Search

Purpose: To evaluate the ocular pharmacokinetics and availability of baicalein following topical application. Methods: Hydroxypropyl beta-cyclodextrin (HP-β -CD) was used to formulate an aqueous eye drop to improve aqueous solubility of baicalein. A single dose of either baicalein suspension (1%) (Bai-SP) or baicalein (1%)/HP-β -CD (10%) solution (Bai-CD) was topically applied to rabbits. Aqueous humor and cornea were collected after 5, 10, 20, 30, 45, 60, 90, and 120 min. Baicalein concentrations were determined by high-performance liquid chromatography (HPLC) after extraction. Results: After topically applying Bai-CD, the baicalein concentrations in aqueous humor were significantly increased at 20-120 min except at 90 min compared with those of Bai-SP (p < 0.05). The highest levels of baicalein in aqueous humor (Cmax, 4.11 ± 0.75 μ g/ml) were obtained after 30 min application of Bai-CD, 3.6 times greater than that corresponding to the Bai-SP at 20 min. The Bai-CD produced an over 2.1-fold bioavailability (AUC0-120, area under the concentration time curve between 0 and 120 min) increase in aqueous humor compared to the Bai-SP. Peak baicalein concentration in cornea (56.53 ± 17.02 μ g/g) was achieved within 5 min after topical application of Bai-CD and 4.5 times higher than that of Bai-SP at the same timepoint. The baicalein levels in corneas obtained after application of Bai-CD were all much higher than those obtained by Bai-SP (p < 0.01), whereas the drug levels became undetectable 30 min after topical application of Bai-SP. Conclusion: Bai-CD formulation is superior to Bai-SP for increasing ocular bioavailability. [ABSTRACT FROM AUTHOR]

The article focuses on various studies related to drying. According to a research, peanuts must be dried to 10.5% moisture content to preserve their quality in the U.S. Another study has found that it is important to keep one's eyes moist to avoid discomfort or possible infection while sitting in airplane cabins.

Purpose: To examine the effects of COX inhibitors on suppressing HSV-1 reactivation in a mouse model. Methods: BALB/c mice were latently infected with HSV-1 and treated by 0.1% bromfenac Na eye drops, 0.1% pranoprofen eye drops, 0.1 mg oral etodolac 4 times/day, and saline for 4 days. After reactivating the latent HSV-1, we swabbed the mouse ocular surface for the culture of the infectious virus and assessed the viral loads in the eyes and trigeminal ganglia (TGs) using real-time PCR to determine the treatment efficacies. Results: With stimulated reactivation, 10 of 24 (41.7%), 5 of 10 (50.0%), 17 of 25 (68%), and 16 of 22 eyes (72.7%) showed positive swab results in the bromfenac Na, etodolac, pranoprofen, and saline groups, respectively; and a significant difference was seen only between the bromfenac Na and saline groups (p = 0.033). None of the three drug-treated groups showed any significant difference from the saline group in the viral DNA in the eyes and TGs (p > 0.05). Conclusions: Bromfenac Na eye drops can suppress HSV-1 reactivation. [ABSTRACT FROM AUTHOR]

Contact lens hygiene has long been recognised as key to the prevention of contact-lens associated infection and inflammation. Microbial keratitis (MK) is the only serious and potentially sight-threatening contact lens adverse event. International studies including recent research in Asia Pacific show that MK is rare but, as the consequences can be severe, it is important to minimise the risk factors. Studies continue to show that one of the key risk factors is lens and lens case hygiene. Therefore, it is also useful to review the behaviour of our patients, to see how closely they follow the recommended hygiene practices. Recent studies in various regions have shown that patients’ lens care habits do not meet a required standard. Patients can become complacent and thus non-compliant with lens care instructions. Furthermore, they do not understand the high risk of some behaviour and they are not hearing the practitioner when instructions and reminders are given. Further education is important to improve patient compliance and safety. The Asia Pacific Contact Lens Care Summit held in Singapore urged the industry and practitioners to restore the emphasis of proper lens care, including the ‘rub and rinse’ technique, and developed a new set of guidelines to help eye-care professionals educate their patients on the importance of proper contact lens care to avoid eye infections. The summit also presented the latest research on how to avoid corneal staining, another important element of contact lens care. This review provides a summary of the summit presentations and the science behind these guidelines. [ABSTRACT FROM AUTHOR]

Interested in star movement the founder of Heidelberg's astronomy observatory, Max Wolf, faced the dilemma that the hitherto used 'Blinkmikrosop' of his Institution was damaged beyond repair following the first world war. He therefore used a new method, stereoscopy, to systematically classify 1053 moving stars between 1915 and 1918. The key problem Wolf identified with the new method was that variation in brightness of the same star on different photographic plates gave rise to an illusory movement. This was a particularly frequent problem with smaller stars close to the very bright Milky Way such as those in the proximity of Cygni or “fade-out stars” such as R Coronae Borealis. Carl Pulfrich, the world-leading expert on stereoscopy at the time, picked up immediately on the technical limitations Wolf published on stereoscopy in 1920. Pulfrich, who was blind in one eye, could not see the effect himself and designed a projection device to demonstrate Wolf's serendipitous observation to an audience which was equipped with a monocular neutral density filter. Pulfrich performed detailed investigations on the relationship of spatial perception and object movement, naming the phenomenon “stereo effect,” but it became widely known as the “Pulfrich effect.” The neuro-anatomical basis of the Pulfrich effect lies in the joint encoding of motion and depth within the visual cortex. Recognising Pulfrich effect is relevant for the management of patients in whom pathology of the visual pathways impairs judgment of object movement/position (e.g., in traffic or sport). Fitting a unilateral tinted lens or contact lens in front of the good eye can abolish the problem. [ABSTRACT FROM AUTHOR]

A multidetector approach for the HPLC analysis of methanolic extracts of three Hypericum species is performed under isocratic conditions through a C18 (ODS) analytical column. Variable wavelength UV-VIS detector (λmax: 230 nm), fluorescence detector (ex: 250 nm em: 450 nm), and a programmable electrochemical detector (+1.30 V vs. Ag/AgCl) were employed simultaneously for detection. The mobile phase used was a combination of methanol and 0.01 M orthophosphoric acid (pH 7) (50:50, v/v). Retention time values were assigned relatively to those of the standards, and the flavonoid contents were quantified by the standard addition method. Rutin, quercetin-3'-glucoside (isoquercitrin), luteolin-4'-glucoside, quercetin-4'-glucoside, quercetin, naringenin, luteolin, and apigenin were chosen as the model compounds to undergo the validation studies with the three different detector systems. For the comparison of the detector performances, analytical method validation parameters were studied and displayed. Defined methods yielded pretty good results regarding linearity, precision (reproducibility), accuracy, limit of detection, and quantification. [ABSTRACT FROM AUTHOR]

