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NAA10-related (Ogden syndrome) and NAA15-related neurodevelopmental syndrome are known to present with varying degrees of intellectual disability, hypotonia, congenital cardiac abnormalities, seizures, and delayed speech and motor development. However, the ophthalmic manifestations of NAA10 and NAA15 variants are not yet fully characterized or understood. This study analyzed the prevalence of six ophthalmic conditions (cortical visual impairment, myopia, hyperopia, strabismus, nystagmus, and astigmatism) in 67 patients with pathogenic (P) or likely pathogenic (LP) variants in the NAA10 cohort (54 inherited, 10 de novo; 65 missense, 2 frameshift) and 19 patients with (L)P variants in the NAA15 cohort (18 de novo; 8 frameshift, 4 missense, 4 nonsense, and 1 splice site). Patients were interviewed virtually or in-person to collect a comprehensive medical history verified by medical records. These records were then analyzed to calculate the prevalence of these ophthalmic manifestations in each cohort. Analysis revealed a higher prevalence of ophthalmic conditions in our NAA10 cohort compared to existing literature (myopia 25.4% vs. 4.7%; astigmatism 37.3% vs. 13.2%; strabismus 28.4% vs. 3.8%; CVI 22.4% vs. 8.5%, respectively). No statistically significant differences were identified in the prevalence of these conditions between the NAA10 and NAA15 variants. Our study includes novel neuroimaging of 13 NAA10 and 5 NAA15 probands, which provides no clear correlation between globe size and severity of comorbid ophthalmic disease. Finally, anecdotal evidence was compiled to underscore the importance of early ophthalmologic evaluations and therapeutic interventions., (© 2024 The Author(s). American Journal of Medical Genetics Part A published by Wiley Periodicals LLC.)

Background: Ophthalmic quality of life (OQoL) has been investigated in selected parts of general populations and in patients with ocular disease, but OQoL in unselected general populations has not been studied in detail. The present study reports OQoL obtained from a representative sample of the adult Danish population 2020-2022., Methods: The FORSYN study invited 10 350 citizen representatives for the adult Danish population for a non-mydriatic eye examination and answer the National Eye Institute Visual Function Questionnaire with 39 items in the validated Danish translation. The results from the 3384 (32.7%) persons who participated in the study were weighted on the basis of relevant socio-economic factors, and data were projected to represent the total population. Binocular visual acuity was below 0.1 corresponding to legal blindness in 0.22% of this population., Results: OQoL was positively correlated with binocular visual acuity up to better than 93 ETDRS letters, negatively correlated with age for persons younger than 60 years of age and again positively correlated with age for persons older than 60 years. OQoL was negatively correlated with increasing ametropia and refractive error above 1 dioptre and encompassed more OQoL parameters for hyperopic than for myopic persons., Conclusions: The study underlines the benefits of improving visual acuity even within the normal range and of adjusting uncorrected refraction errors in the general population. OQoL is positively correlated with age in older persons independently of visual acuity, sex, refractive power and previous cataract surgery., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: The purpose of this study was to examine the association between refractive errors and common chronic diseases using blood biochemistry tests, and to investigate the associated modifiable risk factors, with the goal of informing and developing effective preventive strategies., Methods: A total of 116,245 participants with refractometry at baseline enrolled in the UK Biobank were included in this prospective cohort study. Restricted cubic spline and Cox proportional hazards models were used to detect associations between refractive error, blood biochemistry tests, and common chronic diseases. Interaction effects on the additive scale and effect modification analysis were used to explore excess modifiable risk factors for disease prevention., Results: Spherical equivalent significantly associated with vitamin D, sex hormone binding globulin, apolipoprotein A, blood glucose, and aspartate aminotransferase levels. Subjects with myopia demonstrated a 13% higher risk of type 2 diabetes mellitus (T2DM) incidence compared to those without myopia (hazard ratio [HR] = 1.13, 95% confidence interval [CI] = 1.08-1.19) throughout a median follow-up of 9.12 years. Interaction analysis revealed 15% (95% CI = 9%-21%) of this risk was due to myopia-obesity interaction. However, active engagement in physical activity could potentially mitigate this risk (HR = 1.06, 95% CI = 0.93-1.20)., Conclusions: Refractive errors were associated with specific blood indicators, particularly noting the association between myopia and higher T2DM incidence in middle-aged and elderly populations. This effect interacts with obesity, and promoting physical activity among myopia individuals provides greater benefits in the prevention of T2DM compared to non-myopic individuals.

Purpose: Visual and motility disorders have been reported in cases of syndromic and non-syndromic craniosynostosis. However, to the best of our knowledge, no regional or local studies have addressed the prevalence of ocular manifestations in craniosynostosis among Middle Eastern populations. The purpose of this study was to describe the frequency and nature of ophthalmic abnormalities in Arab children with craniosynostosis and to evaluate these findings pre- and post-craniofacial surgery., Materials and Methods: A prospective cohort study of 31 children with craniosynostosis. Demographic information was gathered along with genetic results and ophthalmic evaluations, including cycloplegic refraction., Results: Age at presentation to the ophthalmology service ranged from 14 months to 8 years, with a median of 3 years. Sixteen patients were female (52%), and 24 patients had undergone a cycloplegic refraction. Of these, 20.8% had significant refractive errors; of those with refractive errors, 40% were myopic and 60% were hyperopic. Eight patients (25.8%) had papilledema, with significant improvement after craniofacial surgery. Five patients (16%) had visual acuity≤20/30 in at least one eye at baseline with improvements in follow-up visits., Conclusion: Craniosynostosis has a significant impact on visual function in the Arab population. Potentially correctable cases of visual impairment, such as those caused by amblyogenic refractive error and papilledema, are commonly encountered; therefore, timely referral and regular ophthalmic evaluation are recommended for these patients., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Comprehensive research on the impact of various types of refractive errors (RE) and anisometropia on dry eye disease is still lacking. This study aimed to estimate the prevalence rates and potential lifestyle factors related to symptomatic dry eye (SDE) among adolescents in eastern China., Methods: A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was used among adolescents in Nantong, China. Demographic information, including sex, age and BMI, were collected. All participants underwent optometric tests, while Ocular Surface Disease Index (OSDI) and self-designed questionnaires were administered. Both univariate and multivariate logistic regression analyses were used to assess associations between SDE and related parameters, and various types of RE and anisometropia were also included in the study., Results: A total of 1,518 participants were enrolled in the study, and the overall prevalence of SDE was 20.3% among adolescents in Nantong, China. Multiple logistic regression analyses showed that high myopia (aOR = 3.42, 95% CI = 1.60-3.36, p = 0.025), frequent use of eye drops (aOR = 2.31, 95% CI = 1.60-3.36, p<0.001), a history of allergic conjunctivitis (aOR = 1.93, 95% CI = 1.09-3.34, p = 0.025), and frequent blinking (aOR = 3.23, 95% CI = 2.31-4.53, p<0.001) were identified as risk factors for SDE. Conversely, male gender (aOR: 0.76, 95% CI: 0.58-0.99, p = 0.043), increased sleep time (6-7 h: aOR = 0.64, 95% CI = 0.46-0.89, p = 0.009; 7-8 h: aOR = 0.64, 95% CI = 0.43-0.95, p = 0.026; >8 h: aOR = 0.43, 95% CI = 0.23-0.82, p = 0.010), and timely intervention when vision decline occurred were protective factors against SDE (aOR = 0.61, 95% CI = 0.43-0.85, p = 0.004)., Conclusion: High myopia was found to be independently associated with an increased risk of SDE., while hyperopia, astigmatism, and anisometropia were not independent risk factors for SDE. The identified risk and protective factors may help provide valuable insights for future research and interventions aimed at improving ocular health in adolescents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Uncorrected refractive error (URE) is one of the main causes of visual impairments. URE may reduce interaction and learning in the classroom, leading to social isolation, irreversible amblyopia, lack of external knowledge, and restrictions on education and employment opportunities. Our aim was to investigate the prevalence and related factors of URE in adolescents using epidemiological surveys and questionnaire surveys related to lifestyle habits., Methods: A cross-sectional school-based study was conducted in Nantong, China, including adolescents 12-19 years of age from 16 schools. URE was defined as presenting visual acuity worse than 6/12 and improving to ≥ 1 lines after correction in either eye. Univariate and multivariate logistic regression analyses were used to investigate specific correlations between URE and related lifestyle parameters. Non-cycloplegic autorefraction was assessed for each adolescent., Results: A total of 2,910 adolescents were analyzed, of which 50.3% (n = 1,465) were male, and 49.7% (n = 1,445) were female. The mean age was 15.23 ± 1.77 years. The overall prevalence of URE was 23.7%. The total prevalence of REC and eREC was 85.1% and 71.7%, respectively, and both of them showed an increasing trend with age (Ptrend = 0.018 and Ptrend = 0.019, respectively). A higher prevalence of URE was related to myopia, anisometropia, and increased daily use of electronic products. Timely visual examination by medical institutions, more extracurricular homework, and older age were protective factors for URE. Among the 689 adolescents with URE, 362 (52.5%) did not receive any refractive correction, and 327 (47.5%) used corrected glasses., Conclusion: URE was highly prevalent among adolescents in China. Myopia was the most important risk factor for URE. The impact of anisometropia and increased daily use of electronic devices on URE was significant. Timely visual examinations by medical institutions served as an effective protective factor against URE. Further research on adjusting intervention strategies is therefore needed to eliminate preventable visual impairments., (© 2024. The Author(s).)

