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In a number of complex refractive cases, the achievement of an accurate refractive result cannot be guaranteed. Simultaneous implantation of a toric or multifocal IOL for the correction of complex ametropias may be accompanied by a significant deviation from the target refraction. The tactics of two-stage implantation with the usage of an additional Sulcoflex IOL for the final correction of astigmatism and possible residual spherical ametropia allows achieving emmetropia. In our study, this method was used in 15 patients with difficult refractive cases. Toric, multifocal, and multifocal toric Sulcoflex IOL were used. Implantation of all Sulcoflex modifications was performed through a 2.4 mm temporal incision using wound assisted technology. In cases of high degree hypermetropia, preventive iridectomy was performed using a 23G vitrectome. The target refraction was achieved in the entire observation group. In the postoperative period, no significant level of ophthalmic hypertension was registered. No cases of introlens opacification, iridocyclitis, or rotational instability were registered either.The method of two-stage IOL implantation allows achieving the target refraction in difficult refractive situations with almost guaranteed accuracy. The calculation method provides good predictability of the refractive result. This technology significantly expands the indications for intraocular correction using toric and multifocal IOL, as well as the limits of correction of high degree astigmatism. Our Sulcoflex IOL implantation experience has shown their high efficiency and safety.

Millions of people are suffering from eye refractive errors such as myopia, hypermetropia, astigmatism, presbyopia, etc. Every day, modern opticianry techniques were used to diagnose and treat the patients. And they find solutions to such disorders; therefore, touching the lives of millions of people. In the last decades, laser surgery becomes popular. However, it still has the risk to damage the inner structure of eyeballs such as the inner lens, cornea, etc. Laser surgery is costly since it requires high tech equipment and good experience with outstanding surgical skills. At this point, people continue their daily life via their glasses or contact lenses where simple and effective techniques can solve the problem of millions of people who suffer from refractive errors. In this report, we briefly explain the eye refractive errors and lenses used in the treatment of such errors. We discuss lens types and properties, lens prescriptions, lens cut and preparation techniques, frame types, and contact lenses., Milyonlarca insan miyopi, hipermetropi, astigmatizm gibi göz kusurlarından muzdariptir. Her gün modern optisyenlik teknikleri kullanılarak milyonlarca insanın muzdarip olduğu bu göz kusurları teşhis ve tedavi edilmektedir. Son yıllarda lazer cerrahisi gibi teknikler göz kusurlarının tedavisinde yaygın olarak kullanılmaktadır. Ancak bahsi geçen tekniklerin göz küresinin içerisinde bulunan kornea, mercek aköz hümor gibi hassas yapılara uygulanması oldukça risklidir. Lazer cerrahisi operasyonlarında yüksek teknoloji içeren ve sınırlı sayıda üretilmiş cihazlar kullanıldığı için bu uygulamalar oldukça pahalıdır. Ayrıca bu operasyonların başarılı bir şekilde uygulanabilmesi için yüksek tecrübeli ve iyi yetişmiş hekimlere ihtiyaç duyulmaktadır. Bu sebepten insanların çoğu günlük hayatına gözlük ya da kontakt lensler ile devam etmektedirler ki bu aparatlar basit ve etkili bir şekilde insanların göz kusurlarından doğan sorunları ortadan kaldırmaktadır. Raporumuzda kısaca göz kusurlarını açıklayıp göz kusurları tedavisinde kullanılan lensler tartışılacaktır. Ayrıca cam (lens / mercek) tipleri ve özellikleri, gözlük camı reçeteleri, gözlük camı (lensi) kesim ve hazırlama teknikleri, çerçeve tipleri ve mercekler ile ilgili genel teknik bilgiler verilecektir.

Background Refractive error is an important preventable cause of visual impairment and blindness worldwide. In adult life, reduced vision can potentially affect the academic performance, choice of occupation and socio-economic status. This study aimed to assess the prevalence of refractive errors and related visual impairment among undergraduate male students in Prince Sattam bin Abdulaziz University in Al-Kharj, Saudi Arabia. Methods A descriptive cross-sectional study was employed in the current work. After obtaining an informed consent; each eligible student was asked to fill a self-constructed survey and have screened in the college premises for visual acuity and refractive error. Candidates detected with defective vision have been referred for further examination at well-equipped ophthalmology clinic in the University Hospital. Results A total of 420 undergraduate students, with age ranged from 18 to 30 years, have participated in the current study. About 25.0% of the participants have used spectacles at the time of examination. Positive family history of spectacles use was found in 71.4%. Our study showed that visual acuity in the better eye was low in 34.76% of the participants. Seventy-eight students (18.6%) of the total participants reported defective vision and have fulfilled refractometric examination. Of the examined students 83.3% were found to have refractive errors. Astigmatism, 52.6%, was the most frequently encountered refractive error among the participants; followed by myopia, 26.9%; and hypermetropia 2.6%. Conclusion The current study confirms that refractive error is an important preventable cause of visual impairment. Significant portion of the examined participants were found to have refractive errors recommending further work to improve visual status in undergraduate students.

Purposes: To evaluate the relationship of changes in hypermetropia and ocular alignment in patients with accommodative esotropia. Methods: The medical records of consecutive patients diagnosed with refractive accommodative esotropia (esotropia eliminated or decreased to within 10 D with full hyperopic correction) were retrospectively reviewed. Cycloplegic refractions culled from medical records were converted into spherical equivalents. Presence of amblyopia, changes in refractive error and ocular alignment at admission and after the follow-up period were evaluated. Results: Seventy patients (mean age: 6.01 ± 5.41 years; female: 60.6%; mean follow-up: 5.8 ± 3 years) had corrected esotropia of 40 ± 20 prismatic diopters at admission. The average decrease per year in near and distance deviations with glasses was 1.71 ± 3.96 prismatic diopters/year and 1.09 ± 3.25 prismatic diopters/year, respectively. The total myopic shift of the right and left eyes was 1.08 ± 1.35 D and 1.20 ± 1.40 D, respectively. Myopic shift/year was 0.22 D/year and 0.26 D/year, respectively. The correlation between the rate of myopic shift and rate of change in corrected near deviation was weak. The correlation for the rate of myopic shift was not high for the right and left eyes (r=0.18; p=0.15). Conclusion: The amount of deviation and hypermetropia gradually decreased in accommodative esotropia during follow-up. On the other hand, it may be incorrect to assure patients that the amount of deviation will decrease in parallel with the refractive error. RESUMO Objetivo: Avaliar a relação entre alterações na hipermetropia e o alinhamento ocular em pacientes com esotropia acomodativa. Métodos: Foram analisados retrospectivamente prontuários médicos de pacientes consecutivos diagnosticados com esotropia acomodativa refrativa (com esotropia eliminada ou reduzida a menos de 10 D com correção completa da hipermetropia). As medidas de refração em cicloplegia obtidas dos prontuários foram convertidas em equivalentes esféricos. Avaliaram-se ainda a presença de ambliopia, alterações do erro refrativo e o alinhamento ocular à admissão e depois do período de acompanhamento. Resultados: Setenta pacientes (média de idade=6,01 ± 5,41 anos, 60,6% do sexo feminino, acompanhamento médio de 5,8 ± 3 anos) apresentaram esotropia de 40 ± 20 dioptrias prismáticas (DP) para perto à admissão. A diminuição média anual no desvio para perto e para longe com o uso de óculos foi de 1,71 ± 3,96 DP/ano e 1,09 ± 3,25 DP/ano, respectivamente. Os desvios miópicos totais dos olhos direito e esquerdo foram de 1,08 ± 1,35 D e 1,20 ± 1,40 D, respectivamente. Os desvios miópicos anuais foram de 0,22 D/ano e 0,26 D/ano para os olhos direito e esquerdo, respectivamente. A correlação entre a taxa de desvio miópico e a taxa de alteração do desvio para perto corrigido foi fraca. A correlação da taxa de desvio miópico não foi alta para os olhos direito e esquerdo (r=0,18, p=0,15). Conclusão: A quantidade de desvio e a hipermetropia diminuem gradualmente na esotropia acomodativa durante o acompanhamento. Por outro lado, pode não ser apropriado garantir aos pacientes que o desvio diminuirá em paralelo ao erro refrativo.

