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This article empirically evaluates advocacy in low- and middle-income countries as a key tool for raising policy priority and securing high-level decision maker support in eye health. We used a unique data set based on a survey conducted by World Health Organization in 2011 on eye care and prevention of blindness in 82 low- and middle-income countries. The theoretical framework derives from the idea that a plethora of stakeholders at local and global level pressure national governments, acting in economic and the political spheres. Previously, eye care has not been investigated in such a framework. We found structural differences across countries with different income levels and proposed policy recommendations to secure high-level decision makers' support for promoting eye health. Three case studies suggest that, in order to secure more support and resources for eye health, domestic and international stakeholders must strengthen their engagement with ministries of health at political and above all economic levels.

The environmental Escherichia albertii strain DM104, which cross-reacts serologically with Shigella dysenteriae was assessed for pathogenic properties, immunogenicity, and protective efficacy in different animal models to evaluate it as a vaccine candidate against S. dysenteriae, which causes the severe disease, shigellosis. The DM104 isolate was found to be non-invasive and did not produce any entero- or cyto-toxins. The strain also showed negative results in the mouse lethal activity assay. The non-pathogenic DM104 strain gave, however, a high protective efficacy as an ocularly administered vaccine in the guinea pig eye model against S. dysenteriae type 4 challenge. It also induced a high titer of serum IgG against S. dysenteriae type 4 whole cell lysate and lipopolysaccharide. Taken together, all these results indicate a good potential for the use of the DM104 as a live vaccine candidate against shigellosis.

Purpose: Alcohol consumption is inversely correlated with the incidence of cardiovascular disease. It is thought that red wine is specifically responsible for these cardiovascular benefits, due to its ability to reduce vascular inflammation, facilitate vasorelaxation, and inhibit angiogenesis. This is because of its high polyphenolic content. Resveratrol is the main biologically active polyphenol within red wine. Owing to its vascular-enhancing properties, resveratrol may be effective in the microcirculation of the eye, thereby helping prevent ocular diseases such as age-related macular degeneration, diabetic retinopathy, and glaucoma. Such conditions are accountable for worldwide prevalence of visual loss., Method: A review of the relevant literature was conducted on the ScienceDirect, Web of Science, and PubMed databases. Key words used to carry out the searches included 'red wine', 'polyphenols', 'resveratrol', 'eye' and 'ocular'. Articles relating to the effects of resveratrol on the eye were reviewed., Results: The protective effects of resveratrol within the eye are extensive. It has been demonstrated to have anti-oxidant, anti-apoptotic, anti-tumourogenic, anti-inflammatory, anti-angiogenic and vasorelaxant properties. There are potential benefits of resveratrol supplementation across a wide range of ocular diseases. The molecular mechanisms underlying these protective actions are diverse., Conclusion: Evidence suggests that resveratrol may have potential in the treatment of several ocular diseases. However, while there are many studies indicating plausible biological mechanisms using animal models and in-vitro retinal cells there is a paucity of human research. The evidence base for the use of resveratrol in the management of ocular diseases needs to be increased before recommendations can be made for the use of resveratrol as an ocular supplement.

The objective of this study is to review the association between ultraviolet (UV) light and ocular diseases. The data are sourced from the literature search of Medline up to Nov 2012, and the extracted data from original articles, review papers, and book chapters were reviewed. There is a strong evidence that ultraviolet radiation (UVR) exposure is associated with the formation of eyelid malignancies [basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)], photokeratitis, climatic droplet keratopathy (CDK), pterygium, and cortical cataract. However, the evidence of the association between UV exposure and development of pinguecula, nuclear and posterior subcapsular cataract, ocular surface squamous neoplasia (OSSN), and ocular melanoma remained limited. There is insufficient evidence to determine whether age-related macular degeneration (AMD) is related to UV exposure. It is now suggested that AMD is probably related to visible radiation especially blue light, rather than UV exposure. From the results, it was concluded that eyelid malignancies (BCC and SCC), photokeratitis, CDK, pterygium, and cortical cataract are strongly associated with UVR exposure. Evidence of the association between UV exposure and development of pinguecula, nuclear and posterior subcapsular cataract, OSSN, and ocular melanoma remained limited. There is insufficient evidence to determine whether AMD is related to UV exposure. Simple behaviural changes, appropriate clothing, wearing hats, and UV blocking spectacles, sunglasses or contact lens are effective measures for UV protection.