Background: Uncorrected refractive errors and amblyopia are reported as the two main causes of childhood visual impairment and blindness worldwide. Our purpose was to evaluate refractive status, ocular alignment and effective refractive error coverage (eREC) of school-aged children from low-income areas of Sao Paulo city, Brazil., Methods: Data from the "Ver na Escola" Project were used for the current study. Children enrolled in the selected schools had an ophthalmic exam including eye alignment assessed by cover test, automatized and subjective dynamic and static refraction. The associations of demographic variables with occurrence and magnitude of refractive errors and eREC were investigated by multiple logistic regressions and multilevel mixed effect models., Results: A total of 17,973 children (51.12% females) with mean ± sd age 8.24 ± 3.54 years old examined from July 2018 to July 2019, were included in the study. Most of the participants (73%) showed orthoposition of the visual axis for both distance and near. Heterophoria was found in about 25% of participants (N = 4,498), with 71.7% of them (N= 3,222) classified as exophoria. Less than 2% (N = 232) showed strabismus, most of them (N = 160) esotropia. Overall, 1,370 (7.70%) of participants had myopia and 577 (3.24%) had hyperopia. Age was found to be significantly associated with increasing static subjective refraction spherical equivalent (Coefficient: -0.18; 95% Confidence Interval (CI): -0.21 to -0.16; p < 0.001). Female sex (Odds Ratio (OR) = 1.13; 95%CI: 1.01-1.27; p = 0.027) and older age (OR = 1.17; 95%CI: 1.16-1.19; p < 0,001) were significantly associated with myopia diagnosis. Older age decreased the odds of hyperopia (OR = 0.95; 95%CI: 0.93-0.98; p < 0.001). The overall effective refractive coverage was 51.76% and was significantly associated with age group, ranging from 32.25% in children aged 3 to 7 years to 61.35% in children aged 8 to 12 years., Conclusions: Most children have shown eye alignment for both distance and near assessments and no refractive error. Myopia was observed in 7.70% of the population and it was associated with older age and female sex. Hyperopia was observed in 3.24% and was associated with younger age. The overall eREC was 51.76%, significantly associated with age., (© 2024. The Author(s).)

Objective: To comprehend the status and changing trend in the burden of refractive errors in China from 1990 to 2019, and to furnish data-driven support for the formulation of rational strategies in refractive error prevention and control. Methods: Using the Global Burden of Disease Database 2019, data on refractive error prevalence and years lived with disability (YLD) in China from 1990 to 2019 were extracted and their standardized rates were calculated. The trend of refractive error prevalence, age, period, and gender was analyzed using joinpoint regression models. Results: From 1990 to 2019, the number of cases, prevalence rate, and YLD rate of refractive errors in China showed an upward trend, which was consistent with global trends. However, the magnitude of the increase in these parameters was higher than the global average. Conversely, the age-standardized prevalence rate and age-standardized YLD rate demonstrated a declining trend, which was also consistent with global trends, but the reduction rate was less pronounced compared to global levels. Notably, all indicators for females, including prevalence and YLD, exceeded those of males. The prevalence and YLD rates of refractive errors in China increased with age. The older individuals had higher rates compared to younger individuals. In 1990, the highest prevalence and YLD rates were found in the ≥70 years group, while the lowest rates were in the <5 years group. The age group with the most substantial increase in the burden of refractive errors was the 15 to 49 years population, which remained consistent during the three decades. The joinpoint regression analysis results revealed a stage-wise fluctuation in the age-standardized prevalence and YLD rates of refractive errors in China from 1990 to 2019. Specifically, the age-standardized prevalence rate increased by 0.765% from 1990 to 2001, decreased by 0.963% from 2001 to 2014, increased by 4.214% from 2014 to 2017, and decreased by 3.029% from 2017 to 2019. In contrast, the age-standardized YLD rate decreased by 0.113% from 1990 to 1995, increased by 2.252% from 1995 to 2000, decreased by 1.102% from 2000 to 2014, increased by 4.326% from 2014 to 2017, and decreased by 5.090% from 2017 to 2019. Conclusions: The standardized prevalence of refractive errors and the standardized YLD rate in China showed a downward trend, which was less than the global average level, but the disease burden was still heavy. Gender and age emerged as significant influencing factors for the prevalence of refractive errors and YLD. It is imperative to enhance efforts in the prevention and treatment of refractive errors among the middle-aged and elderly population. Attention should also be directed towards the increasing burden in the<50 years population.

Purpose: To describe the prevalence and risk factors associated with amblyogenic refractive error in children with Coats disease., Methods: 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., Results: 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., Conclusions: 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., (Copyright © 2024 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Significance: This study brings awareness of racial/ethnic difference of refractive error characteristics in clinics., Purpose: This study aimed to assess longitudinal change in refractive errors over a 36-month period in Hispanic and Black children., Methods: Children (2.4 to 15 years old) were studied. Cycloplegic refraction was measured annually. Spherical equivalent was calculated. Astigmatism was evaluated by magnitude of cylinder and power vector (J 0 and J 45 ). Absolute value of interocular spherical equivalent difference was used to calculate anisometropia. Mixed-linear model was used to analyze longitudinal annual change in spherical equivalent, cylinder, J 0 , and J 45 over 36 months., Results: A total of 485 participants (310 Black, 175 Hispanic) met the criteria. At the baseline examination, prevalence of myopia, emmetropia, and hyperopia was 39% (n = 187), 31% (n = 150), and 30% (n = 148), respectively. Spherical equivalent of Black children was not significantly different from that in Hispanic children (0.10 ± 2.92 vs. -0.37 ± 2.05 D, p=0.06); however, the Hispanic children had a significantly higher cylinder compared with Black children (Hispanic: 1.46 ± 1.57 D vs. Black: 0.92 ± 1.07 D; p<0.001). Both J 0 (p<0.001) and J 45 (p=0.01) were significantly different between two groups; the Hispanic children had more with-the-rule astigmatism and oblique astigmatism than the Black children. Prevalence of anisometropia (≥1 D) was higher in Black children (14%) compared with Hispanic children (5%, p=0.006). Over 36 months, spherical equivalent significantly decreased an average of 0.69 D (0.23 D/y, p<0.001) for both groups; neither astigmatism nor anisometropia changed significantly (p>0.05)., Conclusions: Astigmatism in the Hispanic children was significantly higher than in Black children. However, the Black children had a higher prevalence and degree of anisometropia than the Hispanic children., Competing Interests: Conflict of Interest Disclosure: The author (JW) is a nonremunerative advisory board member for Percept Corporation, which is not related to this article. All other authors have no disclosure., (Copyright © 2024 American Academy of Optometry.)

Introduction: Little is known about the prevalence of refractive errors and amblyopia among school children on the islands of East Coast Malaysia. This study aimed to investigate the prevalence of these conditions and their associated factors in this unique and remote geographical location., Materials and Methods: This multicentre cross-sectional school-based study included 480 children aged 7 to 12 year from primary schools on the islands of the East Coast of Malaysia. All children underwent visual acuity assessment, orthoptic evaluation, anterior and posterior segment examinations and manifest refraction. Demographic data, history of parental refractive error, parental education level, duration of digital screen time and time spent outdoors were documented in a questionnaire distributed to the parents., Results: The mean age was 9.53 ± 1.69 years, with an equal distribution of genders. The ethnic composition of the subjects was 99.4% Malay and 0.6% Orang Asli. The overall prevalence of refractive errors was 11.9% (95% CI: 9.1 to 15.1%), with myopia at 7.1% (95% CI: 5.0 to 9.8%), hyperopia at 2.5% (95% CI: 1.3 to 4.3%), astigmatism at 2.3% (95% CI: 1.1 to 4.1%) and amblyopia at 2.5% (95% CI: 1.3 to 4.3%). Older age, an absence of parental history of refractive error and reduced daily outdoor time were significantly associated with refractive errors (p < 0.05)., Conclusion: The prevalence of refractive error is 11.9% and amblyopia is 2.5% among primary school children on the islands of the East Coast of Peninsular Malaysia. Older age, an absence of parental history of refractive error and reduced daily outdoor time are associated with refractive error.