One way of ensuring effective cleaning in the pharmaceutical industry is to analyze the batch of a product for a potential carry over contamination from a previously manufactured one. The potential cross contamination of timolol maleate (TM) eye drops with cortisone compounds, deserves special consideration, due to the well known deleterious effect of cortisones on glaucoma. Therefore, it was the objective of this study to develop and validate a HPLC method for the detection and quantitative determination of cortisones in TM eye drop preparations. The chromatographic behaviors of the five cortisones that were most likely to be present as contaminants in TM eye drops were characterized on different HPLC stationary phases (normal silica, C18, C8, and CN). Mobile phase and buffer constituents were further optimized on the best stationary phase material (C18). The final recommended mobile phase consisted of a mixture of THF:methanol:0.01M phosphate buffet at ratios of 15:25:60 and containing 0.01 M camphore sulfonic acid (pH adjusted to 4.2). The method was validated in light of ICH guidelines and applied to commercial samples with satisfactory results. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the frequency and epidemiological features of vernal keratoconjunctivitis (VKC) in Italy. Methods: a specific electronic clinical chart for vernal keratoconjunctivitis was created to standardize: 1) medical history; 2) diagnostic criteria; 3) signs and symptoms; and 4) treatments. This study involved 6 Italian referral centers for ocular surface diseases: between March 2005 and March 2006, all referred patients were included, clinical data collected and statistically examined. Results: The mean age of the vernal keratoconjunctivitis population (n = 156) was 13.8 ± 8.8 with 64.1% of subjects under 14 years of age and a male/female ratio of 3.5:1. Among VKC patients, 48.7% showed associated systemic allergic diseases. Only 32.1% of patients were positive for RAST and/or prick test. The limbal form (53.8%) was the most frequent subtype of vernal keratoconjunctivitis. Approximately 9% of patients showed a severe form of vernal keratoconjunctivitis. At the first visit patients were treated with: multiple action or mast cell stabilizer eye drops (58.1% and 41.3% of cases, respectively), topical corticosteroids alone (0.6%) or in association (26.8% of cases). All patients used topical steroids at least once in the studied year. Systemic antihistamine therapy was used by 25.6% of patients. In this cohort, 32.7% of patients required two or more examinations per year for exacerbations of their symptoms. Conclusion: Vernal keratoconjunctivitis is a severe ocular condition that mainly affects young males. Vernal keratoconjunctivitis is characterized by different clinical features and therapeutic responses, suggesting the need for a standardized therapeutic approach on the basis of a grading of disease severity. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess if rates of reported visual impairment (VI) in the United States (US) are declining. The 1997-2005 National Health Interview Survey is an annual probability survey of US households (n = 289,442 adults 18 years of age and older). Participants responding yes to either question were classified as visually impaired: 1) “Do you have any trouble seeing, even when wearing glasses or contact lenses?” 2) “Are you blind or unable to see at all?” Prevalence rates were adjusted for survey design; weighted linear regression models were used to examine VI trends. Annual rates of any VI ranged from 8.6% to 10.0% with a non-significant annual downward trend of -0.04%. Significant downward trends were noted in adults who reported an eye care provider contact in the previous 12 months (-0.18%; [standard error = 0.08], p = 0.047), adults with diabetes (-0.81%; [standard error = 0.30], p = 0.01) and adults 80 years of age and older (-0.46% [0.19]; p = 0.021). Pooled analyses with adjustment for sociodemographic and diabetes status suggested that reductions in VI tended to occur in adults with eye care provider contacts. Downward trends in reported VI in older adults may be due to improvements in the treatment of ocular disease, increased eye care utilization in those with VI, or both. These findings require verification in population-based studies with clinical acuity measures in order to specifically assess the effect of eye care utilization on VI prevalence trends. [ABSTRACT FROM AUTHOR]

Collagen shields are contact lens-shaped, dissolvable protein matrixes placed on the cornea, primarily indicated for the promotion of epithelial wound healing. The shield can also serve to deliver ocular medications if soaked in a water-soluble antibiotic and/or steroid solution prior to their placement. Collagen shields have distinct advantages over other precorneal drug reservoirs, such as intensive topical therapy, which inconveniences both the patients and caregivers, and subconjunctival injections, which risks hemorrhaging and perforation. It has also been suggested that collagen shields can be used to augment ocular tissue concentrations of various medications over topical administration alone. Despite these potential advantages, the use of collagen shields in drug delivery has not become common practice. In this article, we summarize the evidence for and against the use of collagen shields in delivering and sustaining high levels of ocular therapeutics, with a special focus on the prevention of postoperative endophthalmitis. [ABSTRACT FROM AUTHOR]

Purpose: To examine the different dimensions of access to eye care from a public health perspective. Methods: We substantively review the theoretical and empirical literature on access to eye care and summarize the major considerations in measuring access to eye care using a modified behavioral framework. Results: We found that progress has been made, but some gaps still remain in measuring access to eye care. Most studies have focused on individual characteristics and use of eye care services. Only a very few studies have touched on contextual characteristics, such as demographic make-up of the area in which the patient lives, and their impact on the use of eye care services. Few studies have explored the linkage between the use of eye care services and outcomes or between the use of such services and patient satisfaction. Conclusions: To address a variety of demands from patients, providers, and policy makers, it is necessary to account for potential access and realized access measures. We need to adopt new methods in assessing the relationship between contextual characteristics and use of eye care services. Moreover, we need to better understand patients' satisfaction and their relationship with utilization and health outcomes. [ABSTRACT FROM AUTHOR]

A contact lens is a medical device widely used as an alternative to spectacles in order to correct refractive vision problems. The evolution of polymeric biomaterials has heralded a continuous development in the materials used to produce contact lenses and maximize patient comfort and limit adverse events. Microbial keratitis (MK) is a relatively rare but potentially devastating condition associated with contact lens use, particularly with the extended wear of hydrogel lenses. It is the principal complication related to contact lens wear and the large population at risk make it a public health concern. Bacterial binding to the contact lens material is a precursor to the development of MK and is influenced by properties of the material and the bacteria. In order for bacteria to infiltrate the cornea there must be some degree of corneal damage, usually caused by trauma or hypoxia. The most recent materials available aim to allow the continuous wear of lenses while limiting corneal hypoxia, thus helping to prevent the development of MK. Limitations to the treatment of MK require that novel approaches may be necessary in order to limit bacterial adhesion to contact lens materials. [ABSTRACT FROM AUTHOR]

Sunscreen must provide protection against solar radiation and be safe and non-irritating to skin and eyes, especially for children. A unique water-in-oil emulsion sunscreen formula with a sun protection factor of 50 (SPF50) was developed that minimizes irritation potential through careful selection of ingredients, active combinations, preservatives, and the absence of fragrance. The SPF50 sunscreen formulation reported here is non-irritating to the skin or eyes, with an estimated Draize ocular score of 0.0 for lotion and 3.6 for spray lotion formulations. No eyelid inflammation, lacrimation, or palpebral or bulbar conjunctival irritation was observed in human eye instillation studies. This sunscreen provides a new tear-free formulation that protects from ultraviolet radiation. [ABSTRACT FROM AUTHOR]

With a national population now estimated at 1.1 billion people (and growing!), it is often stated that India accounts for 1/3 of all blind and visually impaired individuals in this world! If this statement is correct, this means that there are 5-6 million visually impaired and blind individuals in India. Although certainly real progress is being made, one can reasonably ask, is the existing organizational structure designed to serve the needs of so large a number of people, and are the necessary care-providers available to provide for visual rehabilitation requirements of this very substantial cohort of affected patients? Both continuing growth and aging of the Indian population tend to challenge the capacity of that nation to meet demands for ophthalmic services, as well as their ability to meet the visual rehabilitation requirements of this populace. Modern optometry is, in many ways, a nascent profession in India. On behalf of the large cohort of visually impaired patients, I argue that a difference can be made through effective inter-professional cooperation between emerging modern optometry and more developed ophthalmology. I hope to see an increasing role for optometry in the provision of care for the visually impaired and blind in coming years. Here, I discuss a number of issues pertinent to the needs of the blind and visually impaired population, as well as means for enhancing applicable rehabilitation services. [ABSTRACT FROM AUTHOR]

