Spectacle Wear Research Articles

Using face masks with spectacles versus contact lenses

PurposeTo test the hypothesis that various subjective ocular and task-related parameters associated with wearing a face mask would be better in neophyte contact lens (CL) wear compared to habitual spectacle (Sp) wear. MethodsThirty participants were randomised to continue in Sp (n = 15) or wear somofilcon A daily disposable CL (n = 15) (‘group’). A surgical face mask (Type II R) was worn for at least one hour per day on four or more days per week. After two weeks, participants completed the Quality of Life Impact of Refractive Correction Questionnaire (QIRC), a two-part face mask usability questionnaire and graded ocular-related symptoms using 0–100 visual analogue scales. ResultsThere was no difference between groups for overall QIRC score but some individual question scores reflected better quality of life in the CL: ‘outdoor activities’, ‘keep fit’ and ‘able to do things’ (all p < 0.05). Differences in favour of the CL were seen for the following in the face mask usability questionnaire: ‘breathing’, ‘heat’, ‘comfort on ears’, ‘overall comfort’, ‘walking’, ‘driving’, ‘reading’, ‘computer use’, ‘exercising’ and ‘socialising’ (all p < 0.05). Significant differences were also seen for the 0–100 VAS symptoms probing vision quality in favour of the CL: glare, distance and near vision, fogging, restricted field of view and peripheral blur. ConclusionThis work supports anecdotal reports that CL are a better vision correction option than Sp when used in conjunction with a face mask. Participants reported a range of benefits to the CL/face mask combination for vision-related symptoms, breathing and heat-related symptoms and a number of day-to-day activities including walking, driving and exercising. All of the benefits relating to the CL are likely to result in improved adherence to face mask use. Overall, the findings of this work suggest that where possible, CL should be the preferred vision correction option for people using face masks.

Reliability and Validity of the Persian Version of Quality of Life Impact of Refractive Correction Questionnaire.

Purpose:To evaluate the psychometric properties of the Persian version of quality of life impact of refractive correction (QIRC) questionnaire and its utility in assessment of refractive error-related quality of life (QoL) following photorefractive keratectomy (PRK).Methods:Patients with low-to-moderate myopia (−0.75 to − 6.0) were enrolled in this study. Standard alcohol-assisted PRK was performed in all patients. The QIRC questionnaire was translated into a Persian version using the standard method. Patients completed QIRC questionnaire preoperatively and 3-month postoperatively. A group of patients completed the questionnaire twice preoperatively. Psychometric properties were evaluated by internal consistency (Cronbach's α), item-total correlation, and known group construct validity. Intraclass correlation coefficient (ICC) were used to examine the repeatability.Results:One hundred forty-seven patients (60 males and 87 females) with a mean age of 26.3 ± 5.5 (range, 18–39) years were enrolled. Cronbach's α for total score was 0.923. Item-total correlation was above 0.3 for all items. ICC was 0.978 for total score. Preoperatively, predominantly contact lens wearers showed significantly better total QIRC score than predominantly spectacle wearers (P = 0.017), which showed good known group validity. Total QIRC score significantly increased from 41.31 ± 6.69 preoperatively to 50.47 ± 7.26 postoperatively (P < 0.0001). Improvement in total QIRC score was observed both in contact lens wearers and spectacle wearers.Conclusion:The Persian version of QIRC questionnaire is a valid and reliable tool. Refractive error-related QoL assess by QIRC was significantly improved after PRK in an Iranian population.