Purpose: To evaluate refractive findings in patients with unilateral Duane's retraction syndrome (DRS)., Methods: This retrospective study included 40 patients followed for unilateral DRS. Detailed ophthalmological examinations of the patients were performed. The spherical and cylindrical refractive error, spherical equivalent, and type of refractive error in the eyes with DRS and the fellow eyes were determined. The patients were divided into three subgroups according to their type of DRS. The refractive properties of the eyes with DRS were examined in subgroup analyses. Eye movement limitation was graded between +1 and +4 and compared according to the refractive error type., Results: The mean age of the patients was 16.8±12.6 (range, 1-60) years. Of the eyes with DRS, 11 (27.5%) were emmetropic, four (10%) were hyperopic, two (5%) were myopic, 11 (27.5%) were myopic astigmatic, and 12 (30.0%) were hyperopic astigmatic. There was no statistically significant difference between the eyes with DRS and fellow eyes in relation to the spherical or cylindrical refractive errors or spherical equivalent (P>0.05 for all). The refraction values for the patients with type 1, type 2 and type 3 DRS were similar between groups (P>0.05). No statistically significant difference was detected in the degree of eye movement limitation according to refractive status (P>0.05)., Conclusion: In patients with unilateral DRS, there was no significant difference between the affected eyes and the fellow eyes in terms of refractive error values or types. Refractive status did not significantly differ according to the degree of eye movement limitation. Therefore, although extraocular muscles are affected by DRS, there may not be any significant refractive changes., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Purpose: As per the recent World Health Organization estimates, approximately 2.2 billion people have near and distance vision impairment (VI) globally, and out of this almost 50% is avoidable., Methods: The Rapid Assessment of Avoidable Visual Impairment survey was a cross-sectional study conducted in September 2021, using cluster random sampling in 42 clusters with a cluster size of 140, giving a total of 6000 participants. Two teams comprising of trained optometrists and social workers conducted the ocular examination which included unaided, pinhole, and aided visual acuity assessments followed by examination of the anterior segment and lens. Distance visual acuity was measured using simplified tumbling "E" charts of different sizes for VA of 6/12, 6/18, and 6/60. The lens assessment was done in an un-dilated pupil with torch light by the optometrist., Results: Overall, 6520 individuals aged 6 years and above were enumerated, of whom 5440 (83.4%) were examined. The response rate for examination was better among females (93.1%) than males (73.9%), and it decreased from 93.8% in the age group 6-15 years to 77.1% in the 45+ age group. The prevalence of blindness and VI were 0.18% (95% CI: 0.06-0.29) and 4.19% (95%CI: 3.65-4.72), respectively. The major causes of VI in all age groups were uncorrected refractive error (65.4%), cataract (23.7%), cataract surgical complications (2.6%), corneal opacity (0.4%), and other posterior segment diseases (7.5%). The effective cataract surgical coverage (eCSC) was 61.8%, effective refractive error coverage (eREC) for distance vision was 59.8%, and eREC for near vision was 47.0%., Conclusion: The RAAVI methodology is suitable to measure effective coverage in the general population, both for baseline measurement and periodic monitoring. The 2030 targets for the surveyed district are 90% eCSC and 100% eREC. Such exercises need to be conducted in each district of the country to determine the baseline and target values of effective coverage., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Purpose: To conduct a large retrospective study of screening refractive error in young children., Methods: This retrospective study included children aged from 4 months to 8 years in Daxing District, Beijing, who underwent refractive examinations without cycloplegia. It included a cross-sectional assessment of refractive error screening for all children, and a longitudinal component for a subgroup with data available for two to five visits., Results: A total of 14,987 children were included in the cross-sectional study. In the group <1 year of age, the percentage of children with a spherical equivalent (SE) >+2.00 D or with cylinder <-1.50 D was 15.25% and 33.24%, respectively. These were significantly higher than for the 1- to 4-year-old group (SE 8.1% higher, cylinder 13.2% higher) (χ 2  = 53.57, p < 0.001; χ 2  = 790.39, p < 0.001). Furthermore, 34.83% of children in the 0-year-old group had amblyopia risk factors (ARFs). In the 4-year-old group, boys had a significantly longer axial length (AL) than girls (differences in the right and left eyes were 0.53 and 0.56 mm, respectively; z = 5.48 p < 0.001, z = 5.80, p < 0.001). AL increased with age, while the AL difference between boys and girls remained stable at 4-8 years of age. The percentage of children aged 5-8 years with myopia in 2020-2021 was significantly higher than that in 2018-2019 (H = 12.44, p = 0.006). In the longitudinal study of 4406 children (up to 12-month follow-up), annual changes in SE were -0.27, -0.06, 0.19 and 0.13 D between 0 and 3 years, and -0.38, -0.58, -0.70 and -0.75 D between 5 and 8 years., Conclusions: Children's refractive error varied significantly from ages 4 months to 1 year, with a high proportion having ARFs. Children aged 5-8 years showed a trend towards myopia. The prevalence of myopia in the cross-sectional analysis in 2020-2021 was greater than in 2018-2019. Screening refraction changed minimally over a 12-month period for children aged 1-3 years, but became more myopic for children aged 5-8 years., (© 2024 College of Optometrists.)

Purpose: To compare Hill-RBF 3.0 with Barrett Universal II (BU II), SRK/T, Hoffer Q, Haigis, and Holladay 1 in predicting the accuracy of post-cataract surgery refractive outcomes in Indian eyes., Methods: In this prospective, comparative, observational study, consecutive patients with uncomplicated age-related cataracts undergoing uneventful phacoemulsification with posterior chamber intraocular lens (IOL) implantation were included. The mean absolute errors (MAEs) and median absolute errors were used to determine the accuracy of predicted postoperative target refractions., Results: A total of 219 eyes of 173 patients were enrolled. Based on the axial lengths (AL), the patients were classified into: AL <22 mm (short), 22-24.5 mm (normal), and >24.5 mm (long). BU II exhibited the lowest MAE for normal ALs (0.2683 ± 0.2790 D) as well as for the entire population (0.2764 ± 0.2764 D). For the short ALs, Hill RBF 3.0 exhibited the lowest MAE (0.3268 ± 0.3268 D), while for the long ALs, SRK/T showed the lowest MAE (0.2823 ± 0.2642 D). BU II exhibited the highest percentage of eyes of 57.5%, 95.4%, and 98.6% within ±0.25, ±0.75, and ±1.0 D of postoperative target refractions respectively, whereas Hill RBF 3.0 had the highest percentages of eyes (88.1%) within ±0.5 D of postoperative target refraction., Conclusion: Hill-RBF 3.0 exhibited the least MAE for patients with short ALs, while BU II showed the least MAE for normal ALs as well as for the entire population and SRK/T for long ALs. This study is likely to aid surgeons in selecting the most appropriate IOL power formula, which thereby improves the refractive outcomes with utmost accuracy., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Background: This study aimed to investigate the difference between cycloplegic and noncycloplegic refraction and evaluate the pseudomyopia prevalence in Chinese preschool children during the outbreak of COVID-19., Methods: A cross-sectional study was conducted in the Tongzhou District of Beijing, China. Refractive error was measured under both noncycloplegic and cycloplegic conditions with autorefraction. The difference between noncycloplegic and cycloplegic spherical equivalent refraction (SER) and pseudomyopia prevalence were analyzed. Pseudomyopia was defined as SER ≤-0.50D in precycloplegic assessments and >-0.50D in post-cycloplegic assessments., Results: Out of the 1487 participants who were enrolled in the study, 1471 individuals (98.92%) between the ages of 3-6 years completed all required procedures. A statistically significant difference in refraction was observed between noncycloplegic and cycloplegic measurements, the median of difference in spherical equivalent refraction (SER) of 0.88D (dioptre)(0.50,1.38). There was a high intraclass correlation (ICC) between these two methods for cylinders (ICC = 0.864; 95% CI, 0.850-0.877). The median DSE for myopia, emmetropia and hyperopia were 0.25D (0.00, 0.38),0.25D (0.06, 0.50) and 1.00D (0.62, 1.38), an hypermetropes showed considerably greater differences than myopes and emmetropes (Kruskal-Wallis test, H = 231.023, P = 0.000). Additionally, girls displayed a greater DSE than boys. Furthermore, when comparing against-the-rule (ATR) and oblique astigmatism, it was found that with-the-rule (WTR) astigmatism had the largest DSE. The study found varying prevalence rates of myopia, emmetropia, and hyperopia with and without cycloplegia, which were 1.90% vs. 10.06%, 11.49% vs. 50.31%, and 86.61% vs. 39.63%, respectively. Additionally, the overall prevalence of pseudomyopia was determined to be 8.29%. Participants with pseudomyopia had a significantly higher mean difference in SER (DSE) compared to non-pseudomyopic participants., Conclusions: Cycloplegic refraction is more sensitive than a noncycloplegic one for measuring refractive error in preschool children. Pseudomyopia is prevalent in preschool children during the COVID-19 outbreak period. Our study indicates the possibility that cycloplegic refraction should be performed in preschool children routinely., (© 2024. The Author(s).)

