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Despite advances in systemic care, diabetic disease of the eye (DDE) remains the leading cause of blindness worldwide. There is a critical gap of up-to-date, evidence-based guidance for ophthalmologists in Canada that includes evidence from recent randomized controlled trials. Previous guidance has not always given special consideration to applying treatments and managing DDE in the context of the healthcare system. This consensus statement aims to assist practitioners in the field by providing a spectrum of acceptable opinions on DDE treatment and management from recognized experts in the field. In compiling evidence and generating consensus, a working group of retinal specialists in Canada addressed clinical questions surrounding the four themes of disease, patient, management, and collaboration. The working group reviewed literature representing the highest level of evidence on DDE and shared their opinions on topics surrounding the epidemiology and pathophysiology of diabetic retinopathy and diabetic macular edema; diagnosis and monitoring; considerations around diabetes medication use; strategic considerations for management given systemic comorbidities, ocular comorbidities, and pregnancy; treatment goals and modalities for diabetic macular edema, non-proliferative and proliferative diabetic retinopathy, and retinal detachment; and interdisciplinary collaboration. Ultimately, this work highlighted that the retinal examination in DDE not only informs the treating ophthalmologist but can serve as a global index for disease progression across many tissues of the body. It highlighted further that DDE can be treated regardless of diabetic control, that a systemic approach to patient care will result in the best health outcomes, and prevention of visual complications requires a multidisciplinary management approach. Ophthalmologists must tailor their clinical approach to the needs and circumstances of individual patients and work within the realities of their healthcare setting. [ABSTRACT FROM AUTHOR]

Inadequate public knowledge about eyes and eye care poses avoidable risks to vision-related quality of life. This study of eye care knowledge among Canadians extends earlier findings from focus groups. Perceptions about eyes and eye care were sought using a 21-item online survey and snowball sampling. Inclusion criteria were living in Canada and being at least 18-years old; eye care professionals and staff were excluded. Response frequencies were converted to percentages, with eye condition items analysed according to 'expected' or 'unexpected' eye impacts. Proportions selecting these impacts or 'unsure' were determined. There were 424 respondents: 83.0% aged 20-65 years and 69.6% female. Mismatches existed between perceived recommendations and behaviours for booking eye exams: within two years (86.7% vs. 68.4%) and symptom-driven (3.3% vs. 13.0%). First eye exams after age one year were deemed appropriate by 43.6%. Few respondents associated glaucoma with no symptoms (6.0%) or amblyopia with blurred vision (13.5%). A notable proportion incorrectly related tunnel vision with age-related macular degeneration (AMD, 36.8%) and cataract (21.9%). Identifying all 'expected' responses was unlikely for glaucoma (1.9%), amblyopia (6.7%), and cataract (12.0%). Most respondents identified no 'expected' effects for glaucoma (63.8%) and AMD (46.2%) and some 'expected' effects for cataract (59.5%) and amblyopia (72.6%). Selecting 'unsure' was 9-10 times more common among respondents choosing no 'expected' impacts than those choosing some. Awareness of thyroid-associated eye disease was lowest (32.4%) of seven conditions. Respondents were most likely to consult optometrists for routine eye exams, eye disease, diabetes eye checks and blurred vision but family physicians for red eyes and sore eyes. Respondents typically paid for their eye exams and eyewear but wanted government to pay. Vision-threatening knowledge gaps and misinformation about eyes and eye care among Canadian respondents highlight the need for accessible, targeted public education. [ABSTRACT FROM AUTHOR]

