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Purpose: The aim of this study was to investigate the association between macula thickness and vessel density in African myopic and emmetropic eyes through the use of Spectral Domain Optical Coherence Tomography (OCT). Methods: The study population comprised African adults aged 18–35 years old. The study was conducted at a University eye clinic located in Durban, South Africa. Purposive sampling was utilised to obtain 59 participants of whom 24 were myopes and 35 were emmetropes. Vessel density (VD), foveal avascular zone (FAZ) and retinal thickness (RT) were obtained using the Heidelberg Spectralis OCT with angiography. Thereafter, a multivariate linear regression was used to investigate associations between the spherical equivalent myopic refractive error and VD, FAZ and RT for the myopic group only. Results: Myopic participants had a mean spherical equivalent (MSE) and standard deviation (SD) of −4.79 D (1.27) while the emmetropic group had an MSE (SD) of −0.32 D (0.46). Both superficial and deep VD were significantly decreased at the central fovea (radius (r) = 0.4 mm), peri‐foveal (r = 1.10–1.45 mm) and para‐foveal (r = 0.75–1.10 mm) sectors in myopes when compared with emmetropes. Myopes showed a significant reduction in RT in the inner retinal layer across the inferior and temporal zones of the peri‐foveal region as well as the inferior and temporal zones of the para‐foveal region when compared with emmetropes. A significantly smaller FAZ was found at both the superficial and deep vascular plexuses (p < 0.001). In African myopes, significant associations were not found between MSE and VD or FAZ and macula retinal thickness. Conclusion: Retinal vascular and thickness reduction may occur in young African adults with moderate myopia. A broad‐based study targeting VD and IRT in African myopes is proposed to confirm preclinical myopic macula disruptions in adults of African ethnicity. OCT angiography should be considered when monitoring progressive myopia. [ABSTRACT FROM AUTHOR]

Background: South Africa (SA) has postgraduate research-based master's and doctorate qualifications in optometry with no clinical coursework qualifications in special interest fields. As a result, it hinders professional growth and career path for optometrists and further limits patients' access to various care pathways from would-be upskilled optometrists. Aim: To explore optometrists' perspectives on postgraduate programme development in special interest fields of optometry for SA. Setting: Study population of practicing optometrists registered with the Health Professions Council of South Africa (HPCSA). Methods: A quantitative cross-sectional descriptive design was employed, utilising an online questionnaire developed with the Evasys survey system v8.2. Non-probability sampling was used to access eligible participants. Results: From 424 survey responses, 83.5% had undergraduate qualifications and 95.5% worked in patient-facing environments. Participants responded positively (88%) to this need for educational expansion. Educational needs in Ocular Disease (75.6%), Paediatric Optometry (66.4%), Binocular Vision (65.1%) and sub-specialties of myopia control (41.2%) and Specialised Contact Lens Fitting (31%) were reported. With combined 'highly important' and 'likely important' responses, participants indicated that obtaining professional recognition (94.9%) and to improve patient care (98.8%) were the main drivers for pursuing additional education and training. Conclusion: A notable demand was found for coursework postgraduate programmes by the study populations from which professional recognition can be awarded in various special interest fields of optometry. The benefit of improved patient care from upskilled optometrists was expressed. Contribution: The findings would contribute towards the development of a conceptual framework for postgraduate education and training for optometrists in SA. [ABSTRACT FROM AUTHOR]

People living with HIV (PLWH) may face an increased risk of eye complications associated with ageing, chronic inflammation, and the toxicity arising from long-term antiretroviral therapy (ART). This review aims to understand how inflammatory pathways contribute to retinal alterations observed in PLWH on long-term ART. This review was conducted using four electronic database searches, namely Scopus, Hinari, Google Scholar, and PubMed; from 1996 (when ART became available) until January 2022, without language restriction. Sources from clinical trials, meta-analyses, randomised controlled trials, and systematic reviews were used. Dysregulated para-inflammation (chronic inflammation) damages the blood-retina barrier, resulting in the altered retinal immune privilege and leading to the development of retinal and blood vessel changes. There is an interplay between the effects of the disease versus ART. ART causes mitochondrial toxicity, which affects the retinal ganglion cells and retinal pigment epithelium (RPE) due to oxidative stress. Infection by HIV also affects retinal microglia, which contributes to RPE damage. Both of these mechanisms affect the blood vessels. Assessing the integrity of the inner and outer blood-retina barrier is a pivotal point in pinpointing the pathogenesis of inner retinal alterations. Optical coherence tomography is a valuable tool to assess these changes. There is a paucity of research to understand how these structural changes may affect visual function, such as contrast sensitivity and colour vision. [ABSTRACT FROM AUTHOR]

