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Christian LW, Opoku-Yamoah V, Rose K, Jones DA, McCulloch D, Irving EL, Leat SJ. Comparing paediatric optometric vision care in Canada over a 14-year period. Ophthalmic Physiol Opt 2024; 44:491-500. [PMID: 38317422 DOI: 10.1111/opo.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE In Canada, teaching in paediatric eye care has increased in the past decade both within the optometry curriculum and as continuing education to optometrists. Paediatric vision care guidelines have also been established by North American optometric associations. This study examined whether this exposure was associated with changes in paediatric eye care in Canada over a 14-year period. METHODS Canadian optometrists were invited to participate in an anonymous 35-item survey in 2007 and 2021. The surveys sought to investigate optometrist's recommendations for first eye examinations, the number of paediatric patients seen in a typical week and preparedness to provide eye examinations to children. Response frequencies were determined for each survey item. RESULTS Across Canada, 133/1000 (13.3%) and 261/~6419 (~4.1%) optometrists responded to the survey in 2007 and 2021, respectively. No significant difference was found in the number of years practicing, days per week in practice and total number of patients seen per week. The modal age optometrists recommended children be seen for their first eye examination changed from 3-4 years in 2007 (53%) to 6-12 months in 2021 (61%). In 2007, 87% of respondents provided eye examinations to children <2 years, increasing to 94% in 2021 (p = 0.02). Despite a reduction in the recommended age between the two survey years, the most frequent age children were seen for their first eye examination was 3-4 years (30% in both surveys) and the most common age seen in a typical week remained unchanged (4-6 years-56% 2007; 66% 2021). CONCLUSION Although optometrists' willingness to provide paediatric eye care increased over the past 14 years, the number of children seen in a typical week did not change. Barriers to determine why more children are not being seen at an earlier age need to be investigated.
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Affiliation(s)
- Lisa W Christian
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Victor Opoku-Yamoah
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Kalpana Rose
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah A Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Daphne McCulloch
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Elizabeth L Irving
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Susan J Leat
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
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Lu Y, Zou L, Wang W, Chen R, Qu J, Zhou J. Effects of Monocular Flicker on Binocular Imbalance in Amblyopic and Nonamblyopic Adults. Invest Ophthalmol Vis Sci 2024; 65:33. [PMID: 38530301 PMCID: PMC10982911 DOI: 10.1167/iovs.65.3.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 03/02/2024] [Indexed: 03/27/2024] Open
Abstract
Purpose This study aimed to evaluate the effects of monocular flicker stimulation on binocular imbalance in both amblyopic and nonamblyopic adults. Methods Seven amblyopic patients (28.3 ± 3.3 years; four females) and seven normally sighted participants (27.3 ± 4.1 years; five females) participated in the study. We used liquid crystal spectacles to create externally-generated monocular flicker (4, 7, 10, 15, or 20 Hz) and used the metric of log balance point (logBP) to determine whether imposed flicker could change the eyes' equilibrium interocular contrast ratio. Flicker was applied to either the fellow eye vs. the amblyopic eye or dominant eye (DE) vs. non-DE (non-DE) of amblyopic and nonamblyopic participants, respectively. We defined a logBP of 0 to indicate complete binocular balance and an increase in logBP relative to baseline to indicate a relative strengthening of the non-DE or amblyopic eye. Results Monocular flicker applied to the DE or fellow eye increased logBP, whereas when applied to the non-DE or amblyopic eye, reduced the logBP. These effects were more pronounced at low temporal frequencies than that at high temporal frequencies. The interaction between eye and temporal frequency was significant in both normals, F(4, 24) = 58.082, P < 0.001, η2 = 0.906, and amblyopes, F(1.923, 11.538) = 60.555, P < 0.001, η2 = 0.91. Conclusions Monocular flicker diminishes the contribution of the flickered eye in binocular combination, resulting in a relative dominance of the nonflickered eye in interocular interactions. Furthermore, a more pronounced temporally modulated effect was observed at lower temporal frequencies.
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Affiliation(s)
- Yiqiu Lu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, Zhejiang, China
| | - Liying Zou
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, Zhejiang, China
| | - Wenjing Wang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, Zhejiang, China
| | - Ruyin Chen
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, Zhejiang, China
| | - Jia Qu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision, and Brain Health), Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiawei Zhou
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, Zhejiang, China
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Abstract
Strabismus, or misalignment of the eyes, is the most common ocular disorder in the pediatric population, affecting approximately 2%-4% of children. Strabismus leads to the disruption of binocular vision, amblyopia, social and occupational discrimination, and decreased quality of life. Although it has been recognized since ancient times that strabismus runs in families, its inheritance patterns are complex, and its precise genetic mechanisms have not yet been defined. Family, population, and twin studies all support a role of genetics in the development of strabismus. There are multiple forms of strabismus, and it is not known if they have shared genetic mechanisms or are distinct genetic disorders, which complicates studies of strabismus. Studies assuming that strabismus is a Mendelian disorder have found areas of linkage and candidate genes in particular families, but no definitive causal genes. Genome-wide association studies searching for common variation that contributes to strabismus risk have identified two risk loci and three copy number variants in white populations. Causative genes have been identified in congenital cranial dysinnervation disorders, syndromes in which eye movement is limited or paralyzed. The causative genes lead to either improper differentiation of cranial motor neurons or abnormal axon guidance. This article reviews the evidence for a genetic contribution to strabismus and the recent advances that have been made in the genetics of comitant strabismus, the most common form of strabismus.