Purpose: This study aims to investigate the relationship between the type and severity of refractive error and anisometropia development in preschool children., Design: Retrospective cohort study., Methods: Data from Maccabi Healthcare Services, Israel's second-largest Health Maintenance Organization (HMO), were analyzed. The study included all isometropic children aged 1 to 6 years, re-examined for refraction at least 2 years following their initial examination between 2012 and 2022. Anisometropia was defined as a ≥1 diopter interocular difference in spherical equivalent. Relationships were assessed using logistic regression models adjusted for key sociodemographic factors., Results: Among 33,496 isometropic children (51.2% male, mean age 3.2 ± 1.5 years), the prevalences of emmetropia, myopia, and hyperopia were 26.7% (n = 8944), 4.2% (n = 1397), and 69.1% (n = 23,155), respectively. Over a mean follow-up period of 5.1 ± 2.4 years, 2593 children (7.7%) were diagnosed with anisometropia. Adjusted odds ratios (ORs) for anisometropia gradually increased with baseline refractive error severity, reaching 13.90 (5.32-36.34) in severe myopia and 4.19 (3.42-5.15) in severe hyperopia. This pattern was also evident in cylindrical anisometropia, where ORs increased with greater baseline astigmatism, peaking at 12.10 (9.19-15.92) in children with high astigmatism (≥3 D). Associations remained consistent in sensitivity and subgroup analyses including across both sexes and when using a stricter anisometropia criterion., Conclusions: Children aged 1 to 6 years, initially without anisometropia but showing increasing severity of myopia, hyperopia, or astigmatism, are more likely to develop anisometropia. This underscores the importance of follow-up refractive measurements within this population to promptly diagnose and treat anisometropia and prevent potential visual complications., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background/objective: To determine the prevalence of visual impairment (VI), uncorrected refractive errors (URE), and effective refractive error coverage among individuals aged 15-50 years in Koshi Province, Nepal., Methods: A population-based cross-sectional study was conducted in Koshi Province in which 4800 participants were selected from 80 clusters. The study teams visited the selected households and conducted eye examinations. This included monocular unaided (and aided) visual acuity assessment using a Snellen chart with tumbling E optotypes at a distance of 6 meters. Near vision was assessed binocularly using the N notation chart at a fixed distance of 40 cm for each individual. Torchlight examination and distance direct ophthalmoscopy was done. VI was defined as presenting visual acuity worse than 6/12 in the better eye. URE was defined as presenting visual acuity worse than 6/12 and improving to 6/12 or better on using a pinhole. Near Vision Impairment was defined as binocular presenting near vision worse than N8 among those age 35 years and older., Results: In total, 4057 were examined (84.5% response rate). The prevalence of VI was 3.52% (95% CI:2.89-4.13; n = 143). The prevalence of URE in the better eye was 1.95% (95% CI:1.54-2.42; n = 79). The Refractive Error Coverage and Effective Refractive Error Coverage were 34.8% and 31.3% respectively. The prevalence of NVI was 34.24% (95% CI: 32.1-36.40; n = 666)., Conclusion: The prevalence of VI and  URE was low, attributed to the availability and uptake of services in Koshi province in Nepal., (© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Purpose: Indonesia is a rapidly growing county with over 262 million inhabitants, but among highly populated countries it has one of the lowest concentrations of eye care providers. This study evaluated the cost-effectiveness of a program implemented in South Sulawesi, Indonesia that trained school teachers to conduct vision screenings, organized in-school evaluations by opticians, and provided free eyeglasses to school children with refractive error (RE)., Methods: Schoolteachers across 6 districts in South Sulawesi were trained to screen children with possible RE for subsequent evaluation by opticians. All costs associated with designing and implementing the program (administration, training personnel, labor, service delivery, etc.) were assessed. Expenditures and outcomes data were utilized to calculate the cost per disability-adjusted-life-year (DALY) averted using both 2010 and 2016 Global Burden of Disease (GBD) weights., Results: 521 teachers screened 41,212 students across 172 schools in South Sulawesi. 4,506 (10.9%) students failed screening, 2,652 were seen by optometrists, and 2,038 received glasses.The total program cost was US$97,380, with glasses (39.6%) and labor (23.3%) accounting for the two biggest expenditures. In districts with school-based refraction services, the costs per student screened, refracted, and receiving glasses were $2.57, $31.33, and $41.40, respectively; costs were $2.04, $59.80, and $73.22 when district services were instead provided centrally. The estimated cost per DALY averted was US$89.04 based on GBD 2010 weights., Conclusion: Treating children with correctable RE in limited resource settings can be done cost-effectively through a school-based model.

Clinical Significance: Understanding the refractive profile, amblyopia prevalence, binocular status, and head position in patients with Brown syndrome help clinicians become more familiar with this syndrome., Background: Brown syndrome is identified as an active and passive restricted elevation of the eye in adduction. There is little information on clinical features, including refractive status, amblyopia, abnormal head posture (AHP), and types of deviation in these patients., Methods: This study retrospectively evaluated records of 100 Brown syndrome patients from 2015 to 2022 at Farabi Eye Hospital, Iran., Results: The mean age was 6.99 ± 6.33 years, including 48 (48%) males. A congenital source was found in 74 (74%) and 96 (96%) patients had unilateral involvement. The mean CDVA for the affected and non-affected eyes were 0.05 ± 0.11 and 0.03 ± 0.06 logMAR, respectively ( P  = 0.31). In unilateral cases, hyperopia, myopia, and emmetropia were observed in 55 (57.29%), 2 (2.08%), and 39 (40.63%) affected eyes, respectively. The most common type of deviation was pure hypotropia, which was found in 53 (53%) cases, followed by 'combined exotropia and hypotropia' observed in 26 (26%) patients. The mean angle of hypotropia and horizontal deviation in the primary position at distance was 12.10 ± 8.50 and 8 ± 13.20 prism dioptre, respectively. A V-pattern was found in 76 (76%) patients. Amblyopia was observed in 13 (21.67%) of 60 cooperative patients, and AHP was noticed in 66 (66%) patients, in which "combined chin up and contralateral face turn" was the most common type., Conclusion: About 75% of cases were congenital, 50% had pure hypotropia, 75% showed V-pattern, 20% had amblyopia, and AHP was observed in 67% of patients. The remarkable prevalence of amblyopia alongside the high occurrence of AHP should alert clinicians to carefully assess patients with Brown syndrome for sensory fusion and amblyopia.

Background: Uncorrected refractive error (URE) is one of the leading causes of childhood vision impairment. Increasing effective refractive error coverage (e-REC) is one of the main indicators of WHO's 2030 global eye health targets. The aim of this study is to estimate the e-REC and spectacle coverage among school children in Telangana, South India., Methods: School children aged 4-15 years in the study locations underwent vision screening using 6/12 tumbling E optotype by trained community eye health workers in the schools. Those failing the initial vision screening and/or found to be having eye conditions were referred to a nearby referral centre appropriately, where they underwent detailed eye examination., Results: A total of 774,184 children were screened in schools of which 51.49% were boys. The mean age was 9.40 ± 3.27 years. The prevalence of URE was 1.44% (95%CI:1.41-1.46) of which myopia was 1.38% (95%CI: 1.35-1.41). In multivariate analysis, the risk of myopia was higher among older children (Adj.OR: 17.04; 95%CI: 14.64-19.85), those residing in urban areas (Adj.OR:3.05, 95%CI:2.60-3.57), those with disabilities (Adj.OR:2.61, 95%CI:2.00-3.39) and among girls (Adj.OR:1.30, 95%CI:1.25-1.35) (P < 0.001). The overall e-REC was 56.97% and the spectacle coverage was 62.83%., Conclusion: The need for interventions to improve e-REC to achieve 2030 global eye health target is eminent among children in this region. Improving refractive services through school eye health programs could aid in accelerating this process to achieve the target. Myopia being the most common type of RE, the risk factors included increasing age, urban location, and presence of disability., (© 2024. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Objective: This study determined the prevalence and aetiology of unilateral visual impairment (VI) and blindness and its associated factors in school children., Methods: We conducted a multistage, cross-sectional study in primary and secondary schools of Saki-East Local Government Area of Oyo State, Nigeria. Unilateral VI was defined as presenting visual acuity (PVA) worse than +0.3 LogMAR (6/12) and unilateral blindness as PVA worse than +1.3 LogMAR (3/60) in the worse eye. Detailed ocular examinations were performed for students with unilateral VI, and Logistic regression analysis was performed to explore associations with independent variables., Results: The mean age of participants was 11 ± 3.2 years. Thirty-six (0.98%) of 3671 children had unilateral VI, and fifteen children had unilateral blindness (0.41%), giving a combined prevalence of 1.39 ± 0.5%. History of ocular trauma was reported by 14 (27.5%) participants with unilateral VI and blindness. In addition, those with a history of ocular trauma were 6.5 times more likely to be blind or have a severe VI (95% CI 1.5-2.8) than those without a history of ocular trauma. Uncorrected refractive error was the major cause of unilateral VI in 26 (51%) participants, while traumatic cataract was the main cause of unilateral blindness seen in 5 (9.8%) participants, none of whom had a previous eye examination., Conclusion: Fourteen per thousand school children had unilateral VI in this study; the major causes were refractive error and cataract, which are treatable. Ocular trauma was a significant risk factor for unilateral VI and blindness., (© 2024. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Background: Uncorrected refractive error (URE) is a readily treatable cause of visual impairment (VI). This study provides updated estimates of global and regional vision loss due to URE, presenting temporal change for VISION 2020 METHODS: Data from population-based eye disease surveys from 1980-2018 were collected. Hierarchical models estimated prevalence (95% uncertainty intervals [UI]) of blindness (presenting visual acuity (VA) < 3/60) and moderate-to-severe vision impairment (MSVI; 3/60 ≤ presenting VA < 6/18) caused by URE, stratified by age, sex, region, and year. Near VI prevalence from uncorrected presbyopia was defined as presenting near VA < N6/N8 at 40 cm when best-corrected distance (VA ≥ 6/12)., Results: In 2020, 3.7 million people (95%UI 3.10-4.29) were blind and 157 million (140-176) had MSVI due to URE, a 21.8% increase in blindness and 72.0% increase in MSVI since 2000. Age-standardised prevalence of URE blindness and MSVI decreased by 30.5% (30.7-30.3) and 2.4% (2.6-2.2) respectively during this time. In 2020, South Asia GBD super-region had the highest 50+ years age-standardised URE blindness (0.33% (0.26-0.40%)) and MSVI (10.3% (8.82-12.10%)) rates. The age-standardized ratio of women to men for URE blindness was 1.05:1.00 in 2020 and 1.03:1.00 in 2000. An estimated 419 million (295-562) people 50+ had near VI from uncorrected presbyopia, a +75.3% (74.6-76.0) increase from 2000 CONCLUSIONS: The number of cases of VI from URE substantively grew, even as age-standardised prevalence fell, since 2000, with a continued disproportionate burden by region and sex. Global population ageing will increase this burden, highlighting urgent need for novel approaches to refractive service delivery., (© 2024. The Author(s).)