Objective: Social participation benefits health. We assessed the relationship between self-reported visual impairment (VI) and glaucoma versus seniors’ social participation. Methods: Data from individuals aged ≥65 years responding to the Canadian Community Health Survey Healthy Aging 2008/2009 (n = 16,369) was analyzed. Participation in eight social activities by seniors with and without self-reported VI or glaucoma was compared. Results: Seniors with VI had significantly reduced participation (p<0.05) in sports/physical activities (18.0% vs. 33.6%), family/friendship activities outside the household (39.7% vs. 53.0%), service club/fraternal organization activities (11.4% vs. 18.4%), volunteer/charity work (13.4% vs. 24.9%), educational/cultural activities (16.2% vs. 24.5%), and other social recreational activities (21.6% vs. 31.0%) compared to those without VI. Differences in participation in church/religious activities (40.6% vs. 44.5%) and community/professional association activities (15.3% vs. 18.0%) were non-significant between seniors with and without VI. Seniors with glaucoma versus those without had significantly reduced participation (p<0.05) in family/friendship activities (46.6% vs. 52.9%), sports/physical activities (26.0% vs. 33.6%) and volunteer/charity work (20.4% vs. 24.9%). No participation in any social activity was significantly higher among seniors with VI versus those without (10.1% vs. 2.9%, p<0.05), but was similar among seniors with and without glaucoma (3.9% vs. 3.1%, p>0.05). After adjusting for the effects of age, sex, education, household income, ethnicity, job status and chronic diseases (adjusted odds ratio, aOR = 3.4 (95% confidence interval (CI) 2.0–5.8), seniors with VI but no glaucoma were more likely not to engage in any social activities compared to seniors without VI and no glaucoma. Seniors with glaucoma but without VI had a similar level of non-participation (aOR = 0.9, 95%% CI 0.5–1.7). Conclusions: Significantly reduced social participation was found across six community activities among seniors with self-reported VI and in three activities among those with self-reported glaucoma. Policies and programs that help seniors with VI or glaucoma engage in social activities are needed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Diabetes is a chronic disease with increasing prevalence worldwide. Although research has improved its treatment and management, little is known about which research topics matter to people living with diabetes, particularly among under‐represented groups. Objectives: To explore the importance of research topics among a diverse range of people living with any type of diabetes or caring for someone living with any type of diabetes. Methods: We used a convergent mixed‐method design with quantitative and qualitative aspects. We surveyed a national sample of people living with diabetes and caregivers of people with diabetes, asking them to rate the importance of 10 predetermined important research topics. We also held three focus groups in two major cities to explore research concerns of people who are under‐represented in research. Results: 469 adults (57% men, 42% women) in Canada completed the online survey, indicating that all 10 areas of research mattered to them, with the highest ratings accorded to preventing and treating kidney, eye and nerve complications. Fourteen individuals participated in three focus groups and similarly noted the importance of research on those three complications. Additionally, focus group participants also noted the importance of research around daily management. No new topics were identified. Conclusions: This study confirmed the importance of research topics among a population of people living with or caring for someone with diabetes. Findings from this study were used to inform the vision for Diabetes Action Canada—a pan‐Canadian Strategy for Patient‐Oriented Research (SPOR) Network on diabetes and its complications. [ABSTRACT FROM AUTHOR]

Although Canadian healthcare is commonly referred to as a single-payer system providing universal coverage for only hospital and physician benefits, it is argued herein that their plan actually functions as a multi-payer model; and, it provides a far lesser breadth of coverage than available among most western European countries. Of concern is that in addition to their mandated plan, only 60% of their residents are covered by private insurance for pharmaceuticals, dental care, and eye services most often paid for as a fringe benefit by their employers. In addition, based on their medical loss ratios (74% for group coverage; 38% for individual insurance), these investor-owned, private insurance plans cannot be considered as an effective approach to protect the public against these medical expenditures. An obvious solution is to mandate these benefits as enhancements to the Canada Health Act of 1985, but this alternative is currently thought to be unrealistic for both political and economic reasons. Major issues now facing the Canadian healthcare system, in terms of its routine delivery of patient care, are not the single- versus multi-payer question or the inefficiencies of their supplementary insurance, but (a) the extended patient waits for non-emergent surgical services; (b) the lack of appropriate fiscal incentives when reimbursing their hospitals; and (c) their resident physicians currently completing approved programs in general surgery and the surgical sub-specialties frequently being unable to secure appropriate medical staff appointments. Maybe the Canadian healthcare system, although providing universal hospital and physician services, is not as idyllic as perceived by many throughout the world. [ABSTRACT FROM AUTHOR]

The article focuses on the opportunities for Canadian patients to take advantage of cataract surgery in publicly insured, high-quality and safety surgical procedures in Canada. Overview of the guidelines, codes of ethics and practice standards associated with insured and noninsured cataract services in the nation is provided. Suggestion on the need for ophthalmologists to understand the ethical complexities in providing noninsured services during cataract surgery is also offered.

