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Purpose We aimed to investigate the association between maternal fasting plasma glucose (FPG) trajectories during pregnancy and children's refractive errors at 6 years of age. Design Based on the Ma'anshan Birth Cohort (MABC) in China, a total of 1987 mother-child pairs were included in this study. Methods Using the group-based trajectory model, trajectory fitting was performed on FPG levels during the first, second, and third trimesters of pregnancy. Children's vision was measured at 6 years of age using the standard logarithmic visual acuity E-chart and cycloplegic refraction examination. Logistic regression models and multi-informant generalized estimating equations were used to analyze the association between maternal blood glucose level and 6-year-old children's visual acuity. Results Children born of mothers with high level FPG trajectory had a higher risk of developing refractive error (odds ratio [OR] = 1.46 [95% CI: 1.08, 1.97]), hypermetropia (OR = 1.64 [95% CI: 1.09, 2.46]), and astigmatism (OR = 1.60 [95% CI: 1.06, 2.41]) at age 6 compared to those with low level trajectory. Maternal blood glucose level in the first (β = −.012 [95% CI: −.024, −.001]) and the second (β = −.016 [95% CI: −.025, −.006]) trimesters was associated with 6-year-old children's distance vision value. Conclusion High level of FPG trajectories during pregnancy has been observed to be associated with 6-year-old children's refractive error, hypermetropia, and astigmatism. The first and the second trimesters may be critical periods for the effects of maternal blood glucose on children's vision. The long-term effect of maternal glucose metabolism on children's visual development deserves further study. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of occlusion therapy on the deviation angle in patients with partially accommodative esotropia (ET) and amblyopia. Study Design: Retrospective chart review. Place and Duration of Study: The medical records of patients attending the pediatric ophthalmology clinic at Elite Hospital, Riyadh, Saudi Arabia between June 2014 and September 2021 were reviewed. Methods: We retrospectively analyzed the pre- and post-therapy, angle of deviation of 63 children with partially accommodative ET who underwent occlusion therapy for amblyopia. Results: The mean angle of deviation before and one month after using the full cycloplegic prescription glasses was 31.74 PD (range,12–85 PD) and 16.5 PD (6–45 PD), respectively. After occlusion therapy (6–18 months), the mean angle of deviation decreased to 10.03 PD (0–45 PD). Thirteen patients (20.63%) underwent surgery after completion of occlusion therapy, which was significantly less than the number of patients that would have been scheduled for surgery before proper occlusion therapy (n = 41, 65.07%). Conclusion: Amblyopia therapy should be completed before surgical intervention in patients with hypermetropia, partially accommodative ET, and amblyopia. There was a significant reduction in ET angle following occlusion therapy. Furthermore, it decreased the number of patients requiring surgery and the angle to be corrected. [ABSTRACT FROM AUTHOR]

Background: The American Optometric Association (AOA), in its 2017 Recommendation for Clinical Practice, proposed cycloplegic testing when initially screening preschool children to detect potential vision-impairing diseases such as strabismus, amblyopia and anisometropia. Aim: This study aims to detect the effect of cycloplegia on the measurement of refractive errors in children. Setting: Ophthalmology department, Al-Azhar University, Egypt. Methods: This retrospective interventional study included 388 children with refractive error attending our outpatient clinic in the ophthalmology department, at Al-Azhar University between January 2020 and April 2022. Cycloplegia was induced in each child with topical eye drops of 1% cyclopentolate instilled two times at 5-min intervals. The same optometrist repeated an auto-refraction 30 min after the last eye drop was applied. Results: We compared the pre- and post-cycloplegic refractions and found that the sphere, spherical equivalence and cylinder had significant hypermetropic shift after cycloplegia (P = 0.001). Conclusion: Cycloplegic refractions are more accurate and eliminate the risk of inaccurate refractive error findings, which is essential when managing children. Contribution: This article provides valuable insight, which may inform public health policy.

Sruthi Vijendran,1,&ast; Yogish S Kamath,1,&ast; Yash Alok,2 Neetha IR Kuzhuppilly1 1Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India; 2Department of Community Medicine, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India&ast;These authors contributed equally to this workCorrespondence: Neetha IR Kuzhuppilly, Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India, Tel +91 98861 61979, Fax +91-820-2571934, Email neetha.kir@manipal.eduPurpose: Refractive error is a major cause of visual impairment in children and its early detection can prevent ocular morbidity such as amblyopia and strabismus. Brückner test is a comprehensive test which can be easily administered in children using a direct ophthalmoscope. We aimed to determine refractive error in children by analysis of the red reflex using modified Brückner test.Patients and Methods: This prospective observational study was conducted on 683 undilated eyes of 683 children aged four to 10 years. They were evaluated with a direct ophthalmoscope from one meter in a dimly lit room. The characteristics of the red reflex and crescent obtained were compared with photoscreener refraction value and analyzed.Results: The presence of superior crescent was associated with hypermetropia (Chi square 37.11, p < 0.001, kappa = 0.15) and inferior crescent with myopia (Chi square 157.29, p < 0.001, kappa = 0.477). Superior crescent was 98.4% sensitive in detecting hypermetropia. Hypermetropia greater than +1.5D, was associated with larger superior crescent crossing horizontal midline of pupil (Chi square = 5.29, p = 0.021).Conclusion: The modified Brückner test is useful in detection and quantification of refractive error in children. It is easy, simple, quick and can be employed in the community as a screening test to detect potentially amblyogenic refractive errors.Keywords: visual impairment, pediatric refraction, hypermetropia, myopia, Brückner test, refractive error

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Introduction: Cycloplegic refraction is necessary in children due to their high amplitude of accommodation. A combination of Tropicamide and Cyclopentolate is commonly used as cycloplegics in children. These medications can cause a substantial elevation in Intraocular Pressure (IOP) in a few susceptible children. Therefore, the present study was conducted to investigate the changes in IOP when 1% Cyclopentolate and 1% Tropicamide were used for cycloplegic refraction in children. Aim: To assess the influence of 1% Cyclopentolate eyedrops and 1% Tropicamide eyedrops on IOP in children undergoing cycloplegic refraction and to compare the changes in IOP between the hypermetropic and myopic groups before and after cycloplegia. Materials and Methods: This cross-sectional hospital-based study was conducted in the Outpatient Department (OPD) of Ophthalmology at KLE’s Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, in Northern Karnataka, India over a duration of six months. The study included 55 children in the age group of 5-15 years who met the inclusion criteria. All children underwent visual acuity assessment and a detailed examination of the anterior and posterior segments of the eye. Refraction was expressed in terms of Spherical Equivalence (SE), calculated as sphere plus half of the cylinder. Based on the SE calculated after refraction, children were diagnosed as having either myopia or hypermetropia as types of refractive error. Data were analysed using International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) Statistics (Version 25.0, Chicago, IL, USA). Categorical variables were represented as frequency and percentages, while continuous variables were represented as Mean±Standard Deviation (SD). A p-value ≤0.05 was considered statistically significant. Results: Out of the 55 children included in the study, 25 children were hypermetropic, and 30 children were myopic based on the calculated SE. Among the total of 55 children, 34 were girls, and 21 were boys. The mean age of the 55 children was 10.98±2.4 years. The mean age of the myopic group was 11.97±2.21 years, while the hypermetropic group had a mean age of 9.74±3.29 years. The mean precycloplegic IOP was 14.21±2.76 mmHg, and the mean postcycloplegic IOP was 15.19±3.25 mmHg. The change in IOP was statistically significant (p≤0.0001). In the hypermetropic group of 25 children, the mean precycloplegic IOP was 13.74±2.55 mmHg, while the mean postcycloplegic IOP was 15.10±3.65 mmHg. There was a significant difference in IOP (p=0.0242). In the myopic group of 30, the mean precycloplegic IOP was 14.47±2.86 mmHg, while the postcycloplegic IOP was 15.08±2.86 mmHg. There was no statistically significant change in IOP in the myopic group (p=0.0669). After cycloplegic mydriasis, 2 eyes (3.7%) experienced an increase in IOP greater than 7 mmHg. Conclusion: Cycloplegic mydriasis using 1% Cyclopentolate and 0.8% Tropicamide caused a significant increase in IOP in a few children, with a higher increase observed in hypermetropic children compared to myopic children. Therefore, ophthalmologists should exercise caution and monitor IOP changes in children undergoing cycloplegic refraction to manage any transient rise in IOP and prevent damage to the optic nerve.

