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The Master's thesis focuses on the independent and autonomous mastery of the parental role of people with severe visual impairment. The thesis aims to analyse and convey the experiences of blind parents with childcare tasks they manage independently from the support of seeing persons and with the compensatory strategies used. Furthermore, the thesis analyses the situations when blind parents prefer to be supported by seeing persons and what are the sources of such support. The attitudes of society towards parents with severe visual impairment are also evaluated and analysed. The thesis introduces topics such as the functioning of the family, the needs of its members, parental roles, as well as parenting of disabled individuals. Moreover, it focuses mainly on parents with severe visual impairment, the specifics of parenthood of blind people, prejudices, inappropriate societal attitudes and sources of potential support. Elements of the grounded theory research method were applied during the thesis preparation. Data was collected through semi-structured interviews. The quotations selected illustrate the handling of the various themes and conclusions related to the research questions. The research has demonstrated that the respondents are not reliant on visual support for many childcare tasks and have...

Blindness and complex visual impairments significantly complicate people's daily lives. Today, one of the means of developing the independence of such persons is ergotherapy. Objective. To determine the features of the impact of ergotherapy usage on the formation of independent life of persons with severe visual impairment and blindness in sanatorium conditions. Methods. Pedagogical observation, training, methods of physical therapy. Results. In the course of ergotherapy, the infrastructure of the base was acquainted with the help of mnemonics, training was provided on techniques for proper support of visually impaired people in corridors, doors, elevators, stairs, dining room, gym, on the street, in public transport; the compliance of the length of the tactile cane with the height of its user was checked; training and improvement of tactile cane technique by methods of "sliding", "touch", "pendulum" was carried out. Rehabilitants were taught to use the elevator, which has a sound landmark of the floor and signed buttons in tactile Braille. Orienteering training using the "clock face" method and its use during the movement along the base and during meals was conducted; rehabilitants were taught to prepare drinks using a sound liquid level indicator. Classes were held on mastering sensory gadgets and electronic applications that help solvehousehold problems. Training was provided in determining sound and tactile landmarks-beacons for movement, the level of awareness about the features of assistance in moving blind or partially sighted people with the help of a guide was raised. The use of ergotherapy in a two-week physical therapy program permitted to analyze the typical domestic problems of visually impaired and blind people with disabilities and find ways to solve these problems without assistance, forming faith in their capabilities, independence and autonomy.Keywords: ergotherapy, blind people, visually impaired people, independence, physical therapy, sanatorium conditions.

Purpose Retrobulbar hematoma (RBH) is a rare but serious vision threatening emergency. We analyze the relationship between hematoma volume, visual impairment and outcome. Methods Fifty-four patients with RBH receiving orbital decompression were retrospectively included. Volumetric analysis of RBH was performed by semi-automatic segmentation based on preoperative CT scans using ITK-SNAP software. Best corrected visual acuity (BCVA) measurements were obtained and correlated in 2 groups (no light perception (NLP), severe visual impairment) with the hematoma volume. Results NLP was documented preoperatively in 5/28 and postoperatively in 9/43 patients. Preoperative NLP was significantly associated with a larger hematoma volume (P = .03) and higher hematoma/orbital volume ratio (P = .03). Postoperative severe visual impairment showed significant associations with a larger hematoma volume (P = .02) as well as higher hematoma/orbital volume ratio (P = .02). Conclusion Eyes with severe visual impairment and large hematoma volumes preoperatively are at high risk of permanent vision loss. Hematoma volume calculation might represent an additional prognostic parameter for visual outcome after RBH.