Objective: This survey determined the utilisation of eye care services and associated factors among adults in the Ashanti region of Ghana. Design: A population-based cross-sectional descriptive study. Method: Data for this study was collected from 1615 randomly selected individuals in the Ashanti region of Ghana, using a structured, pretested interviewer-guided questionnaire. Information regarding the accessibility and determinants of, and barriers to, eye care services was based on self-reports, using the WHO Eye Care Services Assessment Questionnaire. Inferential analyses were performed using the chi-square test for statistical significance, set at p=0.05. Setting: Ashanti Region, Ghana. Participants: One thousand six hundred and fifteen randomly selected adults. Results: Public eye care facilities were used by 58.2% of the participants for their last eye exam. Of the participants, 47.0% had travelled less than five kilometres for their last eye exam. Waiting time and service cost were participants' most frequently cited challenges in seeking care. No need felt (40.1%), self-medication (37.7%) and cost (22.2%) were the most frequently mentioned barriers to seeking ophthalmic services. Conclusion: The major challenges encountered in seeking eye care services were waiting time and cost of service. Major barriers to ophthalmic services utilisation were no need felt, self-medication and cost. Factors such as cost, lack of felt need and self-medication, which serve as barriers to utilising eye care services, should be addressed by stakeholders through eye health education and promotion. [ABSTRACT FROM AUTHOR]

Background: Recent graduates are well-positioned to share their preparedness for practice experiences and how their undergraduate education and training have prepared them for transitioning to the practice environment. Aim: The study aimed to investigate the perceptions and experiences of optometrists who graduated from South African institutions between 2016 and 2020 concerning practicereadiness. Setting: The study was conducted among graduates working in South Africa's private sector. Methods: This cross-sectional qualitative study used non-probability purposive sampling. Invitations to participate were emailed to all optometrists who met the inclusion criteria. Qualitative data were collected using online semi-structured focus group interviews. Data were anonymised, transcribed, and thematically analysed using interpretive content analysis. Results: Fifteen optometrists participated in three focus group sessions between 14 December 2020 and 24 February 2021. Four major themes emerged, namely university training, post-graduation learning curve, independent practice, and being an optometrist. Overall, participants perceived their clinical education and training to be strong; however, certain areas of weakness were highlighted regarding preparedness for practice. Conclusion: Key areas for strengthening optometry training in South Africa include training optometry students using a flexible approach to the clinical examination routine and increasing clinical exposure opportunities during training. Strengthening courses such as practice management and optical dispensing, both essential for private practice, are also required. Contribution: The findings of this study contribute to the strengthening of optometry education and training in South Africa. This will, in turn, ensure that optometry graduates are adequately equipped to step into the demands of their expected roles within a private practice context upon graduation. [ABSTRACT FROM AUTHOR]

