Sample records for refraction ocular

  1. Influence of refractive correction on ocular dominance

    NASA Astrophysics Data System (ADS)

    Nakayama, Nanami; Kawamorita, Takushi; Uozato, Hiroshi

    2010-07-01

    We investigated the effects of refractive correction and refractive defocus on the assessment of sensory ocular dominance. In 25 healthy subjects (4 males and 21 females) aged between 20 and 31 years, a quantitative measurement of sensory ocular dominance was performed with refractive correction and the addition of a positive lens on the dominant eye. Sensory ocular dominance was measured with a chart using binocular rivalry targets. The reversal point changed after the addition of a +1.00 D lens on the dominant eye in all subjects. However, sighting ocular dominance and stereopsis did not change after the addition of a positive lens on the dominant eye ( P > 0:05, Wilcoxon test). These results suggest that refractive correction affects sensory ocular dominance, indicating the possible development of a new type of occlusion for amblyopia in the future.

  2. Modeling of mouse eye and errors in ocular parameters affecting refractive state

    NASA Astrophysics Data System (ADS)

    Bawa, Gurinder

    Rodents eye are particularly used to study refractive error state of an eye and development of refractive eye. Genetic organization of rodents is similar to that of humans, which makes them interesting candidates to be researched upon. From rodents family mice models are encouraged over rats because of availability of genetically engineered models. Despite of extensive work that has been performed on mice and rat models, still no one is able to quantify an optical model, due to variability in the reported ocular parameters. In this Dissertation, we have extracted ocular parameters and generated schematics of eye from the raw data from School of Medicine, Detroit. In order to see how the rays would travel through an eye and the defects associated with an eye; ray tracing has been performed using ocular parameters. Finally we have systematically evaluated the contribution of various ocular parameters, such as radii of curvature of ocular surfaces, thicknesses of ocular components, and refractive indices of ocular refractive media, using variational analysis and a computational model of the rodent eye. Variational analysis revealed that variation in all the ocular parameters does affect the refractive status of the eye, but depending upon the magnitude of the impact those parameters are listed as critical or non critical. Variation in the depth of the vitreous chamber, thickness of the lens, radius of the anterior surface of the cornea, radius of the anterior surface of the lens, as well as refractive indices for the lens and vitreous, appears to have the largest impact on the refractive error and thus are categorized as critical ocular parameters. The radii of the posterior surfaces of the cornea and lens have much smaller contributions to the refractive state, while the radii of the anterior and posterior surfaces of the retina have no effect on the refractive error. These data provide the framework for further refinement of the optical models of the rat and mouse eye and suggest that extra efforts should be directed towards increasing the linear resolution of the rodent eye biometry and obtaining more accurate data for the refractive indices of the lens and vitreous.

  3. Visual Survey of Apache Aviators (VISAA)

    DTIC Science & Technology

    1990-09-01

    ocular symptoms ..... . 28 D. Aviator spectacle wear .... ............ 29 E. General discussion and summary .. ........ 30 Part 2: Laboratory...cycloplegic refractive errors . . 36 Lateral phorias ........ ........ . 36 Ocular vergence facility. ..... ........ . 37 Dissociated cross cylinder test...40 Binocular rivalry .. ......... ..... 40 Manifest and cycloplegic refraction ..... . 41 Lateral phorias ........ ......... . 41 Ocular

  4. Müller glia-derived PRSS56 is required to sustain ocular axial growth and prevent refractive error.

    PubMed

    Paylakhi, Seyyedhassan; Labelle-Dumais, Cassandre; Tolman, Nicholas G; Sellarole, Michael A; Seymens, Yusef; Saunders, Joseph; Lakosha, Hesham; deVries, Wilhelmine N; Orr, Andrew C; Topilko, Piotr; John, Simon Wm; Nair, K Saidas

    2018-03-01

    A mismatch between optical power and ocular axial length results in refractive errors. Uncorrected refractive errors constitute the most common cause of vision loss and second leading cause of blindness worldwide. Although the retina is known to play a critical role in regulating ocular growth and refractive development, the precise factors and mechanisms involved are poorly defined. We have previously identified a role for the secreted serine protease PRSS56 in ocular size determination and PRSS56 variants have been implicated in the etiology of both hyperopia and myopia, highlighting its importance in refractive development. Here, we use a combination of genetic mouse models to demonstrate that Prss56 mutations leading to reduced ocular size and hyperopia act via a loss of function mechanism. Using a conditional gene targeting strategy, we show that PRSS56 derived from Müller glia contributes to ocular growth, implicating a new retinal cell type in ocular size determination. Importantly, we demonstrate that persistent activity of PRSS56 is required during distinct developmental stages spanning the pre- and post-eye opening periods to ensure optimal ocular growth. Thus, our mouse data provide evidence for the existence of a molecule contributing to both the prenatal and postnatal stages of human ocular growth. Finally, we demonstrate that genetic inactivation of Prss56 rescues axial elongation in a mouse model of myopia caused by a null mutation in Egr1. Overall, our findings identify PRSS56 as a potential therapeutic target for modulating ocular growth aimed at preventing or slowing down myopia, which is reaching epidemic proportions.

  5. Müller glia-derived PRSS56 is required to sustain ocular axial growth and prevent refractive error

    PubMed Central

    Tolman, Nicholas G; Sellarole, Michael A.; Saunders, Joseph; Lakosha, Hesham; Topilko, Piotr; John, Simon WM.

    2018-01-01

    A mismatch between optical power and ocular axial length results in refractive errors. Uncorrected refractive errors constitute the most common cause of vision loss and second leading cause of blindness worldwide. Although the retina is known to play a critical role in regulating ocular growth and refractive development, the precise factors and mechanisms involved are poorly defined. We have previously identified a role for the secreted serine protease PRSS56 in ocular size determination and PRSS56 variants have been implicated in the etiology of both hyperopia and myopia, highlighting its importance in refractive development. Here, we use a combination of genetic mouse models to demonstrate that Prss56 mutations leading to reduced ocular size and hyperopia act via a loss of function mechanism. Using a conditional gene targeting strategy, we show that PRSS56 derived from Müller glia contributes to ocular growth, implicating a new retinal cell type in ocular size determination. Importantly, we demonstrate that persistent activity of PRSS56 is required during distinct developmental stages spanning the pre- and post-eye opening periods to ensure optimal ocular growth. Thus, our mouse data provide evidence for the existence of a molecule contributing to both the prenatal and postnatal stages of human ocular growth. Finally, we demonstrate that genetic inactivation of Prss56 rescues axial elongation in a mouse model of myopia caused by a null mutation in Egr1. Overall, our findings identify PRSS56 as a potential therapeutic target for modulating ocular growth aimed at preventing or slowing down myopia, which is reaching epidemic proportions. PMID:29529029

  6. Screening athletes with Down syndrome for ocular disease.

    PubMed

    Gutstein, Walter; Sinclair, Stephen H; North, Rachel V; Bekiroglu, N

    2010-02-01

    Persons with Down syndrome are well known to have a high prevalence of vision and eye health problems, many of which are undetected or untreated primarily because of infrequent ocular examinations. Public screening programs, directed toward the pediatric population, have become more popular and commonly use letter or symbol charts. This study compares 2 vision screening methods, the Lea Symbol chart and a newly developed interactive computer program, the Vimetrics Central Vision Analyzer (CVA), in their ability to identify ocular disease in the Down syndrome population. Athletes with Down syndrome participating in the European Special Olympics underwent an ocular screening including history, auto-refraction, colour vision assessment, stereopsis assessment, motility assessment, pupil reactivity, and tonometry testing, as well as anterior segment and fundus examinations to evaluate for ocular disease. Visual acuity was tested with the Lea chart and CVA to evaluate these as screening tests for detecting ocular disease as well as significant, uncorrected refractive errors. Among the 91 athletes that presented to the screening, 79 (158 eyes) were sufficiently cooperative for the examination to be completed. Mean age was 26 years +/-10.8 SD. Significant, uncorrected refractive errors (>/=1.00 spherical equivalent) were detected in 28 (18%) eyes and ocular pathology in 51 (32%) eyes. The Lea chart sensitivity and specificity were 43% and 74%, respectively, for detecting ocular pathology and 58% and 100% for detecting uncorrected refractive errors. The CVA sensitivity and specificity were 70% and 86% for detecting pathology and 71% and 100% for detecting uncorrected refractive errors. This study confirmed the findings of prior studies in identifying a significant presence of uncorrected refractive errors and ocular pathology in the Down syndrome population. Screening with the Lea symbol chart found borderline sufficient sensitivity and specificity for the test to be used for screening in this population. The better sensitivity and specificity of the CVA, if adjusted normative values are utilized, appear to make this test sufficient for testing Down syndrome children for identifying both refractive errors and ocular pathology. Copyright 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  7. Recovery of Peripheral Refractive Errors and Ocular Shape in Rhesus Monkeys (Macaca mulatta) with Experimentally Induced Myopia

    PubMed Central

    Huang, Juan; Hung, Li-Fang; Smith, Earl L.

    2012-01-01

    This study aimed to investigate the changes in ocular shape and relative peripheral refraction during the recovery from myopia produced by form deprivation (FD) and hyperopic defocus. FD was imposed in 6 monkeys by securing a diffuser lens over one eye; hyperopic defocus was produced in another 6 monkeys by fitting one eye with -3D spectacle. When unrestricted vision was re-established, the treated eyes recovered from the vision-induced central and peripheral refractive errors. The recovery of peripheral refractive errors was associated with corresponding changes in the shape of the posterior globe. The results suggest that vision can actively regulate ocular shape and the development of central and peripheral refractions in infant primates. PMID:23026012

  8. Relationship between refractive error and ocular biometrics in twin children: the Guangzhou Twin Eye Study.

    PubMed

    Wang, Decai; Liu, Bin; Huang, Shengsong; Huang, Wenyong; He, Mingguang

    2014-09-01

    A cross-sectional study was conducted to explore the relationship between refractive error and ocular biometrics in children from the Guangzhou twin eye study. Twin participants aged 7-15 years were selected from Guangzhou Twin Eye Study. Ocular examinations included visual acuity measurement, ocular motility evaluation, autorefraction under cycloplegia, and anterior segment, media, and fundus examination. Axial length (AL), anterior chamber depth (ACD), and corneal curvature radius were measured using partial coherence laser interferometry. A multivariate linear regression model was used for statistical analysis. Twin children from Guangzhou city showed a decreased spherical equivalent with age, whereas both AL and ACD were increased and corneal curvature radius remained unchanged. When adjusted by age and gender, the data from 77% of twins presenting with spherical equivalent changes indicated that these were caused by predictable variables (R2 = 0.77, P < 0.001). Primary factors affecting children's refraction included axial length (β = -0.97,P < 0.001), ACD (β = 0.33, P < 0.001), and curvature radius (β = 2.10, P < 0.001). Girls had a higher tendency for myopic status than did boys (β = -0.26, P < 0.001). Age exerted no effect upon the changes in refraction (β = -0.01, P = 0.25). Refraction is correlated with ocular biometrics. Refractive status is largely determined by axial length as the major factor.

  9. Correlation of major components of ocular astigmatism in myopic patients.

    PubMed

    Mohammadpour, Mehrdad; Heidari, Zahra; Khabazkhoob, Mehdi; Amouzegar, Afsaneh; Hashemi, Hassan

    2016-02-01

    To investigate the correlation of major components of ocular astigmatism in myopic patients in an academic hospital. This cross-sectional study was conducted on 376 eyes of 188 patients who were referred to Farabi Eye Hospital for refractive surgery. Preoperative examinations including refraction and corneal topography were performed for all candidates to measure refractive and corneal astigmatism. Ocular residual astigmatism was calculated using vector analysis. Pearson's correlation and ANOVA analysis were used to evaluate the strength of the association between different types of astigmatism. Both eyes were defined as cluster and the Generalized Estimating Equations (GEE) analysis were performed. Mean age of 119 women (63.3%) and 69 men (36.7%) was 27.8 ± 5.7 years. Mean refractive error based on spherical equivalent was -3.59 ± 1.95D (range, -0.54 to -10.22D). Mean refractive and corneal astigmatism was 1.97 ± 1.3D and 1.85 ± 1.01D, respectively. Mean amount of ORA was 0.65 ± 0.36D.There was a significant correlation between ORA and refractive astigmatism(r=0.23, p<0.001), corneal and refractive astigmatism (r=0.91, p<0.001) and a weak correlation between ORA and corneal astigmatism (r=0.13, p=0.014). There was a significant correlation between J0 and J45 values of ORA and corneal astigmatism (p<0.001). There is a significant correlation between ORA and refractive astigmatism, refractive and corneal astigmatism and a weak correlation between ORA and corneal astigmatism in refractive surgery candidates. Identifying the type of astigmatism and preoperative measurement of ocular residual astigmatism is highly recommended prior to any refractive surgery, especially in cases with significant astigmatism. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Association of Body Length with Ocular Parameters in Mice

    PubMed Central

    Chakraborty, Ranjay; Park, Han na; Tan, Christopher C.; Weiss, Paul; Prunt, Megan C.; Pardue, Machelle T.

    2017-01-01

    Purpose To determine the association between changes in body length with ocular refraction, corneal radii, axial length, and lens thickness in two different mouse strains. Methods Body length, ocular refraction, corneal radii, axial length, and lens thickness were measured for two inbred mouse strains: 129S1/SvJ (n=7) and C57BL/6J (n=10) from 4 to 12 weeks of age. Body length, from tip of nose to base of tail was obtained using a digital camera. Biometric parameters, corneal radii and refractions were measured using spectral-domain optical coherence tomography, automated keratometry and infrared photorefraction, respectively. A mixed model ANOVA was performed to examine the changes in ocular parameters as a function of body length and strain in mice controlling for age, gender and weight over time. Results C57BL/6J mice had significantly longer body length (average body length at 10 weeks, 8.60 ± 0.06 cm) compared 129S1/SvJ mice (8.31 ± 0.05 cm) during development (p<0.001). C57BL/6J mice had significantly hyperopic refractions compared to 129S1/SvJ mice across age (mean refraction at 10 weeks, 129S1/SvJ: +0.99 ± 0.44 D versus C57BL/6J: +6.24 ± 0.38 D, p<0.001). Corneal radius of curvature, axial length and lens thickness (except 10 weeks lens thickness) were similar between the two strains throughout the measurement. In the mixed model ANOVA, changes in body length showed an independent and significant association with the changes in refraction (p=0.002) and corneal radii (p=0.016) for each mouse strain. No significant association was found between the changes in axial length (p=0.925) or lens thickness (p=0.973) as a function of body length and strain. Conclusions Changes in body length are significantly associated with the changes in ocular refraction and corneal radii in different mouse strains. Future studies are needed to determine if the association between body length and ocular refraction are related to changes in corneal curvature in mice. PMID:28005683

  11. Heritability of refractive error and ocular biometrics: the Genes in Myopia (GEM) twin study.

    PubMed

    Dirani, Mohamed; Chamberlain, Matthew; Shekar, Sri N; Islam, Amirul F M; Garoufalis, Pam; Chen, Christine Y; Guymer, Robyn H; Baird, Paul N

    2006-11-01

    A classic twin study was undertaken to assess the contribution of genes and environment to the development of refractive errors and ocular biometrics in a twin population. A total of 1224 twins (345 monozygotic [MZ] and 267 dizygotic [DZ] twin pairs) aged between 18 and 88 years were examined. All twins completed a questionnaire consisting of a medical history, education, and zygosity. Objective refraction was measured in all twins, and biometric measurements were obtained using partial coherence interferometry. Intrapair correlations for spherical equivalent and ocular biometrics were significantly higher in the MZ than in the DZ twin pairs (P < 0.05), when refraction was considered as a continuous variable. A significant gender difference in the variation of spherical equivalent and ocular biometrics was found (P < 0.05). A genetic model specifying an additive, dominant, and unique environmental factor that was sex limited was the best fit for all measured variables. Heritability of spherical equivalents of 88% and 75% were found in the men and women, respectively, whereas, that of axial length was 94% and 92%, respectively. Additive genetic effects accounted for a greater proportion of the variance in spherical equivalent, whereas the variance in ocular biometrics, particularly axial length was explained mostly by dominant genetic effects. Genetic factors, both additive and dominant, play a significant role in refractive error (myopia and hypermetropia) as well as in ocular biometrics, particularly axial length. The sex limitation ADE model (additive genetic, nonadditive genetic, and environmental components) provided the best-fit genetic model for all parameters.

  12. Refractive, corneal and ocular residual astigmatism: distribution in a German population and age-dependency - the Gutenberg health study.

    PubMed

    Schuster, Alexander Karl-Georg; Pfeiffer, Norbert; Schulz, Andreas; Hoehn, René; Ponto, Katharina A; Wild, Philipp S; Blettner, Maria; Beutel, Manfred E; Lackner, Karl J; Münzel, Thomas; Mirshahi, Alireza

    2017-12-01

    Worldwide, the most frequent cause of visual impairment is uncorrected refractive error. This analysis focused on the distribution and associations of refractive, corneal and ocular residual astigmatism. As part of the Gutenberg Health study, a population-based cross-sectional study was conducted in the general population of Germany. A comprehensive ophthalmological examination including refraction, tonometry, and Scheimpflug imaging of the anterior cornea (Pachycam) was performed. In addition to the magnitude and type (with-the-rule, against-the-rule, oblique) of the refractive or corneal astigmatism, we calculated the vector components (J 0 , J 45 ) of both astigmatisms and calculated the ocular residual astigmatism. We performed multiple quantile regression analysis to evaluate the factors associated with refractive, corneal and ocular residual astigmatisms. A total of 13,558 subjects (49% female) with a mean age of 54.0 years (range 35-74 years) were included in this study. The prevalence of refractive astigmatism (>1.0D) was 13.0% in right eyes and 12.0% in left eyes, and 85% of these subjects wore spectacles. The distribution of refractive astigmatism showed a two-peak distribution with high astigmatism for with-the-rule and against-the-rule astigmatism. The associated factors were corneal curvature, age and sex for the different astigmatisms (p < 0.001). We analyzed the prevalence of different astigmatisms within a European population. We confirmed a shift with aging from with-the-rule to against-the-rule astigmatism to refractive and corneal astigmatism. Astigmatism has a large impact on visual perception; more than 85% of people with astigmatism over one diopter wore glasses for distance vision.

  13. LASIK for spherical refractive myopia: effect of topographic astigmatism (ocular residual astigmatism, ORA) on refractive outcome.

    PubMed

    Frings, Andreas; Richard, Gisbert; Steinberg, Johannes; Skevas, Christos; Druchkiv, Vasyl; Katz, Toam; Linke, Stephan J

    2015-01-01

    In eyes with a preoperative plano refractive cylinder, it would appear that there is no rationale for astigmatic treatment. The aim of this retrospective, cross-sectional data analysis was to determine the amount of topographic astigmatism in refractive plano eyes that results in reduced efficacy after myopic laser in situ keratomileusis (LASIK). This study included 267 eyes from 267 consecutive myopic patients with a refractive plano cylinder. Receiver operating characteristic analysis was used to find the cut-off values of preoperative ocular residual astigmatism (= topographic astigmatism) that can best discriminate between groups of efficacy and safety indices in preoperative plano refractive cylinder eyes. Preoperative ocular residual astigmatism (ORA) (or topographic astigmatism) of ≤0.9 diopters (D) resulted in an efficacy index of at least 0.8 statistically significantly more frequently than eyes with a preoperative ORA of >0.9 D. Eyes with a high ORA preoperatively also had a high ORA postoperatively. Regression analysis showed that each diopter of preoperative ORA reduced efficacy by 0.07. A preoperative corneal astigmatism of ≥0.9 D could (partially) be taken into account in the LASIK design, even if the subjective refractive astigmatism is neutral.

  14. Evaluation of internal refraction with the optical path difference scan.

    PubMed

    Muftuoglu, Orkun; Erdem, Uzeyir

    2008-01-01

    To evaluate internal refraction and its relation to other optical properties of the eye across a large range of refractive errors, which can provide useful information for the assessment and design of intraocular lenses and corneal ablation patterns. Cohort study. Three hundred ninety-four eyes of 197 healthy subjects with a mean age of 27+/-7 years (range, 18-42). All eyes underwent optical path difference scans to evaluate corneal topography, whole and internal ocular refraction (determined by the subtraction of corneal refraction from whole ocular refraction), and total and higher-order aberrations (HOAs) were assessed. After the conversion of any spherocylindrical refractive errors to vectorial data (sphere equivalent, blurring strength; cylinder, J(0) [power of Jackson cross cylinder at 90 degrees and 180 degrees] and J45 [power of Jackson cross cylinder at 45 degrees and 135 degrees]), the distribution of internal refraction among refraction groups (high myopes, low to moderate myopes, hyperopes, mixed astigmats, and emmetropes) and relationships between internal refraction, corneal refraction, and wavefront aberrations were analyzed. The compensation relation and its rate between corneal and internal astigmatism was assessed by the compensation factor (CF). Whole ocular power and astigmatism, corneal power and astigmatism, internal power and astigmatism, CF for astigmatic data, location of the highest internal refraction zone, and wavefront aberrations. The highest refraction zone was mostly (90%) located in the center in myopes, whereas it was located at the nasal side (71%) in hyperopes. There was a significant correlation between whole ocular and internal powers (P<0.01), but no correlation was observed between corneal and internal powers (P>0.05). Internal astigmatism was mostly against the rule. The mean CF J(0) was 0.63+/-3.78 and CF J(45) was 0.57+/-2.47. The magnitude of the internal astigmatism under the 3-mm zone was correlated with the magnitude of corneal astigmatism (P<0.05). The distribution of astigmatic CF differed among refraction groups. There were significant correlations between internal power and spherical aberration (P<0.05) and internal cylinder under the 5-mm zone and HOAs (P<0.001). There is a remarkable tilt in internal refraction in hyperopes. Although there is a tendency of undercompensation of the corneal astigmatism by internal astigmatism in the entire group of eyes, the compensation differs among refraction groups.

  15. Refractive errors and ocular findings in children with intellectual disability: A controlled study

    PubMed Central

    Akinci, Arsen; Oner, Ozgur; Bozkurt, Ozlem Hekim; Guven, Alev; Degerliyurt, Aydan; Munir, Kerim

    2015-01-01

    PURPOSE To evaluate the ocular findings and refractive errors in children with intellectual disability and in controls of average intellectual development of similar socioeconomic backgrounds. METHODS The study was conducted at Diskapi Children’s Hospital in Ankara, Turkey: 724 subjects with intellectual disability and 151 control subjects were evaluated. The subjects with intellectual disability were subdivided into mild (IQ 50–69, n = 490), moderate (IQ 35–49, n = 164), and severe (IQ <34, n = 70) groups, and syndromic (n = 138) versus nonsyndromic (n = 586) disability. All children underwent cycloplegic autorefraction or retinoscopy, slit-lamp biomicroscopy, and dilated fundus examination. Ocular alignment was assessed by Hirschberg, Krimsky, or prism cover test. The main outcome measure was the prevalence of refractive errors and ocular findings. RESULTS Seventy-seven percent of subjects with intellectual disability, and 42.4% of controls, had ocular findings. The children with intellectual disability had significantly more nystagmus, strabismus, astigmatism, and hypermetropia than controls. Children with syndromic intellectual disability had significantly more nystagmus, strabismus, astigmatism, and hypermetropia than subjects with nonsyndromic intellectual disability. Increasing severity of intellectual disability was related to higher prevalence of nystagmus, strabismus, astigmatism, hypermetropia, and anisometropia. CONCLUSIONS From a public health perspective, evaluation and treatment of ocular and refractive findings in children with moderate, severe, and syndromic intellectual disability categories is urgently needed and likely to be highly effective in alleviating future health and social care costs, as well as improving the productive lives of individuals with intellectual disability. PMID:18595752

  16. LASIK for Spherical Refractive Myopia: Effect of Topographic Astigmatism (Ocular Residual Astigmatism, ORA) on Refractive Outcome

    PubMed Central

    Frings, Andreas; Richard, Gisbert; Steinberg, Johannes; Skevas, Christos; Druchkiv, Vasyl; Katz, Toam; Linke, Stephan J.

    2015-01-01

    Purpose In eyes with a preoperative plano refractive cylinder, it would appear that there is no rationale for astigmatic treatment. The aim of this retrospective, cross-sectional data analysis was to determine the amount of topographic astigmatism in refractive plano eyes that results in reduced efficacy after myopic laser in situ keratomileusis (LASIK). Methods This study included 267 eyes from 267 consecutive myopic patients with a refractive plano cylinder. Receiver operating characteristic analysis was used to find the cut-off values of preoperative ocular residual astigmatism (= topographic astigmatism) that can best discriminate between groups of efficacy and safety indices in preoperative plano refractive cylinder eyes. Results Preoperative ocular residual astigmatism (ORA) (or topographic astigmatism) of ≤0.9 diopters (D) resulted in an efficacy index of at least 0.8 statistically significantly more frequently than eyes with a preoperative ORA of >0.9 D. Eyes with a high ORA preoperatively also had a high ORA postoperatively. Regression analysis showed that each diopter of preoperative ORA reduced efficacy by 0.07. Conclusion A preoperative corneal astigmatism of ≥0.9 D could (partially) be taken into account in the LASIK design, even if the subjective refractive astigmatism is neutral. PMID:25875476

  17. Refractive ocular conditions and reasons for spectacles renewal in a resource-limited economy

    PubMed Central

    2010-01-01

    Background Although a leading cause of visual impairment and a treatable cause of blindness globally, the pattern of refractive errors in many populations is unknown. This study determined the pattern of refractive ocular conditions, reasons for spectacles renewal and the effect of correction on refractive errors in a resource-limited community. Methods A retrospective review of case records of 1,413 consecutive patients seen in a private optometry practice, Nigeria between January 2006 and July 2007. Results A total number of 1,216 (86.1%) patients comprising of (486, 40%) males and (730, 60%) females with a mean age of 41.02 years SD 14.19 were analyzed. The age distribution peaked at peri-adolescent and the middle age years. The main ocular complaints were spectacles loss and discomfort (412, 33.9%), blurred near vision (399, 32.8%) and asthenopia (255, 20.9%). The mean duration of ocular symptoms before consultation was 2.05 years SD 1.92. The most common refractive errors include presbyopia (431, 35.3%), hyperopic astigmatism (240, 19.7%) and presbyopia with hyperopia (276, 22.7%). Only (59, 4.9%) had myopia. Following correction, there were reductions in magnitudes of the blind (VA<3/60) and visually impaired (VA<6/18-3/60) patients by (18, 58.1%) and (89, 81.7%) respectively. The main reasons for renewal of spectacles were broken lenses/frame/scratched lenses/lenses' falling off (47, 63.4%). Conclusions Adequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years. PMID:20459676

  18. Refractive ocular conditions and reasons for spectacles renewal in a resource-limited economy.

    PubMed

    Ayanniyi, Abdulkabir A; Folorunso, Francisca N; Adepoju, Feyisayo G

    2010-05-07

    Although a leading cause of visual impairment and a treatable cause of blindness globally, the pattern of refractive errors in many populations is unknown. This study determined the pattern of refractive ocular conditions, reasons for spectacles renewal and the effect of correction on refractive errors in a resource-limited community. A retrospective review of case records of 1,413 consecutive patients seen in a private optometry practice, Nigeria between January 2006 and July 2007. A total number of 1,216 (86.1%) patients comprising of (486, 40%) males and (730, 60%) females with a mean age of 41.02 years SD 14.19 were analyzed. The age distribution peaked at peri-adolescent and the middle age years. The main ocular complaints were spectacles loss and discomfort (412, 33.9%), blurred near vision (399, 32.8%) and asthenopia (255, 20.9%). The mean duration of ocular symptoms before consultation was 2.05 years SD 1.92. The most common refractive errors include presbyopia (431, 35.3%), hyperopic astigmatism (240, 19.7%) and presbyopia with hyperopia (276, 22.7%). Only (59, 4.9%) had myopia. Following correction, there were reductions in magnitudes of the blind (VA<3/60) and visually impaired (VA<6/18-3/60) patients by (18, 58.1%) and (89, 81.7%) respectively. The main reasons for renewal of spectacles were broken lenses/frame/scratched lenses/lenses' falling off (47, 63.4%). Adequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years.

  19. Matrix metalloproteinases and educational attainment in refractive error: evidence of gene-environment interactions in the AREDS study

    PubMed Central

    Wojciechowski, Robert; Yee, Stephanie S.; Simpson, Claire L.; Bailey-Wilson, Joan E.; Stambolian, Dwight

    2012-01-01

    Purpose A previous study of Old Order Amish families has shown association of ocular refraction with markers proximal to matrix metalloproteinase (MMP) genes MMP1 and MMP10 and intragenic to MMP2. We conducted a candidate gene replication study of association between refraction and single nucleotide polymorphisms (SNPs) within these genomic regions. Design Candidate gene genetic association study. Participants 2,000 participants drawn from the Age Related Eye Disease Study (AREDS) were chosen for genotyping. After quality control filtering, 1912 individuals were available for analysis. Methods Microarray genotyping was performed using the HumanOmni 2.5 bead array. SNPs originally typed in the previous Amish association study were extracted for analysis. In addition, haplotype tagging SNPs were genotyped using TaqMan assays. Quantitative trait association analyses of mean spherical equivalent refraction (MSE) were performed on 30 markers using linear regression models and an additive genetic risk model, while adjusting for age, sex, education, and population substructure. Post-hoc analyses were performed after stratifying on a dichotomous education variable. Pointwise (P-emp) and multiple-test study-wise (P-multi) significance levels were calculated empirically through permutation. Main outcome measures MSE was used as a quantitative measure of ocular refraction. Results The mean age and ocular refraction were 68 years (SD=4.7) and +0.55 D (SD=2.14), respectively. Pointwise statistical significance was obtained for rs1939008 (P-emp=0.0326). No SNP attained statistical significance after correcting for multiple testing. In stratified analyses, multiple SNPs reached pointwise significance in the lower-education group: 2 of these were statistically significant after multiple testing correction. The two highest-ranking SNPs in Amish families (rs1939008 and rs9928731) showed pointwise P-emp<0.01 in the lower-education stratum of AREDS participants. Conclusions We show suggestive evidence of replication of an association signal for ocular refraction to a marker between MMP1 and MMP10. We also provide evidence of a gene-environment interaction between previously-reported markers and education on refractive error. Variants in MMP1- MMP10 and MMP2 regions appear to affect population variation in ocular refraction in environmental conditions less favorable for myopia development. PMID:23098370

  20. Transfer from blue light or green light to white light partially reverses changes in ocular refraction and anatomy of developing guinea pigs.

    PubMed

    Qian, Yi-Feng; Liu, Rui; Dai, Jin-Hui; Chen, Min-Jie; Zhou, Xing-Tao; Chu, Ren-Yuan

    2013-09-26

    Relative to the broadband white light (BL), postnatal guinea pigs develop myopia in a monochromic middle-wavelength light (ML, 530 nm) environment and develop hyperopia in a monochromic short-wavelength light (SL, 430 nm) environment. We investigated whether transfer from SL or ML to BL leads to recuperation of ocular refraction and anatomy of developing guinea pigs. Two-week-old guinea pigs were given (a) SL for 20 weeks, (b) SL recuperation (SLR, SL for 10 weeks then BL for 10 weeks), (c) ML for 20 weeks, (d) ML recuperation (MLR, ML for 10 weeks then BL for 10 weeks), or (e) BL for 20 weeks. Two weeks after transfer from ML to BL (MLR group), ocular refraction increased from 1.95 ± 0.35 D to 2.58 ± 0.24 D, and vitreous length decreased from 3.48 ± 0.06 mm to 3.41 ± 0.06 mm. Two weeks after transfer from SL to BL (SLR group), ocular refraction decreased from 5.65 ± 0.61 D to 4.33 ± 0.49 D, and vitreous length increased from 3.18 ± 0.07 mm to 3.26 ± 0.11 mm. The MLR and SLR groups had final ocular refractions that were significantly different from those of the ML and SL groups at 20 weeks (ML vs. MLR: p < 0.0001; SL vs. SLR: p < 0.0001) but were still significantly different from the BL group (BL vs. MLR: p = 0.0120; BL vs. SLR: p = 0.0010). These results suggest that recuperation was not complete after return to BL for 10 weeks.

  1. Nine Loci for Ocular Axial Length Identified through Genome-wide Association Studies, Including Shared Loci with Refractive Error

    PubMed Central

    Cheng, Ching-Yu; Schache, Maria; Ikram, M. Kamran; Young, Terri L.; Guggenheim, Jeremy A.; Vitart, Veronique; MacGregor, Stuart; Verhoeven, Virginie J.M.; Barathi, Veluchamy A.; Liao, Jiemin; Hysi, Pirro G.; Bailey-Wilson, Joan E.; St. Pourcain, Beate; Kemp, John P.; McMahon, George; Timpson, Nicholas J.; Evans, David M.; Montgomery, Grant W.; Mishra, Aniket; Wang, Ya Xing; Wang, Jie Jin; Rochtchina, Elena; Polasek, Ozren; Wright, Alan F.; Amin, Najaf; van Leeuwen, Elisabeth M.; Wilson, James F.; Pennell, Craig E.; van Duijn, Cornelia M.; de Jong, Paulus T.V.M.; Vingerling, Johannes R.; Zhou, Xin; Chen, Peng; Li, Ruoying; Tay, Wan-Ting; Zheng, Yingfeng; Chew, Merwyn; Rahi, Jugnoo S.; Hysi, Pirro G.; Yoshimura, Nagahisa; Yamashiro, Kenji; Miyake, Masahiro; Delcourt, Cécile; Maubaret, Cecilia; Williams, Cathy; Guggenheim, Jeremy A.; Northstone, Kate; Ring, Susan M.; Davey-Smith, George; Craig, Jamie E.; Burdon, Kathryn P.; Fogarty, Rhys D.; Iyengar, Sudha K.; Igo, Robert P.; Chew, Emily; Janmahasathian, Sarayut; Iyengar, Sudha K.; Igo, Robert P.; Chew, Emily; Janmahasathian, Sarayut; Stambolian, Dwight; Wilson, Joan E. Bailey; MacGregor, Stuart; Lu, Yi; Jonas, Jost B.; Xu, Liang; Saw, Seang-Mei; Baird, Paul N.; Rochtchina, Elena; Mitchell, Paul; Wang, Jie Jin; Jonas, Jost B.; Nangia, Vinay; Hayward, Caroline; Wright, Alan F.; Vitart, Veronique; Polasek, Ozren; Campbell, Harry; Vitart, Veronique; Rudan, Igor; Vatavuk, Zoran; Vitart, Veronique; Paterson, Andrew D.; Hosseini, S. Mohsen; Iyengar, Sudha K.; Igo, Robert P.; Fondran, Jeremy R.; Young, Terri L.; Feng, Sheng; Verhoeven, Virginie J.M.; Klaver, Caroline C.; van Duijn, Cornelia M.; Metspalu, Andres; Haller, Toomas; Mihailov, Evelin; Pärssinen, Olavi; Wedenoja, Juho; Wilson, Joan E. Bailey; Wojciechowski, Robert; Baird, Paul N.; Schache, Maria; Pfeiffer, Norbert; Höhn, René; Pang, Chi Pui; Chen, Peng; Meitinger, Thomas; Oexle, Konrad; Wegner, Aharon; Yoshimura, Nagahisa; Yamashiro, Kenji; Miyake, Masahiro; Pärssinen, Olavi; Yip, Shea Ping; Ho, Daniel W.H.; Pirastu, Mario; Murgia, Federico; Portas, Laura; Biino, Genevra; Wilson, James F.; Fleck, Brian; Vitart, Veronique; Stambolian, Dwight; Wilson, Joan E. Bailey; Hewitt, Alex W.; Ang, Wei; Verhoeven, Virginie J.M.; Klaver, Caroline C.; van Duijn, Cornelia M.; Saw, Seang-Mei; Wong, Tien-Yin; Teo, Yik-Ying; Fan, Qiao; Cheng, Ching-Yu; Zhou, Xin; Ikram, M. Kamran; Saw, Seang-Mei; Teo, Yik-Ying; Fan, Qiao; Cheng, Ching-Yu; Zhou, Xin; Ikram, M. Kamran; Saw, Seang-Mei; Wong, Tien-Yin; Teo, Yik-Ying; Fan, Qiao; Cheng, Ching-Yu; Zhou, Xin; Ikram, M. Kamran; Saw, Seang-Mei; Wong, Tien-Yin; Teo, Yik-Ying; Fan, Qiao; Cheng, Ching-Yu; Zhou, Xin; Ikram, M. Kamran; Saw, Seang-Mei; Tai, E-Shyong; Teo, Yik-Ying; Fan, Qiao; Cheng, Ching-Yu; Zhou, Xin; Ikram, M. Kamran; Saw, Seang-Mei; Teo, Yik-Ying; Fan, Qiao; Cheng, Ching-Yu; Zhou, Xin; Ikram, M. Kamran; Mackey, David A.; MacGregor, Stuart; Hammond, Christopher J.; Hysi, Pirro G.; Deangelis, Margaret M.; Morrison, Margaux; Zhou, Xiangtian; Chen, Wei; Paterson, Andrew D.; Hosseini, S. Mohsen; Mizuki, Nobuhisa; Meguro, Akira; Lehtimäki, Terho; Mäkelä, Kari-Matti; Raitakari, Olli; Kähönen, Mika; Burdon, Kathryn P.; Craig, Jamie E.; Iyengar, Sudha K.; Igo, Robert P.; Lass, Jonathan H.; Reinhart, William; Belin, Michael W.; Schultze, Robert L.; Morason, Todd; Sugar, Alan; Mian, Shahzad; Soong, Hunson Kaz; Colby, Kathryn; Jurkunas, Ula; Yee, Richard; Vital, Mark; Alfonso, Eduardo; Karp, Carol; Lee, Yunhee; Yoo, Sonia; Hammersmith, Kristin; Cohen, Elisabeth; Laibson, Peter; Rapuano, Christopher; Ayres, Brandon; Croasdale, Christopher; Caudill, James; Patel, Sanjay; Baratz, Keith; Bourne, William; Maguire, Leo; Sugar, Joel; Tu, Elmer; Djalilian, Ali; Mootha, Vinod; McCulley, James; Bowman, Wayne; Cavanaugh, H. Dwight; Verity, Steven; Verdier, David; Renucci, Ann; Oliva, Matt; Rotkis, Walter; Hardten, David R.; Fahmy, Ahmad; Brown, Marlene; Reeves, Sherman; Davis, Elizabeth A.; Lindstrom, Richard; Hauswirth, Scott; Hamilton, Stephen; Lee, W. Barry; Price, Francis; Price, Marianne; Kelly, Kathleen; Peters, Faye; Shaughnessy, Michael; Steinemann, Thomas; Dupps, B.J.; Meisler, David M.; Mifflin, Mark; Olson, Randal; Aldave, Anthony; Holland, Gary; Mondino, Bartly J.; Rosenwasser, George; Gorovoy, Mark; Dunn, Steven P.; Heidemann, David G.; Terry, Mark; Shamie, Neda; Rosenfeld, Steven I.; Suedekum, Brandon; Hwang, David; Stone, Donald; Chodosh, James; Galentine, Paul G.; Bardenstein, David; Goddard, Katrina; Chin, Hemin; Mannis, Mark; Varma, Rohit; Borecki, Ingrid; Chew, Emily Y.; Haller, Toomas; Mihailov, Evelin; Metspalu, Andres; Wedenoja, Juho; Simpson, Claire L.; Wojciechowski, Robert; Höhn, René; Mirshahi, Alireza; Zeller, Tanja; Pfeiffer, Norbert; Lackner, Karl J.; Donnelly, Peter; Barroso, Ines; Blackwell, Jenefer M.; Bramon, Elvira; Brown, Matthew A.; Casas, Juan P.; Corvin, Aiden; Deloukas, Panos; Duncanson, Audrey; Jankowski, Janusz; Markus, Hugh S.; Mathew, Christopher G.; Palmer, Colin N.A.; Plomin, Robert; Rautanen, Anna; Sawcer, Stephen J.; Trembath, Richard C.; Viswanathan, Ananth C.; Wood, Nicholas W.; Spencer, Chris C.A.; Band, Gavin; Bellenguez, Céline; Freeman, Colin; Hellenthal, Garrett; Giannoulatou, Eleni; Pirinen, Matti; Pearson, Richard; Strange, Amy; Su, Zhan; Vukcevic, Damjan; Donnelly, Peter; Langford, Cordelia; Hunt, Sarah E.; Edkins, Sarah; Gwilliam, Rhian; Blackburn, Hannah; Bumpstead, Suzannah J.; Dronov, Serge; Gillman, Matthew; Gray, Emma; Hammond, Naomi; Jayakumar, Alagurevathi; McCann, Owen T.; Liddle, Jennifer; Potter, Simon C.; Ravindrarajah, Radhi; Ricketts, Michelle; Waller, Matthew; Weston, Paul; Widaa, Sara; Whittaker, Pamela; Barroso, Ines; Deloukas, Panos; Mathew, Christopher G.; Blackwell, Jenefer M.; Brown, Matthew A.; Corvin, Aiden; Spencer, Chris C.A.; Bettecken, Thomas; Meitinger, Thomas; Oexle, Konrad; Pirastu, Mario; Portas, Laura; Nag, Abhishek; Williams, Katie M.; Yonova-Doing, Ekaterina; Klein, Ronald; Klein, Barbara E.; Hosseini, S. Mohsen; Paterson, Andrew D.; Genuth, S.; Nathan, D.M.; Zinman, B.; Crofford, O.; Crandall, J.; Reid, M.; Brown-Friday, J.; Engel, S.; Sheindlin, J.; Martinez, H.; Shamoon, H.; Engel, H.; Phillips, M.; Gubitosi-Klug, R.; Mayer, L.; Pendegast, S.; Zegarra, H.; Miller, D.; Singerman, L.; Smith-Brewer, S.; Novak, M.; Quin, J.; Dahms, W.; Genuth, Saul; Palmert, M.; Brillon, D.; Lackaye, M.E.; Kiss, S.; Chan, R.; Reppucci, V.; Lee, T.; Heinemann, M.; Whitehouse, F.; Kruger, D.; Jones, J.K.; McLellan, M.; Carey, J.D.; Angus, E.; Thomas, A.; Galprin, A.; Bergenstal, R.; Johnson, M.; Spencer, M.; Morgan, K.; Etzwiler, D.; Kendall, D.; Aiello, Lloyd Paul; Golden, E.; Jacobson, A.; Beaser, R.; Ganda, O.; Hamdy, O.; Wolpert, H.; Sharuk, G.; Arrigg, P.; Schlossman, D.; Rosenzwieg, J.; Rand, L.; Nathan, D.M.; Larkin, M.; Ong, M.; Godine, J.; Cagliero, E.; Lou, P.; Folino, K.; Fritz, S.; Crowell, S.; Hansen, K.; Gauthier-Kelly, C.; Service, J.; Ziegler, G.; Luttrell, L.; Caulder, S.; Lopes-Virella, M.; Colwell, J.; Soule, J.; Fernandes, J.; Hermayer, K.; Kwon, S.; Brabham, M.; Blevins, A.; Parker, J.; Lee, D.; Patel, N.; Pittman, C.; Lindsey, P.; Bracey, M.; Lee, K.; Nutaitis, M.; Farr, A.; Elsing, S.; Thompson, T.; Selby, J.; Lyons, T.; Yacoub-Wasef, S.; Szpiech, M.; Wood, D.; Mayfield, R.; Molitch, M.; Schaefer, B.; Jampol, L.; Lyon, A.; Gill, M.; Strugula, Z.; Kaminski, L.; Mirza, R.; Simjanoski, E.; Ryan, D.; Kolterman, O.; Lorenzi, G.; Goldbaum, M.; Sivitz, W.; Bayless, M.; Counts, D.; Johnsonbaugh, S.; Hebdon, M.; Salemi, P.; Liss, R.; Donner, T.; Gordon, J.; Hemady, R.; Kowarski, A.; Ostrowski, D.; Steidl, S.; Jones, B.; Herman, W.H.; Martin, C.L.; Pop-Busui, R.; Sarma, A.; Albers, J.; Feldman, E.; Kim, K.; Elner, S.; Comer, G.; Gardner, T.; Hackel, R.; Prusak, R.; Goings, L.; Smith, A.; Gothrup, J.; Titus, P.; Lee, J.; Brandle, M.; Prosser, L.; Greene, D.A.; Stevens, M.J.; Vine, A.K.; Bantle, J.; Wimmergren, N.; Cochrane, A.; Olsen, T.; Steuer, E.; Rath, P.; Rogness, B.; Hainsworth, D.; Goldstein, D.; Hitt, S.; Giangiacomo, J.; Schade, D.S.; Canady, J.L.; Chapin, J.E.; Ketai, L.H.; Braunstein, C.S.; Bourne, P.A.; Schwartz, S.; Brucker, A.; Maschak-Carey, B.J.; Baker, L.; Orchard, T.; Silvers, N.; Ryan, C.; Songer, T.; Doft, B.; Olson, S.; Bergren, R.L.; Lobes, L.; Rath, P. Paczan; Becker, D.; Rubinstein, D.; Conrad, P.W.; Yalamanchi, S.; Drash, A.; Morrison, A.; Bernal, M.L.; Vaccaro-Kish, J.; Malone, J.; Pavan, P.R.; Grove, N.; Iyer, M.N.; Burrows, A.F.; Tanaka, E.A.; Gstalder, R.; Dagogo-Jack, S.; Wigley, C.; Ricks, H.; Kitabchi, A.; Murphy, M.B.; Moser, S.; Meyer, D.; Iannacone, A.; Chaum, E.; Yoser, S.; Bryer-Ash, M.; Schussler, S.; Lambeth, H.; Raskin, P.; Strowig, S.; Zinman, B.; Barnie, A.; Devenyi, R.; Mandelcorn, M.; Brent, M.; Rogers, S.; Gordon, A.; Palmer, J.; Catton, S.; Brunzell, J.; Wessells, H.; de Boer, I.H.; Hokanson, J.; Purnell, J.; Ginsberg, J.; Kinyoun, J.; Deeb, S.; Weiss, M.; Meekins, G.; Distad, J.; Van Ottingham, L.; Dupre, J.; Harth, J.; Nicolle, D.; Driscoll, M.; Mahon, J.; Canny, C.; May, M.; Lipps, J.; Agarwal, A.; Adkins, T.; Survant, L.; Pate, R.L.; Munn, G.E.; Lorenz, R.; Feman, S.; White, N.; Levandoski, L.; Boniuk, I.; Grand, G.; Thomas, M.; Joseph, D.D.; Blinder, K.; Shah, G.; Boniuk; Burgess; Santiago, J.; Tamborlane, W.; Gatcomb, P.; Stoessel, K.; Taylor, K.; Goldstein, J.; Novella, S.; Mojibian, H.; Cornfeld, D.; Lima, J.; Bluemke, D.; Turkbey, E.; van der Geest, R.J.; Liu, C.; Malayeri, A.; Jain, A.; Miao, C.; Chahal, H.; Jarboe, R.; Maynard, J.; Gubitosi-Klug, R.; Quin, J.; Gaston, P.; Palmert, M.; Trail, R.; Dahms, W.; Lachin, J.; Cleary, P.; Backlund, J.; Sun, W.; Braffett, B.; Klumpp, K.; Chan, K.; Diminick, L.; Rosenberg, D.; Petty, B.; Determan, A.; Kenny, D.; Rutledge, B.; Younes, Naji; Dews, L.; Hawkins, M.; Cowie, C.; Fradkin, J.; Siebert, C.; Eastman, R.; Danis, R.; Gangaputra, S.; Neill, S.; Davis, M.; Hubbard, L.; Wabers, H.; Burger, M.; Dingledine, J.; Gama, V.; Sussman, R.; Steffes, M.; Bucksa, J.; Nowicki, M.; Chavers, B.; O’Leary, D.; Polak, J.; Harrington, A.; Funk, L.; Crow, R.; Gloeb, B.; Thomas, S.; O’Donnell, C.; Soliman, E.; Zhang, Z.M.; Prineas, R.; Campbell, C.; Ryan, C.; Sandstrom, D.; Williams, T.; Geckle, M.; Cupelli, E.; Thoma, F.; Burzuk, B.; Woodfill, T.; Low, P.; Sommer, C.; Nickander, K.; Budoff, M.; Detrano, R.; Wong, N.; Fox, M.; Kim, L.; Oudiz, R.; Weir, G.; Espeland, M.; Manolio, T.; Rand, L.; Singer, D.; Stern, M.; Boulton, A.E.; Clark, C.; D’Agostino, R.; Lopes-Virella, M.; Garvey, W.T.; Lyons, T.J.; Jenkins, A.; Virella, G.; Jaffa, A.; Carter, Rickey; Lackland, D.; Brabham, M.; McGee, D.; Zheng, D.; Mayfield, R.K.; Boright, A.; Bull, S.; Sun, L.; Scherer, S.; Zinman, B.; Natarajan, R.; Miao, F.; Zhang, L.; Chen;, Z.; Nathan, D.M.; Makela, Kari-Matti; Lehtimaki, Terho; Kahonen, Mika; Raitakari, Olli; Yoshimura, Nagahisa; Matsuda, Fumihiko; Chen, Li Jia; Pang, Chi Pui; Yip, Shea Ping; Yap, Maurice K.H.; Meguro, Akira; Mizuki, Nobuhisa; Inoko, Hidetoshi; Foster, Paul J.; Zhao, Jing Hua; Vithana, Eranga; Tai, E-Shyong; Fan, Qiao; Xu, Liang; Campbell, Harry; Fleck, Brian; Rudan, Igor; Aung, Tin; Hofman, Albert; Uitterlinden, André G.; Bencic, Goran; Khor, Chiea-Chuen; Forward, Hannah; Pärssinen, Olavi; Mitchell, Paul; Rivadeneira, Fernando; Hewitt, Alex W.; Williams, Cathy; Oostra, Ben A.; Teo, Yik-Ying; Hammond, Christopher J.; Stambolian, Dwight; Mackey, David A.; Klaver, Caroline C.W.; Wong, Tien-Yin; Saw, Seang-Mei; Baird, Paul N.

    2013-01-01

    Refractive errors are common eye disorders of public health importance worldwide. Ocular axial length (AL) is the major determinant of refraction and thus of myopia and hyperopia. We conducted a meta-analysis of genome-wide association studies for AL, combining 12,531 Europeans and 8,216 Asians. We identified eight genome-wide significant loci for AL (RSPO1, C3orf26, LAMA2, GJD2, ZNRF3, CD55, MIP, and ALPPL2) and confirmed one previously reported AL locus (ZC3H11B). Of the nine loci, five (LAMA2, GJD2, CD55, ALPPL2, and ZC3H11B) were associated with refraction in 18 independent cohorts (n = 23,591). Differential gene expression was observed for these loci in minus-lens-induced myopia mouse experiments and human ocular tissues. Two of the AL genes, RSPO1 and ZNRF3, are involved in Wnt signaling, a pathway playing a major role in the regulation of eyeball size. This study provides evidence of shared genes between AL and refraction, but importantly also suggests that these traits may have unique pathways. PMID:24144296

  2. What Is Refractive Surgery?

    MedlinePlus

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  3. Implantation of refractive multifocal intraocular lens with a surface-embedded near section for cataract eyes complicated with a coexisting ocular pathology

    PubMed Central

    Ouchi, M; Kinoshita, S

    2015-01-01

    Purpose To evaluate the postoperative outcomes of cataract eyes complicated with coexisting ocular pathologies that underwent implantation of a refractive multifocal intraocular lens (MIOL) with a surface-embedded near section. Methods LENTIS MPlus (Oculentis GmbH) refractive MIOLs were implanted in 15 eyes with ocular pathologies other than cataract (ie, six high-myopia eyes with an axial length longer than 28 mm, two fundus albipunctatus eyes, two branch retinal-vein occlusion eyes, four glaucoma eyes (one with high myopia), and two keratoconus eyes). Uncorrected or corrected distance and near visual acuity (VA) (UDVA, UNVA, CDVA, and CNVA), contrast sensitivity, and defocus curve were measured at 1 day and 6 months postoperatively, and each patient completed a 6-month postoperative questionnaire regarding vision quality and eyeglass use. Results Thirteen eyes (87%) registered 0 or better in CDVA and 12 eyes (73%) registered better than 0 in CNVA. Contrast sensitivity in the eyes of all patients was comparable to that of normal healthy subjects. No patient required eyeglasses for distance vision, but three patients (20%) required them for near vision. No patient reported poor or very poor vision quality. Conclusion With careful case selection, sectorial refractive MIOL implantation is effective for treating cataract eyes complicated with ocular pathologies. PMID:25744442

  4. Implantation of refractive multifocal intraocular lens with a surface-embedded near section for cataract eyes complicated with a coexisting ocular pathology.

    PubMed

    Ouchi, M; Kinoshita, S

    2015-05-01

    To evaluate the postoperative outcomes of cataract eyes complicated with coexisting ocular pathologies that underwent implantation of a refractive multifocal intraocular lens (MIOL) with a surface-embedded near section. LENTIS MPlus (Oculentis GmbH) refractive MIOLs were implanted in 15 eyes with ocular pathologies other than cataract (ie, six high-myopia eyes with an axial length longer than 28 mm, two fundus albipunctatus eyes, two branch retinal-vein occlusion eyes, four glaucoma eyes (one with high myopia), and two keratoconus eyes). Uncorrected or corrected distance and near visual acuity (VA) (UDVA, UNVA, CDVA, and CNVA), contrast sensitivity, and defocus curve were measured at 1 day and 6 months postoperatively, and each patient completed a 6-month postoperative questionnaire regarding vision quality and eyeglass use. Thirteen eyes (87%) registered 0 or better in CDVA and 12 eyes (73%) registered better than 0 in CNVA. Contrast sensitivity in the eyes of all patients was comparable to that of normal healthy subjects. No patient required eyeglasses for distance vision, but three patients (20%) required them for near vision. No patient reported poor or very poor vision quality. With careful case selection, sectorial refractive MIOL implantation is effective for treating cataract eyes complicated with ocular pathologies.

  5. [Difference and distance between the central and thinnest points of the cornea: impact of refractive state, age and ocular side].

    PubMed

    Steinberg, J; Kohl, C; Katz, T; Richard, G; Linke, S J

    2014-04-01

    The aim of the study was to quantify the difference in corneal thickness between the central and thinnest points (∆PachyZ-PachyD), the distance between the center of the cornea and its thinnest point (vector length PachyD) and to explore the impact of refractive state, age and ocular side. This was a multicenter, retrospective, cross-sectional study and medical records of 16,872 eyes were reviewed. The Orbscan® (Bausch and Lomb) procedure was used for pachymetry and keratometry. The results showed that ∆PachyZ-PachyD and vector length PachyD were higher in hyperopic eyes (∆PachyZ-PachyD: 11.99 ± 12.08 µm, vector length PachyD: 0.85 ± 0.44 mm) compared to myopic eyes (∆PachyZ-PachyD: 9.2 ± 7.86 µm, vector length PachyD: 0.7 ± 0.37 mm; p < 0.001). Refractive state, age and ocular side demonstrated an independent, statistically significant impact on ∆PachyZ-PachyD and vector length PachyD. As a result of the significant impact of refractive state, age and ocular side on ∆PachyZ-PachyD and vector length PachyD, these variables should be considered in a normative data collection.

  6. The albino chick as a model for studying ocular developmental anomalies, including refractive errors, associated with albinism.

    PubMed

    Rymer, Jodi; Choh, Vivian; Bharadwaj, Shrikant; Padmanabhan, Varuna; Modilevsky, Laura; Jovanovich, Elizabeth; Yeh, Brenda; Zhang, Zhan; Guan, Huanxian; Payne, W; Wildsoet, Christine F

    2007-10-01

    Albinism is associated with a variety of ocular anomalies including refractive errors. The purpose of this study was to investigate the ocular development of an albino chick line. The ocular development of both albino and normally pigmented chicks was monitored using retinoscopy to measure refractive errors and high frequency A-scan ultrasonography to measure axial ocular dimensions. Functional tests included an optokinetic nystagmus paradigm to assess visual acuity, and flash ERGs to assess retinal function. The underlying genetic abnormality was characterized using a gene microarray, PCR and a tyrosinase assay. The ultrastructure of the retinal pigment epithelium (RPE) was examined using transmission electron microscopy. PCR confirmed that the genetic abnormality in this line is a deletion in exon 1 of the tyrosinase gene. Tyrosinase gene expression in isolated RPE cells was minimally detectable, and there was minimal enzyme activity in albino feather bulbs. The albino chicks had pink eyes and their eyes transilluminated, reflecting the lack of melanin in all ocular tissues. All three main components, anterior chamber, crystalline lens and vitreous chamber, showed axial expansion over time in both normal and albino animals, but the anterior chambers of albino chicks were consistently shallower than those of normal chicks, while in contrast, their vitreous chambers were longer. Albino chicks remained relatively myopic, with higher astigmatism than the normally pigmented chicks, even though both groups underwent developmental emmetropization. Albino chicks had reduced visual acuity yet the ERG a- and b-wave components had larger amplitudes and shorter than normal implicit times. Developmental emmetropization occurs in the albino chick but is impaired, likely because of functional abnormalities in the RPE and/or retina as well as optical factors. In very young chicks the underlying genetic mutation may also contribute to refractive error and eye shape abnormalities.

  7. Ocular refractive and biometric characteristics in patients with tilted disc syndrome.

    PubMed

    Dehghani, Cirous; Nowroozzadeh, Mohammad Hosein; Shankar, Sunita; Razeghinejad, Mohammad Reza

    2010-12-01

    Tilted disc syndrome (TDS) is associated with characteristic ocular findings. The purpose of this study was to evaluate the ocular, refractive, and biometric characteristics in patients with TDS. This case-control study included 41 eyes of 25 patients who had established TDS and 40 eyes of 20 healthy control subjects. All participants underwent a complete ocular examination, including refraction and analysis using Fourier transformation, slit lamp biomicroscopy, pachymetry, keratometry, and ocular biometry. Corneal topography examinations were performed in the syndrome group only. There were no significant differences in spherical equivalent (P = 0.13) and total astigmatism (P = 0.37) between groups. However, mean best spectacle-corrected visual acuity (Log Mar) was significantly worse in TDS patients (P = 0.003). The lenticular astigmatism was greater in the syndrome group, whereas the corneal component was greater in controls (P = 0.059 and P = 0.028, respectively). The measured biometric features were the same in both groups, except for the lens thickness and lens-axial length factor, which were greater in the TDS group (P = 0.007 and P = 0.055, respectively). Clinically significant lenticular astigmatism, more oblique corneal astigmatism, and thicker lenses were characteristic findings in patients with TDS. Copyright © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  8. Modern Diagnostic Techniques for the Assessment of Ocular Blood Flow in Myopia: Current State of Knowledge.

    PubMed

    Grudzińska, Ewa; Modrzejewska, Monika

    2018-01-01

    Myopia is the most common refractive error and the subject of interest of various studies assessing ocular blood flow. Increasing refractive error and axial elongation of the eye result in the stretching and thinning of the scleral, choroid, and retinal tissues and the decrease in retinal vessel diameter, disturbing ocular blood flow. Local and systemic factors known to change ocular blood flow include glaucoma, medications and fluctuations in intraocular pressure, and metabolic parameters. Techniques and tools assessing ocular blood flow include, among others, laser Doppler flowmetry (LDF), retinal function imager (RFI), laser speckle contrast imaging (LSCI), magnetic resonance imaging (MRI), optical coherence tomography angiography (OCTA), pulsatile ocular blood flowmeter (POBF), fundus pulsation amplitude (FPA), colour Doppler imaging (CDI), and Doppler optical coherence tomography (DOCT). Many researchers consistently reported lower blood flow parameters in myopic eyes regardless of the used diagnostic method. It is unclear whether this is a primary change that causes secondary thinning of ocular tissues or quite the opposite; that is, the mechanical stretching of the eye wall reduces its thickness and causes a secondary lower demand of tissues for oxygen. This paper presents a review of studies assessing ocular blood flow in myopes.

  9. Nine loci for ocular axial length identified through genome-wide association studies, including shared loci with refractive error.

    PubMed

    Cheng, Ching-Yu; Schache, Maria; Ikram, M Kamran; Young, Terri L; Guggenheim, Jeremy A; Vitart, Veronique; MacGregor, Stuart; Verhoeven, Virginie J M; Barathi, Veluchamy A; Liao, Jiemin; Hysi, Pirro G; Bailey-Wilson, Joan E; St Pourcain, Beate; Kemp, John P; McMahon, George; Timpson, Nicholas J; Evans, David M; Montgomery, Grant W; Mishra, Aniket; Wang, Ya Xing; Wang, Jie Jin; Rochtchina, Elena; Polasek, Ozren; Wright, Alan F; Amin, Najaf; van Leeuwen, Elisabeth M; Wilson, James F; Pennell, Craig E; van Duijn, Cornelia M; de Jong, Paulus T V M; Vingerling, Johannes R; Zhou, Xin; Chen, Peng; Li, Ruoying; Tay, Wan-Ting; Zheng, Yingfeng; Chew, Merwyn; Burdon, Kathryn P; Craig, Jamie E; Iyengar, Sudha K; Igo, Robert P; Lass, Jonathan H; Chew, Emily Y; Haller, Toomas; Mihailov, Evelin; Metspalu, Andres; Wedenoja, Juho; Simpson, Claire L; Wojciechowski, Robert; Höhn, René; Mirshahi, Alireza; Zeller, Tanja; Pfeiffer, Norbert; Lackner, Karl J; Bettecken, Thomas; Meitinger, Thomas; Oexle, Konrad; Pirastu, Mario; Portas, Laura; Nag, Abhishek; Williams, Katie M; Yonova-Doing, Ekaterina; Klein, Ronald; Klein, Barbara E; Hosseini, S Mohsen; Paterson, Andrew D; Makela, Kari-Matti; Lehtimaki, Terho; Kahonen, Mika; Raitakari, Olli; Yoshimura, Nagahisa; Matsuda, Fumihiko; Chen, Li Jia; Pang, Chi Pui; Yip, Shea Ping; Yap, Maurice K H; Meguro, Akira; Mizuki, Nobuhisa; Inoko, Hidetoshi; Foster, Paul J; Zhao, Jing Hua; Vithana, Eranga; Tai, E-Shyong; Fan, Qiao; Xu, Liang; Campbell, Harry; Fleck, Brian; Rudan, Igor; Aung, Tin; Hofman, Albert; Uitterlinden, André G; Bencic, Goran; Khor, Chiea-Chuen; Forward, Hannah; Pärssinen, Olavi; Mitchell, Paul; Rivadeneira, Fernando; Hewitt, Alex W; Williams, Cathy; Oostra, Ben A; Teo, Yik-Ying; Hammond, Christopher J; Stambolian, Dwight; Mackey, David A; Klaver, Caroline C W; Wong, Tien-Yin; Saw, Seang-Mei; Baird, Paul N

    2013-08-08

    Refractive errors are common eye disorders of public health importance worldwide. Ocular axial length (AL) is the major determinant of refraction and thus of myopia and hyperopia. We conducted a meta-analysis of genome-wide association studies for AL, combining 12,531 Europeans and 8,216 Asians. We identified eight genome-wide significant loci for AL (RSPO1, C3orf26, LAMA2, GJD2, ZNRF3, CD55, MIP, and ALPPL2) and confirmed one previously reported AL locus (ZC3H11B). Of the nine loci, five (LAMA2, GJD2, CD55, ALPPL2, and ZC3H11B) were associated with refraction in 18 independent cohorts (n = 23,591). Differential gene expression was observed for these loci in minus-lens-induced myopia mouse experiments and human ocular tissues. Two of the AL genes, RSPO1 and ZNRF3, are involved in Wnt signaling, a pathway playing a major role in the regulation of eyeball size. This study provides evidence of shared genes between AL and refraction, but importantly also suggests that these traits may have unique pathways. Copyright © 2013 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  10. Ocular findings seen among the staff of an institution in Lagos, Nigeria.

    PubMed

    Ashaye, A O; Asuzu, M C

    2005-01-01

    The degree to which ocular morbidity affects workers productivity in the developing countries has not been studied adequately. A federal government research institute based in Lagos introduced an annual health screen for all its workers, which included eye tests. This provided an opportunity to study the pattern of ocular conditions among workers who were 30 years and above, and to determine the effect of eye diseases on the workers productivity. Detailed eye examination including refraction, was done on every respondent at the institution's clinic by an ophthalmologist. A questionnaire on ocular health status and occupational history was administered independently by an ophthalmic nurse. Sickness absenteeism, use of the clinic were obtained from clinic records, and the results were analysed. The common ocular conditions were uncorrected or poorly corrected refractive error, uncorrected or poorly corrected presbyopia and allergic. conjunctivitis. Glaucoma, maculopathy and optic atrophy were causes of severe visual impairment or blindness in 1.9 % of the subjects. Absenteeism and clinic use were more common in subjects with ocular morbidity than those with non-ocular morbidity. Subjects with ocular morbidity had more illnesses, absenteeism and used the clinic more. Ocular problems which reduce worker's productivity are prevalent among the staff of the institution studied. They are mostly unrecognised.

  11. Retrospective analysis of refractive errors in children with vision impairment.

    PubMed

    Du, Jojo W; Schmid, Katrina L; Bevan, Jennifer D; Frater, Karen M; Ollett, Rhondelle; Hein, Bronwyn

    2005-09-01

    Emmetropization is the reduction in neonatal refractive errors that occurs after birth. Ocular disease may affect this process. We aimed to determine the relative frequency of ocular conditions causing vision impairment in the pediatric population and characterize the refractive anomalies present. We also compared the causes of vision impairment in children today to those between 1974 and 1981. Causes of vision impairment and refractive data of 872 children attending a pediatric low-vision clinic from 1985 to 2002 were retrospectively collated. As a result of associated impairments, refractive data were not available for 59 children. An analysis was made of the causes of vision impairment, the distribution of refractive errors in children with vision impairment, and the average type of refractive error for the most commonly seen conditions. We found that cortical or cerebral vision impairment (CVI) was the most common condition causing vision impairment, accounting for 27.6% of cases. This was followed by albinism (10.6%), retinopathy of prematurity (ROP; 7.0%), optic atrophy (6.2%), and optic nerve hypoplasia (5.3%). Vision impairment was associated with ametropia; fewer than 25% of the children had refractive errors < or = +/-1 D. The refractive error frequency plots (for 0 to 2-, 6 to 8-, and 12 to 14-year age bands) had a Gaussian distribution indicating that the emmetropization process was abnormal. The mean spherical equivalent refractive error of the children (n = 813) was +0.78 +/- 6.00 D with 0.94 +/- 1.24 D of astigmatism and 0.92 +/- 2.15 D of anisometropia. Most conditions causing vision impairment such as albinism were associated with low amounts of hyperopia. Moderate myopia was observed in children with ROP. The relative frequency of ocular conditions causing vision impairment in children has changed since the 1970s. Children with vision impairment often have an associated ametropia suggesting that the emmetropization system is also impaired.

  12. The Correlation between Angle Kappa and Ocular Biometry in Koreans

    PubMed Central

    Choi, Se Rang

    2013-01-01

    Purpose To investigate normative angle kappa data and to examine whether correlations exist between angle kappa and ocular biometric measurements (e.g., refractive error, axial length) and demographic features in Koreans. Methods Data from 436 eyes (213 males and 223 females) were analyzed in this study. The angle kappa was measured using Orbscan II. We used ocular biometric measurements, including refractive spherical equivalent, interpupillary distance and axial length, to investigate the correlations between angle kappa and ocular biometry. The IOL Master ver. 5.02 was used to obtain axial length. Results The mean patient age was 57.5 ± 12.0 years in males and 59.4 ± 12.4 years in females (p = 0.11). Angle kappa averaged 4.70 ± 2.70 degrees in men and 4.89 ± 2.14 degrees in women (p = 0.48). Axial length and spherical equivalent were correlated with angle kappa (r = -0.342 and r = 0.197, respectively). The correlation between axial length and spherical equivalent had a negative correlation (r = -0.540, p < 0.001). Conclusions Angle kappa increased with spherical equivalent and age. Thus, careful manipulation should be considered in older and hyperopic patients when planning refractive or strabismus surgery. PMID:24311927

  13. Ophthalmologic abnormalities among students with cognitive impairment in eastern Taiwan: The special group with undetected visual impairment.

    PubMed

    Tsao, Wei-Shan; Hsieh, Hsi-Pao; Chuang, Yi-Ting; Sheu, Min-Muh

    2017-05-01

    Students with cognitive impairment are at increased risk of suffering from visual impairment due to refractive errors and ocular disease, which can adversely influence learning and daily activities. The purpose of this study was to evaluate the ocular and visual status among students at the special education school in Hualien. All students at the National Hualien Special Education School were evaluated. Full eye examinations were conducted by a skilled ophthalmologist. The students' medical records and disability types were reviewed. A total of 241 students, aged 7-18 years, were examined. Visual acuity could be assessed in 138 students. A total of 169/477 (35.4%) eyes were found to suffer from refractive errors, including 20 eyes with high myopia (≤-6.0 D) and 16 eyes with moderate hypermetropia (+3.0 D to +5.0 D). A total of 84/241 (34.8%) students needed spectacles to correct their vision, thus improving their daily activities and learning process, but only 15/241 (6.2%) students were wearing suitable corrective spectacles. A total of 55/241 students (22.8%) had ocular disorders, which influenced their visual function. The multiple disability group had a statistically significant higher prevalence of ocular disorders (32.9%) than the simple intellectual disability group (19.6%). Students with cognitive impairment in eastern Taiwan have a high risk of visual impairment due to refractive errors and ocular disorders. Importantly, many students have unrecognized correctable refractive errors. Regular ophthalmic examination should be administered to address this issue and prevent further disability in this already handicapped group. Copyright © 2016. Published by Elsevier B.V.

  14. Reduced vision in highly myopic eyes without ocular pathology: the ZOC-BHVI high myopia study.

    PubMed

    Jong, Monica; Sankaridurg, Padmaja; Li, Wayne; Resnikoff, Serge; Naidoo, Kovin; He, Mingguang

    2018-01-01

    The aim was to investigate the relationship of the magnitude of myopia with visual acuity in highly myopic eyes without ocular pathology. Twelve hundred and ninety-two highly myopic eyes (up to -6.00 DS both eyes, no astigmatic cut-off) with no ocular pathology from the ZOC-BHVI high myopia study in China, had cycloplegic refraction, followed by subjective refraction and visual acuities and axial length measurement. Two logistic regression models were undertaken to test the association of age, gender, refractive error, axial length and parental myopia with reduced vision. Mean group age was 19.0 ± 8.6 years; subjective spherical equivalent refractive error was -9.03 ± 2.73 D; objective spherical equivalent refractive error was -8.90 ± 2.60 D and axial length was 27.0 ± 1.3 mm. Using visual acuity, 82.4 per cent had normal vision, 16.0 per cent had mildly reduced vision, 1.2 per cent had moderately reduced vision, 0.3 per cent had severely reduced vision and no subjects were blind. The percentage with reduced vision increased with spherical equivalent to 74.5 per cent from -15.00 to -39.99 D, axial length to 67.7 per cent of eyes from 30.01 to 32.00 mm and age to 22.9 per cent of those 41 years and over. Spherical equivalent and axial length were significantly associated with reduced vision (p < 0.0001). Age and parental myopia were not significantly associated with reduced vision. Gender was significant for one model (p = 0.04). Mildly reduced vision is common in high myopia without ocular pathology and is strongly correlated with greater magnitudes of refractive error and axial length. Better understanding is required to minimise reduced vision in high myopes. © 2017 Optometry Australia.

  15. Correction of Refractive Errors in Rhesus Macaques (Macaca mulatta) Involved in Visual Research

    PubMed Central

    Mitchell, Jude F; Boisvert, Chantal J; Reuter, Jon D; Reynolds, John H; Leblanc, Mathias

    2014-01-01

    Macaques are the most common animal model for studies in vision research, and due to their high value as research subjects, often continue to participate in studies well into old age. As is true in humans, visual acuity in macaques is susceptible to refractive errors. Here we report a case study in which an aged macaque demonstrated clear impairment in visual acuity according to performance on a demanding behavioral task. Refraction demonstrated bilateral myopia that significantly affected behavioral and visual tasks. Using corrective lenses, we were able to restore visual acuity. After correction of myopia, the macaque's performance on behavioral tasks was comparable to that of a healthy control. We screened 20 other male macaques to assess the incidence of refractive errors and ocular pathologies in a larger population. Hyperopia was the most frequent ametropia but was mild in all cases. A second macaque had mild myopia and astigmatism in one eye. There were no other pathologies observed on ocular examination. We developed a simple behavioral task that visual research laboratories could use to test visual acuity in macaques. The test was reliable and easily learned by the animals in 1 d. This case study stresses the importance of screening macaques involved in visual science for refractive errors and ocular pathologies to ensure the quality of research; we also provide simple methodology for screening visual acuity in these animals. PMID:25427343

  16. Correction of refractive errors in rhesus macaques (Macaca mulatta) involved in visual research.

    PubMed

    Mitchell, Jude F; Boisvert, Chantal J; Reuter, Jon D; Reynolds, John H; Leblanc, Mathias

    2014-08-01

    Macaques are the most common animal model for studies in vision research, and due to their high value as research subjects, often continue to participate in studies well into old age. As is true in humans, visual acuity in macaques is susceptible to refractive errors. Here we report a case study in which an aged macaque demonstrated clear impairment in visual acuity according to performance on a demanding behavioral task. Refraction demonstrated bilateral myopia that significantly affected behavioral and visual tasks. Using corrective lenses, we were able to restore visual acuity. After correction of myopia, the macaque's performance on behavioral tasks was comparable to that of a healthy control. We screened 20 other male macaques to assess the incidence of refractive errors and ocular pathologies in a larger population. Hyperopia was the most frequent ametropia but was mild in all cases. A second macaque had mild myopia and astigmatism in one eye. There were no other pathologies observed on ocular examination. We developed a simple behavioral task that visual research laboratories could use to test visual acuity in macaques. The test was reliable and easily learned by the animals in 1 d. This case study stresses the importance of screening macaques involved in visual science for refractive errors and ocular pathologies to ensure the quality of research; we also provide simple methodology for screening visual acuity in these animals.

  17. Management of irregular astigmatism.

    PubMed

    Goggin, M; Alpins, N; Schmid, L M

    2000-08-01

    Using a liberal definition of corneal irregularity, modern videokeratoscopy may define approximately 40% of normal corneas with a toric refractive error as possessing primary irregular astigmatism. The causes of secondary forms of irregular astigmatism include corneal surgery, trauma, dystrophies, and infections. Internal refractive surface and media irregularity or noncorneal astigmatism (ocular residual astigmatism) contribute to irregular astigmatism of the entire refractive path of which crystaline lenticular astigmatism is usually the principal contributing component. Treatment options have increased in recent years, particularly, though not exclusively, through the advent of tailored corneal excimer laser ablations. However, discussion continues concerning the systematic approach necessary to enable treatment to achieve an optimal optical surface for the eye. Discussion also continues as to what constitutes the optimal corneal shape. Some refractive procedures may increase higher order aberrations in the attempt to neutralize refractive astigmatism. The way to further refinement of the commonly performed refractive techniques will ultimately lie in the integrated inclusion of a trio of technologies: topographic analysis of the corneal surface, wavefront analysis of ocular refractive aberrations, and vector planning to enable the appropriate balance in emphasis between these two diagnostic modalities. For the uncommon, irregularly roughened corneas, the ablatable polymer techniques show some promise.

  18. Relation of anthropometric measurements to ocular biometric changes and refractive error in children with thalassemia.

    PubMed

    Elkitkat, Rania S; El-Shazly, Amany A; Ebeid, Weam M; Deghedy, Marwa R

    2018-03-01

    To evaluate and correlate anthropometric, biometric, and refractive error changes in thalassemia major (TM). One hundred children with TM and another hundred healthy controls were recruited. Height, weight, body mass index (BMI), and occipitofrontal circumference (OFC) were the anthropometric parameters recorded. Full ophthalmologic examination was performed, including best-corrected visual acuity, cycloplegic refraction, slit-lamp examination, Goldmann applanation tonometry, indirect ophthalmoscopy, keratometry (K readings), and ocular biometry. Compared to controls, children with TM were shorter and lighter, with a smaller BMI (p<0.001); however, no significant difference existed in OFC. Regarding ocular biometric data, patients with thalassemia had steeper mean K readings (p = 0.03), shorter axial length (AXL) (p = 0.005), shorter vitreous chamber depth (p<0.001), and thicker crystalline lens (p<0.001) than controls. Patients with thalassemia had a significant myopic shift (p = 0.003). Multiple regression analyses only showed a significant correlation between corneal astigmatism and both weight and height (β = -0.05 and p = 0.03 and β = 0.06 and p = 0.04, respectively). Spherical equivalent was significantly correlated to K readings, lens thickness, and anterior chamber depth (p<0.0001 for all parameters). Compared to controls, children with TM have significant retardation in general and ocular growth (smaller BMI and shorter AXL). Ocular growth changes probably resulted in compensatory biometric changes (steeper corneas and thicker lenses) to reach emmetropization, with an exaggerated response and subsequent myopic shift. However, growth retardation is not directly related to ocular growth changes, myopic shift, or variations in biometric parameters.

  19. Ocular findings among young men: a 12-year prevalence study of military service in Poland.

    PubMed

    Nowak, Michal S; Jurowski, Piotr; Gos, Roman; Smigielski, Janusz

    2010-08-01

    To determine the prevalence of ocular diseases among young men and to assess the main ocular causes reflecting discharge from military service in Poland. A retrospective review of the medical records of 105 017 men undergoing a preliminary examination for military service during the period 1993-2004. Sample size for the study was calculated with 99% confidence within an error margin of 5%. All of the study participants were White men of European origin, most of whom live or lived in Poland. Data regarding the vision status were assessed in 1938 eyes of 969 participants. Two groups were distinguished based on the age of the participants: group I aged 18-24 years, and group II aged 25-34 years. Presented visual impairment [visual acuity (VA)<20/40)] followed by colour vision defects were the most common ocular disorders, accounting for 13.2%. There were statistically significant differences in uncorrected VA as well as in the rates of particular refractive errors in between the age groups (p<0.05). The prevalence of glaucoma and ocular hypertension was significantly higher in older participants. Six hundred and sixty-seven (68.8%) participants examined medically in the study period were accepted for military service. However, 302 (31.2%) failed their examination and were temporarily or permanently discharged from duty. Fifty-two of them (17.2%) were discharged because of various ocular disorders. The most common causes were high refractive errors, which accounted for 38.5% of all the ocular discharges, followed by chronic and recurrent diseases of the posterior segment of the eye, which accounted for 19.2%. The prevalence of ocular disorders among young men in an unselected military population was closer to the results obtained in other population-based studies comprising both men and women in the same age group. High refractive errors followed by chronic and recurrent diseases of the posterior segment of the eye are important causes of medical discharges from military service in Poland.

  20. Determinants of ocular deviation in esotropic subjects under general anesthesia.

    PubMed

    Daien, Vincent; Turpin, Chloé; Lignereux, François; Belghobsi, Riadh; Le Meur, Guylene; Lebranchu, Pierre; Pechereau, Alain

    2013-01-01

    The authors attempted to identify the determinants of ocular deviation in a population of patients with esotropia under general anesthesia. Forty-one patients with esotropia were included. Horizontal ocular deviation was evaluated by the photographic Hirschberg test both in the awakened state and under general anesthesia before surgery. Changes in ocular deviation were measured and a multivariate analysis was used to assess its clinical determinants. The mean age (± standard deviation [SD]) of study subjects was 13 ± 11 years and 51% were females. The mean spherical equivalent refraction of the right eye was 2.44 ± 2.50 diopters (D), with no significant difference between eyes (P = .26). The mean ocular deviation changed significantly, from 33.5 ± 12.5 prism diopters (PD) at preoperative examination to 8.8 ± 11.4 PD under general anesthesia (P = .0001). The changes in ocular deviation positively correlated with the pre-operative ocular deviation (correlation coefficient r = 0.59, P = .0001) and negatively correlated with patient age (correlation coefficient r = -0.53, P = .0001). These two determinants remained significant after multivariate adjustment of the following variables: preoperative ocular deviation; age; gender; spherical equivalent refraction; and number of previous strabismus surgeries (model r(2) = 0.49, P = .0001). The ocular position under general anesthesia was reported as a key factor in the surgical treatment of subjects with esotropia; therefore, its clinical determinants were assessed. The authors observed that preoperative ocular deviation and patient age were the main factors that influenced the ocular position under general anesthesia. Copyright 2013, SLACK Incorporated.

  1. [Character of refractive errors in population study performed by the Area Military Medical Commission in Lodz].

    PubMed

    Nowak, Michał S; Goś, Roman; Smigielski, Janusz

    2008-01-01

    To determine the prevalence of refractive errors in population. A retrospective review of medical examinations for entry to the military service from The Area Military Medical Commission in Lodz. Ophthalmic examinations were performed. We used statistic analysis to review the results. Statistic analysis revealed that refractive errors occurred in 21.68% of the population. The most commen refractive error was myopia. 1) The most commen ocular diseases are refractive errors, especially myopia (21.68% in total). 2) Refractive surgery and contact lenses should be allowed as the possible correction of refractive errors for military service.

  2. Refractive error characteristics of early and advanced presbyopic individuals.

    DOT National Transportation Integrated Search

    1977-07-01

    The frequency and distribution of ocular refractive errors among middle-aged and older people were obtained from a nonclinical population holding a variety of blue-collar, clerical, and technical jobs. The 422 individuals ranged in age from 35 to 69 ...

  3. Comparison of Ocular Monochromatic Higher-order Aberrations in Normal Refractive Surgery Candidates of Arab and South Asian Origin

    PubMed Central

    Prakash, Gaurav; Srivastava, Dhruv; Choudhuri, Sounak; Bacero, Ruthchel

    2016-01-01

    Purpose: To compare the ocular monochromatic higher-order aberration. (HOA) profile in normal refractive surgery candidates of Arab and South Asian origin. Methods: This cross-sectional, observational, comparative study was performed in the cornea department of a specialty hospital. Normal refractive surgery candidates with no ocular morbidity except refractive error were recruited. Refractive surgery candidates underwent a preoperative evaluation, including wavefront aberrometry with the iDesign aberrometer (AMO, Inc., Santa Ana, California, United States). The HOA from right eyes were analyzed for HOA signed, absolute, and polar Zernike coefficients. Results: Two hundred Arab participants (group 1) and 200 participants of South-Asian origin (group 2) comprised the study sample. The age and refractive status were comparable between groups. The mean of the HOA root mean square (RMS) was 0.36 ± 17 μ and 0.38 ± 18 μ for Arab and South-Asian eyes, respectively (P < 0.05, rank sum test [RST]). Of the 22 higher order signed Zernike modes, only Z3−3, Z3−1,31, Z4−4, Z4−2, Z40, Z44, and Z5−5 were significantly different from zero (one sample t-test, P < 0.002, with a Bonferroni correction of 0.05/22). All the signed and absolute Zernike terms were comparable between groups (RST, P > 0.002 [0.05/22]). The polar coefficients for coma, trefoil, spherical aberration, and tetrafoil were comparable between groups (P > 0.05, RST). Combined RMS values of third, fourth, fifth, and sixth order also were comparable between groups (P > 0.05, RST). Conclusions: Preoperative whole eye HOA were similar for refractive surgery candidates of Arab and South-Asian origin. The values were comparable to historical data for Caucasian eyes and were lower than Asian (Chinese) eyes. These findings may aid in refining refractive nomograms for wavefront ablations. PMID:26957850

  4. Comparison of Ocular Monochromatic Higher-order Aberrations in Normal Refractive Surgery Candidates of Arab and South Asian Origin.

    PubMed

    Prakash, Gaurav; Srivastava, Dhruv; Choudhuri, Sounak; Bacero, Ruthchel

    2016-01-01

    To compare the ocular monochromatic higher-order aberration. (HOA) profile in normal refractive surgery candidates of Arab and South Asian origin. This cross-sectional, observational, comparative study was performed in the cornea department of a specialty hospital. Normal refractive surgery candidates with no ocular morbidity except refractive error were recruited. Refractive surgery candidates underwent a preoperative evaluation, including wavefront aberrometry with the iDesign aberrometer (AMO, Inc., Santa Ana, California, United States). The HOA from right eyes were analyzed for HOA signed, absolute, and polar Zernike coefficients. Two hundred Arab participants (group 1) and 200 participants of South-Asian origin (group 2) comprised the study sample. The age and refractive status were comparable between groups. The mean of the HOA root mean square (RMS) was 0.36 ± 17 μ and 0.38 ± 18 μ for Arab and South-Asian eyes, respectively (P < 0.05, rank sum test [RST]). Of the 22 higher order signed Zernike modes, only Z3 (-3), Z3 (-1),3 (1), Z4 (-4), Z4 (-2), Z4 (0), Z4 (4), and Z5 (-5) were significantly different from zero (one sample t-test, P < 0.002, with a Bonferroni correction of 0.05/22). All the signed and absolute Zernike terms were comparable between groups (RST, P > 0.002 [0.05/22]). The polar coefficients for coma, trefoil, spherical aberration, and tetrafoil were comparable between groups (P > 0.05, RST). Combined RMS values of third, fourth, fifth, and sixth order also were comparable between groups (P > 0.05, RST). Preoperative whole eye HOA were similar for refractive surgery candidates of Arab and South-Asian origin. The values were comparable to historical data for Caucasian eyes and were lower than Asian (Chinese) eyes. These findings may aid in refining refractive nomograms for wavefront ablations.

  5. Wavefront-guided correction of ocular aberrations: Are phase plate and refractive surgery solutions equal?

    NASA Astrophysics Data System (ADS)

    Marchese, Linda E.; Munger, Rejean; Priest, David

    2005-08-01

    Wavefront-guided laser eye surgery has been recently introduced and holds the promise of correcting not only defocus and astigmatism in patients but also higher-order aberrations. Research is just beginning on the implementation of wavefront-guided methods in optical solutions, such as phase-plate-based spectacles, as alternatives to surgery. We investigate the theoretical differences between the implementation of wavefront-guided surgical and phase plate corrections. The residual aberrations of 43 model eyes are calculated after simulated refractive surgery and also after a phase plate is placed in front of the untreated eye. In each case, the current wavefront-guided paradigm that applies a direct map of the ocular aberrations to the correction zone is used. The simulation results demonstrate that an ablation map that is a Zernike fit of a direct transform of the ocular wavefront phase error is not as efficient in correcting refractive errors of sphere, cylinder, spherical aberration, and coma as when the same Zernike coefficients are applied to a phase plate, with statistically significant improvements from 2% to 6%.

  6. Ophthalmic applications of confocal microscopy: diagnostics, refractive surgery, and eye banking

    NASA Astrophysics Data System (ADS)

    Masters, Barry R.

    1990-11-01

    Confocal microscopy of ocular tissue provides two advantages over traditional imaging techniques: increased range and transverse resolution and increased contrast. The semitransparent cornea and ocular lens in the living eye can be optically sectioned and observed by reflected light confocal microscopy. Within the cornea we observed various cell components nerve fibers nerve cell bodies and fibrous networks. The confocal microscopic images from the in-situ ocular lens show the lens capsule the lens epithelium and the individual lens fibrils. All of the reflected light confocal microscopic images have high contrast and high resolution. Some of the applications of confocal imaging in ophthalmology include: diagnostics of the cornea and the ocular lens examination prior to and after refractive surgery examination of intraocular lenses (IOL) and examination of eye bank material. Other ophthalmic uses of confocal imaging include: studies of wound healing therapeutics and the effects of contact lenses on the cornea. The proposed features of a clinical confocal microscope are reviewed. 2.

  7. Differences between wavefront and subjective refraction for infrared light.

    PubMed

    Teel, Danielle F W; Jacobs, Robert J; Copland, James; Neal, Daniel R; Thibos, Larry N

    2014-10-01

    To determine the accuracy of objective wavefront refractions for predicting subjective refractions for monochromatic infrared light. Objective refractions were obtained with a commercial wavefront aberrometer (COAS, Wavefront Sciences). Subjective refractions were obtained for 30 subjects with a speckle optometer validated against objective Zernike wavefront refractions on a physical model eye (Teel et al., Design and validation of an infrared Badal optometer for laser speckle, Optom Vis Sci 2008;85:834-42). Both instruments used near-infrared (NIR) radiation (835 nm for COAS, 820 nm for the speckle optometer) to avoid correction for ocular chromatic aberration. A 3-mm artificial pupil was used to reduce complications attributed to higher-order ocular aberrations. For comparison with paraxial (Seidel) and minimum root-mean-square (Zernike) wavefront refractions, objective refractions were also determined for a battery of 29 image quality metrics by computing the correcting lens that optimizes retinal image quality. Objective Zernike refractions were more myopic than subjective refractions for 29 of 30 subjects. The population mean discrepancy was -0.26 diopters (D) (SEM = 0.03 D). Paraxial (Seidel) objective refractions tended to be hyperopically biased (mean discrepancy = +0.20 D, SEM = 0.06 D). Refractions based on retinal image quality were myopically biased for 28 of 29 metrics. The mean bias across all 31 measures was -0.24 D (SEM = 0.03). Myopic bias of objective refractions was greater for eyes with brown irises compared with eyes with blue irises. Our experimental results are consistent with the hypothesis that reflected NIR light captured by the aberrometer originates from scattering sources located posterior to the entrance apertures of cone photoreceptors, near the retinal pigment epithelium. The larger myopic bias for brown eyes suggests that a greater fraction of NIR light is reflected from choroidal melanin in brown eyes compared with blue eyes.

  8. Test systems for measuring ocular parameters and visual function in mice.

    PubMed

    Schaeffel, Frank

    2008-05-01

    New techniques are described to measure refractive state, pupil responses, corneal curvature, ocular dimensions and spatial vision in mice. These variables are important for studies on myopia development in mice, but they are also valuable for phenotyping mouse mutants and for pharmacological studies.

  9. Vision Profile and Ocular Characteristics of Special Olympics Athletes: Report from India.

    PubMed

    Gothwal, Vijaya K; Sumalini, Rebecca; Narasaiah, Asa; Panda, Soumya

    2017-08-01

    Previous reports, albeit isolated, of vision and ocular screening of athletes with intellectual disability participating in the Special Olympics, UK, indicated high rates of refractive error and ocular morbidity; however, there have been no reports of similar sports events for this population from India. This study set out to evaluate the vision profile and ocular characteristics of athletes with intellectual disability attending the Special Olympics Lions Club International Opening Eyes (SOLCIOE) event in 2012 in India. A cross-sectional study was conducted, where a protocol-based ophthalmological assessment was performed by trained optometrists at a tertiary eye care center. Overall, 172 athletes (mean age 18.6 years, 70% male) with intellectual disability participated, and 138 (80%) were able to cooperate for complete or nearly complete vision and ocular assessment. A total of 56 (32%) had never had a previous vision or ocular health status examination. A total of 46 (32%) presented with low vision (World Health Organization definition <6/18 to 3/60 in the better eye), 21% needed a first or updated spectacle prescription, and 28% had significant ocular pathology as the cause of visual loss. The proportions of refractive errors and ocular disorders in athletes with intellectual disability attending the SOLCIOE program in South India are similar to those reported for able-bodied school-aged children in urban and rural India. Like that of their able-bodied peers, the visual needs of children with intellectual disability are also not adequately being met.

  10. Profile of refractive errors in cerebral palsy: impact of severity of motor impairment (GMFCS) and CP subtype on refractive outcome.

    PubMed

    Saunders, Kathryn J; Little, Julie-Anne; McClelland, Julie F; Jackson, A Jonathan

    2010-06-01

    To describe refractive status in children and young adults with cerebral palsy (CP) and relate refractive error to standardized measures of type and severity of CP impairment and to ocular dimensions. A population-based sample of 118 participants aged 4 to 23 years with CP (mean 11.64 +/- 4.06) and an age-appropriate control group (n = 128; age, 4-16 years; mean, 9.33 +/- 3.52) were recruited. Motor impairment was described with the Gross Motor Function Classification Scale (GMFCS), and subtype was allocated with the Surveillance of Cerebral Palsy in Europe (SCPE). Measures of refractive error were obtained from all participants and ocular biometry from a subgroup with CP. A significantly higher prevalence and magnitude of refractive error was found in the CP group compared to the control group. Axial length and spherical refractive error were strongly related. This relation did not improve with inclusion of corneal data. There was no relation between the presence or magnitude of spherical refractive errors in CP and the level of motor impairment, intellectual impairment, or the presence of communication difficulties. Higher spherical refractive errors were significantly associated with the nonspastic CP subtype. The presence and magnitude of astigmatism were greater when intellectual impairment was more severe, and astigmatic errors were explained by corneal dimensions. Conclusions. High refractive errors are common in CP, pointing to impairment of the emmetropization process. Biometric data support this In contrast to other functional vision measures, spherical refractive error is unrelated to CP severity, but those with nonspastic CP tend to demonstrate the most extreme errors in refraction.

  11. Surveillance of Vision and Ocular Disorders in Children with Down Syndrome

    ERIC Educational Resources Information Center

    Stephen, Elma; Dickson, Jennifer; Kindley, A. David; Scott, Christopher C.; Charleton, Patricia M.

    2007-01-01

    Children with Down syndrome have a high prevalence of ocular disorders. The UK Down's Syndrome Medical Interest Group (DSMIG) guidelines for ophthalmic screening were locally implemented into a protocol that included neonatal eye examination by an opthalmologist and a comprehensive ophthalmological examination (cycloplegic refraction,…

  12. New Objective Refraction Metric Based on Sphere Fitting to the Wavefront

    PubMed Central

    Martínez-Finkelshtein, Andreí

    2017-01-01

    Purpose To develop an objective refraction formula based on the ocular wavefront error (WFE) expressed in terms of Zernike coefficients and pupil radius, which would be an accurate predictor of subjective spherical equivalent (SE) for different pupil sizes. Methods A sphere is fitted to the ocular wavefront at the center and at a variable distance, t. The optimal fitting distance, topt, is obtained empirically from a dataset of 308 eyes as a function of objective refraction pupil radius, r0, and used to define the formula of a new wavefront refraction metric (MTR). The metric is tested in another, independent dataset of 200 eyes. Results For pupil radii r0 ≤ 2 mm, the new metric predicts the equivalent sphere with similar accuracy (<0.1D), however, for r0 > 2 mm, the mean error of traditional metrics can increase beyond 0.25D, and the MTR remains accurate. The proposed metric allows clinicians to obtain an accurate clinical spherical equivalent value without rescaling/refitting of the wavefront coefficients. It has the potential to be developed into a metric which will be able to predict full spherocylindrical refraction for the desired illumination conditions and corresponding pupil size. PMID:29104804

  13. New Objective Refraction Metric Based on Sphere Fitting to the Wavefront.

    PubMed

    Jaskulski, Mateusz; Martínez-Finkelshtein, Andreí; López-Gil, Norberto

    2017-01-01

    To develop an objective refraction formula based on the ocular wavefront error (WFE) expressed in terms of Zernike coefficients and pupil radius, which would be an accurate predictor of subjective spherical equivalent (SE) for different pupil sizes. A sphere is fitted to the ocular wavefront at the center and at a variable distance, t . The optimal fitting distance, t opt , is obtained empirically from a dataset of 308 eyes as a function of objective refraction pupil radius, r 0 , and used to define the formula of a new wavefront refraction metric (MTR). The metric is tested in another, independent dataset of 200 eyes. For pupil radii r 0 ≤ 2 mm, the new metric predicts the equivalent sphere with similar accuracy (<0.1D), however, for r 0 > 2 mm, the mean error of traditional metrics can increase beyond 0.25D, and the MTR remains accurate. The proposed metric allows clinicians to obtain an accurate clinical spherical equivalent value without rescaling/refitting of the wavefront coefficients. It has the potential to be developed into a metric which will be able to predict full spherocylindrical refraction for the desired illumination conditions and corresponding pupil size.

  14. Ocular morbidity prevalence among school children in Shimla, Himachal, North India.

    PubMed

    Gupta, Madhu; Gupta, Bhupinder P; Chauhan, Anil; Bhardwaj, Ashok

    2009-01-01

    Data on eye diseases among school children is not readily available. Considering the fact that one-third of India's blind lose their eyesight before the age of 20 years and many of them are under five when they become blind, early detection and treatment of ocular morbidity among children is important. To estimate the prevalence of ocular morbidity among school children of age 6-16 years. Government and private coeducational schools in urban area of Shimla. Cross-sectional. Government and private coeducational schools selected by stratified random sampling. About 1561 school children, studying in elementary through secondary class in these schools were examined from August 2001 to January 2002 in Shimla. A doctor did visual acuity and detailed ophthalmic examination. The Chi-square test was used to test differences in proportions. Differences were considered to be statistically significant at the 5% level. Prevalence of ocular morbidity was 31.6% (CI=29.9-32.1%), refractive errors 22% (CI=21.1-22.8%), squint 2.5% (CI=2.4-2.6%), color blindness 2.3% (CI=2.2-2.4%), vitamin A deficiency 1.8 % (CI=1.7-1.9%), conjunctivitis 0.8% (CI=0.79-0.81%). Overall prevalence of ocular morbidity in government and private schools did not show any statistical significant difference. Prevalence of conjunctivitis was significantly (P< 0.5) more in government schools. A high prevalence of ocular morbidity among high-school children was observed. Refractive errors were the most common ocular disorders.

  15. Ocular residual astigmatism's effect on high myopic astigmatism LASIK surgery

    PubMed Central

    Teus, M A; Arruabarrena, C; Hernández-Verdejo, J L; Cañones, R; Mikropoulos, D G

    2014-01-01

    Purpose To analyze the effect of ocular residual astigmatism (ORA) on the effectiveness of LASIK for treating high myopic astigmatism. Methods This is an observational, cross-sectional study. We studied 116 consecutive myopic eyes with −3 diopters (D) or more of astigmatism that underwent LASIK surgery. The magnitude of uncorrected residual refractive astigmatism 3 months postoperatively was measured. Results The mean preoperative cylinder was −4.0±0.83 D (range, −7.5 to −3 D) and the mean preoperative ORA was 0.82±0.5 D. The mean residual refractive cylinder 3 months postoperatively was −0.78±0.83 D (range, −3 to 0 D). No correlation was found between ORA and the refractive cylinder 3 months postoperatively (P=0.6). Conclusion In eyes with high myopic astigmatism undergoing LASIK, ORA was not correlated with the residual postoperative cylinder. PMID:24971989

  16. Ocular Manifestations of Noonan Syndrome: A Prospective Clinical and Genetic Study of 25 Patients.

    PubMed

    van Trier, Dorothée C; Vos, Anna M C; Draaijer, Renske W; van der Burgt, Ineke; Draaisma, Jos M Th; Cruysberg, Johannes R M

    2016-10-01

    To determine the full spectrum of ocular manifestations in patients with Noonan syndrome (NS). Prospective cross-sectional clinical and genetic study in a tertiary referral center. Twenty-five patients with NS (mean age, 14 years; range, 8 months-25 years) clinically diagnosed by validated criteria. All patients were examined by the same team following a detailed study protocol. Genetic analyses were performed in 23 patients. Ocular abnormalities of vision and refraction, external ocular features, ocular position and motility, anterior segment, posterior segment, and intraocular pressure. Ocular features of vision and refraction were amblyopia (32%), myopia (40%), and astigmatism (52%). External ocular features were epicanthic folds (84%), hypertelorism (68%), ptosis (56%), high upper eyelid crease (64%), lower eyelid retraction (60%), abnormal upward slanting palpebral fissures (36%), downward slanting palpebral fissures (32%), and lagophthalmos (28%). Orthoptic abnormalities included strabismus (40%), abnormal stereopsis (44%), and limited ocular motility (40%). Anterior segment abnormalities included prominent corneal nerves (72%) and posterior embryotoxon (32%). Additional ocular features were found, including nonglaucomatous optic disc excavation (20%), relatively low (<10 mmHg) intraocular pressure (22%), and optic nerve hypoplasia (4%). Mutations were established in 22 patients: 19 PTPN11 mutations (76%), 1 SOS1 mutation, 1 BRAF mutation, and 1 KRAS mutation. The patient with the highest number of prominent corneal nerves had an SOS1 mutation. The patient with the lowest visual acuity, associated with bilateral optic nerve hypoplasia, had a BRAF mutation. Patients with severe ptosis and nearly total absence of levator muscle function had PTPN11 mutations. All patients showed at least 3 ocular features (range, 3-13; mean, 7), including at least 1 external ocular feature in more than 95% of the patients. Noonan syndrome is a clinical diagnosis with multiple genetic bases associated with an extensive variety of congenital ocular abnormalities. Ocular features of NS are characterized by 1 or more developmental anomalies of the eyelids (involving the position, opening, and closure) associated with various other ocular abnormalities in childhood, including amblyopia, myopia, astigmatism, strabismus, limited ocular motility, prominent corneal nerves, and posterior embryotoxon. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  17. The effects of methylphenidate on refraction and anterior segment parameters in children with attention deficit hyperactivity disorder.