Background: Several studies have suggested that bifocal and progressive spectacles can reduce progression of myopia in esophoric children. This study compared myopic progression with bifocal (BSCL) and single vision soft contact lenses (SVSCL) in identical twins with near point esophoria. Methods: Two 12-year-old myopic girls were randomly assigned to wear either BSCL or SVSCL for one year using a double-masked design. Both twins then wore BSCLs for another year. Ocular measurements included cycloplegic and manifest refractions, corneal curvature and axial length. Distance and near phorias were measured through distance corrections and near associated phorias, with both types of contact lenses. Results: Through their SVSCLs, both children exhibited near associated esophorias, which were neutralised by the BSCLs. The child wearing SVSCLs over the first year showed significant myopic progression, increasing -1.19 D (binocular average), while the child wearing BSCLs showed no progression (+0.13 D). The latter child showed limited progression (-0.28 D) over the second year, while switching from SVSCLs to BSCLs arrested progression in the other child (+0.44 D after one year). Axial length data were consistent with the refractive findings; the child exhibiting more myopia at the end of the first 12 months of the study had longer eyes (by 0.64 mm) than her sister, although their corneas also had steepened more (by 0.44 D compared to 0.18 D). The children showed similar, small increases in eye size over the second year when both wore BSCLs (binocular averages: 0.05, 0.09 mm, respectively). Conclusion: The apparent inhibitory effect of BSCLs on myopic progression reported in this twin study argues for further study of their efficacy as a control treatment for myopes with near esophoria. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of trachoma in Sao Gabriel da Cachoeira (SGC), the only urban community of the upper Rio Negro Basin of the Amazon state in Brazil, near the Colombian border, and to investigate the risk factors associated with the active forms of the disease. Methods: A total of 1702 people (440 children up to 9 years and 1069 adults aged 15 years and above) were examined. The sample was selected from a probabilistic household sampling procedure based on census data and a previous study of trachoma prevalence in Sao Gabriel da Cachoeira. A two-stage probabilistic household cluster sample was drawn. Household units were randomly selected within each cluster. A variety of socioeconomic and hygiene variables were studied in order to determine the risk factors for active trachoma in a household. Results: The total prevalence of trachoma was 8.9%. Prevalence of active trachoma (TF and/or TI) in children aged 1-9 years was 11.1% and trachomatous trichiasis in adults aged 15 years and above was 0.19%. Trachomatous scarring reached a peak of 22.4% for subjects between 50 to 60 years of age. Corneal opacity occurred in subjects aged 50 years and older with a prevalence of 2.0%. No sex effect was found on the overall prevalence of trachoma in SGC. Risk factors associated with active trachoma were mainly related to poor socioeconomic indicators. Conclusions: Despite the ubiquitous presence of water, the analysis of the risk factors associated with the active forms of the disease supports the idea that a low personal standard of hygiene and not water availability per se, is the key factor associated with trachoma. [ABSTRACT FROM AUTHOR]

Purpose: To describe the methods and innovations used in constructing the VisQoL, a vision-related utility instrument for the health economic evaluation of eye care and rehabilitation programs. Methods: The VisQoL disaggregates vision into six items. Utilities were estimated for item worst responses (the worst level for each item, with all other items at their best level) and VisQoL all-worst responses (all items at their worst level) using the time trade-off procedure. Time trade-off questions require people to imagine living a fixed number of years with a particular health condition and then indicate how many of those years of life they would be willing to trade to have perfect health. Where respondents indicated a health state was “worse than death” negative utilities were estimated. Time trade-off questions minimized the “focusing effect,” which occurs if respondents discount the fact that all other aspects of health are at their best when answering questions, by using pictorial and verbal aids. Results: Item utilities were combined using a multiplicative model, and VisQoL model utilities placed on a scale where 0.00 and 1.00 represent full health and death, respectively. The VisQoL allows utilities to be calculated for a wide range of vision-related conditions. Conclusion: The 6-item VisQoL has excellent psychometric properties and is specifically designed to be sensitive to vision-related quality of life. It is the first instrument to permit the rapid estimation of utility values for use in economic evaluations of vision-related programs. [ABSTRACT FROM AUTHOR]

Purpose: To assess and re-engineer the Vision Core Measure 1 (VCM1) questionnaire in low vision (LV) and cataract participants using Rasch analysis. Methods: 295 participants drawn from a low vision clinic and 181 from a cataract surgery waiting list completed the 10-item VCM1. Unidimensionality, item fit to the model, response category performance, differential item functioning (DIF) and targeting of items to patients were assessed. Category collapsing and item removal were considered to improve the questionnaire. Results: The initial fit of the VCM1 (combined populations) to the Rasch model showed lack of fit (χ 2 = 83.3, df = 50, p = 0.002). There was evidence of DIF between the two populations which could not be resolved. Consequently, each population was assessed separately. Irrespective of the population, disordering of response category thresholds was evident. However, collapsing categories produced ordered thresholds and resulted in fit to the Rasch model for the LV (Total χ 2 = 41.6, df = 30; p = 0.08) and cataract population (Total χ 2 = 17.9, df = 20, p = 0.59). Overall, the VCM1 behaved as a unidimensional scale for each population and no item showed evidence of DIF. Item targeting to patients was however sub-optimal particularly for the cataract population. Conclusion: The VCM1 questionnaire could be improved by shortening the response scale, although different response categories are required for cataract and LV populations. Calibration of items also differed across populations. While the VCM1 performs well within the Rasch model, in line with its initial purpose, it requires the addition of items to satisfactorily target low vision and cataract populations. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate ophthalmic manifestations in patients with Human Immunodeficiency Virus (HIV) infection in the era of highly active antiretroviral therapy (HAART) at the apex institute for eye healthcare in India. Method: This prospective study was undertaken between October 2004 and December 2005. A complete ophthalmological and systemic examination was performed on each patient. Relevant investigations were carried out in selected patients. Results: One hundred consecutive HIV infected patients (199 eyes) were examined for ophthalmic manifestations. Of these 17% (17/100) had Category A HIV infection (asymptomatic or acute HIV or persistent generalized lymphadenopathy), 23%(23/100) had Category B HIV infection (symptomatic, not A or C), 60%(60/100) had Category C HIV infection (AIDS indicator condition).76%(70/100) were male and 24%(24/100) were female. The median age of patients was 34 years and 52%(52/100) were in the fourth decade. 68%(68/100) patients were on HAART. 45% (45/100) patients had ophthalmic manifestations, the most common being cytomegalovirus (CMV) retinitis (20%) (20/100). Retinal detachment was seen in 70% (14/20) of CMV retinitis patients. HIV vasculopathy was seen in 11% (11/100) of patients. Other lesions included immune recovery uveitis (IRU) (5%)(5/100), acute retinal necrosis (ARN) (3%)(3/100), choroiditis (2%)(2/100), neuro-ophthalmic manifestations (12%)(12/100), complicated cataract (6%)(6/100), keratouveitis (1%)(1/100) and corneal ulcer (1%)(1/100). 7%(7/100) patients presented to us with ophthalmic manifestation as the only presenting sign of HIV infection. Amongst those who had ophthalmic involvement, about 50% (19/40) patients had CD4 count below 100 cells/micro liter and 70% (28/40) patients had CD4 count below 200 cells/micro liter. Conclusions: CMV Retinitis (20%) (20/100) is still the most common manifestation of HIV infection in this series, even in the era of HAART, and is more common than HIV vasculopathy. Immune recovery uveitis is appears to be more common with the introduction of HAART in absence of affordable anti CMV therapy in India. 7% (7/100) of patients present with ophthalmological features as the initial manifestation of HIV. As before, most (70%) (28/40) of the ophthalmic manifestations of HIV infection are present when CD4 count is less than 200 cells/micro liter. [ABSTRACT FROM AUTHOR]