BACKGROUND: Green building standards are significantly impacting modern construction practices. The resulting structures are more energy efficient, but their impact on occupant health has not been widely studied. OBJECTIVE: To investigate a range of indoor environment and ergonomic issues in green buildings. METHODS: Retrospective post-occupancy evaluation survey of 319 occupants in two Leadership in Energy and Environmental Design (LEED) certified buildings and one conventional building on a Canadian University campus. RESULTS: Results show that working in the LEED buildings was a generally positive experience for their health, performance, and satisfaction. However, the LEED buildings did not always receive the highest ratings for environmental conditions or for health and productivity. Respondents indicated a range of concerns with thermal conditions, office lighting, noise and their overall workstation designs and these were not always better in the green buildings. CONCLUSIONS: These results highlight the need for better integration of ergonomic design into green buildings and into the LEED rating system, and these implications are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the outcomes of ProKera versus amniotic membrane transplantation (AMT) in managing ocular surface disease., Methods: This study is a retrospective case series of patients who received either ProKera or sutured AMT for ocular surface disease. Patient demographics, treatment indications, retention time, percentage healed area, changes in visual acuity, and costs to the health care system were analyzed., Results: Fourteen patients were identified and analyzed for each group. The main indications for using ProKera and AMT were similar, including corneal ulcer or epithelial defect due to chemical burns, neurotropic state, or herpes zoster keratitis. The average time to dissolution or removal was 24.8 days in the ProKera group, compared with 50.1 days in the AMT group. The average percentage of healed corneal area was 59% for ProKera and 73% for AMT. There was no significant difference between the initial and the final visual acuity within groups and when comparing both groups. In our expense analysis, ProKera had a total cost of 699.00 Canadian dollars (CAD), whereas the cost of suture AMT was 1561.52 CAD. ProKera priced at 11.85 CAD for each percentage healed surface area and at 21.39 CAD for AMT., Conclusions: ProKera allowed for a faster corneal healing than sutured AMT, although its total healed area was less than the latter. Moreover, ProKera is more cost-effective than AMT, thus reducing financial burden to our health care system., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article offers updates related to alternative and complementary therapies in the U.S. and Canada. Researchers have investigated how vitamin D in sunlight can protect the human body against influenza. Chiu and colleagues have examined the effects of eating habits to eye diseases in older people. Canadian researchers have tracked the effects of folic acid in reducing severe birth defects.

Purpose: To evaluate binocular visual function, refraction, and subjective outcomes of intermediate optimization of vision after simultaneous bilateral implantation of the nonaspheric AcrySof SA60D3 ReSTOR multifocal intraocular lens (IOL). Setting: Private clinic, Abbotsford, British Columbia, Canada. Methods: Intermediate optimization was performed by overcorrection of 1.00 diopter (D) to induce mild myopia in the nondominant eye in patients having bilateral implantation of the multifocal IOL. Distance manifest refraction and visual acuity at several distances were determined; contrast sensitivity function (CSF), near-point stereo acuity, and subjective outcomes were assessed postoperatively at 2 weeks and 1, 3, 6, and 12 months. Results: Thirty-two patients with intended intermediate optimization and 5 patients with unintended intermediate optimization were prospectively evaluated. The mean manifest refraction spherical equivalent was stable from 2 weeks (−0.94 D ± 0.22 [SD]) to 12 months (−0.93 ± 0.23 D) in the intermediate optimization eyes. Overall, postoperative mean binocular uncorrected near, intermediate, and distance visual acuities were 20/23, 20/23, and 20/22, respectively. No significant differences were found between best distance-corrected and uncorrected stereo acuity or between best distance-corrected and uncorrected binocular CSF under most conditions (P > .05). On questioning, 97% of patients had little or no difficulty seeing and were bothered occasionally or never by the visual fluctuation between the near range and intermediate range. Conclusion: Intermediate optimization with slight myopia in 1 eye after bilateral implantation of the multifocal IOL offered consistent good vision at all ranges, indicating it a safe option for patients who require good vision at intermediate ranges. [Copyright &y& Elsevier]