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Affiliation(s)
- Mayra Martinez Sanchez
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA, United States
- Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Mary C. Whitman
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA, United States
- Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA, United States
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Archambault C, Azad AD, Al-Moujahed A, Vail D, Wood E, Koo EB. Time to Treatment of Pediatric Retinal Detachments: A US Claims-based Analysis. Ophthalmol Retina 2023; 7:221-226. [PMID: 36002094 PMCID: PMC9941366 DOI: 10.1016/j.oret.2022.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To characterize delays in diagnosis and treatment of retinal detachments (RDs) in a pediatric population. DESIGN Retrospective cohort study using insurance claims data. SUBJECTS Pediatric patients with RD who underwent repair in the outpatient setting. METHODS A retrospective analysis of commercially insured patients from a national cohort (IBM MarketScan Research Databases) aged ≤ 18 years with an incident diagnosis of RD between 2007 and 2016. Patients with preceding eye-related visits, time to diagnosis, and time to repair were calculated and compared between patients with pre-existing ocular diagnosis and those without. MAIN OUTCOME MEASURES The time from diagnosis to specialist consultation, time from diagnosis to repair, time from specialist consultation to repair, number of preceding visits, and presence of previous eye-related diagnosis. RESULTS Our sample consisted of 826 patients, the majority (77%) of whom were diagnosed with rhegmatogenous RD. Only 40% of patients had at least 1 preceding eye-related visit, and 33% had at least 2 visits before RD diagnosis, with a median time from the last eye-related visit of 32 days (4-197 days) and median time from the second to last visit of 118 days (24-437 days). The median time from RD diagnosis to repair was 2 days (0-9 days). The 323 (37.9%) patients with pre-existing ocular diagnoses more frequently had at least 1 (44% vs. 37%; P = 0.079) or 2 preceding eye-related visits (40% vs. 29%; P = 0.002) compared with those without and also had a shorter time to RD diagnosis (median, 14.5 days vs. 44.5 days; P = 0.011) and repair (1 day vs. 3 days; P = 0.003). CONCLUSIONS Retinal detachment is an important cause of morbidity in children. This work highlighted how pediatric patients without previous ocular diagnoses and visits with eye care professional may have a delayed diagnosis and repair of their RD. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Cyril Archambault
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
| | - Amee D Azad
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
| | - Ahmad Al-Moujahed
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
| | - Daniel Vail
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
| | - Edward Wood
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
| | - Euna B Koo
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California.
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Read SA, Hopkins S, Black AA, Bentley SA, Scott J, Wood JM. Prevalence of vision conditions in children in a very remote Australian community. Clin Exp Optom 2023; 106:195-201. [PMID: 36442517 DOI: 10.1080/08164622.2022.2133597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CLINICAL RELEVANCE Understanding the prevalence of vision conditions in a population is critical for determining the most appropriate strategies for detecting and correcting eye conditions in a community. This is particularly important in very remote regions where access to vision testing services is limited. BACKGROUND Although recent studies have provided detailed analyses of the prevalence of vision conditions in Aboriginal and/or Torres Strait Islander children in urban and regional areas of Australia, there is a paucity of research examining vision conditions in children in remote regions. Importantly, a significant proportion of the population in remote and very remote regions identify as Aboriginal and/or Torres Strait Islander people. METHODS Comprehensive eye examinations were provided to 193 primary school children in a very remote Australian region. Ninety eight percent of children identified as Aboriginal and/or Torres Strait Islander. The eye examination included measures of visual acuity, cycloplegic autorefraction, binocular vision and accommodative function, ocular health and colour vision. Previous history of eye examinations and refractive correction were assessed through parental questionnaire. RESULTS Although the average unaided vision in the population was good (mean: 0.02 ± 0.13 logMAR) and the prevalence of reduced unaided visual acuity (>0.3 logMAR in either eye) was low (4%), vision conditions were detected in 32% of children. The most common conditions were clinically significant refractive errors (18% of children) and binocular vision or accommodative disorders (16%). Of the total population of children tested, 10% had previously had an eye examination, and 2% were reported to have previously been prescribed spectacles. CONCLUSIONS In this population of children in a very remote Australian region, up to 1 in 3 children had a vision condition, with many of these conditions being uncorrected and undetected. These findings highlight the important need for additional resources to be made available to very remote communities for the detection and correction of vision conditions in childhood.