The study revealed that the Antarctic territory in the area of the Ukrainian Antarctic station "Academician Vernadsky" can be referred to the zone of the "super high", risk in developing ophthalmological pathology, caused by ultraviolet radiation. The results of the comprehensive dynamic study of 24 winterers of the XVI and XVII Ukrainian Antarctic expeditions (2011-2013) showed the developing of specific changes in the organ of vision under the exposure to the excessive natural ultraviolet radiation (UVR), such as parenchymatous-endothelial keratopathy, nuclear-posteriorcapsular phacopathy, maculopathy. Morphological changes were recorded using the cornea densitometry method: a decrease of the central cornea thickness by 14.3%, a decrease of the density and the number of endothelial cells of hexagonal type by 10.1% and 16.6%, respectively (P < 0.05). Using densitometry method, we detected morphological changes in the lens. Specifically, we found an increase of the optic lens density: in median zone by 10.1%, in maximal zone by 21.6%, in posterior part by 13.1%, P < 0.05. The results of densitometry recordings point to the development of local opacity in the posterior lens parts (in the nucleus and in the capsule). The data of the computed quantitative macula perimetry showed a significant decrease of light sensitivity of retina conicalis cells by 6 times (P < 0.05). The morphological signs of the endured acute solar retinopathy were found in more than 50% winterers. The revealed pathological changes can be considered as pre-, subclinical manifestations of the cornea dystrophy, cataracts and maculodystrophy, caused by specific action of the natural UVR, thus demanding the elaboration of the combined preventive measures.

Calcidius is the only exegete of Plato's Timaeus whose commentary on this Greek dialogue concerned with eyesight has not been lost. This document is all the more valuable since the Latin version is the only testimony regarding theories of and treatments for eye diseases--two domains in which, as can be deduced from the terms used, the commentator is dependent on Greek. The part of the commentary about eyesight is also worthy of interest because it is the only one that openly attacks the iuniores with an overtly hostile tone. We propose to study Calcidius' exegesis of Plato's Timaeus, focusing on Calcidius' portrayal of Greek ophthalmological theories and practices and his representation of a group of people he openly attacks.

Hyperglycemia has toxic effects on almost all cells in the body. Ophthalmic complications of hyperglycemia are most profound in cornea and retina. Seventy percent of diabetics suffer from corneal complications, collectively called diabetic keratopathy, which includes include recurrent erosions, delayed wound healing, ulcers, and edema. Confocal microscopy has permitted in vivo imaging of corneal nerves, which are also affected in diabetic subjects. Gene therapies upregulating MNNG HOS transforming gene (cMet) and/or downregulating MMP10 and cathepsin S are potential future therapies for diabetic keratopathy. Diabetic retinopathy (DR) is the most common cause of blindness in people over the age of 50. There is accumulating evidence that DR is an inflammatory disease. The initial events in animal models of DR are increased vascular permeability and leukostasis. This binding of leukocytes to the endothelium results from an increase in intracellular adhesion molecule-1 (ICAM-1) on the retinal capillary endothelium (EC) and expression of CD11/CD18 on the surface of the activated leukocyte. We have observed polymorphonuclear leukocytes (PMNs) at sites of EC vascular dysfunction in diabetic retinas as well as choroid. Anti-inflammatory drugs like etanercept, aspirin, or meloxicam reduce leukostasis and EC death. Future therapies may include repopulation of the acellular capillaries after EC and pericyte death with vascular progenitors made from the patient's own blood cells.

This volume presents articles based on a workshop held June 14 to 16, 2013 in Rancho Palos Verde, CA sponsored by the Ocular Research Symposia Foundation (ORSF). The mission of the ORSF is to focus attention on unmet needs and current research opportunities in eye research with the objective of accelerating translation of research findings to effective clinical care. In this workshop, the subject of the "The Aging Eye" was addressed, including the prevalence of eye diseases in aging and the economic burden imposed by these diseases. New research work was highlighted on the genetics, biology, biochemistry, neurochemistry, and the impact of nutrition and the environment on function in the older eye. By identifying "low-hanging fruit" (i.e., the best opportunities for successful transition of laboratory research for the prevention of and new treatments and cures for ocular diseases), we seek to spur funding at both the basic research and clinical levels, resulting in sight-saving and sight-restoration measures in the near future.

Antiviral therapy consisting of interferon-alpha and ribavirin for chronic hepatitis C infection is associated with multi-system side-effects. Ophthalmologic complications are common and can be classified into two groups: interferon-associated retinopathy and atypical adverse events. Interferon-associated retinopathy has been investigated by multiple observational studies that have found widely divergent results. The clinical importance of this complication is, consequently, controversial. This review examines the literature with the specific goal of identifying the most important ophthalmologic issues facing the hepatologist prescribing antiviral therapy. Accordingly, it assesses the incidence of interferon-associated retinopathy, as well as its risk factors, pathogenesis, clinical manifestations and options for management using data from the observational studies. The likely benefit of a screening program, especially one targeting patients with the highest risk of developing interferon-associated retinopathy, is analysed. Atypical ophthalmologic adverse events occur less frequently than interferon-associated retinopathy during antiviral therapy for chronic hepatitis C infection. They often, however, lead to irreversible vision loss. We examine the reports of these adverse events - in individual case reports or case series and in the observational studies investigating interferon-associated retinopathy - to describe the spectrum of these adverse events, the likely outcome for patients and to highlight the most important areas of future clinical research., (© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.)

