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Malik Ashtar is a personage educated based on the educational doctrines of Islam in Nahj al-Balagha. The way he was educated led to his selection as one of the governors and rulers during the Imamate (leadership) of Imam Ali (A.S.). Accordingly, this study aimed at identifying the componenets of his educated personality in various dimensions (physical, religious, moral, political, economic, social, intellectual, and emotional). To this end, we used content analysis and semantic network. According to this method, the propositions and themes related to Malik Ashtar’s personality dimensions in Nahj al-Balagha and related historical books were first identified and coded and then analyzed. The research results indicated that Malik Ashtar was educated in various educational dimensions including enjoying physical strength and health, having spiritual beliefs, commitment to righteous deeds and moral virtues, struggling with oppression, doing justice, and making effort to have unity and strength of government, paying attention to people’s material welfare, cooperation and assistance, intellectualism, recognition and insight, affection and loving, and moderation. This can be an inspiration for educating competent rulers and governors in the Islamic society of Iran.

The purpose of the present study is to analyze the narrative of student-teacher lived experiences of the interaction of their professional identity and their personal educational philosophy during university. In this regard, the research approach is qualitative and of a narrative type and the professional identity of this cultural group in proportion to their own personal educational philosophy has been examined. The data collection tool included a list of student-teacher answering questions, and sampling in this study was purposeful and continued until the theoretical data saturation principle was reached. For this purpose, the biographies of seventeen student-teachers of Farhangian University of Kerman have been collected from among fifty students-teachers in the academic year (2015-2016). During the research phase, the researchers reviewed the narrative writings of the student-teachers and compiled the framework for collecting the narratives in the form of a calendar sequence. Therefore, questions were asked about the experiences before, during and after entering the teaching profession. Finally, we have analyzed the findings of this research narrative using the model of Katherine Carter (1993). The results obtained from the research of the study of the interaction of professional identity with the personal educational philosophy of students-teachers can be expressed in the form of these four main categories as follows: a) the type of one's view of his/her own professional identity, b) the type of one's view of his/her professional identity based on the performance of others, c) the type of others' view of one's professional identity, and d) the type of one's philosophical view of his/her life and profession. This study can provide student teachers with a new perspective on their future jobs and professions to achieve a deeper understanding of their professional identity

چکیده هدف از پژوهش حاضر بررسی اهداف، اصول و روشهای تربیت عاطفه «غم و شادی» انسان بر اساس مبنای شادی‌پذیری وغم‌پذیری آدمی در صحیفه علویّه بوده است. بدین منظور براساس رویکرد کیفی، از روش‌های پژوهش استنتاجی و تحلیل زبانی و مفهومی استفاده شده است. از این رو، بر اساس مبنای مفروض، مناجاتهای امام علی (ع) در صحیفه علویّه انتخاب و مورد پژوهش قرار گرفته-اند. براساس نتایج پژوهش می‌توان گفت متربی باید با تکیه بر اصولی چون شناسایی شادیهای ممدوح و چگونگی راه یافتن به آن، شناخت غمهای مذموم و علل و رهایی از آن، شناخت و ایجاد غم‌های ممدوح در قلب خویشتن، در تربیت عاطفه «غم و شادی» وجود خود بکوشد و با روش‌هایی مانند خوشنود نمودن خداوند، پیامبر(ص) و خاندان وی توسل جوید و در جهت شاد نمودن انسانها و شادی برای آخرت خویش اقدام نماید و با شیوه شکرگذاری و ذکر اسماء الهی طی مسیر نماید و به کسب شادی به واسطه نعمتهای خاص الهی چون ایمان و اسلام بپردازد. همچنین غمهای دنیایی، گناهان و پیروی از هوای نفس را از عوامل غمهای مذموم بداند و با روش‌هایی از جمله پناه بردن به خداوند، دعا، ذکرورزی و ملامت نفس پس از ارتکاب گناه و مرگ اندیشی، قلب خویش را برای وجود غمهای مقدس آماده سازد تا به اهداف تربیت این عاطفه یعنی رسیدن به مقام قرب الهی، پیوستن به هدایت یافتگان و سعادت لقاء الله نائل آید.