With multifocal intraocular lenses, the majority of the patients do not wear glasses after cataract surgery which is a potential source of savings. Purpose: To collect data in four European countries on the associated costs for society of wearing spectacles after cataract surgery and the patient willingness to pay to be free of spectacles. Methods: Cross-sectional survey of centers that recruited patients who wore refractive spectacles after cataract surgery. Costs were expressed in 2006 Euros Results: 408 patients were recruited by 22 centers. Patients with a mean age of 68.5 years underwent cataract surgery about 3 years prior to recruitment. In all countries, prescribed lenses were mainly mono-focal and the mean cost of spectacles was EUR366.3. Half the patient population with private health insurance was reimbursed for spectacles at a level of 50%, except Spanish patients who were reimbursed at only 5.3%. However, a large part of the cost was directly paid by the patients. Out of a total mean cost of EUR354.9, patients paid EUR285.2 and health insurances only EUR69.7. More than half the patients were willing to pay at least 0.5EUR/day to be free of spectacles. Conclusion: Large differences were found among the 4 countries. Almost half of all subjects had private health insurance. The total cost of refraction includes a variety of resources not limited to spectacles. A large part of the cost was borne by patients and there is a high patient willingness to pay to be free of spectacles in this population. [ABSTRACT FROM AUTHOR]

Drometrizole is used in cosmetics as an ultraviolet (UV) light absorber and stabilizer. In an earlier safety assessment, the available data were found insufficient to support the safety of this ingredient, but new data have been provided and assessed. In voluntary industry reports to the Food and Drug Administration, this ingredient is reported to be used in noncoloring hair care products, and in an industry use concentration survey, uses in nail care products at 0.07% were reported. Drometrizole has absorbance maxima at 243, 298, and 340 nm. Drometrizole is used widely as a UV absorber and stabilizer in plastics, polyesters, celluloses, acrylates, dyes, rubber, synthetic and natural fibers, waxes, detergent solutions, and orthodontic adhesives. It is similarly used in agricultural products and insecticides. Drometrizole is approved as an indirect food additive for use as an antioxidant and/or stabilizer in polymers. Short-term studies using rats reported liver weight increases, increases in the activities of enzymes aminopyrine N-demethylase, and UDP glucuronosyl transferase, but no significant effects were noted in the activities of acid hydrolases or in hepatocyte organelles. Although Drometrizole is insoluble in water and soluble in a wide range of organic solvents, a distribution and elimination study using rats indicated that some Drometrizole was absorbed, then metabolized and excreted in the urine. Drometrizole and products containing Drometrizole were nontoxic in acute oral, inhalation, and dermal studies using animals. No increase in mortality or local and/or systemic toxicity were observed in a 13-week oral toxicity study using dogs; the no observed effect level (NOEL) was 31.75 mg/kg day- 1 for males and 34.6 mg/kg day-1 for females. In a 2-year feeding study using rats, a NOEL of 47 to 58 mg/kg day- 1 was reported. Developmental studies of Drometrizole in rats and mice found no teratogenic effects and a NOEL of 1000 mg/kg day- 1 was reported. Drometrizole was not genotoxic in Ames tests, a mouse bone marrow micronucleus test, or somatic mutation assays observing interphase nuclei and chromosomal aberrations using Chinese hamsters. There was no evidence of dominant lethal effects in studies using mice or rats. Drometrizole at a 1% concentration was minimally to moderately irritating to rabbit eyes, if followed by rinsing, but mildly to severely irritating in unrinsed eyes. A nail product containing 0.03% Drometrizole, however, was nonirritating to unrinsed rabbit eyes. A nail polish containing 1.0% Drometrizole was nonirritating to rabbit skin and Drometrizole was negative for sensitization in two Magnusson-Kligman maximization tests in guinea pigs. In clinical tests, Drometrizole at 1% was nonirritating in a single-insult patch test. No irritation or eczematous reactions were observed in 300 patients (with or without dermatosis) treated with daily applications of Drometrizole for 8 weeks. In a 3-year clinical therapeutic trial conducted to evaluate the effectiveness of two UV absorbing preparations containing up to 5% Drometrizole, two hypersensitivity reactions were observed during 445 applications. Although there are case reports in which Drometrizole was considered the sensitizing agent, clinical tests of cosmetic products containing 0.03% to 1.0% Drometrizole produced no irritation, sensitization, photosensitization, or phototoxicity in a total of 436 subjects. The Cosmetic Ingredient Review (CIR) Expert Panel assumes that Drometrizole is used in both noncoloring hair care and nail care products at low concentrations. The available safety test data do not suggest any adverse effects associated with exposure to Drometrizole. This toxicologic profile, coupled with the low concentration of use and the unlikely dermal penetration of a chemical that is insoluble in water, support the conclusion that Drometrizole can be safely used in cosmetics. [ABSTRACT FROM AUTHOR]

The contact lens wearing presbyopic population is underserved worldwide. There are several available options, including single vision contact lenses and spectacle over-correction for near, monovision, rigid gas permeable (GP) multifocal and bifocal lens designs and soft bifocal lens designs. This paper presents an overview of the latest research and clinical experience as it pertains to these forms of correction. Recent comparative studies concluded that contact lens multifocals perform better in many different forms of visual measurements, in some cases performing similar to best spectacle correction, than monovision wearers. The future appears to be very promising for multifocal GP and soft lens modalities. [ABSTRACT FROM AUTHOR]

The bovine corneal opacity and permeability (BCOP) assay can be used to predict relative eye irritation potential of surfactant-based personal care formulations relative to a corporate benchmark. The human eye sting test is typically used to evaluate product claims of no tears/no stinging for children's bath products. A preliminary investigation was conducted to test a hypothesis that the BCOP assay could be used as a prediction model for relative ranking of human eye irritation responses under conditions of a standard human eye sting test to surfactant-based formulations. BCOP assays and human eye sting tests were conducted on 4 commercial and 1 prototype body wash (BW) developed specifically for children or as mild bath products. In the human eye sting test, 10 μl of a 10% dosing solution is instilled into one eye of each panelist (n = 20), and the contralateral eye is dosed with sterile water as a control. Bulbar conjunctival erythema responses of each eye are graded at 30 seconds by an ophthalmologist. The BCOP assay permeability values (optical density at 490 nm [OD490]) for the 5 BWs ranged from 0.438 to 1.252 (i.e., least to most irritating). By comparison, the number of panelists exhibiting erythema responses (mild to moderately pink) ranged from 3 of 20 panelists for the least irritating BW to 10 of 20 panelists for the most irritating BW tested. The relative ranking of eye irritation potential of the 5 BWs in the BCOP assay compares favorably with the relative ranking of the BWs in the human eye sting test. Based on these findings, the permeability endpoint of the BCOP assay, as described for surfactant-based formulations, showed promise as a prediction model for relative ranking of conjunctival erythema responses in the human eye. Consequently, screening of prototype formulations in the BCOP assay would allow for formula optimization of mild bath products prior to investment in a human eye sting test. [ABSTRACT FROM AUTHOR]

In this article, the authors describe the self-reported eye conditions, eyecare history, and eye safety practices of migrant farmworkers in eastern North Carolina. The authors administered interviews to 79 farmworkers recruited at migrant clinics. Data collected included eye-related complaints and diagnoses, self-assessed visual acuity, eye symptoms, use of protective gear during work, and attitudes toward eye protection gear. Fair or poor eyesight was reported by 21.3%. Only 4 (5.1%) reported wearing glasses or contact lenses. More than 11% reported difficulty in recognizing a friend across the street, and 19.5% reported difficulty in reading. About 20% reported each of several eye symptoms. Fewer than 1 in 10 wore eye protection at work. Of all, 38% reported never having visited any eyecare professional. Farmworkers have a high level of unmet need for both routine preventive eye care and treatment or correction of vision problems. [ABSTRACT FROM AUTHOR]

