Clinical Optometry最新文献

Purpose: To explore links between subjective comfort and vision in habitual multifocal soft contact lens (MFCL) wearers when refit with daily disposable MFCLs, to determine which factors are relevant for success with MFCLs and evaluate consistency between MFCLs of different designs.

Patients and methods: This work examined subjective measures in a randomised, participant masked, bilateral wear crossover study at five optometry practices. Fifty-eight habitual MFCL wearers wore stenfilcon A multifocal (stenA-MF; CooperVision Inc) and delefilcon A multifocal (delA-MF; Alcon) for two-weeks. Subjective ratings included satisfaction with comfort and vision and agreement questions.

Results: Agreement with "I would like to wear this MFCL in the future" was taken to indicate success with each MFCL; agreement was significantly higher with stenA-MF. There was strong correlation between agreement responses for "I would like to wear this MFCL in the future" and "MFCL met my needs for vision" with both lenses (p<0.01). However, it was only with stenA-MF, which had higher agreement responses to both statements (p<0.05), that responses to these two statements correlated with satisfaction with end-of-day (EOD) comfort (p<0.01). These differences in correlations between the two lenses are seemingly driven by greater satisfaction with stenA-MF for near and intermediate vision (p<0.05).

Conclusion: Subjective vision and comfort were only correlated when vision met the needs of most participants. Meeting participants' needs for vision correlated strongly with wanting to wear a MFCL. Results indicate that meeting vision needs is more important than meeting comfort needs when influencing whether presbyopic patients continue wearing MFCLs.

Background: The global prevalence of diabetic retinopathy (DR) among individuals with diabetes is 22.27%. This highlights the likelihood of developing burden of retinopathy within the at risk population and can have a detrimental impact on an individual's quality of life (QoL). The aim of this study is to assess the vision-related QoL in individuals with (DR) in a hospital-based population in the Al-Buraimi governorate, Sultanate of Oman.

Methods: The study was conducted in the Ophthalmology Outpatient Department of Al Buraimi Hospital and Polyclinic. This study enrolled 218 patients (114 males, 104 females) diagnosed with DR. The NEI-VFQ-25 questionnaire was adopted in this study. The patients were classified into different groups according to their type of diabetes and other relevant demographic information.

Results: A total of 218 patients responded to the NEI-VFQ-25 questionnaire. The mean age of the participants was 57.49 ± 12.3 years, 52.3% were male, and 47.7% were female. The overall QoL score was 41.53± 20.8. Patients aged more than 75 years had the lowest QoL scores compared with the other age groups (p = 0.02). The results showed that the duration of diabetes had no significant impact on the overall QoL scores (p = 0.06). A higher QoL score was observed among patients with type II diabetes mellitus (DM) than with type I diabetes mellitus (p = 0.01). Patients diagnosed with proliferative DR (PDR) had a significantly lower QoL score than those diagnosed at other stages (p < 0.001).

Conclusion: The QoL of the population with DR is negatively affected by various factors, including demographics, disease severity, and in patients with DM type II. It is important to consider these factors to enhance QoL in patients with DR. Regular evaluation of an individual's QoL is beneficial for both physicians and healthcare teams.

Purpose: To assess the prevalence of ocular morbidities and associated factors among hearing-impaired (HI) students at the Embangweni School for the Deaf in Mzimba, Malawi.

Methods: This was an institutional cross-sectional study of HI students at Embangweni School for the Deaf. A series of optometric and audiometric tests was performed, and the results were exported to the Statistical Package for Social Science for statistical analysis (SPSS) version 25. Pearson's chi-square test was used to assess correlations and associations between variables. A P-value less significance was set at p < 0.05.

Results: A total of 147 children comprising of 76 (51.7%) males and 71 (48.3%) females participated in this study. The prevalence of ocular conditions and visual impairment was 39 (26.5%) and 2 (1.4%), respectively. The Prevalence of eye disease was significantly associated with male sex (p=0.02) and type of HI (p=0.031). Allergic conjunctivitis 36 (24.5%) was the most common ocular condition, followed by refractive error 28 (19%).

Conclusion: The prevalence of ocular conditions among HI students was significant and associated with sex. Regular school vision screening of students with HI is highly advised to reduce the burden of visual impairment.

