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ABSTRACTAcademic misconduct and academic integrity are issues of importance to Higher Education Institutions (HEIs). Phraseologies and practices may conflate unintentional mistakes with attempts to gain illegitimate advantage, with some groups potentially at higher risk. HEIs across the United Kingdom (UK) responded to a Freedom of Information Act (FOI) request, and provided data regarding their overall student demographics, the demographic details of their cases of referred and substantiated academic misconduct over a specific time period, as well as information about Turnitin. Available data were analysed with an estimated combined student population of 200,646 with an estimated 2718 students referred for academic misconduct. Analyses revealed some groups being referred out of proportion with their share of the student population, however, no significant differences were observed by demographic for substantiated cases. Most of the responding HEIs indicated Turnitin was used for both identification of misconduct and pedagogical purposes although some reported variations in use for pedagogy by department or module. Implications of the findings are considered. Limitations around available data are discussed and areas requiring more detailed consideration are identified.

Background: Ptosis may result in increased anxiety, appearance-related distress and social avoidance, and impacts visual function. Previous work demonstrates the benefits of ptosis surgery for health-related quality of life, but there is a paucity of research comparing such outcomes before and after surgery. The aim of this study was to determine potential patient benefits in health-related quality of life, social dysfunction and anxiety following successful ptosis surgery using validated measures. Methods: Adult ptosis correction surgery patients completed validated measures of appearance-related social anxiety and avoidance, anxiety and depression, and fear of negative evaluation pre-surgery. Following successful surgery, these measures were repeated post-discharge in addition to another health-related quality of life measure. Results: Of 61 patients recruited, follow-up measures were sent to 33 and completed by 23. Paired samples t-tests demonstrated positive significant changes in appearance-related social distress pre-op m= 30.94, post-op m= 23.67 (t(17) = 3.46, 95% CI 2.84–11.72, p= 0.003), anxiety pre-op m= 7.6, post-op m= 4.9 (t(19) = 4.27, 95% CI 1.38–4.02, p< 0.001) and fear of negative evaluation pre-op m= 34.79, post-op m= 31.26 (t(18) = 2.47, 95% CI 0.52–6.53, p= 0.024). There was no significant difference in depression scores pre-op m= 3.6; post-op m= 3.2 (t(19) = 0.672, 65% CL −0.85 to 1.65, p= 0.510). In total, 85% of patients reported positive benefit to well-being following surgery. Conclusion: Increasingly, evidence suggests ptosis surgery may benefit patient’s well-being, appearance-related social anxiety and avoidance, as well as improving visual function. These psychosocial benefits should be considered alongside functional benefits in the provision of ptosis surgery.

Various therapeutic options such as lid taping or lubricant ointment have been used to alleviate symptoms while waiting for definitive surgical treatment of lower lid entropion. A retrospective survey of 120 patients undergoing entropion surgery was undertaken to assess the adequacy of these interim measures. There was a mean waiting time often weeks during which most patients were provided with a combination of ointment and lid taping to provide symptomatic relief. Twenty patients (16%) were dissatisfied with their treatment regime and 52% of these patients developed corneal erosions. In the second part of the study, 22 patients were recruited in a prospective study to evaluate the efficacy and acceptability of botulinum toxin injection to the lower lid as a temporary measure to relieve involutional entropion while awaiting surgery. These were scored on a sliding scale from 0 (unbearable) to 10 (excellent). Results demonstrate that botulinum toxin brought symptomatic relief to all patients with an improvement in the effectivity and acceptability scores from 3.40 to 9.72 and from 2.39 to 9.47 respectively (p < 0.001). The mean duration of action of the toxin was 70 days. The authors believe that botulinum toxin injection to the lower lid provides a more effective and acceptable interim measure in relieving lower lid entropion by temporary paralysis of the overriding pre-septal orbicularis muscle.

The occurrence of floppy eyelid syndrome in pachydermoperiostosis has not previously been described. The authors present one such case and review the current literature and differential diagnosis. Histological studies demonstrated marked structural changes within the tarsus which appear to be initiated by abnormal meibomian gland hypertrophy.In the light of their findings the authors propose that floppy eyelid syndrome occurs in primary and secondary forms, differentiated by the presence of a systemic or localized disorder with the potential to produce initial structural changes within the eyelids. The surgical management of floppy eyelid syndrome is discussed.