The purpose of this retrospective study is to examine the possible association between iris pigmentation and susceptibility to noise-induced hearing loss in 2407 noise-exposed workers. The workers were between 16 to 65 years of age and were exposed to 2 to 42 years of work-related noise. Results demonstrated that dark-eyed workers presented a greater percentage of normal pure-tone thresholds than fair-eyed workers. Fair-eyed workers had threshold averages of 25.1 dB (right ear) and 26.0 dB (left ear) at 3, 4, and 6 kHz, which were significantly worse than workers with dark irises, with threshold averages of 15.8 dB and 17.2 dB in the right and left ear, respectively (p<0.01). Fair-eyed workers with less than 10 years of noise exposure had the same audiometric pattern as the dark-eyed workers exposed for more than 10 years. Workers not exposed to noise did not present significant differences in their audiometric pattern as a function of eye colour. These results suggest that iris pigmentation may be an additional indication of susceptibility to noise-induced hearing loss. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of color on nonius horopter between color normal and color deficient subjects. Horopter curves were plotted and analyzed for blue (450 nm), green (518 nm), yellow (589 nm) and red (634 nm) wavelengths in four subjects. Color normals and color deficient subjects showed similar horopter plots. One color normal and one color deficient subject perceived red horopter in front of blue and the other two subjects had the opposite effect. Based on these results it was concluded that the changes seen in the horopter for the different wavelengths is purely an optical effect with the primary cause being chromostereopsis due to chromatic aberration. [ABSTRACT FROM AUTHOR]

Objective: Contact lens wear is often associated with signs and symptoms of ocular dryness. These drying effects can be exacerbated by certain environmental factors such as low humidity, wind, and visual tasks. The objective of the study was to compare the ability of senofilcon A contact lenses to subjects'' habitual contact lenses to provide relief from the subjects'' perceived ocular discomfort during contact lens wear in adverse environmental conditions.Research design and methods: Eleven subjects completed a single-center, double-masked, randomized, cross-over, pilot clinical trial. At the qualification visit, and subsequently wearing senofilcon A study lenses (ACUVUE OASYS Brand Contact Lenses with HYDRACLEAR Plus*) and control (habitual) lenses at the following visits, subjects underwent a total of three 75-min Controlled Adverse Environment (CAE) exposures. The primary efficacy variable measured during the 2-week, 3-visit trial was subject-reported ocular discomfort during CAE exposure measured on a five-point scale from 0 (none) to 4 (worst). The endpoint of ocular discomfort was evaluated using a two-sided t-test based on a longitudinal linear mixed model. Lenses were also evaluated for safety, and all adverse events were monitored.Results: Subjects reported a significantly better mean comfort score when wearing senofilcon A contact lenses (1.62 ± 0.71 units) compared to the mean comfort score reported when wearing habitual lenses (2.21 ± 0.80 units) over the course of an entire CAE exposure (p = 0.0068). During exposure, senofilcon A lenses also yielded significantly better mean overall discomfort scores versus no lenses (2.73 ± 0.79 points, p < 0.0001).Conclusions: Senofilcon A contact lenses provided greater relief of subjective ocular discomfort associated with lens wear in adverse environmental conditions than that afforded by both the habitual lenses of contact lens wearers as well as with no contact lens wear. These results should be verified in a larger, appropriately-powered study. [ABSTRACT FROM AUTHOR]

Purpose: To compare two solvents for retrieval of lysozyme deposited on a silicone hydrogel (SH) contact lens material galyfilcon A (GA; Acuvue Advance). Methods: Two buffers used were 50:50 acetonitrile/0.02% trifluoroacetic acid (buffer 1) and 50:50 acetonitrile/50 mM NaOH (buffer 2). Results: Extraction efficiency from GA lenses was 74% (buffer 1) and 83% (buffer 2). Buffer 2 decreased lysozyme activity > buffer 1. Ex vivo GA lenses showed total protein deposition of 2-16 μ g/lens with total lysozyme deposition of 0.3-3.9 μg/lens. Conclusions: We have developed a low acid strength extraction buffer that can be used to efficiently extract active lysozyme protein from novel siloxane-based contact lens materials. [ABSTRACT FROM AUTHOR]

Purpose: To investigate ability of vitamin A (VA, retinol palmitate) to promote wound healing after injury in rabbit eye. Methods: After keratoconjunctival injury by 20 μ L of n-heptanol, VA eye drops at 500, 1000, or 1500 IU/mL were started 6 times a day for 11 days. Fluorescein and rose bengal staining and histological analysis were performed. Results: Fluorescein staining was significantly reduced by 1000 and 1500 IU/mL of VA and rose bengal staining by all concentrations. Histological examination revealed acceleration of wound healing after 7 days (1500 IU/mL). Conclusions: VA may be useful in treatment of keratoconjunctival injury. [ABSTRACT FROM AUTHOR]

Background: Cataract surgery is the most frequently performed ophthalmic procedure worldwide. While benefits gained from cataract surgery outweigh surgical risks, there have been concerns that older persons may have an increased risk of developing age-related macular degeneration (AMD) after cataract surgery. Objective: The Australian Prospective Study of Cataract Surgery and Age-Related Macular Degeneration Study aims to assess the risk of AMD in a large cohort of older patients following cataract surgery. The current report describes the study rationale, design and methodology. Design: Longitudinal studyParticipants: Approximately 2000 cataract surgical patients aged 65 years or older are being recruited from both public and private sources in western Sydney, Australia.Methods: At study visits, participants are interviewed using standardized questionnaires to obtain information on demographic, medical, and ocular conditions and AMD risk factors, together with data on general health and vision-related quality of life. Eye examinations include visual acuity, intraocular pressure, keratometry and A-scan measurements, plus lens and retinal photography, following pupil dilatation. Retinal photographs taken before cataract surgery, and at 1, 6, 12, and 24 months after surgery are graded for early and late AMD lesions, using the Wisconsin age-related maculopathy grading system. The 1-month post-operative retinal photographs supplement the baseline macular assessment for cases in which cataract occludes a clear view of the macula pre-operatively. It is intended that study participants will be followed for up to five years post-operatively to clarify the question of whether aphakic or pseudophakic, compared to phakic eyes, have a greater risk of developing AMD. [ABSTRACT FROM AUTHOR]

Purpose: Prevalence of cataract related blindness and visual impairment is extremely high in India. Service utilization, on the contrary, is sub-optimal. Services offered through outreach screening are often not taken up. Against this background, the decision making processes leading to the uptake of cataract surgery services offered during outreach screening camps were investigated in people with cataract in India. Methods: The study used an exploratory, qualitative approach. Sixty one cataract patients from two eye hospitals in Hyderabad, India, were interviewed using convenience sampling. Two focus group discussions with cataract patients and interviews with seven key informants helped triangulate the information. Results: Lack of access to personal funds limited and delayed the utilization of offered services by patients who had been advised of surgery at outreach screening camps or eye hospitals. Stigma, fatalism and ageism were other limiting factors. The majority of patients did not make the decision regarding uptake of services themselves. Hearsay reports of the outcome of surgery and quality of services had a strong influence on service uptake. Women, particularly widows and those from rural areas, were least likely to use cataract surgery services. Conclusion: Provision of affordable and accessible eye care does not guarantee that the care or service will be utilized. Within the decision making process about cataract surgery, dependency on and importance of the wider family was found to be an often cited context of patients' decisions. Future research and programming activities need to put an emphasis on underserved groups, especially those who may be marginalized or disempowered. [ABSTRACT FROM AUTHOR]