Hypertension affects a significant proportion of the population, however, it is often diagnosed with a delay. The aim of this article is to review the well known and less known eye abnormalities related to hypertension, and place them in the context of population based studies. Hypertension affects various parts of the eye. The originally classified hypertensive retinopathy (retinal microvascular changes) is still relevant, but new features are visible in cases of controlled hypertension. Signs of mild hypertensive retinopathy are more common than expected occurring in nearly 10-15% of the adult non-diabetic population. Hypertensive retinopathy can be an indicator of other hypertensive complications such as neurologic and cardiac complications. Microvascular changes are reversible in well controlled hypertension. Proper treatment of hypertension can reduce the development and progression of diabetic retinopathy and, thus, visual loss due to severe retinal diseases such as retinal vascular occlusion (artery and vein), retinal arteriolar emboli, macroaneurysm, ischemic optic neuropathy and age-related macular degeneration.

The morbidity of ocular diseases, including macular degeneration, diabetic retinopathy, and dry eye disease, has been gradually increasing worldwide. Because these diseases develop from age-associated ocular dysfunctions, interventions against the aging process itself may be a promising strategy for their management. Among the several approaches to interrupt aging processes, calorie restriction (CR) has been shown to recover and/or slow age-related functional declines in various organs, including the eye. Here, we review interventions against the aging process as potential therapeutic approaches to age-related ocular diseases. The effects of CR and CR mimetics in animal models of age-related eye diseases are explored. Furthermore, we discuss the possibilities of expanding this research to prospective studies to elucidate the molecular mechanisms by which CR and/or CR mimetics preserve ocular functions., (Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: Most of the causes of childhood blindness are either treatable or preventable. Eye care-seeking behavior (ESB) of parents for their children plays a pivotal role in reducing this problem. This study was done because there was a sparsity of literature in this context and with a view to help eye care professionals plan better programs and to identify factors facilitating and/or hindering ESB of parents for their school-going children in an urban area., Methods: This study adopted a qualitative snapshot narrative study design. In-depth interviews and focus group discussions were conducted in areas of Chennai with parents and eye care professionals selected through stratified purposive sampling. Parents were based on those who sought care and did not seek care after a school eye screening program and on their socioeconomic status. Data were transcribed to English, familiarized, and inductive coded, and themes were formed. Redundancy was considered as end point of data collection., Results: Two focus group discussions and 11 in-depth interviews were conducted. Squint, redness or watering of eyes, eye irritation, headache, family history of ocular diseases, severity, and repetitiveness of symptoms facilitate parents seeking eye care for their wards/children. Economic status was an important barrier reported to affect the ESB. Logistic factors like taking appointment with doctor, taking leave from work, transport, and traveling distance were noted., Conclusions: This study shows the facilitating factors and barriers for ESB of the Chennai urban parents for their wards. The results suggest that efforts needed to be put to overcome the barriers through planned awareness programs.

Purpose of Review: To discuss the current preschool vision screening (PVS) guidelines and review some of the newest vision screening techniques. The different vision screening practices and barriers to screening are discussed., Recent Findings: Vision screening guidelines, which have been developed in response to the advances in technology and increased understanding of the developing visual system, have been recently updated by some of the major medical organizations that endorse vision screening. With advances in vision screening technology, there is a growing trend for screening at younger ages., Summary: PVS has been widely endorsed by various medical organizations as an effective way to detect preventable and treatable vision problems of childhood. Although PVS is widely recommended, actual screening rates remain low. There are several real and perceived barriers to screening which often prevents successful screening programs. Current vision screening guidelines take into account the recent advances in technology. With the development of new devices, vision screening can effectively be performed at younger ages.

Carotenoid-based visual cues and roles of carotenoids in human vision are reviewed, with an emphasis on protection by zeaxanthin and lutein against vision loss, and dietary sources of zeaxanthin and lutein are summarized. In addition, attention is given to synergistic interactions of zeaxanthin and lutein with other dietary factors affecting human vision (such as antioxidant vitamins, phenolics, and poly-unsaturated fatty acids) and the emerging mechanisms of these interactions. Emphasis is given to lipid oxidation products serving as messengers with functions in gene regulation. Lastly, the photo-physics of light collection and photoprotection in photosynthesis and vision are compared and their common principles identified as possible targets of future research.

