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Yolcu D, Ozdogan S. A novel method to measure margin reflex distance using the autorefractometer. Int Ophthalmol 2021; 42:1241-1247. [PMID: 34738206 DOI: 10.1007/s10792-021-02110-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 10/21/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the margin reflex distance (MRD) in healthy subjects using autorefractometer front monitor images (ARFMI) and validate the accuracy of this method by comparing it with conventional methods. METHODS One hundred eyes of 50 healthy subjects aged 20-59 years were included in the study. Autorefractometer front monitor images were video-recorded using a smartphone camera, and screenshots were taken to analyze the MRD. The results were compared with those from conventional methods to determine the reliability of the method. To evaluate the repeatability and reproducibility of all measurement methods, we performed two different visits by two observers. RESULTS The mean MRD-1 of the autorefractometer image measurement was 4.29 ± 0.90 mm, mean MRD-1 of the of the digital photography image measurement was 3.78 ± 1.03 mm, and mean MRD-1 of the manual measurement was 4.02 ± 1.09 mm. The mean difference (MD) of MRD-1 was analyzed and it was found that MD of the autorefractometer image was significantly higher than the MD of other groups (p < 0.001). The best repeatability was found in the autorefractometer image measurement [intraclass correlation coefficients (ICC): 0.960], and substantial to excellent repeatability was found in the manual (ICC: 0.903) and digital photography image measurements (ICC: 0.843). The mean inter-eye difference of MRD-1 measured by the three methods was analyzed, and there was a statistically significant difference in the autorefractometer and digital image groups (p: 0.001, p: 0.002, respectively). CONCLUSION Margin reflex distance measurement using ARFMI analysis is a novel, simple, accurate, reliable, and objective method. The autorefractometer device is readily available and can be found in any ophthalmic clinic. Therefore, ophthalmologists can easily measure and record MRD values and use the accurate and reliable results for follow-up and medicolegal issues.
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Affiliation(s)
- Demet Yolcu
- Department of Ophthalmology, Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Demetevler, Vatan Cd., Yenimahalle, Ankara, 06200, Turkey.
| | - Sibel Ozdogan
- Department of Ophthalmology, Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Demetevler, Vatan Cd., Yenimahalle, Ankara, 06200, Turkey
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Zimmerman K, Kearns F, Tzekov R. Natural protection of ocular surface from viral infections - A hypothesis. Med Hypotheses 2020; 143:110082. [PMID: 32679424 PMCID: PMC7346787 DOI: 10.1016/j.mehy.2020.110082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 07/04/2020] [Indexed: 01/08/2023]
Abstract
A pandemic outbreak of a viral respiratory infection (COVID-19) caused by a coronavirus (SARS-CoV-2) prompted a multitude of research focused on various aspects of this disease. One of the interesting aspects of the clinical manifestation of the infection is an accompanying ocular surface viral infection, viral conjunctivitis. Although occasional reports of viral conjunctivitis caused by this and the related SARS-CoV virus (causing the SARS outbreak in the early 2000s) are available, the prevalence of this complication among infected people appears low (~1%). This is surprising, considering the recent discovery of the presence of viral receptors (ACE2 and TMPRSS2) in ocular surface tissue. The discrepancy between the theoretically expected high rate of concurrence of viral ocular surface inflammation and the observed relatively low occurrence can be explained by several factors. In this work, we discuss the significance of natural protective factors related to anatomical and physiological properties of the eyes and preventing the deposition of large number of virus-loaded particles on the ocular surface. Specifically, we advance the hypothesis that the standing potential of the eye plays an important role in repelling aerosol particles (microdroplets) from the surface of the eye and discuss factors associated with this hypothesis, possible ways to test it and its implications in terms of prevention of ocular infections.
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Affiliation(s)
- Keith Zimmerman
- Department of Ophthalmology, University of South Florida, Tampa, FL, USA
| | - Fiona Kearns
- Department of Chemistry, University of South Florida, Tampa, FL, USA
| | - Radouil Tzekov
- Department of Ophthalmology, University of South Florida, Tampa, FL, USA; Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL, USA; Department of Medical Engineering, University of South Florida, Tampa, FL, USA.