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Affiliation(s)
- Scott A Read
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shelley Hopkins
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Sharon A Bentley
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - John Scott
- Centre for Justice, School of Justice, Faculty of Creative Industries, Education and Social Justice, Queensland University of Technology, Brisbane, Australia
| | - Joanne M Wood
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Topical Review: Teaching Serious News Delivery in Eye Care. Optom Vis Sci 2023; 100:127-133. [PMID: 36728608 DOI: 10.1097/opx.0000000000001983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
SIGNIFICANCE Eye doctors regularly convey serious illness news to their patients. There is an evolving understanding of how medical educators can effectively teach this vital communication skill during real-time patient care. This article proposes teaching strategies to improve clinical optometric education related to serious illness conversations.Effectively conveying serious illness news is an essential skill in optometry practice. Established protocols can help optometrists navigate these nuanced, emotional, and complex conversations with patients, yet protocols for teaching this skill in eye care settings have not been described. Clinical educators need discrete strategies for making such pivotal communication skills learnable in an environment where patient care, teaching priorities, and limited resources are regularly juggled. Despite the importance of this competency, limited study has focused on teaching optometry learners to deliver serious eye news. In this article, we explore the importance of optometry talk, serious news delivery tools, and considerations for optometric educators teaching serious news delivery. We then adapt specific strategies from medical education to help optometry educators teach serious news delivery in clinical settings.
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Spafford MM, Jones DA, Christian LW, Labreche T, Furtado NM, MacIver S, Irving EL. What the Canadian public (mis)understands about eyes and eye care. Clin Exp Optom 2023; 106:75-84. [PMID: 34875204 DOI: 10.1080/08164622.2021.2008793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
CLINICAL RELEVANCE Inadequate public knowledge about eyes and eye care poses avoidable risks to vision-related quality of life. BACKGROUND This study of eye care knowledge among Canadians extends earlier findings from focus groups. METHODS Perceptions about eyes and eye care were sought using a 21-item online survey and snowball sampling. Inclusion criteria were living in Canada and being at least 18-years old; eye care professionals and staff were excluded. Response frequencies were converted to percentages, with eye condition items analysed according to 'expected' or 'unexpected' eye impacts. Proportions selecting these impacts or 'unsure' were determined. RESULTS There were 424 respondents: 83.0% aged 20-65 years and 69.6% female. Mismatches existed between perceived recommendations and behaviours for booking eye exams: within two years (86.7% vs. 68.4%) and symptom-driven (3.3% vs. 13.0%). First eye exams after age one year were deemed appropriate by 43.6%. Few respondents associated glaucoma with no symptoms (6.0%) or amblyopia with blurred vision (13.5%). A notable proportion incorrectly related tunnel vision with age-related macular degeneration (AMD, 36.8%) and cataract (21.9%). Identifying all 'expected' responses was unlikely for glaucoma (1.9%), amblyopia (6.7%), and cataract (12.0%). Most respondents identified no 'expected' effects for glaucoma (63.8%) and AMD (46.2%) and some 'expected' effects for cataract (59.5%) and amblyopia (72.6%). Selecting 'unsure' was 9-10 times more common among respondents choosing no 'expected' impacts than those choosing some. Awareness of thyroid-associated eye disease was lowest (32.4%) of seven conditions. Respondents were most likely to consult optometrists for routine eye exams, eye disease, diabetes eye checks and blurred vision but family physicians for red eyes and sore eyes. Respondents typically paid for their eye exams and eyewear but wanted government to pay. CONCLUSION Vision-threatening knowledge gaps and misinformation about eyes and eye care among Canadian respondents highlight the need for accessible, targeted public education.
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Affiliation(s)
- Marlee M Spafford
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah A Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lisa W Christian
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Tammy Labreche
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Nadine M Furtado
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Sarah MacIver
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Elizabeth L Irving
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
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8
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Adomfeh J, Jastrzembski BG, Oke I. Association of Race, Ethnicity, and Socioeconomic Status With Visual Impairment in Adolescent Children in the US. JAMA Ophthalmol 2022; 140:1006-1010. [PMID: 36107437 PMCID: PMC9478879 DOI: 10.1001/jamaophthalmol.2022.3627] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/26/2022] [Indexed: 08/26/2023]
Abstract
Importance Although racial, ethnic, and socioeconomic disparities in visual impairment have been described in adults, few studies have focused on the adolescent population, which may provide insight into the emergence of vision health inequities. Objective To describe visual health disparities among adolescent children in the US. Design, Setting, and Participants This was a cross-sectional study of adolescents from the 2005 to 2008 National Health and Nutrition Examination Survey. Participants were aged 12 to 18 years with a completed visual function questionnaire and eye examination. Data analyses were conducted from January 19 to July 20, 2022. Main Outcomes and Measures Outcomes included subjective (self-reported poor vision) and objective (visual acuity worse than 20/40 in the better-seeing eye) measures of visual function. Multivariable logistic and linear regression analyses were conducted to examine the association between the sociodemographic risk factors and each outcome, adjusting for age, sex, and other covariates. Results The 2833 included participants (mean [SD] age, 15.5 [2.0] years; 1407 female participants [49%]) represent a survey-weighted 57 million US adolescent children, of whom 14% were non-Hispanic Black participants (876), 11% were Mexican American participants (828), 63% were non-Hispanic White participants (816), and 11% were other race and ethnicity (313). A total of 5% of participants (266) were not US citizens, and 19% (773) had a family income below the poverty threshold. There were increased odds of self-reported poor vision among Black (odds ratio [OR], 2.85; 95% CI, 2.00-4.05; P < .001), Mexican American (OR, 2.83; 95% CI, 1.70-4.73; P < .001), and low-income (OR, 2.44; 95% CI, 1.63-3.65; P < .001) adolescent children. Similarly, there were increased odds of visual acuity worse than 20/40 in the better-seeing eye among Black (OR, 2.13; 95% CI, 1.41-3.24; P = .001), Mexican American (OR, 2.13; 95% CI, 1.39-3.26; P = .001), and non-US citizen (OR, 1.96; 95% CI, 1.10-3.49; P = .02) participants. Conclusions and Relevance In this nationally representative sample from 2005 to 2008, adolescent children identifying as Black, Mexican American, low-income, or non-US citizen were more likely to report poor subjective visual function and perform worse on objective visual acuity testing. A greater understanding of the underlying etiology of these disparities may yield opportunities for improving vision at the population level.