Purpose: To develop and validate machine learning (ML) models for predicting cycloplegic refractive error and myopia status using noncycloplegic refractive error and biometric data., Methods: Cross-sectional study of children aged five to 18 years who underwent biometry and autorefraction before and after cycloplegia. Myopia was defined as cycloplegic spherical equivalent refraction (SER) ≤-0.5 Diopter (D). Models were evaluated for predicting SER using R2 and mean absolute error (MAE) and myopia status using area under the receiver operating characteristic (ROC) curve (AUC). Best-performing models were further evaluated using sensitivity/specificity and comparison of observed versus predicted myopia prevalence rate overall and in each age group. Independent data sets were used for training (n = 1938) and validation (n = 1476)., Results: In the validation dataset, ML models predicted cycloplegic SER with high R2 (0.913-0.935) and low MAE (0.393-0.480 D). The AUC for predicting myopia was high (0.984-0.987). The best-performing model for SER (XGBoost) had high sensitivity and specificity (91.1% and 97.2%). Random forest (RF), the best-performing model for myopia, had high sensitivity and specificity (92.2% and 96.9%). Within each age group, difference between predicted and actual myopia prevalence was within 4%., Conclusions: Using noncycloplegic refractive error and ocular biometric data, ML models performed well for predicting cycloplegic SER and myopia status. When measuring cycloplegic SER is not feasible, ML may provide a useful tool for estimating cycloplegic SER and myopia prevalence rate in epidemiological studies., Translational Relevance: Using ML to predict cycloplegic refraction based on noncycloplegic data is a powerful tool for large, population-based studies of refractive error.

Purpose: To investigate the prevalence and body mass index (BMI) associations of congenital lower epiblepharon in children in China and the difference in the refractive errors between children with and without epiblepharon., Methods: Children 6-12 years of age in Beichen District of Tianjin were screened for congenital epiblepharon from September to October 2017. All children underwent slit-lamp examination, strabismus screening, visual acuity examination and refraction. Weight and height were also recorded. The prevalence of lower epiblepharon in school-age children was evaluated, and its association with age, sex, BMI, and refractive error was analyzed., Results: A total of 28,225 children were examined; 564 had epiblepharon. The prevalence of epiblepharon was found to be, for 6-year-olds, 2.50%; for 7-year-olds, 2.13%; for 8-year-olds, 2.10%; for 9-year-olds, 1.97%; for 10-year-olds, 1.85%; for 11-year-olds, 1.67%; and for 12-year-olds, 1.19% (P < 0.05). The prevalence of overweight and obesity in children with epiblepharon was found to be 16.7% and 47.2%, respectively. The prevalence and degree of astigmatism was higher than in nonepiblepharon children. We found a possible association between severity of astigmatism and severity of epiblepharon., Conclusions: In our study, the prevalence of epiblepharon decreased with advancing age, and the majority of children with epiblepharon were found to be overweight or obese. Epiblepharon was associated with astigmatism., (Copyright © 2024 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Background: The purpose of this study was to quantify how much of the burden of visual impairment (VI) and unmet need in Talagang, identified by Rapid Assessment of Avoidable Blindness (RAAB) survey data, has been addressed by Community Eye Health (CEH) programme efforts., Methods: A RAAB survey was carried out in November 2018, with 2,824 participants in Talagang Tehsil, Punjab, Pakistan, aged 50 and over. Census data were used to extrapolate survey data to the population. Alongside this, a CEH programme was launched, consisting of community eye screening, and onward referral to rural health centres, secondary or tertiary ophthalmological services, as required. This health intervention aimed to address the eye care needs surfaced by the initial survey. From 2018 to 2022, 30,383 people aged 50 or over were screened; 14,054 needed referral to further steps of the treatment pathway and more detailed data collection. Programme data were compared to estimates of population unmet needs. Main outcome measures were prevalence of VI, and proportion of need met by CEH Programme, by cause and level of VI., Results: Among those aged 50 and over, 51.0% had VI in at least one eye. The leading causes were cataract (46.2%) and uncorrected refractive error (URE) (25.0%). In its first four years, the programme reached an estimated 18.3% of the unmet need from cataract, and 21.1% of URE, equally in both men and women., Conclusions: Robustly collected survey and programme data can improve eye health planning, monitoring and evaluation, address inequities, and quantify the resources required for improving eye health. This study quantifies the time required to reach eye health needs at the community level., (© 2024. The Author(s).)

Purpose: This study evaluates the recent trends in ocular morbidities and vision-related practices in "out-of-school" children in urban slums of Gurugram in North India., Methods: In this observational study, a validated questionnaire was administered to 161 students from two nonformal slum schools. Sociocultural, demographic data, vision-related practices, and visual acuity with subjective refraction of the children were recorded., Results: A total of 80 boys and 81 girls (9.17 ± 2.58 years) participated in this study. About 40% of the children were from lower socioeconomic status. The visual acuity recorded for all the children, except three children, was 6/6 in both eyes. One child had a pre-phthisical eye with no light perception, following a childhood trauma, with the other eye having 6/6 vision. Two children had refractive errors (myopia and compound myopic astigmatism), with a best corrected visual acuity (BCVA) of 6/6. Thirteen children (8%) had Bitot's spots and 67 (35.4%) had allergic conjunctivitis. Eight (5%) children complained of dry eye-related symptoms like redness and watering of eyes, while 19 (11.8%) had diffuse headache. Average number of years spent in school for these children was less than 1.7 years (range: 1 month-6 years). Only 10.5% of the children gave the history of watching television more than 30 h/week. Significant association was found between the income of father and use of digital devices in children below 10 years ( P = 0.003) and children playing outdoors ( P = 0.001). There was a significant association noted for age and use of digital devices ( P = 0.037)., Conclusion: The prevalence of refractive errors in "out-of-school" children of urban slum was much less than the national average. Almost one in three children suffered from eye allergies, while 8% children had Bitot's spots. The data about the prevalence of ocular comorbidities in underserved areas like urban slums can be used to update and strategize eye health-care delivery models for out-of-school children., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Purpose: To report the visual and refractive characteristics and the prevalence of amblyopia in patients with different types of Duane's Retraction Syndrome (DRS)., Method: This retrospective study was performed on hospital records of 582 DRS patients at Farabi Hospital, Iran, from 2012 to March 2022., Results: The mean age of patients was 19.4 ± 11.9 (range, 3-70) years [335 (57.6 %) females and 247 (42.4 %) males (P < .001)]. DRS type I, II, III, and IV were presented in 347 (59.6 %), 148 (25.4 %), 82 (14.1 %), and 5 (0.9 %) patients, respectively. There were 530 (91.1 %) patients with unilateral and 52 (8.9 %) with bilateral involvement. In the unilateral patients, the DRS eyes' corrected distance visual acuity (CDVA) and astigmatism were significantly worse than the Non-DRS Eyes (P < .001). The mean amount of all refractive and visual parameters in bilateral patients' right or left eyes was significantly lower than in unilateral patients' non-DRS eyes (all P < .05). Anisometropia was observed in 75(12.9 %) of the patients. Amblyopia was observed in 18.5 % (98 patients) and 36.5 % (19 patients) of unilateral and bilateral DRS patients, respectively (P < .001). In unilateral patients, amblyopia was found in 57 (16.4 %) patients with Type I, 22 (14.9 %) patients with Type II, 16 (19.5 %) patients with Type III, and 3 (60 %) patients with Type IV. Forty-four (37.6 %) of patients with amblyopia had anisometropia., Conclusion: This large-scale study indicates that DRS types differ in terms of refractive error, visual acuity, and the prevalence of amblyopia and anisometropia. Clinicians should be aware of the clinical features associated with different types of DRS., Competing Interests: Conflicts of interest The authors have no conflicts of interest to declare., (Copyright © 2023 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.)

Purpose: In children under 20 years, refractive development targets a cycloplegic refractive error of +0.5 to +1.5D, while presbyopes over 40 years generally have non-cycloplegic errors of ≥ +1D. Some papers suggest these periods are separated by a period of myopic refractive error (i.e., ≤ -0.50D), but this remains unclear. Hence, this work investigates the mean cycloplegic refractive error in adults aged between 20 - 40 years., Methods: In 2002 a cross-sectional study with stratified cluster sampling was performed on the population of Tehran, providing cycloplegic and non-cycloplegic refractive error data for the right eyes of 3,576 participants, aged 30.6±18.6 years (range: 1-86 years). After grouping these data into age groups of 5 years, the refractive error histogram of each group was fitted to a Bigaussian function. The mean of the central, emmetropized peak was used to estimate the mean refractive error without the influence of myopia., Results: The mean cycloplegic refractive error at the emmetropized peak decreased from +1.10±0.11D (95 % confidence interval) to +0.50±0.04D before 20 years and remains stable at that value until the age of 50 years. The non-cycloplegic refractive error also sees a stable phase at 0.00±0.04D between 15 - 45 years. After 45 - 50 years both cycloplegic and non-cycloplegic refractive error become more hypermetropic over time, +1.14±0.12D at 75 years., Conclusions: The cycloplegic refractive error in adults is about +0.50D between 20 - 50 years, disproving the existence of the myopic period at those ages., Competing Interests: Declaration of competing interests There are no competing interests., (Copyright © 2023 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.)