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3
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Best LJ, Alexiades V, Hendrix DVH, Chen T, Ward DA. Blink patterns and kinematics of eyelid motion in ophthalmologically normal horses. Am J Vet Res 2018; 79:650-657. [DOI: 10.2460/ajvr.79.6.650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Krause M, Kruber D, Hümpfner-Hierl H, Sterker I, Hierl T. Three-dimensional changes of scleral show after surgical treatment of endocrine orbitopathy. J Craniomaxillofac Surg 2018; 46:44-49. [DOI: 10.1016/j.jcms.2017.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/18/2017] [Accepted: 10/24/2017] [Indexed: 11/24/2022] Open
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Digital Analysis of Eyelid Features and Eyebrow Position Following CO 2 Laser-assisted Blepharoptosis Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1063. [PMID: 27826468 PMCID: PMC5096523 DOI: 10.1097/gox.0000000000001063] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/10/2016] [Indexed: 11/26/2022]
Abstract
Background: To compare the margin reflex distance of the upper (MRD-1) and lower (MRD-2) eyelids and the eyebrow height (EBH) in patients with involutional and hard contact lens wear--induced blepharoptosis before and after ptosis surgery. Methods: Sixty patients with acquired blepharoptosis were studied. Group 1 consisted of 30 patients with involutional ptosis (age, 75.8 ± 6.4 years), and group 2 consisted of 30 patients with hard contact lens wear–induced ptosis (age, 50.2 ± 7.1 years). All patients underwent bilateral, CO2 laser–assisted levator aponeurosis advancement surgery. A digital image was taken in the primary position before and 2 months after the surgery. The image was analyzed by the ImageJ (NIH, Bethesda, Md.) software. Parameters included MRD-1, MRD-2, EBH, and ocular surface area (OSA). Results: After surgery, all patients had a significant increase in the MRD-1 and OSA and a decrease in the EBH (all P < 0.001). The increase in MRD-1 was significantly larger in group 1 than in group 2 (P = 0.028). The decrease of EBH was significantly greater in group 1 than in group 2 (P = 0.007). Group 1 had a slight decrease in the MRD-2, but group 2 had a significant increase after surgery (P = 0.026). The change in the OSA was not significantly different between the 2 groups. Conclusions: Digital image analyses can be used for precise measurements of the eyelid features. The disparity in the changes of eyelid and eyebrow features between the 2 groups may suggest different responses of the external eyelid muscles to surgery between cases of different etiology.
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Choi CJ, Lefebvre DR, Yoon MK. Validation of the facial assessment by computer evaluation (FACE) program for software-aided eyelid measurements. Orbit 2016; 35:117-120. [PMID: 27010889 DOI: 10.3109/01676830.2016.1139595] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this article is to validate the accuracy of Facial Assessment by Computer Evaluation (FACE) program in eyelid measurements. Sixteen subjects between the ages of 27 and 65 were included with IRB approval. Clinical measurements of upper eyelid margin reflex distance (MRD1) and inter-palpebral fissure (IPF) were obtained. Photographs were then taken with a digital single lens reflex camera with built-in pop-up flash (dSLR-pop) and a dSLR with lens-mounted ring flash (dSLR-ring) with the cameras upright, rotated 90, 180, and 270 degrees. The images were analyzed using both the FACE and ImageJ software to measure MRD1 and IPF.Thirty-two eyes of sixteen subjects were included. Comparison of clinical measurement of MRD1 and IPF with FACE measurements of photos in upright position showed no statistically significant differences for dSLR-pop (MRD1: p = 0.0912, IPF: p = 0.334) and for dSLR-ring (MRD1: p = 0.105, IPF: p = 0.538). One-to-one comparison of MRD1 and IPF measurements in four positions obtained with FACE versus ImageJ for dSLR-pop showed moderate to substantial agreement for MRD1 (intraclass correlation coefficient = 0.534 upright, 0.731 in 90 degree rotation, 0.627 in 180 degree rotation, 0.477 in 270 degree rotation) and substantial to excellent agreement in IPF (ICC = 0.740, 0.859, 0.849, 0.805). In photos taken with dSLR-ring, there was excellent agreement of all MRD1 (ICC = 0.916, 0.932, 0.845, 0.812) and IPF (ICC = 0.937, 0.938, 0.917, 0.888) values. The FACE program is a valid method for measuring margin reflex distance and inter-palpebral fissure.