Background. The key link in the pathogenesis of angle-closure glaucoma is the formation of structural blocks that initiate a violation of hydrostatic balance. However, if the parameters of the eyeball are equal, the state of the outflow pathways, the level of intraocular pressure and the eye hydrodynamics may be different. It was suggested that the formation of hydrodynamic blocks in patients with hypermetropia may be initiated at a young age by the processes of excessive accommodation, which are aggravated by physiological aging, accompanied by the formation of presbyopia. Aim. To find out the factors that provoke and aggravate the processes of formation of pathological changes in the eye hydrodynamics in patients with older hypermetropia. Materials and methods. A comprehensive study of the anterior segment of the eye was performed in 80 patients aged 45–60 years with hypermetropic refraction. Structural deviations were evaluated using ultrasound biomicroscopy and interactive Scheimpflug registration of the anterior segment of the eye (“Pentacam HR”, Oculus, USA) with the calculation of the parameters of the anterior and posterior chambers of the eye and the Lowe coefficient. Tonometry and tonography were performed on an electronic tonograph “Mentor” (Tecnar Ophthalmic, USA). Results and conclusion. The total results of the study of 80 patients with hypermetropia were processed using cluster analysis, which revealed significant and significant heterogeneity for three clusters. Comparative and regression analysis found that the parameters transformation and intraocular structures position are initial and under the conditions of the load test in subjects of the first and third clusters was accompanied by a violation of the eye hydrodynamics with the predominant inclusion of the lenticular or iridociliary component, respectively. The changes detected in patients of the second cluster were characterized by balanced moderate changes in structural relationships and the absence of a clinically significant intraocular pressure increase.

Aim: To make a comparative evaluation of macular thickness in myopia and hypermetropia versus emmetropia. Materials and Methods: A cross-sectional OCT based study was done in randomly selected 100 emmetropes, 93 myopes, 67 hypermetropes aged between 18 to 30 years regardless of sex. Results: Average outer macular thickness in emmetropia, myopia and hypermetropia is 276.63±12.5, 275.43±12.1, 286.56±11.4 respectively. Average inner macular thickness was 316.45±11.5, 308.83±11.3, 310.70±12.1 respectively and average central subfield thickness was 243.80±11.2, 248.51±22.9, 240.05±21.9 respectively. Conclusion: Overall macular thickness in various quadrants was uniform in emmetropia. As compared to emmetropia in myopia average outer and inner subfield macular thickness is lower while average central thickness is higher. In hypermetropia average inner macular and central subfield thickness is lower while outer macular thickness is higher (p=0.001). Keywords: Macular thickness, Myopia, Hypermetropia, Emmetropia.

Childhood visual impairment is a global public health problem, especially in low and middle-income countries. Its most common causes are avoidable by early diagnosis and treatment.To assess prevalence of refractive error and visual impairment among school-aged children in Hargeisa, Somaliland, Somalia.This was a cross-sectional study of 1204 students (aged 6-15 years) in 8 randomly selected primary schools in Hargeisa from November 2017 to January 2018. We used the modified Refractive Error Study in Children to determine prevalence of refractive error and visual impairment, including the following investigations: distance visual acuity, assessed by Snellen Tumbling E-chart; refraction, assessed by retinoscope binocular vision assessment; and examination of anterior and posterior segments.Prevalence of uncorrected, presenting and best-corrected visual impairment of 6/12 or worse was 13.6%, 7.6% and 0.75%, respectively. Only 16 of 91 (17.6%) children were using spectacles and the rest were unaware of the problem. Refractive error was the cause of visual impairment in 76.8% of participants, amblyopia in 22.0%, trachoma in 2.4%, and corneal opacity and cataract in 0.6%. Anterior segment abnormalities were found in 8.3%, mainly vernal keratoconjunctivitis, while posterior abnormalities were observed in 0.7%. Prevalence of myopia was 9.1%, hypermetropia 2.7% and astigmatism 3.9%. Prevalence of visual impairment because of Refractive Error was associated with increasing age, but there was no significant association with school grade or sex.Prevalence of visual impairment among school-aged children in Hargeisa was high, and the leading cause was uncorrected Refractive Error. There are barriers to care and it is critical that they are overcome.معدل انتشار الخطأ الانكساري وضعف البصر بين الأطفال في سن الدراسة في هرجيسا، صوماليلاند (الصومال).زهرة عبدي أحمد، سيف الرشيد، وليد الغامدي.يُعَدُّ ضعف البصر في مرحلة الطفولة مشكلةً من مشكلات الصحة العامة على الصعيد العالمي، ولا سيَّما في البلدان المنخفضة الدخل. ويمكن تجنب أسبابه الأكثر شيوعاً عن طريق التشخيص والعلاج المُبكرَيْن.هدفت هذه الدراسة إلى تقييم معدل انتشار الخطأ الانكساري وضعف البصر بين الأطفال في سن الدراسة في هرجيسا، صوماليلاند (الصومال).شملت هذه الدراسة المقطعية 1204 طلاب (تتراوح أعمارهم بين 6 سنوات و 15 سنة) في 8 مدارس ابتدائية مختارة عشوائياً في هرجيسا خلال الفترة من نوفمبر/تشرين الثاني 2017 إلى يناير/كانون الثاني 2018. واستخدمنا دراسة الخطأ الانكساري المعدَّلة لدى الأطفال لتحديد معدل انتشار الخطأ الانكساري وضعف البصر، بما في ذلك الاستقصاءات التالية: حدة البصر عن بُعد، التي تم تقييمها بواسطة مخطط Snellen Tumbling E-chart، والانكسار، الذي تم تقييمه من خلال تقييم رؤية العينين بمنظار الشبكية، وفحص الأجزاء الأمامية والخلفية.بلغ معدل انتشار ضعف البصر بقيمة 6/12 أو أقل غير المُصحَّح والمُستعلِن والمُصحَّح على أفضل وجه 13.6٪ و 7.6٪ و 0.75٪ على التوالي. وكان 16 فقط من بين 91 طفلاً (17.6٪) يستخدمون النظارات وكان الباقون غير مدركين للمشكلة. وكان سبب ضعف البصر هو الخطأ الانكساري في 76.8٪ من المشاركين، والغَمَش في 22.0٪ منهم، والتراكوما في 2.4٪ منهم، وعَتَامة القَرْنِيَّة والسادّ في 0.6٪ من المشاركين. ووُجدت تشوهات في الجزء الأمامي في 8.3٪ من المشاركين، وعلى وجه الخصوص التهاب القَرْنِيَّة والملتحمة الربيعي، في حين لوحظت تشوهات في الجزء الخلفي في 0.7٪ منهم. وبلغ معدل انتشار الحَسَ 9.1٪، ومد البصر 2.7٪، واللابؤرية 3.9٪. وارتبط معدل انتشار ضعف البصر الناجم عن الخطأ الانكساري بزيادة العمر، ولكن لم يكن هناك ارتباط مهم بالصف المدرسي أو نوع الجنس.كان معدل انتشار ضعف البصر بين الأطفال في سن الدراسة في هرجيسا مرتفعاً، وكان السبب الرئيسي وراءه الخطأ الانكساري غير المُصحَّح. وثَمَّة عوائق تحول دون تقديم الرعاية، ومن الأهمية بمكان أن يتم التغلب عليها.Prévalence du vice de réfraction et de la déficience visuelle chez les enfants d’âge scolaire de Hargesia, au Somaliland (Somalie).Les troubles visuels chez l’enfant constituent un problème de santé publique mondial, en particulier dans les pays en développement. Ses causes les plus courantes sont évitables par un diagnostic précoce et la mise en place rapide d’un traitement.La présente étude avait pour objectif d’évaluer la prévalence du vice de réfraction et de la déficience visuelle chez les enfants d’âge scolaire à Hargeisa, au Somaliland (Somalie).Il s’agissait d’une étude transversale menée auprès de 1204 élèves (âgés de 6 à 15 ans) de huit écoles primaires sélectionnées de manière aléatoire à Hargeisa, entre novembre 2017 et janvier 2018. Nous avons utilisé l’étude modifiée sur le vice de réfraction chez les enfants afin de déterminer la prévalence de cette affection et de la déficience visuelle, comprenant les examens suivants : acuité visuelle à distance, évaluée par l’échelle de Snellen avec des E ou C directionnels ; la réfraction, évaluée par examen de la vision binoculaire par rétinoscopie ; et examen des segments antérieurs et postérieurs.La prévalence de la déficience visuelle non corrigée, détectée et la mieux corrigée de 6/12 ou un score inférieur était respectivement de 13,6 %, de 7,6 % et de 0,75 %. Seuls 16 enfants sur 91 (17,6 %) portaient des lunettes tandis que les autres n’avaient pas conscience du problème. Le vice de réfraction était la cause de la déficience visuelle chez 76,8 % des participants, l’amblyopie dans 22,0 % des cas, le trachome chez 2,4 % des enfants, et l’opacité cornéenne et la cataracte chez 0,6 % d’entre eux. Des anomalies du segment antérieur ont été observées chez 8,3 % des participants à l’étude, principalement des kératoconjonctivites vernales, tandis que des anomalies du segment postérieur ont été observées dans 0,7 % des cas. La prévalence de la myopie était de 9,1 %, celle de l’hypermétropie de 2,7 % et celle de l’astigmatisme de 3,9 %. La prévalence de la déficience visuelle due à un vice de réfraction était associée à un âge supérieur, sans toutefois que l’on puisse noter de corrélation significative avec le niveau scolaire ou le sexe.La prévalence de la déficience visuelle chez les enfants d’âge scolaire de Hargesia était élevée, principalement en raison d’un vice de réfraction non corrigé. Il existe des obstacles aux soins et il est essentiel de les surmonter.