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Affiliation(s)
- Jean Adomfeh
- Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benjamin G. Jastrzembski
- Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Isdin Oke
- Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
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9
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Azad AD, Al-Moujahed A, Ludwig CA, Vail D, Callaway NF, Rosenblatt TR, Kumm J, Moshfeghi DM. The Utility of Universal Newborn Eye Screening: A Review. Ophthalmic Surg Lasers Imaging Retina 2021; 52:S6-S16. [PMID: 34908491 DOI: 10.3928/23258160-20211115-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Universal newborn eye screening can identify ocular abnormalities early and help mitigate long-term visual impairment. Traditional neonatal and infant eye screening is administered by neonatologists and pediatricians using the red reflex test. If this test identifies an ocular abnormality, then the patient is examined by an ophthalmologist. Notably, the red reflex test may be unable to detect amblyogenic posterior segment pathology. Recent studies using fundus imaging and telemedicine show reduced cost of human resources and increased sensitivity compared with traditional approaches. In this review, the authors discuss universal newborn eye screening pilot programs with regard to disease prevalence, referral-warranted disease, and cost-effectiveness. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:S6-S16.].
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Wilson S, Ctori I, Suttle C, Conway M, Shah R. How accessible is primary eye care for children in England? Ophthalmic Physiol Opt 2021; 41:1021-1033. [PMID: 34402083 DOI: 10.1111/opo.12868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE Good vision during childhood is vital for visual, educational, and social development. Previous research highlights challenges in the accessibility of eye care for children. This study investigates the accessibility of primary eye care for young children with typical development and those with autism in England. METHODS A telephone survey was conducted using four hypothetical scenarios (a child aged 1, 3, 5 years and a 13-year-old with autism). Four hundred community optometric practices (100 different practices for each scenario) were contacted to explore the availability of an eye examination. The caller acted as a parent, asking about the availability of an eye examination for their child and raising concerns regarding the child. Key barriers and enablers to the accessibility of primary eye care were identified through an analysis of qualitative information. RESULTS Of the 400 practices, only three (<1%) stated that they do not perform eye examinations on children. Fifty-six practices (14%) stated that they would examine a child at any age, the remainder (n = 341, 85%) specifying a minimum age at which they would perform eye examinations on children. Lack of 'communication' from the child and 'equipment' were identified as barriers to accessing eye care for young children. Eye care for children with autism was enabled by factors related to adaptability and appointment time. CONCLUSION Our results suggest that communication and a lack of appropriate equipment for examining children are potential barriers to accessing primary eye care. No clear barriers were identified for an older child with autism. Eye examinations are more accessible for older children in these scenarios (aged 5 with typical development and 13 years with autism) than younger children (aged 1 and 3 years old). While the UK General Ophthalmic Services (GOS) terms do not permit contract holders to exclude categories of patients from a GOS eye exam, our findings suggest this is taking place.
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Affiliation(s)
- Salma Wilson
- Division of Optometry and Vision Science, School of Health Sciences, City, University of London, London, UK
| | - Irene Ctori
- Division of Optometry and Vision Science, School of Health Sciences, City, University of London, London, UK
| | - Catherine Suttle
- Division of Optometry and Vision Science, School of Health Sciences, City, University of London, London, UK
| | - Miriam Conway
- Division of Optometry and Vision Science, School of Health Sciences, City, University of London, London, UK
| | - Rakhee Shah
- Division of Optometry and Vision Science, School of Health Sciences, City, University of London, London, UK
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11
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Whitman MC, Di Gioia SA, Chan WM, Gelber A, Pratt BM, Bell JL, Collins TE, Knowles JA, Armoskus C, Pato M, Pato C, Shaaban S, Staffieri S, MacKinnon S, Maconachie GDE, Elder JE, Traboulsi EI, Gottlob I, Mackey DA, Hunter DG, Engle EC. Recurrent Rare Copy Number Variants Increase Risk for Esotropia. Invest Ophthalmol Vis Sci 2021; 61:22. [PMID: 32780866 PMCID: PMC7443120 DOI: 10.1167/iovs.61.10.22] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine whether rare copy number variants (CNVs) increase risk for comitant esotropia. Methods CNVs were identified in 1614 Caucasian individuals with comitant esotropia and 3922 Caucasian controls from Illumina SNP genotyping using two Hidden Markov model (HMM) algorithms, PennCNV and QuantiSNP, which call CNVs based on logR ratio and B allele frequency. Deletions and duplications greater than 10 kb were included. Common CNVs were excluded. Association testing was performed with 1 million permutations in PLINK. Significant CNVs were confirmed with digital droplet polymerase chain reaction (ddPCR). Whole genome sequencing was performed to determine insertion location and breakpoints. Results Esotropia patients have similar rates and proportions of CNVs compared with controls but greater total length and average size of both deletions and duplications. Three recurrent rare duplications significantly (P = 1 × 10−6) increase the risk of esotropia: chromosome 2p11.2 (hg19, 2:87428677-87965359), spanning one long noncoding RNA (lncRNA) and two microRNAs (OR 14.16; 95% confidence interval [CI] 5.4–38.1); chromosome 4p15.2 (hg19, 4:25554332-25577184), spanning one lncRNA (OR 11.1; 95% CI 4.6–25.2); chromosome 10q11.22 (hg19, 10:47049547-47703870) spanning seven protein-coding genes, one lncRNA, and four pseudogenes (OR 8.96; 95% CI 5.4–14.9). Overall, 114 cases (7%) and only 28 controls (0.7%) had one of the three rare duplications. No case nor control had more than one of these three duplications. Conclusions Rare CNVs are a source of genetic variation that contribute to the genetic risk for comitant esotropia, which is likely polygenic. Future research into the functional consequences of these recurrent duplications may shed light on the pathophysiology of esotropia.
