Use Of Spectacles Research Articles

Factors Associated With spectacle-wear compliance among hypermetropic pre-school children in Al-diwaniya Governorate, Iraq

Background: Uncorrected refractive error are community health problem among pre-school children. It's also considered as the most common cause of avoidable visual impairment in children worldwide. Objective: This study intended to measure the extent of compliance of hypermetropic preschool children with spectacle wear and the factors connected with non-compliance.Method: The study was carried out in my ophthalmology private clinic. One hundred and fourteen patients (114 patients) below 6 years old were enrolled this study. Each was interviewed by the author of correspondence. the possible factors associated with non-compliance with spectacle wear were identified.Results: The total number of patients enrolled in this study was 114 among them 36% were compliance with spectacle wear while 73% were non compliance. The results also revealed that children less than 2 years were 12 and 35 in compliant and non compliant respectively. For gender distribution, there were 15 male and 26 female in complaint children while there were 39 male and 34 female in those who non complaint. Urban children showed high compliant for spectacle wear than rural one.Conclusion: One of the risk factor for noncompliance with in the present study were region distribution and ignorance by family. More population based studies with larger sample should be conducted to assess the determinants of the spectacle use and the barriers to spectacle use should be addressed.

Prevalence and Risk Factors of Myopia in Children and Adolescents in Germany - Results of the KiGGS Survey

Purpose To determine the population prevalence and risk factors of myopia in children and adolescents in Germany. Methods The prevalence of myopia in Germany was computed using data from the 2003-2006 German Health Interview and Examination Survey for Children and Adolescents (N=17 640, 49% girls). Status of myopia was derived from parental questionnaire responses for myopia and the use of spectacles. Potential risk factors were identified using directed acyclic graphs and evaluated using multivariable logistic regression analysis. Results The population prevalence of myopia in the age group 3-17 years was estimated at 13.3% (95%-confidential interval 12.6-14.0%). In the age group 3-10 years, myopia was positively associated with age (per 2 years: OR=1.78 [1.59; 2.00]) and negatively associated with male gender (OR=0.73 [0.57; 0.95]), but neither with leisure-time activities nor with media use. In the age group 11-17 years, attending a High School was positively associated with myopia (OR=1.69 [1.32; 2.16]), while regular physical activity (OR=0.67 [0.53; 0.84]) was negatively associated. Media use was not associated. Conclusions In Germany, myopia is one of the most frequent chronic medical conditions among children and adolescents. Girls, adolescents, and pupils attending a Gymnasium are at higher risk of developing myopia while being physically active may be protective.

Visual Outcomes Following Diffractive-Refractive Multifocal Intraocular Lens Implantation : Literature Review


 
 
 Purpose: To evaluate the result of diffractive-refractive multifocal intraocular lens (IOL) implantation, regarding the visual acuity, spectacle independency, and also related disturbing visual pnenomenon such as halo and glare. Methods: Seventeen articles collected from multiple sources including Pubmed, Clinical Key, and Ophthalmology Advance were reviewed. Visual acuity. Five types of diffractive-refractive multifocal IOL were found including ReSTOR SA60D3, SN60D3, SA6AD3, SA6DA1, and AT Lisa 809M. Uncorrected and corrected visual acuity, spectacle independency and undesired visual phenomenon data of each IOL were analyzed. 
 Results: For binocular uncorrected distance and intermediate vision, ReSTOR SN6AD1 is better than other IOL. Meanwhile, in binocular uncorrected near visual acuity category, ReSTOR SA60D3 is superior. Highest percentage of patients reporting spectacle independency found in ReSTOR SA60D3 group. Halo was found in each IOL group, ranged from 32 to 65 percent patients. Glare was found in a smaller percentage, ranged from 25 to 61 percent patients. 
 Conclusion: The best option for patients aiming for best visual acuity in distance to intermediate activity without spectacle use is ReSTOR SN6AD1. Meanwhile, the best option for patients aiming for best near visual acuity is ReSTOR SA60D3. Comprehensive preoperative education is crucial, considering the cost and benefit aspects of multifocal IOL implantation. 
 
 

Spectacle Compliance among Adolescents: A Qualitative Study from Southern India.