Aim: to evaluate the effectiveness of treatment with Optinol on the condition of the ocular surface in people over 35 years of age with refractive error. Patients and methods. The study was carried out in two clinical and in the control group. The first group included 74 patients (148 eyes) with moderate (group 1a) and high (group 1b) myopia, mean age 38.3 ± 0.4 years. The second group consisted of 49 patients (98 eyes) with moderate (group 2a) and high (group 2b) hypermetropia, mean age 42.3 ± 0.5 years. The control group included 25 healthy individuals (50 eyes), mean age 38.2 ± 1.4 years. The anamnesis of patients, complaints and concomitant diseases were assessed by the questionnaire method. Conclusion. The results of the study proved the influence of moderate and high hypermetropia on the likelihood of dry eye syndrome (DES).

Background The prevalence of refractive errors is reported to be higher in children born preterm. Factors such as gestational age, birth weight, and retinopathy of prematurity status, have a significant impact on the refractive development in preterm infants. Prematurity and low birth weight affect the development of organ systems in infants, including the eyes. In addition to immature retinas, other eye conditions, such as refractive status, are also observed. This study aimed to determine the risk factors of refractive status, specifically refractive errors (spherical equivalent, astigmatism, and anisometropia) in premature infants at a tertiary hospital in Bali. Methods A cross-sectional study was conducted involving 53 premature infants. This study collected samples from January to August 2023 at the Neonatal Intensive Care Unit of Prof. dr. IGNG Ngoerah General Hospital. Data regarding gender, gestational age, birth weight, retinal condition, spherical equivalent, and refractive disorders were collected. The relationship between risk factors and spherical equivalent, astigmatism, and anisometropia were analyzed using multiple regression analysis with statistical significance set at p

Purpose: Uncorrected refractive error is one of the most important causes of visual impairment worldwide. Addressing childhood vision impairment (VI) is one of the main goals of the World Health Organization (WHO) to combat blindness strategies. Objective: To ascertain the prevalence and pattern of refractive errors among children aged 10 to 16 years in Baramulla district, Kashmir. Methods: A cross-sectional study was carried out among 680 school children during an eye camp under the school health program of the national program for control of blindness. The screening was conducted in four schools in Baramulla district, Kashmir. The schools were selected using the non-probability convenient sampling technique. Results: A total of 680 school children from classes sixth to tenth aged 10–16 years participated in the study. Out of 680 students, 545 (80%) had normal vision, 97 (14%) had impaired visual acuity ranging between 6/9 and 6/24, and 38 (6%) had severe VI ranging from 6/36 to 6/60. Among the various types of refractive errors, myopia was the most prevalent affecting 54 children. Age distribution of refractive errors showed myopia to be more prevalent in the age group 13–14 years (16, 14 cases), hypermetropia was more prevalent in the age group 14–15 years (10, 8 cases), and astigmatism 5 cases in the age group 14–15 years. Conclusion: The study provides useful and baseline data about the refractive error amongst the school children of the Baramulla district. A larger study needs to be conducted in all schools of the state to get a clear picture of RE and other eye-related problems to detect vision problems earlier. [ABSTRACT FROM AUTHOR]

With the support of the administrative management of Thracian University (TRU) and in collaboration with St. Petka Eye Clinic Varna, under the supervision of Prof Daniela Mitova, the first screening test - a modern method for early diagnosis of childhood vision - was conducted in October 2023 at the Medical College of TrU, Stara Zagora. It involved about 70 children together with their parents, aged between 2 and 16 years from kindergartens and schools in the city. The screening is carriedr out using the Plus Optix - Handheld Vision Screener. During the screening, the device measures the child's diopters, if any, as well as their interpupillary distance. Any child found to have an abnormality was issued a document for the parent to present to the ophthalmologist. In addition to the screening tests, a stereo test was performed in which special glasses were fitted to the child and he or she had to look into a picture. Eye movement relative to a light source was tracked to rule out the possibility of squinting. A complete eye examination for children with pathology includes: visual acuity testing, stereo test, color vision, anterior and posterior eye segment view. A trial frame with glasses is also used for a quick assessment of the given refractive problem. The obtained results were processed by the methods of variational statistics and visualized using Microsoft Office 2013. Through the screening tests, ocular pathology was detected in 25 out of 70 children examined. The highest relative proportion of children tested positive for hypermetropia (28%), followed by those with myopia (25%). In the remaining young patients examined, high astigmatism, a few cases of amblyopia and anisometropia were found in a small number of cases. There were single cases of esotropia, a type of strabismus in which the child curves one or both eyes inward, and exophoria, in which the eyes tend to deviate outward or one eye moves away from the other. Conjunctival nevi, frequent conjunctivitis, and a difference in pupil size, also known as anisocoria, have been found in some children. The study found that most of the parents were neither well aware nor informed about the proper vision care for their children. Awareness campaign was conducted to involve parents to work with doctors for timely vision prophylaxis to reduce the risk of developing refractive errors, prevention of multiple eye diseases and contributes to children not wearing glasses in future. The application of timely screening significantly reduces the incidence of amblyopia, which becomes indelible after a certain age. The role of parents in the control and health of children's eyes is decisive. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the association of presenting clinical features of asthenopia in madrassa students with different refractive errors. METHODS: This cross-sectional study was conducted from September-November 2022 at different Madrassas in Lahore, Pakistan. Study was performed on a sample of 108 patients, who had different refractive difficulties. Informed consent was taken from the patients aging ≥18 years and from parents/ guardians of patients aging 16 years of age. Common asthenopic symptoms included hazy vision (n=106; 98.1%), headache (n=93; 86.1%), discomfort (n=79; 73.1%), pain (n=76; 70.4%) and eye strain (n=72; 66.7%). Common refractive errors were myopia (n=59; 54.6%), hypermetropia (n=25; 23.2%) and astigmatism (n=24; 22.2%). Severity of refractive errors was mild in majority of cases of myopia (n=24/59; and hypermetropia (n= and moderate in astigmatism (n=16; 64%). Headache, eye strain and blurring of vision had significant association with myopia, hypermetropia, and astigmatism. CONCLUSION: Myopia and hypermetropia are the most common refractive errors; hazy vision and headache are the common asthenopic symptoms. There is a strong association between asthenopic symptoms and refractive errors.