While Iranian culture has long enjoyed valuable works in the field of spirituality and mysticism, currently, we are witnessing the spread of new religious movements. Increasing attention to spirituality has led some researchers to focus exclusively on the similarities between the teachings of the nascent spiritual movements and those of Islamic mysticism, which could have serious consequences. Taking that into consideration, and with the aim of depicting the conflicts between the teachings of the new religious movements and Islamic spirituality and mysticism, the present study addresses Osho’s teachings, as the founder of one of the nascent spiritual movements, and examines his views regarding the existence of God and the possibility and ways of knowing Him, as the most important concern of humankind. To illustrate the dissimilarities between his viewpoints and those of Muslim mystics, his teachings in this field are also compared with Rumi’s, as one of the true representatives of Islamic mysticism and spirituality. The findings of this research reveal fundamental differences between the views of Osho and Rumi’s. Lack of coherence in his view of the existence of God, as well as his different perceptions of notions such as love, freedom, and self-knowledge as ways of knowing God, which stand in contrast with the teachings of Rumi, support this issue. This seems to be due to their different origins of thoughts because unlike Osho that clearly denies the divine religions, Rumi's beliefs are rooted in the teachings of Islam.

The purpose of this study was to explain and analyze the concept of sex education and its obstacles based on educational experts’ perspectives in secondary schools in Kerman. To do so, through the phenomenological method and purposive sampling, lived experiences of twelve educational experts via semi-construct interview were collected.The results revealed four criteria for the concept of education: explanation, criteria for offering sex education, inner motivation and critical view. However, these criteria that distinguish education from pseudo-education have not been well fulfilled. There are two main reasons why sex education has become ineffective: 1) people who are in charge of sex education are not commit to sex ethic codes and 2) they have limited knowledge about how to fulfill the sex education goals. It is worth to mention that as a consequence of unsatisfactory performance of the education authority in ‘explanation’ as the first component of education, other components have not yet well developed.

We examined the use of a new scoring system for the meconium-stained infant, which was designed to help the neonatologist decide on the appropriate therapeutic approach in the delivery room. Eighty meconium-stained infants were scored for: presence of fetal distress; meconium quality; performance of nasopharyngeal suctioning before the first breath and clinical condition in the first minute of life. Management consisted of gentle oropharyngeal suctioning or intubation and tracheal suctioning. Clinical outcome was compared with that of 100 meconium-stained infants born a year earlier. All babies in the control group underwent laryngoscopy and 30% were subsequently intubated. Universal laryngoscopy was not performed in the study group, and only 22.5% of these infants were intubated. The clinical outcome of the studied babies was identical to that of the newborns treated by the standard procedure. The use of the meconium intubation score eliminated the need for universal delivery room laryngoscopy for meconium-stained infants and significantly reduced the number of intubations performed. [ABSTRACT FROM AUTHOR]

Magnesium alloys’ mechanical behavior has received increasing attention because of its high strength to weight ratio making them ideal for various industrial applications, such as vehicle components, transportation and aerospace. The objective of this work is to closely investigate the thermo-mechanical properties of magnesium alloy AZ31 at different strain rates and temperatures. Tensile tests are conducted on a 30 mm gauge length MgAZ31 specimens at two quasi-static strain rates (1.11x10−3 s−1 and 0.28 s−1) at a range of temperatures between 25 ºC and 250 ºC. Digital Image Correlation (DIC) system was used to calculate the true strain and provide quantitative assessment of the localized deformation response at high levels of deformation. The stress-strain responses of MgAZ31 show that the yield stress as well as the ultimate stress decreases as temperature increases and strain rate decreases. Moreover, the difference between the yield and ultimate stresses at both strain rates increases rapidly as temperature increases. The material shows a significant increase in ductility as temperature increases while the modulus of elasticity remains independent of change in strain rates.