BACKGROUND Many studies have demonstrated an association between type 2 diabetes mellitus (T2DM) and atrial fibrillation (AF). However, the potential independent contributions of T2DM and AF to the prevalence of visual impairment have not been evaluated. AIM To determine whether such an association between T2DM and incident AF with visual impairment exists, and if so, the prevalence and magnitude of this association. METHODS We conducted a nationwide cross-sectional study based on the DM/HT study of the Medical Research Network of the Consortium of Thai Medical Schools. This study had evaluated adult T2DM patients from 831 public hospitals in Thailand in the year 2013. T2DM patients were categorized into two groups: patients without and with incident AF. T2DM patients without AF were selected as the reference group. The association between incident AF and visual impairment among T2DM patients was assessed using multivariate logistic regression. RESULTS A total of 27281 T2DM patients with available eye examination data were included in this analysis. The mean age was 60.7 ± 10.5 years, and 31.2% were male. The incident AF was 0.2%. The prevalence of severe visual impairment in all T2DM patients, T2DM patients without AF, and T2DM patients with incident AF were 1.4%, 1.4%, and 6.3%, respectively. T2DM patients with incident AF were associated with an increased OR of 3.89 (95%CI: 1.17-13.38) for severe visual impairment compared with T2DM patients without AF. CONCLUSION T2DM patients with incident AF were independently associated with increased severe visual impairment. Therefore, early eye screening should be provided for these high-risk individuals.

Background: Low vision is problem in which it makes hard for the people to do everyday activities and this problem can’t be fixed with glasses, contact lenses, medicines or surgery. Aim: This study was conducted to assess the quality of life in patients with low vision. Materials & Methods: In present study, there were 2 categories of 90 patients each who were joined in the outpatient department of Ophthalmology, Gandhi Medical College, Hyderabad, Telangana State. Category 1 consisted of 90 patients of low vision (Moderate visual impairment). Category 2 consisted of 90 patients of low vision (Severe visual impairment). Results: The mean age was 60.22±10.52 and 60.66±8.96 years respectively. 36% were males and 64% were females in category 1 and 57% were males and 43% were females in category 2. Mean comparision of various questionnaires were found to be statistically significant between two categories. Category 2 people have more difficulty in reading ordinary newspaper, small print on telephone book, medicine bottle while wearing glasses and they need help from others due to their poor eye sight. Category 2 people recognise people with more difficulty even though they know the people across the room. Conclusion: In patients of both categories, low vision affects quality of life. This study concluded that Category 2 people have poor quality of life in comparison to Category 1.

Samiksha Fouzdar-Jain,1 Zena Ibrahim,2 Jeremy Reitinger,3 Dingcai Cao,2 Mehmet C Mocan2 1Department of Pediatric Ophthalmology & Adult Strabismus, Children’s Hospital and Medical Center, Omaha, NE, USA; 2Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA; 3Creighton University School of Medicine, Omaha, NE, USACorrespondence: Samiksha Fouzdar-JainDepartment of Pediatric Ophthalmology & Adult Strabismus, Children’s Hospital and Medical Center, Omaha, NE, USAEmail sjain@childrensomaha.orgPurpose: This study aimed to evaluate the visual outcomes of pediatric patients diagnosed with Peters anomaly (PA) in a tertiary eye care center.Methods: This was a retrospective study undertaken at a single academic center. Clinical records of pediatric patients diagnosed with PA from 2000 to 2017 were reviewed. Parameters recorded included visual acuity (VA), intraocular pressure (IOP), presence of glaucoma, and surgical procedures performed. The impact of PA type on final visual acuity levels was analyzed using generalized estimation equation models.Results: Twenty-one eyes from 11 patients were analyzed. At the final visit, 9 eyes (42.8%) had a VA ≥ 20/200, while 12 (57%) had < 20/200, ranging from 20/250 to no light perception. Of the study cohort, 15 (71.5%) eyes had type I, while six (28.5%) had type II PA. Glaucoma was present in 20 eyes (95%) at the final visit. One eye had dense central leucoma and microphthalmos where IOP could not be measured accurately. Seventeen eyes (81%) underwent at least one intraocular surgery, while the average number of surgeries per eye was 2.9 ± 2.5 (range=0– 9). The type of PA beta(se)=0.53 (0.41),p= 0.20] was not found to be a significant risk factor for worse VA.Conclusion: Severe visual impairment develops in the majority of patients with PA. The type of anomaly does not appear to be associated with a worse visual function in patients with PA. Glaucoma develops in a high percentage of this patient population, and thus close monitoring of IOP in this patient population is crucial.Keywords: Peters anomaly, penetrating keratoplasty, visual outcomes, logMAR, corneal opacity

