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The importance of the corneal epithelium and its role in influencing the refractive state of the eye is well established, as is the association between periocular mass lesions, such as chalazia, and changes in corneal refractive status. This case report provides new evidence linking these 2 phenomena.A 74-year-old man presented with gradual onset of blurred vision in his right eye. Examination revealed a large central right upper lid chalazion, with associated hypermetropic shift. Corneal topography showed central corneal flattening, and anterior segment optical coherence tomography epithelial thickness mapping showed central focal epithelial thinning. The chalazion was treated with incision and drainage and subsequent LipiFlow thermal pulsation treatment. At 3- and 4-month review, corneal epithelial thickness and topographic changes were seen to normalize, with a corresponding return toward emmetropic refractive status.Chalazia can cause reversible corneal epithelial remodeling and should be considered as a differential diagnosis in cases of unexplained vision loss and changes in refractive status.

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.

Facial dysmorphism is a common diagnosis which represents a broad spectrum of aetiologies with different outcomes spreading from normal outcome to foetal demise or new-borns with multiple malformations. Prenatal diagnosis can be difficult, making counselling a challenging task even in experienced hands. This paper aims to present an unusual case of facial dysmorphism (Binder phenotype) which resulted in a normal pregnancy. However, throughout the pregnancy, future parents experienced excruciating anxiety, which required multiple prenatal counselling appointments. We believe that in case of a Binder phenotype, genetic testing, multiple scanning appointments and extensive discussion with future parents are vital in the prevention of an unneeded ending of a pregnancy.

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.

LASIK (Laser-Assisted in Situ Keratomileusis) is the second generation of laser vision correction methods, which replaced PRK (photorefractive keratectomy) and became a wide-spread method of laser keratorefractive surgery. The technology can improve vision in cases of myopia, hypermetropia, and astigmatism. The article analyzes the advantages and disadvantages of the LASIK method, its risks and side effects. Presented data is obtained from the analysis of scientific publications and by practical means.

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.

Photorefractive keratectomy (PRK) is the first generation of laser vision correction, which marked the beginning of the era of laser keratorefractive surgery. The technology can improve vision in case of myopia, hypermetropia, and astigmatism. The article analyzes the advantages and disadvantages of the PRK method, its risks and side effects. The data obtained as a result of the analysis of scientific publications and by practical means are presented.

Refractive errors are the failure of the eye to focus light from an object to the retina to form a clear picture. Refractive disorders are divided into myopia, hypermetropia, and astigmatism. Inadequate light, reading books, watching television and using mobile phones for long periods of time are found to be statistically significant risk factors for refractive abnormalities. The purpose of this study is to analyze the correlation between risk factors for refractive abnormalities. This research is an analytic study with cross sectional research design. Research data is primary data obtained through interviews using a research instrument in the form of a questionnaire. The results were obtained from 96 students, there were 33 students with refractive abnormalities with fewer males than females (24% compared to 76%). The results of statistical calculations with the Chi Square correlation test showed no significant correlation between the occurrence of refractive errors with a history of refractive errors in siblings (p = 0.223), and there was a significant correlation between reading activity (p = 0.001), activity using gadgets (p = 0,0001) and outdoor activities (p = 0.041). The conclusion from this study there is no meaningful correlation between the risk factors of history of refractive errors in siblings and there is a significant correlation between the risk factors of reading activity, activities using gadgets and outdoor activities on the occurrence of refractive errors in students of Bersama Private Middle School Berastagi in 2019.

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: Refractive errors are the second most important cause of blindness and account for 18% of the burden. An estimated 123.7 million people suffer from visual impairment due to unaddressed refractive errors worldwide. International agencies recognize that globally, there is insufficient data on the prevalence and types of refractive errors in different populations and age groups. The present study evaluated the proportion of refractive errors with their clinico-demographic context among 10–24-year old patients, presenting to the Ophthalmology Outpatient Department (OPD) of a tertiary hospital of Bihar state of India. Material and methods: This prospective, descriptive study collected information about refractive errors in 2739 eyes of 1482 young people. The association between the refractive errors and clinico-demographic variables such as age group, gender, residential background and educational status was evaluated using the chi-square test (taking p < 0.05 as significant). Results: Hypermetropic errors were more common (51%) comprising of hypermetropia (32%) and hypermetropic astigmatism (19%). They marginally exceeded myopic errors (about 49%), comprising myopic astigmatism (26%) and myopia (22%) while mixed astigmatism was the least common (0.4%). Myopic errors were significantly more common in the 10–14 years age group (76%) while hypermetropic errors predominated in older age-groups (54%, p < 0.001). Myopia predominated in females (39%) and in rural young people (53%), myopic astigmatism in the illiterate (45%) but hypermetropia in males (37%, p < 0.001), urban (35%, p < 0.001) and literate young people (31%, p < 0.001). Conclusions: This study revealed a broad picture of proportion and predominance of different refractive errors and their associations with clinico-demographic profile of the patients.