Introduction:Many diabetics do not have regular eye examinations, although it is known that early diagnosis and treatment of sight-threatening retinopathy reduces the risk of blindness. The barriers that prevent diabetics from attending eye clinics are poorly understood. Purpose:To determine what factors may influence diabetic patients' attendance at eye clinics. Methods: A qualitative survey of both patients and eye care providers was undertaken in a rural district general hospital and in an urban tertiary teaching hospital. Methods employed included semi-structured interviews, focus groups and non-participatory observations. All interviews and discussions were recorded and transcribed. The transcripts were then analyzed to detect emerging themes. Data collection continued until no new themes emerged. Results: Lack of awareness was seen as the greatest barrier by both patients and providers. Patients were aware that diabetes could affect the eye, but not that it could lead to blindness, nor that severe retinopathy could be asymptomatic. Patients reported that fundus images used for screening were a valuable educational resource. Fear, particularly of laser treatment, and guilt, about poor control causing retinopathy, deterred patients from attending. Both patients and providers recognized that regular attendance was inconvenient; however, providers underestimated the difficulties patients faced in obtaining time off work to attend clinics. Conclusion: Providing more complete information about diabetic retinopathy, and making eye clinic attendance more convenient for patients, may increase the number of diabetics who have regular eye examinations. [ABSTRACT FROM AUTHOR]

Purpose : To examine the effect of lipid-lowering agents in the development of age-related macular degeneration (AMD) through the techniques of meta-analysis. Methods : Case-control and cohort studies presenting relative risks and 95% confidence intervals were identified through a literature review. Inclusion was limited to studies where both the exposure of interest (lipid-lowering agents) and outcome (AMD) were explicitly defined. Pooled estimates were computed using the random effects model. To quantify heterogeneity we calculated the proportion of total variance of between study variance using the Ri statistic. The Q statistic for heterogeneity was also calculated. Results : Eight studies were identified. The pooled relative risk (RR) for all studies was 0.74 (95% CI, 0.55-1.00). When only those studies examining the use of statins were pooled (n = 7), the RR was 0.70 (95% CI, 0.48-1.03). Using the Ri statistic, the heterogeneity between studies was found to be 0.85 for all studies and 0.89 for studies examining statins. Conclusion : Lipid-lowering agents, including statins, do not appear to lower the risk of developing AMD, although clinically significant effects cannot be excluded. The use of these agents in the prevention of AMD cannot be recommended until well designed prospective studies with long follow up have demonstrated a benefit. [ABSTRACT FROM AUTHOR]

Changing global population demographics and effective eye care programs are tipping the scale towards an increase in nonpreventable and nontreatable vision disorder that can lead to low vision. Comprehensive low vision services are important to maintain or improve the quality of life of people with low vision. However, globally, coverage and access to services is estimated to be 5–10%. Research regarding the effectiveness of services has emerged in recent decades. This paper provides an overview of the effectiveness of international low vision models of service delivery. It presents a history of service evolution, an overview of the epidemiology of low vision, and a critique of past and present models concluding with a discussion of models of best practice. [ABSTRACT FROM AUTHOR]

Purpose: 1. To estimate the prevalence and identify the determinants of Trachomatous Trichiasis (TT) among the > 40 years old Omani population. 2. To compare the results of the present study to those of the survey conducted in 1996 and propose public health policies for eye care in Oman. Methods: Ophthalmologists randomly selected 75 houses in 24 clusters. The visual status per eye was noted. The anterior segment of the eye was examined to detect TT, using the WHO simplified grading. Frequencies, the age sex standardized prevalence and their 95% Confidence Intervals (unadjusted for clustering) were calculated and the numbers of people with TT in the population were estimated. Results: Persons examined numbered 2,339. The prevalence of TT among the > 40 years old Omani population was 4.14% (CI 95% 3.3 to 4.9). The gender variation [OR = 1.51 (CI 95% 1.01 to 2.37)] and regional variation of TT was significant (p < 0.001). The standardized prevalence of TT in the > 40 years old Omani population had declined from 7.25% in 1996 to 3.96% in 2005. Predictors of TT were female gender, and age > 60 years. Conclusions: Trichiasis is still a public health problem in Oman. The prevalence is higher than the "< 1 TT case per 1000" target set for the "Ultimate Intervention Goals" for the "Elimination of Blinding Trachoma." The TT surgery rate in Oman should be increased to reach this goal. The underlying causes of low coverage should be identified and addressed through a program approach. [ABSTRACT FROM AUTHOR]

Latanoprost is one of the greatest success stories of medical treatment of glaucoma. Latanoprost was developed in the early 1990s and quickly became the best selling eye drop for glaucoma treatment replacing timolol as the drug of choice in the USA within 3 years. Its use led to a sharp decline in surgical treatment for glaucoma in the developed world. Timolol had been introduced with similar success in the 1970s, replacing pilocarpine, a drug that needed more frequent instillation and caused significant topical side effects including pain and blurred vision. Fixed-combination therapy with latanoprost and timolol was introduced in Europe several years ago with the hope that convenience and better compliance would improve clinical outcomes. However, the results of this therapy have been disappointing with less intraocular pressure lowering than might be expected from the two most effective eye drops for the treatment of glaucoma. [ABSTRACT FROM AUTHOR]

Eye and health care are and always will be both art and science. The science of discovery, its translation to clinical care and the education that necessarily follows for practitioners is witnessing remarkable change and increasing impact on patient care. An independent and vibrant profession commits to discovery as a basis of better patient care; optometry is no exception. Some recent discoveries in our field are breathtaking and the increasing awareness in health care, including in optometry, of the advantages of accepting the challenge of translating these discoveries to patient care is becoming more evident. Health-care practice is increasingly evidence-based on careful science. The implications of evidence-based health care are surprisingly broad, with impact on clinical care guidelines, reimbursement, future scope of practice responsibilities and education both within our schools of optometry and for our practitioner. [ABSTRACT FROM AUTHOR]

The purpose of the work was to assess the contrast sensitivity function of individuals wearing gas permeable (GP) multifocal contact lenses, soft bifocal contact lenses, and GP monovision lenses. Twenty-six females and six males between the ages of 42 and 65 participated in this study. The study included subjects wearing monovision (N = 8), the Acuvue Bifocal (Johnson & Johnson) (N = 8), Essential GP Multifocal (Blanchard) lenses (N = 8) and progressive addition spectacle lenses (PAL) (N = 8), with PAL wearers forming the control group. Measurements of binocular contrast sensitivity were obtained using the VISTECH 6500 system. Thresholds for each spatial frequency were fit to the equation CS(k) = ak exp(-bk) [1 + c exp(bk)]-1/2, to describe the human contrast sensitivity function. The area under the contrast sensitivity function (CSF) curve was calculated for all four groups and compared. An index of performance was obtained, which was defined as the ratio of CSF with the contact lens correction to the CSF with spectacles. Of the contact lens wearing groups, GP multifocal contact lens wearers had the highest contrast sensitivity at all the spatial frequencies. Soft bifocal contact lens wearers exhibited higher contrast sensitivity than monovision wearers at all spatial frequencies. Subjects wearing GP multifocals had the largest area under the CSF; followed by those wearing soft bifocals, with monovision wearers having the smallest area. GP multifocals have the best visual function at 0.98, soft bifocals have an index of 0.65 and monovision has an index of 0.59. This study quantifies the visual performance of the three lens systems by measuring the area under the CSF curve. In addition, it provides indices of visual function with the contact lenses that will be helpful for analyses and comparisons in future studies. [ABSTRACT FROM AUTHOR]