To understand the perceptions of adolescents and their parents about spectacle compliance of adolescents in Southern India. Using a qualitative snapshot design, three focus group discussions were conducted each with parents and adolescents studying in schools located in and around Chennai, Tamil Nadu. Purposive sampling technique was used in the selection of participants. Separate focus group guides were developed for parents and adolescents. All focus group discussions were conducted in the school premises and audio recorded. These audio files were then transcribed verbatim and then translated into English. A framework analytical approach was used for data analysis that involved gaining familiarity with the data to identify a thematic framework. Two major themes that emerged were (1) perceptions on barriers to spectacle compliance that was further subdivided into physical, psychological, and societal barriers; and (2) solutions to improve spectacle use. Barriers identified included scars on the nose, unattractive frames contributing to poor appeal, adolescents feeling discriminated and set apart, fears of injury to eyes, lack of parental involvement, and negative attitudes of society toward those wearing spectacles. Solutions given by the stakeholders included provision of lightweight, well-fitting, trendy frames of adolescents' choice, importance and need for periodical eye examinations, including teachers in encouraging spectacle use and preventing bullying and teasing by other adolescents, provision of free spectacles along with periodic replacement, and inclusion of awareness sessions on spectacle use for both parents and adolescents. The study has identified both barriers and solutions for improving spectacle compliance among school adolescents from the viewpoint of the stakeholders involved. Implementing the solutions suggested by the stakeholders through planned intervention programs could possibly help in ensuring better compliance of spectacle use among school adolescents.

Multiple issues in multifocal intraocular lens

The occurrence of multifocal intraocular lens (MIOL) is known as an important period in the development of cataract surgery, which can provide a simultaneous vision without the use of spectacles or contact lenses. However, in the current stage, MIOL implantation may also lead to decreased visual acuity and increased risk of photic phenomena, thus in some instance a second procedure to exchange the MIOL is necessary. Optimizing visual outcomes of MIOL implantation and controlling adverse effects has become the focus for ophthalmologists. In the future, a more remarkable, flexible and high cost-effective intraocular lens (IOL), which can mimic human natural crystalline lens, should emerge. (Chin J Ophthalmol, 2017, 53: 244-248).

Effects of audiovisual distraction in children with special healthcare needs during dental restorations: a randomized crossover clinical trial.

Audiovisual distraction using video eyeglasses is useful in managing distress and reducing fear and anxiety in healthy children during dental treatments. To evaluate the effect of audiovisual distraction on behavior and self-reported pain of children with special healthcare needs (SHCN) without intellectual disability during dental restorations and its influence on the operator stress and the time of the appointment. This randomized controlled crossover trial comprised 48 children with SHCN requiring at least two dental restorations. One restoration was done wearing the video eyeglasses and one wearing conventional behavior management techniques. Subjective and objective pain was evaluated using the Faces Pain Scale - Revised (FPS-R) and the revised Face, Leg, Activity, Cry, and Consolability scale (r-FLACC). The operator stress using a VAS, the time of the appointment, and the child satisfaction were recorded. The use of video eyeglasses significantly reduced the operator stress. The bivariate analysis showed that the mean FPS-R score and the mean r-FLACC score were significantly lower using the video eyeglasses only during the second clinical session. Audiovisual distraction could be useful in managing distress in SHCN children without intellectual disability but cannot replace the conventional behavior management techniques.

Traffic-related air pollution and spectacles use in schoolchildren.

