Search

OBJECTIVE: To assess the effectiveness of a 3D-printed custom mask fitter in lieu of N95 respirators among ophthalmologists and other eye care professionals who may not be prioritized to receive N95 respirators amidst the coronavirus disease 2019 pandemic. METHODS: This was a proof-of-concept study from a tertiary eye care center in Oakville, Canada. All participants underwent the N95 Qualitative Fit Test with a custom mask fitter secured over an American Society for Testing and Materials Level 3 face mask. Participants answered a 10-point Likert scale questionnaire on comfort, ease of use, and feasibility of the custom mask fitter, as well as comfort of a regular face mask. RESULTS: Twenty participants were recruited. Of the 20 recruited, 18 (90%) successfully passed the fit test. The median scores for comfort, ease of use, and everyday feasibility for the custom mask fitter were 3.5, 4.5, and 3, respectively, whereas the median score for comfort of a regular face mask was 8.5. CONCLUSION: A reusable, low-cost, 3D-printed custom mask fitter is a potential effective alternative to an N95 respirator among eye care professionals but may require improvement in its design and comfort. This is especially relevant in the context of a limited supply of N95 respirators amidst a global pandemic.

CLINICAL RELEVANCE Nunavik Inuit patients, in Northern Canada, have a significant burden of refractive error. The frequency at which they access eye care is insufficient. This exposes children of this population to a substantial risk of refractive amblyopia. BACKGROUND No data are available on eye health and services among Nunavik Inuit in Quebec, Canada. This study aims to describe the prevalence of ametropias, risk of refractive amblyopia, and eye health services uptake amongst a sample of Nunavik Inuit. METHODS Retrospective cohort using data from electronic records of the sole government-contracted eye team travelling to all 14 Nunavik villages, from 2006 to 2018. RESULTS Some 26,541 examinations were analysed, with data from 6,341 patients (median age 27 years (IQR 30); 32% aged under 19 years; 60.3% female) representing 48% of the census population. Population weighted prevalence of ametropias was myopia 46.5% (95% CI 45.3 - 47.6), hyperopia 17.1% (95% CI 16.2 - 18.1), astigmatism 39.6% (95% CI 38.4 - 40.8) and presbyopia 30.0% (95% CI 28.9 - 31.0). Some 5.9% of patients aged 0-9 years present a risk of refractive amblyopia. Mean frequency of examinations for all ages was once per 4 years (95% CI 4.0 - 4.0) and for children aged 5 - 19 years, frequency was once per 4.8 years (95% CI 4.8 - 5.0). In 2018, 74% of patients who were prescribed spectacles purchased them, with a median time of procurement of 21 days (IQR 247, skewness 2.7). CONCLUSION There is a high prevalence of ametropias amongst the clinical population of Nunavik Inuit. Most patients needing spectacles obtain them within a few weeks. Frequency of eye health services is insufficient to meet recommended guidelines, especially in children, for whom the risk of refractive amblyopia is pervasive.

BACKGROUND/OBJECTIVES To characterise the patterns of presentation and diagnostic frequencies in Hospital Emergency Eye Care Services (HEECS) across 13 hospitals in England. METHODS Retrospective, cross-sectional, observational multi-centre (n = 13) study to assess HEECS attendances over a 28-day study period. Data derived included: number of consecutive attendances, patient demographics and diagnoses. Age and gender variations, the impact of day of the week on attendance patterns, diagnostic frequencies and estimates of the annual incidence and attendance rates were evaluated. RESULTS A total of 17,667 patient (mean ± standard deviation age = 49.6 ± 21.8 years) attendances were identified with an estimated HEECS annual new attendance rate of 31.0 per 1,000 population. Significantly more females (53%) than males (47%) attended HEECS (p

BACKGROUND Fundus fluorescin angiography (FFA) has been traditional gold standard for detection of cystoid macular oedema (CME) but nowadays optical coherence tomography (OCT) is used more often by to detect CME due to various conditions. Although FFA can assess CME qualitatively, OCT provides quantitative measurement of foveal thickness. The purpose of this study is to compare sensitivity of FFA and OCT for detection of CME and know the etiological distribution of CME and the ability of FFA and OCT in diagnosing CME in different aetiologies. METHODS A hospital based prospective observational diagnostic study was conducted in tertiary eye care centre in central India on 143 eyes of 103 patients. FFA and OCT findings in patients of CME diagnosed provisionally on fundus examination were studied. RESULTS Of total 103 patients studied, maximum patients 20 (19.42 %) were in age group of 55 - 59 years whereas minimum 6 (5.83 %) were in age group of 40 - 44 years. In 103 patients, 61 (59.22 %) were males and 42 (40.78 %) were females. Both eyes were involved in 41 (40.78 %) cases. Most common cause of CME was nonproliferative diabetic retinopathy (NPDR) 52 eyes (35.86 %), followed by branch retinal vein occlusion (BRVO) 32 eyes (22.06 %), then proliferative diabetic retinopathy (PDR) 14 eyes (9.6 %), central retinal vein occlusion (CRVO) 13 eyes (8.96 %). CME on OCT was seen in maximum of retinal vein occlusion patients - CRVO (84.61 %) and BRVO (84.37 %). Of 145 eyes, 114 (78.32 %) eyes had CME. CONCLUSIONS Most common cause of CME was NPDR followed by BRVO, PDR and CRVO. Sensitivity of OCT in comparison with FFA was 100 % with diagnostic accuracy of 81.38 %. Hence, one can use OCT as first modality investigation for diagnosis of CME. KEYWORDS Optical Coherence Tomography, Fundus Fluorescein Angiography, Cystoid Macular Oedema, NPDR