This case report highlights the risks that may be associated with amoebae in the water of a dental unit. A woman with contact lenses visited her dentist for replacement of a bridge. During the treatment, a stream of water was directed from the handpiece into her right eye. Because of subsequent pain in the eye, the patient consulted several ophthalmologists, who discovered abrasive lesions of the cornea and inflammation. Despite antibacterial and anti-inflammatory treatments, the patient's visual acuity declined gradually over a period of several days. A microbiological examination nearly 2 months later revealed amoebae in corneal samples. A lawsuit against the dentist was initiated. Although a causal relation with the dental treatment was rejected by the judge in this case, high numbers of amoebae in the water of dental units can present a risk if a patient with pre-existing corneal lesions is splashed. According to the precautionary principle, complete evidence of risk does not have to exist to institute measures to protect individuals and society from that risk. This case reinforces the importance of having patients wear safety glasses during dental treatments and of dental personnel draining the waterlines of dental units, as recommended by the Canadian Dental Association. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PurposeThe purpose of this study was to ascertain the prevalence and primary causes of visual impairment in a representative Canadian population.MethodsWe reviewed a representative sample of patients who attended ophthalmologists' offices in a medium-sized Canadian city between 1996 and 2001 in order to estimate the prevalence of visual impairment. Demographic data, visual diagnoses, best-corrected visual acuities (BCVA), and visual field information were recorded. Visual status was categorized based on accepted World Health Organization (WHO) and North American criteria. Population data were obtained from the Canadian census.ResultsThe prevalence of low vision and blindness in our population was 35.6 and 3.8 per 10 000 individuals, according to the WHO classification, and 71.2 and 23.6 per 10 000 individuals, using the North American definition. Among individuals with some vision loss (vision worse than 20/40), cataract and visual pathway disease were the most common causes, together accounting for 40% of visual impairment. Age-related macular degeneration and other retinal diseases were the next most common causes of vision loss. Diabetic retinopathy and glaucoma were less frequently encountered as causes of visual impairment.ConclusionThe overall prevalence of low vision and blindness in Canada are in keeping with data from large population-based studies from other developed nations. Cataract, visual pathway disease, and macular degeneration are the leading causes of visual impairment. These results are important for enhancing our understanding of the scope of vision health in Canada and may direct future health planning and cost-utilization research.Eye (2006) 20, 341–346. doi:10.1038/sj.eye.6701879; published online 20 May 2005 [ABSTRACT FROM AUTHOR]

PurposeTo evaluate the efficacy of Ahmed valve (AV) implantation in patients with uveitic glaucoma.MethodsIn total, 18 patients (19 eyes) with glaucoma secondary to chronic uveitis, who underwent AV implantation were retrospectively reviewed. Visual acuity, intraocular pressure (IOP), and glaucoma medications at the most recent examination prior to surgery, were compared with those of last postoperative examination. The surgical success was defined as IOP less than 21 mmHg and greater than 4 mmHg without loss of light perception and visually devastating complications at the last postoperative examination. Decrease in the number of glaucoma medications was also a criterion for surgical success.ResultsThe mean follow-up period was 26±9.7 months. The mean preoperative and postoperative IOPs were 33.3±9.7 (range, 20–57) mmHg and 17.3±10.8 (range, 6–40) mmHg respectively (P<0.0001). The mean number of antiglaucoma medications was 3.5±0.8 (range, 2–5) preoperatively and 1.4±1.3 (range, 0–4) postoperatively (P<0.0001). Valve occlusion (five eyes, 26.3%) was the most commonly observed complication. Surgical success was achieved in 13 eyes (68.4%). The cumulative probability of success was 94.4% at 1 year and 60% at 2 years. Five eyes (26.3%) with IOP greater than 21 mmHg and one (5.3%) with corneal decompensation requiring penetrating keratoplasty were considered as failures.ConclusionsThe implantation of AV is an effective surgical procedure for the management of uveitic glaucoma. The inflammatory background might contribute to the occurrence of valve occlusion, which is the most common complication. Prevention of this complication is an essential factor for improving the surgical outcome.Eye (2006) 20, 178–183. doi:10.1038/sj.eye.6701841; published online 11 March 2005 [ABSTRACT FROM AUTHOR]