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Affiliation(s)
- Catherine J Choi
- a Ophthalmic Plastic Surgery , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA
- b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA
| | - Daniel R Lefebvre
- a Ophthalmic Plastic Surgery , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA
- b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA
| | - Michael K Yoon
- a Ophthalmic Plastic Surgery , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA
- b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA
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Margin Reflex Distance: Differences Based on Camera and Flash Positions. Ophthalmic Plast Reconstr Surg 2016; 32:199-203. [DOI: 10.1097/iop.0000000000000456] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Two-dimensional analysis of palpebral opening in blepharoptosis: visual iris-pupil complex percentage by digital photography. Ann Plast Surg 2014; 72:375-80. [PMID: 24621784 DOI: 10.1097/sap.0b013e318269e4c9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The vertical dimension of the palpebral fissure and the marginal reflex distance are conventionally used to assess the amount or degree of blepharoptosis, and levator function is assessed by measuring total upper lid excursion between the extremes of down-gaze and up-gaze. However, these are 1-dimensional measures obtained with a ruler, and the results obtained are dependent on examiner skill. Digital photographs were obtained of 692 patients before and after upper blepharoplasty. Visual iris-pupil complex percentage (VIP) was measured in the 1,305 eyes by digital calculation using Adobe Photoshop CS3 (Adobe Systems, Inc). Perioperative eye images in primary gaze were evaluated independently by 2 surgeons, 2 nurses, and a graphic designer, and after excluding 50 eyes which were nonconcordant and 29 eyes which revealed retracted upper lids, the remaining 1,305 eyes were classified into 4 major groups, that is, into excellent (n = 415), good (n = 435), subclinical (n = 270), and prominent ptosis (n = 185) groups. In addition, eyes were subdivided into 5 types according to the iris-pupil complex position within the palpebral fissure. Visual iris-pupil complex percentages were from 85% to 94% in the excellent, from 78% to 84% in the good, from 70% to 77% in the subclinical ptosis, and below 70% in the prominent ptosis group. Patients in the subclinical or prominent ptosis eye group required surgery for blepharoptosis. Iris-pupil complex relation to the palpebral opening was classified into 5 eye types, namely, standard (n = 961), scleral (n = 266), sinking (n = 151), retracted (n = 3), and fish (n = 3). The authors devised a new prospective measurement method for assessing blepharoptosis in a clinical setting. Graphical comparisons between the devised method of measuring VIP and mathematical estimations showed that the devised method is easier, more practical, and more precise for measuring degree of blepharoptosis from general population trends, and that VIP also provides a useful objective index for evaluating the postoperative results of blepharoptosis.