Background/objectives: The See4School programme in Scotland is a pre-school vision screening initiative delivered by orthoptists on a national scale. The primary objective of any vision screening programme is to identify amblyopia, given the common understanding that this condition is unlikely to be detected either at home or through conventional healthcare channels. The target condition is not bilateral visual impairment, as it is believed that most children will be identified within the first year of life either through observations at home or as part of the diagnosis of another related disorder. This belief persists even though bilateral visual impairment is likely to have a more detrimental impact on a child's day-to-day life, including their education. If this hypothesis were accurate, the occurrence of bilateral visual impairment detected through the Scottish vision screening programme would be minimal as children already under the hospital eye service are not invited for testing. The overarching aim of this study was therefore to determine the prevalence of presenting bilateral visual impairment associated with refractive error detected via the Scottish preschool screening programme., Subjects/methods: Retrospective anonymised data from vision screening referrals in Scotland from 2013-2016 were collected. Children underwent an assessment using a crowded logMAR vision test and a small number of orthoptic tests., Results: During the 3-year period, out of 165,489 eligible children, 141,237 (85.35%) received the vision screening assessment. Among them, 27,010 (19.12%) failed at least one part of the screening and were subsequently referred into the diagnostic pathway, where they received a full sight test. The prevalence of bilateral visual impairment associated with refractive error and detected via the vision screening programme (≥ 0.3LogMAR) was reported to range between 1.47% (1.37-1.59) and 2.42% (2.29-2.57)., Conclusions: It is estimated that up to 2.42% (2.29-2.57) of children living Scotland have poorer than driving standard of vision (6/12) in their pre-school year, primarily due to undetected refractive error. Reduced vision has the potential to impact a child's their day-to-day life including their future educational, health and social outcomes., (© 2024. The Author(s).)

Objective: To assess the association between ethnicity and self-reported refractive errors (REs) among Peruvian children aged 7-11 years., Materials and Methods: We conducted a cross-sectional study incorporating a secondary data analysis of 2017-2021 data from the Peruvian Demographic and Health Survey (DHS). REs and ethnicity were obtained from focal child's mother's report. Four outcomes were assessed: hyperopia, myopia, astigmatism and any RE. We included potential confounders, such as age, sex, wealth index, area of residence, region of origin, frequency of watching TV and watching screens at less than 30 cm distance. Generalised linear models with the Poisson family and log link function were used to calculate crude prevalence ratio and adjusted prevalence ratio (aPR) with 95% confidence intervals (95% CI)., Results: Data from a total of 52,753 children were included. The prevalence of RE in children aged 7-11 years was 10.90% (95% CI 10.49-11.33), of which 5.19% were hyperopia, 3.35% myopia and 2.36% astigmatism. Those of the Aymara ethnicity were less likely to suffer from any RE and astigmatism (aPR = 0.68, 95% CI 0.46-0.99, p = 0.046; aPR = 0.70, 95% CI 0.53-0.92, p = 0.012, respectively), Members of Amazon groups were more likely to have hyperopia (aPR = 1.95, 95% CI 1.14-3.36, p = 0.015) and Quechuas were more likely to have myopia (aPR =1.29, 95% CI 1.02-1.62, p = 0.028), where all were compared to Mestizos., Conclusion: About 1 in 10 Peruvian children suffer from a RE. The most frequent RE in this study was hyperopia. Ethnic differences were seen in the frequency of RE., Competing Interests: Conflicts of interest None of the authors have any proprietary interests or conflicts of interest related to this submission., (Copyright © 2023. Published by Elsevier España, S.L.U.)

Background: Preventable blindness is a global public health problem. In South Africa (SA) the prevalence of blindness is increasing, with a higher proportion of cataracts than the global norm, and a large rural population with limited access to specialised eye-care services., Objective: To determine the level of knowledge regarding preventable blindness and treatment options within a rural and urban population., Setting: Rural and urban areas in the Eastern Cape, SA., Methods: A descriptive cross-sectional study was conducted among 309 participants. Questionnaires were administered by fieldworkers at the different sites. Proportions were calculated and χ2 tests done to determine whether there was any significant relationship between the categorical variables. Data analysis was done using Stata version 15., Results: Participants were almost equally distributed among the urban (49.2%) and rural areas (50.8%). Both groups had a similar composition of males and females. Most participants had completed high school. The results showed a statistically significant difference between the urban and rural participants' knowledge about the causes of blindness: refractive error χ 2 (1, N=30) = 8.20, p<0.05, and cataract χ2 (1, N=28) = 8.64, p<0.05. The top two differences in the views between urban and rural participants regarding symptoms associated with eye problems (p<0.05) were: 'people who need spectacles have double vision', χ2 (1, N=122) = 28.19; and 'people who need spectacles squint their eyes', χ2 (1, N=124) = 17.37. The majority of urban participants reported opting to go to a private optometrist for eye health services, while the majority of rural participants would go to a pharmacy. Both groups were aware of the role of ageing in blindness., Conclusion: Urban participants in this study appeared to be more knowledgeable than rural participants about the causes and symptoms of blindness and its treatment options. These findings should provide some value to those who provide primary healthcare services in rural areas as there is a clear opportunity for patient education and health promotion regarding the causes and symptoms of these common preventable causes of blindness. Addressing this knowledge gap regarding the causes and symptoms of blindness and the treatment options is a critical first step for awareness programmes in rural areas. Without this, there will be little demand for any treatment or service. Future studies are needed to understand which health promotion interventions are effective in preventable blindness in rural populations.

The Persian Eye Cohort Study, a population-based cross-sectional study from 2015 to 2020, examined refractive error prevalence among 48,618 Iranian adults aged 31 to 70. The study encompassed six centers in Iran, employing random cluster sampling for demographic, medical, and socioeconomic data collection through interviews. Ophthalmic exams included visual acuity, automated and manual objective refraction, subjective refraction, slit lamp, and fundus examinations. Using the spherical equivalent definition, the sample population was categorized into groups. Results indicated a mean age of 49.52 ± 9.31 and a mean refractive error of 0.26 diopters (D) ± 1.6 SD (95% CI - 0.27 to -0.24), ranging from -26.1 to + 18.5 SD. Prevalence of myopia (< -0.5D) and hyperopia (> + 0.5D) was 22.6% (95% CI 22.2-23%) and 12.5% (95% CI 12.1-12.8%), respectively. Regarding different age groups, the prevalence of hyperopia and astigmatism exhibited a steady and significant rise with increasing age (p-value < 0.001 for both). The prevalence of Myopia, however, showed a distinctive pattern, initially increasing in adults under 45, declining in those aged 55-64, and rising again among individuals aged 60 and older. Female gender, older age, urban residency, higher education, higher income, and Fars ethnicity were significantly related to a higher prevalence of myopia (p-value < 0.001 for all). Female gender (p-value < 0.001), aging (p-value < 0.001), urban residency (p-value = 0.029), and lower-income (p-value = 0.005) were significantly related to higher prevalence of hyperopia. Astigmatism (> 1D) was prevalent in 25.5% of participants (95% CI 25.1-25.9%) and correlated with male gender, aging, urban residency, illiteracy, and higher income (p-value < 0.001, < 0.001, < 0.001, < 0.001, 0.014, respectively). The study's comparison with regional and international surveys highlighted the increase in myopia among those over 65 due to higher nuclear cataract rates in older adults. Myopia positively related to education, income, and urban residency, while hyperopia did not exhibit such associations., (© 2024. The Author(s).)

Background: Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment., Methods: Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI)., Results: In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden., Conclusions: The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interest., (Copyright © 2024 by the Journal of Global Health. All rights reserved.)

Background and Aim: Refractive errors, amblyopia, strabismus, and low vision are more common among children with hearing impairments in comparison with their hearing peers. Neglecting visual disorders can pose educational and social problems for these children. The present study aimed to assess the prevalence of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah., Materials and Methods: A total of 79 deaf and hearing impaired students within the age range of 7-20 years (mean age of 15.01 ± 2.72) underwent optometric examinations, including autorefractometry, retinoscopy, ophthalmoscopy, slit lamp, visual acuity measurement, and cover-uncover test. Those who needed further evaluation were referred to the Ophthalmology Clinic of Imam Khomeini Hospital., Results: Regarding the prevalence of refractive errors, 32 (40.5%) subjects had one or a combination of refractive errors, the most common of which was astigmatism (36.7%), followed by amblyopia (15.1%). The most common type of strabismus was latent strabismus (heterophoria) (88.6%), followed by exophoria (81%). Moreover, 3 (3.7%) cases had nystagmus. A significant difference was observed between the prevalence of amblyopia and the degree of hearing loss (P = 0.026), and no significant difference was detected in other cases., Conclusion: As evidenced by the obtained results, refractive errors, amblyopia, strabismus, and low vision are more prevalent among deaf and hearing-impaired children compared to normal children because deaf and hearing-impaired children are not able to convey their vision problems and need to compensate for their poor hearing with an enhanced sense of sight, inattention to these disorders can present these children with serious educational and social problems. Therefore, eye screening examinations are of paramount importance in deaf and hearing-impaired children., (© 2024. The Author(s).)

Background: Functional visual impairments in children are primarily caused by amblyopia or strabismus. This study aimed to determine the prevalence and clinical profile of amblyopia and strabismus among individuals aged 3-16 years in Shanghai, China., Methods: From February 2023 to February 2024, this hospital-based, cross-sectional study included data of children who visited the Ophthalmology Department of Shanghai General Hospital. Comprehensive ocular examinations included visual acuity measurement after cycloplegic refraction, slit lamp examination, cover test, and dilated fundus examination. Descriptive statistics were performed to estimate the proportion and clinical characteristics of amblyopia and strabismus., Results: A total of 920 children were enrolled in our study. Among them, 223 (24.24%) children were identified as amblyopia. Unilateral amblyopia occupied 57.85%, and bilateral amblyopia occupied 42.15%. Most participants were within the age range of 5-10 years (75.97% for unilateral amblyopia, and 70.21% for bilateral amblyopia). Anisometropia was the primary cause of unilateral amblyopia (68.99%). Most amblyopic children have high hyperopia (38.76% for unilateral amblyopia, and 39.89% for bilateral amblyopia). 30 (3.26%) children were diagnosed with strabismus, and 19 (63.3%) of them were aged 5-10 years. Seven of the children had both strabismus and amblyopia., Conclusion: The proportion of patients with amblyopia and strabismus was determined as 24.24% and 3.26% in our study. Anisometropia was the leading cause of unilateral amblyopia, whereas high hyperopia was a crucial refractive error in the amblyopic population. These findings shed light on further longitudinal studies targeting the age-related changes in amblyopia, strabismus and refraction errors. Therefore, efforts should be made to manage uncorrected refractive errors, amblyopia, and strabismus among children in Shanghai., (© 2024. The Author(s).)