    PubMed

    Larrañaga-Fragoso, Paula; Noval, Susana; Rivero, José C; Boto-de-los-Bueis, Ana

    2015-08-01

    Methylphenidate hydrochloride is used as first-line treatment for attention deficit hyperactivity disorder (ADHD). However, there is concern that this treatment may be associated with increased risk of angle closure glaucoma and disturbance of ocular refraction. The aim of this study was to investigate the effects of methylphenidate treatment on refraction, intraocular pressure, and the anterior chamber in children with ADHD. In this prospective pilot study, children diagnosed with ADHD were examined before the start of methylphenidate treatment and again 3 and 9 months after the start of treatment. Ocular examination before and after cycloplegia was performed at each visit, including Pentacam imaging of the anterior chamber. A total of 14 patients (mean age, 11 years) were recruited. The mean visual acuity, sphere, spherical equivalent refraction, intraocular pressure, and cup:disk ratio did not change significantly after the start of treatment. The anterior chamber depth after cycloplegia decreased significantly between baseline and 9 months, from 3.26 ± 0.22 mm to 3.24 ± 0.23 mm in the right eye (P = 0.037) and from 3.28 ± 0.22 mm to 3.25 ± 0.24 mm in the left eye (P = 0.001). Methylphenidate does not seem to affect refraction in most children with ADHD. After 9 months of treatment, however, there was a reduction in the anterior chamber depth, which has been described as a powerful predictor of angle closure glaucoma. Further investigation of the potential ocular side effects of methylphenidate treatment is warranted. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  18. Ocular morbidity on headache ruled out of systemic causes—A prevalence study carried out at a community based hospital in Nepal

    PubMed Central

    Marasini, Sanjay; Khadka, Jyoti; Sthapit, Purnima Raj Karnikar; Sharma, Ranjana; Nepal, Bhagvat Prasad

    2012-01-01

    Purpose The association between ophthalmic anomalies and headache still needs to be investigated largely. We aimed to look for it in the context of a rural community hospital of Nepal. Methods Hundred patients with headache were investigated for ophthalmic anomalies after the probable systemic association was ruled out. All the patients were first examined by general physician, otorhinolaryngologist and psychiatrist. Ocular evaluation consisted of detailed refractive, binocularity assessment and anterior and posterior segment examination. Data were analyzed using t-test, chi-square test, multiple logistic regression, odds ratio as well as frequency and percentages. Results Female above the age of 17 suffered more (p < 0.05). Frontal headache was more common than occipital (p > 0.05). In students and housewives frontal headache was more common (OR 3.467, 0.848–14.174; 95% CI and 1.167, 0.303–4.499; 95% CI). Refractive error was associated with frontal headache (OR, 1.429, 1.130–0.806, 95% CI). On presentation, 88% had visual acuity 6/9 or better. Forty-four percent had refractive error among whom astigmatism was more frequent (63.63%) followed by hyperopia (27.27%) and myopia (9.09%). Known eye problems were significantly associated with refractive error and binocular vision anomalies (p < 0.001). Convergence insufficiency (16.25%) and fusional vergence (11.25%) deficiencies were common among unstable binocularity. Conclusion Ocular anomalies co-exist with headache complains very frequently. Refractive and binocular vision anomalies need to be largely investigated in all headache patients. It is important to get a good headache history so that patients can be referred to the appropriate specialist.

  19. Association between Refractive Errors and Ocular Biometry in Iranian Adults

    PubMed Central

    Hashemi, Hassan; Khabazkhoob, Mehdi; Emamian, Mohammad Hassan; Shariati, Mohammad; Miraftab, Mohammad; Yekta, Abbasali; Ostadimoghaddam, Hadi; Fotouhi, Akbar

    2015-01-01

    Purpose: To investigate the association between ocular biometrics such as axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD) and corneal power (CP) with different refractive errors. Methods: In a cross-sectional study on the 40 to 64-year-old population of Shahroud, random cluster sampling was performed. Ocular biometrics were measured using the Allegro Biograph (WaveLight AG, Erlangen, Germany) for all participants. Refractive errors were determined using cycloplegic refraction. Results: In the first model, the strongest correlations were found between spherical equivalent with axial length and corneal power. Spherical equivalent was strongly correlated with axial length in high myopic and high hyperopic cases, and with corneal power in high hyperopic cases; 69.5% of variability in spherical equivalent was attributed to changes in these variables. In the second model, the correlations between vitreous chamber depth and corneal power with spherical equivalent were stronger in myopes than hyperopes, while the correlations between lens thickness and anterior chamber depth with spherical equivalent were stronger in hyperopic cases than myopic ones. In the third model, anterior chamber depth + lens thickness correlated with spherical equivalent only in moderate and severe cases of hyperopia, and this index was not correlated with spherical equivalent in moderate to severe myopia. Conclusion: In individuals aged 40-64 years, corneal power and axial length make the greatest contribution to spherical equivalent in high hyperopia and high myopia. Anterior segment biometric components have a more important role in hyperopia than myopia. PMID:26730304

  20. Nature of the refractive errors in rhesus monkeys (Macaca mulatta) with experimentally induced ametropias.

    PubMed

    Qiao-Grider, Ying; Hung, Li-Fang; Kee, Chea-Su; Ramamirtham, Ramkumar; Smith, Earl L

    2010-08-23

    We analyzed the contribution of individual ocular components to vision-induced ametropias in 210 rhesus monkeys. The primary contribution to refractive-error development came from vitreous chamber depth; a minor contribution from corneal power was also detected. However, there was no systematic relationship between refractive error and anterior chamber depth or between refractive error and any crystalline lens parameter. Our results are in good agreement with previous studies in humans, suggesting that the refractive errors commonly observed in humans are created by vision-dependent mechanisms that are similar to those operating in monkeys. This concordance emphasizes the applicability of rhesus monkeys in refractive-error studies. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. Nature of the Refractive Errors in Rhesus Monkeys (Macaca mulatta) with Experimentally Induced Ametropias

    PubMed Central

    Qiao-Grider, Ying; Hung, Li-Fang; Kee, Chea-su; Ramamirtham, Ramkumar; Smith, Earl L.

    2010-01-01

    We analyzed the contribution of individual ocular components to vision-induced ametropias in 210 rhesus monkeys. The primary contribution to refractive-error development came from vitreous chamber depth; a minor contribution from corneal power was also detected. However, there was no systematic relationship between refractive error and anterior chamber depth or between refractive error and any crystalline lens parameter. Our results are in good agreement with previous studies in humans, suggesting that the refractive errors commonly observed in humans are created by vision-dependent mechanisms that are similar to those operating in monkeys. This concordance emphasizes the applicability of rhesus monkeys in refractive-error studies. PMID:20600237

  2. A comparative clinical survey of the prevalence of refractive errors and eye diseases in urban and rural school children.

    PubMed

    Uzma, Nazia; Kumar, B Santhosh; Khaja Mohinuddin Salar, B M; Zafar, Mohammed Atheshm; Reddy, V Devender

    2009-06-01

    To assess the prevalence of refractive error and common ocular diseases in school-aged children in urban and rural populations in and around Hyderabad, India. Population-based, cross-sectional study. A total of 3314 school children, 1789 from urban areas and 1525 from rural areas. The examination included visual acuity measurements, retinoscopy and autorefraction under cycloplegia, examination of the anterior segment and external eye, and ocular motility evaluation. In the urban group the prevalence of uncorrected presenting and best-corrected visual impairment (< or = 20/40 in the better eye) was 9.8%, which dropped to 7.1% with presenting vision and was further reduced to 1.1% with best-corrected visual acuity. Uncorrected visual acuity in the rural group was 6.6%, which dropped to 3.3% with presenting vision and was further reduced to 2.5% with best-corrected visual acuity. The prevalence of refractive error was greater (25.2%) in the urban than the rural group (8%). Myopia measured with autorefraction was observed in 51.4% of urban children and 16.7% in rural children. Increased literacy rate, duration of study hours, and older age of the child were found to have contributed more to the prevalence of myopia in the urban group. Hyperopia with autorefraction was found to be 3.3% in the urban and 3.1% in the rural group. Hyperopia was associated with younger age in the study group. Trachoma was the leading cause of ocular morbidity in the rural group (3.5%) compared with the urban group (0.16%). Night blindness was reported in 3.2% of children in the rural group and 0.33% in the urban group. Vitamin A deficiency, low socio-economic status, and poor personal and environmental hygienic practice were found to have a positive correlation with ocular morbidity among rural group children. Provision of health education, periodic visual screening programs, and primary eye care by trained health care personnel in the elementary schools will prevent the prevalence of refractive errors and common ocular diseases in school children.

  3. Significant Axial Elongation with Minimal Change in Refraction in 3- to 6-Year-Old Chinese Preschoolers: The Shenzhen Kindergarten Eye Study.

    PubMed

    Guo, Xinxing; Fu, Min; Ding, Xiaohu; Morgan, Ian G; Zeng, Yangfa; He, Mingguang

    2017-12-01

    To document the distribution of ocular biometry and to evaluate its associations with refraction in a group of Chinese preschoolers. Population-based cross-sectional study. A total of 1133 preschoolers 3 to 6 years of age from 8 representative kindergartens. Biometric measurements including axial length (AL), anterior chamber depth (ACD), and corneal radius of curvature (CR) were obtained from partial-coherence laser interferometry (IOL Master; Carl Zeiss Meditec, Oberkochen, Germany) before cycloplegia. Lens power (LP) and AL-to-CR ratio were calculated. Cycloplegic refraction (3 drops of 1% cyclopentolate) was measured using an autorefractor (KR8800; Topcon Corp., Tokyo, Japan), and spherical equivalent refraction (SER) was calculated. Biometric and refractive parameters were assessed as a function of age and gender. Multiple regression analysis was performed to explore the associations between refraction and ocular biometry. Ocular biometric distributions and their relationships to refraction. Among the 1127 children (99.5%) with successful cycloplegic refraction, mean SER was 1.37±0.63 diopters (D). Prevalence of myopia increased from 0% at 3 years of age to 3.7% (95% confidence interval, 1.0%-6.5%) at 6 years of age. Biometric parameters followed Gaussian distributions with means of 22.39±0.68 mm for AL, 7.79±0.25 mm for CR, and 24.61±1.42 D for calculated LP; and non-Gaussian distributions with means of 3.34±0.24 mm for ACD and 2.88±0.06 for AL-to-CR ratio. Axial length, ACD, and AL-to-CR ratio increased from 3 to 6 years of age, CR remained stable, whereas LP declined. Overall, SER declined slightly. For the SER variance, AL explained 18.6% and AL-to-CR ratio explained 39.8%, whereas AL, CR, and LP accounted for 80.0% after adjusting for age and gender. Young Chinese children are predominantly mildly hyperopic, with a low prevalence of myopia by the age of 6 years. An increase of 1 mm in AL was associated with only 0.45 D of myopic change. Decreases in LP reduce the myopic shifts that normally would be associated with increases in AL, and thus play a key role in refractive development in this age group. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  4. Childhood exposure to constricted living space: a possible environmental threat for myopia development.

    PubMed

    Choi, Kai Yip; Yu, Wing Yan; Lam, Christie Hang I; Li, Zhe Chuang; Chin, Man Pan; Lakshmanan, Yamunadevi; Wong, Francisca Siu Yin; Do, Chi Wai; Lee, Paul Hong; Chan, Henry Ho Lung

    2017-09-01

    People in Hong Kong generally live in a densely populated area and their homes are smaller compared with most other cities worldwide. Interestingly, East Asian cities with high population densities seem to have higher myopia prevalence, but the association between them has not been established. This study investigated whether the crowded habitat in Hong Kong is associated with refractive error among children. In total, 1075 subjects [Mean age (S.D.): 9.95 years (0.97), 586 boys] were recruited. Information such as demographics, living environment, parental education and ocular status were collected using parental questionnaires. The ocular axial length and refractive status of all subjects were measured by qualified personnel. Ocular axial length was found to be significantly longer among those living in districts with a higher population density (F 2,1072  = 6.15, p = 0.002) and those living in a smaller home (F 2,1072  = 3.16, p = 0.04). Axial lengths were the same among different types of housing (F 3,1071  = 1.24, p = 0.29). Non-cycloplegic autorefraction suggested a more negative refractive error in those living in districts with a higher population density (F 2,1072  = 7.88, p < 0.001) and those living in a smaller home (F 2,1072  = 4.25, p = 0.02). After adjustment for other confounding covariates, the population density and home size also significantly predicted axial length and non-cycloplegic refractive error in the multiple linear regression model, while axial length and refractive error had no relationship with types of housing. Axial length in children and childhood refractive error were associated with high population density and small home size. A constricted living space may be an environmental threat for myopia development in children. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

  5. The Relationship between Crystalline Lens Power and Refractive Error in Older Chinese Adults: The Shanghai Eye Study.

    PubMed

    He, Jiangnan; Lu, Lina; He, Xiangui; Xu, Xian; Du, Xuan; Zhang, Bo; Zhao, Huijuan; Sha, Jida; Zhu, Jianfeng; Zou, Haidong; Xu, Xun

    2017-01-01

    To report calculated crystalline lens power and describe the distribution of ocular biometry and its association with refractive error in older Chinese adults. Random clustering sampling was used to identify adults aged 50 years and above in Xuhui and Baoshan districts of Shanghai. Refraction was determined by subjective refraction that achieved the best corrected vision based on monocular measurement. Ocular biometry was measured by IOL Master. The crystalline lens power of right eyes was calculated using modified Bennett-Rabbetts formula. We analyzed 6099 normal phakic right eyes. The mean crystalline lens power was 20.34 ± 2.24D (range: 13.40-36.08). Lens power, spherical equivalent, and anterior chamber depth changed linearly with age; however, axial length, corneal power and AL/CR ratio did not vary with age. The overall prevalence of hyperopia, myopia, and high myopia was 48.48% (95% CI: 47.23%-49.74%), 22.82% (95% CI: 21.77%-23.88%), and 4.57% (95% CI: 4.05-5.10), respectively. The prevalence of hyperopia increased linearly with age while lens power decreased with age. In multivariate models, refractive error was strongly correlated with axial length, lens power, corneal power, and anterior chamber depth; refractive error was slightly correlated with best corrected visual acuity, age and sex. Lens power, hyperopia, and spherical equivalent changed linearly with age; Moreover, the continuous loss of lens power produced hyperopic shifts in refraction in subjects aged more than 50 years.

  6. Refraction and Ocular Biometry of Preschool Children in Shanghai, China

    PubMed Central

    He, Xiangui; You, Xiaofang; Wang, Bingjie; Tan, Hui; Zhu, Jianfeng

    2018-01-01

    Purpose To investigate the refraction and ocular biometry characteristics and to examine the prevalence of refractive errors in preschool children aged 3 to 6 years in Shanghai, China. Methods A school-based cross-sectional study was conducted in Jiading and Xuhui District, Shanghai, in 2013. We randomly selected 7 kindergartens in Jiading District and 10 kindergartens in Xuhui District, with a probability proportionate to size. The children underwent comprehensive eye examinations, including cycloplegic refraction and biometric measurements. Myopia, hyperopia, astigmatism were defined as spherical equivalent (SE) ≤ −0.50 D, SE ≥ +2.00 D, and cylindrical diopters ≤ −1.00 D. Results The mean SE for 3- to 6-year-old children was +1.20 D (standard deviation [SD] 1.05), and the mean axial length (AL) was 22.29 mm (SD 0.73). The overall prevalence of myopia and astigmatism was 3.7% and 18.3%, respectively. No difference in prevalence of astigmatism was found across age groups. There was a statistically significant association between lower cylindrical diopters and higher spherical diopters (Spearman's correlation: −0.21, P < 0.001). Conclusion Chinese children aged 3 to 6 years in the Shanghai area were mostly mildly hyperopic, with a low prevalence of myopia. Refractive astigmatism for children may be relatively stable throughout the preschool stage. Astigmatism was significantly associated with refractive error. PMID:29692930

  7. Refractive status and optical components of premature babies with or without retinopathy of prematurity at 3-4 years old.

    PubMed

    Ouyang, Li-Juan; Yin, Zheng-Qin; Ke, Ning; Chen, Xin-Ke; Liu, Qin; Fang, Jing; Chen, Lin; Chen, Xiu-Rong; Shi, Hui; Tang, Ling; Pi, Lian-Hong

    2015-01-01

    To investigate the refractive status and optical components of premature babies with or without retinopathy of prematurity (ROP) at 3-4 years old, and to explore the influence of prematurity and ROP on the refractive status and optical components. Premature babies receiving fundus examination were recruited into ROP group and non-ROP group, with age-matched full-term babies as controls. The incidence of myopia was the highest in ROP (3/59, 5.08%). The incidence of astigmatism was significantly different between ROP (37.29%, 22/59) and controls (17.86%, 15/84). The corneal refractive power in ROP and non-ROP was more potent compared with controls (P<0.05); corneal curvature was steeper (P<0.05); lens thickness was thinner (P<0.05); ocular axial length was shorter P<0.05). The gestational age was negatively related to corneal astigmatism and astigmatism, positively associated with vitreous thickness and axial length. The birth-weight was negatively associated with corneal astigmatism, astigmatism and corneal refractive power, positively related to corneal radius of curvature, vitreous thickness and ocular axial length. Premature babies with or without ROP are susceptible to myopia and astigmatism. ROP, prematurity and low birth-weight synergistically influence the development of refractive status and optical components, of which the prematurity and low birth-weight are more important.

  8. Myopic refractive shift represents dense nuclear sclerosis and thin lens in lenticular myopia.

    PubMed

    Cho, Yang Kyung; Huang, Wei; Nishimura, Eiichi

    2013-09-01

    It is not rare to meet unilateral nuclear sclerotic cataracts with myopic refractive changes (lenticular myopia) compared with the fellow eye in the ophthalmic examination of patients with decreased visual acuity. To determine the relationship between the myopic refractive changes and interocular differences of parameters, we investigated the interocular differences of ocular parameters between a lenticular myopic eye and the fellow eye. This retrospective study included 68 eyes of 34 patients, who showed unilateral lenticular myopia. We compared the dimensions of ocular component, such as anterior chamber depth, anterior chamber volume, lens thickness, vitreous chamber depth, lens position, lens density of nuclear sclerosis, anterior lens curvature and myopic refractive changes (spherical equivalent refraction) between the lenticular myopic eye and the myopic refractive change were examined. Statistically significant differences were found between the lenticular myopic eye and the fellow eye for anterior chamber depth (p = 0.015) anterior chamber volume (p = 0.031), lens thickness (p < 0.001), lens density of the nuclear sclerosis (p < 0.001) and the spherical equivalent myopic refractive changes (p < 0.001). Based on univariate analysis, the interocular difference in spherical equivalent refraction was significantly correlated with interocular differences of the density of the nuclear sclerosis (r = 0.79, p < 0.001), lens thickness (r = -0.70, p < 0.001) and vitreous chamber depth (r = 0.43, p = 0.012). Based on multiple regression analysis, the interocular difference in spherical equivalent refraction was significantly correlated with interocular differences of density of nuclear sclerosis (p < 0.001) and lens thickness (p = 0.007). The difference in myopic spherical change reflects the differences in the severity of nuclear sclerosis and lens thickness between the lenticular myopic eye and the fellow eye. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

  9. Ocular morbidity prevalence among school children in Shimla, Himachal, North India

    PubMed Central

    Gupta, Madhu; Gupta, Bhupinder P; Chauhan, Anil; Bhardwaj, Ashok

    2009-01-01

    Background Data on eye diseases among school children is not readily available. Considering the fact that one-third of India's blind lose their eyesight before the age of 20 years and many of them are under five when they become blind, early detection and treatment of ocular morbidity among children is important. Aim To estimate the prevalence of ocular morbidity among school children of age 6-16 years. Settings Government and private coeducational schools in urban area of Shimla. Design Cross-sectional Materials and Methods Government and private coeducational schools selected by stratified random sampling. About 1561 school children, studying in elementary through secondary class in these schools were examined from August 2001 to January 2002 in Shimla. A doctor did visual acuity and detailed ophthalmic examination. Statistical analysis The Chi-square test was used to test differences in proportions. Differences were considered to be statistically significant at the 5% level. Results Prevalence of ocular morbidity was 31.6% (CI=29.9-32.1%), refractive errors 22% (CI=21.1-22.8%), squint 2.5% (CI=2.4-2.6%), color blindness 2.3% (CI=2.2-2.4%), vitamin A deficiency 1.8 % (CI=1.7-1.9%), conjunctivitis 0.8% (CI=0.79-0.81%). Overall prevalence of ocular morbidity in government and private schools did not show any statistical significant difference. Prevalence of conjunctivitis was significantly (P<0.5) more in government schools. Conclusion A high prevalence of ocular morbidity among high-school children was observed. Refractive errors were the most common ocular disorders. PMID:19237787

  10. Pseudolentogenic astigmatic effect of multifocal intraocular lenses: non-corneal ocular residual astigmatism (N-CORA) as a new parameter in astigmatic change analysis.

    PubMed

    Frings, Andreas; Steinberg, Johannes; Druchkiv, Vasyl; Linke, Stephan J; Katz, Toam

    2017-08-01

    This study was initiated to introduce the term non-corneal ocular residual astigmatism (N-CORA) as a new parameter in astigmatic change analysis after implantation of two different types of non-toric, multifocal intraocular lenses (MIOL). Seventy-two eyes from 72 consecutive patients after MIOL surgery were studied in terms of a retrospective, cross-sectional data analysis. Two types of spherical MIOL were used. Surgical technique in all patients was a 2.4-mm incision phacoemulsification, performed by one surgeon. To investigate the magnitude and axis of astigmatic changes, the true corneal astigmatism and Alpins vector method were applied. There were no statistically significant between-group differences related to the preoperative refraction or ocular residual astigmatism (ORA). After surgery, the mean refractive surgically induced astigmatism (RSIA) and the topographic SIA (TSIA) did not differ significantly between the lenses. The magnitude and orientation of ORA and N-CORA changed after surgery. There are no statistically significant differences in postoperative ORA in magnitude or axis when implanting different types of MIOL. The similarity of N-CORA between both MIOL types shows that both diffractive and refractive asymmetric MIOLs with plate haptics have the same pseudolentogenic astigmatic effect which could be presented in terms of the newly introduced parameter N-CORA.

  11. Automatic diagnostic system for measuring ocular refractive errors

    NASA Astrophysics Data System (ADS)

    Ventura, Liliane; Chiaradia, Caio; de Sousa, Sidney J. F.; de Castro, Jarbas C.

    1996-05-01

    Ocular refractive errors (myopia, hyperopia and astigmatism) are automatic and objectively determined by projecting a light target onto the retina using an infra-red (850 nm) diode laser. The light vergence which emerges from the eye (light scattered from the retina) is evaluated in order to determine the corresponding ametropia. The system basically consists of projecting a target (ring) onto the retina and analyzing the scattered light with a CCD camera. The light scattered by the eye is divided into six portions (3 meridians) by using a mask and a set of six prisms. The distance between the two images provided by each of the meridians, leads to the refractive error of the referred meridian. Hence, it is possible to determine the refractive error at three different meridians, which gives the exact solution for the eye's refractive error (spherical and cylindrical components and the axis of the astigmatism). The computational basis used for the image analysis is a heuristic search, which provides satisfactory calculation times for our purposes. The peculiar shape of the target, a ring, provides a wider range of measurement and also saves parts of the retina from unnecessary laser irradiation. Measurements were done in artificial and in vivo eyes (using cicloplegics) and the results were in good agreement with the retinoscopic measurements.

  12. Bell's Palsy Treatment

    MedlinePlus

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  13. Using Eye Makeup

    MedlinePlus

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  14. Diplopia after laser in situ keratomileusis (LASIK) in a patient with a history of strabismus.

    PubMed

    Heinmiller, Laura J; Wasserman, Barry N

    2013-02-01

    In patients with a history of strabismus, refractive surgery can result in decompensation of ocular alignment, with subsequent diplopia. Refractive surgery in the management of strabismus has been described, although it remains controversial. We present a young adult with past history of strabismus surgery and new-onset diplopia after refractive surgery. Binocular diplopia was treated surgically with laser in situ keratomileusis. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  15. Monochromatic ocular wave aberrations in young monkeys

    PubMed Central

    Ramamirtham, Ramkumar; Kee, Chea-su; Hung, Li-Fang; Qiao-Grider, Ying; Roorda, Austin; Smith, Earl L.

    2006-01-01

    High-order monochromatic aberrations could potentially influence vision-dependent refractive development in a variety of ways. As a first step in understanding the effects of wave aberration on refractive development, we characterized the maturational changes that take place in the high-order aberrations of infant rhesus monkey eyes. Specifically, we compared the monochromatic wave aberrations of infant and adolescent animals and measured the longitudinal changes in the high-order aberrations of infant monkeys during the early period when emmetropization takes place. Our main findings were that (1) adolescent monkey eyes have excellent optical quality, exhibiting total RMS errors that were slightly better than those for adult human eyes that have the same numerical aperture and (2) shortly after birth, infant rhesus monkeys exhibited relatively larger magnitudes of high-order aberrations predominately spherical aberration, coma, and trefoil, which decreased rapidly to assume adolescent values by about 200 days of age. The results demonstrate that rhesus monkey eyes are a good model for studying the contribution of individual ocular components to the eye’s overall aberration structure, the mechanisms responsible for the improvements in optical quality that occur during early ocular development, and the effects of high-order aberrations on ocular growth and emmetropization. PMID:16750549

  16. Eye model for the ground squirrel

    NASA Astrophysics Data System (ADS)

    Sussman, Dafna; Chou, B. Ralph; Lakshminarayanan, Vasudevan

    2011-11-01

    This paper presents an anatomically-correct eye model for the ground squirrel, a diurnal, highly-developed mammal with high visual acuity. This model can assist in understanding the relationship between ocular structural development and its corresponding function. The eye model is constructed based on anatomical measurements of thicknesses and indices of refraction of the various ocular media. The model then derives the gradient index distribution of the crystalline lens using a ray tracing method with a Monte Carlo optimization. Results indicate a diffraction-limited ocular behaviour, implying the visual acuity of the ground squirrel is more likely to be limited by photoreceptor density and diffraction effects, than by ocular geometry.

  17. Childhood Eye Diseases and Conditions

    MedlinePlus

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  18. Genetic Testing and Eye Disease

    MedlinePlus

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  19. What Is Giant Cell Arteritis?

    MedlinePlus

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  20. The Relationship between Crystalline Lens Power and Refractive Error in Older Chinese Adults: The Shanghai Eye Study

    PubMed Central

    He, Jiangnan; Lu, Lina; He, Xiangui; Xu, Xian; Du, Xuan; Zhang, Bo; Zhao, Huijuan; Sha, Jida; Zhu, Jianfeng; Zou, Haidong; Xu, Xun

    2017-01-01

    Purpose To report calculated crystalline lens power and describe the distribution of ocular biometry and its association with refractive error in older Chinese adults. Methods Random clustering sampling was used to identify adults aged 50 years and above in Xuhui and Baoshan districts of Shanghai. Refraction was determined by subjective refraction that achieved the best corrected vision based on monocular measurement. Ocular biometry was measured by IOL Master. The crystalline lens power of right eyes was calculated using modified Bennett-Rabbetts formula. Results We analyzed 6099 normal phakic right eyes. The mean crystalline lens power was 20.34 ± 2.24D (range: 13.40–36.08). Lens power, spherical equivalent, and anterior chamber depth changed linearly with age; however, axial length, corneal power and AL/CR ratio did not vary with age. The overall prevalence of hyperopia, myopia, and high myopia was 48.48% (95% CI: 47.23%–49.74%), 22.82% (95% CI: 21.77%–23.88%), and 4.57% (95% CI: 4.05–5.10), respectively. The prevalence of hyperopia increased linearly with age while lens power decreased with age. In multivariate models, refractive error was strongly correlated with axial length, lens power, corneal power, and anterior chamber depth; refractive error was slightly correlated with best corrected visual acuity, age and sex. Conclusion Lens power, hyperopia, and spherical equivalent changed linearly with age; Moreover, the continuous loss of lens power produced hyperopic shifts in refraction in subjects aged more than 50 years. PMID:28114313

  1. The combination of vestibular impairment and congenital sensorineural hearing loss predisposes patients to ocular anomalies, including Usher syndrome.

    PubMed

    Kletke, S; Batmanabane, V; Dai, T; Vincent, A; Li, S; Gordon, K A; Papsin, B C; Cushing, S L; Héon, E

    2017-07-01

    The co-occurrence of hearing impairment and visual dysfunction is devastating. Most deaf-blind etiologies are genetically determined, the commonest being Usher syndrome (USH). While studies of the congenitally deaf population reveal a variable degree of visual problems, there are no effective ophthalmic screening guidelines. We hypothesized that children with congenital sensorineural hearing loss (SNHL) and vestibular impairment were at an increased risk of having USH. A retrospective chart review of 33 cochlear implants recipients for severe to profound SNHL and measured vestibular dysfunction was performed to determine the ocular phenotype. All the cases had undergone ocular examination and electroretinogram (ERG). Patients with an abnormal ERG underwent genetic testing for USH. We found an underlying ocular abnormality in 81.81% (27/33) of cases; of which 75% had refractive errors, and 50% of those patients showed visual improvement with refractive correction. A total of 14 cases (42.42%; 14/33) had generalized rod-cone dysfunction on ERG suggestive of Usher syndrome type 1, confirmed by mutational analysis. This work shows that adding vestibular impairment as a criterion for requesting an eye exam and adding the ERG to detect USH increases the chances of detecting ocular anomalies, when compared with previous literature focusing only on congenital SNHL. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Clear lens phacoemulsification in Alport syndrome: refractive results and electron microscopic analysis of the anterior lens capsule.

    PubMed

    Bayar, Sezin Akca; Pinarci, Eylem Yaman; Karabay, Gulten; Akman, Ahmet; Oto, Sibel; Yilmaz, Gursel

    2014-01-01

    To report the ocular findings of patients with Alport syndrome and the results of clear lens extraction in this patient group. Twenty-three eyes of 15 patients with a diagnosis of Alport syndrome were included in this study. Clear corneal phacoemulsification and intraocular foldable lens implantation was performed in eyes with indeterminate refractive errors and/or poor visual acuity and anterior capsule samples were analyzed with electron microscopy. All patients had a history of hereditary nephritis and/or deafness as systemic involvement. Ophthalmologic examination revealed anterior lenticonus with high myopia and/or irregular astigmatism in all patients. The mean best-corrected visual acuity (BCVA) was 0.67 ± 0.17 logMAR (range 1.0-0.4) preoperatively and 0.17 ± 0.08 logMAR (range 0.3-0.0) postoperatively. Postoperative refractive lenticular astigmatism dramatically decreased and no ocular complications arose during the follow-up period. Transmission electron microscopic analysis of the lens capsules supported the diagnosis of Alport syndrome. Clear lens phacoemulsification and foldable intraocular lens implantation is a safe and effective therapeutic choice for the management of uncorrectable refractive errors and low visual acuity due to anterior lenticonus in patients with Alport syndrome.

  3. Preventable visual impairment in children 
with nonprofound intellectual disability.

    PubMed

    Aslan, Lokman; Aslankurt, Murat; Aksoy, Adnan; Altun, Hatice

    2013-01-01

    To assess the preventable visual impairment in children with nonprofound intellectual disability (ID). 
 A total of 215 children with IDs (90 Down syndrome [DS], 125 nonprofound ID) and 116 age- and sex-matched healthy subjects were enrolled in this study. All participants underwent ophthalmologic examinations including cycloplegic refraction measurements, ocular movement evaluation, screening for strabismus (Hirschberg, Krimsky, or prism cover test), slit-lamp biomicroscopy, funduscopy, and intraocular pressure measurements. All data were recorded for statistical analysis.
 Ocular findings in decreasing prevalence were as follows: refractive errors 55 (61.1%), strabismus 30 (33.2%), cataract 7 (7.8%), and nystagmus 7 (7.8%) in children with DS; refractive errors 57 (45.6%), strabismus 19 (15.2%), cataract 7 (6.4%), nystagmus 5 (4%), and glaucoma 1 (0.8%) in children with other ID; and refractive errors 13 (11.2%) and strabismus 4 (3.5%) in controls. Cataracts, glaucoma, and nystagmus were not observed in the control group. The most common ophthalmic findings in children with DS compared with other ID and controls were with hyperopia (p<0.03 and 
p<0.001, respectively) and esotropia (p<0.01 and p<0.01, respectively).
 The pediatric population with ID has a high prevalence of preventable visual impairments, refractive errors, strabismus, and cataracts. The prevalence of strabismus and refractive errors was more frequent in children with DS. The importance of further health screenings including ophthalmic examinations should be utilized to implement appropriate care management and improve quality of life.

  4. [Refractive errors in patients with cerebral palsy].

    PubMed

    Mrugacz, Małgorzata; Bandzul, Krzysztof; Kułak, Wojciech; Poppe, Ewa; Jurowski, Piotr

    2013-04-01

    Ocular changes are common in patients with cerebral palsy (CP) and they exist in about 50% of cases. The most common are refractive errors and strabismus disease. The aim of the paper was to estimate the relativeness between refractive errors and neurological pathologies in patients with selected types of CP. MATERIAL AND METHODS. The subject of the analysis was showing refractive errors in patients within two groups of CP: diplegia spastica and tetraparesis, with nervous system pathologies taken into account. Results. This study was proven some correlations between refractive errors and type of CP and severity of the CP classified in GMFCS scale. Refractive errors were more common in patients with tetraparesis than with diplegia spastica. In the group with diplegia spastica more common were myopia and astigmatism, however in tetraparesis - hyperopia.

  5. Surveillance of vision and ocular disorders in children with Down syndrome.

    PubMed

    Stephen, Elma; Dickson, Jennifer; Kindley, A David; Scott, Christopher C; Charleton, Patricia M

    2007-07-01

    Children with Down syndrome have a high prevalence of ocular disorders. The UK Down's Syndrome Medical Interest Group (DSMIG) guidelines for ophthalmic screening were locally implemented into a protocol that included neonatal eye examination by an ophthalmologist and a comprehensive ophthalmological examination (cycloplegic refraction, ophthalmoscopy, and orthoptic assessment) by at least the age of 3 years, followed by preschool follow-up as indicated. We audited retrospectively surveillance for ocular disorders before and after the DSMIG-based guidelines were locally adopted in 1995. Results were compared for children born before and after the implementation of screening guidelines. A total of 81 children (43 females, 38 males) with Down syndrome were identified. After the DSMIG protocol, 34/36 children received a full ophthalmological examination in the neonatal period, compared with 9/27 children before 1995 (p<0.001). Neonatal screening resulted in the detection of cataracts in three infants. Mean age of first comprehensive ophthalmic screening outside the neonatal period was similar in the two groups (1y 6mo before guidelines vs 1y 9mo after), as were the proportion of children receiving preschool eye checks (27/30 before; 17/18 after). Overall, 65.7% children were screened in accordance with the guidelines, improving to 100% in recent years. At school age, 43% of the study population had significant refractive errors, with 27% having hypermetropia and astigmatism. Earlier prescription of glasses for refractive errors was seen (mean age 5y 6mo before guidelines; 3y 6mo after; p<0.001). Prevalence of other ocular disorders included strabismus (34/72, 47%), nasolacrimal duct obstruction (26/73, 35.6%), cataracts (5/64, 7.8%), and nystagmus (12/72, 16%). Establishment of the DSMIG-based local protocol has streamlined ocular surveillance. It is anticipated that this will improve developmental and functional outcomes in Down syndrome.

  6. Retinal Detachment: Torn or Detached Retina Symptoms

    MedlinePlus

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  7. Visual defects in Nepalese children with Down syndrome.

    PubMed

    Paudel, Nabin; Leat, Susan J; Adhikari, Prakash; Woodhouse, J Margaret; Shrestha, Jyoti Baba

    2010-03-01

    Down syndrome (DS) is a common chromosomal anomaly. People with this syndrome have recognisable physical characteristics and limited intellectual abilities. The aim of this study was to determine visual defects, especially refractive error and binocular anomalies, in a sample of Nepalese children with DS. Thirty-six children with DS (19 boys and 17 girls) from the Kathmandu valley, aged from four months to 18 years, underwent detailed optometric examination. Cycloplegic refraction was performed on all subjects. Vision on presentation of all the children was assessed with preferential looking cards, the Kay picture cards, the Bailey-Lovie logMAR chart or the Snellen chart. Binocular function was assessed with cover test, Hirschberg or Bruckner test. Cycloplegic refraction of the children revealed that 80 per cent of the children had significant refractive error. Most of them had hyperopia (55 per cent), followed by astigmatism (44 per cent), myopia (25 per cent) and anisometropia (19 per cent). Only two (5.6 per cent) children were strabismic and both of them were alternating esotropes. Nystagmus was present in 10 (28 per cent). Other ocular findings were upward slanting palpebral fissures, blepharitis, congenital nasolacrimal duct obstruction, blepharoconjunctivitis, chalazion and lenticular opacities. Nepalese children with DS have a high prevalence of refractive error and nystagmus. Regular eye examinations are indicated for these children to enable early diagnosis and appropriate management of ocular disorders to improve their vision and quality of life.

  8. Test and evaluation of the 2.4-micron photorefractor ocular screening system

    NASA Technical Reports Server (NTRS)

    Richardson, J. R.

    1985-01-01

    An improved 2.4-m photorefractor ocular screening system was tested and evaluated. The photorefractor system works on the principal of obtaining a colored photograph of both human eyes; and, by analysis of the retinal reflex images, certain ocular defects can be detected such a refractive error, strabismus, and lens obstructions. The 2.4-m photorefractory system uses a 35-mm camera with a telephoto lens and an electronic flash attachment. Retinal reflex images obtained from the new 2.4-m system are significantly improved over earlier systems in image quality. Other features were also improved, notably portability and reduction in mass. A total of 706 school age children were photorefracted, 211 learning disabled and 495 middle school students. The total students having abnormal retinal reflexes were 156 or 22 percent, and 133 or 85 percent of the abnormal had refractive error indicated. Ophthalmological examination was performed on 60 of these students and refractive error was verified in 57 or 95 percent of those examined. The new 2.4-m system has a NASA patent pending and is authorized by the FDA. It provides a reliable means of rapidly screening the eyes of children and young adults for vision problems. It is especially useful for infants and other non-communicative children who cannot be screened by the more conventional methods such as the familiar E chart.

  9. Outcome Analysis Tool for Army Refractive Surgery Program

    DTIC Science & Technology

    2005-03-01

    analysis function produces reports on the following information: " Evaluation of the safety of PRK and LASIK for maintenance of optimal visual...performance and ocular integrity. " Evaluation of the efficacy of PRK and LASIK by assessing the improvement in uncorrected vision for target detection...discrimination and recognition. "* Evaluation of the efficacy of PRK and LASIK by evaluating the stability of the refractive error over time

  10. The subject-fixated coaxially sighted corneal light reflex: a clinical marker for centration of refractive treatments and devices.

    PubMed

    Chang, Daniel H; Waring, George O

    2014-11-01

    To describe the inconsistencies in definition, application, and usage of the ocular reference axes (optical axis, visual axis, line of sight, pupillary axis, and topographic axis) and angles (angle kappa, lambda, and alpha) and to propose a precise, reproducible, clinically defined reference marker and axis for centration of refractive treatments and devices. Perspective. Literature review of papers dealing with ocular reference axes, angles, and centration. The inconsistent definitions and usage of the current ocular axes, as derived from eye models, limit their clinical utility. With a clear understanding of Purkinje images and a defined alignment of the observer, light source/fixation target, and subject eye, the subject-fixated coaxially sighted corneal light reflex can be a clinically useful reference marker. The axis formed by connecting the subject-fixated coaxially sighted corneal light reflex and the fixation point, the subject-fixated coaxially sighted corneal light reflex axis, is independent of pupillary dilation and phakic status of the eye. The relationship of the subject-fixated coaxially sighted corneal light reflex axis to a refined definition of the visual axis without reference to nodal points, the foveal-fixation axis, is discussed. The displacement between the subject-fixated coaxially sighted corneal light reflex and pupil center is described not by an angle, but by a chord, here termed chord mu. The application of the subject-fixated coaxially sighted corneal light reflex to the surgical centration of refractive treatments and devices is discussed. As a clinically defined reference marker, the subject-fixated coaxially sighted corneal light reflex avoids the shortcomings of current ocular axes for clinical application and may contribute to better consensus in the literature and improved patient outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Bright Light Suppresses Form-Deprivation Myopia Development With Activation of Dopamine D1 Receptor Signaling in the ON Pathway in Retina.

    PubMed

    Chen, Si; Zhi, Zhina; Ruan, Qingqing; Liu, Qingxia; Li, Fen; Wan, Fen; Reinach, Peter S; Chen, Jiangfan; Qu, Jia; Zhou, Xiangtian

    2017-04-01

    To determine whether dopamine receptor D1 (D1R) signaling pathway activation by bright light (BL) in specific retinal neuronal cell types contributes to inhibiting form-deprivation myopia (FDM) in mice. Mice (3-weeks old) were raised under either normal light (NL: 100-200 lux) or BL (2500-5000 lux) conditions with or without form deprivation. Refraction changes were evaluated with an eccentric infrared photorefractor, and ocular axial components with optical coherence tomography. The D1R antagonist, SCH39166, was intraperitoneally injected daily to evaluate if BL mediates declines in FDM development through D1R activation. Six different biomarkers of retinal neuronal types delineated differential distribution of D1R expression. c-Fos and phosphorylated tyrosine hydroxylase (p-TH) immunofluorescent staining evaluated D1R receptor activation and dopamine synthesis, respectively. Bright light exposure for 4 weeks (6 hours per day) inhibited FDM development by reducing ocular elongation and shifting refraction toward hyperopia compared with changes occurring in NL. SCH39166 injections completely reversed the inhibitory effects of BL on both refraction and ocular elongation. Bright light increased the number of cells expressing p-TH and c-fos. Increases in c-fos+ cells occurred mainly in D1R+ bipolar cells (BCs), especially D1R+ ON-BCs. Bright light increases D1R activity in the BCs of the ON pathway, which is associated with less myopic shift and ocular elongation than those occurring in NL. These declines suggest that increased D1R activity in the ON pathway contributes to the BL suppression of FDM development in mice.

  12. Indication of advanced orthokeratology as an additional treatment after refractive surgeries

    NASA Astrophysics Data System (ADS)

    Mitsui, Iwane; Yamada, Yoshida

    2005-04-01

    Ortho-K was indicated for twenty-three eyes of thirteen patients after refractive surgeries such as RK(1) ,PRK(2), and LASIK(3). The average of their Uncorrective Visual Acuity (UCVA) after surgeries was 20/30 or worse, and mean spherical equivalent (SE) was -2.42D. They were followed at least two years wearing of Advanced Ortho-K lenses during night. The following studies were examined on their auto-refraction, auto-keratometry, uncorrected and corrected visual acuity, intra-ocular pressure, corneal endothelium, corneal thickness, corneal curvature, and corneal shape for more than two years. 95% of the patients improved in UCVA up to 20/20 or better, 86% of them improved up to 20/15 or better, and 76% of them improved up to 20/10. The mean SEs improved to -1.20+/-1.02D during six months, - 1.03+/-0.83D during one year, and -0.73+/-0.64D during two years. Astigmatism also slightly decreased. Ophthalmologic examinations showed no abnormalities including flap formation, intra-ocular pressure, and endothelium. Among the refractive surgeries as well as RK and PRK, LASIK has been most popularly spread all over the world. However, patient's quality of vision is not always satisfied during and/or after refractive surgeries, because of several complications such as instability of flap formation, unexpected keratoectasia, diffuse lamellar keratitis, epithelial ingrowth, irregularity of corneal surface which caused myopia regression. In such cases, additional surgical procedures should not be indicated easily. However, Ortho-K is safe and effective enough to correct refractive errors still remained or re-appeared after refractive surgeries. It enables to restore the corneal irregularity to the ideal shape.

  13. The retina/RPE proteome in chick myopia and hyperopia models: Commonalities with inherited and age-related ocular pathologies

    PubMed Central

    Riddell, Nina; Faou, Pierre; Murphy, Melanie; Giummarra, Loretta; Downs, Rachael A.; Rajapaksha, Harinda

    2017-01-01

    Purpose Microarray and RNA sequencing studies in the chick model of early optically induced refractive error have implicated thousands of genes, many of which have also been linked to ocular pathologies in humans, including age-related macular degeneration (AMD), choroidal neovascularization, glaucoma, and cataract. These findings highlight the potential relevance of the chick model to understanding both refractive error development and the progression to secondary pathological complications. The present study aimed to determine whether proteomic responses to early optical defocus in the chick share similarities with these transcriptome-level changes, particularly in terms of dysregulation of pathology-related molecular processes. Methods Chicks were assigned to a lens condition (monocular +10 D [diopters] to induce hyperopia, −10 D to induce myopia, or no lens) on post-hatch day 5. Biometric measures were collected following a further 6 h and 48 h of rearing. The retina/RPE was then removed and prepared for liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) on an LTQ-Orbitrap Elite. Raw data were processed using MaxQuant, and differentially abundant proteins were identified using moderated t tests (fold change ≥1.5, Benjamini-Hochberg adjusted p<0.05). These differentially abundant proteins were compared with the genes and proteins implicated in previous exploratory transcriptome and proteomic studies of refractive error, as well as the genes and proteins linked to the ocular pathologies listed above for which myopia or hyperopia are risk factors. Finally, gene set enrichment analysis (GSEA) was used to assess whether gene sets from the Human Phenotype Ontology database were enriched in the lens groups relative to the no lens groups, and at the top or bottom of the protein data ranked by Spearman’s correlation with refraction at 6 and 48 h. Results Refractive errors of −2.63 D ± 0.31 D (mean ± standard error, SE) and 3.90 D ± 0.37 D were evident in the negative and positive lens groups, respectively, at 6 h. By 48 h, refractive compensation to both lens types was almost complete (negative lens −9.70 D ± 0.41 D, positive lens 7.70 D ± 0.44 D). More than 140 differentially abundant proteins were identified in each lens group relative to the no lens controls at both time points. No proteins were differentially abundant between the negative and positive lens groups at 6 h, and 13 were differentially abundant at 48 h. As there was substantial overlap in the proteins implicated across the six comparisons, a total of 390 differentially abundant proteins were identified. Sixty-five of these 390 proteins had previously been implicated in transcriptome studies of refractive error animal models, and 42 had previously been associated with AMD, choroidal neovascularization, glaucoma, and/or cataract in humans. The overlap of differentially abundant proteins with AMD-associated genes and proteins was statistically significant for all conditions (Benjamini-Hochberg adjusted p<0.05), with over-representation analysis implicating ontologies related to oxidative stress, cholesterol homeostasis, and melanin biosynthesis. GSEA identified significant enrichment of genes associated with abnormal electroretinogram, photophobia, and nyctalopia phenotypes in the proteins negatively correlated with ocular refraction across the lens groups at 6 h. The implicated proteins were primarily linked to photoreceptor dystrophies and mitochondrial disorders in humans. Conclusions Optical defocus in the chicks induces rapid changes in the abundance of many proteins in the retina/RPE that have previously been linked to inherited and age-related ocular pathologies in humans. Similar changes have been identified in a meta-analysis of chick refractive error transcriptome studies, highlighting the chick as a model for the study of optically induced stress with possible relevance to understanding the development of a range of pathological states in humans. PMID:29259393

  14. Model of the Human Eye Based on ABCD Matrix

    NASA Astrophysics Data System (ADS)

    González, G. Díaz; Castillo, M. David Iturbe

    2008-04-01

    At the moment several models of the human eye exist, nevertheless the gradient index models of the human lens (crystalline) have received little attention in optometry and vision sciences, although they consider how the refractive index and the refracting power can change with the accommodation. On the other hand, in study fields like ophthalmology and optometry, exist cases where there is a lack of information about the factors that influence the change of refractive power and therefore the focal length of the eye. By such reason, in this paper we present a model of the human eye based on the ABCD matrix in order to describe the propagation of light rays, that can be understood by professional people in optics, ophthalmology and optometry, and the dispersions of the different ocular mediums are taken into account,. The aim of the model is to obtain data about the refractive power of the eye under different considerations, such as: changes in wavelength, radius of curvature and thicknesses of the ocular mediums. We present results of simulations in Matlab of our model, assuming that the object is punctual and is placed to a certain distance of the eye, and considering at the beginning to the crystalline like a medium with fixed refractive index, and after like a gradient lens. By means of graphs, we show the total refractive power of the eye and its form and type of dependence with respect to variations in radius of curvature and thicknesses of the cornea and crystalline, as well as variations in the thickness of the previous and later cameras.

  15. Ametropia and ocular biometry in a U.K. university student population.

    PubMed

    Logan, Nicola S; Davies, Leon N; Mallen, Edward A H; Gilmartin, Bernard

    2005-04-01

    The prevalence of myopia is known to vary with age, ethnicity, level of education, and socioeconomic status, with a high prevalence reported in university students and in people from East Asian countries. This study determines the prevalence of ametropia in a mixed ethnicity U.K. university student population and compares associated ocular biometric measures. Refractive error and related ocular component data were collected on 373 first-year U.K. undergraduate students (mean age = 19.55 years +/- 2.99, range = 17-30 years) at the start of the academic year at Aston University, Birmingham, and the University of Bradford, West Yorkshire. The ethnic variation of the students was as follows: white 38.9%, British Asian 58.2%, Chinese 2.1%, and black 0.8%. Noncycloplegic refractive error was measured with an infrared open-field autorefractor, the Shin-Nippon NVision-K 5001 (Shin Nippon, Ryusyo Industrial Co. Ltd, Osaka, Japan). Myopia was defined as a mean spherical equivalent (MSE) less than or equal to -0.50 D. Hyperopia was defined as an MSE greater than or equal to +0.50 D. Axial length, corneal curvature, and anterior chamber depth were measured using the Zeiss IOLMaster (Carl Zeiss, Jena, GmBH). The analysis was carried out only for white and British Asian groups. The overall distribution of refractive error exhibited leptokurtosis, and prevalence levels were similar for white and British Asian (the predominant ethnic group) students across each ametropic group: myopia (50% vs. 53.4%), hyperopia (18.8% vs. 17.3%), and emmetropia (31.2% vs. 29.3%). There were no significant differences in the distribution of ametropia and biometric components between white and British Asian samples. The absence of a significant difference in refractive error and ocular components between white and British Asian students exposed to the same educational system is of interest. However, it is clear that a further study incorporating formal epidemiologic methods of analysis is required to address adequately the recent proposal that juvenile myopia develops principally from "myopiagenic" environments and is relatively independent of ethnicity.

  16. [Internal astigmatism with other ocular lesions].

    PubMed

    Limaiem, R; Baba, A; Bouraoui, R; Mghaieth, F; El Matri, L

    2012-04-01

    Astigmatism is a refractive defect whose origin is not always purely corneal, and is sometimes the result of corneal, crystalline lens or mixte contributions. The aim of our study is to report, through two cases, ocular lesions associated with a lenticular astigmatism and their evolution after treatment. In the first observation, it is a 25-year-old patient with a unilateral extra corneal astigmatism within the framework of the "tilted disc syndrome" associated with bilateral myopia. This patient has received treatment by Lasik. The postoperative course was good with a decline of 5 ans. The second observation is that of a patient aged 35 years without having a general history with a posterior lenticonus associated with keratoconus responsible for a major mixed astigmatism. She received combined surgery: penetrating keratoplasty with lens extraction and implantation of an artificial lens. The evolution was good with good visual recovery. The balance of internal astigmatism must include the systematic achievement of a subjective and objective refraction under cycloplegia and corneal topography. The search for etiology is critical to screen for eye or general disease and guide the therapeutic strategy. Knowledge of the refractive power of the cornea and crystalline lens of astigmatism separately would be important for surgery refractive and crystalline lens surgery. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  17. [Refractive errors as causes of visual impairment in children from public schools of the Botucatu region - SP].

    PubMed

    Oliveira, Claudia Akemi Shiratori de; Hisatomi, Kenia Scrocaro; Leite, Cristiano Pinheiro; Schellini, Silvana Artioli; Padovani, Carlos Roberto; Padovani, Carlos Roberto Pereira

    2009-01-01

    To evaluate the refractive errors as cause of visual impairment in school children from the Botucatu region. A sectional study was conducted evaluating preschool and elementary school students, according to gender, refractive error, visual acuity and treatment. Four thousand six hundred and twenty-three (4,623) children were submitted to visual acuity evaluation and 8.1% of them were submitted to complete ocular examination. There were 63.2% hyperopic astigmatism, 15.7% myopic astigmatism, 12.5% astigmatism, 4.9% hyperopia and 3.7% myopia. Corrective lenses were prescribed for 48.7% of the evaluated children. The most frequent refractive error was hyperopic astigmatism and 50% of the children received treatment. The frequency of refractive errors was 3.9% of the studied population.

  18. Crystalline lens and refractive development.

    PubMed

    Iribarren, Rafael

    2015-07-01

    Individual refractive errors usually change along lifespan. Most children are hyperopic in early life. This hyperopia is usually lost during growth years, leading to emmetropia in adults, but myopia also develops in children during school years or during early adult life. Those subjects who remain emmetropic are prone to have hyperopic shifts in middle life. And even later, at older ages, myopic shifts are developed with nuclear cataract. The eye grows from 15 mm in premature newborns to approximately 24 mm in early adult years, but, in most cases, refractions are maintained stable in a clustered distribution. This growth in axial length would represent a refractive change of more than 40 diopters, which is compensated by changes in corneal and lens powers. The process which maintains the balance between the ocular components of refraction during growth is still under study. As the lens power cannot be measured in vivo, but can only be calculated based on the other ocular components, there have not been many studies of lens power in humans. Yet, recent studies have confirmed that the lens loses power during growth in children, and that hyperopic and myopic shifts in adulthood may be also produced by changes in the lens. These studies in children and adults give a picture of the changing power of the lens along lifespan. Other recent studies about the growth of the lens and the complexity of its internal structure give clues about how these changes in lens power are produced along life. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Ocular health assessment of cocoa farmers in a rural community in Ghana.

    PubMed

    Boadi-Kusi, Samuel Bert; Hansraj, Rekha; Kumi-Kyereme, Akwasi; Mashige, Khathutshelo Percy; Awusabo-Asare, Kofi; Ocansey, Stephen; Kyei, Samuel

    2014-01-01

    Cocoa farming provides employment for over 800,000 households in rural Ghana, with the country currently touted as the second largest producer of cocoa worldwide. Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The authors conducted an ocular health assessment among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, to examine the ocular health status and the ocular safety measures used by cocoa farmers. A structured questionnaire was used to evaluate demographic characteristics, ocular injuries, and utilization of eye care services and ocular protection, and a clinical examination was used to evaluate their ocular status. Cocoa farmers were at high risk for ocular injuries and farm-related vision disorders and utilized eye care services and ocular protection poorly. Ocular condition identified were mainly refractive error (28.6%), cataract (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%). There is a need for the introduction of an interventional eye care program to help address the ocular health challenges identified among the farmers. This can be done through collaborative efforts by educational institutions, government, and other role players in the agricultural industry to improve the quality of life of the vulnerable cocoa farmers in rural Ghana.

  20. Micro-processing of polymers and biological materials using high repetition rate femtosecond laser pulses

    NASA Astrophysics Data System (ADS)

    Ding, Li

    High repetition rate femtosecond laser micro-processing has been applied to ophthalmological hydrogel polymers and ocular tissues to create novel refractive and diffractive structures. Through the optimization of laser irradiation conditions and material properties, this technology has become feasible for future industrial applications and clinical practices. A femtosecond laser micro-processing workstation has been designed and developed. Different experimental parameters of the workstation such as laser pulse duration, focusing lens, and translational stages have been described and discussed. Diffractive gratings and three-dimensional waveguides have been fabricated and characterized in hydrogel polymers, and refractive index modifications as large as + 0.06 have been observed within the laser-irradiated region. Raman spectroscopic studies have shown that our femtosecond laser micro-processing induces significant thermal accumulation, resulting in a densification of the polymer network and increasing the localized refractive index of polymers within the laser irradiated region. Different kinds of dye chromophores have been doped in hydrogel polymers to enhance the two-photon absorption during femtosecond laser micro-processing. As the result, laser scanning speed can be greatly increased while the large refractive index modifications remain. Femtosecond laser wavelength and pulse energy as well as water and dye concentration of the hydrogels are optimized. Lightly fixed ocular tissues such as corneas and lenses have been micro-processed by focused femtosecond laser pulses, and refractive index modifications without any tissue-breakdown are observed within the stromal layer of the corneas and the cortex of the lenses. Living corneas are doped with Sodium Fluorescein to increase the two-photon absorption during the laser micro-processing, and laser scanning speed can be greatly increased while inducing large refractive index modifications. No evidence of cell death has been observed in or around the laser-induced refractive index modification regions. These results support the notion that femtosecond laser micro-processing method may be an excellent means of altering the refraction or higher order aberration content of corneal tissue without cell death and short-term tissue damage, and has been named as Intra-tissue Refractive Index Shaping (IRIS). The femtosecond laser micro-processing workstation has also been employed for laser transfection of single defined cells. Some preliminary results suggest that this method can be used to trace individual cells and record their biological and morphological evolution, which is quite promising in many biomedical applications especially in immunology science. In conclusion, high repetition rate femtosecond laser micro-processing has been employed to fabricate microstructures in ophthalmological hydrogels and ocular tissues. Its unique three-dimensional capability over transparent materials and biological media makes it a powerful tool and will greatly impact the future of laser material-processing.

  1. Measuring ocular characteristics after gel injection adjustable keratoplasty (GIAK) in the rabbit

    NASA Astrophysics Data System (ADS)

    Comander, Jason I.; Parel, Jean-Marie A.; Simon, Gabriel; Takesue, Yoshiko; Villain, Franck L.

    1995-05-01

    Gel Injection Adjustable Keratoplasty (GIAK) is a refractive surgery procedure which uses an ocular ring implant made of a polyethylene oxide hydrogel to cause a refractive change in the cornea. Unlike laser photo refractive keratectomy, GIAK does not interfere with the central cornea because the ring lies around the optical axis. Thus, vision can be assessed immediately after surgery. Our in vivo study was designed to quantify GIAK's effects on tissues, the biocompatibility of the polymer and in the process investigate which ocular changes in the rabbit model can be monitored with precision using current technology. Thirty-two young rabbits underwent a delamination in one eye, 22 of which were injected with a new polymeric gel. Corneal topography, keratometry, pachymetry, and tonometry were performed on both eyes for up to 105 days. All corneas flattened with growth. In GIAK animals, we found an average flattening of 6.51 +/- 1.23 diopters (p < 0.0001) relative to the fellow eye. No statistically significant regression over the 102 days was observed. Intraocular pressure dropped slightly by 0.69 +/- 1.21 mmHg (p equals 0.025), a clinically insignificant value, while no significant change was detected in corneal thickness. Keratometry can be tracked in rabbits after GIAK surgery from POD 1. Measuring unoperated fellow eyes allows for the effects of surgery to be assessed without bias from growth. Using this protocol, GIAK was shown to be stable. It was more difficult to draw conclusions from pachymetry, tonometry, and topography data.

  2. Choroidal and scleral mechanisms of compensation for spectacle lenses in chicks.

    PubMed

    Wildsoet, C; Wallman, J

    1995-05-01

    It is known that when hyperopic or myopic defocus is imposed on chick eyes by spectacle lenses, they rapidly compensate, becoming myopic or hyperopic respectively, by altering the depth of their vitreous chamber. Changes in two components--ocular length and choroidal thickness--underlie this rapid compensation. With monocular lens treatment, hyperopic defocus imposed by negative lenses resulted in substantially increased ocular elongation and a slight thinning of the choroid, both changes resulting in myopia; myopic defocus imposed by positive lenses resulted a dramatic increase in choroidal thickness, which pushed the retina forward toward the image plane, and a slight decrease in ocular elongation, both changes resulting in hyperopia. The refractive error after 5 days of lens wear correlated well with vitreous chamber depth, which reflected the changes in both choroidal thickness and ocular length. The degree of compensation for lenses was not affected by whether the fellow eye was covered or open. Both form-deprivation myopia and lens-induced myopia declined with age in parallel, but wearing a -15 D lens produced more myopia than did form deprivation. The spectacle lenses affected the refractive error not only of the lens-wearing eye, but also, to a much lesser degree, of the untreated fellow eye. At lens removal refractive errors were opposite in sign to the lense worn, and the subsequent changes in choroidal thickness and ocular length were also opposite to those that occurred when the lenses were in place. In this situation as well, effects of the spectacle lenses on the fellow eyes were observed. Eyes with no functional afferent connection to the brain because of either prior optic nerve section or intraocular tetrodotoxin injections showed compensatory changes to imposed defocus, but these were limited to compensation for imposed myopic defocus, at least for the eyes with optic nerve section. In addition, optic nerve section, but not tetrodotoxin treatment, moved the set-point of the visual compensatory mechanism toward hyperopia. Optic nerve section prevents myopia in response to negative lenses but not to diffusers, suggesting that compensation for hyperopia requires the central nervous system.

  3. First Demonstration of Ocular Refractive Change Using Blue-IRIS in Live Cats

    PubMed Central

    Savage, Daniel E.; Brooks, Daniel R.; DeMagistris, Margaret; Xu, Lisen; MacRae, Scott; Ellis, Jonathan D.; Knox, Wayne H.; Huxlin, Krystel R.

    2014-01-01

    Purpose. To determine the efficacy of intratissue refractive index shaping (IRIS) using 400-nm femtosecond laser pulses (blue light) for writing refractive structures directly into live cat corneas in vivo, and to assess the longevity of these structures in the eyes of living cats. Methods. Four eyes from two adult cats underwent Blue-IRIS. Light at 400 nm with 100-femtosecond (fs) pulses were tightly focused into the corneal stroma of each eye at an 80-MHz repetition rate. These pulses locally increased the refractive index of the corneal stroma via an endogenous, two-photon absorption process and were used to inscribe three-layered, gradient index patterns into the cat corneas. The optical effects of the patterns were then tracked using optical coherence tomography (OCT) and Shack-Hartmann wavefront sensing. Results. Blue-IRIS patterns locally changed ocular cylinder by −1.4 ± 0.3 diopters (D), defocus by −2.0 ± 0.5 D, and higher-order root mean square (HORMS) by 0.31 ± 0.04 μm at 1 month post-IRIS, without significant changes in corneal thickness or curvature. Refractive changes were maintained for the duration they were tracked, 12 months post-IRIS in one eye, and just more than 3 months in the remaining three eyes. Conclusions. Blue-IRIS can be used to inscribe refractive structures into live cat cornea in vivo that are stable for at least 12 months, and are not associated with significant alterations in corneal thicknesses or radii of curvature. This result is a critical step toward establishing Blue-IRIS as a promising technique for noninvasive vision correction. PMID:24985471

  4. The Effect of Age, Accommodation and Refractive Error on the Adult Human Eye

    PubMed Central

    Richdale, Kathryn; Bullimore, Mark A.; Sinnott, Loraine T.; Zadnik, Karla

    2015-01-01

    Purpose To quantify changes in ocular dimensions associated with age, refractive error, and accommodative response, in vivo, in 30- to 50-year-old human subjects. Methods The right eyes of 91 adults were examined using ultrasonography, phakometry, keratometry, pachymetry, interferometry, anterior segment optical coherence tomography, and high resolution magnetic resonance imaging. Accommodation was measured subjectively with a push-up test and objectively using open-field autorefraction. Regression analyses were used to assess differences in ocular parameters with age, refractive error and accommodation. Results With age, crystalline lens thickness increased (0.03 mm/yr), anterior lens curvature steepened (0.11 mm/yr), anterior chamber depth decreased (0.02 mm/y) and lens equivalent refractive index decreased (0.001 /y) (all p < 0.01). With increasing myopia, there were significant increases in axial length (0.37 mm/D), vitreous chamber depth (0.34 mm/D), vitreous chamber height (0.09 mm/D) and ciliary muscle ring diameter (0.10 mm/D) (all p < 0.05). Increasing myopia was also associated with steepening of both the cornea (0.16 mm/D) and anterior lens surface (0.011 mm/D) (both p < 0.04). With accommodation, the ciliary muscle ring diameter decreased (0.08 mm/D), and the muscle thinned posteriorly (0.008 mm/D), allowing the lens to shorten equatorially (0.07 mm/D) and thicken axially (0.06 mm/D) (all p < 0.03). Conclusions Refractive error is significantly correlated with not only the axial dimensions, but the anterior equatorial dimension of the adult eye. Further testing and development of accommodating intraocular lenses should account for differences in patients’ preoperative refractive error. PMID:26703933

  5. First demonstration of ocular refractive change using blue-IRIS in live cats.

    PubMed

    Savage, Daniel E; Brooks, Daniel R; DeMagistris, Margaret; Xu, Lisen; MacRae, Scott; Ellis, Jonathan D; Knox, Wayne H; Huxlin, Krystel R

    2014-07-01

    To determine the efficacy of intratissue refractive index shaping (IRIS) using 400-nm femtosecond laser pulses (blue light) for writing refractive structures directly into live cat corneas in vivo, and to assess the longevity of these structures in the eyes of living cats. Four eyes from two adult cats underwent Blue-IRIS. Light at 400 nm with 100-femtosecond (fs) pulses were tightly focused into the corneal stroma of each eye at an 80-MHz repetition rate. These pulses locally increased the refractive index of the corneal stroma via an endogenous, two-photon absorption process and were used to inscribe three-layered, gradient index patterns into the cat corneas. The optical effects of the patterns were then tracked using optical coherence tomography (OCT) and Shack-Hartmann wavefront sensing. Blue-IRIS patterns locally changed ocular cylinder by -1.4 ± 0.3 diopters (D), defocus by -2.0 ± 0.5 D, and higher-order root mean square (HORMS) by 0.31 ± 0.04 μm at 1 month post-IRIS, without significant changes in corneal thickness or curvature. Refractive changes were maintained for the duration they were tracked, 12 months post-IRIS in one eye, and just more than 3 months in the remaining three eyes. Blue-IRIS can be used to inscribe refractive structures into live cat cornea in vivo that are stable for at least 12 months, and are not associated with significant alterations in corneal thicknesses or radii of curvature. This result is a critical step toward establishing Blue-IRIS as a promising technique for noninvasive vision correction. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  6. Age-dependence of the average and equivalent refractive indices of the crystalline lens

    PubMed Central

    Charman, W. Neil; Atchison, David A.

    2013-01-01

    Lens average and equivalent refractive indices are required for purposes such as lens thickness estimation and optical modeling. We modeled the refractive index gradient as a power function of the normalized distance from lens center. Average index along the lens axis was estimated by integration. Equivalent index was estimated by raytracing through a model eye to establish ocular refraction, and then backward raytracing to determine the constant refractive index yielding the same refraction. Assuming center and edge indices remained constant with age, at 1.415 and 1.37 respectively, average axial refractive index increased (1.408 to 1.411) and equivalent index decreased (1.425 to 1.420) with age increase from 20 to 70 years. These values agree well with experimental estimates based on different techniques, although the latter show considerable scatter. The simple model of index gradient gives reasonable estimates of average and equivalent lens indices, although refinements in modeling and measurements are required. PMID:24466474

  7. [Peripheral refraction: cause or effect of refraction development?

    PubMed

    Tarutta, E P; Iomdina, E N; Kvaratskheliya, N G; Milash, S V; Kruzhkova, G V

    to study peripheral refraction and the shape of the eyeball in children with different clinical refraction. Using an original method, peripheral refraction was measured at 10-12 degrees temporally and nasally from the fovea in 56 right eyes with different clinical, or axial, refraction of 20 boys and 36 girls aged 7 to 16 years (11.9±1.17 years on average). The shape of the eyeball was judged of by the ratio of its anterior-posterior axial length (AL) to horizontal diameter (HD). The incidence and value of peripheral myopic defocus in children appeared to decrease with clinical refraction increasing from high hyperopia to high myopia. This was the first time, mixed peripheral refraction was found in children, occurring more frequently in higher myopia. This mixed peripheral defocus, shown to be a transitional stage between relative peripheral myopia and relative hyperopia, indicates non-uniform stretching of posterior pole tissues in the course of refraction development and myopia progression. As ocular refraction increases from high hyperopia to high myopia, the growth of AL outpaces that of HD. Obviously, natural peripheral defocus results from changes in size and shape of the eyeball in the course of refraction development.

  8. Refractive errors in Aminu Kano Teaching Hospital, Kano Nigeria.

    PubMed

    Lawan, Abdu; Eme, Okpo

    2011-12-01

    The aim of the study is to retrospectively determine the pattern of refractive errors seen in the eye clinic of Aminu Kano Teaching Hospital, Kano-Nigeria from January to December, 2008. The clinic refraction register was used to retrieve the case folders of all patients refracted during the review period. Information extracted includes patient's age, sex, and types of refractive error. All patients had basic eye examination (to rule out other causes of subnormal vision) including intra ocular pressure measurement and streak retinoscopy at two third meter working distance. The final subjective refraction correction given to the patients was used to categorise the type of refractive error. Refractive errors was observed in 1584 patients and accounted for 26.9% of clinic attendance. There were more females than males (M: F=1.0: 1.2). The common types of refractive errors are presbyopia in 644 patients (40%), various types of astigmatism in 527 patients (33%), myopia in 216 patients (14%), hypermetropia in 171 patients (11%) and aphakia in 26 patients (2%). Refractive errors are common causes of presentation in the eye clinic. Identification and correction of refractive errors should be an integral part of eye care delivery.

  9. The ocular surface and tear film and their dysfunction in dry eye disease.

    PubMed

    Rolando, M; Zierhut, M

    2001-03-01

    The ocular surface, tear film, lacrimal glands, and eyelids act as a functional unit to preserve the quality of the refractive surface of the eye and to resist injury and protect the eye against changing bodily and environmental conditions. Events that disturb the homeostasis of this functional unit can result in a vicious cycle of ocular surface disease. The tear film is the most dynamic structure of the functional unit, and its production and turnover is essential to maintaining the health of the ocular surface. Classically, the tear film is reported to be composed of three layers: the mucin, aqueous, and lipid layers. The boundaries and real thickness of such layers is still under discussion. A dysfunction of any of these layers can result in dry eye disease.

  10. Relative axial myopia in Egr-1 (ZENK) knockout mice.

    PubMed

    Schippert, Ruth; Burkhardt, Eva; Feldkaemper, Marita; Schaeffel, Frank

    2007-01-01

    Experiments in chickens have implicated the transcription factor ZENK (also known as Egr-1, NGFI-A, zif268, tis8, cef5, and Krox24) in the feedback mechanisms for visual control of axial eye growth and myopia development. ZENK is upregulated in retinal glucagon amacrine cells when axial eye growth is inhibited by positive spectacle lens wear and is downregulated when it is enhanced by negative spectacle lens wear, suggesting that ZENK may be linked to an inhibitory signal for axial eye growth. This study was undertaken to determine whether a Egr-1(-/-) knockout mouse mutant, lacking ZENK completely, has longer eyes and more myopic refraction, than do Egr-1(+/)(-) heterozygous and Egr-1(+/+) wild-type mice with near-identical genetic backgrounds. Eye growth and refractive development were tracked from day P28 to P98. Corneal radius of curvature was measured with infrared photokeratometry, refractive state with infrared photoretinoscopy, and ocular dimensions with low-coherence interferometry. As a functional vision test, grating acuity was determined in an automated optomotor task. The abundance of ZENK protein in the retina was quantified by immunohistochemistry. Egr-1 knockout mice had longer eyes and a relative myopic shift in refraction, with additional minor effects on anterior chamber depth and corneal radius of curvature. Paraxial schematic eye modeling suggested changes in the optics of the crystalline lens as well. With increasing age, the differences between mutant and wild-type mice declined, although the differences in refraction persisted over the observation period. Grating acuity was not affected by the lack of the Egr-1 protein during development. Although it has been shown that different mouse strains may have differently large eyes, the present study shows that a specific gene knockout can produce relative myopia, compared with the wild-type with near-identical genetic background. Further experiments are needed to determine whether the observed effects of Egr-1 deletion are due to changes in function within the retina or other ocular tissues or to changes of function in other systems that may affect ocular growth from outside the eye.

  11. Prevalence and causes of visual impairment and rate of wearing spectacles in schools for children of migrant workers in Shanghai, China.

    PubMed

    He, Jiangnan; Lu, Lina; Zou, Haidong; He, Xiangui; Li, Qiangqiang; Wang, Weijie; Zhu, Jianfeng

    2014-12-22

    To assess the prevalence of visual impairment and rate of wearing spectacles in schools for children of migrant workers in Shanghai, China. Children from grade 1 to 5 in schools for children of migrant workers were randomly chosen for ocular examinations. All children were screened for uncorrected visual acuity and presenting visual acuity. After screening, the children whose uncorrected visual acuity was 20/40 or less received ocular motility evaluation, cycloplegic refraction/non-cycloplegic refraction, and external eye, anterior segment, media, and fundus examinations. A total of 9673 children were enumerated and 9512 (98.34%) participated in this study. The prevalence of uncorrected, presenting, and best-corrected visual acuity of 20/40 or worse in the better eye were 13.33%, 11.26%, and 0.63%, respectively. The rate of wearing spectacles of the children with visual impairment in one or both eyes was 15.50%. Of these, 26.05% were wearing spectacles with inaccurate prescriptions. Refractive error was a major cause of visual impairment, accounting for 89.48% of all the visual impairment causes. Other causes of visual impairment included amblyopia accounting for 10.12%; congenital cataract, 0.1%; congenital nystagmus, 0.1%; ocular prosthesis, 0.1%; macular degeneration, 0.05%; and opaque cornea, 0.05%. This is the first study of the prevalence and causes of visual impairment in schools for children of migrant workers in Shanghai, China. The visual impairment rate in schools for children of migrant workers in suburbs of Shanghai in the best eye before vision correction was lower than those of urban children in mainstream schools in Guangzhou in 2012, and higher than students in rural of Beijing in 1998 and in suburb of Chongqing in 2007. The refractive error was the principal cause of the visual impairment of the children of migrant workers. The rate of wearing spectacles was low and the percentage of inaccurate prescriptions, among those who wore spectacles, was high. Uncorrected refractive error was a significant cause of visual impairment in migrant children.

  12. Does blunt ocular trauma induce corneal astigmatism?

    PubMed

    Akinci, Arsen; Ileri, Dilek; Polat, Sibel; Can, Cigdem; Zilelioglu, Orhan

    2007-06-01

    To determine the effect of blunt ocular trauma on refractive astigmatism. Eighty-six eyes of 86 patients with known previous refractive status exposed to blunt ocular trauma were included in the study. Trauma-induced astigmatism (TIA) was calculated using vector analysis. In eyes with TIA, central corneal thickness was assessed by ultrasound pachymetry, and corneal topographies were obtained. Anterior-chamber angles were examined by Goldmann 3-mirror lens to find microhemorrhages, scarring, or recession. Patients were followed up between 8 and 12 months (average, 9.2 months). In 18 eyes (21%), TIA was detected. Six (7%) of these eyes had lenticular astigmatism caused by traumatic lens subluxation. In the remaining 12 eyes (14%), corneal topography showed regular astigmatic patterns, which were symmetrical in 3 eyes and asymmetric in the remaining 9. The etiologic factor was a game marble in 6 eyes and a stone in the remaining 6. The mean central corneal thickness was 535.75 microm (range, 498-570 microm) in these 12 eyes. In 9 of these 12 eyes, recession or scarring in the anterior-chamber angle was detected at 1 edge of the steepest axis. Blunt trauma can induce astigmatism. Hard and small objects are more likely to induce astigmatism.

  13. Ocular higher-order aberrations and axial eye growth in young Hong Kong children.

    PubMed

    Lau, Jason K; Vincent, Stephen J; Collins, Michael J; Cheung, Sin-Wan; Cho, Pauline

    2018-04-30

    This retrospective longitudinal analysis aimed to investigate the association between ocular higher-order aberrations (HOAs) and axial eye growth in Hong Kong children. Measures of axial length and ocular HOAs under cycloplegia were obtained annually over a two-year period from 137 subjects aged 8.8 ± 1.4 years with mean spherical equivalent refraction of -2.04 ± 2.38 D. A significant negative association was observed between the RMS of total HOAs and axial eye growth (P = 0.03), after adjusting for other significant predictors of axial length including age, sex and refractive error. Similar negative associations with axial elongation were found for the RMS of spherical aberrations ([Formula: see text] and [Formula: see text] combined) (P = 0.037). Another linear mixed model also showed that greater levels of vertical trefoil [Formula: see text], primary spherical aberration [Formula: see text] and negative oblique trefoil [Formula: see text] were associated with slower axial elongation and longer axial length (all P < 0.05). These findings support the potential role of HOAs, image quality and a vision-dependent mechanism in childhood eye growth.

  14. Ocular dispersion

    NASA Astrophysics Data System (ADS)

    Hammer, Daniel X.; Noojin, Gary D.; Thomas, Robert J.; Stolarski, David J.; Rockwell, Benjamin A.; Welch, Ashley J.

    1999-06-01

    Spectrally resolved white-light interferometry (SRWLI) was used to measure the wavelength dependence of refractive index (i.e., dispersion) for various ocular components. The accuracy of the technique was assessed by measurement of fused silica and water, the refractive indices of which have been measured at several different wavelengths. The dispersion of bovine and rabbit aqueous and vitreous humor was measured from 400 to 1100 nm. Also, the dispersion was measured from 400 to 700 nm for aqueous and vitreous humor extracted from goat and rhesus monkey eyes. For the humors, the dispersion did not deviate significantly from water. In an additional experiment, the dispersion of aqueous and vitreous humor that had aged up to a month was compared to freshly harvested material. No difference was found between the fresh and aged media. An unsuccessful attempt was also made to use the technique for dispersion measurement of bovine cornea and lens. Future refinement may allow measurement of the dispersion of cornea and lens across the entire visible and near-infrared wavelength band. The principles of white- light interferometry including image analysis, measurement accuracy, and limitations of the technique, are discussed. In addition, alternate techniques and previous measurements of ocular dispersion are reviewed.

  15. Ocular residual astigmatism (ORA) in pre-cataract eyes prior to and after refractive lens exchange.

    PubMed

    Katz, Toam; Steinberg, Johannes; Druchkiv, Vasyl; Linke, Stephan J; Frings, Andreas

    2017-08-01

    The purpose of this study was to analyze ocular residual astigmatism (ORA) before and after implantation of two different optical types of non-toric multifocal intraocular lenses (MIOL) in pre-cataract patients. This retrospective cohort study analyzed 72 eyes from 72 consecutive patients after MIOL surgery . To investigate magnitude and axis of astigmatic changes, the concepts of true corneal astigmatism and Alpins vector method were applied. There were no statistically significant between-group differences prior to surgery. The mean refractive surgically induced astigmatism (RSIA) (P = 0.063) and the topographic SIA (TSIA) (P = 0.828) did not differ significantly between the lenses, and the summated vector mean for ORA was reduced in terms of magnitude by approximately 0.30 Diopter. ORA in pseudophakic eyes mainly results from the posterior corneal surface and less from IOL tilting, postoperative posterior capsule shrinkage, or secondary cataract.

  16. Surgical and healing changes to ocular aberrations following refractive surgery

    NASA Astrophysics Data System (ADS)

    Straub, Jochen; Schwiegerling, Jim

    2003-07-01

    Purpose: To measure ocular aberrations before and at several time periods after LASIK surgery to determine the change to the aberration structure of the eye. Methods: A Shack-Hartmann wavefront sensor was used to measure 88 LASIK patients pre-operatively and at 1 week and 12 months following surgery. Reconstructed wavefront errors are compared to look at induced differences. Manifest refraction was measured at 1 week, 1 month, 3 months, 6 months and 12 months following surgery. Sphere, cylinder, spherical aberration, and pupil diameter are analyzed. Results: A dramatic elevation in spherical aberration is seen following surgery. This elevation appears almost immediately and remains for the duration of the study. A temporary increase in pupil size is seen following surgery. Conclusions: LASIK surgery dramatically reduces defocus and astigmatism in the eye, but simultaneously increases spherical aberration levels. This increase occurs at the time of surgery and is not an effect of the healing response.

  17. Gene Profiling in Experimental Models of Eye Growth: Clues to Myopia Pathogenesis

    PubMed Central

    Stone, Richard A.; Khurana, Tejvir S.

    2010-01-01

    To understand the complex regulatory pathways that underlie the development of refractive errors, expression profiling has evaluated gene expression in ocular tissues of well-characterized experimental models that alter postnatal eye growth and induce refractive errors. Derived from a variety of platforms (e.g. differential display, spotted microarrays or Affymetrix GeneChips), gene expression patterns are now being identified in species that include chicken, mouse and primate. Reconciling available results is hindered by varied experimental designs and analytical/statistical features. Continued application of these methods offers promise to provide the much-needed mechanistic framework to develop therapies to normalize refractive development in children. PMID:20363242

  18. Ocular Complications in Children with Diabetes Mellitus.

    PubMed

    Geloneck, Megan M; Forbes, Brian J; Shaffer, James; Ying, Gui-shuang; Binenbaum, Gil

    2015-12-01

    The effectiveness of annual eye examinations in diabetic children is unclear. We sought to determine the prevalence and onset of ocular pathology in children with diabetes mellitus (DM), identify risk factors for ocular disease, and recommend a screening regimen for asymptomatic children. Retrospective, consecutive cohort study. Children aged less than 18 years with type 1 or 2 DM examined over a 4-year period. All children underwent a complete eye examination, including dilated fundoscopy and cycloplegic refraction. A literature review was performed, identifying the youngest reported age and shortest reported duration of DM before the diagnosis of diabetic retinopathy (DR). Prevalence of DR, cataract, high refractive error, and strabismus. A total of 370 children (mean age, 11.2 years; range, 1-17.5 years) had 693 examinations, with a mean DM duration of 5.2 years (range, 0.1-16.2 years) and a mean hemoglobin A1c (HbA1c) of 8.6 (range, 5-≥14). No children had DR. A total of 12 children had cataract; 5 required extraction but were identified by decreased vision, not diabetic screening. A total of 19 children had strabismus; only 1 was microvascular paralytic strabismus. A total of 41 children had high refractive error. There were no associations between these conditions and duration or control of DM. In the literature, the youngest age at diagnosis of severe DR was 15 years, and the shortest duration of disease was 5 years. Diabetic retinopathy is rare in children regardless of duration and control of DM. On the basis of our study and literature review, screening examinations for type 1 diabetes could begin at age 15 years or at 5 years after the diagnosis of DM, whichever occurs later, unless the child is judged by the endocrinologist as being at unusually high risk. Other ocular complications are identifiable through existing amblyopia screening methods. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  19. Long-Term Visual Outcomes of Secondary Intraocular Lens Implantation in Children with Congenital Cataracts

    PubMed Central

    Jiang, Yongxiang; Lu, Yi

    2015-01-01

    Aim The aim of this study was to evaluate the long-term visual outcomes and factors affecting visual results in children undergoing secondary intraocular lens (IOL) implantation following primary congenital cataract extraction. Methods Children with congenital cataracts who underwent secondary IOL implantation for aphakia at the Eye and ENT Hospital of Fudan University between January 1, 2001, and December 31, 2007, were retrospectively reviewed. One eye was randomly selected in children with bilateral cataracts. Laterality, type of cataract (total or partial opacity), sex, age at primary and secondary surgeries, visual axis opacity (VAO), compliance with amblyopia therapy, postoperative ocular complications, refractive error, ocular alignment, and best corrected visual acuity (BCVA) at last follow-up were recorded; potential factors that might have affected the visual results were evaluated. Results Seventy-six bilateral and 34 unilateral congenital cataract cases were analyzed; the mean ages of the children were 12.70±5.06 and 12.50±2.71 years at final follow-up, the mean follow-up periods from IOL implantation were 94.93±24.22 and 109.09±18.89 months, and the mean BCVA (Log MAR) values were 0.51±0.37 and 1.05±0.46, respectively. Final BCVA after secondary IOL implantation was significantly associated with laterality, type of cataract, age at primary cataract extraction, compliance with amblyopia therapy, and refractive correction after surgery. No significant associations were found between BCVA and sex, age at secondary IOL implantation, VAO, or other ocular complications. The most common ocular complications were VAO and elevated intraocular pressure after surgery. There were no other complications, with the exception of one eye with IOL dislocation. Conclusions The results indicate that the important determinants of long-term visual outcomes in children with congenital cataracts undergoing secondary IOL implantation are laterality, cataract type, age at initial cataract extraction, compliance with amblyopia therapy, and refractive error. PMID:26230501

  20. Ocular Biometrics of Myopic Eyes With Narrow Angles.

    PubMed

    Chong, Gabriel T; Wen, Joanne C; Su, Daniel Hsien-Wen; Stinnett, Sandra; Asrani, Sanjay

    2016-02-01

    The purpose of this study was to compare the ocular biometrics between myopic patients with and without narrow angles. Patients with a stable myopic refraction (myopia worse than -1.00 D spherical equivalent) were prospectively recruited. Angle status was assessed using gonioscopy and biometric measurements were performed using an anterior segment optical coherence tomography and an IOLMaster. A total of 29 patients (58 eyes) were enrolled with 13 patients (26 eyes) classified as having narrow angles and 16 patients (32 eyes) classified as having open angles. Baseline demographics of age, sex, and ethnicity did not differ significantly between the 2 groups. The patients with narrow angles were on average older than those with open angles but the difference did not reach statistical significance (P=0.12). The central anterior chamber depth was significantly less in the eyes with narrow angles (P=0.05). However, the average lens thickness, although greater in the eyes with narrow angles, did not reach statistical significance (P=0.10). Refractive error, axial lengths, and iris thicknesses did not differ significantly between the 2 groups (P=0.32, 0.47, 0.15). Narrow angles can occur in myopic eyes. Routine gonioscopy is therefore recommended for all patients regardless of refractive error.

  1. Predicting Accommodative Response Using Paraxial Schematic Eye Models

    PubMed Central

    Ramasubramanian, Viswanathan; Glasser, Adrian

    2016-01-01

    Purpose Prior ultrasound biomicroscopy (UBM) studies showed that accommodative optical response (AOR) can be predicted from accommodative biometric changes in a young and a pre-presbyopic population from linear relationships between accommodative optical and biometric changes, with a standard deviation of less than 0.55D. Here, paraxial schematic eyes (SE) were constructed from measured accommodative ocular biometry parameters to see if predictions are improved. Methods Measured ocular biometry (OCT, A-scan and UBM) parameters from 24 young and 24 pre-presbyopic subjects were used to construct paraxial SEs for each individual subject (individual SEs) for three different lens equivalent refractive index methods. Refraction and AOR calculated from the individual SEs were compared with Grand Seiko (GS) autorefractor measured refraction and AOR. Refraction and AOR were also calculated from individual SEs constructed using the average population accommodative change in UBM measured parameters (average SEs). Results Schematic eye calculated and GS measured AOR were linearly related (young subjects: slope = 0.77; r2 = 0.86; pre-presbyopic subjects: slope = 0.64; r2 = 0.55). The mean difference in AOR (GS - individual SEs) for the young subjects was −0.27D and for the pre-presbyopic subjects was 0.33D. For individual SEs, the mean ± SD of the absolute differences in AOR between the GS and SEs was 0.50 ± 0.39D for the young subjects and 0.50 ± 0.37D for the pre-presbyopic subjects. For average SEs, the mean ± SD of the absolute differences in AOR between the GS and the SEs was 0.77 ± 0.88D for the young subjects and 0.51 ± 0.49D for the pre-presbyopic subjects. Conclusions Individual paraxial SEs predict AOR, on average, with a standard deviation of 0.50D in young and pre-presbyopic subject populations. Although this prediction is only marginally better than from individual linear regressions, it does consider all the ocular biometric parameters. PMID:27092928

  2. Prevalence and risk factors for refractive errors and ocular biometry parameters in an elderly Asian population: the Singapore Longitudinal Aging Study (SLAS).

    PubMed

    Tan, C S H; Chan, Y H; Wong, T Y; Gazzard, G; Niti, M; Ng, T-P; Saw, S M

    2011-10-01

    To determine the prevalence rates of refractive errors and pattern of ocular biometry in a multi-ethnic elderly Asian population. A population-based study of 1835 residents aged 55-85 years, evaluating the refractive error and ocular biometry parameters, including axial length (AL) and anterior chamber depth. The age-standardized prevalence of myopia, hyperopia, astigmatism, and anisometropia were 30.0% (95% confidence interval (CI): 29.6, 30.4), 41.5% (95% CI: 41.1, 41.9), 43.5% (95% CI: 43.1, 44.0), and 22.1% (95% CI: 21.7, 22.4), respectively. Male gender (P=0.02), age ≥ 75 years (P=0.033), and higher educational level (P<0.001) were significantly associated with higher rates of myopia in multivariate analyses. The prevalence of astigmatism was higher in persons with diabetes (odds ratio (OR) 1.4, 95% CI: 1.03, 1.90, P=0.031). AL was longer in Chinese than other ethnic groups (23.7 vs 23.4 mm, P=0.018), and in men compared with women (24.2 vs 23.4 mm, P<0.001). AL was associated with increasing height (AL increased by 0.3 mm for every 10 cm increase in height, P<0.001). There is a high prevalence of myopia in elderly Singaporeans, consistent with trends seen in younger populations in Asia. Male gender and higher education were independent risk factors for myopia. These data suggest that higher rates of myopia in East Asians compared with Caucasians may not be a recent phenomenon.

  3. Management of the ocular surface and tear film before, during, and after laser in situ keratomileusis.

    PubMed

    Albietz, Julie M; Lenton, Lee M

    2004-01-01

    To identify evidence-based, best practice strategies for managing the ocular surface and tear film before, during, and after laser in situ keratomileusis (LASIK). After a comprehensive review of relevant published literature, evidence-based recommendations for best practice management strategies are presented. Symptoms of ocular irritation and signs of dysfunction of the integrated lacrimal gland/ocular surface functional gland unit are common before and after LASIK. The status of the ocular surface and tear film before LASIK can impact surgical outcomes in terms of potential complications during and after surgery, refractive outcome, optical quality, patient satisfaction, and the severity and duration of dry eye after LASIK. Before LASIK, the health of the ocular surface should be optimized and patients selected appropriately. Dry eye before surgery and female gender are risk factors for developing chronic dry eye after LASIK. Management of the ocular surface during LASIK can minimize ocular surface damage and the risk of adverse outcomes. Long-term management of the tear film and ocular surface after LASIK can reduce the severity and duration of dry eye symptoms and signs. Strategies to manage the integrated ocular surface/lacrimal gland functional unit before, during, and after LASIK can optimize outcomes. As problems with the ocular surface and tear film are relatively common, attention should focus on the use and improvement of evidence-based management strategies.

  4. INVOLVEMENT OF MULTIPLE MOLECULAR PATHWAYS IN THE GENETICS OF OCULAR REFRACTION AND MYOPIA.

    PubMed

    Wojciechowski, Robert; Cheng, Ching-Yu

    2018-01-01

    The prevalence of myopia has increased dramatically worldwide within the last three decades. Recent studies have shown that refractive development is influenced by environmental, behavioral, and inherited factors. This review aims to analyze recent progress in the genetics of refractive error and myopia. A comprehensive literature search of PubMed and OMIM was conducted to identify relevant articles in the genetics of refractive error. Genome-wide association and sequencing studies have increased our understanding of the genetics involved in refractive error. These studies have identified interesting candidate genes. All genetic loci discovered to date indicate that refractive development is a heterogeneous process mediated by a number of overlapping biological processes. The exact mechanisms by which these biological networks regulate eye growth are poorly understood. Although several individual genes and/or molecular pathways have been investigated in animal models, a systematic network-based approach in modeling human refractive development is necessary to understand the complex interplay between genes and environment in refractive error. New biomedical technologies and better-designed studies will continue to refine our understanding of the genetics and molecular pathways of refractive error, and may lead to preventative and therapeutic measures to combat the myopia epidemic.

  5. Ocular dimensions in relation to auxological data in a sample of Swedish children aged 4-15 years.

    PubMed

    Raffa, Lina H; Hellström, Ann; Aring, Eva; Andersson, Susann; Grönlund, Marita Andersson

    2014-11-01

    The purpose was to characterize normal growth patterns of ocular and optical components and to relate them to auxological data in a sample of Swedish children aged 4-15 years. A prospective cross-sectional study was carried out in 143 Swedish children with a mean age of 9.8 years. Variables including gestational age (GA), weight, length and head circumference (HCF) at birth and at the time of assessment were registered. Visual acuity (VA), cycloplegic refraction and biometric measures were obtained. Palpebral fissure length and inner canthal distance were measured. Optic disc morphology as seen on fundus photographs was analysed. Children born more mature, with male predilection, were found to have deeper anterior and vitreous chamber depths, longer axial lengths and thinner crystalline lens thickness. No correlations were found between ocular biometric measurements and VA or refraction after adjustment for confounding variables. Inner canthal distance was significantly correlated with birth length (p = 0.03), height, weight, BMI and HCF (p = 0.0008, p = 0.0007, p = 0.037, and p = 0.04, respectively) at time of assessment. Total axial length was found to be significantly correlated with GA (p = 0.0226) and length at assessment in girls (p = 0.0084). Right optic disc and rim areas decreased with increasing age (p = 0.0078 and p = 0.0107, respectively); however, optic disc parameters were not dependent on any other variable. These normative values may serve as a basis for the ocular findings and their relationship to auxological data in Caucasian children aged 4-15 years, as well as for future comparison in patients with paediatric ocular pathologies. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  6. Comfort, Ocular Dryness, and Equilibrium Water Content Changes of Daily Disposable Contact Lenses.

    PubMed

    Insua Pereira, Eduardo; Lira, Madalena

    2017-10-26

    The objective of this investigation was to evaluate the level of comfort and ocular dryness during wear with six daily disposable contact lenses (DDCL) and also determine the changes in contact lens equilibrium water content (EWC) resulting from their wear. In this contralateral open trial, 27 subjects were randomly fitted with six DDCL (stenfilcon A, delefilcon A, nelfilcon A, narafilcon A, nesofilcon A, and omafilcon A). The evaluation of comfort and ocular dryness sensation was recorded by the participants at two moments of the day (11 AM and 5 PM) over a period of 10 days of contact lens wear. The assessment was made with the aid of visual analogue scales (0-10). The refractive index of 54 contact lenses was accessed by a single operator using a digital automated refractometer (CLR 12-70; Index Instruments). The EWC of the lenses was estimated based on its refractive index values. Comfort ratings were slightly higher for delefilcon A (9.56±0.67, P=0.01) and narafilcon A (9.40±0.93, P=0.01) and these lenses wearers also reported less ocular dryness. The results revealed a pronounced water content reduction for omafilcon A (P=0.002), narafilcon A (P=0.008), and nesofilcon A (P=0.003). Although changes in subjective responses and EWC were distinct among the materials analyzed, all the contact lenses performed well during the 10 days of wear.

  7. Total ocular, anterior corneal and lenticular higher order aberrations in hyperopic, myopic and emmetropic eyes.

    PubMed

    Philip, Krupa; Martinez, Aldo; Ho, Arthur; Conrad, Fabian; Ale, Jit; Mitchell, Paul; Sankaridurg, Padmaja

    2012-01-01

    Total ocular higher order aberrations and corneal topography of myopic, emmetropic and hyperopic eyes of 675 adolescents (16.9 ± 0.7 years) were measured after cycloplegia using COAS aberrometer and Medmont videokeratoscope. Corneal higher order aberrations were computed from the corneal topography maps and lenticular (internal) higher order aberrations derived by subtraction of corneal aberrations from total ocular aberrations. Aberrations were measured for a pupil diameter of 5mm. Multivariate analysis of variance followed by multiple regression analysis found significant difference in the fourth order aberrations (SA RMS, primary spherical aberration coefficient) between the refractive error groups. Hyperopic eyes (+0.083 ± 0.05 μm) had more positive total ocular primary spherical aberration compared to emmetropic (+0.036 ± 0.04 μm) and myopic eyes (low myopia=+0.038 ± 0.05 μm, moderate myopia=+0.026 ± 0.06 μm) (p<0.05). No difference was observed for the anterior corneal spherical aberration. Significantly less negative lenticular spherical aberration was observed for the hyperopic eyes (-0.038 ± 0.05 μm) than myopic (low myopia=-0.088 ± 0.04 μm, moderate myopia=-0.095 ± 0.05 μm) and emmetropic eyes (-0.081 ± 0.04 μm) (p<0.05). These findings suggest the existence of differences in the characteristics of the crystalline lens (asphericity, curvature and gradient refractive index) of hyperopic eyes versus other eyes. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  8. Intermediate visual acuity of presbyopic individuals with and without distance and bifocal lens corrections.

    DOT National Transportation Integrated Search

    1977-03-01

    Visual acuity was determined at the intermediate range for older individuals with various combinations of ocular refractive error (nine subcategories) and accommodative power (three subcategories). Subjects (N=249) read numerals ranging in size to me...

  9. Comparable change in stromal refractive index of cat and human corneas following blue-IRIS.

    PubMed

    Wozniak, Kaitlin T; Gearhart, Sara M; Savage, Daniel E; Ellis, Jonathan D; Knox, Wayne H; Huxlin, Krystel R

    2017-05-01

    Blue intratissue refractive index shaping (blue-IRIS) is a method with potential to correct ocular refraction noninvasively in humans. To date, blue-IRIS has only ever been applied to cat corneas and hydrogels. To test the comparability of refractive index change achievable in cat and human tissues, we used blue-IRIS to write identical phase gratings in ex vivo feline and human corneas. Femtosecond pulses (400 nm) were focused ? 300 ?? ? m below the epithelial surface of excised cat and human corneas and scanned to write phase gratings with lines ? 1 ?? ? m wide, spaced 5 ?? ? m apart, using a scan speed of 5 ?? mm / s . Additional cat corneas were used to test writing at 3 and 7 ?? mm / s in order to document speed dependence of the refractive index change magnitude. The first-order diffraction efficiency was immediately measured and used to calculate the refractive index change attained. Our data show that blue-IRIS induces comparable refractive index changes in feline and human corneas, an essential requirement for further developing its use as a clinical vision correction technique.

  10. Comparable change in stromal refractive index of cat and human corneas following blue-IRIS

    NASA Astrophysics Data System (ADS)

    Wozniak, Kaitlin T.; Gearhart, Sara M.; Savage, Daniel E.; Ellis, Jonathan D.; Knox, Wayne H.; Huxlin, Krystel R.

    2017-05-01

    Blue intratissue refractive index shaping (blue-IRIS) is a method with potential to correct ocular refraction noninvasively in humans. To date, blue-IRIS has only ever been applied to cat corneas and hydrogels. To test the comparability of refractive index change achievable in cat and human tissues, we used blue-IRIS to write identical phase gratings in ex vivo feline and human corneas. Femtosecond pulses (400 nm) were focused ˜300 μm below the epithelial surface of excised cat and human corneas and scanned to write phase gratings with lines ˜1 μm wide, spaced 5 μm apart, using a scan speed of 5 mm/s. Additional cat corneas were used to test writing at 3 and 7 mm/s in order to document speed dependence of the refractive index change magnitude. The first-order diffraction efficiency was immediately measured and used to calculate the refractive index change attained. Our data show that blue-IRIS induces comparable refractive index changes in feline and human corneas, an essential requirement for further developing its use as a clinical vision correction technique.