Low vision care and rehabilitation is often limited by access to assistive devices, especially in low-resourced countries, due to their high cost and unavailability. Smartphones have the potential to serve as an alternative assistive device for people living with severe visual impairment and blindness (SVIB). This study aims to investigate the use of smartphones among people living with SVIB. The study was a cross-sectional study of 166 people living with SVIB in a low resourced setting. The participants were recruited from two tertiary institutions and four eye care facilities. A questionnaire was administered to all respondents and for those who could not read prints they were read out to them and their responses recorded. The majority of respondents (n = 88, 53.1%) either had no phone or used a basic phone. The prevalence of smartphone usage among people living with SVIB was found to be 46.90% (n = 78). Most respondents use their smartphones to interact on social media [n = 75 (96%)] and web browsing [n = 69,92%]. The most frequently demanded [n = 22 (44%)] smartphone functionality by the respondents was the image and color description feature. Most participants were unaware that 90% of their functionality demands already existed and were compatible with current smartphones. A significant number of people living with SVIB in this study used smartphones; however, most users are unaware of its full functionality and assistive capabilities.

Aim: To assess the prevalence of severe visual impairment (SVI) and reasons for not accessing eye care services in a field practice area of a tertiary care hospital. Study design: Cross-sectional observational study. Materials and methods: Through a cross-sectional study using simple random sampling, a total of 1510, individuals above 18 years of age, from six rural and maternity welfare centers (RMCW) within a distance of 20 km from a tertiary hospital were approached. All participants underwent basic assessment of visual acuity, anterior segment evaluation using torch light, and answered a structured questionnaire on eye care. Results: Of 1510 subjects, 267 had SVI (defined as visual acuity < 6/60 either in one or both eyes) with a prevalence of 17.7%. SVI was higher among men and those above 60 years of age (52.8%). Significant association was found between barriers to accessing eye care facilities and lack of knowledge to access health care (p = 0.004), lack of financial support (95% CI, p = 0.006), and social reasons (95% CI, p = 0.028). Prevalence of SVI among diabetics was 32.7% as compared to non-diabetics (OR: 2.630; 95% confidence interval: 1.864–3.712), and among hypertensives was 34.61% as compared to non-hypertensives (OR: 2.836; 95% confidence interval: 1.977–4.068). Conclusion: In spite of being close to a tertiary care center, a prevalence of SVI in 17.7% of this population indicates a lack of knowledge regarding the importance of self-health care in subjects. This emphasizes the need to increase the awareness among the general public to access the ophthalmic health care facilities in order to improve the ocular health of the patients.

Bardet–Biedl syndrome (BBS) is a rare familial and multi-system disorder with an autosomal recessive pattern of inheritance and wide range of clinical variability. Its main manifestations are progressive retinal dystrophy, renal dysfunction, post-axial polydactyly, central obesity, mental retardation, and hypogonadism. Renal failure is known to be the main cause of death in patients with BBS. Retinal dystrophy and other eye diseases seen in patients with BBS can cause severe visual impairment and blindness at an early age. After written consent was obtained from the patient, we report the clinical and laboratory data of the first case from Ethiopia of an 18-year-old boy with multi-system manifestations of the Bardet–Biedl Syndrome. We discuss the main clinical manifestations of the syndrome including its potentially blinding and fatal features. We emphasize the need for diagnosis of this syndrome at an early age as possible so that proper and multidisciplinary medical care can be given for such patients to prevent unnecessary morbidity and early mortality.