This paper describes a study analysing eye care professional students’ written reflections following their engagement with clients with low vision conditions. By embedding a reflective practice model (Schon’s reflection-in-action and reflection-on-action) within a higher education curriculum, students’ assumptions and beliefs were challenged. Analysis of fifty-two reflective essays were analysed using the Braun and Clarke’s 6-phase process for inductive thematic analysis. This generated three themes: (i) Students’ perceptions that visual limitations do not necessarily equate to a poorer quality of life; (ii) Extrinsic and intrinsic influences affect patient care; and (iii) Eye care professionals’ role expands to holistic care. An additional outcome of this study supports embedding reflective practice activities within the curriculum. By providing students with a platform to reflect and challenge their assumptions, may have the potential to enhance their understanding and improve future practice.

Introduction Vision health is an important and underutilized health service among newly arrived refugees in Canada, yet the body of literature on eye-care delivery in this population is limited. The study objective was to identify patterns of eye-care utilization among refugee patients with type 2 diabetes mellitus (T2DM) in Newfoundland and Labrador (NL) under an interdisciplinary clinic model comprised of family physicians, eye-care providers, and settlement services. Methods This was a retrospective cohort study at the Memorial University Family Medicine clinic. All patients with a new T2DM diagnosis between 2015–2020 were included. Data were described using basic statistics and unpaired t-tests. This study received full ethics approval. Results Seventy-three (18 refugee, 55 non-refugee) patients were included. Refugees had a higher rate of referral to an eye-care provider ( p = 0.0475) and were more likely to attend their eye-care provider appointment than non-refugees ( p = 0.016). The time from diagnosis to referral was longer for refugees than non-refugees ( p = 0.0498). A trend towards longer time from referral to appointment attendance for refugees than non-refugees was noted ( p = 0.9069). Discussion Refugee patients had higher rates of referral to eye-care providers and utilization of eye-care services. However, refugees also experienced a longer time to access vision screening services suggesting possible gaps in accessible care delivery. This suggests that the interdisciplinary model of care may be effective in referring refugee patients for vision screening and there may be a role for increased collaboration across family physicians, eye-care providers, and settlement services to improve accessibility of vision screening services.

BACKGROUND Colour vision is a function of three types of cone pigments present in the retina. Colour vision deficiency is an important disorder of vision that may pose a handicap to the performance of an affected individual. The prevalence of colour blindness varies in different geographical areas. The identification and estimation of the prevalence of colour vision deficiency in school-going children will help to educate and guide the caregivers to help the children in selecting their profession. This study was done to estimate the prevalence, sex distribution, and types of colour vision deficiency among school-going children of 5 to 15 years. METHODS A cross-sectional observational study was done among 500 students to evaluate the colour vision during the period from 1st January 2018 to 30th June 2019 at the Regional Institute of Ophthalmology, Kolkata. Ishihara’s pseudo isochromatic colour vision chart 38th edition was used to assess the school children for colour vision status. The children who were found to be colour blind were further classified into degree and types of colour vision deficiency. RESULTS A total of 500 students (250 male & 250 female) of surrounding schools, in the age group of 5 years to 15 years, were screened. 480 students (96 %) had normal colour vision while 20 (4 %) students were found to have defective colour vision. Prevalence (4 %) for colour blindness was found to be higher in males (3.6 %) than females (0.4 %). It was observed that out of 20 (4 %) colour-blind subjects 3.6 % were protanopes and 0.4 % were deuteranopes. CONCLUSIONS The present study shows the prevalence of colour blindness found to be quite low (4 %) and more common in males (3.6 %) in comparison to females (0.4 %). Protanomaly (3.6 %) was more common than deuteranomaly (0.4 %). KEYWORDS Colour Blindness, Protanomaly, Deuteranomaly, School Children

BACKGROUND: Certain occupations and career paths require potential candidates who meet certain visual standards that allow them to apply or hold realistic possibilities for career advancement. AIM: This study aims to assess the visual function requirements for public jobs in Saudi Arabia and compare them with international standards. METHODS: Interview with eye care specialists in the fields of optometry and ophthalmology was conducted. This interview was consisted of seven pre-approved questions on current vision health requirements for eyesight-dependent careers. RESULTS: Interview responses revealed the existence of several visual requirements which were visual acuity, color vision, and visual field. These requirements are essential for various government jobs and functions, with examinations of applicants being necessary for acceptance of a vacancy or subsequent career progression. CONCLUSION: Many government positions of employment require predefined level visual standards which are not widely known. Defining what these standards are and making them publicly accessible will aid both future candidates in better planning their employment options and specialists in providing the required standards on request.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. Purpose: This study analyzes the factors associated with eye care service utilization among Peruvians 50 years of age and older, measured as self-reporting of having undergone examination of visual acuity during the last 12 months. Methods: A secondary analysis of the 2019 Demographic and Family Health Survey (ENDES, for its acronym in Spanish) database was carried out. We estimated the weighted proportion of adults 50 years of age and older that reported having undergone a visual acuity examination in the previous 12 months and the frequency according to the variables of interest. Crude (PR) and adjusted prevalence ratios (aPR) of eye care service utilization were constructed using generalized linear models. Results: Approximately 28.8% of Peruvians 50 years of age and older underwent a visual acuity examination in the previous 12 months. Having a higher education (aPR = 1.79; 95% CI: 1.33–2.40), health insurance such as EsSalud (aPR = 1.54; 95% CI: 1.28–1.87), a previous diagnosis of cataracts (aPR = 1.86; 95% CI: 1.67–2.09) and being part of the richest wealth quintile (aPR = 2.36; 95% CI: 1.74–3.20) were associated with greater utilization of eye care services, while living in the jungle was associated with a lower likelihood of utilization of these services. Conclusion: The unequal distribution of health resources within the territory and socioeconomic gaps among the population could explain our findings. Further efforts are needed to fulfill the eye health needs of the Peruvian population.