Background: Over the last few years, major health care systems have been trying to control increasing pharmaceutical expenditures by a variety of methods, such as the controversial copayment policy, as essential health expenditures were being jeopardized.Objective: To analyze the regulatory intervention of preauthorization on a rofecoxib model in the medical corps of the Israeli Defense Forces (IDF) in terms of indications for prescription, consumption, and cost.Interventions: Guidelines established by the medical services branch based on current literature and communication with diverse specialists and hospitals were implemented by a general practitioner who checked each rofecoxib prescription that was written for IDF personnel by a specialist. The intervention was initiated in November 2000 and continued until August 2001 and after the study.Design: The study was divided into two parts. The first part was a retrospective monthly, preintervention analysis of computerized medical records of IDF personnel (N = 247) for whom rofecoxib was prescribed. The second was a prospective monthly, postintervention analysis of filled-out guideline forms (N = 250) of approved rofecoxib prescriptions.Participants: Patients, were IDF personnel, age 18 to 45, treated in military and civilian outpatient clinics for whom rofecoxib was prescribed.Setting: The study took place at the Medical Service Branch of the IDF between August 2000 and August 2001.Results: We demonstrated a significant decrease in average monthly consumption (43.0%) and estimated monthly expenditures (40.84%) of rofecoxib, as well as significant shifts (p < 0.001) in indications for whom rofecoxib was approved. These shifts (from pre- to postintervention) include the following: others/nonspecified (80 to 12%), known peptic disorder (7 to 32%), peptic complaints (4 to 22%), and rheumatic (8 to 19%).Conclusion: This type of intervention can be cost-effective, can provide quality care, and may be a viable alternative to the controversial and problematic copayment policy. [ABSTRACT FROM AUTHOR]

Purpose: Previous research highlights the adverse effects of visual impairment (VI) on academic achievement in children, yet its impact on cognitive performance among adolescents and young adults remains under-studied. Therefore, this investigation aimed to analyse this association in a nationwide sample of Israeli adolescents., Methods: A retrospective population-based cross-sectional study was conducted among 1,410,616 Israeli-born adolescents aged 16-19 years, who were assessed before mandatory military service between 1993 and 2017. The definition of VI was based on best-corrected visual acuity (BCVA) measurements using a standard Snellen chart. Adolescents with BCVA worse than 6/9 in either or both eyes were classified as having unilateral or bilateral VI, respectively. Cognitive performance was measured using the General Intelligence Score (GIS), based on a validated four-domain test. Relationships were analysed using regression models yielding adjusted odds ratios (ORs) for low (<-1 standard deviation [SD]) and high (≥1 SD) cognitive Z-scores., Results: Of 1,410,616 adolescents (56.1% men), 13,773 (1.0%) had unilateral and 3980 (0.3%) had bilateral VI. Unilateral VI was associated with adjusted ORs for low and high cognitive Z-scores of 1.24 (1.19-1.30) and 0.84 (0.80-0.89), respectively. ORs were accentuated for bilateral VI, reaching 1.62 (1.50-1.75) and 0.81 (0.74-0.90) for low and high cognitive Z-scores, respectively. Cognitive performance subscores mirrored these results, with the visual-spatial functioning subtest demonstrating the greatest effect size. These associations persisted in sub-analyses restricted to adolescents with amblyopia-related VI, mild VI and unimpaired health status., Conclusions: Visual impairment, including mild and unilateral cases, is associated with reduced cognitive performance scores assessed in late adolescence. Further research is required to gain a comprehensive understanding of the dynamics underlying this relationship., (© 2024 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)