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Peng CC, Cerretani C, Li Y, Bowers S, Shahsavarani S, Lin MC, Radke CJ. Flow Evaporimeter To Assess Evaporative Resistance of Human Tear-Film Lipid Layer. Ind Eng Chem Res 2014. [DOI: 10.1021/ie5030497] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C.-C. Peng
- Department of Chemical and Biomolecular Engineering, ‡Clinical Research Center, School
of Optometry, and §Vision Science Graduate Program, University of California, Berkeley, California 94720, United States
| | - C. Cerretani
- Department of Chemical and Biomolecular Engineering, ‡Clinical Research Center, School
of Optometry, and §Vision Science Graduate Program, University of California, Berkeley, California 94720, United States
| | - Y. Li
- Department of Chemical and Biomolecular Engineering, ‡Clinical Research Center, School
of Optometry, and §Vision Science Graduate Program, University of California, Berkeley, California 94720, United States
| | - S. Bowers
- Department of Chemical and Biomolecular Engineering, ‡Clinical Research Center, School
of Optometry, and §Vision Science Graduate Program, University of California, Berkeley, California 94720, United States
| | - S. Shahsavarani
- Department of Chemical and Biomolecular Engineering, ‡Clinical Research Center, School
of Optometry, and §Vision Science Graduate Program, University of California, Berkeley, California 94720, United States
| | - M. C. Lin
- Department of Chemical and Biomolecular Engineering, ‡Clinical Research Center, School
of Optometry, and §Vision Science Graduate Program, University of California, Berkeley, California 94720, United States
| | - C. J. Radke
- Department of Chemical and Biomolecular Engineering, ‡Clinical Research Center, School
of Optometry, and §Vision Science Graduate Program, University of California, Berkeley, California 94720, United States
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Rezayat F, Dehghan Nayeri N. Self-efficacy after life skills training: a case-control study. Nurs Midwifery Stud 2013; 2:83-8. [PMID: 25414884 PMCID: PMC4228906 DOI: 10.5812/nms.11691] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 05/10/2013] [Accepted: 08/24/2013] [Indexed: 11/16/2022] Open
Abstract
Background: Nursing students’ self-efficacy is a predictor for their educational progress. Students, who believe that they can be successful in their studies, are more confident. Therefore, many universities have focused on life skills training programs to improve the mental health of their students. Objectives: This study was conducted to evaluate and compare self-efficacy in two groups of nursing students of Tehran University of Medical Sciences (TUMS). One group of students was trained on life skill programs, and the second group was not trained on the issue. Materials and Methods: A case-control study was conducted on two groups of nursing students in TUMS in the late 2012. The case group (n = 112) had passed life skills training course, and the control group (n = 139) was not trained on the issue. Data was collected using a questionnaire containing 12 questions about demographic features, and the Sherer’s general self-efficacy questionnaire. Data analysis was performed using independent sample t-test, Chi-square, odds ratio, and Fisher’s exact test. Results: In the untrained and trained groups, 23% and 8% of the students had very high self-efficacy, respectively. The overall mean scores of self-efficacy were 41.99 ± 9.31 and 38.99 ± 10.48 in the trained and untrained groups, respectively (P = 0.015), and the higher mean score indicates lower level of self-efficacy. A significant difference was also found between the self-efficacy and family income (P = 0.029). Conclusions: The present study showed that life skills training program did not affect self-efficacy of nursing students. Perhaps, the methods used in education were influencing and then, more effective techniques such as role-play and group discussion should be substituted in life skills training.
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Affiliation(s)
- Fatemeh Rezayat
- Department of Psychiatric Nursing, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Nahid Dehghan Nayeri
- Department of Management, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Nahid Dehghan Nayeri, Department of Management, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Dr. Mirkhani (Nosrat) Ave., Tohid Sq., 1419733171 Tehran, IR Iran. Tel.: +98-2166927171, Fax: +98-66421685, E-mail:
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Bravo FG, Kufeke M, Pascual D. Incidence of lower eyelid asymmetry: an anthropometric analysis of 204 patients. Aesthet Surg J 2013; 33:783-8. [PMID: 23825308 DOI: 10.1177/1090820x13495406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To avoid complications and improve patient satisfaction with lower lid blepharoplasty, a precise assessment of any preoperative eyelid asymmetry is essential. OBJECTIVES The authors describe a method of assessing preoperative eyelid asymmetry through readily available software and classifying the resulting measurements. METHODS Digital images of 204 patients were analyzed using Photoshop CS3 Extended software (Adobe Systems, San Jose, California). The left eye was superimposed over the right eye using layers in the software program, and the lower eyelid margin and axis were outlined to obtain a diagram with the superimposed outlines of both eyes. Several measurements (ie, lateral canthal height, lower eyelid margin length and axis angle, and lower palpebral fissure surface area) were obtained for each patient. Differences between the right and left eyelids were recorded, and these data were compared between patients. RESULTS Of the 204 patients studied, 184 (90.2%) had some degree of asymmetry. Most (118; 64.13%) presented with the right lower eyelid at a more inferior position than the left (R-), while 66 (35.87%) presented with the right lower eyelid at a higher position than the left (R+), a difference that was highly significant (P < .001). CONCLUSIONS This software is a powerful and precise tool to evaluate and measure eyelid asymmetries. The use of this method showed a large degree of eyelid asymmetry preoperatively (more than 90%), which proves the importance of detecting and adequately analyzing this condition prior to surgery. The authors' simple method may be an important adjunct to obtaining optimal results in patients who seek eyelid surgery.