  11. Ocular Findings in Children With 22q11.2 Deletion Syndrome.

    PubMed

    Gokturk, Bahar; Topcu-Yilmaz, Pinar; Bozkurt, Banu; Yildirim, Mahmut Selman; Guner, Sukru Nail; Sayar, Esra Hazar; Reisli, Ismail

    2016-07-01

    To identify the ocular features of children diagnosed as having 22q11.2 deletion syndrome in a Turkish population, which is the most common microdeletion syndrome with a wide range of facial and ocular abnormalities. Sixteen children aged between 4 months and 18 years with a microdeletion in chromosome 22q11.2 underwent a detailed ophthalmological examination including uncorrected and best corrected visual acuity testing, stereoscopic vision examination, biomicroscopic and indirect fundus examination, and ocular motility testing. All patients had at least one ocular abnormality. The major abnormalities were eyelid abnormalities (eye hooding, narrow palpebral fissure, telecanthus, hypertelorism, sparse and thin eyebrows and eyelashes, blepharitis, and distichiasis), posterior embryotoxon, and tortuous retinal vessels in at least half of the patients. Other ophthalmological disorders were refractive errors, iris remnants, and strabismus. The chromosome 22q11.2 deletion syndrome is associated with a wide range of ocular disorders, which necessitates a comprehensive eye examination for appropriate treatment and follow-up. Ocular findings sometimes can provide a clue to the diagnosis of 22q11.2 deletion. [J Pediatr Ophthalmol Strabismus. 2016;53(4):218-222]. Copyright 2016, SLACK Incorporated.

  12. Correlation between apical protrusion in the Scheimflug imaging and Corneal Hysteresis and Corneal Resistance factor by Ocular Response Analyzer, among refractive non-keratoconic Egyptian patients.

    PubMed

    Refai, Tamer Adel

    2015-10-01

    Apical protrusion in the central 4-mm ring in the Scheimflug imaging (Pentacam), both for the anterior and posterior floats as well as Corneal Hysteresis and Corneal Resistance Factor by Ocular Response Analyzer (ORA), generally are considered important predictors for post-Lasik ectasia. The aim of this work was to find out if there is a statistically significant correlation between these different predictors and their correlation with the central corneal thickness for refractive non-keratoconic Egyptian patients trying to achieve a better decision and avoiding ectasia. This case-control study involved 142 eyes (of 77 patients with various refractive errors) arriving at the refractive surgery unit in the Research Institute of Ophthalmology in Giza (Egypt) in 2014-2015 seeking excimer laser ablation. The flattest, steepest keratometry readings, central corneal thickness as well as the apical protrusion in the central 4-mm ring, both for the anterior and posterior floats, in microns were measured by Scheimflug imaging. The Corneal Hysteresis and Corneal Resistance Factor were measured by the ocular response analyzer. Statistical analysis was performed by SPSS, using the Pearson correlation test. The spherical refractive error ranged from +7.00 to -13.00 diopters (-3.80 ± 2.89). The central pachymetry ranged from 494 to 634 μm (550.35 ± 32.13). For the central 4-mm ring, the apical protrusion ranged from 0 to +15 μ (6.93 ± 2.99) for the anterior float and from -3 to +20 μ (9.33 ± 4.55) for the posterior float. The Corneal Hysterisis (CH) ranged from 7 to 14.8 mmHg (10.18±1.44), while the Corneal Resistance Factor (CRF) ranged from 7.5 to 14.9 mmHg (10.58 ± 1.67). There was a strong positive correlation between the central corneal thickness and both Corneal Hysteresis (CH: r = 0.56, P ≤ 0.01) and Corneal Resistance Factor (r = 0.46, P ≤ 0.01). A significant correlation (P < 0.05, r = 0.15) existed between apical protrusion in the posterior float and the central corneal thickness. Also, significant negative correlation (P < 0.05, r = -0.12) existed between apical protrusion in the anterior float by pentacam and the Corneal Resistance Factor by ocular response analyzer. Our finding of a strong positive correlation between both Corneal Hysteresis and Corneal Resistance Factor and the Central corneal thickness being important for biomechanical corneal stability. The findings of this study also support using both machines preoperatively to decrease the risk of post-Lasik ectasia.

  13. Ocular refractive and biometric characteristics in patients with thalassaemia major.

    PubMed

    Nowroozzadeh, Mohammad Hosein; Kalantari, Zahra; Namvar, Khadije; Meshkibaf, Mohammad Hassan

    2011-07-01

    Thalassaemia major is associated with characteristic findings in craniofacial bony structures and thereby may render abnormal bony orbit and subsequently distinctive ocular biometry. The purpose of the present study was to evaluate the ocular refractive and biometric characteristics in patients with thalassaemia major. This case-controlled study comprised 94 eyes of 47 patients with thalassaemia major and 88 eyes of 44 age- and sex-matched healthy control subjects. All participants had a complete ocular examination including slitlamp biomicroscopy, fundoscopy, ocular biometry, keratometry, refraction and analysis using Fourier transformation. There were no significant differences in spherical equivalent (p = 0.66) and total astigmatism (p = 0.83) between groups. Mean uncorrected vision and visual acuities (logMar) were similar (p = 0.32 and p = 0.71, respectively). Compared with controls, thalassaemic patients had a shorter axial length (23.01 ± 0.12 [SEM] mm versus 23.46 ± 0.12 mm, p = 0.035), thicker crystalline lens (4.01 ± 0.11 mm versus 3.87 ± 0.1 mm, p = 0.046) and steeper average keratometry (44.02 ± 0.24 D versus 43.44 ± 0.24, p = 0.03). Fifty-seven per cent of thalassaemic patients had against-the-rule astigmatism (total), while 64.6 per cent of controls showed a with-the-rule pattern (p < 0.05). These patterns were also found for corneal astigmatism. The magnitudes of total, corneal and lenticular astigmatism were similar among groups. Regression analysis showed significant correlation between corneal (J0 and J45) and total (J0 and J45) astigmatism. The correlations were less prominent between lenticular and total J0 and J45. The mean intraocular pressure was 14.68 ± 0.27 mmHg and 13.3 ± 0.26 mmHg in the thalassaemia and control groups, respectively (p < 0.001). Six eyes (12.8 per cent) of four patients in the thalassaemia group had posterior subcapsular cataract, while the condition had not been observed in controls (p = 0.049). Shorter axial length, thicker lens, steeper corneal curvature and more against-the-rule pattern were characteristic findings in patients with thalassaemia major. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.

  14. Design considerations of a real-time clinical confocal microscope

    NASA Astrophysics Data System (ADS)

    Masters, Barry R.

    1991-06-01

    A real-time clinical confocal light microscope provides the ophthalmologist with a new tool for the observation of the cornea and the ocular lens. In addition, the ciliary body, the iris, and the sclera can be observed. The real-time light microscopic images have high contrast and resolution. The transverse resolution is about one half micron and the range resolution is one micron. The following observations were made with visible light: corneal epithelial cells, wing cells, basal cells, Bowman's membrane, nerve fibers, basal lamina, fibroblast nuclei, Descemet's membrane, endothelial cells. Observation of the in situ ocular lens showed lens capsule, lens epithelium, lens fibrils, the interior of lens fibrils. The applications of the confocal microscope include: eye banking, laser refractive surgery, observation of wound healing, observation of the iris, the sciera, the ciliary body, the ocular lens, and the intraocular lens. Digital image processing can produce three-dimensional reconstructions of the cornea and the ocular lens.

  15. Space Flight-Associated Neuro-ocular Syndrome.

    PubMed

    Lee, Andrew G; Mader, Thomas H; Gibson, C Robert; Tarver, William

    2017-09-01

    New and unique physiologic and pathologic systemic and neuro-ocular responses have been documented in astronauts during and after long-duration space flight. Although the precise cause remains unknown, space flight-associated neuro-ocular syndrome (SANS) has been adopted as an appropriate descriptive term. The Space Medicine Operations Division of the US National Aeronautics and Space Administration (NASA) has documented the variable occurrence of SANS in astronauts returning from long-duration space flight on the International Space Station. These clinical findings have included unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and nerve fiber layer infarcts. The clinical findings of SANS have been correlated with structural changes on intraorbital and intracranial magnetic resonance imaging and in-flight and terrestrial ultrasonographic studies and ocular optical coherence tomography. Further study of SANS is ongoing for consideration of future manned missions to space, including a return trip to the moon or Mars.

  16. Cyclodialysis: an update.

    PubMed

    González-Martín-Moro, Julio; Contreras-Martín, Inés; Muñoz-Negrete, Francisco José; Gómez-Sanz, Fernando; Zarallo-Gallardo, Jesús

    2017-04-01

    Cyclodialysis is the result of the separation of the longitudinal ciliary muscle fibers from the scleral spur, which creates an abnormal pathway for aqueous humor drainage that may lead to ocular hypotony. For many years cyclodialysis was considered a treatment option for glaucoma. However, today it usually occurs as a complication of blunt trauma or more rarely as a complication of anterior segment ocular surgery. Ocular hypotony can lead to cataract development, optic disk swelling, refractive changes, and several retinal complications, making accurate identification and timely intervention of the cleft mandatory. Traditionally gonioscopy was the only available technique to diagnose and localize the cleft. However, other tests such as optical coherence tomography, magnetic resonance imaging, transillumination, and specially ultrasound biomicroscopy are now available for the diagnosis of cyclodialysis. Multiple treatment options are also available for this condition. Although medical treatment can be effective to close small clefts, surgery is needed in most patients to restore ocular pressure.

  17. Developments in Ocular Genetics: 2013 Annual Review

    PubMed Central

    Aboobakar, Inas F.; Allingham, R. Rand

    2014-01-01

    Purpose To highlight major advancements in ocular genetics from the year 2013. Design Literature review. Methods A literature search was conducted on PubMed to identify articles pertaining to genetic influences on human eye diseases. This review focuses on manuscripts published in print or online in the English language between January 1, 2013 and December 31, 2013. A total of 120 papers from 2013 were included in this review. Results Significant progress has been made in our understanding of the genetic basis of a broad group of ocular disorders, including glaucoma, age-related macular degeneration, cataract, diabetic retinopathy, keratoconus, Fuchs’ endothelial dystrophy, and refractive error. Conclusions The latest next-generation sequencing technologies have become extremely effective tools for identifying gene mutations associated with ocular disease. These technological advancements have also paved the way for utilization of genetic information in clinical practice, including disease diagnosis, prediction of treatment response and molecular interventions guided by gene-based knowledge. PMID:25097799

  18. The effects of Ramadan fasting on the health and function of the eye.

    PubMed

    Javadi, Mohammad Ali; Assadi, Mahsan; Einollahi, Bahram; Rabei, Hossein Mohammad; Afarid, Mehrdad; Assadi, Majid

    2014-08-01

    Ramadan fasting may alter a variety of physiological parameters which by themselves influence ocular system. Here, we review the effects of Ramadan fasting on the health and function of the eye. Literature records in PubMed/MEDLINE, Web of Science, EMBASE, Google Scholar, and Iran Medex databases as well as proceedings of related meetings from January 1986 to March 2014 were systematically reviewed. The search key words was based on the terms "Ramadan Fasting," "Ramadan," "Islamic Fasting," "Fasting in Ramadan" accompanied with one of the eye, tear drop, myopia, intraocular pressure (IOP), tear break up time, basal tear secretion, refractive error, and visual acuity. Predawn water loading and dehydration in the evening are shown to increase and decrease IOP and tear secretion, respectively. Ocular blood flow is changed in Ramadan fasting, and patients with ocular vein occlusion may experience more frequent attacks. There are no or minimal fluctuations in visual acuity and refractive errors, but most of them are decompensated after Ramadan. Although the influence of fasting in different eye parameters is evaluated in several studies, there are no or only limited studies conducted on patients suffering from glaucoma, damage to ophthalmic vasculature, tear dysfunction, and minimal visual acuity. Such studies are required to make a definite decision before fasting is declared harmless to these patients.

  19. Prevalence and risk factors for refractive errors and ocular biometry parameters in an elderly Asian population: the Singapore Longitudinal Aging Study (SLAS)

    PubMed Central

    Tan, C S H; Chan, Y H; Wong, T Y; Gazzard, G; Niti, M; Ng, T-P; Saw, S M

    2011-01-01

    Purpose To determine the prevalence rates of refractive errors and pattern of ocular biometry in a multi-ethnic elderly Asian population. Methods A population-based study of 1835 residents aged 55–85 years, evaluating the refractive error and ocular biometry parameters, including axial length (AL) and anterior chamber depth. Results The age-standardized prevalence of myopia, hyperopia, astigmatism, and anisometropia were 30.0% (95% confidence interval (CI): 29.6, 30.4), 41.5% (95% CI: 41.1, 41.9), 43.5% (95% CI: 43.1, 44.0), and 22.1% (95% CI: 21.7, 22.4), respectively. Male gender (P=0.02), age ≥75 years (P=0.033), and higher educational level (P<0.001) were significantly associated with higher rates of myopia in multivariate analyses. The prevalence of astigmatism was higher in persons with diabetes (odds ratio (OR) 1.4, 95% CI: 1.03, 1.90, P=0.031). AL was longer in Chinese than other ethnic groups (23.7 vs23.4 mm, P=0.018), and in men compared with women (24.2 vs23.4 mm, P<0.001). AL was associated with increasing height (AL increased by 0.3 mm for every 10 cm increase in height, P<0.001). Conclusion There is a high prevalence of myopia in elderly Singaporeans, consistent with trends seen in younger populations in Asia. Male gender and higher education were independent risk factors for myopia. These data suggest that higher rates of myopia in East Asians compared with Caucasians may not be a recent phenomenon. PMID:21720418

  20. The significance of retinal image contrast and spatial frequency composition for eye growth modulation in young chicks

    PubMed Central

    Tran, Nina; Chiu, Sara; Tian, Yibin; Wildsoet, Christine F.

    2009-01-01

    Purpose This study sought further insight into the stimulus dependence of form deprivation myopia, a common response to retinal image degradation in young animals. Methods Each of 4 Bangerter diffusing filters (0.6, 0.1, <0.1, and LP (light perception only)) combined with clear plano lenses, as well as plano lenses alone, were fitted monocularly to 4-day-old chicks. Axial ocular dimensions and refractive errors were monitored over a 14-day treatment period, using high frequency A-scan ultrasonography and an autorefractor, respectively. Results Only the <0.1 and LP filters induced significant form deprivation myopia; these filters induced similarly large myopic shifts in refractive error (mean interocular differences ±SEM: -9.92 ±1.99, -7.26 ± 1.60 D respectively), coupled to significant increases in both vitreous chamber depths and optical axial lengths (p<0.001). The other 3 groups showed comparable, small changes in their ocular dimensions (p>0.05), and only small myopic shifts in refraction (<3.00 D). The myopia-inducing filters eliminated mid-and-high spatial frequency information. Conclusions Our results are consistent with emmetropization being tuned to mid-spatial frequencies. They also imply that form deprivation is not a graded phenomenon. PMID:18533221

  1. Effect of Common Visual Dysfunctions on Reading.

    ERIC Educational Resources Information Center

    McPartland, Brian P.

    1985-01-01

    Six common visual dysfunctions are briefly explained and their relationships to reading noted: (1) ametropia, refractive error; (2) inaccurate saccades, the small jumping eye movements used in reading; (3) inefficient binocularity/fusion; (4) insufficient convergence/divergence; (5) heterophoria, imbalance in extra-ocular muscles; and (6)…

  2. Unbiased Estimation of Refractive State of Aberrated Eyes

    PubMed Central

    Martin, Jesson; Vasudevan, Balamurali; Himebaugh, Nikole; Bradley, Arthur; Thibos, Larry

    2011-01-01

    To identify unbiased methods for estimating the target vergence required to maximize visual acuity based on wavefront aberration measurements. Experiments were designed to minimize the impact of confounding factors that have hampered previous research. Objective wavefront refractions and subjective acuity refractions were obtained for the same monochromatic wavelength. Accommodation and pupil fluctuations were eliminated by cycloplegia. Unbiased subjective refractions that maximize visual acuity for high contrast letters were performed with a computer controlled forced choice staircase procedure, using 0.125 diopter steps of defocus. All experiments were performed for two pupil diameters (3mm and 6mm). As reported in the literature, subjective refractive error does not change appreciably when the pupil dilates. For 3 mm pupils most metrics yielded objective refractions that were about 0.1D more hyperopic than subjective acuity refractions. When pupil diameter increased to 6 mm, this bias changed in the myopic direction and the variability between metrics also increased. These inaccuracies were small compared to the precision of the measurements, which implies that most metrics provided unbiased estimates of refractive state for medium and large pupils. A variety of image quality metrics may be used to determine ocular refractive state for monochromatic (635nm) light, thereby achieving accurate results without the need for empirical correction factors. PMID:21777601

  3. Visual impairment in urban school children of low-income families in Kolkata, India.

    PubMed

    Ghosh, Sambuddha; Mukhopadhyay, Udayaditya; Maji, Dipankar; Bhaduri, Gautam

    2012-01-01

    To evaluate pattern of visual impairment in school children from low-income families in Kolkata, India, an institutional cross-sectional study was conducted among 2570 children of 10 primary schools. Ocular examination including refraction was done and pattern of visual impairment and refractive error was studied. The age range was 6-14 years. Refractive error was seen in 14.7%. Only 4 children were already wearing correction. Myopia and hypermetropia was present in 307 (11.9%) and 65 (2.5%) children, respectively. Visual acuity of less than 6/12 in better eye was present in 109 (4.2%) and 5 (0.2%) children pre- and post-correction, respectively. Eighteen children had amblyopia. Although prevalence of refractive error in this group is less compared to school children of all income categories reported from other cities of India, it is more compared to school children of all income categories from the same city. Refractive error mostly remains uncorrected in this group.

  4. Ophthalmic Phenotypes and the Representativeness of Twin Data for the General Population

    PubMed Central

    Sanfilippo, Paul G.; Medland, Sarah E.; Hewitt, Alex W.; Kearns, Lisa S.; Ruddle, Jonathan B.; Sun, Cong; Hammond, Christopher J.; Young, Terri L.; Martin, Nicholas G.

    2011-01-01

    Purpose. To compare the distributional parameters for a series of ocular biometric traits between twins and their singleton siblings, to evaluate the generalizability of twin data, as used in heritability analyses to the general population. Methods. A series of birth, anthropometric, and 13 ocular biometric traits were selected for analysis: interpupillary distance (IPD), visual acuity (logMAR), spherical equivalent refractive error, corneal curvature, axial length, anterior chamber depth (ACD), central corneal thickness (CCT), intraocular pressure (IOP), optic disc, cup and rim areas, and measures of retinal vessel caliber; central retinal arteriolar equivalent (CRAE), and central retinal venular equivalent (CRVE). Structural equation modeling was used to test the assumption that the means and variances for each trait did not differ between twins and their siblings. Results. Significant differences in log-likelihood for birth weight and gestational age were observed between twins and siblings, with the latter being both heavier and closer to full-term at birth. Siblings were also found to have larger IPD and axial length, and better visual acuity compared with their twin counterparts. Refractive error, corneal curvature, ACD, CCT, optic disc parameters, and retinal vascular calibers did not differ significantly between the two groups. Conclusions. Twins are representative of the general population for some but not all measures of ocular biometry. Consequently, care should be taken when extrapolating twin data for these traits in heritability and other genetic studies. Birth weight differences between twins and siblings do not appear to account for the differences in ocular biometry observed in this study. PMID:21498610

  5. Errors Associated with IOLMaster Biometry as a Function of Internal Ocular Dimensions

    PubMed Central

    Faria-Ribeiro, Miguel; Lopes-Ferreira, Daniela; López-Gil, Norberto; Jorge, Jorge; González-Méijome, José Manuel

    2014-01-01

    Purpose To evaluate the error in the estimation of axial length (AL) with the IOLMaster partial coherence interferometry (PCI) biometer and obtain a correction factor that varies as a function of AL and crystalline lens thickness (LT). Methods Optical simulations were produced for theoretical eyes using Zemax-EE software. Thirty-three combinations including eleven different AL (from 20 mm to 30 mm in 1 mm steps) and three different LT (3.6 mm, 4.2 mm and 4.8 mm) were used. Errors were obtained comparing the AL measured for a constant equivalent refractive index of 1.3549 and for the actual combinations of indices and intra-ocular dimensions of LT and AL in each model eye. Results In the range from 20 mm to 30 mm AL and 3.6–4.8 mm LT, the instrument measurements yielded an error between −0.043 mm and +0.089 mm. Regression analyses for the three LT condition were combined in order to derive a correction factor as a function of the instrument measured AL for each combination of AL and LT in the theoretical eye. Conclusions The assumption of a single “average” refractive index in the estimation of AL by the IOLMaster PCI biometer only induces very small errors in a wide range of combinations of ocular dimensions. Even so, the accurate estimation of those errors may help to improve accuracy of intra-ocular lens calculations through exact ray tracing, particularly in longer eyes and eyes with thicker or thinner crystalline lenses. PMID:24766863

  6. Errors associated with IOLMaster biometry as a function of internal ocular dimensions.

    PubMed

    Faria-Ribeiro, Miguel; Lopes-Ferreira, Daniela; López-Gil, Norberto; Jorge, Jorge; González-Méijome, José Manuel

    2014-01-01

    To evaluate the error in the estimation of axial length (AL) with the IOLMaster partial coherence interferometry (PCI) biometer and obtain a correction factor that varies as a function of AL and crystalline lens thickness (LT). Optical simulations were produced for theoretical eyes using Zemax-EE software. Thirty-three combinations including eleven different AL (from 20mm to 30mm in 1mm steps) and three different LT (3.6mm, 4.2mm and 4.8mm) were used. Errors were obtained comparing the AL measured for a constant equivalent refractive index of 1.3549 and for the actual combinations of indices and intra-ocular dimensions of LT and AL in each model eye. In the range from 20mm to 30mm AL and 3.6-4.8mm LT, the instrument measurements yielded an error between -0.043mm and +0.089mm. Regression analyses for the three LT condition were combined in order to derive a correction factor as a function of the instrument measured AL for each combination of AL and LT in the theoretical eye. The assumption of a single "average" refractive index in the estimation of AL by the IOLMaster PCI biometer only induces very small errors in a wide range of combinations of ocular dimensions. Even so, the accurate estimation of those errors may help to improve accuracy of intra-ocular lens calculations through exact ray tracing, particularly in longer eyes and eyes with thicker or thinner crystalline lenses. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  7. Polymerizable-group capped ZnS nanoparticle for high refractive index inorganic-organic hydrogel contact lens.

    PubMed

    Zhao, Peili; Xu, Jinku; Zhang, Yongchun; Zhu, Weiyue; Cui, Yuezhi

    2018-09-01

    Refractive index (RI) is an important parameter for contact lens biomaterials. In this paper, a novel polymerizable-group capped ZnS nanoparticle (NP) was synthesized by chemical link between hydroxyl group on the surface of ZnS (ME-capped) and isocyanate group of polymerizable molecule of 2-isocyanatoethyl methacrylate. Then the ZnS NP copolymerized with monomer of 2-hydroxyethyl methacrylate (HEMA) and N,N-dimethylacrylamide (DMA) to prepare high refractive index hydrogel contact lens with high content of inorganic ZnS NP. Increasing polymerizable-group capped ZnS content in the hydrogels improved its RI value and mechanical properties, however decreased slightly its transmittance, equilibrium (ESR) and lysozyme deposition on the hydrogel surface. The ZnS-containing hydrogels possessed good cytocompatibility and in vivo biocompatibility in rabbit eyes, demonstrating a potential application as high RI ocular refractive correction biomaterial. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Anisometropia of ocular refractive and biometric measures among 66- to 79-year-old female twins.

    PubMed

    Pärssinen, Olavi; Kauppinen, Markku; Kaprio, Jaakko; Rantanen, Taina

    2016-12-01

    To examine the prevalence of anisometropia of spherical refraction (AnisoSR), astigmatism (AnisoAST) and spherical equivalent (AnisoSE) and their associations with spherical refraction (SR), refractive astigmatism (AST), spherical equivalent (SE) and interocular differences of ocular biometric parameters among elderly female twins. Refraction of 117 monozygotic (MZ) and 116 dizygotic (DZ) female twin subjects aged 66-79 years was assessed with an auto-refractor (Topcon AT) and controlled by subjective refraction. Corneal refraction, anterior chamber depth and axial length were measured with a Zeiss IOL Master. Participants with eyes operated for cataract or glaucoma were excluded, but the grade of nuclear opacity was not recorded. The associations between the absolute values of AnisoSR, AnisoAST and AnisoSE with SR, AST, SE, corneal refractive power (CR), corneal astigmatism (CAST), anterior chamber depth (ACD) and axial length (AL) and with their interocular differences were calculated. When calculating the interdependencies of the differences, the real and absolute differences between the right and left eye were used. Means ± standard deviations for AnisoSR, AnisoAST and AnisoSE were 0.67 ± 0.92 D, 0.42 ± 0.41 D and 0.65 ± 0.71 D, respectively. AnisoSR, AnisoAST and AnisoSE >1.0 D were present in 14.7%, 4.2% and 17.7% of cases, respectively. Anisometropia of spherical refraction (AnisoSR), AnisoAST and AnisoSE were higher the more negative the values of SR or SE. Hyperopic ametropia did not increase these anisometropia values. The correlations of AnisoSR and AnisoSE with the absolute values of interocular differences in CR and AL were non-significant. Using the real values of the interocular differences, the respective correlations were significant. The correlation between the real interocular differences in CR and AL was negative (r = -0.258, p < 0.001). Thus, the combined effect of the real interocular differences in CR and AL was a decrease in AnisoSR and AnisoSE (emmetropization). Higher AnisoSR and AnisoSE were associated with more myopic refraction and longer AL. Higher AnisoAST was associated with more negative SR and higher AST and CAST. The negative correlation between real interocular differences in CR and AL indicated their influence of emmetropization in AnisoSR and AnisoSE. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  9. Space flight-associated neuro-ocular syndrome (SANS).

    PubMed

    Lee, Andrew G; Mader, Thomas H; Gibson, C Robert; Brunstetter, Tyson J; Tarver, William J

    2018-03-12

    Interesting novel and somewhat perplexing physiologic and pathologic neuro-ocular findings have been documented in astronauts during and after long duration space flight (LDSF). These findings collectively have been termed the "space flight-associated neuro-ocular syndrome" (SANS). The National Aeronautics and Space Administration (NASA) in the United States has meticulously and prospectively documented the clinical, ultrasound, optical coherence tomography imaging, and radiographic findings of SANS including unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and nerve fiber layer infarcts (i.e., cotton wool spots). NASA and collaborating researchers continue to study SANS in preparation for future manned missions to space, including continued trips to the ISS, a return to the moon, or perhaps new voyages to the asteroid belt, or the planet, Mars.

  10. Refractive and ocular biometric profile of children with a history of laser treatment for retinopathy of prematurity.

    PubMed

    Kaur, Savleen; Sukhija, Jaspreet; Katoch, Deeksha; Sharma, Mansi; Samanta, Ramanuj; Dogra, Mangat R

    2017-09-01

    Indian children belong to a diverse socioeconomic strata with retinopathy of prematurity (ROP) developing in mature, higher birth weight babies as well. The purpose of our study is to analyze the long-term status of refractive errors and its relationship with ocular biometry in children with ROP who were laser treated at a tertiary center in North India. Cross sectional study. Children (<16 years) enrolled from January 2014 to December 2014 with a history of laser treatment for ROP and examined for refractive and biometric status. Thirty-six children presenting to us at the mean age of 7.37 ± 3.07 years (6-15 years) were included. Mean spherical equivalent (SE) was -4.05 D ± 5.10. 75% were myopic, with high astigmatism in 31%. Higher lens thickness (P = 0.03) and higher SE (P = 0.002) at 1 year postnatal age were predictors of larger SE. 79.4% achieved a favorable functional outcome (visual acuity ≥20/40). 5.88% achieved unsatisfactory outcome (<20/200) despite having a favorable structural outcome. There are a substantial number of children who develop myopia and high astigmatism while undergoing laser treatment for ROP. We found myopia in our cohort to be lenticular and greater axial length contributing to the development of high myopia. An initial large refractive error predicts the future development of myopia in these children. Nearly 6% of patients with good structural outcome have unexplained subnormal vision. Our threshold for prescribing glasses in these children should be low.

  11. Refractive and ocular biometric profile of children with a history of laser treatment for retinopathy of prematurity

    PubMed Central

    Kaur, Savleen; Sukhija, Jaspreet; Katoch, Deeksha; Sharma, Mansi; Samanta, Ramanuj; Dogra, Mangat R

    2017-01-01

    Purpose: Indian children belong to a diverse socioeconomic strata with retinopathy of prematurity (ROP) developing in mature, higher birth weight babies as well. The purpose of our study is to analyze the long-term status of refractive errors and its relationship with ocular biometry in children with ROP who were laser treated at a tertiary center in North India. Methods: Cross sectional study. Children (<16 years) enrolled from January 2014 to December 2014 with a history of laser treatment for ROP and examined for refractive and biometric status. Results: Thirty-six children presenting to us at the mean age of 7.37 ± 3.07 years (6–15 years) were included. Mean spherical equivalent (SE) was −4.05 D ± 5.10. 75% were myopic, with high astigmatism in 31%. Higher lens thickness (P = 0.03) and higher SE (P = 0.002) at 1 year postnatal age were predictors of larger SE. 79.4% achieved a favorable functional outcome (visual acuity ≥20/40). 5.88% achieved unsatisfactory outcome (<20/200) despite having a favorable structural outcome. Conclusion: There are a substantial number of children who develop myopia and high astigmatism while undergoing laser treatment for ROP. We found myopia in our cohort to be lenticular and greater axial length contributing to the development of high myopia. An initial large refractive error predicts the future development of myopia in these children. Nearly 6% of patients with good structural outcome have unexplained subnormal vision. Our threshold for prescribing glasses in these children should be low. PMID:28905827

  12. Crystalline lens paradoxes revisited: significance of age-related restructuring of the GRIN.

    PubMed

    Sheil, Conor J; Goncharov, Alexander V

    2017-09-01

    The accommodating volume-constant age-dependent optical (AVOCADO) model of the crystalline lens is used to explore the age-related changes in ocular power and spherical aberration. The additional parameter m in the GRIN lens model allows decoupling of the axial and radial GRIN profiles, and is used to stabilise the age-related change in ocular power. Data for age-related changes in ocular geometry and lens parameter P in the axial GRIN profile were taken from published experimental data. In our age-dependent eye model, the ocular refractive power shows behaviour similar to the previously unexplained "lens paradox". Furthermore, ocular spherical aberration agrees with the data average, in contrast to the proposed "spherical aberration paradox". The additional flexibility afforded by parameter m , which controls the ratio of the axial and radial GRIN profile exponents, has allowed us to study the restructuring of the lens GRIN medium with age, resulting in a new interpretation of the origin of the power and spherical aberration paradoxes. Our findings also contradict the conceptual idea that the ageing eye is similar to the accommodating eye.

  13. Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review.

    PubMed

    Pinazo-Durán, María D; Zanón-Moreno, Vicente; García-Medina, José J; Arévalo, J Fernando; Gallego-Pinazo, Roberto; Nucci, Carlo

    2016-01-01

    Coexistence of several ocular diseases is more frequent than suspected. In spite of the refractive errors, one or more of the following can be detected simultaneously: glaucoma, cataracts, uveitis, age-related macular degeneration, and dry eyes. In addition, as people age, ocular comorbidities are much more usually seen. Specific diseases are openly acknowledged to affect the eyes and vision, such as diabetes mellitus, hypertension blood pressure, arthritis, hyperthyroidism, neurodegenerative disorders, hematologic malignancies, and/or systemic infections. Recent advances in early diagnosis and therapy of the ophthalmic pathologies have reinforced patient options to prevent visual impairment and blindness. Because of this, it is essential not to overlook sight-threatening conditions such as the ocular comorbidities and/or the eye involvement in the context of systemic disorders. Moreover, the important role of the multidisciplinary cooperation to improve and sustain management of patients affected with eclectic ocular comorbidities and/or systemic disorders with eye repercussion is specifically addressed. This review intends to shed light on these topics to help in making opportune diagnosis and appropriately managing the affected patients.

  14. Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review

    PubMed Central

    Zanón-Moreno, Vicente; García-Medina, José J.; Arévalo, J. Fernando; Gallego-Pinazo, Roberto; Nucci, Carlo

    2016-01-01

    Coexistence of several ocular diseases is more frequent than suspected. In spite of the refractive errors, one or more of the following can be detected simultaneously: glaucoma, cataracts, uveitis, age-related macular degeneration, and dry eyes. In addition, as people age, ocular comorbidities are much more usually seen. Specific diseases are openly acknowledged to affect the eyes and vision, such as diabetes mellitus, hypertension blood pressure, arthritis, hyperthyroidism, neurodegenerative disorders, hematologic malignancies, and/or systemic infections. Recent advances in early diagnosis and therapy of the ophthalmic pathologies have reinforced patient options to prevent visual impairment and blindness. Because of this, it is essential not to overlook sight-threatening conditions such as the ocular comorbidities and/or the eye involvement in the context of systemic disorders. Moreover, the important role of the multidisciplinary cooperation to improve and sustain management of patients affected with eclectic ocular comorbidities and/or systemic disorders with eye repercussion is specifically addressed. This review intends to shed light on these topics to help in making opportune diagnosis and appropriately managing the affected patients. PMID:27051666

  15. [A study of refractive errors in a primary school in Cotonou, Benin].

    PubMed

    Sounouvou, I; Tchabi, S; Doutetien, C; Sonon, F; Yehouessi, L; Bassabi, S K

    2008-10-01

    Determine the epidemiologic aspects and the degree of severity of different refractive errors in primary schoolchildren. A prospective and descriptive study was conducted from 1 December 2005 to 31 March 2006 on schoolchildren ranging from 4 to 16 years of age in a public primary school in Cotonou, Benin. The refraction was evaluated for any visual acuity lower than or equal to 0.7. The study included 1057 schoolchildren. The average age of the study population was 8.5+/-2.6 years with a slight predominance of females (51.8%). The prevalence of refractive error was 10.6% and astigmatism accounted for the most frequent refractive anomaly (91.9%). Myopia and the hyperopia were associated with astigmatism in 29.4% and 16.1% of the cases, respectively. The age bracket from 6 to 11 years accounted for the majority of refractive errors (75.9%), without age and sex being risk factors (p=0.811 and p=0.321, respectively). The average vision of the ametropic eye was 0.61, with a clear predominance of slight refractive errors (89.3%) and particularly of low-level simple astigmatism (45.5%). The relatively low prevalence of refractive error observed does not obviate the need for implementing actions to improve the ocular health of schoolchildren.

  16. The Use of Orthoptics in Dyslexia.

    ERIC Educational Resources Information Center

    Haddad, Herskel M.; And Others

    1984-01-01

    In 73 children (6-13 years old) with reading difficulty, ophthalmological evaluation showed that 18 had overt refractive errors, 18 dyslexia and no ocular anomalies, and 37 impaired fusional amplitudes, 24 of whom were dyslexic. In all Ss with poor fusional amplitudes the reading mechanism could be improved with orthoptic exercises. (Author/CL)

  17. [Biomechanical condition of the cornea as a new indicator for pathological and structural changes].

    PubMed

    Spörl, E; Terai, N; Haustein, M; Böhm, A G; Raiskup-Wolf, F; Pillunat, L E

    2009-06-01

    Several methods permit the measurement of geometric parameters of the cornea, but until now biomechanical conditions of the cornea have been ignored (e.g. in refractive corneal surgery). Besides the geometric condition, biomechanical properties of the cornea have been shown to influence applanation measurement of intra-ocular pressure (IOP) and epidemiological studies have identified corneal thickness as an independent risk factor for the development and progression of glaucoma. The aim of this investigation was to characterize the biomechanical properties of the cornea using the ocular response analyzer (ORA). The ocular response analyzer (ORA) is a new method available for non-contact measurement of the biomechanical properties of the cornea. We evaluated the reproducibility of measurements, the difference between static and dynamic factors and the impact of independent factors (e.g. IOP, age, CCT, swelling of the cornea) on 2,500 measurements of corneal hysteresis (CH) and corneal resistance factor (CRF). In a large sample size we observed changes in CH and CRF after refractive surgery procedures (LASIK, UV-A cross-linking, keratoplasty) and in other corneal disorders (keratoconus, corneal dystrophies). CRF and CH changes may reflect structural changes of the cornea. Thus, the ORA provides valuable information for a better understanding and characterization of the biomechanical condition of the cornea, especially with regard to diseases such as keratoconus and glaucoma.

  18. The effects of Ramadan fasting on the health and function of the eye

    PubMed Central

    Javadi, Mohammad Ali; Assadi, Mahsan; Einollahi, Bahram; Rabei, Hossein Mohammad; Afarid, Mehrdad; Assadi, Majid

    2014-01-01

    Background: Ramadan fasting may alter a variety of physiological parameters which by themselves influence ocular system. Here, we review the effects of Ramadan fasting on the health and function of the eye. Materials and Methods: Literature records in PubMed/MEDLINE, Web of Science, EMBASE, Google Scholar, and Iran Medex databases as well as proceedings of related meetings from January 1986 to March 2014 were systematically reviewed. The search key words was based on the terms “Ramadan Fasting,” “Ramadan,” “Islamic Fasting,” “Fasting in Ramadan” accompanied with one of the eye, tear drop, myopia, intraocular pressure (IOP), tear break up time, basal tear secretion, refractive error, and visual acuity. Results: Predawn water loading and dehydration in the evening are shown to increase and decrease IOP and tear secretion, respectively. Ocular blood flow is changed in Ramadan fasting, and patients with ocular vein occlusion may experience more frequent attacks. There are no or minimal fluctuations in visual acuity and refractive errors, but most of them are decompensated after Ramadan. Conclusion: Although the influence of fasting in different eye parameters is evaluated in several studies, there are no or only limited studies conducted on patients suffering from glaucoma, damage to ophthalmic vasculature, tear dysfunction, and minimal visual acuity. Such studies are required to make a definite decision before fasting is declared harmless to these patients. PMID:25422666

  19. Evaluation of Refractive Errors and Ocular Biometric Outcomes after Intravitreal Bevacizumab for Retinopathy of Prematurity.

    PubMed

    Gunay, Murat; Sekeroglu, Mehmet Ali; Bardak, Handan; Celik, Gokhan; Esenulku, Cenap Mahmut; Hekimoglu, Emre; Bardak, Yavuz

    2016-06-01

    To assess ocular biometric outcomes following intravitreal bevacizumab (IVB) monotherapy for retinopathy of prematurity (ROP) and compare these results with those of laser photocoagulated infants and with the ones with spontaneously regressed ROP. Premature infants including those who underwent IVB monotherapy (Group 1) or laser photocoagulation (Group 2) for ROP and infants with spontaneously regressed ROP (Group 3) were recruited for the study. Refractive errors and ocular biometric parameters (Axial length [AL], anterior chamber depth [ACD], and lens thickness [LT]) were measured at adjusted 1 year of age in all subjects. There was no significant difference of spherical equivalent (SE) value between the groups (P = 0.781). The incidence of high myopia was 7.4% in Group 1 and 12.7% in Group 2 (P = 0.081). No infants exhibited high myopia in Group 3. LT was greater in Group 2 when compared to Group 1 and Group 3 (P = 0.011). Lower SE was significantly correlated to longer AL in Group 1 (r = -0.656, P = 0.015). There was a significant positive correlation between SE and ACD values in Group 2 (r = 0.391, P = 0.005). The study showed no significant difference of SE between the groups. High myopia was only present among the treated infants either with IVB or laser. Infants who received laser treatment significantly had thicker lenses.

  20. Quantitative Fourier Domain Optical Coherence Tomography Imaging of the Ocular Anterior Segment

    NASA Astrophysics Data System (ADS)

    McNabb, Ryan Palmer

    Clinical imaging within ophthalmology has had transformative effects on ocular health over the last century. Imaging has guided clinicians in their pharmaceutical and surgical treatments of macular degeneration, glaucoma, cataracts and numerous other pathologies. Many of the imaging techniques currently used are photography based and are limited to imaging the surface of ocular structures. This limitation forces clinicians to make assumptions about the underlying tissue which may reduce the efficacy of their diagnoses. Optical coherence tomography (OCT) is a non-invasive, non-ionizing imaging modality that has been widely adopted within the field of ophthalmology in the last 15 years. As an optical imaging technique, OCT utilizes low-coherence interferometry to produce micron-scale three-dimensional datasets of a tissue's structure. Much of the human body consists of tissues that significantly scatter and attenuate optical signals limiting the imaging depth of OCT in those tissues to only 1-2mm. However, the ocular anterior segment is unique among human tissue in that it is primarily transparent or translucent. This allows for relatively deep imaging of tissue structure with OCT and is no longer limited by the optical scattering properties of the tissue. This goal of this work is to develop methods utilizing OCT that offer the potential to reduce the assumptions made by clinicians in their evaluations of their patients' ocular anterior segments. We achieved this by first developing a method to reduce the effects of patient motion during OCT volume acquisitions allowing for accurate, three dimensional measurements of corneal shape. Having accurate corneal shape measurements then allowed us to determine corneal spherical and astigmatic refractive contribution in a given individual. This was then validated in a clinical study that showed OCT better measured refractive change due to surgery than other clinical devices. Additionally, a method was developed to combine the clinical evaluation of the iridocorneal angle through gonioscopy with OCT.

  1. Crystalline lens power and refractive error.

    PubMed

    Iribarren, Rafael; Morgan, Ian G; Nangia, Vinay; Jonas, Jost B

    2012-02-01

    To study the relationships between the refractive power of the crystalline lens, overall refractive error of the eye, and degree of nuclear cataract. All phakic participants of the population-based Central India Eye and Medical Study with an age of 50+ years were included. Calculation of the refractive lens power was based on distance noncycloplegic refractive error, corneal refractive power, anterior chamber depth, lens thickness, and axial length according to Bennett's formula. The study included 1885 subjects. Mean refractive lens power was 25.5 ± 3.0 D (range, 13.9-36.6). After adjustment for age and sex, the standardized correlation coefficients (β) of the association with the ocular refractive error were highest for crystalline lens power (β = -0.41; P < 0.001) and nuclear lens opacity grade (β = -0.42; P < 0.001), followed by axial length (β = -0.35; P < 0.001). They were lowest for corneal refractive power (β = -0.08; P = 0.001) and anterior chamber depth (β = -0.05; P = 0.04). In multivariate analysis, refractive error was significantly (P < 0.001) associated with shorter axial length (β = -1.26), lower refractive lens power (β = -0.95), lower corneal refractive power (β = -0.76), higher lens thickness (β = 0.30), deeper anterior chamber (β = 0.28), and less marked nuclear lens opacity (β = -0.05). Lens thickness was significantly lower in eyes with greater nuclear opacity. Variations in refractive error in adults aged 50+ years were mostly influenced by variations in axial length and in crystalline lens refractive power, followed by variations in corneal refractive power, and, to a minor degree, by variations in lens thickness and anterior chamber depth.

  2. Image processing and analysis using neural networks for optometry area

    NASA Astrophysics Data System (ADS)

    Netto, Antonio V.; Ferreira de Oliveira, Maria C.

    2002-11-01

    In this work we describe the framework of a functional system for processing and analyzing images of the human eye acquired by the Hartmann-Shack technique (HS), in order to extract information to formulate a diagnosis of eye refractive errors (astigmatism, hypermetropia and myopia). The analysis is to be carried out using an Artificial Intelligence system based on Neural Nets, Fuzzy Logic and Classifier Combination. The major goal is to establish the basis of a new technology to effectively measure ocular refractive errors that is based on methods alternative those adopted in current patented systems. Moreover, analysis of images acquired with the Hartmann-Shack technique may enable the extraction of additional information on the health of an eye under exam from the same image used to detect refraction errors.

  3. Form deprivation and lens-induced myopia: are they different?

    PubMed Central

    Morgan, Ian G.; Ashby, Regan S.; Nickla, Debora L.; Guggenheim, Jeremy A.

    2013-01-01

    Animal models have been crucial in shaping our understanding of emmetropisation as an active, visually-guided mechanism for overcoming innate refractive errors. For instance, when a ‘minus’ power spectacle lens is mounted in front of the eye of a juvenile animal, the eye is cued to thin its choroid and accelerate its rate of axial elongation. Such altered ocular growth responses serve to attenuate the imposed defocus and so continue over a period of days, weeks or months (depending on the rate of emmetropisation of the species concerned) until the eye attains its optimal refraction. Notably, refracted without the minus lens in place, the eye of an animal emmetropising to a minus lens is myopic (its axial length now being excessive for its anterior segment optics). Similar ocular growth changes are seen with form deprivation, typically achieved by covering the eye with a frosted diffuser, and preventing the eye from receiving clear vision. However while both minus lens wear and form deprivation induce axial myopia, the absence of meaningful visual feedback allows growth to continue in an ‘open-loop’ manner in the latter case, limited mostly by the duration of treatment. Here, Ian Morgan and Regan Ashby present the evidence that form deprivation and lens-induced myopia share the same physiological mechanisms, while Debora Nickla presents the opposing evidence that the underlying mechanisms are different. PMID:23662966

  4. Changes in ocular biometry and anterior chamber parameters after pharmacologic mydriasis and peripheral iridotomy in primary angle closure suspects.

    PubMed

    Razeghinejad, Mohammad Reza; Lashkarizadeh, Hamid; Nowroozzadeh, Mohammad Hossein; Yazdanmehr, Mohammad

    2016-01-01

    The aim of this study was to evaluate the effects of pharmacologic mydriasis and Peripheral Iridotomy (PI) on ocular biometry and anterior chamber parameters in primary angle closure suspects. In this prospective interventional case series, 21 primary angle closure suspects were enrolled. Intraocular pressure, refraction, ocular biometry (Lenstar, LS900), and anterior chamber parameters (Pentacam HR) were measured at four occasions: before PI (before and after mydriasis with phenylephrine) and two weeks after PI (before and after mydriasis). The study was conducted on both eyes and only one eye per patient, in random, was included in the analysis. The mean age of the participants was 60±7 years and 17 (81%) were female. There were no significant differences in intraocular pressure, refraction, keratometry, biometric and anterior chamber parameters between groups, except for anterior chamber volume, which showed increments with PI and mydriasis. The corresponding values for anterior chamber volume were as follows: 88.2±13.7mm(3) before PI, undilated; 106.3±18.8 before PI, dilated; 99.0±14.6 after PI, undilated, and 107.4±16.5 after PI, dilated (P<0.001). This study showed no change in the ocular biometric and anterior chamber parameters including iridocorneal angle after PI and/or pharmacologic mydriasis except for increments in anterior chamber volume. This factor has the potential to be used as a numerical proxy for iris position in evaluating and monitoring patients with primary angle closure suspects after PI. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  5. Measuring wearing times of glasses and ocular patches using a thermosensor device from orthodontics.

    PubMed

    Januschowski, Kai; Bechtold, Till E; Schott, Timm C; Huelber-Januschowski, Maren S; Blumenstock, Gunnar; Bartz-Schmidt, Karl-Ulrich; Besch, Dorothea; Schramm, Charlotte

    2013-12-01

    Amblyopia is one of the most common visual disorders in children. The risk of severe visual impairment on the healthy eye is doubled in patients with amblyopia. If detected early enough, the chances of visual rehabilitation are good. Treatment consists of refractive correction and occlusion of the dominant eye. Patient compliance is an important factor and can be monitored using thermosensors. It was the goal of our study to give proof of the principle that the wearing times of glasses and patches can be measured using a comparatively small and commercially available microsensor. Agreement between wearing times protocols of ocular patching/refractive correction and temperature measurements of thermosensors attached to the patches or glasses of three individuals were analysed using the Bland-Altman method. It was also analysed whether blinded persons could distinguish between temperature curves of patches and glasses, or temperature curves of an incubator or while worn in a pocket. The temperatures picked up by the microsensors indicate the beginning and the end wearing times of either glasses or ocular patches through steep temperature difference and a distinct temperature curve during measurements. Although blinded test persons were able to cleary distinguish between temperature profiles from incubator/pocket measurements compared to glasses/patching, glasses and patching curves could be discriminated correctly in only 50%. Differences between wearing time protocols and temperature measurements were within the limits of agreement as stated by the Bland-Altman plots. The TheraMon(®) microsensor can reliably measure wearing times of glasses and ocular patches without making the wearer uncomfortable, although the data are not unquestionable, especially in higher surrounding temperatures. Further studies on a larger number of individuals with different wearing profiles are needed. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  6. High-hyperopia database, part I: clinical characterisation including morphometric (biometric) differentiation of posterior microphthalmos from nanophthalmos

    PubMed Central

    Relhan, N; Jalali, S; Pehre, N; Rao, H L; Manusani, U; Bodduluri, L

    2016-01-01

    Purpose To characterise and differentiate posterior microphthalmos (PM) and nanophthalmos (NO) using morphometric parameters. Patients and methods Consecutive case database of patients with hyperopia >+7.00 D sphere was analysed retrospectively for clinical and biometric characterisation. Thirty-eight consecutive high-hyperopic subjects (75 eyes) with axial lengths <20.5 mm underwent uniform comprehensive ocular evaluation. Twenty-five subjects were diagnosed as PM and 13 as NO based on the horizontal corneal diameter. Parameters analysed included visual acuity, refraction, horizontal corneal diameter, anterior chamber depth, lens thickness, axial length, fundus changes, and associated ocular pathology. Primary outcome measures: ocular biometry difference between PM and NO. Secondary outcome measures: differences in associated ocular pathologies between PM and NO. Results Hyperopia ranged from +7 to +17 D and was similar in the two groups. Lens thickness was statistically more in NO than in PM group (4.53±0.75 mm vs 3.82±0.48 mm, P <0.001), whereas anterior chamber depth was more in the PM than in NO group (3.26±0.36 mm, vs 2.59±0.37 mm, P<0.001). NO had higher association with angle-closure glaucoma (66.7% vs 0%) and pigmentary retinopathy (38.5 vs 8.0%) but lesser association with macular folds (0% vs 24%) as compared with PM. NO was associated with poorer visual acuity. Conclusion PM and NO have significant differences in lens thickness, anterior chamber depth, prevalence of glaucoma, pigmentary retinopathy, macular pathology, and visual acuity while being similar in hyperopic refraction. PMID:26493039

  7. The Effect of Spectacle Lenses Containing Peripheral Defocus on Refractive Error and Horizontal Eye Shape in the Guinea Pig

    PubMed Central

    E. Bowrey, Hannah; Zeng, Guang; Y. Tse, Dennis; J. Leotta, Amelia; Wu, Yi; To, Chi-Ho; F. Wildsoet, Christine; McFadden, Sally A.

    2017-01-01

    Purpose It has been proposed that the peripheral retina, responding to local optical defocus, contributes to myopia and associated altered eye growth in humans. To test this hypothesis, we measured the changes in central (on-axis) and peripheral ocular dimensions in guinea pigs wearing a concentric bifocal spectacle lens design with power restricted to the periphery. Methods Five groups of guinea pigs (n = 83) wore either a unifocal (UF) spectacle lens (−4, 0, or +4 Diopters [D]), or a peripheral defocus (PF) spectacle lens that had a plano center (diameter of 5 mm) with either −4 or +4 D in the surround (−4/0 or +4/0 D). The overall optical diameter of all lenses was 12 mm. Lenses were worn over one eye from 8 to 18 days of age for negative and plano lenses, or from 8 to 22 days of age for positive lenses. Refractive error was measured centrally and 30° off-axis in the temporal and nasal retina. The shape of the eye was analyzed from images of sectioned eyes. Results Lenses of −4 D UF induced myopia, reflecting enhanced ocular elongation, which was centered on the optic nerve head and included the surrounding peripapillary zone (PPZ, 18° in diameter). Some ocular expansion, including within the PPZ, also was recorded with −4/0 and +4/0 D PF lenses while the +4 D UF lens inhibited rather than enhanced elongation, centrally and peripherally. Conclusions Peripheral defocus-induced ocular expansion encompasses the PPZ, irrespective of the sign of the inducing defocus. Understanding the underlying mechanism potentially has important implications for designing multifocal lenses for controlling myopia in humans and also potentially for understanding the link between myopia and glaucoma. PMID:28549092

  8. Heritability of lenticular myopia in English Springer spaniels.

    PubMed

    Kubai, Melissa A; Labelle, Amber L; Hamor, Ralph E; Mutti, Donald O; Famula, Thomas R; Murphy, Christopher J

    2013-11-08

    We determined whether naturally-occurring lenticular myopia in English Springer spaniels (ESS) has a genetic component. Streak retinoscopy was performed on 226 related ESS 30 minutes after the onset of pharmacologic mydriasis and cycloplegia. A pedigree was constructed to determine relationships between affected offspring and parents. Estimation of heritability was done in a Bayesian analysis (facilitated by the MCMCglmm package of R) of refractive error in a model, including terms for sex and coat color. Myopia was defined as ≤-0.5 diopters (D) spherical equivalent. The median refractive error for ESS was 0.25 D (range, -3.5 to +4.5 D). Median age was 0.2 years (range, 0.1-15 years). The prevalence of myopia in related ESS was 19% (42/226). The ESS had a strong correlation (r = 0.95) for refractive error between the two eyes. Moderate heritability was present for refractive error with a mean value of 0.29 (95% highest probability density, 0.07-0.50). The distribution of refractive error, and subsequently lenticular myopia, has a moderate genetic component in ESS. Further investigation of genes responsible for regulation of the development of refractive ocular components in canines is warranted.

  9. The Charles F. Prentice Award Lecture 2010: A Case for Peripheral Optical Treatment Strategies for Myopia

    PubMed Central

    Smith, Earl L.

    2011-01-01

    It is well established that refractive development is regulated by visual feedback. However, most optical treatment strategies designed to reduce myopia progression have not produced the desired results, primarily because some of our assumptions concerning the operating characteristics of the vision-dependent mechanisms that regulate refractive development have been incorrect. In particular, because of the prominence of central vision in primates, it has generally been assumed that signals from the fovea determine the effects of vision on refractive development. However, experiments in laboratory animals demonstrate that ocular growth and emmetropization are mediated by local retinal mechanisms and that foveal vision is not essential for many vision-dependent aspects of refractive development. On the other hand, the peripheral retina, in isolation, can effectively regulate emmetropization and mediate many of the effects of vision on the eye’s refractive status. Moreover, when there are conflicting visual signals between the fovea and the periphery, peripheral vision can dominate refractive development. The overall pattern of results suggests that optical treatment strategies for myopia that take into account the effects of peripheral vision are likely to be more successful than strategies that effectively manipulate only central vision. PMID:21747306

  10. Clinical Outcomes of an Optimized Prolate Ablation Procedure for Correcting Residual Refractive Errors Following Laser Surgery.

    PubMed

    Chung, Byunghoon; Lee, Hun; Choi, Bong Joon; Seo, Kyung Ryul; Kim, Eung Kwon; Kim, Dae Yune; Kim, Tae-Im

    2017-02-01

    The purpose of this study was to investigate the clinical efficacy of an optimized prolate ablation procedure for correcting residual refractive errors following laser surgery. We analyzed 24 eyes of 15 patients who underwent an optimized prolate ablation procedure for the correction of residual refractive errors following laser in situ keratomileusis, laser-assisted subepithelial keratectomy, or photorefractive keratectomy surgeries. Preoperative ophthalmic examinations were performed, and uncorrected distance visual acuity, corrected distance visual acuity, manifest refraction values (sphere, cylinder, and spherical equivalent), point spread function, modulation transfer function, corneal asphericity (Q value), ocular aberrations, and corneal haze measurements were obtained postoperatively at 1, 3, and 6 months. Uncorrected distance visual acuity improved and refractive errors decreased significantly at 1, 3, and 6 months postoperatively. Total coma aberration increased at 3 and 6 months postoperatively, while changes in all other aberrations were not statistically significant. Similarly, no significant changes in point spread function were detected, but modulation transfer function increased significantly at the postoperative time points measured. The optimized prolate ablation procedure was effective in terms of improving visual acuity and objective visual performance for the correction of persistent refractive errors following laser surgery.

  11. Rapid, Accurate, and Non-Invasive Measurement of Zebrafish Axial Length and Other Eye Dimensions Using SD-OCT Allows Longitudinal Analysis of Myopia and Emmetropization

    PubMed Central

    Collery, Ross F.; Veth, Kerry N.; Dubis, Adam M.; Carroll, Joseph; Link, Brian A.

    2014-01-01

    Refractive errors in vision can be caused by aberrant axial length of the eye, irregular corneal shape, or lens abnormalities. Causes of eye length overgrowth include multiple genetic loci, and visual parameters. We evaluate zebrafish as a potential animal model for studies of the genetic, cellular, and signaling basis of emmetropization and myopia. Axial length and other eye dimensions of zebrafish were measured using spectral domain-optical coherence tomography (SD-OCT). We used ocular lens and body metrics to normalize and compare eye size and relative refractive error (difference between observed retinal radial length and controls) in wild-type and lrp2 zebrafish. Zebrafish were dark-reared to assess effects of visual deprivation on eye size. Two relative measurements, ocular axial length to body length and axial length to lens diameter, were found to accurately normalize comparisons of eye sizes between different sized fish (R2 = 0.9548, R2 = 0.9921). Ray-traced focal lengths of wild-type zebrafish lenses were equal to their retinal radii, while lrp2 eyes had longer retinal radii than focal lengths. Both genetic mutation (lrp2) and environmental manipulation (dark-rearing) caused elongated eye axes. lrp2 mutants had relative refractive errors of −0.327 compared to wild-types, and dark-reared wild-type fish had relative refractive errors of −0.132 compared to light-reared siblings. Therefore, zebrafish eye anatomy (axial length, lens radius, retinal radius) can be rapidly and accurately measured by SD-OCT, facilitating longitudinal studies of regulated eye growth and emmetropization. Specifically, genes homologous to human myopia candidates may be modified, inactivated or overexpressed in zebrafish, and myopia-sensitizing conditions used to probe gene-environment interactions. Our studies provide foundation for such investigations into genetic contributions that control eye size and impact refractive errors. PMID:25334040

  12. Correlation between dry eye and refractive error in Saudi young adults using noninvasive Keratograph 4

    PubMed Central

    Fahmy, Rania M; Aldarwesh, Amal

    2018-01-01

    Purpose: The purpose is to study the correlation between dry eye and refractive errors in young adults using noninvasive Keratograph. Methods: In this cross sectional study, a total of 126 participants in the age range of 19–25 years and who were free of ocular surface disease, were recruited from King Saud University Campus. Refraction was defined by the spherical equivalent (SE) as the following: 49 emmetropic eyes (±0.50 SE), 48 myopic eyes (≤−0.75 SE and above), and 31 hyperopic eyes (>+0.75 SE). All participants underwent full ophthalmic examinations assessing their refractive status and dryness level including noninvasive breakup time (NIBUT) and tear meniscus height using Keratograph 4. Results: The prevalence of dry eye was 24.6%, 36.5%, and 17.4% in emmetropes, myopes, and hypermetropes, respectively. NIBUT has a negative correlation with hyperopia and a positive correlation with myopia with a significant reduction in the average NIBUT in myopes and hypermetropes in comparison to emmetropes. Conclusion: The current results succeeded to demonstrate a correlation between refractive errors and dryness level. PMID:29676308

  13. Prevalence of refractive errors in Tibetan adolescents.

    PubMed

    Qian, Xuehan; Liu, Beihong; Wang, Jing; Wei, Nan; Qi, Xiaoli; Li, Xue; Li, Jing; Zhang, Ying; Hua, Ning; Ning, Yuxian; Ding, Gang; Ma, Xu; Wang, Binbin

    2018-05-11

    The prevalence of adolescent eye disease in remote areas of the Qinghai-Tibet Plateau has rarely been reported. To understand the prevalence of common eye diseases in Tibet, we performed ocular-disease screening on students from primary and secondary schools in Tibet, and compared the prevalence to that in the Central China Plain (referred to here as the "plains area"). The refractive status of students was evaluated with a Spot™ vision screener. The test was conducted three or fewer times for both eyes of each student and results with best correction were recorded. A total of 3246 students from primary and secondary schools in the Tibet Naidong district were screened, yielding a refractive error rate of 28.51%, which was significantly lower than that of the plains group (28.51% vs. 56.92%, p < 0.001). In both groups, the prevalence of refractive errors among females was higher than that among males. We found that Tibetan adolescents had a lower prevalence of refractive errors than did adolescents in the plains area, which may be related to less intensive schooling and greater exposure to sunlight.

  14. The refractive state of the eye in Icelandic horses with the Silver mutation.

    PubMed

    Johansson, Maria K; Jäderkvist Fegraeus, Kim; Lindgren, Gabriella; Ekesten, Björn

    2017-06-02

    The syndrome Multiple Congenital Ocular Anomalies (MCOA) is a congenital eye disorder in horses. Both the MCOA syndrome and the Silver coat colour in horses are caused by the same missense mutation in the premelanosome protein (PMEL) gene. Horses homozygous for the Silver mutation (TT) are affected by multiple ocular defects causing visual impairment or blindness. Horses heterozygous for the Silver mutation (CT) have less severe clinical signs, usually cysts arising from the ciliary body iris or retina temporally. It is still unknown if the vision is impaired in horses heterozygous for the Silver mutation. A recent study reported that Comtois horses carrying the Silver mutation had significantly deeper anterior chambers of the eye compared to wild-type horses. This could potentially cause refractive errors. The purpose of the present study was to investigate if Icelandic horses with the Silver mutation have refractive errors compared to wild-type horses. One hundred and fifty-two Icelandic horses were included in the study, 71 CT horses and five TT horses. All horses were genotyped for the missense mutation in PMEL. Each CT and TT horse was matched by a wild-type (CC) horse of the same age ± 1 year. Skiascopy and a brief ophthalmic examination were performed in all horses. Association between refraction and age, eye, genotype and sex was tested by linear mixed-effect model analysis. TT horses with controls were not included in the statistical analyses as they were too few. The interaction between age and genotype had a significant impact on the refractive state (P = 0.0001). CT horses older than 16 years were on average more myopic than wild-type horses of the same age. No difference in the refractive state could be observed between genotypes (CT and CC) in horses younger than 16 years. TT horses were myopic (-2 D or more) in one or both eyes regardless of age. Our results indicate that an elderly Icelandic horse (older than 16 years) carrying the Silver mutation is more likely to be myopic than a wild-type horse of the same age.

  15. [Ocular findings in Polish Armed Forces in Iraq and Afghanistan, a review of medical examinations by The Military Medical Commission in Łodz].

    PubMed

    Pastuszka, Mirosław; Goś, Roman; Jurowski, Piotr; Chrzaszcz, Agnieszka; Smigielski, Janusz; Nowak, Michał S

    2013-01-01

    To determine the prevalence of ocular disorders among Polish soldiers returning from Iraq and Afghanistan military campaigns. A retrospective review of medical records of the Military Medical Commission of Lodz, Poland was performed. Records of 296 randomly selected soldiers, including 98 who returned from Iraq in 2004 and in 198 who returned from Afghanistan in 2012, were assessed. All subjects underwent comprehensive ocular examinations according to the military regulations. We used statistical analysis to review the results. The incidence of ocular disorders in Iraq and Afghanistan groups was 17.3% and 15.1%, respectively. The study revealed that the most common disorders among soldiers were refractive errors affecting 6.8% subjects, followed by defective color vision (4.7%) and solar retinopathy (3.0%). Combat injuries were diagnosed in 3 subjects, including 2 cases of corneal injury and 1 case of retinal detachment due to blast exposure. Combat injuries occurred in 1% of soldiers returning from Iraq and Afghanistan military campaigns. There were no statistically significant differences between Iraq and Afghanistan groups in the incidence of ocular disorders. Solar retinopathy was the most common problem related to the long-term exposure to rough climate conditions in both groups. ocular findings, Iraq, Afghanistan.

  16. Refractive errors and ocular biometry components in thalassemia major patients.

    PubMed

    Heydarian, Samira; Jafari, Reza; Karami, Hosein

    2016-04-01

    The aim of this study is to determine and compare biometric and refractive characteristics of thalassemia major patients and normal individuals. In this cross-sectional study, 54 thalassemia major patients were selected randomly as case group, and 54 age- and sex-matched healthy subjects were regarded as control group. Refractive errors, corneal curvature and ocular components were measured by autokeratorefractometery and A-scan ultrasonography, respectively. Mean spherical equivalent was -0.0093 ± 0.86 D in thalassemia patients and -0.22 ± 1.33 D in the normal group. The prevalence of myopia, Hyperopia, and emmetropia among thalassemia patients was 16.7, 19.4, and 63.9 %, respectively. While in the control group, 26.9 % were myopic, 25 % were hyperopic, and 48.1 % were emmetropic. The prevalence of astigmatism in case group was 22.2 %, which was not significantly different from that in control group, (27.8 %, p = 0.346). Mean axial length in thalassemia patients was 22.89 ± 0.70 which was significantly lower than that in normal group (23.37 ± 0.91, p = 0.000). The flattest meridian of the cornea (R1) was significantly steeper in thalassemia patients (7.77 ± 0.24) in comparison to normal individuals (7.85 ± 0.28). Although thalassemic patients had significantly smaller axial length and vitreous chamber depth in comparison to normal group, which could be due to their abnormal physical growth, there was no significant difference between the mean of spherical equivalent among two groups. This can be due to their steeper corneal curvature that overcomes the refractive disadvantage of their shorter axial length.

  17. Trial Frame Refraction versus Autorefraction among New Patients in a Low-Vision Clinic

    PubMed Central

    DeCarlo, Dawn K.; McGwin, Gerald; Searcey, Karen; Gao, Liyan; Snow, Marsha; Waterbor, John; Owsley, Cynthia

    2013-01-01

    Purpose. To determine the relationship between refractive error as measured by autorefraction and that measured by trial frame refraction among a sample of adults with vision impairment seen in a university-based low-vision clinic and to determine if autorefraction might be a suitable replacement for trial frame refraction. Methods. A retrospective chart review of all new patients 19 years or older seen over an 18-month period was conducted and the following data collected: age, sex, primary ocular diagnosis, entering distance visual acuity, habitual correction, trial frame refraction, autorefraction, and distance visual acuity measured after trial frame refraction. Trial frame refraction and autorefraction were compared using paired t-tests, intraclass correlations, and Bland-Altman plots. Results. Final analyses included 440 patients for whom both trial frame refraction and autorefraction data were available for the better eye. Participants were mostly female (59%) with a mean age of 68 years (SD = 20). Age-related macular degeneration was the most common etiology for vision impairment (44%). Values for autorefraction and trial frame refraction were statistically different, but highly correlated for the spherical equivalent power (r = 0.92), the cylinder power (r = 0.80) and overall blurring strength (0.89). Although the values of the cross-cylinders J0 and J45 were similar, they were poorly correlated (0.08 and 0.15, respectively). The range of differences in spherical equivalent power was large (−8.6 to 4.9). Conclusions. Autorefraction is highly correlated with trial frame refraction. Differences are sometimes substantial, making autorefraction an unsuitable substitute for trial frame refraction. PMID:23188726

  18. Uncorrected and corrected refractive error experiences of Nepalese adults: a qualitative study.

    PubMed

    Kandel, Himal; Khadka, Jyoti; Shrestha, Mohan Krishna; Sharma, Sadhana; Neupane Kandel, Sandhya; Dhungana, Purushottam; Pradhan, Kishore; Nepal, Bhagavat P; Thapa, Suman; Pesudovs, Konrad

    2018-04-01

    The aim of this study was to explore the impact of corrected and uncorrected refractive error (URE) on Nepalese people's quality of life (QoL), and to compare the QoL status between refractive error subgroups. Participants were recruited from Tilganga Institute of Ophthalmology and Dhulikhel Hospital, Nepal. Semi-structured in-depth interviews were conducted with 101 people with refractive error. Thematic analysis was used with matrices produced to compare the occurrence of themes and categories across participants. Themes were identified using an inductive approach. Seven major themes emerged that determined refractive error-specific QoL: activity limitation, inconvenience, health concerns, psycho-social impact, economic impact, general and ocular comfort symptoms, and visual symptoms. Activity limitation, economic impact, and symptoms were the most important themes for the participants with URE, whereas inconvenience associated with wearing glasses was the most important issue in glasses wearers. Similarly, possibilities of having side effects or complications were the major concerns for participants wearing contact lens. In general, refractive surgery addressed socio-emotional impact of wearing glasses or contact lens. However, the surgery participants had concerns such as possibility of having to wear glasses again due to relapse of refractive error. Impact of refractive error on people's QoL is multifaceted. Significance of the identified themes varies by refractive error subgroups. Refractive correction may not always address QoL impact of URE but often add unique QoL issues. This study findings also provide content for developing an item-bank for quantitatively measuring refractive error-specific QoL in developing country setting.

  19. Trial frame refraction versus autorefraction among new patients in a low-vision clinic.

    PubMed

    DeCarlo, Dawn K; McGwin, Gerald; Searcey, Karen; Gao, Liyan; Snow, Marsha; Waterbor, John; Owsley, Cynthia

    2013-01-02

    To determine the relationship between refractive error as measured by autorefraction and that measured by trial frame refraction among a sample of adults with vision impairment seen in a university-based low-vision clinic and to determine if autorefraction might be a suitable replacement for trial frame refraction. A retrospective chart review of all new patients 19 years or older seen over an 18-month period was conducted and the following data collected: age, sex, primary ocular diagnosis, entering distance visual acuity, habitual correction, trial frame refraction, autorefraction, and distance visual acuity measured after trial frame refraction. Trial frame refraction and autorefraction were compared using paired t-tests, intraclass correlations, and Bland-Altman plots. Final analyses included 440 patients for whom both trial frame refraction and autorefraction data were available for the better eye. Participants were mostly female (59%) with a mean age of 68 years (SD = 20). Age-related macular degeneration was the most common etiology for vision impairment (44%). Values for autorefraction and trial frame refraction were statistically different, but highly correlated for the spherical equivalent power (r = 0.92), the cylinder power (r = 0.80) and overall blurring strength (0.89). Although the values of the cross-cylinders J(0) and J(45) were similar, they were poorly correlated (0.08 and 0.15, respectively). The range of differences in spherical equivalent power was large (-8.6 to 4.9). Autorefraction is highly correlated with trial frame refraction. Differences are sometimes substantial, making autorefraction an unsuitable substitute for trial frame refraction.

  20. Pre- and postoperative optical resolution of the cornea: a preliminary report

    NASA Astrophysics Data System (ADS)

    Parel, Jean-Marie A.; Simon, Gabriel; Rol, Pascal O.; Ren, Qiushi; Lee, William E.

    1993-06-01

    The effect of novel refractive surgical techniques on visual acuity and contrast sensitivity is normally determined by the outcome of human clinical trials. For example, ArF laser photorefractive keratoplasty follows an algorithm based on the patient's preoperative data for keratometry, refraction, pachometry, and ocular length all measured with ultrasound. A normalized ablation rate (which is function of the laser fluence), and the desired refractive correction are then used to calculate the ablation depth. On the day of surgery, the epithelium is mechanically removed and the bare cornea photoablated. Finally, the cornea may be medicated with a topical application of antibiotics and the eye is patched. On postoperative day 7, the epithelium is healed and visual acuity and keratometry are measured. With PRK, the theoretical outcome refraction should be within +/- 0.25 D. Thus far however, reproducibility is only of +/- 2 D. We believe the large discrepancy between theory and practice is due to several parameters that vary patient-to-patient.

  1. Refractive indices used by the Haag-Streit Lenstar to calculate axial biometric dimensions.

    PubMed

    Suheimat, Marwan; Verkicharla, Pavan K; Mallen, Edward A H; Rozema, Jos J; Atchison, David A

    2015-01-01

    To estimate refractive indices used by the Lenstar biometer to translate measured optical path lengths into geometrical path lengths within the eye. Axial lengths of model eyes were determined using the IOLMaster and Lenstar biometers; comparing those lengths gave an overall eye refractive index estimate for the Lenstar. Using the Lenstar Graphical User Interface, we noticed that boundaries between media could be manipulated and opposite changes in optical path lengths on either side of the boundary could be introduced. Those ratios were combined with the overall eye refractive index to estimate separate refractive indices. Furthermore, Haag-Streit provided us with a template to obtain 'air thicknesses' to compare with geometrical distances. The axial length estimates obtained using the IOLMaster and the Lenstar agreed to within 0.01 mm. Estimates of group refractive indices used in the Lenstar were 1.340, 1.341, 1.415, and 1.354 for cornea, aqueous, lens, and overall eye, respectively. Those refractive indices did not match those of schematic eyes, but were close in the cases of aqueous and lens. Linear equations relating air thicknesses to geometrical thicknesses were consistent with our findings. The Lenstar uses different refractive indices for different ocular media. Some of the refractive indices, such as that for the cornea, are not physiological; therefore, it is likely that the calibrations in the instrument correspond to instrument-specific corrections and are not the real optical path lengths. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

  2. Corneal biomechanical properties in different ocular conditions and new measurement techniques.

    PubMed

    Garcia-Porta, Nery; Fernandes, Paulo; Queiros, Antonio; Salgado-Borges, Jose; Parafita-Mato, Manuel; González-Méijome, Jose Manuel

    2014-01-01

    Several refractive and therapeutic treatments as well as several ocular or systemic diseases might induce changes in the mechanical resistance of the cornea. Furthermore, intraocular pressure measurement, one of the most used clinical tools, is also highly dependent on this characteristic. Corneal biomechanical properties can be measured now in the clinical setting with different instruments. In the present work, we review the potential role of the biomechanical properties of the cornea in different fields of ophthalmology and visual science in light of the definitions of the fundamental properties of matter and the results obtained from the different instruments available. The body of literature published so far provides an insight into how the corneal mechanical properties change in different sight-threatening ocular conditions and after different surgical procedures. The future in this field is very promising with several new technologies being applied to the analysis of the corneal biomechanical properties.

  3. Corneal Biomechanical Properties in Different Ocular Conditions and New Measurement Techniques

    PubMed Central

    Garcia-Porta, Nery; Salgado-Borges, Jose; Parafita-Mato, Manuel; González-Méijome, Jose Manuel

    2014-01-01

    Several refractive and therapeutic treatments as well as several ocular or systemic diseases might induce changes in the mechanical resistance of the cornea. Furthermore, intraocular pressure measurement, one of the most used clinical tools, is also highly dependent on this characteristic. Corneal biomechanical properties can be measured now in the clinical setting with different instruments. In the present work, we review the potential role of the biomechanical properties of the cornea in different fields of ophthalmology and visual science in light of the definitions of the fundamental properties of matter and the results obtained from the different instruments available. The body of literature published so far provides an insight into how the corneal mechanical properties change in different sight-threatening ocular conditions and after different surgical procedures. The future in this field is very promising with several new technologies being applied to the analysis of the corneal biomechanical properties. PMID:24729900

  4. Effect of Ramadan fasting in tropical summer months on ocular refractive and biometric characteristics.

    PubMed

    Nowroozzadeh, Mohammad Hosein; Mirhosseini, Amirhossein; Meshkibaf, Mohammad Hassan; Roshannejad, Javad

    2012-03-01

    Islamic Ramadan is the month of fasting, in which intake of food and drink is restricted from sunrise until sunset. The objective of the present study was to find out the effect of altered eating habits during Ramadan fasting on ocular refractive and biometric properties. In this prospective case series, 40 eyes of 22 healthy volunteers with a mean age of 60.55 ± 12.20 years were enrolled. Patients with any systemic disorder and eyes with pathology or previous surgery were excluded. One month before Ramadan (at 8.00 am), during Ramadan fasting (at 8.00 am and 4.00 pm) and one month later during the non-fasting period (at 8.00 am), ocular refractive and biometric characteristics were measured using an autokeratorefractometer (Auto-Kerato-Refractometer KR-8900; Topcon Co, Tokyo, Japan) and contact ultrasonic biometry (Nidek Echoscan US 800; Nidek Co, Tokyo, Japan). Anterior chamber depth was significantly increased during fasting compared with baseline measurements and returned to baseline one month after Ramadan (3.22 ± 0.07 mm and 4.33 ± 0.17 mm for non-fasting and fasting, respectively; p < 0.001). The anterior chamber depth measurements were significantly larger at 8.00 am during fasting compared with 4.00 pm (p = 0.01). Axial length was significantly decreased during fasting and returned to baseline one month after Ramadan (23.09 ± 0.14 mm and 22.65 ± 0.18 mm, for non-fasting and fasting, respectively; p < 0.001). Intraocular lens power calculations were significantly increased during fasting and returned to baseline one month after Ramadan (SRK-T formula: 21.46 ± 0.27 D and 22.92 ± 0.46 D, for non-fasting and fasting, respectively; p < 0.001). There were no significant differences in spherical equivalent, corneal astigmatism, mean keratometry and flatter and steeper corneal radii of curvature between time intervals. Ramadan fasting is associated with statistically significant alterations in anterior chamber depth and axial length that result in both statistically and clinically significant changes in intraocular lens power calculations. Therefore, relying on measurements taken during this month might lead to refractive errors after cataract surgery. © 2012 The Authors. Clinical and Experimental Optometry © 2012 Optometrists Association Australia.

  5. Responses of the Ocular Anterior Segment and Refraction to 0.5% Tropicamide in Chinese School-Aged Children of Myopia, Emmetropia, and Hyperopia.

    PubMed

    Yuan, Ying; Zhang, Zhengwei; Zhu, Jianfeng; He, Xiangui; Du, Ergang; Jiang, Kelimu; Zheng, Wenjing; Ke, Bilian

    2015-01-01

    Purpose. To investigate the changes of anterior segment after cycloplegia and estimate the association of such changes with the changes of refraction in Chinese school-aged children of myopia, emmetropia, and hyperopia. Methods. 309 children were recruited and eligible subjects were assigned to three groups: hyperopia, emmetropia, or myopia. Cycloplegia was achieved with five cycles of 0.5% tropicamide. The Pentacam system was used to measure the parameters of interest before and after cycloplegia. Results. In the myopic group, the lenses were thinner and the lens position was significantly more posterior than that of the emmetropic and hyperopic groups in the cycloplegic status. The correlations between refraction and lens thickness (age adjusted; r = 0.26, P < 0.01), and lens position (age adjusted; r = -0.31, P < 0.01) were found. After cycloplegia, ACD and ACV significantly increased, while ACA significantly decreased. Changes in refraction, ACD, ACV, and ACA were significantly different among the three groups (P < 0.05, all). Changes of refraction were correlated with changes of ACD (r = 0.41, P < 0.01). Conclusions. Myopia presented thinner lenses and smaller changes of anterior segment and refraction after cycloplegia when compared to emmetropia and hyperopia. Changes of anterior chamber depth were correlated with refraction changes. This may contribute to a better understanding of the relationship between anterior segment and myopia.

  6. Prevalence of refractive errors among school children in gondar town, northwest ethiopia.

    PubMed

    Yared, Assefa Wolde; Belaynew, Wasie Taye; Destaye, Shiferaw; Ayanaw, Tsegaw; Zelalem, Eshete

    2012-10-01

    Many children with poor vision due to refractive error remain undiagnosed and perform poorly in school. The situation is worse in the Sub-Saharan Africa, including Ethiopia, and current information is lacking. The objective of this study is to determine the prevalence of refractive error among children enrolled in elementary schools in Gondar town, Ethiopia. This was a cross-sectional study of 1852 students in 8 elementary schools. Subjects were selected by multistage random sampling. The study parameters were visual acuity (VA) evaluation and ocular examination. VA was measured by staff optometrists with the Snellen E-chart while students with subnormal vision were examined using pinhole, retinoscopy evaluation and subjective refraction by ophthalmologists. The study cohort was comprised of 45.8% males and 54.2% females from 8 randomly selected elementary schools with a response rate of 93%. Refractive errors in either eye were present in 174 (9.4%) children. Of these, myopia was diagnosed in 55 (31.6%) children in the right and left eyes followed by hyperopia in 46 (26.4%) and 39 (22.4%) in the right and left eyes respectively. Low myopia was the most common refractive error in 61 (49.2%) and 68 (50%) children for the right and left eyes respectively. Refractive error among children is a common problem in Gondar town and needs to be assessed at every health evaluation of school children for timely treatment.

  7. Surgical outcomes after application of a liquid adhesive ocular bandage to clear corneal incisions during cataract surgery.

    PubMed

    Uy, Harvey S; Kenyon, Kenneth R

    2013-11-01

    To compare the anatomic and refractive outcomes in eyes having phacoemulsification with 1 of 3 clear corneal incision (CCI) closure methods. Ambulatory surgical center, Makati, Philippines. Prospective randomized clinical trial. Patients having phacoemulsification cataract surgery had wound closure using no additional treatment (control), a single 10-0 nylon suture, or a liquid adhesive ocular bandage (Ocuseal). The main outcome measures were wound-edge closure rates, surgically induced astigmatism (SIA), foreign-body sensation, and intraocular pressure (IOP) 1, 3, 5, 7, and 14 days postoperatively. The study evaluated 90 eyes. There was a significant improvement in wound-edge closure rates in the suture group and the ocular bandage group compared with the control group (P<.001). A significant increase in SIA occurred in the sutured group but not in the control or ocular bandage groups (P<.001). The ocular bandage group had significantly less foreign-body sensation than the control and suture groups (P<.001). There were no significant differences in IOP between the groups (P=.515). The liquid adhesive ocular bandage resulted in improved wound-edge closure, reduced SIA, and diminished foreign-body sensation. Suturing was associated with improved wound-edge closure but increased SIA and foreign-body sensation. Unsutured incisions led to delayed wound-edge closure and increased foreign-body sensation. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Prevalence of amblyopia and patterns of refractive error in the amblyopic children of a tertiary eye care center of Nepal.

    PubMed

    Sapkota, K; Pirouzian, A; Matta, N S

    2013-01-01

    Refractive error is a common cause of amblyopia. To determine prevalence of amblyopia and the pattern and the types of refractive error in children with amblyopia in a tertiary eye hospital of Nepal. A retrospective chart review of children diagnosed with amblyopia in the Nepal Eye Hospital (NEH) from July 2006 to June 2011 was conducted. Children of age 13+ or who had any ocular pathology were excluded. Cycloplegic refraction and an ophthalmological examination was performed for all children. The pattern of refractive error and the association between types of refractive error and types of amblyopia were determined. Amblyopia was found in 0.7 % (440) of 62,633 children examined in NEH during this period. All the amblyopic eyes of the subjects had refractive error. Fifty-six percent (248) of the patients were male and the mean age was 7.74 ± 2.97 years. Anisometropia was the most common cause of amblyopia (p less than 0.001). One third (29 %) of the subjects had bilateral amblyopia due to high ametropia. Forty percent of eyes had severe amblyopia with visual acuity of 20/120 or worse. About twothirds (59.2 %) of the eyes had astigmatism. The prevalence of amblyopia in the Nepal Eye Hospital is 0.7%. Anisometropia is the most common cause of amblyopia. Astigmatism is the most common types of refractive error in amblyopic eyes. © NEPjOPH.

  9. The relationship between refractive and biometric changes during Edinger–Westphal stimulated accommodation in rhesus monkeys

    PubMed Central

    Vilupuru, Abhiram S.; Glasser, Adrian

    2010-01-01

    Experiments were undertaken to understand the relationship between dynamic accommodative refractive and biometric (lens thickness (LT), anterior chamber depth (ACD) and anterior segment length (ASL=ACD+LT)) changes during Edinger–Westphal stimulated accommodation in rhesus monkeys. Experiments were conducted on three rhesus monkeys (aged 11·5, 4·75 and 4·75 years) which had undergone prior, bilateral, complete iridectomies and implantation of a stimulating electrode in the Edinger–Westphal (EW) nucleus. Accommodative refractive responses were first measured dynamically with video-based infrared photorefraction and then ocular biometric responses were measured dynamically with continuous ultrasound biometry (CUB) during EW stimulation. The same stimulus amplitudes were used for the refractive and biometric measurements to allow them to be compared. Main sequence relationships (ratio of peak velocity to amplitude) were calculated. Dynamic accommodative refractive changes are linearly correlated with the biometric changes and accommodative biometric changes in ACD, ASL and LT show systematic linear correlations with increasing accommodative amplitudes. The relationships are relatively similar for the eyes of the different monkeys. Dynamic analysis showed that main sequence relationships for both biometry and refraction are linear. Although accommodative refractive changes in the eye occur primarily due to changes in lens surface curvature, the refractive changes are well correlated with A-scan measured accommodative biometric changes. Accommodative changes in ACD, LT and ASL are all well correlated over the full extent of the accommodative response. PMID:15721617

  10. Ocular wavefront aberration and refractive error in pre-school children

    NASA Astrophysics Data System (ADS)

    Thapa, Damber; Fleck, Andre; Lakshminarayanan, Vasudevan; Bobier, William R.

    2011-11-01

    Hartmann-Shack images taken from an archived collection of SureSight refractive measurements of pre-school children in Oxford County, Ontario, Canada were retrieved and re-analyzed. Higher-order aberrations were calculated over the age range of 3 to 6 years. These higher-order aberrations were compared with respect to magnitudes of ametropia. Subjects were classified as emmetropic (range -0.5 to + 0.5D), low hyperopic (+ 0.5 to +2D) and high hyperopic (+2D or more) based upon the resulting spherical equivalent. Higher-order aberrations were found to increase with higher levels of hyperopia (p < 0.01). The strongest effect was for children showing more than +2.00D of hyperopia. The correlation coefficients were small in all of the higher-order aberrations; however, they were significant (p < 0.01). These analyses indicate a weak association between refractive error and higher-order aberrations in pre-school children.

  11. Eye laterality: a comprehensive analysis in refractive surgery candidates.

    PubMed

    Linke, Stephan J; Druchkiv, Vasyl; Steinberg, Johannes; Richard, Gisbert; Katz, Toam

    2013-08-01

    To explore eye laterality (higher refractive error in one eye) and its association with refractive state, spherical/astigmatic anisometropia, age and sex in refractive surgery candidates. Medical records of 12 493 consecutive refractive surgery candidates were filtered. Refractive error (subjective and cycloplegic) was measured in each subject and correlated with eye laterality. Only subjects with corrected distance visual acuity (CDVA) of >20/22 in each eye were enrolled to exclude amblyopia. Associations between eye laterality and refractive state were analysed by means of t-test, chi-squared test, Spearman's correlation and multivariate logistic regression analysis, respectively. There was no statistically significant difference in spherical equivalent between right (-3.47 ± 2.76 D) and left eyes (-3.47 ± 2.76 D, p = 0.510; Pearson's r = 0.948, p < 0.001). Subgroup analysis revealed (I) right eye laterality for anisometropia >2.5 D in myopic (-5.64 ± 2.5 D versus -4.92 ± 2.6 D; p = 0.001) and in hyperopic (4.44 ± 1.69 D versus 3.04 ± 1.79 D; p = 0.025) subjects, (II) a tendency for left eye cylindrical laterality in myopic subjects, and (III) myopic male subjects had a higher prevalence of left eye laterality. (IV) Age did not show any significant impact on laterality. Over the full refractive spectrum, this study confirmed previously described strong interocular refractive correlation but revealed a statistically significant higher rate of right eye laterality for anisometropia >2.5 D. In general, our results support the use of data from one eye only in studies of ocular refraction. © 2013 The Authors. Acta Ophthalmologica © 2013 Acta Ophthalmologica Scandinavica Foundation.

  12. Refractive and corneal astigmatism in white school children in northern ireland.

    PubMed

    O'Donoghue, Lisa; Rudnicka, Alicja R; McClelland, Julie F; Logan, Nicola S; Owen, Christopher G; Saunders, Kathryn J

    2011-06-08

    To study the prevalence of and relation between refractive and corneal astigmatism in white school children in Northern Ireland and to describe the association between refractive astigmatism and refractive error. Stratified random clustering was used to recruit 1053 white children, 392 aged 6-7 years and 661 aged 12-13 years. Eye examinations included cycloplegic autorefraction and ocular biometric measures of axial length and corneal curvature. The prevalence of refractive astigmatism (≥ 1 DC) did not differ significantly between 6- to 7-year-old children (24%; 95% confidence interval [CI], 19-30) and 12- to 13-year-old children (20%; 95% CI, 14-25). The prevalence of corneal astigmatism (≥ 1 DC) also did not differ significantly between 6- to 7-year-old children (29%; 95% CI, 24-34) and 12- to 13-year-old children (25%; 95% CI, 21-28). While levels of refractive astigmatism and corneal astigmatism were similar, refractive astigmatism was predominantly oblique (76%; 95% CI, 67-85, of 6- to 7-year-olds; 59%; 95% CI, 48-70, of 12- to 13-year-olds), but corneal astigmatism was predominantly with-the-rule (80%; 95% CI, 72-87, of 6- to 7-year-olds; 82%; 95% CI, 74-90, of 12- to 13-year-olds). The prevalence of refractive astigmatism was associated with increasing myopia and hyperopia. This study is the first to provide robust population-based data on the prevalence of astigmatism in white school children in the United Kingdom. The prevalence of refractive astigmatism and corneal astigmatism is stable between 6 and 7 years and 12 and 13 years, although this finding would need to be confirmed by prospective studies. There is a high prevalence of refractive and corneal astigmatism which is associated with ametropia.

  13. Refractive aim and visual outcome after phacoemulsification: A 2-year review from a Tertiary Private Eye Hospital in Sub-Saharan Africa.

    PubMed

    Oderinlo, O; Hassan, A O; Oluyadi, F O; Ogunro, A O; Okonkwo, O N; Ulaikere, M O; Ashano, O

    2017-02-01

    To review the short-term visual outcome of phacoemulsification in adults with uncomplicated cataracts in Eye Foundation Hospital, Lagos, Nigeria. A retrospective review of records of patients that had phacoemulsification between January 2012 and December 2013 in Eye Foundation Hospital, Lagos, Nigeria, was done. Preoperative visual acuity, refractive aim, intraoperative complications, postoperative unaided, and best-corrected visual acuity at 1 and 3 months were analyzed. Only eyes of adults that had phacoemulsification for uncomplicated cataracts were included in the study, all pediatric cataracts and eyes with ocular comorbidities were excluded. Common ocular comorbidities excluded were corneal opacity/corneal scar, glaucoma, uveitis, pseudo exfoliation syndrome, moderate and severe nonproliferative diabetic retinopathy, macula edema, proliferative diabetic retinopathy, eye trauma, age-related macular degeneration, previous corneal surgery, glaucoma surgery, and previous or simultaneous vitreoretinal surgery. A total of 157 eyes of 119 patients who met the inclusion criteria were analyzed. There were 60 (50.4%) females and 59 (49.6%) males, with age range from 31 to 91 years and a mean of 65.3 ± 11.10 years. Only eyes with available data were analyzed at 1 and 3 months postoperatively. In 112 eyes (85.7%), the refractive aim was met, 21 eyes (14.3%) did not meet their refractive aim, 20 eyes (12.7%) were excluded, the refractive aim could not be determined from the records as surgeons did not specify, and in 4 eyes, the required information was missing from the case files. An unaided visual acuity of 6/18 and better was achieved in 134 eyes (85.4%) at 1 month and 126 eyes (85.9%) at 3 months whereas best-corrected vision of 6/18 and better was achieved by 145 eyes (92.4%) at 1 month and 146 eyes (98.0%) at 3 months. Surgical outcomes after phacoemulsification are comparable with international benchmarks for good outcomes, with 85.4% of eyes achieving within 1 D of spherical equivalent of the refractive aim, 92.4% and 98.0% of eyes also achieving best-corrected visual acuities of 6/18 and better at 1 and 3 postoperative months, respectively. Unaided vision of 6/18 and better was also achieved in 85.4% and 85.9% at 1 and 3 postoperative months, respectively.

  14. Ocular residual and corneal astigmatism in a clinical population of high school students.

    PubMed

    Chen, Zhao; Liu, Luoru; Pan, Chenglin; Li, Xiaoning; Pan, Lun; Lan, Weizhong; Yang, Zhikuan

    2018-01-01

    Total refractive astigmatism is usually the first consideration that guides the selection of contact lens type (e.g., spherical or toric), while the ocular source of the astigmatism is a second, but more important consideration, for the final clinical decision. This study was conducted to provide detailed data on this topic by evaluating astigmatic components in Chinese adolescents. Participants were recruited from healthy high school students undergoing an annual ocular examination at a local hospital. Total astigmatism (TA), corneal astigmatism (CA), and ocular residual astigmatism (ORA) were determined by a Hartmann-Shack wavefront analyzer system (KR-1W, Topcon) with the natural pupil. The axis relationship between CA and ORA was placed into three categories: on-axis, defined as an axis with a difference of 0 ± 10°; opposite-axis, a difference of 90 ± 10°; and the rest defined as oblique-axis. The study consisted of 1,466 students (57.84% girls, age: 16.49 ± 1.05 years). ORA was present in 83.97%, 66.64%, and 45.23% of participants, according to the various criteria for astigmatism (≥ 0.50 D, ≥ 0.75 D, and ≥ 1.00 D, respectively). While with-the-rule was the most common axis orientation for both TA (76.28%) and CA (89.94%), against-the-rule predominated in ORA (93.82%; χ2 = 1688.544, p < 0.001). Opposite-axis was the major type of axis difference (90.96%) of clinical significance (i.e., ≥ 1.00 D) between CA and ORA, which also prevailed in all levels of TA (range: 56.25-82.26%). ORA is common in high school students and usually demonstrates a compensation relationship with CA, which should be taken into consideration when determining the design of contact lenses to correct refractive error.

  15. Ocular residual and corneal astigmatism in a clinical population of high school students

    PubMed Central

    Liu, Luoru; Pan, Chenglin; Li, Xiaoning; Pan, Lun; Yang, Zhikuan

    2018-01-01

    Purpose Total refractive astigmatism is usually the first consideration that guides the selection of contact lens type (e.g., spherical or toric), while the ocular source of the astigmatism is a second, but more important consideration, for the final clinical decision. This study was conducted to provide detailed data on this topic by evaluating astigmatic components in Chinese adolescents. Methods Participants were recruited from healthy high school students undergoing an annual ocular examination at a local hospital. Total astigmatism (TA), corneal astigmatism (CA), and ocular residual astigmatism (ORA) were determined by a Hartmann-Shack wavefront analyzer system (KR-1W, Topcon) with the natural pupil. The axis relationship between CA and ORA was placed into three categories: on-axis, defined as an axis with a difference of 0 ± 10°; opposite-axis, a difference of 90 ± 10°; and the rest defined as oblique-axis. Results The study consisted of 1,466 students (57.84% girls, age: 16.49 ± 1.05 years). ORA was present in 83.97%, 66.64%, and 45.23% of participants, according to the various criteria for astigmatism (≥ 0.50 D, ≥ 0.75 D, and ≥ 1.00 D, respectively). While with-the-rule was the most common axis orientation for both TA (76.28%) and CA (89.94%), against-the-rule predominated in ORA (93.82%; χ2 = 1688.544, p < 0.001). Opposite-axis was the major type of axis difference (90.96%) of clinical significance (i.e., ≥ 1.00 D) between CA and ORA, which also prevailed in all levels of TA (range: 56.25–82.26%). Conclusions ORA is common in high school students and usually demonstrates a compensation relationship with CA, which should be taken into consideration when determining the design of contact lenses to correct refractive error. PMID:29630629

  16. Prevalence of refractive errors in Möbius sequence.

    PubMed

    Cronemberger, Monica Fialho; Polati, Mariza; Debert, Iara; Mendonça, Tomás Scalamandré; Souza-Dias, Carlos; Miller, Marilyn; Ventura, Liana Oliveira; Nakanami, Célia Regina; Goldchmit, Mauro

    2013-01-01

    To assess the prevalence of refractive errors in Möbius sequence. This study was carried out during the Annual Meeting of the Brazilian Möbius Society in November 2008. Forty-four patients diagnosed with the Möbius sequence were submitted to a comprehensive assessment, on the following specialties: ophthalmology, neurology, genetics, psychiatry, psychology and dentistry. Forty-three patients were cooperative and able to undertake the ophthalmological examination. Twenty-two (51.2 %) were male and 21 (48.8%) were female. The average age was 8.3 years (from 2 to 17 years). The visual acuity was evaluated using a retro-illuminated logMAR chart in cooperative patients. All children were submitted to exams on ocular motility, cyclopegic refraction, and fundus examination. From the total of 85 eyes, using the spherical equivalent, the major of the eyes (57.6%) were emmetropics (>-0.50 D and <+2.00 D). The prevalence of astigmatism greater than or equal to 0.75 D was 40%. The prevalence of refractive errors, by the spherical equivalent, was 42.4% in this studied group.

  17. Comparison between refraction measured by Spot Vision Screening™ and subjective clinical refractometry.

    PubMed

    de Jesus, Daniela Lima; Villela, Flávio Fernandes; Orlandin, Luis Fernando; Eiji, Fernando Naves; Dantas, Daniel Oliveira; Alves, Milton Ruiz

    2016-02-01

    The purpose of this study was to evaluate the accuracy of Spot Vision Screening™ as an autorefractor by comparing refraction measurements to subjective clinical refractometry results in children and adult patients. One-hundred and thirty-four eyes of 134 patients were submitted to refractometry by Spot and clinical refractometry under cycloplegia. Patients, students, physicians, staff and children of staff from the Hospital das Clínicas (School of Medicine, University of São Paulo) aged 7-50 years without signs of ocular disease were examined. Only right-eye refraction data were analyzed. The findings were converted in magnitude vectors for analysis. The difference between Spot Vision Screening™ and subjective clinical refractometry expressed in spherical equivalents was +0.66±0.56 diopters (D), +0.16±0.27 D for the vector projected on the 90 axis and +0.02±0.15 D for the oblique vector. Despite the statistical significance of the difference between the two methods, we consider the difference non-relevant in a clinical setting, supporting the use of Spot Vision Screening™ as an ancillary method for estimating refraction.

  18. Ethnic variations in myopia and ocular biometry among adults in a rural community in China: the Yunnan minority eye studies.

    PubMed

    Pan, Chen-Wei; Chen, Qin; Sheng, Xun; Li, Jun; Niu, Zhiqiang; Zhou, Hua; Wei, Tao; Yuan, Yuansheng; Zhong, Hua

    2015-05-01

    To determine the prevalence of myopia and ocular biometry in population-based samples of ethnic Yi and Han people living in an inland rural community in China. A random cluster sampling strategy was used to select ethnic Han and Yi adults aged 50 years or older living in Yunnan. Refractive error was determined by subjective refraction and ocular biometric parameters, including axial length (AL), anterior chamber depth (ACD), vitreous chamber depth (VCD), and lens thickness (LT), which were measured using an Echoscan. Adults of Yi ethnicity had lower prevalence of myopia (10.3% vs. 8.1%; P = 0.02) and high myopia (2.3% vs. 1.6%; P = 0.10) than their counterparts of Han ethnicity. The prevalence of myopia increased with age (P for trend < 0.05), whereas the mean AL did not differ significantly among age groups in both ethnic groups (both P for trend > 0.05). In multivariate analysis, time spent outdoors was associated with myopia (P = 0.003) and AL (P < 0.001) but not high myopia (P = 0.33). No interaction effect was detected between ethnicity and other risk factors on myopia (all P > 0.05). Adjustment for lens nuclear opacity score reduced the excess prevalence of myopia in Han ethnicity by 37.5%. There was little evidence showing that ethnic disparities existed in the prevalence and risk factors between the major and minor ethnic groups living in the same communities in rural China. The "cohort effect" on myopia observed in many other populations was not seen in this study.