Purpose: Myopia management is practiced by ophthalmologists and optometrists . This study evaluated the approach and standard of myopia management among eye-care practitioners (ECPs) in Israel. The findings may ultimately affect the quality of care., Methods: A questionnaire was sent to 954 optometrists and 365 ophthalmologists, including demographic questions; whether they owned any devices to monitor myopia progression; the lowest progression they considered significant; various questions pertaining to myopia management and treatment methods., Results: Responses from 135 optometrists and 126 ophthalmologists were collected, the majority practicing more than five years; 94% of optometrists, and 64% of ophthalmologists. Around 53% of optometrists and 27% of the ophthalmologists proclaimed to practice myopia management. ECPs primary parameters influencing risk assessment for progression were age, genetic background and history of progression. Time outdoors, during daylight hours, is advised by ophthalmologists (97%) and optometrists (78%). Limiting screentime is encouraged by 87% of ophthalmologists and 69% of optometrists. Myopia progression of 0.50D-0.75D after six months is regarded to require intervention by 93% of ophthalmologists and 83% of optometrists. Optometrists selected multiple myopia management treatments, primarily optical (ophthalmic myopia management lenses 40%, multifocal ophthalmic lenses 24%, peripheral blur contact lenses 38%, orthokeratology 11%), while 95% of ophthalmologists chose atropine and only 3-11% selected any additional treatments to consider., Conclusion: This study highlighted ECPs' agreement on the principles, importance of, and timeline of intervention with myopia management. The disconnect between the two professions lies in management methods. Genuine dialogue and co-management should be encouraged for maximum implementation, benefit and effectiveness of available patient treatments., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: To report our experience with systemic cyclosporine as a treatment for severe vernal keratoconjunctivitis (VKC) in pediatric patients who did not respond to previous treatments., Methods: We analyzed the medical records of 6 patients, aged 4 to 15 years, with severe VKC treated with systemic cyclosporine for VKC at Shamir Medical Center in Zerifin, Israel, between the years 2000 and 2023. The average treatment duration was 18 months. In all patients, previous treatments with antihistamines, mast cells stabilizers, topical steroids and topical cyclosporine, and systemic steroids did not result in sufficient improvement. The severity of inflammation was evaluated during clinical examinations and the patients' subjective assessment of their quality of life., Results: In all 6 patients, signs and symptoms showed significant improvement within 2 to 4 weeks of initiating systemic cyclosporine treatment. All patients were able to discontinue regular steroids use and reported a significant improvement in their quality of life. No significant side effects were observed in any of the patients., Conclusions: Systemic cyclosporine is a safe and effective treatment for severe VKC. It is a steroid-sparing treatment that allows good quality of life, while keeping the disease latent., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To ascertain the effectiveness of 0.01% atropine treatment to inhibit myopia progression and the possible additive potency with peripheral defocus contact lenses over 3 years and the rebound effect 1 year after cessation of treatment., Methods: This prospective study included 127 children aged 8 to 5 years, divided into three treatment groups: 0.01% atropine and single-vision spectacles (At+SV, n = 36), 0.01% atropine and peripheral defocus contact lens (At+PDCL, n = 30), and 0.01% atropine and dual-focus contact lens (At+DF, n = 25). A control group was prescribed single-vision spectacles (n = 36). Cycloplegic spherical equivalence refraction was measured every 6 months during 3 years of treatment and 1 year after cessation., Results: Myopia progression decreased over 3 years of treatment, more during the second and third years than the first year, to a statistically significant degree in the atropine groups ( P < .01): in the first, second, and third years, respectively, -0.42 ± 0.34, -0.19 ± 0.18, -0.22 ± 0.19 diopters (D) in the At+SV group, -0.26 ± 0.21, -0.14 ± 0.37, and -0.15 ± 0.31 D in the At+PDCL group, and -0.22 ± 0.15, -0.15 ± 0.22, and -0.11 ± 0.14 D in the At+DF group. Myopia progressed 1 year after cessation of treatment: -0.29 ± 0.28 D in the At+SV group, -0.13 ± 0.28 D in the At+PDCL group, and -0.09 ± 0.18 D in the At+DF group. After 3 years, there was no statistically significant difference in myopia progression between the At+SV and At+PDCL or At+DF groups ( P < .05)., Conclusions: Low-dose atropine has been substantiated in this cohort as an effective treatment to decelerate myopia progression over 3 years, more effective in the second and third years of treatment. The combination treatment did not exhibit a statistically significant advantage over monotherapy in this cohort. The At+DF group exhibited a statistically lower rebound effect than the At+SV group. [ J Pediatr Ophthalmol Strabismus . 2024;61(3):204-210.] .

Introduction: The importance of myopia management lies in the desire to minimize the potential ocular risks that increase with high myopia., Aims: To assess the decrease in myopia progression using topical low dose atropine combined with peripheral blur contact lenses (CL)., Methods: This retrospective review study included 25 children between the ages of 8.5 years to 14 years. The children all had a minimal increase in myopia of 0.75D during the year prior to treatment. The children were divided into two groups. The control group included 14 children who wore single-vision spectacles )SV) averaging 3.20±0.9D ranging from 1.5-5.3D. The study group included 11 children who wore dual-focus CL, with an average prescription of 3.4±0.7D ranging from 2.5 to 4.3D, for one year. At that point, when an additional myopia increase was observed, the children were additionally treated with topical 0.01% atropine for two years (CL+A0.01)., Results: There was an increase in myopia in the SV group of 1.12±0.52D, 1.08±0.56D and 0.96±0.53D in the first, second, and third years, respectively. The myopia increase in the CL+A0.01 group was 0.57±0.48D, 0.14±0.34D, and 0.17±0.29D in the first, second, and third years, respectively., Conclusions: Low-dose atropine combined with peripheral blur contact lenses was effective in decreasing myopia progression in this study. Additional, larger-scale studies are required in the future., Discussion: This study found a significant decrease in myopia progression in the second and third years of treatment. The CL group showed less effectivity than the CL+A0.01 group.