Objective: Xeroderma pigmentosum (XP) is a rare autosomal recessive disease caused by mutations in DNA repair genes. Clinical manifestations of XP include mild to extreme sensitivity to ultraviolet radiation resulting in inflammation and neoplasia in sun-exposed areas of the skin, mucous membranes, and ocular surfaces. This report describes the ocular manifestations of XP in patients systematically evaluated in the Clinical Center at the National Institutes of Health., Design: Retrospective observational case series., Participants: Eighty-seven participants, aged 1.3 to 63.4 years, referred to the National Eye Institute (NEI) for examination from 1964 to 2011. Eighty-three patients had XP, 3 patients had XP/Cockayne syndrome complex, and 1 patient had XP/trichothiodystrophy complex., Methods: Complete age- and developmental stage-appropriate ophthalmic examination., Main Outcome Measures: Visual acuity; eyelid, ocular surface, and lens pathology; tear film and tear production measures; and cytologic analysis of conjunctival surface swabs., Results: Of the 87 patients, 91% had at least 1 ocular abnormality. The most common abnormalities were conjunctivitis (51%), corneal neovascularization (44%), dry eye (38%), corneal scarring (26%), ectropion (25%), blepharitis (23%), conjunctival melanosis (20%), and cataracts (14%). Thirteen percent of patients had some degree of visual axis impingement, and 5% of patients had no light perception in 1 or both eyes. Ocular surface cancer or a history of ocular surface cancer was present in 10% of patients. Patients with an acute sunburning skin phenotype were less likely to develop conjunctival melanosis and ectropion but more likely to develop neoplastic ocular surface lesions than nonburning patients. Some patients also showed signs of limbal stem cell deficiency., Conclusions: Our longitudinal study reports the ocular status of the largest group of patients with XP systematically examined at 1 facility over an extended period of time. Structural eyelid abnormalities, neoplasms of the ocular surface and eyelids, tear film and tear production abnormalities, ocular surface disease and inflammation, and corneal abnormalities were present in this population. Burning and nonburning patients with XP exhibit different rates of important ophthalmologic findings, including neoplasia. In addition, ophthalmic characteristics can help refine diagnoses in the case of XP complex phenotypes. DNA repair plays a major role in protection of the eye from sunlight-induced damage., (Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Aims: To determine the causes of severe visual impairment and blindness (SVI/BL) in children in Suriname (Dutch Guyana) and to identify preventable and treatable causes., Methods: 4643 children under 16 years of age were recruited from two locations: 33 children attending the only school for the blind were examined and 4610 medical records were analysed at an eye clinic. Data have been collected using the WHO Prevention of Blindness Programme eye examination record for children., Results: 65 children were identified with SVI/BL, 58.5% were blind and 41.5% were severely visually impaired (SVI). The major anatomical site of SVI/BL was the retina in 33.8%, lens in 15.4% and normal appearing globe in 15.4%. The major underlying aetiology of SVI/BL was undetermined in 56.9% (mainly cataract and abnormality since birth) and perinatal factors 21.5% (mainly retinopathy of prematurity (ROP)). Avoidable causes of SVI/BL accounted for 40% of cases; 7.7% were preventable and 32.3% were treatable with cataracts and ROP the most common causes (15.4% and 12.3%, respectively)., Conclusions: More than a third of the SVI/BL causes are potentially avoidable, with childhood cataract and ROP the leading causes. Corneal scarring from vitamin A deficiency does not seem to be a continuing issue in Suriname.

Among the prognostic factors when it comes to patients with high-grade gliomas, we find the radicality of the surgery performed. The limitations of this factor are caused by either the extension of the tumour or its location in an eloquent area. To achieve this goal, in the last few years we have developed several methods that allow us to maximise tumour resection, while always trying to cause the least possible co-morbidity. One of these methods includes the use of 5-amino-levulinic acid (5-ALA) and the development of fluorescence guided surgery. However, optimal performance requires knowledge of the product employed, the mode of administration and precautions to consider. Members of the neuro-oncology work group of the Spanish Neurosurgical Society (SENEC) have prepared this guideline or consensus document for anyone who wishes to become familiar with the use of 5-ALA fluorescence-guided surgery in the management of high-grade gliomas. For those who already utilise this technique, this document can be useful for consultation purposes., (Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.)

Aim: The aim of this study was to evaluate the occupational health problems among dentists in the Moldavian Region of Romania., Material and Methods: Questionnaire-based study was conducted on 152 dentists aged between 25-65 years practicing in 6 counties the Moldavian Region of Romania. The questionnaire included questions related to the dentists' occupational health pathology. Data were statistically analyzed using SPSS 14.0 and chi-square test (p<0.05)., Results: The majority of the dentists (91%) consider that they are exposed to an occupational risk and 41.8% of them experienced a percutaneus injury caused by sharp instruments in the last year.74.6% of the dentists are protected by vaccination against hepatitis B and 76.1% against influenza. 49.3% of the dentists reported eye injuries caused by solid particles (13.2%), blood splashes (14.7%) and/or chemicals (20,5%). Allergies associated to professional activity were reported by 76.1% of the dentists., Conclusions: The dental staff must be informed in order to recognize, control and prevent the potential occupational hazards in the workplace.

Purpose: To review and summarize the available literature on the effect of preservatives on the eye, to provide practical guidance for the clinical assessment of the ocular surface in glaucoma patients, and to define patient populations that might benefit from preservative-free topical intraocular pressure (IOP)-lowering agents., Methods: This manuscript is based on a combination of a literature review on preservatives and the eye and expert opinion from glaucoma specialists with an interest in ocular surface disease., Results: There is an increasingly recognized association between eyedrop preservatives and ocular surface disease. Preservative-free therapy is now available for a wide range of active compounds, although there are still some misconceptions regarding their appropriate use. For patients treated topically for glaucoma or ocular hypertension, a rough estimate could be that 20% may need treatment with topical IOP-reducing agents that are free from preservatives., Conclusion: This review provides an up-to-date account of the literature regarding preservatives and the eye, as well as suggestions and recommendations on to when to use preservative-free antiglaucoma treatment.

