.8 (IQR: 0.5-1). Thirty-four eyes (85%) had good visual acuity (greater than or equal to 0.5). Thirty-seven patients (74eyes) had cycloplegic refraction measured. Median spherical equivalent at the last visit was +0.94 (IQR: −0.25; 1.88). Treatment success rate was 96.05%. ConclusionIntravitreal bevacizumab treatment showed good functional outcome in patients with high-risk ROP type1. In our study, good response to treatment was observed with a success rate over 95%.

A Study on Refractive Error in Patients of Chennai City in India during Covid 19 Pandemic Period

Objectives: To compare the results of techniques Decision Tree, Discriminant, KNN, SVM applied to pre Covid-19 data collected in 2018 and data collected during Covid-19 pandemic period (2020) patients in Chennai city. Methods: The variables in the data are Refractive Error in both left and right eye, Age, Gender, Educational Status, Employment Status, Nature of Job, Working Hours, Working with Computer, Watching TV, Sleeping Hours, Type of Food, Extra Activity, Light in Residence, Light in Work Place, Family Members Wearing Specs, Parents Wearing Specs, Other Disease and Other eye disease. Findings: In this study, 22 classification algorithms were applied to the data, and accuracy results as well as comparisons in two distinct sample sizes were obtained. Although adhering to the strict lockdown regulations helps to prevent the spread of COVID-19, it also negatively affects the visual health of those who are confined to their homes and have limited access to outdoor activities, leading to an excessive confidence on digital screens for studies or leisure. Novelty: Due to public health restrictions, the present Covid 19 pandemic has altered people’s social lives all around the world. As a result, kids have spent more time in front of computer and television monitor screens, which is bad for their eyes. Refractive error affects a significant number of patients in Chennai. Across all kinds of refractive defects, myopia, hyperopia, astigmatism, and presbyopia constitute the most prevalent. Keywords: Covid19; Refractive error; KNN; SVM; Decision Tree; Discriminant

A Study to Analyze Refractive Errors in Relation to Age and Sex.

Background and objective Refractive defects should be detected and treated early to avoid irreversible vision lossand other potential problems in the future. In this study, we aimedto analyze the refractive errors (REs) and their relationship with gender and age. Methods This study was conducted at the Northern Border University Health Center, Arar, Saudi Arabia. REs were analyzed using spherical equivalents (SEs), cylinders, and their orientations. SEs of REs were taken as half the cylinder plus the spherical component. Emmetropia was defined as SE between -0.50 and +0.50 diopter sphere (DS), myopia as SE ≤0.50 DS, and hyperopia as SE ≥0.50 DS for adults and SE ≥1.0 for children (up to 10 years). Statistical analysis was performed using the IBM SPSS Statistics software package (IBM, Armonk, NY). Qualitative data were presented as frequency and percentage while quantitative data were presented as mean and standard deviation (SD). Chi-squarewas used as a significant test and a p-value <0.05 was considered statistically significant. Results A total of 240 patients were included in the study. There were138 men and 102 females aged 3-60years (57.5 and 42.5%, respectively). The mean age of males was 24.4 years and that of females was 25.5 years.The p-value was statistically significant in terms of analysis with age. The study found an association between age and RE magnitude and variability. Conclusion Based on our findings, RE is a common problem that affects individuals of all ages. Regular screenings are advised for individuals in order to detect REs early.

Evaluation of the Prevalence of Refractive Defects and Ocular Function in a Group of 1518 Children Aged 8 Years in Northwestern Poland-A Retrospective Study.

To determine the prevalence of refractive errors in a group of 8-year-old school children in northwestern Poland. In 2017-2019, refractive errors were examined in a group of 1518 Caucasian children aged 8 years old with cycloplegia. Refraction was obtained with a hand-held autorefractor (Retinomax 3). The refractive error reading was expressed as the spherical equivalent (SE) as myopia (≤-0.5 D), emmetropia (>-0.5 D to ≤+0.5 D), mild hyperopia (>+0.5 D to ≤+2.0 D) and hyperopia (>+2.0 D), and astigmatism (≤-0.75 DC) and anisometropia (≥1.00 D). Data analysis was performed using Statistica 13.5 software and included Pearson's chi-squared and Mann-Whitney U tests. p-values of <0.05 were considered statistically significant. Mild hyperopia was most common (37.6%), myopia was observed in 16.8% and astigmatism in 10.6% of participants. Pseudomyopia concerned up to 51.91% children. Girls were significantly more likely to have mild hyperopia (p = 0.0144) and were significantly more likely to wear glasses (p = 0.00093). Screening children for refractive errors after cycloplegia is key for detecting accommodative spasm and refractive errors. The largest group of children presented with mild hyperopia, which is a physiological feature of refraction in 8-year-old children, but myopia and astigmatism were the most common refractive errors.