Purpose: To study the features of the clinical and functional state of the eyes in children after laser damage to the retina. Material and methods: We examined six patients who incurred retinal photodamage (nine eyes) after using a laser pointer. Results: It was shown that laser-induced damage to the macula led to a decrease in vision in five of the nine eyes, which correlated with changes in the parameters of the rhythmic and macular electroretinogram. The main pathognomonic symptom of photo damage to the macula is the presence of signs of local destruction of the pigment epithelium and the ellipsoid zone of the retina, according to optical coherence tomography (OCT). In two cases, after a macular burn, a neovascular membrane formed, which led to an irreversible decrease in vision. Conclusion: Uncontrolled use of household laser devices (pointers) by children can lead to severe visual impairment. For this reason, the main priority should be prevention, conducting active sanitary and educational work, informing teachers, parents, and children about the potential harm, and timely detection and treatment of retinal photodamage.

Purpose The aim of this study was to describe the effectiveness of goniotomy for childhood glaucoma in Indian eyes. Methods Consecutive patients with pediatric glaucoma who underwent goniotomy between July 2017 and June 2020, in a single center in Northwest India were prospectively analyzed. Goniotomy was done as a primary procedure or a re-do surgery of the untreated angle in failed filtering surgery. Success was defined as intraocular pressure (IOP) ≦18 mm Hg with or without 2 topical medications. Results A total of 172 eyes of 126 children underwent goniotomy during this period (37.9% of all pediatric glaucoma surgeries). Goniotomy comprised 132 of 211 (62.5%) primary pediatric glaucoma surgeries and 40 of 243 (16.5%) re-do surgeries. 145, 112, and 54 eyes had a six months, 1-year and 2-year follow-up, respectively. At 1 year, success rates in Primary Congenital Glaucoma (PCG) were 79.7% for primary surgery and 68.4% for re-do surgery. For non-PCG eyes, the success rate was 62% at 1 year. Among PCG subgroups, infantile and newborn glaucoma had 87.5% and 57.1% success rates, respectively. On logistic regression analysis, lower baseline IOP and lesser axial length at presentation were significantly predictive of successful outcomes (P = 0.03 and P = 0.02, respectively). At 1 year, in the primary surgery group, 50% had good vision (better than logMAR 0.5), 28.9% had moderate (better than LOGMAR 1.0) and 20% had severe visual impairment. There were no significant intraoperative or post-operative complications. Conclusion Goniotomy appears to be an effective surgery for childhood glaucoma in Indian eyes. Being minimally invasive, it obviates the need for conjunctival and scleral dissection and antifibrotic agents.

Purpose: Cataract remains the leading cause of blindness and visual impairment in most low-and middle-income countries, with the greatest burden borne by women. To achieve Global Action Plan targets, cataract programs must target people, especially women, with maximum need. This study examines whether cataract surgical programs in three major north Indian eyecare institutions are equitable and describes a refined indicator for reporting equity. Methods: Retrospective one-year cross-sectional study of cataract surgery utilization using routine administrative data from three north Indian eyecare institutions. Patient data were categorized by paying category, sex, and preoperative visual acuity. Comparisons were made between payment categories and sexes. Results: Out of the total number of patients operated, 86,230 were in the non-paying category and 56,738 in the paying category. Overall, 8.2% were blind, 21.1% were severely visual impaired (SVI) or worse, and 86.1% were moderate visual impaired (MVI) or worse. Non-paying patients had a significantly higher proportion of poorer visual categories compared to paying patients [(blind, 9.7% vs. 5.8%; SVI or worse, 24.6% vs. 15.8%; and MVI or worse, 89.1% vs. 81.6%, respectively, (P < 0.001)]. Women had significantly higher proportion of poorer visual categories than men [(blind, 8.9% vs. 7.4%, SVI or worse, 21.9% vs. 20.3% and MVI or worse 87.6 vs. 84.7%) (P < 0.001)]. Conclusion: The institutions primarily provided surgery to patients with maximum need: too poor to pay, low visual acuity, and women. Similar data from all service providers of a region can help estimate the proposed “equitable cataract surgical rate”: the proportion of patients operated with maximum need among those operated in a year. This can be used for targeting people in need.

