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Introduction: Visual impairment is a handicap defined as any alteration of visual function responsible for a partial or total limitation of the activities of daily living (OMS, 2004). The objective of this study is to assess quality of life in patients before and after management of low vision., Patients and Methods: This was a mono-centric, transverse, analytical study over a period of 6 months. Our study population included all adult patients seen in ophthalmologic consultation and followed in the low vision unit with visual acuity less than 3/10 and greater than or equal to 1/20 in the best eye with best optical correction. The National Eye Institute's quality of life questionnaire, the NEF VFQ 25, was administered to patients on site prior to management and then a month later., Results: Low-vision management improved overall the dimensions of the quality of life questionnaire. Following the end-of-care assessment, the score for ocular pain was lowest (38.20), followed by the overall vision score (44.95) and near vision difficulty score (45.33)., Discussion: Our sample population was distinguished by a cultural mix, with diversity of beliefs and lifestyles, and also by the relatively advanced age of the subjects constituting it. This can influence the individual's perception of him- or herself within his or her environment, modifying the patient's estimation of his or her condition and therefore his or her behavior., Conclusion: Low-vision rehabilitation can improve the quality of life of visually impaired patients, particularly for near vision, activities of daily living and psychological health., (Copyright © 2019. Published by Elsevier Masson SAS.)

Purpose: To describe epidemiological characteristics of outpatients examined by university medical center ophthalmologists in emergency rooms (ER), and to determine factors associated with true emergencies., Methods: A monocentric cross-sectional study including all patients examined by an ophthalmologist in the ER of in the university hospital of Nancy over a two-month period was conducted. Demographics and medical characteristics were assessed. The visits were categorized by ophthalmologists as true emergencies or not., Results: Among the 1,308 patients included, the median (IQR) age was 49 (32-64) years, and 56 % were males. The main reasons for seeking care were eye redness (32.6 %), eye pain (30.0 %), eye trauma (26.1 %), and visual loss (23.3 %). Nearly 40 % of the consultations were judged as not truly emergent. Factors significantly associated with true emergencies were: age under 60, male gender, some reasons for seeking care (visual loss, eye redness, eye pain), and a period of less than 3 days between symptom occurrence and the ER visit., Conclusion: The proportion of non-emergent ER visits was relatively high, and factors associated with true emergencies have been identified in our study. Standardized protocols may be useful to help emergency physicians and nurses to determine when to refer a patient to an ophthalmologist., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

This study aimed to precisely map current ophthalmologic consultation in France through systematic data collection in one consultation day. Nine ophthalmologic centers participated in the survey, performing 1148 observations of patients aged from 2 to 102 years old, with a mean of 55.12years old and a male/female distribution of 43.8 %/56.2 %. In general, the patients came in either spontaneously (28.8 %) or for follow-up (59.6 %). Emergency consultations comprised 5.7 % of all cases. Comorbidities or major risk factors were found. Most the patients already wore visual correction (82.6 %), mainly glasses (77.3 %). At the end of the consultation, 48.2 % received a prescription for new optical correction. During the interview, 53.3 % of patients reported visual symptoms, most frequently blurriness, distortion or loss of vision. 25.3 % of the patients experienced ocular symptoms such as pain, watery eyes or itching. An ophthalmic disease was the reason for the consultation in 77.1 % of all cases. Its management included medicinal and/or surgical treatment (45.6 % and10.5 % respectively). The necessary tests were performed on site the same day and only 2.6 % of the patients were given a prescription for additional testing to be performed elsewhere in a referral center. From a qualitatively and quantitatively representative sample, this survey describes ophthalmologic consultation in France today in terms of age, male/female distribution, reason for the visit, the proportion of visual correction and other diseases, diagnosis and treatment., (Copyright © 2017. Published by Elsevier Masson SAS.)

Background and Objectives: Wet AMD is characterized by the formation of choroidal neovascularization, mediated by vascular endothelial growth factor (VEGF) and responsible for a decrease in visual acuity and metamorphopsia of sudden onset. Intravitreal anti-VEGF can stabilize or even improve visual acuity. Although there is a consensus among ophthalmologists about the induction phase injection of anti-VEGF, there appear to be differences in practice regarding therapeutic treatment modalities. The goal of this work was to explore this hypothesis and to better understand real life practices., Method: The Ipsos institute conducted a qualitative survey of 16 retinal specialists and 9 general ophthalmologists in September and October 2013, using a questionnaire developed by a scientific committee of experts. Fifteen telephone interviews and 4 face-to-face meetings with a retina specialist and an ophthalmologist were conducted. This qualitative study allowed the development of a quantitative survey of 200 retina specialists and general ophthalmologists, conducted between November 2013 and January 2014, to describe practices in diagnosis, treatment and follow-up of wet AMD., Results: A distribution of roles between the ophthalmologist making the initial diagnosis and the retinal specialists responsible for treatment and follow-up was noted. Treatment was initiated within 10 days of diagnosis as recommended by the HAS in only one third of patients. After the induction phase of treatment, i.e. three monthly injections of anti-VEGF, treatment and monitoring practices were heterogeneous with 74% of physicians using a PRN treatment protocol, 22% a bimonthly protocol (with monthly monitoring in 19.4% of cases) and 4% a "treat and extend" protocol. There was little change in the protocol chosen in the case of recurrence., Conclusion: Three quarters of ophthalmologists report using a PRN protocol, and over 90% report seeing their patients monthly, either for injection or for a check-up. This apparent uniformity is in reality more complex: for the large majority, they prefer to closely follow the patient so as to treat the slightest recurrence, but with great variability in practices with regard to individualization of treatment., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