Background: This study sought to establish the association between retinal morphology, visual function and linear parameters of cerebral atrophy in non‐immunocompromised people living with HIV (NIPLHIV). Methods: Sixty participants (30 NIPLHIV, 30 controls), aged 18–45 years, were sourced from an outpatient clinic in South Africa. NIPLHIV on antiretroviral therapy (ART) had elevated CD4 counts and low viral loads. Macula thickness and volume measurements were obtained using the Spectralis optical coherence tomographer. Contrast sensitivity (CS), colour vision and visual‐evoked potentials (VEP) were also obtained. Linear parameters of cerebral atrophy (Sylvian fissure ratio, SFR) and bicaudate nucleus ratio (BCR) were all acquired from computed tomography (CT) scans. Associations between retinal thickness and volume and visual function were established by principal component factor analysis. Results: CS scores were indirectly associated with the Inner Nuclear Layer (INL)‐ETDRS thickness and volume subfields (co‐efficient = −0.07; p = 0.02 and −0.11; p = 0.001), respectively. F100 total error scores (TES) were directly associated with the thicknesses of Ganglion Cell Layer‐ETDRS subfields (co‐efficient = 6.06; p = 0.04) but indirectly associated with INL‐ETDRS subfields (co‐efficient = −5.49; p = 0.04). F100‐TES were indirectly associated with volumes of RNFL (Retinal Nerve Fibre Layer)‐ETDRS subfields (co‐efficient = −5.54; p = 0.02) and inner retina ‐ETDRS subfields (co‐efficient = −6.70; p = 0.02). P100 latency was directly associated with RNFL‐ETDRS subfield thickness (co‐efficient = 2.90; p = 0.02) and volumes of outer retina subfields (co‐efficient = 2.72; p = 0.04). CS scores were directly associated with SFR (co‐efficient = −0.04; p = 0.01). F100‐TES were directly associated with BCR (co‐efficient = 0.003; p = 0.004) and SFR (co‐efficient = 0.002; p = 0.02). P100 latency was indirectly associated with BCR (co‐efficient = −0.001; p = 0.03). Conclusion: The recognition of associations may be the first step in the proposal to develop a framework for the surveillance of vision in patients with NIPLHIV. We recommend a study of the sample population to track the stability of these observations before general recommendations for clinical care. [ABSTRACT FROM AUTHOR]

Background: Digital blue light is the blue light emitted from light emitting diode (LED) displays, which may be regarded as a health hazard to our eyes and vision. Aim: This review sought to map out evidence on the effects of blue light on the eye from digital devices. Methods: The study design is a scoping review. Peer-reviewed studies published in the last 25 years were sourced from Google Scholar, PubMed, Cochrane and Medline databases. Data were extracted using the relevant search terms followed by thematic analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework was utilised to report this process. The Mixed Method Appraisal Tool (MMAT) assessed the quality of included studies. Results: Thirty-seven articles met the eligibility criteria. After the full-text screening, the exclusion of 32 articles resulted in five articles to map. The majority of studies included the indirect measuring of the effects of digital blue light using blue-blocking spectacles on blink rate, critical flicker frequency, near point of convergence and eyestrain. The central theme identified across mapped studies regarding the effects of digital blue light was its role in resultant visual discomfort. Of the five accepted studies, three studies had an MMAT score of 100%, whilst two studies scored 80%, suggesting that their results were reliable. Conclusion: The review concluded that blocking short-wavelength blue light reduced visual discomfort or digital eyestrain. The gap identified was a lack of research on the exposure of digital blue light on the retina in human eyes in vivo and required more investigations to corroborate the animal studies. [ABSTRACT FROM AUTHOR]

Increased screen time (ST) in children is quickly becoming a public health concern as children are now reliant on technology for social interaction and educational development. The eye-health community has paid considerable attention to this in the recent literature, documenting it as digital eye strain. Continual close eye work and a lack of outdoor play contribute to digital eye strain and today's myopia epidemic. This is a cause for concern for public health stakeholders insofar as it leads to sedentary, screen-based behaviour (SSB) in children. This results in a lack of physical activity and impacts both their bodies and their mental health. The potentially harmful effects of prolonged screen exposure on developing brains and bodies are likely to be unique and significant as physiological growth changes intersect with exponentially expanding e-platforms. While embracing the benefits of a highly digitalised world, we need to simultaneously mitigate the potential risks they pose to the health of growing children. [ABSTRACT FROM AUTHOR]

The article "Artificial intelligence: An innovation shaping modern eye care" discusses the transformative role of artificial intelligence (AI) in modern eye care, highlighting its impact on patient care, disease detection, and treatment recommendations. AI technologies, such as deep learning algorithms, are utilized to analyze retinal images and assist clinicians in diagnosing conditions like diabetes, glaucoma, and age-related macular degeneration. While AI offers significant advancements in eye care, challenges such as the lack of diverse datasets and the need for robust regulatory frameworks are also addressed. The article emphasizes the importance of collaboration between researchers, data scientists, and clinicians to harness the vast possibilities of AI in revolutionizing eye care. [Extracted from the article]

