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Refractive surgeries have evolved from the archaic incisional corneal procedures to the use of sophisticated femtosecond lasers and new-generation phakic intraocular lenses (pIOL) for surgical correction of refractive errors. The armamentarium of modern-day refractive surgery includes corneal-based procedures such as photorefractive keratectomy, laser-assisted in situ keratomileusis and keratorefractive lenticule extraction, as well as lensbased pIOL implantation. The current procedures are associated with a high index of efficacy and predictability, with enhanced safety and a significant reduction in sight-threatening complications. Patient counselling and case selection is imperative to achieve optimal visual outcomes and patient satisfaction. This review article provides a comprehensive overview of current refractive surgery procedures, with an emphasis on decision-making. Evolving frontiers in refractive surgeries like customised corneal ablation and presbyopia correcting pIOL are also discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the prevalence of myopic eyes over 11 years (2008-2018) in a private clinic and a public assistance service. Methods: We retrospectively evaluated 6332 individuals (12,664 eyes) between 5 and 25 years old, seen at a private clinic-CEMO (2,663 individuals) and a public service-HOIP (3,669 individuals) from 2008 to 2018. We evaluated the prevalence of myopic eyes (EE ≤-0.50) and high myopic eyes (EE ≤-6.00). Results: Sex and services did not show statistical differences. The variation in the prevalence of myopic and high myopic eyes showed a random pattern during the study period (this prevalence could not be increased). Prevalences ranged from 20.7% (in 2017) to 32.4% (in 2015) for myopic eyes and from 1.6% (in 2009 and 2016) to 3.3% (in 2015) for eyes with high myopia. The prevalence of myopia showed a statistically significant increase based on the age group. Conclusion: The prevalence of myopic eyes did not increase in our study. The mean prevalence of myopic eyes was similar in the private clinic and public service. [ABSTRACT FROM AUTHOR]

Intraocular lens (IOL) implantation is currently the most effective clinical treatment for cataracts. Nevertheless, due to the growth of the eye axis in patients with congenital cataracts during the process of growth and development, the progressive incapacity of an IOL with a fixed focus does not meet the demands of practical usage, leading to the occurrence of ametropia. This work describes an innovative class of an IOL bulk material that offers good biosafety and light-controlled refractive index adjustment. Acrylate materials were synthesized for the preparation of IOLs by free radical polymerization of ethylene glycol phenyl ether methacrylate (EGPEMA), hydrophilic monomer 2-(2-ethoxyethoxy) ethyl acrylate (EA), and functional monomer hydroxymethyl coumarin methacrylate (CMA). Under 365/254 nm ultraviolet (UV) irradiation, the coumarin group could adjust the polymer material's refractive index through reversible photoinduced dimerization/depolymerization. Meanwhile, the potential for the IOL use is enabled by its satisfactory biosafety. Such a light-induced diopter adjustable IOL will be more appropriate for implantation during cataract surgery since it will not require the correction needed for ametropia and will offer more accurate and humane treatment. • A coumarin group containing-copolymer was synthesized and fabricated into intraocular lenses (IOL). • A functional IOL is diopter adjustable by light irradiation through triggering the [2 + 2] cycloaddition of the coumarin groups. • Such light-triggered diopter-adjustable copolymer IOLs have a great potential in clinical application. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose: The study aims to report various ocular manifestations among renal transplant recipients. Methods: The cross-sectional study was conducted on renal transplant patients, with at least 4 months of posttransplant duration, attending a nephrology clinic. A comprehensive ophthalmic evaluation was performed to record various ocular manifestations. The statistical association between ocular findings and pretransplant as well as posttransplant duration was assessed. Results: One hundred and twenty-three eyes of 62 patients, with a mean age of 37.6 ± 8.2 years and functional graft, were included in the study. Diabetic nephropathy was found to be the most common underlying cause of end-stage renal disease (ESRD) and renal transplant. Hypertensive retinopathy (37.4%) was found to be the most frequent ophthalmic manifestation, followed by diabetic retinopathy (24.39%), dry eye (22.76%), cataract (18.69%), and change in refractive error (17.89%). The occurrence of hypertensive retinopathy and refractive power change was found to be significantly associated with pretransplant dialysis duration. In contrast, concerning the posttransplant period, the frequency of all the major ocular manifestations, except the dry eye, was observed to be statistically significant. Conclusion: Patients with ESRD and renal transplant should be advised to undergo regular comprehensive eye examinations. Many ocular manifestations are preventable and/or treatable, thus interdisciplinary partnership between nephrologists and ophthalmologists is warranted to improve vision and quality of life in transplant recipients. [ABSTRACT FROM AUTHOR]