The aim of the work was to compare the acceptance and feasibility of high add spectacles over other low vision aids (telescope and magnifiers) in patients in tertiary eye care centres in western India. Materials used included visual acuity charts, pinhole, retinoscope and trial lenses, slit lamp, indirect ophthalmoscope, low vision assessment equipment and high add spectacles and other optical low vision aids. Retrospectively, 128 eyes from patient prescriptions who reported to the OPD, in different ophthalmological and optical set-ups, of western India were studied. The subjects were enrolled irrespective of the cause of low vision. All patients underwent routine examination of vision and anterior segment of the eye in the OPD, followed by applanation tonometry and dilated retinal examination. The patients considered for low vision prescription underwent complete low vision assessment with both spectacles and other optical low vision aids. It was prescribed as per clinical acceptance. The number of accepted as spectacles and other low vision aids (telescopes and magnifiers) were analysed for acceptability and feasibility. The average age of presentation was 44.05 years and ranged from 6 to 84 years. There were 77 males. One prescription for each patient, either for a low vision or a spectacle was accepted. The complaints were mainly regarding distance and near vision. Only 54 (42.19%) subjects had a problem of mobility with the rest comfortable both in a known and unknown atmosphere. Near vision could be improved to N8, N6 in 74.2% with a good reading speed and acceptable field and reading distance. 53.12% subjects had a vision improvement of about Snellen's 6/24 to 6/9 partial though the field was constricted. 25.78% was overall clinical acceptance of the telescopic prescription; only five (15.15%) subjects bought the prescribed telescopes. The overall clinical acceptance for spectacle low vision aids prescription was 74.22% and acceptance level 94.7% (only five rejections). The statistical analysis was done by Chi-square test, standard error of proportion and z test to find the significance of difference in prescription and acceptance and the acceptability of spectacles over other low vision aids. The value for the Chi-square test was, p=<0.001, which showed that the difference between the prescription of both spectacles and other low vision aids and acceptance by patients for the same was of high statistical significance. The test of error of proportion followed by the z test showed a value of p< 0.01. It expressed that there was an absolute preference for high add spectacles over the other low vision aids which was of high statistical significance. The study reveals even though telescopes are absolute vision enhancers they are not readily acceptable to the patients though the vision is good with the low vision aids other than the high add spectacle aids. [ABSTRACT FROM AUTHOR]

Exposure to glutaraldehyde is a recognized cause of work-related asthma. An investigation was undertaken to describe exposure to glutaraldehyde among workers making bioprosthetic heart valves and to make recommendations for prevention. At the two largest heart valve manufacturing facilities in California, the work process was observed; employer representatives and glutaraldehyde-exposed workers were interviewed; and employer written records, including company-generated industrial hygiene data, were analyzed. Approximately 600 female workers had continuous airborne exposure to glutaraldehyde over the course of every work shift and the routine potential for skin and eye contact with glutaraldehyde while making heart valves. Employee short-term (15-min) glutaraldehyde exposures were all well below the current regulatory ceiling level (0.20 ppm). Overall, approximately 40% of the glutaraldehyde-related job tasks involved exposures above the American Conference of Industrial Hygienists threshold limit value ceiling of 0.05 ppm; the majority (71.4% and 83.3%, depending on the company) involved exposures greater than 0.015 ppm. At one company, two cases of physician-diagnosed asthma were recorded by the employer in the previous 5-year period; these reports met the surveillance case definition for new-onset, work-related asthma associated with a known asthma inducer. Factors that contributed to worker exposure included large exposed surface areas of glutaraldehyde under agitation; working with glutaraldehyde-treated tissue in proximity to workers' breathing zones; manual pouring and disposal of glutaraldehyde solutions without local exhaust ventilation, eye protection, and waste neutralization; and prolonged use of latex gloves. Workers making bioprosthetic heart valves are at risk for occupationally acquired asthma. Employers should implement additional engineering controls to minimize workers' exposures to at least below a level of 0.015 ppm, an appropriate glove to prevent workers' skin exposure to glutaraldehyde, consistent and universal use of eye protection, and a medical surveillance program for glutaraldehyde-exposed workers. [ABSTRACT FROM AUTHOR]

Purpose: The aims were to determine the level of compliance of contact lens wearers, to identify which procedures have highest levels of non-compliance and to study the effectiveness of a compliance enhancement strategy on the level of compliance. Methods: The level of compliance for each subject was evaluated with a self-administered questionnaire together with microbiological examination of their contact lenses, lens cases and lens care solutions. The effect of an intervention to improve the level of compliance was determined by a controlled trial. A regular self-review exercise on proper lens handling was given to the test group once every three months for 12 months. The levels of compliance and contamination of contact lenses and lens care accessories between test and control groups were compared at the end of the 12-month period to evaluate the effect of the intervention. Results: Sixty-five subjects who were experienced contact lens wearers were recruited and 60 completed the study. All showed some degree of non-compliance in the care of their contact lenses and lens accessories. Most (about 60 per cent) were non-compliant with at least six of a total of 15 lens care procedures. The most common non-compliant behaviour among contact lens wearers was associated with the care of the lens case. By the end of the study period, our compliance enhancement strategy did not appear to have had a significant effect on the behaviour of our subjects, except for improvement in the care of lens cases. Compliance for other procedures improved in both test and control groups. Conclusion: All subjects showed some degree of non-compliance and the spectrum of non-compliance was wide. The poorest levels of compliance were associated with care of the lens case, which was also the most frequently contaminated item. Our compliance enhancement strategy showed a significant difference in improvement in compliance between the intervention and control groups only in the care of lens cases. [ABSTRACT FROM AUTHOR]

Purpose: To determine if a community screening with Frequency Doubling Technology perimetry (FDT) results in a high proportion of follow-up with an eye care provider and the factors associated with follow-up. Design:Cross-sectional study. Setting: Telephone survey Methods: We conducted a telephone survey of participants with abnormal results 3-6 months after the community screening. Results: We were able to interview 121 participants (57% of 212 eligible subjects). Sixty-nine percent (83 of 121) of participants visited an eye care provider after the screening. Patients were more likely to attain an eye exam if they were female, older, or had an educational level of high school or more (p < 0.05). Of those participants who did not visit an eye care provider, 41% (18/38) did not believe the results of the test, 21% (8/38) reported not having insurance or an eye care provider, 11% (4/38) did not have time for an eye exam, and 11% (4/38) reported not knowing they needed to see an eye care provider. Conclusion: A community screening program with FDT encouraged more than two thirds of participants with abnormal results to seek an eye exam. The most common reason not to attain an eye exam was failing to recognize the importance of an abnormal test result. [ABSTRACT FROM AUTHOR]

Objective/Purpose: This survey was conducted to determine the effect on activities of daily living of persons who report that they have received vision rehabilitation. Design/Methodology: This study used a clinical sample to gather information from 417 patients. Of the 417, 105 reported receiving vision rehabilitation. The efficacy of rehabilitation was assessed by asking 20 questions about their activities of daily living prior to and after their rehabilitation. A retrospective pretest (post-then-pre) design was used. Paired t tests were conducted to evaluate the effect of rehabilitation. Results: A significant difference was found for 13 of 20 questions. Difficulty reading ordinary prints in newspapers showed a large effect size (p = 0.0005). Difficulty reading the small print in a telephone book showed a large effect size (p = 0.0005). Difficulty doing work or hobbies that require one to see up close showed a moderate effect size (p = 0.0005). Difficulty finding something on a crowded shelf showed a moderate effect size (p = 0.0005). Difficulty figuring out whether bills received are accurate showed a moderate effect size (p = 0.0005). Difficulty shaving, styling one's hair, or putting on makeup showed a small effect size (p = 0.016). Difficulties seeing and enjoying programs on television showed a moderate effect size (p = 0.0005). Conclusion: Patients with low vision who report having received vision rehabilitation show significant improvements in activities of daily living or specific types of functioning after rehabilitation. Improvement in both near and distance vision activities and in social activities indicates daily functioning was improved and that barriers to activities of daily living were removed. [ABSTRACT FROM AUTHOR]