  19. Photorefractive keratectomy in the cat eye: biological and optical outcomes.

    PubMed

    Nagy, Lana J; MacRae, Scott; Yoon, Geunyoung; Wyble, Matthew; Wang, Jianhua; Cox, Ian; Huxlin, Krystel R

    2007-06-01

    To quantify optical and biomechanical properties of the feline cornea before and after photorefractive keratectomy (PRK) and assess the relative contribution of different biological factors to refractive outcome. Department of Ophthalmology, University of Rochester, Rochester, New York, USA. Adult cats had 6.0 diopter (D) myopic or 4.0 D hyperopic PRK over 6.0 or 8.0 mm optical zones (OZ). Preoperative and postoperative wavefront aberrations were measured, as were intraocular pressure (IOP), corneal hysteresis, the corneal resistance factor, axial length, corneal thickness, and radii of curvature. Finally, postmortem immunohistochemistry for vimentin and alpha-smooth muscle actin was performed. Photorefractive keratectomy changed ocular defocus, increased higher-order aberrations, and induced myofibroblast differentiation in cats. However, the intended defocus corrections were only achieved with 8.0 mm OZs. Long-term flattening of the epithelial and stromal surfaces was noted after myopic, but not after hyperopic, PRK. The IOP was unaltered by PRK; however, corneal hysteresis and the corneal resistance factor decreased. Over the ensuing 6 months, ocular aberrations and the IOP remained stable, while central corneal thickness, corneal hysteresis, and the corneal resistance factor increased toward normal levels. Cat corneas exhibited optical, histological, and biomechanical reactions to PRK that resembled those previously described in humans, especially when the OZ size was normalized to the total corneal area. However, cats exhibited significant stromal regeneration, causing a return to preoperative corneal thickness, corneal hysteresis and the corneal resistance factor without significant regression of optical changes induced by the surgery. Thus, the principal effects of laser refractive surgery on ocular wavefront aberrations can be achieved despite clear interspecies differences in corneal biology.

  20. The use of contact lenses in low vision rehabilitation: optical and therapeutic applications.

    PubMed

    Vincent, Stephen J

    2017-09-01

    Ocular pathology that manifests at an early age has the potential to alter the vision-dependent emmetropisation mechanism, which co-ordinates ocular growth throughout childhood. The disruption of this feedback mechanism in children with congenital or early-onset visual impairment often results in the development of significant ametropia, including high levels of spherical refractive error, astigmatism and anisometropia. This review examines the use of contact lenses as a refractive correction, low vision aid and therapeutic intervention in the rehabilitation of patients with bilateral, irreversible visual loss due to congenital ocular disease. The advantages and disadvantages of the use of contact lenses for increased magnification (telescopes and microscopes) or field expansion (reverse telescopes) are discussed, along with the benefits and practical considerations for the correction of pathological high myopia. The historical and present use of therapeutic tinted contact lenses to reduce photosensitivity and nystagmus in achromatopsia, albinism and aniridia are also presented, including clinical considerations for the contact lens practitioner. In addition to the known optical benefits in comparison to spectacles for high levels of ametropia (an improved field of view for myopes and fewer inherent oblique aberrations), contact lenses may be of significant psycho-social benefit for patients with low vision, due to enhanced cosmesis and reduced conspicuity and potential related effects of improved self-esteem and peer acceptance. The contact lens correction of patients with congenital vision impairment can be challenging for both practitioner and patient but should be considered as a potential optical or therapeutic solution in modern low vision rehabilitation. © 2017 Optometry Australia.

  1. Photorefractive keratectomy in the cat eye: biological and optical outcomes

    PubMed Central

    Nagy, Lana J.; MacRae, Scott; Yoon, Geunyoung; Wyble, Matthew; Wang, Jianhua; Cox, Ian; Huxlin, Krystel R.

    2007-01-01

    PURPOSE To quantify optical and biomechanical properties of the feline cornea before and after photorefractive keratectomy (PRK) and assess the relative contribution of different biological factors to refractive outcome. SETTING Dept. Ophthalmology, University of Rochester, Rochester, New York, U.S.A. METHODS Adult cats underwent 6D myopic or 4D hyperopic PRK over 6 or 8mm optical zones (OZ). Pre- and post-operative wavefront aberrations were measured, along with intraocular pressure, corneal hysteresis (CH), corneal resistance factor (CRF), axial length, corneal thickness and radii of curvature. Finally, post-mortem imunohistochemistry for Vimentin and α-smooth muscle actin was performed. RESULTS PRK changed ocular defocus, increased higher order aberrations and induced myofibroblast differentiation in cats. However, the intended defocus corrections were only achieved with 8mm OZs. Long-term flattening of the epithelial and stromal surfaces was noted following myopic, but nor hyperopic PRKs. Feline intraocular pressure was unaltered by PRK, but CH and CRF decreased. Over the ensuing 6 months, ocular aberrations and intraocular pressure remained stable, while central corneal thickness, CH and CRF increased back towards normal levels. CONCLUSIONS Cat corneas exhibited optical, histological and biomechanical reactions to PRK that resembled those previously described in humans, especially when optical zone size was normalized to total corneal area. However, cats exhibited significant stromal regeneration, causing a return to pre-operative corneal thickness, CH and CRF without significant regression of optical changes induced by the surgery. Thus, the principal effects of laser refractive surgery on ocular wavefront aberrations can be achieved in spite of clear, inter-species differences in corneal biology. PMID:17531702

  2. Emmetropization and Eye Growth in Young Aphakic Chickens

    PubMed Central

    Ai, Likun; Li, Jing; Guan, Huan; Wildsoet, Christine F.

    2009-01-01

    Purpose To establish a chick model to investigate the trends of eye growth and emmetropization after early lensectomy for congenital cataract. Methods Four monocular treatments were applied: lens extraction (LX); sham surgery/-30 D lens; LX/+20 D lens; and LX/+30-D lens (nine per group). Lens powers were selected to slightly undercorrect or overcorrect the induced hyperopia in LX eyes and to induce comparable hyperopia in sham-surgery eyes. Refractive errors and axial ocular dimensions were measured over a 28-day period. External ocular dimensions were obtained when the eyes were enucleated on the last day. Results The growth patterns of experimental (Exp) eyes varied with the type of manipulation. All eyes experiencing hyperopia initially grew more than their fellow eyes and exhibited myopic shifts in refraction. The sham/-30 D lens group showed the greatest increase in optical axial length, followed by the LX group, and then the LX/+20 D lens group. The Exp eyes of the LX/+30 D lens group, which were initially slightly myopic, grew least, and showed a small hyperopic shift. Lensectomized eyes enlarged more equatorially than axially (i.e., oblate), irrespective of the optical treatment applied. Conclusions The refractive changes observed in young, aphakic eyes are consistent with compensation for the defocus experienced, and thus emmetropization. However, differences in the effects of lensectomy compared to those of sham surgery raise the possibility that the lens is a source of essential growth factors. Alterative optical and mechanical explanations are offered for the oblate shapes of aphakic eyes. PMID:18719085

  3. Macular Pigment Optical Density and Ocular Pulse Amplitude in Subjects with Different Axial Lengths and Refractive Errors.

    PubMed

    Czepita, Maciej; Karczewicz, Danuta; Safranow, Krzysztof; Czepita, Damian

    2015-06-13

    The purpose of our study was to: (1) investigate the macular pigment optical density (MPOD) and ocular pulse amplitude (OPA) in subjects with different axial lengths (AL) and refractive errors (RE); (2) determine if there is a correlation between MPOD and OPA; and (3) evaluate whether MPOD and OPA depend on intraocular pressure (IOP). This study included 140 eyes of 70 subjects - 17 men and 53 women, aged 18 to 29 years (mean: 22.5 years; SD=2.8). Every examined person underwent a thorough eye examination including: visual acuity, anterior segment and fundus examination, keratometry, auto-refractometry, and MPOD, OPA, AL, and IOP measurements. The obtained results were analyzed statistically using Statistica 10 software. P values of <0.05 were considered statistically significant. The following refractive errors were selected: emmetropia (34 eyes), hyperopia (18 eyes), low myopia (60 eyes), medium myopia (19 eyes), and high myopia (9 eyes). It has been established that the OPA increases with the rise in the spherical equivalents (SE) (Rs=+0.38, P<0.001), while the increase in AL correlates with the decrease of OPA (Rs=-0.40, P<0.001). The increase in IOP correlates with the rise in the OPA (Rs=+0.20, P<0.05). There were no significant correlations between IOP and SE or AL. (1) MPOD is not correlated with the OPA in subjects with different AL and RE; (2) OPA decreases with the rise of AL; (3) OPA decreases with the fall of the SE; and (4) OPA increases with the rise in IOP.

  4. Peripheral refraction and retinal contour in stable and progressive myopia.

    PubMed

    Faria-Ribeiro, Miguel; Queirós, António; Lopes-Ferreira, Daniela; Jorge, Jorge; González-Méijome, José Manuel

    2013-01-01

    To compare the patterns of relative peripheral astigmatic refraction (tangential and sagittal power errors) and eccentric eye length between progressing and stable young-adult myopes. Sixty-two right eyes of 62 white patients participated in the study, of which 30 were nonprogressing myopes (NP group) for the last 2 years and 32 were progressing myopes (P group). Groups were matched for mean spherical refraction, axial length, and age. Peripheral refraction and eye length were measured along the horizontal meridian up to 35 and 30 degrees of eccentricity, respectively. There were statistically significant differences between groups (p < 0.001) in the nasal retina for the astigmatic components of peripheral refraction. The P group presented a hyperopic relative sagittal focus at 35 degrees in the nasal retina of +1.00 ± 0.83 diopters, as per comparison with a myopic relative sagittal focus of -0.10 ± 0.98 diopters observed in the NP group (p < 0.001). Retinal contour in the P group had a steeper shape in the nasal region than that in the NP group (t test, p = 0.001). An inverse correlation was found (r = -0.775; p < 0.001) between retinal contour and peripheral refraction. Thus, steeper retinas presented a more hyperopic trend in the periphery. Stable and progressing myopes of matched age, axial length, and central refraction showed significantly different characteristics in their peripheral retinal shape and astigmatic components of tangential and sagittal power errors. The present findings may help explain the mechanisms that regulate ocular growth in humans.

  5. Hemiretinal form deprivation: evidence for local control of eye growth and refractive development in infant monkeys.

    PubMed

    Smith, Earl L; Huang, Juan; Hung, Li-Fang; Blasdel, Terry L; Humbird, Tammy L; Bockhorst, Kurt H

    2009-11-01

    To determine whether refractive development in primates is mediated by local retinal mechanisms, the authors examined the effects of hemiretinal form deprivation on ocular growth and the pattern of peripheral refractions in rhesus monkeys. Beginning at approximately 3 weeks of age, nine infant monkeys were reared wearing monocular diffuser lenses that eliminated form vision in the nasal field (nasal field diffuser [NFD]). Control data were obtained from the nontreated fellow eyes, 24 normal monkeys, and 19 monkeys treated with full-field diffusers. Refractive development was assessed by retinoscopy performed along the pupillary axis and at eccentricities of 15 degrees, 30 degrees, and 45 degrees. Central axial dimensions and eye shape were assessed by A-scan ultrasonography and magnetic resonance imaging, respectively. Hemiretinal form deprivation altered refractive development in a regionally selective manner, typically producing myopia in the treated hemifields. In particular, six of the NFD monkeys exhibited substantial amounts (-1.81 to -9.00 D) of relative myopia in the nasal field that were most obvious at the 15 degrees and 30 degrees nasal field eccentricities. The other three NFD monkeys exhibited small amounts of relative hyperopia in the treated field. The alterations in peripheral refraction were associated with local, region-specific alterations in vitreous chamber depth in the treated hemiretina. The effects of form deprivation on refractive development and eye growth in primates are mediated by mechanisms, presumably retinal, that integrate visual signals in a spatially restricted manner and exert their influence locally.

  6. Prevalence of Refractive Errors Among School Children in Gondar Town, Northwest Ethiopia

    PubMed Central

    Yared, Assefa Wolde; Belaynew, Wasie Taye; Destaye, Shiferaw; Ayanaw, Tsegaw; Zelalem, Eshete

    2012-01-01

    Purpose: Many children with poor vision due to refractive error remain undiagnosed and perform poorly in school. The situation is worse in the Sub-Saharan Africa, including Ethiopia, and current information is lacking. The objective of this study is to determine the prevalence of refractive error among children enrolled in elementary schools in Gondar town, Ethiopia. Materials and Methods: This was a cross-sectional study of 1852 students in 8 elementary schools. Subjects were selected by multistage random sampling. The study parameters were visual acuity (VA) evaluation and ocular examination. VA was measured by staff optometrists with the Snellen E-chart while students with subnormal vision were examined using pinhole, retinoscopy evaluation and subjective refraction by ophthalmologists. Results: The study cohort was comprised of 45.8% males and 54.2% females from 8 randomly selected elementary schools with a response rate of 93%. Refractive errors in either eye were present in 174 (9.4%) children. Of these, myopia was diagnosed in 55 (31.6%) children in the right and left eyes followed by hyperopia in 46 (26.4%) and 39 (22.4%) in the right and left eyes respectively. Low myopia was the most common refractive error in 61 (49.2%) and 68 (50%) children for the right and left eyes respectively. Conclusions: Refractive error among children is a common problem in Gondar town and needs to be assessed at every health evaluation of school children for timely treatment. PMID:23248538

  7. Study of Theories about Myopia Progression (STAMP) Design and Baseline Data

    PubMed Central

    Berntsen, David A.; Mutti, Donald O.; Zadnik, Karla

    2011-01-01

    Purpose The Study of Theories about Myopia Progression (STAMP) is a two-year, double-masked, randomized clinical trial of myopic children 6 to 11 years old. STAMP will evaluate the one-year effect of progressive addition lenses (PALs) compared to single vision lenses (SVLs) on central refraction, peripheral refraction in four quadrants, and accommodative response and convergence. STAMP will also evaluate any changes one year after discontinuing PALs. Baseline characteristics of enrolled children are reported. Methods Eligible children had a high accommodative lag and either: (1) low myopia (less myopic than −2.25 D spherical equivalent) or (2) high myopia (more myopic that −2.25 D spherical equivalent) and esophoria at near. Children were randomly assigned to wear either PALs or SVLs for one year to determine the difference in myopia progression in the PAL group relative to the SVL group. All children will then wear SVLs for the second year to evaluate the permanence of any treatment effect. Complete ocular biometric data are collected at six-month intervals. Results Over 17 months, 192 children were screened, and 85 (44%) were eligible and enrolled. Of these 85 children, 44 (52%) were female, and 54 (64%) were esophoric at near. The mean age (± SD) was 9.8 ± 1.3 years. The right eye mean cycloplegic spherical equivalent refractive error was −1.95 ± 0.78 D. Horizontal relative peripheral hyperopia (30° nasal retina +0.56 ± 0.59 D; 30° temporal retina +0.61 ± 0.77 D) and vertical relative peripheral myopia (30° superior retina −0.36 ± 0.92 D; 20° inferior retina −0.48 ± 0.83 D) were found. Conclusions The baseline data for STAMP are reported. Asymmetry between vertical and horizontal meridian relative peripheral refraction was found. STAMP will utilize the ocular biometric changes associated with the PAL-treatment effect to attempt to elucidate the mechanism responsible for the treatment effect. PMID:20935586

  8. Levodopa inhibits the development of form-deprivation myopia in guinea pigs.

    PubMed

    Mao, Junfeng; Liu, Shuangzhen; Qin, Wenjuan; Li, Fengyun; Wu, Xiaoying; Tan, Qian

    2010-01-01

    It has been shown that visual deprivation leads to a myopic refractive error and also reduces the retinal concentration of dopamine. Exogenously 3,4-dihydroxy-L-phenylalanine (levodopa, L-DOPA) can be converted into dopamine in vivo, which safely and effectively treats Parkinson disease. Moreover, L-DOPA was also used in the treatment of amblyopia in clinical studies. However, the effect of L-DOPA on the development of myopia has not been studied. The aim of this study was to investigate whether intraperitoneal injection of L-DOPA could inhibit form-deprivation myopia in guinea pigs and to explore a new strategy for drug treatment of myopia. Sixty guinea pigs, at age of 4 weeks, were randomly divided into six groups: normal control, L-DOPA group, saline group, deprived group, deprived plus L-DOPA group, and deprived plus saline group. Form deprivation was induced with translucent eye shields on the right eye and lasted for 10 days. L-DOPA was injected intraperitoneally into the guinea pig once a day. The corneal radius of curvature, refraction, and axial length were measured in all animals. Subsequently, retinal dopamine content was evaluated by high-performance liquid chromatography with electrochemical detection. Ten days of eye occlusion caused the form-deprived eyes to elongate and become myopic, and retinal dopamine content to decrease, but the corneal radius of curvature was not affected. Repeated intraperitoneal injection of L-DOPA could inhibit the myopic shift (from -3.62 +/- 0.98 D to -1.50 +/- 0.38 D; p < 0.001) due to goggles occluding and compensate retinal dopamine (from 0.65 +/- 0.10 ng to 1.33 +/- 0.23 ng; p < 0.001). Administration of L-DOPA to the unoccluded animals had no effect on its ocular refraction. There was no effect of intraperitoneal saline on the ocular refractive state and retinal dopamine. Systemic L-DOPA was partly effective in this guinea pig model and, therefore, is worth testing for effectiveness in progressing human myopes.

  9. Intraocular pressure change over a habitual 24-hour period after changing posture or drinking water and related factors in normal tension glaucoma.

    PubMed

    Sakata, Rei; Aihara, Makoto; Murata, Hiroshi; Saito, Hitomi; Iwase, Aiko; Yasuda, Noriko; Araie, Makoto

    2013-08-07

    We investigated the correlation between 24-hour IOP in the habitual (sitting during day and supine during night) position (H24h-IOP) and IOP after a postural-change test (PCT-IOP) and a water-drinking test (WDT-IOP). We also investigated ocular and systemic factors related with them in patients with normal tension glaucoma (NTG). Japanese NTG patients underwent H24h-IOP, PCT-IOP, and WDT-IOP measurements during a 24-hour period. Correlations among H24h-IOP, PCT-IOP, and WDT-IOP, and contributing ocular/systemic factors were investigated using regression analysis. There were 33 patients included. Peak H24h-IOP correlated positively with peak PCT-IOP and peak WDT-IOP (estimate = 0.422 and 0.419, P ≤ 0.010), and peak PCT-IOP with WDT-IOP (0.44, P = 0.002). Peak H24h-IOP correlated with refraction (0.36, P = 0.048) and negatively with the mean deviation (MD, -0.066, P = 0.031). MD and baseline IOP (the mean of H24h-IOP) correlated negatively with the H24h-IOP fluctuation (-0.058 and -0.58, P ≤ 0.050). Refraction, baseline IOP, mean blood pressure (mBP), and body mass index (BMI) correlated with peak PCT-IOP (0.23, 0.52, 0.097, and 0.32, respectively, P ≤ 0.038). PCT-IOP difference correlated with refraction and mBP (0.31 and 0.093, P ≤ 0.016) and negatively with age (-0.069, P = 0.003). Central corneal thickness, baseline IOP, age, and BMI correlated with peak WDT-IOP (0.030, 0.40, 0.088, and 0.26, P ≤ 0.050). Age and BMI correlated with WDT-IOP difference (0.086 and 0.20, P < 0.032). Positive correlation was found among the peaks of H24h-, PCT-, and WDT-IOP. A worse visual field was associated with higher peak and greater fluctuation of H24h-IOP in NTG. Several ocular/systemic factors were important in interpreting H24h-, PCT-, and WDT-IOP.

  10. Integration of Defocus by Dual Power Fresnel Lenses Inhibits Myopia in the Mammalian Eye

    PubMed Central

    McFadden, Sally A.; Tse, Dennis Y.; Bowrey, Hannah E.; Leotta, Amelia J.; Lam, Carly S.; Wildsoet, Christine F.; To, Chi-Ho

    2014-01-01

    Purpose. Eye growth compensates in opposite directions to single vision (SV) negative and positive lenses. We evaluated the response of the guinea pig eye to Fresnel-type lenses incorporating two different powers. Methods. A total of 114 guinea pigs (10 groups with 9–14 in each) wore a lens over one eye and interocular differences in refractive error and ocular dimensions were measured in each of three experiments. First, the effects of three Fresnel designs with various diopter (D) combinations (−5D/0D; +5D/0D or −5D/+5D dual power) were compared to three SV lenses (−5D, +5D, or 0D). Second, the ratio of −5D and +5D power in a Fresnel lens was varied (50:50 compared with 60:40). Third, myopia was induced by 4 days of exposure to a SV −5D lens, which was then exchanged for a Fresnel lens (−5D/+5D) or one of two SV lenses (+5D or −5D) and ocular parameters tracked for a further 3 weeks. Results. Dual power lenses induced an intermediate response between that to the two constituent powers (lenses +5D, +5D/0D, 0D, −5D/+5D, −5D/0D and −5D induced +2.1 D, +0.7 D, +0.1 D, −0.3 D, −1.6 D and −5.1 D in mean intraocular differences in refractive error, respectively), and changing the ratio of powers induced responses equal to their weighted average. In already myopic animals, continued treatment with SV negative lenses increased their myopia (from −3.3 D to −4.2 D), while switching to SV positive lenses or −5D/+5D Fresnel lenses reduced their myopia (by 2.9 D and 2.3 D, respectively). Conclusions. The mammalian eye integrates competing defocus to guide its refractive development and eye growth. Fresnel lenses, incorporating positive or plano power with negative power, can slow ocular growth, suggesting that such designs may control myopia progression in humans. PMID:24398103

  11. Integration of defocus by dual power Fresnel lenses inhibits myopia in the mammalian eye.

    PubMed

    McFadden, Sally A; Tse, Dennis Y; Bowrey, Hannah E; Leotta, Amelia J; Lam, Carly S; Wildsoet, Christine F; To, Chi-Ho

    2014-02-14

    Eye growth compensates in opposite directions to single vision (SV) negative and positive lenses. We evaluated the response of the guinea pig eye to Fresnel-type lenses incorporating two different powers. A total of 114 guinea pigs (10 groups with 9-14 in each) wore a lens over one eye and interocular differences in refractive error and ocular dimensions were measured in each of three experiments. First, the effects of three Fresnel designs with various diopter (D) combinations (-5D/0D; +5D/0D or -5D/+5D dual power) were compared to three SV lenses (-5D, +5D, or 0D). Second, the ratio of -5D and +5D power in a Fresnel lens was varied (50:50 compared with 60:40). Third, myopia was induced by 4 days of exposure to a SV -5D lens, which was then exchanged for a Fresnel lens (-5D/+5D) or one of two SV lenses (+5D or -5D) and ocular parameters tracked for a further 3 weeks. Dual power lenses induced an intermediate response between that to the two constituent powers (lenses +5D, +5D/0D, 0D, -5D/+5D, -5D/0D and -5D induced +2.1 D, +0.7 D, +0.1 D, -0.3 D, -1.6 D and -5.1 D in mean intraocular differences in refractive error, respectively), and changing the ratio of powers induced responses equal to their weighted average. In already myopic animals, continued treatment with SV negative lenses increased their myopia (from -3.3 D to -4.2 D), while switching to SV positive lenses or -5D/+5D Fresnel lenses reduced their myopia (by 2.9 D and 2.3 D, respectively). The mammalian eye integrates competing defocus to guide its refractive development and eye growth. Fresnel lenses, incorporating positive or plano power with negative power, can slow ocular growth, suggesting that such designs may control myopia progression in humans.

  12. Prevalence and association of refractive anisometropia with near work habits among young schoolchildren: The evidence from a population-based study

    PubMed Central

    Lee, Chia-Wei; Fang, Shao-You; Huang, Nicole; Hsu, Chih-Chien; Chen, Shing-Yi; Chiu, Allen Wen-Hsiang

    2017-01-01

    Background Lifestyle behaviour may play a role in refractive error among children, but the association between near work habits and refractive anisometropia remains unclear. Methods We estimated the prevalence of refractive anisometropia and examined its association with near work activities among 23,114 children in the Myopia Investigation Study in Taipei who were grade 2 elementary school students at baseline in 2013 and 2014. Baseline data on demographics, medical history, parental history and near work habits were collected by parent-administered questionnaire survey. Refractive status was determined by cycloplegic autorefraction. Refractive anisometropia was defined as the spherical equivalent difference ≥ 1.0 diopter between eyes. Results The prevalence of refractive anisometropia was 5.3% (95% confidence interval [CI], 5.0% to 5.6%). The prevalence and severity of refractive anisometropia increased with both myopic and hyperopic refractive error. Multivariate logistic regression analysis revealed that refractive anisometropia was significantly associated with myopia (odds ratio [OR], 2.98; 95% CI, 2.53–3.51), hyperopia (OR, 2.37; 95% CI, 1.98–2.83), degree of astigmatism (OR, 1.005; 95% CI, 1.005–1.006), amblyopia (OR, 2.54; 95% CI, 2.06–3.12), male gender (OR, 0.88; 95% CI, 0.78–0.99) and senior high school level of maternal education (OR, 0.69; 95% CI, 0.52–0.92). Though anisometropic children were more likely to spend more time on near work (crude OR, 1.15; 95% CI, 1.02–1.29) and to have less eye-to-object distance in doing near work (crude OR, 1.15; 95% CI, 1.01–1.30), these associations became insignificant after additional adjustment for ocular, demographic and parental factors. Conclusions The present study provides large-scale, population-based evidence showing no independent association between refractive anisometropia and near work habits, though myopia is associated with refractive anisometropia. PMID:28273153

  13. Prevalence and association of refractive anisometropia with near work habits among young schoolchildren: The evidence from a population-based study.

    PubMed

    Lee, Chia-Wei; Fang, Shao-You; Tsai, Der-Chong; Huang, Nicole; Hsu, Chih-Chien; Chen, Shing-Yi; Chiu, Allen Wen-Hsiang; Liu, Catherine Jui-Ling

    2017-01-01

    Lifestyle behaviour may play a role in refractive error among children, but the association between near work habits and refractive anisometropia remains unclear. We estimated the prevalence of refractive anisometropia and examined its association with near work activities among 23,114 children in the Myopia Investigation Study in Taipei who were grade 2 elementary school students at baseline in 2013 and 2014. Baseline data on demographics, medical history, parental history and near work habits were collected by parent-administered questionnaire survey. Refractive status was determined by cycloplegic autorefraction. Refractive anisometropia was defined as the spherical equivalent difference ≥ 1.0 diopter between eyes. The prevalence of refractive anisometropia was 5.3% (95% confidence interval [CI], 5.0% to 5.6%). The prevalence and severity of refractive anisometropia increased with both myopic and hyperopic refractive error. Multivariate logistic regression analysis revealed that refractive anisometropia was significantly associated with myopia (odds ratio [OR], 2.98; 95% CI, 2.53-3.51), hyperopia (OR, 2.37; 95% CI, 1.98-2.83), degree of astigmatism (OR, 1.005; 95% CI, 1.005-1.006), amblyopia (OR, 2.54; 95% CI, 2.06-3.12), male gender (OR, 0.88; 95% CI, 0.78-0.99) and senior high school level of maternal education (OR, 0.69; 95% CI, 0.52-0.92). Though anisometropic children were more likely to spend more time on near work (crude OR, 1.15; 95% CI, 1.02-1.29) and to have less eye-to-object distance in doing near work (crude OR, 1.15; 95% CI, 1.01-1.30), these associations became insignificant after additional adjustment for ocular, demographic and parental factors. The present study provides large-scale, population-based evidence showing no independent association between refractive anisometropia and near work habits, though myopia is associated with refractive anisometropia.

  14. Body height and ocular dimensions in the adult population in rural Central India. The Central India Eye and Medical Study.

    PubMed

    Nangia, Vinay; Jonas, Jost B; Matin, Arshia; Kulkarni, Maithili; Sinha, Ajit; Gupta, Rajesh

    2010-11-01

    To investigate associations between anthropomorphic parameters and ocular dimensions in a typical rural society untouched by the effects of urbanization. The Central India Eye and Medical Study performed in rural Central India included 4,711 participants aged 30 or more years. The participants underwent a detailed ophthalmic and medical examination. After controlling for age, gender, level of education, and body mass index (BMI), taller subjects were more likely to have larger eyes with a longer axial length (+0.23 mm for each 10 cm increase in height), lower corneal refractive power (-0.50 diopters for each 10 cm increase in height), deeper anterior chambers (+0.03 mm for each 10 cm increase in height), and longer vitreous cavity (+0.20 mm for each 10 cm increase in height). Central corneal thickness (P = 0.97) and lens thickness (P = 0.08) were not significantly associated with body height. After controlling for age, gender, level of education and height, subjects with a higher BMI had shorter globes (-0.02 mm for each unit increase in BMI), flatter corneas (-0.03 diopters for each unit increase in BMI) and thicker corneas (+0.49 μm for each unit increase in BMI), thicker lenses and longer vitreous cavities. Body height as compared with the BMI had a stronger influence on the ocular biometric data. After correcting for age, gender, level of education and axial length, for each increase in body height by 10 cm or for each increase in BMI by one unit, the refractive error significantly increased by 0.23 diopters (P < 0.001) and by 0.40 diopters (P < 0.001) respectively. In the rural population of Central India without urbanization-associated myopization, body height and size of the eye were associated with each other: taller subjects had larger eyes with a flatter cornea. An increase in body height per 10 cm was associated with an increase in anterior chamber depth by 1% and an increase in vitreous cavity length by 1%. Subjects with a higher body mass index had shorter eyes, flatter and thicker corneas, and thicker lenses. Taller subjects and subjects with a higher BMI were more hyperopic. Since the occurrence of some ocular diseases depends on eye size and refractive error, the results may be helpful for screening examinations and for elucidating pathogenic associations.

  15. Ocular Screening System

    NASA Technical Reports Server (NTRS)

    1987-01-01

    Used to detect eye problems in children through analysis of retinal reflexes, the system incorporates image processing techniques. VISISCREEN's photorefractor is basically a 35 millimeter camera with a telephoto lens and an electronic flash. By making a color photograph, the system can test the human eye for refractive error and obstruction in the cornea or lens. Ocular alignment problems are detected by imaging both eyes simultaneously. Electronic flash sends light into the eyes and the light is reflected from the retina back to the camera lens. Photorefractor analyzes the retinal reflexes generated by the subject's response to the flash and produces an image of the subject's eyes in which the pupils are variously colored. The nature of a defect, where such exists, is identifiable by atrained observer's visual examination.

  16. Photorefractor ocular screening system

    NASA Technical Reports Server (NTRS)

    Richardson, John R. (Inventor); Kerr, Joseph H. (Inventor)

    1987-01-01

    A method and apparatus for detecting human eye defects, particularly detection of refractive error is presented. Eye reflex is recorded on color film when the eyes are exposed to a flash of light. The photographs are compared with predetermined standards to detect eye defects. The base structure of the ocular screening system is a folding interconnect structure, comprising hinged sections. Attached to one end of the structure is a head positioning station which comprises vertical support, a head positioning bracket having one end attached to the top of the support, and two head positioning lamps to verify precise head positioning. At the opposite end of the interconnect structure is a camera station with camera, electronic flash unit, and blinking fixation lamp, for photographing the eyes of persons being evaluated.

  17. Relevance of Lipid-Based Products in the Management of Dry Eye Disease.

    PubMed

    Garrigue, Jean-Sébastien; Amrane, Mourad; Faure, Marie-Odile; Holopainen, Juha M; Tong, Louis

    2017-11-01

    Components of the ocular surface synergistically contribute to maintaining and protecting a smooth refractive layer to facilitate the optimal transmission of light. At the air-water interface, the tear film lipid layer (TFLL), a mixture of lipids and proteins, plays a key role in tear surface tension and is important for the physiological hydration of the ocular surface and for ocular homeostasis. Alterations in tear fluid rheology, differences in lipid composition, or downregulation of specific tear proteins are found in most types of ocular surface disease, including dry eye disease (DED). Artificial tears have long been a first line of treatment in DED and aim to replace or supplement tears. More recently, lipid-containing eye drops have been developed to more closely mimic the combination of aqueous and lipid layers of the TFLL. Over the last 2 decades, our understanding of the nature and importance of lipids in the tear film in health and disease has increased substantially. The aim of this article is to provide a brief overview of our current understanding of tear film properties and review the effectiveness of lipid-based products in the treatment of DED. Liposome lid sprays, emulsion eye drops, and other lipid-containing formulations are discussed.

  18. Correlation between ocular parameters and amplitude of accommodation

    PubMed Central

    Abraham, Lekha Mary; Kuriakose, Thomas; Sivanandam, Viswanathan; Venkatesan, Nithya; Thomas, Ravi; Muliyil, Jayaprakash

    2010-01-01

    Aim: To study the relationship between ocular parameters and amplitude of accommodation (AA) in the peri-presbyopic age group (35–50 years). Materials and Methods: Three hundred and sixteen right eyes of consecutive patients in the age group 35–50 years, who attended our outpatient clinic, were studied. Emmetropes, hypermetropes and myopes with best-corrected visual acuity of 20/20, J1 in both eyes were included. The AA was calculated by measuring the near point of accommodation. The axial length (AL), central anterior chamber depth (CACD) and lens thickness (LT) were also measured. Results: There was moderate correlation (Pearson’s correlation coefficient r = 0.56) between AL and AA as well as between CACD and AA (r = 0.53) in myopes in the age group 35–39 years. In the other age groups and the groups taken as a whole, there was no correlation. In hypermetropes and emmetropes, there was no correlation between AA and the above ocular parameters. No significant correlation existed between LT and AA across different age groups and refractive errors. Conclusion: There was no significant correlation between AA and ocular parameters like anterior chamber depth, AL and LT. PMID:20952831

  19. Inter-ethnic variation of ocular traits-design and methodology of comparison study among American Caucasians, American Chinese and mainland Chinese.

    PubMed

    Wang, Dan Dan; Huang, Guo Fu; He, Ming Guang; Wu, Ling Ling; Lin, Shan

    2011-03-01

    To summarize the design and methodology of a multi-center study. With the existed ethnic differences of glaucoma, this survey will explore the differences with regard to anterior and posterior ocular segment parameters between Caucasians and Chinese. In this study, four cohorts including American Caucasians and American Chinese from San Francisco, southern mainland Chinese from Guangzhou, and northern mainland Chinese from Beijing were prospectively enrolled for a series of eye examinations and tests from May 2008 to December 2010. A total of 120 subjects including 15 of each gender in each age decade from 40s to 70s were recruited for each group. Data of the following tests were collected: a questionnaire eliciting systemic and ocular disease history, blood pressure, presenting and best corrected visual acuity, auto-refraction, Goldmann applanation tonometry, gonioscopy, A-scan, anterior segment optical coherence tomography (ASOCT), ultrasound biomicroscopy (UBM), visual field (VF), Heidelberg retinal tomography (HRT), OCT for optic nerve, and digital fundus photography. this study will provide insights to the etiologies of glaucoma especially PACG through inter-ethnic comparisons of relevant ocular anatomic and functional parameters.

  20. Dopaminergic agonists that result in ocular growth inhibition also elicit transient increases in choroidal thickness in chicks

    PubMed Central

    Nickla, Debora L.; Totonelly, Kristen; Dhillon, Balprit

    2010-01-01

    The dopaminergic system has been implicated in ocular growth regulation in chicks and monkeys. In both, dopamine D2 agonists inhibit the development of myopia in response to form deprivation, and in chicks, to negative lenses as well. Because there is mounting evidence that the choroidal response to defocus plays a role in ocular growth regulation, we asked whether the effective agonists also elicit transient thickening of the choroid concomitant with the growth inhibition. Negative lenses mounted on velcro rings were worn on one eye starting at age 8-12 days. Intravitreal injections (20 μl; dose=10 nmole) of the agonist (dissolved in saline) or saline, were given through the superior temporal sclera using a 30G needle. Eyes were injected daily at noon, for 4 days, and the lenses immediately replaced. Agonists used were apomorphine (non-specific; n=17), quinpirole (D2; n=10), SKF-38393 (D1; n=9), and saline controls (n=22). For the antagonists, the same protocol was used, but on each day, the lenses were removed for 2 hours. Immediately prior to lens-removal, the antagonist was injected (20 μl; dose=5 nmole). Antagonists used were methylergonovine (non-specific; n=12), spiperone (D2; n=20), SCH-23390 (D1 n=6) and saline controls (n=27). Comparisons to saline (continuous lens wear) controls were from the agonist experiment. Axial dimensions were measured using high frequency A-scan ultrasonography at the start of lens wear, and on day 4 prior to the injections, and then again 3 hours later. Refractive errors were measured using a Hartinger's refractometer at the end of the experiment. Apomorphine and quinpirole inhibited the refractive response to the hyperopic defocus induced by the negative lenses (drug vs saline controls: -1.3 and 1.2 D vs -5.6 D; p<0.005 for both). This effect was axial: both drugs prevented the excessive ocular elongation (change in axial length: 233 and 205 μm vs 417 um; p<0.01 for both). Both drugs were also associated with a transient thickening of the choroid over 3 hours (41 and 32 um vs –1 um; p<0.01; p=0.059 respectively) that did not summate: choroids thinned significantly over the 4 day period in all lens-wearing eyes. Two daily hours of unrestricted vision during negative lens wear normally prevents the development of myopia. Spiperone and SCH-23390 inhibited the ameliorating effects of periods of vision on lens-induced refractive error (-2.9 and –2.8 D vs 0.6 D; p<0.0001), however, the effects on neither axial length nor choroidal thickness were significant. These data support a role for both D1 and D2 receptors in the ocular growth responses. PMID:20801115

  1. Single-lens stereovision system using a prism: position estimation of a multi-ocular prism.

    PubMed

    Cui, Xiaoyu; Lim, Kah Bin; Zhao, Yue; Kee, Wei Loon

    2014-05-01

    In this paper, a position estimation method using a prism-based single-lens stereovision system is proposed. A multifaced prism was considered as a single optical system composed of few refractive planes. A transformation matrix which relates the coordinates of an object point to its coordinates on the image plane through the refraction of the prism was derived based on geometrical optics. A mathematical model which is able to denote the position of an arbitrary faces prism with only seven parameters is introduced. This model further extends the application of the single-lens stereovision system using a prism to other areas. Experimentation results are presented to prove the effectiveness and robustness of our proposed model.

  2. Prevalence and pattern of refractive errors among primary school children in Al Hassa , Saudi Arabia.

    PubMed

    Al Wadaani, Fahd Abdullah; Amin, Tarek Tawfik; Ali, Ayub; Khan, Atuar Rahman

    2012-11-11

    Some 12.8 million in the age group 5-15 years are visually impaired from uncorrected or inadequately corrected refractive errors. In Saudi Arabia, the size of this public health problem is not well defined especially among primary schoolchildren. The purpose of this cross-sectional study was to assess the prevalence and pattern of refractive errors among primary school children in Al Hassa, Saudi Arabia.  A total of 2246 Saudi primary school children aged 6 to 14 years of both genders were selected using multistage sampling method form 30 primary schools located in the three different areas of Al Hassa. School children were interviewed to collect demographics and vision data using a special data collection form followed by screening for refractive errors by trained optometrists within the school premises using a standardized protocol. Assessment of visual acuity and ocular motility evaluation were carried out and cover-uncover test was performed. Children detected with defective vision were referred for further examination employing subjective refraction with auto refractometer and objective refraction using streak retinoscopy after 1% cyclopentolate. Of the screened school children (N=2002), the overall prevalence of refractive errors was 13.7% (n=274), higher among females (Odds ratio, OR=1.39, P=0.012) and significantly more among students of rural residence (OR=2.40, P=0.001). The prevalence of refractive errors was disproportionately more among those aged 12-14 years (OR=9.02, P=0.001). Only 9.4% of students with poor vision were wore spectacles for correction. Myopia was the most commonly encountered refractive error among both genders (65.7% of the total errors encountered). Uncorrected refractive errors affected a sizable portion of primary school children in Al Hassa, Saudi Arabia. Primary schoolchildren especially females, rural and older children represents high risk group for refractive errors for which the included children were unaware.

  3. Prevalence and Pattern of Refractive Errors among Primary School Children in Al Hassa, Saudi Arabia

    PubMed Central

    Wadaani, Fahd Abdullah Al; Amin, Tarek Tawfik; Ali, Ayub; Khan, Ataur Rahman

    2013-01-01

    Some 12.8 million in the age group 5–15 years are visually impaired from uncorrected or inadequately corrected refractive errors. In Saudi Arabia, the size of this public health problem is not well defined especially among primary schoolchildren. The purpose of this cross-sectional study was to assess the prevalence and pattern of refractive errors among primary school children in Al Hassa, Saudi Arabia. A total of 2246 Saudi primary school children aged 6 to 14 years of both genders were selected using multistage sampling method form 30 primary schools located in the three different areas of Al Hassa. School children were interviewed to collect demographics and vision data using a special data collection form followed by screening for refractive errors by trained optometrists within the school premises using a standardized protocol. Assessment of visual acuity and ocular motility evaluation were carried out and cover-uncover test was performed. Children detected with defective vision were referred for further examination employing subjective refraction with auto refractometer and objective refraction using streak retinoscopy after 1% cyclopentolate. Of the screened school children (N=2002), the overall prevalence of refractive errors was 13.7% (n=274), higher among females (Odds ratio, OR=1.39, P=0.012) and significantly more among students of rural residence (OR=2.40, P=0.001). The prevalence of refractive errors was disproportionately more among those aged 12-14 years (OR=9.02, P=0.001). Only 9.4% of students with poor vision were wore spectacles for correction. Myopia was the most commonly encountered refractive error among both genders (65.7% of the total errors encountered). Uncorrected refractive errors affected a sizable portion of primary school children in Al Hassa, Saudi Arabia. Primary schoolchildren especially females, rural and older children represents high risk group for refractive errors for which the included children were unaware. PMID:23283044

  4. Surveillance of Ocular Parameters and Visual Function in Bed Rest Subjects

    NASA Technical Reports Server (NTRS)

    Cromwell, Ronita L.

    2011-01-01

    Recent visual changes in astronauts have raised concern about ocular health during long duration spaceflight. Seven cases have been documented in astronauts who spent 6 months aboard the International Space Station. These astronauts were male ranging in age from 45 to 55 years old. All astronauts exhibited pre- to post flight refractive changes. Decreased intraocular pressure (IOP) post flight was observed in 3 cases. Fundoscopic exams revealed post flight findings of choroidal folds in 4 cases, optic disc edema in 5 cases and the presence of cotton wool spots in 3 cases. Optical coherence tomography (OCT) confirmed findings of choroidal folds and disc edema, and also documented retinal nerve fiber layer thickening (5 cases). Findings from MRI examinations showed posterior globe flattening (5 cases), optic nerve sheath distention (6 cases) and torturous optic nerves (2 cases). Of the 7 cases, intracranial pressure was measured on 4 astronauts. These 4 showed elevated ICP post-flight that remained elevated for as long as 19 months in one case. While the etiology remains unknown, hypotheses speculate that venous insufficiency or hypertension in the brain caused by cephalad fluid shifts during spaceflight are possible mechanisms for ocular changes seen in astronauts. Head-down tilt bed rest is a spaceflight analog that induces cephalad fluid shifts. This study is designed to provide ocular monitoring of bed rest subjects and determine whether clinically relevant changes are found. Ocular Changes

  5. Sources of Asthenopia in Navy Flight Simulators

    DTIC Science & Technology

    1988-04-25

    strain with problems of focusing (e.g., Donders, 1864), and hence with ametropia , e.g., myopia (near sightedness), hyperopia (far sightedness) and...characteristics of the target and its background 2. Ocular and oculomotor factors. a) uncorrected ametropia : hyperopia, myopia, astigma- tism, anisometropia b...pupil in ametropia . American Journal of Ophthalmology, 40, 4e1-485. Donders, F.C. (1864). On the anomalies of accommodation and refraction of the eye

  6. Gradient moduli lens models: how material properties and application of forces can affect deformation and distributions of stress

    NASA Astrophysics Data System (ADS)

    Wang, Kehao; Venetsanos, Demetrios; Wang, Jian; Pierscionek, Barbara K.

    2016-08-01

    The human lens provides one-third of the ocular focussing power and is responsible for altering focus over a range of distances. This ability, termed accommodation, defines the process by which the lens alters shape to increase or decrease ocular refractive power; this is mediated by the ciliary muscle through the zonule. This ability decreases with age such that around the sixth decade of life it is lost rendering the eye unable to focus on near objects. There are two opponent theories that provide an explanation for the mechanism of accommodation; definitive support for either of these requires investigation. This work aims to elucidate how material properties can affect accommodation using Finite Element models based on interferometric measurements of refractive index. Gradients of moduli are created in three models from representative lenses, aged 16, 35 and 48 years. Different forms of zonular attachments are studied to determine which may most closely mimic the physiological form by comparing stress and displacement fields with simulated shape changes to accommodation in living lenses. The results indicate that for models to mimic accommodation in living eyes, the anterior and posterior parts of the zonule need independent force directions. Choice of material properties affects which theory of accommodation is supported.

  7. Gradient moduli lens models: how material properties and application of forces can affect deformation and distributions of stress

    PubMed Central

    Wang, Kehao; Venetsanos, Demetrios; Wang, Jian; Pierscionek, Barbara K.

    2016-01-01

    The human lens provides one-third of the ocular focussing power and is responsible for altering focus over a range of distances. This ability, termed accommodation, defines the process by which the lens alters shape to increase or decrease ocular refractive power; this is mediated by the ciliary muscle through the zonule. This ability decreases with age such that around the sixth decade of life it is lost rendering the eye unable to focus on near objects. There are two opponent theories that provide an explanation for the mechanism of accommodation; definitive support for either of these requires investigation. This work aims to elucidate how material properties can affect accommodation using Finite Element models based on interferometric measurements of refractive index. Gradients of moduli are created in three models from representative lenses, aged 16, 35 and 48 years. Different forms of zonular attachments are studied to determine which may most closely mimic the physiological form by comparing stress and displacement fields with simulated shape changes to accommodation in living lenses. The results indicate that for models to mimic accommodation in living eyes, the anterior and posterior parts of the zonule need independent force directions. Choice of material properties affects which theory of accommodation is supported. PMID:27507665

  8. Impact of nuclear cataract density on postoperative refractive outcome: IOL Master versus ultrasound.

    PubMed

    Ueda, Tetsuo; Taketani, Futoshi; Ota, Takeo; Hara, Yoshiaki

    2007-01-01

    To evaluate the effect of cataract density on the postoperative refractive outcome. For 59 nuclear cataract eyes, the axial length was preoperatively measured by the IOL Master (Zeiss, Germany) and ultrasound (US; UD-6000, Tomey, Japan) and the cataract density by EAS-1000 (Nidek, Japan). The prediction error was used as evaluation of the accuracy of ocular biometry. There were significant differences between IOL Master and US in the mean error (0.24 +/- 0.63 vs. 0.69 +/- 0.64 dpt, p < 0.001) and the mean absolute error (0.57 +/- 0.36 vs. 0.79 +/- 0.53 dpt, p < 0.001). The cataract density was significantly correlated with the prediction error with IOL Master (r = 0.24, p = 0.03) and US (r = 0.29, p = 0.01). Measurements with the IOL Master are slightly affected by the cataract density due to the refractive index change, but its accuracy is less affected than US. (c) 2007 S. Karger AG, Basel.

  9. Early screening of an infant's visual system

    NASA Astrophysics Data System (ADS)

    Costa, Manuel F. M.; Jorge, Jorge M.

    1999-06-01

    It is of utmost importance to the development of the child's visual system that she perceives clear focused retinal images. Furthermore if the refractive problems are not corrected in due time amblyopia may occur--myopia and hyperopia can only cause important problems in the future when they are significantly large, however for the astigmatism (rather frequent in infants) and anisometropia the problems tend to be more stringent. The early evaluation of the visual status of human infants is thus of critical importance. Photorefraction is a convenient technique for this kind of subjects. Essentially a light beam is delivered into the eyes. It is refracted by the ocular media, strikes the retina, focusing or not, reflects off and is collected by a camera. The photorefraction setup we established using new technological breakthroughs on the fields of imaging devices, digital image processing and fiber optics, allows a fast noninvasive evaluation of children visual status (refractive errors, accommodation, strabismus, ...). Results of the visual screening of a group of risk' child descents of blinds or amblyopes will be presented.

  10. Delayed visual attention caused by high myopic refractive error.

    PubMed

    Winges, Kimberly M; Zarpellon, Ursula; Hou, Chuan; Good, William V

    2005-06-01

    Delayed visual maturation (DVM) is usually a retrospective diagnosis given to infants who are born with no or poor visually-directed behavior, despite normal acuity on objective testing, but who recover months later. This condition can be organized into several types based on associated neurodevelopmental or ocular findings, but the etiology of DVM is probably complex and involves multiple possible origins. Here we report two infants who presented with delayed visual maturation (attention). They were visually unresponsive at birth but were later found to have high myopic errors. Patient 1 had -4 D right eye, -5 D left eye. Patient 2 had -9 D o.u. Upon spectacle correction at 5 and 4 months, respectively, both infants immediately displayed visually-directed behavior, suggesting that a high refractive error was the cause of inattention in these patients. These findings could add to knowledge surrounding DVM and the diagnosis of apparently blind infants. Findings presented here also indicate the importance of prompt refractive error measurement in such cases.

  11. Stability of corneal topography and wavefront aberrations in young Singaporeans.

    PubMed

    Zhu, Mingxia; Collins, Michael J; Yeo, Anna C H

    2013-09-01

    The aim was to investigate the differences between and variations across time in corneal topography and ocular wavefront aberrations in young Singaporean myopes and emmetropes. We used a videokeratoscope and wavefront sensor to measure the ocular surface topography and wavefront aberrations of the total-eye optics in the morning, midday and late afternoon on two separate days. Topographic data were used to derive the corneal surface wavefront aberrations. Both the corneal and total wavefronts were analysed up to the fourth radial order of the Zernike polynomial expansion and were centred on the entrance pupil (5.0 mm). The participants included 12 young progressing myopes, 13 young stable myopes and 15 young age-matched emmetropes. For all subjects considered together, there were significant changes in some of the aberrations across the day, such as spherical aberration ( Z(4 0)) and vertical coma ( Z (3 - 1)) (repeated measures analysis of variance, p < 0.05). The magnitude of positive spherical aberration ( Z(4 0)) was significantly lower in the progressing myopic group than in the stable myopic (p = 0.04) and emmetropic (p = 0.02) groups. There were also significant interactions between refractive group and time of day for with and against-the-rule astigmatism ( Z(2 2)). Significantly lower fourth-order root mean square of ocular wavefront aberrations were found in the progressing myopic group compared with the stable myopes and emmetropes (p < 0.01). These differences and variations in the corneal and total aberrations may have significance for our understanding of refractive error development and for clinical applications requiring accurate wavefront measurements. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

  12. Guinea Pig Ciliary Muscle Development

    PubMed Central

    Pucker, Andrew D.; Carpenter, Ashley R.; McHugh, Kirk M.; Mutti, Donald O.

    2014-01-01

    Purpose The purpose of this study was to develop a method for quantifying guinea pig ciliary muscle volume (CMV) and to determine its relationship to age and ocular biometric measurements. Methods Six albino guinea pigs eyes were collected at each of five ages (n=30 eyes). Retinoscopy and photography were used to document refractive error, eye size, and eye shape. Serial sections through the excised eyes were made and then labeled with an α-smooth muscle actin antibody. The CM was then visualized with an Olympus BX51 microscope, reconstructed with Stereo Investigator (MBF Bioscience) and analyzed using Neurolucida Explorer (MBF Bioscience). Full (using all sections) and partial (using a subset of sections) reconstruction methods were used to determine CMV. Results There was no significant difference between the full and partial volume determination methods (P = 0.86). The mean CMV of the 1, 10, 20, 30, and 90-day old eyes was 0.40 ± 0.16 mm3, 0.48 ± 0.13 mm3, 0.67 ± 0.15 mm3, 0.86 ± 0.35 mm3, and 1.09 ± 0.63 mm3, respectively. CMV was significantly correlated with log age (P = 0.001), ocular length (P = 0.003), limbal circumference (P = 0.01), and equatorial diameter (P = 0.003). It was not correlated with refractive error (P = 0.73) or eye shape (P = 0.60). Multivariate regression determined that biometric variables were not significantly associated with CMV after adjustment for age. Conclusions Three-dimensional reconstruction was an effective means of determining CMV. These data provide evidence that CM growth occurs with age in tandem with eye size in normal albino guinea pigs. Additional work is needed to determine the relationship between CMV and abnormal ocular growth. PMID:24901488

  13. Association of disease-specific causes of visual impairment and 10-year mortality amongst Indigenous Australians: the Central Australian Ocular Health Study.

    PubMed

    Estevez, José; Kaidonis, Georgia; Henderson, Tim; Craig, Jamie E; Landers, John

    2018-01-01

    Visual impairment significantly impairs the length and quality of life, but little is known of its impact in Indigenous Australians. To investigate the association of disease-specific causes of visual impairment with all-cause mortality. A retrospective cohort analysis. A total of 1347 Indigenous Australians aged over 40 years. Participants visiting remote medical clinics underwent clinical examinations including visual acuity, subjective refraction and slit-lamp examination of the anterior and posterior segments. The major ocular cause of visual impairment was determined. Patients were assessed periodically in these remote clinics for the succeeding 10 years after recruitment. Mortality rates were obtained from relevant departments. All-cause 10-year mortality and its association with disease-specific causes of visual impairment. The all-cause mortality rate for the entire cohort was 29.3% at the 10-year completion of follow-up. Of those with visual impairment, the overall mortality rate was 44.9%. The mortality rates differed for those with visual impairment due to cataract (59.8%), diabetic retinopathy (48.4%), trachoma (46.6%), 'other' (36.2%) and refractive error (33.4%) (P < 0.0001). Only those with visual impairment from diabetic retinopathy were any more likely to die during the 10 years of follow-up when compared with those without visual impairment (HR 1.70; 95% CI, 1.00-2.87; P = 0.049). Visual impairment was associated with all-cause mortality in a cohort of Indigenous Australians. However, diabetic retinopathy was the only ocular disease that significantly increased the risk of mortality. Visual impairment secondary to diabetic retinopathy may be an important predictor of mortality. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  14. Visual outcome of cataract surgery; study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery.

    PubMed

    Lundström, Mats; Barry, Peter; Henry, Ype; Rosen, Paul; Stenevi, Ulf

    2013-05-01

    To analyze the visual outcome after cataract surgery. Cataract surgery clinics in 15 European countries. Database study. Data were drawn from case series of cataract extractions reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery database. These data were entered into the database via the Web by surgeons or by transfer from existing national registries or electronic medical record systems. The database contains individual anonymous data on preoperative, intraoperative, and postoperative measurements. Data on 368,256 cataract extractions were available for analysis. The best visual outcome was achieved in age groups 40 to 74 years, and men showed a higher percentage of excellent vision (1.0 [20/20] or better) than women. A corrected distance visual acuity (CDVA) of 0.5 (20/40) or better and of 1.0 (20/20) or better was achieved in 94.3% and 61.3% of cases, respectively. Ocular comorbidity and postoperative complications were the strongest influences on the visual outcome; however, surgical complications and ocular changes requiring complex surgery also had a negative influence. Deterioration of visual acuity after the surgery (n= 6112 [1.7% of all cases]) was most common in patients with a good preoperative visual acuity. The visual outcomes of cataract surgery were excellent, with 61.3% of patients achieving a corrected distance visual acuity of 1.0 (20/20) or better. Age and sex influenced the visual outcomes, but the greatest influences were short-term postoperative complications, ocular comorbidity, surgical complications, and complex surgery. A weakness of the study could be that some of the data is self-reported to the registry. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. Longitudinal study of iris concavity, corneal biomechanics, and correlations to ocular biometry in a cohort of 10- to 12-year-old UK schoolboys: 2-year follow-up data.

    PubMed

    Shah, Ameet; Lascaratos, Gerassimos; Garway-Heath, David F; Foster, Paul J; Barton, Keith

    2014-06-10

    To explore changes in iris curvature over a 2-year period. To investigate associations between iris curvature and ocular biometric parameters. To explore relationships between a number of nonocular measurements and ocular biometric parameters. Schoolboys enrolled 2 years previously were invited to return for anterior segment optical coherence tomography, corneal hysteresis (CH), corneal resistance factor (CRF), and axial biometric measurements. Refractive error was assessed and measures of height, weight, waist circumference, digit ratio, and percentage body fat taken. Mean spherical equivalent refraction reduced by 0.76 diopters and mean iris concavity, defined as a measurement of less than or equal to -0.1 mm, increased by 0.018 mm at distance fixation and 0.04 mm on accommodation. Compared with 2 years previously, the prevalence of iris concavity increased from 24% to 32% on distance fixation and from 65% to 84% on accommodation. Variables significantly associated with nonaccommodating iris curvature were anterior chamber depth (ACD, P = 0.029) and mean scleral spur angle (P = 0.0001). Variables significantly associated with accommodating iris curvature were ACD (P = 0.02), lens vault (P = 0.047), and scleral spur angle (P < 0.0001). Significant association was again found between CH and accommodating spur-to-spur distance (R(2) = 0.13, P = 0.007). Iris concavity was more prevalent in this cohort of schoolboys than 2 years earlier. The degree of concavity remains related to ACD and lens vault. The association between spur-to-spur distance and CH was similar at baseline and after 2 years. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  16. Ocular Risk Factors for Age-related Macular Degeneration: The Los Angeles Latino Eye Study (LALES)

    PubMed Central

    Fraser-Bell, Samantha; Choudhury, Farzana; Klein, Ronald; Azen, Stanley; Varma, Rohit

    2010-01-01

    Purpose To assess the association of ocular factors and age-related macular degeneration (AMD) in Latinos. Design Population-based, cross-sectional study of 6357 self-identified Latinos aged 40 years and older. Methods Ophthalmic examination included subjective refraction, measurement of axial length, evaluation of iris color, Lens Opacities Classification System II (LOCS II) grading of cataracts, and stereoscopic macular photographs for AMD lesions. Generalized estimating equation analysis incorporated data from both eyes to estimate odds ratios adjusted for covariates. Results After controlling for confounders (age, gender and smoking), prior cataract surgery was associated with advanced AMD (OR: 2.8, 95% CI 1.0, 7.8), increased retinal pigment (OR: 1.6, 95% CI 1.0, 1.5) and retinal pigment epithelial depigmentation (OR: 2.2, 95% CI 1.1, 4.4). The presence of any lens opacity was associated with soft drusen (OR: 1.2; 95% CI 1.0, 1.5). Longer axial length (per mm) was associated with a decreased odds of soft drusen, increased retinal pigment, and geographic atrophy (GA) (ORs: 0.8 [95% CI 0.7, 0.9], 0.8 [95% CI 0.7, 0.9], 0.7 [95% CI 0.5, 0.9], respectively. Myopia was inversely associated with soft drusen (OR: 0.8; 95% CI 0.7, 1.0). Lighter colored irises were associated with GA (OR: 5.0; 95% CI 1.0, 25.3). Conclusions Cross-sectional associations of ocular factors such as cataract, cataract surgery, and refractive errors with early AMD lesions found in Latinos were consistent with those in whites. Additionally, prior cataract surgery was associated with advanced AMD. PMID:20138605

  17. Mesopic pupil size in a refractive surgery population (13,959 eyes).

    PubMed

    Linke, Stephan J; Baviera, Julio; Munzer, Gur; Fricke, Otto H; Richard, Gisbert; Katz, Toam

    2012-08-01

    To evaluate factors that may affect mesopic pupil size in refractive surgery candidates. Medical records of 13,959 eyes of 13,959 refractive surgery candidates were reviewed, and one eye per subject was selected randomly for statistical analysis. Detailed ophthalmological examination data were obtained from medical records. Preoperative measurements included uncorrected distance visual acuity, corrected distance visual acuity, manifest and cycloplegic refraction, topography, slit lamp examination, and funduscopy. Mesopic pupil size measurements were performed with Colvard pupillometer. Relationship between mesopic pupil size and age, gender, refractive state, average keratometry, and pachymetry (thinnest point) were analyzed by means of ANOVA (+ANCOVA) and multivariate regression analyses. Overall mesopic pupil size was 6.45 ± 0.82 mm, and mean age was 36.07 years. Mesopic pupil size was 5.96 ± 0.8 mm in hyperopic astigmatism, 6.36 ± 0.83 mm in high astigmatism, and 6.51 ± 0.8 mm in myopic astigmatism. The difference in mesopic pupil size between all refractive subgroups was statistically significant (p < 0.001). Age revealed the strongest correlation (r = -0.405, p < 0.001) with mesopic pupil size. Spherical equivalent showed a moderate correlation (r = -0.136), whereas keratometry (r = -0.064) and pachymetry (r = -0.057) had a weak correlation with mesopic pupil size. No statistically significant difference in mesopic pupil size was noted regarding gender and ocular side. The sum of all analyzed factors (age, refractive state, keratometry, and pachymetry) can only predict the expected pupil size in <20% (R = 0.179, p < 0.001). Our analysis confirmed that age and refractive state are determinative factors on mesopic pupil size. Average keratometry and minimal pachymetry exhibited a statistically significant, but clinically insignificant, impact on mesopic pupil size.

  18. Five-year change in refraction and its ocular components in the 40- to 64-year-old population of the Shahroud eye cohort study.

    PubMed

    Hashemi, Hassan; Khabazkhoob, Mehdi; Iribarren, Rafael; Emamian, Mohammad Hassan; Fotouhi, Akbar

    2016-11-01

    To assess 5-year refractive changes and their related factors in the 40- to 64-year-old population of Shahroud, Iran. Prospective cohort study. Of the 5190 participants of Phase I, 4737 participated in Phase II (response rate = 91.3%). Participants were tested by refraction, visual acuity, slit-lamp biomicroscopy, ophthalmoscopy and biometry. Myopia was defined as a spherical equivalent more negative than -0.5 dioptre (D) and hyperopia as a spherical equivalent more positive than +0.5 D. Mean 5-year change in spherical equivalent refraction. The mean 5-year change in spherical equivalent refraction was +0.24 D (95% CI: +0.22 to +0.25). After 5 years, 4.77% (95% CI: 4.08 to 5.46) of subjects developed at least 0.5 D of myopia and 22.27% (95% CI: 20.97 to 23.57) developed at least 0.5 D of hyperopia. Five-year changes in refraction included a hyperopic shift in all age groups. The greatest hyperopic shift was seen in middle-aged women. The greatest loss of lens power was observed in hyperopic women and the least in myopic men. Nuclear cataract was associated with a myopic shift in refraction. The axial length and the corneal power had very small changes during this period. Myopes showed the greatest increase in axial length. Corneal power increased by a very small amount in all refractive groups. The most important biometric index related to hyperopic shifts, which were greater in magnitude in women, was loss of lens power, whereas nuclear cataract was associated with myopic shifts. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  19. Comparison of the visual and intraocular optical performance of a refractive multifocal IOL with rotational asymmetry and an apodized diffractive multifocal IOL.

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José

    2012-02-01

    To compare the visual outcomes and intraocular optical quality observed postoperatively in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL) and an apodized diffractive multifocal IOL. Seventy-four consecutive eyes of 40 cataract patients (age range: 36 to 79 years) were divided into two groups: zonal refractive group, 39 eyes implanted with a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 IOL, Oculentis GmbH); and diffractive group, 35 eyes implanted with an apodized diffractive multifocal IOL (ReSTOR SN6AD3, Alcon Laboratories Inc). Distance and near visual acuity outcomes, contrast sensitivity, intraocular optical quality, and defocus curves were evaluated during 3-month follow-up. Calculation of the intraocular aberrations was performed by subtracting corneal aberrations from total ocular aberrations. Uncorrected near visual acuity and distance-corrected near visual acuity were better in the diffractive group than in the zonal refractive group (P=.01), whereas intermediate visual acuity (defocus +1.00 and +1.50 diopters) was better in the zonal refractive group. Photopic contrast sensitivity was significantly better in the zonal refractive group (P=.04). Wavefront aberrations (total, higher order, tilt, primary coma) were significantly higher in the zonal refractive group than in the diffractive group (P=.02). Both multifocal IOLs are able to successfully restore visual function after cataract surgery. The zonal refractive multifocal IOL provides better results in contrast sensitivity and intermediate vision, whereas the diffractive multifocal IOL provides better near vision at a closer distance. Copyright 2012, SLACK Incorporated.

  20. Prevalence of refractive errors in children in Equatorial Guinea.

    PubMed

    Soler, Margarita; Anera, Rosario G; Castro, José J; Jiménez, Raimundo; Jiménez, José R

    2015-01-01

    The aim of this work is to evaluate the epidemiological aspects of the refractive errors in school-aged children in Malabo (Island of Bioko), Equatorial Guinea (western-central Africa). A total of 425 schoolchildren (209 male subjects and 216 female subjects, aged between 6 and 16 years) were examined to evaluate their refraction errors in Malabo, Equatorial Guinea (western-central Africa). The examination included autorefraction with cycloplegia, measurement of visual acuity (VA) for far vision, and the curvature radii of the main meridians of the anterior surface of the cornea. A low prevalence of myopia was found (≤-0.50 diopters [D] spherical equivalent), with unilateral and bilateral myopia being 10.4 and 5.2%, respectively. The prevalence of unilateral and bilateral hypermetropia (≥2.0 D spherical equivalent) was 3.1 and 1.6%, respectively. Astigmatism (≤-0.75 D) was found in unilateral form in 32.5% of these children, whereas bilateral astigmatism was found in 11.8%. After excluding children having any ocular pathology, the low prevalence of high refractive errors signified good VA in these children. Significant differences were found in the distribution of the refractive errors by age and type of schooling (public or private) but not by sex. In general, the radii of the anterior of the cornea did not vary significantly with age. The mean refractive errors found were low and therefore VA was high in these children. There was a low prevalence of myopia, with significantly higher values in those who attended private schools (educationally and socioeconomically more demanding). Astigmatism was the most frequent refractive error.

  1. Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh.

    PubMed

    Lindfield, R; Kuper, H; Polack, S; Eusebio, C; Mathenge, W; Wadud, Z; Rashid, A M; Foster, A

    2009-07-01

    To assess the change in vision following cataract surgery in Kenya, Bangladesh and the Philippines and to identify causes and predictors of poor outcome. Cases were identified through surveys, outreach and clinics. They underwent preoperative visual acuity measurement and ophthalmic examination. Cases were re-examined 8-15 months after cataract surgery. Information on age, gender, poverty and literacy was collected at baseline. 452 eyes of 346 people underwent surgery. 124 (27%) eyes had an adverse outcome. In Kenya and the Philippines, the main cause of adverse outcome was refractive error (37% and 49% respectively of all adverse outcomes) then comorbid ocular disease (26% and 27%). In Bangladesh, this was comorbid disease (58%) then surgical complications (21%). There was no significant association between adverse outcome and gender, age, literacy, poverty or preoperative visual acuity. Adverse outcomes following cataract surgery were frequent in the three countries. Main causes were refractive error and preoperative comorbidities. Many patients are not attaining the outcomes available with modern surgery. Focus should be on correcting refractive error, through operative techniques or postoperative refraction, and on a system for assessing comorbidities and communicating risk to patients. These are only achievable with a commitment to ongoing surgical audit.

  2. Comparison between refraction measured by Spot Vision ScreeningTM and subjective clinical refractometry

    PubMed Central

    de Jesus, Daniela Lima; Villela, Flávio Fernandes; Orlandin, Luis Fernando; Eiji, Fernando Naves; Dantas, Daniel Oliveira; Alves, Milton Ruiz

    2016-01-01

    OBJECTIVE: The purpose of this study was to evaluate the accuracy of Spot Vision ScreeningTM as an autorefractor by comparing refraction measurements to subjective clinical refractometry results in children and adult patients. METHODS: One-hundred and thirty-four eyes of 134 patients were submitted to refractometry by Spot and clinical refractometry under cycloplegia. Patients, students, physicians, staff and children of staff from the Hospital das Clínicas (School of Medicine, University of São Paulo) aged 7-50 years without signs of ocular disease were examined. Only right-eye refraction data were analyzed. The findings were converted in magnitude vectors for analysis. RESULTS: The difference between Spot Vision ScreeningTM and subjective clinical refractometry expressed in spherical equivalents was +0.66±0.56 diopters (D), +0.16±0.27 D for the vector projected on the 90 axis and +0.02±0.15 D for the oblique vector. CONCLUSIONS: Despite the statistical significance of the difference between the two methods, we consider the difference non-relevant in a clinical setting, supporting the use of Spot Vision ScreeningTM as an ancillary method for estimating refraction. PMID:26934234

  3. The prevalence and risk factors of visual impairment among the elderly in Eastern Taiwan.

    PubMed

    Wang, Wen-Li; Chen, Nancy; Sheu, Min-Muh; Wang, Jen-Hung; Hsu, Wen-Lin; Hu, Yih-Jin

    2016-09-01

    Visual impairment is associated with disability and poor quality of life. This study aimed to investigate the prevalence and associated risk factors of visual impairment among the suburban elderly in Eastern Taiwan. The cross-sectional research was conducted from April 2012 to August 2012. The ocular condition examination took place in suburban areas of Hualien County. Medical records from local infirmaries and questionnaires were utilized to collect demographic data and systemic disease status. Logistic regression models were used for the simultaneous analysis of the association between the prevalence of visual impairment and risk factors. Six hundred and eighty-one residents participated in this project. The mean age of the participants was 71.4±7.3 years. The prevalence of vision impairment (better eye<6/18) was 11.0%. Refractive error and cataract were the main causes of vision impairment. Logistic regression analysis showed that people aged 65-75 years had a 3.8 times higher risk of developing visual impairment (p=0.021), while the odds ratio of people aged > 75 years was 10.0 (p<0.001). In addition, patients with diabetic retinopathy had a 3.7 times higher risk of developing visual impairment (p=0.002), while the odds ratio of refractive error was 0.36 (p<0.001). The prevalence of visual impairment was relatively high compared with previous studies. Diabetic retinopathy was an important risk factor of visual impairment; by contrast, refractive error was beneficial to resist visual impairment. Therefore, regular screening of ocular condition and early intervention might aid in the prevention of avoidable vision loss. Copyright © 2016. Published by Elsevier Taiwan.

  4. Single-step transepithelial photorefractive keratectomy in myopia and astigmatism: 18-month follow-up.

    PubMed

    Adib-Moghaddam, Soheil; Soleyman-Jahi, Saeed; Salmanian, Bahram; Omidvari, Amir-Houshang; Adili-Aghdam, Fatemeh; Noorizadeh, Farsad; Eslani, Medi

    2016-11-01

    To evaluate the long-term quantitative and qualitative optical outcomes of 1-step transepithelial photorefractive keratectomy (PRK) to correct myopia and astigmatism. Bina Eye Hospital, Tehran, Iran. Prospective interventional case series. Eyes with myopia with or without astigmatism were evaluated. One-step transepithelial PRK was performed with an aberration-free aspheric optimized profile and the Amaris 500 laser. Eighteen-month follow-up results for refraction, visual acuities, vector analysis, higher-order aberrations, contrast sensitivity, postoperative pain, and haze grade were assessed. The study enrolled 146 eyes (74 patients). At the end of follow-up, 93.84% of eyes had an uncorrected distance visual acuity of 20/20 or better and 97.94% of eyes were within ±0.5 diopter of the targeted spherical refraction. On vector analysis, the mean correction index value was close to 1 and the mean index of success and magnitude of error values were close to 0. The achieved correction vector was on an axis counterclockwise to the axis of the intended correction. Photopic and mesopic contrast sensitivities and ocular and corneal spherical, cylindrical, and corneal coma aberrations significantly improved (all P < .001). A slight amount of trefoil aberration was induced (P < .001, ocular aberration; P < .01, corneal aberration). No eye lost more than 1 line of corrected distance visual acuity. No eye had a haze grade of 2+ degrees or higher throughout the follow-up. Eighteen-month results indicate the efficacy and safety of transepithelial PRK to correct myopia and astigmatism. It improved refraction and quality of vision. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. Different roles of retinal dopamine in albino Guinea pig myopia.

    PubMed

    Mao, Junfeng; Liu, Shuangzhen

    2017-02-03

    To investigate whether the different role of ocular dopamine was involved in the myopic development between spontaneous myopia (SM) and form deprivation myopia (FDM) in albino guinea pigs. 55 myopic animals were randomly divided into SM, Levodapa (L-DOPA), L-DOPA+carbidopa and vehicle. 70 non-myopic animals were randomly divided into normal control, FDM, L-DOPA+FDM, L-DOPA+carbidopa+FDM and vehicle. Once per day, for 14days, L-DOPA (10mg/kg) was injected intraperitoneally, and carbidopa (1μg) was injected at the same time into the peribulbar space of the right eye. Refractive parameters and dopamine content in neural retina and RPE/choroid complex were measured. In SM animals, high myopia was formed at 5 week of ages. L-DOPA treatment could reduce its myopic degree, and inhibit the increase of axial length and vitreous chamber depth with the increase of retinal dopamine in both eyes. Administration of carbidopa could prevent the increase of retinal dopamine induced by L-DOPA, but no influenced on its refractive state in the injected eyes. In non-SM animals, intraperitoneal L-DOPA could inhibit FDM, accompanied by the increase of retinal dopamine. Carbidopa treatment diminished the inhibition of FDM and prevented the increase in retinal dopamine by L-Dopa. Retinal dopamine was highly correlated with ocular refraction in FDM, but not in SM. There was no significant difference in dopamine content of RPE/choroid complex among all groups. The role of retinal dopamine was different between SM and FDM in albino guinea pigs. Although systemic L-DOPA could inhibit the development of SM and FDM, retinal dopamine was only involved in the L-DOPA inhibition on FDM, but not on SM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. The Montrachet Study: study design, methodology and analysis of visual acuity and refractive errors in an elderly population.

    PubMed

    Creuzot-Garcher, Catherine; Binquet, Christine; Daniel, Sandrine; Bretillon, Lionel; Acar, Nyiazi; de Lazzer, Aurélie; Arnould, Laurent; Tzourio, Christophe; Bron, Alain M; Delcourt, Cécile

    2016-03-01

    To describe the design of the Montrachet Study (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases) and to report visual acuity and refractive errors in this elderly population. Participants were recruited in Dijon (France), from the ongoing population-based 3C Study. In 2009-2011, 1153 participants from the 3 Cities Study, aged 75 years or more, had an initial eye examination and were scheduled for eye examinations. The eye examination comprised visual acuity, refraction, visual field, ocular surface assessment, photographs and OCT of the macula and the optic disc, measurement of intra-ocular pressure, central corneal thickness and macular pigment assessment. Information on cardiovascular and neurologic diseases and a large comprehensive database (blood samples, genetic testing, cognitive tests, MRI) were available from the 3C Study. Presenting visual acuity <20/60 in the better eye was found in 2.3% (95% CI 1.5-3.2) of the participants with no gender differences. Visual impairment increased with age from 1.5% (95% CI 0.3-2.7) for those aged 75-79 years to 5.6% (95% CI 2.9-8.4) for patients 85 years and older (p = 0.0003). Spherical equivalent did not differ between men and women (p = 0.8) and decreased with age whatever the lens status. Despite the high prevalence of self-reported eye diseases in this elderly population, visual impairment was low and increased with age. The Montrachet Study may help to better estimate the prevalence of eye diseases in people over 75 years of age and to seek associations with cardiovascular and neurologic diseases and their potential risk factors. © 2015 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

  7. The Tehran Eye Study: research design and eye examination protocol

    PubMed Central

    Hashemi, Hassan; Fotouhi, Akbar; Mohammad, Kazem

    2003-01-01

    Background Visual impairment has a profound impact on society. The majority of visually impaired people live in developing countries, and since most disorders leading to visual impairment are preventable or curable, their control is a priority in these countries. Considering the complicated epidemiology of visual impairment and the wide variety of factors involved, region specific intervention strategies are required for every community. Therefore, providing appropriate data is one of the first steps in these communities, as it is in Iran. The objectives of this study are to describe the prevalence and causes of visual impairment in the population of Tehran city; the prevalence of refractive errors, lens opacity, ocular hypertension, and color blindness in this population, and also the familial aggregation of refractive errors, lens opacity, ocular hypertension, and color blindness within the study sample. Methods Design Through a population-based, cross-sectional study, a total of 5300 Tehran citizens will be selected from 160 clusters using a stratified cluster random sampling strategy. The eligible people will be enumerated through a door-to-door household survey in the selected clusters and will be invited. All participants will be transferred to a clinic for measurements of uncorrected, best corrected and presenting visual acuity; manifest, subjective and cycloplegic refraction; color vision test; Goldmann applanation tonometry; examination of the external eye, anterior segment, media, and fundus; and an interview about demographic characteristics and history of eye diseases, eye trauma, diabetes mellitus, high blood pressure, and ophthalmologic cares. The study design and eye examination protocol are described. Conclusion We expect that findings from the TES will show the status of visual problems and their causes in the community. This study can highlight the people who should be targeted by visual impairment prevention programs. PMID:12859794

  8. The Tehran Eye Study: research design and eye examination protocol.

    PubMed

    Hashemi, Hassan; Fotouhi, Akbar; Mohammad, Kazem

    2003-07-15

    Visual impairment has a profound impact on society. The majority of visually impaired people live in developing countries, and since most disorders leading to visual impairment are preventable or curable, their control is a priority in these countries. Considering the complicated epidemiology of visual impairment and the wide variety of factors involved, region specific intervention strategies are required for every community. Therefore, providing appropriate data is one of the first steps in these communities, as it is in Iran. The objectives of this study are to describe the prevalence and causes of visual impairment in the population of Tehran city; the prevalence of refractive errors, lens opacity, ocular hypertension, and color blindness in this population, and also the familial aggregation of refractive errors, lens opacity, ocular hypertension, and color blindness within the study sample. Through a population-based, cross-sectional study, a total of 5300 Tehran citizens will be selected from 160 clusters using a stratified cluster random sampling strategy. The eligible people will be enumerated through a door-to-door household survey in the selected clusters and will be invited. All participants will be transferred to a clinic for measurements of uncorrected, best corrected and presenting visual acuity; manifest, subjective and cycloplegic refraction; color vision test; Goldmann applanation tonometry; examination of the external eye, anterior segment, media, and fundus; and an interview about demographic characteristics and history of eye diseases, eye trauma, diabetes mellitus, high blood pressure, and ophthalmologic cares. The study design and eye examination protocol are described. We expect that findings from the TES will show the status of visual problems and their causes in the community. This study can highlight the people who should be targeted by visual impairment prevention programs.

  9. Postoperative ocular higher-order aberrations and contrast sensitivity: femtosecond lenticule extraction versus pseudo small-incision lenticule extraction.

    PubMed

    Tan, Deborah K L; Tay, Wan Ting; Chan, Cordelia; Tan, Donald T H; Mehta, Jodhbir S

    2015-03-01

    To evaluate and compare changes in contrast sensitivity and ocular higher-order aberrations (HOAs) after femtosecond lenticule extraction (FLEx) and pseudo small-incision lenticule extraction (SMILE). Singapore National Eye Centre, Singapore. Retrospective case series. Patients had femtosecond lenticule extraction (Group 1) or pseudo small-incision lenticule extraction (Group 2) between March 2010 and December 2011. The main outcome measures were manifest refraction, HOAs, and contrast sensitivity 1, 3, 6, and 12 months postoperatively. Fifty-two consecutive patients (102 eyes) were recruited, 21 patients (42 eyes) in Group 1 and the 31 patients (60 eyes) in Group 2. The uncorrected and corrected distance visual acuities were significantly better in Group 2 than in Group 1 at 12 months (P = .032). There was no significant increase in 3rd- or 4th-order aberrations at 1 year and no significant difference between the 2 groups preoperatively or postoperatively. At 1 year, there was a significant increase in mesopic contrast sensitivity in Group 2 at 1.5 cycles per degree (cpd) (P = .008) that was not found in Group 1, and photopic contrast sensitivity at 6.0 cpd was higher in Group 2 (P = .027). These results indicate that refractive lenticule extraction is safe and effective with no significant induction of HOAs or deterioration in contrast sensitivity at 1 year. Induction of HOAs was not significantly different between both variants of refractive lenticule extraction. However, there was significant improvement in photopic contrast sensitivity after pseudo small-incision lenticule extraction, which persisted through 1 year. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. Opposite Effects of Glucagon and Insulin on Compensation for Spectacle Lenses in Chicks

    PubMed Central

    Zhu, Xiaoying; Wallman, Josh

    2009-01-01

    Purpose Chick eyes compensate for defocus imposed by positive or negative spectacle lenses. Glucagon may signal the sign of defocus. Do insulin (or IGF-1) and glucagon act oppositely in controlling eye growth, as they do in metabolic pathways and in control of retinal neurogenesis? Methods Chicks, wearing either lenses or diffusers or neither over both eyes, were injected with glucagon, a glucagon antagonist, insulin, or IGF-1 in one eye (saline in other eye). Alternatively, chicks without lenses received insulin plus glucagon in one eye, and either glucagon or insulin in the fellow eye. Ocular dimensions, refractive errors and glycosaminoglycan synthesis were measured over 2-4 days. Results Glucagon attenuated the myopic response to negative lenses or diffusers by slowing ocular elongation and thickening the choroid; in contrast, with positive lenses, it increased ocular elongation to normal levels and reduced choroidal thickening, as did a glucagon antagonist. Insulin prevented the hyperopic response to positive lenses by speeding ocular elongation and thinning the choroid. In eyes without lenses, both insulin and IGF-1 speeded, and glucagon slowed, ocular elongation, but either glucagon or insulin increased the rate of thickening of the crystalline lens. When injected together, insulin blocked choroidal thickening by glucagon, at a dose that did not, by itself, thin the choroid. Conclusions Glucagon and insulin (or IGF-1) cause generally opposite modulations of eye-growth, with glucagon mostly increasing choroidal thickness and insulin mostly increasing ocular elongation. These effects are mutually inhibitory and depend on the visual input. PMID:18791176

  11. Accommodation and the Visual Regulation of Refractive State in Marmosets

    PubMed Central

    Troilo, David; Totonelly, Kristen; Harb, Elise

    2009-01-01

    Purpose To determine the effects of imposed anisometropic retinal defocus on accommodation, ocular growth, and refractive state changes in marmosets. Methods Marmosets were raised with extended-wear soft contact lenses for an average duration of 10 wks beginning at an average age of 76 d. Experimental animals wore either a positive or negative contact lens over one eye and a plano lens or no lens over the other. Another group wore binocular lenses of equal magnitude but opposite sign. Untreated marmosets served as controls and three wore plano lenses monocularly. Cycloplegic refractive state, corneal curvature, and vitreous chamber depth were measured before, during, and after the period of lens wear. To investigate the accommodative response, the effective refractive state was measured through each anisometropic condition at varying accommodative stimuli positions using an infrared refractometer. Results Eye growth and refractive state are significantly correlated with the sign and power of the contact lens worn. The eyes of marmosets reared with monocular negative power lenses had longer vitreous chambers and were myopic relative to contralateral control eyes (p<0.01). Monocular positive power lenses produced a significant reduction in vitreous chamber depth and hyperopia relative to the contralateral control eyes (p<0.05). In marmosets reared binocularly with lenses of opposite sign, we found larger interocular differences in vitreous chamber depths and refractive state (p<0.001). Accommodation influences the defocus experienced through the lenses, however, the mean effective refractive state was still hyperopia in the negative-lens-treated eyes and myopia in the positive-lens-treated eyes. Conclusions Imposed anisometropia effectively alters marmoset eye growth and refractive state to compensate for the imposed defocus. The response to imposed hyperopia is larger and faster than the response to imposed myopia. The pattern of accommodation under imposed anisometropia produces effective refractive states that are consistent with the changes in eye growth and refractive state observed. PMID:19104464

  12. Effects of Optically Imposed Astigmatism on Early Eye Growth in Chicks

    PubMed Central

    Chu, Chin Hung Geoffrey; Kee, Chea Su

    2015-01-01

    Purpose To determine the effects of optically imposed astigmatism on early eye growth in chicks. Methods 5-day-old (P5) White Leghorn chicks were randomly assigned to either wear, monocularly, a “high magnitude” (H: +4.00DS/-8.00DC) crossed-cylindrical lens oriented at one of four axes (45, 90, 135, and 180; n = 20 in each group), or were left untreated (controls; n = 8). Two additional groups wore a “low magnitude” (L: +2.00DS/−4.00DC) cylindrical lens orientated at either axis 90 or 180 (n = 20 and n = 18, respectively). Refractions were measured at P5 and after 7 days of treatment for all chicks (P12), whereas videokeratography and ex-vivo eyeshape analysis were performed at P12 for a subset of chicks in each group (n = 8). Results Compared to controls, chicks in the treatment groups developed significant amounts of refractive astigmatism (controls: 0.03±0.22DC; treatment groups: 1.34±0.22DC to 5.51±0.26DC, one-way ANOVAs, p≤0.05) with axes compensatory to those imposed by the cylindrical lenses. H cylindrical lenses induced more refractive astigmatism than L lenses (H90 vs. L90: 5.51±0.26D vs. 4.10±0.16D; H180 vs. L180: 2.84±0.44D vs. 1.34±0.22D, unpaired two-sample t-tests, both p≤0.01); and imposing with-the-rule (H90 and L90) and against-the-rule astigmatisms (H180 and L180) resulted in, respectively, steeper and flatter corneal shape. Both corneal and internal astigmatisms were moderately to strongly correlated with refractive astigmatisms (Pearson’s r: +0.61 to +0.94, all p≤0.001). In addition, the characteristics of astigmatism were significantly correlated with multiple eyeshape parameters at the posterior segments (Pearson’s r: -0.27 to +0.45, all p≤0.05). Conclusions Chicks showed compensatory ocular changes in response to the astigmatic magnitudes imposed in this study. The correlations of changes in refractive, corneal, and posterior eyeshape indicate the involvement of anterior and posterior ocular segments during the development of astigmatism. PMID:25675443

  13. Relevance of Lipid-Based Products in the Management of Dry Eye Disease

    PubMed Central

    Amrane, Mourad; Faure, Marie-Odile; Holopainen, Juha M.; Tong, Louis

    2017-01-01

    Abstract Components of the ocular surface synergistically contribute to maintaining and protecting a smooth refractive layer to facilitate the optimal transmission of light. At the air–water interface, the tear film lipid layer (TFLL), a mixture of lipids and proteins, plays a key role in tear surface tension and is important for the physiological hydration of the ocular surface and for ocular homeostasis. Alterations in tear fluid rheology, differences in lipid composition, or downregulation of specific tear proteins are found in most types of ocular surface disease, including dry eye disease (DED). Artificial tears have long been a first line of treatment in DED and aim to replace or supplement tears. More recently, lipid-containing eye drops have been developed to more closely mimic the combination of aqueous and lipid layers of the TFLL. Over the last 2 decades, our understanding of the nature and importance of lipids in the tear film in health and disease has increased substantially. The aim of this article is to provide a brief overview of our current understanding of tear film properties and review the effectiveness of lipid-based products in the treatment of DED. Liposome lid sprays, emulsion eye drops, and other lipid-containing formulations are discussed. PMID:28956698

  14. Perspectives of using the 223-nm wavelength of the KrCl excimer laser for refractive surgery and for the treatment of some eye diseases

    NASA Astrophysics Data System (ADS)

    Bagayev, Sergei N.; Chernikh, Valery V.; Razhev, Alexander M.; Zhupikov, Andrey A.

    2000-06-01

    The new surgical UV ophthalmic laser system Medilex based on the KrCl (223 nm) excimer laser for refractive surgery was created. The comparative analysis of using the UV ophthalmic laser systems Medilex based on the ArF (193 nm) and the KrCl (223 nm) excimer lasers for the correction of refractive errors was performed. The system with the radiation wavelength of 223 nanometer of the KrCl excimer laser for refractive surgery was shown to have several medical and technical advantages over the system with the traditionally used radiation wavelength of 193 nanometer of the ArF excimer laser. In addition the use of the wavelength of 223 nanometer extends functional features of the system, allowing to make not only standard for this type systems surgical and therapeutic procedures but also to treat such ocular diseases as the glaucoma and herpetic keratities. For the UV ophthalmic laser systems Medilex three variations of the beam delivery system including special rotating masks and different beam homogenize systems were developed. All created beam delivery systems are able to make the correction of myopia, hyperopia, astigmatism and myopic or hyperopic astigmatism and may be used for therapeutic procedures. The results of the initial treatments of refractive error corrections using the UV ophthalmic laser systems Medilex for both photorefractive keratectomy (PRK) and LASIK procedures are presented.

  15. Does Posterior Capsule Opacification Affect the Results of Diagnostic Technologies to Evaluate the Retina and the Optic Disc?

    PubMed Central

    Garcia-Medina, Jose Javier; del Rio-Vellosillo, Monica; Santos-Bueso, Enrique

    2015-01-01

    The visual outcome obtained after cataract removal may progressively decline because of posterior capsular opacification (PCO). This condition can be treated by creating an opening in the posterior lens capsule by Nd:YAG laser capsulotomy. PCO optical imperfections cause several light reflection, refraction, and diffraction phenomena, which may interfere with the functional and structural tests performed in different ocular locations for the diagnosis and follow-up of ocular disease, like macular and optic nerve diseases. Some parameters measured by visual field examinations, scanning laser polarimetry, and optical coherence tomography (OCT) have changed after PCO removal. Imaging quality also changes following capsulotomy. Consequently, the results of ancillary tests in pseudophakic eyes for studying ocular diseases like glaucoma or maculopathies should be correlated with other clinical examinations, for example, slit-lamp biomicroscopy or funduscopy. If PCO is clinically significant, a new baseline should be set for future comparisons following capsulotomy when using automated perimetry and scanning laser polarimetry. To perform OCT in the presence of PCO, reliable examinations (considering signal strength) apparently guarantee that measurements are not influenced by PCO. PMID:26167499

  16. François Pourfour du Petit (1664-1741): pioneer in ocular biometry.

    PubMed

    Charman, W Neil

    2016-07-01

    To outline the important contributions of the French physician Petit to the development of ocular biometry. After a brief review of Petit's life and his studies in neurology, anatomy, and cataract surgery, the methodology and results of his work in measuring many of the biometric parameters of the human eye are discussed. Among other techniques, he made use of frozen sections of eyes to explore their dimensions and employed an immersion technique to avoid the effect of corneal refraction on the appearance of the iris. His pioneering biometric results have been largely confirmed by modern studies. Those on the changes in the crystalline lens with age are particularly striking and suggest that these ocular aging effects have changed little over the last 300 years. Although largely forgotten today, his biometric work exercised a considerable influence on his more immediate successors, including Porterfield and Thomas Young. François Pourfour du Petit deserves to be remembered as an important contributor to our understanding of the structure and dimensions of the human eye. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.

  17. Identification of biomechanical properties of the cornea: the ocular response analyzer.

    PubMed

    Terai, Naim; Raiskup, Frederik; Haustein, Michael; Pillunat, Lutz E; Spoerl, Eberhard

    2012-07-01

    Several methods have been devised for measuring geometric parameters of the cornea but, until now, the biomechanics of the cornea have been largely ignored. The relatively new Ocular Response Analyzer (ORA) provides such biomechanical information. In order to correctly interpret the underlying biomechanics of ORA data, we review reported ORA measurements and provide a compendium of factors influencing these measurements, with discussion of possible explanations for ORA measurement results. This review comprised a literature search using "ocular response analyzer" and "ocular response analyser" as keywords. We reviewed and compared reported results from recent ORA studies so obtained, with an eye to understanding corneal biomechanics. Several ORA biomechanical parameters of the cornea - corneal hysteresis (CH) and corneal resistant factor (CRF) - characterize the viscoelastic properties of the cornea, especially those of the ground substance. The impact on CH and CRF values of various independent factors, e.g. intraocular pressure (IOP), age, central corneal thickness (CCT), and corneal swelling, are discussed. The impact on CH and CRF of treatment-related structural changes of the cornea, i.e. those occurring after refractive surgical procedures, placement of intracorneal rings, and collagen crosslinking (CXL), as well as pathological changes of the cornea, e.g. those resulting from keratoconus, edema, and glaucoma, are discussed. Changes in CRF and CH may be reflective of structural changes in the ground substance of the cornea. Thus, ORA provides invaluable information for delineating biomechanical conditions pertaining to the cornea, with special regard to ocular diseases, e.g. keratoconus and glaucoma.

  18. Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital: Outcomes and ocular healthcare-seeking behaviours.

    PubMed

    Khan, Ruhi A; Souru, Ches; Vaghese, Sejo; Yasir, Ziaul; Khandekar, Rajiv

    2017-02-01

    This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot ™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA). A total of 150 nurses participated in the study (response rate: 30.0%). The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%), 32 (21.3%) and 10 (6.7%) nurses, respectively. A total of 58 nurses (38.7%) failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%). With regards to regular eye checkups, 77 participants (51.3%) reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids ( P <0.01 each). A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population.

  19. Ocular Determinants of Refractive Error and Its Age- and Sex-Related Variations in the Chinese American Eye Study.

    PubMed

    Richter, Grace M; Wang, Mingwu; Jiang, Xuejuan; Wu, Shuang; Wang, Dandan; Torres, Mina; Choudhury, Farzana; Varma, Rohit

    2017-07-01

    Uncorrected refractive error (RE) is a leading cause of visual impairment, and variations in ocular anatomy determine RE. The unique ocular determinants of RE in Chinese American individuals have not been studied previously. To report ocular determinants of RE in a Chinese American population 50 years and older in Monterey Park, California. The Chinese American Eye Study, a population-based, cross-sectional study, was conducted from February 1, 2010, through October 31, 2013, in Monterey Park, with this particular data analysis performed from January 1 through December 31, 2016. This study included data from 4582 participants who underwent an eye examination to obtain axial length (AL), central corneal thickness, vitreous chamber depth (VCD), anterior chamber depth (ACD), lens thickness (LT), corneal power (CP), noncycloplegic subjective refraction, and lens nuclear opalescence (NOP) grading. Data from the right phakic eye of each participant were used. Multiple regression models (standardized regression coefficients [SRCs] and semipartial correlation coefficients squared [SPCCs2]) identified key determinants of RE. Ocular determinants of RE. Among the 4071 participants eligible for analysis (1496 men [36.7%] and 2575 women [63.3%]; mean [SD] age, 60.5 [8.1] years), mean (SD) RE was -0.52 (2.95) diopters (D), with no sex-related difference. A hyperopic shift occurred in women from -0.62 (2.95) D at 50 to 59 years to 0.60 (1.62) D at 80 years or older and in men from -0.69 (3.00) D at 50 to 59 years to 0.40 (2.29) D at 80 years or older (P < .001 for both). Compared with men, women had shorter AL (mean [SD], 23.62 [1.34] vs 24.14 [1.27] mm; P = .006), shorter ACD (mean [SD], 3.33 [0.34] vs 3.44 [0.34] mm; P < .001), and steeper CP (mean [SD], 43.50 [1.52] vs 42.88 [1.45] D; P = .02), after adjusting for age and height. No sex differences were found in VCD, LT, and NOP after height adjustment. Compared with younger individuals, older individuals had shallower ACD, thicker LT, and more NOP compared with younger individuals (P < .001 for both), even after adjustment for height. Axial length was the strongest determinant of RE (SRC = -0.92; SPCC2 = 0.55), followed by CP (SRC = -0.43; SPCC2 = 0.15). When individual components of AL were evaluated, VCD had the greatest contributing effect (SRC = -0.99; SPCC2 = 0.52), followed by CP (SRC = -0.47; SPCC2 = 0.15) and LT (SRC = -0.29; SPCC2 = 0.06). These data suggest that Chinese American individuals have longer AL and greater contribution of AL to RE than do Latino and other Chinese populations. Future studies should explore risk factors for increased AL in Chinese Americans and potential interventions that may ultimately prevent myopia-related disease.

  20. Dopaminergic agonists that result in ocular growth inhibition also elicit transient increases in choroidal thickness in chicks.

    PubMed

    Nickla, Debora L; Totonelly, Kristen; Dhillon, Balprit

    2010-11-01

    The dopaminergic system has been implicated in ocular growth regulation in chicks and monkeys. In both, dopamine D2 agonists inhibit the development of myopia in response to form deprivation, and in chicks, to negative lenses as well. Because there is mounting evidence that the choroidal response to defocus plays a role in ocular growth regulation, we asked whether the effective agonists also elicit transient thickening of the choroid concomitant with the growth inhibition. Negative lenses mounted on velcro rings were worn on one eye starting at age 8-12 days. Intravitreal injections (20 μl; dose = 10 nmole) of the agonist (dissolved in saline) or saline, were given through the superior temporal sclera using a 30G needle. Eyes were injected daily at noon, for 4 days, and the lenses immediately replaced. Agonists used were apomorphine (non-specific; n = 17), quinpirole (D2; n = 10), SKF-38393 (D1; n = 9), and saline controls (n = 22). For the antagonists, the same protocol was used, but on each day, the lenses were removed for 2 h. Immediately prior to lens-removal, the antagonist was injected (20 μl; dose = 5 nmole). Antagonists used were methylergonovine (non-specific; n = 12), spiperone (D2; n = 20), SCH-23390 (D1; n = 6) and saline controls (n = 27). Comparisons to saline (continuous lens wear) controls were from the agonist experiment. Axial dimensions were measured using high frequency A-scan ultrasonography at the start of lens wear, and on day 4 prior to the injections, and then again 3 h later. Refractive errors were measured using a Hartinger's refractometer at the end of the experiment. Apomorphine and quinpirole inhibited the refractive response to the hyperopic defocus induced by the negative lenses (drug vs saline controls: -1.3 and 1.2 D vs -5.6 D; p < 0.005 for both). This effect was axial: both drugs prevented the excessive ocular elongation (change in axial length: 233 and 205 μm vs 417 μm; p < 0.01 for both). Both drugs were also associated with a transient thickening of the choroid over 3 h (41 and 32 μm vs -1 μm; p < 0.01; p = 0.059 respectively) that did not summate: choroids thinned significantly over the 4 day period in all lens-wearing eyes. Two daily hours of unrestricted vision during negative lens wear normally prevents the development of myopia. Spiperone and SCH-23390 inhibited the ameliorating effects of periods of vision on lens-induced refractive error (-2.9 and -2.8 D vs 0.6 D; p < 0.0001), however, the effects on neither axial length nor choroidal thickness were significant. These data support a role for both D1 and D2 receptors in the ocular growth responses. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Keratometry obtained by corneal mapping versus the IOLMaster in the prediction of postoperative refraction in routine cataract surgery.

    PubMed

    Dulku, Simon; Smith, Henry B; Antcliff, Richard J

    2013-01-01

    To establish whether simulated keratometry values obtained by corneal mapping (videokeratography) would provide a superior refractive outcome to those obtained by Zeiss IOLMaster (partial coherence interferometry) in routine cataract surgery. Prospective, non-randomized, single-surgeon study set at the The Royal United Hospital, Bath, UK, District General Hospital. Thirty-three patients undergoing routine cataract surgery in the absence of significant ocular comorbidity. Conventional biometry was recorded using the Zeiss IOLMaster. Postoperative refraction was calculated using the SRK/T formula and the most appropriate power of lens implanted. Preoperative keratometry values were also obtained using Humphrey Instruments Atlas Version A6 corneal mapping. Achieved refraction was compared with predicted refraction for the two methods of keratometry after the A-constants were optimized to obtain a mean arithmetic error of zero dioptres for each device. The mean absolute prediction error was 0.39 dioptres (standard deviation 0.29) for IOLMaster and 0.48 dioptres (standard deviation 0.31) for corneal mapping (P = 0.0015). Keratometry readings between the devices were highly correlated by Spearman correlation (0.97). The Bland-Altman plot demonstrated close agreement between keratometers, with a bias of 0.0079 dioptres and 95% limits of agreement of -0.48-0.49 dioptres. The IOLMaster was superior to Humphrey Atlas A6 corneal mapping in the prediction of postoperative refraction. This difference could not have been predicted from the keratometry readings alone. When comparing biometry devices, close agreement between readings should not be considered a substitute for actual postoperative refraction data. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  2. Effects of the chromatic defocus caused by interchange of two monochromatic lights on refraction and ocular dimension in guinea pigs.