Knowledge and practices of teachers about child eye healthcare in the public sector in Swaziland

Background: Vision-related problems have a negative impact on the learning abilities and school performance of a child. Adequate knowledge and practices of teachers enable the early identification and intervention of school children with visual deficits.Aim: This study aimed to investigate the knowledge and practices of teachers about child eye healthcare in the public education system in Swaziland.Setting: The setting for this study was Swaziland.Methods: This was a cross-sectional quantitative study using a survey instrument containing closed-ended questions to investigate the knowledge and practices of teachers about child eye health in the public sector.Results: Two hundred and forty-three (N = 243) teachers responded to the questionnaire. The majority (90.1%) of teachers indicated that they were able to detect signs and symptoms of eye diseases. Most teachers without a family member wearing spectacles were more likely to be informed about eye health (p = 0.001) than those who had family wearing spectacles. A significant proportion (44%) of teachers indicated that refractive errors were not serious among school children. Above one-third (38.7%) of the teachers indicated that they referred children with vision problems to public hospitals. One hundred and fifty-five (63.8%) reported that health officials have never visited their schools. One hundred and forty-nine (61.3%) teachers agreed that they did not monitor children wearing spectacles and 94 (38.7%) monitored them. Monitoring children wearing spectacles was significantly associated with teachers who indicated being well informed about eye health (p 0.001) and teachers who were more likely to advise parents to take their children for eye testing (p = 0.003).Conclusion: The lack of adequate knowledge by some teachers may contribute to the already existing barriers for children to access eye health. Addressing the broader issues of child eye health requires the participation of well-trained and knowledgeable teachers.

How Contact Lenses Have Influenced Research Developments in Optics and Vision Science

Initially, contact lenses were developed as the only viable option to provide improved vision for patients suffering from conditions which distortedthe corneal surface in an irregular fashion, rendering spectacle correction an unsatisfactory option. Developments in materials, fitting methods andmanufacturing technologies soon made contact lenses an appealing option for all spectacle wearers, particularly with the development of toricand multifocal lens options. Although the optical challenges of contact lenses appeared to be relatively straightforward in their early years, thedevelopment of improved in-vivo diagnostic and in-vitro metrology instrumentation led to a significantly greater understanding of the nature of theoptical errors (e.g. higher order wavefront aberrations) of the eye and contact lenses and the interactions between them when worn. The featuresof contact lenses having extremely steep curvatures and being aligned closely to the eye’s visual axis in all positions of gaze provide both uniquechallenges and opportunities for improving the visual performance of both physiological and pathological eyes, and have guided the efforts ofsignificant vison science research in more recent times.

Factors affecting non-compliance to spectacle wear in children aged six years and below with refractive errors: A hospital based cross-sectional study in India

Uncorrected refractive errors (RE) are the most common cause of preventable visual Impairment (VI) in children, which if not treated in time can lead to amblyopia. VI in early childhood interferes with their overall development affecting their future opportunities in life. Spectacles remain the most popular and effective method for correction of RE. Children unlike adults, often don’t understand the need for wearing spectacles, thus prescribing spectacles in children becomes difficult. Aim of this study was to find out proportion of spectacle wear non-compliance in children aged six years and below and identify factors associated with it. The study was conducted among 115 children aged six years and below with refractive errors who were prescribed spectacle correction. Children were selected using simple random sampling. Multivariate logistic regression was used to identify independent factors associated with spectacle wear non-compliance. Proportion of spectacle wear non-compliance was 53.04%. Children with spectacle wear non-compliance were more likely to: belong to age of two to four years (AOR = 4.3; 95%CI: 1.3-14.3); have mother with up-to primary school education (AOR = 3.7; 95%CI: 1.2-11.7); have anisometropia (AOR = 11.1; 95%CI: 3.4-36.7). Statistically significant association was observed between spectacle wear non-compliance and child’s age, mother’s education, anisometropia, astigmatism, manifest squint, intolerance to glasses, glasses lost, glasses broken, concerned teasing and cost issues. Children less than four years of age; with anisometropia and those whose mothers had up-to primary school education were more likely to be non-compliant to spectacle wear.