Background: Ocular perfusion pressure (OPP) is defined as blood pressure (BP) minus intraocular pressure (IOP). Low OPP may result in decreased ocular blood flow (OBF) and oxygen to the optic nerve head (ONH) and retina. Aim: To review the role of systemic hypotension and similar conditions in OPP and its influence on retinal nerve fibre layer (RNFL) thickness and the ganglion cell complex (GCC). Method: A literature search was conducted using the following search terms: 'systemic hypotension'; 'glaucoma'; 'retinal nerve fibre layer'; 'optic nerve'; 'ocular blood flow' and 'ocular perfusion pressure'. Results: The Los Angeles Eye Study and Barbados Eye Study found that decreased OPP and BP increased the risk of glaucoma development by up to six times. Reduced retinal perfusion with resultant thinning of the RNFL in conditions with a similar mechanism, such as obstructive sleep apnoea syndrome, has indicated the importance of reduced OPP in retinal thickness. In the absence of any study directly showing the effect of systemic hypotension on OPP and retinal thickness, a working hypothesis proposes that reduced BP with or without normal-to-raised IOP will reduce OPP. The reduced OPP and OBF in those with systemic hypotension may result in oxidative stress and hypoxia which may then cause retinal ganglion cell death and the resultant retinal thinning. Conclusion: The increased risk of glaucoma development and progression relating to decreased BP and OPP has been proven to be of importance. Monitoring patients with systemic hypotension and evaluating the macula, ONH RNFL and GCC thickness may alert clinicians to possible glaucomatous changes. [ABSTRACT FROM AUTHOR]

Background: The advancement of the fourth industrial revolution has increased the penetrance of e-devices among younger populations, particularly with e-learning technology which has become widespread due to special circumstances such as the coronavirus disease 2019 (COVID-19) pandemic. Aim: The purpose of this review is to explore the prevalence of convergence insufficiency (CI) in younger populations and to map any associations between CI, near work and e-device usage. Method: A comprehensive literature search was conducted using Elsevier, PubMed, Medline and Ebscohost databases. The literature search used the following keywords in various combinations: 'Convergence Insufficiency', 'Binocular vision status of primary school children', 'E-learning', 'M-learning', 'Computer vision syndrome', 'Digital eye syndrome', 'E-devices and children'. Results: The observed prevalence of CI ranges from 5.46% to 13.00% among non-clinical studies and from 3.50% to 18.00% among clinical studies. The prevalence among primary school children ranges from 6.80% to 31.40% whilst CI among high school children may be as prevalent as 32.60%, depending on the diagnostic criteria employed. There is mixed evidence showing the association between screen time and myopia. No studies were identified showing a direct association between CI and e-device use. Conclusion: Convergence insufficiency has proven to be a prevalent condition among both young children and young adult populations. There is a need for studies to investigate the prevalence of CI in younger populations who learn in a digital environment. This may highlight exposure to the modifiable factor of screen time in managing the condition in the context of a tech-infused lifestyle. [ABSTRACT FROM AUTHOR]

Background: People living with HIV (PLHIV) on antiretroviral therapy (ART) without retinitis may not have a healthy retinal structure. Aim: To examine the impact of the virus together with the ART medication in PLHIV without retinitis. Methods: This review used the following databases: PubMed, Google Scholar and EBSCOhost. Search terms included: HIV and/or retinal nerve fibre layer (RNFL); perimetry; colour vision; contrast sensitivity (CS); visual evoked potentials (VEPs); electroretinograms (ERGs); and the brain. All peer-reviewed studies related to PLHIV on ART without retinitis, up until September 2019, were included. Results: The mean RNFL thickness, and superior and inferior zones showed thinning. Affected visual functions include transient pattern VEP and ERG; contrast sensitivity; reduced total error scores on colour vision evaluation; and reduced mean deviation and pattern standard deviations on perimetry. Studies also showed concurrent thinning of the peripapillary retinal nerve fibre layer (ppRNFL) and perimetry, contrast sensitivity and colour vision. All these significant observations were seen at a cluster of differentiation 4 (CD4) count of less than 200 cells/mm3 in PLHIV on ART with no retinitis. Further to this, studies have also related the retina to grey and white matter changes in PLHIV in the era of ART. A gap in research involves studies on the vascular impact of ART on the retina, which should be factored into studies going forward when studying PLHIV on ART. Conclusion: The decrease in visual function, the RNFL changes and neuro-ophthalmic involvement in PLHIV allow us to recognise the threat to vision loss when factoring in the expected longer lifespan that PLHIV on ART are afforded today. [ABSTRACT FROM AUTHOR]