Hypotrichosis with juvenile macular dystrophy is an autosomal recessive disorder due to a mutation in the CDH3 gene. As its name indicates, the disease classically presented with hypotrichosis and early visual impairment. We describe herein a family member with alopecia since birth associated with severe visual impairment in their early life. We suspect the diagnosis of hypotrichosis with juvenile macular dystrophy. Genetic testing confirms the clinical suspension. We emphasize the importance of genetic testing for proper genetic counseling.

Diabetic retinopathy (DR) is the most common microvascular complication in diabetes and may cause severe visual impairment. Until late stages of DR, treatment options are limited. The aim of the present review was to investigate whether changes of DR might be influenced by topical treatment with eye drops. This systematic review included both randomized and non-randomized human clinical studies on the subject. A systematic search of PubMed Medline, Embase and Scopus databases yielded 710 studies. No inclusion criteria regarding classification of DR were defined. Reference lists as well as first authors were screened for the inclusion of additional studies. Potential bias of the randomized studies was assessed using the Cochrane Risk of Bias tool. Nineteen studies suitable for inclusion were identified. Seven studies were randomized trials. These examined 11 different pharmacological groups of drugs in DR. A favourable effect of corticosteroid eye drops in diabetic macular oedema (DMO) was reported in four studies, and another study reported a positive trend. Eye drops with non-steroidal anti-inflammatory drugs were also reported to have a favourable effect in DMO, but not in non-center involving DMO. Application of neuroprotective agents was found effective in patients with pre-existing neurodegeneration in three studies. The remaining studies of DMO and DR were heterogeneous in both designs and results. Studies on treatment of DR with topical eye drops vary with regards to patient population, interventional drugs, study design, and outcome measures. Treatment of DR with eye drops was found effective in the aforementioned cases, but there is still a need for further investigations of long-term, randomized controlled trials in any of the reported pharmacological group.

Purpose To describe the etiological causes and clinical profile of dry eye disease (DED) among children and adolescents seeking eye care in India. Methods This was a cross-sectional study of 1023 new patients (≤21 years of age) diagnosed with DED presenting between 2010 and 2018 to a multi-tier ophthalmology hospital network. Children and adolescents with both symptoms and signs of dry eyes were considered as subjects. The data entry and retrieval were done using an electronic medical record system and analyzed using appropriate statistical tests. Results The mean age of the patients was 15.2 ± 5.6 years and 76% were in their early and late adolescence. Overall, the main etiologies responsible for DED in children and adolescents were Meibomian gland dysfunction (MGD) in 49% of cases, Stevens-Johnson Syndrome (SJS) in 33% and Vitamin A deficiency (VAD) in 9%. Aqueous deficiency dry eye (ADDE) because of SJS and VAD accounted for most of the cases in infancy (92%), toddlerhood (96%), early childhood (76%) and middle childhood (68%). While Meibomian gland dysfunction (MGD) related evaporative dry eye (EDE) was the leading cause of DED in early (51%) and late adolescence (66%). Severe visual impairment and blindness was significantly greater in eyes with ADDE as compared to those with EDE (p Conclusion The causes of and visual morbidity due to DED varied significantly in different age-groups. Most of the visual morbidity in children and adolescents was limited to eyes with ADDE due to SJS.

The usability of the mobile applications is the most important factor in developing, so the key to develop successful mobile applications is usability, especially for users have specific needs such as visually impaired. However, developers do not focus on visually impaired users. Moreover, there are limited studies and usability evaluation models for mobile applications for visually impaired so developers use just a modified usability evaluation methods which are not enough and useful to evaluate mobile applications for visually impaired, or they use general usability evaluation models. Therefore, using these methods or models is difficult for evaluator and not useful for visually impaired users. This study conducts Systematic Literature Review (SLR) to identify usability dimensions that help mobile applications developers and evaluators to evaluate mobile application for users which have moderate and severe visual impairment. The result shows that, six dimensions that have a significant impact on moderate and severe visually impaired users' satisfaction, who use mobile applications. These dimensions namely efficiency, effectiveness, satisfaction, errors, accessibility and understandability.