Objectives To identify the prevalence of Borzoi chorioretinopathy in western Canada, characterize lesions with fluorescein angiography, determine if lesions were progressive, clarify the association of progressive retinal atrophy and investigate the etiology. Materials and methods Serial ophthalmic examination, fundus photography, electroretinography, and fluorescein angiography were used to evaluate Borzoi dogs with lesions of Borzoi chorioretinopathy. Pedigree analysis and test breeding of two affected dogs were completed to determine the heritability of Borzoi chorioretinopathy. Results One hundred three Borzoi dogs were examined between 1998 and 2003. Focal, peripheral, tapetal, hyper-reflective and pigmented areas consistent with focal retinal degeneration and RPE pigmentation were identified in 12 dogs between 7 months and 7 years of age. Seven males and five female dogs were affected. Ophthalmoscopy and fundus photography over 5 years revealed individual lesions that did not progress or coalesce in 12 affected dogs. Electroretinography of affected and normal Borzoi dogs confirmed that retinal function was similar in normal and affected dogs up to 7 years of age. Fluorescein angiography was performed in three affected dogs and confirmed intact blood–ocular barriers, focal retinal pigment epithelium hypertrophy, and focal absence of choroiocapillaris corresponding to chronic, focal lesions. Pedigree analysis precluded simple dominant, X-linked dominant, or X-linked recessive inheritance. One male dog from the test-bred litter developed bilateral lesions at 14 months of age. Simple recessive, polygenetic, and acquired etiologies of these lesions cannot be ruled out at this time. Conclusions Borzoi chorioretinopathy is an acquired condition that initially manifests as focal retinal edema and loss of choriocapillaris and tapetum. With time the retina degenerates becoming hyper-reflective and with RPE hyper-pigmentation and clumping within the borders of the tapetal lesions. Choriocapillaris remains hypofluorescent on fluorescein angiography. Progressive retinal atrophy was excluded as an etiology of multifocal chorioretinopathy in Borzois dogs. This condition is not inherited by simple autosomal dominant or sex-linked modes of inheritance. [ABSTRACT FROM AUTHOR]

To compare the costs of the new fixed combinations for glaucoma medical therapy.The studied drugs were: Cosopt® (5-mL bottle), Combigan® (5-mL bottle) and Xalacom® (2·5-mL bottle). Five bottles of each drug were obtained from pharmacies, and the medications lot numbers were recorded. To calculate the drop volume, 10 drops and 1 mL of each bottle were weighed with a digital precision scale. Drop volume was calculated by the relation between volume and weight. The cost of each bottle of medication was determined from the average retail price in Canada. The prices were obtained in Canadian dollars ($).The drops of Cosopt® (39·60 ± 0·45 μL) were considerably larger than the drops of Combigan® (33·75 ± 0·60 μL) and Xalacom® (30·87 ± 0·37 μL). The average number of drops per millilitre varied from 25·25 ± 0·29 (Cosopt®) to 32·40 ± 0·39 μL (Xalacom®). Combigan® presented the lowest daily cost ($0·87 ± 0·02) followed by Xalacom® ($1·09 ± 0·01) and Cosopt® ($1·22 ± 0·01). The average cost by year varied from$316·75 ± 5·59 (Combigan®) to$445·96 ± 5·16 (Cosopt®), with a total difference of$129·21 per year of treatment.There was a statistically significant difference in average drop size and cost among the three studied drugs. Combigan® presented the lowest daily cost followed by Xalacom® and Cosopt®. [ABSTRACT FROM AUTHOR]

: PurposeTo characterize the molecular defects in two x-linked retinitis pigmentosa (RP) families. We hypothesized that different RPGR mutations result in distinct RP phenotypes.: DesignObservational case series.: MethodsFifteen members in family I and three members in family II were evaluated. Full ophthalmic evaluations were done. Linkage analyses were performed and likelihood of odds scores (LOD score) were calculated. For mutation analyses, we used dHPLC and automated sequencing.: ResultsTwo novel RPGR mutations were identified in the two families; a Glu 414 (2-bp del) frameshift mutation in family I and an IVS 2–1 (g to a) splice site mutation in family II. All male family members in family I were severely affected by RP but maintained central visual acuities until their 50s and did not develop a bull’s eye maculopathy. The female phenotype was highly variable. Some of the carriers exhibited a severe phenotype, one female displayed an asymmetric phenotype, and other carriers were asymptomatic. All members with the RPGR frameshift mutation exhibited rod-cone electroretinograms abnormalities, whereas five members had hearing loss. Male members of family II were severely affected, with early visual acuity loss, central scotomas, and bull’s eye maculopathy. The female family members were asymptomatic but displayed cone-rod electroretinograms changes. There was no hearing loss.: ConclusionsDifferent RPGR mutations lead to distinct RP phenotypes, with a highly variable inter- and intrafamilial phenotypic spectrum of disease that is associated with the type of mutation in RPGR and nonrandom X chromosome inactivation, respectively. [Copyright &y& Elsevier]