Purpose: This meta-analysis aimed to review the safety and efficacy of topical cyclosporine A (CsA) and topical tacrolimus in allergic eye disease., Methods: A systematic search identified thirteen studies and a total of 445 patients for inclusion, making this the largest meta-analysis published on the subject. The current review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)., Results: Thirteen randomized control trials were included in the meta-analysis. Eleven studies used CsA as the treatment, and two used Tacrolimus. In total, 445 participants were included, of whom 76.6% were male. The mean age of participants across the included studies was 14 years. All studies reported clinical signs as evaluated by an examining clinician. Signs were usually assessed by anatomical region, with the most common regions being the conjunctiva and the cornea, and the most common signs assessed were hyperemia and papillae. Three studies accounted for more than 50% of the meta-analysis's weight. Effect size (d) ranged from - 2.37 to - 0.03, negative values favoring immunomodulators. Fixed Effect Meta-Analysis returned an SMD of - 0.81 (95% CI [- 0.98, - 0.65]). However, there was significant heterogeneity (I 2  = 61%, Q w  = 30.76) in the outcome measure (P = 0.0021); therefore, a random-effect meta-analysis was also completed in which the pooled SMD was - 0.98 (95% CI [- 1.26, - 0.69], τ 2  = 0.16)., Conclusions: This study affirms the current scientific community's stance that immunomodulators effectively treat clinical signs, including blepharitis, conjunctival hyperemia, edema, papillae, and corneal damage in severe ocular allergic disease., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

This retrospective study evaluates the effectiveness of combining 0.05% atropine with MF60 contact lenses in managing rapid myopia progression in children over one year. The study involved three groups: the treatment group (TG) with 15 children (53% male, average age 12.9 ± 1.04), the MF group (MF) with 12 children (50% male, average age 12.8 ± 0.8) using only MF60 lenses, and the control group (CG) with 14 children (43% male, average age 12.1 ± 0.76). Baseline myopia and axial length (AL) were similar across groups, with the TG, MF, and CG showing -4.02 ± 0.70 D, -4.18 ± 0.89 D, -3.86 ± 0.99 D, and 24.72 ± 0.73 mm, 24.98 ± 0.70 mm, 24.59 ± 1.02 mm, respectively. Prior to the study, all groups exhibited significant myopia and AL progression, with no previous myopia control management. The treatment involved daily 0.05% atropine instillation, the use of MF60 lenses and increased outdoor activity. Biannual cycloplegic refraction and slit lamp evaluations confirmed no adverse reactions. After one year, the TG showed a significant reduction in myopia and AL progression (-0.43 ± 0.46 D, p < 0.01; 0.22 ± 0.23 mm, p < 0.01), whereas the CG showed minimal change (-1.30 ± 0.43 D, p = 0.36; 0.65 ± 0.35 mm, p = 0.533). The MF group also exhibited a notable decrease (-0.74 ± 0.45 D, p < 0.01; 0.36 ± 0.23 mm). Increased outdoor activity during the treatment year did not significantly impact myopia control, suggesting its limited additional effect in this cohort. The study concludes that the combination of 0.05% atropine and peripheral defocus soft contact lenses effectively controls myopia progression in children.