Vitamin C is an essential dietary nutrient for the biosynthesis of collagen and a co-factor in the biosynthesis of catecholamines, L-carnitine, cholesterol, amino acids, and some peptide hormones. The lack of vitamin C causes scurvy, a pathological condition leading to blood vessel fragility and connective tissue damage due to failure in producing collagen, and, finally, to death as result of a general collapse. Vitamin C is potentially involved also in cancer and cardiovascular diseases prevention. In addition, vitamin C effects on nervous system and chronically ill patients have been also documented. This review attempts to summarize recent and well established advances in vitamin C research and its clinical implications. Since vitamin C has the potential to counteract inflammation and subsequent oxidative damage that play a major role in the initiation and progression of several chronic and acute diseases, it represents a practical tool to administer for the early prevention of these pathologic conditions.

Background: Visual loss in the wilderness setting is at best disabling and at worst potentially fatal. However many physicians have a poor knowledge of ophthalmology and the basic skills that could be applied in situations away from definitive care., Method: This paper is intended for physicians, interested non-medical people and expedition operators as a practical guide to the treatment and prevention of eye problems on expeditions., Results: Some of the eye conditions described in this paper are unique to the high altitude setting, such as high altitude retinopathy and some could happen in any environment, such as trauma, dry eyes and contact lens problems. As with any aspect of an expedition, preparation is vital to prevent and avoid eye problems. It is therefore important that pre-existing ocular conditions are known about and appropriate drugs and equipment are available in expedition first aid kits., Conclusions: In the event of a visual problem, it is always better to be cautious and evacuate a patient rather than a risk a sight-threatening complication. However this paper should provide a non-ophthalmologist with the skills to treat the eye conditions described., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective., Methods: A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework., Results: Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care., Conclusion: Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices. Multi-national research may provide guidance about how to scale up eye health interventions that are integrated into primary health systems.

Unlabelled: We examined the impact of an eye health education program for older African Americans on attitudes about eye care and utilization, using a randomized trial design in a community setting. Participants were older African Americans attending activities at senior centers: Ten centers were randomized to an eye health education (InCHARGE) or social-contact control presentation. InCHARGE addressed the importance of annual dilated comprehensive examination and strategies reducing barriers to care. The control presentation was on the importance of physical activity. Outcomes were attitudes about eye care 6 months post event through questionnaire and eye care utilization during 12 months post event through medical record abstraction. At baseline, more than 80% participants in both arms said transportation and finding, communicating, and trusting a doctor were not problematic and agreed that yearly care was important. One-fourth said eye examination cost was problematic; one-half said spectacle cost was problematic. There were no group differences 6 months post event. During the 12 months pre event, the dilated exam rate was similar in the groups (38.3% InCHARGE, 40.8% control) and unchanged during the 12 moiths post event. Results suggest fewer than half of older African Americans received annual dilated eye care. Group-administered eye health education did not increase this rate. Even before the program, they had positive attitudes about care, yet many cited examination and spectacle cost as problematic, which was not mitigated by health education. Evidence-based strategies in a community setting for increasing eye care utilization rate in older African Americans have yet to be identified. Policy changes may be more appropriate avenues for addressing cost., Trial Registration: NCT00591110, www.ClinicalTrials.gov

In March 2011 the new Nintendo 3DS went on sale in Switzerland and Germany. The game console features an attractive 3D display without the need of special glasses. By means of a so-called parallax barrier the depth perception can be increased or even turned off. In adults excessive use may cause symptoms such as headaches, dizziness or nausea. In children a visual impairment could be reinforced and an amblyopia could become manifest. Excessive, long hours of use especially in children could have its risks and the possible long-term effects remain unpredictable. On the other hand in the future it is likely that these kinds of 3D screens will be of considerable diagnostic value in orthoptics. The issue is likely to become a more important issue in everyday life in the future. As there is hardly any information available in the medical literature on this subject it is the aim of this article to provide an overview of the technology and physiology with the advantages and disadvantages.

Background: The aim of the study was to present the results of welders' occupational exposure to "blue light" and UV radiation carried out at industrial workstations during TIG and MMA welding., Materials and Methods: Measurements were performed at 13 workstations (TIG welding: 6; MMA welding: 7), at which different welding parameters and materials were used. The radiation level was measured using a wide-range radiometer and a set of detectors, whose spectral responses were adequately fit to particular hazard under study. The measurement points corresponded with the location of eye and hand., Results: The highest values of eye irradiance were found for aluminum TIG welding. Effective irradiance of actinic UV was within the range E(s) = 7.79-37.6 W/m2; UVA total irradiance, E(UVA) = 18-53.1 W/m2 and effective blue-light irradiance E(B) = 35-67 W/m2. The maximum allowance time ranged from 1.7 to 75 s, which means that in some cases even unintentional very short eye exposure can exceed MPE., Conclusions: The influence of welded material and the type of electrode coating on the measured radiation level were evidenced. The exceeded value of MPE for photochemical hazard arising for the eyes and skin was found at all measured workstations. Welders should use appropriately the eye and face protective equipment and avoid direct staring at welding arc when starting an arc-welding operation. Besides, the lack of head and neck skin protection can induce acute and chronic harmful health effects. Therefore, an appropriate wear of personal protective equipment is essential for welders' health.