Purpose: The objective of this study was to estimate the level of visual impairment in patients diagnosed to have age-related macular degeneration (ARMD) who presented to low-vision care (LVC) clinic at a tertiary eye care center in India, to analyze the type of distant and near devices prescribed to them and to compare the visual benefit in different age groups among patients with ARMD. Methods: A retrospective review was done for 91 patients with low-vision secondary to ARMD who were referred to the LVC clinic from 2016 to 2017. Demographic profile: age, gender, occupation, ocular history, visual acuity status, and type of low-vision device (LVD) preferred were documented. The details of LVDs and subsequent improvements were noted. Result: Of the 91 patients, 64 (70.3%) were men and 27 (29.7%) were women. Of the cases which were referred, 36.26% had a severe visual impairment (VI), 32.96% had moderate VI, 28.57% had mild VI, and 5.49% had profound VI. The majority of the patients had myopia 57 (62.63%), followed by hyperopia in 25 (27.47%) subjects. The subjects were divided into three groups based on age 40–65 years, 66–75 years, and above 75 years for the analysis of VI. There was a statistically significant improvement (P < 0.01) in near vision with the help of LVDs in all three groups. SEE TV binocular telescope was the most commonly prescribed LVD for viewing distant objects. The most commonly preferred magnifier for near work was half-eye spectacle (56%) followed by stand magnifier (9.9%) and portable video magnifier (9.9%). Conclusion: The use of LVDs can help these patients with ARMD in cases where medical and surgical treatment have no or a limited role in restoring useful vision.

PurposeTo describe the indications and prognosis for keratoplasty in eyes with severe visual impairment and blindness due to corneal diseases in India.MethodsThis hospital-based cross-sectional study included 1 057 215 new patients presenting to a multitier ophthalmology network from 2016 to 2018. All patients with a central corneal pathology and best corrected visual acuity of less than 20/200 in the affected eye(s) were identified as cases and grouped according to laterality. The main outcome measure was the prognosis for keratoplasty, based on the surgical indication.ResultsA total of 28 824 (2.73%) patients were identified with severe visual impairment or blindness due to corneal diseases; of which, 22 582 (78.3%) had unilateral and 6242 (21.7%) had bilateral affliction. Overall, 85% of the corneal pathologies were due to avoidable causes, which accounted for 97% and 63% of the unilateral and bilateral cases, respectively (pConclusionsThe indications and prognosis for keratoplasty varied greatly based on whether the affliction was unilateral or bilateral. Most of the eyes affected by corneal visual impairment or blindness, however, carried an unfavourable prognosis for keratoplasty.

Objectives: To observe and analyze the visual outcomes of cataract surgery of ten years at a tertiary eye care hospital, Karachi. Methods: An observational study with retrospective data search was conducted in Al Ibrahim Eye Hospital (AIEH), Karachi. Data of all adults (above 16 years) who underwent cataract surgery from 2010-2019 was retrieved from HIMS. Presence of opacity in the lens was labelled as cataract. Surgery was advised when patient’s BCVA was found to be 6/18. Visual assessments of the patients were done on day 01, one week and six weeks postoperatively. Postoperatively, 6/6 – 6/12 was considered as good, 6/18 as mild visual impairment, < 6/18 to 6/60 as moderate visual impairment and < 6/60 as severe visual impairment. Results: A total of 1,027,840 patients visited AIEH with different eye diseases. Among 1027840 individuals, cataract was identified in 88443 (8.6%). Surgery was advised to 58371 and performed in 38616. Records of operated cases (38616) were retrieved. Mean age of patients was 54.96±14.22 years. There were 20578 (53.29%) males and 18038 (46.71%) females who underwent surgery . At the end of sixth week, 3561 (18.4%), patients were found to have “good vision”, 12242 (63.43%) had mild visual impairment, 2676 (13.86%) had moderate visual impairment and 822 (4.26%) had severe visual impairment. Corneal Complications was the commonest cause (33.56%) at sixth week. Conclusions: The institution achieved WHO recommended criteria of “good visual outcome” (6/6 to 6/18) of 81.83% which is near to recommended ≥ 90% and severe visual impairment of 4.26%. doi: https://doi.org/10.12669/pjms.37.7.4428 How to cite this:Ahsan S, Memon MS, Bukhari S, Mahmood T, Fahim MF, Haseeb U, et al. Visual outcomes of cataract surgery: An observational study of ten years from a tertiary eye care hospital in Pakistan. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4428 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Digital games can be designed and used to improve many specific skills, related to both cognitive and sensory-motor goals. A set of novel mini-games explicitly aimed to children with severe visual impairments are presented. The games are played by moving within the range of a large-scale interactive environment, i.e. a floor portion placed under a motion capture system which allows the tracking of one or more people. It is then possible to link the players movements to audio and graphic output, producing meaningful interactions. The games are the results of a design process that involved computer engineers and a multidisciplinary therapy team from the R. Hollman Foundation (Padova, Italy). A set of guidelines useful to designers and developers are presented as a result of the co-design process.