Self-reported radiation safety behaviors among veterinary specialists and residents performing fluoroscopic procedures on small animals

To describe the radiation safety behaviors of veterinary specialists performing small animal fluoroscopic procedures and examine potential risk factors for these behaviors, including knowledge of radiation risk and training regarding machine operating parameters. 197 veterinary specialists and residents in training. An electronic questionnaire was distributed to members of the American Colleges of Veterinary Internal Medicine (subspecialties of cardiology and small animal internal medicine), Veterinary Radiology, and Veterinary Surgery. The overall survey response rate was 6% (240/4,274 email recipients). Of the 240 respondents, 197 (82%) had operated an x-ray unit for a small animal fluoroscopic procedure in the preceding year and fully completed the questionnaire. More than 95% of respondents believed that radiation causes cancer, yet approximately 60% of respondents never wore hand or eye protection during fluoroscopic procedures, and 28% never adjusted the fluoroscopy machine operating parameters for the purpose of reducing their radiation dose. The most common reasons for not wearing eye shielding included no requirement to wear eyeglasses, poor fit, discomfort, and interference of eyeglasses with task performance. Respondents who had received training regarding machine operating parameters adjusted those parameters to reduce their radiation dose during procedures significantly more frequently than did respondents who had not received training. On the basis of the self-reported suboptimal radiation safety practices among veterinary fluoroscopy users, we recommend formal incorporation of radiation safety education into residency training programs. All fluoroscopy machine operators should be trained regarding the machine operating parameters that can be adjusted to reduce occupational radiation exposure.

Objective Assessment of Spectacle Wear in Infants and Toddlers Using a Wearable Sensor.

PurposeTo assess the feasibility of using a thermal microsensor to monitor spectacle wear in infants and toddlers, to determine the inter-method reliability of two methods of estimating spectacle wear from sensor data, and to validate sensor estimates of wear.MethodsFourteen children, 3 to <48 months of age, and one adult were provided pediatric spectacles containing their spectacle prescription. A thermal microsensor attached to the spectacle headband recorded date, time, and ambient temperature every 15 minutes for 14 days. Parents were asked for daily spectacle wear reports, and the adult recorded wear using a smartphone app. Sensor data were dichotomized (wear/non-wear) using two methods: temperature threshold (TT) and human judgment (HJ). Kappa statistics assessed inter-method reliability (child data) and accuracy (adult data).ResultsData from two child participants were excluded (one because of corrupted sensor data and the other because of no parent log data). Sensor data were collected more reliably than parent wear reports. The TT and HJ analysis of child data yielded similar reliability. Adult sensor data scored using the HJ method provided more valid estimates of wear than the TT method (κ = 0.94 vs. 0.78).ConclusionsWe have demonstrated that it is feasible to deduce periods of spectacle wear using a thermal data logger and that the sensor is tolerated by children.Translational RelevanceResults indicate that it is feasible to use a thermal microsensor to measure spectacle wear for use in clinical monitoring or for research on spectacle treatment in children under 4 years of age.

Barriers and Perception Towards Spectacle Wear among a Student Population of University of Buraimi, Oman.

ObjectivesThe study aimed to evaluate the barriers and perceptions towards spectacle wear among the student population of the University of Buraimi, Oman.MethodsA descriptive, questionnaire-based and cross-sectional study was conducted between December 2017 and May 2018. Ophthalmic examination and a standard spectacle prescription protocol were used to identify those with inappropriate spectacle coverage. A self-designed and expert validated English-language questionnaire was utilised. A chi-square test was used to assess the association between the participants’ types of perceptions and sociodemographic and refractive error-related profiles.ResultsIn total, 275 students participated in the study (response rate: 17.19%) and 170 (61.8%) were having inappropriate spectacle correction. Only 26% of them used spectacles since the majority (73.5%) had never had their eyes examined before this study. Most perceived spectacle wear positively (53.5%), followed by some having negative (36.5%) or neutral (10.0%) perceptions. Those from a health science background including Nursing and Optometry had a higher positive perception towards spectacle wear than others (P = 0.012). The difference in the perception scores between myopic and hypermetropic refractive error groups was statistically insignificant (P = 0.882).ConclusionThe majority of the participants had had inappropriate vision corrections with spectacles and not undergone any prior ocular examinations. Few wore spectacles; however, these were inappropriate given their current refractive status. The reasons for spectacle non-wear were that either new spectacles had been ordered or spectacles were lost or broken. It is recommended that the school eye health initiative be extended to the university level. A holistic eye-health promotional approach toward integrating students, teachers and parents into this initiative can improve spectacle wear within the studied population.