Background: One of the leading causes of preventable blindness is cataract affecting approximately 18 million people worldwide. Twenty per cent of cataract operations worldwide are performed on people with diabetes mellitus (PDM). Aim: The aim of this review article is to analyse the scientific literature relating to visual changes associated with diabetes mellitus (DM) in pseudophakic, aphakic and phakic people, and to discuss the consequences of these changes for optometrists. Method: A literature search was conducted on PubMed, the University of KwaZulu-Natal Libraries and Google Scholar databases from August 2017 to August 2018. Results: Acute and chronic hyperglycaemia in DM causes myopia in phakic PDM, whilst in aphakic PDM it causes a hyperopic shift in refraction. It has been reported that contrast sensitivity and visual acuity are affected by changes in blood glucose. People with DM have increased central corneal thickness as compared to non-diabetics, whilst only the posterior corneal curvature is affected by hyperglycaemia in PDM. No evidence exists on the effects of glycaemic changes in pseudophakes. Conclusion: It should be noted that high blood glucose level (BGL) induces transient myopia and hyperopia in chronic phakic PDM and aphakic PDM, respectively. All refractive procedures, including prescription of spectacles, corneal refractive procedures and lens extraction, should be deferred until normalisation of BGL in phakic and pseudophakic PDM, as higher sugar levels affect corneal curvature and thickness and overall vision. [ABSTRACT FROM AUTHOR]

Background: In recent years, it has been established that the suppression of the amblyopic eye by the fellow eye is the major cause of amblyopia. New behavioural therapies like dichoptic therapy attempt to reduce suppression in amblyopic adults who have passed the critical stage of visual cortex development. Anisometropic amblyopia has the highest prevalence of amblyopia, and managing this condition in adults may lead to improvement in the quality of life. Aim: The purpose of the review is to assess the impact of this novel treatment of amblyopia, with particular focus on using dichoptic therapy for anisometropic amblyopia in adults. Methods: A literature search was conducted on articles published in the last 20 years, and papers were sourced from databases such as Elsevier, Science Direct and PubMed using the reference manager Mendeley. (The search was performed from December 2017 to December 2018.) Results: Evidence from located studies in adults with anisometropic or mixed amblyopia managed with new behavioural treatments including dichoptic therapy showed some significant improvement in the best-corrected distance visual acuity, stereopsis and contrast sensitivity whilst improving or restoring optimal binocular vision. Conclusion: Adults with anisometropic and/or mixed amblyopia can benefit from dichoptic therapy with a unique approach to improve binocularity concurrently. The therapy represents a viable option for managing amblyopia in adults and can be administered as office-based or home-based treatment in a timely manner that could improve the quality of life for such patients. [ABSTRACT FROM AUTHOR]

Purpose: Ocular perfusion pressure (OPP) regulates the flow of blood to the optic nerve and is determined by the interaction between intraocular pressure (IOP) and blood pressure (BP). Low OPP increases the incidence of primary open-angle glaucoma (POAG). The aim is to compare the diurnal (i.e. morning vs. afternoon) and postural (i.e. seated vs. supine) OPP in healthy individuals from different ethnicities aged between 18 and 30 years. Methodology: Averaged IOP and BP measurements were obtained with an ICare rebound tonometer and an automated sphygmomanometer, respectively. Measurements were taken in the morning and afternoon, in the supine and seated positions in healthy young adults: Africans (n = 10), white people (n = 10), mixed-race people (n = 10) and Indians (n = 10). Results: The whole sample (N = 40) displayed a statistically significant reduction in postural and diurnal OPP both in the supine position and in the morning, respectively. A comparative analysis revealed that Africans displayed statistically significant reduction in OPP when compared to other ethnicities. Discussion: A change in posture to the supine position has a greater impact on the reduction of OPP when compared to diurnal changes. Africans displayed clinically significant reduction in OPP which may increase the incidence of POAG in this ethnicity at an early age. Conclusion: Our findings question whether OPP should be considered as a biomarker in the dark-skinned individuals. An evaluation of BP and IOP in the supine position is recommended for all patients to obtain more conclusive readings. [ABSTRACT FROM AUTHOR]