Introduction: Cycloplegic refraction is necessary in children due to their high amplitude of accommodation. A combination of Tropicamide and Cyclopentolate is commonly used as cycloplegics in children. These medications can cause a substantial elevation in Intraocular Pressure (IOP) in a few susceptible children. Therefore, the present study was conducted to investigate the changes in IOP when 1% Cyclopentolate and 1% Tropicamide were used for cycloplegic refraction in children. Aim: To assess the influence of 1% Cyclopentolate eyedrops and 1% Tropicamide eyedrops on IOP in children undergoing cycloplegic refraction and to compare the changes in IOP between the hypermetropic and myopic groups before and after cycloplegia. Materials and Methods: This cross-sectional hospital-based study was conducted in the Outpatient Department (OPD) of Ophthalmology at KLE's Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, in Northern Karnataka, India over a duration of six months. The study included 55 children in the age group of 5-15 years who met the inclusion criteria. All children underwent visual acuity assessment and a detailed examination of the anterior and posterior segments of the eye. Refraction was expressed in terms of Spherical Equivalence (SE), calculated as sphere plus half of the cylinder. Based on the SE calculated after refraction, children were diagnosed as having either myopia or hypermetropia as types of refractive error. Data were analysed using International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) Statistics (Version 25.0, Chicago, IL, USA). Categorical variables were represented as frequency and percentages, while continuous variables were represented as Mean±Standard Deviation (SD). A p-value =0.05 was considered statistically significant. Results: Out of the 55 children included in the study, 25 children were hypermetropic, and 30 children were myopic based on the calculated SE. Among the total of 55 children, 34 were girls, and 21 were boys. The mean age of the 55 children was 10.98±2.4 years. The mean age of the myopic group was 11.97±2.21 years, while the hypermetropic group had a mean age of 9.74±3.29 years. The mean precycloplegic IOP was 14.21±2.76 mmHg, and the mean postcycloplegic IOP was 15.19±3.25 mmHg. The change in IOP was statistically significant (p=0.0001). In the hypermetropic group of 25 children, the mean precycloplegic IOP was 13.74±2.55 mmHg, while the mean postcycloplegic IOP was 15.10±3.65 mmHg. There was a significant difference in IOP (p=0.0242). In the myopic group of 30, the mean precycloplegic IOP was 14.47±2.86 mmHg, while the postcycloplegic IOP was 15.08±2.86 mmHg. There was no statistically significant change in IOP in the myopic group (p=0.0669). After cycloplegic mydriasis, 2 eyes (3.7%) experienced an increase in IOP greater than 7 mmHg. Conclusion: Cycloplegic mydriasis using 1% Cyclopentolate and 0.8% Tropicamide caused a significant increase in IOP in a few children, with a higher increase observed in hypermetropic children compared to myopic children. Therefore, ophthalmologists should exercise caution and monitor IOP changes in children undergoing cycloplegic refraction to manage any transient rise in IOP and prevent damage to the optic nerve. [ABSTRACT FROM AUTHOR]

Purpose: During routine eye examinations, we noticed widened and flattened foveal pits with loss of normal V-shaped foveal profile and a pseudohole-like appearance in some otherwise healthy hypermetropic children. Our purpose was to describe clinical significance and multimodal imaging features of this incidental finding. Methods: Prospectively, 25 eyes of 13 hypermetropic children with these foveal changes and 36 eyes of 19 hypermetropic children with normal foveal appearance were enrolled. The macular thickness measurements and foveal parameters including pit diameter, depth, base, and area obtained by optical coherence tomography (OCT) (Heidelberg Spectralis, Heidelberg Engineering, Heidelberg, Germany), macular superficial and deep vessel density (VD) and foveal avascular zone values obtained by optical coherence tomography angiography (Avanti RTVue‑XR; Optovue, Fremont, CA, USA) were noted. The correlations of these parameters with visual function were evaluated. Results: In the study group, significantly widened and flattened pit contours with decreased central foveal thickness (p = 0.01), and increased distance between foveal edges (p < 0.001) were observed. While the whole image superficial macular VD was similar between the groups (p = 0.74), a significant decrease in deep macular VD was observed in the study group (p = 0.01). None of these changes were correlated with visual acuity. Conclusion: Wider and flattened foveal pits described here represent a newly defined variation in healthy hypermetropic children. Although a correlation with visual acuity was not evident, these changes in foveal profile are shown to be related with macular microvascular changes in deep capillary plexus. Awareness of these morphologic changes will help clinicians in the differential diagnosis of macular pseudohole. [ABSTRACT FROM AUTHOR]

Purpose: India has the largest population of youth in the world, thereby making them important contributors to the “India of Tomorrow”. Over 80% of knowledge gained is by the visual sense, thereby making school screening programs a necessity in our country. Data from the pre-COVID era, that is, 2017–18 was collected from close to 19,000 children in Gurugram, Haryana, a tier two city in National Capital Region, India. A similar prospective observational study is planned post COVID-19 (2022–23) for further analysis to depict the impact of COVID-19 in these areas. Methods: The program They See, They Learn was set at government schools in the area of operations (district of Gurgaon, Haryana), where the children and their families were unable to afford eye care services. All children who were screened underwent a comprehensive eye examination at the school premises itself. Results: A total of 18,939 students were screened over a period of 18 months, covering a total of 39 schools in the Gurugram belt, in the first phase of the program. Eleven point eight percent (n = 2254) of all school students had some form of refractive error. Girl students were found to have a higher refractive error rate (13.3%) compared to boy students (10.1%) across the schools screened. Myopia was the most common type of refractive error. Conclusion: School students require perfect vision or else they can be discouraged and may become a major burden to the economy of any developing nation. A school screening program aiming at populations that cannot afford such basic needs like spectacles is a must in all zones of the country.

Cornea plana (CP) is a rare ocular condition existing in two distinct clinical and hereditary forms: a milder, autosomal dominant type I and a more severe, autosomal recessive type II. The condition is more commonly found in Finnish, Saudi, and Czech families. We report three brothers from a consanguineous marriage that presented with complaints of decreased vision of varying degrees. All three of them have blue, thick, and hazy corneas with shallow anterior chamber depths. The additional features of CP type II were seen in the older two brothers including arcus lipoids, ill-demarcated limbus, and an accommodative squint. They were managed by the correction of refractive errors through spectacles and detailed counseling with follow-up visits to look for progressive complications. The management is mainly centered around optically or surgically correcting the developmental anomalies. This is complimented with proper genetic counseling and regular follow-up visits to look for and manage complications. There are, however, novel therapies that can be considered in these patients including corneal transplants or corneal stromal stem cellular therapies.