    PubMed

    Qian, Yi-Feng; Dai, Jin-Hui; Liu, Rui; Chen, Min-Jie; Zhou, Xing-Tao; Chu, Ren-Yuan

    2013-01-01

    To investigate refractive and axial responses to the shift of focal plane resulting from the interchange of two monochromatic lights separately corresponding to the peak wavelengths of the cones absorption spectrum in retina, fifty 2-week-old pigmented guinea pigs were randomly assigned to five groups based on the mode of illumination: short-wavelength light (SL), middle-wavelength light (ML) and broad-band white light (BL) for 20 weeks, SL for 10 weeks followed by ML for 10 weeks (STM), as well as ML for 10 weeks followed by SL for 10 weeks (MTS). Biometric and refractive measurements were then performed every 2 weeks. After 10 weeks, SL and STM groups became more hyperopic and had less vitreous elongation than BL group. However, ML and MTS groups became more myopic and had more vitreous elongation. After interchange of the monochromatic light, the refractive error decreased rapidly by about 1.93D and the vitreous length increased by 0.14 mm in STM group from 10 to 12 weeks. After that, there were no significant intergroup differences between STM and BL groups. The interchange from ML to SL quickly increased the refractive error by about 1.53D and decreased the vitreous length by about 0.13 mm in MTS group after two weeks. At this time, there were also no significant intergroup differences between MTS and BL groups. The guinea pig eye can accurately detect the shift in focal plane caused by interchange of two monochromatic lights and rapidly generate refractive and axial responses. However, an excessive compensation was induced. Some properties of photoreceptors or retina may be changed by the monochromatic light to influence the following refractive development.

  3. Refraction during incipient presbyopia: The Aston Longitudinal Assessment of Presbyopia (ALAP) study.

    PubMed

    Laughton, Deborah S; Sheppard, Amy L; Davies, Leon N

    To investigate non-cycloplegic changes in refractive error prior to the onset of presbyopia. The Aston Longitudinal Assessment of Presbyopia (ALAP) study is a prospective 2.5 year longitudinal study, measuring objective refractive error using a binocular open-field WAM-5500 autorefractor at 6-month intervals in participants aged between 33 and 45 years. From the 58 participants recruited, 51 participants (88%) completed the final visit. At baseline, 21 participants were myopic (MSE -3.25±2.28 DS; baseline age 38.6±3.1 years) and 30 were emmetropic (MSE -0.17±0.32 DS; baseline age 39.0±2.9 years). After 2.5 years, 10% of the myopic group experienced a hypermetropic shift (≥0.50 D), 5% a myopic shift (≥0.50 D) and 85% had no significant change in refraction (<0.50 D). From the emmetropic group, 10% experienced a hypermetropic shift (≥0.50 D), 3% a myopic shift (≥0.50 D) and 87% had no significant change in refraction (<0.50 D). In terms of astigmatism vectors, other than J 45 (p<0.001), all measures remained invariant over the study period. The incidence of a myopic shift in refraction during incipient presbyopia does not appear to be as large as previously indicated by retrospective research. The changes in axis indicate ocular astigmatism tends towards the against-the-rule direction with age. The structural origin(s) of the reported myopic shift in refraction during incipient presbyopia warrants further investigation. Copyright © 2017 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  4. The prevalence of refractive conditions in Puerto Rican adults attending an eye clinic system

    PubMed Central

    Rodriguez, Neisha M.; Romero, Angel. F.

    2014-01-01

    Purpose To determine the prevalence of refractive conditions in the adult population that visited primary care optometry clinics in Puerto Rico. Methods A retrospective cross-sectional study of patients examined at the Inter American University of Puerto Rico School of Optometry Eye Institute Clinics between 2004 and 2010. Subjects considered had best corrected visual acuity by standardized subjective refraction of 20/40 or better. The refractive errors were classified by the spherical equivalent (SE): sphere+½ cylinder. Myopia was classified as a SE>−0.50 D, hyperopia as a SE>+0.50  D, and emmetropia as a SE between −0.50 and +0.50, both included. Astigmatism equal or higher than 0.25 D in minus cylinder form was used. Patients with documented history of cataract extraction (pseudophakia or aphakia), amblyopia, refractive surgery or other corneal/ocular surgery were excluded from the study. Results A total of 784 randomly selected subjects older than 40 years of age were selected. The estimated prevalence (95%, confidence interval) among all subjects was hyperopia 51.5% (48.0–55.0), emmetropia 33.8% (30.5–37.2), myopia 14.7% (12.1–17.2) and astigmatism 69.6% (68.8–73.3). Hyperopia was more common in females than males although the difference was not statistically significant. The mean spherical equivalent values was hyperopic until 70 y/o and decreased slightly as the population ages. Conclusion Hyperopia is the most common refractive error and its prevalence and seems to increase among the aging population who visited the clinics. Further programs and studies must be developed to address the refractive errors needs of the adult Puerto Rican population. PMID:25000872

  5. Effects of Foveal Ablation on Emmetropization and Form-Deprivation Myopia

    PubMed Central

    Smith, Earl L.; Ramamirtham, Ramkumar; Qiao-Grider, Ying; Hung, Li-Fang; Huang, Juan; Kee, Chea-su; Coats, David; Paysse, Evelyn

    2009-01-01

    Purpose Because of the prominence of central vision in primates, it has generally been assumed that signals from the fovea dominate refractive development. To test this assumption, the authors determined whether an intact fovea was essential for either normal emmetropization or the vision-induced myopic errors produced by form deprivation. Methods In 13 rhesus monkeys at 3 weeks of age, the fovea and most of the perifovea in one eye were ablated by laser photocoagulation. Five of these animals were subsequently allowed unrestricted vision. For the other eight monkeys with foveal ablations, a diffuser lens was secured in front of the treated eyes to produce form deprivation. Refractive development was assessed along the pupillary axis by retinoscopy, keratometry, and A-scan ultrasonography. Control data were obtained from 21 normal monkeys and three infants reared with plano lenses in front of both eyes. Results Foveal ablations had no apparent effect on emmetropization. Refractive errors for both eyes of the treated infants allowed unrestricted vision were within the control range throughout the observation period, and there were no systematic interocular differences in refractive error or axial length. In addition, foveal ablation did not prevent form deprivation myopia; six of the eight infants that experienced monocular form deprivation developed myopic axial anisometropias outside the control range. Conclusions Visual signals from the fovea are not essential for normal refractive development or the vision-induced alterations in ocular growth produced by form deprivation. Conversely, the peripheral retina, in isolation, can regulate emmetropizing responses and produce anomalous refractive errors in response to abnormal visual experience. These results indicate that peripheral vision should be considered when assessing the effects of visual experience on refractive development. PMID:17724167

  6. Spherical subjective refraction with a novel 3D virtual reality based system.

    PubMed

    Pujol, Jaume; Ondategui-Parra, Juan Carlos; Badiella, Llorenç; Otero, Carles; Vilaseca, Meritxell; Aldaba, Mikel

    To conduct a clinical validation of a virtual reality-based experimental system that is able to assess the spherical subjective refraction simplifying the methodology of ocular refraction. For the agreement assessment, spherical refraction measurements were obtained from 104 eyes of 52 subjects using three different methods: subjectively with the experimental prototype (Subj.E) and the classical subjective refraction (Subj.C); and objectively with the WAM-5500 autorefractor (WAM). To evaluate precision (intra- and inter-observer variability) of each refractive tool independently, 26 eyes were measured in four occasions. With regard to agreement, the mean difference (±SD) for the spherical equivalent (M) between the new experimental subjective method (Subj.E) and the classical subjective refraction (Subj.C) was -0.034D (±0.454D). The corresponding 95% Limits of Agreement (LoA) were (-0.856D, 0.924D). In relation to precision, intra-observer mean difference for the M component was 0.034±0.195D for the Subj.C, 0.015±0.177D for the WAM and 0.072±0.197D for the Subj.E. Inter-observer variability showed worse precision values, although still clinically valid (below 0.25D) in all instruments. The spherical equivalent obtained with the new experimental system was precise and in good agreement with the classical subjective routine. The algorithm implemented in this new system and its optical configuration has been shown to be a first valid step for spherical error correction in a semiautomated way. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  7. Insulinlike growth factor I affects ocular development: a study of untreated and treated patients with Laron syndrome.

    PubMed

    Bourla, Dan Haim; Laron, Zvi; Snir, Moshe; Lilos, Pearl; Weinberger, Dov; Axer-Siegel, Ruth

    2006-07-01

    To evaluate the ocular dimensions in patients with primary growth hormone receptor insensitivity (Laron syndrome [LS]) and to study the effect of supplemental insulinlike growth factor I (IGF-I) on ocular growth. Retrospective case series. Twelve patients with LS, 8 untreated (LS group) and 4 treated (LS-T group) with supplemental IGF-I, and 30 healthy controls. Ocular dimensions and refraction were measured, and a full ophthalmologic examination was performed. Differences in the average ocular dimension data among IGF-I-treated patients, untreated ones, and controls. The average axial length of eyes in the LS group was 21.94 mm (standard deviation [SD], 0.81). Corresponding values for the LS-T and control group eyes were 22.53 mm (SD, 1.74) and 23.20 mm (SD, 1.35) respectively. The average anterior chamber depth of eyes in the LS group was 2.55 mm (SD, 0.26). Corresponding values for eyes in the LS-T and control groups were 3.48 mm (SD, 0.09) and 3.84 mm (SD, 0.16) respectively. The average lens thickness of eyes in the LS group was 4.56 mm (SD, 0.36). Corresponding values for the LS-T and control groups were 3.77 mm (SD, 0.23) and 3.51 mm (SD, 0.25), respectively. The average corneal curvature of eyes in the LS group was 46.9 diopters (D) (SD, 2.32). Corresponding values for the LS-T and control groups were 47.6 D (SD, 2.83) and 44.4 D (SD, 1.5), respectively. Insulinlike growth factor I seems to be an important regulator of ocular growth as documented in patients with primary growth hormone insensitivity. The mechanism of this observation should be investigated further.

  8. [Neuronal and hormonal regulatory mechanisms of tears production and secretion].

    PubMed

    Mrugacz, Małgorzata; Zywalewska, Nella; Bakunowicz-Lazarczyk, Alina

    2005-01-01

    The ocular surface, tear film, lacrimal glands act as a functional unit to preserve the quality of the refractive surface of the eye, and to resist injury and protect the eye against bodily and environmental conditions. Homeostasis of this functional unit involves neuronal and hormonal regulatory mechanisms. The eye appears to be a target organ for sex hormones particulary the androgen, as they modulate the immune system and trophic functions of the lacrimal and Meibomian glands.

  9. Influence of the difference between corneal and refractive astigmatism on LASIK outcomes using solid-state technology.

    PubMed

    Piñero, David P; Ribera, David; Pérez-Cambrodí, Rafael J; Ruiz-Fortes, Pedro; Blanes-Mompó, Francisco J; Alzamora-Rodríguez, Antonio; Artola, Alberto

    2014-12-01

    To evaluate the influence of the difference between preoperative corneal and refractive astigmatism [ocular residual astigmatism (ORA)] on outcomes obtained after laser in situ keratomileusis (LASIK) surgery for correction of myopic astigmatism using the solid-state laser technology. One hundred one consecutive eyes with myopia or myopic astigmatism of 55 patients undergoing LASIK surgery using the Pulzar Z1 solid-state laser (CustomVis Laser Pty Ltd, currently CV Laser) were included. Visual and refractive changes at 6 months postoperatively and changes in ORA and anterior corneal astigmatism and posterior corneal astigmatism (PCA) were analyzed. Postoperatively, uncorrected distance visual acuity improved significantly (P < 0.01). Likewise, refractive cylinder magnitude and spherical equivalent were reduced significantly (P < 0.01). In contrast, no significant changes were observed in ORA magnitude (P = 0.81) and anterior corneal astigmatism (P = 0.12). The mean overall efficacy and safety indices were 0.96 and 1.01, respectively. These indices were not correlated with preoperative ORA (r = -0.15, P = 0.15). Furthermore, a significant correlation was found between ORA (r = 0.81, P < 0.01) and PCA postoperatively, but not preoperatively (r = 0.12, P = 0.25). Likewise, a significant correlation of ORA with manifest refraction was only found postoperatively (r = -0.38, P < 0.01). The magnitude of ORA does not seem to be a predictive factor of efficacy and safety of myopic LASIK using a solid-state laser platform. The higher relevance of PCA after surgery in some cases may explain the presence of unexpected astigmatic residual refractive errors.

  10. Ocular manifestations of sickle cell disease and genetic susceptibility for refractive errors

    PubMed Central

    Shukla, Palak; Verma, Henu; Patel, Santosh; Patra, P. K.; Bhaskar, L. V. K. S.

    2017-01-01

    PURPOSE: Sickle cell disease (SCD) is the most common and serious form of an inherited blood disorder that lead to higher risk of early mortality. SCD patients are at high risk for developing multiorgan acute and chronic complications linked with significant morbidity and mortality. Some of the ophthalmological complications of SCD include retinal changes, refractive errors, vitreous hemorrhage, and abnormalities of the cornea. MATERIALS AND METHODS: The present study includes 96 SCD patients. A dilated comprehensive eye examination was performed to know the status of retinopathy. Refractive errors were measured in all patients. In patients with >10 years of age, cycloplegia was not performed before autorefractometry. A subset of fifty patients’ genotyping was done for NOS3 27-base pair (bp) variable number of tandem repeat (VNTR) and IL4 intron-3 VNTR polymorphisms using polymerase chain reaction-electrophoresis. Chi-square test was performed to test the association between the polymorphisms and refractive errors. RESULTS: The results of the present study revealed that 63.5% of patients have myopia followed by 19.8% hyperopia. NOS3 27-bp VNTR genotypes significantly deviated from Hardy–Weinberg equilibrium (P < 0.0001). Although IL4 70-bp VNTR increased the risk of developing refractive errors, it is not statistically significant. However, NOS3 27-bp VNTR significantly reduced the risk of development of myopia. CONCLUSION: In summary, our study documents the prevalence of refractive errors along with some retinal changes in Indian SCD patients. Further, this study demonstrates that the NOS3 VNTR contributes to the susceptibility to development of myopia in SCD cases. PMID:29018763

  11. Increased Incidence of Visual Field Abnormalities as Determined by Frequency Doubling Technology Perimetry in High Computer Users Among Japanese Workers: A Retrospective Cohort Study.

    PubMed

    Nakano, Tadashi; Hayashi, Takeshi; Nakagawa, Toru; Honda, Toru; Owada, Satoshi; Endo, Hitoshi; Tatemichi, Masayuki

    2018-04-05

    This retrospective cohort study primarily aimed to investigate the possible association of computer use with visual field abnormalities (VFA) among Japanese workers. The study included 2,377 workers (mean age 45.7 [standard deviation, 8.3] years; 2,229 men and 148 women) who initially exhibited no VFA during frequency doubling technology perimetry (FDT) testing. Subjects then underwent annual follow-up FDT testing for 7 years, and VFA were determined using a FDT-test protocol (FDT-VFA). Subjects with FDT-VFA were examined by ophthalmologists. Baseline data about the mean duration of computer use during a 5-year period and refractive errors were obtained via self-administered questionnaire and evaluations for refractive errors (use of eyeglasses or contact lenses), respectively. A Cox proportional hazard analysis demonstrated that heavy computer users (>8 hr/day) had a significantly increased risk of FDT-VFA (hazard ratio [HR] 2.85; 95% confidence interval [CI], 1.26-6.48) relative to light users (<4 hr/day), and this association was strengthened among subjects with refractive errors (HR 4.48; 95% CI, 1.87-10.74). The computer usage history also significantly correlated with FDT-VFA among subject with refractive errors (P < 0.05), and 73.1% of subjects with FDT-VFA and refractive errors were diagnosed with glaucoma or ocular hypertension. The incidence of FDT-VFA appears to be increased among Japanese workers who are heavy computer users, particularly if they have refractive errors. Further investigations of epidemiology and causality are warranted.

  12. Ocular manifestations of sickle cell disease and genetic susceptibility for refractive errors.

    PubMed

    Shukla, Palak; Verma, Henu; Patel, Santosh; Patra, P K; Bhaskar, L V K S

    2017-01-01

    Sickle cell disease (SCD) is the most common and serious form of an inherited blood disorder that lead to higher risk of early mortality. SCD patients are at high risk for developing multiorgan acute and chronic complications linked with significant morbidity and mortality. Some of the ophthalmological complications of SCD include retinal changes, refractive errors, vitreous hemorrhage, and abnormalities of the cornea. The present study includes 96 SCD patients. A dilated comprehensive eye examination was performed to know the status of retinopathy. Refractive errors were measured in all patients. In patients with >10 years of age, cycloplegia was not performed before autorefractometry. A subset of fifty patients' genotyping was done for NOS3 27-base pair (bp) variable number of tandem repeat (VNTR) and IL4 intron-3 VNTR polymorphisms using polymerase chain reaction-electrophoresis. Chi-square test was performed to test the association between the polymorphisms and refractive errors. The results of the present study revealed that 63.5% of patients have myopia followed by 19.8% hyperopia. NOS3 27-bp VNTR genotypes significantly deviated from Hardy-Weinberg equilibrium ( P < 0.0001). Although IL4 70-bp VNTR increased the risk of developing refractive errors, it is not statistically significant. However, NOS3 27-bp VNTR significantly reduced the risk of development of myopia. In summary, our study documents the prevalence of refractive errors along with some retinal changes in Indian SCD patients. Further, this study demonstrates that the NOS3 VNTR contributes to the susceptibility to development of myopia in SCD cases.

  13. Refractive errors and binocular dysfunctions in a population of university students.

    PubMed

    Risovic, D J; Misailovic, K R; Eric-Marinkovic, J M; Kosanovic-Jakovic, N G; Milenkovic, S M; Petrovic, L Z

    2008-01-01

    This clinical study was performed to determine the presence of refractive errors and binocular dysfunctions in a population of university students. Refraction and binocular function were evaluated in a young patient population (230 students and 234 nonstudent subjects, aged 18-27 years). Distance visual acuity (DVA) and near visual acuity (NVA), refraction, cover test (CT), ocular motility, near-point of convergence, horizontal phoria measurement by Maddox wing, negative and positive vergence amplitude in prism diopters, fusion amplitude in synoptophore, as well as stereoacuity (Titmus test) were tested. Emmetropia was the most frequent refractive status in our student and nonstudent groups (78.7%). Myopia was the most frequent refractive disorder in the whole population (13.1%). Myopia and hypermetropia were significantly more frequent in the students than in nonstudents (chi-square emp 47.55). Exophoria is significantly more frequent in myopic subjects. Vergence amplitude (t test 0.000) and fusion amplitude (t test 0.005) show significantly lower values in student population. Results of Titmus test in the student group is significantly worse than in the nonstudent group (t test 0.000). Maddox wing resulted in significantly higher degree of heterophoria in the student population (t test 0.000). Myopic subjects, in the student group (t test 0.002) as well as in the nonstudent group (t test 0.001), show significantly better results in Titmus test. High near visual demand could be the most important factor for higher incidence of myopia, worse convergence and fusion amplitude, higher degree of exophoria, and worse results in Titmus test in the student population.

  14. Amblyopia and refractive errors among school-aged children with low socioeconomic status in southeastern Turkey.

    PubMed

    Caca, Ihsan; Cingu, Abdullah Kursat; Sahin, Alparslan; Ari, Seyhmus; Dursun, Mehmet Emin; Dag, Umut; Balsak, Selahattin; Alakus, Fuat; Yavuz, Abdullah; Palanci, Yilmaz

    2013-01-01

    To investigate the prevalence of refractive errors and other eye diseases, incidence and types of amblyopia in school-aged children, and their relation to gender, age, parental education, and socioeconomic factors. A total of 21,062 children 6 to 14 years old were screened. The examination included visual acuity measurements and ocular motility evaluation. Autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus were performed. There were 11,118 females and 9,944 males. The average age was 10.56 ± 3.59 years. When all of the children were evaluated, 3.2% had myopia and 5.9% had hyperopia. Astigmatism 0.50 D or greater was present in 14.3% of children. Myopia was associated with older age, female gender, and higher parental education. Hyperopia was inversely proportional with older age. Spectacles were needed in 4,476 (22.7%) children with refractive errors, and 10.6% of children were unaware of their spectacle needs. Amblyopia was detected in 2.6% of all children. The most common causes of amblyopia were anisometropia (1.2%) and strabismus (0.9%). Visual impairment is a common disorder in school-aged children. Eye health screening programs are beneficial in early detection and proper treatment of refractive errors. Copyright 2013, SLACK Incorporated.

  15. Interocular symmetry in macular choroidal thickness in children.

    PubMed

    Al-Haddad, Christiane; El Chaar, Lama; Antonios, Rafic; El-Dairi, Mays; Noureddin, Baha'

    2014-01-01

    Objective. To report interocular differences in choroidal thickness in children using spectral domain optical coherence tomography (SD-OCT) and correlate findings with biometric data. Methods. This observational cross-sectional study included 91 (182 eyes) healthy children aged 6 to 17 years with no ocular abnormality except refractive error. After a comprehensive eye exam and axial length measurement, high definition macular scans were performed using SD-OCT. Two observers manually measured the choroidal thickness at the foveal center and at 1500 µm nasally, temporally, inferiorly, and superiorly. Interocular differences were computed; correlations with age, gender, refractive error, and axial length were performed. Results. Mean age was 10.40 ± 3.17 years; mean axial length and refractive error values were similar between fellow eyes. There was excellent correlation between the two observers' measurements. No significant interocular differences were observed at any location. There was only a trend for right eyes to have higher values in all thicknesses, except the superior thickness. Most of the choroidal thickness measurements correlated positively with spherical equivalent but not with axial length, age, or gender. Conclusion. Choroidal thickness measurements in children as performed using SD-OCT revealed a high level of interobserver agreement and consistent interocular symmetry. Values correlated positively with spherical equivalent refraction.

  16. PSF and MTF comparison of two different surface ablation techniques for laser visual correction

    NASA Astrophysics Data System (ADS)

    Cruz Félix, Angel Sinue; López Olazagasti, Estela; Rosales, Marco A.; Ibarra, Jorge; Tepichín Rodríguez, Eduardo

    2009-08-01

    It is well known that the Zernike expansion of the wavefront aberrations has been extensively used to evaluate the performance of image forming optical systems. Recently, these techniques were adopted in the field of Ophthalmology to evaluate the objective performance of the human ocular system. We have been working in the characterization and evaluation of the performance of normal human eyes; i.e., eyes which do not require any refractive correction (20/20 visual acuity). These data provide us a reference model to analyze Pre- and Post-Operated results from eyes that have been subjected to laser refractive surgery. Two different ablation techniques are analyzed in this work. These techniques were designed to correct the typical refractive errors known as myopia, hyperopia, and presbyopia. When applied to the corneal surface, these techniques provide a focal shift and, in principle, an improvement of the visual performance. These features can be suitably described in terms of the PSF and MTF of the corresponding Pre- and Post-Operated wavefront aberrations. We show the preliminary results of our comparison.

  17. [Regularities of the refractive genesis of school myopia and criteria for its prediction].

    PubMed

    Onufriĭchuk, O N; Rozenblium, Iu Z

    2007-01-01

    The paper provides the data of a 2-year monitoring of ocular refraction in 327 consecutive 10-14-year-old schoolchildren (654 eyes) unrandomized under natural conditions and cycloplegia. The authors studied whether there was an association of refraction and its changes with absolute and relative accommodation, habitual accommodation tonicity, the length of the anteroposterior optic axis, and the presence of pseudomyopathy and astigmatism. Over 2 years, myopia occurred in 15.4% of the eyes, its degree increased from -0.88 (-1.37/-0.50) to -1.25 (-2.31/-0.62) diopters. Criteria for myopia prediction were identified. These included a relative accommodation reserve of less than 2.5 diopters, an anteroposterior optic axis length of more than 24.33 mm, a habitual accommodation tonicity of less than + 0.41 diopters, the presence of pseudomyopia (77.8% of cases), reversed astigmatism and underlying emmetropia. A mathematical model was constructed for prediction of myopia, the proportion of its correct prediction being 90.4%, which makes it possible to recommend for clinical application.

  18. Intraocular lens power estimation by accurate ray tracing for eyes underwent previous refractive surgeries

    NASA Astrophysics Data System (ADS)

    Yang, Que; Wang, Shanshan; Wang, Kai; Zhang, Chunyu; Zhang, Lu; Meng, Qingyu; Zhu, Qiudong

    2015-08-01

    For normal eyes without history of any ocular surgery, traditional equations for calculating intraocular lens (IOL) power, such as SRK-T, Holladay, Higis, SRK-II, et al., all were relativley accurate. However, for eyes underwent refractive surgeries, such as LASIK, or eyes diagnosed as keratoconus, these equations may cause significant postoperative refractive error, which may cause poor satisfaction after cataract surgery. Although some methods have been carried out to solve this problem, such as Hagis-L equation[1], or using preoperative data (data before LASIK) to estimate K value[2], no precise equations were available for these eyes. Here, we introduced a novel intraocular lens power estimation method by accurate ray tracing with optical design software ZEMAX. Instead of using traditional regression formula, we adopted the exact measured corneal elevation distribution, central corneal thickness, anterior chamber depth, axial length, and estimated effective lens plane as the input parameters. The calculation of intraocular lens power for a patient with keratoconus and another LASIK postoperative patient met very well with their visual capacity after cataract surgery.

  19. Refraction data survey: 2nd generation correlation of myopia.

    PubMed

    Greene, Peter R; Medina, Antonio

    2016-10-01

    The objective herein is to provide refraction data, myopia progression rate, prevalence, and 1st and 2nd generation correlations, relevant to whether myopia is random or inherited. First- and second-generation ocular refraction data are assembled from N = 34 families, average of 2.8 children per family. From this group, data are available from N = 165 subjects. Inter-generation regressions are performed on all the data sets, including correlation coefficient r, and myopia prevalence [%]. Prevalence of myopia is [M] = 38.5 %. Prevalence of high myopes with |R| >6 D is [M-] = 20.5 %. Average refraction is  = -1.84 D ± 3.22 (N = 165). For the high myopes, |R| >6 D, prevalence for the parents is [M-] = 25 %, for the 2nd generation [M-] = 16.5 %. Average myopia level for the high myopes, both generations, is  = -7.52 D ± 1.31 D (N = 33). Regression parameters are calculated for all the data sets, yielding correlation coefficients in the range r = 0.48-0.72 for some groups of myopes and high myopes, fathers to daughters, and mothers to sons. Also of interest, some categories show essentially no correlation, -0.20 < r < 0.20, indicating that the refractive errors occur randomly. Time series results show myopia diopter rates = -0.50 D/year.

  20. Non-cycloplegic spherical equivalent refraction in adults: comparison of the double-pass system, retinoscopy, subjective refraction and a table-mounted autorefractor.

    PubMed

    Vilaseca, Meritxell; Arjona, Montserrat; Pujol, Jaume; Peris, Elvira; Martínez, Vanessa

    2013-01-01

    To evaluate the accuracy of spherical equivalent (SE) estimates of a double-pass system and to compare it with retinoscopy, subjective refraction and a table-mounted autorefractor. Non-cycloplegic refraction was performed on 125 eyes of 65 healthy adults (age 23.5±3.0 years) from October 2010 to January 2011 using retinoscopy, subjective refraction, autorefraction (Auto kerato-refractometer TOPCON KR-8100, Japan) and a double-pass system (Optical Quality Analysis System, OQAS, Visiometrics S.L., Spain). Nine consecutive measurements with the double-pass system were performed on a subgroup of 22 eyes to assess repeatability. To evaluate the trueness of the OQAS instrument, the SE laboratory bias between the double-pass system and the other techniques was calculated. The SE mean coefficient of repeatability obtained was 0.22D. Significant correlations could be established between the OQAS and the SE obtained with retinoscopy (r=0.956, P<0.001), subjective refraction (r=0.955, P<0.001) and autorefraction (r=0.957, P<0.001). The differences in SE between the double-pass system and the other techniques were significant (P<0.001), but lacked clinical relevance except for retinoscopy; Retinoscopy gave more hyperopic values than the double-pass system -0.51±0.50D as well as the subjective refraction -0.23±0.50D; More myopic values were achieved by means of autorefraction 0.24±0.49D. The double-pass system provides accurate and reliable estimates of the SE that can be used for clinical studies. This technique can determine the correct focus position to assess the ocular optical quality. However, it has a relatively small measuring range in comparison with autorefractors (-8.00 to +5.00D), and requires prior information on the refractive state of the patient.

  1. Non-cycloplegic spherical equivalent refraction in adults: comparison of the double-pass system, retinoscopy, subjective refraction and a table-mounted autorefractor

    PubMed Central

    Vilaseca, Meritxell; Arjona, Montserrat; Pujol, Jaume; Peris, Elvira; Martínez, Vanessa

    2013-01-01

    AIM To evaluate the accuracy of spherical equivalent (SE) estimates of a double-pass system and to compare it with retinoscopy, subjective refraction and a table-mounted autorefractor. METHODS Non-cycloplegic refraction was performed on 125 eyes of 65 healthy adults (age 23.5±3.0 years) from October 2010 to January 2011 using retinoscopy, subjective refraction, autorefraction (Auto kerato-refractometer TOPCON KR-8100, Japan) and a double-pass system (Optical Quality Analysis System, OQAS, Visiometrics S.L., Spain). Nine consecutive measurements with the double-pass system were performed on a subgroup of 22 eyes to assess repeatability. To evaluate the trueness of the OQAS instrument, the SE laboratory bias between the double-pass system and the other techniques was calculated. RESULTS The SE mean coefficient of repeatability obtained was 0.22D. Significant correlations could be established between the OQAS and the SE obtained with retinoscopy (r=0.956, P<0.001), subjective refraction (r=0.955, P<0.001) and autorefraction (r=0.957, P<0.001). The differences in SE between the double-pass system and the other techniques were significant (P<0.001), but lacked clinical relevance except for retinoscopy; Retinoscopy gave more hyperopic values than the double-pass system -0.51±0.50D as well as the subjective refraction -0.23±0.50D; More myopic values were achieved by means of autorefraction 0.24±0.49D. CONCLUSION The double-pass system provides accurate and reliable estimates of the SE that can be used for clinical studies. This technique can determine the correct focus position to assess the ocular optical quality. However, it has a relatively small measuring range in comparison with autorefractors (-8.00 to +5.00D), and requires prior information on the refractive state of the patient. PMID:24195036

  2. Refractive Error and Visual Functions in Children with Special Needs Compared with the First Grade School Students in Oman

    PubMed Central

    Vora, Urmi; Khandekar, Rajiv; Natrajan, Sarvanan; Al-Hadrami, Khalfan

    2010-01-01

    Background: We evaluated the refractive status and visual function of children with special needs (other handicap) in 2010 and compared them with healthy 1st grade school students in Oman. Materials and Methods: This was a cohort study. Optometrists recorded vision using a logarithm of minimum angle of resolution (LogMAR) chart. Preferential looking method was used for testing 31 children. Cycloplegic refraction was performed on all children. Contrast sensitivity was tested using 2.5%, 10%, and 100% contrast charts. Ocular movement, alignment, and anterior segment were also assessed. A pediatrician reviewed the health records of all the children at the time of their enrollment in this study to determine if the child had been diagnosed with a systemic condition or syndromes. The visual functions were assessed by study investigators. We estimated the rates and the risk of different visual function defects in children with special needs. Result: The prevalence of refractive error in 70 children (4.7 ± 0.8 years) with special needs (group 1) and 175 normal healthy first grade students (group 2) were 58.5% and 2.9%, respectively. The risk of refractive error was significantly higher in children with special needs [relative risk, 48.1 (95% confidence interval, 17.54–131.8)]. Hyperopia (>1.00 D), myopia (≥ 1.00D) and astigmatism (≥ ±1.00 D) were found in 18.6%, 24.3%, and 27.1%, respectively, in group 1. Six children in this group had defective near vision. Sixteen (80%) children with Down syndrome had refractive error. Seven (50%) children with developmental disorder showed decreased contrast sensitivity. Conclusion: Prevalence of uncorrected refractive error was much higher in children with special needs. Prevalence of strabismus, nystagmus, and reduced contrast sensitivity was also higher in children with special needs. Early vision screening, visual function assessment, correction of refractive error, and frequent follow-up are recommended. PMID:21180428

  3. Child Development and Refractive Errors in Preschool Children

    PubMed Central

    Ibironke, Josephine O.; Friedman, David S.; Repka, Michael X.; Katz, Joanne; Giordano, Lydia; Hawse, Patricia; Tielsch, James M.

    2011-01-01

    Purpose Many parents are concerned about their child's development. The purpose of this study is to determine if parental concerns about overall development are associated with significant refractive errors among urban preschool children. Methods A cross-sectional population-based study was conducted to evaluate the prevalence of ocular disorders in white and African American children 6 through 71 months of age in Baltimore, Maryland, United States. A comprehensive eye examination with cycloplegic refraction was performed. Parental concerns about development were measured with the Parents' Evaluation of Developmental Status screening tool. 2381 of 2546 eligible children (93.5%) completed the refraction and the parental interview. Results Parental concerns about development were present in 510 of the 2381 children evaluated (21.4%; 95% CI: 9.8% – 23.1%). The adjusted odds ratios [OR] of parental concerns with hyperopia (≥ 3.00D) was 1.26 (95% CI: 0.90 – 1.74), with myopia (≥ 1.00D) was 1.29 (95% CI: 0.83 – 2.03), with astigmatism (≥ 1.50D) was 1.44 (95% CI: 1.08 – 1.93) irrespective of the type of astigmatism, and with anisometropia ≥ 2.00D was 2.61 (95% CI: 1.07 – 6.34). The odds of parental concerns about development significantly increased in children older than 36 months with hyperopia ≥ 3.00D, astigmatism ≥ 1.50D, or anisometropia ≥ 2.00D. Conclusions Parental concerns about general developmental problems were associated with some types of refractive error, astigmatism ≥ 1.50D and anisometropia ≥ 2.00D in children ages 6 to 71 months. Parental concerns were also more likely in children older than 36 months of age with hypermetropia, astigmatism or anisometropia. Parental concerns were not associated with myopia. Due to the potential consequences of uncorrected refractive errors, children whose parents have expressed concerns regarding development should be referred for an eye examination with cycloplegic refraction to rule out significant refractive errors. PMID:21150680

  4. Development of Causative Treatment Strategies for Lacrimal Gland Insufficiency by Tissue Engineering and Cell Therapy. Part 2: Reconstruction of Lacrimal Gland Tissue: What Has Been Achieved So Far and What Are the Remaining Challenges?

    PubMed

    Massie, Isobel; Dietrich, Jana; Roth, Mathias; Geerling, Gerd; Mertsch, Sonja; Schrader, Stefan

    2016-10-01

    The lacrimal gland is located in the upper temporal compartment of the orbita, and along with the ocular surface, eye lids, and sensory and motor nerves forms the lacrimal functional unit (LFU). The LFU is responsible for producing, distributing, and maintaining the tear film in order to maintain a smooth, moist, and regular ocular surface epithelium such that appropriate refractive properties are achieved and the eyeball is protected against dust, debris, and pathogens. If the main lacrimal gland is impaired (due to either disease or injury), this balance is disrupted, and severe quantitative dry eye syndrome (DES) can develop. DES treatments remain palliative, with the most commonly used therapies being based on tear substitution, tear retention, and control of inflammation on the ocular surface. Causative treatments such as salivary gland transplantation have shown to reduce symptoms in very severe cases, however can cause problems on the ocular surface due to different properties of saliva and tears. Therefore, causative approaches for treating DES by regeneration or reconstruction of lacrimal gland tissue depending on disease severity seem highly appealing. This article reviews current approaches for in vitro reconstruction of lacrimal gland tissue. Finally, the limitations that must be overcome before a new, tissue-engineered therapy may be delivered to clinic will be discussed.

  5. Anterior Corneal, Posterior Corneal, and Lenticular Contributions to Ocular Aberrations.

    PubMed

    Atchison, David A; Suheimat, Marwan; Mathur, Ankit; Lister, Lucas J; Rozema, Jos

    2016-10-01

    To determine the corneal surfaces and lens contributions to ocular aberrations. There were 61 healthy participants with ages ranging from 20 to 55 years and refractions -8.25 diopters (D) to +3.25 D. Anterior and posterior corneal topographies were obtained with an Oculus Pentacam, and ocular aberrations were obtained with an iTrace aberrometer. Raytracing through models of corneas provided total corneal and surface component aberrations for 5-mm-diameter pupils. Lenticular contributions were given as differences between ocular and corneal aberrations. Theoretical raytracing investigated influence of object distance on aberrations. Apart from defocus, the highest aberration coefficients were horizontal astigmatism, horizontal coma, and spherical aberration. Most correlations between lenticular and ocular parameters were positive and significant, with compensation of total corneal aberrations by lenticular aberrations for 5/12 coefficients. Anterior corneal aberrations were approximately three times higher than posterior corneal aberrations and usually had opposite signs. Corneal topographic centers were displaced from aberrometer pupil centers by 0.32 ± 0.19 mm nasally and 0.02 ± 0.16 mm inferiorly; disregarding corneal decentration relative to pupil center was significant for oblique astigmatism, horizontal coma, and horizontal trefoil. An object at infinity, rather than at the image in the anterior cornea, gave incorrect aberration estimates of the posterior cornea. Corneal and lenticular aberration magnitudes are similar, and aberrations of the anterior corneal surface are approximately three times those of the posterior surface. Corneal decentration relative to pupil center has significant effects on oblique astigmatism, horizontal coma, and horizontal trefoil. When estimating component aberrations, it is important to use correct object/image conjugates and heights at surfaces.

  6. Analysis of Factors Associated With the Tear Film Lipid Layer Thickness in Normal Eyes and Patients With Dry Eye Syndrome.

    PubMed

    Jung, Ji Won; Park, Si Yoon; Kim, Jin Sun; Kim, Eung Kweon; Seo, Kyoung Yul; Kim, Tae-Im

    2016-08-01

    To determine the effects of clinical variables, including age, sex, history of refractive or cataract surgery, contact lens use, and ocular surface and meibomian gland parameters on the lipid layer thickness (LLT) in normal subjects and patients with dry eye syndrome (DES). A total of 64 normal subjects and 326 patients with DES were enrolled, and they underwent measurements of LLT with a LipiView interferometer and tear meniscus height using optical coherence tomography, tear film break-up time (TBUT) determination, ocular surface staining, Schirmer's test, examination of the lid margins and meibomian glands, and assessment using the Ocular Surface Disease Index (OSDI). In normal subjects, the median (range) LLT was 67 (33-100) nm, and age was the only factor that was significantly associated with LLT (β = 0.678, P = 0.028). In patients with DES, the median (range) LLT was 84 (20-100) nm, and 79.0% of the participants fulfilled the diagnostic criteria for meibomian gland dysfunction (MGD). In a multivariate analysis, increased age and female sex were significantly related to increased LLT (β = 0.282, P = 0.005 and β = 11.493, P < 0.001), and hypersecretory MGD and lid margin inflammation were independently associated with increased LLT (β = 11.299, P = 0.001 and β = 12.747, P = 0.001). Lipid layer thickness measurements using a new interferometer are significantly affected by demographic factors such as age, sex, ocular surgical history, and MGD type. Therefore, all of these factors must be considered in the diagnosis of ocular surface diseases.

  7. Temporal properties of compensation for positive and negative spectacle lenses in chicks.

    PubMed

    Zhu, Xiaoying; Wallman, Josh

    2009-01-01

    Chicks' eyes rapidly compensate for defocus imposed by spectacle lenses by changing their rate of elongation and their choroidal thickness. Compensation may involve internal emmetropization signals that rise and become saturated during episodes of lens wear and decline between episodes. The time constants of these signals were measured indirectly by measuring the magnitude of lens compensation in refractive error and ocular dimensions as a function of the duration of episodes and the intervals between the episodes. First, in a study of how quickly the signals rose, chicks were subjected to episodes of lens-wear of various durations (darkness otherwise), and the duration required to cause a half-maximum effect (rise-time) was estimated. Second, in a study of how quickly the signals declined, various dark intervals were imposed between episodes of lens-wear, and the interval required to reduce the maximum effect by half (fall-time) was estimated. The rise-times for the rate of ocular elongation and choroidal thickness were approximately 3 minutes for positive and negative lenses. The fall-times had a broad range of time courses: Positive lenses caused an enduring inhibition of ocular elongation with a fall-time of 24 hours. In contrast, negative lenses caused a transient stimulation of ocular elongation with a fall-time of 0.4 hour. The effects of episodes of defocus rise rapidly with episode duration to an asymptote and decline between episodes, with the time course depending strongly on the sign of defocus and the ocular component. The complex etiology of human myopia may reflect these temporal properties.

  8. Common visual problems in children with disability

    PubMed Central

    Salt, Alison; Sargent, Jenefer

    2014-01-01

    Children with disability are at a substantially higher risk of visual impairment (VI) (10.5% compared with 0.16%) but also of ocular disorders of all types, including refractive errors and strabismus. The aetiology of VI in children with disability reflects that of the general population and includes cerebral VI, optic atrophy, as well as primary visual disorders such as retinal dystrophies and structural eye anomalies. VI and other potentially correctable ocular disorders may not be recognised without careful assessment and are frequently unidentified in children with complex needs. Although assessment may be more challenging than in other children, identifying these potential additional barriers to learning and development may be critical. There is a need to develop clearer guidelines, referral pathways and closer working between all professionals involved in the care of children with disability and visual disorders to improve our focus on the assessment of vision and outcomes for children with disability. PMID:25165073

  9. Determinants of peripapillary retinal nerve fiber layer thickness regarding ocular and systemic parameters - the MIPH Eye&Health Study.

    PubMed

    Schuster, Alexander Karl-Georg; Fischer, Joachim Ernst; Vossmerbaeumer, Christine; Vossmerbaeumer, Urs

    2016-10-01

    Optical coherence tomography (OCT) allows quantitative image analysis of retinal tissue in vivo. Peripapillary retinal nerve fiber layer (pRNFL) thickness is widely used for evaluation of retinal nerve fiber rarefaction in several optic neuropathies. This study evaluates associations of pRNFL thickness in healthy adult subjects in order to evaluate influencing factors. A cross-sectional study was performed in a working-age population. Only eyes without detectable ocular pathologies were included in the analysis. Among analyzed systemic cardiovascular parameters were age, gender, body-mass index, mean arterial blood pressure, HbA1c, high- and low-density-lipoproteins, and triglycerides. A comprehensive ophthalmological examination including refraction, tonometry, keratometry, and central corneal thickness measurmentwas performed. In addition, pRNFL thickness was imaged by spectral-domain OCT. Univariable and multivariable associations of pRNFL thickness in all four quadrants and on average with systemic and ocular parameters were calculated using a generalized estimating equation model. Three hundred and six subjects were included. pRNFL thickness measurements showed a significant association with spherical equivalent: pRNFL thickness decreased with increasing myopia in all quadrants (multivariable regression coefficients Beta: superior: 1.16, 95 % CI [0.62;1.71], p < 0.001; temporal: 0.87, [0.33;1.41], p = 0.001; inferior: 1.80, [1.18;2.42], p < 0.001; nasal: 2.60, [2.01;3.20], p < 0.001) and on average (1.51, [1.20;1.82], p < 0.001). A thicker central cornea thickness was related to lower pRNFL in the superior (-0.05, [-0.10; -0.01], p = 0.01), the inferior quadrant (-0.05, [-0.10;0.00], p = 0.03) and on average (-0.04, [-0.07; -0.01], p = 0.02). All other parameters were not  associated. Our findings highlight the importance of refraction when evaluating pRNFL thickness and its independence from other systemic parameters.

  10. NASA's Current Evidence and Hypothesis for the Visual Impairment and Intracranial Pressure Risk

    NASA Technical Reports Server (NTRS)

    Otto, Christian A.; Norsk, Peter; Oubre, Cherie M.; Pass, Anastas F.; Tarver, William

    2012-01-01

    While 40 years of human spaceflight exploration has reported visual decrement to a certain extent in a subgroup of astronauts, recent data suggests that there is indeed a subset of crewmembers that experience refraction changes (hyperoptic shift), cotton wool spot formation, choroidal fold development, papilledema, optic nerve sheath distention and/or posterior globe flattening with varying degrees of severity and permanence. Pre and postflight ocular measures have identified a potential risk of permanent visual changes as a result of microgravity exposure, which has been defined as the Visual Impairment and Intracranial Pressure risk (VIIP). The combination of symptoms are referred to as the VIIP syndrome. It is thought that the ocular structural and optic nerve changes are caused by events precipitated by the cephalad fluid shift crewmembers experience during long-duration spaceflight. Three important systems, ocular, cardiovascular, and central nervous, seem to be involved in the development of symptoms, but the etiology is still under speculation. It is believed that some crewmembers are more susceptible to these changes due to genetic/anatomical predisposition or lifestyle (fitness) related factors. Future research will focus on determining the etiology of the VIIP syndrome and development of mechanisms to mitigate the spaceflight risk.

  11. Influence of internal optical astigmatism on the correction of myopic astigmatism by LASIK.

    PubMed

    Qian, Yi-Shan; Huang, Jia; Liu, Rui; Chu, Ren-Yuan; Xu, Ye; Zhou, Xing-Tao; Hoffman, Matthew R

    2011-12-01

    To investigate the influence of the origin of astigmatism on the correction of myopic astigmatism by LASIK. A retrospective study was conducted of the records of 192 patients (192 eyes) undergoing LASIK for correction of myopia and myopic astigmatism from January to September 2010. Ocular residual astigmatism (ORA) and lenticular astigmatism (LA) were determined by vector analysis using objective refraction and Pentacam (Oculus Optikgeräte GmbH) imaging of both corneal surfaces. Patients were divided into two groups according to ORA (high ORA group: ORA/preoperative refractive astigmatism >1; normal ORA group: ORA/preoperative refractive astigmatism ≤ 1) and LA (high LA group: LA/preoperative refractive astigmatism >1; normal LA group: LA/preoperative refractive astigmatism ≤ 1). Procedural efficacy was compared between those eyes with and without a significant amount of internal optical astigmatism using index of success. Mean preoperative vectors for the astigmatism of the anterior cornea, posterior cornea, and lens were -1.33 × 3.0°, -0.33 × 95.3°, and -0.27 × 103.3°, respectively. Mean indices of success in the high and low ORA groups were 1.75 and 0.59, respectively (t=7.81, P<.001). Mean indices of success in the high and low LA groups were 2.07 and 0.70, respectively (t=12.36, P<.001). The higher indices of success in the high ORA and high LA groups suggest a lower efficacy of LASIK in treating astigmatism primarily located intraocularly. Myopic LASIK is less effective in correcting astigmatism when astigmatism is mainly located at the internal optics. Topography and refractive value should be incorporated in the treatment of patients when a significant amount of internal optical astigmatism is detected preoperatively.

  12. Wave aberrations in rhesus monkeys with vision-induced ametropias

    PubMed Central

    Ramamirtham, Ramkumar; Kee, Chea-su; Hung, Li-Fang; Qiao-Grider, Ying; Huang, Juan; Roorda, Austin; Smith, Earl L.

    2007-01-01

    The purpose of this study was to investigate the relationship between refractive errors and high-order aberrations in infant rhesus monkeys. Specifically, we compared the monochromatic wave aberrations measured with a Shack-Hartman wavefront sensor between normal monkeys and monkeys with vision-induced refractive errors. Shortly after birth, both normal monkeys and treated monkeys reared with optically induced defocus or form deprivation showed a decrease in the magnitude of high-order aberrations with age. However, the decrease in aberrations was typically smaller in the treated animals. Thus, at the end of the lens-rearing period, higher than normal amounts of aberrations were observed in treated eyes, both hyperopic and myopic eyes and treated eyes that developed astigmatism, but not spherical ametropias. The total RMS wavefront error increased with the degree of spherical refractive error, but was not correlated with the degree of astigmatism. Both myopic and hyperopic treated eyes showed elevated amounts of coma and trefoil and the degree of trefoil increased with the degree of spherical ametropia. Myopic eyes also exhibited a much higher prevalence of positive spherical aberration than normal or treated hyperopic eyes. Following the onset of unrestricted vision, the amount of high-order aberrations decreased in the treated monkeys that also recovered from the experimentally induced refractive errors. Our results demonstrate that high-order aberrations are influenced by visual experience in young primates and that the increase in high-order aberrations in our treated monkeys appears to be an optical byproduct of the vision-induced alterations in ocular growth that underlie changes in refractive error. The results from our study suggest that the higher amounts of wave aberrations observed in ametropic humans are likely to be a consequence, rather than a cause, of abnormal refractive development. PMID:17825347

  13. Refraction and the axial length of the eyeball in patients with the optic disc drusen.

    PubMed

    Obuchowska, Iwona; Mariak, Zofia

    2009-01-01

    The aim of the study was to demonstrate the relationship between the optic disc drusen (ODD) and the axial length of the eyeball as well as refractive error. We examined prospectively 40 patients with ODD, 18 men and 22 women, age range from 34 to 69 years. All subjects underwent full ophthalmic examination, visual field testing and color-coded duplex sonography of the ocular vessels. Refraction was determined with an autorefractometer (Topcon RM-8000B) and further refined subjectively. Spherical equivalent refraction was calculated as the spherical dioptre plus one half of the cylindrical dioptre. Axial lengths were measured with a Sonomed ultrasound scanner model E-Z Scan AB5500. Clinical signs were observed in 65% of the eyes with drusen, among them, 38% had symptoms of visual acuity loss and all had visual fields defects. There were 21 eyes (18 eyes with and 3 without drusen), with a recorded refractive error. Significant differences in hyperopia were observed between the eyes with and without drusen (p = 0.048). The rate of occurrence of myopia did not differ significantly between affected and unaffected eyes (p = 0.06). The mean spherical equivalent refraction and axial dimensions of the eye differed significantly among the groups of eyes with and without drusen (p < 0.05). Significant differences in mean values of peak-systolic and end-diastolic velocities (p < 0.001) as well as in the resistivity index (p = 0.047) were observed between eyes with and without drusen. The optic disc drusen are often associated with shorter and hyperopic eyes. This anatomical conditions and vascular factors may contribute to pathogenesis of drusen.

  14. Transient Ocular Wavefront Data in Type 1 Diabetes Mellitus.

    PubMed

    Blendowske, Ralf; Kalb, Max

    2016-07-01

    We report transient ocular wavefront and blood glucose data for one patient with acute type 1 diabetes mellitus after the treatment with insulin has been initiated. The wavefront data for both eyes of a 34-year-old male patient were examined by a Hartmann-Shack wavefront sensor. Refraction data and higher-order aberrations were recorded during 130 days for eyes in natural conditions, without cycloplegia. At the beginning, we sampled data every 3 to 4 days and enlarged the intervals, when values settled. In total, we report 20 measurements and 1 baseline entry. Blood glucose levels were recorded at least six times a day during the complete period. For the equivalent sphere, we recorded a bilateral hyperopic shift of 5 D from -2.75 DS to +2.25 DS, followed by a reverse myopic shift of the same amount. The equivalent sphere peaked about 15 to 18 days after the treatment with insulin had begun. Cylinder values kept remarkably stable. Higher-order aberrations are dominated by the spherical aberration. The Zernike coefficient c12 for both eyes changed substantially from OD 0.036 μm and OS 0.062 μm to OD 0.24 μm and OS 0.22 μm (5 mm pupil diameter) following the time pattern of the equivalent sphere. About 60 days after they had reached their peak, all refraction values and higher-order aberrations stabilized at their baseline levels. The baseline was defined by records taken 4 years before the treatment with insulin was commenced. Wavefront aberrometry gives quantitative insights in the transient alteration and recovering of the eye's optics whilst the therapy of acute type 1 diabetes mellitus is being initiated. The data of this case support the assumption that variations in the crystalline lens, most probably the modification of its refractive gradient index, as a cause for the transient behavior. An explanation is still missing.

  15. Eye Examination Testability in Children with Autism and in Typical Peers

    PubMed Central

    Coulter, Rachel Anastasia; Bade, Annette; Tea, Yin; Fecho, Gregory; Amster, Deborah; Jenewein, Erin; Rodena, Jacqueline; Lyons, Kara Kelley; Mitchell, G. Lynn; Quint, Nicole; Dunbar, Sandra; Ricamato, Michele; Trocchio, Jennie; Kabat, Bonnie; Garcia, Chantel; Radik, Irina

    2015-01-01

    ABSTRACT Purpose To compare testability of vision and eye tests in an examination protocol of 9- to 17-year-old patients with autism spectrum disorder (ASD) to typically developing (TD) peers. Methods In a prospective pilot study, 61 children and adolescents (34 with ASD and 27 who were TD) aged 9 to 17 years completed an eye examination protocol including tests of visual acuity, refraction, convergence (eye teaming), stereoacuity (depth perception), ocular motility, and ocular health. Patients who required new refractive correction were retested after wearing their updated spectacle prescription for 1 month. The specialized protocol incorporated visual, sensory, and communication supports. A psychologist determined group status/eligibility using DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) criteria by review of previous evaluations and parent responses on the Social Communication Questionnaire. Before the examination, parents provided information regarding patients’ sex, race, ethnicity, and, for ASD patients, verbal communication level (nonverbal, uses short words, verbal). Parents indicated whether the patient wore a refractive correction, whether the patient had ever had an eye examination, and the age at the last examination. Chi-square tests compared testability results for TD and ASD groups. Results Typically developing and ASD groups did not differ by age (p = 0.54), sex (p = 0.53), or ethnicity (p = 0.22). Testability was high on most tests (TD, 100%; ASD, 88 to 100%), except for intraocular pressure (IOP), which was reduced for both the ASD (71%) and the TD (89%) patients. Among ASD patients, IOP testability varied greatly with verbal communication level (p < 0.001). Although IOP measurements were completed on all verbal patients, only 37.5% of nonverbal and 44.4% of ASD patients who used short words were successful. Conclusions Patients with ASD can complete most vision and eye tests within an examination protocol. Testability of IOPs is reduced, particularly for nonverbal patients and patients who use short words to communicate. PMID:25415280

  16. Prevalence of Amblyopia in School-Aged Children and Variations by Age, Gender, and Ethnicity in a Multi-Country Refractive Error Study.

    PubMed

    Xiao, Ou; Morgan, Ian G; Ellwein, Leon B; He, Mingguang

    2015-09-01

    To estimate the age-, gender-, and ethnicity-specific prevalence of amblyopia in children aged 5 to 15 years using data from the multi-country Refractive Error Study in Children (RESC). Population-based, cross-sectional study. Among 46 260 children aged 5 to 15 years who were enumerated from 8 sites in the RESC study, 39 551 had a detailed ocular examination and a reliable visual acuity (VA) measurement in 1 or both eyes. Information on ethnicity was available for 39 321 of these participants. This study focused on findings from the 39 321 children. The examination included VA measurements, evaluation of ocular alignment and refractive error under cycloplegia, and examination of the external eye, anterior segment, media, and fundus. The proportion of children aged 5 to 15 years with amblyopia in different ethnic cohorts. Amblyopia was defined as best-corrected visual acuity (BCVA) of ≤20/40 in either eye, with tropia, anisometropia (≥2 spherical equivalent diopters [D]), or hyperopia (≥+6 spherical equivalent D), after excluding children with fundus or anterior segment abnormalities. The overall prevalence of amblyopia was 0.74% (95% confidence interval, 0.64-0.83) with significant (P < 0.001) variation across ethnic groups: 1.43% in Hispanic, 0.93% in Chinese, 0.62% in Indian, 0.52% in Malay, 0.35% in Nepali, and 0.28% in African children. Amblyopia was not associated with age or gender. The most common cause of amblyopia was anisometropia. In this study, the prevalence of amblyopia varied with ethnicity and was highest in Hispanic children and lowest in African children. Most cases were unilateral and developed before the age of 5 years. The impact of changes of definitions on prevalence estimates is discussed. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  17. The SCHWIND AMARIS Total-Tech Laser as An All-Rounder in Refractive Surgery

    PubMed Central

    Arbelaez, Maria Clara; Mosquera, Samuel Arba

    2009-01-01

    Purpose: To describe and argument an overview of the main features and unique technical points of AMARIS Total-Tech Laser, coupled with patient outcomes supporting the decision to perform LASIK treatments with maximised outcomes. Settings: Dr. M.C. Arbelaez, Muscat Eye Laser Center, Muscat, Sultanate of Oman. Methods: The findings collected during 18-month experience using SCHWIND AMARIS Total-Tech Laser have been reviewed to provide arguments for supporting the decision to perform LASIK treatments with maximised outcomes. For updated clinical outcomes, the last 100 myopic astigmatism treatments, the last 100 hyperopic astigmatism treatments, the last 30 ocular-wavefront-guided treatments, and the last 30 corneal-wavefront-guided treatments, all with 6-month follow-up, were included. For all those, LDV femtosecond system was used to prepare the flaps, and AMARIS flying spot system was used to perform ablations. Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, wavefront aberration, and contrast sensitivity. Results: 6-month postoperatively, mean defocus was −0.14±0.31D and astigmatism 0.25±0.37D. 70± eyes were within ±0.25D of emmetropia. 43± eyes gained lines of best spectacle-corrected visual acuity. For Aberration-Free treatments, none of the aberration metrics changed from pre- to postoperative values in a clinically relevant amount. For ocular-wavefront-guided treatments, the surgery did not change coma or spherical aberration, and reduced trefoil (p<0.005). For corneal-wavefront-guided treatments, the trefoil, coma, and spherical aberrations, as well as the total root-mean-square values of higher order aberration, were significantly reduced (p<.05) when the pre-existing aberrations were greater than the repeatability and the biological noise. Conclusions: Although this review does not allow for evidence-based conclusions, following our strategy, LASIK results were excellent. LASIK surgery with AMARIS system yield excellent outcomes. Refractions were reduced to subclinical values with no induction of High-Order-Aberrations. Neither adverse events nor complications were observed. PMID:20142960

  18. The Visual Effects of Intraocular Colored Filters

    PubMed Central

    Hammond, Billy R.

    2012-01-01

    Modern life is associated with a myriad of visual problems, most notably refractive conditions such as myopia. Human ingenuity has addressed such problems using strategies such as spectacle lenses or surgical correction. There are other visual problems, however, that have been present throughout our evolutionary history and are not as easily solved by simply correcting refractive error. These problems include issues like glare disability and discomfort arising from intraocular scatter, photostress with the associated transient loss in vision that arises from short intense light exposures, or the ability to see objects in the distance through a veil of atmospheric haze. One likely biological solution to these more long-standing problems has been the use of colored intraocular filters. Many species, especially diurnal, incorporate chromophores from numerous sources (e.g., often plant pigments called carotenoids) into ocular tissues to improve visual performance outdoors. This review summarizes information on the utility of such filters focusing on chromatic filtering by humans. PMID:24278692

  19. Prevalence of refractive error among preschool children in an urban population: the Baltimore Pediatric Eye Disease Study.

    PubMed

    Giordano, Lydia; Friedman, David S; Repka, Michael X; Katz, Joanne; Ibironke, Josephine; Hawes, Patricia; Tielsch, James M

    2009-04-01

    To determine the age-specific prevalence of refractive errors in white and African-American preschool children. The Baltimore Pediatric Eye Disease Study is a population-based evaluation of the prevalence of ocular disorders in children aged 6 to 71 months in Baltimore, Maryland. Among 4132 children identified, 3990 eligible children (97%) were enrolled and 2546 children (62%) were examined. Cycloplegic autorefraction was attempted in all children with the use of a Nikon Retinomax K-Plus 2 (Nikon Corporation, Tokyo, Japan). If a reliable autorefraction could not be obtained after 3 attempts, cycloplegic streak retinoscopy was performed. Mean spherical equivalent (SE) refractive error, astigmatism, and prevalence of higher refractive errors among African-American and white children. The mean SE of right eyes was +1.49 diopters (D) (standard deviation [SD] = 1.23) in white children and +0.71 D (SD = 1.35) in African-American children (mean difference of 0.78 D; 95% confidence interval [CI], 0.67-0.89). Mean SE refractive error did not decline with age in either group. The prevalence of myopia of 1.00 D or more in the eye with the lesser refractive error was 0.7% in white children and 5.5% in African-American children (relative risk [RR], 8.01; 95% CI, 3.70-17.35). The prevalence of hyperopia of +3 D or more in the eye with the lesser refractive error was 8.9% in white children and 4.4% in African-American children (RR, 0.49; 95% CI, 0.35-0.68). The prevalence of emmetropia (<-1.00 D to <+1.00 D) was 35.6% in white children and 58.0% in African-American children (RR, 1.64; 95% CI, 1.49-1.80). On the basis of published prescribing guidelines, 5.1% of the children would have benefited from spectacle correction. However, only 1.3% had been prescribed correction. Significant refractive errors are uncommon in this population of urban preschool children. There was no evidence for a myopic shift over this age range in this cross-sectional study. A small proportion of preschool children would likely benefit from refractive correction, but few have had this prescribed.

  20. Absence of neurovisual effects due to tissue and blood cholinesterase depression in a chronic disulfoton feeding study in dogs.

    PubMed

    Jones, R D; Hastings, T F; Landes, A M

    1999-06-01

    Technical grade disulfoton (DiSyston) was fed to Beagle dogs (four animals per sex and treatment level) at nominal concentrations of 0, 0.5, 4 and 12 ppm for 1 year. The purpose of this study was to characterize the potential general and neurovisual toxicity according to routine Environmental Protection Agency (EPA) guideline requirements, and by use of ancillary ocular and neurologic tests established in this Laboratory. Ophthalmological tests included: ocular tissue cholinesterase and histopathology, electroretinography (ERG), tracking, refractivity, intraocular pressure and pachymetry (corneal thickness) measurements. Neurological examinations included; peripheral and cranial reflex tests, task performance tests, gait and behavioral observations, and rectal temperature measurements. Plasma, erythrocyte and corneal cholinesterase were significantly depressed at 4 and 12 ppm in both sexes. Brain cholinesterase was depressed at 4 and 12 ppm in females. Retinal cholinesterase was depressed at 4 ppm in females and at 12 ppm in males. Ciliary body cholinesterase was depressed at 12 ppm in both sexes. Despite these cholinergic effects, there were no ophthalmologic findings in measurements of ERG, tracking, refractivity, intraocular pressure or pachymetry. There were no clinical neurology findings related to compound administration. We conclude that 0.5 ppm was a no-observable effect level (NOEL), and effects were limited to cholinesterase changes that had no detectable physiologic impact. This study demonstrates that special mechanistic investigations incorporated within guideline studies, enhances scientific integrity and can minimize the need for dedicated organ system studies.

  1. A comparison of interocular differences in patients with pigment dispersion syndrome.

    PubMed

    Yip, Leonard W; Sothornwit, Nisa; Berkowitz, Jonathan; Mikelberg, Frederick S

    2009-01-01

    Pigment dispersion syndrome (PDS) and pigmentary glaucoma (PG) are characterized by loss of iris pigment because of reverse pupillary block. The loss of iris pigment is manifested as transillumination defects. Differences in ocular anatomy have been found between subjects with PDS and controls. Our study aims to see if differences in interocular anatomic features are also related to differences in the quantity of transillumination defects between eyes. This is an observational case series of 30 eyes of 15 subjects with PDS/PG in at least 1 eye. Patients underwent refraction, exophthalmometry, corneal and anterior chamber analysis by Pentacam, biometry, A-scan, ultrasound biomicroscopy, and anterior segment digital photography. The Pentacam mean central radii of the posterior corneal surface (cornea back Rm), vertical central radius of curvature of the posterior corneal surface (cornea back Rv), and keratometric power deviation (influence of the posterior surface of the cornea on refractive power) were statistically different between eyes with greater pigment loss and eyes with lesser pigment loss. Eyes with greater pigment loss had a larger back radius of corneal curvature and a correspondingly numerically smaller keratometric power deviation. Other measurements of ocular anatomy were not statistically significant. A flatter curvature of the posterior corneal surface of the eye is associated with increased pigment loss in PDS and PG. The authors postulate that this could result in a difference in the biomechanical properties of the cornea, increased deformation with blinking, and a pumping action resulting in the reverse pupil block of PDS.

  2. Foldable iris-fixated intraocular lens implantation in children.

    PubMed

    Ryan, Andrea; Hartnett, Claire; Lanigan, Bernadette; O'Keefe, Michael

    2012-09-01

      To describe the results of foldable iris-fixated intraocular lens (IOL) implantation in children.   Children with high bilateral or unilateral myopia who were intolerant of spectacle or contact lens correction were implanted with an iris-fixated foldable IOL and prospectively followed. We measured pre- and postoperative visual acuity, refraction, endothelial cell density (ECD) and National Eye Institute Visual Functioning Questionnaire-25.   Eleven eyes of six children were implanted. Indications were high bilateral myopia in children with comorbid neurobehavioural disorders, high anisometropia and high myopic astigmatism. Mean preoperative spherical equivalent (SE) refraction was -14.6 dioptres (D)±4.2 SD. Mean follow-up was 15 months. Postoperative SE refraction was -2.40 D±2.40 SD. Corrected distance visual acuity (CDVA) improved from mean logMAR 0.84±0.4 SD to postoperative 0.67±0.34 SD (p=0.005). CDVA was reduced because of coexistent ocular disorders and amblyopia. Vision-related quality of life (QOL) measures improved significantly. There were no intraoperative or postoperative serious complications.   Foldable iris-fixated IOL insertion can give a significant improvement in vision and in vision-related QOL in a subset of paediatric patients with special refractive needs who are intolerant to conventional treatment. Long-term follow-up is required for monitoring of ECD. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  3. Light intensity modulates corneal power and refraction in the chick eye exposed to continuous light.

    PubMed

    Cohen, Yuval; Belkin, Michael; Yehezkel, Oren; Avni, Isaac; Polat, Uri

    2008-09-01

    Continuous exposure of chicks to light was shown to result in severe hyperopia, accompanied by anterior segment changes, such as severe corneal flattening. Since rearing chicks in complete darkness results only in mild hyperopia and minor changes in corneal curvature, we hypothesized that light intensity may play a role in the development of refractive changes under continuous light illumination. To test this hypothesis, we examined the effects of rearing chicks under various continuous light intensities. More specifically, we investigated the refractive parameters of the chicks' eyes, and avoided light cycling effects on ocular development. To this end, thirty-eight chicks were reared under 24-h incandescent illumination, at three different light intensities: 10,000 lux (n=13), 500 lux (n=12), and 50 lux (n=13). Their eyes underwent repeated retinoscopy, keratometry, and ultrasound biometry, as well as caliper measurements of enucleated eyes. Both refraction and corneal refractive power were found to be correlated with light intensity. On day 90 after hatching, exposure to light intensities of 10,000, 500, and 50 lux resulted in hyperopia of +11.97+/-3.7 (mean+/-SD) +7.9+/-4.08 and +0.63+/-3.61 diopters (D), respectively. Under those intensities, corneal refractive power was 46.10+/-3.62, 49.72+/-4.16, and 56.88+/-4.92D, respectively. Axial length did not differ significantly among the groups. The vitreous chamber was significantly deeper in the high than in the low-intensity groups. Thus, during the early life of chicks exposed to continuous lighting, light intensity affects the vitreous chamber depth as well as the anterior segment parameters, most notably the cornea. The higher the intensity, the more severe was the corneal flattening observed and the hyperopia that developed, whereas continuous illumination at low intensities resulted in emmetropia. Thus, light intensity is an important factor that should be taken into account when studying refractive development.

  4. Temporal properties of the myopic response to defocus in the guinea pig.

    PubMed

    Leotta, Amelia J; Bowrey, Hannah E; Zeng, Guang; McFadden, Sally A

    2013-05-01

    Hyperopic defocus induces myopia in all species tested and is believed to underlie the progression of human myopia. We determined the temporal properties of the effects of hyperopic defocus in a mammalian eye. In Experiment 1, the rise and decay time of the responses elicited by hyperopic defocus were calculated in 111 guinea pigs by giving repeated episodes of monocular -4 D lens wear (from 5 to 6 days of age for 12 days) interspersed with various dark intervals. In Experiment 2, the decay time constant was calculated in 152 guinea pigs when repeated periods of monocular -5 D lens-wear (from 4 days of age for 7 days) were interrupted with free viewing periods of different lengths. At the end of the lens-wear period, ocular parameters were measured and time constants were calculated relative to the maximum response induced by continuous lens wear. When hyperopic defocus was experienced with dark intervals between episodes, the time required to induce 50% of the maximum achievable myopia and ocular elongation was at most 30 min. Saturated 1 h episodes took at least 22 h for refractive error and 31 h for ocular length, to decay to 50% of the maximum response. However, the decay was an order of magnitude faster when hyperopic defocus episodes were interrupted with a daily free viewing period, with only 36 min required to reduce relative myopia and ocular elongation by 50%. Hyperopic defocus causes myopia with brief exposures and is very long lasting in the absence of competing signals. However, this myopic response rapidly decays if interrupted by periods of 'normal viewing' at least 30 min in length, wherein ocular growth appears to be guided preferentially by the least amount of hyperopic defocus experienced. Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

  5. Scleral fixation of foldable acrylic intraocular lenses in aphakic post-vitrectomy eyes

    PubMed Central

    Mutoh, Tetsuya; Matsumoto, Yukihiro; Chikuda, Makoto

    2011-01-01

    Purpose To evaluate the outcome for scleral fixation of a foldable acrylic intraocular lens (IOL) in aphakic post-pars plana vitrectomy eyes for vitreoretinal disease. Methods The medical records of 15 patients were reviewed. We evaluated such factors as the underlying vitreoretinal disease, preoperative expected refraction and postoperative actual refraction, best corrected visual acuity (BCVA), corneal endothelial cell density, and intraoperative and postoperative complications. Results The most common cause of underlying vitreoretinal disease was retinal detachment, which was found in 8 cases. The mean refractive error was −0.10 diopters (D). The mean minimum angle of resolution (logMAR) values of BCVA were 0.27 preoperatively and 0.14 postoperatively. The mean corneal endothelial cell density was 2400 cells/mm2 preoperatively and 2187 cells/mm2 postoperatively. No significant differences were observed in either the logMAR values of BCVA or the corneal endothelial cell density before and after surgery. No intraoperative complications occurred in any of the patients. Postoperative complications occurred in a total of 7 eyes, and the most severe complications comprised 4 cases of transient ocular hypertension. Conclusion The results for the scleral fixation of foldable acrylic IOLs were good in aphakic post-vitrectomy eyes. PMID:21311652

  6. Simultaneous refraction measurement and OCT axial biometry of the eye during accommodation (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    De Freitas, Carolina; Hernandez, Victor M.; Ruggeri, Marco; Durkee, Heather A.; Williams, Siobhan; Gregori, Giovanni; Ho, Arthur; Manns, Fabrice; Parel, Jean-Marie

    2016-03-01

    The purpose of this project is to design and evaluate a system that will enable objective assessment of the optical accommodative response in real-time while acquiring axial biometric information. The system combines three sub-systems which were integrated and mounted on a joystick x-y-z adjustable modified slit-lamp base to facilitate alignment and data acquisition: (1) a Shack-Hartmann wavefront sensor for dynamic refraction measurement, provided software calculates sphere, cylinder and axis values, (2) an extended-depth Optical Coherence Tomography (OCT) system using an optical switch records high-resolution cross-sectional images across the length of the eye, from which, dynamic axial biometry (corneal thickness, anterior chamber depth, crystalline lens thickness and vitreous depth) can be extracted, and (3) a modified dual-channel accommodation stimulus unit based on the Badal optometer for providing a step change in accommodative stimulus. The prototypal system is capable of taking simultaneous measurements of both the optical and the mechanical response of lens accommodation. These measurements can provide insight into correlating changes in lens shape with changes in lens power and ocular refraction and ultimately provide a more comprehensive understanding of accommodation, presbyopia and an objective assessment of presbyopia correction techniques.

  7. Dry eye disease after refractive surgery: comparative outcomes of small incision lenticule extraction versus LASIK.

    PubMed

    Denoyer, Alexandre; Landman, Elise; Trinh, Liem; Faure, Jean-François; Auclin, François; Baudouin, Christophe

    2015-04-01

    To compare small incision lenticule extraction (SMILE) versus LASIK for post-refractive dry eye disease. Prospective, comparative, nonrandomized clinical study. Thirty patients scheduled for bilateral myopic SMILE and 30 age-, sex-, and refraction-matched patients scheduled for bilateral myopic LASIK were enrolled and followed for 6 months after the surgery. Complete evaluation of dry eye disease was performed at 1 and 6 months postoperatively, which included vision-related quality of life (Ocular Surface Disease Index [OSDI]), clinical examinations (tear film breakup time [TBUT], Schirmer I test, corneal staining), and tear osmolarity measurements, together with an overall severity score. Function and morphology of the corneal innervation were evaluated by corneal esthesiometry and subbasal nerve imaging using in vivo confocal microscopy (IVCM). Overall analysis of dry eye disease and corneal innervation. High incidence of mild to moderate dry eye disease was observed in both groups 1 month postoperatively, which remained significantly higher in the LASIK group than in the SMILE group 6 months after surgery (overall severity score [0-4]: 1.2±1.1 vs. 0.2±0.4, respectively, P < 0.01), leading to more frequent use of tear substitutes over the long term. Corneal sensitivity was better in SMILE than in LASIK eyes 1 month postoperatively (3.5±1.79 vs. 2.45±2.48, respectively, P < 0.01) and then recovered to statistically similar values at 6 months. Corneal nerve density, number of long fibers, and branchings as assessed by IVCM were significantly higher in the SMILE group compared with the LASIK group 1 and 6 months after surgery. Corneal sensitivity was negatively correlated with dry eye-related corneal damage (R² = 0.48, P < 0.01), and the long fiber nerve density was independently correlated with the OSDI score (R² = 0.50, P < 0.01) and the Schirmer test (R² = 0.21, P < 0.01) 6 months postoperatively. The SMILE procedure has a less pronounced impact on the ocular surface and corneal innervation compared with LASIK, further reducing the incidence of dry eye disease and subsequent degradation in quality of life after refractive surgery. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  8. Ocular Health and Safety Assessment among Mechanics of the Cape Coast Metropolis, Ghana.

    PubMed

    Abu, Emmanuel Kwasi; Boadi-Kusi, Samuel Bert; Opuni, Prince Quarcoo; Kyei, Samuel; Owusu-Ansah, Andrew; Darko-Takyi, Charles

    2016-01-01

    To conduct an ocular health and safety assessment among mechanics in the Cape Coast Metropolis, Ghana. This descriptive cross sectional study included 500 mechanics using multistage sampling. All participants filled a structured questionnaire on demographic data, occupational history and ocular health history. Study participants underwent determination of visual acuity (VA) using LogMAR chart, external eye examination with a handheld slit lamp biomicroscope, dilated fundus examination, applanation tonometry and refraction. Out of 500 mechanics, 433 were examined (response rate, 87%) comprised of 408 (94.2%) male and 25 (5.8%) female subjects. The prevalence of visual impairment (i.e. presenting VA < 6/18) among the respondents was 2.1%. Eye injuries were reported in 171 (39.5%) mechanics probably due to the large number of workers, 314 (72.5%), who did not use eye protective devices. Mechanics in the auto welding category were at the highest risk of sustaining an eye injury (odds ratio [OR], 13.4; P < 0.001). Anterior segment ocular disorders were mostly pterygia while posterior segment eye disorders included glaucoma suspects and retinochoroidal lesions. The development of pterygia was associated with the number of years a mechanic stayed on the job. Eye care seeking behavior among the participants was poor. Eye injuries were prevalent among the mechanics as the use of eye protection was low. Eye safety should be made an integral part of the public health agenda in the Cape Coast Metropolis.

  9. Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital

    PubMed Central

    Khan, Ruhi A.; Souru, Ches; Vaghese, Sejo; Yasir, Ziaul; Khandekar, Rajiv

    2017-01-01

    Objectives This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. Methods This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA). Results A total of 150 nurses participated in the study (response rate: 30.0%). The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%), 32 (21.3%) and 10 (6.7%) nurses, respectively. A total of 58 nurses (38.7%) failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%). With regards to regular eye checkups, 77 participants (51.3%) reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids (P <0.01 each). Conclusion A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population. PMID:28417032

  10. Unusual Internal Astigmatism Due to Severe Capsule Contraction Syndrome.

    PubMed

    Zéboulon, Pierre; Gatinel, Damien

    2018-01-01

    To describe a case of severe capsule contraction syndrome causing significant astigmatism due to intraocular lens (IOL) folding. Case report. Capsule fibrosis and contraction resulted in bending of the hydrophilic IOL along its long axis. Anterior Nd:YAG capsulotomy resolved the situation and restored the patient's visual acuity. Hydrophilic IOLs are more susceptible to capsule contraction due to the increased flexibility of highly hydrated materials. They should be avoided in patients at risk of capsule contraction to prevent ocular complications. [J Refract Surg. 2018;34(1):65-67.]. Copyright 2018, SLACK Incorporated.

  11. Improvement of visual acuity by refraction in a low-vision population.

    PubMed

    Sunness, Janet S; El Annan, Jaafar

    2010-07-01

    Refraction often may be overlooked in low-vision patients, because the main cause of vision decrease is not refractive, but rather is the result of underlying ocular disease. This retrospective study was carried out to determine how frequently and to what extent visual acuity is improved by refraction in a low-vision population. Cross-sectional study. Seven hundred thirty-nine low-vision patients seen for the first time. A database with all new low-vision patients seen from November 2005 through June 2008 recorded presenting visual acuity using an Early Treatment Diabetic Retinopathy Study chart; it also recorded the best-corrected visual acuity (BCVA) if it was 2 lines or more better than the presenting visual acuity. Retinoscopy was carried out on all patients, followed by manifest refraction. Improvement in visual acuity. Median presenting acuity was 20/80(-2) (interquartile range, 20/50-20/200). There was an improvement of 2 lines or more of visual acuity in 81 patients (11% of all patients), with 22 patients (3% of all patients) improving by 4 lines or more. There was no significant difference in age or in presenting visual acuity between the group that did not improve by refraction and the group that did improve. When stratified by diagnosis, the only 2 diagnoses with a significantly higher rate of improvement than the age-related macular degeneration group were myopic degeneration and progressive myopia (odds ratio, 4.8; 95% confidence interval [CI], 3.0-6.7) and status post-retinal detachment (odds ratio, 7.1; 95% CI, 5.2-9.0). For 5 patients (6% of those with improvement), the eye that was 1 line or more worse than the fellow eye at presentation became the eye that was 1 line or more better than the fellow eye after refraction. A significant improvement in visual acuity was attained by refraction in 11% of the new low-vision patients. Improvement was seen across diagnoses and the range of presenting visual acuity. The worse-seeing eye at presentation may become the better-seeing eye after refraction, so that the eye behind a balance lens should be refracted as well. Proprietary or commercial disclosure may be found after the references. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  12. Predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia.

    PubMed

    Guber, Ivo; Rémont, Laurent; Bergin, Ciara

    2015-01-01

    To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia. This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 250 patients were reviewed. Patients having full refraction reported (110 patients/220 eyes) were included. 210 (95 %) eyes had a straight forward phacoemulsification with posterior chamber intraocular lens implantation, seven eyes had a planned extracapsular cataract extraction (ECCE); three eyes had an intracapsular cataract extraction. Both eyes of 110 patients (64 women, 46 men) with a mean age of 79.0 years, standard deviation (SD) ±11.4 (range 26 to 97 years) were included. Median preoperative best corrected visual acuity (BCVA) was 0.5 LogMAR in the first eye, the interquartile range (IQR) was [0.4, 1.2]; 0.7 LogMAR in the second eye with IQR [0.4, 1.8]. At one month, the median BCVA was 0.2 LogMAR, IQR [0.1, 0.3] in the first eye, median BCVA was 0.1 LogMAR and IQR [0.0, 0.5] in the second eye. There were 3 eyes (3 %) that lost 3 lines or more in BCVA at one month (control vs. pre-operatively). In all three cases, poor visual acuity had been recorded pre-operatively (>1 LogMAR). Achieved refraction was within ±1.0 D of the target in 83 % of eyes. There were only 5 % (n = 6) of cases where if delayed sequential bilateral extraction had been performed could potentially intraocular lens (IOL) choice have been adjusted, in four of these cases, target refraction was within ±1.0 D in the second eye. ISBCS performed under general anaesthesia achieves target refraction in 83 % of eyes after consideration of complications, ocular co-morbidities and systemic restrictions. In the majority of cases where IOL power calculation could be considered, the achieved refraction of the second surgical eye was within ±1.0 D of intended refraction. This undermines the utility of IOL power adjustments in the second surgical eye.

  13. Complete 360° circumferential SSOCT gonioscopy of the iridocorneal angle

    NASA Astrophysics Data System (ADS)

    McNabb, Ryan P.; Kuo, Anthony N.; Izatt, Joseph A.

    2014-02-01

    The ocular iridocorneal angle is generally an optically inaccessible area when viewed directly through the cornea due to the high angle of incidence required and the large index of refraction difference between air and cornea (nair = 1.000 and ncornea = 1.376) resulting in total internal reflection. Gonioscopy allows for viewing of the angle by removing the aircornea interface through the use of a special contact lens on the eye. Gonioscopy is used clinically to visualize the angle directly but only en face. Optical coherence tomography (OCT) has been used to image the angle and deeper structures via an external approach. Typically, this imaging technique is performed by utilizing a conventional anterior segment OCT scanning system. However, instead of imaging the apex of the cornea, either the scanner or the subject is tilted such that the corneoscleral limbus is orthogonal to the optical axis of the scanner requiring multiple volumes to obtain complete circumferential coverage of the ocular angle. We developed a novel gonioscopic OCT (GOCT) system that images the entire ocular angle within a single volume via an "internal" approach through the use of a custom radially symmetric gonioscopic contact lens. We present, to our knowledge, the first complete 360° circumferential volumes of the iridocorneal angle from a direct, internal approach.

  14. The Chinese American Eye Study: Design and Methods

    PubMed Central

    Varma, Rohit; Hsu, Chunyi; Wang, Dandan; Torres, Mina; Azen, Stanley P.

    2016-01-01

    Purpose To summarize the study design, operational strategies and procedures of the Chinese American Eye Study (CHES), a population-based assessment of the prevalence of visual impairment, ocular disease, and visual functioning in Chinese Americans. Methods This population-based, cross-sectional study, included 4,570 Chinese, 50 years and older, residing in the city of Monterey Park, California. Each eligible participant completed a detailed interview and eye examination. The interview included an assessment of demographic, behavioral, and ocular risk factors and health-related and vision-related quality of life. The eye examination included measurements of visual acuity, intraocular pressure, visual fields, fundus and optic disc photography, a detailed anterior and posterior segment examination, and measurements of blood pressure, glycosylated hemoglobin levels, and blood glucose levels. Results The objectives of the CHES are to obtain prevalence estimates of visual impairment, refractive error, diabetic retinopathy, open-angle and angle-closure glaucoma, lens opacities, and age-related macular degeneration in Chinese-Americans. In addition, outcomes include effect estimates for risk factors associated with eye diseases. Lastly, CHES will investigate the genetic determinates of myopia and glaucoma. Conclusion The CHES will provide information about the prevalence and risk factors of ocular diseases in one of the fastest growing minority groups in the United States. PMID:24044409

  15. Refractive astigmatism and the toricity of ocular components in human infants.

    PubMed

    Mutti, Donald O; Mitchell, G Lynn; Jones, Lisa A; Friedman, Nina E; Frane, Sara L; Lin, Wendy K; Moeschberger, Melvin L; Zadnik, Karla

    2004-10-01

    Many studies have characterized astigmatism in infancy, but few have been longitudinal or contained ocular component data. This study characterized the frequency, orientation, and longitudinal change with age of infant astigmatism. Additional factors investigated were the influence of early astigmatism on emmetropization and its relation to corneal and lenticular toricity. Three hundred two infants were enrolled in the study. Of these, 298 provided data for at least one visit at 3 +/- 1 months, 9 +/- 1 months, 18 +/- 2 months, and 36 +/- 3 months. Testing included cycloplegic retinoscopy (cyclopentolate 1%), video-based keratophakometry, and ultrasonography over the closed eyelid. Astigmatism > or =1.00 DC was common at 3 months of age (41.6%) but decreased in prevalence to 4.1% by 36 months (p < 0.0001). The most common orientation was with-the-rule at 3 months (37.0% compared with 2.7% for against-the-rule) but against-the-rule at 36 months (3.2% compared with 0.9% for with-the-rule). Most of the change in the average value of the horizontal/vertical component of astigmatism (J0) occurred between 3 and 9 months (-0.26 +/- 0.36 D; p < 0.0001) with no significant change between 9 and 36 months (-0.05 +/- 0.36 D; p=0.09). Spherical equivalent refractive error was not correlated with J0 at 3 and 9 months (R=0.002, p=0.48 and R=0.001, p=0.56, respectively). The two were only weakly correlated at 18 and 36 months (R=0.06 for each age, p <0.0001, p=0.0002, respectively). Changes in spherical equivalent between 3 and 9 months were unrelated to either the initial value of J0 (partial R for J0=0.0001; p=0.85) or the change in J0 (partial R for change in J0=0.0031; p=0.31). Across all the ages, corneal toricity was with-the-rule, and lenticular toricity was against-the-rule (produced by the toricity of the posterior lens surface). The cornea and anterior lens surface became more spherical with age, contributing to the shift away from with-the-rule refractive astigmatism. Toricity of all the refractive surfaces became less variable with age. Consistent with many reports, astigmatism was common in early infancy but decreased in prevalence with age, particularly when with-the-rule in orientation. The reduction in percentage of infants with astigmatism appeared to be caused by decreases in the toricity of the cornea and the anterior lens combined with decreases in the variability of corneal and lenticular surfaces. Astigmatism in infancy appeared to be unrelated to emmetropization of spherical equivalent refractive error.

  16. Computer vision syndrome: A review.

    PubMed

    Gowrisankaran, Sowjanya; Sheedy, James E

    2015-01-01

    Computer vision syndrome (CVS) is a collection of symptoms related to prolonged work at a computer display. This article reviews the current knowledge about the symptoms, related factors and treatment modalities for CVS. Relevant literature on CVS published during the past 65 years was analyzed. Symptoms reported by computer users are classified into internal ocular symptoms (strain and ache), external ocular symptoms (dryness, irritation, burning), visual symptoms (blur, double vision) and musculoskeletal symptoms (neck and shoulder pain). The major factors associated with CVS are either environmental (improper lighting, display position and viewing distance) and/or dependent on the user's visual abilities (uncorrected refractive error, oculomotor disorders and tear film abnormalities). Although the factors associated with CVS have been identified the physiological mechanisms that underlie CVS are not completely understood. Additionally, advances in technology have led to the increased use of hand-held devices, which might impose somewhat different visual challenges compared to desktop displays. Further research is required to better understand the physiological mechanisms underlying CVS and symptoms associated with the use of hand-held and stereoscopic displays.

  17. Corneal thickness in dry eyes in an Iraqi population.

    PubMed

    Ali, Noora Mauwafak; Hamied, Furkaan M; Farhood, Qasim K

    2017-01-01

    Dry eye disorder is a multifactorial disease of the tears and ocular surface that results in discomfort and visual disturbance. Corneal pachymetry becomes increasingly important in refractive surgery, for the accurate assessment of intraocular pressure, and in the preoperative assessment of other ocular surgeries. To assess the effect of dry eye disorder on the central corneal thickness (CCT) by comparing with CCT of normal eyes of age-matched individuals. The total number of eyes examined was 280 (140 dry eyes from 70 patients and 140 normal eyes from 70 individuals). Pentacam (Scheimpflug imaging system) was used for measuring the CCT of all eyes. Patients with dry eye syndrome had significantly lower CCT compared to the control group ( P <0.01). Its mean was 536.5 versus 561.3, respectively. CCT of dry eyes was significantly reduced when compared with age- and gender-matched population. This result can be attributed to chronic desiccation by the inflammatory mediators in dry eyes, leading to corneal thinning.

  18. Laser in situ keratomileusis surgery is not safe for military personnel.

    PubMed

    Xiao, Jian-He; Zhang, Mao-Nian; Jiang, Cai-Hui; Zhang, Ying; Qiu, Huai-Yu

    2012-01-01

    To investigate the relationship between eye injury and laser in-situ keratomileusis (LASIK) surgery in military personnel. This retrospective study collected the data from 27 evacuation hospitals of Chinese army. All medical records of eye injuries in military personnel admitted to the 27 hospitals between January 2006 and December 2010 were reviewed. Patients'detailed information was analyzed, including the injury time, place, type, cause, as well as examination, treatment and outcome. There were 72 eye-injured patients who had been treated by LASIK before. The incidence was rising year by year. Among them, 69 patients were diagnosed with mechanical ocular injury and 3 with non-mechanical ocular injury; 29 patients had traumatic flap-related complications and 21 patients need surgery. There was statistical difference when compared with those having no refractive surgery history. Visual acuity recovered well at discharge. There is a high risk of potential traumatic flap problems after LASIK and it is not recommended in army service.

  19. Symptomatic accommodative and binocular dysfunctions from the use of flat-panel displays

    PubMed Central

    Porcar, Esteban; Montalt, Juan Carlos; Pons, Álvaro M.; España-Gregori, Enrique

    2018-01-01

    AIM To determine the presence of symptomatic accommodative and non-strabismic binocular dysfunctions (ANSBD) in a non-presbyopic population of video display unit (VDU) users with flat-panel displays. METHODS One hundred and one VDU users, aged between 20 to 34y, initially participated in the study. This study excluded contact-lens wearers and subjects who had undergone refractive surgery or had any systemic or ocular disease. First, subjects were asked about the type and nature of eye symptoms they experienced during VDU use. Then, a thorough eye examination excluded those subjects with a significant uncorrected refractive error or other problem, such as ocular motility disorders, vertical deviation, strabismus and eye diseases. Finally, the remaining participants underwent an exhaustive assessment of their accommodative and binocular vision status. RESULTS Eighty-nine VDU users (46 females and 43 males) were included in this study. They used flat-panel displays for an average of 5±1.9h a day. Twenty subjects presented ANSBD (22.5%). Convergence excess was the most frequent non-strabismic binocular dysfunction (9 subjects), followed by fusional vergence dysfunction (3 subjects) and convergence insufficiency (2 subjects). Within the accommodative dysfunctions, accommodative excess was the most common (4 subjects), followed by accommodative insufficiency (2 subjects). Moderate to severe eye symptoms were found in 13 subjects with ANSBD. CONCLUSION Significant eye symptoms in VDU users with accommodative and/or non-strabismic binocular dysfunctions often occur and should not be underestimated; therefore, an appropriate evaluation of accommodative and binocular vision status is more important for this population. PMID:29600186

  20. Mouse Experimental Myopia Has Features of Primate Myopia

    PubMed Central

    Tkatchenko, Tatiana V.; Shen, Yimin

    2010-01-01

    Purpose. Several recent studies have suggested that experimental myopia can be induced in mice. However, it is not clear what role the photopic visual input plays in this process and whether mouse myopia is similar to human myopia. The purpose of this study was to carry out an in vivo high-resolution analysis of changes in ocular components and refractive state of the eye upon induction of experimental myopia in mice. Methods. A high-resolution small animal MRI system and a high-resolution automated eccentric infrared photorefractor were used to analyze changes of the refractive state and ocular components in C57BL/6J mice associated with experimental myopia induced by diffusers and −25 D lenses under photopic conditions. Results. The authors found that both diffusers and −25 D lenses induce myopia in C57BL/6J mice under photopic conditions (continuous light, 200 ± 15 lux). The extent of myopic shift induced by −25 D lenses was greater than the shift induced by diffusers (−15.2 ± 0.7 D, lenses; −12.0 ± 1.4 D, diffusers). Myopia in mice is attributed to an increase in size of the postequatorial segment of the eye. Experimental myopia in mice can be induced only during the susceptible period in postnatal development, which ends around postnatal day 67. Conclusions. Both diffusers and spectacle lenses induce myopia in mice under photopic conditions, during the susceptible period in postnatal development. Myopia in mice is associated with elongation of the vitreous chamber of the eye, as in humans and nonhuman primates. PMID:19875658

  1. Axial Length Variation Impacts on Superficial Retinal Vessel Density and Foveal Avascular Zone Area Measurements Using Optical Coherence Tomography Angiography.

    PubMed

    Sampson, Danuta M; Gong, Peijun; An, Di; Menghini, Moreno; Hansen, Alex; Mackey, David A; Sampson, David D; Chen, Fred K

    2017-06-01

    To evaluate the impact of image magnification correction on superficial retinal vessel density (SRVD) and foveal avascular zone area (FAZA) measurements using optical coherence tomography angiography (OCTA). Participants with healthy retinas were recruited for ocular biometry, refraction, and RTVue XR Avanti OCTA imaging with the 3 × 3-mm protocol. The foveal and parafoveal SRVD and FAZA were quantified with custom software before and after correction for magnification error using the Littman and the modified Bennett formulae. Relative changes between corrected and uncorrected SRVD and FAZA were calculated. Forty subjects were enrolled and the median (range) age of the participants was 30 (18-74) years. The mean (range) spherical equivalent refractive error was -1.65 (-8.00 to +4.88) diopters and mean (range) axial length was 24.42 mm (21.27-28.85). Images from 13 eyes were excluded due to poor image quality leaving 67 for analysis. Relative changes in foveal and parafoveal SRVD and FAZA after correction ranged from -20% to +10%, -3% to +2%, and -20% to +51%, respectively. Image size correction in measurements of foveal SRVD and FAZA was greater than 5% in 51% and 74% of eyes, respectively. In contrast, 100% of eyes had less than 5% correction in measurements of parafoveal SRVD. Ocular biometry should be performed with OCTA to correct image magnification error induced by axial length variation. We advise caution when interpreting interocular and interindividual comparisons of SRVD and FAZA derived from OCTA without image size correction.

  2. Visual impairment and amblyopia in Malaysian pre-school children - The SEGPAEDS study.

    PubMed

    Chew, F L M; Thavaratnam, L K; Shukor, I N C; Ramasamy, S; Rahmat, J; Reidpath, D D; Allotey, P; Alagaratnam, J

    2018-02-01

    Little is known regarding the extent of visual impairment amongst pre-school children in Malaysia. To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children. A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria. A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia. Our study highlights an urgent need for initiation of preschool vision screening in Malaysia.

  3. A retrospective analysis of eye conditions among children attending St. John Eye Hospital, Hebron, Palestine.

    PubMed

    Banayot, Riyad G

    2016-04-05

    Eye diseases are important causes of medical consultations, with the spectrum varying in different regions. This hospital-based descriptive study aimed to determine the profile of childhood eye conditions at St. John tertiary Eye hospital serving in Hebron, Palestine. Files of all new patients less than 16 years old who presented to St. John Eye Hospital-Hebron, Palestine between January 2013 and December 2013 were retrospectively reviewed. Age at presentation, sex, and clinical diagnosis were extracted from medical records. Data were stored and analyzed using Wizard data analysis version 1.6.0 by Evan Miller. The Chi square test was used to compare variables and a p value of less than 0.05 was considered statistically significant. We evaluated the records of 1102 patients, with a female: male ratio of 1:1.1. Patients aged 0-5 years old were the largest group (40.2%). Refractive errors were the most common ocular disorders seen (31.6%), followed by conjunctival diseases (23.7%) and strabismus and amblyopia (13.8%). Refractive errors were recorded more frequently and statistically significant (p < 0.001) among (11-15) age group. Within the conjunctival diseases category, conjunctivitis and dry eyes was more prominent and statistically significant (p < 0.001) among the 6-10 year old age group. Within the strabismus and amblyopia category, convergent strabismus was more common and statistically significant among the youngest age group (0-5 years old). The most common causes of ocular morbidity are largely treatable or preventable. These results suggest the need for awareness campaigns and early intervention programs.

  4. Pharmacology of Myopia and Potential Role for Intrinsic Retinal Circadian Rhythms

    PubMed Central

    Stone, Richard A.; Pardue, Machelle T.; Iuvone, P. Michael; Khurana, Tejvir S.

    2013-01-01

    Despite the high prevalence and public health impact of refractive errors, the mechanisms responsible for ametropias are poorly understood. Much evidence now supports the concept that the retina is central to the mechanism(s) regulating emmetropization and underlying refractive errors. Using a variety of pharmacologic methods and well-defined experimental eye growth models in laboratory animals, many retinal neurotransmitters and neuromodulators have been implicated in this process. Nonetheless, an accepted framework for understanding the molecular and/or cellular pathways that govern postnatal eye development is lacking. Here, we review two extensively studied signaling pathways whose general roles in refractive development are supported by both experimental and clinical data: acetylcholine signaling through muscarinic and/or nicotinic acetylcholine receptors and retinal dopamine pharmacology. The muscarinic acetylcholine receptor antagonist atropine was first studied as an anti-myopia drug some two centuries ago, and much subsequent work has continued to connect muscarinic receptors to eye growth regulation. Recent research implicates a potential role of nicotinic acetycholine receptors; and the refractive effects in population surveys of passive exposure to cigarette smoke, of which nicotine is a constituent, support clinical relevance. Reviewed here, many puzzling results inhibit formulating a mechanistic framework that explains acetylcholine’s role in refractive development. How cholinergic receptor mechanisms might be used to develop acceptable approaches to normalize refractive development remains a challenge. Retinal dopamine signaling not only has a putative role in refractive development, its upregulation by light comprises an important component of the retinal clock network and contributes to the regulation of retinal circadian physiology. During postnatal development, the ocular dimensions undergo circadian and/or diurnal fluctuations in magnitude; these rhythms shift in eyes developing experimental ametropia. Long-standing clinical ideas about myopia in particular have postulated a role for ambient lighting, although molecular or cellular mechanisms for these speculations have remained obscure. Experimental myopia induced by the wearing of a concave spectacle lens alters the retinal expression of a significant proportion of intrinsic circadian clock genes, as well as genes encoding a melatonin receptor and the photopigment melanopsin. Together this evidence suggests a hypothesis that the retinal clock and intrinsic retinal circadian rhythms may be fundamental to the mechanism(s) regulating refractive development, and that disruptions in circadian signals may produce refractive errors. Here we review the potential role of biological rhythms in refractive development. While much future research is needed, this hypothesis could unify many of the disparate clinical and laboratory observations addressing the pathogenesis of refractive errors. PMID:23313151

  5. The visual and functional impacts of astigmatism and its clinical management.

    PubMed

    Read, Scott A; Vincent, Stephen J; Collins, Michael J

    2014-05-01

    To provide a comprehensive overview of research examining the impact of astigmatism on clinical and functional measures of vision, the short and longer term adaptations to astigmatism that occur in the visual system, and the currently available clinical options for the management of patients with astigmatism. The presence of astigmatism can lead to substantial reductions in visual performance in a variety of clinical vision measures and functional visual tasks. Recent evidence demonstrates that astigmatic blur results in short-term adaptations in the visual system that appear to reduce the perceived impact of astigmatism on vision. In the longer term, uncorrected astigmatism in childhood can also significantly impact on visual development, resulting in amblyopia. Astigmatism is also associated with the development of spherical refractive errors. Although the clinical correction of small magnitudes of astigmatism is relatively straightforward, the precise, reliable correction of astigmatism (particularly high astigmatism) can be challenging. A wide variety of refractive corrections are now available for the patient with astigmatism, including spectacle, contact lens and surgical options. Astigmatism is one of the most common refractive errors managed in clinical ophthalmic practice. The significant visual and functional impacts of astigmatism emphasise the importance of its reliable clinical management. With continued improvements in ocular measurement techniques and developments in a range of different refractive correction technologies, the future promises the potential for more precise and comprehensive correction options for astigmatic patients. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

  6. Height, weight, body mass index and ocular biometry in patients with sickle cell disease.

    PubMed

    Osuobeni, Ebi Peter; Okpala, Iheanyi; Williamson, Tom H; Thomas, Peter

    2009-03-01

    To investigate the effects of physical size on refractive error and the dimensions of optical components in sickle cell disease (SCD). The design was cross sectional. Height and weight of adult patients suffering from SCD were measured, and body mass index (BMI) was calculated. Anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD) and axial length (AL) were measured using A-scan ultrasonography. Corneal radius of curvature (CR) was measured using a keratometer. Non-cycloplegic refractive error was determined subjectively. Subjects with SC genotype were significantly taller than those with SS genotype. In the unadjusted data, height was correlated with VCD [p = 0.02, 0.44 mm deeper per 10 cm increase in height, 95% CI (0.65, 8.25)] and AL [p = 0.03, 0.42 mm longer for every 10 cm increase in height, 95%CI (0.49, 7.99)]. The relationship between height, VCD and AL was absent after adjustment for age, gender, genotype and weight. BMI (kg m(-2)) was correlated with AL/CR ratio in both unadjusted (p = 0.04, -0.10 decrease per 1 kg m(-2), 95% CI (-0.018, -0.001) and adjusted data (p = 0.05, -0.10 decrease per 10 kg m(-2), 95% CI (-0.0189, 0.0001). Refractive error was not related to height, weight or BMI. Physical size does not affect refractive error or optical components in adult patients with SCD.

