Clinical Optometry最新文献

Purpose: To investigate the effect of a single application of cationic emulsion in controlling tear film evaporation and improving tear quality and quantity.

Materials a methods: Twenty male subjects diagnosed with DE were enrolled in the study with an average age of 45.8 ± 6.37 years. The tear film parameters were observed at several time points post-instillation of the cationic emulsion (10, 20, 30, and 60 min). The tear evaporation rate (TER) was measured with a VapoMeter. Noninvasive tear break-up time and meniscus height were assessed using OCULUS Keratograph.

Results: TER decreased by more than 20% at 20, 30, and 60 minutes time points after instillation of single drop of cationic emulsion. Also, a significant improvement in tear film stability was found at all time points following the instillation of cationic emulsion eye drops. The mean tear break-up time increased from 5.55 ± 2.87 to 6.6 ± 4.2 sec at 60 minutes. The maximum increase in tear break-up time occurred at 30 minutes time point. The TMH was also significantly higher post-instillation of oil emulsion eye drops. There was a significant increase in the TMH post-therapy with oil drop at all time points.

Conclusion: The overall study findings of this study illustrate that the single application of a cationic emulsion effectively controls tear film evaporation in patients with mild to moderate DEs. The cationic emulsion efficiently enhanced both the tear film stability and the tear meniscus volume.

Purpose: To study the prevalence of the prescription glasses given to first-grade students due to the "Good Sight for Thai Children" (GSTC) policy.

Methods: This was a cross-sectional study that examined all prescription glasses given to first-grade students throughout Thailand, after visual screening due to the GSTC policy between 2016 and 2017. Trained class teachers screened their students' visual acuity and referred children who had less than 20/40 visual acuity in either eye to a hospital for an eye examination and prescription glasses.

Results: A total of 786,729 students were screened. Of these, 20,401 (2.59%) students were referred to hospital. However, only 9867 (48.37%) students presented to a hospital. Glasses were prescribed for 5324 (53.96%) students following cycloplegic refraction by ophthalmologists or trained refractionists. The mean spherical equivalent was -1.08 (-19.00 to +10.00, SD 2.32) diopters. There were 1626 (30.54%) children at amblyopic risk without glasses. A 5.49% had high myopia (< -6 diopters), 5.22% had high hyperopia (> +5 diopters) and 27.82% had high astigmatism (>2 diopters). A cylindrical lens analysis showed that 81.53% had with-the-rule astigmatism, 4.07% had against-the-rule astigmatism, and 14.40% had oblique astigmatism.

Conclusion: Although the reliable prevalence of refractive error cannot be estimated, the prevalence of visual impairment may be estimated. There were a number of students who required glasses. The astigmatism was the most common refractive error on prescription glasses for first-grade children. With-the-rule astigmatism was the most prevalent. The visual screening program of school children proved to be valuable and should be continued and developed.

Purpose: This study aimed to assess the level of stereopsis, proportion of poor stereopsis, and factors influencing stereopsis in adults with refractive error.

Methods: This was a cross-sectional, descriptive study conducted on 153 adults with refractive error at Gondar University Hospital Tertiary Eye Care Center from April 08 to June 07, 2019. Structured questionnaires and ophthalmic instruments (Retinoscope, Worth Four Dot test and TNO Stereo plates) were used to collect the data. Data were entered and analyzed with Statistical Package for Social Sciences (SPSS) version 20. The result was summarized using summary statistics such as mean. Chi-squared test of association was applied between stereopsis and independent variables.

Results: The level of stereopsis after correction of refractive error ranged from 1.89 to 2.65 log arc second. Before correction of refractive error, poor stereopsis was observed in 46.4% of the participants, while after correction, it dropped to 39.8% (CI: 95%: 31.1%-47.8%). Stereopsis after correction had a significant association with age, best visual acuity, type of refractive error, and fusional status at distance with a p value < 0.05.

Conclusion: Given refractive error corrected, the mean stereopsis in patients with refractive error was 2.42 log arc second. Proportion of poor stereopsis was noted in 39.8% of the participants corrected for refractive error. Age, best corrected visual acuity, type of refractive error, and fusional status had a significant association with stereopsis. Further studies on stereoacuity on a large scale are recommended.

Background: The link between hand and surface hygiene and the spread of disease has been reported by various studies and understanding the appropriate use of hand hygiene is important in healthcare. The World Health Organization (WHO) introduced the "My Five Moments for Hand Hygiene" model to educate healthcare workers about the importance of hand hygiene to stop the spread of disease.

