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Aim: To evaluate level of agreement of specialist trained retinopathy of prematurity (ROP) nurses compared with an experienced paediatric ophthalmologist in detection of referral‐warranted ROP (RWROP) using wide‐field digital retinal imaging. Methods: This is a prospective, observational, blinded study of neonates in a level III neonatal intensive care unit, from July 2020 to November 2022. Image capture using wide‐field digital retinal imaging followed by ROP grading and staging was completed by trained ROP nurses. This was then compared with findings by an experienced paediatric ophthalmologist. The primary outcome was presence of RWROP in either eye. Results: One hundred and ninety‐five neonates (55% male) with a total of 768 screening visits were included. At the initial screen, nurse and ophthalmologist agreed about presence of RWROP for 191 of 195 neonates (98%, kappa = 0.79, P < 0.0001), with 100% sensitivity for RWROP detection. Including all 768 screening episodes, agreement was 98% for RWROP. There was disagreement in 16 screenings (2%) for 11 (6%) neonates. Of the five screenings (0.7%) that the ophthalmologist thought were RWROP and the nurse did not, three were disagreements about whether the zone was posterior zone 2 or zone 1. Conclusions: We found excellent levels of agreement and add evidence that interpretations by specialist trained nurses could be safely integrated into a 'hybrid ROP screening system'. [ABSTRACT FROM AUTHOR]

In intermittent exotropia (IXT), deviation is better controlled at near fixation. Understanding of the mechanism responsible for this common observation may improve clinical management of IXT. The physiological basis for the distance-near difference in control of deviation in IXT is vastly undetermined. A new parameter, 'control score disparity (CSD)', defined as the difference between distance and near control scores, is introduced. Association of CSD with positive fusional amplitude (PFA), accommodative convergence to accommodation (AC/A) ratio and distance angle of deviation was investigated to further understand the mechanisms. Patients aged between four and fifteen years with basic and divergence excess IXT were included. Subjects with previous strabismus surgery, amblyopia and inability to perform clinical tests were excluded. A standardized office-based scoring system was used to assess IXT controls. Subjects were sub-divided into group 1 (CSD <2) and group 2 (CSD ≥2). Pearson's univariate and regression analysis were used to determine relationships between CSD and other independent variables. Mean age of the total 141 subjects (57.6% female) was 6.8 ± 2.5 years. Basic IXT was more common (60%) and 60% had CSD ≥2. The mean±SD distance angle of deviation, AC/A ratio, PFA and CSD were 22.1 ± 6.6 prism dioptres, 5.0 ± 1.0, 28.6 ± 6.3 prism dioptre and 2.0 ± 0.5, respectively. CSD was significantly correlated to PFA (r = 0.64, p < 0.001) and AC/A ratio (r = 0.27, p < 0.001) in overall samples and Group 2 subjects (r = 0.41, p = 0.001). PFA is a major factor associated with the distance/near difference of IXT control. Individuals with a higher PFA demonstrated greater CSD. While AC/A ratio was associated in better control at near in divergence excess IXT, magnitude of angle appears irrelevant. [ABSTRACT FROM AUTHOR]

Background Overminus lens is an effective nonsurgical treatment of intermittent exotropia (IXT). Whether this treatment causes development of myopia is recently debated. This study evaluated ocular biometric changes in IXT children treated with and without overminus lens. Methods Children with IXT were randomly assigned to control and overminus groups. Cycloplegic refraction, axial length and other parameters (keratometry, anterior chamber depth and lens thickness) were evaluated for up to 30 months and compared between the groups. Axial length to corneal curvature (AL/CR) ratio was examined as an indicator of myopia progression. Changes prior to and after overminus were also assessed in a subgroup. Results Mean age of the total 84 subjects (58% women) was 7.2 years (range 4–15 years). Baseline refractive and biometric parameters of 39 control and 45 overminus subjects were not significantly different. Mean±SD change in refraction was −0.34±0.45D in controls and −0.41±0.66D in overminus group (p=0.527). AL increased by 0.29±0.20 millimetre (mm) in controls and 0.28±0.23 mm in overminus group (p=0.766). In the subgroup, the changes before and after overminus therapy was not significantly different (p>0.05). AL/CR ratio was maintained from baseline to follow-up visit (p=0.298) in both groups. Conclusion No significant differences in biometry or refraction were found between the two groups and before and after the therapy. We conclude that the overminus therapy in children, not accounting for other myopia risk factors, does not affect normal refractive growths. [ABSTRACT FROM AUTHOR]