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Affiliation(s)
- Mary C Whitman
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Silvio Alessandro Di Gioia
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Wai-Man Chan
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Alon Gelber
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Brandon M Pratt
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Jessica L Bell
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Thomas E Collins
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - James A Knowles
- Department of Cell Biology, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
| | - Christopher Armoskus
- Department of Cell Biology, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
| | - Michele Pato
- Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, New York, United States
| | - Carlos Pato
- Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, New York, United States
| | - Sherin Shaaban
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States.,Present address: Department of Pathology and ARUP Laboratories, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Sandra Staffieri
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Sarah MacKinnon
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Gail D E Maconachie
- Department of Neuroscience, Psychology and Behavior, The University of Leicester Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom
| | - James E Elder
- Department of Ophthalmology, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Elias I Traboulsi
- Department of Pediatric Ophthalmology and Strabismus, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Irene Gottlob
- Department of Neuroscience, Psychology and Behavior, The University of Leicester Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - David G Hunter
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Elizabeth C Engle
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Harvard Medical School, Boston, Massachusetts, United States.,Howard Hughes Medical Institute, Chevy Chase, Maryland, United States
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12
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Cox RA, Read SA, Hopkins S, Wood JM. High Rates of Uncorrected Vision Conditions among Schoolchildren in Rural Queensland, Australia. Optom Vis Sci 2021; 98:51-57. [PMID: 33394931 DOI: 10.1097/opx.0000000000001628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This study is the first to report high rates of uncorrected vision conditions among Australian secondary schoolchildren living in a rural area and to comment on the rate of eye examinations undertaken on Australian Indigenous children. Uncorrected vision problems that continue throughout the school years have significant implications for children's quality of life and education. PURPOSE This study aimed to investigate the prevalence of uncorrected vision conditions among Australian schoolchildren. METHODS Participants included 280 students from rural primary and secondary schools (aged 4 to 18 years), of whom 40% identified as being of Aboriginal and/or Torres Strait Islander descent (Indigenous). All participants underwent an eye examination including measurements of monocular distance and near visual acuity, assessment of accommodative and vergence function, stereoacuity, color vision, and cycloplegic autorefraction. A parental questionnaire was used to determine whether the child had previously had his/her eyes examined. RESULTS The overall prevalence of uncorrected vision conditions in this population was 35%. The odds of previously having had an eye examination were 2.3× higher for non-Indigenous compared with Indigenous children despite both groups exhibiting high rates of uncorrected vision conditions (Indigenous, 31 [29%]; non-Indigenous, 66 [40%]; χ21 = 3.24, P = .07). Of the children who had significant refractive error (Indigenous, 23 [21%]; non-Indigenous, 49 [30%]; χ21 = 2.70, P = .10), 82% were uncorrected, and only 39% of Indigenous children and 54% of non-Indigenous children had previously had an eye examination. CONCLUSIONS These findings suggest that high rates of uncorrected vision conditions are present among Australian primary and secondary schoolchildren from a rural area and highlight that Indigenous children are much less likely to have had an eye examination. Understanding factors that affect the rate of eye examinations and compliance with spectacle correction must be addressed given the potential impact of these vision conditions.
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Affiliation(s)
- Rebecca A Cox
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Shelley Hopkins
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Joanne M Wood
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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13
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Abstract
Republished with written permission granted from the American Optometric Association, October 2, 2020.