Purpose: To investigate the relationship between refraction and ocular axial length in albinos., Patients and Methods: A cross-sectional, analytical study was carried out from June to November 2021 at the Central Hospital of Yaounde (Cameroon), which included consenting albino subjects aged over 15years. All subjects underwent visual acuity testing, axial length measurements and objective refraction under cycloplegia., Results: We included 51 albino subjects. The mean age was 26.06±9.47years, and the sex ratio was 0.5. Type 2 oculocutaneous albinism (OCA2) was predominant, representing 82.4% of cases. The mean uncorrected visual acuity was 0.93±0.25 logMAR, and the most common ametropia was myopic astigmatism (52.9%). The mean axial length was 24.65±2.54mm with extremes of 21.54 and 30.33mm. Eyes with myopia and myopic astigmatism had significantly longer axial lengths than those with hyperopic and mixed astigmatism. A strong, significant negative correlation (r=-0.93; P˂0.001) between the spherical component of the refraction and axial length was found., Conclusion: The spherical component of the refraction decreases significantly with increasing axial length in albinos., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Introduction: Retinopathy of prematurity (ROP) is a vision-threatening disease of premature infants. Practice guidelines recommend that all infants screened for ROP receive follow-up eye examinations to screen for ophthalmic complications. 1 The purpose of this study was to identify risk factors for the development of strabismus, amblyopia, high refractive error, and cataracts among ROP-screened, non-treated infants., Methods: Retrospective single-centre study of ROP-screened, non-treated premature infants with ophthalmic follow-up. Clinical variables were screened for association with ocular findings at follow-up. Multivariable logistic regression was used to determine the risk factors associated with ocular findings., Results: 309 patients were seen for follow-up at 0.97 (0.69) [mean (SD)] years after neonatal intensive care unit (NICU) discharge. Strabismus was predicted by occipitofrontal circumference (OFC) z-score at NICU discharge (OR 0.61; 95% CI [0.42, 0.88]; p = 0.008), intraventricular haemorrhage (IVH) grade III or IV (OR 3.18; 95% CI [1.18, 8.54]; p = 0.02), and exclusive formula feeding at NICU discharge (OR 2.20; 95% CI [1.07, 4.53]; p = 0.03). Significant predictors of amblyopia were OFC z-score at discharge (OR 0.55; 95% CI [0.31, 0.96]; p = 0.03) and necrotising enterocolitis (NEC) (OR 6.94; 95% CI [1.38, 35.00]; p = 0.02). NEC was a significant risk factor for high refractive error (OR 7.27; 95% CI [1.39, 37.94]; p = 0.02)., Conclusions: Among premature infants screened but not treated for ROP, severe IVH, NEC, low OFC z-score, and exclusive formula feeding at NICU discharge were risk factors for ocular morbidity. These findings affirm the value of ophthalmic follow-up for all ROP-screened infants, particularly those with the identified risk factors., (© 2024. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Purpose: This article aims to describe the causes of ophthalmological disqualification from the military services detected during specialist consultations conducted at Army Training Hospitals., Methods: This observational, cross-sectional, multicenter study retrospectively included individuals deemed as "unfit for military service" due to eye diseases identified during the specialist consultation conducted at 3 ATHs between January 2020 and December 2021. The data collected included age, medical and surgical history, reasons for ophthalmological disqualification, uncorrected distance visual acuity, best corrected distance visual acuity and cycloplegic refraction., Results: Over this period, 133 subjects (98 men and 35 women) were included. Thirty-eight candidates (28.6%) were declared unfit due to a refractive error beyond the required limits, including 30 myopic subjects in excess of -10 diopters (D) and 8 hypermetropic subjects over +8 D. Twenty-five candidates (18.8%) were unfit under the age of 21 years due to corneal refractive surgery performed before the required age. Four subjects (3.0%) were unfit due to phakic intraocular lenses. Degenerative conditions were observed in 23 subjects (17.3%), including 21 patients with severe keratoconus. Other causes of incapacity were linked to oculo-orbital trauma in 11 subjects (8.3%), moderate or severe amblyopia in 7 patients (5.3%), congenital causes in 7 subjects (5.3%), inflammatory or infectious diseases in 7 candidates (5.3%), hereditary causes in 6 subjects (4.5%) and undetermined visual dysfunctions in 4 subjects (3.0%)., Conclusion: The three main causes of ophthalmological disqualification were high ametropia, refractive surgery performed before the required age and keratoconus., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Scoliosis is one of the most common surgical disorders of the pediatric spine. Refractive errors are commonly associated with vision impairment worldwide. However, it is currently unclear whether refractive error correlates directly with the development of scoliosis., Methods: A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was employed among school-aged students in Nantong City, China. Univariate and multivariate logistic regression analyses were used to investigate specific correlations between scoliosis and related parameters; various types of refractive errors were also included in the study., Results: The prevalence of scoliosis among school-aged students was 2.2% in Nantong city. Multiple logistic regression analyses showed that myopia, hyperopia, astigmatism, and anisometropia were not correlated with the development of scoliosis (all, p≥0.05). Lower body mass index (BMI) [adjusted odds ratio (aOR) = 0.92; 95% confidence interval (CI): 0.88-0.95; p<0.001], living in rural areas (aOR = 1.40; 95% CI: 1.05-1.86; p = 0.020), and older age (aOR = 1.32; 95% CI: 1.25-1.38; p<0.001) had significantly higher risks of scoliosis., Conclusions: Refractive errors did not correlate with the development of scoliosis. However, BMI, living in rural areas and older age did correlate with the development of scoliosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Cai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: To understand the ocular biometric parameters characteristics and refractive errors in 3-to 6-year-old preschool children in Chengdu, China, and to investigate the prevalence of refractive errors., Method: A school-based cross-sectional study was conducted in Chengdu from 2020 to2022 with a total of 666 kindergartens. All children were measured by non-cycloplegic autorefraction and uncorrected visual acuity (UCVA) and ocular biometric parameters. Finally, univariate linear regression models were used to analyze the relationship between ocular biometric parameters and refraction., Results: A total of 108,578 preschool children aged 3-6 underwent examinations, revealing a myopia prevalence of 6.1%. The mean axial length (AL), keratometry (K), corneal radius (CR), axial length/corneal radius (AL/CR) Ratio, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and vitreous chamber depth (VCD) were 22.35 ± 0.69 mm, 43.35 ± 1.58 D, 7.80 ± 0.28 mm, 2.87 ± 0.08, 533.31 ± 32.51 μm, 2.70 ± 0.28 mm, 3.91 ± 0.27 mm, and 15.20 ± 0.68 mm, respectively. With increasing age, AL, CR, AL/CR ratio, CCT, ACD, LT, and VCD also increased. Regardless of age, males consistently exhibited longer AL, flatter corneal curvature, shallower ACD, thicker CCT, thinner LT, and longer VCD compared to females. AL, K, CR, LT, and VCD all showed significant linear relationships with SE (all P < 0.001) in univariate linear regression analysis after adjusting for gender and age., Conclusion: The prevalence of myopia among preschool children aged 3-6 in Chengdu is relatively low. Ocular biometric parameters affecting refractive errors include AL, K, CR, LT, and VCD. The preschool period serves as a critical phase for myopia prevention and control., (© 2024. The Author(s).)

Refractive errors can have profound effects on children. Cost and logistics prohibit national population-based studies and global data do not accurately reflect the burden among Nigerian children. This systematic review and meta-analysis aim to provide pooled prevalence and pattern of refractive error in Nigerian children. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol for this study was pre-specified and registered on the International Prospective Register of Systematic Review (registration number ID: CRD42022303419). A systematic search of PubMed, EMBASE, Scopus, CINAHL Cochrane Library, African Journal Online, and African Index Medicus databases, was done for school-based, or population-based studies on refractive error prevalence in Nigerian children younger than 18 years of age or school children in pre-tertiary institutions. Quality-effect model was used to calculate weighted prevalence, odds ratio, and corresponding 95% confidence interval. Twenty-eight school-based studies including 34,866 children were identified. No population-based studies were found. The pooled prevalence of refractive error in Nigerian children was 5.9% (3.6-8.7%) and varied between regions and with the definition of refractive error used in the studies. The number of children needed to be screened to detect one case of refractive error was 15 (9-21). The odds of refractive error was higher in girls (odds ratio: 1.3 {1.1 to 1.5}), children >10 years (odds ratio: 1.7 {1.3 to 2.2}), and urban residents (odds ratio: 2.0 {1.6 to 2.5}). The high prevalence of refractive error in Nigerian children substantiates the value of screening school children for refractive error, particularly targeting urban and older children. Research is needed to refine case definitions and improve screening protocol. Population-based studies are needed to define the prevalence of refractive error in communities. The epidemiologic and methodological challenges in conducting prevalence reviews is discussed.