Corneal neovascularization (CNV) can induce severe visual impairment and even blindness. Current treatments have limited efficacy and some undesirable side effects. Phototherapy (PT) is a modern medical technique in CNV treatment and worth further improvement. Nanotechnology has various advantages and nanoparticle-mediated drug delivery also contributes to CNV elimination. Phototherapy combined with functional nanoparticles featuring photoacoustic imaging contrast properties can accomplish accurate and safe inhibition of CNV, thus is promising in clinical application.

Zusammenfassung Fragestellung Ziel unserer Studie war die Analyse der Effektivität von intravitrealen Injektionen mit Aflibercept. Ein weiterer Untersuchungsgegenstand waren mögliche negative Einflussfaktoren auf die Behandlung von PatientInnen mit therapienaiver exsudativer Makuladegeneration. Methode Es wurden Real-Life-Daten von PatientInnen mit exsudativer altersbedingter Makuladegeneration (nAMD) unter Aflibercept-Therapie retrospektiv erhoben. Erfasst wurden u. a. Geschlecht, Alter, Entfernung zur Klinik in km, Art des Transports, bestkorrigierter Visus (BCVA), zentrale Foveadicke (CFT) bei Diagnosestellung und allen Verlaufskontrollen, Sehbehinderung nach WHO-Kriterien, Anzahl der Kontrollen und Anzahl der Injektion im 1. Jahr sowie im 2. Jahr nach Behandlungsbeginn. Ergebnisse Es wurden Daten von 483 PatientInnen erhoben. Die PatientInnen erhielten in den ersten 12 Monaten 4,91 ± 1,9 Injektionen und nach 26 Monaten 7,06 ± 3,6 Injektionen. Nach der initialen Loading Dose steigerte sich der BCVA signifikant von 0,72 logMAR (± 0,44) auf 0,63 logMAR (± 0,45; p = 0,03), jedoch kam es bis zum Ende des Beobachtungszeitraums zu einem signifikant schlechteren Visus als zu Behandlungsbeginn (0,82 logMAR ± 0,48; p Schlussfolgerung Die Real-Life-Daten therapienaiver PatientInnen mit exsudativer AMD unter Aflibercept-Therapie zeigen, dass im Vergleich zu randomisierten klinischen Studien ein schlechteres Visusergebnis und eine niedrigere Injektionsfrequenz erzielt wurde. Der höhere Bedarf für einen begleitenden Patiententransport und der Anstieg der Prävalenz höhergradiger Sehbehinderungen bei zunehmender Entfernung des Wohnorts zur Klinik könnten einen Hinweis auf strukturelle Probleme der Versorgungsqualität von PatientInnen mit nAMD darstellen.