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14
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Harvey H, Ashworth M, Palikara O, Van Herwegen J. The Underreporting of Vision Problems in Statutory Documents of Children with Williams Syndrome and Down Syndrome. J Autism Dev Disord 2020; 50:4553-4556. [PMID: 32347468 DOI: 10.1007/s10803-020-04520-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Vision problems can lead to negative developmental outcomes. Children with Williams syndrome and Down syndrome are at higher risk of vision problems, and these are less likely to be detected due to diagnostic overshadowing and difficulty accessing eye-care. Education, Health and Care (EHC) plans are statutory documents, introduced by the Children and Families Act 2014 in England, with the intention of integrating provision across these domains. Vision issues should be reported in these plans, and recommendations made about appropriate adjustments for them. We analysed the EHC plans from 53 children with Down or Williams syndrome. Our results showed significant underreporting, especially for children with Williams syndrome, and little explanation of what adjustments should be made. We also report pockets of good practice.
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Affiliation(s)
- Hannah Harvey
- SeeAbility, Newplan House 41 East Street, Epsom, KT17 1BL, UK.
| | - Maria Ashworth
- Department of Psychology and Human Development, UCL Institute of Education, London, UK
| | - Olympia Palikara
- Centre for Education Studies, University of Warwick, Coventry, UK
| | - Jo Van Herwegen
- Department of Psychology and Human Development, UCL Institute of Education, London, UK
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15
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Lee SSY, Lingham G, Yazar S, Sanfilippo PG, Charng J, Chen FK, Hewitt AW, Ng F, Hammond C, Straker LM, Eastwood PR, MacGregor S, Rose KA, Lucas RM, Guggenheim JA, Saw SM, Coroneo MT, He M, Mackey DA. Rationale and protocol for the 7- and 8-year longitudinal assessments of eye health in a cohort of young adults in the Raine Study. BMJ Open 2020; 10:e033440. [PMID: 32217560 PMCID: PMC7170556 DOI: 10.1136/bmjopen-2019-033440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Eye diseases and visual impairment more commonly affect elderly adults, thus, the majority of ophthalmic cohort studies have focused on older adults. Cohort studies on the ocular health of younger adults, on the other hand, have been few. The Raine Study is a longitudinal study that has been following a cohort since their birth in 1989-1991. As part of the 20-year follow-up of the Raine Study, participants underwent a comprehensive eye examination. As part of the 27- and 28-year follow-ups, eye assessments are being conducted and the data collected will be compared with those of the 20-year follow-up. This will provide an estimate of population incidence and updated prevalence of ocular conditions such as myopia and keratoconus, as well as longitudinal change in ocular parameters in young Australian adults. Additionally, the data will allow exploration of the environmental, health and genetic factors underlying inter-subject differential long-term ocular changes. METHODS AND ANALYSIS Participants are being contacted via telephone, email and/or social media and invited to participate in the eye examination. At the 27-year follow-up, participants completed a follow-up eye screening, which assessed visual acuity, autorefraction, ocular biometry and ocular sun exposure. Currently, at the 28-year follow-up, a comprehensive eye examination is being conducted which, in addition to all the eye tests performed at the 27-year follow-up visit, includes tonometry, optical coherence tomography, funduscopy and anterior segment topography, among others. Outcome measures include the incidence of refractive error and pterygium, an updated prevalence of these conditions, and the 8-year change in ocular parameters. ETHICS AND DISSEMINATION The Raine Study is registered in the Australian New Zealand Clinical Trials Registry. The Gen2 20-year, 27-year and 28-year follow-ups are approved by the Human Research Ethics Committee of the University of Western Australia. Findings resulting from the study will be published in health or medical journals and presented at conferences. TRIAL REGISTRATION NUMBER ACTRN12617001599369; Active, not recruiting.
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Affiliation(s)
- Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
| | - Gareth Lingham
- Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
- Single Cell and Computational Genomics Lab, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia Ltd, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia Ltd, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Fletcher Ng
- Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Christopher Hammond
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK
| | - Leon M Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Peter R Eastwood
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Sir Charles Gairdner Hospital, West Australian Sleep Disorders Research Institute, Nedlands, Western Australia, Australia
| | - Stuart MacGregor
- Genetics and Population Health, Queensland Institute of Medical Research - QIMR, Brisbane, Queensland, Australia
| | - Kathryn A Rose
- University of Sydney, Sydney, New South Wales, Australia
| | - Robyn M Lucas
- Australian National University, Research School of Population Health, College of Health and Medicine, Canberra, Australian Capital Territory, Australia
| | - Jeremy A Guggenheim
- School of Optometry and Vision Science, Cardiff University, Cardiff, South Glamorgan, UK
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Minas T Coroneo
- Department of Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
| | - Mingguang He
- Centre for Eye Research Australia Ltd, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
- Centre for Eye Research Australia Ltd, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
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16
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Fu Z, Hong H, Su Z, Lou B, Pan CW, Liu H. Global prevalence of amblyopia and disease burden projections through 2040: a systematic review and meta-analysis. Br J Ophthalmol 2019; 104:1164-1170. [DOI: 10.1136/bjophthalmol-2019-314759] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 12/11/2022]
Abstract
PurposeAmblyopia is a leading cause of vision impairment among children and young adults. Individual studies showed significant variations in the prevalence of amblyopia in different regions and age groups. This study is to estimate the global prevalence of amblyopia by pooling its prevalence from the previous studies and to project the number of people affected through 2040.MethodsWe performed a systematic review and meta-analysis on the prevalence of amblyopia using data published before 20 October 2018. We estimated the prevalence rate of amblyopia and its 95% CI globally and by subgroups (eg, region and age). The prevalence data were applied to United Nations World Population Prospects to derive the projected number with amblyopia through 2040.ResultsA meta-analysis of 60 studies (1 859 327 subjects) showed that the pooled prevalence rate of amblyopia was 1.44% (95% CI 1.17% to 1.78%). Prevalences in Europe (2.90%) and North America (2.41%) were higher than in Asia (1.09%) and Africa (0.72%). The highest prevalence was found in subjects over 20 years old (3.29%). There was no difference in the prevalence between genders. We estimated 99.2 (95% CI 71.7 to 146.1) million people with amblyopia in 2019 worldwide, increasing to 175.2 (95% CI 81.3 to 307.8) million by 2030 and 221.9 (95% CI 83.7 to 429.2) million by 2040.ConclusionsThe amblyopia is becoming a significant vision problem worldwide. It is of great importance to design and implement amblyopia screening, treatment and related public health strategies.