We present the methodology of a population-based Randomised Controlled Trial, comparing an intensive programme of primary preschool vision screening by orthoptists with the usual non-specialist screening. The aims of the trial are to compare the effectiveness and costs of intensive orthoptic screening with non-specialist measures. The orthoptic screening programme will be evaluated both as a composite package and in terms of the screening value of the individual tests at specific ages. This trial is nested within a large population-based longitudinal study. Additional demographic and developmental data on the children in the trial are therefore available. The results of the trial will be used to help clarify which methods of preschool ophthalmic population screening are best in terms of disease detection and cost efficiency.

1. Disturbance of vision commonly accompanies hypoglycaemia. This study was designed to investigate the nature of the visual disturbance, the blood glucose threshold at which the disturbance occurred and the physiological basis. 2. Measurements were made of the corrected visual acuity, colour vision (100 Hue test), visual evoked potentials (VEP), electroencephalography (EEG) frequency analysis and psychometry (digit recall) during stepwise induction of controlled hypoglycaemia produced by an intravenous insulin infusion. Six male volunteers and five insulin-dependent diabetic subjects were studied. 3. During hypoglycaemia corrected visual acuity was unchanged. Colour vision was significantly impaired. Baseline VEP were normal in both groups but significantly prolonged during hypoglycaemia (mean increment 10.8 ms) and increased by >5 ms in nine out of 11 subjects. Quantitative EEG analysis demonstrated slowing with a power density spectral shift from fast α to slow α, θ and δ which correlated with VEP latency and amplitude changes. 4. The findings have clinical implications. A deterioration in colour vision is likely to impair the ability to read reagent strips by eye. VEP measurements in diabetic patients are likely to be misleading if hypoglycaemia is present; EEG changes are a sensitive index of cortical dysfunction during hypoglycaemia and provide a theoretical basis for developing a portable device to detect early hypoglycaemia.

22 patients with thyroid eye disease were examined with magnetic resonance imaging (MRI) and the results compared with 10 controls. Imaging was performed on a 1.0 T scanner using a head coil. All patients were examined using both T1W and short tau inversion recovery (STIR) sequences. The relative signal intensity (SI) of individual extraocular muscles were quantified by comparison with SI from the adjacent temporalis muscle to give a signal intensity ratio (SIR). The results were compared with clinical disease activity assessed by the Werner grading system. Visual evaluation of muscle size and calculated SIRs showed an increase when compared to normals in 15 of the 22 patients. This difference was significant in patients with high grade (4–6) clinical disease. The known histological changes in this disease suggest that this increase in signal is caused by oedema secondary to acute inflammation. STIR sequences suppress the retro-orbital fat and thus enhance these changes both in the muscles and in the fat itself. The MR findings suggest that the STIR sequence can be used to predict those patients that will respond to anti-antiflammatory treatment.

OBJECTIVE: To assess the effectiveness of early treatment for amblyopia in children. DESIGN: Follow up of outcomes of treatment for amblyopia in a randomised controlled trial comparing intensive orthoptic screening at 8, 12, 18, 25, 31, and 37 months (intensive group) with orthoptic screening at 37 months only (control group). SETTING: Avon, southwest England. PARTICIPANTS: 3490 children who were part of a birth cohort study. MAIN OUTCOME MEASURES: Prevalence of amblyopia and visual acuity of the worse seeing eye at 7.5 years of age. RESULTS: Amblyopia at 7.5 years was less prevalent in the intensive group than in the control group (0.6% v 1.8%; P=0.02). Mean visual acuities in the worse seeing eye were better for children who had been treated for amblyopia in the intensive group than for similar children in the control group (0.15 v 0.26 LogMAR units; P<0.001). A higher proportion of the children who were treated for amblyopia had been seen in a hospital eye clinic before 3 years of age in the intensive group than in the control group (48% v 13%; P=0.0002). CONCLUSIONS: The intensive screening protocol was associated with better acuity in the amblyopic eye and a lower prevalence of amblyopia at 7.5 years of age, in comparison with screening at 37 months only. These data support the hypothesis that early treatment for amblyopia leads to a better outcome than later treatment and may act as a stimulus for research into feasible screening programmes.