Excimer laser keratectomy for hyperopia in special needs children: longer-term outcomes

We report the results of excimer laser photorefractive keratectomy (PRK) for hyperopia in special needs children who are intolerant of spectacle wear or contact lenses.

Teacher and school staff perspectives on their role in school-based vision programs

ObjectiveSchool-based vision programs (SBVPs) are one approach to increase access to vision care by providing vision screenings, eye examinations, and eyeglasses directly in schools. Few studies report on the perspectives of teachers and staff, who are important stakeholders, on SBVPs. We examined teacher and staff perspectives on their involvement in SBVPs. DesignQualitative study using focus groups. ParticipantsTeachers and staff at Baltimore and Chicago public schools served by SBVPs between 2016 and 2018. MethodsWe conducted 21 semistructured focus groups with 117 teachers and staff in 10 Baltimore and 11 Chicago public preK–12 schools that participated in SBVPs. Sessions were recorded, transcribed, and coded using inductive thematic analysis. ResultsParticipants identified 2 main themes regarding teacher and staff involvement in SBVPs: (i) program outreach, including using multiple communication modalities to engage parents, explaining program details to families, and helping with program consent form return and (ii) promoting vision health, including identifying vision problems in the classroom, encouraging eyeglasses wear, and supporting eyeglasses maintenance. Participants also discussed limitations in capacity to partake in these activities. ConclusionTeachers interact with parents and students throughout the SBVP process, undertaking important roles in outreach and health promotion to ensure uptake of SBVP services. SBVPs and other school-based health programs should explore strategies to support teachers in the roles they fill to optimize program impact.

Visual outcomes and safety of an extended depth-of-focus intraocular lens: results of a pivotal clinical trial.

To compare the effectiveness and safety of the TECNIS Symfony intraocular lens (IOL; ZXR00) with the TECNIS 1-piece monofocal IOL (ZCB00). 15 sites in the United States. Prospective, randomized, patient-masked/evaluator-masked clinical trial. Randomized participants received either the ZXR00 or ZCB00 IOL bilaterally. The 6-month postoperative outcomes included monocular and binocular distance, intermediate, and near visual acuity (VA), spherical equivalent refraction and refractive cylinder, spectacle wear, and visual symptoms. Overall, 299 patients were implanted with a study IOL (ZXR00 IOL, n = 148; ZCB00 IOL control, n = 151). At the 6-month follow-up, mean binocular uncorrected distance VA was comparable between ZXR00 and ZCB00 IOL recipients (P = .1011). The ZXR00 IOL group had significantly better mean binocular uncorrected intermediate VA and uncorrected near VA (both P < .0001) than the ZCB00 IOL group. The mean binocular distance-corrected intermediate VA and distance-corrected near VA were also better in the ZXR00 IOL group (both P < .0001). More ZXR00 IOL recipients reported wearing spectacles none of the time or a little of the time for overall vision at 6 months compared with the ZCB00 IOL group (85.0% vs 59.9%, P < .0001). In the ZXR00 IOL-implanted patients, low incidence rates of night glare (mild to moderate, 2.7%), halo (mild to moderate, 13.6%; severe, 2.7%), and starbursts (mild to moderate, 7.5%; severe, 1.4%) were reported. The TECNIS Symfony IOL provided comparable distance vision and improved uncorrected and distance-corrected intermediate and near vision, along with decreased spectacle wear and low incidence rates of dysphotopsia, compared with the TECNIS 1-piece monofocal IOL.