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PURPOSE: To evaluate the clinical profile of amblyopia among patients referred to a tertiary care facility in Saudi Arabia. METHODS: All patients between 1 and 14 years presenting to the amblyopia clinic from 2016 to 2020 were retrospectively reviewed. Amblyopia was defined as visual acuity <0.2 LogMAR (20/30) in the worse eye or two-line difference between the two eyes. We classified patients into strabismic, refractive, mixed strabismic, and refractive and deprivation amblyopia. We subclassified our cohort according to age (< and ≥5 years). RESULTS: Three hundred and eighty-three patients (199 male 54%) were seen in our clinic. Seventeen patients were excluded because they did not meet our inclusion criteria. The mean age at presentation was 5.05 ± 2.49 years. Strabismic amblyopia was found in 180 (49%), refractive in 101 (27.6%), mixed in 69 (19%), and deprivation in 16 (4.2%). Anisometropia in 85.25% and isometropia in 14.75%. Hyperopic astigmatism was the most common refractive error in 246 (67.2%). Esotropia was the most common deviation (90%). Strabismic amblyopia was significantly higher in the <5 years group (62.4% vs. 36.7%). While refractive amblyopia was significantly higher in ≥5 years group (38.8% vs. 15.7%) (P < 0.001). CONCLUSION: Strabismic amblyopia was the most commonly diagnosed in our cohort, especially among patients <5 years of age. Refractive amblyopia was more common in older patients and may be under-detected due to the lack of proper vision screening. The implementation of proper vision screening should help in early detection and successful treatment at an early age. [ABSTRACT FROM AUTHOR]

Copyright of Saúde & Tecnologia is the property of Escola Superior de Tecnologia da Saude de Lisboa-ESTESL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde & Tecnologia is the property of Escola Superior de Tecnologia da Saude de Lisboa-ESTESL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Considering the burden of refractive error, clinical-based research methods are often used as epidemiological tools. This study aimed to generate evidence on the prevalence and distribution of refractive error in Portugal. A cross-sectional retrospective study was designed to review optometric records from Portuguese practices during July 2021. 348 optometric records were analysed. Subjects had a mean age of 44.2 ± 19.2 years (range 6–81) and 58.4% were female. The mean spherical equivalent was myopic, −0.65 ± 2.38 Diopters (D), varying from a minimum of −13.63 to a maximum of 6.25 D. According to sex, the mean spherical equivalent was −0.76 ± 2.29 D for female and −0.49 ± 2.49 D for male, with no significant difference between them (p =.307). The distribution of the spherical equivalent mean across the age groups, linearly varies from a myopic −1.62 ± 1.74 D in the age group of [6 – 29]; −1.58 ± 2.80 D in [30 – 44]; −0.09 ± 2.40 in [45 – 59] to a hyperopic 0.67 ± 1.61 D in the group of [60 – 81]. High myopia had a prevalence of 2.7% in the sample. Myopia was the most prevalent refractive error in the sample representing 41.3%. In the age group [6–29], myopia had a prevalence of 69.3%. Hyperopia had a prevalence in the sample of 29.7%. Myopia represents the most prevalent refractive error within the sample and is the prevalence is higher in the younger age groups, demonstrating a shift towards an increase of myopia in the next years. [ABSTRACT FROM AUTHOR]