Carotenoids are natural pigments attracting attention of physicists, chemists and biologists due to their multiple functions in the nature. While carotenoids have unusually high extinction coefficients, they do not exhibit adequate emission. This fact has resulted in detailed studies of photophysical and photochemical properties of carotenoids and their role as light-harvesting pigments in photosynthesis. Carotenoids are abundantly present in fruits and vegetables and are considered as important species with beneficial effect on human health by decreasing the risk of various diseases, particularly decreasing the incidence of cancers and eye disease. More trials are needed to ascertain the role of carotenoids in prevention of cardiovascular disease and metabolic disease. Carotenoids effectively scavenge peroxyl radicals and act predominantly as antioxidants. However, under conditions of increased concentration of oxygen and carotenoid concentration, beta-carotene was found to exhibit prooxidant behaviour. Photophysical properties of carotenoids and conditions affecting a switch between antioxidant and prooxidant behaviour of carotenoids are the main aims of this review. In addition, the localization of carotenoids in biological membranes, their interactions and reactions with ascorbic acid (vitamin C) and alpha-tocopherol (vitamin E) as well as their redox potentials are discussed in view of their antioxidant properties as beneficial species in preventing various diseases., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Ophthalmoheliosis are a class of diseases in which acute or chronic exposure to UV radiation is crucial. Pathology is different, depending on the duration, wave-lenghth, size and intensity of exposure. The aim of this paper is to highlight the mechanisms by which UVR absorption occurs in the eye and patho-physiological changes with many types of pathology. There are also presented categories risk factors and preventive measures of the disease.

Hass avocados, the most common commercial avocado cultivars in the world, contain a variety of essential nutrients and important phytochemicals. Although the official avocado serving is one-fifth of a fruit (30 g), according to NHANES analysis the average consumption is one-half an avocado (68 g), which provides a nutrient and phytochemical dense food consisting of the following: dietary fiber (4.6 g), total sugar (0.2 g), potassium (345 mg), sodium (5.5 mg), magnesium (19.5 mg), vitamin A (43 μg), vitamin C (6.0 mg), vitamin E (1.3 mg), vitamin K1 (14 μg), folate (60 mg), vitamin B-6 (0.2 mg), niacin (1.3 mg), pantothenic acid (1.0 mg), riboflavin (0.1 mg), choline (10 mg), lutein/zeaxanthin (185 μg), phytosterols (57 mg), and high-monounsaturated fatty acids (6.7 g) and 114 kcals or 1.7 kcal/g. The avocado oil consists of 71% monounsaturated fatty acids (MUFA), 13% polyunsaturated fatty acids (PUFA), and 16% saturated fatty acids (SFA), which helps to promote healthy blood lipid profiles and enhance the bioavailability of fat soluble vitamins and phytochemicals from the avocado or other fruits and vegetables, naturally low in fat, which are consumed with avocados. There are eight preliminary clinical studies showing that avocado consumption helps support cardiovascular health. Exploratory studies suggest that avocados may support weight management and healthy aging.

Eye cosmetics such as mascara, eye shadow and eyeliner are used extensively to highlight the eyes, and are normally applied external to the ocular surface. Adverse reactions of cosmetics within the ocular surface include mild discomfort, eyelid dermatitis, pre-corneal tear film instability, and keratitis. These are attributed mainly to the preservative (benzalkonium chloride (BAC)) constituent of cosmetic product material (CPM). Transport of CPM from an external environment to any location on the ocular surface, essentially precedes the adverse interactions occurring at the location, and the control of these transport modes is therefore of clinical relevance. The inter-transport of CPM across the TF occurs due to both diffusion and drift processes. Diffusion of neutral species is driven by concentration gradients, and the drift of cationic BAC is influenced by the inherent electric field; determined by the distribution of the various ions secreted into the aqueous layer, and the negative glycocalyx charge at the mucin layer. In the presence of mucin deficiency, the corneal epithelium is exposed to invasion by both incident BAC and lipophilic species. The transport of cationic BAC across the TF may be controlled by regulating the secretion of various electrolytes at the lacrimal gland. This is of clinical significance in reducing corneal epithelial adverse effects. However, the risks of adverse effects at the corneal surface due to invasion by the lipophilic species remain. Patients with mucin deficiency, and especially those on eye ointment/drops medication, should be discouraged from using cosmetics in a way likely to contaminate the TF., (Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)