For some years now, the Braille League has been thinking about ways of improving information of the public with visual impairment about the assistance and services that it can seek. The conclusion that this information was inadequate was highlighted by all those in charge of assisting people with disabilities. As one of the key moments is the announcement of the diagnosis, the association wanted to contact health professionals in order to measure the level of information in their possession and pass on their expectations. Two approaches were used. First, there was a questionnaire that ophthalmologists completed at the Ophtalmologica Belgica 2010 conference. The topics raised were very diverse: their professional context, conditions of announcement, information given to patients, information requested by patients, and their wishes for the future. Moreover, semi-structured interviews enabled various areas of the study to be examined in greater depth: definition of impairment, conditions of announcement of the diagnosis, non-medical aspects, conclusion about lack of information and avenues for improvement. This study confirmed that ophthalmologists lack information on the subject of the psychosocial components of disability and have poor awareness of the existing aids and services. After the presentation of the results, a series of recommendations was made so that the announcement of the diagnosis could be optimal, so as to enable patients to embark on a process of adaptation and acceptance of their visual impairment.

Purpose: Several recent clinical studies have shown the benefit of lowering intraocular pressure in both ocular hypertensive and glaucoma patients. However, in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT), there is no consensus on the value of intraocular pressure (IOP) to be reached to prevent the progression of visual field defects. This IOP value, called target IOP, is defined by the ophthalmologist according to the patient and the progression of the disease, without a clear explicit justification of this decision. In France, ophthalmologists' education is mainly based on scientific meetings and the European Guidelines. This study was conducted to investigate the position of the IOP target in the treatment strategy for patients with glaucoma or OHT., Material: and methods: A cross-sectional descriptive survey was conducted in France among ophthalmologists in private practice. Patients with simple OHT or with OAG who required an initiation or a modification of treatment were included., Results: We included 1735 patients (805 males, 46.4%) in the study. An OAG was diagnosed in 1338 patients (77.1%) and a simple OHT in 397 patients (22.9%). The patients with OAG were older than the OHT patients (65 years vs 61.7 years, p<0.0001). Most patients (73.5%) were included for treatment modification (77.5% of the patients with OAG and 59.9% of the patients with simple OHT; p<0.0001). The main reason for treatment change was an unsatisfactory IOP value. The main therapeutic objective was to reach a target IOP in 46.0% of the patients. The choice of the ocular hypotensive drugs depended on the IOP value in 51.9% of the patients. When the treatment was modified, monotherapy was preferred in 60.8% of the patients., Conclusion: Among ophthalmologists, the main objective for the treatment of patients with simple OHT or with OAG was to reach a target IOP. About half the participants were used to set up a target pressure for their patients. This fairly good ratio shows the comprehensiveness and the adaptation of our colleagues to relatively new concepts in treating and managing patients with ocular hypertension or chronic open-angle glaucoma. If a modification in the treatment was necessary, then monotherapy was preferred. This decision was motivated by the efficacy of the treatment but also by expected better patient compliance.

Ophthalmic consultations account for 15% of all activity at the medical department of the Caritas Center at Sidon. Over a period of 26 months, 1,000 ophthalmic diagnoses were made at this center, with some patients diagnosed with up to three conditions (for example, presbyopia, with cataracts and dryness of the eye). Two major symptoms, redness and pain, were the cause of most of the consultations. Ametropia (37.8%) and conjunctivitis (33.2%) were the most frequent diagnoses. Cheap reading glasses are sold at the center, to reduce the cost of optical treatment, and they are sometimes bought purely for the frame. We found no cases of xerophthalmia due to vitamin A deficiency or of florid trachoma, indicating that eye health is adequate in the region studied. The frequency of certain diseases causing blindness (cataracts, glaucoma, retinopathies and neuropathies) is certainly underestimated. Retinopathies were of diabetic origin and complicated in 70% of cases (stage IV or higher) because diabetologists do not systematically send patients to ophthalmologists. They often wait for loss of vision to become evident, by which time it is often too late for effective treatment to be given. For many reasons, the elderly do not consult as frequently as young patients. The feasibility of a mobile consultation service should be studied. It seems to be very important to initiate national mass campaigns for: - health education in the field of ophthalmology; - screening and treatment of diseases causing irreversible blindness; - recovery of old glasses for the use of poor patients.

The main objective of this first epidemiological ocular allergy survey was to precise the profile of patients with an ocular allergy, especially in terms of antecedents, clinical type and trigger or favourising factors, in order to better determine the evolution of the type of diagnosed allergy. This survey covered 399 sufferers drown from amongst general ophthalmologists patients consulting for ocular allergy. Three main points which came out of the survey were: - the chronic aspect of this pathology and the multiplicity of responsible allergens; - the almost permanent existence of conjunctival lesions (9 patients out of 10) and corneal epithelial disease (1 patient out of 3); - the need for an extremely rigourous and thorough questioning of the patient and a complete ophthalmologic examination covering not only the symptoms but equally the lesions of ocular allergy.