BACKGROUND Uncorrected Refractive Errors (REs) are a major cause of visual impairment in children resulting in poor academic performance and increased school dropouts. Children with refractive errors, even if small, suffer from visual strain and consequently perform poorly at school. There are only a few studies carried out in India in this age group. The purpose of this study is to provide a framework for assessment and correction of ocular morbidity in pre-school children. We wanted to assess the magnitude of the problem of refractive errors and other ocular morbidity in pre-primary school children in the age group of 4 - 7 years. METHODS This is a descriptive cross-sectional study conducted at one of Central India’s industrial towns among 2000 children attending pre-primary school in the age group of 4 - 7 years. Children were screened by ophthalmologists. The examination included visual acuity measurements, ocular motility evaluation, cover uncover test and colour vision test. Children with defective vision were subjected to dilated retinoscopy and fundus examination. The pattern and distribution of visual acuity, its impairment, and any accompanying visual morbidity were studied. Refractive errors such as myopia, hypermetropia and astigmatism were defined as correction equivalent to or more than - 0.5 diopter (- 0.5 D), + 0.5 D and ± 0.5D respectively in children with reduced visual acuity. Amblyopia was defined as non-improvement or reduced visual acuity (< 6 / 9) with optical correction without any organic cause. Statistical analysis was done using percentage analysis using Epi Info software version 7. RESULTS A total of 2000 children from kindergarten were examined out of which 1126 were male and 874 were females. Refractive error was found in 146 students. Hypermetropia was found in 70, myopia in 50 and 12 had amblyopia. Apart from refractive errors, other ocular morbidities found in our study included colour vision defect (1 %), squint (0.5 %), eyelid diseases like blepharitis, stye, conjunctival diseases like allergic conjunctivitis and traumatic mydriasis of the iris. CONCLUSIONS Ocular morbidities noted included refractive errors (7.3 %), colour vision defects, squint, eyelid diseases and allergic conjunctivitis. Many of these are causes of correctable blindness and remedial measures taken on time will go a long way to reduce the burden of disease.

Conjunctival lymphomas are predominantly extranodal B-cell non-Hodgkin’s lymphomas (NHL), most of them are MALT-lymphomas originating from the mucosa-associated lymphoid tissue. The paper is devoted to the study of the feasibility of using hypercorrection in the functional treatment of children with non-paralytic strabismus.The purpose of this work is evaluation of the effectiveness of hypercorrection in the diagnosis and functional treatment of children with non-paralytic strabismus. Patients and methods. We observed 166 school-age children with friendly strabismus: 140 children with esotropia (134 children with hypermetropic refraction and 6 children with myopic refraction) and 26 children with exotropia (17 children with myopic refraction and 9 children with hypermetropic refraction). The control group of children included 151 school-age children with ametropia without strabismus: 110 children with hypermetropia and 41 children with myopia. Optimal optical correction, accommodation and visual acuity were studied under monocular observation conditions and then under bifixation control using a binarimeter at different distances from the eyes (0.5, 1, and 5 m).Results. In children with esotropia and hypermetropic refraction, the most favorable conditions for the formation of a binocular visual image (BVI) were created using hypercorrection (average values from 2.4 ± 0.06 to 2.8 ± 0.06 D for different distances from the eyes). Children with exotropia and myopic refraction also needed hypercorrection to form BVI (Me = 2.5 [Q1 = 2.0; Q3 = 3.0] D at all distances from the eyes). At the same time, a strong positive correlation was found between the deviation value and the hypercorrection value necessary for the formation of BVI in children with both esotropia and exotropua (r = 0.85, p < 0.001 and r = 0.8, p < 0.001, respectively). In children with “inappropriate” refraction (myopic with esotropia and hypermetropic — with exotropia), BVI was easier to occur and better maintained under hypocorrection by an average of 1.75 ± 0.06 d. In the control group of children, the maximum visual acuity under the control of BVI was observed with the strength of correcting lenses 0.5 D less compared to monocular conditions of the study.Conclusion. The effectiveness of using hypercorrection in children with non-paralytic strabismus and “appropriate” refraction for the formation of BVI on a binarimeter is shown. In this case, the value of hypercorrection has a direct dependence on the value of deviation, which is consistent with the principles of accommodation-convergent synkinesia. In children with non-paralytic strabismus and “inappropriate” refraction, more favorable conditions for the formation of BVI are created when using hypocorrection. The result of functional treatment on a binarimeter with an individual selection of optimal optics for performing exercises is an improvement of accommodation, binocular and stereo vision, an increase of fusion reserves and visual acuity.