Background/Aims: Retinopathy of prematurity (ROP) is a leading cause of visual impairment in premature neonates. The BOOST II, SUPPORT and COT trials recommended increasing O2 saturation targets for pre‐term neonates to reduce mortality; however, this is a risk factor for ROP. We aimed to determine whether these targets increased prevalence of ROP among pre‐term neonates and higher risk groups. Methods: Retrospective cohort study conducted using data from the Australian and New Zealand Neonatal Network. 17 298 neonate cohort born 2012–2018 at <32 weeks' GA and/or <1500 g BW was analysed. Adjusted odds ratios (aORs) were calculated for post‐2015 risk of: any ROP; ROP ≥ Stage 2; and treated ROP. Sub‐analysis stratified at <28 GA, < 26 weeks' GA, <1500 g BW and <1000 g BW was performed. Results: Risk of any ROP increased in the post‐2015 group (aOR = 1.23, 95% confidence interval (CI) = 1.14–1.32), <28 weeks' GA (aOR = 1.31, 95% CI = 1.17–1.46), <26 weeks (aOR = 1.57, 95% CI = 1.28–1.91), <1500 g (aOR = 1.24, 95% CI = 1.14–1.34) and <1000 g (aOR = 1.34, 95% CI = 1.20–1.50). ROP ≥ Stage 2 increased at <28 weeks (aOR = 1.30, 95% CI = 1.16–1.46), <26 weeks (aOR = 1.57, 95% CI = 1.28–1.91), <1500 g (aOR = 1.18, 95% CI = 1.08–1.30), and <1000 g (aOR = 1.26, 95% CI = 1.13–1.42). Conclusion: O2 therapy guidelines since 2015 have resulted in decreased mortality but increased risk of ROP. Individualised NICU adjustments of ROP screening/follow‐up methods are necessary to address the clinical burden. [ABSTRACT FROM AUTHOR]

The clinical assessment of distance stereoacuity is important in some ocular conditions. Given the different neurophysiological mechanism for crossed and uncrossed stereoacuities, evaluation of both may provide additional insight into binocular vision disorders. Clinical devices measuring distance crossed and uncrossed stereopsis are not readily available. Visotec Distance Stereo Test (VDST) is a contour-based device designed to measure both forms of distance stereoacuity. This study assesses the validity and test–retest reliability of the device in comparison to the random dot-based Randot Distance Stereo Test (RDST). VDST and RDST were administered to a total of 107 children, that included 51 'normal' and 56 'abnormal' (37 intermittent exotropia and 19 amblyopia) between the ages of 5 and 15 years. Two examiners retested stereoacuities in a sub-set of 62 randomly selected subjects. Stereoacuity was transformed to log scale. 95% limits of agreement were calculated for test–retest reliability. The Bland–Altman plot was used to demonstrate the agreement between the tests and the examiners. The mean ± SD crossed distance stereoacuities using VDST in normal, intermittent exotropia and amblyopic children were 93.1 ± 43.8, 161.9 ± 89.8 and 236.3 ± 122.4 arcseconds, respectively. For uncrossed stereoacuity, these were 104.7 ± 54.0, 187.6 ± 89.6 and 265.5 ± 144.0 arcseconds, respectively. Crossed stereoacuity was significantly better than uncrossed stereoacuity. 95% limits of test–retest agreement for crossed and uncrossed stereoacuities using the VDST were 0.27 and 0.30, respectively. An exact test–retest match using VDST was 84% in normals and 77% in abnormals for crossed and 83% in normal and 74% in abnormal for uncrossed stereoacuities. VDST is a reliable, valid and easy-to-administer distance crossed and uncrossed stereoacuity measuring device. Further studies are required to establish the clinical importance of assessing these two forms stereoacuities in relation to various binocular vision disorders. [ABSTRACT FROM AUTHOR]