The regular use of visual display units (VDUs) at work has been shown to cause the development of a constellation of symptoms ranging from dry eyes to temporary myopia. European workers who use VDUs are now protected under detailed legislation enacted by the European Union (Directive 90/270/EEC). The use of picture archiving and communications systems, which are almost ubiquitous in European countries, means that, as a profession, radiologists fall under the remit of this legislation. This paper aims to assess the impact that full implementation of this law would have on a radiologist's practice and to more broadly examine the issue of eye care as an occupational health issue in radiology. The authors conclude that eye care in the setting of regular VDU use among radiologists is an important quality control and occupational health issue. There is a clear legal basis requiring employers to provide regular eye examinations and reporting breaks. In the absence of leadership from employers on this issue individual radiologists have a responsibility to ensure that their work practices reflect the legal situation and minimise the effect of eye strain on their performance.

Ophthalmologic complications are frequently encountered in intensive care unit (ICU) patients (Grixti et al. Ocul Surf 2012;10(1):26-42). However, eye care is often overlooked in the critical care setting or just limited to the ocular surface because treatment is focussed on the management of organ failures. Lack of awareness about other less common intraocular sight-threatening conditions may have a devastating effect on the patient's vision. To identify specific, frequently missed uncommon ocular disorders in ICU, a literature review using the keywords "Intensive Care," "Eye care," "ITU," "ICU," "Ophthalmological disorders," "Eye disorders" was performed. The databases of CINAHL, PuBMed, EMBASE, and Cochrane library were searched. The higher quality studies are summarized in the table with statements of methodology to clarify the level of evidence. The most prevalent ophthalmologic disorders identified in critically ill subjects include exposure keratopathy, chemosis, and microbial keratitis. In addition, uncommon eye disorders reported in ICU include metastatic endogenous endophthalmitis, acute primary angle closure, ischemic optic neuropathy, pupil abnormalities, vascular occlusions, and rhino-orbital cerebral mucormycosis. Early diagnosis and effective treatment will help to prevent visual loss., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Preservatives are a legal requirement for eye drops in multidose containers. Moreover, they are necessary for stabilization and intraocular penetration for a number of ophthalmic preparations. Most preservatives act in a relatively unspecific manner as detergents or by oxidative mechanisms and thereby cause side effects at the ocular surface. They may also affect the lens, trabecular meshwork and the retina. Benzalkonium chloride is the most commonly used preservative in ophthalmology and is more toxic than other or newer preservatives, such as polyquaternium-1 (Polyquad), sodium perborate, oxychloro-complex (Purite®) and SofZia. Preservative-free topical medication is highly recommended for patients with ocular surface disease, frequent eye drop administration, proven allergy to preservatives and contact lens wear.

India has a proud tradition of blindness prevention, being the first country in the world to implement a blindness control programme which focused on a model to address blinding eye disease. However, with 133 million people blind or vision impaired due to the lack of an eye examination and provision of an appropriate pair of spectacles, it is imperative to establish a cadre of eye care professionals to work in conjunction with ophthalmologists to deliver comprehensive eye care. The integration of highly educated four year trained optometrists into primary health services is a practical means of correcting refractive error and detecting ocular disease, enabling co-managed care between ophthalmologists and optometrists. At present, the training of optometrists varies from two year trained ophthalmic assistants/optometrists or refractionists to four year degree trained optometrists. The profession of optometry in India is not regulated, integrated into the health care system or recognised by the majority of people in India as provider of comprehensive eye care services. In the last two years, the profession of optometry in India is beginning to take the necessary steps to gain recognition and regulation to become an independent primary health care profession. The formation of the Indian Optometry Federation as the single peak body of optometry in India and the soon to be established Optometry Council of India are key organisations working towards the development and regulation of optometry.

The effectiveness of eye care service delivery is often dependant on how the different stakeholders are aligned. These stakeholders range from the ministries of health who have the capacity to grant government subsidies for eye care, down to the primary healthcare workers who can be enrolled to screen for basic eye diseases. Advocacy is a tool that can help service providers draw the attention of key stakeholders to a particular area of concern. By enlisting the support, endorsement and participation of a wider circle of players, advocacy can help to improve the penetration and effectiveness of the services provided. There are several factors in the external environmental that influence the eye care services - such as the availability of trained manpower, supply of eye care consumables, government rules and regulations. There are several instances where successful advocacy has helped to create an enabling environment for eye care service delivery. Providing eye care services in developing countries requires the support - either for direct patient care or for support services such as producing trained manpower or for research and dissemination. Such support, in the form of financial or other resources, can be garnered through advocacy.

Understanding health systems have now become the priority focus of researchers and policy makers, who have progressively moved away from a project-centred perspectives. The new tendency is to facilitate a convergence between health system developers and disease-specific programme managers in terms of both thinking and action, and to reconcile both approaches: one focusing on integrated health systems and improving the health status of the population and the other aiming at improving access to health care. Eye care interventions particularly in developing countries have generally been vertically implemented (e.g. trachoma, cataract surgeries) often with parallel organizational structures or specialised disease specific services. With the emergence of health system strengthening in health strategies and in the service delivery of interventions there is a need to clarify and examine inputs in terms governance, financing and management. This present paper aims to clarify key concepts in health system strengthening and describe the various components of the framework as applied in eye care interventions.