Objective: The objectives of this paper were to determine if the WHO Hand Hygiene Observation Form could be used to monitor for hand and personal hygiene practices of Optometry students, and what their actual hygiene practices are in an Optometry training facility in South Africa.

Methods: This cross-sectional study was performed at an Optometry training facility in South Africa using third (n=32) and fourth year (n=39) students. The Hand Hygiene Knowledge Questionnaire for Health Care Workers by the WHO was used to determine their knowledge regarding hand hygiene. After completing the questionnaire, participants were observed in the clinic while consulting patients to determine the hand and surface hygiene practices they apply.

Results: The WHO hand hygiene observation rubric was not appropriate to evaluate hand and surface hygiene in Optometry facilities. The adapted observation rubric created was a better tool to evaluate student hygiene practices and was able to record which hand or surface hygiene were missed when presented with such opportunities. Although 90.1% of the students knew that germs could be transferred to the patients via hands, only 46.5% routinely used an alcohol-based hand sanitizer.

Conclusion: This observation rubric developed during this study can assist in creating awareness with students about their own hand and surface hygiene deficiencies when interacting with patients.

Midday fogging is a common problem in scleral lens wear, as particles accumulate in the tear reservoir between the posterior surface of the lens and the front of the ocular surface during wear. As particulate waste collects, symptoms of blurred vision and discomfort arise, typically leading patients to remove their lenses for cleaning, refilling with fresh solution, and reinsertion into the eye. The appearance of the particulate can vary, likely due to different causes for midday fogging. Studies which attempted to identify the particulate have given some insight into some of the causes, but larger studies are needed to identify this debris. Research on lens solutions used for filling the lens reservoir and of various aspects of scleral lens fits have also begun to culminate in the concept that midday fogging may ultimately be related to inflammation. Since scleral lens wearers can have varied and multiple sources of inflammation, strategies in minimizing midday fogging can differ between patients.

Introduction: Refractive error (RE) is the main cause of visual impairment and blindness in the world. Lack of knowledge and unfavorable attitude of refractive error can have long-term consequences and dramatic effects in children and adults, such as loss of educational and employment opportunities, loss of economic gain for individuals, families, and societies, and impaired quality of life.

Aim: The aim of this study was to assess the level of knowledge and attitude of refractive error among public high school students in Gondar city, Northwest Ethiopia.

Methods: A school-based cross-sectional study was conducted on 390 public high school students. Those participants were selected by applying a systematic random sampling technique with an interval of 4. Data were collected using a pre-tested structured questionnaire through face-to-face interviews. The collected data were entered into Epi Info version 7.0 and exported into SPSS version 20 for analysis. Results were described using tables and text.

Results: A total of 390 study participants were included in this study with a 92.4% response rate. The overall proportion of good knowledge and a favorable attitude towards a refractive error were 53.8% and 52.1%, respectively. From the study participants, 38.7%, 41.7%, and 64.1% did not know the definition, the risk factors, and the symptoms of refractive error, respectively. Moreover, about 31.3% of the participants believed that wearing spectacle could damage their eyes, whereas 44.1% of the participants agreed with the need for spectacle correction for young people with RE.

Conclusion: The proportion of good knowledge and a favorable attitude towards refractive error among public high school students were fair. We recommended that eye care practitioners be committed to increasing the knowledge and attitude of students towards refractive error through eye health education to reduce visual impairment due to refractive error.

Purpose: The purpose of this study was to show the effect of increasing blood glucose level (BGL) on psychophysical visual function represents by visual acuity and contrast sensitivity in pseudophakic people living with diabetes (PDM).

Study design: This was quasi-experimental, quantitative study using a pretest-posttest approach.

Methods: The study was conducted at Gamalakhe community health centre located in Gamalakhe township and included a sample of 50 pseudophakic people living without diabetes mellitus (PWDM) and 50 pseudophakic PDM. BGL as well as psychophysical measurements of visual function were measured preprandial and postprandial. Visual acuity (VA) was measured at distance (4 m) and near (40 cm) using logMAR VA charts, and contrast sensitivity (CS) was measured at 50 cm using a Mars chart. The data collected were captured and subsequently analyzed using SPSS version 25.

Results: Glycemic changes measured preprandial and postprandial observed a mean increase of 2.06±1.35 mmol/L (p=0.350) and 1.08±0.47 mmol/L (p=0.291) in pseudophakia PDM and pseudophakic PWDM, respectively. CS showed a mean increase of 0.01±0.10 (p=0.23) and 0.002±0.02 (p=0.19) log units in PDM and PWDM, respectively; however, the independent t-test showed this was insignificant between PDM and PWDM (p=0.27). A insignificant mean increase of 0.01±0.04 log units (p=0.25) and 0.001±0.01 (p=0.32) in distance VA of pseudophakic PDM and PWDM was found, respectively. A mean increase of 0.001±0.01 log units (p=0.32) and 0.01±0.03 (p=0.06) near logMAR VA of pseudophakic PDM and PWDM was found, respectively.