Aim: To study the prevalence of myopia among school children in Aba, Nigeria. Methods: This cross-sectional study was conducted in public and private (primary and secondary) schools. A multi-stage random sampling technique was used for selecting participants aged between 8 and 15 years from 12 schools in Aba, Nigeria. Data were analysed for 1197 children who underwent a comprehensive eye examination. The children were divided according to the following criteria: age groups (group 1 [8-11 years] or group 2 [12-15 years]), gender (male or female), level of education (primary or secondary) and type of school (public or private). Myopia was defined as spherical equivalent refraction (SER) ≤ -0.50 D in the poorer eye. Results: The prevalence of myopia was estimated to be 2.7%. Of the 96 children with refractive error, 78.1% were uncorrected. In using logistic regression analysis, risk of developing myopia was associated with older age groups (odds ratio [OR]: 1.20; 95% confidence interval [CI], 0.16-9.11; p < 0.010) and higher level of education (OR: 1.73; 95% CI, 1.05-2.86; p < 0.030). There was no significant difference in myopia prevalence between male and female children (p = 0.89). Conclusion: Although the prevalence of myopia and overall prevalence of refractive error in school children in Aba were low, the high prevalence of uncorrected refractive error is a significant public health problem. An effective and sustainable children's vision screening programme is needed to prevent visual impairment and blindness. [ABSTRACT FROM AUTHOR]

Background: There is rarity of normative data on retinal parameters associated with glaucoma in Ghanaians. Aim: This study aimed to provide normative data on retinal parameters associated with glaucoma in an at-risk Ghanaian clinical population. Setting: The study was conducted at the Eye Clinic of the Komfo Anokye Teaching Hospital, Ghana. Methods: Ophthalmic data were obtained from 338 eyes of 116 males and 222 females (mean age: 61.86 ± 9.54 years, range: 45--89 years). The participants underwent eye examinations including visual acuity measurement using the Snellen chart at 6 m, auto-refraction using the Retinomax K+ Screen Hand-Held Autorefractor Keratometer, Goldmann applanation tonometry, slit-lamp biomicroscopy, fundus examination using a 90D Volks lens, and optical coherence tomography (OCT) using the Zeiss Cirrus HD OCT (Carl Zeiss Meditec, Dublin, CA, United States). Height and weight of participants were measured using a measuring tape and a weighing scale, respectively. Results: Mean ± standard deviation values for retinal parameters were: global peripapillary retinal nerve fibre layer (ppRNFL) = 96.11 ± 9.87 μm, global macula ganglion cell complex (mGCC) = 80.91 ± 5.61 μm, optic disc area = 2.05 ± 0.39 mm², rim area = 1.52 ± 0.27 mm², cup volume = 0.13 ± 0.12 mm³, average cup to disc ratio (ACDR) = 0.47 ± 0.15 and vertical cup to disc ratio (VCDR) = 0.44 ± 0.14. Conclusion: Thicker ppRNFL and mGCC may delay diagnosis of pre-perimetric glaucoma in Ghanaians, while larger ACDR and VCDR measurements may lead to glaucoma misdiagnosis. Contribution: This study established normative values for retinal parameters associated with glaucoma in Ghanaians. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol ingestion has a significant effect on speech, vision and coordination. The legal limit for driving under the influence in South Africa is 0.05% blood alcohol concentration (BAC), whilst intoxication is considered to occur at 0.10% BAC. The aim of our study was to investigate the effect of acute alcohol ingestion of 0.05% and 0.10% blood respiratory alcohol concentration (BrAC) on heterophoria. Methodology: The effect of alcohol ingestion on the oculomotor systems of 31 subjects was the basis of this quasi-experimental quantitative study. Various parameters were compared before and after the ingestion of 10% alc red wine. The Alcoscan ALP-1 breathalyser test was used as an indicator of BrAC. Heterophoric, fusional vergence and near point of convergence (NPC) measurements were measured during an experimental phase at 0.05% and 0.10% BrAC levels and a control phase at a 0% BrAC. Results: Mean changes in heterophoria for distance showed an increase of 1.13Δ ± 1.34Δ and 2.19Δ ± 1.70Δ towards esophoria at a BrAC of 0.05% and 0.10% respectively. At near, the results showed a mean increase of 0.84Δ ± 1.75Δ and 0.97Δ ± 1.70Δ towards exophoria at a BrAC of 0.05% and 0.10% respectively. There was a further mean decrease in the positive and negative fusional vergences as well as receded NPC break and recovery measurements at 0.05% and 0.10% BAC. Conclusion: It can be concluded that a BrAC of 0.05% has a minimal effect on heterophoria. However, at a BrAC of 0.1% there is a significant effect on heterophoria, fusional vergences and the NPC. This may or may not be clinically significant. [ABSTRACT FROM AUTHOR]