Day length and intensity are commonly manipulated aspects of the light environment in commercial broiler production. Both influence circadian rhythms, but it is unclear if they do this independently or synergistically. The effect of light:dark (20L:4D, 16L:8D) and intensity contrasts (1 lx:0.5 lx, 200 lx:0.5 lx) on broiler behavior and health (n=1,004, 4 replicates/treatment) was evaluated. Activity was measured using passive infrared detection, and feeding activity was measured by the amount of feed consumed/h over one 24-h period each week. Broilers were gait scored and weighed at 6 wk of age. Following euthanasia, eyes were dissected from 30 birds/treatment. Behavior and performance were analyzed using the GLM, gait score using the Kruskal-Wallis test, and eye measures using a MANOVA. The 200 lx birds were more active (P=0.03) and fed more (P=0.001) during the photophase but were less active (P=0.02) and fed less (P<0.001) during the scotophase, than the 1 lx birds. There were no differences in G:F (mean±SEM, 1.63±0.01 kg of feed/kg of BW). However, 1 lx birds were slightly heavier (2.79±0.01 kg; P=0.02) than 200 lx birds (2.72±0.01 kg). The 200 lx birds had better (P<0.001) mean gait scores than 1 lx birds, although treatment differences were small. One lux birds had greater side-to-side (18.86±0.11 mm vs. 17.63±0.11 mm, P<0.001) and back-to-front (13.39±0.09 mm vs. 12.89±0.09 mm, P<0.001) eye diameters and heavier eyes (2.42±0.03 g vs. 1.99±0.03 g, P<0.001) than 200 lx birds. There was only one effect of light:dark, with 16:8 having greater back-to-front eye diameters than 20:4 (13.30±0.10 mm vs. 13.00±0.10 mm, P=0.02). There were no interactions. These results indicated that light intensity, not day length, was the major factor affecting broiler behavior and health under these lighting conditions. Low contrast light intensity dampened behavioral rhythms and had possible health effects.

There are many controversies among ophthalmologists and obstetricians regarding indications for caesarean section due to preexisting eye diseases. Many ophthalmologists still believe myopia, retinal detachment, glaucoma or diabetic retinopathy to be indications for a caesarean section. There is a discrepancy between clinical practice and evidence-based medicine, as none of the published trials have reported any retinal changes after vaginal delivery This report provides information on the influence of physiological changes on eye diseases during the final stage of the delivery. We conclude that an eye disease is not an indication for a caesarean section.

Unlabelled: A technique that uses an implanted intraocular lens (IOL) to create a barrier for the management of posterior capsule rupture is described. When a rupture occurs, surgery is halted and a dispersive ophthalmic viscosurgical device (OVD) injected into the anterior chamber to prevent vitreous prolapse. The remaining nucleus is maneuvered into the anterior chamber away from the pupillary space. The posterior capsule tear is converted into a continuous curvilinear capsulorhexis where possible. Dissociated anterior vitrectomy is performed as indicated, keeping the large nuclear fragments trapped in the OVD-filled anterior chamber. An IOL is implanted in the capsular bag or sulcus with optic capture through the anterior capsulorhexis. Using reduced parameters, phacoemulsification of the remaining fragments is completed over the IOL, which functions as a barrier to seal off the vitreous cavity. Residual nuclear fragments and vitreous are cleared from beneath the optic by placing the vitreous cutter under the optic, recapturing the optic before the instruments are removed from the eye., Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned., (Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the effect of the Honan intraocular pressure reducer (HIPR) on vitreous reflux during intravitreal (IVT) injection., Methods: Prospective, comparative, controlled, investigator-blinded, randomized clinical study. Sixty eyes of 60 patients who underwent IVT injection were allocated into 2 groups with or without using the HIPR. Vitreous reflux was estimated by measuring largest diameter of the conjunctival bleb formed after IVT injection. Preoperative intraocular pressure (IOP) before and after application of the HIPR and IOP immediately postoperatively and 3 and 10 minutes postoperatively were evaluated., Results: The mean amount of vitreous reflux was significantly less with the HIPR than without the HIPR (1.46±1.04 mm vs 2.61±1.37 mm; p<0.001). The preoperative IOP was significantly lower with the HIPR than without the HIPR (11.62±4.04 mmHg vs 16.26±3.86 mmHg; p=0.026). The 3-minute postoperative IOP was 31.34±3.16 mmHg with the HIPR and 32.61±5.62 mmHg without the HIPR (no statistical significance; p=0.345)., Conclusions: The HIPR prevents vitreous reflux after IVT through a reduction in the preoperative IOP. However, the HIPR appears not to affect the postoperative course of transient IOP elevation.