Compliance of spectacle wear among adolescents in a tertiary care hospital

Context: Unaddressed refractive errors account for a large proportion of ocular morbidities among adolescents and can hamper their overall development. Hence, compliance with the use of visual aids should be ensured. Aim: To evaluate the degree of spectacle compliance and to assess the principle determinants for non-compliance among adolescents in a tertiary care hospital. Settings and Design: Hospital based, prospective observational study. Methods and Material: A prospective observational study was conducted over 2 years. 365 adolescents (10-19 years) attending ophthalmology OPD were observed and interviewed using questionnaire and possible causes associated with non-compliance identified. Results: Out of 365 adolescents, 190 (52.05 %) were females and 175 (47.95 %) males. Overall compliance rate was 47.12 %. Compliance was more with urban residence (p value 0.014), father’s education (p value 0.022), myopia (p value 0.001) and poor uncorrected visual acuity in better eye (p value 0.0015). The common causes for not wearing spectacles were peer pressure (17.62 %), parental disapproval (15.03 %), broken spectacles (13.47 %), dislike spectacles (11.92%), social stigma/misconceptions (10.87%), occasional use (8.81 %), forgetfulness (7.25 %), lost spectacles (6.22%), headache due to spectacles (5.18 %) and discomfort due to spectacles (3.63 %). Conclusion: Proper counselling of adolescents and their parents regarding importance of using spectacles is essential at the time of prescribing spectacles and it can improve spectacle compliance and visual outcome.

Visual performance with multifocal contact lenses and progressive addition spectacles

PurposeAs presbyopia occurs, new visual demands create a need for clear vision at multiple distances. Many spectacle wearers adapt into progressive addition lenses (PAL) in order to see clearly at distance, intermediate, and near. A multifocal contact lens provides the ability to see at these same distances without the prismatic effects of a spectacle lens or the peripheral obstruction of a spectacle frame. No studies have been done to date comparing the effect of these types of presbyopic vision correction on a variety of tests of visual performance representative of everyday tasks. MethodsA battery of visual performance tasks were completed by subjects while wearing their habitual PAL spectacles. These subjects were then fit with a multifocal contact lens and wore lenses for 2 weeks or more before completing the tasks again. These functional vision tests included assessments of coincidence anticipation timing, peripheral search and hand-eye coordination, and dynamic visual acuity. Following functional vision testing, subjects completed a preference survey comparing both types of refractive correction while performing common activities of daily living. ResultsPerformance on the majority of the tests of visual performance were equivalent (P < 0.05) when comparing PAL spectacles and multifocal contact lenses. Survey results demonstrated a preference for multifocal contact lenses overall. ConclusionPAL spectacles are widely prescribed for presbyopic patients. The findings of this study suggest that in addition to providing excellent vision, multifocal contact lenses provide functional vision performance equal to PAL spectacle wear and patients may prefer them over PAL spectacles.

Spectacle frames: Disposal practices, biodegradability and biocompatibility – A pilot study

Background: Only limited information is available on the disposal methods for spectacle frames, and their interaction with the environment once such disposal occurs.Aim: This study investigates the disposal of spectacle frames and provides a preliminary report on their biodegradability and biocompatibility.Setting: The study was conducted at a university in the south eastern part of South Africa.Methods: The study was conducted in two parts: Part A consisted of an explorative, quantitative design using a closed-ended questionnaire investigating the current disposal methods of 375 spectacle wearers for their old spectacles; and Part B consisted of a descriptive, cross-sectional design involving chemical analyses of metal and plastic spectacle frames.Results: Almost 55% of the participants reported either keeping or reusing their spectacles. Only 5% had used a recycling method when disposing their previous spectacles. Inductively coupled plasma optical emission spectroscopy results showed that metal frames do not degrade easily unless they are oxidised in an acidic environment. Lead was detected in two metal frames. Results of thermogravimetric analysis revealed that plastic frames only begin to degrade at temperatures over 250 °C. Gas chromatography-mass spectrometry results suggest that plastic frames, except three dimensional (3-D) polarisers, are biocompatible as they are stable, not chlorinated and do not possess heavy metals. The results suggested that eco-friendly frames may be the most biocompatible.Conclusion: It appears that few spectacle wearers use recycling for disposing their frames. Current metal and plastic spectacle frames appear to have poor biodegradability but good biocompatibility.