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 compare the refractive outcome and residual accommodation with respect to various degrees of iris and skin pigmentation in hypermetropic children using 2 drops of cyclopentolate 1% (C + C) or 1 drop of cyclopentolate 1% and 1 drop of tropicamide 1% (C + T). Methods Two hundred fifty-one hypermetropic children were classified according to iris and skin pigmentation (light, medium, dark) and received randomized and double-blind C + C or C + T. Refractive error (spherical equivalent, SEQ) was determined using the Retinomax-K + 3. In 204 subjects, residual accommodation (RA) was determined using the PlusoptiX PowerRefractor. Results A linear mixed model with a light-irided and light skin-pigmented reference group receiving C + T (mean SEQ +3.10 +/- 1.87D) indicated significant less hypermetropia in subjects with a dark iris having a medium- and dark-pigmented skin in C + T, -1.02 +/- 0.29 (-1.59/-0.45) and -1.53 +/- 0.30 (-2.10/-0.95); and in subjects having a light-, medium- and dark-pigmented skin in C + C, -0.74 +/- 0.34 (-1.41/-0.06), -1.26 +/- 0.30 (-1.85/-0.66) and -1.84 +/- 0.30 (-2.42/-1.26). Similar findings were present for RA. Our model with a light-irided and light skin-pigmented reference group receiving C + T (mean RA +0.84 +/- 0.61D) indicated significantly higher RA in dark-irided subjects with medium- and dark-pigmented skin in C + T, +1.05 +/- 0.19 (+0.67/+1.43) and +1.35 +/- 0.20 (+0.9/+1.74), and in C + C, +1.13 +/- 0.21 (+0.71/+1.55) and +1.90 +/- 0.19 (+1.51/+2.28). Conclusions We found solid evidence that skin pigmentation rather than iris pigmentation is the decisive factor for effectiveness of cycloplegics. Awareness of the limitations of cycloplegic regimens in dark-irided/pigmented children is needed. Our study showed that cyclopentolate 1% combined with tropicamide 1% provides more accurate refractive outcomes both statistically and clinically integrating the factor skin pigmentation for dark-irided subjects.

Purpose To compare the refractive outcome and residual accommodation with respect to various degrees of iris and skin pigmentation in hypermetropic children using 2 drops of cyclopentolate 1% (C + C) or 1 drop of cyclopentolate 1% and 1 drop of tropicamide 1% (C + T). Methods Two hundred fifty-one hypermetropic children were classified according to iris and skin pigmentation (light, medium, dark) and received randomized and double-blind C + C or C + T. Refractive error (spherical equivalent, SEQ) was determined using the Retinomax-K + 3. In 204 subjects, residual accommodation (RA) was determined using the PlusoptiX PowerRefractor. Results A linear mixed model with a light-irided and light skin-pigmented reference group receiving C + T (mean SEQ +3.10 +/- 1.87D) indicated significant less hypermetropia in subjects with a dark iris having a medium- and dark-pigmented skin in C + T, -1.02 +/- 0.29 (-1.59/-0.45) and -1.53 +/- 0.30 (-2.10/-0.95); and in subjects having a light-, medium- and dark-pigmented skin in C + C, -0.74 +/- 0.34 (-1.41/-0.06), -1.26 +/- 0.30 (-1.85/-0.66) and -1.84 +/- 0.30 (-2.42/-1.26). Similar findings were present for RA. Our model with a light-irided and light skin-pigmented reference group receiving C + T (mean RA +0.84 +/- 0.61D) indicated significantly higher RA in dark-irided subjects with medium- and dark-pigmented skin in C + T, +1.05 +/- 0.19 (+0.67/+1.43) and +1.35 +/- 0.20 (+0.9/+1.74), and in C + C, +1.13 +/- 0.21 (+0.71/+1.55) and +1.90 +/- 0.19 (+1.51/+2.28). Conclusions We found solid evidence that skin pigmentation rather than iris pigmentation is the decisive factor for effectiveness of cycloplegics. Awareness of the limitations of cycloplegic regimens in dark-irided/pigmented children is needed. Our study showed that cyclopentolate 1% combined with tropicamide 1% provides more accurate refractive outcomes both statistically and clinically integrating the factor skin pigmentation for dark-irided subjects.

Though the technology has been a boon to us in many ways, continuous watching of digital displays would definitely cause power related problems to the eyes. Power problems are common in all age groups irrespective of the age, Children are facing the critical eye issues by keenly watching the television, they are not even aware of the issue what they are going through. The spectacles are sometimes not effective over the increase in power. Hence the detection of power based vision would reduce the problems. Presbyopia is caused due to ageing factors, whereas myopia and hypermetropia are farsightedness and short sightedness common among the young people who are the victims of being attracted by harmful rays radiating digital displays. To overcome these problems mems based lens is designed as an implant using hydrogel material with flex sensors, which is presented here.

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.