Aim: To assess the prevalence of severe visual impairment (SVI) and reasons for not accessing eye care services in a field practice area of a tertiary care hospital. Study design: Cross-sectional observational study. Materials and methods: Through a cross-sectional study using simple random sampling, a total of 1510, individuals above 18 years of age, from six rural and maternity welfare centers (RMCW) within a distance of 20 km from a tertiary hospital were approached. All participants underwent basic assessment of visual acuity, anterior segment evaluation using torch light, and answered a structured questionnaire on eye care. Results: Of 1510 subjects, 267 had SVI (defined as visual acuity < 6/60 either in one or both eyes) with a prevalence of 17.7%. SVI was higher among men and those above 60 years of age (52.8%). Significant association was found between barriers to accessing eye care facilities and lack of knowledge to access health care (p = 0.004), lack of financial support (95% CI, p = 0.006), and social reasons (95% CI, p = 0.028). Prevalence of SVI among diabetics was 32.7% as compared to non-diabetics (OR: 2.630; 95% confidence interval: 1.864–3.712), and among hypertensives was 34.61% as compared to non-hypertensives (OR: 2.836; 95% confidence interval: 1.977–4.068). Conclusion: In spite of being close to a tertiary care center, a prevalence of SVI in 17.7% of this population indicates a lack of knowledge regarding the importance of self-health care in subjects. This emphasizes the need to increase the awareness among the general public to access the ophthalmic health care facilities in order to improve the ocular health of the patients.

Old age often marks a period of changed socioeconomic position and physical infirmity. Older adults make up a large and complex population sub-group where several identities and characteristics coa...

Medical attention to vision impairment and associated eye care complications are a vital component of daily living and overall well-being. In the United States today, the physician to patient deficit places great strain on the availability of medical attention tenable to patients nationwide; in terms of specialty medicine, this deficit is even more widespread. The field of ophthalmology faced the same physician to patient deficit in 2020, a grim reality that has left many states void of ophthalmic care, rending millions of aging individuals without domestic eye care. The implementation of trained, ophthalmic nurse practitioners (NPs) can fill the needs of this deficit; however, efficient, accredited, and board-approved American ophthalmic fellowships and residencies that secure proper ophthalmic NP transitions from academia to clinical practice are nonexistent. Though scant, evidence-based literature presents sound findings that support the efficacy and benefit for superior patient outcomes with care provided by ophthalmictrained NPs, offering a viable, long-term solution to the need for ophthalmic medical providers across all states without mitigating patient care, emphasizing the great need for the implementation of ophthalmic NP residencies and fellowships to ensure the continuity of impeccable ophthalmic care for all populations.

Introduction Glaucoma outcomes are closely associated with patients’ awareness of the disease. However, little is known about glaucoma awareness and knowledge in Addis Ababa, a densely populated and ethnolinguistically diverse capital city in Ethiopia, the second largest country in Africa. Methods We performed a cross-sectional survey in the ophthalmology waiting room at St. Paul’s Hospital, a tertiary care center in Addis Ababa. Respondents included patients, patient family members, and non-clinical staff. Participants were asked if they had read or heard about glaucoma to gauge basic awareness of the disease; those with awareness were asked to take a quiz to measure their objective glaucoma knowledge. We performed multivariable regression to identify factors associated with glaucoma awareness, quiz performance, and self-rated ability to use eye drops. Results Of 298 respondents, 145 (48.7%) were female, and the average age was 44.9 ± 17.2 years. A majority (167; 56.0%) had primary school or less than primary school education. Only 131 (44.0%) had basic glaucoma awareness. Of these, 95 (72.5%) knew that glaucoma causes permanent vision loss, 103 (78.6%) knew glaucoma is often asymptomatic in early stages, 62 (47.3%) identified elevated intraocular pressure as a glaucoma risk factor, and 124 (94.7%) knew glaucoma was treatable. A majority of this subset (126; 96.2%) said they would be willing to use medicated eye drops, and 130 (99.2%) indicated a willingness to undergo surgery if recommended. Education level was independently associated with glaucoma awareness (p