Purpose: To describe the prevalence of refractive error in school children in a tribal district, Rayagada, Odisha state, India. Methods: In a cross-sectional school eye health study, the students with diminished vision and other ocular abnormalities were referred for a further eye examination to the vision technicians after initial screening by the trained school teachers. The examination by vision technicians consisted of an external eye examination, photorefraction using a Spot screener and subjective correction. Those not improving with subjective correction were referred to the ophthalmologist for further examination. Results: The school teachers measured vision in 153,107 children; 5,990 students reached a vision technician. There was a near equal number of boys (50.06%) and girls (49.94%). The average age was 10.5 ± 2.63 (range: 5–15) years. The prevalence of refractive error was 9.7% (95% [CI]; 9.0–10.5%) in the vision technician-examined children. Myopia (4.9%) and astigmatism (5.4%) were more common than hyperopia (0.2%). The presenting visual acuity (PVA) was worse in children with hypermetropia (PVA 20/100-20/200 in 40% of children). Spherical equivalent of refractive error did not have a good correlation with age (R2 = 1.3); but increasing age was associated with increased risk of myopia (odds ratio 1.14; 95% CI 1.09–1.20; P < 0.001). Conclusion: The quantum of refractive error was close to other similar studies in India but the prevalence of myopia was relatively less.

Introduction: The refractive state of the eye changes as the eye’s axial length increases and the cornea and lens flatten. In general, eyes are hyperopic at birth, become slightly more hyperopic until the age of 7, which at this point we see a myopic shift toward plano until the eyes reach their adult dimensions, usually by about the age 16. Aim: To determine the prevalence of refractive error in preschool children aged 3 - 6 in the city of Kazanlak, Bulgaria. Materials and methods: A cross-sectional study was conducted in a kindergarten based school within the city of Kazanlak, Bul­garia. Out of 15 kindergarten schools, 10 chose to participate in the study. The children underwent non-mydriatic refraction screening using a Plus-Optix S12с mobile camera. Myopia, hyperopia and astigmatism were defined as being a spherical equivalent (SE) ≤ −0.50 D, SE ≥ +2.00 D and cylindrical diopters ≤ −1.00 D. Results: A total of 596 children were screened. Out of these 596 children; 526 were with ametropia (470 hypermetropia, 46 myopia) and 50 had astigmatism. Strabismus was found in 12 children, with a further 8 children suffering from amblyopia and finally 8 children were also found to be diagnosed with anisometropia. In 8 cases there were no results due to opacities or due to the small size of the pupil. Conclusion: The prevalence of refractive error in preschool children is similar to that found in other research in the field. While most cases fall into the category of emmetropia or mild hypermetropia, most of the children had never been to an ophthalmologist. A manda­tory checkup should be issued for all children below the age of seven.

Objective Inter-ocular asymmetry in anterior corneal high-order aberrations has previously not been investigated. This study aims to investigate the normal range of inter-ocular asymmetry in corneal high-order aberrations (HOAs) using a Placido disk-based corneal topographer to explore the relationship between the HOA parameters of the anterior corneal for each eye individually and the refractive error. Patients and methods A total of 257 subjects (98 males and 159 females) were participated, with an age range of 6 to 81 years (average of 40.2 ±17.53). Participants were divided into three groups: myopia (spherical equivalent (SEQ) of refraction ≥-0.50 D), hypermetropia (SEQ ≥+0.50 D), and emmetropia. For all patients, high-order aberrations were measured using a corneal topographer (CA.200TM; Topcon). Inter-ocular asymmetry was represented by RMS (root mean square) for three, five, and seven mm as pupil entry; aberrations for five mm pupil (vertical and oblique trefoil, vertical and horizontal comma, and primary spherical aberration) were recorded using the instrument's built-in software. Results Hypermetropes exhibit the highest inter-ocular asymmetry of all RMS values, mostly in spherical aberrations, and higher-order trefoil values. Oblique trefoil aberrations had the highest interocular asymmetry in the myopic groups. The interocular asymmetry in horizontal coma values was the highest in emmetropes and the lowest in hypermetropes. Conclusion To our knowledge, this is the first observational study of inter-ocular differences in high-order aberrations of the anterior corneal surface of the human eye. This study's results could be used to establish normal values of inter-ocular asymmetry of HOAs of the anterior cornea. The use of such normal values should be investigated further to serve as a guideline for clinicians when establishing the best management route for the patient's refractive error.

Background: In order to improve the quality of life of newborns, it is important to detect the earliest visual problems. This study aimed to determine the refractive status in healthy term babies and to investigate whether there is a correlation between refractive status and birth weight Materials and Methods: Two hundred and three healthy full-term babies at an age of postnatal 8 weeks were included in the study. In order to evaluate refractive status handheld autorefractometer device was used in all subjects. The types of refractive errors were analyzed both in right and left eyes separately. Measurements taken under cycloplegic condition were analyzed for spherical equivalent, astigmatism and anisometropia. Results: Hypermetropia was found as the most common refractive error among the participants (65% in right eyes, 62% in left eyes). With the rule astigmatism is found to be the most common astigmatic pattern in both eyes (75% in right eyes, 70% in left eyes). Anisometropia incidence was found to be 8%. No correlation between refractive status and birth weight (p=0.105 r=-0.280) Conclusion: Hypermetropia and with the rule astigmatism is the most common refractive error in term babies and there is no relationship between refractive status and birth weight in healthy infants born in term., Amaç: Yenidoğanların yaşam kalitesini arttırmak için en erken görsel problemleri tespit etmek önemlidir. Bu çalışmada sağlıklı term bebeklerde refraktif durumun belirlenmesi ve refraktif durum ile doğum ağırlığı arasında bir korelasyon olup olmadığı araştırıldı. Gereç ve Yöntem: Çalışmaya doğum sonrası 8 haftalık term doğan iki yüz üç sağlıklı bebek alındı. Kırılma durumunu değerlendirmek için tüm olgularda el otorefraktometre cihazı kullanıldı. Kırılma kusurları hem sağ hem de sol gözde ayrı ayrı analiz edildi. Sikloplejik koşullar altında yapılan ölçümler, sferik eşdeğer, astigmatizma ve anizometropi açısından analiz edildi. Bulgular: Hipermetropi, katılımcılar arasında en sık kırılma kusuru olarak saptadı(sağ gözlerde % 65, sol gözlerde % 62). Kurala uygun astigmatizma her iki gözde de en sık rastlanan astigmatik patern tespit edildi (sağ gözlerde % 75, sol gözlerde % 70). Anizometri insidansı% 8 olarak bulundu. Kırılma durumu ile doğum ağırlığı arasında korelasyon bulunmadı (p = 0.105 r = -0.280). Sonuç: Hipermetropi ve kurala uygun astigmatizma term doğan sağlıklı türk bebeklerde en sık görülen kırma kusuru olup, bu bebeklerde kırılma kusuru ile doğum ağırlığı arasında bir ilişki yoktur.