Refractive and Topographic Parameters of the Belin/Ambrósio Module in Patients with Refractive Defects in Cuenca, Ecuador

Objective: This study aimed to describe the refractive and topographic parameters of the Belin/Ambrósio module in patients with refractive defects at the Latino clinic in Cuenca, Ecuador, between 2017 to 2021. Methods: A descriptive, cross-sectional study was carried out. A database included anonymous cases of patients with refractive defects treated at the ophthalmological consultation of a Latino clinic from January, 2017 to June, 2021 was searched. Data was collected using a form containing study variables. Microsoft Excel and SPSS were used for data collection and analysis using frequencies, percentages, and measures of central tendency. Results: The sample consisted of 120 patients; 61.7% were women, and 38.3% were men. Moreover, 70.8% of patients were young adults. The pachymetry mean of the center of the pupil, apex, and position of lowest pachymetry was 521 µm, 520 µm, and 513 µm, respectively. The means of the flattest keratometry, curviest keratometry, and maximum keratometry were 43.30 D, 46.32 D, and 48.01 D, respectively. Conclusion: Cases distribution according to anterior and posterior elevation showed pathological values ​​in more than 50% of the studied corneas. According to the average progression index, pathological elevation was found in 18.8% of the cases, and according to the average deviations, 25.4% presented corneal ectasia in different stages.

Targeting Mast Cells: Sodium Cromoglycate as a Possible Treatment of Lipedema.

Mast cells are immune cells that mediate hypersensi-tivity and allergic reactions in the body, secreting histamine and other inflammatory molecules. They have been associated with different inflammatory conditions such as obesity and other adipose tissue di-sorders. Lipedema is a chronic disease characterized by an abnormal accumulation of adipose tissue on the legs and arms, pain, and other symptoms. Mast cells may play a role in the pathology of lipedema. Pilot study to determine levels of histamine and its metabolites in lipedema subcutaneous adipose tissue (SAT) biopsy samples, and to test sodium cromoglycate for the treatment of mast cells in women with lipedema. Biopsies from lipedema and control SAT were collected and analyzed histologically for the presence of mast cells. Mass spec-trometry was used to measure the levels of histamine, a key marker of mast cells, and its metabolites in SAT in women with lipedema and controls, and after a group of women with lipedema were administered oral and topical doses of sodium cromoglycate for two weeks. Histological examination of biopsies from lipedema patients confirmed the presence of mast cells. Metabolomic analysis revealed high levels of histamine and its metabolites in samples from women with lipedema compared to controls. Following a two-week treatment period, lipedema tissue samples exhibited reduced levels of histamine, suggesting a reduction of mast cell activity. Sodium cromoglycate has the ability to stabilize mast cells and reduce histamine levels in lipedema patients, which could be useful in lowering the symptoms of lipedema.

Dry eye in primary care: the relationship between digital display device usage and dry eye syndrome (DES) in medical students.

As digital display devices become more and more indispensable, associated health problems have started to increase. We aimed to investigate the frequency and relationship of digital display device usage behaviours and dry eye syndrome (DES) in medical students. An observational, cross-sectional study was conducted on medical school students who voluntarily participated in our study online, about the duration and variety of their digital screen use, usage patterns, and protective measures, together with the Ocular Surface Disease Index (OSDI) questionnaire. Where necessary, the Schirmer-I, tear break-up time, and fluorescein staining tests were carried out. Of the 255 participants, 75.3% (n = 192) were female, 63.1% (n = 161) had no refractive vision defects, and 45.9% used smartphones for more than 5 h a day. According to the OSDI scores for DES screening, only 36.1% of the participants were normal, 17.3% had mild DES, 20.4% had moderate DES, and 26.3% had severe DES. A positive correlation was found between digital display usage time in hours per day and a high OSDI score. As the distance between the eye and the screen decreased, the DES score increased, which is significant for computer, e-book, and tablet use (P < 0.005). The DES rate of the 25 participants who underwent further evaluation was 40% for the tear break-up time test and 52% for the fluorescein staining test. The high prevalence of DES due to digital screen use among medical school students highlights the importance of DES screening as a preventive measure in family medicine.

Distribution Analysis of Refraction Defects in Prescriptions in Terms of Opticians: the Case of Karaman Province

The aim of this study is to analyze and evaluate refraction errors in prescriptions written in foundation and state hospitals in Karaman province. 213 people who applied to an ophthalmologist in the province of Karaman and were given prescriptions were included in the study. Of the 213 people included in the study; 126 (59.15%) are women, 87 (40.85%) are men. Near and far eyeglasses data on prescriptions were divided into 7 groups as simple myopia, simple hyperopia, simple myopic astigmatism, simple hyperopia astigmatism, composite myopic astigmatism, compound hyperopia astigmatism, and mixed astigmatism. In the near-eyeglass right glass refraction defects analysis in the research; simple hypermetropia was the most common with 22.06%, while the least common simple myopic astigmatism was detected with 0.94%. In the near eyeglass left eyeglass refraction defects analysis; while mixed astigmatism was the most common with 22.53%, it was determined that it was the least seen simple myopic astigmatism with 0.47%. In the far eyeglass right glass refraction defects analysis; compound myopic astigmatism was the most common with 30.98%, and the least common was simple hypermetropic astigmatism with 2.35%. In the far eyeglass left eyeglass refraction defects analysis; compound myopic astigmatism was the most common with 29.11%, while the least common was simple hypermetropic astigmatism with 2.35%. The research is important due to it is the first study to examine the refractive error distribution in Karaman.