Aim The aim of this research was to study the distribution and patterns of refractive errors (REs) among school children and the incidence of amblyopia in each type. Patients and methods This is an observational nonrandomized population-based cross-sectional study that included children aged 6-18 years attending the Outpatient Clinic of Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt. All children were subjected to comprehensive eye examination including best corrected visual acuity (BCVA), expressed in LogMAR, cycloplegic REs that was documented using a NIDEK auto-refractometer-keratometer, cover-uncover testing, and fundus examination. The prevalence of REs, amblyopia, and anisometropia was estimated. Results The study included 960 children (1920 eyes), with a mean age of 13.08±3.41 years. Emmetropia was found in 834 (43.4%) eyes, while myopia was reported in 587 (30.6%) eyes, hypermetropia in 114 (5.9%) eyes, and myopic astigmatism in 385 (20%) eyes. Anisometropia was reported in 65 (6.77%) children, while amblyopia was found in 49 (5.1%) eyes. The amblyopia prevalence was statistically significantly higher among the hypermetropic group (3.9%) than the myopic astigmatism group (1.2%), (P = 0.031). Conclusion The overall prevalence of REs among the examined children was 56.6% mainly myopia followed by myopic astigmatism and lastly hypermetropia. This draws the attention to the increased incidence of myopia which needs further social studies.

Purpose: To describe a condition with the following features: chronic central serous chorioretinopathy (CCSC), chorioretinal folds, scleral changes (including any of the following flattened or 'squared off' posterior pole, 'T sign', or thickened ocular coats), accompanied by a short axial length and hypermetropia in a series of 7 patients. Methods: The case notes of 7 patients presenting with a combination of CSC, choroidal folds scleral changes and hypermetropia were reviewed as part of a retrospective case series. Corrected visual acuities, serial refraction, colour imaging, fluorescein and indocyanine green angiography findings, together with B-ultrasound scan features were recorded, with axial length measurements as available (< 23.3 mm was defined as short). Results: The study included 14 eyes of 7 subjects (2 females and 5 males) with a primary presentation of central vision disturbance. All patients showed signs of previous or current episodes of the following features in at least one eye: CSC (5/7 bilateral); choroidal folds (6/7 bilateral), thickening of ocular coats in the 5 in whom this was measured, at least one scleral abnormality on ultrasound in at least one eye. A short axial length at final appointment was recorded in 13/14 eyes. Conclusions and relevance: The combination of CCSC with choroidal folds, hypermetropia with apparent shortening of the eyeball associated with one or more scleral abnormalities such as a flattened or 'squared off 'appearance of the B ultrasound may be a specific ocular condition. The aetiology of this particular combination of posterior segment manifestations is unknown; the choroid could be the primary focus of disease with secondary involvement of the sclera. Alternatively, the features observed may result from a chronic inflammatory process affecting the sclera with secondary effects on the choroid, retinal pigment epithelium and retina. In our case series, the final vision was not significantly different from vision at presentation. [ABSTRACT FROM AUTHOR]

Background: The prevalence of refractive errors has sharply risen over recent decades. Despite the established role of genetics in the onset and progression of such conditions, the environment was also shown to play a pivotal role. Indeed, the COVID-19 pandemic has majorly impacted people's lifestyles and healthy habits, especially among the youth, which might have led to a significant increase in this trend. Therefore, the aim of this study was to investigate the actual prevalence of refractive errors in a large cohort of pediatric patients. Methods: A large cohort of 496 participants was screened through anamnesis, a non-cycloplegic autorefractometry, a corrected and uncorrected visual acuity assessment, and a questionnaire and was retrospectively evaluated. Results: Overall, refractive errors were present in 25.1% of eyes, of which 14.6% were diagnosed with myopia/myopic astigmatism and 10.5% with hyperopia/hyperopic astigmatism. Among the patients enrolled, 298 (60%) had their eyes checked one year earlier or before and 122 (25%) had never had ophthalmological consultations; a total of 105 (21%) needed glasses and 34 (7%) required a change in their previous prescription. A substantial increase in daily electronic device screen exposure was declared by 426 patients (87.6%). Conclusions: Pediatric patients appear to have a higher prevalence of refractive errors than before. [ABSTRACT FROM AUTHOR]

Purpose: To describe clinical characteristics of horizontal strabismus in Sudanese patients. Purpose: To describe clinical characteristics of horizontal strabismus in Sudanese patients. Place and Duration of Study: Al-Neelain Eye Hospital, Khartoum, Sudan, from January 2017 to May 2021. Methods: There were 773 patients, who presented with horizontal strabismus. Data regarding demographics and eye examination including visual acuity, refractive error, and angle of deviation, type of strabismus (intermittent, constant, or alternating) were collected. Data analysis was done by SPSS 23 and statistical significance was set at P< 0.05. Results: The commonest strabismus was esotropia 522 (71.5%). There were 415 (56.8%) females. Most patients had alternating strabismus 436 (59.7%), followed by constant strabismus 206 (28.2%). Vision differed by types of strabismus (P =0.032) with worse vision found in esotropia (mean, 0.69 ± 0.34) compared to exotropia (mean, 0.78 ± 0.33). Refractive error varied by types of strabismus. Hyperopia was common with esotropia (mean, +3.9 ± 3.8 D)and myopia was associated with exotropia (-3.4 ± 2.8 D). The main cause of horizontal strabismus was congenital and presence of refractive error. Hyperopia was a major cause of esotropia for children aged 6 - 10 years which was highly significant (P < 0.003) and myopia was the primary reason for exotropia at > 15 years (P = 0.485). Conclusion: The most common type of strabismus among Sudanese was esotropia. Causes of strabismus differed by age group with refractive error and congenital disorders accounting for most of the children aged less than six years and myopia for the majority of exotropia aged more than 15 years. [ABSTRACT FROM AUTHOR]

Background: In eyes with significant hyperopia, where attaining precise surgical refractive outcomes may be particularly problematic, the predictive efficiency of the formulas falls. Aim of work: The goals of this research were: (1) To determine how well the individual can see after having cataract operation in hyperopic persons utilizing the IOL master (Carl Zeiss Meditec, Inc., Dublin, CA, USA) & the Topcon RM-8000B, and (2) To contrast the prediction error of two biometric equations (Hoffer Q and SRK/T). Methods: Our study was an observational clinical study (analytical cross-sectional). 180 eyes from 180 patients of both sexes with axial length below 22 mm were recognized from individuals performing cataract surgery by phacoemulsification at Ophthalmology Department, Faculty of Medicine, Suez Canal University. A sample of cases was chosen & divided into two groups, each including 90 eyes. One group used Hoffer Q formula (n= 90) and the other group used SRK/T formula (n= 90). Biometry was performed on all participants utilizing the intraocular lens (IOL) master. Each participant had one of their eyes chosen at random. Errors in prediction were computed by comparing preoperative refraction with the refraction measured after surgery utilizing the improved formulae (Hoffer and SRK/T). Results: Our findings also revealed that the Hoffer Q formula is not with greater precision than SRK/T formula in refractive outcome in hypermetropic patients undergoing cataract surgery as there was no significant variation among them in refractive outcome. Conclusion: Hoffer Q formula is not superior in terms of accuracy to SRK/T formula in refractive outcome in hypermetropic patients undergoing cataract surgery as there was no significant distinction among them in refractive outcome. [ABSTRACT FROM AUTHOR]