Background: A blurred image caused by the shape of the eye which does not bend light correctly. It is a major health problem globally affecting a large number of people with many ocular morbidities. Aim: The aim of the study was to compare the noncycloplegic refractive error with cycloplegic refractive error using autorefractometer. Materials and methods: This study was conducted in Department of ophthalmology, Nizam Medical College, Hyderabad between August 2018 to August 2019. Total number of patients selected were 70. Results: Autorefractometer values were comparable between pre and post cycloplegic values which were 23 and 24 right and left eyes of hypermetropia patients. From dioptric range, number of patients increased significantly (+0.25 to +1.25) to (+2.75 to +3.75) which was 11 to 26 and 21 to 32 right and left eyes respectively. P value in right eye and left eye was

Purpose: To determine the frequency of different ocular conditions leading to ocular morbidity in a tertiary care hospital. Study Design: Descriptive cross sectional study. Place and Duration of Study: Study was done in Dow University of medical sciences, from May 2018 to October 2018. Methods: A total of 278 patients presenting in the eye out-patient department were included. Patients with unaided visual acuity of 6/6 in both eye and no ocular abnormality were excluded from the study. Children with congenital syndromes like Down’s syndrome, etc. leading to eye diseases were also excluded. All children underwent complete ocular examination. Data was analyzed by using SPSS version 22. Frequency and percentages were computed for gender and different ocular diseases e.g., myopia, hypermetropia, strabismus, Vernal Kerato-conjunctivitis, astigmatism, red eye, subconjunctival hemorrhage etc. Post-stratification chi-square test was applied with p-value ≤ 0.05. Results: Out of 278 participants of the study, there were 154 (55.4%) males and 124 (44.6%) females. Average age of the patients was 11.15 ± 3.44 years. Myopia and red eyes were the major causes of pediatric ocular morbidity i.e. 33.81% and 26.6% respectively. Comparison between two age groups showed that Myopia was higher in children with 11 to 15 years. Myopia and astigmatism were more common in females while sub-conjunctival hemorrhage was more in males. Conclusion: Refractive errors are the commonest cause of childhood visual impairment in our setup. Correcting these preventable diseases can have a positive impact on the performance of children at school. Key Words: Visual acuity, Pediatric, Myopia, Hypermetropia, Kerato-conjunctivitis.

Introduction: Refractive errors are apparently more prevalent among the high educational group and have become a huge economic and social burden.1 Materials and Methods: The study was conducted at Era’s Lucknow Medical College and Hospital and included 420 medical students of consecutive 4ys (2013-2016). Refractive error was assessed under cycloplegia using Snellen’s visual acquity drum and streak retinoscope. The students were categorized according to their refractive error and the prevalence was calculated. Results: Of 420 students 54% had refractive error. Of these 77.7% had myopia, 8.4% had hypermetropia and 1.7% had astigmatism. Myopes were further divided into mild moderate & severe. It was found that 62.8% had mild, 35.4% had moderate and 13.7% had severe myopia. Conclusion: The commonest refractive error among medical students is myopia of varying grades. Keywords: Medical students, Myopia, Refractive error.

To investigate the effect of different eye exercises on hypermetropia in school-aged children and to determine whether exercise protocols have superiority to each other. 60 hypermetropia school-aged children were randomly assigned to three groups: Bates Exercise Group (BEG), Convergence Exercise Group (CEG) and Oculo-Motor Exercise Group (OMEG). Outcome measures included sciascopy, Snellen chart and The Pediatric Quality of Life Inventory Version 4.0(PedsQI4.0). All three groups were given home exercises which warranted eye exercises twice a day, repeated 10 times daily for 6 weeks. CEG showed a statistically significant effect on visual acuity for the right and left eye (p=0.004, p=0.014, respectively) and Pediatric Quality of Life Inventory (p

Purpose: Attention-deficit/hyperactivity disorder (ADHD) was reported to be associated with disturbances in the prefrontal circuitry and seems to be associated with dysfunctions of eye motility. This study aimed to explore associations between ADHD and ocular abnormalities, including amblyopia, hypermetropia, astigmatism, and heterotropia, using a large, nationwide population-based dataset in Taiwan.Methods: We retrieved our sample for this cross-sectional study from the Taiwan National Health Insurance Research Database. In total, 116,308 children with ADHD were selected as the study group and 116,308 randomly selected children without ADHD as the comparison group. We used conditional logistic regression analyses to examine the odds ratios (ORs) of amblyopia, hypermetropia, astigmatism, and heterotropia between children with and those without ADHD.Results: We found that children with ADHD had significantly higher prevalences of amblyopia (1.6% vs. 0.9%, p< .001), hypermetropia (2.4% vs. 1.3%, p < .001), astigmatism (0.2% vs. 0.1%, p < .001), and heterotropia (1.1% vs. 0.5%, p < .001) than children without ADHD. The ORs of amblyopia, hypermetropia, astigmatism and heterotropia for children with ADHD were 1.89 (95% confidence interval (CI) = 1.76 ~ 2.05), 1.82 (95% CI = 1.68 ~ 1.92), 1.73 (95% CI = 1.34 ~ 2.16), and 2.01 (95% CI = 1.82 ~ 2.21) compared to children without ADHD.Conclusions: The findings suggest that ADHD is associated with ocular abnormalities, including amblyopia, hypermetropia, astigmatism, and heterotropia.

BACKGROUND Refractive error is an optical defect, intrinsic to the eye which prevents light from being brought to a single point focus on the retina, thus reducing normal vision. Diagnosis and treatment of refractive error is relatively simple and is one of easiest ways to reduce impaired vision. We wanted to determine the prevalence and frequency of various types of refractive errors in rural population of Ganjam, Odisha. METHODS This is a cross sectional study in which 7,384 individuals in the age group of 5-60 years were evaluated during teleophthalmology visits during the period October 2016 to September 2018, in the rural population of Ganjam, Odisha. Individuals whose VA was

Accommodative esotropia or refractive esotropia is one of the commonest forms of strabismus or squint. It is usually seen in infants, children. Normal visual acuity of a new born child is first detected as early as sixth week of post natal life. Thereafter it progresses rapidly and achieves the visual acuity of a normal adult by the time the child reaches sixth year of life. Any refractory error especially hypermetropia, will tend to make the visual axis deviate resulting in refractive esotropia. Early detection and timely refractory error correction tend to bring the visual axis parallel and correct the strabismus. Materials and Methods: Twenty three infants with an youngest age of 9 months and oldest age of 4 years that attended the clinical department from the period two years from 2008 to 2010 were selected and screened. Results: All the twenty three children were screened thoroughly and their hypermetropic refractive errors were detected and proper spectacles were given till 8 years of their life and constant follow up was done for 4 more years. The convergent squint started to decrease after three months of usage of glasses and never returned. Conclusion: Accommodative esotropia is one of the commonly seen squints of infants and young children. If properly detected, diagnosed, investigated and promptly treated with spectacles, this is the squint which gives best results without any surgical intervention. Keywords: Accommodation, Convergent, Hypermetropia, Spectacle, Squint.

