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Purpose: To compare the proportions of school children with myopia and impaired visual acuity in Greece and Bulgaria. Methods: A sample of 898 children, aged 10–15 years, was selected from two primary and two secondary schools in a Greek city (Heraklion), and one primary and secondary school in a Bulgarian city (Stara Zagora). Five hundred and eighty eight children were Greek (65.5%, mean age 12.5 ± 0.08 years) and 310 Bulgarian (34.5%, age 12.4 ± 0.07 years). VA was assessed with the habitual refractive correction. Refractive error was measured in the absence of cycloplegia using an auto-refractor. Results: The percentage of children, tested with their habitual refractive correction, with decimal VA <0.5 in at least one eye was 11.7% (95% CI 9.1–14.3%) for Greek and 5.2% (95% CI 2.7–7.6%) for Bulgarian pupils. The percentage of myopic children also differed between the two countries with the proportion with myopic refractive error ≤−0.75 D and decimal VA <0.8 at primary school level being 14.1% and 28.9% in Stara Zagora and Heraklion respectively and 13.0% and 46.9% (95% CI 18.2–29.2%, p < 0.0001) at secondary school level. Among the myopic pupils only 35.8% used corrective spectacles in Stara Zagora, compared to 70.7% of the children in Heraklion. Finally, myopia appeared more prevalent in female adolescents with the effect being statistically significant only for Greek children (55% vs 40% of males, p = 0.015). Conclusions: The increased proportion of myopic children in Heraklion, compared to Stara Zagora, may arise from a number of environmental and socio-economic factors, which need to be further investigated in order to understand the differences observed among European populations. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the epidemiological correlation between age-related macular degeneration and pseudoexfoliation syndrome in the inhabitants of the island of Crete (Greece). Subjects and Methods: A total of 777 persons (315 men and 462 women, aged 40-99 years), representing a randomized sample (1.43%) of the Cretan population, underwent slitlamp and fundus examinations according to protocol. The results were statistically analyzed. Results: The prevalence of pseudoexfoliation was 16.1% (21.3% in men and 12.6% in women) and that of maculopathy, 7.9% (11.7% in men and 5.2% in women). The conditions were significantly correlated with each other (P = .002). Also, both displayed a significant direct correlation with age and altitude (for pseudoexfoliation, P < .001 and P = .002 for age and altitude, respectively; for age-related macular degeneration, P<.001 for age and for altitude) and an increase in bilateral incidence with progressing age. Conclusions: The observed prevalences of pseudoexfoliation and maculopathy were lower than those reported in the mainland of Greece and other Mediterranean regions. The correlation between age-related macular degeneration and pseudoexfoliation syndrome may be explained by the relationship of each disease with age and altitude. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy of 2 types of silicone hydrogel bandage contact lenses with high oxygen transmissibility after photorefractive keratectomy (PRK). Setting: Institute of Vision and Optics, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece. Methods: In this prospective study, 1 eye of patients having bilateral PRK was randomly fitted with a bandage contact lens of lotrafilcon A (Night & Day) and the fellow eye, with a bandage contact lens of lotrafilcon B (O2Optix). The patients and the examiner were masked to which bandage contact lens type was in which eye. Patients were examined on the day of surgery and 1, 3, and 5 days postoperatively. Postoperative examinations included uncorrected distance visual acuity and slitlamp biomicroscopy to assess epithelial defect size. Subjective evaluation of pain and vision was recorded 1, 2, 3, and 4 days postoperatively. Results: The study enrolled 44 patients (88 eyes). The mean epithelial defect size immediately after surgery was 47.0 mm2 with both types of bandage contact lenses. There was no statistically significant difference in epithelial defect size between the 2 lenses at any postoperative visit. Three days postoperatively, reepithelialization was complete in 75.0% of eyes in the lotrafilcon A group and 72.7% of the eyes in the lotrafilcon B group. Conclusion: There were no differences in corneal reepithelialization or subjective measurements after PRK between the 2 types of silicone hydrogel bandage contact lenses. [Copyright &y& Elsevier]

Purpose: The primary objective of the study was to explore the statistics of ocular higher-order aberrations in a population of primary and secondary school children., Methods: A sample of 557 children aged 10-15 years were selected from two primary and two secondary schools in Heraklion, Greece. Children were classified by age in three subgroups: group I (10.7±0.5 years), group II (12.4±0.5 years) and group III (14.5±0.5 years). Ocular aberrations were measured using a wavefront aberrometer (COAS, AMO Wavefront Sciences, USA) at mesopic light levels (illuminance at cornea was 4lux). Wavefront analysis was achieved for a 5mm pupil. Statistical analysis was carried out for the right eye only., Results: The average coefficient of most high-order aberrations did not differ from zero with the exception of vertical (0.076μm) and horizontal (0.018μm) coma, oblique trefoil (-0.055μm) and spherical aberration (0.018μm). The most prominent change between the three groups was observed for the spherical aberration, which increased from 0.007μm (SE 0.005) in group I to 0.011μm (SE 0.004) in group II and 0.030μm (SE 0.004) in group III. Significant differences were also found for the oblique astigmatism and the third-order coma aberrations., Conclusions: Differences in the low levels of ocular spherical aberration in young children possibly reflect differences in lenticular spherical aberration and relate to the gradient refractive index of the lens. The evaluation of spherical aberration at certain stages of eye growth may help to better understand the underlying mechanisms of myopia development., (Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.)