PurposeTo investigate the association between exposure to traffic-related air pollution and use of spectacles (as a surrogate measure for myopia) in schoolchildren.MethodsWe analyzed the impact of exposure to NO2 and PM2.5 light absorbance at home (predicted by land-use regression models) and exposure to NO2 and black carbon (BC) at school (measured by monitoring campaigns) on the use of spectacles in a cohort of 2727 schoolchildren (7–10 years old) in Barcelona (2012–2015). We conducted cross-sectional analyses based on lifelong exposure to air pollution and prevalent cases of spectacles at baseline data collection campaign as well as longitudinal analyses based on incident cases of spectacles use and exposure to air pollution during the three-year period between the baseline and last data collection campaigns. Logistic regression models were developed to quantify the association between spectacles use and each of air pollutants adjusted for relevant covariates.ResultsAn interquartile range increase in exposure to NO2 and PM2.5 absorbance at home was respectively associated with odds ratios (95% confidence intervals (CIs)) for spectacles use of 1.16 (1.03, 1.29) and 1.13 (0.99, 1.28) in cross-sectional analyses and 1.15 (1.00, 1.33) and 1.23 (1.03, 1.46) in longitudinal analyses. Similarly, odds ratio (95% CIs) of spectacles use associated with an interquartile range increase in exposures to NO2 and black carbon at school was respectively 1.32 (1.09, 1.59) and 1.13 (0.97, 1.32) in cross-sectional analyses and 1.12 (0.84, 1.50) and 1.27 (1.03, 1.56) in longitudinal analyses. These findings were robust to a range of sensitivity analyses that we conducted.ConclusionWe observed increased risk of spectacles use associated with exposure to traffic-related air pollution. These findings require further confirmation by future studies applying more refined outcome measures such as quantified visual acuity and separating different types of refractive errors.

Airbag deployment–related eye injuries

ABSTRACTObjective: We studied the correlation between airbag deployment and eye injuries using 2 different data sets.Methods: The registry of the Finnish Road Accident (FRA) Investigation Teams was analyzed to study severe head- and eyewear-related injuries. All fatal passenger car or van accidents that occurred during the years 2009–2012 (4 years) were included (n = 734). Cases in which the driver's front airbag was deployed were subjected to analysis (n = 409). To determine the proportion of minor, potentially airbag-related eye injuries, the results were compared to the data for all new eye injury patients (n = 1,151) recorded at the Emergency Clinic of the Helsinki University Eye Hospital (HUEH) during one year, from May 1, 2011, to April 30, 2012.Results: In the FRA data set, the unbelted drivers showed a significantly higher risk of death (odds ratio [OR] = 5.89, 95% confidence interval [CI], 3.33–10.9, P = 2.6E-12) or of sustaining head injuries (OR = 2.50, 95% CI, 1.59–3.97, P = 3.8E-5). Only 4 of the 1,151 HUEH patients were involved in a passenger car accident. In one of the crashes, the airbag operated, and the belted driver received 2 sutured eye lid wounds and showed conjunctival sugillation. No permanent eye injuries were recorded during the follow-up. The calculated annual airbag-related eye injury incidence was less than 1/1,000,000 people, 4/100,000 accidents, and 4/10,000 injured occupants.Conclusions: Airbag-related eye injuries occurred very rarely in car accidents in cases where the occupant survived and the restraint system was appropriately used. Spectacle use did not appear to increase the risk of eye injury in restrained occupants.

Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study.

PurposeThe aim of this study was to assess the effectiveness of the Verion-LenSx guided arcuate incision technique to reduce refractive astigmatism in a pseudophakic population.Patients and methodsA prospective single-arm study was conducted in which one or both eyes of subjects required reduction of 1.0–2.0 D of refractive astigmatism after previous cataract surgery or refractive lens exchange. The surgeon used the refractive cylinder in the eye and the Woodcock astigmatism nomogram for preoperative planning, while the LenSx femtosecond laser with the Verion Image Guided System was used to create all arcuate incisions. The primary outcome measure was the uncorrected monocular distance visual acuity (UCVA). Secondary outcome measures included the change in corneal astigmatism, the change in refractive astigmatism, the best-corrected visual acuity and spectacle independence at distance from preoperative stage to 1 month and 2 months postoperatively.ResultsTwenty-eight eyes of 18 subjects were treated. The best-corrected visual acuity at the 2-month postoperative (PO) stage was not statistically significantly different from the preoperative visual acuity (0.02 logarithm of the minimum angle of resolution [logMAR] in both cases, P>0.05). Uncorrected visual acuity was statistically significantly better at the 2-month PO stage relative to the preoperative value (0.14 versus 0.34 logMAR, P<0.01). The mean change in refractive cylinder from the preoperative stage to the 2-month PO stage was 1.0 D. At the 2-month PO stage, two-thirds of the subjects (12/18) reported that they did not use glasses for distance vision and that their spectacle use for distance vision at 2 months was “lower” or “much lower” than the preoperative stage; in 71% of eyes (20/28), the residual refractive cylinder was ≤0.50 D. Vector changes in keratometric astigmatism were weakly associated with changes in refractive cylinder.ConclusionArcuate incisions made with a femtosecond laser to treat moderate levels of residual refractive astigmatism after previous cataract surgery may reduce dependence on spectacles for distance vision.