Cornea plana (CP) is a rare ocular condition existing in two distinct clinical and hereditary forms: a milder, autosomal dominant type I and a more severe, autosomal recessive type II. The condition is more commonly found in Finnish, Saudi, and Czech families. We report three brothers from a consanguineous marriage that presented with complaints of decreased vision of varying degrees. All three of them have blue, thick, and hazy corneas with shallow anterior chamber depths. The additional features of CP type II were seen in the older two brothers including arcus lipoids, ill-demarcated limbus, and an accommodative squint. They were managed by the correction of refractive errors through spectacles and detailed counseling with follow-up visits to look for progressive complications. The management is mainly centered around optically or surgically correcting the developmental anomalies. This is complimented with proper genetic counseling and regular follow-up visits to look for and manage complications. There are, however, novel therapies that can be considered in these patients including corneal transplants or corneal stromal stem cellular therapies. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence of refractive errors and their types among medical students at the University of Tabuk, Saudi Arabia. Design: A quantitative, cross-sectional, descriptive study using self-administered electronic questionnaires. Materials and Methods: We conducted our study among medical students and interns that included 325 participants at the University of Tabuk using a self-administered questionnaire that contains demographics and an assessment of refractive errors. Results were stratified according to gender, age group, and academic year. Results: Around half of the participants wear eyeglasses. 43.2% of the females are myopic, while 30.6% of males have myopia. Hypermetropia was found in 7.7% of females and 6.4% of males. Astigmatism was reported in 13.5% of females and 16.8% of males. Discussions: The percentage of students with eyeglasses at University of Tabuk is higher than in Al-Kharj. Compared with students at Jazan University, our results showed a comparable proportion of myopia, a lower percentage of hypermetropia, and a higher percentage of astigmatism. Conclusions: Refractive errors were documented in many medical students at the University of Tabuk. Further studies regarding visual impairment among undergraduates are needed to identify the associated risk factors so preventive methods can be applied. [ABSTRACT FROM AUTHOR]

Copyright of Lege Artis Medicine (LAM) is the property of LifeTime Media Kft. 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.)

Purpose: India has the largest population of youth in the world, thereby making them important contributors to the "India of Tomorrow". Over 80% of knowledge gained is by the visual sense, thereby making school screening programs a necessity in our country. Data from the pre-COVID era, that is, 2017–18 was collected from close to 19,000 children in Gurugram, Haryana, a tier two city in National Capital Region, India. A similar prospective observational study is planned post COVID-19 (2022–23) for further analysis to depict the impact of COVID-19 in these areas. Methods: The program They See, They Learn was set at government schools in the area of operations (district of Gurgaon, Haryana), where the children and their families were unable to afford eye care services. All children who were screened underwent a comprehensive eye examination at the school premises itself. Results: A total of 18,939 students were screened over a period of 18 months, covering a total of 39 schools in the Gurugram belt, in the first phase of the program. Eleven point eight percent (n = 2254) of all school students had some form of refractive error. Girl students were found to have a higher refractive error rate (13.3%) compared to boy students (10.1%) across the schools screened. Myopia was the most common type of refractive error. Conclusion: School students require perfect vision or else they can be discouraged and may become a major burden to the economy of any developing nation. A school screening program aiming at populations that cannot afford such basic needs like spectacles is a must in all zones of the country. [ABSTRACT FROM AUTHOR]

In recent years, due to advances in surgical technique, instruments and design of intraocular lenses (IOLs), patient expectations of cataract surgery have increased significantly, often matching those after refractive interventions. A number of factors affect postoperative visual acuity, including the presence of concomitant pathology in patients, the experience of the surgeon, the choice of IOL model and other factors. In the presence of “short” eyes, with an axial length of less than 22 mm, the formulas available in the arsenal for calculating the optical power of the IOL are less accurate than for eyes with normal sizes, which is of great difficulty for the surgeon. The most important factors include the choice of model and calculation of IOL optic power associated in case of failure with patient dissatisfaction with the treatment. The review discusses the definitions of the concepts of hyperopia, microphthalmos and nanophthalmos. The sources of errors are presented when choosing a formula for calculating the IOL optic power, including the use of various instruments for measuring axial length and other parameters of the eye. The necessity of optimizing the IOL constants for “short” eyes is given. The effectiveness of the main currently used formulas is considered, including Hoffer Q, Haigis, Holladay 1, Holladay 2, SRK / T, Barrett Universal, Super Formula, Olsen, T2, Hill-RBF, Kane. Progress in lens disease surgery does not stand still and is aimed at improving diagnostic equipment and standardizing and synchronizing various types of biometers, increasing the number of variables in formulas for calculating the IOL optic power, further standardizing diopter power in the manufacturing of IOLs, and the need to develop a unified formula for calculating optical power Artificial Intelligence IOL with the possibility of its constant access to a huge array of preoperative research data manhole and postoperative assessment of results. Management of patients with an axial length of less than 22.00 mm remains a challenge for ophthalmic surgeons, given the difficulties encountered in choosing an IOL and the complications of surgery. The available formulas for calculating the IOL optic powerneed to be adjusted for this group of patients.

Purpose: to choose the optimal formula for calculating the IOL optical power in patients with an axial eye length of less than 20 mm.Patients and methods. A total of 78 patients (118 eyes) were included in the prospective study. Group I included 30 patients (52 eyes) with extremely short eyes (average axial eye length of 19.60 ± 0.42 (18.54–20.00) mm), group II consisted of 48 patients (66 eyes) with a normal axial length 22.75 ± 0.46 (22.00–23.77) mm with implantation of various monofocal IOL models. The average follow-up period was 13 months. IOL optical power was calculated using the SRK / T formula, retrospective comparison — according to the formulas Hoffer-Q, Holladay II, Olsen, Haigis and Barrett Universal II.Results. In group I, the maximum average estimation error was determined for the formula Haigis (0.88 ± 0.35), then for the formula Olsen, Barrett Universal II, Kane, SRK / T, Holladay 2 and Hoffer-Q (0.51 ± 0.12, 0.16 ± 0.38, 0.13 ± 0.28, 0.10 ± 0.59, 0.05 ± 0.54 and –0.12 ± 0.42, respectively). Similar data were obtained for the average absolute error — for the formulas Haigis, Olsen, Barrett Universal II, SRK / T, Holladay 2, Hoffer-Q and Kane, it was 0.85 ± 0.31, 0.78 ± 0.25, 0.21 ± 0.10, 0.79 ± 0.23, 0.73 ± 0.24, 0.19 ± 0.08 and 0.17 ± 0.06, respectively. When comparing the formulas, significant differences were found for the formulas Hoffer-Q, Barrett Universal II and Kane in comparison with the formulas Haigis, Olsen, SRK / T and Holladay II (p < 0.05) in all cases, respectively, which indicates the advantage of these formulas for the group patients with extremely short eyes. In group II, there were no significant differences between the studied formulas (p > 0.05).Conclusion. This paper presents an analysis of our own data on the effectiveness of six formulas for calculating the IOL optical power in extremely short (less than 20 mm) eyes in comparison with the normal axial length. The advantage of the Hoffer-Q, Barrett Universal II and Kane formulas over Haigis, Holladay 2, Olsen, and SRK / T is shown. To determine the exact indications for using these formulas, further studies are necessary taking into account the anterior chamber depth and a lesser degree of hyperopia.