To assess the agreement between the Eye Refract, an instrument to perform subjective automated refraction, and the traditional subjective refraction, as the gold standard, in young hyperopes under noncycloplegic and cycloplegic conditions. A cross-section and randomized study was carried out, involving 42 participants (18.2 ± 7.7 years, range 6 to 31 years). Only one eye was chosen for the analysis, randomly. An optometrist conducted the refraction with the Eye Refract, while another different optometrist conducted the traditional subjective refraction. Spherical equivalent (M), cylindrical components (J0 and J45), and corrected distance visual acuity (CDVA) were compared between both refraction methods under noncycloplegic and cycloplegic conditions. A Bland-Altman analysis was performed to assess the agreement (accuracy and precision) between both refraction methods. Without cycloplegia, the Eye Refract showed significantly lower values of hyperopia than the traditional subjective refraction (p < 0.009), the mean difference (accuracy) and its 95% limits of agreement (precision) being -0.31 (+0.85, -1.47) D. Conversely, there were no statistical differences between both refraction methods under cycloplegic conditions (p ≥ 0.05). Regarding J0 and J45, both refraction methods manifested no significant differences between them under noncycloplegic and cycloplegic conditions (p ≥ 0.05). Finally, the Eye Refract significantly improved CDVA (0.04 ± 0.01 logMAR) compared with the traditional subjective refraction without cycloplegia (p = 0.01). The Eye Refract is presented as a useful instrument to determine the refractive error in young hyperopes, the use of cycloplegia being necessary to obtain accurate and precise spherical refraction. [ABSTRACT FROM AUTHOR]

The dynamic optotype (DYOP) visual acuity (VA) test is based on motion detection rather than element resolution and has been proposed for routine clinical assessment. This investigation examined the validity, inter- and intra-session repeatability and subjective preference for the DYOP versus a static letter chart and examined its utility in detecting astigmatic defocus. VA of 103 participants was measured three times with the letter and DYOP charts and repeated within two weeks in 75 participants who also rated their subjective experience. The VA of 29 participants was measured using DYOP, letter, Landolt C, and Tumbling E charts, with habitual correction and astigmatism induced with +1.00, +2.00 or +3.00 cylinders at 45, 60, 90 and 180°. The charts differed by a mean of 0.02 logMAR, with 81% of the measurements within one line of acuity. Inter-session, intraclass correlation coefficients, within-subject SD and repeatability were 0.03 logMAR, 0.95, 0.11 and 0.30 versus 0.01 logMAR, 0.92, 0.15 and 0.42 for the DYOP and letter charts, respectively. The DYOP was significantly more frustrating (1.79 vs.1.36), with 59% preferring the letter chart. The DYOP was least affected by induced astigmatism. The DYOP and letter charts differed significantly in their mean values with wide limits of agreement. DYOP had better within-subject SD and narrower limits of agreement between sessions, though clinically insignificant, and performed significantly worse for the detection of uncorrected astigmatism. Thus, it is difficult to recommend this test for the clinical determination of refractive error. [ABSTRACT FROM AUTHOR]

The cornea is the major contributor to the refractive power of the eye, and corneal diseases are a leading cause of reversible blindness. The main treatment for advanced corneal disease is keratoplasty: allograft transplantation of the cornea. Examples include lenticule implantation to treat corneal disorders (e.g. keratoconus) or correct refractive errors. These procedures are limited by the shelf-life of the corneal tissue, which must be discarded within 2-4 weeks. Electron-beam irradiation is an emerging sterilisation technique, which extends this shelf life to 2 years. Here, we produced lenticules from fresh and electron-beam (E-beam) irradiated corneas to establish a new source of tissue for lenticule implantation. In vitro, in vivo , and ex vivo experiments were conducted to compare fresh and E-beam-irradiated lenticules. Results were similar in terms of cutting accuracy, ultrastructure, optical transparency, ease of extraction and transplantation, resilience to mechanical handling, biocompatibility, and post-transplant wound healing process. Two main differences were noted. First, ∼59% reduction of glycosaminoglycans resulted in greater compression of E-beam-irradiated lenticules post-transplant, likely due to reduced corneal hydration—this appeared to affect keratometry after implantation. Cutting a thicker lenticule would be required to ameliorate the difference in refraction. Second, E-beam-sterilised lenticules exhibited lower Young's modulus which may indicate greater care with handling, although no damage or perforation was caused in our procedures. In summary, E-beam-irradiated corneas are a viable source of tissue for stromal lenticules, and may facilitate on-demand lenticule implantation to treat a wide range of corneal diseases. Our study suggested that its applications in human patients are warranted. Corneal blindness affects over six million patients worldwide. For patients requiring corneal transplantation, current cadaver-based procedures are limited by the short shelf-life of donor tissue. Electron-beam (E-beam) sterilisation extends this shelf-life from weeks to years but there are few published studies of its use. We demonstrated that E-beam-irradiated corneas are a viable source of lenticules for implantation. We conducted in vitro, in vivo , and ex vivo comparisons of E-beam and fresh corneal lenticules. The only differences exhibited by E-beam-treated lenticules were reduced expression of glycosaminoglycans, resulting in greater tissue compression and lower refraction suggesting that a thicker cut is required to achieve the same optical and refractive outcome; and lower Young's modulus indicating extra care with handling. [Display omitted] [ABSTRACT FROM AUTHOR]