Background:  Best practice in optometry and ophthalmology recommends regular visits to eye care professionals, as routine eye examinations support early detection of ocular defects and associated systemic, sometimes potentially life-threatening, conditions., Aim:  The study sought to determine the utilisation of ophthalmic services and its associated factors in the Ashanti region of Ghana., Setting:  Fifty electoral areas in 10 of the 43 districts in the Ashanti region of Ghana., Methods:  A total of 1615 participants, aged 18 years and above, were randomly selected in the Ashanti region of Ghana for this population-based, cross-sectional survey. The factors associated with having had an eye examination were guided by Andersen's Behavioural Model. The data were analysed using multiple logistic regression, employing the IBM SPSS software, version 25., Results:  After statistical adjustments, compared with the 18-29-year-old age group, older participants were found to be more likely to utilise eye care services: In addition, participants with higher formal education had higher odds for eye care utilisation compared with no former education: Being hypertensive, self-reported vision problems and feeling that regular eye examinations are important, were statistically associated with eye care utilisation., Conclusion:  There is alarmingly poor utilisation of ophthalmic services in the Ashanti region of Ghana. Effective programmes to promote public health by addressing the socio-economic and individual barriers hindering the uptake of ophthalmic services in the Ashanti region of Ghana are thus necessary.Contribution: The study addresses a gap in the knowledge of factors associated with ophthalmic services utilisation in the Ashanti region of Ghana.

Purpose: The purpose of this study was to show the effect of increasing blood glucose level (BGL) on psychophysical visual function represents by visual acuity and contrast sensitivity in pseudophakic people living with diabetes (PDM)., Study Design: This was quasi-experimental, quantitative study using a pretest-posttest approach., Methods: The study was conducted at Gamalakhe community health centre located in Gamalakhe township and included a sample of 50 pseudophakic people living without diabetes mellitus (PWDM) and 50 pseudophakic PDM. BGL as well as psychophysical measurements of visual function were measured preprandial and postprandial. Visual acuity (VA) was measured at distance (4 m) and near (40 cm) using logMAR VA charts, and contrast sensitivity (CS) was measured at 50 cm using a Mars chart. The data collected were captured and subsequently analyzed using SPSS version 25., Results: Glycemic changes measured preprandial and postprandial observed a mean increase of 2.06±1.35 mmol/L ( p =0.350) and 1.08±0.47 mmol/L ( p =0.291) in pseudophakia PDM and pseudophakic PWDM, respectively. CS showed a mean increase of 0.01±0.10 ( p =0.23) and 0.002±0.02 ( p =0.19) log units in PDM and PWDM, respectively; however, the independent t -test showed this was insignificant between PDM and PWDM ( p =0.27). A insignificant mean increase of 0.01±0.04 log units ( p =0.25) and 0.001±0.01 ( p =0.32) in distance VA of pseudophakic PDM and PWDM was found, respectively. A mean increase of 0.001±0.01 log units ( p =0.32) and 0.01±0.03 ( p =0.06) near logMAR VA of pseudophakic PDM and PWDM was found, respectively., Conclusion: Acute hyperglycemic changes do not result in overall significant changes in visual acuity and contrast sensitivity in pseudophakic PDM and PWDM for an increase in glycemia of 2 mmol/L. We recommend studies investigate if changes occur for glycemic increases exceeding 2 mmol/L., Competing Interests: The authors reported no conflicts of interest in this work and declare that they have no financial or personal relationships which may have inappropriately influenced them in writing this article., (© 2021 Majola and Munsamy.)