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17
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Kesarwani P, Narang S, Chawla D, Jain S, Chandel M, Sood S. Vision-related quality of life in children with treated retinopathy of prematurity. Indian J Ophthalmol 2019; 67:932-935. [PMID: 31124518 PMCID: PMC6552614 DOI: 10.4103/ijo.ijo_323_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To evaluate vision-related quality of life in children treated for retinopathy of prematurity. Methods: Cross sectional observational study of 54 treated ROP babies 2–7 years of age. The study excluded babies with chronic pediatric conditions and babies of parents suffering from mental illness. Detailed examination including visual acuity was done for all. Two versions of CVFQ questionnaire for children under 3 and above 3 years of age were posed to parents in this study. CVFQ contains six subscales: General health, vision health, competence, personality, family impact, and treatment difficulty. The scores ranged from 0 (worst score) to 1 (best score). Results: The study included 54 children with mean birth weight was 1194 grams, mean gestation age 30 weeks. The age, gender, birth weight, and gestational age didn’t affect the overall quality of life (P > 0.05). The severity of ROP (stage 4 and 5) had poorer CVFQ scores (personality and family impact subscales). Competence and personality scores were significantly lower in zone I disease. The quality of life especially general vision, competence, personality, and treatment difficulty subscales had significantly lower values in ROP with higher clock hour involvement (P < 0.05). With myopia after ROP treatment, only personality subscale was significantly affected (P 0.02). Mean CVFQ score including the family impact and treatment difficulty subscale score was also significantly lower in amblyopic and anisometropic children (P value < 0.05). Family impact subscale and overall quality of life was significantly lower in children with strabismus than children without strabismus (P 0.001). Conclusion: ROP has negative effect on the vision-related quality of life of children and their parents. The overall quality of life worsened with the increase in the severity of disease and the occurrence of ocular sequelae of ROP. The vision of the baby may not be the only cause of low scores in the quality of life questionnaire in ROP.
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Affiliation(s)
- Prem Kesarwani
- Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Subina Narang
- Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Deepak Chawla
- Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Suksham Jain
- Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Meenakshi Chandel
- Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Sunandan Sood
- Government Medical College and Hospital, Sector 32, Chandigarh, India
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18
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Falkenberg HK, Langaas T, Svarverud E. Vision status of children aged 7-15 years referred from school vision screening in Norway during 2003-2013: a retrospective study. BMC Ophthalmol 2019; 19:180. [PMID: 31409305 PMCID: PMC6693216 DOI: 10.1186/s12886-019-1178-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 07/24/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Undetected vision problems is an important cause of reduced academic achievement, performance in everyday life and self-esteem. This receives little attention in national health care services in Norway even though most of these vision problems are easily correctable. There are no published data on how many Norwegian schoolchildren are affected by correctable vision problems. This study aims to determine the vision status in primary and secondary schoolchildren referred from vision screening during the 10 year period of 2003-2013. METHODS Of the 1126 children (15%) aged 7-15 years referred to the university eye clinic by the school screening program, all 782 who attended the eye clinic were included in the study. Patient records were retrospectively reviewed with regard to symptoms, refractive error, best corrected visual acuity (BCVA) of logMAR, binocular vision, ocular health and management outcomes. RESULTS Previously undetected vision problems were confirmed in 650 (83%) of the children. The most frequent outcomes were glasses (346) or follow-up (209), but types of treatment modalities varied with age. Mean refractive errors were hyperopic for all age groups but reduced with age (ANOVA, p < 0.001). Overall, 51% were hyperopic, 32% emmetropic and 17% myopic. Refractive errors did not change across the decade (linear regression, all p > 0.05). Mean logMAR BCVAs were better than 0.0 and improved with age (ANOVA, p < 0.001). The most prevalent symptoms were headaches (171), near vision problems (149) and reduced distance vision (107). CONCLUSIONS The vision screening identified children with previously undetected visual problems. This study shows that the types of visual problems varied with age and that most problems could be solved with glasses. Our results stress the importance of regular eye examinations and that vision examinations should be included in primary health care services. Furthermore, there is a need for raised awareness among parents and teaching staff regarding vision problems in children.