PURPOSE: Refractive errors are common in Saudi Arabia and keratorefractive surgeries are usually done to correct them. However, not all patients are fit and complications postoperatively are a concern. Implantable collamer lens (ICL) implantation can be used for patients who are not fit for keratorefractive surgeries. ICL can also be used for keratoconus. We elected to evaluate the outcomes of patients who had ICL implantation for refractive errors or keratoconus. METHODS: We retrospectively reviewed patients aged between 21 and 45 years old, who attended the anterior segment clinic at King Khaled Eye Specialist Hospital and who had spherical equivalent (SE) ranging between (+16 to −23 diopters), and had ICL implantation between February 2015 and September 2017. The SE was documented before and after the surgery. Depending on the SE, patients were divided into two groups (myopia and hyperopia). Statistical analysis was done to evaluate the change in mean SE before and after surgery for patients. RESULTS: We identified 169 eyes and 155 (92%) were myopic before the surgery. Before surgery, the mean SE was −8.6 and the standard deviation (SD) was 4.4. Only 14 eyes (8%) were hyperopic before the surgery with a mean SE of +5.5 and SD of 4.8. The difference in the mean of SE between after and before the surgery for myopic eyes was statistically significant (mean difference: 7.8, SD: 5, P < 0.0001). The difference in the mean of SE between post- and pre-operatively was also significant for hyperopic eyes (mean difference: −6.1, SD: 5.2, P = 0.0007). In 32 eyes with keratoconus, the mean SE before surgery was −7.9 with an SD of 4.1. For the keratoconus eyes, the mean difference of SE between after and before surgery was statistically significant as the mean difference in SE was 7.2 with an SD of 4.6 (P < 0.0001). CONCLUSION: The effect of ICL implantation was significant in improving the SE for myopic, hyperopic, and keratoconus eyes. [ABSTRACT FROM AUTHOR]

Purpose: To compare the refractive prediction error of Hill-radial basis function 3.0 with those of 3 conventional formulas and 11 combination methods in eyes with short axial lengths. Methods: The refractive prediction error was calculated using 4 formulas (Hoffer Q, SRK-T, Haigis, and Hill-RBF) and 11 combination methods (average of two or more methods). The absolute error was determined, and the proportion of eyes within 0.25-diopter (D) increments of absolute error was analyzed. Furthermore, the intraclass correlation coefficients of each method were computed to evaluate the agreement between target refractive error and postoperative spherical equivalent. Results: This study included 87 eyes. Based on the refractive prediction error findings, Hoffer Q formula exhibited the highest myopic errors, followed by SRK-T, Hill-RBF, and Haigis. Among all the methods, the Haigis and Hill-RBF combination yielded a mean refractive prediction error closest to zero. The SRK-T and Hill-RBF combination showed the lowest mean absolute error, whereas the Hoffer Q, SRK-T, and Haigis combination had the lowest median absolute error. Hill-radial basis function exhibited the highest intraclass correlation coefficient, whereas SRK-T showed the lowest. Haigis and Hill-RBF, as well as the combination of both, demonstrated the lowest proportion of refractive surprises (absolute error >1.00 D). Among the individual formulas, Hill-RBF had the highest success rate (absolute error ≤0.50 D). Moreover, among all the methods, the SRK-T and Hill-RBF combination exhibited the highest success rate. Conclusions: Hill-radial basis function showed accuracy comparable to or surpassing that of conventional formulas in eyes with short axial lengths. The use and integration of various formulas in cataract surgery for eyes with short axial lengths may help reduce the incidence of refractive surprises. [ABSTRACT FROM AUTHOR]