Purpose: To assess the in vitro susceptibility of Streptococcus pneumoniae, Staphylococcus aureus and coagulase-negative staphylococci (CoNS) ocular isolates to antibiotics, and identify changing trends in resistance over a 10-year period., Methods: All isolates from ocular infections collected between 2000 and 2009 were prospectively tested against several antibiotics in vitro. S. pneumoniae isolates (n = 93) were tested against 20 and S. aureus (n = 120) and CoNS (n = 214) against 19 antibiotics. To identify changes in susceptibility patterns, we compared results from 2000-2004 with those from 2005-2009. We also compared the antibiotic susceptibilities against aminoglycosides and quinolones between methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) isolates., Results: All S. pneumoniae isolates were susceptible to quinolones, and 99% were susceptible to chloramphenicol. Regarding S. aureus, we noted a significant increase in resistance against penicillin in recent years (p = 0.016). Over 90% of S. aureus isolates were susceptible to quinolones and aminoglycosides. MRSA isolates were more resistant to ciprofloxacin and ofloxacin than MSSA isolates were (p = 0.016). Concerning CoNS, a significant increase in susceptibility to amikacin was noted in the second study period (p = 0.01)., Conclusion: Quinolones remain an excellent treatment option for bacterial conjunctivitis and keratitis due to Gram-positive cocci in our region., (Copyright © 2011. Published by Elsevier B.V.)

Introduction: Estimation of the prevalence of vision impairment in a population can be performed using epidemiological research. The purpose of this study was to measure, using spatial statistics, the prevalence of ophthalmologic disease identified at visits of the Mobile Ophthalmologic Unit (MOU) of the Vardinogiannion Eye Institute of Crete (VEIC) to villages in Crete. The study also aimed to estimate increased 'risk' of ophthalmological disease according to demographic and location factors and, thus, use the present findings as a basis for planning future services., Methods: Estimation of risks for cataract, glaucoma, and refractive errors were assessed by multiple logistic regression models in order to measure the effect of demographic (age, sex) and location (province, distance from nearest ophthalmologist) parameters. Spatial analysis was applied in order to produce a density and probability density map of ophthalmologic disorders using kriging interpolation methods., Results: Newly diagnosed cataracts and refractive errors were found more frequently in locations greater than 70 km from the nearest ophthalmologist (respectively, OR = 6.0 [95% CI = 1.637-9.482]; OR = 27.4 [20.038-39.028] p-value = 0.004). Those aged >60 years had higher risk for all eye abnormalities: cataracts (OR = 0.7; 95% CI = 0.238-0.938), glaucoma (OR = 1.6; 95% CI = 1.227-2.037), and refractive errors (OR = 0.5; 95% CI = 0.183-0.829)., Conclusion: The present study supports the use of local policies and preventive measures in rural areas of Crete in order to improve rural health standards. Some insights concerning the effectiveness of future visits of MOUs are provided, guided by spatial analysis.

Purpose: To evaluate the leading indications for penetrating keratoplasty (PKP) and their trends in Greece during the period 1982 to 2006., Methods: Retrospective data review of 1,929 patients (2233 eyes) who underwent PKP in the period between 1982 and 2006 at three cornea transplantation units of three hospitals in Greece (Athens General Hospital, Heraklion University Hospital of Crete, and Thessaloniki University Hospital). Indications were classified into nine different groups: keratoconus, herpes simplex keratitis, microbial (nonviral) keratitis (fungal, bacterial, and acanthamoeba), aphakic/pseudophakic corneal edema, posttraumatic corneal scars, chemical/thermal injury, regraft, Fuchs' endothelial dystrophy, and other., Results: The leading indications for PKP, in order of decreasing frequency, were aphakic/pseudophakic corneal edema (n = 649 [29.1%]), keratoconus (n = 580 [26%]), regraft (n = 265 [11.9%]), microbial (nonviral) keratitis (n = 188 [8.4%]), posttraumatic corneal scar (n = 171 [7.7%]), herpes simplex keratitis (n = 104 [4.6%]), Fuchs' endothelial dystrophy (n = 104 [4.6%]), chemical/thermal injury (n = 61 [2.7%]), and other (n = 111 [5%]). The prevalence of regrafts as an indication for PKP increased during the study period., Conclusions: Aphakic/pseudophakic corneal edema was the most common indication for PKP in a multicenter series in Greece followed by keratoconus. The number of regrafts dramatically increased during the 25-year period.