Conclusion: Acute hyperglycemic changes do not result in overall significant changes in visual acuity and contrast sensitivity in pseudophakic PDM and PWDM for an increase in glycemia of 2 mmol/L. We recommend studies investigate if changes occur for glycemic increases exceeding 2 mmol/L.

Purpose: Stereo-anomaly is commonly associated with amblyopia. An investigation was conducted to determine whether the measurements of stereoacuity obtained with the stereoacuity reference test (TNO Test) show an agreement with a computer stereoscope video game.

Methods: Thirty-two subjects (mean age 9.37±2.00 years) with an amblyopia history were selected for a blind and randomized study of stereoacuity improvement through a new random dot game. A masked examiner measured the stereoacuity three times per subject using the TNO test (at the beginning, at the end and after 6 months of the treatment). A second masked examiner measured stereoacuity using the new computerized game after the TNO masked evaluation.

Results: The Pearson's correlation coefficient one test against the other was r² = 0.767 and the Bland-Altman plot was r²= 0.069 (mean difference -0.03 log sec). Using three categories: poor (840-300 seconds of arc), coarse (480-210 seconds of arc) and moderate-fine stereoacuity (210-30 seconds of arc). Positive predictive values were 89.5% for moderate-fine; 72.7% for coarse; and 90.0% for poor stereoacuity. In addition, the agreement was evaluated using the Kappa coefficient (K= 0.743) with a 0.95 confidence interval and lower and upper Kappa limits were (0.628 and 0.858), respectively. Kappa coefficient and limits were still good when analyzing data before (K =0.663, 0.420 and 0.906) and after the treatment (K= 0.765, 0.632 and 0.899).

Conclusion: The Computerized Stereoscopic Game test allows the measure of stereoacuity. It can be used for both the purpose of detecting stereo vision deficits or tracking stereo vision development.

Aim: Our study aims to produce an estimation of the keratoconus disease epidemiology and important demographic factors in disease presentation in Najran city in the south of Saudi Arabia.

Methods: Keratoconus patients between 9 and 29 years of age at the eye clinic of King Khaled General Hospital in Najran Province with a confirmed diagnosis of keratoconus were recruited over one year period. Visual acuity, keratometry, corneal thickness and demographic data were collected and analysed.

Results: The keratoconus prevalence in Najran Province was found to be 87.3 cases per 100,000 people with an incidence of 28.47 per 100,000 cases. The disease presented more frequently in male patients (67.9%) with a statistically significant difference in the mean age between genders (p=0.014). Most cases presented at a moderate stage, and almost half of the cases reported a family history of the disease. There were statistically significant differences in best visual acuity and corneal thickness between genders (p<0.05). The majority of the cases were managed with contact lenses (56.08%).

Conclusion: Genetic and environmental factors could have a substantial role in the increased rate of keratoconus presentation in Najran Province. Screening programmes should dedicate more attention to late presentation to improve prevention and early detection. More studies on keratoconus epidemiology in Saudi Arabia are needed.

Purpose: To assess the prevalence of occupational ocular injury and associated factors among small-scale industry workers in Gondar town, Northwest Ethiopia.

Methods and materials: Institution-based cross-sectional study was conducted on 542 manufacturing and construction workers in Gondar town from April 23 to May 4, 2019. A pre-tested questionnaire was used to collect data using face-to-face interview. Binary logistic regression was used to identify factors associated with occupational ocular injury.

Results: A total of 542 small-scale industry workers participated with a 95.1% response rate. The prevalence of occupational ocular injury was 31.4% (95% CI, 27.2-35.5). Employment pattern (temporary workers) (AOR: 1.84, 95% CI: 1.14-2.95), health and safety training (AOR: 2.22, 95% CI: 1.06-4.66), non-use of eye safety device (AOR: 7.43, 95% CI: 4.44-12.43), and job category (woodwork (AOR: 0.56, 95% CI: 0.32-0.97)), and brickwork (AOR: 2.19, 95% CI: 1.08-7.21) had statistically significant with occupational ocular injury.

Conclusion: This study showed the prevalence of occupational ocular injury among small-scale industry workers was 31.4%. Iron chips are the most common agent responsible for the injury. Type of employment, having health and safety training, use of eye safety devices, and job category had a significant association with occupational ocular injury.