Copyright of Investigaciones ANDINA is the property of Fundacion Universitaria del Area Andina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The main objective of this study was to obtain percentile curves of refractive errors in a Spanish paediatric population aged between 3 and 12 years. A descriptive, observational and cross-sectional study was conducted, including children aged between 3 and 12 years who did not present with any known ocular and/or systemic diseases. The convenience sampling method was used to select the sample from three schools and one hospital in the Community of Madrid. The refractive error was obtained using a Retinomax K-plus 3 autorefractometer (RTX; Right Mfg. Co. Ltd., Tokyo, Japan). The 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles were calculated using the IBM SPSS Statistics v.24 statistical software (IBM Corporation, Armonk, NY, United States). A total of 688 children with a mean age of 7.68 ± 2.17 years were analysed. In the 50th percentile curve, spherical equivalent values started to become myopic at 3 years (SE < –0.50 D) and the 75th percentile curve also turned myopic at 4 years. As a result, it was observed that the spherical equivalent value became more negative with time, starting from the ages indicated above. Therefore, the 90th percentile curve was negative at 11 years. Percentile curves of refractive errors in a Spanish paediatric population have been presented for the first time in order to help eyecare professionals detect children with refractive errors at an early age. [ABSTRACT FROM AUTHOR]

The aim of this study was to systematically review and meta-analyse epidemiological data of refractive error prevalence in Portugal. A structured search strategy and systematic literature review was applied to multiple databases, such as MEDLINE/PubMed, Web of Science, Scopus, Google Scholar, official organizations and academic repositorium's, to identify all relevant epidemiological studies in Portugal until February 2021. The outcome measure was the prevalence of refractive error among the Portuguese population. The events and sample size were entered as raw data and the effect size parameters were computed by Comprehensive Meta-Analysis Software. A total of 9 studies were pooled for the meta-analysis. The fixed effects model points to an estimated effect size of 43% (95% CI: 41.9–44.1%). However, the statistics of heterogeneity (Q-value p < 0.001; I-squared =99.344) showed very high heterogeneity among studies and recommends using a random-effects model. The random effects model points to an estimated effect size of 31.9% (95% CI: 19.8–47.0%) prevalence of refractive error in the Portuguese population. A prevalence of refractive error in Portugal of 31.9% (95% CI: 20.0–47.0%) can be considered as a conservative approach to the real burden of this condition. However, it translates into at least 2 to 4.5 million Portuguese individuals with a refractive error. The high heterogeneity between studies, the wide estimate and the random effects involved demonstrate the need for more studies and consistent sources to obtain narrower estimates. [ABSTRACT FROM AUTHOR]