Case Report: Primary Hypothyroidism Caused by Autoimmune Thyroiditis in Infancy Requires Early Intervention

Abstract Background: Primary hypothyroidism due to autoimmune thyroiditis is extremely rare in infants, especially under the age of 3 years. For infants, hypothyroidism is most commonly congenital, originating from thyroid dysgenesis with an absent, ectopic, or hypoplastic thyroid gland (1 in 4,000 live births). If left untreated, it can lead to permanent neurodevelopmental deficits. In this report, we describe a male infant who was diagnosed with Hashimoto thyroiditis at 18 months of life, providing a learning example to aid in recognition of this rare disease and enable timely intervention. Clinical Case:Patient was a 2,765 gram, appropriate for gestational age, male born at term with hypospadias of the penis (surgical correction at 11 months). Patient passed meconium in the first 24 hours of life. During the first few months of life, patient developed constipation. Patient had amblyopia necessitating eye patching and began to wear eye glasses at 18 months of life. Patient’s linear and weight growth were within normal limits. Patient had normal motor development, however had language development delay. No known family history of thyroid disease. Screening labs performed at 17-months of age showed abnormal thyroid function: elevated TSH at 14.86 µIU/mL (ref: 0.45 - 4.50 µIU/mL) and normal free T4 level at 1.24 ng/dL (ref: 0.85-1.75 ng/dL). Repeat testing at 18 months of age continued to show elevated TSH at 6.18 µIU/mL (ref: 0.64 - 4.00 µIU/mL), normal free T4 at 1.07 ng/dL (ref: 0.88 - 2.03 ng/dL), and elevated thyroid peroxidase (TPO) antibodies at 163 IU/ml (ref: &amp;lt;35 IU/ml). At 21 months of age, patient was initiated on L-thyroxine therapy for elevation of TSH (9.570 µIU/mL; ref: 0.64 - 4.00 µIU/mL) and free T4 was normal (1.03ng/dL; ref: 0.88 - 2.03 ng/dL). Notably, the newborn screen for hypothyroidism was within normal limits, suggesting chronic autoimmune thyroiditis instead of congenital thyroid dysgenesis. Conclusions: This case report provides insights into autoimmune thyroiditis in infancy, which, although especially rare under age 3 years, should be considered in infants who present with autoimmunity or abnormal thyroid testing. In the neonatal period, infants’ immune systems are learning to discriminate requirements for self-tolerance versus protection against pathogens and may be more prone to infections. Although autoimmunity in this stage of development is uncommon, there can be breakthroughs in tolerance, as seen in this case. In addition to this patient, two other infants were seen with elevated TPO antibodies, diagnosed at 17 and 31 months old, with similar clinical trends. There remains a need for additional studies providing further insights into autoimmunity in infancy. Importantly, this case illustrates that, when infants have abnormal thyroid levels (with or without other autoimmune conditions), consideration should be made for anti-thyroid antibody testing.

Overview of Evidence Concerning School-Based Interventions for Improving the Health of School-Aged Children and Adolescents.

Universal prevention approaches that target the general population can be effective for promoting children's health. This overview aims to summarize evidence presented in existing reviews of school-based interventions. We present an overview of evidence sourced from Campbell and Cochrane systematic reviews. These reviews examined randomized controlled trials concerning school-based health-promotion programs for children (mostly aged 4-18 years) in the general population. We identified 56 high-quality reviews. The reviews focused on emotional and behavioral outcomes, infectious diseases, injury reduction, mental health, nutrition intake, oral health, physical and developmental changes, sense-organ diseases, sexual-health outcomes, and substance use/abuse. Positive evidence-such as vision screening plus provision of free spectacles for spectacle wear increase and a combination of social competence and social-influence approaches for preventing illicit drug use-were considered high certainty. Of the various interventions implemented in school settings that involved people from various occupations, some positive effects were found. In most cases, evidence certainty was negatively affected by a high risk of bias within studies, inconsistencies within the estimates, and insufficient sample sizes. Further primary studies in these areas would be helpful for accumulating evidence to promote stronger cooperation between health and education stakeholders.