Introduction: Artificial intelligence (AI) was first introduced in 1956, and effectively represents the fourth industrial revolution in human history. Over time, this medium has evolved to be the preferred method of medical imagery interpretation. Today, the implementation of AI in the medical field as a whole, and the ophthalmological field in particular, is diverse and includes diagnose, follow-up and monitoring of the progression of ocular diseases. For example, AI algorithms can identify ectasia, and pre-clinical signs of keratoconus, using images and information computed from various corneal maps. Machine learning (ML) is a specific technique for implementing AI. It is defined as a series of automated methods that identify patterns and templates in data and leverage these to perform predictions on new data. This technology was first applied in the 1980s. Deep learning is an advanced form of ML inspired by and designed to imitate the human brain process, constructed of layers, each responsible for identifying patterns, thereby successfully modeling complex scenarios. The significant advantage of ML in medicine is in its' ability to monitor and follow patients with efficiency at a low cost. Deep learning is utilized to monitor ocular diseases such as diabetic retinopathy, age-related macular degeneration, glaucoma, cataract, and retinopathy of prematurity. These conditions, as well as others, require frequent follow-up in order to track changes over time. Though computer technology is important for identifying and grading various ocular diseases, it still necessitates additional clinical validation and does not entirely replace human diagnostic skill.

Myopia is the most common refractive error in the world, and its' prevalence continually increases. The potential pathological and visual complications of progressive myopia have inspired researchers to study the sources of myopia, axial elongation, and explore modalities to arrest progression. Considerable attention has been given over the past few years to the myopia risk factor known as hyperopic peripheral blur, the focus of this review. The primary theories currently believed to be the cause of myopia, the parameters considered to contribute and influence the effect of peripheral blur, such as the surface retinal area or depth of blur will be discussed. The currently available optical devices designed to provide peripheral myopic defocus will be discussed, including bifocal and progressive addition ophthalmic lenses, peripheral defocus single vision ophthalmic lenses, orthokeratology lenses, and bifocal or multifocal center distance soft lenses, as well as their effectivity as mentioned in the literature to date.

Myopia is the most common refractive error in the world and has reached a pandemic level. The potential complications of progressive myopia have inspired researchers to attempt to understand the sources of myopia and axial elongation and to develop modalities to arrest progression. Considerable attention has been given over the past few years to the myopia risk factor known as hyperopic peripheral blur, which is the focus of this review. It will discuss the primary theories believed to be the cause of myopia and the parameters considered to contribute to and influence the effect of peripheral blur, such as the surface retinal area of blur or the depth of blur. The multitude of optical devices designed to provide peripheral myopic defocus will be mentioned, including bifocal and progressive addition ophthalmic lenses, peripheral defocus single-vision ophthalmic lenses, orthokeratology lenses, and bifocal or multifocal center distance soft lenses, as well as their effectivity as discussed in the literature to date., Competing Interests: The authors declare that there are no conflicts of interests of this paper., (Copyright: © 2023 Taiwan J Ophthalmol.)

Objectives: To assess the decrease in myopia progression and rebound effect using topical low-dose atropine compared to a combined treatment with contact lenses for myopic control. Methods: This retrospective review study included 85 children aged 10.34 ± 2.27 (range 6 to 15.5) who were followed over three years. All had a minimum myopia increase of 1.00 D the year prior to treatment. The children were divided into two treatment groups and a control group. One treatment group included 29 children with an average prescription of 4.81 ± 2.12 D (sphere equivalent (SE) range of 1.25−10.87 D), treated with 0.01% atropine for two years (A0.01%). The second group included 26 children with an average prescription of 4.14 ± 1.35 D (SE range of 1.625−6.00 D), treated with MiSight 1 day dual focus contact lenses (DFCL) and 0.01% atropine (A0.01% + DFCL) for two years. The control group included 30 children wearing single-vision spectacles (SV), averaging −5.06 ± 1.77 D (SE) range 2.37−8.87 D). Results: There was an increase in the SE myopia progression in the SV group of 1.19 ± 0.43 D, 1.25 ± 0.52 D, and 1.13 ± 0.36 D in the first, second, and third years, respectively. Myopia progression in the A0.01% group was 0.44 ± 0.21 D (p < 0.01) and 0.51 ± 0.39 D (p < 0.01) in the first and second years, respectively. In the A0.01% + DFCL group, myopia progression was 0.35 ± 0.26 D and 0.44 ± 0.40 D in the first and second years, respectively (p < 0.01). Half a year after the cessation of the atropine treatment, myopia progression (rebound effect) was measured at −0.241 ± 0.35 D and −0.178 ± 0.34 D in the A0.01% and A0.01% + DFCL groups, respectively. Conclusions: Monotherapy low-dose atropine, combined with peripheral blur contact lenses, was clinically effective in decreasing myopia progression. A low rebound effect was found after the therapy cessation. In this retrospective study, combination therapy did not present an advantage over monotherapy.