Significance Estimating a broader set of measures of local eye care provider availability than used in prior research offers information that is useful for policy decisions related to access to eye care. Purpose The purpose of this study was to examine whether policy-relevant information was gained when measures of local eye care provider availability in addition to the estimated travel time (ETT) to the closest provider were estimated for the population 65 years or older in Kentucky, New Mexico, and Oklahoma. These states have expanded surgical scope of practice for optometrists. Methods This study used block group-level population data from the 2010 U.S. Decennial Census and eye care provider office address information from the 2016 Medicare Provider Utilization and Payment Data. Geographic information system analysis was used to calculate ETTs between individuals and eye care providers. Expanded measures of availability included the difference in ETT to an individual's second closest and closest ophthalmologist, the difference in ETT to an individual's closest ophthalmologist and closest optometrist, and whether only one ophthalmologist at the closest office accepted Medicare. Descriptive statistics were calculated for each state and by urbanicity. Results Of the population 65 years or older in each state, between 10.8 (Kentucky) and 16.6% (Oklahoma) had a one-way ETT to the second closest ophthalmologist >15 minutes longer than to the closest ophthalmologist, between 21.1 (Kentucky) and 27.6% (Oklahoma) had a one-way ETT to the closest ophthalmologist >15 minutes longer than to the closest optometrist, and between 56.4 (Kentucky) and 70.0% (Oklahoma) had only one ophthalmologist at the closest office who accepted Medicare. Findings differed substantially by urbanicity. Conclusions Using a portfolio of travel time-based measures enhances the understanding of local eye care provider availability.

Background A suitable fundus camera for telemedicine screening can expand the scale of eye care service. The purpose of this study was to compare a handheld nonmydriatic digital fundus camera and a conventional mydriatic fundus camera according to the image quality of their photographs and usability of those photographs to accurately diagnose various retinal diseases. Methods A handheld nonmydriatic fundus camera and conventional fundus camera were used to take fundus photographs of outpatients at an ophthalmic clinic before and after pupillary dilation. Image quality and diagnostic agreement of the photos were graded by two masked and experienced retinal specialists. Results A total of 867 photographs of 393 eyes of 200 patients were collected. Approximately 80% of photos taken under nonmydriasis status using the handheld nonmydriatic fundus camera had good (55.7%) or excellent (22.7%) image quality. The overall agreement of diagnoses between the doctors was more than 90%. When the handheld nonmydriatic fundus camera was used after mydriasis, the proportion of images with good (45%) or excellent (49.7%) quality reached 94.7% and diagnostic agreement was 93.4%. Lens opacity was associated with the quality of images obtained using the handheld camera (p = 0.041), and diagnosis disagreement for handheld camera images was associated with preexisting diabetes diagnosis (p = 0.009). Approximately 40% of patients expressed preference for use of the handheld nonmydriatic camera. Conclusion This study demonstrated the effectiveness of the handheld nonmydriatic fundus camera in clinical practice and its feasibility for telemedicine screening of retinal diseases.

Introducción: la baja agudeza visual es un problema educativo de interés mundial, cuya progresión es evitable con métodos de detección temprana y cooperación activa por parte de los padres y de la institución educativa. El presente estudio tiene como fin definir la cantidad de estudiantes de un centro educativo de El Carretón, Peravia, República Dominicana, que poseen algún tipo de condición que amerite atención oftalmológica especializada, y recalcar la falta de importancia que se le da a la salud oftalmológica en dicha localidad. Metodología: estudio prospectivo, descriptivo, transversal y observacional en el que se analizó la prevalencia de trastornos de la agudeza visual, discromatopsia y signos y síntomas asociados en una población estudiantil. Resultados: se puede apreciar que la agudeza visual en el ojo izquierdo fue normal en el 47 % de los casos, siendo mayor que en el ojo derecho (43 %). Los estudiantes de ocho (8) años de edad tuvieron predominancia en las alteraciones de la agudeza visual en ojo derecho, así como los estudiantes de doce (12) años de edad tuvieron predominancia en las alteraciones en el ojo izquierdo. El 77 % del porcentaje que presentó alteración en la agudeza visual tuvo como síntoma más común la cefalea, y un 10 % no presentó signos y síntomas asociados. Se observó que con el agujero estenopeico hubo mayor mejoría de la visión en el ojo derecho, con un 7 % en comparación con el ojo izquierdo, que fue de un 5 %. Conclusiones: los estudiantes con alteración de la AV presentaron en mayor frecuencia una discapacidad visual leve, tanto en el ojo derecho como en el ojo izquierdo. Los síntomas más asociados a las alteraciones de la vista fueron la cefalea y la visión borrosa. De los signos evaluados, no se evidenció ninguno en la población examinada. Ningún estudiante presentó discromatopsia. Recomendaciones: realizar campañas de salud pública que enfaticen la importancia de cuidado de los ojos. Involucrar al sistema educativo y a todas las instituciones relacionadas, como aliados en la creación de conciencia sobre la importancia de la identificación de afecciones oculares y el acceso a servicios de atención ocular para estudiantes.

Background The New Zealand Ministry of Health provides funding for the delivery of health care across regions via 20 District Health Boards. Funding includes the subsidisation of therapeutic pharmaceutical agents/drugs. The distribution of optometrists and ophthalmologists across the regions was investigated to understand the accessibility of eye care in New Zealand. Changes made to the optometrists' scope of practice in 2005 and in 2014 increased the range of drugs that suitably qualified optometrists could prescribe. Therefore, the distribution of optometrists authorised to prescribe drugs and those not authorised to prescribe drugs was also investigated. Methods Information from the New Zealand Optometrists and Dispensing Opticians Board register and information from the Medical Council's website were used to create a database of ophthalmic practitioners and their locations. The χ2 goodness-of-fit test was carried out to determine whether the distribution of the number of practitioners across the regions was in proportion to the population of the regions. Results Ophthalmologists were distributed across the regions in proportion to the regional population size. However, optometrists were concentrated in Auckland and other regions with high populations. Optometrists authorised to prescribe drugs comprised over 74 per cent of optometrists and were the majority of optometrists in most regions. Many of the regions with populations less than 200,000 had high population-to-practitioner ratios, indicating that they may not have sufficient numbers of ophthalmic practitioners in order to provide for the ocular needs of the community. Conclusion Better distribution of the optometric workforce could make eye care more accessible in many regions of New Zealand.