Mathematical education is currently undergoing significant changes that are driven by technology and digital-based learning. Students with visual impairments (VI) may face different challenges in mathematical education due to a lack of accessible materials designed to support the development of conceptual understanding in mathematics. The aim of the study was to summarize current evidence-based knowledge about e-learning in mathematics among students with severe VI. A systematic review was conducted of articles published from January 2000 to November 2017. A total of 13 publications met the inclusion criteria, of which 12 reported studies with an intervention or an experimental design and one had a cross-sectional design. The number of students with VI varied from three to 16 (Mage = 19 years). Four publications reported either ophthalmic diagnoses or World Health Organization’s (WHO) definition of vision loss. The mathematical training was reported as lasting from one session to 18 weeks of training. Eight papers reported the use of audio-based applications as learning aids. The authors conclude that interactive e-learning with audio and tactile learning programmes may be a useful resource for students with VI to enhance their mathematical skills. However, there is lack of evidence for how digital technologies improve inclusion potentials and learning in mathematics for students with VI, and hence, there is a need for additional research and more reflection on the subject. © 2019. This is the authors' accepted and refereed manuscript to the article. The final authenticated version is available online at: https://doi.org/10.1177%2F0264619619876975

Substantial research has demonstrated that an external (vs. internal) attentional focus enhances motor performance among various populations. Interest has recently grown in examining the effects of attentional focus among individuals with visual impairments (VI), and, to date, research results have been conflicting with some studies supporting a potential benefit to an external focus among adults with VI, while a study of children with severe VI was inconclusive regarding this benefit. The present investigation compared the effects of an internal versus an external attentional focus on a discrete throwing task among adolescents with severe VI. We recruited 13 participants with a visual acuity score of less than 6/60 and had them throw a Goalball (25 cm ball with bells often used in competitive sports designed for people with VI) as fast as possible for three familiarization trials, three internal focus trials, and three external focus trials. These participants threw the ball with significantly higher velocity when using an external focus than in other conditions, indicating a benefit from an external focus for this population when performing this discrete task.

AIM: To understand the barriers in utilisation of low vision assistive products (LVAPs) from the perspective of patients with low vision. METHODS: Patients referred to low vision clinic in a tertiary eye care hospital in India who were prescribed LVAPs but were un-willing to accept the products were interviewed using questionnaires. Data pertaining to the age, diagnosis, gender, occupation, preferred LVAPs, patient’s perception of vision loss and the primary reason for non-acceptance of LVAPs were analysed. RESULTS: A total of 235 among the 413 patients who noticed improvement in visual performance with LVAPs were unwilling to utilise these products. The questionnaire revealed that 53% of the patients who felt they were not candidates for LVAPs were experiencing severe visual impairment (p 60 years (25%; p

Purpose: To estimate the prevalence and causes of blindness (BL), severe visual impairment (SVI), moderate visual impairment (ModVI) and mild visual impairment (MildVI) in children in Narayani Zone, Nepal. Methods: In 2017, 100 population clusters within the Narayani Zone of Nepal were selected using RAAB software. Children (aged 0-15 years) suspected of having visual problems were identified using Key Informants (KIs) and school teachers and were referred for ophthalmologic examination. Eye care staff actively sought children who failed to present for examination. Causes of BL/SVI/ModVI/MildVI were categorized using standard World Health Organization definitions. Results: Of 76,588 children selected, 72,900 (95%) were screened. Of 2,158 children referred for examination, 1,322 were referred by teachers and 836 by KIs. A total of 1,617 (75%) children received a detailed examination, of whom 128 children [65 girls (51%)] mean age of 9.4 (± 4.1 years) were confirmed to have BL 7 (5.5%), SVI 16 (12.5%), ModVI 19 (15%) or MildVI 86 (67%). The combined prevalence of BL/SVI/ModVI/MildVI was 175/100,000 (95% CI 172-178/100,000); BL/SVI/ModVI was 55/100,000 (95% CI 53-57/100,000) and the combined BL/SVI estimate was 30/100,000 (95% CI 29-31/100,000). The leading causes of BL/SVI/MVI were refractive error 23 (55%) and whole globe disorders 5 (12%). Total avoidable causes were 31 (74%). Conclusion: The prevalence of BL/SVI/ModVI among children in Narayani Zone was moderate and included a high proportion of avoidable and treatable cases. Pediatric ophthalmic services need improvement, mainly refractive error correction in rural areas of Nepal.