Objectives: To identify the perceived barriers to the provision of clinical low-vision service among ophthalmologists in Nigeria, with a view to proffering measures for their removal. Methods: A cross-sectional survey of ophthalmologists attending the Annual Ophthalmological Society of Nigeria Congress in September 2005 was conducted. Using self-administered questionnaires, information relevant to low-vision practice and the perceived barriers to the provision of low-vision services was garnered. Results: Eighty-three (70.9%) ophthalmologists out of 117 eligible participants at the congress responded to all of the questions and returned the study questionnaires. Non-availability of low-vision devices within the country (88%), lack of training in low-vision care (73.5%), lack of public awareness of low-vision care and its practitioners (60.2%), and the ophthalmologists' preoccupation with general ophthalmic practice (56.6%) were cited as the major barriers. With regard to the fellows and the residents in training, there was a statistically significant difference in their perception of two of the investigated barriers, namely, that low-vision care is not lucrative (T value: 4.46; 95% CI: 0.16± 0.07) and low-vision care is time-consuming (T value: 2.05; 95% CI: 0.145± 0.14). Conclusion: Training in low-vision care should be provided within the country for interested relevant personnel at all levels. Moreover, low-vision devices should be made accessible and available to the practitioners. There is a need in Nigeria for widespread health education/awareness campaigns in low-vision care, targeted primarily at ophthalmologists, allied eye-care providers, and the general public. There is a need to include low-vision practice in the curriculum of the ophthalmology residency program in Nigeria. Further qualitative research may need to be conducted to explain the differences in responses between subsets of the study population. [ABSTRACT FROM AUTHOR]

Purpose: Evisceration is an alternative treatment modality to enucleation for many end-stage eye diseases. No study has addressed the indications for evisceration of eyes in Saudi Arabia. The aim of this study was to determine the current clinical indications for evisceration in patients at a tertiary eye care center and attempt clinicopathological correlation. Methods: Clinical records of patients who had undergone evisceration at a tertiary eye care center over a 4-year period were reviewed retrospectively. The patients' demographic data and clinical indications for evisceration were studied, and the results from histopathological findings were correlated with the clinical diagnosis. Results: Evisceration of the eyes was performed in 187 patients. Males outnumbered females in a ratio of 1.3:1 (105 males and 82 females). Blind painful eye was the primary presenting symptom in 117 (62.6%) patients and unsightly eye in 38 (20.3%) patients. Clinical indications for evisceration included endophthalmitis in 85 (45.5%), phthisis bulbi in 38 (20.3%), traumatic injury in 36 (19.2%), and glaucoma in 14 (7.5%) patients. Sixty-three patients (33.7%) had prior history of cataract surgery, penetrating keratoplasty, glaucoma surgery, or retina surgery. Clinicopathological correlation was 100% in cases with definite clinical diagnosis of endophthalmitis. Conclusion: Blind painful eye, endophthalmitis, phthisis bulbi, severe traumatic injury, and glaucoma were the major indications for eviscerations in a tertiary eye care center. [ABSTRACT FROM AUTHOR]

Introduction and Background: The Pediatric Eye Disease Investigator Group is a network of pediatric eye care providers undertaking clinical trials with National Eye Institute support. The network includes university- and community-based providers. Methods: Randomized and observation studies have involved refining the best amblyopia treatment in children from 3 to less than 18 years of age, observation of the behavior of early-onset esotropia, treatment of primary congenital nasolacrimal duct obstruction, and observation of the stability of strabismic angle in esotropia. Conclusions: To date 16 studies have been undertaken enrolling 5064 children and teens. [ABSTRACT FROM AUTHOR]

Purpose: The present paper describes an accurate and cost-effective method requiring simple equipment to measure the oxygen permeability and transmissibility of contact lenses. Method: The method involves accurate measurement of oxygen across the material by allowing the gas (oxygen) to pass through the lens material in a specially fabricated lens mould. The expelled gas is collected by dissolution in ethanol and the oxygen is measured by titration of the solvent. Result: This method is suitable for the measurement of oxygen permeability and transmissibility of contact lenses of varying thickness and different radii of curvature. It can measure Dk and Dk/t of collagen bandage lenses in both wet and dry conditions. Conclusion: The oxygen permeability and transmissibility values obtained by this method were compared with the oxygen permeability standard values of commercially available contact lenses and the results are summarised. [ABSTRACT FROM AUTHOR]

Purpose: To determine the awareness, use, and barriers to use of eye services in Fiji's Central Province. Methods: A cross-sectional survey study design with random clusters of households was used. Semi-structured interviews were conducted (152 females and 22 males). For 267 household members, presenting distance and near visual acuities were measured, and the perception of and satisfaction with their vision were recorded. Results: Most (86%; 150/174) respondents were aware of at least one conventional eye care service. However, only 66% (121/183) of household members with previous eye problems had consulted one of these; the proportion was even lower for those in the older age groups (p < 0.01). Rural dwellers expressed satisfaction with their vision, despite being more likely to regard it as limiting their activities and being less likely to seek conventional care. A higher proportion of females were reported to have (or have had) eye problems (60:40) and were found to have bilateral visual impairment (60:40). Despite this, females and males attended the hospital eye clinic (47:53) or sought treatment from conventional services (51:49) nearly equally. The reasons given for not seeking conventional care were “fatalistic attitude” (“did not bother”, “could manage”, or accepted the condition: 57%), expense (12%), and fear (8%). Conclusion: Central Province Fijians, particularly the old, rural, and female, under-utilise conventional eye care services. As in developing countries elsewhere, fatalistic attitudes to visual impairment are a significant contributor to this. To improve eye health, planning and implementation of eye care services must overcome under-utilisation by addressing local barriers to uptake through community participation in education and affirmative action. [ABSTRACT FROM AUTHOR]

The Boston keratoprosthesis (KPro) is one of several types of artificial cornea manufactured worldwide that are being implanted in increasing numbers in patients with severe corneal diseases and graft failures. The prognosis for long-term success varies greatly between diseases, with autoimmune conditions, such as ocular cicatricial pemphigoid and Stevens-Johnson syndrome, and severe chemical burns remaining difficult. In the potentially much larger cohort with little preoperative inflammation, retention is excellent, complications are manageable and outcome is usually very good. Early implantation in congenital corneal opacities to offset amblyopia shows promise. The Boston KPro uses a 'collar button' design of polymethyl methacrylate that is sturdy and easily machined and polished, giving excellent vision if the remainder of the eye is healthy. This is implanted into a carrier corneal graft or into the patient's own cornea. Holes in the back plate allow nutrition from the aqueous humor to reach the graft and long-term use of around-the-clock soft contact lenses protects the ocular surface from excessive dehydration. In nonautoimmune diseases, these measures have virtually eliminated necrosis and melt of the corneal tissue holding the device. Postoperative prophylactic antibiotics can now fully protect eyes from infection. [ABSTRACT FROM AUTHOR]

DuoTrav™ eye drop solution is a fixed combination of travoprost 0.004% and timolol 0.5% that has proven efficacious in lowering intraocular pressure in clinical trials. This combination of two of the more potent topical medications available today has the potential to contribute significantly to the success of medical glaucoma therapy. By maximizing patient adherence through the use of a combination drug, the burden of topical glaucoma therapy is reduced and is likely to improve both the convenience of care and clinical outcomes. [ABSTRACT FROM AUTHOR]