Objective: To evaluate the incidence of consecutive exotropia following bilateral medial rectus muscle recession surgery (BMR) for esotropia using non-absorbable compared with absorbable sutures in children undergoing strabismus surgery., Methods: A retrospective cohort study of all children with esotropia who underwent BMR by a single surgeon in a tertiary public hospital. As of February 2018, only non-absorbable sutures were used. The primary outcome was the incidence of consecutive exotropia., Results: A total of 121 children were included in the analysis, 3.66 ± 2.62 years, 53% were male. In 80 children (66%) non-absorbable sutures were used (non-absorbable group) and in 41 children (34%) absorbable sutures were used (absorbable group). Consecutive exotropia (≥ 8 prism dioptres) occurred in ten children (24%) in the absorbable group and in three children (4%) in the non-absorbable group (OR = 8.28, 95% CI = 2.13-32.13; P = 0.002). This difference between groups remained significant after adjustment for potential confounders and follow-up time (HR = 4.98, 95% CI = 1.30-19.05, P = 0.019). Mean follow-up time was 22 and 12 months in the absorbable and non-absorbable groups, respectively (P < 0.001). Two children in the non-absorbable group had pyogenic granuloma that resolved after 3 months of topical steroidal therapy., Conclusion: Routine use of non-absorbable sutures in BMR surgery for esotropia may be a preferable alternative to absorbable sutures for the prevention of consecutive exotropia., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Purpose: To assess the additive potency of low-dose atropine combined with optical measures designed to decrease myopia progression., Materials and Methods: This retrospective study included 104 myopic children aged 5-12 over 4 years, divided into five groups: daily instillation of 0.01% atropine and distance single-vision spectacles (A), 0.01% atropine and progressive addition lenses (A + PAL), 0.01% atropine and soft contact lens with peripheral blur (A + CL). Two control groups were included, prescribed bifocal spectacles or single vision (SV) spectacles. Cycloplegic spherical equivalence refraction was measured biannually, including 1 year after cessation of treatment., Results: A significant decrease in myopia progression was noted during the 2 nd and 3 rd years of atropine treatment: A -0.55 ± 0.55D, -0.15 ± 0.15, -0.12 ± 0.12D were 1 st , 2 nd , 3 rd years, respectively, A + PAL -0.47 ± 0.37D, -0.10 ± 0.25D, and -0.11 ± 0.25D were 1 st , 2 nd , 3 rd years, respectively, A + CL -0.36 ± 0.43D, -0.13 ± 0.29D, and -0.10 ± 0.27D were 1 st , 2 nd , 3 rd years, respectively. Myopia progression over 3 years, respectively, was -0.82 ± 0.50D, -0.70 ± 0.69D, -0.59 ± 0.66D in the bifocal group and -1.20 ± 1.28D, -0.72 ± 0.62D, -0.65 ± 0.47D in the SV group. One year after cessation of atropine treatment, myopia progression was - 0.32 ± 0.31D in A, -0.23 ± 0.28D in A + PAL, and -0.18 ± 0.35D in A + CL., Conclusion: Atropine 0.01% presented as effective at decelerating myopia progression, more prominent in the 2 nd and 3 rd years of treatment. Combining atropine 0.01% with optical modalities exhibited a trend for added efficacy over monotherapy. A + CL exhibited the least rebound effect 1 year after cessation of treatment., Competing Interests: The authors declare that there are no conflicts of interests of this paper., (Copyright: © 2022 Taiwan J Ophthalmol.)