EEC staff were provided with rapidly changing personal PPE guidance by Public Health England (PHE) with specific subspecialty advice from the British Emergency Eye Care Society (BEECS) and the Royal College of Ophthalmologists (RCOphth) UK during the COVID19 pandemic. BEECS undertook a baseline survey of its members after the initial response from the RCOphth 16/3/20 mirroring Public Health England (PHE) advice and a follow- up survey after the guidance was updated on 9/4/20. A combined total of 84 responses were received. Improvements after RCOphth changes between the two surveys from hospital respondents showed increases in temperature screening (13%), scrub use (34%), use of aprons (31%), masks (4%), eye protection (35%), gloves (25%) and slit lamp guard (1%). Our findings demonstrate a positive and significant adaptation of PPE in response to change in guidance published by PHE, RCOphth and BEECS between 16/3/20 and 11/4/20. The COVID19 pandemic has rapidly taken over the normal activity of Ophthalmic departments creating unprecedented challenges. Following initial confusion and vulnerability expressed by EEC professionals to PPE guidance, most Trusts appear to have adapted and are doing similar things. The response has been swift and effective as a result of good team work and early advice from BEECS and the RCOphth. On the whole, management teams are listening.

Epidemiological information is expected to be used to develop key aspects of eye care such as to control and minimise the impact of diseases, to allocate resources, to monitor public health actions, to determine the best treatment options and to forecast the consequence of diseases in populations. Epidemiological studies are expected to provide information about the prevalence and/or incidence of eye diseases or conditions. To determine prevalence is necessary to perform a cross-sectional screening of the population at risk to ascertain the number of cases.The aim of this review is to describe and evaluate capture-recapture methods (or models) to ascertaining the number of individuals with a disease (e.g. diabetic retinopathy) or condition (e.g. vision impairment) in the population.The review covers the fundamental aspects of capture-recapture methods that would enable non-experts in epidemiology to use it in ophthalmic studies. The review provides information about theoretical aspects of the method with examples of studies in ophthalmology in which it has been used. We also provide a problem/solution approach for limitations arising from the lists obtained from registers or other reliable sources.We concluded that capture-recapture models can be considered reliable to estimate the total number of cases with eye conditions using incomplete information from registers. Accordingly, the method may be used to maintain updated epidemiological information about eye conditions helping to tackle the lack of surveillance information in many regions of the globe., This study was supported by FCT (COMPETE/QREN) grant reference [PTDC/DPT-EPI/0412/2012] in the context of the Prevalence and Costs of Visual Impairment in Portugal: a hospital-based study (PCVIP-study) and FCT Strategic Funding UID/FIS/04650/2013. PLR is funded by FCT (COMPETE/QREN) grant reference [SFRH/BD/119420/2016].

Dry eye disease (DED) is among the most common reasons for visiting eye care practitioners and represents a substantial health and cost burden. Disease prevalence ranges from 5% to 33% and is increasing in the younger population. The core mechanism of DED involves a vicious cycle where hyperosmolarity leads to an inflammatory cascade resulting in ocular surface damage. No cure is available for DED, and patients require ongoing disease management. Over-the-counter medications can provide temporary symptom relief but do not tackle the inflammatory pathophysiology of DED. A number of medications with anti-inflammatory activity are available, but there is a need for development of pharmacotherapies with novel delivery methods and targets to widen the variety of treatment options. This review discusses current anti-inflammatory pharmacotherapies approved in the United States and Europe for DED and highlights novel drugs that have been recently approved or are in development.

Purpose: To describe the use of eye care services among adults treated for diabetes from 2008 to 2017 in the French population. Methods: We used a random representative sampling of the French national health insurance database. Participants were adults treated for diabetes. Data regarding visits to ophthalmologists, eye examination procedures, and medical treatments were extracted using reimbursement codes. Cross-sectional analyses of eye care claims were performed each year from 2008 to 2017. Results: Less than 50% of people with diabetes underwent an annual eye examination (2008: 44.7%; 2017: 47.9%), and less than two-thirds underwent a biennial eye examination (2008–2009: 62.6%; 2016–2017: 66.4%). From 2008 to 2017, the yearly use of optical coherence tomography examinations increased steadily and markedly from 2.7% to 16.2%, while the use of fluorescein and indocyanine green angiographies decreased from 2.4% to 0.9%. In the same period, the yearly rate of intravitreal injection increased from 0.3% to 1.5%, and the use of laser photocoagulation decreased progressively from 2008 to 2014 (1.3% vs. 0.7%) but slightly increased from 2015 to 2017 (0.8% vs. 1.0%). Conclusions: Strategies to increase compliance with eye care recommendations are needed to improve early detection and management of diabetic eye complications.