Visual impairment among 10–14-year school children in Puducherry: A cross-sectional study

Introduction:According to the 2010 estimates by the World Health Organization, nearly 285 million (4.24% of total population) people of all ages worldwide are visually impaired. Almost 18.9 million children under 15 years of age are visually impaired globally. In developing countries, 7%–31% of childhood blindness and visual impairment is avoidable.Materials and Methods:The study was conducted as a cross-sectional study among 1884 school students in Puducherry, in the age group of 10–14 years. A child with presenting maximum vision ≤6/12 Snellen equivalent in the better eye is considered visually impaired. Data were entered in Microsoft Excel 2013 and analyzed using the statistical software SPSS version 21.0. Chi-square test was applied for testing difference in proportion and a P < 0.05 was considered statistically significant.Results:The overall prevalence of visual impairment (vision ≤6/12) among the study participants was 6.37% (95% confidence interval = 5.27–7.47). The prevalence of visual impairment increased with age and it was found to be high among male students (6.6%) when compared to female students (6%). Presenting vision of 6/6 was observed in 79.8% of the children while with pinhole correction, the proportion increased to 94.6%.Conclusion:The prevalence of visual impairment in our study population was found to be 6.37% and the prevalence was even higher among children who belonged to schools of urban region or private schools. Children with a positive family history of spectacle use were more likely to have visual impairment.

Long-term Changes in Refractive Error after Spectacle Use

Long-term Changes in Refractive Error after Spectacle Use

Prevalence of Vision Impairment in School Children of Puente Piedra, Peru

Purpose : To document the prevalence and sociodemographic factors associated with vision impairment in Peruvian children living in Puente Piedra, a resource-poor community in Peru. Methods : Cross-sectional study of children ages 5-19 in Puente Piedra, Peru from March to April, 2011. Participants underwent a standard vision screening exam consisting of distance visual acuity (VA), stereopsis, external eye exam, and color vision testing and completed a sociodemographic and health risk factor questionnaire. Results : 387 children were examined; the mean uncorrected visual acuity of 20/25 ± 1 line. Eyeglasses were used by 3.7%. VA less than 20/30 was present in both eyes of 8.9% of children and in the worse eye of 26.3% of children. Severe visual impairment (<20/200) was found in both eyes of one child (0.3%) and in the worse eye of 3 (0.7%) children. Thirteen (3.5%) children failed the stereopsis exam and 20 (5.5%) boys and 7 (1.9%) girls failed the color vision exam. Overall, 37.3% of children met criteria for referral to an ophthalmologist. Risk factors for referral included: history of eyeglasses use, previous eye exam, or parental concern about the child’s vision. Risk factors for untreated vision impairment included: not having seen a physician regularly, no previous eye exam, and having a blind family member. Conclusion : There was a high prevalence of untreated vision impairment in Peruvian children living in Puente Piedra. Increased screening and eye care is needed for this impoverished population.