Aims of Study: 1. To determine the choroidal thickness CT in eyes of subjects with high refractive errors, using SD-OCT.; 2. To correlate the CT with the refractive error and the axial length in these eyes. Materials and Methods: In this cross-sectional observational study 87 subjects with high myopia, i.e., spherical equivalents (SE) >-6.0D and high hypermetropia, i.e., SE> +3.0 D, aged between 5 to 50 years and with a best-corrected visual acuity (BCVA) of 6/9 or better, were included. In each eye, the CT was measured using SD-OCT scanning at seven retinal points, i.e., subfovea and 0.5 mm, 1.0 mm and 1.5 mm nasal as well as temporal to the fovea. Results: The CT in high myopic eyes was significantly less and in high hypermetropic eyes significantly more than in the controls, with the thinnest choroid present 1.5 mm nasal to the fovea in high myopic eyes and the thickest choroid present subfoveally in high hypermetropic eyes. The subfoveal CT in high myopic eyes had the strongest positive correlation with the SE of refractive error. In high hypermetropic eyes, the strongest positive correlation was found 1.5 mm temporal to the fovea, the point that also showed the strongest negative correlation between the axial length (AL) and the CT. Conclusions: High myopic eyes, i.e., with SE>-6D, have significantly thinner choroids than emmetropes. The CT decreases with an increase in the degree of myopia. High hypermetropes (i.e., SE > + 3 D) have significantly thicker choroids than emmetropes. Higher degrees of hypermetropia and shorter eyeballs are associated with thicker choroids. Keywords: Choroidal thickness, High myopia, High hypermetropia, Optical coherence tomography.

We report a case of giant macular hole progression after rupture of giant retinal pigment epithelial detachment (PED). The patient was a 91-year-old man who had a giant PED in the left eye. He had bilateral hypermetropia (+2.00 dpt), and he had developed posterior vitreous detachment. The PED was 5,800 μm in diameter and 800 μm in height and ruptured during follow-up. A macular hole was formed, with a diameter of 400 μm, and the height of the PED had reduced to 360 μm. After 5 months, the macular hole expanded up to a diameter of 600 μm. Therefore, some cases of giant PED may lead to macular hole.

Khulood Muhammad Sayed, Marwa Mahmoud Abdellah, Ahmad Gad Kamel The Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, EgyptCorrespondence: Marwa Mahmoud AbdellahThe Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag 82524, EgyptTel +2010071291010Email MarwamahmoudAbdellah@yahoo.comPurpose: To find out and analyze the points of difference in the refractive profile between children with complete oculocutaneous albinism (OCA) and an age-matched, non-albino group seeking paediatric ophthalmic examination.Methods: A cross-sectional study was conducted on 164 infants and young children in Paediatric Ophthalmology Center, Sohag City, Egypt. Informed consent was obtained from the participants’ guardians. The study divided the population into 2 equal groups: albino group = 82 eyes, non-albino group = 82 eyes. Cycloplegic refraction and average keratometric measurements using the hand-held autokeratometer were taken for the study groups.Results: In the albino group, astigmatism and hypermetropia were the most common refractive errors, 100% and 62% respectively, with significant difference between both groups. Mean total (TA), corneal (CA) and lenticular astigmatism (LA) were significantly higher in albino group (P< 0.05). All albino eyes were high astigmats (≥ 1.25 D).Conclusion: This study is novel in being comparative and includes the largest sample size ever reported for albino eyes of infants and children. High WTR astigmatism is the most prevalent refractive error in albinos with an overall bias toward hyperopia, but extreme errors (>− 11.00D myopia or >+10.00D hyperopia) are not common. Albino eyes have a significantly higher degree of LA which compensates for the high CA to decrease the amount of TA. The study emphasizes the importance of refraction examination and visual rehabilitation for OCA children as early as possible to reduce eye morbidity-associated low vision.Keywords: refractive error, albinism, young children, autorefractometer, non-albinos

Background Inaccurate biometry can lead to the wrong intraocular lens implantation and result in refractive surprise following cataract surgery. It is important to be sceptical of biometry results that do not match the refractive or clinical picture and ask for it to be repeated. Case presentation We present a unique cause of refractive surprise in a patient undergoing cataract surgery. Pre-operative refraction demonstrated hypermetropia, yet swept-source optical coherence tomography (SS-OCT) biometry repeatedly calculated the axial length as > 35.00 mm in both eyes. The patient underwent phacoemulsification and intraocular lens insertion using the provided biometry calculations, however post-operatively the patient had a + 14.00 dioptre refractive surprise. Analysis of biometry performed on the same day identified other patients with exaggerated axial lengths, supporting the theory that the biometer’s smeared optical surface was responsible. Following servicing of the machine, repeat biometry of the patient calculated the axial length consistent with a hypermetrope (21.67 mm) and the intraocular lens exchange was successful in correcting the refractive error. Conclusions Ensure the optical surfaces of the biometer are cleaned regularly, and consider repeating biometry on separate days if repeat biometry still is not in keeping with the refractive or clinical picture. Additionally, re-confirm the axial length with another modality.

The article reveals the essence of the impact of a corrective training program on reducing the level of negative emotional states and disorders in adolescents with impaired vision. The sample of the investigated, which includes such groups of the investigated: patients with diagnoses "Myopia", "Hypermetropia", "Astigmatism" is substantiated. The results of experimental studies of input and output controls for each of the proposed psychodiagnostic tests are substantiated. A formative experiment in our study was a correction training on the harmonization of the emotional sphere, which helped to reduce the level of negative emotional states in the subjects.Keywords: emotional sphere, sensory pathology, myopia, hypermetropia, astigmatism.

Encephalotrigeminal angiomatosis (Sturge-Weber syndrome) is a congenital sporadic disease characterized by angiomatosis of meningeal vessels, facial and eye capillaries. The article presents a clinical case of comorbidity between monolateral skin angioma, ipsilateral conjunctival and choroidal angiomas without intraocular pressure elevation. The case is unusual due to asynchronous manifestation of the clinical signs of Sturge-Weber syndrome. Facial angioma was diagnosed at birth, while conjunctival angioma appeared at the age of 45 - at the same time as monolateral hypermetropia, which may be the first symptom of diffuse choroidal angioma.Энцефалотригеминальный ангиоматоз, или синдром Sturge-Weber - врожденное, спорадически возникающее заболевание, характеризующееся ангиоматозом сосудов мозговых оболочек, капилляров лица и глаз. В статье описан клинический случай, демонстрирующий сочетание односторонней кожной ангиомы с ангиоматозом конъюнктивы и диффузной гемангиомой хориоидеи на ипсилатеральной стороне без признаков нарушения офтальмотонуса. Интерес данного клинического случая обусловлен тем, что имеет место разновременное появление клинических признаков синдрома Sturge-Weber. Кожная ангиома у пациентки была с рождения, ангиома конъюнктивы появилась в возрасте 45 лет, тогда же у нее появился гиперметропический сдвиг рефракции, что может быть первым проявлением диффузной гемангиомы хориоидеи.