Background: Eye care workers comprise of both clinical and non-clinical staff. For effective prevention of blindness and visual impairment the eye care health professionals must work in harmony. Also, the consumer of the eye care servicers must have good knowledge of these categories of workers to prevent financial loss, ocular morbidity from quackery and late hospital presentation. The main aim of this study is to assess the knowledge of students of school of optical dispensing technology, Birnin Kebbi, Nigeria about eye care workers. Methods: A cross-sectional study was conducted in August 2017, among students of School of Optical Dispensing Technology, Birnin Kebbi. A semi-structured questionnaire was used to elicit information which include socio-demographic characteristics, the knowledge of students about eye care team, the composition of eye care team, and the functions of eye care team members. Data entry and analysis was done using SPSS version 20. Results: 71 students participated, of which 44(62%) were males. The mean age of the participants was 23.6 ± 4.8years, with age range between 18-48years. Majority 32 (45.1%) were in the age group of 23 - 27years. Most 28 (39.4) of the participants were in year 2. More than two-third (97.2%) of the students agreed that eye care was a team work. About 98.2% of the respondents were aware that different cadres of eye care workers exist. Sources of information about eye care team among the study participants was mainly during workshop or hospital seminar 31 (43.7%) organised by the department of ophthalmology Conclusions: The awareness and knowledge about different cadres of eye care workers was high among the students. The participants agreed that eye care is a team work. The sources of informations about eye care team was hospital seminal/workshop organised by the department of ophthalmology.

To assess the ocular health status of Syrian pediatric refugees in Canada and report the prevalence of vision impairment within this population.Cross-sectional descriptive study.Syrian refugees 18 years old or younger.Five clinic days were organized from July 2016 to November 2017 in Toronto, Ontario. A total of 274 patients were enrolled. Data collection involved surveys, vision screening, and ocular examinations. χThe prevalence of uncorrected vision was 17.2% for distance, 4.7% for near, and 0.7% for both distance and near vision, including loss of vision. Of these, 95.3% had not visited an eye specialist in the past year, and 25.2% of parents were dissatisfied with their children's vision. The presenting visual acuity in the better-seeing eye was 20/50 or worse in 5.8% (95% confidence interval [CI] 3.6%-9.3%), and this did not correct with pinhole. This rate is 32 times (p0.01) higher than the prevalence rate in the average Canadian pediatric population (0.17%). Uncorrected refractive error prevalence was 26.3% (95% CI 21.2%-31.9%), with the most common etiology being myopia (19.7% CI 15.2%-24.9%). Myopia was 17.9 times (p0.0001) more prevalent among our Syrian refugee children compared with the average Canadian pediatric population (1.1%).Syrian pediatric refugees residing in Canada have a high prevalence of vision problems. Comprehensive vision screening, improved access to eye clinics, and developing evidence-based guidelines may help address the unmet eye care needs of this vulnerable population.

The Asia-Pacific region is home to a 4.3-billion population and one of the most rapidly aging regions. Addressing the eye care needs in the region would greatly boost the progress toward achieving universal eye health. Over 20 countries/regions have actively engaged in the "VISION 2020" initiative launched since 1999, and remarkable achievements have been witnessed as demonstrated by an increase in both the number and density of ophthalmologists in almost all countries. Nevertheless, formidable and emerging challenges are to be overcome in the coming century. From 1990 to 2015, the absolute number of blind people increased by 17.9%, largely due to population growth and aging. The Asia-Pacific region, the most populous continent with a rapidly aging population, would inevitably be left to tackle this challenge. Furthermore, a high prevalence of blinding eye diseases imposes great pressure on current eye care services, with South Asia having the highest age-standardized prevalence of moderate to severe visual impairment (17.5%) and mild vision impairment (12.2%) globally, and high-income countries having the highest overall prevalence of myopia, reaching 53.4% with East Asia having the second-highest overall prevalence (51.6%). Moreover, the availability of ophthalmic resources varies greatly in the region, with the density of ophthalmologists ranging from over 114 ophthalmologists per million population in Japan to 0 in Micronesia, and a highly disproportionate urban-rural distribution. This article aims to shed light on challenges faced by the Asia-Pacific ophthalmic community and propose corresponding strategies to tackle those challenges.

Purpose To determine (1) the factors associated with a high degree of self-reported symptoms with Japanese translations of the 8-Item Contact Lens Dry Eye Questionnaire (J-CLDEQ-8) in a cross-section of soft contact lens (SCL) wearers in Japan and (2) whether the difference in translation of the CLDEQ-8 affects the scores between validated and non-validated versions of the Japanese translation. Methods Habitual SCL wearers completed the validated J-CLDEQ-8 and a previous non-validated version. Demographics and SCL history questions were queried when they presented for routine eye care in nine geographically distinct clinics across Japan. The following risk factors for high J-CLDEQ-8 scores (≥11) were tested: sex, age, SCL replacement (daily disposable vs. bi-weekly and monthly reusable), years of SCL wear, and self-reported use of rewetting drops. The scores of the validated and non-validated questionnaires were compared. Results Significant patient-related risk factors for high J-CLDEQ-8 scores were female sex, use of reusable SCLs, longer years of SCL wear, and use of rewetting drops. Scores for six out of eight questions in the validated J-CLDEQ-8 were significantly higher than those of the non-validated version, resulting in a significant difference in the average total score between the two questionnaires (validated J-CLDEQ-8: 10.5 ± 5.9 vs non-validated J-CLDEQ-8: 9.5 ± 5.8, P Conclusions Female sex, use of reusable SCLs, longer years of SCL wear, and use of rewetting drops were significant risk factors for high J-CLDEQ-8 scores in a cross-sectional clinical population of Japanese SCL wearers. Symptoms with SCL are not predicted by age and must therefore be queried at follow-up visits for all SCL wearers. Differences in the two translations affected the ability of the questionnaire to identify individuals with high symptoms associated with SCL wear.