Introduction: In children uncorrected refractive errors have a profound effect on educational and psychosocial development hence it is necessary to estimate the prevalence both at the community and at the school level to aid planning and implementation of refractive error services in children. Objective: To determine the refractive status of 5 to 15 years old children attending government schools of rural areas of district Agra, Uttar Pradesh (UP), India. Method: Study conducted on 902 students of age group 5-15 years of randomly selected government schools of Bichpuri Block of district Agra. Children underwent visual acuity assessment and torch light examination, height and weight measurement. Children with VA ≤6/9 were further examined and cycloplegic retinoscopy, fundus examination, slit lamp examination and post mydriatic refraction was done. On the basis of values of cycloplegic refraction and post mydriatic refraction, refractive error was classified as myopia, hypermetropia and astigmatism. Statistical Analysis was done by applying Chi square test. Result: Out of 902 children, 125 children (13.86 %) were having refractive error of which 76 were myopic (8.43%), 39 were astigmatic (4.32%) and 10 were hypermetropic (1.11%). There was an increase in the overall prevalence of refractive error with advancing age. There was no significant association of refractive error with gender and nutritional status. Conclusion: Vision screening of school children is very useful for early detection and correction of refractive errors. Screening of the refractive errors in school should be carried out periodically and regularly.

Introduction: Worldwide refractive error remains one of the most common causes of visual impairment in children. Uncorrected refractive error can lead to long term effect on acadaemic progression and employment opportunities. The study was conducted in remote area of district of Kathua, Jammu, India. Aim: To estimate type of refractive error among children and its association with demographic characters. Materials and Methods: The descriptive, cross-sectional, observational, hospital-based study was carried out in Out Patient Department (OPD) of Ophthalmology, Government Medical College, Kathua. The study of population included 351 children of age 5-16 years with complaint of diminution of vision. Examination included visual acuity recording, slit lamp, fundus examination and dilated retinoscopy. Inferential statistics was calculated using Open Epi version 3.01 Results: Out of 1582 children, 351(22.18%) children had refractive error. Their mean age was 12.52±2.87 years. The refractive errors were more common in the age group 13-16 years (61.5%), followed by 9-12 years (29.9%), and 5-8 years (8.51%). Refractive errors were more in males (56.12%) as compared to females (43.87%); 247(70.37%) children had refractive error in both the eyes, whereas 104(29.6%) had it in one eye. Astigmatism was most common (50.14%) followed by myopia (40.45%), hypermetropia (7.4%) and amblyopia (1.99%). Maximum astigmatism was seen in 13-16 years (56.25%) followed by 9-12 years (34.09%) and least in 5-8 years (9.65%). Conclusion: A high percentage of refractive errors in the study indicate that school health services should be strengthened and implemented effectively.

Background and Objective: The fracture rate in the range recommended is planted in the event of a patient suffering from myopia/hypermetropia between 10 and -20 diopters in the case of the patient suffering from astigmatism and maximum refractive rate in the lens to +6 diopters. Objective: This study aimed to examine patients after the surgery compared to visual acuity before and after the procedure. Methods: This study included 25 patients who came to Al-habobi Teaching Hospital and underwent treatment by planting lens to get the best visual acuity. Results: The difference between extracapsular cataract extraction (ECCE) and (phaco) emulsification resulting in cataract surgery was determined, where one is better than the other. 3 cases underwent E.C.C.E operation, and 22 cases underwent phaco surgery. phacoemulsification (PACHO) was good or better for visual acuity post-operation without complications, unlike E.C.C.E, which had some side effects such as astigmatism Conlcusion: Phacoemulsification (PACHO) is better for visual acuity post-operation without complications, unlike additional E.C.C.E, which has some side effects such as astigmatism. [ABSTRACT FROM AUTHOR]

Purpose: To study the effect of refractive errors on pattern visual evoked potential (VEP) recordings in the pediatric population. Methods: This cross-sectional observational study assessed 240 eyes of 120 participants attending the outpatient department of a tertiary care center in North India. Participants were between 8 and 18 years of age; 30 participants each were recruited into four groups, namely emmetropia, myopia, hypermetropia, and amblyopia. They were then subjected to pattern reversal VEP, with P-100 amplitude and latency recorded for each participant. Results: The emmetropic group in this study provided normal values of P-100 parameters, namely P-100 latency and P-100 amplitude with readings of 115.78 ± 10.19 ms and 11.11 ± 4.08 μV, respectively. P-100 amplitude was significant compared to P-100 latency in detecting the presence or absence of a specific type of refractive error. It was found that there was a significant association between severity of myopia and P-100 latency (both unaided and aided) with P < 0.05. The severity of hypermetropia showed a significant association with P-100 amplitude (unaided) (P < 0.05). Receiver operating characteristics analysis revealed P-100 amplitude to be a good predictor of refractive error and the cut-offs were calculated. Conclusion: The P-100 parameters of the pediatric Indian population were comparatively higher than conventional values. P-100 latency seemed to better correlate with myopia, while hypermetropia correlated with P-100 amplitude. P-100 amplitude appears to be the most significant predictor of the presence of refractive error in an individual.

AIM: The aim of this study is to determine the outcome of accommodative esotropia (ET) and influencing factors in young Omani children. SUBJECTS AND METHODS: In this retrospective cohort, children diagnosed with accommodative ET who had followed up in a tertiary hospital from 2006 to 2011 were identified. Parameters studied included cycloplegic refraction and its change with time, ocular alignment, binocularity, visual acuity (VA), amblyopia, and requirement for surgery. RESULTS: A total of 51 patients were identified. Twenty-four patients were diagnosed with fully accommodative ET (FAET) and 27 with partially accommodative ET (PAET). The mean (± standard deviation [SD]) age of onset and reporting were 2.6 (±1.58) and 3.2 (±1.84) years in the two groups, respectively. The mean (SD) cycloplegic refraction at presentation was 4.50 (±1.66) in the FAET group and 3.65 (±1.67) in the PAET group. Anisometropia was present in 28% of patients. The mean follow-up period was 4.9 years. The following were detected in the final visit. A reduction in amblyopia from 43% to 6% of patients, binocularity in 75% of patients, and a mean increase of 0.64 (±1.3) D in cycloplegic refraction from the first visit (P = 0.005). The mean angle of deviation at near and distance was 29.86 (±15.21) and 17.80 (±10.14) prism diopters, respectively, in FAET patients and 30.15 (±14.83) and 29.53 (±15.53), respectively, in PAET patients. Thirty-seven percent of the PAET patients underwent surgery within 5 years from diagnosis. All participants in this cohort continued to wear glasses in the last follow-up visit. CONCLUSION: Most children with refractive accommodative ET have an excellent outcome in terms of VA and binocular vision. The PAET group was characterized by delayed reporting, the presence of anisometropia, and lower hypermetropia. Further study is required to determine the possibility of weaning glasses in FAET patients.