Quantifying the Effect of Spectacle Frame Dimensions on Wind-Induced Ocular Plane Evaporation Using an in Vitro Model.

To quantify the effect of spectacle frame dimensions on wind-induced ocular plane evaporation. A drop of 0.5 μL water was pipetted onto an eye of a mannequin head. The face was fitted with a spectacle frame. A fan positioned 10 cm away directed air (185 CFM) toward the face and the time required for the drop to evaporate was recorded. This procedure was repeated with 31 different frames to obtain evaporation times for various eye sizes, vertical heights, vertex distances, temperature, and humidity. This was also repeated 30 times without spectacle wear to obtain evaporation times for various temperature and humidity conditions. Spectacle wear increased evaporation times compared with nonspectacle wear, in both high (>35%) and low humidity (<30%) conditions (both P<0.01). Humidity was correlated with evaporation time, regardless of spectacle and nonspectacle wear (both P<0.01). Evaporation time did not correlate with spectacle eye size, vertical height, or vertex distance (all P≥0.21). This study showed that spectacle wear guarded against wind-induced evaporation at the ocular plane compared with nonspectacle wear. However, once spectacles were worn, eye size, vertical height, and vertex distance were not correlated with evaporation times. Humidity drove evaporation independent of spectacle wear.

Determinants of compliance to the facemask directive in Greece: A population study.

PurposePrimary objective of this study was to identify potential difficulties and/or discomfort when using a facemask. Moreover, to explore the impact of spectacles, contact lenses and visual acuity on the compliance to the facemask directive.MethodsThis is a prospective study that was conducted at the Department of Ophthalmology, University Hospital of Alexandroupolis, Greece between June 2020 and August 2020. Greek speaking citizens with permanent residency in Greece above 18 years old were included. A custom questionnaire (DeMask-20) was constructed and validated, which pertained to the perceived difficulty and discomfort when using a facemask. It contained 20 items grouped in 8 subscales (driving, near vision, distance vision, ocular discomfort, role limitation, collaboration, dependency on others, emotional stress). Perceived difficulty and discomfort when using a facemask, compliance and correlations of compliance with DeMask-20 scores, demographics, spectacle and/or contact lens use, and visual acuity were evaluated.ResultsThe number of factors was determined through factor analysis. Cronbach’s alpha ranged from 0.716 for the “Role limitation” subscale to 0.938 for “Ocular discomfort” subscale. 1,214 participants (402 men, 812 women, mean age 36.79±12.50 years) completed the DeMask-20 instrument. Mean DeMask-20 score of all study participants was 3.79±0.71. Significant differences in DeMask-20 score were detected in gender (p = 0.009), spectacle use (p = 0.034), contact lens use (p = 0.049), and binocular distance visual acuity (bDVA) (p = 0.001). Mean compliance of all participants was 4.05±0.96. Men, people <50 years and spectacle wearers showed significantly worse compliance (p<0.05). Moreover, professional workers and professional drivers demonstrated significantly better compliance (p = 0.008 and p = 0.047). Significant correlation was detected between compliance and DeMask-20 score (p<0.001, R2 = 0.471). Significant correlations were detected with driving, near vision, distance vision, collaboration, role limitation, emotional stress (p<0.05, R2: 0.386–0.493).ConclusionsFactor analysis suggested that the DeMask-20 instrument demonstrates adequate validity, while Cronbach’s alpha indicated sufficient internal consistency of all subscales. This study provided the necessary methods that could evaluate compliance trends and the efficacy of healthcare interventions against COVID-19. Our outcomes suggest that young males who use spectacles should be targeted by Greek Healthcare authorities in order to improve compliance rates.