The COVID-19 pandemic of 2020 and its' accompanied lockdowns impacted the entire globe in ways the world is only beginning to comprehend. In Israel, children age 9-15 had not been in a frontal classroom and been socially restricted from March 2020 till March 2021. Fourteen of these children that had been under myopia control treatment which had been effective prior to the pandemic were included in this retrospective study to learn if their myopia continued to stay under control, or if the unique environmental modifications affected their progression. The results showed that average increase in spherical equivalent refraction and axial length, measured with optical biometer OA-2000 (Tomey GmbH, Nagoya, Japan), during the year of lockdowns was -0.73 ± 0.46D/0.46 ± 0.31 mm respectively, while the average increase in the year prior was -0.33 ± 0.27D/0.24 ± 0.21 mm. Though several articles have indicated the pandemic environment has influenced myopia progression in children, this communication indicates a possible significant impact of the environment on myopia increase even in individuals under effective atropine treatment. These children's' progression suggests practitioners consider and address multiple aspects simultaneously when attempting myopia control., (Copyright © 2021 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)

Introduction: Presbyopia is the physiological, gradual, progressive loss of the ability to see clearly at near point which affects people as they age. It is primarily caused by the thickening and stiffening of the lens leading to an inability to adjust its shape to become convex enough to induce adequate plus power to see at short distances. Symptoms usually begin affecting individuals around 40 years of age, the most common being discomfort in or around the eyes after prolonged near work, blur at distance after near work, and eventually progressing to near blur, often with a natural tendency to distance the object by holding it farther away to try to see it better. At a certain point near tasks become impossible and the patient will seek an external solution. Various therapies are available and being developed to treat presbyopia, which include glasses, contact lenses, intraocular lens implants, corneal laser procedures, intracorneal implants, scleral alterations and pharmacological ocular drops. Untreated presbyopia negatively affects quality of life as well as the world productivity since presbyopia progresses from approximately an age when people are still an active part of the workforce. As the population and life expectancy grow, so will the number of presbyopes. This article will discuss the various options available to treat presbyopia.

Context: A correlation between myopia and insulin resistance has been suggested., Objective: We investigated the association between myopia in adolescence and type 2 diabetes (T2D) incidence in young adulthood., Methods: This population-based, retrospective, cohort study comprised 1 329 705 adolescents (579 543 women, 43.6%) aged 16 to 19 years, who were medically examined before mandatory military service during 1993 to 2012, and whose data were linked to the Israel National Diabetes Registry. Myopia was defined based on right-eye refractive data. Cox proportional models were applied, separately for women and men, to estimate hazard ratios (HRs) for T2D incidence per person-years of follow-up., Results: There was an interaction between myopia and sex with T2D (P < .001). For women, T2D incidence rates (per 100 000 person-years) were 16.6, 19.2, and 25.1 for those without myopia, and with mild-to-moderate and high myopia, respectively. These corresponded to HRs of 1.29 (95% CI, 1.14-1.45) and 1.63 (1.21-2.18) for women with mild-to-moderate and high myopia, respectively, compared to those without myopia, after adjustment for age at study entry, birth year, adolescent body mass index, cognitive performance, socioeconomic status, and immigration status. Results persisted in extensive sensitivity and subgroup analyses. When managed as a continuous variable, every 1-diopter lower spherical equivalent yielded a 6.5% higher adjusted HR for T2D incidence (P = .003). There was no significant association among men., Conclusion: For women, myopia in adolescence was associated with a significantly increased risk for incident T2D in young adulthood, in a severity-dependent manner. This finding may support the role of insulin resistance in myopia pathogenesis., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: To report the outcomes of superior oblique split tendon elongation in Brown's syndrome., Methods: Charts of 17 consecutive Brown's syndrome patients who underwent superior oblique split tendon elongation were reviewed and clinical data regarding preoperative, intraoperative, and postoperative data were collected., Results: About 17 eyes of 17 children with congenital Brown's syndrome underwent superior oblique split tendon elongation between January 2012 and March 2020 by a single surgeon. Mean age at surgery was 5.47 ± 2.82 (range 1.50-13.2). Eight (47.1%) were female. Preoperative deficit of elevation in adduction was -4 in all children. At the end of surgery, all eyes were freely elevated on adduction, on forced duction test. Mean follow-up time of 26.24 ± 11.22 (range 11-53) months. In 15 of 17 children (88.2%), motility improved, orthotropia in primary position was achieved, and head posture eliminated ( p  < 0.001). Superior oblique palsy occurred in two children, who after reoperation, achieved an acceptable outcome. No intraoperative complications were recorded., Conclusion: The superior oblique split tendon elongation procedure is a useful surgical technique with stable and satisfying outcomes for the treatment of severe congenital Brown's syndrome.