BACKGROUND Vision plays a significant role in acquisition of skills such as sign language in children with hearing impairment. Auditory training after cochlear implant surgery is given in combination with visual gestures. Thus even subnormal vision will adversely affect their social development. Hence there is a need to do ophthalmic evaluation in children with severe and profound hearing loss. In this study children with severe sensorineural deafness prepared for cochlear implant surgery were evaluated for the presence of ophthalmic manifestation. MATERIALS AND METHODS This is a retrospective hospital-based study from April 2017 to March 2018. Children under the age of 10 years with severe sensorineural hearing loss who were referred to us for ophthalmological evaluation were included in the study. Complete ophthalmic evaluation including anterior segment examination with slitlamp, detailed fundus examination and cycloplegic refraction were done. Syndromic associations were also studied. RESULTS Fourteen children were included in the study period. All the children showed severe sensorineural hearing loss in otoacoustic emission and brainstem evoked response audiometry tests. Maximum number of patients (9 patients) were below 3 years of age (64.7%). There was a female predominance (57.1%). 35.7% of our study population had ocular involvement. Hypermetropia was noticed in two children (14.2%). One patient (7.14%) had salt and pepper appearance of fundus along with other features of congenital rubella syndrome. Waardenburg syndrome with heterochromia iridis in one patient (7.14%) and Usher Syndrome (7.14%) with retinitis pigmentosa in another patient were also noted. Three patients (21.4%) had associated cardiac involvement. CONCLUSION The results of our study indicate that there is a high prevalence of ocular problems in children with severe sensorineural deafness. Coincidence of visual disorders with hearing impairment especially in the early years can negatively impact the development of child. Hence addressing the visual problems helps a lot for them to improve their communication skills.

BACKGROUND: To determine the sensitivity and specificity of school nurse screening for hypermetropia and convergence insufficiency exophoria (CIE) in schoolchildren.METHODS: Near point of convergence and distance visual acuity with +2.00D lenses were measured in 2097 children (6-15 years) during standard school nurse screening in the municipality of Randers, Denmark. One hundred and ninety-four children with positive screening results (near point of convergence >10 cm and/or distance visual acuity improved or maintained with +2.00D) and 182 controls with negative screening results received a full vision assessment, including cycloplegic refraction and orthoptic evaluation.RESULTS: Sensitivity and specificity of screening was 0.75 and 0.69 for CIE and 0.59 and 0.87 for hypermetropia (≥+2.00), respectively. While precision of screening for CIE was significantly higher for symptomatic children aged 9-15 than for younger and asymptomatic children, precision of screening for hypermetropia was independent of age and presence of visually related symptoms.CONCLUSION: While precision of screening for CIE and hypermetropia (>+2.00) was low, additional vision evaluation of children older than 9 years with asthenopic symptoms identified most children with CIE with a low absolute number of false positives.

Tear fluid has a critical role for the function of the refraction index of the light and the quality of the image. The purpose of this study is to compare tear fluid and ocular dominance in patients with refractive errors. One hundred three patients with mean age of 35.63±14.95 who was referred to ophthalmology service for refraction examination were enrolled to the study. The handedness and ocular dominance were determined by the Edinburgh hand preference questionnaire and other tests. Visual acuity was tested by ophthalmological methods and Schirmer test was administered in patients. Our study was included seventy-three female and thirty male patients. Right hand-dominance was found as 94.1% and right eye dominance as 66.0%. Myopia was higher in both right (- 0 .74±1.16D) and left eye (-0.68±1.01D) dominance. There were statically negative correlation between hypermetropia degree and tear volume in the left eye (p= 0.015; r = -0.240) there is a negative non-statically correlation for the right eye (p=0.060; r= -0.186). There was no correlation either between the myopia degree and tear fluid, eye dominance, tear fluid. The existence of a negative correlation between the amounts of hypermetropia with tear fluid, suggesting that the evaluation of tear fluid should be considered in clinical significance.

Refractive surgery is a dynamically developing field of ophthalmic surgery, which requires studying new approaches for determining indications and contraindications for refractive surgery.Purpose. To investigate the possibility of expanding indications for refractive surgery in conditions related to contraindications on the example of four clinical cases.Material and methods. The study included 4 clinical cases of photorefractive operations in patients with relative contraindications who underwent refractive surgery (Femto-Lasik, photorefractive keratectomy (PRK), phototherapeutic keratectomy (PTK)).Results and discussion. Follow-up period of patients after Femto-Lasik, PRK and PTK was 1 year. During this period, stabilization of such parameters as intraocular pressure (IOP), progression of diabetic retinopathy, visual acuity was detected on all operated eyes. There were no postoperative complications. In the first clinical example, to avoid flap injury pneumotonometry was performed 72 hours after the surgery. IOP indices differed from preoperative ones and were 15 mm Hg because of the flap cut and the removal of part of the corneal tissue as a result of laser ablation. In the second clinical example, BCVA OU was 1.0 throughout the whole follow-up period. In the third clinical example recurrence of retinal detachment and any formations of new zones of peripheral vitreochorioretinal were not observed. BCVA improved up to 0.9–1.0. In the fourth clinical example, 3 months later, the patient complained for “misting” in the right eye. On examination, subepithelial fibroplasia of the 1st degree was revealed. After the course of treatment, the transparency of the cornea was restored. The data of the diagnostic examination after the surgery at the period of 1 month, 3 months did not differ and corresponded to preoperative ones. Diagnostic examination data 1 year after the operation: visual acuity: OD — 1.0; OS — 0.4 sph + 1.0Dcyl + 1.5Dax 45 = 0.8.Conclusion. The presented clinical examples allow us to reconsider the list of relative contraindications for performing refractive operations for compensated diabetes mellitus, glaucoma, retinal detachment, corneal opacities, as it can be performed safely and effectively with good refractive results.

Purpose: comparison of some ophthalmobiometric parameters in natural and cycloplegic conditions in myopia and hypermetropia.Material and methods: eyes biometric parameters were examined (the depth of the anterior chamber, the lens thickness and AL)before and after cycloplegia (1% Cyclopentolate hydrochloride — 2 times) in 244 eyes with myopic and hyperopic refraction in 122patients aged 5–32 years. Biometric parameters were examined on the Galilei G6 optical system analyzer (Ziemer Ophthalmic SystemsAG 6.0.6). The thickness of the choroid was measured with a spectral optical coherent tomograph (SD-OCT wavelength 800 nm) of Nidek RS-3000 Retina Scan Advance in 20 eyes of 10 patients aged 11 ± 1.3 years from the examined group before and 40 minutes after double injection of 1% Cyclopentolate hydrochloride. Results: the depth of anterior chamber and the axial, both in the narrow pupil and under the cycloplegia, are significantly higher in the myopic eyes than in the hyperopic eyes (p < 0.05 for ACD and p < 0.01 for AL), and the lens thickness is practically does not differ. In absolute terms, the position of irido-lens diaphragm, i.e. distance from the posterior surface of the cornea to the center of the lens in myopia group was significantly higher than with hyperopia respectively, of 5.62 ± 0.02 mm of 5.29 ± 0.01 mm (p < 0.01). However, the coefficient Lowе ((ACD + 1/2LT)/AL) in myopia was significantly lower (of 0.219 ± 0.001 and 0,238 ± 0,001, respectively) is due to the greater of the AL. After cycloplegia, in both myopic and hyperopic eyes, DAC increases: in myopia, on average, 0.12 mm, with hyperopia — by 0.14 mm, and accordingly the thickness of the lens decreases. The coefficient Lowe in both cases is increased by 0,04 mm. Interesting changes were observed in the length of AL: under conditions of cycloplegia, it decreased by 0.03 mm (30 microns) in eyes with myopia (p > 0.05) and by 40 microns (0.04 mm) with hyperopia (p < 0.01). Conclusion: In cyclopegic condidions, as compared to the existing accommodation, increasing the depth of the anterior chamber decreased the thickness of the lens center of the lens somewhat extended posteriorly and decreases the axial length. The revealed changes in the AL can be associated with a change in the position of the pigment epithelium layer due to changes in the thickness of the choroid under different accommodation conditions. The significant changes in the thickness of the choroid the influence of cycloplegia was not proved in this study.