Purpose: To determine the frequency of potential non-strabismic accommodative-vergence anomalies (NSAVA) and investigate associations between NSAVA, refractive errors and age among children attending a paediatric ophthalmology clinic., Methods: This study included children and adolescents aged 5-19 years attending an ophthalmology clinic with at least two follow-up visits. At their first visit, children had a comprehensive ophthalmic examination, including refractive error measurement by cycloplegic autorefraction and spectacles were prescribed if necessary. At the second visit, children had an examination of best-corrected visual acuity, convergence and accommodation to identify potential NSAVA. The relationship between age, sex, heterophoria and refractive error and potential NSAVA was assessed by a multivariable logistic regression model., Results: A total of 384 children and adolescents were evaluated. Their mean age was 10.97 ± 3.07 years and 58.9% were females. Forty-two per cent of children failed the NSAVA tests and 34.1% had myopia (≤-0.50 D). Children who failed NSAVA tests self-reported a higher proportion of reading problems (73.7%) compared to those who passed the tests (26.3%; p < 0.001). Children with self-reported reading problems were more likely to have accommodative infacility (57.9%) compared with children without (42.1%; p < 0.001). Refractive error and age were not associated with failure in NSAVA tests (p > 0.05)., Conclusions: NSAVA was a frequent cause of vision problems found in a sample of children from an ophthalmology paediatric clinic. Thus, further research is necessary to understand the potential of public health policies to prevent, refer, diagnose and treat those conditions., (© 2023 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Background Refractive error is considered as an important component of the priority disease "childhood blindness" within the Vision 2020' initiative to eliminate avoidable blindness. The large majority of vision impairment in school aged children is due to uncorrected refractive error. Hence, refractive errors are considered as a public health challenge. The aim of this study was to estimate the prevalence of refractive error and spectacle compliance among children in Tokha municipality, Kathmandu. Objective The aim of this study was to estimate the prevalence of refractive error and spectacle compliance among children from Tokha municipality, Kathmandu. Method A descriptive, cross-sectional study was conducted by enrolling 1366 children from Tokha municipality from 1st to 3rd week of April 2022 after obtaining the Institutional Review Board (Reference number:60/2079/80). Assent was taken from all children and informed consent was signed by the legal guardians of the children. All the samples underwent a comprehensive ocular history taking, visual acuity and refraction and ocular health assessments. The inclusion criteria was school going children within age group 5-16 years. Result Out of a total of 1366 samples, 10.91% (149) of the school children were identified to have refractive error. The primary type of refractive error observed was compound myopic astigmatism, which accounted for 52.3% (78) of the cases. A spectacle compliance rate of 72.15% was found. Conclusion Refractive error prevalence in this study is consistent with findings from other part of Nepal. The most common type of refractive error was compound myopic astigmatism. The frequency of refractive errors was notably higher among individuals who frequently use electronic devices, attend private schools, and reside in densely populated areas. It is recommended to organize regular community eye camps and conduct vision screenings to identify and promptly address refractive errors in children.

Importance: Refractive error remains the largest cause of correctable visual impairment in the US. Correction of refractive error will reduce visual impairment and its associated morbidity but also improve quality of life and productivity., Objective: To determine the burden of and risk factors (RFs) associated with any uncorrected refractive error (UCRE) and unmet refractive need (URN) in a population-based sample of African American adults., Design, Setting, and Participants: This cross-sectional study, conducted from April 2014 to April 2018, included a population-based sample of self-identified African American participants 40 years and older from 30 contiguous census tracts in Inglewood, California. Participants underwent a complete ophthalmic examination and an in-home-administered questionnaire to assess sociodemographic, lifestyle, biological, medical, and health care and eye care usage RFs associated with UCRE and URN. Measurements of visual acuity (VA) were performed using a standard Early Treatment Diabetic Retinopathy Study protocol. Noncycloplegic automated refraction with supplemental subjective refraction was performed. UCRE was defined as an improvement of 2 or more lines with refraction in the better-seeing eye. URN was defined as an improvement of 2 or more lines with refraction in the better-seeing eye in those persons who were visually impaired. Sex- and age-specific burden of UCRE and URN were calculated, and multiple regression analyses were used to identify independent RFs. Study data were analyzed from May 2018 to December 2023., Exposures: Presence or absence of correctable refractive error., Main Outcomes and Measures: Self-reported sex- and age-specific prevalence of and risk indicators of UCRE and URN., Results: Of the 7957 eligible participants in the African American Eye Disease Study (AFEDS), 6347 (80%) completed both the in-home interview and the clinical examination. Of these, 6337 participants (mean [SD] age, 61 [11] years; 3997 female [63%]) with complete refractive error data were included in the analysis. Refractive error-related correctable visual impairment was present in over two-thirds of participants with visual impairment (68.7%). The overall prevalence of any UCRE was 14.6% (925 of 6337), and the overall prevalence of any URN was 5.4% (URN1 [those with presenting VA of worse than 20/40 in the better-seeing eye but who could achieve 20/40 or better with correction], 157 of 2893; URN2 [those with presenting VA of worse than 20/40 in the better-seeing eye but who could achieve an improvement of 2 or more lines with refractive correction], 155 of 2891)., Conclusions and Relevance: Results of this cross-sectional study suggest a high burden of refractive error-associated correctable refractive error in African American adults, making it the leading cause of visual impairment in this population. Providing universal coverage for vision care and prescription glasses is an affordable and achievable health care intervention that could reduce the burden of visual impairment in African American adults by over two-thirds and likely raise the quality of life and work productivity, especially in this vulnerable minority population.

Ophthalmological conditions are underreported in patients with KBG syndrome, which is classically described as presenting with dental, developmental, intellectual, skeletal, and craniofacial abnormalities. This study analyzed the prevalence of four ophthalmological conditions (strabismus, astigmatism, myopia, hyperopia) in 43 patients with KBG syndrome carrying variants in ANKRD11 or deletions in 16q24.3 and compared it to the literature. Forty-three patients were recruited via self-referral or a private Facebook group hosted by the KBG Foundation, with 40 of them having pathogenic or likely pathogenic variants. Virtual interviews were conducted to collect a comprehensive medical history verified by medical records. From these records, data analysis was performed to calculate the prevalence of ophthalmological conditions. Out of the 40 participants with pathogenic or likely pathogenic variants, strabismus was reported in 9 (22.5%) participants, while astigmatism, myopia, and hyperopia were reported in 11 (27.5%), 6 (15.0%), and 8 (20.0%) participants, respectively. Other reported conditions include anisometropia, amblyopia, and nystagmus. When compared to the literature, the prevalence of strabismus and refractive errors is higher than other studies. However, more research is needed to determine if variants in ANKRD11 play a role in abnormal development of the visual system. In patients with established KBG syndrome, screening for misalignment or refractive errors should be done, as interventions in patients with these conditions can improve functioning and quality of life., (© 2023 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals LLC.)

Purpose: This study set out to determine the prevalence and the factors contributing to ocular disorders among children with physical and mental disabilities, who represent a vulnerable group in Osun State., Methodology: This was a cross-sectional study among children with physical and mental disabilities aged 5-17 years using a multistage sampling technique. Demographics, presence of ocular symptoms and determinants of ocular disorders were noted. Distant visual acuities were measured; refraction and ocular examination were performed. Appropriate drug treatment, prescribed spectacle or low vision aids were dispensed as necessary, at subsidized rates., Results: Of 189 children enrolled, 103(54.5%) were males and 86(45.5%) were females, with male to female ratio of 1.2:1. Mean age was 14.7 ± 0.45 years and 28/189 (14.8%) had ocular disorders in either eye. Some of the participants had multiple pathologies. The commonest identified visual disorder was refractive error (11.1%). There was a statistically significant ocular disorder determinant among most mothers of respondents (82.1%) who had ocular disorders and did not receive antenatal care in the hospital, p<0.05. Only 28.6% of children who had ocular disorders were fully immunized., Conclusion: The majority of mothers of children with ocular disorders did not receive antenatal care in the hospital. Health education on the importance of early antenatal care in the hospital is advocated to reduce the occurrence of ocular disorders. Early assessment and correction of ocular problems will prevent unnecessary visual impairment in these vulnerable children., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Introduction: The increasing prevalence of refractive error has become a serious health issue that needs serious attention. However, there are few studies regarding the prevalence and associated factors of refractive error at the community level in Ethiopia as well as in the study area. Therefore, providing updated data is crucial to reduce the burdens of refractive error in the community., Objective: To assess the prevalence and associated factors of refractive error among adults in Hawassa City, South Ethiopia, 2023., Method: A community-based cross-sectional study was conducted on 951 adults using a multistage sampling technique from May 8 to June 8, 2023, in Hawassa City, South Ethiopia. A pretested, structured questionnaire combined with an ocular examination and a refraction procedure was used to collect data. The collected data from the Kobo Toolbox was exported to a statistical package for social sciences for analysis. Binary and multivariable logistic regression analyses were performed. A P-value of less than 0.05 was considered statistically significant in the multivariable analysis., Result: A total of 894 study participants were involved in this study with a 94.1% response rate. The prevalence of refractive error was 12.3% (95% CI: 10.2, 14.5%). Regular use of electronic devices (adjusted odds ratio = 3.64, 95% CI: 2.25, 5.91), being diabetic (adjusted odds ratio = 4.02, 95% CI: 2.16, 7.48), positive family history of refractive error (adjusted odds ratio = 2.71, 95% CI 1.59, 4.61) and positive history of cataract surgery (adjusted odds ratio = 5.17, 95% CI 2.19, 12.4) were significantly associated with refractive error., Conclusion and Recommendation: The overall magnitude of refractive error in our study area was high. Regular use of electronic devices, being diabetic, positive family history of refractive error, and a positive history of cataract surgery were associated with refractive error., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Abebe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)