This study aimed to evaluate the association between intelligence and refractive error in children. Children with refractive error were consecutively enrolled from the outpatient eye disease clinic at the blinded for peer review. Seventy-six Turkish children were thirty-two female and Forty-four male, aged 6-16 years, participated in this study. Wechsler Intelligence Scale for Children Revised was used for Intelligence quotient. Full Intelligence quotient score and verbal Intelligence quotient, picture completion, similarities comprehension, digit span subgroups in children with myopia were higher than that of hypermetropia group (p<0.05). Present study indicated cognitive ability in children with myopia is higher than that of hypermetropia children. The mechanisms of high cognitive ability in children with myopia should be described in further studies. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: To study the effect of refractive errors on pattern visual evoked potential (VEP) recordings in the pediatric population.Methods: This cross-sectional observational study assessed 240 eyes of 120 participants attending the outpatient department of a tertiary care center in North India. Participants were between 8 and 18 years of age; 30 participants each were recruited into four groups, namely emmetropia, myopia, hypermetropia, and amblyopia. They were then subjected to pattern reversal VEP, with P-100 amplitude and latency recorded for each participant.Results: The emmetropic group in this study provided normal values of P-100 parameters, namely P-100 latency and P-100 amplitude with readings of 115.78 ± 10.19 ms and 11.11 ± 4.08 μV, respectively. P-100 amplitude was significant compared to P-100 latency in detecting the presence or absence of a specific type of refractive error. It was found that there was a significant association between severity of myopia and P-100 latency (both unaided and aided) with P < 0.05. The severity of hypermetropia showed a significant association with P-100 amplitude (unaided) (P < 0.05). Receiver operating characteristics analysis revealed P-100 amplitude to be a good predictor of refractive error and the cut-offs were calculated.Conclusion: The P-100 parameters of the pediatric Indian population were comparatively higher than conventional values. P-100 latency seemed to better correlate with myopia, while hypermetropia correlated with P-100 amplitude. P-100 amplitude appears to be the most significant predictor of the presence of refractive error in an individual. [ABSTRACT FROM AUTHOR]

Aim To establish the prevalence of refractive errors in preschool and school children between 4 and 15 years of age, living in Tuzla, Bosnia and Herzegovina. Methods Children from all elementary schools in the city of Tuzla and as well from eight day-care centres were screened for refractive errors in the period 2015-2019. Any child, who failed to pass the screening examination, was referred to an ophthalmologist for complete ophthalmological evaluation. The obtained data were analysed using non-parametric statistics. Results The highest number of children who were tested after the screening process was during 2015. A total of 7415 children (3790 males and 3625 females), in the age range of 4-15 were screened. In the total sample of children who were completely evaluated (n=145; 290 eyes) the most common refractive error was astigmatism, in 152 (52.4%) eyes. In the preschool children (n=18; 36 eyes), the most common refractive error was astigmatism, in 19 (52.8%) eyes, followed by hyperopia, in 9 (25%) eyes. In the school children (n=127) (254 eyes), the most common refractive error was astigmatism, in 133 (52.4%) eyes, followed by myopia, in 92 (36.2%) eyes. The overall prevalence of refractive errors was 1.95% (145 with refractive error out of 7415 screened). Conclusion Prevalence of refractive errors is high enough to justify a school eye screening programme.

We present the results of visual screening in Aghosh special school in Karachi. Complete ocular examination was done with special attention to visual acuity, refractive errors, and frequency of associated syndromes in 103 individuals, from July 2022 to December 2022. Age ranged between 5 and 25 years. There were 50.5% females and 49.5% males. Majority of the subjects (62%) had visual acuities of 6/6 – 6/12 in both eyes, followed by 27% of subjects with visual acuities of 6/18 – 6/60, 7.7% had visual acuities of 6/60-3/60, and 2.9% had less than 3/60. Down syndrome was seen in 34%, mental retardation in 55.3% and ADHD in 10.7%. Hypermetropia was the commonest refractive error and exotropia was the commonest ocular deviation. [ABSTRACT FROM AUTHOR]

Introduction: Uncorrected refractive errors form a major ocular morbidity in children. They often go unnoticed and affect child development. The prevalence of refractive error in Indian children is 10.8%. They are known to affect the overall development of children. However, if the error is high it could lead to amblyopia or strabismus. Snellen's visual acuity along with cycloplegic refraction is an accepted method to detect refractive errors, but in children, it needs special skill, patience and understanding. The Brückner test is useful for early detection of refractive errors especially in children. Aim: To re-evaluate the results of Brückner test in the form of sensitivity, specificity and provide data about a simpler, easy, ergonomic technique for mass screening of refractive errors. Materials and Methods: This cross-sectional study was conducted at Bharati Hospital (tertiary care hospital), Pune, Maharashtra, India, among 532 children (1064 eyes) in the age group of 2-15 years visiting the Ophthalmology Outpatient Department from October 2018 to September 2020. Position and size of pupillary crescent was recorded among children with direct ophthalmoscope. Children were classified according to errors of refraction as Emmetropia (no crescent), Myopia {inferior crescent (mild (<1/3), moderate (1/3-2/3), high (>2/3)}, Hypermetropia {superior crescent (mild (<1/3), moderate (1/3-2/3), high (>2/3)}. Subsequently, cycloplegic refraction was performed using autorefractometer. Sensitivity, specificity, positive predictive value and negative predictive value of the test for emmetropia, myopia and hypermetropia were calculated. Subjective refraction was prescribed to children diagnosed with refractive errors during the course of this study. Results: Total 275 females and 257 males (mean age 8.3 years) were included in this study, out of which, the study found 354 Emmetropic eyes, 326 Myopic eyes and 384 Hypermetropic eyes. Sensitivity of Brückner for emmetropia was 86.4%, specificity was 95.2%. Whereas for myopia, sensitivity was 95.1% and specificity was 94.6%. Also for hyperopia sensitivity was 95.3% and specificity was 98.8%. The crescent size was found to be significant (p-value<0.001) in diagnosing grades of myopia and hypermetropia as divided. Conclusion: The Brückner test has good sensitivity, specificity, positive and negative predictive value. It is a useful, accurate, and simple screening test. [ABSTRACT FROM AUTHOR]

Introduction: There are some population-based studies on refractive errors from India, but to the best of our knowledge, there is no hospital- or population-based study on refractive errors in 5 to 70 years (children and adults both) of age group reported from central India. Methodology: Records of all the patients who presented at the hospital with visual acuity of 6/9 or less and showed improvement in distance vision of one or more lines with refraction were reviewed. Results: In present study, on evaluating the different types of refractive errors, it was found that most common refractive errors in right eye was simple myopic astigmatism (29.3%) followed by compound myopic astigmatism (27.5%) and compound hypermetropic astigmatism (10.7%). Similarly, in left eye most common refractive errors reported was compound myopic astigmatism (28%) followed by simple myopic astigmatism (22.8%) and simple hypermetropia (17.4%). Conclusion: Most prevalent refractive error in present study was compound myopic astigmatism.(27.5%). [ABSTRACT FROM AUTHOR]

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 subconjunctival 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. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Univesity of Thi-Qar is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) 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.)