Natnael Lakachew Assefa, Melkamu Temeselew Tegegn, Sara Yirgalem Wolde Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Melkamu Temeselew TegegnDepartment of Optometry, College of Medicine and Health Sciences, University of Gondar, PO Box: 196, Gondar, EthiopiaTel +251-9-47-30-41-25Email melkamuopta@gmail.comIntroduction: Refractive error (RE) is the main cause of visual impairment and blindness in the world. Lack of knowledge and unfavorable attitude of refractive error can have long-term consequences and dramatic effects in children and adults, such as loss of educational and employment opportunities, loss of economic gain for individuals, families, and societies, and impaired quality of life.Aim: The aim of this study was to assess the level of knowledge and attitude of refractive error among public high school students in Gondar city, Northwest Ethiopia.Methods: A school-based cross-sectional study was conducted on 390 public high school students. Those participants were selected by applying a systematic random sampling technique with an interval of 4. Data were collected using a pre-tested structured questionnaire through face-to-face interviews. The collected data were entered into Epi Info version 7.0 and exported into SPSS version 20 for analysis. Results were described using tables and text.Results: A total of 390 study participants were included in this study with a 92.4% response rate. The overall proportion of good knowledge and a favorable attitude towards a refractive error were 53.8% and 52.1%, respectively. From the study participants, 38.7%, 41.7%, and 64.1% did not know the definition, the risk factors, and the symptoms of refractive error, respectively. Moreover, about 31.3% of the participants believed that wearing spectacle could damage their eyes, whereas 44.1% of the participants agreed with the need for spectacle correction for young people with RE.Conclusion: The proportion of good knowledge and a favorable attitude towards refractive error among public high school students were fair. We recommended that eye care practitioners be committed to increasing the knowledge and attitude of students towards refractive error through eye health education to reduce visual impairment due to refractive error.Keywords: refractive error, knowledge, attitude, public high school, Gondar

Purpose To explore stakeholders' perceptions of a school-based vision programme (SBVP). Methods We conducted 20 focus groups with 105 parents and teachers at schools in Baltimore, MD, that participated in a SBVP. Facilitators used a semi-structured interview guide to discuss participants' perceptions of the SBVP. Focus groups were audio-recorded, transcribed, and coded using inductive thematic analysis. Results Participant perceptions fell into three categories: benefits of school-based eye care, limitations of school-based eye care, and observation of impact. The majority of participants had positive comments about the programme; benefits included convenience (location, time, and cost), the comprehensive nature of the programme, the quality of the eyeglasses and ability to receive replacements, and a positive screening/exam experience. Limitations of programme impact were related to communication and organisation, the time to receive the glasses, missed instructional time, and uncertainty about screenings. Observations of impact included academic and classroom improvements, as well as visual and other health improvements. Conclusion Parents and teachers reported mostly positive perceptions regarding the SBVP. Their appreciation for the convenience underscores that location, cost, time, and comprehensive services are crucial aspects for implementing a successful programme. To maximize impact, programs must also implement robust communication campaigns that integrate into the schools' workflow to help parents and teachers stay engaged in the process from start to finish.

The Mayan population of Guatemala is understudied within eye and vision research. Studying an observational homogenous, geographically isolated population of individuals seeking eye care may identify unique clinical, demographic, environmental and genetic risk factors for blinding eye disease that can inform targeted and effective screening strategies to achieve better and improved health care distribution. This study served to: (a) identify the ocular health needs within this population, and (b) identify any possible modifiable risk factors contributing to disease pathophysiology within this population. We conducted a cross-sectional study with 126 participants. Each participant completed a comprehensive eye examination, provided a blood sample for genetic analysis, and received a structured core baseline interview for a standardized epidemiological questionnaire at the Salama Lions Club Eye Hospital in Salama, Guatemala. Interpreters were available for translation to the patients’ native dialect, to assist participants during their visit. We performed a genome-wide association study for ocular disease association on the blood samples using Illumina’s HumanOmni2.5-8 chip to examine single nucleotide polymorphism SNPs in this population. After implementing quality control measures, we performed adjusted logistic regression analysis to determine which genetic and epidemiological factors were associated with eye disease. We found that the most prevalent eye conditions were cataracts (54.8%) followed by pseudoexfoliation syndrome (PXF) (24.6%). The population with both conditions was 22.2%. In our epidemiological analysis, we found that eye disease was significantly associated with advanced age. Cataracts were significantly more common among those living in the 10 districts with the least resources. Furthermore, having cataracts was associated with a greater likelihood of PXF after adjusting for both age and sex. In our genetic analysis, the SNP most nominally significantly associated with PXF lay within the gene KSR2 (p &lt, 1 × 10−5). Several SNPs were associated with cataracts at genome-wide significance after adjusting for covariates (p &lt, 5 × 10−8). About seventy five percent of the 33 cataract-associated SNPs lie within 13 genes, with the majority of genes having only one significant SNP (5 × 10−8). Using bioinformatic tools including PhenGenI, the Ensembl genome browser and literature review, these SNPs and genes have not previously been associated with PXF or cataracts, separately or in combination. This study can aid in understanding the prevalence of eye conditions in this population to better help inform public health planning and the delivery of quality, accessible, and relevant health and preventative care within Salama, Guatemala.