COVID-19 is a viral illness that can cause severe respiratory symptoms. COVID-19 has caused a worldwide pandemic that necessitated many countries to perform a national lockdown. In Jordan, a lockdown was imposed by the government. During the lockdown, the hospitals were only dealing with outpatient emergency cases, urgent referrals from primary or secondary health institutions, and inpatients whose medical conditions required keeping them admitted. Elective clinics and surgeries were canceled. At the King Abdullah University Hospital (KAUH), which is the only tertiary center in northern Jordan, we dealt with an unusual case of uncontrolled and advanced primary open angle glaucoma in a 38-year-old pregnant female patient. The patient was presented with an intraocular pressure (IOP) of 53 mmHg in the right eye and 40 mmHg in the left eye despite using dorzolamide and timolol eye drops twice daily. The angle was opened in gonioscopy. The decision was made to implant Ahmed glaucoma valves (AGV) in each eye in one session under general anesthesia which was performed successfully. At the last follow-up visit 4 years later, the IOP was maintained at 15 mmHg.

Introduction: Patients expect to have excellent vision and comfort when wearing soft contact lenses. The purpose of this study was to compare the wear experiences of participants with astigmatism when wearing a daily disposable soft toric lens to an established, commonly used reusable toric lens.

Methods: In this crossover study, habitual soft toric lens wearers were fit with a daily replacement soft toric lens (delefilcon A) and a reusable, 1-month replacement soft toric lens (comfilcon A) in a randomized order. After 30 days of wear, Visual analog scale (VAS) surveys were used to assess wear experience, including vision and comfort, for overall wear and end-of-day wear. Scores were compared statistically with mixed-effects linear models. Participants also responded to questions about convenience, ease of use, and satisfaction with both lenses and preference questions based upon comfort, vision, and overall performance.

Results: Fifty-nine participants completed the multi-site crossover study. VAS scores [mean(std dev)] for overall quality of vision for the delefilcon A [80.4(16.4)] and comfilcon A [66.8(27.7)] lenses were statistically significant (P=0.002). The difference in the mean overall comfort scores for the delefilcon A lenses [71.6(26.3)] and comfilcon A lenses [63.2(28.9)] was 8.4, which exceeds the establish criteria for clinical significance, although not statistically significant (P=0.08). Overall satisfaction scores were 68.8(26.9) for the delefilcon A and 59.7(30.3) for the comfilcon A lenses (P=0.08). Both lenses provided mean binocular visual acuities better than 20/20 Snellen equivalent. Over half of the participants preferred the delefilcon A lenses based upon comfort, vision, and overall performance. Convenience, ease of use, and satisfaction all scored higher with delefilcon A lenses.

Conclusion: The results of this study show that wear experience with delefilcon A lenses for astigmatism can meet or exceed that of comfilcon A toric lenses while also providing healthy, daily disposable lens wear.

Background: Early diagnosis and management of keratoconus (KC) are important for limiting visual complications of the disease. This study aimed to explore the perspectives of optometrists on the barriers to effective diagnosis and management of KC in Kenya.

Methods: An online questionnaire was distributed to optometrists in Kenya to collect data on barriers to the diagnosis and management of KC.

Results: The majority (60.9%) of optometrists were confident in retinoscopy and subjective refraction. Fewer were confident in the use of keratometers (46.4%) and corneal topographers (24.9%) and in the fitting of rigid gas permeable (RGP) contact lenses (25.0%). The most commonly reported barriers to improving their knowledge and skills were, limited continuous professional development opportunities (87.4%), high costs of conferences (86.1%) and the lack of diagnostic tools (79.5%). Impediments cited to diagnosing and managing KC effectively were a lack of national guidelines (64.9%), patient education material (71.5%), equipment (58.9%) and RGP supply (68.2%) and cost (67.5%). Most commonly reported barriers related to patients were compliance (91.4%), affordability (90.7%), RGP discomfort (89.4%), willingness to pay (88.1%) and the lack of patient education about KC (87.4%).

Conclusion: This study showed that the lack of national guidelines, essential equipment and adequate practitioner knowledge and skills were barriers to KC diagnosis and management. Regulation of optometric education and clinical practice, development of national guidelines for diagnosis and management of KC, up-skilling of practitioners and cost-effective solutions for equipment procurement and maintenance may improve both access to, and quality of, care to patients with KC.