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Affiliation(s)
- Francisco G. Bravo
- Dr Bravo is Assistant Professor of Plastic Surgery at the Complutense University of Madrid and Program Director of the Plastic and Reconstructive Surgery Department of the Doce de Octubre University Hospital in Madrid, Spain
| | - Matias Kufeke
- Dr Kufeke is a plastic surgery resident at the Doce de Octubre University Hospital in Madrid
| | - David Pascual
- Dr David Pascual was a biostatistics and cardiology specialist and a faculty member of the Cardiology Department of the Gregorio Maranon University Hospital in Madrid. He passed away on May 9, 2011, during the study period
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Effect of brow lifting using botulinum a toxin on upper eyelid height in patients with ptosis undergoing the frontal sling technique. Ann Plast Surg 2012; 70:175-9. [PMID: 22791060 DOI: 10.1097/sap.0b013e31823b680a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In this study, brow lifting with botulinum A toxin was performed on patients whose ptosis was corrected using the frontal sling technique, and the effects of this application on ptosis were investigated. Seven patients (with 12 eyelids) on whom the frontal sling procedure was performed using a tensor fascia lata graft were enrolled in the study. The patients underwent brow lifting using botulinum A toxin. Digital photographs of the patients were obtained before and 21 days after botulinum A injection. In digital imaging analysis, although a statistically significant elevation was detected in the eyelids and brows of the patients following botulinum A injection, it did not to lead to a significant difference in the degree of lagophthalmos. In the current study, this procedure was found to reduce the degree of ptosis without increasing the degree of lagophthalmos in patients who had previously undergone ptosis correction using the frontal sling.
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Tsai PY, Wu YC, Lai CH, Huang SH, Lai YW, Lai CS. Ocular surface area changes after double eyelidplasty. J Plast Reconstr Aesthet Surg 2012; 65:e141-5. [DOI: 10.1016/j.bjps.2012.01.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 11/03/2011] [Accepted: 01/23/2012] [Indexed: 11/25/2022]
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Ballesteros R, Bonsfills N, Chacón M, García-Lázaro J, Gómez-Barrena E. Histomorphometry of the ligaments using a generic-purpose image processing software, a new strategy for semi-automatized measurements. J Digit Imaging 2011; 25:527-36. [PMID: 22143412 DOI: 10.1007/s10278-011-9440-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Gold chloride technique can be combined with Adobe Photoshop® software to yield a quantitative assessment of the different areas in heterogeneous structures as are ligament. A semi-automatized method based on the sum of two- and three-dimensional morphological criteria upon colorimetric criteria allows the identification and measurement of the area occupied by a structure of interest. It also allows the quantification of color intensity to differentiate structures with similar staining avidity, like vessels and nerves. This computer-assisted, semiquantitative procedure for computerized morphometry is relatively simple to perform. The accuracy, efficiency, and reproducibility of this method based on a commercially available imaging program were considered adequate when tested on the anterior cruciate ligament of the cat. Image normalization by trained observers using a commercially available software package designed for photography, applied to a sample randomly chosen, has provided the means of making reproducible measurements of heterogeneous structures.
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Affiliation(s)
- Rafael Ballesteros
- Department of Orthopedics, Universitary Hospital of Fuenlabrada, Camino del Molino 2, Fuenlabrada, 28942, Madrid, Spain.
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