  7. Small-incision lenticule extraction (SMILE): outcomes of 722 eyes treated for myopia and myopic astigmatism.

    PubMed

    Hansen, Rasmus Søgaard; Lyhne, Niels; Grauslund, Jakob; Vestergaard, Anders Højslet

    2016-02-01

    To study the outcomes of small-incision lenticule extraction (SMILE) for treatment of myopia and myopic astigmatism. Retrospective study of patients treated for myopia or myopic astigmatism with SMILE, using a VisuMax(®) femtosecond laser (Carl Zeiss Meditec, Jena, Germany), at the Department of Ophthalmology, Odense University Hospital, Odense, Denmark. Inclusion criteria were corrected distance visual acuity (CDVA) of 20/25 or better before surgery and no ocular conditions other than myopia up to -10.00 diopters (D) with astigmatism up to 3.00 D. Of the 729 treatments, 722 were included. The spherical equivalent (SE) refraction averaged -6.82 ± 1.66 diopters (D) before surgery. After 3 months, 88 % of eyes were within ±0.50 D of the intended refraction, whilst 98 % were within ±1.00 D. The mean difference between attempted and achieved SE refraction at 3 months after surgery was -0.06 ± 0.01 D (range: -1.25 to 1.25 D). In eyes with emmetropia as target refraction (n = 362), 63 % had uncorrected distance visual acuity (UDVA) of 20/25 or better 1 day after surgery, rising to 83 % at 3 months after surgery. The average gain in CDVA from before surgery to 3 months after surgery was 0.07 ± 0.03 (logMAR). However, 12 eyes (1.6 %) lost 2 or more lines of CDVA from before surgery to 3 months postoperatively. Simultaneous treatment of up to 3.00 D of astigmatism was not associated with less predictable refractive outcomes. In the short term, SMILE seemed predictable, efficient, and safe for treatment of myopia and myopic astigmatism.

  8. Evaluation of the measurement of refractive error by the PowerRefractor: a remote, continuous and binocular measurement system of oculomotor function

    PubMed Central

    Hunt, O A; Wolffsohn, J S; Gilmartin, B

    2003-01-01

    Background/aim: The technique of photoretinoscopy is unique in being able to measure the dynamics of the oculomotor system (ocular accommodation, vergence, and pupil size) remotely (working distance typically 1 metre) and objectively in both eyes simultaneously. The aim of this study was to evaluate clinically the measurement of refractive error by a recent commercial photoretinoscopic device, the PowerRefractor (PlusOptiX, Germany). Method: The validity and repeatability of the PowerRefractor was compared to: subjective (non-cycloplegic) refraction on 100 adult subjects (mean age 23.8 (SD 5.7) years) and objective autorefraction (Shin-Nippon SRW-5000, Japan) on 150 subjects (20.1 (4.2) years). Repeatability was assessed by examining the differences between autorefractor readings taken from each eye and by re-measuring the objective prescription of 100 eyes at a subsequent session. Results: On average the PowerRefractor prescription was not significantly different from the subjective refraction, although quite variable (difference +0.05 (0.63) D, p = 0.41) and more negative than the SRW-5000 prescription (by −0.20 (0.72) D, p<0.001). There was no significant bias in the accuracy of the instrument with regard to the type or magnitude of refractive error. The PowerRefractor was found to be repeatable over the prescription range of −8.75D to +4.00D (mean spherical equivalent) examined. Conclusion: The PowerRefractor is a useful objective screening instrument and because of its remote and rapid measurement of both eyes simultaneously is able to assess the oculomotor response in a variety of unrestricted viewing conditions and patient types. PMID:14660462

  9. Prevalence of vision impairment and refractive error in school children in Ba Ria – Vung Tau province, Vietnam

    PubMed Central

    Paudel, Prakash; Ramson, Prasidh; Naduvilath, Thomas; Wilson, David; Phuong, Ha Thanh; Ho, Suit M; Giap, Nguyen V

    2014-01-01

    Background To assess the prevalence of vision impairment and refractive error in school children 12–15 years of age in Ba Ria – Vung Tau province, Vietnam. Design Prospective, cross-sectional study. Participants 2238 secondary school children. Methods Subjects were selected based on stratified multistage cluster sampling of 13 secondary schools from urban, rural and semi-urban areas. The examination included visual acuity measurements, ocular motility evaluation, cycloplegic autorefraction, and examination of the external eye, anterior segment, media and fundus. Main Outcome Measures Visual acuity and principal cause of vision impairment. Results The prevalence of uncorrected and presenting visual acuity ≤6/12 in the better eye were 19.4% (95% confidence interval, 12.5–26.3) and 12.2% (95% confidence interval, 8.8–15.6), respectively. Refractive error was the cause of vision impairment in 92.7%, amblyopia in 2.2%, cataract in 0.7%, retinal disorders in 0.4%, other causes in 1.5% and unexplained causes in the remaining 2.6%. The prevalence of vision impairment due to myopia in either eye (–0.50 diopter or greater) was 20.4% (95% confidence interval, 12.8–28.0), hyperopia (≥2.00 D) was 0.4% (95% confidence interval, 0.0–0.7) and emmetropia with astigmatism (≥0.75 D) was 0.7% (95% confidence interval, 0.2–1.2). Vision impairment due to myopia was associated with higher school grade and increased time spent reading and working on a computer. Conclusions Uncorrected refractive error, particularly myopia, among secondary school children in Vietnam is a major public health problem. School-based eye health initiative such as refractive error screening is warranted to reduce vision impairment. PMID:24299145

  10. Prevalence of vision impairment and refractive error in school children in Ba Ria - Vung Tau province, Vietnam.

    PubMed

    Paudel, Prakash; Ramson, Prasidh; Naduvilath, Thomas; Wilson, David; Phuong, Ha Thanh; Ho, Suit M; Giap, Nguyen V

    2014-04-01

    To assess the prevalence of vision impairment and refractive error in school children 12-15 years of age in Ba Ria - Vung Tau province, Vietnam. Prospective, cross-sectional study. 2238 secondary school children. Subjects were selected based on stratified multistage cluster sampling of 13 secondary schools from urban, rural and semi-urban areas. The examination included visual acuity measurements, ocular motility evaluation, cycloplegic autorefraction, and examination of the external eye, anterior segment, media and fundus. Visual acuity and principal cause of vision impairment. The prevalence of uncorrected and presenting visual acuity ≤6/12 in the better eye were 19.4% (95% confidence interval, 12.5-26.3) and 12.2% (95% confidence interval, 8.8-15.6), respectively. Refractive error was the cause of vision impairment in 92.7%, amblyopia in 2.2%, cataract in 0.7%, retinal disorders in 0.4%, other causes in 1.5% and unexplained causes in the remaining 2.6%. The prevalence of vision impairment due to myopia in either eye (-0.50 diopter or greater) was 20.4% (95% confidence interval, 12.8-28.0), hyperopia (≥2.00 D) was 0.4% (95% confidence interval, 0.0-0.7) and emmetropia with astigmatism (≥0.75 D) was 0.7% (95% confidence interval, 0.2-1.2). Vision impairment due to myopia was associated with higher school grade and increased time spent reading and working on a computer. Uncorrected refractive error, particularly myopia, among secondary school children in Vietnam is a major public health problem. School-based eye health initiative such as refractive error screening is warranted to reduce vision impairment. © 2013 The Authors. Clinical & Experimental Ophthalmology published by Wiley Publishing Asia Pty Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.

  11. Evaluation of the measurement of refractive error by the PowerRefractor: a remote, continuous and binocular measurement system of oculomotor function.

    PubMed

    Hunt, O A; Wolffsohn, J S; Gilmartin, B

    2003-12-01

    The technique of photoretinoscopy is unique in being able to measure the dynamics of the oculomotor system (ocular accommodation, vergence, and pupil size) remotely (working distance typically 1 metre) and objectively in both eyes simultaneously. The aim of this study was to evaluate clinically the measurement of refractive error by a recent commercial photoretinoscopic device, the PowerRefractor (PlusOptiX, Germany). The validity and repeatability of the PowerRefractor was compared to: subjective (non-cycloplegic) refraction on 100 adult subjects (mean age 23.8 (SD 5.7) years) and objective autorefraction (Shin-Nippon SRW-5000, Japan) on 150 subjects (20.1 (4.2) years). Repeatability was assessed by examining the differences between autorefractor readings taken from each eye and by re-measuring the objective prescription of 100 eyes at a subsequent session. On average the PowerRefractor prescription was not significantly different from the subjective refraction, although quite variable (difference +0.05 (0.63) D, p=0.41) and more negative than the SRW-5000 prescription (by -0.20 (0.72) D, p<0.001). There was no significant bias in the accuracy of the instrument with regard to the type or magnitude of refractive error. The PowerRefractor was found to be repeatable over the prescription range of -8.75D to +4.00D (mean spherical equivalent) examined. The PowerRefractor is a useful objective screening instrument and because of its remote and rapid measurement of both eyes simultaneously is able to assess the oculomotor response in a variety of unrestricted viewing conditions and patient types.

  12. Education influences the association between genetic variants and refractive error: a meta-analysis of five Singapore studies

    PubMed Central

    Fan, Qiao; Wojciechowski, Robert; Kamran Ikram, M.; Cheng, Ching-Yu; Chen, Peng; Zhou, Xin; Pan, Chen-Wei; Khor, Chiea-Chuen; Tai, E-Shyong; Aung, Tin; Wong, Tien-Yin; Teo, Yik-Ying; Saw, Seang-Mei

    2014-01-01

    Refractive error is a complex ocular trait governed by both genetic and environmental factors and possibly their interplay. Thus far, data on the interaction between genetic variants and environmental risk factors for refractive errors are largely lacking. By using findings from recent genome-wide association studies, we investigated whether the main environmental factor, education, modifies the effect of 40 single nucleotide polymorphisms on refractive error among 8461 adults from five studies including ethnic Chinese, Malay and Indian residents of Singapore. Three genetic loci SHISA6-DNAH9, GJD2 and ZMAT4-SFRP1 exhibited a strong association with myopic refractive error in individuals with higher secondary or university education (SHISA6-DNAH9: rs2969180 A allele, β = −0.33 D, P = 3.6 × 10–6; GJD2: rs524952 A allele, β = −0.31 D, P = 1.68 × 10−5; ZMAT4-SFRP1: rs2137277 A allele, β = −0.47 D, P = 1.68 × 10−4), whereas the association at these loci was non-significant or of borderline significance in those with lower secondary education or below (P for interaction: 3.82 × 10−3–4.78 × 10−4). The evidence for interaction was strengthened when combining the genetic effects of these three loci (P for interaction = 4.40 × 10−8), and significant interactions with education were also observed for axial length and myopia. Our study shows that low level of education may attenuate the effect of risk alleles on myopia. These findings further underline the role of gene–environment interactions in the pathophysiology of myopia. PMID:24014484

  13. Prevalence of refractive error, presbyopia, and unmet need of spectacle coverage in a northern district of Bangladesh: Rapid Assessment of Refractive Error study.

    PubMed

    Muhit, Mohammad; Minto, Hasan; Parvin, Afroza; Jadoon, Mohammad Z; Islam, Johurul; Yasmin, Sumrana; Khandaker, Gulam

    2018-04-01

    To determine the prevalence of refractive error (RE), presbyopia, spectacle coverage, and barriers to uptake optical services in Bangladesh. Rapid assessment of refractive error (RARE) study following the RARE protocol was conducted in a northern district (i.e., Sirajganj) of Bangladesh (January 2010-December 2012). People aged 15-49 years were selected, and eligible participants had habitual distance and near visual acuity (VA) measured and ocular examinations were performed in those with VA<6/18. Those with phakic eyes with VA <6/18, but improving to ≥6/18 with pinhole or optical correction, were considered as RE and people aged ≥35 years with binocular unaided near vision of

  14. Optical and Biometric Characteristics of Anisomyopia in Human Adults

    PubMed Central

    Tian, Yibin; Tarrant, Janice; Wildsoet, Christine F.

    2011-01-01

    Purpose To investigate the role of higher order optical aberrations and thus retinal image degradation in the development of myopia, through the characterization of anisomyopia in human adults in terms of their optical and biometric characteristics. Methods The following data were collected from both eyes of fifteen young adult anisometropic myopes and sixteen isometropic myopes: subjective and objective refractive errors, corneal power and shape, monochromatic optical aberrations, anterior chamber depth, lens thickness, vitreous chamber depth, and best corrected visual acuity. Monochromatic aberrations were analyzed in terms of their higher order components, and further analyzed in terms of 31 optical quality metrics. Interocular differences for the two groups (anisomyopes vs. isomyopes) were compared and the relationship between measured ocular parameters and refractive errors also analyzed across all eyes. Results As expected, anisomyopes and isomyopes differed significantly in terms of interocular differences in vitreous chamber depth, axial length and refractive error. However, interocular differences in other optical properties showed no significant intergroup differences. Overall, higher myopia was associated with deeper anterior and vitreous chambers, higher astigmatism, more prolate corneas, and more positive spherical aberration. Other measured optical and biometric parameters were not significantly correlated with spherical refractive error, although some optical quality metrics and corneal astigmatism were significantly correlated with refractive astigmatism. Conclusions An optical cause for anisomyopia related to increased higher order aberrations is not supported by our data. Corneal shape changes and increased astigmatism in more myopic eyes may be a by-product of the increased anterior chamber growth in these eyes; likewise, the increased positive spherical aberration in more myopic eyes may be a product of myopic eye growth. PMID:21797915

  15. Prevalence of Refractive Error among Preschool Children in an Urban Population: The Baltimore Pediatric Eye Disease Study

    PubMed Central

    Giordano, Lydia; Friedman, David S.; Repka, Michael X.; Katz, Joanne; Ibironke, Josephine; Hawes, Patricia; Tielsch, James M.

    2009-01-01

    Purpose To determine the age-specific prevalence of refractive errors in White and African-American preschool children. Design The Baltimore Pediatric Eye Disease Study is a population-based evaluation of the prevalence of ocular disorders in children aged six through 71 months in Baltimore, Maryland, United States. Participants Among 4,132 children identified, 3,990 eligible children (97%) were enrolled and 2,546 children (62%) were examined. Methods Cycloplegic autorefraction was attempted on all children using a Nikon Retinomax K-Plus 2. If a reliable autorefraction could not be obtained after three attempts, cycloplegic streak retinoscopy was performed. Main Outcome Measures Mean spherical equivalent (SE) refractive error, astigmatism, and prevalence of higher refractive errors among African American and White children. Results The mean spherical equivalent (SE) of right eyes was +1.49 diopter (D) (standard deviation (SD) =1.23) in White and +0.71D (SD=1.35) in African-American children (mean difference of 0.78D, 95% CI: 0.67, 0.89). Mean SE refractive error did not decline with age in either group. The prevalence of myopia of 1.00 D or more in the eye with the lesser refractive error was 0.7% in White and 5.5% in African-American children (RR: 8.01 95% confidence interval (CI): 3.70, 17.35). The prevalence of hyperopia of +3D or more in the eye with the lesser refractive error was 8.9% in White and 4.4% in African-American children (relative risk (RR): 0.49, 95% CI: 0.35, 0.68). The prevalence of emmetropia (less than −1.00 D to less than +1.00 D) was 35.6% in Whites and 58.0 % in African-Americans (RR: 1.64, 95% CI: 1.49, 1.80). Based on published prescribing guidelines 5.1% of the children would have benefited from spectacle correction. However, only 1.3% had been previously prescribed correction. Conclusions Significant refractive errors are uncommon in this population of urban preschool children. There was no evidence for a myopic shift over this age range in this cross-sectional study. A small proportion of preschool children would likely benefit from refractive correction, but few have had this prescribed. PMID:19243832

  16. Comparison of refractive development and retinal dopamine in OFF pathway mutant and C57BL/6J wild-type mice

    PubMed Central

    Chakraborty, Ranjay; Park, Han na; Aung, Moe H.; Tan, Christopher C.; Sidhu, Curran S.; Iuvone, P. Michael

    2014-01-01

    Purpose Proper visual transmission depends on the retinal ON and OFF pathways. We used Vsx1−/− mice with a retinal OFF visual pathway defect to determine the role of OFF pathway signaling in refractive development (RD) of the eye. Methods Refractive development was measured every 2 weeks in Vsx1−/−, Vsx1+/+ (both on 129S1/Sv background), and commonly used C57BL/6J mice from 4 to 12 weeks of age. Form deprivation (FD) was induced monocularly from 4 weeks of age using head-mounted diffuser goggles. Refractive state, corneal curvature, and ocular biometry were obtained weekly using photorefraction, keratometry, and 1310 nm spectral-domain optical coherence tomography. Retinal dopamine and its metabolite, 3,4-dihydroxyphenylacetate (DOPAC), were measured using high-performance liquid chromatography (HPLC). Results During normal development, the Vsx1−/− and Vsx1+/+ mice showed similar myopic refractions at younger ages (4 weeks, Vsx1−/−: −5.28±0.75 diopter (D); WT: −4.73±0.98 D) and became significantly hyperopic by 12 weeks of age (Vsx1−/−: 3.28±0.82 D; WT: 5.33±0.81 D). However, the C57BL/6J mice were relatively hyperopic at younger ages (mean refraction at 4 weeks, 3.40±0.43 D), and developed more hyperopic refractions until about 7 weeks of age (8.07±0.55 D) before stabilizing. Eight weeks of FD did not induce a myopic shift in the 129S1/Sv animals (0.16±0.85 D), as opposed to a significant shift of −4.29±0.42 D in the C57BL/6J mice. At 4 weeks of visual development, dopamine turnover (the DOPAC/dopamine ratio) was significantly greater in the 129S1/Sv mice compared to the C57BL/6J mice. FD did not alter the levels of dopamine between the goggled and opposite eyes for any genotype or strain. Conclusions OFF pathway signaling may not be critically important for normal refractive development in mice. Elevated retinal dopamine turnover in early refractive development may prevent FD myopia in 129S1/Sv mice compared to C57BL/6J mice. PMID:25352740

  17. Heritability of myopia and ocular biometrics in Koreans: the healthy twin study.

    PubMed

    Kim, Myung Hun; Zhao, Di; Kim, Woori; Lim, Dong-Hui; Song, Yun-Mi; Guallar, Eliseo; Cho, Juhee; Sung, Joohon; Chung, Eui-Sang; Chung, Tae-Young

    2013-05-01

    To estimate the heritabilities of myopia and ocular biometrics among different family types among a Korean population. We studied 1508 adults in the Healthy Twin Study. Spherical equivalent, axial length, anterior chamber depth, and corneal astigmatism were measured by refraction, corneal topography, and A-scan ultrasonography. To see the degree of resemblance among different types of family relationships, intraclass correlation coefficients (ICC) were calculated. Variance-component methods were applied to estimate the genetic contributions to eye phenotypes as heritability based on the maximum likelihood estimation. Narrow sense heritability was calculated as the proportion of the total phenotypic variance explained by additive genetic effects, and linear and nonlinear effects of age, sex, and interactions between age and sex were adjusted. A total of 240 monozygotic twin pairs, 45 dizygotic twin pairs, and 938 singleton adult family members who were first-degree relatives of twins in 345 families were included in the study. ICCs for spherical equivalent from monozygotic twins, pooled first-degree pairs, and spouse pairs were 0.83, 0.34, and 0.20, respectively. The ICCs of other ocular biometrics were also significantly higher in monozygotic twins compared with other relative pairs, with greater consistency and conformity. The estimated narrow sense heritability (95% confidence interval) was 0.78 (0.71-0.84) for spherical equivalent; 0.86 (0.82-0.90) for axial length; 0.83 (0.76-0.91) for anterior chamber depth; and 0.70 (0.63-0.77) for corneal astigmatism. The estimated heritability of spherical equivalent and ocular biometrics in the Korean population suggests the compelling evidence that all traits are highly heritable.

  18. Prevalence of Childhood Blindness and Ocular Morbidity in a Rural Pediatric Population in Southern India: The Pavagada Pediatric Eye Disease Study-1.

    PubMed

    Kemmanu, Vasudha; Hegde, Kaushik; Giliyar, Subramanya K; Shetty, Bhujanga K; Kumaramanickavel, G; McCarty, Catherine A

    2016-06-01

    To determine the prevalence of childhood blindness and ocular morbidity in a rural pediatric population in South India. A population-based, cross-sectional survey of children was conducted in three phases in Pavagada and Madhugiri taluks (subdivisions) of Tumkur district in the state of Karnataka, India. In the first phase, trained fieldworkers screened 23,100 children. In the second phase, children with eye diseases were referred to the peripheral hospital to be examined by a general ophthalmologist. In the third phase, children with major eye diseases were examined by a pediatric ophthalmologist. The prevalence of ocular morbidity was 2.66% (95% confidence interval, CI, 2.46-2.87%). The most commonly observed ocular morbidity was Bitot spots (1%) followed by refractive error (0.6%). In total, 18 children were blind and the prevalence of childhood blindness (best-corrected visual acuity <3/60) was 0.08% (95% CI 0.04-0.11%); 8 (44.44%) had retinal blindness, 5 (27.76%) had lens-related blindness, 2 (11.11%) had bilateral microphthalmos, 1 (5.56%) was blind due to anterior staphyloma in the right eye and anophthalmos in the left eye, 1 (5.56%) had bilateral uveal coloboma and 1 (5.56%) had cortical visual impairment. Nearly half of the blindness in the population was due to unavoidable causes (retinal). In addition to providing eye care services, an appropriate service delivery model would include the provision of rehabilitative and low vision services and implementation of genetic studies to understand the causes and increase awareness of inherited eye diseases.

  19. Longitudinal Increase in Anisometropia in Older Adults

    PubMed Central

    Haegerstrom-Portnoy, Gunilla; Schneck, Marilyn E.; Lott, Lori A.; Hewlett, Susan E.; Brabyn, John A.

    2014-01-01

    Purpose Anisometropia shows an exponential increase in prevalence with increasing age based on cross-sectional studies. The purpose of this study was to evaluate longitudinal changes in anisometropia in all refractive components in older observers and to assess the influence of early cataract development. Methods Refractive error was assessed at two time points separated by ~12 years in 118 older observers (ages 67.1 and 79.3 years at the two test times). Anisometropia defined as ≥1.00 D was calculated for all refractive components. The subjects had intact ocular lenses in both eyes throughout the study. Lens evaluations were performed at the second test using LOCS III. Results All refractive components approximately doubled in prevalence of anisometropia. Spherical equivalent anisometropia changed from 16.1% to 32.2%. Similar changes were found for spherical error (17% to 38.1%), primary astigmatism (7.6% to 17.8%) and oblique astigmatism (14.4% to 29.7%). Many who did not have anisometropia at the first visit subsequently developed anisometropia (for ex. 26.3% for spherical error and 22.9% for oblique cylinder). The onset of anisometropia occurred at all ages within the studied age range with no particular preference for any one age. A small number lost anisometropia over time. Individual comparisons of refractive error changes in the two eyes in combination with nuclear lens changes showed that early changes in nuclear sclerosis in the two eyes could account for a large proportion of anisometropia (~40%) but unequal hyperopic shift in the spherical component in the two eyes was the primary cause of the anisometropia. Conclusions Anisometropia is at least 10 times more common in the elderly than in children and anisometropia develops in all refractive components in the oldest observers. Clinicians need to be aware of this common condition that could lead to binocular vision problems and potentially cause falls in the elderly. PMID:24276578

  20. Macular Ganglion Cell and Retinal Nerve Fiber Layer Thickness in Children With Refractive Errors-An Optical Coherence Tomography Study.

    PubMed

    Goh, Jody P; Koh, Victor; Chan, Yiong Huak; Ngo, Cheryl

    2017-07-01

    To study the distribution of macular ganglion cell-inner plexiform layer (GC-IPL) thickness and peripapillary retinal nerve fiber layer (RNFL) thickness in children with refractive errors. Two hundred forty-three healthy eyes from 139 children with refractive error ranging from -10.00 to +5.00 D were recruited from the National University Hospital Eye Surgery outpatient clinic. After a comprehensive ocular examination, refraction, and axial length (AL) measurement (IOLMaster), macular GC-IPL and RNFL thickness values were obtained with a spectral domain Cirrus high definition optical coherence tomography system (Carl Zeiss Meditec Inc.). Only scans with signal strength of >6/10 were included. Correlation between variables was calculated using the Pearson correlation coefficient. A multivariate analysis using mixed models was done to adjust for confounders. The mean spherical equivalent refraction was -3.20±3.51 D and mean AL was 24.39±1.72 mm. Average, minimum, superior, and inferior GC-IPL were 82.59±6.29, 77.17±9.65, 83.68±6.96, and 81.64±6.70 μm, respectively. Average, superior, and inferior peripapillary RNFL were 99.00±11.45, 123.20±25.81, and 124.24±22.23 μm, respectively. Average, superior, and inferior GC-IPL were correlated with AL (β=-2.056, P-value 0.000; β=-2.383, P-value 0.000; β=-1.721, P-value 0.000), but minimum GC-IPL was not (β=-1.056, P-value 0.115). None of the RNFL parameters were correlated with AL. This study establishes normative macular GC-IPL and RNFL thickness in children with refractive errors. Our results suggest that high definition optical coherence tomography RNFL parameters and minimum GC-IPL are not affected by AL or myopia in children, and therefore warrants further evaluation in pediatric glaucoma patients.

  1. Digital photorefraction

    NASA Astrophysics Data System (ADS)

    Costa, Manuel F. M.; Jorge, Jorge M.

    1998-01-01

    The early evaluation of the visual status of human infants is of a critical importance. It is of utmost importance to the development of the child's visual system that she perceives clear, focused, retinal images. Furthermore if the refractive problems are not corrected in due time amblyopia may occur. Photorefraction is a non-invasive clinical tool rather convenient for application to this kind of population. A qualitative or semi-quantitative information about refractive errors, accommodation, strabismus, amblyogenic factors and some pathologies (cataracts) can the easily obtained. The photorefraction experimental setup we established using new technological breakthroughs on the fields of imaging devices, image processing and fiber optics, allows the implementation of both the isotropic and eccentric photorefraction approaches. Essentially both methods consist on delivering a light beam into the eyes. It is refracted by the ocular media, strikes the retina, focusing or not, reflects off and is collected by a camera. The system is formed by one CCD color camera and a light source. A beam splitter in front of the camera's objective allows coaxial illumination and observation. An optomechanical system also allows eccentric illumination. The light source is a flash type one and is synchronized with the camera's image acquisition. The camera's image is digitized displayed in real time. Image processing routines are applied for image's enhancement and feature extraction.

  2. Digital photorefraction

    NASA Astrophysics Data System (ADS)

    Costa, Manuel F.; Jorge, Jorge M.

    1997-12-01

    The early evaluation of the visual status of human infants is of a critical importance. It is of utmost importance to the development of the child's visual system that she perceives clear, focused, retinal images. Furthermore if the refractive problems are not corrected in due time amblyopia may occur. Photorefraction is a non-invasive clinical tool rather convenient for application to this kind of population. A qualitative or semi-quantitative information about refractive errors, accommodation, strabismus, amblyogenic factors and some pathologies (cataracts) can the easily obtained. The photorefraction experimental setup we established using new technological breakthroughs on the fields of imaging devices, image processing and fiber optics, allows the implementation of both the isotropic and eccentric photorefraction approaches. Essentially both methods consist on delivering a light beam into the eyes. It is refracted by the ocular media, strikes the retina, focusing or not, reflects off and is collected by a camera. The system is formed by one CCD color camera and a light source. A beam splitter in front of the camera's objective allows coaxial illumination and observation. An optomechanical system also allows eccentric illumination. The light source is a flash type one and is synchronized with the camera's image acquisition. The camera's image is digitized displayed in real time. Image processing routines are applied for image's enhancement and feature extraction.

  3. Bidirectional Expression of Metabolic, Structural, and Immune Pathways in Early Myopia and Hyperopia

    PubMed Central

    Riddell, Nina; Giummarra, Loretta; Hall, Nathan E.; Crewther, Sheila G.

    2016-01-01

    Myopia (short-sightedness) affects 1.45 billion people worldwide, many of whom will develop sight-threatening secondary disorders. Myopic eyes are characterized by excessive size while hyperopic (long-sighted) eyes are typically small. The biological and genetic mechanisms underpinning the retina's local control of these growth patterns remain unclear. In the present study, we used RNA sequencing to examine gene expression in the retina/RPE/choroid across 3 days of optically-induced myopia and hyperopia induction in chick. Data were analyzed for differential expression of single genes, and Gene Set Enrichment Analysis (GSEA) was used to identify gene sets correlated with ocular axial length and refraction across lens groups. Like previous studies, we found few single genes that were differentially-expressed in a sign-of-defocus dependent manner (only BMP2 at 1 day). Using GSEA, however, we are the first to show that more subtle shifts in structural, metabolic, and immune pathway expression are correlated with the eye size and refractive changes induced by lens defocus. Our findings link gene expression with the morphological characteristics of refractive error, and suggest that physiological stress arising from metabolic and inflammatory pathway activation could increase the vulnerability of myopic eyes to secondary pathologies. PMID:27625591

  4. Role of optometry school in single day large scale school vision testing

    PubMed Central

    Anuradha, N; Ramani, Krishnakumar

    2015-01-01

    Background: School vision testing aims at identification and management of refractive errors. Large-scale school vision testing using conventional methods is time-consuming and demands a lot of chair time from the eye care professionals. A new strategy involving a school of optometry in single day large scale school vision testing is discussed. Aim: The aim was to describe a new approach of performing vision testing of school children on a large scale in a single day. Materials and Methods: A single day vision testing strategy was implemented wherein 123 members (20 teams comprising optometry students and headed by optometrists) conducted vision testing for children in 51 schools. School vision testing included basic vision screening, refraction, frame measurements, frame choice and referrals for other ocular problems. Results: A total of 12448 children were screened, among whom 420 (3.37%) were identified to have refractive errors. 28 (1.26%) children belonged to the primary, 163 to middle (9.80%), 129 (4.67%) to secondary and 100 (1.73%) to the higher secondary levels of education respectively. 265 (2.12%) children were referred for further evaluation. Conclusion: Single day large scale school vision testing can be adopted by schools of optometry to reach a higher number of children within a short span. PMID:25709271

  5. Femtosecond laser-assisted LASIK versus PRK for high myopia: comparison of 18-month visual acuity and quality.

    PubMed

    Hashemi, Hassan; Ghaffari, Reza; Miraftab, Mohammad; Asgari, Soheila

    2017-08-01

    To compare 18-month outcomes between femtosecond laser-assisted LASIK (femto-LASIK) and photorefractive keratectomy with mitomycin-C (PRK-MMC) for myopia of more than 7.0 D in terms of visual acuity and quality. In this comparative nonrandomized clinical trial, 60 eyes from 30 patients (30 eyes in each group) were enrolled. The two procedures were compared in terms of 18-month changes in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, ocular and corneal higher order aberrations (HOAs), and contrast sensitivity (CS). Mean myopia was -8.65 ± 1.51 and -8.04 ± 1.70 D (P = 0.149) and mean ablation depth was 109.37 ± 9.07 and 105.09 ± 12.59 µm (P = 0.138), in the femto-LASIK and PRK-MMC groups, respectively. Baseline parameters were not significantly different between the two groups (all P > 0.05). At 18 months postoperatively, 75 % in the femto-LASIK, versus 57.1 % in the PRK-MMC group, had 20/20 UDVA (P = 0.017). CDVA remained similarly unchanged in both groups (P = 0.616). No case had residual refractive error more than 1.0 D in the femto-LASIK group, while 33.5 % in the other group had more than 1.0 D residual error (P = 0.390). Changes in corneal HOA were not significantly different between the two groups (P = 0.260). Cases in the femto-LASIK group showed more increase in ocular HOA (P = 0.032) and coma (P = 0.083, power = 72 %). CS remained similarly unchanged in all spatial frequencies in both groups (all P > 0.05). Although femto-LASIK induces more HOA compared to PRK-MMC, considering outcomes in terms of 20/20 UDVA, residual refractive error, and CS stability, femto-LASIK provides more favorable results than PRK-MMC in high myopia.

  6. The Relationship between Anisometropia and Amblyopia

    PubMed Central

    Barrett, Brendan T.; Bradley, Arthur; Candy, T. Rowan

    2013-01-01

    This review aims to disentangle cause and effect in the relationship between anisometropia and amblyopia. Specifically, we examine the literature for evidence to support different possible developmental sequences that could ultimately lead to the presentation of both conditions. The prevalence of anisometropia is around 20% for an inter-ocular difference of 0.5D or greater in spherical equivalent refraction, falling to 2-3%, for an inter-ocular difference of 3D or above. Anisometropia prevalence is relatively high in the weeks following birth, in the teenage years coinciding with the onset of myopia and, most notably, in older adults starting after the onset of presbyopia. It has about one-third the prevalence of bilateral refractive errors of the same magnitude. Importantly, the prevalence of anisometropia is higher in highly ametropic groups, suggesting that emmetropization failures underlying ametropia and anisometropia may be similar. Amblyopia is present in 1-3% of humans and around one-half to two-thirds of amblyopes have anisometropia either alone or in combination with strabismus. The frequent co-existence of amblyopia and anisometropia at a child’s first clinical examination promotes the belief that the anisometropia has caused the amblyopia, as has been demonstrated in animal models of the condition. In reviewing the human and monkey literature however it is clear that there are additional paths beyond this classic hypothesis to the co-occurrence of anisometropia and amblyopia. For example, after amblyopia secondary to either deprivation or strabismus has emerged, anisometropia often follows. In cases of anisometropia with no apparent deprivation or strabismus, questions remain about the failure of the emmetropization mechanism that routinely eliminates infantile anisometropia. Also, the chronology of amblyopia development is poorly documented in cases of ‘pure’ anisometropic amblyopia. Although indirect, the therapeutic impact of refractive correction on anisometropic amblyopia provides strong support for the hypothesis that the anisometropia caused the amblyopia. Direct evidence for the aetiology of anisometropic amblyopia will require longitudinal tracking of at-risk infants, which poses numerous methodological challenges. However, if we are to prevent this condition, we must understand the factors that cause it to develop. PMID:23773832

  7. Duke-Elder's Views on Prognosis, Prophylaxis, and Treatment of Myopia: Way Ahead of His Time.

    PubMed

    Polling, Jan Roelof; Verhoeven, Virginie J M; Tideman, J Willem L; Klaver, Caroline C W

    2016-01-01

    Sir Stewart Duke-Elder was probably the most influential ophthalmologist of the 20th century. One of his visionary pieces of work was his writing on myopia in the second edition of The Practice of Refraction, published in 1935. Many of his insights are now, 80 years later, supported by scientific proof. In terms of prognosis of myopia, he stated that this largely depended on the age of the patient. We now have epidemiologic evidence that age of onset is strongly related to final refractive error, and that high myopia carries a high risk of blindness. With respect to prophylaxis, he claimed that accessory risk factors were excessive near work, bad ocular hygiene, and physical debility in the early years of growth: "The régime of modern schools imposes far too much application to books upon young children at an age when they require all their available vitality for physical growth and development." He recommended open-air pursuits and avoidance of indoor activities, in particular for children with a hereditary tendency toward myopia. Current investigations indeed point to a crucial role for near work, although not all findings are consistent. The most established factor that is protective from myopia is outdoor exposure, more likely due to intense exposure to light rather than to "open-air." Ocular hygiene and physical activity have not been confirmed as protective factors, but Duke-Elder's views on gene-environment interactions are truly insightful. Concerning treatment, he suggested that adequate correction by glasses, intake of vitamin D, and restriction of education in "myope classes" could halt progression of myopia. Optical correction is considered helpful nowadays, but sound statistical evidence has only been provided for orthokeratology. High vitamin D serum levels are indeed related to low refractive error, but it is not yet clear whether high dietary intake is beneficial. Restriction of education does not meet current moral standards, but in China, "myopia classrooms" in the form of large cubes of windows, admitting lots of light, have been built. In this report, we highlight Duke-Elder's insights into the causes and clinical care of myopia, and discuss their merit for ophthalmic care today.

  8. Optimizing outcomes with multifocal intraocular lenses

    PubMed Central

    Sachdev, Gitansha Shreyas; Sachdev, Mahipal

    2017-01-01

    Modern day cataract surgery is evolving from a visual restorative to a refractive procedure. The advent of multifocal intraocular lenses (MFIOLs) allows greater spectacle independence and increased quality of life postoperatively. Since the inception in 1980s, MFIOLs have undergone various technical advancements including trifocal and extended depth of vision implants more recently. A thorough preoperative workup including the patients’ visual needs and inherent ocular anatomy allows us to achieve superior outcomes. This review offers a comprehensive overview of the various types of MFIOLs and principles of optimizing outcomes through a comprehensive preoperative screening and management of postoperative complications. PMID:29208809

  9. Brief light exposure at night disrupts the circadian rhythms in eye growth and choroidal thickness in chicks

    PubMed Central

    Nickla, Debora L.; Totonelly, Kristen

    2016-01-01

    Changes in ocular growth that lead to myopia or hyperopia are associated with alterations in the circadian rhythms in eye growth, choroidal thickness and intraocular pressure in animal models of emmetropization. Recent studies have shown that light at night has deleterious effects on human health, acting via “circadian disruptions” of various diurnal rhythms, including changes in phase or amplitude. The purpose of this study was to determine the effects of brief, 2-hour episodes of light in the middle of the night on the rhythms in axial length and choroidal thickness, and whether these alter eye growth and refractive error in the chick model of myopia. Starting at 2 weeks of age, birds received 2 hours of light between 12:00 am and 2:00 am for 7 days (n=12; total hours of light: 14 hrs). Age-matched controls had a continuous dark night (n=14; 14L/10D). Ocular dimensions were measured using high-frequency A-scan ultrasonography on the first day of the experiment, and again on day 7, at 6-hour intervals, starting at noon (12pm, 6pm, 12am, 6am, 12pm). Measurements during the night were done under a photographic safe-light. These data were used to determine rhythm parameters of phase and amplitude. 2 groups of birds, both experimental (light at night) and control, were measured with ultrasound at various intervals over the course of 4 weeks to determine growth rates. Refractive errors were measured in 6 experimental and 6 control birds at the end of 2 weeks. Eyes of birds in a normal L/D cycle showed sinusoidal 24-hour period diurnal rhythms in axial length and choroid thickness. Light in the middle of the night caused changes in both the rhythms in axial length and choroidal thickness, such that neither could be fit to a sine function having a period of 24 hours. Light caused an acute, transient stimulation in ocular growth rate in the subsequent 6-hour period (12 am to 6 am), that may be responsible for the increased growth rate seen 4 weeks later, and the more myopic refractive error. It also abolished the increase in choroidal thickness that normally occurs between 6 pm and 12 am. We conclude that light at night alters the rhythms in axial length and choroidal thickness in an animal model of eye growth, and that these circadian disruptions might lead to the development of ametropias. These results have implications for the use of light during the night in children. PMID:26970497

  10. Refractive index measurement of the mouse crystalline lens using optical coherence tomography

    PubMed Central

    Chakraborty, Ranjay; Lacy, Kip D.; Tan, Christopher C.; Park, Han na; Pardue, Machelle T.

    2014-01-01

    In recent years, there has been a growing interest for using mouse models in refractive development and myopia research. The crystalline lens is a critical optical component of the mouse eye that occupies greater than 50% of the ocular space, and significant increases in thickness with age. However, changes in refractive index of the mouse crystalline lens are less known. In this study, we examined the changes in thickness and refractive index of the mouse crystalline lens for two different strains, wild-type (WT) and a nyx mutant (nob) over the course of normal visual development or after form deprivation. Refractive index and lens thickness measurements were made on ex vivo lens using spectral domain optical coherence tomography (SD-OCT). Comparison of refractive index measurements on 5 standard ball lenses using the SD-OCT and their known refractive indices (manufacturer provided) indicated good precision (intra-class correlation coefficient, 0.998 and Bland-Altman coefficient of repeatability, 0.116) of the SD-OCT to calculate mouse lens refractive index ex vivo. During normal visual development, lens thickness increased significantly with age for three different cohorts of mice, aged 4 (average thickness from both eyes; WT: 1.78 ± 0.03, nob: 1.79 ± 0.08 mm), 10 (WT: 2.02 ± 0.05, nob: 2.01 ± 0.04 mm) and 16 weeks (WT: 2.12 ± 0.06, nob: 2.09 ± 0.06 mm, p<0.001). Lens thickness was not significantly different between the two strains at any age (p=0.557). For mice with normal vision, refractive index for isolated crystalline lenses in nob mice was significantly greater than WT mice (mean for all ages; WT: 1.42 ± 0.01, nob: 1.44 ± 0.001, p<0.001). After 4 weeks of form deprivation to the right eye using a skull-mounted goggling apparatus, a thinning of the crystalline lens was observed in both right and left eyes of goggled animals compared to their naïve controls (average from both the right and the left eye) for both strains (p=0.052). In form deprived mice, lens refractive index was significantly different between the goggled animals and non-goggled naïve controls in nob mice, but not in WT mice (p=0.009). Both eyes of goggled nob mice had significantly greater lens refractive index (goggled, 1.49 ± 0.01; opposite, 1.47 ± 0.03) compared to their naïve controls (1.45 ± 0.02, p<0.05). The results presented here suggest that there are genetic differences in the crystalline lens refractive index of the mouse eye, and that the lens refractive index in mice significantly increase with form deprivation. Research applications requiring precise optical measurements of the mouse eye should take these lens refractive indices into account when interpreting SD-OCT data. PMID:24939747

  11. The biometric study in different stages of primary angle-closure glaucoma

    PubMed Central

    Chen, Y-Y; Chen, Y-Y; Sheu, S-J; Chou, P

    2013-01-01

    Purpose This study compared the general and ocular biometric characteristics of normal, primary angle closure (PAC), and primary angle-closure glaucoma (PACG) patients to better understand the possible relationship between differences in ocular parameters that might predict risk for PACG in PAC patients. Methods One hundred normal, 90 PAC, and 90 PACG eyes were retrospectively reviewed. General characteristics such as age, gender, body height, body weight, blood pressure, pulse, systemic diseases, and education level were recorded. Ocular findings included visual acuity, intraocular pressure, refraction, cup to disc ratio, and ocular biometry. Ocular biometry was obtained by A-scan ultrasonography (Digital A/B scan 5500; Sonomed Inc., Lake Success, NY, USA). The parameters recorded were anterior chamber depth (ACD), lens thickness (LT), axial length (AXL), lens/axial length factor (LAF), and relative lens position (RLP). Results Although the controls, PAC group, and PACG group were found to be significantly different in age (62.7±9.8; 65.3±7.5; and 66.0±7.4, respectively), there were no gender differences. With regard to ocular parameters, the ACD tended to decrease and the LT and LAF tended to increase from normal to PAC to PACG. The eyes of the PACG group had significantly shallower ACD (P<0.001) and thicker lens (P<0.001) than those of the PAC group. While PAC had similar lens position to the control group, PACG had more anteriorly positioned lens than the PAC group (P<0.001). Logistic regression analysis found a significant association between a decrease in ACD and increased risk of PACG (odds ratio (OR)=3.59 for 0.2 mm decrease in ACD) as well as a significant association between an increase in LT and increased risk of PACG (OR=1.30). Conclusions In addition to LT, a shallower ACD owing to a change in RLP may have a role in the progression from PAC to PACG. Owing to the differences of certain biometric characteristics between PAC and PACG, A-scan ultrasonography might potentially be used for the early detection of PACG in PAC eyes. PMID:23788204

  12. Intracameral phenylephrine and ketorolac during cataract surgery to maintain intraoperative mydriasis and reduce postoperative ocular pain: Integrated results from 2 pivotal phase 3 studies.

    PubMed

    Hovanesian, John A; Sheppard, John D; Trattler, William B; Gayton, Johnny L; Malhotra, Ranjan P; Schaaf, David T; Ng, Edmund; Dunn, Steven H

    2015-10-01

    To evaluate the efficacy and safety of phenylephrine 1.0%-ketorolac 0.3% (Omidria) for maintenance of mydriasis during, and reduction of ocular pain after, cataract surgery. Twenty centers in the United States and the Netherlands. Prospective randomized clinical trials. Patients having cataract surgery or refractive lens exchange were enrolled in 2 clinical trials. Phenylephrine 1.0%-ketorolac 0.3% or placebo was added to irrigation solution and administered intracamerally during the procedure. Integrated analyses of primary and secondary endpoints were conducted. The clinical trials comprised 808 patients (403 treatment and 405 placebo). Phenylephrine 1.0%-ketorolac 0.3% was superior to placebo for the maintenance of mydriasis during, and reduction of ocular pain following, cataract surgery. The mean area under the curve (AUC) change from baseline in pupil diameter was 0.08 mm for treatment compared with -0.50 mm for placebo (P < .0001). The mean AUC of ocular pain visual analog scale scores within 12 hours postoperatively was 4.16 mm for the treatment group and 9.06 mm for the placebo group (P < .001). Results of all secondary efficacy analyses demonstrated a significant treatment effect associated with phenylephrine 1.0%-ketorolac 0.3%. Treatment-emergent adverse events were as expected for a population having cataract surgery; no clinically significant differences in safety measures were observed between treatment groups. In this integrated analysis, phenylephrine 1.0%-ketorolac 0.3% administered intracamerally with irrigation solution during cataract surgery was safe and effective for maintaining mydriasis during the procedure and reducing postoperative ocular pain. Dr. Schaaf is an employee and holds an equity interest in Omeros Corporation. Drs. Hovanesian, Sheppard, Trattler, Gayton, and Ng are consultants to Omeros Corporation. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Ocular findings in acquired immunodeficiency syndrome patients in Lagos, Nigeria.

    PubMed

    Onakoya, A O; Odeyemi, M G; Aribaba, O T; Akinsola, F B

    2012-01-01

    There is paucity of studies on the prevalence and pattern of ocular complication in HIV patients in developing countries where 90% of all HIV sufferers live. Most studies were carried out in industrialized countries and are not representative of the spectrum of ocular complication of HIV and it's prevalence in developing countries. To determine the prevalence of ocular disorders in adult (> 15 years ) AIDS patients at PEPFAR clinic in Lagos, Nigeria. All consecutive adult Seropositive HIV/AIDS patients of PEPFAR Clinic at the Lagos University Teaching Hospital between February 1st-March 15th 2008 were enrolled into the study Cross sectional and non randomized, convenient study was used. Biodata and medical history were recorded on interviewer administered questionnaire. Participants were examined according to standard protocol comprising visual acuity, intraocular pressure, anterior segment examination with slit lamp biomicroscopy, dilated fundoscopy and fundus photograph where necessary. PCV, CD4+ count, viral load at diagnosis, stage of HIV disease were extracted from patients' records. Details of drug were regimen also recorded. Data analysis was performed with EPI-lnfo 6.04 version; Chi square and student t test used to describe statistical association. A total of 400 patients were studied. Male:female ratio was 1.7 and mean age was 40 years (S.D. + 9.12). Ocular disorders seen in 78.5% of patients; HIV related ocular disorders occurred in 45 (11.3) patients. Conjunctival microvasculopathy 166 patients (41.5%), pingueculum in 114 (28.5%), pterygium in 76 (19.0%), refractive error in 93 (23.3%), cataract in 12 (3.0%), and 22 (5.5%) Glaucoma suspects. HIV retinopathy and allergic eye disease in one patient each (0.3%). Presumed Cytomegalovirus retinitis 7 (1.8%), 14 (3.5%) Toxoplasmosis, 8 (2.0%) HZO, and 15 (3.8%) Presumed Squamous cell carcinoma. Eighty six (21.5%) of the patients had no abnormality. 91.4% of eyes examined had visual acuity with best correction of > 6/18. CD4+ in 79.3% of the patients was > 200 cells/ul and < 5% had counts < 50 cells with an overall mean of 406 cell/ul. 375 (93.8%) patients were on Highly Active Antiretroviral therapy (HAART), and 25 (6.2%) were not. Study revealed low prevalence of HIV related ocular disorders. This could be due to few patients at low level of immunosuppresion where the infections occur.

  14. Cyclodextrin Enhances Corneal Tolerability and Reduces Ocular Toxicity Caused by Diclofenac

    PubMed Central

    Abdelkader, Hamdy; Fathalla, Zeinab; Moharram, Hossam; Ali, Taha F. S.

    2018-01-01

    With advances in refractive surgery and demand for cataract removal and lens replacement, the ocular use of nonsteroidal anti-inflammatory drugs (NSAIDs) has increased. One of the most commonly used NSAIDs is diclofenac (Diclo). In this study, cyclodextrins (CDs), α-, β-, γ-, and HP-β-CDs, were investigated with in vitro irritation and in vivo ulceration models in rabbits to reduce Diclo toxicity. Diclo-, α-, β-, γ-, and HP-β-CD inclusion complexes were prepared and characterized and Diclo-CD complexes were evaluated for corneal permeation, red blood cell (RBCs) haemolysis, corneal opacity/permeability, and toxicity. Guest- (Diclo-) host (CD) solid inclusion complexes were formed only with β-, γ-, and HP-β-CDs. Amphipathic properties for Diclo were recorded and this surfactant-like functionality might contribute to the unwanted effects of Diclo on the surface of the eye. Contact angle and spreading coefficients were used to assess Diclo-CDs in solution. Reduction of ocular toxicity 3-fold to16-fold and comparable corneal permeability to free Diclo were recorded only with Diclo-γ-CD and Diclo-HP-β-CD complexes. These two complexes showed faster healing rates without scar formation compared with exposure to the Diclo solution and to untreated groups. This study also highlighted that Diclo-γ-CD and Diclo-HP-β-CD demonstrated fast healing without scar formation. PMID:29636847

  15. Wavefront Derived Refraction and Full Eye Biometry in Pseudophakic Eyes

    PubMed Central

    Mao, Xinjie; Banta, James T.; Ke, Bilian; Jiang, Hong; He, Jichang; Liu, Che; Wang, Jianhua

    2016-01-01

    Purpose To assess wavefront derived refraction and full eye biometry including ciliary muscle dimension and full eye axial geometry in pseudophakic eyes using spectral domain OCT equipped with a Shack-Hartmann wavefront sensor. Methods Twenty-eight adult subjects (32 pseudophakic eyes) having recently undergone cataract surgery were enrolled in this study. A custom system combining two optical coherence tomography systems with a Shack-Hartmann wavefront sensor was constructed to image and monitor changes in whole eye biometry, the ciliary muscle and ocular aberration in the pseudophakic eye. A Badal optical channel and a visual target aligning with the wavefront sensor were incorporated into the system for measuring the wavefront-derived refraction. The imaging acquisition was performed twice. The coefficients of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated. Results Images were acquired and processed successfully in all patients. No significant difference was detected between repeated measurements of ciliary muscle dimension, full-eye biometry or defocus aberration. The CoR of full-eye biometry ranged from 0.36% to 3.04% and the ICC ranged from 0.981 to 0.999. The CoR for ciliary muscle dimensions ranged from 12.2% to 41.6% and the ICC ranged from 0.767 to 0.919. The defocus aberrations of the two measurements were 0.443 ± 0.534 D and 0.447 ± 0.586 D and the ICC was 0.951. Conclusions The combined system is capable of measuring full eye biometry and refraction with good repeatability. The system is suitable for future investigation of pseudoaccommodation in the pseudophakic eye. PMID:27010674

  16. Wavefront Derived Refraction and Full Eye Biometry in Pseudophakic Eyes.

    PubMed

    Mao, Xinjie; Banta, James T; Ke, Bilian; Jiang, Hong; He, Jichang; Liu, Che; Wang, Jianhua

    2016-01-01

    To assess wavefront derived refraction and full eye biometry including ciliary muscle dimension and full eye axial geometry in pseudophakic eyes using spectral domain OCT equipped with a Shack-Hartmann wavefront sensor. Twenty-eight adult subjects (32 pseudophakic eyes) having recently undergone cataract surgery were enrolled in this study. A custom system combining two optical coherence tomography systems with a Shack-Hartmann wavefront sensor was constructed to image and monitor changes in whole eye biometry, the ciliary muscle and ocular aberration in the pseudophakic eye. A Badal optical channel and a visual target aligning with the wavefront sensor were incorporated into the system for measuring the wavefront-derived refraction. The imaging acquisition was performed twice. The coefficients of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated. Images were acquired and processed successfully in all patients. No significant difference was detected between repeated measurements of ciliary muscle dimension, full-eye biometry or defocus aberration. The CoR of full-eye biometry ranged from 0.36% to 3.04% and the ICC ranged from 0.981 to 0.999. The CoR for ciliary muscle dimensions ranged from 12.2% to 41.6% and the ICC ranged from 0.767 to 0.919. The defocus aberrations of the two measurements were 0.443 ± 0.534 D and 0.447 ± 0.586 D and the ICC was 0.951. The combined system is capable of measuring full eye biometry and refraction with good repeatability. The system is suitable for future investigation of pseudoaccommodation in the pseudophakic eye.

  17. Progressive myopia or hyperopia can be induced in chicks and reversed by manipulation of the chromaticity of ambient light.

    PubMed

    Foulds, Wallace S; Barathi, Veluchamy A; Luu, Chi D

    2013-12-09

    To determine whether progressive ametropia can be induced in chicks and reversed by manipulation of the chromaticity of ambient light. One-day-old chicks were raised in red light (90% red, 10% yellow-green) or in blue light (85% blue, 15% green) with a 12 hour on/off cycle for 14 to 42 days. Refraction was determined by streak retinoscopy, and by automated infrared photoretinoscopy and ocular biometry by A-scan ultrasonography. Red light induced progressive myopia (mean refraction ± SD at 28 days, -2.83 ± 0.25 diopters [D]). Progressive hyperopia was induced by blue light (mean refraction at 28 days, +4.55 ± 0.21 D). The difference in refraction between the groups was highly significant at P < 0.001. Induced myopia or hyperopia was axial as confirmed by ultrasound biometry. Myopia induced by 21 days of red light (-2.21 ± 0.21 D) was reversed to hyperopia (+2.50 ± 0.29 D) by subsequent 21 days of blue light. Hyperopia induced by 21 days of blue light (+4.21 ± 0.19 D) was reversed to myopia (-1.23 ± 0.12 D) by 21 days of red light. Rearing chicks in red light caused progressive myopia, while rearing in blue light caused progressive hyperopia. Light-induced myopia or hyperopia in chicks can be reversed to hyperopia or myopia, respectively, by an alteration in the chromaticity of ambient light. Manipulation of chromaticity may be applicable to the management of human childhood myopia.

  18. Refractive Amblyopia among children in Ibadan: the need for amblyopia screening programmes.

    PubMed

    Olusanya, B A; Ugalahi, M O; Okoli, C E; Baiyeroju, A M

    2015-09-01

    The prevalence and burden of amblyopia in developing countries is probably underestimated, and little is known about the pattern of amblyopia in West Africa. To determine the relative frequency and types of amblyopia among children with refractive errors seen in the eye clinic of a tertiary hospital over a 2 year period. A cross-sectional study conducted at the eye clinic of the University College Hospital, Ibadan, Nigeria between January 2012 and December 2013. Case notes of children with refractive errors seen during this period were retrieved and information including socio-demographic data, presenting visual acuity and visual acuity with correction were recorded. Amblyopia was defined as best corrected visual acuity worse than 6/9 or a difference of ≥ 2 Snellen chart lines between both eyes in the absence of any ocular pathology that could explain the visual impairment. A total of 250 eligible patients who had refractive errors were included in the study. Visual acuity was corrected to 6/9 or better in 224 (89.6%) children while 26 (10.4%) of them had amblyopia. Among the 26 children with amblyopia, 21 (80.8%) children had amblyopia in both eyes and majority (65.4%) had iso-ametropic amblyopia. Of the 47 amblyopic eyes, 36 (76.6%) eyes had moderate amblyopia while 11 (23.4%) eyes had severe amblyopia. There is a high relative frequency of amblyopia in this study and we recommend preschool eye examinations for all children to ensure early detection and management of amblyopia, thereby reducing the burden of amblyopia in our populace.

  19. Visual outcome and refractive status in first 3 years of age in preterm infants suffered from laser-treated Type 1 retinopathy of prematurity (ROP): a 6-year retrospective review in a tertiary centre in Hong Kong.

    PubMed

    Lok, Julie Y C; Yip, Wilson W K; Luk, Abbie S W; Chin, Joyce K Y; Lau, Henry H W; Young, Alvin L

    2018-02-01

    To report the visual outcome and refractive status in first 3 years of age in preterm infants suffered from laser-treated Type 1 retinopathy of prematurity (ROP): a 6-year review in Hong Kong DESIGN: Retrospective case series METHODOLOGY: Clinical records of all infants suffered from Type 1 ROP who had undergone laser therapy between 2007 and 2012 were retrospectively reviewed. Basic demographic data, serial changes of refractive error, visual acuity, severity of ROP and laser were analyzed. Correlation with myopia and astigmatism progression, body weight, height, growth and gestational age were also analyzed. Among 494 babies screened, 14 Chinese babies (26 eyes) recruited with 1:1 male-to-female ratio in this study. All eyes showed gradual progression of myopia in first 3 years of age but no significant change of astigmatism. Further correlation analysis showed no correlation with laser energy consumed, birth weight (p = 0.14), head circumference growth (p = 0.57) and body weight growth (p = 0.71). However, severity of myopia was related to the post-conceptual age when receiving laser therapy (p < 0.005), gestation age (p = 0.02) and possibly body height growth with age (p = 0.05). Myopia in early life is one of the most common ocular sequelae in Type 1 ROP survivors. Early detection of refractive error is important for prompt correction and visual rehabilitation to prevent amblyopia.

  20. Prevalence of Color Vision Deficiency and its Correlation with Amblyopia and Refractive Errors among Primary School Children.

    PubMed

    Rajavi, Zhale; Sabbaghi, Hamideh; Baghini, Ahmad Shojaei; Yaseri, Mehdi; Sheibani, Koroush; Norouzi, Ghazal

    2015-01-01

    To determine the prevalence of color vision deficiency (CVD) and its correlation with amblyopia and refractive errors among primary school children. In this population-based cross-sectional study, 2160 children were selected from 36 primary schools; 60 students were from each school (10 students in each grade), with equal sex distribution. A complete eye examination including refraction using a photorefractometer, determination of visual acuity (VA) and color vision using a Yang vision tester, and evaluation of ocular media opacity using a direct ophthalmoscope was performed. Children who could not answer at least 4 plates of the Ishihara color test were considered as color vision deficient subjects. Amblyopia was determined if pinhole VA was worse than 0.3 LogMAR (equal to 20/40). The prevalence of CVD was 2.2% (95% CI: 1.5% to 3%) which was higher in male subjects (37 [3.5%] boys vs. 11 [1.0%] girls, P < 0.001). Mean VA was lower among students with CVD as compared to normal color vision children (P = 0.035) and amblyopia was observed in 8.3% (95% CI: 0.2% to 16.4%) of patients with CVD versus 2.1% (95% CI: 1.5% to 2.08%) of children with normal color vision perception (P = 0.005). A statistically significant correlation between lower VA and CVD was observed (P = 0.023). Although CVD was correlated with lower VA and amblyopia, there was no relationship between CVD and the type of amblyopia, refractive error, anisometropia or strabismus.

  1. Eyesight quality and Computer Vision Syndrome.

    PubMed

    Bogdănici, Camelia Margareta; Săndulache, Diana Elena; Nechita, Corina Andreea

    2017-01-01

    The aim of the study was to analyze the effects that gadgets have on eyesight quality. A prospective observational study was conducted from January to July 2016, on 60 people who were divided into two groups: Group 1 - 30 middle school pupils with a mean age of 11.9 ± 1.86 and Group 2 - 30 patients evaluated in the Ophthalmology Clinic, "Sf. Spiridon" Hospital, Iași, with a mean age of 21.36 ± 7.16 years. The clinical parameters observed were the following: visual acuity (VA), objective refraction, binocular vision (BV), fusional amplitude (FA), Schirmer's test. A questionnaire was also distributed, which contained 8 questions that highlighted the gadget's impact on the eyesight. The use of different gadgets, such as computer, laptops, mobile phones or other displays become part of our everyday life and people experience a variety of ocular symptoms or vision problems related to these. Computer Vision Syndrome (CVS) represents a group of visual and extraocular symptoms associated with sustained use of visual display terminals. Headache, blurred vision, and ocular congestion are the most frequent manifestations determined by the long time use of gadgets. Mobile phones and laptops are the most frequently used gadgets. People who use gadgets for a long time have a sustained effort for accommodation. A small amount of refractive errors (especially myopic shift) was objectively recorded by various studies on near work. Dry eye syndrome could also be identified, and an improvement of visual comfort could be observed after the instillation of artificial tears drops. Computer Vision Syndrome is still under-diagnosed, and people should be made aware of the bad effects the prolonged use of gadgets has on eyesight.

  2. Management of digital eye strain.

    PubMed

    Coles-Brennan, Chantal; Sulley, Anna; Young, Graeme

    2018-05-23

    Digital eye strain, an emerging public health issue, is a condition characterised by visual disturbance and/or ocular discomfort related to the use of digital devices and resulting from a range of stresses on the ocular environment. This review aims to provide an overview of the extensive literature on digital eye strain research with particular reference to the clinical management of symptoms. As many as 90 per cent of digital device users experience symptoms of digital eye strain. Many studies suggest that the following factors are associated with digital eye strain: uncorrected refractive error (including presbyopia), accommodative and vergence anomalies, altered blinking pattern (reduced rate and incomplete blinking), excessive exposure to intense light, closer working distance, and smaller font size. Since a symptom may be caused by one or more factors, a holistic approach should be adopted. The following management strategies have been suggested: (i) appropriate correction of refractive error, including astigmatism and presbyopia; (ii) management of vergence anomalies, with the aim of inducing or leaving a small amount of heterophoria (~1.5 Δ Exo); (iii) blinking exercise/training to maintain normal blinking pattern; (iv) use of lubricating eye drops (artificial tears) to help alleviate dry eye-related symptoms; (v) contact lenses with enhanced comfort, particularly at end-of-day and in challenging environments; (vi) prescription of colour filters in all vision correction options, especially blue light-absorbing filters; and (vii) management of accommodative anomalies. Prevention is the main strategy for management of digital eye strain, which involves: (i) ensuring an ergonomic work environment and practice (through patient education and the implementation of ergonomic workplace policies); and (ii) visual examination and eye care to treat visual disorders. Special consideration is needed for people at a high risk of digital eye strain, such as computer workers and contact lens wearers. © 2018 Optometry Australia.

  3. Effect of a contact lens on mouse retinal in vivo imaging: Effective focal length changes and monochromatic aberrations.

    PubMed

    Zhang, Pengfei; Mocci, Jacopo; Wahl, Daniel J; Meleppat, Ratheesh Kumar; Manna, Suman K; Quintavalla, Martino; Muradore, Riccardo; Sarunic, Marinko V; Bonora, Stefano; Pugh, Edward N; Zawadzki, Robert J

    2018-03-28

    For in vivo mouse retinal imaging, especially with Adaptive Optics instruments, application of a contact lens is desirable, as it allows maintenance of cornea hydration and helps to prevent cataract formation during lengthy imaging sessions. However, since the refractive elements of the eye (cornea and lens) serve as the objective for most in vivo retinal imaging systems, the use of a contact lens, even with 0 Dpt. refractive power, can alter the system's optical properties. In this investigation we examined the effective focal length change and the aberrations that arise from use of a contact lens. First, focal length changes were simulated with a Zemax mouse eye model. Then ocular aberrations with and without a 0 Dpt. contact lens were measured with a Shack-Hartmann wavefront sensor (SHWS) in a customized AO-SLO system. Total RMS wavefront errors were measured for two groups of mice (14-month, and 2.5-month-old), decomposed into 66 Zernike aberration terms, and compared. These data revealed that vertical coma and spherical aberrations were increased with use of a contact lens in our system. Based on the ocular wavefront data we evaluated the effect of the contact lens on the imaging system performance as a function of the pupil size. Both RMS error and Strehl ratios were quantified for the two groups of mice, with and without contact lenses, and for different input beam sizes. These results provide information for determining optimum pupil size for retinal imaging without adaptive optics, and raise critical issues for design of mouse optical imaging systems that incorporate contact lenses. Copyright © 2018. Published by Elsevier Ltd.

  4. Eyesight quality and Computer Vision Syndrome

    PubMed Central

    Bogdănici, Camelia Margareta; Săndulache, Diana Elena; Nechita, Corina Andreea

    2017-01-01

    The aim of the study was to analyze the effects that gadgets have on eyesight quality. A prospective observational study was conducted from January to July 2016, on 60 people who were divided into two groups: Group 1 – 30 middle school pupils with a mean age of 11.9 ± 1.86 and Group 2 – 30 patients evaluated in the Ophthalmology Clinic, “Sf. Spiridon” Hospital, Iași, with a mean age of 21.36 ± 7.16 years. The clinical parameters observed were the following: visual acuity (VA), objective refraction, binocular vision (BV), fusional amplitude (FA), Schirmer’s test. A questionnaire was also distributed, which contained 8 questions that highlighted the gadget’s impact on the eyesight. The use of different gadgets, such as computer, laptops, mobile phones or other displays become part of our everyday life and people experience a variety of ocular symptoms or vision problems related to these. Computer Vision Syndrome (CVS) represents a group of visual and extraocular symptoms associated with sustained use of visual display terminals. Headache, blurred vision, and ocular congestion are the most frequent manifestations determined by the long time use of gadgets. Mobile phones and laptops are the most frequently used gadgets. People who use gadgets for a long time have a sustained effort for accommodation. A small amount of refractive errors (especially myopic shift) was objectively recorded by various studies on near work. Dry eye syndrome could also be identified, and an improvement of visual comfort could be observed after the instillation of artificial tears drops. Computer Vision Syndrome is still under-diagnosed, and people should be made aware of the bad effects the prolonged use of gadgets has on eyesight. PMID:29450383

  5. Changes in biomechanical properties of the cornea and intraocular pressure after myopic laser in situ keratomileusis using a femtosecond laser for flap creation determined using ocular response analyzer and Goldmann applanation tonometry.

    PubMed

    Shin, Jonghoon; Kim, Tae Won; Park, Soo Jeong; Yoon, Min; Lee, Ji Woong

    2015-03-01

    To compare intraocular pressure (IOP) measurements before and after laser in situ keratomileusis (LASIK) using a femtosecond laser for flap creation, and to identify factors that may influence the preoperative and postoperative IOP, and the change in IOP after LASIK. Forty eyes from 20 patients who underwent treatment for myopia using a femtosecond laser for flap creation were enrolled in this study. The IOP and corneal biomechanical markers were prospectively measured preoperatively and 1 month after LASIK with Goldmann applanation tonometry (GAT) and the ocular response analyzer (ORA). Manifest refraction spherical equivalent, central corneal thickness, ablation depth, and mean corneal curvature (K reading) were also recorded. After LASIK, there was a significant reduction in the IOP measurement with respect to the corneal-compensated intraocular pressure (IOPcc) (Δ=-0.67±2.07 mm Hg), Goldmann-correlated pressure (IOPg) (Δ=-3.92±2.19 mm Hg), and GAT (Δ=-2.6±2.51). Multiple regression analysis revealed that the corneal hysteresis (CH) and corneal resistance factor (CRF) are statistically significant predictors of IOPcc, IOPg, and GAT (P<0.000). In this analysis, the preoperative manifest refraction spherical equivalent, CH, and CRF were significant predictors of ΔIOPcc (adjusted R²=0.401) and ΔIOPg (adjusted R²=0.386). The preoperative SE and central corneal thickness significantly predicted ΔGAT (adjusted R²=0.464). ORA provides a more complete measurement of IOP after LASIK with a femtosecond laser than GAT because ORA provides greater knowledge of the corneal biomechanics in terms of CH and CRF.

  6. Biometry and spectral domain optical coherence tomography parameters in children with large cupping.

    PubMed

    Jung, Jong Jin; Baek, Seung-Hee; Kim, Ungsoo Samuel

    2013-09-01

    The purpose of this study is to investigate optic nerve head using spectral domain optical coherence tomography (SD-OCT) in children with large cupping. 111 eyes (4-10 years) were divided into three groups according to the cup to disc ratio: group 1, ≤0.3; group 2, 0.4-0.6; and group 3, ≥0.7. The rim area, disc area, average cup to disc ratio, vertical cup to disc ratio, and cup volume were investigated using SD-OCT (Cirrus HD-OCT, Carl Zeiss, Jena, Germany), and the axial length and anterior chamber depth (ACD) were measured by IOL master (IOL master 500, Carl Zeiss, Jena, Germany). Next, we compared ocular biometry and SD-OCT between the three groups. The mean age of group 1 was 6.48 ± 1.42 years, 7.00 ± 1.75 years in group 2, and 6.63 ± 1.82 years in group 3 (p = 0.370). A significant difference was seen in the spherical equivalent between the groups (p = 0.001). Group 2 had the most myopic refractive errors. As the cup to disc ratio increases, disc area, average cup to disc ratio, vertical cup to disc ratio, and cup volume increase significantly. When the results of ocular biometry and SD-OCT are adjusted for axial length, only disc area showed a significant correlation with cup to disc ratio (ACD: p = 0.473, rim area: p = 0.639, disc area: p = 0.005, and cup volume: p = 0.325). Axial length is the key factor determining disc size, which in turn is important for determining cup to disc ratio. Normal children with large cupping should be examined for axial length, myopic refractive errors, and disc size.

  7. The practice of optometry: National Board of Examiners in Optometry survey of optometric patients.

    PubMed

    Soroka, Mort; Krumholz, David; Bennett, Amy

    2006-09-01

    A study commissioned by the National Board of Examiners in Optometry was designed to obtain information about patients seen in general practice. Providers completed an encounter form for patients seen during a 2-day sample. Data were obtained from 11,012 patients in rural, urban, and suburban environments from a diverse population of 480 optometrists representative of profession-wide practitioners in terms of geographic distribution and practice settings. Although practitioners were selected randomly, the response rate among those who were invited to participate was only 17.7%. Optometrists who specialized and did not classify themselves as general practitioners were excluded from the study. The study provides insights into the most common diagnostic and therapeutic procedures performed, medications prescribed, and referrals made in general practices. Seventy-one percent of all examinations were categorized as comprehensive, approximately 13% were because of disease, and 11% were for contact lens care. Almost 17% of all patients received a formal visual field test (Goldmann or automated). Refractive error was the most prevalent diagnosis, reflective of the ocular problems found in the general population, and systemic conditions were the second largest category. Although 12% of all patients were referred to an ophthalmologist for further care, other types of referrals were infrequent. Referrals to a primary care physician, laboratory, and imaging or for refractive surgery accounted for only 8% of all referrals. Ocular disease treatment was found to be an integral part of the optometrist's practice. Prescribing topical medications, both legend and "over-the-counter," was a primary treatment option. The most common medications prescribed were for glaucoma, with antibiotics, anti-inflammatory and anti-allergy drops making up the remainder, in descending order.

  8. Medical and legal point of view for low-vision patients.

    PubMed

    Bogdănici, Camelia-Margareta; Bogdănici, Ştefan Tudor; Săndulache, Diana Elena; Diaconu, Carmen-Mariana

    2018-01-01

    The aim of the study was to highlight the medical and legal difficulties in framing low-vision patients for certification. We performed a retrospective observational study conducted from January 2013 to January 2016, on 63 patients with the mean age of 16.37±3.34 years, evaluated at the Ophthalmology Clinic from "Sf. Spiridon" Hospital, Iași, in order to release a medical certificate required at the Expertise Board. The clinical parameters observed were visual acuity (VA) with correction, objective refraction (in Spherical Equivalent - SEq), intraocular pressure, slit lamp examination of the anterior pole, fundus examination, orthoptic eye exam, and ocular ultrasonography (in selected cases). The main causes for the decreased visual acuity found are refractive or strabic amblyopia determined by: high myopia (28.57%), esotropia (19.04%), astigmatism (17.46); congenital diseases - congenital nystagmus (12.69%), congenital cataract (7.93%), microphthalmia (7.93%); acquired diseases - retinopathy of prematurity (9.52%), optic nerve atrophy (7.93%), bandelette keratopathy (6.34); ocular trauma (7.93%). In 52.38% of the cases for the RE and 53.96% of the cases for the LE, decreased visual acuity was caused by an irreversible condition and could not be improved. Patients come every year for reevaluation in order to receive the medical certificate required at the Expertise Board. Evaluating the patient for a certificate for visual impairment is a time consuming process due to the high number of investigations necessary and, sometimes, difficult collaboration with the patient with associated general pathology. It also requires knowledge of frequently changing legislation to complete legal forms for patients with visual impairment. A medical certificate may now be issued with a validity of up to four years, given that certain diseases are irreversible and visual functional status does not change over time.

  9. Precision of higher-order aberration measurements with a new Placido-disk topographer and Hartmann-Shack wavefront sensor.

    PubMed

    López-Miguel, Alberto; Martínez-Almeida, Loreto; González-García, María J; Coco-Martín, María B; Sobrado-Calvo, Paloma; Maldonado, Miguel J

    2013-02-01

    To assess the intrasession and intersession precision of ocular, corneal, and internal higher-order aberrations (HOAs) measured using an integrated topographer and Hartmann-Shack wavefront sensor (Topcon KR-1W) in refractive surgery candidates. IOBA-Eye Institute, Valladolid, Spain. Evaluation of diagnostic technology. To analyze intrasession repeatability, 1 experienced examiner measured eyes 9 times successively. To study intersession reproducibility, the same clinician obtained measurements from another set of eyes in 2 consecutive sessions 1 week apart. Ocular, corneal, and internal HOAs were obtained. Coma and spherical aberrations, 3rd- and 4th-order aberrations, and total HOAs were calculated for a 6.0 mm pupil diameter. For intrasession repeatability (75 eyes), excellent intraclass correlation coefficients (ICCs) were obtained (ICC >0.87), except for internal primary coma (ICC = 0.75) and 3rd-order (ICC = 0.72) HOAs. Repeatability precision (1.96 × S(w)) values ranged from 0.03 μm (corneal primary spherical) to 0.08 μm (ocular primary coma). For intersession reproducibility (50 eyes), ICCs were good (>0.8) for ocular primary spherical, 3rd-order, and total higher-order aberrations; reproducibility precision values ranged from 0.06 μm (corneal primary spherical) to 0.21 μm (internal 3rd order), with internal HOAs having the lowest precision (≥0.12 μm). No systematic bias was found between examinations on different days. The intrasession repeatability was high; therefore, the device's ability to measure HOAs in a reliable way was excellent. Under intersession reproducibility conditions, dependable corneal primary spherical aberrations were provided. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. Ocular higher-order aberrations in a school children population.

    PubMed

    Papamastorakis, George; Panagopoulou, Sophia; Tsilimbaris, Militadis K; Pallikaris, Ioannis G; Plainis, Sotiris

    2015-01-01

    The primary objective of the study was to explore the statistics of ocular higher-order aberrations in a population of primary and secondary school children. A sample of 557 children aged 10-15 years were selected from two primary and two secondary schools in Heraklion, Greece. Children were classified by age in three subgroups: group I (10.7±0.5 years), group II (12.4±0.5 years) and group III (14.5±0.5 years). Ocular aberrations were measured using a wavefront aberrometer (COAS, AMO Wavefront Sciences, USA) at mesopic light levels (illuminance at cornea was 4lux). Wavefront analysis was achieved for a 5mm pupil. Statistical analysis was carried out for the right eye only. The average coefficient of most high-order aberrations did not differ from zero with the exception of vertical (0.076μm) and horizontal (0.018μm) coma, oblique trefoil (-0.055μm) and spherical aberration (0.018μm). The most prominent change between the three groups was observed for the spherical aberration, which increased from 0.007μm (SE 0.005) in group I to 0.011μm (SE 0.004) in group II and 0.030μm (SE 0.004) in group III. Significant differences were also found for the oblique astigmatism and the third-order coma aberrations. Differences in the low levels of ocular spherical aberration in young children possibly reflect differences in lenticular spherical aberration and relate to the gradient refractive index of the lens. The evaluation of spherical aberration at certain stages of eye growth may help to better understand the underlying mechanisms of myopia development. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  11. Ocular higher-order aberrations in a school children population

    PubMed Central

    Papamastorakis, George; Panagopoulou, Sophia; Tsilimbaris, Militadis K.; Pallikaris, Ioannis G.; Plainis, Sotiris

    2014-01-01

    Purpose The primary objective of the study was to explore the statistics of ocular higher-order aberrations in a population of primary and secondary school children. Methods A sample of 557 children aged 10–15 years were selected from two primary and two secondary schools in Heraklion, Greece. Children were classified by age in three subgroups: group I (10.7 ± 0.5 years), group II (12.4 ± 0.5 years) and group III (14.5 ± 0.5 years). Ocular aberrations were measured using a wavefront aberrometer (COAS, AMO Wavefront Sciences, USA) at mesopic light levels (illuminance at cornea was 4 lux). Wavefront analysis was achieved for a 5 mm pupil. Statistical analysis was carried out for the right eye only. Results The average coefficient of most high-order aberrations did not differ from zero with the exception of vertical (0.076 μm) and horizontal (0.018 μm) coma, oblique trefoil (−0.055 μm) and spherical aberration (0.018 μm). The most prominent change between the three groups was observed for the spherical aberration, which increased from 0.007 μm (SE 0.005) in group I to 0.011 μm (SE 0.004) in group II and 0.030 μm (SE 0.004) in group III. Significant differences were also found for the oblique astigmatism and the third-order coma aberrations. Conclusions Differences in the low levels of ocular spherical aberration in young children possibly reflect differences in lenticular spherical aberration and relate to the gradient refractive index of the lens. The evaluation of spherical aberration at certain stages of eye growth may help to better understand the underlying mechanisms of myopia development. PMID:25288226

  12. A model for predicting sulcus-to-sulcus diameter in posterior chamber phakic intraocular lens candidates: correlation between ocular biometric parameters.

    PubMed

    Ghoreishi, Mohammad; Abdi-Shahshahani, Mehdi; Peyman, Alireza; Pourazizi, Mohsen

    2018-02-21

    The aim of this study was to determine the correlation between ocular biometric parameters and sulcus-to-sulcus (STS) diameter. This was a cross-sectional study of preoperative ocular biometry data of patients who were candidates for phakic intraocular lens (IOL) surgery. Subjects underwent ocular biometry analysis, including refraction error evaluation using an autorefractor and Orbscan topography for white-to-white (WTW) corneal diameter and measurement. Pentacam was used to perform WTW corneal diameter and measurements of minimum and maximum keratometry (K). Measurements of STS and angle-to-angle (ATA) were obtained using a 50-MHz B-mode ultrasound device. Anterior optical coherence tomography was performed for anterior chamber depth measurement. Pearson's correlation test and stepwise linear regression analysis were used to find a model to predict STS. Fifty-eight eyes of 58 patients were enrolled. Mean age ± standard deviation of sample was 28.95 ± 6.04 years. The Pearson's correlation coefficient between STS with WTW, ATA, mean K was 0.383, 0.492, and - 0.353, respectively, which was statistically significant (all P < 0.001). Using stepwise linear regression analysis, there is a statistically significant association between STS with WTW (P = 0.011) and mean K (P = 0.025). The standardized coefficient was 0.323 and - 0.284 for WTW and mean K, respectively. The stepwise linear regression analysis equation was: (STS = 9.549 + 0.518 WTW - 0.083 mean K). Based on our result, given the correlation of STS with WTW and mean K and potential of direct and essay measurement of WTW and mean K, it seems that current IOL sizing protocols could be estimating with WTW and mean K.

  13. Bilateral symmetry in vision and influence of ocular surgical procedures on binocular vision: A topical review.

    PubMed

    Arba Mosquera, Samuel; Verma, Shwetabh

    2016-01-01

    We analyze the role of bilateral symmetry in enhancing binocular visual ability in human eyes, and further explore how efficiently bilateral symmetry is preserved in different ocular surgical procedures. The inclusion criterion for this review was strict relevance to the clinical questions under research. Enantiomorphism has been reported in lower order aberrations, higher order aberrations and cone directionality. When contrast differs in the two eyes, binocular acuity is better than monocular acuity of the eye that receives higher contrast. Anisometropia has an uncommon occurrence in large populations. Anisometropia seen in infancy and childhood is transitory and of little consequence for the visual acuity. Binocular summation of contrast signals declines with age, independent of inter-ocular differences. The symmetric associations between the right and left eye could be explained by the symmetry in pupil offset and visual axis which is always nasal in both eyes. Binocular summation mitigates poor visual performance under low luminance conditions and strong inter-ocular disparity detrimentally affects binocular summation. Considerable symmetry of response exists in fellow eyes of patients undergoing myopic PRK and LASIK, however the method to determine whether or not symmetry is maintained consist of comparing individual terms in a variety of ad hoc ways both before and after the refractive surgery, ignoring the fact that retinal image quality for any individual is based on the sum of all terms. The analysis of bilateral symmetry should be related to the patients' binocular vision status. The role of aberrations in monocular and binocular vision needs further investigation. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  14. Width of anterior chamber angle determined by OCT, and correlation to refraction and age in a German working population: the MIPH Eye&Health Study.

    PubMed

    Vossmerbaeumer, Urs; Schuster, Alexander K; Fischer, Joachim E

    2013-12-01

    Optical coherence tomography (OCT) of the anterior segment allows quantitative analysis of the geometry of the chamber angle. We performed bilateral spectral-domain OCT measurements in healthy, emmetropic, hyperopic, and myopic subjects to establish correlations between the width of the angle, the refraction, and intraocular pressure of the test persons. Out of 4,617 eyes (2,309 subjects), those with refractive errors of < -4 or > +3 diopters were identified by objective refraction measurement (KR-8800 Kerato-Refractometer, Topcon Inc., Japan) and examined using the anterior segment mode of a spectral-domain 3D OCT-2000 (Topcon Inc., Japan). Non-contact tonometry was performed (CT-80, Topcon Inc., Japan). One hundred and eight eyes of 54 emmetropic subjects (± 0.5 dpt) served as reference group. Previous ocular surgery was exclusion criterion in all groups. Width of the chamber angle was determined using semi-automated software tools and statistical analysis of the data (Pearson correlation, ANOVA with post-hoc test and Bonferroni correction, regression analysis) was performed using SPSS software (SPSS 19.0, Chicago, IL, USA). Six hundred and sixty-eight eyes of 398 persons (292 male, 96 female) were included in the study. Mean hyperopic refraction was +4.24 (+3  to +7.75) dpt, mean myopic refraction was -5.86 (-4 to -11.75) dpt. Valid chamber angle OCT measurements could be obtained from 50 (69.4 %) hyperopic and 400 (71.4 %) myopic eyes meeting the inclusion criteria. The mean width of the chamber angle was determined as 31.8° (range: 13.5 to 45.6, SD 7.49) in the hyperopic group, 40.8° (range: 19.3 to 66.0, SD 8.1) in the myopic group, and 36.3° (range: 21.1 to 51.8, SD 6.8) in the emmetropic reference group. Correlation was highly significant (p > 0.001) between refractive error and the aperture of the chamber angle as measured from OCT. The association of the intraocular pressure and the refraction was also highly significant (p > 0.001) for the three groups. The spectral-domain OCT yielded measurements that could be used for digital analysis of the chamber angle geometry. Our results highlight the correlation between refraction and aperture of the angle in hyperopia and myopia as determined by the 3D OCT-2000: hyperopia is associated with a narrower chamber angle, myopia with a wider aperture of the angle.

  15. Brillouin microscopy: assessing ocular tissue biomechanics.

    PubMed

    Yun, Seok Hyun; Chernyak, Dimitri

    2018-07-01

    Assessment of corneal biomechanics has been an unmet clinical need in ophthalmology for many years. Many researchers and clinicians have identified corneal biomechanics as source of variability in refractive procedures and one of the main factors in keratoconus. However, it has been difficult to accurately characterize corneal biomechanics in patients. The recent development of Brillouin light scattering microscopy heightens the promise of bringing biomechanics into the clinic. The aim of this review is to overview the progress and discuss prospective applications of this new technology. Brillouin microscopy uses a low-power near-infrared laser beam to determine longitudinal modulus or mechanical compressibility of tissue by analyzing the return signal spectrum. Human clinical studies have demonstrated significant difference in the elastic properties of normal corneas versus corneas diagnosed with mild and severe keratoconus. Clinical data have also shown biomechanical changes after corneal cross-linking treatment of keratoconus patients. Brillouin measurements of the crystalline lens and sclera have also been demonstrated. Brillouin microscopy is a promising technology under commercial development at present. The technique enables physicians to characterize the biomechanical properties of ocular tissues.

  16. Common visual problems in children with disability.

    PubMed

    Salt, Alison; Sargent, Jenefer

    2014-12-01

    Children with disability are at a substantially higher risk of visual impairment (VI) (10.5% compared with 0.16%) but also of ocular disorders of all types, including refractive errors and strabismus. The aetiology of VI in children with disability reflects that of the general population and includes cerebral VI, optic atrophy, as well as primary visual disorders such as retinal dystrophies and structural eye anomalies. VI and other potentially correctable ocular disorders may not be recognised without careful assessment and are frequently unidentified in children with complex needs. Although assessment may be more challenging than in other children, identifying these potential additional barriers to learning and development may be critical. There is a need to develop clearer guidelines, referral pathways and closer working between all professionals involved in the care of children with disability and visual disorders to improve our focus on the assessment of vision and outcomes for children with disability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Refractive index measurement of the mouse crystalline lens using optical coherence tomography.

    PubMed

    Chakraborty, Ranjay; Lacy, Kip D; Tan, Christopher C; Park, Han Na; Pardue, Machelle T

    2014-08-01

    In recent years, there has been a growing interest for using mouse models in refractive development and myopia research. The crystalline lens is a critical optical component of the mouse eye that occupies greater than 50% of the ocular space, and significant increases in thickness with age. However, changes in refractive index of the mouse crystalline lens are less known. In this study, we examined the changes in thickness and refractive index of the mouse crystalline lens for two different strains, wild-type (WT) and a nyx mutant (nob) over the course of normal visual development or after form deprivation. Refractive index and lens thickness measurements were made on ex vivo lenses using spectral domain optical coherence tomography (SD-OCT). Comparison of refractive index measurements on 5 standard ball lenses using the SD-OCT and their known refractive indices (manufacturer provided) indicated good precision (intra-class correlation coefficient, 0.998 and Bland-Altman coefficient of repeatability, 0.116) of the SD-OCT to calculate mouse lens refractive index ex vivo. During normal visual development, lens thickness increased significantly with age for three different cohorts of mice, aged 4 (average thickness from both eyes; WT: 1.78 ± 0.03, nob: 1.79 ± 0.08 mm), 10 (WT: 2.02 ± 0.05, nob: 2.01 ± 0.04 mm) and 16 weeks (WT: 2.12 ± 0.06, nob: 2.09 ± 0.06 mm, p < 0.001). Lens thickness was not significantly different between the two strains at any age (p = 0.557). For mice with normal vision, refractive index for isolated crystalline lenses in nob mice was significantly greater than WT mice (mean for all ages; WT: 1.42 ± 0.01, nob: 1.44 ± 0.001, p < 0.001). After 4 weeks of form deprivation to the right eye using a skull-mounted goggling apparatus, a thinning of the crystalline lens was observed in both right and left eyes of goggled animals compared to their naïve controls (average from both the right and the left eye) for both strains (p = 0.052). In form deprived mice, lens refractive index was significantly different between the goggled animals and non-goggled naïve controls in nob mice, but not in WT mice (p = 0.009). Both eyes of goggled nob mice had significantly greater lens refractive index (goggled, 1.49 ± 0.01; opposite, 1.47 ± 0.03) compared to their naïve controls (1.45 ± 0.02, p < 0.05). The results presented here suggest that there are genetic differences in the crystalline lens refractive index of the mouse eye, and that the lens refractive index in mice significantly increase with form deprivation. Research applications requiring precise optical measurements of the mouse eye should take these lens refractive indices into account when interpreting SD-OCT data. Published by Elsevier Ltd.

  18. Three-dimensional ophthalmic optical coherence tomography with a refraction correction algorithm

    NASA Astrophysics Data System (ADS)

    Zawadzki, Robert J.; Leisser, Christoph; Leitgeb, Rainer; Pircher, Michael; Fercher, Adolf F.

    2003-10-01

    We built an optical coherence tomography (OCT) system with a rapid scanning optical delay (RSOD) line, which allows probing full axial eye length. The system produces Three-dimensional (3D) data sets that are used to generate 3D tomograms of the model eye. The raw tomographic data were processed by an algorithm, which is based on Snell"s law to correct the interface positions. The Zernike polynomials representation of the interfaces allows quantitative wave aberration measurements. 3D images of our results are presented to illustrate the capabilities of the system and the algorithm performance. The system allows us to measure intra-ocular distances.

  19. Bilateral reading performance of 4 multifocal intraocular lens models and a monofocal intraocular lens under bright lighting conditions.

    PubMed

    Rasp, Max; Bachernegg, Alexander; Seyeddain, Orang; Ruckhofer, Josef; Emesz, Martin; Stoiber, Josef; Grabner, Günther; Dexl, Alois K

    2012-11-01

    To compare changes in reading performance parameters after implantation of 4 multifocal intraocular lens (IOL) models and a monofocal IOL. Department of Ophthalmology, Paracelsus Medical University, Salzburg, Austria. Prospective randomized controlled clinical trial. Patients with bilateral cataract without additional ocular pathology were scheduled for bilateral implantation of Acri.Smart 48S monofocal, Acrysof Restor SN6AD3 apodized multifocal, AT LISA 366D diffractive multifocal, Tecnis ZMA00 diffractive multifocal, or Rezoom refractive multifocal IOLs. Bilateral corrected and uncorrected reading acuity, reading distance, mean and maximum reading speeds, and smallest log-scaled print size of a Radner reading chart were evaluated under bright lighting conditions (500 lux) using the Salzburg Reading Desk. Pupil size was not measured throughout the trial. The minimum follow-up was 12 months. The diffractive multifocal groups had significantly better uncorrected reading acuity and uncorrected smallest print size than the monofocal and refractive multifocal groups 1, 6, and 12 months postoperatively. The diffractive IOL groups had comparable uncorrected reading distance of approximately 32 cm, which was larger in the monofocal group (38.9 ± 8.4 cm) and refractive multifocal group (37.1 ± 7.3 cm) at the last visit. Patients with diffractive IOLs could read print sizes of approximately 0.74 to 0.87 mm, which was much better than in the monofocal and refractive multifocal groups. The diffractive AT LISA IOL provided the best reading speed values (mean and maximum, corrected and uncorrected). Multifocal IOLs with a diffractive component provided good reading performance that was significantly better than that obtained with a refractive multifocal or monofocal IOL. Drs. Grabner and Dexl were patent owners of the Salzburg Reading Desk technology (now owned by SRD-Vision, LLC). No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  20. Intraoperative aberrometry versus standard preoperative biometry and a toric IOL calculator for bilateral toric IOL implantation with a femtosecond laser: One-month results.

    PubMed

    Woodcock, Michael G; Lehmann, Robert; Cionni, Robert J; Breen, Michael; Scott, Maria C

    2016-06-01

    To compare astigmatic outcomes in patients with bilateral cataracts having toric intraocular lens (IOL) implantation with intraoperative aberrometry measurements in 1 eye and standard power calculation and a toric IOL calculator with inked axis marking in the contralateral eye. Twelve sites in the United States. Prospective cohort study. The eye with the more visually significant cataract was randomized to intraoperative aberrometry measurements (Ocular Response Analyzer with Verifeye) or standard preoperative biometry and use of a toric calculator with the contralateral eye automatically assigned to the other group. The primary effectiveness outcome was the proportion of eyes with a postoperative refractive astigmatism of 0.50 diopter (D) or less at 1 month. Of the 130 patients (260 eyes) enrolled, 124 (248 eyes) were randomized; 121 (242 eyes) completed the trial. The percentage of eyes with astigmatism of 0.50 D or less at 1 month was higher in the intraoperative aberrometry group than in the standard group (89.2% versus 76.6%) (P = .006). The mean postoperative refractive astigmatism was lower in the intraoperative aberrometry group (0.29 D ± 0.28 [SD] versus 0.36 ± 0.35 D) (P = .041). Secondary effectiveness endpoints, including manifest refraction spherical equivalent prediction error, uncorrected distance visual acuity, and corrected distance visual acuity, were similar. Compared with standard methods, the use of the intraoperative aberrometry system increased the proportion of eyes with postoperative refractive astigmatism of 0.50 D or less and reduced the mean postoperative refractive astigmatism at 1 month. Other efficacy outcomes were similar. Drs. Woodcock, Lehmann, and Cionni are consultants to Alcon Laboratories, Inc. Dr. Breen is an employee of Alcon Laboratories, Inc. Dr. Scott has no financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Intra-tissue Refractive Index Shaping (IRIS) of the cornea and lens using a low-pulse-energy femtosecond laser oscillator

    PubMed Central

    Ding, Li; Knox, Wayne H.; Bühren, Jens; Nagy, Lana J.; Huxlin, Krystel R.

    2009-01-01

    Purpose To assess the optical effect of high-repetition-rate, low energy femtosecond laser pulses on lightly-fixed corneas and lenses. Methods Eight corneas and eight lenses were extracted post-mortem from normal, adult cats. They were lightly fixed and stored in a solution that minimized swelling and opacification. An 800nm Ti:Sapphire femtosecond laser oscillator with a 27fs pulse duration and 93MHz repetition rate was used to inscribe gratings consisting of 20-40 lines, each 1μm wide, 100μm long and 5μm apart, 100μm below the tissue surface. Refractive index changes in the micromachined regions were calculated immediately and after one month of storage by measuring the intensity distribution of diffracted light when the gratings were irradiated with a 632.8nm He-Ne laser. Results Periodic gratings were created into the stromal layer of the corneas and the cortex of the lenses by adjusting the laser pulse energy until visible plasma luminescence and bubbles were no longer generated. The gratings had low scattering loss and could only be visualized using phase microscopy. Refractive index changes measured 0.005±0.001 to 0.01±0.001 in corneal tissue and 0.015±0.001 to 0.021±0.001 in the lenses. The gratings and refractive index changes were preserved after storing the micromachined corneas and lenses for one month. Conclusions These pilot experiments demonstrate a novel application of low-pulse-energy, MHz femtosecond lasers in modifying the refractive index of transparent ocular tissues without apparent tissue destruction. Although it remains to be verified in living tissues, the stability of this effect suggests that the observed modifications are due to long-term molecular and/or structural changes. PMID:18641284

  2. The effects of simultaneous dual focus lenses on refractive development in infant monkeys.

    PubMed

    Arumugam, Baskar; Hung, Li-Fang; To, Chi-Ho; Holden, Brien; Smith, Earl L

    2014-10-16

    We investigated the effects of two simultaneously imposed, competing focal planes on refractive development in monkeys. Starting at 3 weeks of age and continuing until 150 ± 4 days of age, rhesus monkeys were reared with binocular dual-focus spectacle lenses. The treatment lenses had central 2-mm zones of zero power and concentric annular zones with alternating powers of +3.0 diopter [D] and plano (pL or 0 D) (n = 7; +3D/pL) or -3.0 D and plano (n = 7; -3D/pL). Retinoscopy, keratometry, and A-scan ultrasonography were performed every 2 weeks throughout the treatment period. For comparison purposes data were obtained from monkeys reared with full field (FF) +3.0 (n = 4) or -3.0 D (n = 5) lenses over both eyes and 33 control animals reared with unrestricted vision. The +3 D/pL lenses slowed eye growth resulting in hyperopic refractive errors that were similar to those produced by FF+3 D lenses (+3 D/pL = +5.25 D, FF +3 D = +4.63 D; P = 0.32), but significantly more hyperopic than those observed in control monkeys (+2.50 D, P = 0.0001). One -3 D/pL monkey developed compensating axial myopia; however, in the other -3 D/pL monkeys refractive development was dominated by the zero-powered portions of the treatment lenses. The refractive errors for the -3 D/pL monkeys were more hyperopic than those in the FF -3 D monkeys (-3 D/pL = +3.13 D, FF -3D = -1.69 D; P = 0.01), but similar to those in control animals (P = 0.15). In the monkeys treated with dual-focus lenses, refractive development was dominated by the more anterior (i.e., relatively myopic) image plane. The results indicate that imposing relative myopic defocus over a large proportion of the retina is an effective means for slowing ocular growth. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  3. The Effects of Simultaneous Dual Focus Lenses on Refractive Development in Infant Monkeys

    PubMed Central

    Arumugam, Baskar; Hung, Li-Fang; To, Chi-ho; Holden, Brien; Smith, Earl L.

    2014-01-01

    Purpose. We investigated the effects of two simultaneously imposed, competing focal planes on refractive development in monkeys. Methods. Starting at 3 weeks of age and continuing until 150 ± 4 days of age, rhesus monkeys were reared with binocular dual-focus spectacle lenses. The treatment lenses had central 2-mm zones of zero power and concentric annular zones with alternating powers of +3.0 diopter [D] and plano (pL or 0 D) (n = 7; +3D/pL) or −3.0 D and plano (n = 7; −3D/pL). Retinoscopy, keratometry, and A-scan ultrasonography were performed every 2 weeks throughout the treatment period. For comparison purposes data were obtained from monkeys reared with full field (FF) +3.0 (n = 4) or −3.0 D (n = 5) lenses over both eyes and 33 control animals reared with unrestricted vision. Results. The +3 D/pL lenses slowed eye growth resulting in hyperopic refractive errors that were similar to those produced by FF+3 D lenses (+3 D/pL = +5.25 D, FF +3 D = +4.63 D; P = 0.32), but significantly more hyperopic than those observed in control monkeys (+2.50 D, P = 0.0001). One −3 D/pL monkey developed compensating axial myopia; however, in the other −3 D/pL monkeys refractive development was dominated by the zero-powered portions of the treatment lenses. The refractive errors for the −3 D/pL monkeys were more hyperopic than those in the FF −3 D monkeys (−3 D/pL = +3.13 D, FF −3D = −1.69 D; P = 0.01), but similar to those in control animals (P = 0.15). Conclusions. In the monkeys treated with dual-focus lenses, refractive development was dominated by the more anterior (i.e., relatively myopic) image plane. The results indicate that imposing relative myopic defocus over a large proportion of the retina is an effective means for slowing ocular growth. PMID:25324283

  4. Comparison of IOL--master and ultrasound biometry in preoperative intra ocular lens (IOL) power calculation.

    PubMed

    Kolega, Marija Škara; Kovačević, Suzana; Čanović, Samir; Pavičić, Ana Didović; Bašić, Jadranka Katušić

    2015-03-01

    Postoperative refractive outcome largely depends on the accuracy of calculating power of implanted IOL. Lens power calculation can be done by conventional ultrasound biometry and partial coherence laser interferometry (IOL Master). The aim was to compare the accuracy of IOL power calculations using conventional ultrasound biometry and partial coherence laser interferometry.40 eyes were included in this prospective randomized trial. Twenty eyes underwent IOL master and 20 eyes had aplanation ultrasound biometry. There were included only eyes with age-related cataract and postoperative natural visual acuity (VA) 0.7. Visual acuity was performed 6 weeks after cataract surgery. After 6 weeks best natural visual acuity were 0.9 (± 0.1) in IOL-Master group and 0.85 (± 0.15) in ultrasound biometry. The postoperative mean absolute refractive error was 0.75 (± 0.5) D for ultrasound biometry and 0.50 (± 0.50) D for IOL-Master. Optical biometry with the IOL-Master proved to be slightly more accurate than ultrasound biometry for IOL power calculation.

  5. Direct laser interference patterning of ophthalmic polydimethylsiloxane (PDMS) polymers

    NASA Astrophysics Data System (ADS)

    Sola, D.; Lavieja, C.; Orera, A.; Clemente, M. J.