Lamb-Shaffer syndrome, caused by haploinsufficiency of SOX5, leads to a unique constellation of dysmorphic features and intellectual delay. The SOX5 family of proteins plays an integral role in neuronal development. We present the clinical traits of an 11-year-old boy with Lamb-Shaffer syndrome and highlight the ocular findings of the syndrome reported thus far in the literature. Approximately 55% of all patients reviewed had some form of ocular abnormality associated with Lamb-Shaffer syndrome, including, predominantly, strabismus as well as optic nerve abnormalities, epicanthal folds, and refractive errors, highlighting the potential significance of SOX5 on neurologic development.▪ [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To determine the fixation disparity and refractive error of first-year optometry students to ascertain any relationship between them and also identify any association between fixation disparity and visual symptoms at near. It was an analytical cross-sectional study involving 85 participants aged 17 to 27 years (18.60 ± 1.37), 41% of whom were males. Subjective refraction was done at 3 m and fixation disparity was measured with and without spectacle correction using the Wesson Fixation Disparity Card. All analysis was set within a 95% confidence interval with a p -value ≤ 0.05 considered statistically significant. Refractive error ranged from 0.25 SEQ (spherical equivalent) to 5.50 SEQ. Mean fixation disparity ranged from 2.9 ± 2.6 to 3.9 ± 2.8 min arc. There was no statistically significant correlation between refractive error and fixation disparity without correction (r = −0.180, p = 0.098) and with correction (r = 0.155, p = 0.157). For fixation disparity in the ortho and exo direction, mean fixation disparity with correction of participants who experienced headaches during or after reading (5.1 ± 2.6 min arc) was significantly higher (p = 0.032) than participants who did not (2.0 ± 2.6 min arc). Myopia is common among first-year optometry students. Refractive error has no significant effect on fixation disparity. Headache is significantly associated with exo fixation disparity at near. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to compare central and peripheral refraction using an open view Shin-Nippon NVision-K 5001 autorefractor and an open view COAS-HD VR aberrometer in young children. Cycloplegic central and peripheral autorefraction was measured in the right eye of 123 children aged 8 to 16 years. Three measurements each were obtained with both Shin-Nippon NVision-K 5001 autorefractor and COAS-HD VR aberrometer along the horizontal visual field up to 30° (nasal and temporal) in 10° steps. The refraction from the autorefractor was compared with aberrometer refraction for pupil analysis diameters of 2.5-mm and 5.0-mm. The Shin-Nippon was 0.30 D more hyperopic than COAS-HD VR at 2.5-mm pupil and 0.50 D more hyperopic than COAS-HD VR at 5-mm pupil for central refraction. For both pupil sizes, the 95% limits of agreement were approximately 0.50 D for central refraction, and limits were wider in the nasal visual field compared to the temporal visual field. The mean difference for both J 0 and J 45 were within 0.15 D and the 95% limits of agreement within 0.90 D across the horizontal visual field. Defocus components were similar between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 2.5-mm pupil for most visual field angles. However, there was a significant difference in defocus component between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 5.0-mm pupil, wherein the autorefractor measured more hyperopia. The astigmatic components J 0 and J 45 were similar between instruments for both central and peripheral refraction. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To describe the prevalence and risk factors associated with amblyogenic refractive error in children with Coats disease. The medical records of children (<18 years of age) with unilateral Coats disease treated at a single tertiary care center were retrospectively reviewed. Data collected included patient demographics, ocular examinations, and treatments. Outcomes included the prevalence and factors associated with amblyogenic refractive error. A total of 50 children (82% male) were included; of these, 37 (74%) had refractive data to review. The median age at presentation was 5 years (IQR, 2-10). The Coats disease classification was stage 1 in 1 (2%), stage 2 in 29 (58%), and stage 3 or greater in 20 (40%). Most children (76%) had at least one visit with a pediatric specialist; the rest were only seen by a retina specialist. Among patients with refractive data, amblyogenic refractive error was identified in 46%. Glasses were prescribed to 50% of children. Children diagnosed at an earlier age had increased odds of amblyogenic refractive error (OR = 0.72; 95% CI, 0.57-0.91; P = 0.006) than those diagnosed at an older age. Our results suggest that amblyogenic refractive error is prevalent among children with Coats disease, and refractions are not always performed. There is a need to coordinate care between pediatric and retina specialists caring for children with Coats disease to ensure timely diagnosis of amblyogenic refractive error to optimize visual outcomes in this population. [ABSTRACT FROM AUTHOR]

The article presents the discussion on opinions varied regarding the treatment both in clinical management with the use of occlusion. Topics include large-angle deviation with reasonable control generally having a better prognosis in the development of binocular vision than a small angle deviation with poor control; and measurement of distance stereopsis being infrequently used providing more data regarding the deterioration of binocular vision.