Green spaces and spectacles use in schoolchildren in Barcelona

Myopia is one of the major causes of low visual acuity during childhood, and hence of the need for spectacles. It is generally more prevalent in urban areas where children are often less exposed to green spaces than in rural areas. This study evaluated the association between exposure to green space and use of spectacles (as a surrogate measure for myopia) in a cohort of 2727 schoolchildren (7–10 years old) recruited from 39 primary schools in Barcelona (2012–2015). We assessed exposure to green spaces by characterizing outdoor surrounding greenness at home and school and during commuting using satellite data on greenness (Normalized Difference Vegetation Index). We also obtained data on the annual average time children spent playing in green spaces through questionnaires. Cross-sectional analyses were conducted based on prevalent cases of spectacles use at baseline data collection campaign and longitudinal analyses based on incident cases of spectacles use during the three-year period between the baseline and last data collection campaigns. An interquartile range (IQR) increase in exposure to green space at home (500m buffer) and school and during commuting was associated with respectively 14% (95% CI: 2%, 26%), 27% (95% CI: 6%, 44%), and 20% (95% CI: 5%, 33%) decrease in spectacles use in cross-sectional analyses. In longitudinal analyses, we observed a reduction of 23% (95% CI: 4%, 39%) and 34% (95% CI: 2%, 55%) associated with an IQR increase in greenness at home and school, respectively. Moreover, an IQR increase in time playing in green spaces was associated with a 28% (95% CI: 7%, 45%) reduction in the risk of spectacles use in the longitudinal analysis. Our observed reduced risk of spectacles use associated with higher contact with green space calls for more refined studies of the association between green spaces and refractive errors of visions.

Knowledge, attitude, practice and associated factors towards spectacles use among adults in Gondar town, northwest Ethiopia.

BackgroundRefractive error is the main cause of visual impairment in the world. Spectacles are the most frequently used options for correcting refractive errors. In addition, they can be used for protection and fashion. It is the simplest, cheapest and only method used in developing countries like Ethiopia. This study aims to explore the knowledge, attitude, practice and associated factors towards spectacles use among adult population of Gondar town, northwest Ethiopia.MethodsCommunity based cross sectional study was conducted on 780 participants using a pre-tested structured questionnaire in Gondar. Data were analyzed using Statistical Package for Social Sciences (SPSS) 20 version computer software. Association and strength between variables was determined using odds ratio with 95 % confidence interval.ResultA total of 780 study subjects participated in this study. The male to female ratio was 1:2.4. The median age of the participants was 29 (±22 IQR) with a range of 18–86 years. About fifty percent of participants were married and 284 (36.4 %) were educated up to secondary school. Seven hundred and three (90.6 %) participants had adequate knowledge about spectacles and 90.4 % had favorable attitude towards spectacle use. About 25 % of the participants have been using spectacles during the study. Participants with primary school education (AOR: 2.79, 95 % CI 1.20–6.50) had good knowledge about spectacles. Housewives (AOR = 3.40, 95 % CI; 1.35–8.54) and participants who unable to read and write (AOR: 3.51, 95 % CI 14–10.72) had favorable attitude towards spectacles use.ConclusionGondar town adult population has adequate knowledge and favorable attitude towards spectacles. However, practice of spectacles use is poor. Eye health education related to spectacles utilization need to be given due emphasis by eye care professionals in collaboration with University of Gondar and Gondar town administration.

Does spectacle use lead to vestibular suppression?

Laboratory experiments indicate that changes in retinal image size result in adaptive recalibration or suppression of the vestibulo-ocular reflex. Myopia correction with spectacles or contact lenses also leads to retinal image size changes, and may bring about similar vestibulo-ocular reflex alterations. A hypothesis-generating preliminary investigation was conducted. In this cross-sectional study, findings of electronystagmography including bithermal caloric testing were compared between 17 volunteer myopes using spectacles or contact lenses and 17 volunteer emmetropes (with no refractive error). Bilateral hypoactive caloric responses were demonstrated in 6 of 11 spectacle users, in 1 of 6 contact lens users and in 1 of 17 emmetropes. Hypoactive caloric responses were significantly more likely in spectacle users than in emmetropes (p < 0.01; relative risk = 9.3). A significant proportion of myopes using spectacles have vestibulo-ocular reflex suppression, as demonstrated by the caloric test. This has implications for the interpretation of electronystagmography and videonystagmography results, and highlights spectacle use as a possible cause of vestibular impairment. Further corroboration of these findings is warranted, with more precise and direct vestibulo-ocular reflex tests such as rotational tests and the head impulse test.