Objective To describe the preoperative surgical case mix among patients undergoing cataract extraction and explore associations between case mix, country level of development (as measured by the Human Development Index, HDI) and cataract surgery rates (CSRs). Methods Ophthalmologists in 50 countries were invited to join the newly-established International Eye Research Network and asked to complete a web-based questionnaire about their eye hospitals. Those who complied received a data collection form for recording demographic and clinical data on 100 consecutive patients about to undergo cataract surgery. Countries were ranked into five HDI categories and multivariable regression was used to explore associations. Findings Ophthalmologists at 112 eye hospitals (54% of them nongovernmental) in 50 countries provided data on 11 048 cataract procedures over 9 months in 2008. Patients whose visual acuity (VA) before surgery was Conclusion The proportion of patients with very poor preoperative VA is a simple indicator that can be easily measured periodically to monitor progress in ophthalmological services. Additionally, the internet can be an effective tool for developing and supporting an ophthalmological research network capable of providing a global snapshot of service activity, particularly in developing countries. Objectif Decrire l'eventail des cas chirurgicaux pre-operatoires des patients subissant une operation de la cataracte et analyser les associations qui existent entre l'eventail des cas traites, le niveau de developpement des pays (mesure par l'indice du developpement humain--IDH) et le taux d'operation de la cataracte (TOC). Methodes Les ophtalmologues de 50 pays ont ete invites a rejoindre le tout nouveau Reseau international de Recherche ophtalmologique (International Eye Research Network) et a completer, sur Internet, un questionnaire relatif a leurs services hospitaliers d'ophtalmologie. Ceux qui ont accepte ont recu un formulaire de collecte de donnees permettant de recueillir les donnees cliniques et demographiques de 100 patients consecutifs sur le point de subir une operation de la cataracte. Les pays ont ete classes en cinq categories IDH et on a utilise une regression multivariable pour analyser les associations. Resultats Les ophtalmologues de 112 services d'ophtalmologie (dont 54% sont non gouvernementaux) de 50 pays ont fourni des donnees sur 11 048 interventions de la cataracte sur 9 mois en 2008. Les patients dont l'acuite visuelle (AV) avant l'intervention etait inferieure a 6/60 pour le meilleur oeil representaient 47% de l'eventail descas traites dans les pays peu developpes et 1% de ceux des pays developpes (P < 0,001). Dans l'ensemble, 72% des yeux subissant l'intervention presentaient une AV inferieure a 6/60. Une tres faible acuite visuelle avant l'operation de la cataracte a ete fortement associee a un developpement faible au niveau du pays et inversement associee au TOC national. Conclusion La proportion des patients presentant une tres faible AV pre-operatoire est un indicateur simple qu'il est possible de mesurer periodiquement pour controler les progres realises par les services d'ophtalrnologie. De plus, Internet peut etre un outil efficace dans le de developpement et la prise en charge d'un reseau de recherche ophtalmologique capable de foumir un instantane mondial de l'activite des services, en particulier dans les pays en voie de developpement. Objetivo Describir la variedad de casos quirurgicos preoperatorios en pacientes sometidos a extraccion de cataratas y examinar las asociaciones existentes entre la variedad de casos, el nivel de desarrollo del pais (de conformidad con la medicion del Indice de desarrollo humano [IDH]) y las tasas de cirugia de catarata (TCC). Metodos Se invito a oftalmologos de 50 paises a que se unieran a la recien creada Red Internacional de Investigacion Ocular y seles solicito que completaran un cuestionario basado en web sobre sus hospitales oftalmologicos. Aquellos profesionales que cumplieron lo solicitado recibieron un formulario de recopilacion de datos para el registro de datos demograficos y clinicos de 100 pacientes consecutivos que se iban a someter a una cirugia de cataratas. Se clasifico a los paises en cinco categorias de IDH y se utilizo una regresion multivariable para evaluar las asociaciones. Resultados .En el ano 2008, oftalmologos de 112 hospitales oftalmologicos (el 54% de ellos no gubernamentales) de 50 paises proporcionaron datos sobre 11.048 cirugias de catarata durante 9 meses. Los pacientes cuya agudeza visual (AV) antes de la intervencion era < 6/60 en el mejor ojo constituyeron el 47% de la variedad de casos total en los paises poco desarrollados, cifra que fue del 1% en los paises desarrollados (P Conclusion La proporcion de pacientes con una AV preoperatoria muy deficiente es un indicador simple que se puede medir facilmente con cierta regularidad con el fin de supervisar los avances de los servicios oftalmologicos. Asimismo, Internet puede convertirse en una herramienta eficaz para el desarrollo y apoyo de una red de investigacion oftalmologica capaz de ofrecer una vision global de la actividad de los servicios, especialmente en los paises en desarrollo., Introduction Blindness is both a cause and an outcome of poverty. (1) Cataract, defined by the World Health Organization (WHO) as a visual acuity (VA) of less than 3/60 in [...]