Communication in modern days has developed a lot, including wireless networks, Artificial Intelligence (AI) interaction, and human-computer interfaces. People with paralysis and immobile disorders face daily difficulties communicating with others and gadgets. Eye tracking has proven to promote accessible and accurate interaction compared to other complex automatic interactions. The project aims to develop an electronic eye blinker that integrates with the experimental setup to determine clinical pupil redundancy. The proposed solution comes up with an eye-tracking tool within an inbuilt laptop webcam that tracks the eye’s pupil in the given screen dimensions and generates heat maps on the tracked locations. These heat maps can denote a letter (in case of eye writing), an indication to click on that location (in case of gadget communication), or for blinking analysis. The proposed method achieves a perfect F-measure score of 0.998 to 1.000, which is comparatively more accurate and efficient than the existing technologies. The solution also provides an effective method to determine the eye's refractive error, which can replace the complex refractometers. Further, the spatially tracked coordinates obtained during the experiment can be used to analyze the patient’s blinking pattern, which, in turn, can detect retinal disorders and their progress during medication. One of the applications of the project is to integrate the derived model with a Brain-computer interface system to allow fast communications for the disabled. [ABSTRACT FROM AUTHOR]

A 2-week-old girl presented with bilateral congenital corneal opacities. Additional systemic manifestations included microcephaly, patent foramen ovale, and poor feeding. Patient and parents underwent whole exome sequencing trio analysis that revealed a de novo pathogenic variant in POGZ (p.Val1150GlyfsX8), which is causative of the White-Sutton syndrome. This rare genetic condition is usually associated with intellectual and developmental delay, facial dysmorphism, strabismus, refractive error, and retinal changes. To our knowledge, this is the first reported case of White-Sutton syndrome presenting with congenital corneal opacities. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Why myopia develops, why it is reaching epidemic proportions and what is its cause are questions that puzzle many people. There is an answer to these questions and it is a simple one. This paper makes the connection between ametropic and in particular myopic development and theory to come with a summary of what we know about myopia and its governing equation. Key experiments, involving myopia and the effect of lenses in humans and animals have been done with unmistakable results. The observed effect of lenses implies a feedback mechanism. Feedback theory explains those results with mathematical precision. Disruption of emmetropization, is the mechanism behind ametropia and particularly myopia. Feedback theory for emmetropization was derived by observation of the input and output of the emmetropization feedback system in many patients. We show that it has the same equation as it is derived here independently from simple homeostasis principles. Classical observations and recent clinical studies have shown the association of many variables with myopia. They include near work, atropine, lenses, blur and outdoors versus indoors activities. We propose that human refractive development is controlled by homeostasis and based on that alone we derive the equation for the calculation of refraction for any patient and the effect of lenses. We provide software to calculate the refraction of any individual at any time. The editor of this journal makes the following statement: "This manuscript is intended for scientific discussion rather than clinical application. The present work does not intend to promote clinical under correction or no correction of myopia. Instead, clinicians should follow current clinical myopia management guidelines." [ABSTRACT FROM AUTHOR]

This study aimed to investigate the correlation between convergence insufficiency symptom survey (CISS) score and the signs of convergence insufficiency (CI) and to evaluate the sensitivity and specificity of the CISS to predict CI and ametropia among young adult university students. This prospective cross-sectional clinic-based study included 300 first year university students (mean age = 21.58 (SD ± 2.2) years) who consecutively reported for eye examination. Participants were administered the CISS questionnaire and investigated for the signs of CI. Diagnosis of CI was based on presence of three or four signs. The correlation between the CISS score and the signs of CI were determined and Receiver Operation Characteristics (ROC) curves were used to evaluate sensitivity and specificity. There were significant correlations between CISS score and the clinical signs of CI namely NPC break (r s = 0.622, p = 0.0001), NPC recovery (r s = 0.620, p = 0.0001), near exophoria (r s = 0.434, p = 0.0001), near PFV blur (r s = -0.359, p = 0.0001), near PFV break (-0.306, p = 0.0001), near PFV recovery (r s = -0.326, p = 0.0001) and gradient AC/A ratio (r s = -0.290, p = 0.0001). There was a significant positive correlation between CISS score and the number of clinical signs of CI (r s = 0.575, p -value = 0.0001). The CISS had good sensitivity (AOC = 0.882) to predict CI and poor sensitivity (AOC = 0.642) to predict ametropia. The CISS score is correlated with the severity and number of signs of CI in young adult Ghanaian university students. Its use in addition to clinical investigative testing may give a definitive diagnosis of symptomatic CI. [ABSTRACT FROM AUTHOR]