Update on epidemiological evidence for an association between sun exposure and cataract

SummaryThere is currently substantial evidence for an epidemiological association between long‐term daily sub‐threshold exposure of the eye to mid wavelength ultraviolet radiation (UVR) from the sun and cortical cataract. Initial observation of a potential association between exposure of the eye to UVR from the sun were limited to case reports in regions with abundant sun hrs. In the late 1900 cataract incidence was correlated to meterological recordings of intense exposure of UVR direct to the surface of the earth and lack of use use of spectacles. It was subsequently pointed out that the ocular exposure to UVR from the sun substantially depends on exposure of the eye to indirect UVR from the sun rather than direct, indicating that only meterological observations is not sufficient to establish an epidemiological association. This triggered attempts to make personal dose estimations based on both meterological observations and concomitant interviews of use of sun‐glasses, hats and behavior. An appropriate cross‐sectional case–control study with personal dose estimation and graded cataract measurement demonstrated an association between cortical cataract and intermediate UVR‐dose comparing Chesapeake Bay bay fishermen with mainland inhabitants in the same area in USA. A similar approach was later used in Australia and found a similar association. A Japanese group, using detailed monitoring of the distribution of light scattering in the lens demonstrated an association between incidence of lower nasal opacity in the lens and latitude spanning from the equator to Island. Later, a large number of epidemiological studies have confirmed an association between exposure to intermediate UVR and cortical cataract.

Visual Performance and Rotational Stability of a Multifocal Toric Intraocular Lens.

To evaluate the visual results, refractive predictability, rotational stability, and spectacle independence of patients who had cataract surgery with implantation of a diffractive multifocal toric intraocular lens (IOL) (Tecnis Multifocal Toric ZMT 150-400; Abbott Medical Optics, Santa Ana, CA). This prospective study included 60 eyes of 30 patients with cataract and regular corneal astigmatism who had phacoemulsification with bilateral implantation of a Tecnis Multifocal Toric IOL. Over a 6-month follow-up period, the main outcome measures were uncorrected and corrected monocular and binocular distance (UDVA and DCVA), intermediate at 80 cm (UIVA and DCIVA), and near at 40 cm (UNVA and DCNVA) visual acuities, spherical equivalent (SE) refraction, residual astigmatism, rotational stability, defocus curves, contrast sensitivity, presence of photic phenomena, and use of spectacles. Results at 6 months showed mean UDVA of 0.07 ± 0.1 logMAR (range: 0.3 to 0.0 logMAR), mean UIVA of 0.18 ± 0.09 logMAR (range: 0.3 to -0.1 log-MAR, and mean UNVA of 0.03 ± 0.09 logMAR (range: 0.2 to -0.1 logMAR). Refractive predictability was excellent with a mean SE of 0.05 ± 0.47 diopters (D) (range: -0.75 to +1.00 D) and a mean refractive cylinder of -0.44 ± 0.49 D (range: -1.25 to 0.00). Mean rotation was 3.18° ± 3.28°. Photic phenomena were moderate or severe in 30% of patients. All patients were spectacle independent at the 6-month follow-up visit at all distances in this case series. The implantation of the Tecnis multifocal toric IOL in patients with cataract and corneal astigmatism provided excellent distance and near visual acuities with good intermediate visual acuity. Predictability of refractive results, rotational stability, and optical performance were excellent, allowing all patients in this series to achieve spectacle independence. [J Refract Surg. 2016;32(7):444-450.].

Rapid assessment of refractive error in the eThekwini Municipality of KwaZulu‐Natal, Durban, South Africa

BackgroundPopulation‐based studies involving refractive error in South Africa are few because they are expensive to conduct and require a high level of expertise. Rapid assessment of refractive error (RARE) is a relatively less resource‐intensive method designed to assess the magnitude of uncorrected refractive error (URE), spectacle coverage and barriers to access of services. This information is useful for designing and implementing programs as well as for policy development.PurposeThe purpose of this study was to determine the prevalence of uncorrected refractive error and spectacle coverage and to explore the barriers to uptake of refractive services in persons 15 to 35-years old in the eThekwini municipality, Durban, South Africa.MethodsA cross‐sectional epidemiological study was conducted using the RARE protocol. A total of 1,543 participants were enumerated and 1,516 were examined. Uncorrected refractive error was defined as presenting visual acuity less than 6/12 that could be corrected to 6/12 or better using a pinhole. Spectacle coverage was defined as the proportion of need that was already met with spectacle correction.ResultsThe prevalence of age and sex adjusted URE was 1.5% (95 per cent CI: 0.7 –2.3). Odds for uncorrected refractive error in women were 0.5 (95 per cent CI: 0.3‐0.9) lower compared to men. There was a statistically significant association between uncorrected refractive error and respondents 15 to 24-years old (p < 0.001). The spectacle coverage (6/12 cut‐off) was 51.4 per cent (95 per cent CI: 28.1–74.7). The prevalence of spectacle use among participants was 3.8 per cent.ConclusionsThe low prevalence of uncorrected refractive error found in this study agrees with previous studies that indicate that despite uncorrected refractive error being the most common cause of visual impairment and the second most common cause of blindness worldwide, its prevalence is relatively low in South Africans.