    2018-07-01

    The inscription of diffractive elements in ophthalmic polymers and ocular tissues to induce refractive index changes is of great interest in the fields of Optics and Ophthalmology. In this work fabrication of linear periodic patterns in polydimethylsiloxane (PDMS) intraocular lenses by means of the direct laser interference patterning (DLIP) technique was studied. A Q-Switch Nd:YAG laser coupled to second and third harmonic modules emitting linearly polarized 4 ns pulses at 355 nm with 20 Hz repetition rate was used as the laser source. Laser processing parameters were modified to produce the linear patterns. Processed samples were characterized by means of optical confocal microscopy, Scanning Electron Microscopy SEM, Energy Dispersive X-ray Spectroscopy EDX, Attenuated Total Reflectance-Infrared Spectroscopy ATR-FTIR, and Raman Spectroscopy. Depending on the laser parameters both photo-thermal and photo-chemical damage were observed in the DLIP irradiated areas. Finally, diffractive techniques were used to characterize the diffraction gratings inscribed in the samples resulting in a refractive index change of 1.9 × 10-2 under illumination of a 632.8 nm He-Ne laser.

  6. Variability in Objective Refraction for Persons with Down Syndrome.

    PubMed

    Marsack, Jason D; Ravikumar, Ayeswarya; Benoit, Julia S; Anderson, Heather A

    2017-05-01

    Down syndrome (DS) is associated with ocular and cognitive sequelae, which both have the potential to influence clinical measures of refractive error. This study compares variability of autorefraction among subjects with and without DS. Grand Seiko autorefraction was performed on 139 subjects with DS (age: 8-55, mean: 25 ± 9 yrs) and 138 controls (age: 7-59, mean: 25 ± 10 yrs). Subjects with three refraction measures per eye (DS: 113, control: 136) were included for analysis. Each refraction was converted to power vector notation (M, J0, J45) and a difference in each component (ΔM, ΔJ0, ΔJ45) was calculated for each refraction pairing. From these quantities, average dioptric strength ((Equation is included in full-text article.): square root of the sum of the squares of M, J0, and J45) and average dioptric difference ((Equation is included in full-text article.): square root of the sum of the squares of ΔM, ΔJ0, and ΔJ45) were calculated. The DS group exhibited a greater median (Equation is included in full-text article.)(1Q: 1.38D M: 2.38D 3Q: 3.41D) than control eyes (1Q: 0.47D M: 0.96D 3Q: 2.75D) (P < .001). Likewise, the DS group exhibited a greater median (Equation is included in full-text article.)in refraction (1Q: 0.27D M: 0.42D 3Q: 0.78D) than control eyes (1Q: 0.11D M: 0.15D 3Q: 0.23D) (P < .001) with 97.1% of control eyes exhibiting (Equation is included in full-text article.)≤0.50D, compared to 59.3% of DS eyes. An effect of (Equation is included in full-text article.)on (Equation is included in full-text article.)was not detected (P = .3009) nor was a significant interaction between (Equation is included in full-text article.)and group detected (P = .49). In the current study, comparing three autorefraction readings, median total dioptric difference with autorefraction in DS was 2.8 times the levels observed in controls, indicating greater potential uncertainty in objective measures of refraction for this population. The analysis demonstrates that J45 is highly contributory to the observed variability.

  7. Visual impairment and spectacle use in schoolchildren in rural and urban regions in Beijing.

    PubMed

    Guo, Yin; Liu, Li Juan; Xu, Liang; Lv, Yan Yun; Tang, Ping; Feng, Yi; Meng, Lei; Jonas, Jost B

    2014-01-01

    To determine prevalence and associations of visual impairment and frequency of spectacle use among grade 1 and grade 4 students in Beijing. This school-based, cross-sectional study included 382 grade 1 children (age 6.3 ± 0.5 years) and 299 grade 4 children (age 9.4 ± 0.7 years) who underwent a comprehensive eye examination including visual acuity, noncycloplegic refractometry, and ocular biometry. Presenting visual acuity (mean 0.04 ± 0.17 logMAR) was associated with younger age (p = 0.002), hyperopic refractive error (p<0.001), and male sex (p = 0.03). Presenting visual impairment (presenting visual acuity ≤20/40 in the better eye) was found in 44 children (prevalence 6.64 ± 1.0% [95% confidence interval (CI) 4.74, 8.54]). Mean best-corrected visual acuity (right eyes -0.02 ± 0.04 logMAR) was associated with more hyperopic refractive error (p = 0.03) and rural region of habitation (p<0.001). The prevalence of best-corrected visual impairment (best-corrected visual acuity ≤20/40 in the better eye) was 2/652 (0.30 ± 0.21% [95% CI 0.00, 0.72]). Undercorrection of refractive error was present in 53 children (7.99 ± 1.05%) and was associated with older age (p = 0.003; B 0.53; OR 1.71 [95% CI 1.20, 2.42]), myopic refractive error (p = 0.001; B -0.72; OR 0.49 [95% CI 0.35, 0.68]), and longer axial length (p = 0.002; B 0.74; OR 2.10 [95% CI 1.32, 3.32]). Spectacle use was reported for 54 children (8.14 ± 1.06%). Mean refractive error of the worse eyes of these children was -2.09 ± 2.88 D (range -7.38 to +7.25 D). Factors associated with presenting visual impairment were older age, myopic refractive error, and higher maternal education level. Despite a prevalence of myopia of 33% in young schoolchildren in Greater Beijing, prevalence of best-corrected visual impairment (0.30% ± 0.21%), presenting visual impairment (6.64% ± 1.0%), and undercorrection of refractive error (7.99% ± 1.05%) were relatively low.

  8. Effect of Rebamipide Ophthalmic Suspension on Intraocular Light Scattering for Dry Eye After Corneal Refractive Surgery.

    PubMed

    Igarashi, Akihito; Kamiya, Kazutaka; Kobashi, Hidenaga; Shimizu, Kimiya

    2015-08-01

    To assess the changes in intraocular scattering before and after instillation of rebamipide ophthalmic suspension in patients with dry eye after corneal refractive surgery. This study enrolled 60 eyes of 30 dry eye patients undergoing corneal refractive surgery. Patients were randomly assigned to start topical administration of rebamipide ophthalmic suspension (rebamipide group) or artificial tears (control group) 4 times daily for 4 weeks. Tear secretion, tear break-up time (TBUT), and the fluorescein score were measured before and after treatment. Intraocular light scattering was also measured as the objective scattering index (OSI) at 0.5-second intervals over 10 seconds. In the rebamipide group, the Schirmer I test, TBUT, and fluorescein score improved significantly, from 11.4 ± 9.0 mm, 2.2 ± 0.7 seconds, and 4.3 ± 1.3 to 14.9 ± 7.4 mm, 4.5 ± 1.7 seconds, and 1.9 ± 1.0, respectively (P = 0.006, P < 0.001, P < 0.001, Wilcoxon signed rank test). We found significant improvements in OSI at 5.0 to 10.0 seconds after blinking (5-8 seconds, P = 0.01; 9 seconds, P = 0.02; 10 seconds, P < 0.001). The mean OSI, the OSI change rate, and the OSI slope of the linear regression line improved significantly, from 2.73 ± 1.52, 74.7 ± 69.5%, and 0.10 ± 0.12 to 2.19 ± 1.19, 28.6 ± 48.7%, and 0.04 ± 0.08, respectively (P = 0.02, 0.003, and 0.03). Rebamipide ophthalmic suspension was effective for improving both ocular surface parameters and optical quality in patients with dry eye undergoing corneal refractive surgery, suggesting that it may hold promise for the treatment of such patients.

  9. Visual impairment attributable to uncorrected refractive error and other causes in the Ghanaian youth: The University of Cape Coast Survey.

    PubMed

    Abokyi, Samuel; Ilechie, Alex; Nsiah, Peter; Darko-Takyi, Charles; Abu, Emmanuel Kwasi; Osei-Akoto, Yaw Jnr; Youfegan-Baanam, Mathurin

    2016-01-01

    To determine the prevalence of visual impairment attributable to refractive error and other causes in a youthful Ghanaian population. A prospective survey of all consecutive visits by first-year tertiary students to the Optometry clinic between August, 2013 and April, 2014. Of the 4378 first-year students aged 16-39 years enumerated, 3437 (78.5%) underwent the eye examination. The examination protocol included presenting visual acuity (PVA), ocular motility, and slit-lamp examination of the external eye, anterior segment and media, and non-dilated fundus examination. Pinhole acuity and fundus examination were performed when the PVA≤6/12 in one or both eyes to determine the principal cause of the vision loss. The mean age of participants was 21.86 years (95% CI: 21.72-21.99). The prevalence of bilateral visual impairment (BVI; PVA in the better eye ≤6/12) and unilateral visual impairment UVI; PVA in the worse eye ≤6/12) were 3.08% (95% CI: 2.56-3.72) and 0.79% (95% CI: 0.54-1.14), respectively. Among 106 participants with BVI, refractive error (96.2%) and corneal opacity (3.8%) were the causes. Of the 27 participants with UVI, refractive error (44.4%), maculopathy (18.5%) and retinal disease (14.8%) were the major causes. There was unequal distribution of BVI in the different age groups, with those above 20 years having a lesser burden. Eye screening and provision of affordable spectacle correction to the youth could be timely to eliminate visual impairment. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  10. Visual impairment attributable to uncorrected refractive error and other causes in the Ghanaian youth: The University of Cape Coast Survey

    PubMed Central

    Abokyi, Samuel; Ilechie, Alex; Nsiah, Peter; Darko-Takyi, Charles; Abu, Emmanuel Kwasi; Osei-Akoto, Yaw Jnr; Youfegan-Baanam, Mathurin

    2015-01-01

    Purpose To determine the prevalence of visual impairment attributable to refractive error and other causes in a youthful Ghanaian population. Methods A prospective survey of all consecutive visits by first-year tertiary students to the Optometry clinic between August, 2013 and April, 2014. Of the 4378 first-year students aged 16–39 years enumerated, 3437 (78.5%) underwent the eye examination. The examination protocol included presenting visual acuity (PVA), ocular motility, and slit-lamp examination of the external eye, anterior segment and media, and non-dilated fundus examination. Pinhole acuity and fundus examination were performed when the PVA ≤ 6/12 in one or both eyes to determine the principal cause of the vision loss. Results The mean age of participants was 21.86 years (95% CI: 21.72–21.99). The prevalence of bilateral visual impairment (BVI; PVA in the better eye ≤6/12) and unilateral visual impairment UVI; PVA in the worse eye ≤6/12) were 3.08% (95% CI: 2.56–3.72) and 0.79% (95% CI: 0.54–1.14), respectively. Among 106 participants with BVI, refractive error (96.2%) and corneal opacity (3.8%) were the causes. Of the 27 participants with UVI, refractive error (44.4%), maculopathy (18.5%) and retinal disease (14.8%) were the major causes. There was unequal distribution of BVI in the different age groups, with those above 20 years having a lesser burden. Conclusion Eye screening and provision of affordable spectacle correction to the youth could be timely to eliminate visual impairment. PMID:26025809

  11. Variant myopia: A new presentation?

    PubMed Central

    Hussaindeen, Jameel Rizwana; Anand, Mithra; Sivaraman, Viswanathan; Ramani, Krishna Kumar; Allen, Peter M

    2018-01-01

    Purpose: Variant myopia (VM) presents as a discrepancy of >1 diopter (D) between subjective and objective refraction, without the presence of any accommodative dysfunction. The purpose of this study is to create a clinical profile of VM. Methods: Fourteen eyes of 12 VM patients who had a discrepancy of >1D between retinoscopy and subjective acceptance under both cycloplegic and noncycloplegic conditions were included in the study. Fourteen eyes of 14 age- and refractive error-matched participants served as controls. Potential participants underwent a comprehensive orthoptic examination followed by retinoscopy (Ret), closed-field autorefractor (CA), subjective acceptance (SA), choroidal and retinal thickness, ocular biometry, and higher order spherical aberrations measurements. Results: In the VM eyes, a statistically and clinically significant difference was noted between the Ret and CA and Ret and SA under both cycloplegic and noncycloplegic conditions (multivariate repeated measures analysis of variance, P < 0.0001). A statistically significant difference was observed between the VM eyes, non-VM eyes, and controls for choroidal thickness in all the quadrants (Univariate ANOVA P < 0.05). The VM eyes had thinner choroids (197.21 ± 13.04 μ) compared to the non-VM eyes (249.25 ± 53.70 μ) and refractive error-matched controls (264.62 ± 12.53 μ). No statistically significant differences between groups in root mean square of total higher order aberrations and spherical aberration were observed. Conclusion: Accommodative etiology does not play a role in the refractive discrepancy seen in individuals with the variant myopic presentation. These individuals have thinner choroids in the eye with variant myopic presentation compared to the fellow eyes and controls. Hypotheses and clinical implications of variant myopia are discussed. PMID:29785987

  12. Genetic Deletion of the Adenosine A2A Receptor Confers Postnatal Development of Relative Myopia in Mice

    PubMed Central

    Zhou, Xiangtian; Huang, Qinzhu; An, Jianhong; Lu, Runxia; Qin, Xiaoyi; Jiang, Liqin; Li, Yuan; Wang, Jianhua; Chen, Jiangfan; Qu, Jia

    2010-01-01

    Purpose. To critically evaluate whether the adenosine A2A receptor (A2AR) plays a role in postnatal refractive development in mice. Methods. Custom-built biometric systems specifically designed for mice were used to assess the development of relative myopia by examining refraction and biometrics in A2AR knockout (KO) mice and wild-type (WT) littermates between postnatal days (P)28 and P56. Ocular dimensions were measured by customized optical coherence tomography (OCT), refractive state by eccentric infrared photorefraction (EIR), and corneal radius of curvature by modified keratometry. Scleral collagen diameter and density were examined by electron microscopy on P35. The effect of A2AR activation on collagen mRNA expression and on soluble collagen production was examined in cultured human scleral fibroblasts by real-time RT-PCR and a collagen assay kit. Results. Compared with WT littermates, the A2AR KO mice displayed relative myopia (average difference, 5.1 D between P28 and P35) and associated increases in VC depth and axial length from P28 to P56. Furthermore, the myopic shift in A2AR KO mice was associated with ultrastructural changes in the sclera: Electron microscopy revealed denser collagen fibrils with reduced diameter in A2AR KO compared with WT. Last, A2AR activation induced expression of mRNAs for collagens I, III, and V and increased production of soluble collagen in cultured human scleral fibroblasts. Conclusions. Genetic deletion of the A2AR promotes development of relative myopia with increased axial length and altered scleral collagen fiber structure during postnatal development in mice. Thus, the A2AR may be important in normal refractive development. PMID:20484596

  13. TOPOGRAPHICALLY GUIDED LASIK FOR MYOPIA USING THE NIDEK CXII CUSTOMIZED ASPHERIC TREATMENT ZONE (CATZ)

    PubMed Central

    Waring, George; Dougherty, Paul J.; Chayet, Arturo; Fischer, Jeffery; Fant, Barbara; Stevens, Gary; Bains, Harkaran S.

    2007-01-01

    Purpose To assess the efficacy, predictability, and safety of topography-guided laser in situ keratomileusis (LASIK) for the surgical correction of low to moderate myopia with astigmatism using the Nidek CXIII excimer laser equipped with the customized aspheric treatment zone (CATz) algorithm. Methods In a multicenter US Food and Drug Administration study of topography-guided LASIK, 4 centers enrolled 135 eyes with manifest refraction sphere that ranged from −0.50 to −7.00 D (mean, −3.57 ± 1.45) with up to −4.00 D of astigmatism (mean, −1.02 ± 0.64 D). The intended outcome was plano in all eyes. Refractive outcomes and higher-order aberrations were analyzed preoperatively and postoperatively. Patient satisfaction was assessed using both the validated Refractive Status and Vision Profile (RSVP) questionnaire and a questionnaire designed for this study. Six-month postoperative outcomes are reported here. Results By 6 months postoperatively, the manifest refraction spherical equivalent (MRSE) for all eyes was −0.09 ± 0.31 D. Six months postoperatively, 116 of 131 eyes (88.55%) had an uncorrected visual acuity of 20/20 or better, and 122 of 131 eyes (93.13%) had a MRSE within ±0.50 D. Distance best spectacle-corrected visual acuity (BSCVA) increased by 2 or more lines in 21 of 131 eyes (19.01%), and no eyes lost 2 lines or more of BSCVA. The total ocular higher-order aberrations root-mean-square increased by 0.04 μm postoperatively. Patients reported significantly fewer night driving and glare and halo symptoms postoperatively than preoperatively. Conclusions Nidek CXIII CATz treatment of myopia with astigmatism is safe, efficacious, and predictable, and it reduces patient symptoms associated with night driving and glare and halo symptoms. PMID:18427614

  14. Prevalence of refractive errors in a multiethnic Asian population: the Singapore epidemiology of eye disease study.

    PubMed

    Pan, Chen-Wei; Zheng, Ying-Feng; Anuar, Ainur Rahman; Chew, Merwyn; Gazzard, Gus; Aung, Tin; Cheng, Ching-Yu; Wong, Tien Y; Saw, Seang-Mei

    2013-04-09

    To determine the prevalence of refractive errors in a multiethnic Asian population aged over 40 years and to examine secular trends and racial differences. A total of 10,033 adults (3353 Chinese, 3400 Indians, and 3280 Malays) participated in this study. Refractive error was determined by subjective refraction. Ocular biometric parameters were determined by partial coherence interferometry. Myopia and high myopia were defined as spherical equivalent (SE) of less than -0.5 diopters (D) and -5.0 D, respectively. Hyperopia was defined as SE of more than 0.5 D. Astigmatism was defined as cylinders less than -0.5 D. The prevalence of myopia, high myopia, hyperopia and astigmatism in Singapore adults aged over 40 years was 38.9% (95% confidence interval [CI] 37.1, 40.6); 8.4% (95% CI 8.0, 8.9); 31.5% (95% 30.5, 32.5); and 58.8% (95% CI 57.8, 59.9), respectively. Compared with the Tanjong Pagar Survey 12 years ago, there was a significant increase in the prevalence of astigmatism and mean axial length (AL) in Chinese adults aged over 40 years in Singapore. Chinese were most likely to be affected by myopia, high myopia, astigmatism, and had the longest AL among the three racial groups. The prevalence of myopia in Singapore adults is lower compared with the younger "myopia" generation in Singapore. The prevalence of astigmatism and mean AL have been increasing significantly within the past 12 years in the Chinese population. Chinese adults had higher prevalence of myopia, high myopia, astigmatism, as well as the longer AL compared with non-Chinese adults in Singapore.

  15. Prevalence of visual impairment due to uncorrected refractive error: Results from Delhi-Rapid Assessment of Visual Impairment Study.

    PubMed

    Senjam, Suraj Singh; Vashist, Praveen; Gupta, Noopur; Malhotra, Sumit; Misra, Vasundhara; Bhardwaj, Amit; Gupta, Vivek

    2016-05-01

    To estimate the prevalence of visual impairment (VI) due to uncorrected refractive error (URE) and to assess the barriers to utilization of services in the adult urban population of Delhi. A population-based rapid assessment of VI was conducted among people aged 40 years and above in 24 randomly selected clusters of East Delhi district. Presenting visual acuity (PVA) was assessed in each eye using Snellen's "E" chart. Pinhole examination was done if PVA was <20/60 in either eye and ocular examination to ascertain the cause of VI. Barriers to utilization of services for refractive error were recorded with questionnaires. Of 2421 individuals enumerated, 2331 (96%) individuals were examined. Females were 50.7% among them. The mean age of all examined subjects was 51.32 ± 10.5 years (standard deviation). VI in either eye due to URE was present in 275 individuals (11.8%, 95% confidence interval [CI]: 10.5-13.1). URE was identified as the most common cause (53.4%) of VI. The overall prevalence of VI due to URE in the study population was 6.1% (95% CI: 5.1-7.0). The elder population as well as females were more likely to have VI due to URE (odds ratio [OR] = 12.3; P < 0.001 and OR = 1.5; P < 0.02). Lack of felt need was the most common reported barrier (31.5%). The prevalence of VI due to URE among the urban adult population of Delhi is still high despite the availability of abundant eye care facilities. The majority of reported barriers are related to human behavior and attitude toward the refractive error. Understanding these aspects will help in planning appropriate strategies to eliminate VI due to URE.

  16. A retrospective analysis of children with anisometropic amblyopia in Nepal.

    PubMed

    Sapkota, Kishor

    2014-06-01

    Anisometropia is one of the main causes of amblyopia. This study was conducted to investigate the association between the depth of amblyopia and the magnitude of anisometropia. A retrospective record review was conducted at the Nepal Eye Hospital between July 2006 and June 2011. Those children included in this study were aged ≤13 years and diagnosed with unilateral anisometropic amblyopia, no strabismus and ocular pathology. Associations between the depth of amblyopia and the age and/or gender of the subjects, the laterality of the amblyopic eyes, the type and magnitude of refractive error of amblyopic eyes, and the magnitude of anisometropia were statistically analyzed. Out of the 189 children with unilateral anisometropic amblyopia (mean age 9.1 ± 2.8 years), 59% were boys. Amblyopia was more commonly found in left eye (p < 0.001). The most common type of refractive error was astigmatism (61%). The depth of amblyopia was not associated with the gender (p = 0.864) or age (p = 0.341) of the subjects or the laterality of the eyes (p = 0.159), but it was associated with the type (p = 0.049) and magnitude (p = 0.013) of refractive error of the amblyopic eye and the magnitude of anisometropia (p = 0.002). Nepalese anisometropic amblyopic children were presented late to hospital. The depth of amblyopia was highly associated with the type and magnitude of refractive error of the amblyopic eye and the magnitude of anisometropia. So, basic vision screening programs may help to find out the anisometropic children and reefer them to the hospital for timely management of anisometropic amblyopia if present.

  17. Refractive Error Study in Children: results from Mechi Zone, Nepal.

    PubMed

    Pokharel, G P; Negrel, A D; Munoz, S R; Ellwein, L B

    2000-04-01

    To assess the prevalence of refractive error and vision impairment in school age children in the terai area of the Mechi zone in Eastern Nepal. Random selection of village-based clusters was used to identify a sample of children 5 to 15 years of age. Children in the 25 selected clusters were enumerated through a door-to-door household survey and invited to village sites for examination. Visual acuity measurements, cycloplegic retinoscopy, cycloplegic autorefraction, ocular motility evaluation, and anterior segment, media, and fundus examinations were done from May 1998 through July 1998. Independent replicate examinations for quality assurance monitoring took place in all children with reduced vision and in a sample of those with normal vision in seven villages. A total of 5,526 children from 3,724 households were enumerated, and 5,067 children (91.7%) were examined. The prevalence of uncorrected, presenting, and best visual acuity 0.5 (20/40) or worse in at least one eye was 2.9%, 2.8%, and 1.4%, respectively; 0.4% had best visual acuity 0.5 or worse in both eyes. Refractive error was the cause in 56% of the 200 eyes with reduced uncorrected vision, amblyopia in 9%, other causes in 19%, with unexplained causes in the remaining 16%. Myopia -0.5 diopter or less in either eye or hyperopia 2 diopters or greater was observed in less than 3% of children. Hyperopia risk was associated with female gender and myopia risk with older age. The prevalence of reduced vision is very low in school-age children in Nepal, most of it because of correctable refractive error. Further studies are needed to determine whether the prevalence of myopia will be higher for more recent birth cohorts.

  18. PRK and butterfly LASEK: prospective, randomized, contralateral eye comparison of epithelial healing and ocular discomfort.

    PubMed

    Ghanem, Vinícius C; Souza, Giselle C; Souza, Denise C; Viese, Juliana M Z; Weber, Sarah L P; Kara-José, Newton

    2008-06-01

    To compare corneal reepithelialization, pain scores, ocular discomfort, and tear production after photorefractive keratectomy (PRK) and butterfly laser epithelial keratomileusis (LASEK). This prospective, randomized, double-masked study comprised 102 eyes of 51 patients who underwent laser refractive surgery. Each patient was randomized to have one eye operated on with PRK and the other with butterfly LASEK. Patients were followed for 1 year. The mean reepithelialization time in the PRK group was 4.35+/-0.48 days (range: 4 to 5 days) and 4.75+/-0.72 days (range: 4 to 6 days) in the butterfly LASEK group (P<.002). Pain scores and ocular discomfort were not statistically different between groups, although a trend towards a lower pain level with PRK was noted (3.31+/-4.09 vs 4.43+/-4.27; P=.18). Schirmer test values were significantly reduced from preoperative levels through 12 months with both PRK (23.6+/-8.1 vs 19.4+/-10.1; P<.002) and butterfly LASEK (22.4+/-8.7 vs 18.9+/-9.7; P=.01); however, no difference between groups was noted at any time. Photorefractive keratectomy showed a modest but statistically significant shorter reepithelialization time and a tendency towards lower pain scores than butterfly LASEK. The reepithelialization time was strongly associated with the duration of surgery in both techniques. A similar reduction of Schirmer test values was observed up to 1 year postoperatively in both groups.

  19. Digital-holographic analysis of femtosecond laser-induced photodisruption in ocular tissue

    NASA Astrophysics Data System (ADS)

    Saerchen, Emanuel; Biessy, Kevin; Kemper, Björn; Lubatschowski, Holger

    2014-02-01

    High repetition rated femtosecond laser oscillator systems with low pulse energy are more often applied for precise and safer eye surgery. Especially, the cutting procedure in the crystalline lens is of high important for presbyopia treatment. Nevertheless, the fundamental laser tissue interaction process is not completely understood, because apparently a self-induced process takes place, were one modified region changes the focusing behavior of following laser pulses. We used a MHz repetition rate femtosecond laser system with nJ-pulse energy which were focused inside an ocular-tissue-phantom (Hydroxy-ethylmethacrylat - HEMA) to induce photodisruption. The material change, caused by the fs-pulses was measured simultaneously with a compact digital-holographic microscope. To investigate the material manipulation at different time scales, we used a continuously illuminating light source. The holographic images provide quantitative values for optical path length difference (OPL), which is equivalent to a refractive index change. This change of the optical properties may cause following pulses to obtain different focusing conditions. Time lapse measurements during the laser application were performed, which show the temporal evolution of OPL. An increase of OPL during the laser application was measured, which was followed by a decrease in OPL after laser processing. Furthermore, similar experiments were performed in distilled water and in native porcine crystalline lenses. The fs-laser cutting effects in HEMA and crystalline lens were transferable. Simultaneous measurements of the material modification during the cutting process give rise to better knowledge of treatment modalities during ocular tissue processing.

  20. Anti-Vascular Endothelial Growth Factor Therapy for Primary Treatment of Type 1 Retinopathy of Prematurity: A Report by the American Academy of Ophthalmology.

    PubMed

    VanderVeen, Deborah K; Melia, Michele; Yang, Michael B; Hutchinson, Amy K; Wilson, Lorri B; Lambert, Scott R

    2017-05-01

    To review the available evidence on the ocular safety and efficacy of anti-vascular endothelial growth factor (VEGF) agents for the treatment of retinopathy of prematurity (ROP) compared with laser photocoagulation therapy. A literature search of the PubMed and Cochrane Library databases was conducted last on September 6, 2016, with no date restrictions and limited to articles published in English. This search yielded 311 citations, of which 37 were deemed clinically relevant for full-text review. Thirteen of these were selected for inclusion in this assessment. The panel methodologist assigned ratings to the selected articles according to the level of evidence. Of the 13 citations, 6 articles on 5 randomized clinical trials provided level II evidence supporting the use of anti-VEGF agents, either as monotherapy or in combination with laser therapy. The primary outcome for these articles included recurrence of ROP and the need for retreatment (3 articles), retinal structure (2 articles), and refractive outcome (1 article). Seven articles were comparative case series that provided level III evidence. The primary outcomes included the effects of anti-VEGF treatment on development of peripheral retinal vessels (1 article), refractive outcomes (1 article), or both structural and refractive or visual outcomes (5 articles). Current level II and III evidence indicates that intravitreal anti-VEGF therapy is as effective as laser photocoagulation for achieving regression of acute ROP. Although there are distinct ocular advantages to anti-VEGF pharmacotherapy for some cases (such as eyes with zone I disease or aggressive posterior ROP), the disadvantages are that the ROP recurrence rate is higher, and vigilant and extended follow-up is needed because retinal vascularization is usually incomplete. After intravitreal injection, bevacizumab can be detected in serum within 1 day, and serum VEGF levels are suppressed for at least 8 to 12 weeks. The effects of lowering systemic VEGF levels on the developing organ systems of premature infants are unknown, and there are limited long-term data on potential systemic and neurodevelopmental effects after anti-VEGF use for ROP treatment. Anti-VEGF agents should be used judiciously and with awareness of the known and unknown or potential side effects. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  1. Dynamics of active emmetropisation in young chicks – influence of sign and magnitude of imposed defocus

    PubMed Central

    Hammond, David S; Wallman, Josh; Wildsoet, Christine F

    2014-01-01

    Purpose Young eyes compensate for the defocus imposed by spectacle lenses by changing their rate of elongation and their choroidal thickness, bringing their refractive status back to the pre-lens condition. We asked whether the initial rate of change either in the ocular components or in refraction is a function of the power of the lenses worn, a result that would be consistent with the existence of a proportional controller mechanism. Methods Two separate studies were conducted; both tracked changes in refractive errors and ocular dimensions. Study A: To study the effects of lens power and sign, young chicks were tracked for 4 days after they were fitted with positive (+5, +10 or +15 D) or negative (−5, −10, −15 D) lenses over one eye. In another experiment, biometric changes to plano, +1, +2 and +3 D lenses were tracked over a 24 h treatment period. Study B: Normal emmetropisation was tracked from hatching to 6 days of age and then a defocusing lens, either +6 D or −7 D, was fitted over one eye and additional biometric data collected after 48 h. Results In study A, animals treated with positive lenses (+5, +10 or +15 D) showed statistical similar initial choroid responses, with a mean thickening 24 μm h−1 over the first 5 h. Likewise, with the low power positive lenses, a statistically similar magnitude of choroidal thickening was observed across groups (+1 D: 46.0 ± 7.8 μm h−1; +2 D: 53.5 ± 9.9 μm h−1; +3 D 53.3 ± 24.1 μm h−1) in the first hour of lens wear compared to that of a plano control group. These similar rates of change in choroidal thickness indicate that the signalling response is binary in nature and not influenced by the magnitude of the myopic defocus. Treatments with −5, −10 and −15 D lenses induced statistically similar amounts of choroidal thinning, averaging −70 ± 15 μm after 5h and −96 ± 45 μm after 24 h. Similar rates in inner axial length changes were also seen with these lens treatments until compensation was reached, once again indicating that the signalling response is not influenced by the magnitude of hyperopic defocus. In study B, after 48 h of +6 D lens treatment, the average refractive error and choroidal changes were found to be larger in magnitude than expected if perfect compensation had taken place, with a + 2.4 D overshoot in refractive compensation. Conclusion Taken together, our results with both weak and higher power positive lenses suggest that eye growth is guided more by the sign than by the magnitude of the defocus, and our results for higher power negative lenses support a similar conclusion. These behaviour patterns and the overshoot seen in Study B are more consistent with the behaviour of a bang-bang controller than a proportional controller. PMID:23662956

  2. Femtosecond Lasers in Ophthalmology: Surgery and Imaging

    NASA Astrophysics Data System (ADS)

    Bille, J. F.

    Ophthalmology has traditionally been the field with prevalent laser applications in medicine. The human eye is one of the most accessible human organs and its transparency for visible and near-infrared light allows optical techniques for diagnosis and treatment of almost any ocular structure. Laser vision correction (LVC) was introduced in the late 1980s. Today, the procedural ease, success rate, and lack of disturbing side-effects in laser assisted in-situ keratomileusis (LASIK) have made it the most frequently performed refractive surgical procedure (keratomileusis(greek): cornea-flap-cutting). Recently, it has been demonstrated that specific aspects of LVC can take advantage of unique light-matter interaction processes that occur with femtosecond laser pulses.

  3. Contact lenses and corrective flying spectacles in military aircrew--implications for flight safety.

    PubMed

    Partner, Andrew M; Scott, Robert A H; Shaw, Penny; Coker, William J

    2005-07-01

    Refractive devices used by aviators need to suit the aerospace environment or their failure can have serious implications. A relatively minor visual disability can result in loss of life and aircraft. We surveyed commonly occurring problems with the different types of refractive correction worn by Royal Air Force (RAF) aircrew over the previous 12 mo. We also asked if they had experienced any flight safety incidents (FSI) relating to their refractive correction. A retrospective anonymous questionnaire survey was given to 700 active aircrew occupationally graded as requiring corrective flying spectacles (CFS) or contact lenses (CL) for flying. 63% (443) of the questionnaires were completed. CL were worn by 53% of aircrew; 71% of them used daily disposable CL. CFS were worn by the remaining 47% of aircrew, 14% of whom used multifocal lenses. Of CFS wearers, 83% reported problems including misting, moving, discomfort, and conflict with helmet-mounted devices (HMD). CL-related ocular symptoms were reported in 67% of wearers including cloudy vision, dry eye, photophobia, red eyes, excessive mucus formation, CL movement, itching, and grittiness. No CL-related FSI were reported over the previous 12 mo compared with 5% CFS-related FSI (p < 0.001). The graded performance of CL for vision, comfort, handling, convenience, and overall satisfaction was significantly higher than for CFS. CFS are associated with problems in terms of comfort and safety. CL are well tolerated by aircrew, and deliver improved visual performance.

  4. Post-traumatic pseudomyopia.

    PubMed

    London, Richard; Wick, Bruce; Kirschen, David

    2003-02-01

    Many clinicians have noted that patients demonstrate a myopic refractive change following Traumatic Brain Injury (TBI). This apparent myopic shift disappears with cycloplegia, yet stubbornly reappears as soon as the pharmaceutical effect wears off. We propose that this shift is secondary to an irritative lesion that affects the parasympathetic innervation, resulting in ciliary body contracture. The dilemma for the clinician is whether to provide the immediate relief of clear distance vision by prescribing additional minus lenses, or to work toward attempting to re-establish the baseline refractive error. The natural history of post-traumatic pseudomyopia in our experience involves one of the following three courses: (1) a transient condition that will occasionally resolve; (2) the typical case, a recalcitrant condition that will resolve under cycloplegic intervention, but immediately return as the cycloplegic wears off; or (3) a less-common subgroup of patients who continue to show an increase in myopia over time. Our description of these cases demonstrates management strategies (including atropinization) to relax accommodative spasm, traditional vision therapy techniques aimed at loosening the accommodative system, and refractive corrections. Pseudomyopia is one of many ocular and behavioral sequelae following TBI. By understanding the natural course and potential management options for post-traumatic pseudomyopia, the clinician will be better prepared to deal with these challenging cases. Flexibility is required, since options that work with one patient may prove ineffective with another. Counseling the patient as to potential outcomes given the natural history of this condition helps establish more-realistic expectations by the patients being treated.

  5. Selective breeding for susceptibility to myopia reveals a gene-environment interaction.

    PubMed

    Chen, Yen-Po; Hocking, Paul M; Wang, Ling; Povazay, Boris; Prashar, Ankush; To, Chi-Ho; Erichsen, Jonathan T; Feldkaemper, Marita; Hofer, Bernd; Drexler, Wolfgang; Schaeffel, Frank; Guggenheim, Jeremy A

    2011-06-08

    Purpose. To test whether the interanimal variability in susceptibility to visually induced myopia is genetically determined. Methods. Monocular deprivation of sharp vision (DSV) was induced in outbred White Leghorn chicks aged 4 days. After 4 days' DSV, myopia susceptibility was quantified by the relative changes in axial length and refraction. Chicks in the extreme tails of the distribution of susceptibility to DSV were kept and paired for breeding (high- and low-susceptibility lines). A second round of selection was then performed. The third generation of chicks, derived from the selected parents, was assessed after either monocular DSV (4 or 10 days) or lens wear. Results. After two rounds of selective breeding, the chicks from the high-susceptibility line developed approximately twice as much myopia in response to 4 days' DSV as did those from the low-susceptibility line (P < 0.001). All ocular component dimensions differed significantly (P < 0.001) between the two selected lines, both before treatment and in the responses of the treated eye. When DSV was conducted for 10 days, the relative changes in axial length and refractive error were still significantly different between the high and low lines (P < 0.001). The chicks bred for high or low susceptibility to DSV also showed significantly different responses to minus lens wear, but not to plus lens wear. Additive genetic effects explained ∼50% of the interanimal variability in response to DSV. Conclusions. Genes and environment interact to shape refractive development in chicks.

  6. Effects of Ocular Optics on Perceived Visual Direction and Depth

    NASA Astrophysics Data System (ADS)

    Ye, Ming

    Most studies of human retinal image quality have specifically addressed the issues of image contrast, few have examined the problem of image location. However, one of the most impressive properties of human vision involves the location of objects. We are able to identify object location with great accuracy (less than 5 arcsec). The sensitivity we exhibit for image location indicates that any optical errors, such as refractive error, ocular aberrations, pupil decentration, etc., may have noticeable effects on perceived visual direction and distance of objects. The most easily observed effects of these optical factors is a binocular depth illusion called chromostereopsis in which equidistance colored objects appear to lie at the different distances. This dissertation covers a series of theoretical and experimental studies that examined the effects of ocular optics on perceived monocular visual direction and binocular chromostereopsis. Theoretical studies included development of an adequate eye model for predicting chromatic aberration, a major ocular aberration, using geometric optics. Also, a wave optical analysis is used to model the effects of defocus, optical aberrations, Stiles-Crawford effect (SCE) and pupil location on retinal image profiles. Experimental studies used psychophysical methods such as monocular vernier alignment tests, binocular stereoscopic tests, etc. This dissertation concludes: (1) With a decentered large pupil, the SCE reduces defocused image shifts compare to an eye without the SCE. (2) The blurred image location can be predicted by the centroid of the image profile. (3) Chromostereopsis with small pupils can be precisely accounted for by the interocular difference in monocular transverse chromatic aberration. (4) The SCE also plays an important role in the effect of pupil size on chromostereopsis. The reduction of chromostereopsis with large pupils can be accurately predicted by the interocular difference in monocular chromatic diplopia which is also reduced with large pupils. This supports the hypothesis that the effect of pupil size on chromostereopsis is due to monocular mechanisms.

  7. Ocular Aberrations Across the Visual Field During Accommodation

    NASA Astrophysics Data System (ADS)

    Liu, Tao

    Myopia is classically defined as a mismatch between the optical power of the relaxed eye and its dioptric length. This definition is entirely foveocentric without concern for the contributions of peripheral refractive errors to myopia development. Long periods of steady near-work was considered to cause myopia development due to inadequate accommodation. Consequently, not only the on-axis optical features but also off-axis ones should be probed to gain insight about myopia progression. Moreover, these features need to be understood not only for the relaxed eye, but also for the accommodating eye. To acquire complete data set, a custom-built Indiana Scanning Aberrometer for Wavefront (I SAW) was developed to measure wavefront aberration along 37 line-of-sights at 8 different accommodation states in the central 30 degree visual field. We found that ocular refractive state changed uniformly over the central visual field as the eye accommodates up to 6D, and the accuracy of accommodation across the central visual field is similar to that measured in the fovea. No systematic difference between emmetropic and myopic eyes was evident. Then, a linear vector-summation rule for axial and oblique astigmatism was found to account for their interaction over the central visual field. Using this combination rule, our experimental evidence revealed no systematic effect of accommodation on axial or oblique astigmatism for two adult populations. The axial and oblique astigmatism of the whole eye is less than for the cornea alone, indicating a compensatory role for internal optics at all accommodative states. This compensation mechanism was further validated theoretically with schematic eye model. Lastly, we developed a hybrid method yielding customized eye models that accurately reproduce the empirical measurements and reasonably represent the anatomical structure, thus providing a mechanistic explanation for the changes in the eye's aberration structure that occur over the central visual field during accommodation.

  8. [Ocular findings in patients older than 99 years].

    PubMed

    Cypel, Marcela Colussi; Palácio, Guilherme; Dantas, Paulo Elias Correa; Lottenberg, Cláudio Luis; Belfort, Rubens

    2006-01-01

    To determine vision conditions and ocular findings in patients older than 99 years. Patients were recruited by media advertisement and examined at the Vision Institute of UNIFESP. The following examinations were performed: visual acuity, ectoscopy, refraction, biomicroscopy, tear film break-up time, Schirmer basal test, tonometry, direct and indirect ophthalmoscopy. Complementary examinations such as optical coherence tomography were performed when indicated. Thirty patients older than 99 years were identified. Mean age of 101.5+/-1.8, 25 females and 5 males. Most common systemic disease, according to history, was arterial hypertension. In 11 patients (55%), the best corrected far visual acuity was 20/100 or better. The best corrected near visual acuity was J4 or better also in 55% (11 patients) and 63.0% (7 patients) of these were the ones that had not been submitted to cataract surgery. The most frequent visual complaint was low vision for reading (55%) and other 8 patients (40%) reported no disturbance (satisfied with their vision). Lens opacity was present in 9 patients (60%) and 8 patients (40%) had previous cataract surgery (5 aphakic eyes, 9 pseudophakic eyes). Cataract was identified as important for impairment of vision in 5 patients but only 2 of them wanted to be submitted to surgery. The main cause of visual impairment was age-related macular degeneration, present in all patients, 95% with no exudative form. Vision improved with new refractive prescription in 4 patients. Once we understand the needs we can plan specific diagnostic and treatment strategies. This sample showed that most were female (83.3%), with good general health (35%), most with systemic arterial hypertension (40%), complaining of low vision for reading (55%) because of age-related macular degeneration (100%, 95% dry form). Only 40% had been previously submitted to cataract surgery. Most of the patients with cataract said to be satisfied with their vision; of the 5 patients that could be operated only 2 decided to do it. Low vision for reading, AMD and cataract were the main findings.

  9. Effect of Laser in Situ Keratomileusis on Schiøtz, Goldmann, and Dynamic Contour Tonometric Measurements.

    PubMed

    Sales-Sanz, Marco; Arranz-Marquez, Esther; Piñero, David P; Arruabarrena, Carolina; Mikropoulos, Dimitrios G; Teus, Miguel A

    2016-04-01

    To assess the effect of laser in situ keratomileusis (LASIK) on ocular rigidity and compare its effect on intraocular pressure (IOP) readings with Goldmann applanation tonometry (GAT), Schiøtz indentation tonometry (ST), and dynamic contour tonometry (DCT). Prospective, observational, single-masked study. Eighty-one patients who underwent myopic LASIK and 108 unoperated myopic control patients were included in the study. The IOP was measured using GAT, DCT, and ST. The coefficient of ocular rigidity (Ko) was obtained from the regression analysis of the 3 readings obtained with each weight of the ST. Linear multiple regression analysis was performed with dummy variables to assess the effects of age, central corneal thickness (CCT), and refractive surgery on measured IOP values. Age, CCT, and previous LASIK explained 39.41% of the IOP readings with GAT, 25.31% with DCT, and 3.28% with ST. LASIK caused a mean decrease of -2.51 mm Hg in IOP readings (P=0.000) with GAT, -1.29 mm Hg (P=0.036) with DCT, and no significant change in IOP readings with ST (P=0.299). Significant differences in the Ko were observed between the LASIK and control groups. The Ko values were unrelated to age and CCT in the LASIK and control groups. ST seems to be less affected by previous LASIK procedures. There is a difference in the ocular rigidity between the unoperated and LASIK eyes that is not correlated with the CCT. Therefore, ST seems to measure changes in the biomechanical behavior of corneas that underwent LASIK surgery.

  10. Ocular biometric measurements in cataract surgery candidates in Portugal.

    PubMed

    Ferreira, Tiago B; Hoffer, Kenneth J; Ribeiro, Filomena; Ribeiro, Paulo; O'Neill, João G

    2017-01-01

    Describe the ocular biometric parameters and their associations in a population of cataract surgery candidates. A cross-sectional study of 13,012 eyes of 6,506 patients was performed. Biometric parameters of the eyes were measured by optical low-coherence reflectometry. The axial length (AL), mean keratometry (K) and astigmatism, anterior chamber depth (ACD) (epithelium to lens), lens thickness (LT), and Corneal Diameter (CD) were evaluated. The mean age was 69 ± 10 years (44-99 years). Mean AL, Km, and ACD were 23.87 ± 1.55 mm (19.8-31.92 mm), 43.91 ± 1.71 D (40.61-51.14 D), and 3.25 ± 0.44 mm (2.04-5.28 mm), respectively. The mean LT was 4.32 ± 0.49 mm (2.73-5.77 mm) and the mean CD was 12.02 ± 0.46 mm (10.50-14.15 mm). The mean corneal astigmatism was 1.08 ± 0.84 D (0.00-7.58 D) and 43.5% of eyes had astigmatism ≥ 1.00 D. Male patients had longer AL and ACDs (p < .001) and flatter corneas (p < .001). In regression models considering age, gender, Km, ACD, LT, and CD, a longer AL was associated with being male and having higher ACD, LT and CD. These data represent normative biometric values for the Portuguese population. The greatest predictor of ocular biometrics was gender. There was no significant correlation between age and AL, ACD, or Km. These results may be relevant in the evaluation of refractive error and in the calculation of intraocular lens power.

  11. Corneal Biomechanics in Ectatic Diseases: Refractive Surgery Implications

    PubMed Central

    Ambrósio, Jr, Renato; Correia, Fernando Faria; Lopes, Bernardo; Salomão, Marcella Q.; Luz, Allan; Dawson, Daniel G.; Elsheikh, Ahmed; Vinciguerra, Riccardo; Vinciguerra, Paolo; Roberts, Cynthia J.

    2017-01-01

    Background: Ectasia development occurs due to a chronic corneal biomechanical decompensation or weakness, resulting in stromal thinning and corneal protrusion. This leads to corneal steepening, increase in astigmatism, and irregularity. In corneal refractive surgery, the detection of mild forms of ectasia pre-operatively is essential to avoid post-operative progressive ectasia, which also depends on the impact of the procedure on the cornea. Method: The advent of 3D tomography is proven as a significant advancement to further characterize corneal shape beyond front surface topography, which is still relevant. While screening tests for ectasia had been limited to corneal shape (geometry) assessment, clinical biomechanical assessment has been possible since the introduction of the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, USA) in 2005 and the Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) in 2010. Direct clinical biomechanical evaluation is recognized as paramount, especially in detection of mild ectatic cases and characterization of the susceptibility for ectasia progression for any cornea. Conclusions: The purpose of this review is to describe the current state of clinical evaluation of corneal biomechanics, focusing on the most recent advances of commercially available instruments and also on future developments, such as Brillouin microscopy. PMID:28932334

  12. The use of contact lens telescopic systems in low vision rehabilitation.

    PubMed

    Vincent, Stephen J

    2017-06-01

    Refracting telescopes are afocal compound optical systems consisting of two lenses that produce an apparent magnification of the retinal image. They are routinely used in visual rehabilitation in the form of monocular or binocular hand held low vision aids, and head or spectacle-mounted devices to improve distance visual acuity, and with slight modifications, to enhance acuity for near and intermediate tasks. Since the advent of ground glass haptic lenses in the 1930's, contact lenses have been employed as a useful refracting element of telescopic systems; primarily as a mobile ocular lens (the eyepiece), that moves with the eye. Telescopes which incorporate a contact lens eyepiece significantly improve the weight, comesis, and field of view compared to traditional spectacle-mounted telescopes, in addition to potential related psycho-social benefits. This review summarises the underlying optics and use of contact lenses to provide telescopic magnification from the era of Descartes, to Dallos, and the present day. The limitations and clinical challenges associated with such devices are discussed, along with the potential future use of reflecting telescopes incorporated within scleral lenses and tactile contact lens systems in low vision rehabilitation. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  13. Photopic visual input is necessary for emmetropization in mice

    PubMed Central

    Tkatchenko, Tatiana V.; Shen, Yimin; Braun, Rod D.; Bawa, Gurinder; Kumar, Pradeep; Avrutsky, Ivan; Tkatchenko, Andrei V.

    2013-01-01

    It was recently demonstrated that refractive errors in mice stabilize around emmetropic values during early postnatal development, and that they develop experimental myopia in response to both visual form deprivation and imposed optical defocus similar to other vertebrate species. Animal studies also suggest that photopic vision plays critical role in emmetropization in diurnal species; however, it is unknown whether refractive eye development is guided by photopic vision in the mouse, which is a nocturnal species. We used an infrared mouse photorefractor and a high-resolution MRI to clarify the role of photopic visual input in refractive eye development in the mouse. Refractive eye development and form-deprivation myopia in P21-P89 C57BL/6J mice were analyzed under 12:12 h light-dark cycle, constant light and constant darkness regimens. Animals in all experimental groups were myopic at P21 (-13.2 ± 1.6 D, light-dark cycle; -12.5 ± 0.9 D, constant light; -12.5 ± 2.0 D, constant dark). The mean refractive error in the light-dark-cycle-reared animals was -0.5 ± 1.3 D at P32 and, and did not change significantly until P40 (+0.3 ± 0.6 D, P40). Animals in this group became progressively hyperopic between P40 and P89 (+2.2 ± 0.6, P67; +3.7 ± 2.0, P89). The mean refractive error in the constant-light-reared mice was -1.0 ± 0.7 D at P32 and remained stable until P89 (+0.1 ± 0.6, P40; +0.3 ± 0.6, P67; 0.0 ± 0.4, P89). Dark-reared animals exhibited highly hyperopic refractive errors at P32 (+5.2 ± 1.8) and became progressively more hyperopic with age (+8.7 ± 1.9, P40; +11.2 ± 1.4, P67). MRI analysis revealed that emmetropization in the P40-P89 constant-light-reared animals was associated with larger eyes, a longer axial length and a larger vitreous chamber compared to the light-dark-cycle-reared mice. Constant-light-reared mice also developed 4 times higher degrees of form-deprivation myopia on average compared to light-dark-cycle-reared animals (-12.0 ± 1.4, constant light; -2.7 ± 0.7, light-dark cycle). Dark-rearing completely prevented the development of form-deprivation myopia (-0.3 ± 0.5). Thus, photopic vision plays important role in normal refractive eye development and ocular response to visual form deprivation in the mouse. PMID:23838522

  14. Axial Length/Corneal Radius of Curvature Ratio and Myopia in 3-Year-Old Children

    PubMed Central

    Foo, Valencia Hui Xian; Verkicharla, Pavan Kumar; Ikram, Mohammad Kamran; Chua, Sharon Yu Lin; Cai, Shirong; Tan, Chuen Seng; Chong, Yap-Seng; Kwek, Kenneth; Gluckman, Peter; Wong, Tien-Yin; Ngo, Cheryl; Saw, Seang-Mei; on behalf of the GUSTO study group

    2016-01-01

    Purpose This study investigated the association of axial length (AL) to corneal radius of curvature (CRC) ratio with spherical equivalent (SE) in a 3-year old Asian cohort. Methods Three-hundred forty-nine 3-year old Asian children from The Growing Up in Singapore towards Healthy Outcomes (GUSTO) birth cohort study underwent AL and CRC measurements with a noncontact ocular biometer and cycloplegic refraction using an autorefractor. The ratio of AL to CRC (AL/CRC) was calculated for all the participants, and subsequently AL, CRC, and AL/CRC were analyzed in relationship to SE. Results The SE showed better correlation with AL/CRC (Spearman's correlation coefficient, ρ = −0.53; 95% confidence interval [CI]: −0.66; −0.49; P < 0.001) compared to either AL or CRC alone ([ρ = −0.36; 95% CI: −0.51 to 0.51; P = 0.01] and [ρ = 0.05; 95% CI: −0.04 to 0.17; P = 0.34], respectively). Mean AL/CRC was 2.91 ± 0.06 among myopes and decreased to 2.79 ± 0.06 among hyperopes. Axial length to corneal radius of curvature was strongly correlated with SE in myopes (ρ = −0.78; 95% CI: −3.76; −0.79; P = < 0.001), but not in emmetropes and hyperopes ([ρ = −0.39; 95% CI: −10.73; −0.57; P = 0.01] and [ρ = −0.18; 95% CI: −17.28; 12.42; P = 0.38], respectively). Linear regression adjusted for gender and ethnicity showed a 0.74-diopter shift in SE towards myopia with every 0.1 increase in AL/CRC ratio (P < 0.001, r2 = 0.33). Conclusion The correlation between SE and AL/CRC is stronger than that between AL or CRC alone. This suggests that in a research setting, when cycloplegic refraction is difficult to perform on 3-year-old children, AL/CRC may be the next best reference for refractive error. Translational Relevance In the research setting, AL/CRC may be the next best reference for refractive error over AL alone when cycloplegic refraction is unavailable in 3-year old children. PMID:26929885

  15. Vision Impairment and Ocular Morbidity in a Refugee Population in Malawi.

    PubMed

    Kaphle, Dinesh; Gyawali, Rajendra; Kandel, Himal; Reading, Angela; Msosa, Joseph Matiya

    2016-02-01

    To provide screening services and obtain information on the eye health status and distribution of visual impairments in a refugee population of the sole refugee camp in Malawi. A general eye screening at Dzaleka refugee settlement camp was organized in November 2012. Final-year optometry students conducted detailed optometry examinations, including visual acuity (VA) assessment for near and distance, retinoscopy, and subjective refraction in cases with distance VA less than 6/12 or near VA less than N8, anterior and posterior segment evaluation. Their findings were then verified by an optometrist. The World Health Organization definition of vision impairment was followed, and the cause of vision impairment was determined at the end of each examination. Where possible, participants requiring refractive correction were provided spectacles free of cost. Of a total 635 participants examined, around one-half were male with 61% in the 16 to 49 years age group. The overall prevalence of presenting blindness, severe vision impairment, and vision impairment were 1.3% (95% confidence interval [95% CI], 0.5 to 2.4), 0.5% (95% CI, 0.0 to 1.1), and 3.6% (95% CI, 2.3 to 5.2), respectively. Overall vision impairment (VA <6/18) was present in 5.4% (95% CI, 3.6 to 7.1) of the participants. The principal causes of blindness, severe vision impairment, and vision impairment were cataracts, refractive errors, and corneal opacities, respectively; and more than 90% of the overall vision impairment was avoidable. Refractive errors and presbyopia were the most common morbidity, present in more than two-thirds of the participants examined. Only 5% of all the participants ever had a previous eye examination. The prevalence and causes of blindness and vision impairment in a refugee population are comparable with those of the general population. Lack of basic eye care services in the health center for refugees is a major concern. The health care facility in the settlement camp needs to be upgraded to provide comprehensive eye care including refractive care services.

  16. Ocular diurnal rhythms and eye growth regulation: Where we are 50 years after Lauber

    PubMed Central

    Nickla, Debora L.

    2013-01-01

    Many ocular processes show diurnal oscillations that optimize retinal function under the different conditions of ambient illumination encountered over the course of the 24 h light/dark cycle. Abolishing the diurnal cues by the use of constant darkness or constant light results in excessive ocular elongation, corneal flattening, and attendant refractive errors. A prevailing hypothesis is that the absence of the Zeitgeber of light and dark alters ocular circadian rhythms in some manner, and results in an inability of the eye to regulate its growth in order to achieve emmetropia, the matching of the front optics to eye length. Another visual manipulation that results in the eye growth system going into a “default” mode of excessive growth is form deprivation, in which a translucent diffuser deprives the eye of visual transients (spatial or temporal) while not significantly reducing light levels; these eyes rapidly elongate and become myopic. It has been hypothesized that form deprivation might constitute a type of “constant condition” whereby the absence of visual transients drives the eye into a similar default mode as that in response to constant light or dark. Interest in the potential influence of light cycles and ambient lighting in human myopia development has been spurred by a recent study showing a positive association between the amount of time that children spent outdoors and a reduced prevalence of myopia. The growing eyes of chickens and monkeys show a diurnal rhythm in axial length: Eyes elongate more during the day than during the night. There is also a rhythm in choroidal thickness that is in approximate anti-phase to the rhythm in eye length. The phases are altered in eyes growing too fast, in response to form deprivation or negative lenses, or too slowly, in response to myopic defocus, suggesting an influence of phase on the emmetropization system. Other potential rhythmic influences include dopamine and melatonin, which form a reciprocal feedback loop, and signal “day” and “night” respectively. Retinal dopamine is reduced during the day in form deprived myopic eyes, and dopamine D2 agonists inhibit ocular growth in animal models. Rhythms in intraocular pressure as well, may influence eye growth, perhaps as a mechanical stimulus triggering changes in scleral extracellular matrix synthesis. Finally, evidence shows varying influences of environmental lighting parameters on the emmetropization system, such as high intensity light being protective against myopia in chickens. This review will cover the evidence for the possible influence of these various factors on ocular growth. The recognition that ocular rhythms may play a role in emmetropization is a first step toward understanding how they may be manipulated in treatment therapies to prevent myopia in humans. PMID:23298452

  17. Ultrasonographic study on changes in axial eye dimensions after encircling procedure in retinal detachment surgery.

    PubMed

    Larsen, J S; Syrdalen, P

    1979-06-01

    The pre- and postoperative results of ultrasonographic measurements on the axial ocular components in 10 phakic eyes with retinal detachment treated with encircling silicone rubber band are presented. A significant increase (P less than 0.001) in axial eye length from 0.62 to 1.24 mm (average: 0.98 mm) was found. The elongation of the eye was caused by a corresponding increase in the length of the vitreous cavity. No significant changes were found in the anterior segment of the eyes. These data demonstrate that the postoperative refractive change in a myopic direction, which an encircling procedure with moderate indentation often produces, is caused by an axial elongation of the eye.

  18. Blue Light Protects Against Temporal Frequency Sensitive Refractive Changes.

    PubMed

    Rucker, Frances; Britton, Stephanie; Spatcher, Molly; Hanowsky, Stephan

    2015-09-01

    Time spent outdoors is protective against myopia. The outdoors allows exposure to short-wavelength (blue light) rich sunlight, while indoor illuminants can be deficient at short-wavelengths. In the current experiment, we investigate the role of blue light, and temporal sensitivity, in the emmetropization response. Five-day-old chicks were exposed to sinusoidal luminance modulation of white light (with blue; N = 82) or yellow light (without blue; N = 83) at 80% contrast, at one of six temporal frequencies: 0, 0.2, 1, 2, 5, 10 Hz daily for 3 days. Mean illumination was 680 lux. Changes in ocular components and corneal curvature were measured. Refraction, eye length, and choroidal changes were dependent on the presence of blue light (P < 0.03, all) and on temporal frequency (P < 0.03, all). In the presence of blue light, refraction did not change across frequencies (mean change -0.24 [diopters] D), while in the absence of blue light, we observed a hyperopic shift (>1 D) at high frequencies, and a myopic shift (>-0.6 D) at low frequencies. With blue light there was little difference in eye growth across frequencies (77 μm), while in the absence of blue light, eyes grew more at low temporal frequencies and less at high temporal frequencies (10 vs. 0.2 Hz: 145 μm; P < 0.003). Overall, neonatal astigmatism was reduced with blue light. Illuminants rich in blue light can protect against myopic eye growth when the eye is exposed to slow changes in luminance contrast as might occur with near work.

  19. Blue Light Protects Against Temporal Frequency Sensitive Refractive Changes

    PubMed Central

    Rucker, Frances; Britton, Stephanie; Spatcher, Molly; Hanowsky, Stephan

    2015-01-01

    Purpose Time spent outdoors is protective against myopia. The outdoors allows exposure to short-wavelength (blue light) rich sunlight, while indoor illuminants can be deficient at short-wavelengths. In the current experiment, we investigate the role of blue light, and temporal sensitivity, in the emmetropization response. Methods Five-day-old chicks were exposed to sinusoidal luminance modulation of white light (with blue; N = 82) or yellow light (without blue; N = 83) at 80% contrast, at one of six temporal frequencies: 0, 0.2, 1, 2, 5, 10 Hz daily for 3 days. Mean illumination was 680 lux. Changes in ocular components and corneal curvature were measured. Results Refraction, eye length, and choroidal changes were dependent on the presence of blue light (P < 0.03, all) and on temporal frequency (P < 0.03, all). In the presence of blue light, refraction did not change across frequencies (mean change −0.24 [diopters] D), while in the absence of blue light, we observed a hyperopic shift (>1 D) at high frequencies, and a myopic shift (>−0.6 D) at low frequencies. With blue light there was little difference in eye growth across frequencies (77 μm), while in the absence of blue light, eyes grew more at low temporal frequencies and less at high temporal frequencies (10 vs. 0.2 Hz: 145 μm; P < 0.003). Overall, neonatal astigmatism was reduced with blue light. Conclusions Illuminants rich in blue light can protect against myopic eye growth when the eye is exposed to slow changes in luminance contrast as might occur with near work. PMID:26393671

  20. Correlations between internal and external ocular factors and macular pigment optical density.

    PubMed

    Tudosescu, Ruxandra; Alexandrescu, Cristina Mihaela; Istrate, Sânziana Luminiţa; Vrapciu, Alexandra Diana; Ciuluvică, Radu Constantin; Voinea, Liliana

    2018-01-01

    To assess the relationship between the macular pigment optical density and blue-light issued by computers, glare sensibility, with iris color, age, sex, or refractive errors. 83 patients (166 eyes) were enrolled in a prospective observational study. They were divided into 2 groups: group 1 (study group) - computer using patients (time spent in front of the computer for minimum 8 hours per day, 5 days per week, 2 years) - 43 patients and group 2 (control group) - 40 patients. The following investigations were conducted in all the selected cases: visual acuity, refraction, biomicroscopy, measurement of the MPOD, glare sensitivity, assessment of eye color. 51.81% of the patients were included in group 1, while the rest, 48.19%, were in group 2. Thus, the MPOD had a mean value of (+/ -SD) 0.42+/ -0.13 (t = -1.08, p = 0.28) in group 1, and 0.44+/ -0.16 on the LE. The results showed a MPOD mean value of 0.51+/ - 0.16 in group 2 and 0.51+/ -0 .16. (t = 0.49, p = 0 .62) on the LE. 55.77% of the patients with light colored iris and 56.14% of those with dark iris had a low MPOD. The data from our study failed to illustrate a significant correlation between MPOD and blue-light issued by computers. Furthermore, a statistic significant relationship regarding iris color, refractive errors, glare, and MPOD was not observed. L = lutein, Z = zeaxanthin, MZ = meso-zeaxanthin, AMD = age related macular degeneration, MPOD = macular pigment optical density, MP = macular pigment, HFP = Heterochromatic Flicker Photometry, RE = right eye, LE = left eye.

  1. Management of moderate and severe corneal astigmatism with AcrySof® toric intraocular lens implantation - Our experience.

    PubMed

    Farooqui, Javed Hussain; Koul, Archana; Dutta, Ranjan; Shroff, Noshir Minoo

    2015-01-01

    Visual performance following toric intraocular lens implantation for cataract with moderate and severe astigmatism. Cataract services, Shroff Eye Centre, New Delhi, India. Case series. This prospective study included 64 eyes of 40 patients with more than 1.50 dioptre (D) of pre-existing corneal astigmatism undergoing phacoemulsification with implantation of the AcrySof® toric IntraOcular Lens (IOL). The unaided visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere and refractive cylinders were evaluated. Toric IOL axis and alignment error was measured by slit lamp method and Adobe Photoshop (version 7) method. Patient satisfaction was evaluated using a satisfaction questionnaire at 3 months. The mean residual refractive astigmatism was 0.57 D at the final follow-up of 3 months. Mean alignment error was 3.44 degrees (SD = 2.60) by slit lamp method and 3.88 degrees (SD = 2.86) by Photoshop method. Forty-six (71.9%) eyes showed misalignment of 5 degrees or less, and 60 (93.8%) eyes showed misalignment of 10 degrees or less. The mean log MAR UCVA at 1st post-op day was 0.172 (SD = 0.02), on 7th post-op day was 0.138 (SD = 0.11), and on 30th post-op day was 0.081 (SD = 0.11). The mean log MAR BCVA at three months was -0.04 (SD = 0.76). We believe that implantation of AcrySof® toric IOL is an effective, safe and predictable method to correct high amounts of corneal astigmatism during cataract surgery.

  2. The prevalence of refractive errors among adult rural populations in Iran.

    PubMed

    Hashemi, Hassan; Nabovati, Payam; Yekta, Abbasali; Shokrollahzadeh, Fereshteh; Khabazkhoob, Mehdi

    2018-01-01

    The aim was to determine the prevalence of myopia and hyperopia and related factors in underserved rural areas in Iran. Under random cluster sampling, two rural regions were randomly selected in the north and southwest of the country, and 3,061 persons over 15 years of age were invited into the study. After selecting samples, all participants had refraction, measurement of uncorrected vision and visual acuity and ocular health examination by slitlamp biomicroscopy. Of the 3,061 invitees, 2,575 participated in the study (response rate: 84.1 per cent). After excluding those who met the exclusion criteria or had missing refractive data, eventually there were 2,518 subjects available for this analysis. The mean age of the participants was 44.3 ± 17.5 years (range: 16 to 93 years) and 1,460 of them (58.0 per cent) were female. The overall prevalence of myopia and hyperopia in this study was 25.2 per cent (95 per cent CI: 23.2 to 27.2) and 22.5 per cent (95 per cent CI: 20.6 to 24.4), respectively. The prevalence of myopia increased from 20.9 per cent in participants 16 to 20 years to 32.9 per cent in the 21 to 30 years age group, declined up to the age of 60 years and increased again afterwards. The lowest prevalence was 6.8 per cent observed in the 16 to 20 years age group and the highest was 45.8 per cent in 61- to 70-year-olds. In the final logistic regression model, myopia significantly associated with age, higher education levels and cataracts, while hyperopia associated with age, lower education levels and male gender. In our study, the prevalence of myopia was lower and the prevalence of hyperopia was higher compared to most previous studies. The findings of this study imply that refractive errors vary by age. © 2017 Optometry Australia.

  3. Does corneal hysteresis correlate with endothelial cell density?

    PubMed

    Akova-Budak, Berna; Kıvanç, Sertaç Argun

    2015-05-21

    Our aim was to determine if there is a correlation between corneal biomechanical properties, endothelial cell count, and corneal pachymetry in healthy corneas. Ninety-two eyes of all subjects underwent complete ocular examination, including intraocular pressure measurement by Goldmann applanation tonometer, objective refraction, and slit-lamp biomicroscopy. Topographic measurements and corneal pachymetry were performed using a Scheimpflug-based (Pentacam, Oculus, Germany) corneal topographer. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with an Ocular Response Analyzer (ORA, Reichert Ophthalmic Instruments, Buffalo, NY). Endothelial cell count measurement was done using a specular microscope (CellChek, Konan, USA). Right eye values of the subjects were taken for the study. The mean CH was 11.5±1.7 mmHg and the mean CRF was 11.2±1.4 mmHg. Mean intraocular pressure was 15.3±2.3 mmHg. The mean endothelial cell count was 2754±205 cells/mm2. No correlation was found between biomechanical properties of cornea and endothelial cell count. There was a significant positive correlation between CH, CRF, and corneal thickness (p<0.001; r=0.79). The corneal biomechanical properties significantly correlated with corneal thickness. We found no correlation between CH and CRF with the endothelial cell density in normal subjects.

  4. A Clinical and Confocal Microscopic Comparison of Transepithelial PRK and LASEK for Myopia

    PubMed Central

    Korkmaz, Safak; Bilgihan, Kamil; Sul, Sabahattin; Hondur, Ahmet

    2014-01-01

    Purpose. To compare the clinical and confocal microscopic results of transepithelial PRK versus LASEK for correction of myopia. Materials and Methods. Twelve patients with myopia received transepithelial PRK in one eye and LASEK in the other. In transepithelial PRK-treated eyes, the corneal epithelium was removed with 40 microns of excimer laser ablation and in LASEK-treated eyes with 25-second application of 18% ethanol. Time to epithelial healing, ocular discomfort, uncorrected and best corrected visual acuities, manifest refraction, haze, greyscale value, and keratocyte apoptosis in confocal microscopy were recorded. Results. The mean time to epithelial healing was significantly longer after LASEK (4.00 ± 0.43 versus 3.17 ± 0.6 days). On day 1, ocular discomfort was significantly higher after transepithelial PRK. The grade of haze, keratocyte apoptosis, and greyscale value in confocal microscopy were significantly higher in transepithelial PRK-treated eyes at 1 month. All transepithelial PRK- and LASEK-treated eyes achieved 20/25 or better UCVA and were within ±1.00 D of emmetropia at final visits. Conclusions. Both transepithelial PRK and LASEK offer effective correction of myopia at 1 year. However, LASEK appeared to induce less discomfort and less intense wound healing in the early postoperative period. PMID:25120924

  5. A Clinical and Confocal Microscopic Comparison of Transepithelial PRK and LASEK for Myopia.

    PubMed

    Korkmaz, Safak; Bilgihan, Kamil; Sul, Sabahattin; Hondur, Ahmet

    2014-01-01

    Purpose. To compare the clinical and confocal microscopic results of transepithelial PRK versus LASEK for correction of myopia. Materials and Methods. Twelve patients with myopia received transepithelial PRK in one eye and LASEK in the other. In transepithelial PRK-treated eyes, the corneal epithelium was removed with 40 microns of excimer laser ablation and in LASEK-treated eyes with 25-second application of 18% ethanol. Time to epithelial healing, ocular discomfort, uncorrected and best corrected visual acuities, manifest refraction, haze, greyscale value, and keratocyte apoptosis in confocal microscopy were recorded. Results. The mean time to epithelial healing was significantly longer after LASEK (4.00 ± 0.43 versus 3.17 ± 0.6 days). On day 1, ocular discomfort was significantly higher after transepithelial PRK. The grade of haze, keratocyte apoptosis, and greyscale value in confocal microscopy were significantly higher in transepithelial PRK-treated eyes at 1 month. All transepithelial PRK- and LASEK-treated eyes achieved 20/25 or better UCVA and were within ±1.00 D of emmetropia at final visits. Conclusions. Both transepithelial PRK and LASEK offer effective correction of myopia at 1 year. However, LASEK appeared to induce less discomfort and less intense wound healing in the early postoperative period.

  6. Development of a human eye model incorporated with intraocular scattering for visual performance assessment

    NASA Astrophysics Data System (ADS)

    Chen, Yi-Chun; Jiang, Chong-Jhih; Yang, Tsung-Hsun; Sun, Ching-Cherng

    2012-07-01

    A biometry-based human eye model was developed by using the empirical anatomic and optical data of ocular parameters. The gradient refractive index of the crystalline lens was modeled by concentric conicoid isoindical surfaces and was adaptive to accommodation and age. The chromatic dispersion of ocular media was described by Cauchy equations. The intraocular scattering model was composed of volumetric Mie scattering in the cornea and the crystalline lens, and a diffusive-surface model at the retina fundus. The retina was regarded as a Lambertian surface and was assigned its corresponding reflectance at each wavelength. The optical performance of the eye model was evaluated in CodeV and ASAP and presented by the modulation transfer functions at single and multiple wavelengths. The chromatic optical powers obtained from this model resembled that of the average physiological eyes. The scattering property was assessed by means of glare veiling luminance and compared with the CIE general disability glare equation. By replacing the transparent lens with a cataractous lens, the disability glare curve of cataracts was generated to compare with the normal disability glare curve. This model has high potential for investigating visual performance in ordinary lighting and display conditions and under the influence of glare sources.

  7. Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics.

    PubMed

    Chakraborty, Ranjay; Read, Scott A; Collins, Michael J

    2011-07-11

    To investigate the pattern of diurnal variations in axial length (AL), choroidal thickness, intraocular pressure (IOP), and ocular biometrics over 2 consecutive days. Measurements of ocular biometrics and IOP were collected for 30 young adult subjects (15 myopes, 15 emmetropes) at 10 different times over 2 consecutive days. Five sets of measurements were collected each day at approximately 3-hour intervals, with the first measurement taken at ~9 AM and final measurement at ~9 PM. AL underwent significant diurnal variation (P < 0.0001) that was consistently observed across the 2 measurement days. The longest AL was typically observed at the second measurement session (mean time, 12:26) and the shortest AL at the final session of each day (mean time, 21:06). The mean diurnal change in AL was 0.032 ± 0.018 mm. Choroidal thickness underwent significant diurnal variation (mean change, 0.029 ± 0.016 mm; P < 0.001) and varied approximately in antiphase to the AL changes. Significant diurnal variations were also found in vitreous chamber depth (VCD; mean change, 0.06 ± 0.029 mm; P < 0.0001) and IOP (mean change, 3.54 ± 0.84 mm Hg; P < 0.0001). A positive association was found between the variations of AL and IOP (r(2) = 0.17, P < 0.0001) and AL and VCD (r(2) = 0.31, P < 0.0001) and a negative association between AL and choroidal thickness (r(2) = 0.13, P < 0.0001). There were no significant differences in the magnitude and timing of diurnal variations associated with refractive error. Significant diurnal variations in AL, choroidal thickness, and IOP were consistently observed over 2 consecutive days of testing.

  8. Analyses of Factors Affecting Endothelial Cell Density in an Eye Bank Corneal Donor Database.

    PubMed

    Kwon, Ji Won; Cho, Kyong Jin; Kim, Hong Kyu; Lee, Jimmy K; Gore, Patrick K; McCartney, Mitchell D; Chuck, Roy S

    2016-09-01

    To analyze the factors affecting central corneal endothelial cell density (ECD) in an eye bank corneal donor database. The Lion's Eye Institute corneal donor database consisting of 18,665 donors (34,234 corneas) aged 20 years or older was analyzed. In particular, differences in the ECD based on age, sex, race, prior ocular surgery, a history of systemic diseases, and smoking were investigated. Furthermore, risk factors for donor cell count inadequacy (defined here as ECD less than 2000/mm) were identified. ECD decreased with age. Regarding race, the average ECD of African American donors was higher than those of white or Hispanic donors. A history of diabetes mellitus (DM) and ocular surgery were associated with a lower ECD. Donor medical history of hypertension, glaucoma, depression, dementia, Parkinson disease, hyper- or hypothyroidism, or smoking did not seem to affect the ECD. The risk factors for donor cell count inadequacy, based on binary logistic regression analyses were advanced age [65-74 years yielded an odds ratio of 17.8; confidence interval (CI), 10.6-29.8; P < 0.001; and 75-99 years yielded an odds ratio of 24.6 (CI, 14.5-41.61; P < 0.001) when compared with 20-34 years], cataract surgery (odds ratio, 4.3; CI, 4.0-4.8; P < 0.001), and DM (odds ratio, 1.2; CI, 1.1-1.3; P = 0.001). Age, race, ocular surgery (cataract and refractive), and DM seem to significantly affect donor corneal ECD. Of these variables, age, a history of cataract surgery, and DM were found to be the greatest risk factors for inadequate donor cell density (less than 2000/mm).

  9. Choroidal retinoic acid synthesis: a possible mediator between refractive error and compensatory eye growth.

    PubMed

    Mertz, J R; Wallman, J

    2000-04-01

    Research over the past two decades has shown that the growth of young eyes is guided by vision. If near- or far-sightedness is artificially imposed by spectacle lenses, eyes of primates and chicks compensate by changing their rate of elongation, thereby growing back to the pre-lens optical condition. Little is known about what chemical signals might mediate between visual effects on the retina and alterations of eye growth. We present five findings that point to choroidal retinoic acid possibly being such a mediator. First, the chick choroid can convert retinol into all-trans-retinoic acid at the rate of 11 +/- 3 pmoles mg protein(-1) hr(-1), compared to 1.3 +/- 0.3 for retina/RPE and no conversion for sclera. Second, those visual conditions that cause increased rates of ocular elongation (diffusers or negative lens wear) produce a sharp decrease in all-trans-retinoic acid synthesis to levels barely detectable with our assay. In contrast, visual conditions which result in decreased rates of ocular elongation (recovery from diffusers or positive lens wear) produce a four- to five-fold increase in the formation of all-trans-retinoic acid. Third, the choroidal retinoic acid is found bound to a 28-32 kD protein. Fourth, a large fraction of the choroidal retinoic acid synthesized in culture is found in a nucleus-enriched fraction of sclera. Finally, application of retinoic acid to cultured sclera at physiological concentrations produced an inhibition of proteoglycan production (as assessed by measuring sulfate incorporation) with a EC50 of 8 x 10(-7) M. These results show that the synthesis of choroidal retinoic acid is modulated by those visual manipulations that influence ocular elongation and that this retinoic acid may reach the sclera in concentrations adequate to modulate scleral proteoglycan formation.

  10. Ocular disorders in children with spastic subtype of cerebral palsy.

    PubMed

    Ozturk, A Taylan; Berk, A Tulin; Yaman, Aylin

    2013-01-01

    To document common ocular abnormalities in children with spastic subtype of cerebral palsy (CP) and to find out whether any correlation exists between their occurance and etiologic factors. Totally 194 patients with the diagnosis of spastic type CP were enrolled in this retrospective study. Detailed ophthalmic examinations were performed. Demographic data and neuroradiological findings were documented. Kruskal-Wallis, Mann Whitney U, Pearson Chi-square tests and Student's t tests were used in the statistical analysis. The mean age was 64.7±44.2 months on the first ophthalmic examination. Prevalences of diplegia (47.4%) and tetraplegia (36.1%) were found to be higher than the frequency of hemiplegia (16.5%) in our study population. Etiologic factor was asphyxia in 60.8% of the patients. Abnormal ocular findings were present in 78.9% of the patients. Statistically significant poor vision was detected in tetraplegia group among all the spastic ubtypes of CP (P=0.000). Anisometropia and significant refractive error were found in 14.4% and 70.1% of the patients, respectively. Thirty-six children (18.6%) had nystagmus and 107 children (55.2%) had strabismus. Lower gestational age and birth weight were statistically higher in patients with esotropia than exotropia (P=0.009 and P=0.024, respectively). Abnormal morphology of the optic disc was present in 152 eyes (39.2%). Severe periventricular leukomalacia (PVL) was found in 48 patients and statistically significant poor vision was detected in the presence of PVL (P=0.000). Spastic diplegic or tetraplegic CP patients with positive neuroradiological symptoms, younger gestational age and lower birth weight ought to have detailed ophthalmic examinations as early as possible to provide best visual rehabilitation.

  11. [Analysis of AC/A ratio after myopic excimer laser in situ keratomileusis].

    PubMed

    Wu, Xiao-ying; Liu, Shuang-zhen

    2003-03-01

    To study the changes of AC/A ratio of myopia after excimer laser in situ keratomileusis (LASIK). 135 myopia patients were treated by LASIK, their AC/A ratios were measured with synoptohore before surgery and 3 months after surgery. The average AC/A ratios of naked eyes or eyes wearing glasses before surgery and the naked after surgery were (0.724 +/- 0.587) (Delta)/D, (2.754 +/- 1.565) (Delta)/D, (1.618 +/- 1.027) (Delta)/D in turn. There were significant difference among those groups (P < 0.001). That also appeared in different degree of myopia naked before surgery (P < 0.01). We found no significant difference between the groups wearing glasses before surgery and naked after surgery (P > 0.05). A positive correlation was built up between postoperative AC/A ratio and AC/A ratio of wearing glasses or refractive diopter before surgery (r = 0.550, P < 0.001; r = 0.185, P < 0.005). And the postoperative AC/A ratios had a negative correlation to age or length of ocular axis (r = -0.340, P < 0.001; r = -0.192, P < 0.002). The regression equation for postoperative AC/A ratios was figured out as Y((Delta)/D) = 4.080 0 - 0.031 8X(1) - 0.097 1X(2) + 0.325 0X(3) (P < 0.001). X(1) = age (year), X(2) = length of ocular axis (mm), X(3) = preoperative AC/A ratio with weaning glasses ((Delta)/D). The naked AC/A ratios are higher than the preoperative's after LASIK, but lower than the wearing glasses's before surgery. It is influenced by the factors, such as: the preoperative AC/A ratio of wearing glasses, the length of ocular axis and the age.

  12. Impact of dehydration and fasting on intraocular pressure and corneal biomechanics measured by the Ocular Response Analyzer.

    PubMed

    Uysal, Betul Seher; Duru, Necati; Ozen, Umut; Arikan Yorgun, Mucella; Akcay, Emine; Caglayan, Mehtap; Cagil, Nurullah

    2018-04-01

    To investigate the effects of dehydration and fasting on the intraocular pressure (IOP) and corneal biomechanics during Ramadan in healthy subjects. A total of 36 healthy fasting male volunteers with a mean age of 32.7 ± 5.1 years (range 28-38 years) were enrolled in the study. A Reichert Ocular Response Analyzer (ORA) was used to measure the corneal resistance factor (CRF), corneal hysteresis (CH), Goldman-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc), additionally IOP with Goldmann applanation tonometer (IOP-GAT) was taken. All measurements were recorded at 8:00 am and 4:00 p.m. during Ramadan and during a 1-month follow-up after Ramadan was over. Statistical analysis demonstrated no difference in the ORA measurements including CH, CRF, IOPcc, and IOPg; CCT and CV values between fasting and non-fasting periods or within a single day (diurnal changes). Nine volunteers (25% of total subjects) were excluded because eyedrops were believed to disrupt the Ramadan fast consequently IOP-GAT could not be measured from these subjects. No statistically significant difference was noted between IOP-GAT and IOPg measurements of twenty-seven subjects at the different periods and time points. Our results reveal that fasting during Ramadan does not profoundly affect corneal biomechanics and IOP values in healthy volunteers without ocular diseases such as glaucoma. When planning corneal refractive surgery and determining IOP, the ORA measurements can be done safely during a Ramadan fast. Moreover, ORA may be a better alternative for patients that refuse IOP measurement via GAT for examining the accuracy of IOP during fasting. Further studies are needed to better understand the role of these parameters on corneal disease and glaucoma during fasting.

  13. Ocular biometric measurements in cataract surgery candidates in Portugal

    PubMed Central

    Hoffer, Kenneth J.; Ribeiro, Filomena; Ribeiro, Paulo; O’Neill, João G.

    2017-01-01

    Objective Describe the ocular biometric parameters and their associations in a population of cataract surgery candidates. Methods A cross-sectional study of 13,012 eyes of 6,506 patients was performed. Biometric parameters of the eyes were measured by optical low-coherence reflectometry. The axial length (AL), mean keratometry (K) and astigmatism, anterior chamber depth (ACD) (epithelium to lens), lens thickness (LT), and Corneal Diameter (CD) were evaluated. Results The mean age was 69 ± 10 years (44–99 years). Mean AL, Km, and ACD were 23.87 ± 1.55 mm (19.8–31.92 mm), 43.91 ± 1.71 D (40.61–51.14 D), and 3.25 ± 0.44 mm (2.04–5.28 mm), respectively. The mean LT was 4.32 ± 0.49 mm (2.73–5.77 mm) and the mean CD was 12.02 ± 0.46 mm (10.50–14.15 mm). The mean corneal astigmatism was 1.08 ± 0.84 D (0.00–7.58 D) and 43.5% of eyes had astigmatism ≥ 1.00 D. Male patients had longer AL and ACDs (p < .001) and flatter corneas (p < .001). In regression models considering age, gender, Km, ACD, LT, and CD, a longer AL was associated with being male and having higher ACD, LT and CD. Conclusions These data represent normative biometric values for the Portuguese population. The greatest predictor of ocular biometrics was gender. There was no significant correlation between age and AL, ACD, or Km. These results may be relevant in the evaluation of refractive error and in the calculation of intraocular lens power. PMID:28982150

  14. Contact lens management of irregular corneas after traumatic aphakia: A pediatric case series.

    PubMed

    Aung, Yin-Yin; McLeod, Andrew

    2015-10-01

    Pediatric patients account for 35% of all cases that present after ocular trauma and 20.9% of those result in a ruptured globe. When repairing the globe, the removal of the natural lens results in a significant change in refractive error and loss of accommodation. In addition, the eye can have scarring, irregular astigmatism, and changes to the ocular surface. Treatment and vision rehabilitation should be aggressive and done quickly to prevent amblyopia. Advanced lens designs are often needed to treat both the irregular ocular surface and the aphakia. Treatment options are often confounded with the usual issues of contact lens compliance, intolerance, and complications. This case series follows three aphakic pediatric patients through the contact lens fitting process after sustaining a ruptured globe that left them aphakic with residual irregular astigmatism and corneal scarring. Patient 1 is a 3-year-old Hispanic male fit with a bitoric gas permeable contact lens with irregular astigmatism and an elevated central corneal scarring. Patient 2 is a 12-year-old Caucasian male with minimal residual astigmatism fit in a multifocal soft contact lens. Patient 3 is an 8-year-old African American male fit with a hybrid contact lens that was needed to vault the irregular astigmatism and central corneal scarring. Treating patients with irregular corneas or aphakia can be challenging in their own right, but in combination are some of the most advanced specialty contact lens fittings. This case series followed three pediatric patients through the fitting process and demonstrated the options and challenges when fitting this unique patient population. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  15. Exome Sequence Analysis of 14 Families With High Myopia.

    PubMed

    Kloss, Bethany A; Tompson, Stuart W; Whisenhunt, Kristina N; Quow, Krystina L; Huang, Samuel J; Pavelec, Derek M; Rosenberg, Thomas; Young, Terri L

    2017-04-01

    To identify causal gene mutations in 14 families with autosomal dominant (AD) high myopia using exome sequencing. Select individuals from 14 large Caucasian families with high myopia were exome sequenced. Gene variants were filtered to identify potential pathogenic changes. Sanger sequencing was used to confirm variants in original DNA, and to test for disease cosegregation in additional family members. Candidate genes and chromosomal loci previously associated with myopic refractive error and its endophenotypes were comprehensively screened. In 14 high myopia families, we identified 73 rare and 31 novel gene variants as candidates for pathogenicity. In seven of these families, two of the novel and eight of the rare variants were within known myopia loci. A total of 104 heterozygous nonsynonymous rare variants in 104 genes were identified in 10 out of 14 probands. Each variant cosegregated with affection status. No rare variants were identified in genes known to cause myopia or in genes closest to published genome-wide association study association signals for refractive error or its endophenotypes. Whole exome sequencing was performed to determine gene variants implicated in the pathogenesis of AD high myopia. This study provides new genes for consideration in the pathogenesis of high myopia, and may aid in the development of genetic profiling of those at greatest risk for attendant ocular morbidities of this disorder.

  16. Increased Expression of CCN2 in the Red Flashing Light-Induced Myopia in Guinea Pigs

    PubMed Central

    Wang, Hong; Zhuang, Kang; Gao, Lei; Zhang, Linna; Yang, Hongling

    2013-01-01

    Visual environment plays an important role in the occurrence of myopia. We previously showed that the different flashing lights could result in distinct effects on the ocular growth and development of myopia. CCN2 has been reported to regulate various cellular functions and biological processes. However, whether CCN2 signaling was involved in the red flashing light-induced myopia still remains unknown. In the present study, we investigated the effects of the red flashing lights exposure on the refraction and axial length of the eyes in vivo and then evaluated their effects on the expression of CCN2 and TGF-β in sclera tissues. Our data showed that the eyes exposed to the red flashing light became more myopic with a significant increase of the axial length and decrease of the refraction. Both CCN2 and TGF-β, as well as p38 MAPK and PI3K, were highly expressed in the sclera tissues exposed to the red flashing light. Both CCN2 and TGF-β were found to have the same gene expression profile in vivo. In conclusion, our findings found that CCN2 signaling pathway plays an important role in the red flashing light-induced myopia in vivo. Moreover, our study establishes a useful animal model for experimental myopia research. PMID:23936844

  17. Retinal degeneration increases susceptibility to myopia in mice

    PubMed Central

    Park, Hanna; Tan, Christopher C.; Faulkner, Amanda; Jabbar, Seema B.; Schmid, Gregor; Abey, Jane; Iuvone, P. Michael

    2013-01-01

    Purpose Retinal diseases are often associated with refractive errors, suggesting the importance of normal retinal signaling during emmetropization. For instance, retinitis pigmentosa, a disease characterized by severe photoreceptor degeneration, is associated with myopia; however, the underlying link between these conditions is not known. This study examines the influence of photoreceptor degeneration on refractive development by testing two mouse models of retinitis pigmentosa under normal and form deprivation visual conditions. Dopamine, a potential stop signal for refractive eye growth, was assessed as a potential underlying mechanism. Methods Refractive eye growth in mice that were homozygous for a mutation in Pde6b, Pde6brd1/rd1 (rd1), or Pde6brd10/rd10 (rd10) was measured weekly from 4 to 12 weeks of age and compared to age-matched wild-type (WT) mice. Refractive error was measured using an eccentric infrared photorefractor, and axial length was measured with partial coherence interferometry or spectral domain ocular coherence tomography. A cohort of mice received head-mounted diffuser goggles to induce form deprivation from 4 to 6 weeks of age. Dopamine and 3,4-dihydroxyphenylacetic acid (DOPAC) levels were measured with high-performance liquid chromatography in each strain after exposure to normal or form deprivation conditions. Results The rd1 and rd10 mice had significantly greater hyperopia relative to the WT controls throughout normal development; however, axial length became significantly longer only in WT mice starting at 7 weeks of age. After 2 weeks of form deprivation, the rd1 and rd10 mice demonstrated a faster and larger myopic shift (−6.14±0.62 and −7.38±1.46 diopter, respectively) compared to the WT mice (−2.41±0.47 diopter). Under normal visual conditions, the DOPAC levels and DOPAC/dopamine ratios, a measure of dopamine turnover, were significantly lower in the rd1 and rd10 mice compared to the WT mice, while the dopamine levels were similar or higher than WT in the rd10 mice. Lower basal levels of DOPAC were highly correlated with increasing myopic shifts. Conclusions Refractive development under normal visual conditions was disrupted toward greater hyperopia from 4 to 12 weeks of age in these photoreceptor degeneration models, despite significantly lower DOPAC levels. However, the retinal degeneration models with low basal levels of DOPAC had increased susceptibility to form deprivation myopia. These results indicate that photoreceptor degeneration may alter dopamine metabolism, leading to increased susceptibility to myopia with an environmental visual challenge. PMID:24146540

  18. Prevalence and causes of visual impairment in Asian and non-Hispanic white preschool children: Multi-ethnic Pediatric Eye Disease Study.

    PubMed

    Tarczy-Hornoch, Kristina; Cotter, Susan A; Borchert, Mark; McKean-Cowdin, Roberta; Lin, Jesse; Wen, Ge; Kim, Jeniffer; Varma, Rohit

    2013-06-01

    To determine the prevalence and causes of decreased visual acuity (VA). Population-based cross-sectional study. Multi-ethnic sample of children 30 to 72 months of age identified in Los Angeles. All eligible children underwent a comprehensive ophthalmic evaluation including monocular VA testing, cover testing, cycloplegic autorefraction, fundus evaluation, and VA retesting with refractive correction. Decreased VA was defined as presenting or best-measured VA worse than 20/50 in children 30 to 47 months of age and worse than 20/40 for children 48 months of age and older. The prevalence and causes of decreased VA were determined, for both presenting and best-measured VA, in the better-seeing and the worse-seeing eyes. Prevalence and causes of decreased vision. Presenting VA was assessed in 1840 children and best-measured VA was assessed in 1886 children. Presenting VA was decreased in the worse eye of 4.2% of Asian children and of 3.6% of non-Hispanic white (NHW) children. Close to one-fourth of these cases had no identifiable cause, and 81% of these resolved on retesting. Decreased presenting VA in the worse eye with an identifiable ophthalmic cause was present in 3.4% of Asian children and in 2.6% of NHW children. Decreased presenting VA attributable to simple refractive error (myopia ≥ 0.5 diopters [D]; hyperopia ≥ 3.0 D; astigmatism ≥ 2.0 D or ≥ 1.5 D for children older than 36 months) was present in the worse eye of 2.3% of Asian children and of 1.4% of NHW children and in the better eye of 0.5% of Asian children and of 0.3% of NHW children. Decreased best-measured VA attributable to a cause was present in the worse eye of 1.2% of both Asian children and NHW children and in the better eye of 0.2% of Asian and of 0.3% of NHW children. Amblyopia related to refractive error was the most common cause, and was 10 times as common as ocular disease. Severe visual impairment was rare. Seventy percent of all decreased VA in Asian and NHW preschool children and more than 90% of decreased VA with an identifiable cause is related to refractive error--either uncorrected refractive error or amblyopia resulting from refractive error. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  19. Optical aberrations, retinal image quality and eye growth: Experimentation and modeling

    NASA Astrophysics Data System (ADS)

    Tian, Yibin

    2007-12-01

    Retinal image quality is important for normal eye growth. Optical aberrations are of interest for two reasons: first, they degrade retinal images; second, they might provide some cues to defocus. Higher than normal ocular aberrations have been previously associated with human myopia. However, these studies were cross-sectional in design, and only reported aberrations in terms of root mean square (RMS) errors of Zernike coefficients, a poor metric of optical quality. This dissertation presents results from investigations of ocular optical aberrations, retinal image quality and eye growth in chicks and humans. A number of techniques were utilized, including Shack-Hartmann aberrometry, high-frequency A-scan ultrasonography, ciliary nerve section (CNX), photorefractive keratectomy (PRK) as well as computer simulations and modeling. A technique to extract light scatter information from Shack-Hartmann images was also developed. The main findings of the dissertation are summarized below. In young chicks, most ocular aberrations decreased with growth in both normal and CNX eyes, and there were diurnal fluctuations in some aberrations. Modeling suggested active reduction in higher order aberrations (HOAs) during early development. Although CNX eyes manifested greater than normal HOAs, they showed near normal growth. Retinal image degradation varied greatly among individual eyes post-PRK in young chicks. Including light scatter information into analyses of retinal image quality better estimated the latter. Albino eyes showed more severe retinal image degradation than normal eyes, due to increased optical aberrations and light scatter, but their growth was similar to those of normal eyes, implying that they are relatively insensitive to retina image quality. Although the above results questioned the influence of optical aberrations on early ocular growth, some optical quality metrics, derived from optical aberrations data, could predict how much the eyes of young chicks subsequently elongated. The performance of some focus measures was very poor when non-defocus aberrations exceeded a certain level; presumably, these non-defocus aberrations might interfere with the eye's ability to interpret defocus. In anisomyopic human adults, more myopic eyes had larger anterior and vitreous chambers, greater astigmatism, and more positive spherical aberration. However, compared to isometropes, only interocular differences in spherical equivalent refractive errors were significantly increased.

  20. Plasma rich in growth factors eye drops to treat secondary ocular surface disorders in patients with glaucoma

    PubMed Central

    Sánchez-Avila, Ronald M; Merayo-Lloves, Jesus; Fernández, Maria Laura; Rodríguez-Gutiérrez, Luis Alberto; Rodríguez-Calvo, Pedro Pablo; Fernández-Vega Cueto, Andres; Muruzabal, Francisco; Orive, Gorka; Anitua, Eduardo

    2018-01-01

    Purpose To evaluate the efficacy and safety of plasma rich in growth factors (PRGF) eye drops in patients with glaucoma with secondary ocular surface disorders (OSDs) due to surgeries and topical hypotensive drugs use. Materials and methods A retrospective case-series study design was used including six patients (eight eyes) diagnosed with glaucoma who received surgical (nonpenetrating deep sclerectomy and/or trabeculectomy) and medical treatments (hypotensive eye drops) to control intraocular pressure (IOP) and who developed secondary OSDs, unresponsive to conventional treatments. Patients were treated with PRGF eye drops (four times a day). Outcome measures were ocular surface disease index (OSDI), best-corrected visual acuity (BCVA, in logarithm of the minimum angle of resolution), visual analog scale (VAS), frequency and severity of symptoms, and IOP. The safety of the treatment was also evaluated. Results Six patients (seven eyes with open-angle glaucoma and one eye with uveitic glaucoma) treated with PRGF eye drops were evaluated. Mean age was 71 years (SD=7.2, range 58–79 years). Five were female and one was male. The mean treatment time was 21.8 weeks (SD=9.0, range 12–36 weeks). The mean time to reach closure of the corneal ulcer was 14.5 (SD=5.5) weeks. A statistical significant reduction in OSDI scale (50.6%), VAS frequency (53.1%), VAS severity (42.0%), and a 41.8% improvement in BCVA were observed (p<0.05). IOP also decreased by 16.6% (p=0.010). Only one of the six patients reported itching in both eyes as an adverse event (AE); however, the patient continued with the PRGF eye drops until the end of therapy; the remaining patients did not report any AEs during the follow-up period. Conclusions In patients with glaucoma and secondary OSDs refractive to conventional treatments, the treatment with PRGF eye drops could be considered a possible therapeutic option, because it demonstrates an improvement in the signs and symptoms of the ocular surface, as well as a better control of the IOP. This is an initial research work that can open doors for future research to confirm these findings. PMID:29760570

  1. Plasma rich in growth factors eye drops to treat secondary ocular surface disorders in patients with glaucoma.

    PubMed

    Sánchez-Avila, Ronald M; Merayo-Lloves, Jesus; Fernández, Maria Laura; Rodríguez-Gutiérrez, Luis Alberto; Rodríguez-Calvo, Pedro Pablo; Fernández-Vega Cueto, Andres; Muruzabal, Francisco; Orive, Gorka; Anitua, Eduardo

    2018-01-01

    To evaluate the efficacy and safety of plasma rich in growth factors (PRGF) eye drops in patients with glaucoma with secondary ocular surface disorders (OSDs) due to surgeries and topical hypotensive drugs use. A retrospective case-series study design was used including six patients (eight eyes) diagnosed with glaucoma who received surgical (nonpenetrating deep sclerectomy and/or trabeculectomy) and medical treatments (hypotensive eye drops) to control intraocular pressure (IOP) and who developed secondary OSDs, unresponsive to conventional treatments. Patients were treated with PRGF eye drops (four times a day). Outcome measures were ocular surface disease index (OSDI), best-corrected visual acuity (BCVA, in logarithm of the minimum angle of resolution), visual analog scale (VAS), frequency and severity of symptoms, and IOP. The safety of the treatment was also evaluated. Six patients (seven eyes with open-angle glaucoma and one eye with uveitic glaucoma) treated with PRGF eye drops were evaluated. Mean age was 71 years (SD=7.2, range 58-79 years). Five were female and one was male. The mean treatment time was 21.8 weeks (SD=9.0, range 12-36 weeks). The mean time to reach closure of the corneal ulcer was 14.5 (SD=5.5) weeks. A statistical significant reduction in OSDI scale (50.6%), VAS frequency (53.1%), VAS severity (42.0%), and a 41.8% improvement in BCVA were observed ( p <0.05). IOP also decreased by 16.6% ( p =0.010). Only one of the six patients reported itching in both eyes as an adverse event (AE); however, the patient continued with the PRGF eye drops until the end of therapy; the remaining patients did not report any AEs during the follow-up period. In patients with glaucoma and secondary OSDs refractive to conventional treatments, the treatment with PRGF eye drops could be considered a possible therapeutic option, because it demonstrates an improvement in the signs and symptoms of the ocular surface, as well as a better control of the IOP. This is an initial research work that can open doors for future research to confirm these findings.

  2. Corneal densitometry and its correlation with age, pachymetry, corneal curvature, and refraction.

    PubMed

    Garzón, Nuria; Poyales, Francisco; Illarramendi, Igor; Mendicute, Javier; Jáñez, Óscar; Caro, Pedro; López, Alfredo; Argüeso, Francisco

    2017-12-01

    To determine normative corneal densitometry values in relation to age, sex, refractive error, corneal thickness, and keratometry, measured using the Oculus Pentacam system. Three hundred and thirty-eight healthy subjects (185 men; 153 women) with no corneal disease underwent an exhaustive ocular examination. Corneal densitometry was expressed in standardized grayscale units (GSU). The mean corneal densitometry over the total area was 16.46 ± 1.85 GSU. The Pearson correlation coefficient for total densitometry was r = 0.542 (p < 0.001). Statistically significant differences were found between men and women for the total area (p = 0.006), with readings of 16.22 ± 1.54 GSU and 16.60 ± 1.83 GSU, respectively. When the cornea was divided into layers of different depths, a significant correlation was found for all layers and age: r = 0.447 (p < 0.001), r = 0.563 (p < 0.001), and r = 0.520 (p < 0.001) for the anterior, central, and posterior layers, respectively. However, when the cornea was divided into concentric annuli starting from the center of the cornea, densitometry was strongly correlated only with age in the 6-10-mm annulus (p < 0.001). Neither mean keratometry nor spherical equivalent was correlated with corneal densitometry in any zone of the cornea (p > 0.05). This is the first report of normative corneal densitometry values in relation to keratometry, corneal thickness, and spherical equivalent measured with the latest Oculus Pentacam software. Corneal densitometry increases with age, but corneal keratometry and refractive parameters do not affect light scattering in the human cornea.