The article focuses on the veterinary medicine research about horner's syndrome of an eastern screech owl, which was presented to the Wild Bird Clinic at the Ontario Veterinary College in Canada. The bird undergone a complete physical examination through radiographs and indirect ophthalmoscopy. The result of the physical examination appeared to be normal. However, the complete blood count of the bird appeared to have abnormalities like mild regenerative anemia and eosinophilia.

Purpose: Globally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries., Methods: Searches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis., Results: We screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by 'all eye care' (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment., Conclusions: The geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

Objectives: Prenatal substance exposure is associated with abnormal visual evoked potentials in offspring, but whether ocular abnormalities are present past infancy is unclear. We determined the association between prenatal substance exposure and hospitalizations for eye disorders in childhood., Methods: We conducted a longitudinal cohort study of 794,099 infants born between 2006 and 2016 in all hospital centers in Quebec, Canada. We identified infants prenatally exposed to opioids, cocaine, cannabis, and other illicit substances and followed them over time to assess eye disorders that required in-hospital treatment, including retinal detachment and breaks, strabismus, and other ocular pathologies. We calculated incidence rates and hazard ratios (HR) with 95% confidence intervals (CI) for the association of prenatal substance exposure with risk of eye disorders, adjusted for patient characteristics., Results: Infants exposed to substances prenatally had a higher incidence of hospitalizations for eye disorders compared with unexposed infants (47.0 vs 32.0 per 10,000 person-years). Prenatal substance exposure was associated with 1.23 times the risk of hospital admission for any eye disorder during childhood compared with no exposure (95% CI 1.04-1.45). Risks were greatest for strabismus (HR 1.55, 95% CI 1.16-2.07) and binocular movement disorders (HR 1.96, 95% CI 1.00-3.83). Opioid use was strongly associated with the risk of ocular muscle disorders (HR 3.15, 95% CI 1.98-5.01)., Conclusions: Prenatal substance exposure is significantly associated with future hospitalizations for eye disorders in childhood. Efforts to minimize substance use in women of reproductive age are needed in light of the current opioid epidemic.

The article presents a study of a Guinea pig evaluated for white spots in its left eye at the Western College of Veterinary Medicine in Canada. It mentions that the Guinea pig was diagnosed with heterotopic bone formation in the anterior uvea. It states that no known treatment is discovered for the condition, but treatment is not necessary.

The article focuses on the commitment of the journal "Academy of Ophthalmic Education (AOE)" to provide information on optometry in Canada. The journal will publish articles related to the therapeutic pharmaceutical agent (TPA) regulations for optometrist, and a review on the non-surgical treatment of eye diseases. Moreover, the journal will provide ongoing continuing education (CE) articles and case studies related to optometry.

The article discusses the importance of vision screening program for Canada's school system. Based on research, approximately 25% of school-aged children have some sort of visual problem, and six out of ten children have difficulty reading as the result of a visual condition that is either uncorrected or undetected. Meanwhile, the Canadian Paediatric Society (CPS), a national association of pediatricians whose mandate is to advance children's health, believes that it is absolutely necessary to have children screened during their pre-school years for eye conditions, ocular diseases, and other visual problems. On the other hand, the College of Opticians of Ontario is running a pilot project in local municipalities and is to be conducted by registered opticians.

Reports on the investigation conducted by Health Canada of the occurrence of sudden peripheral vision loss among users of the erectile dysfunction drug sildenafil. Number of cases investigated by the U.S. Food and Drug Administration; Result of a study on vision problems associated with sildenafil use.

Presents information on the Canadian Foundation for Aniridia Research. Function of the foundation; Membership; Publications.