What is the influence of parents' myopia on their children's myopic progression? A 22-year follow-up study.

To study the connection between parental myopia and their children's myopia from school age to adulthood. Two hundred and forty myopic schoolchildren (119 boys, 121 girls, mean age 10.9years) with no previous spectacles for myopia were recruited to a 3-year treatment trial with different use of spectacles. Follow-ups were performed at mean ages of 13.9, 23.7 and 33.2years for 238, 176 and 170 subjects respectively. Subjective refraction was calibrated to the spherical equivalent at corneal level (SEcor). Corneal refractive power (CR) and axial length (AL) were measured. Parental myopia was assessed with a questionnaire and the children assigned accordingly to one of three hereditary groups: both parents myopic H++, one myopic parent=H+- and no myopic parents=H-. At baseline, no significant gender differences in age or SEcor were found in the different hereditary groups. Among girls, CR was significantly higher in hereditary group H++ (45.20±1.08 D) than in group H+- (44.19±1.28 D; p=0.006) or H- (43.84±1.18 D; p<0.001). Among boys, the differences in CR between the hereditary groups were smaller and significant at follow-up 2 only. At follow-up end, among males, no significant differences between the hereditary groups were found in SEcor, CR, AL or myopic progression. Among females, myopic progression was 4.21±1.81 D if one or both parents were myopic and -3.19±1.36 D if neither parent was myopic (p=0.035), but no significant difference was observed in AL. The main difference between the hereditary groups was higher CR and myopic progression among females with myopic parents than non-myopic parents, but with no significant difference in AL with respect to parental myopia at study end.

Barriers to availing refractive error services among an urban slum population in Mumbai, India

Barriers to availing refracti ve error services among an urban slum population in Mumbai, India. Background: A refractive error project for management of refractive errors in adults was undertaken in the urban slums of Mumbai, India. The project looked at the burden of refractive errors in the predominantly lower socio economic status groups as well as what common barriers prevent access to refractive services amongst this population. This presentation highlights the barriers that were elicited for availing and accessing refractive error services among the urban slum population in Mumbai, India. AIM: The study aimed to identify the common barriers to availing &amp; accessing refractive error services among an urban slum population in Mumbai, India. Methods : A situation analysis of the community, with respect to availability of services was done as a part of the service delivery planning. The analysis revealed that services were available but the community was not accessing the same. Based on the situation analysis report a questionnaire with all perceived barriers was developed and the same was validated. Service delivery was done by establishing vision centers within the community. Trained health workers performed a door to door vision screening, identified and referred the needy population to the vision centre. Here the questionnaire was run by trained social workers on the people visiting the centers for eye examinations, who were referred by the social workers. Results : Data analysis was carried out to know the reasons for not availing the services within the community. Of the 4070 subjects who visited the vision centre, 4039 case records were complete and analyzed. The demographic associations of the use of spectacles and reasons for not availing services were assessed with age, gender, education, socioeconomic status. On further analyses it was revealed, that, 3373 (83.5%) were aware of their poor vision, of these 2000 people did not visit an eye doctor. When the questions were analyzed as economic reasons and lack of awareness, lack of awareness superseded economic reasons, as lack of awareness was 54.5% Vs economic was 53.70%. Conclusion: When refractive error service delivery was planned for this population, besides providing free spectacles, emphasis on generating awareness for need for refractive errors was also considered.