Introduction:. Higher-order aberrations (HOAs) are small optical irregularities or imperfections of the eye which cannot be corrected by simple sphere and cylinder corrections. Many authors believe that HOAs are the reason many patients complain of halo, glare and decreased contrast sensitivity after successful corneal refractive surgery.(Baily et al., 2003) Many studies in the past showed significant variability of HOAs among the individuals of same population. Popularization of laser corneal refractive surgery and its potential to induce or remove optical aberrations (both low order and higher order aberrations) is the main reason behind better understanding of the nature of aberrations as well as their influence on visual quality. (Bisneto et al., 2007) Aim of the work:To measure and evaluate the distribution of HOAs among various refractive errors in individuals screened for refractive surgery and compare them .correlation with errors. Patients and Methods: prospective cross sectional analytical study was conducted at ophathalmology center for refactive surgery ,sohag started in February 2016. two hundred eyes of patients with age ranging from 18-40 years were included in the study. Results: Patients in hypermetropia group had statistically significant higher amount of HOA than other three groups followed by mixed group.No significant correlation of HOAs with amount of refractive error in all the groups except in mixed error group. Conclusion: In overall comparison we noticed the mean RMS of total HOAs were significantly higher in hypermetropia group and there was a statistically significant correlation between SE of Mixed group and RMS of Total HOAs.

Paravartajanya vikara is the lack of ability of the eye to focus the rays of light on to the retina, one such vikara is dooradrishti where in light focuses behind the retina. Various modalities of Ayurvedic treatments are tried, tested and proved efficaciously in this single case study which is presented.

The eye optics and topographic distribution of ganglion cells were studied using whole mount preparations from European beaver Castor fiber L. The beaver eye optics provides emmetropia in air and hypermetropia in water. The optometrical measurements predict retinal resolution of the beaver eye around 17' in air and 9' in water. In air, retinal resolution corresponds to the real visual acuity, whereas in water, visual acuity is below the retinal resolution because of the non-precise focusing.

Introduction: Refractive errors are becoming a problem in many societies, with prevalence rates of myopia in many Asian urban countries reaching epidemic proportions. This study aims to determine the prevalence rates of various refractive errors among medical students of Kist Medical College Teaching Hospital, Nepal.Materials and Methods: Medical students were included in the study. Demographic data was obtained via questionnaires filled in by the students after taking informed verbal consent. Refractive error measurements were determined by dry retinoscopy and additional cycloplegic refraction as and when needed.Results: The prevalence rate of simple myopia was 64.81% and 3.7% had high myopia. Hyperopia (Hypermetropia) was present in 1.8% of the participants while overall astigmatism prevalence rate was 29.6% among medical students. Conclusion: Prevalence rates of myopia in medical students are found to be quite high.Conclusions: Prevalence rates of myopia in medical students are found to be quite high.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 21-23

Objectives: This present study was to evaluate the clinical profile of patients with amblyopia. Methods: A detail history, clinical examinations and relevant investigations were performed to all cases of amblyopia. Cycloplegic refraction under atropine sulphate 1 % eye ointment for 5-10 years and eye drop homatropine 2 % for 11-20 years age group was performed. Management material was tissue paper and micropore tape for patching. It was done in the form of 3 hours or 6 hours patching. Visual improvement tested every month upto 3 months and then after 3 months by Snellen’s distant visual acuity or Landolt C chart. Results: Data was analyzed by using simple statistics methods with the help of MS-Office software. Conclusions: Amblyopia was commonly seen in children. Anisometropic amblyopia was very common. Refractive error was commonly seen in cases with hypermetropia with astigmatism, myopia with astigmatism and hypermetropia. Majorities of these cases had 2-4D and 4.25-6D refractive error differences and had 6/24-6/12 visual acuity.Alternate divergent and unilateral partially accommodative convergent were the most common type of squint seen. Majorities of cases with anisometropic amblyopia had seen >2 snellen’s line improvement of visual acuity in 3 hours patching regimens. Hence, early intervention is ideal, with appropriate management and treatment amblyopia patients are likely obtain a successful outcome, and possibly full resolution. Key words: Children, amblyopia, refractive error, visual acuity

Background To describe clinical features, evaluation, surgical management and outcomes in children with esotropia associated with high hypermetropia. Methods Medical records of healthy children who received strabismus surgery for accommodative esotropia with hypermetropia larger than spherical equivalence of + 4.0 diopters from 2009 to 2015, were reviewed. Results A total of 47 patients were identified. The average age was 2.9 years old. The average spherical equivalence of cycloplegic refraction was + 6.0 diopters (D). All patients presented with large angle esotropia with spectacle correction. Average age of esotropia onset was 1.3 years. Average time between the onset of esotropia to spectacle correction was 7.2 months. Average duration between onset of constant esotropia to strabismus surgery was 28.1 months. Average duration between spectacle correction to strabismus surgery was 21.8 months. Post-operatively, 74.5% of patients achieved ocular alignment within 10 prism diopters (PD) of orthotropia. Overall, 66.0% patients developed sensory fusion. For patients who achieved surgical success, 71.4% developed sensory fusion, compared at 50.0% for patients who were over- or under-corrected (p = 0.18). For patients who received hyperopic spectacles within 6 months of esotropia onset, 92.3% developed sensory fusion, compared with 54.5% for patients who received hyperopic spectacles at 6 month or later after esotropia onset (p = 0.02). Conclusions Strabismus surgery for esotropia with high hypermetropia has high rate of surgical success with low rate of under- or over-correction. There is a trend toward higher rate of sensory fusion for patients with surgical success. Shorter time interval between esotropia onset and receiving hyperopic spectacles is associated with higher rate of sensory fusion development.

Purpose: To determine the magnitude and pattern of refractive errors among patients attending the ophthalmology department of a new medical college in North-East India. Materials and Methods: A prospective study of the new patients (age ≥5 years), who were phakic and whose unaided visual acuities were worse than 20/20 but improved with pinhole, was done. Complete ophthalmic examination and refraction with appropriate cycloplegia for age were done for the 4582 eligible patients. Spherical equivalents (SE) of refractive errors of the right eyes were used for analysis. Results: Of the 4582 eligible patients, 2546 patients had refractive errors (55.56%). The proportion of emmetropia (SE − 0.50–+0.50 diopter sphere [DS]), myopia (SE −5.0 DS), and hypermetropia (>+0.50 DS for adults and >+2.0 DS for children) were 53.1%, 27.4%, 2.6%, and 16.9%, respectively. The proportion of hyperopia increased till 59 years and then decreased with age (P = 0.000). The proportion of myopia and high myopia decreased significantly with age after 39 years (P = 0.000 and P = 0.004, respectively). Of the 1510 patients with astigmatism, 17% had with-the-rule (WTR), 23.4% had against-the-rule (ATR), and 19% had oblique astigmatisms. The proportion of WTR and ATR astigmatisms significantly decreased (P = 0.000) and increased (P = 0.000) with age, respectively. Conclusions: This study has provided the magnitude and pattern of refractive errors in the study population. It will serve as the initial step for conducting community-based studies on the prevalence of refractive errors in this part of the country since such data are lacking from this region. Moreover, this study will help the primary care physicians to have an overview of the magnitude and pattern of refractive errors presenting to a health-care center as refractive error is an established and significant public health problem worldwide.