Prevalence and Factors Associated With Eyeglass Wear Compliance Among Preschoolers From Low-Income Families in San Francisco, California

Despite growing support for early school-based vision screening and eyeglass provision, few studies have rigorously monitored the compliance of eyeglass wear among preschool-aged children who receive eyeglasses through such programs. To assess the prevalence and factors associated with eyeglass wear compliance among preschoolers from low-income families who receive eyeglasses through the See Well to Learn program. Longitudinal cross-sectional study of eyeglass wear compliance patterns among 188 children 3 to 5 years of age from 51 Bay Area Head Start preschools in San Francisco, California. The study conducted during the 2017 to 2018 school year included students with a failed vision screening who met predetermined refractive criteria following cycloplegic refraction and received eyeglasses through the See Well to Learn program. Eyeglass distribution. Eyeglass wear compliance, measured by a school-year's worth of weekly teacher reports, was a longitudinal measure of consistent eyeglass wear, defined by eyeglass wear for more than 50% of every school day (compliance score of 4). Of 188 students (91 boys [49%]; 94 girls [51%]; mean [SD] age, 3.89 [0.5] years), 133 (71%; 95% CI, 64%-77%) maintained a mean compliance score throughout the school year of 4 or higher. Compliance prevalence was relatively stable throughout the school year, ranging from 139 students (74%) to 164 students (87%). Baseline uncorrected visual acuity in both the better-seeing and worse-seeing eyes was the only assessed factor that was associated with compliance. In the better-seeing eye, the mean uncorrected visual acuity of students with eyeglass wear compliance was 0.473 logMAR (95% CI, 0.433-0.514) (Snellen equivalent, 20/60) compared with 0.394 logMAR (95% CI, 0.334-0.454) (Snellen equivalent, 20/50) for students with noncompliance (P = .03). In the worse-seeing eye, the mean uncorrected visual acuity of students with compliance was 0.576 logMAR (95% CI, 0.530-0.623) (Snellen equivalent, 20/75) compared with 0.492 logMAR (95% CI, 0.433-0.551) (Snellen equivalent, 20/62) for students with noncompliance (P = .03). In the better-seeing eye, the difference between students with compliance vs noncompliance was 0.079 logMAR (95% CI, 0.009-0.150) (5 Snellen letter difference) compared with 0.084 logMAR (95% CI, 0.007-0.160) (5 Snellen letter difference) in the worse-seeing eye. This study found that nearly 3 of 4 preschool students consistently wore their glasses at school during their first year of use, supporting the continued implementation of preschool-based vision screening programs. These findings suggest that programs involving school-based screening and eyeglass delivery may lessen disparities in accessing pediatric vision care. Consistent with previous studies, students with poorer uncorrected baseline visual acuity were found to be more likely to wear eyeglasses compliantly.

Spontaneous eye blink activity during slitlamp-based assessments

ABSTRACT Clinical relevance Slitlamp‐type assessments of eye blink activity with head and chin support need to consider time‐related differences that can occur. Background Previous studies have not assessed the predictability of changes in spontaneous eye blink rate occurring during slitlamp observations. Methods Video recordings were made of eye blink activity of 85 young adults who were either emmetropic or spectacle wearers for refractive errors between −8.25 D and +8.25 D. After an initial adjustment period of one to two minutes positioned at the slitlamp (including the time after removing spectacles), participants had a five minutes recording made in silence while seated with forehead and chin support and directing their gaze to a high‐contrast target on a distant whiteboard under ambient luminance of 35 cd per square metre. Results The mean spontaneous eye blink rate values over five minutes were 13.4 ± 3.1 blinks/minute (± SD), ranging from 7.4 to 20.8 blinks/minute. Overall, incomplete eye blink events were noted 39 times in the total of 5,704 recorded (that is, 0.68 per cent of all eye blinks). There was a progressive decline in averaged spontaneous eye blink rate values (r = 0.897, p < 0.05), with 70.6 per cent of the participants exhibiting a higher spontaneous eye blink rate value in the first minute compared to the fifth minute. The inter‐participant variability in spontaneous eye blink rate also progressively declined over time, but there was no detectable difference in either averaged values or the variability in spontaneous eye blink rate in relation to refractive error. Conclusions In slitlamp‐based assessments of eye blink activity, a small progressive time‐related reduction appears likely but is not obviously related to visual blur in ametropic individuals.