  3. Cohort study with 4-year follow-up of myopia and refractive parameters in primary schoolchildren in Baoshan District, Shanghai.

    PubMed

    Ma, Yingyan; Zou, Haidong; Lin, Senlin; Xu, Xun; Zhao, Rong; Lu, Lina; Zhao, Huijuan; Li, Qiangqiang; Wang, Ling; Zhu, Jianfeng; He, Xiangui

    2018-03-25

    Cohort studies could not only reveal associations between change of refractive components and onset/progression of myopia, but also risk factors, which is important for understanding mechanism and providing strategies. Prevalence of myopia is high in Shanghai, being reported to be 52.2% in children aged 10 years old. Cohort study. A total of 1856 students from six randomly selected primary schools in Baoshan District, Shanghai. Children underwent comprehensive ocular measurement, including axial length (AL), corneal curvature radius and cycloplegic auto-refraction. Questionnaires about eye usage time were collected. Grade 1 students were followed for 4 years, and grade 2 and 3 students for 2 years. (i) Change of spherical equivalent (SE) and AL and (ii) risk factors for progression and incidence of myopia. The average 2-year progress of SE was 0.91D, 0.91D and 1.11D for grade 1, 2 and 3, respectively, and the average elongation of AL was 0.70 mm, 0.64 mm and 0.71 mm, respectively. Only parental myopia, but not near work time, near work diopter time, outdoor activity time or attending tutoring classes, was associated with myopia incidence and progression in the present population. Using baseline SE could be a simple and effective indicator for myopia prediction. Incidence and progression of myopia is relatively high in schoolchildren in Shanghai compared with children of Western countries, East Asia and other parts of China. Effective strategies to control myopia prevalence are in urgent need. © 2018 The Authors Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.

  4. Working sketch of an anatomically and optically equivalent physical model eye

    NASA Astrophysics Data System (ADS)

    Bakaraju, Ravi Chandra; Ehrmann, Klaus; Falk, Darrin; Papas, Eric B.; Ho, Arthur

    2009-02-01

    Our aim was to fabricate a bench-top physical model eye that closely replicates anatomical and optical properties of the average human eye, and to calibrate and standardize this model to suit normal viewing conditions and subsequently utilize it to understand the optical performance of corrective lens designs; especially multifocal soft contact lenses. Using available normative data on ocular biometrics and Zemax ray-tracing software as a tool, we modeled 25, 45 and 55 year-old average adult human eyes with discrete accommodation levels and pupil sizes. Specifications for the components were established following manufacturing tolerance analyses. The cornea was lathed from an optical material with refractive index of 1.376 @ 589 nm and the crystalline lenses were made of Boston RGP polymers with refractive indices of 1.423 (45 & 55yr) and 1.429 (25yr) @ 589 nm. These two materials served to model the equivalent crystalline lens of the different age-groups. A camera, the acting retina, was hosted on the motor-base having translatory and rotary functions to facilitate the simulation of different states of ametropia and peripheral refraction respectively. We report on the implementation of the first prototype and present some simulations of the optical performance of certain contact lenses with specific levels of ametropia, to demonstrate the potential use of such a physical model eye. On completion of development, calibration and standardization, optical quality assessment and performance predictions of different ophthalmic lenses can be studied in great detail. Optical performance with corrective lenses may be reliably simulated and predicted by customized combined computational and physical models giving insight into the merits and pitfalls of their designs

  5. Management of moderate and severe corneal astigmatism with AcrySof® toric intraocular lens implantation – Our experience

    PubMed Central

    Farooqui, Javed Hussain; Koul, Archana; Dutta, Ranjan; Shroff, Noshir Minoo

    2015-01-01

    Purpose Visual performance following toric intraocular lens implantation for cataract with moderate and severe astigmatism. Setting Cataract services, Shroff Eye Centre, New Delhi, India. Design Case series. Method This prospective study included 64 eyes of 40 patients with more than 1.50 dioptre (D) of pre-existing corneal astigmatism undergoing phacoemulsification with implantation of the AcrySof® toric IntraOcular Lens (IOL). The unaided visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere and refractive cylinders were evaluated. Toric IOL axis and alignment error was measured by slit lamp method and Adobe Photoshop (version 7) method. Patient satisfaction was evaluated using a satisfaction questionnaire at 3 months. Results The mean residual refractive astigmatism was 0.57 D at the final follow-up of 3 months. Mean alignment error was 3.44 degrees (SD = 2.60) by slit lamp method and 3.88 degrees (SD = 2.86) by Photoshop method. Forty-six (71.9%) eyes showed misalignment of 5 degrees or less, and 60 (93.8%) eyes showed misalignment of 10 degrees or less. The mean log MAR UCVA at 1st post-op day was 0.172 (SD = 0.02), on 7th post-op day was 0.138 (SD = 0.11), and on 30th post-op day was 0.081 (SD = 0.11). The mean log MAR BCVA at three months was −0.04 (SD = 0.76). Conclusion We believe that implantation of AcrySof® toric IOL is an effective, safe and predictable method to correct high amounts of corneal astigmatism during cataract surgery. PMID:26586976

  6. Clinical and optical intraocular performance of rotationally asymmetric multifocal IOL plate-haptic design versus C-loop haptic design.

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José; Vega-Estrada, Alfredo

    2013-04-01

    To compare the visual and intraocular optical quality outcomes with different designs of the refractive rotationally asymmetric multifocal intraocular lens (MFIOL) (Lentis Mplus; Oculentis GmbH, Berlin, Germany) with or without capsular tension ring (CTR) implantation. One hundred thirty-five consecutive eyes of 78 patients with cataract (ages 36 to 82 years) were divided into three groups: 43 eyes implanted with the C-Loop haptic design without CTR (C-Loop haptic only group); 47 eyes implanted with the C-Loop haptic design with CTR (C-Loop haptic with CTR group); and 45 eyes implanted with the plate-haptic design (plate-haptic group). Visual acuity, contrast sensitivity, defocus curve, and ocular and intraocular optical quality were evaluated at 3 months postoperatively. Significant differences in the postoperative sphere were found (P = .01), with a more myopic postoperative refraction for the C-Loop haptic only group. No significant differences were detected in photopic and scotopic contrast sensitivity among groups (P ⩾ .05). Significantly better visual acuities were present in the C-Loop haptic with CTR group for the defocus levels of -2.0, -1.5, -1.0, and -0.50 D (P ⩽.03). Statistically significant differences among groups were found in total intraocular root mean square (RMS), high-order intraocular RMS, and intraocular coma-like RMS aberrations (P ⩽.04), with lower values from the plate-haptic group. The plate-haptic design and the C-Loop haptic design with CTR implantation both allow good visual rehabilitation. However, better refractive predictability and intraocular optical quality was obtained with the plate-haptic design without CTR implantation. The plate-haptic design seems to be a better design to support rotational asymmetric MFIOL optics. Copyright 2013, SLACK Incorporated.

  7. Adenomatous Polyposis Coli Mutation Leads to Myopia Development in Mice

    PubMed Central

    Li, Jing; Zhu, Zhenzhen; Yang, Wenzhao; Zhou, Xiangtian; An, Jianhong; Huang, Furong; Wang, Qiongsi; Reinach, Peter S.; Li, Wei; Chen, Wensheng; Liu, Zuguo

    2015-01-01

    Myopia incidence in China is rapidly becoming a very serious sight compromising problem in a large segment of the general population. Therefore, delineating the underlying mechanisms leading to myopia will markedly lessen the likelihood of other sight compromising complications. In this regard, there is some evidence that patients afflicted with familial adenomatous polyposis (FAP), havean adenomatous polyposis coli (APC) mutation and a higher incidence of myopia. To clarify this possible association, we determined whether the changes in pertinent biometric and biochemical parameters underlying postnatal refractive error development in APCMin mice are relevant for gaining insight into the pathogenesis of this disease in humans. The refraction and biometrics in APCMin mice and age-matched wild-type (WT) littermates between postnatal days P28 and P84 were examined with eccentric infrared photorefraction (EIR) and customized optical coherence tomography (OCT). Compared with WT littermates, the APCMin mutated mice developed myopia (average -4.64 D) on P84 which was associated with increased vitreous chamber depth (VCD). Furthermore, retinal and scleral changes appear in these mice along with: 1) axial length shortening; 2) increased retinal cell proliferation; 3) and decreased tyrosine hydroxylase (TH) expression, the rate-limiting enzyme of DA synthesis. Scleral collagen fibril diameters became heterogeneous and irregularly organized in the APCMin mice. Western blot analysis showed that scleral alpha-1 type I collagen (col1α1) expression also decreased whereas MMP2 and MMP9 mRNA expression was invariant. These results indicate that defective APC gene function promotes refractive error development. By characterizing in APCMin mice ocular developmental changes, this approach provides novel insight into underlying pathophysiological mechanisms contributing to human myopia development. PMID:26495845

  8. Impact of correcting visual impairment and low vision in deaf-mute students in Pune, India.

    PubMed

    Gogate, Parikshit; Bhusan, Shashi; Ray, Shantanu; Shinde, Amit

    2016-12-01

    The aim of this study was to evaluate visual acuity and vision function before and after providing spectacles and low vision devices (LVDs) in deaf-mute students. Schools for deaf-mute in West Maharashtra. Hearing-impaired children in all special schools in Pune district underwent detailed visual acuity testing (with teachers' help), refraction, external ocular examination, and fundoscopy. Students with refractive errors and low vision were provided with spectacles and LVD. The LV Prasad-Functional Vision Questionnaire consisting of twenty items was administered to each subject before and after providing spectacles, LVDs. Wilcoxon matched-pairs signed-ranks test. 252/929 (27.1%) students had a refractive error. 794 (85.5%) were profound deaf. Two-hundred and fifty students were dispensed spectacles and LVDs. Mean LogMAR visual acuity before introduction of spectacles and LVDs were 0.33 ± 0.36 which improved to 0.058 (P < 0.0001) after intervention. It was found that difference in functional vision pre- and post-intervention was statistically significant (P < 0.0001) for questions 1-19. The most commonly reported difficulties were for performing distance task like reading the bus destination (58.7%), making out the bus number (51.1%), copying from blackboard (47.7%), and seeing whether somebody is waving hand from across the road (45.5%). In response to question number 20, 57.4% of students felt that their vision was much worse than their friend's vision, which was reduced to 17.6% after dispensing spectacles and LVDs. Spectacle and LVD reduced visual impairment and improved vision function in deaf-mute students, augmenting their ability to negotiate in and out of school.

  9. A prospective, contralateral comparison of photorefractive keratectomy (PRK) versus thin-flap LASIK: assessment of visual function.

    PubMed

    Hatch, Bryndon B; Moshirfar, Majid; Ollerton, Andrew J; Sikder, Shameema; Mifflin, Mark D

    2011-01-01

    To compare differences in visual acuity, contrast sensitivity, complications, and higher-order ocular aberrations (HOAs) in eyes with stable myopia undergoing either photo-refractive keratectomy (PRK) or thin-flap laser in situ keratomileusis (LASIK) (intended flap thickness of 90 μm) using the VISX Star S4 CustomVue excimer laser and the IntraLase FS60 femtosecond laser at 1, 3, and 6 months postoperatively. In this prospective, masked, and randomized pilot study, refractive surgery was performed contralaterally on 52 eyes: 26 with PRK and 26 with thin-flap LASIK. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and complications. At 6 months, mean values for UDVA (logMAR) were -0.043 ± 0.668 and -0.061 ± 0.099 in the PRK and thin-flap LASIK groups, respectively (n = 25, P = 0.466). UDVA of 20/20 or better was achieved in 96% of eyes undergoing PRK and 92% of eyes undergoing thin-flap LASIK, whereas 20/15 vision or better was achieved in 73% of eyes undergoing PRK and 72% of eyes undergoing thin-flap LASIK (P > 0.600). Significant differences were not found between treatment groups in contrast sensitivity (P ≥ 0.156) or CDVA (P = 0.800) at postoperative 6 months. Types of complications differed between groups, notably 35% of eyes in the thin-flap LASIK group experiencing complications, including microstriae and 2 flap tears. Under well-controlled surgical conditions, PRK and thin-flap LASIK refractive surgeries achieve similar results in visual acuity, contrast sensitivity, and induction of HOAs, with differences in experienced complications.

  10. A prospective, contralateral comparison of photorefractive keratectomy (PRK) versus thin-flap LASIK: assessment of visual function

    PubMed Central

    Hatch, Bryndon B; Moshirfar, Majid; Ollerton, Andrew J; Sikder, Shameema; Mifflin, Mark D

    2011-01-01

    Purpose: To compare differences in visual acuity, contrast sensitivity, complications, and higher-order ocular aberrations (HOAs) in eyes with stable myopia undergoing either photo-refractive keratectomy (PRK) or thin-flap laser in situ keratomileusis (LASIK) (intended flap thickness of 90 μm) using the VISX Star S4 CustomVue excimer laser and the IntraLase FS60 femtosecond laser at 1, 3, and 6 months postoperatively. Methods: In this prospective, masked, and randomized pilot study, refractive surgery was performed contralaterally on 52 eyes: 26 with PRK and 26 with thin-flap LASIK. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and complications. Results: At 6 months, mean values for UDVA (logMAR) were −0.043 ± 0.668 and −0.061 ± 0.099 in the PRK and thin-flap LASIK groups, respectively (n = 25, P = 0.466). UDVA of 20/20 or better was achieved in 96% of eyes undergoing PRK and 92% of eyes undergoing thin-flap LASIK, whereas 20/15 vision or better was achieved in 73% of eyes undergoing PRK and 72% of eyes undergoing thin-flap LASIK (P > 0.600). Significant differences were not found between treatment groups in contrast sensitivity (P ≥ 0.156) or CDVA (P = 0.800) at postoperative 6 months. Types of complications differed between groups, notably 35% of eyes in the thin-flap LASIK group experiencing complications, including microstriae and 2 flap tears. Conclusion: Under well-controlled surgical conditions, PRK and thin-flap LASIK refractive surgeries achieve similar results in visual acuity, contrast sensitivity, and induction of HOAs, with differences in experienced complications. PMID:21573091

  11. Comparing sports vision among three groups of soft tennis adolescent athletes: Normal vision, refractive errors with and without correction.

    PubMed

    Chang, Shih-Tsun; Liu, Yen-Hsiu; Lee, Jiahn-Shing; See, Lai-Chu

    2015-09-01

    The effect of correcting static vision on sports vision is still not clear. To examine whether sports vision (depth perception [DP], dynamic visual acuity [DVA], eye movement [EM], peripheral vision [PV], and momentary vision [MV],) were different among soft tennis adolescent athletes with normal vision (Group A), with refractive error and corrected with (Group B) and without eyeglasses (Group C). A cross-section study was conducted. Soft tennis athletes aged 10-13 who played softball tennis for 2-5 years, and who were without any ocular diseases and without visual training for the past 3 months were recruited. DPs were measured in an absolute deviation (mm) between a moving rod and fixing rod (approaching at 25 mm/s, receding at 25 mm/s, approaching at 50 mm/s, receding at 50 mm/s) using electric DP tester. A smaller deviation represented better DP. DVA, EM, PV, and MV were measured on a scale from 1 (worse) to 10 (best) using ATHLEVISION software. Chi-square test and Kruskal-Wallis test was used to compare the data among the three study groups. A total of 73 athletes (37 in Group A, 8 in Group B, 28 in Group C) were enrolled in this study. All four items of DP showed significant difference among the three study groups (P = 0.0051, 0.0004, 0.0095, 0.0021). PV displayed significant difference among the three study groups (P = 0.0044). There was no significant difference in DVA, EM, and MV among the three study groups. Significant better DP and PV were seen among soft tennis adolescent athletes with normal vision than those with refractive error regardless whether they had eyeglasses corrected. On the other hand, DVA, EM, and MV were similar among the three study groups.

  12. Wavefront-guided versus wavefront-optimized laser in situ keratomileusis: contralateral comparative study.

    PubMed

    Padmanabhan, Prema; Mrochen, Michael; Basuthkar, Subam; Viswanathan, Deepa; Joseph, Roy

    2008-03-01

    To compare the outcomes of wavefront-guided and wavefront-optimized treatment in fellow eyes of patients having laser in situ keratomileusis (LASIK) for myopia. Medical and Vision Research Foundation, Tamil Nadu, India. This prospective comparative study comprised 27 patients who had wavefront-guided LASIK in 1 eye and wavefront-optimized LASIK in the fellow eye. The Hansatome (Bausch & Lomb) was used to create a superior-hinged flap and the Allegretto laser (WaveLight Laser Technologie AG), for photoablation. The Allegretto wave analyzer was used to measure ocular wavefront aberrations and the Functional Acuity Contrast Test chart, to measure contrast sensitivity before and 1 month after LASIK. The refractive and visual outcomes and the changes in aberrations and contrast sensitivity were compared between the 2 treatment modalities. One month postoperatively, 92% of eyes in the wavefront-guided group and 85% in the wavefront-optimized group had uncorrected visual acuity of 20/20 or better; 93% and 89%, respectively, had a postoperative spherical equivalent refraction of +/-0.50 diopter. The differences between groups were not statistically significant. Wavefront-guided LASIK induced less change in 18 of 22 higher-order Zernike terms than wavefront-optimized LASIK, with the change in positive spherical aberration the only statistically significant one (P= .01). Contrast sensitivity improved at the low and middle spatial frequencies (not statistically significant) and worsened significantly at high spatial frequencies after wavefront-guided LASIK; there was a statistically significant worsening at all spatial frequencies after wavefront-optimized LASIK. Although both wavefront-guided and wavefront-optimized LASIK gave excellent refractive correction results, the former induced less higher-order aberrations and was associated with better contrast sensitivity.

  13. Curvature of iris profile in spectral domain optical coherence tomography and dependency to refraction, age and pupil size - the MIPH Eye&Health Study.

    PubMed

    Schuster, Alexander K; Fischer, Joachim E; Vossmerbaeumer, Urs

    2017-03-01

    Optical coherence tomography (OCT) of the anterior segment allows quantitative analysis of the geometry of the iris. We performed spectral domain OCT examinations in healthy emmetropic, hyperopic and myopic subjects to investigate iris curvature and its associations. In a cross-sectional study, out of 4617 eyes (2309 subjects) those with refractive errors of <-4 or >+3 dioptres were identified by objective refraction. The iris was examined using the anterior segment mode of a spectral domain 3D OCT-2000 (Topcon Inc., Japan) in the temporal meridian, and OCT scans were investigated with respect to presence and amount of convex and concave iris configuration. Ninety-three eyes of 50 subjects served as emmetropic group (-0.5 ≤ x ≤+0.5 dioptres). Previous ocular surgery was exclusion criterion. Six hundred and sixty-eight eyes of 398 persons [292 male (76%); age range; 18-66 years] were included in the study. In the myopic group, 105 eyes had a concave iris configuration (26%), while in the hyperopic group, no eye had this configuration (0%) and in the emmetropic group five eyes (5%). Convex iris configuration was found in 96% of hyperopic, in 85% of the emmetropic and in 67% of the myopic eyes. There was an association between concave iris configuration and myopia, younger age and male gender, and with anterior chamber angle width. Spectral domain OCT images can be used for analysis of the iris structure and geometry. Our results are limited to the properties of the study population having an age range from 18 to 66 years and consisting mainly of men. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  14. Iris colour in relation to myopia among Chinese school-aged children.

    PubMed

    Pan, Chen-Wei; Qiu, Qin-Xiao; Qian, Deng-Juan; Hu, Dan-Ning; Li, Jun; Saw, Seang-Mei; Zhong, Hua

    2018-01-01

    Understanding the association of iris colour and myopia may provide further insights into the role of the wavelength of lights in the pathophysiology of myopia. We aim to assess the association of iris colour and myopia in a school-based sample of Chinese students. Two thousand three hundred and forty-six Year 7 students from 10 middle schools (93.5% response rate) aged 13-14 years in Mojiang, a small county located in Southwestern China, participated in the study. We obtained standardised slit lamp photographs and developed a grading system assessing iris colour (higher grade denoting a darker iris). Refractive error was measured after cycloplegia using an autorefractor by optometrists or trained technicians. An IOLMaster (www.zeiss.com) was used to measure ocular biometric parameters including axial length (AL). Of all the study participants, 693 (29.5%) were affected by myopia with the prevalence estimates being higher in girls (36.8%; 95% confidence interval [CI]: 34.0, 39.6) than in boys (22.8%; 95% CI: 20.4, 25.1) (p < 0.001). After adjusting for gender, height, parental history of myopia, time spent on computer, time spent watching TV, time spent outdoors, and time spent reading and writing, participants with a darker iris colour tended to have a higher prevalence of myopia, a more myopic refraction and a longer AL. Dose-response relationships were observed in all regression models (p for trend <0.05). Darker iris colour was associated with more myopic refractive errors and longer ALs among Chinese school-aged children and this association was independent of other known myopia-related risk factors. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

  15. Temporal integration characteristics of the axial and choroidal responses to myopic defocus induced by prior form deprivation versus positive spectacle lens wear in chickens.

    PubMed

    Nickla, Debora L; Sharda, Vandhana; Troilo, David

    2005-04-01

    In chicks, the temporal response characteristics to form deprivation and to spectacle lens wear (myopic and hyperopic defocus) show essential differences, suggesting that the emmetropization system "weights" the visual signals differently. To further explore how the eye integrates opposing visual signals, we examined the responses to myopic defocus induced by prior form deprivation vs. that induced by positive spectacle lenses, in both cases alternating with form deprivation. Three experimental paradigms were used: 1) Form deprivation was induced by monocular occluders for 7 days. Over the subsequent 7 days, the occluders were removed daily for 12 hours (n = 13), 4 hours (n = 7), 2 hours (n = 7), or 0 hours (n = 6). 2) Birds were form-deprived on day 12. Over the subsequent 7 days, occluders were replaced with a +10 D lens for 2 hours per day (n = 13). 3) Starting at day 11, a +10 D lens was placed over one eye for 2 hours (n = 13), 3 hours (n = 5), or 6 hours (n = 10) per day and were otherwise untreated. Ocular dimensions were measured with high-frequency A-scan ultrasonography; refractive errors were measured by streak retinoscopy at various intervals. In recovering eyes, 2 hours per day of myopic defocus was as effective as 12 hours at inducing refractive and axial recovery (change in refractive error: +10 D vs. +13 D, respectively). By contrast, 2 hours of lens-induced defocus (alternating with form deprivation) was not sufficient to induce refractive or axial compensation (change in refractive error: -1.7 D). When myopic defocus alternated with unrestricted vision, 6 hours per day were sufficient to induce nearly full compensation (2 hours vs. 6 hours: 4.4 D vs. 8.2 D; p < 0.0005). Choroids showed rapid increases in thickness to the daily episodes of myopic defocus; these resulted in "long-term" thickness changes in recovering eyes and eyes wearing lenses for 3 or 6 hours per day. The response to myopic defocus induced by prior form deprivation is more robust than the response induced by positive lenses, suggesting that the underlying mechanisms differ. Presumably, this difference is related to the size of the eye at the onset. Compensatory decreases in growth rate occur without full compensatory choroidal thickening.

  16. Herbal Supplement in a Buffer for Dry Eye Syndrome Treatment.

    PubMed

    Chen, Hung-Chang; Chen, Zhi-Yu; Wang, Tsung-Jen; Drew, Victor J; Tseng, Ching-Li; Fang, Hsu-Wei; Lin, Feng-Huei

    2017-08-03

    Dry eye syndrome (DES) is one of the most common types of ocular diseases. There is a major need to treat DES in a simple yet efficient way. Artificial tears (AT) are the most commonly used agents for treating DES, but are not very effective. Herbal extractions of ferulic acid (FA), an anti-oxidant agent, and kaempferol (KM), an anti-inflammatory reagent, were added to buffer solution (BS) to replace ATs for DES treatment. The cytotoxicity and anti-inflammatory effects were examined in vitro by co-culture with human corneal epithelial cells (HCECs) to obtain the optimal concentration of KM and FA for treating HCECs. Physical properties of BS, such as pH value, osmolality, and refractive index were also examined. Then, rabbits with DES were used for therapeutic evaluation. Tear production, corneal damage, and ocular irritation in rabbits' eyes were examined. The non-toxic concentrations of KM and FA for HCEC cultivation over 3 days were 1 µM and 100 µM, respectively. Live/dead stain results also show non-toxicity of KM and FA for treating HCECs. Lipopolysaccharide-stimulated HCECs in inflammatory conditions treated with 100 µM FA and 1 µM KM (FA100/KM1) showed lower IL-1B , IL-6 , IL-8 , and TNFα expression when examined by real-time PCR. The BS with FA100/KM1 had neutral pH, and a similar osmolality and refractive index to human tears. Topical delivery of BS + FA100/KM1 showed no irritation to rabbit eyes. The corneal thickness in the BS + FA100/KM1 treated group was comparable to normal eyes. Results of DES rabbits treated with BS + FA100/KM1 showed less corneal epithelial damage and higher tear volume than the normal group. In conclusion, we showed that the combination of FA (100 µM) and KM (1 µM) towards treating inflamed HCECs had an anti-inflammatory effect, and it is effective in treating DES rabbits when BS is added in combination with these two herbal supplements and used as a topical eye drop.

  17. Ocular Outcomes Comparison Between 14- and 70-day Head-down Tilt Bed Rest

    NASA Technical Reports Server (NTRS)

    Cromwell, R.L.; Taibbi, G.; Zanello, S.B.; Yarbough, P.O.; Ploutz-Snyder, R.J.; Vizzen, G.

    2015-01-01

    INTRODUCTION: Ophthalmological changes, including optic disc edema with optic nerve sheath distension, posterior globe flattening with hyperopic shift, choroidal folds and cotton wool spots have been detected in some astronauts involved in long-duration spaceflights. (sup 1) It is hypothesized that elevated intracranial pressure resulting from microgravity-induced cephalad fluid shifts may be responsible for most of these findings. Head-down tilt bed rest (HTDBR) is a ground-based microgravity analog which also produces cephalad fluid shifts. It is conceivable that prolonged HDTBR exposure may induce ocular changes similar to those experienced in microgravity. Therefore, the purpose of the present study was to compare structural and functional ocular outcomes between 14- and 70-day HDTBR in healthy human subjects. It is hypothesized that 70-d HDTBR induced ocular changes of greater magnitude as compared to 14-d HDTBR. METHODS: Two HDTBR studies were conducted at the NASA Flight Analogs Research Unit, located at The University of Texas Medical Branch at Galveston, TX. Identical NASA standard screening procedures and BR conditions (e.g., strict sleep-wake cycle, standardized diet, continuous video monitoring) were implemented in both studies. Participants spent 14 and/or 70 consecutive days in a 6deg HDT position and did not engage in exercise. Subjects received weekly ocular examinations before, during, and after HDTBR. Ocular testing included: distance and near best-corrected visual acuity (BCVA), cycloplegic refraction, intraocular pressure (IOP) measurement, color vision, red dot test, modified Amsler grid test, confrontational visual field, color fundus photography and Spectral-domain OCT scans of the macula and the optic disc. Pre/post HDTBR differences between the two studies will be evaluated for BCVA, spherical equivalent, IOP, retinal nerve fiber layer (RNFL) thickness and macular OCT parameters. RESULTS: 16 (12 males and 4 females) and 6 (5 males and 1 female) subjects participated in the 14 and 70-day HDTBR studies, respectively. One subject participated in both studies. The demographic and ophthalmological characteristics of the 14-day HDTBR study have been presented elsewhere.2 In the 70- day study, subjects age averaged 39.5 +/- 7.8 years; pre- and post-HDTBR Goldmann IOP were, on average, 15.4 and 14.6 mmHg in the right eye, and 15.3 and 14.4 mmHg in the left eye, respectively; preand post-HDTBR Spectralis OCT (Heidelberg Engineering, GmbH, Heidelberg, Germany) average RNFL thickness were 103.8 and 106 µm in the right eye, and 103 and 104.3 µm in the left eye, respectively. In both studies, color vision, red dot test, modified Amsler grid test and confrontational visual field were within normal limits at all time points; no changes were detected on stereoscopic color optic disc photography. For the above outcomes, preliminary results of the pre/post HDTBR differences between the two studies will be presented at the 2015 Human Research Program Investigators' Workshop. CONCLUSIONS: Although 14-day HDTBR did not seem to induce clinically relevant ocular changes, (sup 2) a systematic evaluation and comparison with the 70-day HDTBR study results will elucidate whether the magnitude of ocular structural and functional changes is affected by the time spent in the recumbent position. Further research will also address the effects of integrated resistance and aerobic training during HDTBR on the ocular outcomes. REFERENCES: 1. Mader TH et al. Optic disc edema, globe flattening, choroidal folds, and hyperopic shifts observed in astronauts after long-duration space flight. Ophthalmology. 2011;118(10):2058-69. 2. Taibbi G et al. Ocular outcomes evaluation in a 14-day head-down bed rest study. Aviat Space Environ Med. 2014;85(10):983-92.

  18. Accuracy of vision technicians in screening ocular pathology at rural vision centres of southern India.

    PubMed

    Suram, Vasantha; Addepalli, Uday Kumar; Krishnaiah, Sannapaneni; Kovai, Vilas; Khanna, Rohit C

    2016-03-01

    There is paucity of data on the inter-observer agreement and diagnostic accuracy between a primary-care technician (vision technician) and an ophthalmologist. Hence, the current study was conducted to assess the accuracy of vision technicians, to screen potentially sight-threatening ocular conditions at rural vision centres of southern India and their agreement with an ophthalmologist. In July to August 2010, patients presenting to seven vision centres in Adilabad district (Andhra Pradesh) were selected and screened in a masked manner by seven vision technicians followed by an examination by a consultant ophthalmologist. Agreement was assessed between vision technicians and the ophthalmologist for screening of potential sight-threatening ocular conditions and decisions for referral. The ophthalmologist's findings were considered as the reference standard. Two hundred and seventy-nine patients were enrolled at seven vision centres with a mean age of 32.9 ± 21.8 years. Agreement for screening of ocular pathology was 0.82 (95 per cent CI, 0.8-0.83). There was excellent agreement for cataract (0.97; 95 per cent CI, 0.93-1), refractive error (0.98; 95 per cent CI, 0.96-1), corneal pathology (1.0; 95 per cent CI, 1.0-1.0) and other anterior segment pathology (0.95; 95 per cent CI, 0.9-1); the agreement was moderate to fair for detection of glaucoma suspects (0.43; 95 per cent CI, 0.28-0.60) and retinal pathology (0.39; 95 per cent CI, 0.14-0.63). Sensitivity for screening of anterior segment pathology was 94.6-100 per cent. There was a fair to moderate sensitivity for glaucoma suspect; 35.6 per cent (95 per cent CI, 21.9-51.2) and retinal pathology 26.3 per cent (95 per cent CI, 9.2-51.2). Specificity for screening of ocular pathology was 98.2 to 100 per cent. The kappa (κ) agreement for referral for any pathology was 0.82 (0.8-0.83) CONCLUSION: As there is good agreement between the vision technicians and the ophthalmologist for screening and referral of anterior segment pathology but moderate to fair for glaucoma suspects and retinal pathology, vision technicians would be a good resource at the primary level to screen for anterior segment pathology; however, they may need further training to detect posterior segment pathology. © 2016 Optometry Australia.

  19. Density of the crystalline lens in obese and nonobese children.

    PubMed

    Acer, Semra; Ağladıoğlu, Sebahat Yılmaz; Pekel, Gökhan; Özhan, Bayram; Çetin, Ebru Nevin; Yağcı, Ramazan; Yıldırım, Cem

    2016-02-01

    To compare crystalline lens density in obese and nonobese children. A total of 40 obese (25 females) and 46 age-sex matched controls (26 females) were included in this prospective study. Children with ocular diseases (except for mild refractive errors), ocular trauma, or surgery and any systemic disorders, including diabetes, were excluded. Lens densitometry (LD), central corneal thickness (CCT), anterior chamber depth (ACD) and corneal volume (CV) were measured by Pentacam HR. Mean participant age was 12.0 ± 1.9 (range, 7.2-18 years) in the obese group and 11.7 ± 2.0 (range, 7.5-16.1 years) in the control group. The BMI was 29.9 ± 4.5 in the obese group and 18.7 ± 2.5 in the control group (P ≤ 0.05). The vertical, horizontal, and areal lens density measurements were higher in obese group than in controls (P ≤ 0.05). There was a positive correlation between BMI and vertical, horizontal, and areal lens density measurements. The difference in CCT, ACD, and CV was not statistically significant between groups (P ≥ 0.05). There is increased lens density in the obese children compared with controls. Pentacam HR may provide objective data about lens density in children. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  20. The Distinct Biometric Features of High Myopia Compared to Moderate Myopia.

    PubMed

    Chung, Hye Jin; Park, Chan Kee

    2016-12-01

    To evaluate changes in biometric parameters in myopic eyes. 412 eyes of 412 young myopic patients underwent ophthalmic examinations including assessments of refractive error, axial length (AL), anterior chamber depth (ACD), and central corneal thickness (CCT). By using spectral domain optical coherence tomography (SD-OCT), peripapillary retinal nerve fiber layer (pRNFL) thickness was measured. Subjects were divided into two groups: a moderate-myope group (-6 diopters (D) or more) and a high-myope group (less than -6 D). The relationships among ocular biometric parameters including pRNFL thickness, AL, ACD, and CCT were calculated for each group. In the moderate-myopia group, the anterior chamber deepened as AL increased (Pearson's coefficient = 0.346, p < 0.01). However, in the high-myopia group, ACD did not correlate with AL (Pearson's r = 0.065, p = 0.383). Average pRNFL thickness was also more related to SE than AL in highly myopic eyes. In highly myopic eyes, ACD did not increase as AL increased. pRNFL thickness was more related to SE than to AL. That might be due to the uneven elongation of anterior and posterior portions of the eyeball and the discrepancy between distance from the cornea to the fovea and distance from the cornea to the bottom of the eyeball as axial eye elongation. Interpretation of ocular biometric parameter in highly myopic eyes should consider these differences.

  1. The Kenny syndrome, a rare type of growth deficiency with tubular stenosis, transient hypoparathyroidism and anomalies of refraction.

    PubMed

    Majewski, F; Rosendahl, W; Ranke, M; Nolte, K

    1981-03-01

    One family (3 cases) with the Kenny syndrome and a second family (3 cases) with features of Kenny syndrome but lacking medullary stenosis are reported. The main symptoms in both families are proportionate dwarfism, cortical thickening of tubular bones, variable anomalies of the calvaria, anemia, transient hypoparathyroidism and variable ocular anomalies. The latter include microphthalmia, and moderate-to-severe myopia or hyperopia. In the first family there was medullary stenosis of most tubular bones. In the second family two cases exhibited mild-to-moderate cortical thickening of tubular bones, but absent or mild medullary stenosis. Possible variability of the Kenny syndrome is discussed. Endocrine studies failed to demonstrate any permanent disturbance of parathormone or calcitonin metabolism, or GH deficiency. Pathogenesis remains unclear. Autosomal dominant inheritance seems to be likely.

  2. The cellular and molecular mechanisms of vertebrate lens development

    PubMed Central

    Cvekl, Aleš; Ashery-Padan, Ruth

    2014-01-01

    The ocular lens is a model system for understanding important aspects of embryonic development, such as cell specification and the spatiotemporally controlled formation of a three-dimensional structure. The lens, which is characterized by transparency, refraction and elasticity, is composed of a bulk mass of fiber cells attached to a sheet of lens epithelium. Although lens induction has been studied for over 100 years, recent findings have revealed a myriad of extracellular signaling pathways and gene regulatory networks, integrated and executed by the transcription factor Pax6, that are required for lens formation in vertebrates. This Review summarizes recent progress in the field, emphasizing the interplay between the diverse regulatory mechanisms employed to form lens progenitor and precursor cells and highlighting novel opportunities to fill gaps in our understanding of lens tissue morphogenesis. PMID:25406393

  3. Vision screening of abused and neglected children by the UCLA Mobile Eye Clinic.

    PubMed

    Yoo, R; Logani, S; Mahat, M; Wheeler, N C; Lee, D A

    1999-07-01

    The purpose of our study was to present descriptive findings of ocular abnormalities in vision screening examinations of abused and neglected children. We compared the prevalence and the nature of eye diseases and refractive error between abused and neglected boys staying at the Hathaway Home, a residential facility for abused children, and boys from neighboring Boys and Girls clubs. The children in the study received vision screening examinations through the UCLA Mobile Eye Clinic following a standard format. Clinical data were analyzed by chi-square test. The children with a history of abuse demonstrated significantly higher prevalence of myopia, astigmatism, and external eye disorders. Our study suggests that children with a history of abuse may be at higher risk for visual impairment. These visual impairments may be the long-term sequelae of child abuse.

  4. Coagulase-negative staphylococci isolated from ocular wound infections after laser refractive surgery: attachment to and accumulation on soft contact lenses.

    PubMed

    Faghri, Jamshid; Razavi, Mohamad Reza

    2009-03-01

    Disposable soft contact lenses that are commonly used after laser refractive surgery are known to be colonized by bacteria and play a key role in Bacterial Keraitis (BK) pathogenesis. Coagulase-negative staphylococci (CoNS) have been found to be the most common pathogen involved in this postoperative infection. In this study a rapid and a simple assay was developed for studying attachment and accumulation of CoNS on soft contact lenses in vitro using [3H] thymidine. Thirty-five isolates of CoNS were obtained from 27 laser refractive surgery patients. Twenty-five of these thirty-five CoNS were isolated in multiple cultures. Ten CoNS were isolated in cultures from patients who underwent reoperation. The assay was optimized using a biofilm-producing strain, S. epidermidis RP62A, which was subcultured overnight at 37 degrees C on blood agar medium. Quantitative determination of biofilm production was tested. Presence of the genes icaADB and icaD was determined in all isolates. All isolates were biochemically analyzed using the Phene Plate (PhP) system modified for typing of CoNS. The CoNS isolates were further characterized to species level using ID32Staph.Mann-Whitney rank sum test and chi-square test were used to identify statistical differences in adherence, index, antibiotic susceptibility patterns, and biofilm production or presence of the ica operon between clinically significant isolates and non-postoperative BK isolates. No differences in attachment and accumulation were found between isolates causing BK after laser refractive surgery and contaminant isolates. In addition, there were no differences in the distribution of the ica operon between the two groups, as determined by polymerase chain reaction. Nevertheless, the ability to produce biofilm was found to be present significantly more frequently among BK isolates than among non-postoperative BK isolates. This study shows that the method using radioactive thymidine to analyze adherence of CoNS to soft contact lenses enables detection of differences in the adherence patterns of individual isolates.

  5. Peripheral refraction and higher-order aberrations with cycloplegia and fogging lenses using the BHVI-EyeMapper

    PubMed Central

    Bakaraju, Ravi Chandra; Fedtke, Cathleen; Ehrmann, Klaus; Falk, Darrin; Thomas, Varghese; Holden, Brien Anthony

    2015-01-01

    Purpose To determine if a fogging lens ameliorates accommodative effects driven by the closed-view design of the BHVI-EyeMapper (EM) instrument. We compared cycloplegic refraction and higher-order aberration measurements of the EM with those obtained with a fogging lens. Methods Twenty-six, young, participants (15F, 25 ± 5 years, range: 18–35 years, SE: +0.25 D and −3.50 D) with good ocular health were recruited. Five independent measurements of on- and off-axis refraction and higher-order aberrations were recorded across the horizontal visual field, under two conditions: non-cycloplegic measurements with +1.00 D fogging lens and cycloplegia, always in the same sequence. The contralateral eye was occluded during the measurements. Two drops of 1% Tropicamide delivered within 5 min facilitated cycloplegic measurements. All participants were refracted 30 min after installation of the second drop. Results Mean spherical equivalent measures of the non-cycloplegic condition were significantly more myopic than their cycloplegic counterparts (p < 0.05); approximately by 0.50 D centrally, increasing to 1.00 D towards the periphery. The horizontal astigmatic component, J180, demonstrated small but statistically significant differences between the test conditions. Differences were predominant for eccentricities greater than 30°, in both nasal and temporal meridians. The oblique astigmatic component, J45, was not significantly different between the test conditions. The primary spherical aberration coefficient C(4, 0) was significantly less positive for the non-cycloplegic state than its cycloplegic counterpart. This result held true across the entire horizontal visual field. The horizontal coma and trefoil coefficients C(3, 1) and C(3, 3) were not significantly different between the two conditions. Conclusions The use of +1.00 D fogging lens without cycloplegia did not provide complete relaxation of accommodation. The discrepancies between cycloplegic and non-cycloplegic EM measurements were found to be more pronounced for peripheral field angles than central measures, for both M and J180 components. PMID:26190684

  6. Peripheral refraction and higher-order aberrations with cycloplegia and fogging lenses using the BHVI-EyeMapper.

    PubMed

    Bakaraju, Ravi Chandra; Fedtke, Cathleen; Ehrmann, Klaus; Falk, Darrin; Thomas, Varghese; Holden, Brien Anthony

    2016-01-01

    To determine if a fogging lens ameliorates accommodative effects driven by the closed-view design of the BHVI-EyeMapper (EM) instrument. We compared cycloplegic refraction and higher-order aberration measurements of the EM with those obtained with a fogging lens. Twenty-six, young, participants (15F, 25±5 years, range: 18-35 years, SE: +0.25 D and -3.50 D) with good ocular health were recruited. Five independent measurements of on- and off-axis refraction and higher-order aberrations were recorded across the horizontal visual field, under two conditions: non-cycloplegic measurements with +1.00 D fogging lens and cycloplegia, always in the same sequence. The contralateral eye was occluded during the measurements. Two drops of 1% Tropicamide delivered within 5 min facilitated cycloplegic measurements. All participants were refracted 30 min after installation of the second drop. Mean spherical equivalent measures of the non-cycloplegic condition were significantly more myopic than their cycloplegic counterparts (p<0.05); approximately by 0.50 D centrally, increasing to 1.00 D towards the periphery. The horizontal astigmatic component, J180, demonstrated small but statistically significant differences between the test conditions. Differences were predominant for eccentricities greater than 30°, in both nasal and temporal meridians. The oblique astigmatic component, J45, was not significantly different between the test conditions. The primary spherical aberration coefficient C(4, 0) was significantly less positive for the non-cycloplegic state than its cycloplegic counterpart. This result held true across the entire horizontal visual field. The horizontal coma and trefoil coefficients C(3, 1) and C(3, 3) were not significantly different between the two conditions. The use of +1.00 D fogging lens without cycloplegia did not provide complete relaxation of accommodation. The discrepancies between cycloplegic and non-cycloplegic EM measurements were found to be more pronounced for peripheral field angles than central measures, for both M and J180 components. Copyright © 2015 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  7. Two-year changes in refractive error and related biometric factors in an adult Chinese population.

    PubMed

    He, Mingguang; Kong, Xiangbin; Chen, Qianyun; Zeng, Yangfa; Huang, Yuanzhou; Zhang, Jian; Morgan, Ian G; Meltzer, Mirjam E; Jin, Ling; Congdon, Nathan

    2014-08-01

    This article provides, to our knowledge, the first longitudinal population-based data on refractive error (RE) in Chinese persons. To study cohort effects and changes associated with aging in REs among Chinese adults. A 2-year, longitudinal population-based cohort study was conducted in southern China. Participants, identified using cluster random sampling, included residents of Yuexiu District, Guangzhou, China, aged 35 years or older who had undergone no previous eye surgery. Participants underwent noncycloplegic automated refraction and keratometry in December 2008 and December 2010; in a random 50% sample of the participants, anterior segment ocular coherence tomography measurement of lens thickness, as well as measurement of axial length and anterior chamber depth by partial coherence laser interferometry, were performed. Two-year change in spherical equivalent refraction (RE), lens thickness, axial length, and anterior chamber depth in the right eye. A total of 745 individuals underwent biometric testing in both 2008 and 2010 (2008 mean [SD] age, 52.2 [11.5] years; 53.7% women). Mean RE showed a 2-year hyperopic shift from -0.44 (2.21) to -0.31 (2.26) diopters (D) (difference, +0.13; 95% CI, 0.11 to 0.16). A consistent 2-year hyperopic shift of 0.09 to 0.22 D was observed among participants aged 35 to 64 years when stratifying by decade, suggesting that a substantial change in RE with aging may occur during this 30-year period. Cross-sectionally, RE increased only in the cohort younger than 50 years (0.11 D/y; 95% CI, 0.06 to 0.16). In the cross-sectional data, axial length decreased at -0.06 mm/y (95% CI, -0.09 to -0.04), although the 2-year change in axial length was positive and thus could not explain the cross-sectional difference. These latter results suggest a cohort effect, with greater myopia developing among younger persons. This first Chinese population-based longitudinal study of RE provides evidence for both important longitudinal aging changes and cohort effects, most notably greater myopia prevalence among younger persons.

  8. The prevalence and causes of visual impairment in seven-year-old children.

    PubMed

    Ghaderi, Soraya; Hashemi, Hassan; Jafarzadehpur, Ebrahim; Yekta, Abbasali; Ostadimoghaddam, Hadi; Mirzajani, Ali; Khabazkhoob, Mehdi

    2018-05-01

    To report the prevalence and causes of visual impairment in seven-year-old children in Iran and its relationship with socio-economic conditions. In a cross-sectional population-based study, first-grade students in the primary schools of eight cities in the country were randomly selected from different geographic locations using multistage cluster sampling. The examinations included visual acuity measurement, ocular motility evaluation, and cycloplegic and non-cycloplegic refraction. Using the definitions of the World Health Organization (presenting visual acuity less than or equal to 6/18 in the better eye) to estimate the prevalence of vision impairment, the present study reported presenting visual impairment in seven-year-old children. Of 4,614 selected students, 4,106 students participated in the study (response rate 89 per cent), of whom 2,127 (51.8 per cent) were male. The prevalence of visual impairment according to a visual acuity of 6/18 was 0.341 per cent (95 per cent confidence interval 0.187-0.571); 1.34 per cent (95 per cent confidence interval 1.011-1.74) of children had visual impairment according to a visual acuity of 6/18 in at least one eye. Sixty-six (1.6 per cent) and 23 (0.24 per cent) children had visual impairment according to a visual acuity of 6/12 in the worse and better eye, respectively. The most common causes of visual impairment were refractive errors (81.8 per cent) and amblyopia (14.5 per cent). Among different types of refractive errors, astigmatism was the main refractive error leading to visual impairment. According to the concentration index, the distribution of visual impairment in children from low-income families was higher. This study revealed a high prevalence of visual impairment in a representative sample of seven-year-old Iranian children. Astigmatism and amblyopia were the most common causes of visual impairment. The distribution of visual impairment was higher in children from low-income families. Cost-effective strategies are needed to address these easily treatable causes of visual impairment. © 2017 Optometry Australia.

  9. Six-year changes in refraction and related ocular biometric factors in an adult Chinese population.

    PubMed

    Han, Xiaotong; Guo, Xinxing; Lee, Pei Ying; Morgan, Ian G; He, Mingguang

    2017-01-01

    To investigate longitudinal changes in refraction and biometry in Chinese adults. Population-based prospective cohort study. 1817 subjects aged ≥ 35 years were randomly recruited from Yuexiu district, Guangzhou, China in 2008. Of which 1595 (87.8%) were reexamined in 2010 and 1427 (78.5%) were reexamined in 2014. Non-cycloplegic automated refraction and visual acuity test were performed at baseline and the 6-year follow-up examination for all participants. In addition, 50% of the participants were randomly selected for axial length (AL), anterior chamber depth (ACD) and lens thickness (LT) measurements using non-contact partial coherence laser interferometry. Lens power (LP) was calculated with the Bennett's equation. A total of 1300 participants were included in current analysis (2008 mean [SD] age, 51.4 [10.6] years; 54.5% women). Mean change in spherical equivalence (SE) was +0.24 (95% confidence interval [CI], +0.19 to +0.30), +0.51 (95% CI, +0.46 to +0.57), +0.26 (95% CI, +0.15 to +0.38) and -0.05 (95% CI, -0.21 to +0.10) diopters (D) for individuals in the age groups of 35 to 44, 45 to 54, 55 to 64 and 65+ years at baseline, respectively. Corneal power, AL and LT increased while ACD and LP decreased during the follow-up. Baseline SE and changes in biometric factors could explain 97.2% of the variance in longitudinal SE change while LP solely could explain 65.2%. Six-year mean change in cylinder power was -0.16 (95% CI, -0.19 to -0.13) D, the axis of astigmatism changed from "with-the-rule" to "against-the-rule" in 16.4% of the participants and to "oblique" in 0.9%. This study confirms a hyperopic shift in the elderly before 65 years old and a myopic shift thereafter. Longitudinal refraction change could be well explained by corresponding biometry changes, especially LP. There is also a shift to "against-the-rule" astigmatism for the adult population.

  10. Exceptionally low prevalence of refractive error and visual impairment in schoolchildren from Lao People's Democratic Republic.

    PubMed

    Casson, Robert J; Kahawita, Shyalle; Kong, Aimee; Muecke, James; Sisaleumsak, Siphetthavong; Visonnavong, Vithoune

    2012-10-01

    Vientiane Province is an urbanizing region in Southeast Asia. We aimed to determine the prevalence of refractive error and visual impairment in primary school-aged children in this region. Prospective, cross-sectional survey. A total of 2899 schoolchildren from Vientiane Province, Lao People's Democratic Republic (Lao PDR). Ten districts from Vientiane were randomly selected and 2 primary schools were randomly selected from each district. All children aged 6 to 11 years at selected schools were eligible to participate. The examination included visual acuity (VA) testing, cycloplegic retinoscopy with subjective refinement if indicated, ocular motility testing, and anterior segment and fundus examinations in visually impaired children. Cycloplegic refraction and VA. There was an estimated total of 3330 children who were eligible to participate, and data were recorded from 2899 (87%) of these children. Complete refractive data were available on 2842 children (85% of eligible population). The mean spherical equivalent (SE) in the right eyes was +0.60 diopter (D) (95% confidence interval [CI], 0.49-0.72), and the mean SE in the left eyes was +0.59 (95% CI, 0.50-0.68). The prevalence of hyperopia was 2.8% (95% CI, 1.9-3.7; 88 subjects), and the prevalence of myopia was 0.8% (95% CI, 0.3-1.4; 24 subjects). The majority of children (98%; 95% CI, 97.0-99.0) had normal unaided binocular VA (at least 20/32 in their better eye). The overall prevalence of any visual impairment (presenting VA <20/32 in the better eye) was 1.9% (95% CI, 1.0-2.9; 55 subjects). In multivariate logistic regression analysis, age (P = 0.001) was a significant predictor, and female gender (P = 0.08) and Yao ethnicity (P = 0.09) were borderline significant predictors of the presence of any visual impairment. Visual impairment is not a public health concern in this primary school-aged population; however, visually impaired children in the community were not studied. From this baseline, future surveys could determine the effect of increasing urbanization on myopia prevalence in this population. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  11. Six-year changes in refraction and related ocular biometric factors in an adult Chinese population

    PubMed Central

    Han, Xiaotong; Guo, Xinxing; Lee, Pei Ying; Morgan, Ian G.; He, Mingguang

    2017-01-01

    Purpose To investigate longitudinal changes in refraction and biometry in Chinese adults. Design Population-based prospective cohort study. Methods 1817 subjects aged ≥ 35 years were randomly recruited from Yuexiu district, Guangzhou, China in 2008. Of which 1595 (87.8%) were reexamined in 2010 and 1427 (78.5%) were reexamined in 2014. Non-cycloplegic automated refraction and visual acuity test were performed at baseline and the 6-year follow-up examination for all participants. In addition, 50% of the participants were randomly selected for axial length (AL), anterior chamber depth (ACD) and lens thickness (LT) measurements using non-contact partial coherence laser interferometry. Lens power (LP) was calculated with the Bennett’s equation. Results A total of 1300 participants were included in current analysis (2008 mean [SD] age, 51.4 [10.6] years; 54.5% women). Mean change in spherical equivalence (SE) was +0.24 (95% confidence interval [CI], +0.19 to +0.30), +0.51 (95% CI, +0.46 to +0.57), +0.26 (95% CI, +0.15 to +0.38) and -0.05 (95% CI, -0.21 to +0.10) diopters (D) for individuals in the age groups of 35 to 44, 45 to 54, 55 to 64 and 65+ years at baseline, respectively. Corneal power, AL and LT increased while ACD and LP decreased during the follow-up. Baseline SE and changes in biometric factors could explain 97.2% of the variance in longitudinal SE change while LP solely could explain 65.2%. Six-year mean change in cylinder power was -0.16 (95% CI, -0.19 to -0.13) D, the axis of astigmatism changed from “with-the-rule” to “against-the-rule” in 16.4% of the participants and to “oblique” in 0.9%. Conclusions This study confirms a hyperopic shift in the elderly before 65 years old and a myopic shift thereafter. Longitudinal refraction change could be well explained by corresponding biometry changes, especially LP. There is also a shift to “against-the-rule” astigmatism for the adult population. PMID:28854269

  12. The pattern of childhood blindness in Karnataka, South India.

    PubMed

    Gogate, Parikshit; Kishore, H; Dole, Kuldeep; Shetty, Jyoti; Gilbert, Clare; Ranade, Satish; Kumar, Mohan; Srihari; Deshpande, Madan

    2009-01-01

    To determine the causes of severe visual impairment and blindness in children in schools for the blind in southern Karnataka state of India. Children aged less than 16 years with a visual acuity of < 6/60 in the better eye, attending the residential schools for the blind were examined in 2005-2006, in the Karnataka state in the south of India. History taking, visual acuity estimation, external ocular examination, retinoscopy, and fundoscopy were done on all students. Refraction and low vision work-up done where indicated. The anatomical and etiological causes of severe visual impairment (< 6/60-3/60) and blindness (< 3/60 in the better eye) were classified using the World Health Organization's prevention of blindness programs' record system. A total of 1,179 students were examined, 891 of whom fulfilled the eligibility criteria. The major anatomical sites of visual loss were congenital anomalies (microphthalmos, anophthalmos) (321, 35.7%), corneal conditions (mainly scarring due to vitamin A deficiency, measles, trauma) (133, 14.9%), cataract or aphakia in 102 (11.4%), and retinal disorders (mainly dystrophies) in 177 children (19.9%). Nearly one-fourth of children were blind from conditions which could have been prevented or treated (27.8%), 87 of whom were referred for surgery. Low vision devices improved near acuity in 27 children (3%), and 43 (4.8%) benefited from refraction. Congenital anomalies, cataract, and retinal conditions account for most of the blindness in children.

  13. Role of intraocular lens parameters in visual rehabilitation of patients after extracapsular cataract extraction

    NASA Astrophysics Data System (ADS)

    Bakutkin, Valery V.; Galanzha, Vladimir A.

    2001-01-01

    The main method of cataract treatment is micro surgical removing of the opaque lens from the eye with implantation of an intra ocular lens. We performed the comparative study of using various IOL models differing in its materials, index of refraction, spectral properties, configuration, shape, size and other features. Before and after the IOL implantation we performed the following test: visual acuity measuring, refractometry, keratometry, laser interferometric retinometry, color perception assessment, digital photo- and videorecording of the eye with image processing and some others. We found a number of correlations between the IOL properties and some characteristics of the patient's vision. The decentration of the IOL optical part more than 1,5 mm conduced to the non-corneal astigmatism and the prismatic effect. A small diameter of the IOL optical part and high index of refraction promotes to the appearance of the optical aberrations. Leucosapphire IOLs revealed the high degree of light reflection and the minimal adhesive ability of the IOL surface. Leucosapphire IOL revealed the high degree of light reflection and the minimal adhesive ability of the IOL surface. PMMA IOL revealed the low reflective power and the high adhesive ability. The best color vision was revealed in patients with PMMA IOL with an additional compound absorbing not only UV light but also short-wave blue light.

  14. An injectable oxidated hyaluronic acid/adipic acid dihydrazide hydrogel as a vitreous substitute.

    PubMed

    Su, Wen-Yu; Chen, Ko-Hua; Chen, Yu-Chun; Lee, Yen-Hsien; Tseng, Ching-Li; Lin, Feng-Huei

    2011-01-01

    Vitrectomy is a common procedure for treating ocular-related diseases. The surgery involves removing the vitreous humor from the center of the eye, and vitreous substitutes are needed to replace the vitreous humor after vitrectomy. In the present study, we developed a colorless, transparent and injectable hydrogel with appropriate refractive index as a vitreous substitute. The hydrogel is formed by oxidated hyaluronic acid (oxi-HA) cross-linked with adipic acid dihydrazide (ADH). Hyaluronic acid (HA) was oxidized by sodium periodate to create aldehyde functional groups, which could be cross-linked by ADH. The refractive index of this hydrogel ranged between 1.3420 and 1.3442, which is quite similar to human vitreous humor (1.3345). The degradation tests demonstrated that the hydrogel could maintain the gel matrix over 35 days, depending on the ADH concentration. In addition, the cytotoxicity was evaluated on retina pigmented epithelium (RPE) cells cultivated following the ISO standard (tests for in vitro cytotoxicity), and the hydrogel was found to be non-toxic. In a preliminary animal study, the oxi-HA/ADH hydrogel was injected into the vitreous cavity of rabbit eyes. The evaluations of slit-lamp observation, intraocular pressure, cornea thickness and histological examination showed no significant abnormal biological reactions for 3 weeks. This study suggests that the injectable oxi-HA/ADH hydrogel should be a potential vitreous substitute. Koninklijke Brill NV, Leiden, 2011

  15. Epithelial ingrowth following laser in situ keratomileusis (LASIK): prevalence, risk factors, management and visual outcomes

    PubMed Central

    Srinivasan, Sathish; Danjoux, Jean-Pierre

    2018-01-01

    The number of laser in situ keratomileusis (LASIK) procedures is continuing to rise. Since its first application for correcting simple refractive errors over 25 years ago, the role of LASIK has extended to treat other conditions, including postkeratoplasty astigmatism/ametropia, postcataract surgery refractive error and presbyopia, among others. The long-term effectiveness, predictability and safety have been well established by many large studies. However, due to the creation of a potential interface between the flap and the underlying stroma, interface complications such as infectious keratitis, diffuse lamellar keratitis and epithelial ingrowth may occur. Post-LASIK epithelial ingrowth (PLEI) is an uncommon complication that usually arises during the early postoperative period. The reported incidence of PLEI ranged from 0%–3.9% in primary treatment to 10%–20% in retreatment cases. It can cause a wide spectrum of clinical presentations, ranging from asymptomatic interface changes to severe visual impairment and flap melt requiring keratoplasty. PLEI can usually be treated with mechanical debridement of the affected interface; however, additional interventions, such as alcohol, mitomycin C, fibrin glue, ocular hydrogel sealant, neodymium:yttriumaluminum garnet laser and amniotic membrane graft, may be required for recurrent or refractory cases. The aims of this review are to determine the prevalence and risk factors of PLEI; to describe its pathogenesis and clinical features and to summarise the therapeutic armamentarium and the visual outcome of PLEI. PMID:29657982

  16. Epithelial ingrowth following laser in situ keratomileusis (LASIK): prevalence, risk factors, management and visual outcomes.

    PubMed

    Ting, Darren Shu Jeng; Srinivasan, Sathish; Danjoux, Jean-Pierre

    2018-01-01

    The number of laser in situ keratomileusis (LASIK) procedures is continuing to rise. Since its first application for correcting simple refractive errors over 25 years ago, the role of LASIK has extended to treat other conditions, including postkeratoplasty astigmatism/ametropia, postcataract surgery refractive error and presbyopia, among others. The long-term effectiveness, predictability and safety have been well established by many large studies. However, due to the creation of a potential interface between the flap and the underlying stroma, interface complications such as infectious keratitis, diffuse lamellar keratitis and epithelial ingrowth may occur. Post-LASIK epithelial ingrowth (PLEI) is an uncommon complication that usually arises during the early postoperative period. The reported incidence of PLEI ranged from 0%-3.9% in primary treatment to 10%-20% in retreatment cases. It can cause a wide spectrum of clinical presentations, ranging from asymptomatic interface changes to severe visual impairment and flap melt requiring keratoplasty. PLEI can usually be treated with mechanical debridement of the affected interface; however, additional interventions, such as alcohol, mitomycin C, fibrin glue, ocular hydrogel sealant, neodymium:yttriumaluminum garnet laser and amniotic membrane graft, may be required for recurrent or refractory cases. The aims of this review are to determine the prevalence and risk factors of PLEI; to describe its pathogenesis and clinical features and to summarise the therapeutic armamentarium and the visual outcome of PLEI.

  17. The burden of pure anisometropic amblyopia: a cross-sectional study on 2800 Iranians.

    PubMed

    Akbarzadeh, Siamak; Vahabi, Reihaneh; Bazzazi, Nooshin; Roshanaei, Ghodratollah; Heydarian, Samira; Fouladi, Daniel F

    2018-02-01

    To assess the proportion of pure anisometropic amblyopia in a sample Iranian (white) population. A total of 2800 consecutive individuals who presented at a referral eye clinic for any reason were examined for the presence of pure anisometropic amblyopia. Anisometropia was reported when a spherical equivalent refraction difference of at least 1.0 D with or without a cylinder refraction difference of at least 1.0 D was present between the two eyes. Amblyopia was defined as the best-corrected visual acuity of 20/30 or worse or a two-line interocular visual acuity difference between eyes that could not be attributed to any structural ocular pathology or visual pathway abnormality. Subjects were 1528 females and 1272 males with a mean age of 30.25 ± 14.93 years (range, 5-65). Amblyopia was diagnosed in 192 cases (6.9%), significantly more frequent among females (7.9 vs. 5.7%, p = 0.02). Pure anisometropic amblyopia was present in 6.1% of the study population, significantly more common in patients with spherical hyperopic anisometropia (37.7%) compared to patients with spherical myopic anisometropia (21.3%), cylindrical myopic anisometropia (4.1%), and cylindrical hyperopic anisometropia (15%) (p < 0.001). Pure anisometropic amblyopia is a common finding in Caucasians seeking eye care, particularly when anisometropia is of spherical hyperopic subtype.

  18. CHOROIDAL THICKNESS IN HEALTHY CHINESE CHILDREN AGED 6 to 12: The Shanghai Children Eye Study.

    PubMed

    He, Xiangui; Jin, Peiyao; Zou, Haidong; Li, Qiangqiang; Jin, Jiali; Lu, Lina; Zhao, Huijuan; He, Jiangnan; Xu, Xun; Wang, Mingjin; Zhu, Jianfeng

    2017-02-01

    To explore the characteristics of choroidal thickness (ChT) in Chinese children. A total of 144 healthy children, aged 6 years to 12 years old, were enrolled in the study. The ChT of subfovea and peripheral locations 0.5, 1.5, and 2.5 mm away from the fovea were evaluated by enhanced depth imaging optical coherence tomography. The association between subfoveal ChT and systemic, as well as ocular factors, including age, sex, height, weight, body mass index, axial length, refractive error, intraocular pressure, preterm history, and the refractive status of parents were studied. The mean subfoveal ChT was 302 ± 63 μm. In the nasal, superior, and inferior areas, the ChT of locations closer to the fovea was thicker than those farther away from the fovea (all P < 0.05); however, ChT was not significantly different among different locations in the temporal area (P = 0.16). The ChT of the nasal quadrant was significantly thinner than that of other areas (P < 0.01). Subfoveal ChT decreased with age, axial length, preterm history, and increased with height. Sex was not statistically associated with subfoveal ChT. In Chinese children, the ChT is thinnest in the nasal quadrant and thicker in central regions than in peripheral areas. The subfoveal ChT independently decreases with age, axial length, preterm history, and increases with height.

  19. THE UTILIZATION OF EYE CARE SERVICES BY PERSONS WITH GLAUCOMA IN RURAL SOUTH INDIA

    PubMed Central

    Robin, Alan L; Nirmalan, Praveen K; Krishnadas, Ramasamy; Ramakrishnan, Rengappa; Katz, Joanne; Tielsch, James; Thulasiraj, Ravilla D; Friedman, David S

    2004-01-01

    ABSTRACT Purpose To determine utilization of eye care services, in particular those relating to glaucoma, in a rural population of southern India aged 40 years or older. Methods A total of 5,150 subjects aged 40 years or older selected through a random cluster sampling technique from three districts in southern India underwent detailed ocular examinations for vision impairment, blindness, and ocular morbidity. Information regarding previous use of eye care services was collected from this population through a questionnaire administered by trained social workers prior to ocular examinations. Results One thousand eight hundred and twenty-seven persons (35.5%) gave a history of prior eye examinations, primarily from a general hospital (n = 1,073, 58.7%). Increasing age and education were associated with increased utilization of eye care services. Among the 3,323 persons who had never sought eye care, 912 (27.4%) had felt the need to have an eye examination but did not do so. Only one third of persons with vision impairment, cataracts, refractive errors, and glaucoma had previously utilized services. Of the 64 subjects diagnosed as having primary open-angle glaucoma, 32 (50%) had previously seen an ophthalmologist, but none had had an eye examination within 1 year before the study. Only six (19%) of the 32 had been diagnosed as having glaucoma (9% of all subjects found to have glaucoma in the survey). Thirteen (20.3%) of the 64 subjects were blind in either eye due to glaucoma, including one person who was bilaterally blind. Conclusions A large proportion of persons in a rural population of southern India who require eye care are currently not utilizing existing eye care services. Strategies to improve the uptake of services are required to reduce the burden of blindness due to glaucoma in southern India. PMID:15747744

  20. Ophthalmic Evaluation in Beta-Thalassemia.

    PubMed

    Merchant, Rashid H; Punde, Hrishikesh; Thacker, Neepa; Bhatt, Deepak

    2017-07-01

    To determine the association of ocular manifestations in beta-thalassemia with the patient's age, blood transfusion requirements, average serum ferritin and dose and duration of iron chelation therapy. Sixty multi-transfused beta thalassemia patients of 12 to 18 y of age on chelation therapy were included in this cross-sectional analysis. Structural and functional evaluation of the retina was done using Optical coherence tomography (OCT) and Electroretinography (ERG), including flash ERG and Pattern ERG (PERG). Routine ophthalmic examination and B scan of the eye was also done. Flash ERG a-waves and b-waves were recorded, however only a-wave amplitude was evaluated. Pattern ERG n35, n95 and p50 waves were recorded and p50 wave amplitude was evaluated. The a-wave on flash and p50 on pattern waves represent retinal photoreceptor epithelium (RPE) photoreceptor response, which is mainly affected in beta-thalassemia. Ocular changes were detected in 38.3% and a significant correlation was noted with increase in age (p = 0.045) but not with serum ferritin, transfusion requirements or chelation therapy. Refractive errors were found in 14 cases (23%), such as myopia with astigmatism in 13 (21.7%) and only myopia in 6 subjects (10%). OCT abnormality was noted in 1 patient (1.7%) who had thinning of central retina; right eye 132 μm and left eye 146 μm (n > 200 μm). Abnormalities were noted in a-wave amplitude on flash ERG in 20% of cases, while reduced p50 amplitude on PERG was noted in 15%. A significant correlation was noted between ocular findings and increase in age, but not with serum ferritin, transfusion requirements or chelation therapy. ERG appears to be a promising tool for screening patients with beta-thalassemia and can serve as a follow-up test for evaluating retinal function.

  1. Clinical Applications of Wavefront Refraction

    PubMed Central

    Bruce, Adrian S.; Catania, Louis J.

    2014-01-01

    ABSTRACT Purpose To determine normative reference ranges for higher-order wavefront error (HO-WFE), compare these values with those in common ocular pathologies, and evaluate treatments. Methods A review of 17 major studies on HO-WFE was made, involving data for a total of 31,605 subjects. The upper limit of the 95% confidence interval (CI) for HO-WFE was calculated from the most comprehensive of these studies using normal healthy patients aged 20 to 80 years. There were no studies identified using the natural pupil size for subjects, and for this reason, the HO-WFE was tabulated for pupil diameters of 3 to 7 mm. Effects of keratoconus, pterygium, cataract, and dry eye on HO-WFE were reviewed and treatment efficacy was considered. Results The calculated upper limit of the 95% CI for HO-WFE in a healthy normal 35-year-old patient with a mesopic pupil diameter of 6 mm would be 0.471 μm (471 nm) root-mean-square or less. Although the normal HO-WFE increases with age for a given pupil size, it is not yet completely clear how the concurrent influence of age-related pupillary miosis affects these findings. Abnormal ocular conditions such as keratoconus can induce a large HO-WFE, often in excess of 3.0 μm, particularly attributed to coma. For pterygium or cortical cataract, a combination of coma and trefoil was more commonly induced. Nuclear cataract can induce a negative spherical HO-WFE, usually in excess of 1.0 μm. Conclusions The upper limit of the 95% CI for HO-WFE root-mean-square is about 0.5 μm with normal physiological pupil sizes. With ocular pathologies, HO-WFE can be in excess of 1.0 μm, although many devices and therapeutic and surgical treatments are reported to be highly effective at minimizing HO-WFE. More accurate normative reference ranges for HO-WFE will require future studies using the subjects’ natural pupil size. PMID:25216319

  2. A study of factors affecting the human cone photoreceptor density measured by adaptive optics scanning laser ophthalmoscope.

    PubMed

    Park, Sung Pyo; Chung, Jae Keun; Greenstein, Vivienne; Tsang, Stephen H; Chang, Stanley

    2013-03-01

    To investigate the variation in human cone photoreceptor packing density with various demographic or clinical factors, cone packing density was measured using a Canon prototype adaptive optics scanning laser ophthalmoscope and compared as a function of retinal eccentricity, refractive error, axial length, age, gender, race/ethnicity and ocular dominance. We enrolled 192 eyes of 192 subjects with no ocular pathology. Cone packing density was measured at three different retinal eccentricities (0.5 mm, 1.0 mm, and 1.5 mm from the foveal center) along four meridians. Cone density decreased from 32,200 to 11,600 cells/mm(2) with retinal eccentricity (0.5 mm to 1.5 mm from the fovea, P < 0.001). A trend towards a slightly negative correlation was observed between age and density (r = -0.117, P = 0.14). There was, however, a statistically significant negative correlation (r = -0.367, P = 0.003) between axial length and cone density. Gender, ocular dominance, and race/ethnicity were not important determinants of cone density (all, P > 0.05). In addition, to assess the spatial arrangement of the cone mosaics, the nearest-neighbor distances (NNDs) and the Voronoi domains were analyzed. The results of NND and Voronoi analysis were significantly correlated with the variation of the cone density. Average NND and Voronoi area were gradually increased (all, P ≤ 0.001) and the degree of regularity of the cone mosaics was decreased (P ≤ 0.001) with increasing retinal eccentricity. In conclusion, we demonstrated cone packing density decreases as a function of retinal eccentricity and axial length and the results of NND and Voronoi analysis is a useful index for cone mosaics arrangements. The results also serve as a reference for further studies designed to detect or monitor cone photoreceptors in patients with retinal diseases. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. A study of factors affecting the human cone photoreceptor density measured by adaptive optics scanning laser ophthalmoscope

    PubMed Central

    Park, Sung Pyo; Chung, Jae Keun; Greenstein, Vivienne; Tsang, Stephen H.; Chang, Stanley

    2015-01-01

    To investigate the variation in human cone photoreceptor packing density with various demographic or clinical factors, cone packing density was measured using a Canon prototype adaptive optics scanning laser ophthalmoscope and compared as a function of retinal eccentricity, refractive error, axial length, age, gender, race/ethnicity and ocular dominance. We enrolled 192 eyes of 192 subjects with no ocular pathology. Cone packing density was measured at three different retinal eccentricities (0.5 mm, 1.0 mm, and 1.5 mm from the foveal center) along four meridians. Cone density decreased from 32,200 to 11,600 cells/mm2 with retinal eccentricity (0.5 mm to 1.5 mm from the fovea, P < 0.001). A trend towards a slightly negative correlation was observed between age and density (r = −0.117, P = 0.14). There was, however, a statistically significant negative correlation (r = −0.367, P = 0.003) between axial length and cone density. Gender, ocular dominance, and race/ethnicity were not important determinants of cone density (all, P > 0.05). In addition, to assess the spatial arrangement of the cone mosaics, the nearest-neighbor distances (NNDs) and the Voronoi domains were analyzed. The results of NND and Voronoi analysis were significantly correlated with the variation of the cone density. Average NND and Voronoi area were gradually increased (all, P ≤ 0.001) and the degree of regularity of the cone mosaics was decreased (P ≤ 0.001) with increasing retinal eccentricity. In conclusion, we demonstrated cone packing density decreases as a function of retinal eccentricity and axial length and the results of NND and Voronoi analysis is a useful index for cone mosaics arrangements. The results also serve as a reference for further studies designed to detect or monitor cone photoreceptors in patients with retinal diseases. PMID:23276813

  4. Femtosecond-Assisted LASIK Versus PRK: Comparison of 6-Month Visual Acuity and Quality Outcome for High Myopia.

    PubMed

    Hashemi, Hassan; Miraftab, Mohammad; Ghaffari, Reza; Asgari, Soheila

    2016-11-01

    To compare the results of femtosecond-assisted laser in situ keratomileusis (femto-LASIK) and photorefractive keratectomy with mitomycin C (PRK-MMC) for the correction of myopia more than 7.0 diopters (D). In this comparative nonrandomized trial, 60 eyes (30 eyes in each group) were enrolled. Patients were tested for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, ocular and corneal aberrations, and contrast sensitivity (CS) before surgery and at 3 and 6 months postoperatively. Mean preoperative myopia was -8.65±1.51 and -8.04±1.70 D in the femto-LASIK and PRK-MMC groups, respectively (P=0.149). Intergroup differences in baseline indices were not statistically significant. At 6 months after surgery, UDVA showed an improving trend, but it was better in the femto-LASIK group (P=0.026). CDVA in the two groups remained similarly unchanged (P=0.170). For the femto-LASIK and PRK-MMC groups, the safety indices were 1.01±0.05 and 1.01±0.14 (P=0.949), respectively, and the efficacy indices were 0.99±0.07 and 0.93±0.22 (P=0.192), respectively. Comparing CS, only CS18 showed a significantly greater decrease in the femto-LASIK group compared with the PRK-MMC group (P=0.016). Intergroup differences were not statistically significant in other spatial frequencies. Changes in the ocular and corneal higher order aberrations were not statistically different between the two groups except ocular coma, which increased in the femto-LASIK group (P=0.041). Femto-LASIK improves UDVA better than PRK-MMC in high myopia. However, because of increased coma, the quality of vision is reduced. In other words, visual acuity outcome is better with femto-LASIK and visual quality outcome is better with PRK-MMC.

  5. Visumax femtolasik versus Moria M2 microkeratome in mild to moderate myopia: efficacy, safety, predictability, aberrometric changes and flap thickness predictability.

    PubMed

    Torky, Magda A; Al Zafiri, Yousif A; Khattab, Abeer M; Farag, Rania K; Awad, Eman A

    2017-07-17

    This is an interventional prospective clinical study which was conducted to evaluate the efficacy, safety, predictability, ocular aberrations, and flap thickness predictability of Visumax femtosecond laser (FSL) compared to Moria M2 microkeratome (MK) in mild to moderate myopia. This study included 60 eyes who were divided into two groups. Thirty eyes in group (I) in which the flap was created with Visumax FSL, while in group II (30 eyes) the Moria M2 MK was used. Keratometric, refractive, and aberrometric measurements were compared preoperatively and 3 months postoperatively. The intraoperative subtraction pachymetry (the SP 100 Handy pachymeter (Tomey, Nagoya, Japan) was used for preoperative pachymetry and flap thickness measurement. No significant difference was found between the two groups in regards to postoperative manifest sphere, spherical equivalent, astigmatism, safety indices nor ocular aberrations. Twenty six eyes (86.6%) in group I and 23 eyes in group II (76.6%) were within ±0.5D of the intended correction and 23 eyes (76.6%) in group I and 15 eyes in group II (50%) were within ±0.25D of the intended correction. In group I, the mean postoperative actual flap thickness was 100.12 ± 16.1 μm (81 to 122 μm), while in group II, it was 104.6 ± 20.1 μm (62 to 155 μm). The difference was statistically significant (p = 0.001). Both Visumax and Moria M2 MK are safe and effective in treating myopia with no statistically significant difference in induction of ocular aberrations but with potential advantage for Visumax regarding predictability. More accurate flap thickness is achieved with Visumax femtolasik. This study was retrospectively registered on 19/6/2017. Trial registration number NCT03193411 , clinicalTrials.gov .

  6. M to L cone ratios determine eye sizes and baseline refractions in chickens.

    PubMed

    Gisbert, Sandra; Schaeffel, Frank

    2018-07-01

    Following a hypothesis raised by M. and J. Neitz, Seattle, we have tested whether the abundance and the ratio of Long wavelength-sensitive (L) to Middle wavelength-sensitive (M) cones may affect eye size and development of myopia in the chicken. Fourteen chickens were treated with frosted plastic diffusers in front of one eye on day 10 post-hatching for a period of 7 days to induce deprivation myopia. Ocular dimensions were measured by A-scan ultrasonography at the beginning and at the end of the treatment and development of refractive state was tracked using infrared photorefraction. At the end of the treatment period, L and M cone densities and ratios were analyzed in retinal flat mounts of both myopic and control eyes, using the red and yellow oil droplets as markers. Because large numbers of cones were counted (>10000), software was written in Visual C++ for automated cone detection and density analysis. (1) On average, 9.7 ± 1.7D of deprivation myopia was induced in 7 days (range from 6.8D to 13.7D) with an average increase in axial length by 0.65 ± 0.20 mm (range 0.42 mm-1.00 mm), (2) the increase in vitreous chamber depth was correlated with the increase in myopic refractive error, (3) average central M cone densities were 10,498 cells/mm 2 , and L cone densities 9574 cells/mm 2 . In the periphery, M cone densities were 6343 cells/mm 2 and L cones 5735 cells/mm 2 (4) M to L cone ratios were highly correlated in both eyes of each animal (p < 0.01 in all cases), (5) the most striking finding was that ratios of M to L cones were significantly correlated with vitreous chamber depths and refractive states in the control eyes with normal vision, both in the central and peripheral retinas (p < 0.05 to p < 0.01), (6) M to L cone ratios did however not predict the amount of deprivation myopia that could be induced. M and L cone ratios are most likely genetically determined in each animal. The more L cones, the deeper the vitreous chambers and the more myopic were the refractions in eyes. M to L cone ratios may determine the set point of emmetropization and thereby ultimately the probability of becoming myopic. Deprivation myopia was not determined by M to L cone ratios. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted In Situ Keratomileusis (FS-LASIK) for Myopia: A Systematic Review and Meta-Analysis

    PubMed Central

    Shen, Zeren; Shi, Keda; Yu, Yinhui; Yu, Xiaoning; Lin, Yuchen; Yao, Ke

    2016-01-01

    Purpose The goal of this study was to compare small incision lenticule extraction (SMILE) with femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for treating myopia. Methods The CENTRAL, EMBASE, PubMed databases and a Chinese database (SinoMed) were searched in May of 2016. Twelve studies with 1,076 eyes, which included three randomized controlled trials (RCTs) and nine cohorts, met our inclusion criteria. The overall quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group framework. Data were extracted and analysed at three to six months postoperatively. Primary outcome measures included a loss of one or more lines of best spectacle corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA) of 20/20 or better, mean logMAR UCVA, postoperative mean spherical equivalent (SE) and postoperative refraction within ±1.0 D of the target refraction. Secondary outcome measures included ocular surface disease index (OSDI), tear breakup time (TBUT) and Schirmer’s 1 test (S1T) as dry eye parameters, along with corneal sensitivity. Results The overall quality of evidence was considered to be low to very low. Pooled results revealed no significant differences between the two groups with regard to a loss of one or more lines in the BSCVA (OR 1.71; 95% CI: 0.81, 3.63; P = 0.16), UCVA of 20/20 or better (OR 0.71; 95% CI: 0.44, 1.15; P = 0.16), logMAR UCVA (MD 0.00; 95% CI: -0.03, 0.04; P = 0.87), postoperative refractive SE (MD -0.00; 95% CI: -0.05, 0.05; P = 0.97) or postoperative refraction within ±1.0 D of the target refraction (OR 0.78; 95% CI: 0.22, 2.77; P = 0.70) within six months postoperatively. The pooled analysis also indicated that the FS-LASIK group suffered more severely from dry eye symptoms (OSDI; MD -6.68; 95% CI: -11.76, -2.00; P = 0.006) and lower corneal sensitivity (MD 12.40; 95% CI: 10.23, 14.56; P < 0.00001) at six months postoperatively. Conclusions In conclusion, both FS-LASIK and SMILE are safe, effective and predictable surgical options for treating myopia. However, dry eye symptoms and loss of corneal sensitivity may occur less frequently after SMILE than after FS-LASIK. PMID:27367803

  8. Prevalence of visual impairment and refractive errors among different ethnic groups in schoolchildren in Turpan, China.

    PubMed

    Chin, Man Pan; Siong, Kar Ho; Chan, Ka Ho; Do, Chi Wai; Chan, Henry Ho Lung; Cheong, Allen Ming Yan

    2015-05-01

    There is currently limited information about ethnic differences in myopia prevalence within mainland China, especially in rural or semi-rural areas. We examined the prevalence of refractive errors, visual impairment and spectacle coverage in school children of varying ethnicity in Turpan, Xinjiang province. A community eye care service was provided for five schools. Presenting monocular distance and near visual acuity (VA), and ocular alignment were assessed. Retinoscopy and cycloplegic subjective refraction were performed for participants with presenting visual impairment (distance VA worse than 0.3 logMAR; Snellen 6/12 or 20/40) or abnormal binocular vision. Questionnaires administered prior to the eye examinations were used to collect information regarding personal lifestyle and parental myopia. A total of 646 out of 690 (94%) subjects aged four to 19 years (11.9 ± 2.6; mean ± S.D.) completed the eye examination. Three hundred and eighty-two (59%) of participants were of Uyghur ethnicity, followed by Han, 176 (27%) and Hui, 74 (12%). The mean age of Uyghur, Han and Hui students was 12.3 ± 2.7, 11.4 ± 2.6 and 11.4 ± 2.3 years respectively, in which the Uyghur students were significantly older than the Han and Hui students (F(3,631) = 5.58 p < 0.001). In total, 170 (27%) and 85 (13%) subjects failed the screening examination for one eye or both eyes, respectively. The prevalence of presenting visual impairment was not significantly different among the ethnic groups (p = 0.26). After cycloplegic refraction, most subjects' VA (98%) improved to better than 0.3 logMAR (Snellen 6/12 or 20/40). The prevalence of "clinically-significant myopia" (≤-0.50 dioptres) was 27%, 18% and 13% in Han, Hui and Uyghur children, respectively (p < 0.001). In contrast, Uyghur students had the highest prevalence of astigmatism (Uyghur 12%, Han 5%, Hui 4%). The overall spectacle coverage was 36%, while spectacle coverage among ethnic groups were similar (Han, 41%; Uyghur, 32%; Hui, 41%; χ(2) = 2.23, df = 2, p = 0.33). The prevalence of clinically significant myopia varied markedly with ethnicity in school children sampled from a semi-rural region of mainland China (Han > Hui > Uyghur). As reported previously, uncorrected/under-corrected refractive error was the main cause of presenting visual impairment. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.

  9. Post-keratoplasty astigmatism management by relaxing incisions: a systematic review.

    PubMed

    Ho Wang Yin, Gaëlle; Hoffart, Louis

    2017-01-01

    Postoperative visual acuity can be limited by post-keratoplasty astigmatism, even with a clear corneal graft. Astigmatism management can be performed by selective suture removal, adjustment of sutures, optical correction, photorefractive procedures, wedge resection, intra-ocular lens implantation, intracorneal ring segments, relaxing incisions with or without compression sutures and repeated keratoplasty. Relaxing incisions can be made in the graft, graft-host interface or host cornea. Despite the unpredictability of the method because the flat and steep meridians are usually not orthogonal after penetrating keratoplasty, with asymmetric power distribution, all the studies showed an overall reduction of refractive, keratometric or topographic astigmatism, ranging from 30% to 72% with manual or femtosecond-assisted techniques. Most patients with astigmatism higher than 6 diopters had residual cylinder less than or equal to 3 diopters, which can be treated by laser excimer ablation or secondary intraocular lens implantation.

  10. A review of environmental risk factors for myopia during early life, childhood and adolescence.

    PubMed

    Ramamurthy, Dharani; Lin Chua, Sharon Yu; Saw, Seang-Mei

    2015-11-01

    Myopia is a significant public health problem worldwide, particularly in East Asian countries. The increasing prevalence of myopia poses a huge socio-economic burden and progressive high myopia can lead to sight-threatening ocular complications. Hence, the prevention of early-onset myopia progressing to pathological high myopia is important. Recent epidemiological studies suggest that increased outdoor time is an important modifiable environmental factor that protects young children from myopia. This protective effect may be due to high light intensity outdoors, the chromaticity of daylight or increased vitamin D levels. This review summarises the possible underlying biological mechanisms for the protective association between time outdoors and myopia, including the potential role of nicotinic acetylcholine receptors in refractive error development. Recent evidence for the role of other environmental risk factors such as near work, birth seasons, parental smoking and birth order are also summarised. © 2015 Optometry Australia.

  11. In vitro testing of thiolated poly(aspartic acid) from ophthalmic formulation aspects.

    PubMed

    Budai-Szű Cs, Mária; Horvát, Gabriella; Gyarmati, Benjámin; Szilágyi, Barnabás Áron; Szilágyi, András; Csihi, Tímea; Berkó, Szilvia; Szabó-Révész, Piroska; Mori, Michela; Sandri, Giuseppina; Bonferoni, Maria Cristina; Caramella, Carla; Csányi, Erzsébet

    2016-08-01

    Ocular drug delivery formulations must meet anatomical, biopharmaceutical, patient-driven and regulatory requirements. Mucoadhesive polymers can serve as a better alternative to currently available ophthalmic formulations by providing improved bioavailability. If all requirements are addressed, a polymeric formulation resembling the tear film of the eye might be the best solution. The optimum formulation must not have high osmotic activity, should provide appropriate surface tension, pH and refractive index, must be non-toxic and should be transparent and mucoadhesive. We would like to highlight the importance of in vitro polymer testing from a pharmaceutical aspect. We, therefore, carried out physical-chemical investigations to verify the suitability of certain systems for ophthalmic formulations. In this work, in situ gelling, mucoadhesive thiolated poly(aspartic acid)s were tested from ophthalmic formulation aspects. The results of preformulation measurements indicate that these polymers can be used as potential carriers in ophthalmic drug delivery.

  12. Full ocular biometry through dual-depth whole-eye optical coherence tomography

    PubMed Central

    Kim, Hyung-Jin; Kim, Minji; Hyeon, Min Gyu; Choi, Youngwoon; Kim, Beop-Min

    2018-01-01

    We propose a new method of determining the optical axis (OA), pupillary axis (PA), and visual axis (VA) of the human eye by using dual-depth whole-eye optical coherence tomography (OCT). These axes, as well as the angles “α” between the OA and VA and “κ” between PA and VA, are important in many ophthalmologic applications, especially in refractive surgery. Whole-eye images are reconstructed based on simultaneously acquired images of the anterior segment and retina. The light from a light source is split into two orthogonal polarization components for imaging the anterior segment and retina, respectively. The OA and PA are identified based on their geometric definitions by using the anterior segment image only, while the VA is detected through accurate correlation between the two images. The feasibility of our approach was tested using a model eye and human subjects. PMID:29552378

  13. Plasticity in the Human Visual Cortex: An Ophthalmology-Based Perspective

    PubMed Central

    Rosa, Andreia Martins; Silva, Maria Fátima; Murta, Joaquim

    2013-01-01

    Neuroplasticity refers to the ability of the brain to reorganize the function and structure of its connections in response to changes in the environment. Adult human visual cortex shows several manifestations of plasticity, such as perceptual learning and adaptation, working under the top-down influence of attention. Plasticity results from the interplay of several mechanisms, including the GABAergic system, epigenetic factors, mitochondrial activity, and structural remodeling of synaptic connectivity. There is also a downside of plasticity, that is, maladaptive plasticity, in which there are behavioral losses resulting from plasticity changes in the human brain. Understanding plasticity mechanisms could have major implications in the diagnosis and treatment of ocular diseases, such as retinal disorders, cataract and refractive surgery, amblyopia, and in the evaluation of surgical materials and techniques. Furthermore, eliciting plasticity could open new perspectives in the development of strategies that trigger plasticity for better medical and surgical outcomes. PMID:24205505

  14. Multiparameter vision testing apparatus

    NASA Technical Reports Server (NTRS)

    Hunt, S. R., Jr.; Homkes, R. J.; Poteate, W. B.; Sturgis, A. C. (Inventor)

    1975-01-01

    Compact vision testing apparatus is described for testing a large number of physiological characteristics of the eyes and visual system of a human subject. The head of the subject is inserted into a viewing port at one end of a light-tight housing containing various optical assemblies. Visual acuity and other refractive characteristics and ocular muscle balance characteristics of the eyes of the subject are tested by means of a retractable phoroptor assembly carried near the viewing port and a film cassette unit carried in the rearward portion of the housing (the latter selectively providing a variety of different visual targets which are viewed through the optical system of the phoroptor assembly). The visual dark adaptation characteristics and absolute brightness threshold of the subject are tested by means of a projector assembly which selectively projects one or both of a variable intensity fixation target and a variable intensity adaptation test field onto a viewing screen located near the top of the housing.

  15. Retrospective Analysis of the Post-Operative Changes in Higher-Order Aberrations: A Comparison of the WaveLight EX500 to the VISX S4 Laser in Refractive Surgery.

    PubMed

    Reed, Donovan S; Apsey, Douglas; Steigleman, Walter; Townley, James; Caldwell, Matthew

    2017-11-01

    In an attempt to maximize treatment outcomes, refractive surgery techniques are being directed toward customized ablations to correct not only lower-order aberrations but also higher-order aberrations specific to the individual eye. Measurement of the entirety of ocular aberrations is the most definitive means to establish the true effect of refractive surgery on image quality and visual performance. Whether or not there is a statistically significant difference in induced higher-order corneal aberrations between the VISX Star S4 (Abbott Medical Optics, Santa Ana, California) and the WaveLight EX500 (Alcon, Fort Worth, Texas) lasers was examined. A retrospective analysis was performed to investigate the difference in root-mean-square (RMS) value of the higher-order corneal aberrations postoperatively between two currently available laser platforms, the VISX Star S4 and the WaveLight EX500 lasers. The RMS is a compilation of higher-order corneal aberrations. Data from 240 total eyes of active duty military or Department of Defense beneficiaries who completed photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK) refractive surgery at the Wilford Hall Ambulatory Surgical Center Joint Warfighter Refractive Surgery Center were examined. Using SPSS statistics software (IBM Corp., Armonk, New York), the mean changes in RMS values between the two lasers and refractive surgery procedures were determined. A Student t test was performed to compare the RMS of the higher-order aberrations of the subjects' corneas from the lasers being studied. A regression analysis was performed to adjust for preoperative spherical equivalent. The study and a waiver of informed consent have been approved by the Clinical Research Division of the 59th Medical Wing Institutional Review Board (Protocol Number: 20150093H). The mean change in RMS value for PRK using the VISX laser was 0.00122, with a standard deviation of 0.02583. The mean change in RMS value for PRK using the WaveLight EX500 laser was 0.004323, with a standard deviation of 0.02916. The mean change in RMS value for LASIK using the VISX laser was 0.00841, with a standard deviation of 0.03011. The mean change in RMS value for LASIK using the WaveLight EX500 laser was 0.0174, with a standard deviation of 0.02417. When comparing the two lasers for PRK and LASIK procedures, the p values were 0.431 and 0.295, respectively. The results of this study suggest no statistically significant difference concerning induced higher-order aberrations between the two laser platforms for either LASIK or PRK. Overall, the VISX laser did have consistently lower induced higher-order aberrations postoperatively, but this did not reach statistical significance. It is likely the statistical significance of this study was hindered by the power, given the relatively small sample size. Additional limitations of the study include its design, being a retrospective analysis, and the generalizability of the study, as the Department of Defense population may be significantly different from the typical refractive surgery population in terms of overall health and preoperative refractive error. Further investigation of visual outcomes between the two laser platforms should be investigated before determining superiority in terms of visual image and quality postoperatively. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  16. Quantification of the ultraviolet radiation (UVR) field in the human eye in vivo using novel instrumentation and the potential benefits of UVR blocking hydrogel contact lens.

    PubMed

    Walsh, J E; Bergmanson, J P; Wallace, D; Saldana, G; Dempsey, H; McEvoy, H; Collum, L M

    2001-09-01

    Certain degenerative eye conditions occur predominantly nasally, at the limbal region, and are associated with solar ultraviolet radiation (UVR) induced damage. The relative contribution to the in vivo ocular flux of (a) the reflection of UVR incident on the skin of the nose onto the nasal limbus, and (b) the focusing of UVR incident on the temporal side of the cornea onto the nasal limbus were examined. A novel photodiode sensor array was used to measure the UVR field across the eye. In addition, a novel spectrometer set-up was used to measure the spectrum of radiation refracted across the cornea. The efficacy of UVR blocking hydrogel contact lenses in filtering incident UVR was assessed in vivo. Qualitative and quantitative data indicated an increase nasally of UVR. Photodiode readings showed a net UVR increase from the temporal to the nasal side. Transmission curves showed that most UVR incident on the limbal region is either absorbed by, or transmitted through, the ocular tissues. This radiation is filtered by UVR blocking soft contact lens. An increased UVR flux on the nasal side of the eye, due to reflection off the nasal skin, was identified in vivo. Any UVR passing through the cornea is either absorbed by the conjunctiva and/or transmitted through it onto the sclera where it is absorbed. UVR blocking hydrogel contact lenses can eliminate these sources of UVR.

  17. Non-Invasive Health Diagnostics using Eye as a 'Window to the Body'

    NASA Technical Reports Server (NTRS)

    Ansari, Rafat R.

    2002-01-01

    As a 'window to the body', the eye offers the opportunity to use light in various forms to detect ocular and systemic abnormalities long before clinical symptoms appear and help develop preventative/therapeutic countermeasures early. The effects of space travel on human body are similar to those of normal aging. For example, radiation exposure in space could lead to formation of cataracts and cancer by damaging the DNA and causing gene mutation. Additionally, the zero-gravity environment causes fluid shifts in the upper extremities of the body and changes the way blood flows and organ system performs. Here on Earth, cataract, age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma are major eye diseases and are expected to double in next two decades. To detect, prevent, and treat untoward effects of prolonged space travel in real-time requires the development of non-invasive diagnostic technologies that are compact and powerful. We are developing fiber-optic sensors to evaluate the ocular tissues in health, aging, and disease employing the techniques of dynamic light scattering (cataract, uveitis, Alzheimer's, glaucoma, DR, radiation damage, refractive surgery outcomes), auto-fluorescence (aging, DR), laser-Doppler flowmetry (choroidal blood flow), Raman spectroscopy (AMD), polarimetry (diabetes), and retinal oximetry (occult blood loss). The non-invasive feature of these technologies integrated in a head-mounted/goggles-like device permits frequent repetition of tests, enabling evaluation of the results to therapy that may ultimately be useful in various telemedicine applications on Earth and in space.

  18. The ocular biometric differences of diabetic patients.

    PubMed

    Kocatürk, Tolga; Zengin, Mehmet Özgür; Cakmak, Harun; Evliçoglu, Gökhan Evren; Dündar, Sema Oruç; Omürlü, Imran Kurt; Unübol, Mustafa; Güney, Engin

    2014-01-01

    To investigate the differences in ocular biometric and keratometric characteristics in comparison with biometric measurements using the noncontact optical low coherence reflectometer (OLCR) (Lenstar LS 900, Haag-Streit) on diabetic patients. The eyes of 170 patients were included in this study, including 81 diabetic and 89 nondiabetic subjects. Optical biometric measurements of diabetic and nondiabetic patients (between the ages of 25 and 85 years) who applied to the ophthalmology clinic were noted from March to June 2013. Detailed ophthalmologic examinations were done for every subject. Biometric measurements were done using the noncontact OLCR device. Patient age ranged from 29 to 83 years. Subgroup analyses were done in diabetic patients according to their Hba1C levels. The minimum Hba1C value was 5.3, maximum was 12.4, and mean was 7.56 ± 1.48. The median duration of diabetes was 5 years (25th-75th percentile 3.00-11.75). Diabetic patients were found to have thicker lens and shallower anterior chamber in both eyes compared to nondiabetic control subjects. There were no statistical differences between the groups according to central corneal thickness, axial length, or keratometric values in both eyes. However, lens thicknesses were found to be thicker and anterior chamber depth values were found to be shallower in the diabetic group in both eyes. It may useful to determine eyeglasses prescription, refractive surgery calculation, lens selection, and previous cataract surgery according to biometric measurements after the regulation of blood glucose.

  19. Comparison of visual acuity estimates using three different letter charts under two ambient room illuminations

    PubMed Central

    Chen, Ai-Hong; Norazman, Fatin Nur Najwa; Buari, Noor Halilah

    2012-01-01

    Background: Visual acuity is an essential estimate to assess ability of the visual system and is used as an indicator of ocular health status. Aim: The aim of this study is to investigate the consistency of acuity estimates from three different clinical visual acuity charts under two levels of ambient room illumination. Materials and Methods: This study involved thirty Malay university students aged between 19 and 23 years old (7 males, 23 females), with their spherical refractive error ranging between plano and –7.75D, astigmatism ranging from plano to –1.75D, anisometropia less than 1.00D and with no history of ocular injury or pathology. Right eye visual acuity (recorded in logMAR unit) was measured with Snellen letter chart (Snellen), wall mounted letter chart (WM) and projected letter chart (PC) under two ambient room illuminations, room light on and room light off. Results: Visual acuity estimates showed no statistically significant difference when measured with the room light on and with the room light off (F1,372 = 0.26, P = 0.61). Post-hoc analysis with Tukey showed that visual acuity estimates were significantly different between the Snellen and PC (P = 0.009) and between Snellen and WM (P = 0.002). Conclusions: Different levels of ambient room illumination had no significant effect on visual acuity estimates. However, the discrepancies in estimates of visual acuity noted in this study were purely due to the type of letter chart used. PMID:22446903

  20. Clinical outcomes of laser in situ keratomileusis with an aberration-neutral profile centered on the corneal vertex comparing vector planning with manifest refraction planning for the treatment of myopic astigmatism.

    PubMed

    Arbelaez, Maria Clara; Alpins, Noel; Verma, Shwetabh; Stamatelatos, George; Arbelaez, Juan Guillermo; Arba-Mosquera, Samuel

    2017-12-01

    To evaluate clinical outcomes of laser in situ keratomileusis (LASIK) with an aberration-neutral profile centered on the estimated visual axis (considering 70% of the pupil offset toward the corneal vertex) comparing vector planning with manifest refraction planning for the treatment of myopic astigmatism. Muscat Eye Laser Center, Muscat, Sultanate of Oman, Muscat, Oman. Retrospective case series. The outcomes were evaluated at a 6-month follow-up in eyes showing ocular residual astigmatism (ORA) over 0.75 diopters (D) preoperatively. Eighty-five treatments were based on manifest astigmatism (preoperative sphere -2.11 D ± 1.3 [SD], cylinder -0.90 ± 1.0 D), and 79 treatments were based on vector planning (preoperative sphere -2.46 ± 1.5 D, cylinder -0.78 ± 0.79 D). At a 6-month follow-up, 128 patients (164 eyes) were evaluated and no significant differences were observed between the 2 groups in terms of difference between corrected distance visual acuity and uncorrected distance visual acuity (UDVA) (P = .1, t test and Fisher exact test Snellen lines 1 or better, P = .4) and postoperative UDVA (P = .05, t test and Fisher exact test for UDVA 20/16 or better, P = .3). Significant differences were observed between the 2 groups in terms of achieved spherical equivalent (P = .04), corneal toricity, and ORA (P < .001, t test and Fisher exact test for ORA ≤0.75 D, P < .001). Performing LASIK for myopic astigmatism with the vector planning approach resulted in comparable visual outcomes to manifest refraction planning. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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