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. 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. 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%. 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. [ABSTRACT FROM AUTHOR]

Objective: To identify the prevalence of refractive errors and their different types in school going children. Study Design: Cross-sectional analytical study. Place and Duration of Study: Schools located in Mangla Cantonment and Combined Military Hospital (CMH) Mangla, from May 2017 to Jun 2017. Material and Methods: Two qualified nursing assistants were sent to two schools located in Mangla cantonment, after obtaining prior permission from school authorities. They checked distance visual acuity of all the present students of these schools. The children with impaired visual acuity were then sent to a consultant ophthalmologist at CMH Mangla who obtain detailed history regarding asthenopic symptoms, ocular diseases and of wearing glasses. Their ocular examination was carried out which included refraction and slit lamp examination. Cycloplegic refraction of children less than 8 years of age was done. Results: A total of 2491 children were included in this study. But only 235 (9.4%) children were diagnosed to have refractive error; out of which 109 (46.4%) were males and 126 (53.6%) were females. Refractive errors were more common in children of age 10 years and above i.e. 82% as compared to children less than 10 years of age (18%). In our study, myopia was the most common (42.2%) refractive error diagnosed. In children below 10 years of age, Simple astigmatism was more prevalent (40.5%) whereas in 10 years and above age group, myopia was the commonest (46.6%). Hypermetropia constituted 8.9% of total refractive error diagnosed and it was more prevalent in 10 years and above age group (9.4%). Compound astigmatism was more prevalent in 10 years and above age group (30.5%). Simple astigmatism was 11.9% of total refractive errors and it was more prevalent in below 10 years age group (40.5%). Mixed astigmatism was also found to be more prevalent in below 10 years age group (16.7%). Conclusion: Myopia was the commonest refractive error among school going children. However prevalence of different types of refractive errors varies between different age groups.

Modern human life conditions are associated with the increase of visual load in the volume and intensity. It determines the social and scientific significance of the study of the visual system functional capabilities with refractive errors. Due to peculiarities such types of ametropia as hypermetropia, hypermetropic and mixed astigmatism are the cause of inadequate load on the visual analyzer. Foreign and Russian scientists mainly pay attention to the study of these functions in childhood, adolescence or presbyopic age. We studied the frequency and degree of binocular and accommodative disorders in adult patients (18–48 years) with hypermetropia, complex hypermetropic and mixed astigmatism. Depending on the type of ametropia, the patients were divided into 2 groups. Group I Hm ast included 58 patients with hypermetropia and complex hypermetropic astigmatism, group II Mixed ast — 60 patients with mixed astigmatism. Patients were divided into two subgroups depending on age: subgroup A included patients aged 18–34 years, subgroup B — patients aged 35–48 years. The control group was 50 persons with emmetropic refraction, which were also divided according to age into two subgroups. In the course of the study, there were noted violations of the accommodative, binocular, oculomotor functions in various combinations of one or several parameters in adult patients with hyperopia, complex hyperopic astigmatism, mixed astigmatism in 10–32 % of cases. A significant percentage of detected latent sensory-motor disorders determines the need for a detailed study of these functions to choose the optimal correction method.

Abstract 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.

Back ground:Refractive error is a condition in which parallel rays of light from infinity do not focus on the retina at the resting state of accommodation. Its prevalence is increasing dramatically in the group of people who are getting education at higher level. It is developed by hereditary as well as other factors like environmental life style etc. Objective:To determine the prevalence of refractive error, other eyedisorders, and its associated risk factors amongst the medical students. Methodology: A cross sectional survey was conducted through non probability consecutive sampling technique with permission from the Principal and a verbal consent of each student. A pre tested and validated questionnaire having socio demographic, the prevalence of refractive errors, eye disorders, and its associated risk factors were used and the data analyses through SPSS version 21 was recorded. For continuous variables i.e. age, mean and standard deviation were computed and for categorical variables, frequencies and percentages were calculated. To determine any association between the two categorical variables, Chi-Square test was applied and P value at 0.05 was fixed for any statistical significant association. Result: Frequency of refractive error was found in 257 students (68.2%). Out of total 377 students, the parents / siblings of 72.1% were also having reflective error. Majority of the students (197 i.e. 52.3%) suffering with the myopia followed by hypermetropia (36 i.e.9.5%) and astigmatism (20 i.e. 5.3%). Four students were also suffering with colour blindness. Factors found statistical significance to develop the refractive error were age, gender, parental/siblings having refractive error and reading while lying down. Conclusion: Refractive error was found at its peak in medical students. The factors causing the refractive error were age, gender, parental/siblings having refractive errors and reading while lying down. The other factors like use of computer, mobileetc etc., were found insignificant to develop refractive error. [ABSTRACT FROM AUTHOR]

Background: Refractive errors (REs) are the major cause of blindness and impaired vision with considerable morbidity. Finding the prevalence with early detection of REs with appropriate corrective measures can bring down eye morbidity in children., Aim: The aim of the study was to find the prevalence of REs among children attending Raichur Institute of Medical Sciences Teaching Hospital in Karnataka State of South India., Methodology: This hospital-based cross-sectional study was conducted with a total of 420 study subjects. Examination of the eyes for REs was carried out using a refractometer. The REs were noted in myopia < -0.5 dioptres (D), hypermetropia > + 0.5 D, and astigmatism > 0.5 cylinder D. The data were statistically subjected to a statistics test. Categorical measurement was presented as frequency (percentage). The association between the parameters was done using the chi-square test. A p-value < 0.05 was considered statistically significant., Results: Out of 420 examined, REs were present among 147 (35%) study subjects, and myopia 67 (16%) was the highest prevalent in comparison to hypermetropia 42 (10%) and astigmatism 38 (9%). The male subjects had 77 (34.4%) REs, and the female subjects had 70 (35.7%) REs. In both genders, myopia was the highest prevalent, followed by hypermetropia and astigmatism., Conclusion:  The prevalence of REs among children is alarming, and it should be corrected at an early age to prevent further complications in adulthood. Ophthalmologists should generate regional data about the prevalence of REs, create awareness about the prevention of REs among the risk population, and utilize government-sponsored blind eradication programs for comprehensive eye care in the larger interest of the affected population and risk population., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethical Committee, Raichur Institute of Medical Sciences issued approval RIMS/IEC/2023-24/18. Study approved. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Munoli et al.)