The coronavirus disease (COVID-19) began spreading in December 2019 and rapidly evolved to a global pandemic. Initially information was nonexistent and eye care professionals (ECPs) were anxious as the close proximity involved in patient care put them at high risk. Recognizing this stress and the probable effect on behavior initiated this survey. The survey presented here was conducted in three stages. The expectation was a change in behavior during the second wave when modes of transmission and methods of protection clarified. Yet nearly a third of ECPs still refrained from examining patients. This continuing trend can have severe health and economic ramifications.

No abstract available.

Background: In order to gather evidence to guide eye care policy changes in Rwanda, a national population-based blindness and visual impairment survey was undertaken in 2015. Aim: To influence and direct policy changes using blindness survey findings. Setting: Nationwide sampling. Methods: Standard Rapid Assessment of Avoidable Blindness (RAAB) survey methodology was used across to examine 5065 (97.5% response rate) people aged 50 years and older. This is a case report of how the government used the evidence from the survey. Results: The age- and sex-adjusted prevalence of blindness was 1.1% (0.7–1.4) of which 83.9% was avoidable, with cataract being the major cause. The age- and sex-adjusted prevalence of visual impairment at the 6/18 level is 4.4% (3.7–5.1), with refractive errors and cataract being the major causes. The prevalence of all refractive errors was 4.3%, the majority of which was uncorrected. The cataract surgical coverage (CSC) was 68.4%, with 45.4% of surgeries performed at the secondary level. Difficulty in reaching surgical facilities (33.3%) was the main barrier to surgery. These results informed policy changes aimed towards an increase in the number of cataract surgeons, the volume of cataract surgery performed and broader spectacle provision. Conclusion: The prevalence of blindness in Rwanda is low compared to the previous estimates, although a considerable proportion is avoidable and the majority of refractive errors were uncorrected. The CSC and surgical outcomes are improving. The government, informed by this evidence, has introduced targeted initiatives to improve eye-care delivery in Rwanda.

Editor – As reported in recent articles, the pandemic has accelerated digital healthcare's rise. Following are initial teleophthalmology observations from the Philippines, a lower-middle-income archipelago whose population spends the most time online and on social media, worldwide.1–3 Health gatekeeper mechanisms are absent, out-of-pocket financing is >50%, and population indigency is ∼30%.3 While teleophthalmology examinations and portable technology have limitations, benefits include advocacy, triage/appointment-setting and care resulting in reduction of in-person visits.4–6 During March–June 2020, we explored website and social media presence/footprints of eyecare centres: 135 private ambulatory surgicentres (ASCs) and 27 tertiary centres with …

Presbyopia is an age-related condition that affects approximately 1.8 billion people worldwide. Strategies to correct presbyopia include both nonsurgical and surgical approaches. Although eye care providers assume that multifocal spectacles and monovision have lower risks than surgical interventions, there is evidence to suggest that the use of these nonsurgical approaches in the older population increases the risk for trips and falls. Each year, fall-related injuries and deaths are reported in a substantial portion of the population, both globally and in the United States. Previous studies have shown a link between visual acuity, contrast sensitivity, stereoacuity, and visual field impairments and falls. More recent mechanistic and epidemiological studies have shown that multifocal spectacles and monovision can increase the risk for falls as well. Although evidence on the financial burden of falls related to multifocal spectacles or monovision is limited, total direct medical costs related to falls associated with multifocal spectacles are estimated to be approximately $11 billion annually in the United States. Therefore, it is important that eye care providers consider the risk for falls associated with multifocal spectacles and monovision when making decisions on the best strategy for correcting presbyopia in older adults. [ J Refract Surg . 2021;37(6 Suppl):S12–S16.]

Background: The development of human resources for eye health (HReH), aimed at achieving a 25% reduction in visual impairment by the year 2020, was one of the VISION 2020 objectives. Aim: To assess HReH in the public sector of KwaZulu-Natal (KZN), and its effect on the accessibility of eye care in the province. Setting: All public eye facilities in KZN. Methods: A quantitative cross-sectional study using a close-ended questionnaire to assess distribution and outputs of HReH. At the end of the questionnaire, respondents gave general comments on their ability to provide services. Results: Human resource rates were 0.89 for ophthalmologists, 2.44 for cataract surgeons, 4.8 for optometrists and 4.7 for ophthalmic nurses per 1 million population. Most health facilities had some HReH working in them, albeit none had dispensing opticians. Regression analysis showed that 67.1% of variation in cataract surgery was because of the number of surgeons available. Cataract surgical rates were low with a waiting period of up to 18 months. In addition to the refractive error regression analysis of 33.7%, spectacle supply was low, with a backlog of up to 9 months in some facilities. Conclusion: Overall, HReH targets as per VISION 2020 and the National Prevention of Blindness have not been met in this region. Dispensing opticians are not employed in any of the province’s health districts. An increase in the eye health workforce is necessary to improve the eye health outcomes for people dependent on public eye facilities.