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Affiliation(s)
- Helle K Falkenberg
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Hasbergs vei 36, 3616, Kongsberg, Norway.
| | - Trine Langaas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Hasbergs vei 36, 3616, Kongsberg, Norway
| | - Ellen Svarverud
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Hasbergs vei 36, 3616, Kongsberg, Norway
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19
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Abstract
Early vision care is critical for all children. If undetected, eye disorders such as amblyopia and strabismus may result in permanent vision loss. Vision exams should include a careful history and physical including fix and follow, red reflex, and cover/uncover testing. Photo screening and visual acuity exams should be administered whenever possible.
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Affiliation(s)
- Elaine F Martin
- Elaine F. Martin is an assistant professor at Southern Connecticut State University, New Haven, Conn
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20
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Shahid E, Shaikh A, Aziz S, Rehman A. Frequency of Ocular Diseases in Infants at a Tertiary Care Hospital. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 33:287-293. [PMID: 31179661 PMCID: PMC6557792 DOI: 10.3341/kjo.2017.0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/10/2018] [Accepted: 04/19/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine the frequency of ocular diseases in infants visiting the ophthalmology department of a tertiary care hospital. Methods This was a cross-sectional descriptive study conducted in the department of ophthalmology, Abbasi Shaheed Hospital, from January 2015 to May 2016. The study included 377 infants ranging in age from 1 day to less than 1 year who were, selected by a nonprobability consecutive sampling technique. A detailed history was taken, and a complete ocular examination was performed. Descriptive statistics were used to calculate the mean and standard deviation for age. Frequencies were calculated for ocular diseases along with the percentages. Outcome variables included various congenital and acquired diseases such as conjunctivitis, congenital cataract, glaucoma, nasolacrimal duct blockage, squint, trauma, and fundus abnormalities. Results The mean age of infants was 5.0 ± 3.7 months. There were 196 (52%) males and 181 (48%) females. The sample included 330 (87.5%) full term infants. Acquired ocular diseases occurred in 230 (61%) infants; and congenital diseases, in 147 (39%). The most common ocular disease was conjunctivitis, which occurred in 173 (46%) infants, followed by congenital blocked nasolacrimal duct, which occurred in 57 (15 %) infants. Conjunctivitis was more common among neonates than infants. Conclusions Acquired ocular diseases were more common than congenital ocular diseases. The most common ocular pathology was conjunctivitis, followed by congenital nasolacrimal duct obstruction, in infants. Conjunctivitis was more common in neonates than infants.
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Affiliation(s)
- Erum Shahid
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan.
| | - Arshad Shaikh
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
| | - Sina Aziz
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
| | - Atya Rehman
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
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21
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Whitman MC, Nguyen EH, Bell JL, Tenney AP, Gelber A, Engle EC. Loss of CXCR4/CXCL12 Signaling Causes Oculomotor Nerve Misrouting and Development of Motor Trigeminal to Oculomotor Synkinesis. Invest Ophthalmol Vis Sci 2019; 59:5201-5209. [PMID: 30372748 PMCID: PMC6204880 DOI: 10.1167/iovs.18-25190] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Proper control of eye movements is critical to vision, but relatively little is known about the molecular mechanisms that regulate development and axon guidance in the ocular motor system or cause the abnormal innervation patterns (oculomotor synkinesis) seen in developmental disorders and after oculomotor nerve palsy. We developed an ex vivo slice assay that allows for live imaging and molecular manipulation of the growing oculomotor nerve, which we used to identify axon guidance cues that affect the oculomotor nerve. Methods Ex vivo slices were generated from E10.5 IslMN-GFP embryos and grown for 24 to 72 hours. To assess for CXCR4 function, the specific inhibitor AMD3100 was added to the culture media. Cxcr4cko/cko:Isl-Cre:ISLMN-GFP and Cxcl12KO/KO:ISLMN-GFP embryos were cleared and imaged on a confocal microscope. Results When AMD3100 was added to the slice cultures, oculomotor axons grew dorsally (away from the eye) rather than ventrally (toward the eye). Axons that had already exited the midbrain continued toward the eye. Loss of Cxcr4 or Cxcl12 in vivo caused misrouting of the oculomotor nerve dorsally and motor axons from the trigeminal motor nerve, which normally innervate the muscles of mastication, aberrantly innervated extraocular muscles in the orbit. This represents the first mouse model of trigeminal-oculomotor synkinesis. Conclusions CXCR4/CXCL12 signaling is critical for the initial pathfinding decisions of oculomotor axons and their proper exit from the midbrain. Failure of the oculomotor nerve to innervate its extraocular muscle targets leads to aberrant innervation by other motor neurons, indicating that muscles lacking innervation may secrete cues that attract motor axons.
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Affiliation(s)
- Mary C Whitman
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Elaine H Nguyen
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Jessica L Bell
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Alan P Tenney
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Harvard Medical School, Boston, Massachusetts, United States
| | - Alon Gelber
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Elizabeth C Engle
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Neurology, Harvard Medical School, Boston, Massachusetts, United States.,Howard Hughes Medical Institute, Chevy Chase, Maryland, United States
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22
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Prevalence of childhood ocular morbidity in a peri-urban setting in Bangladesh: a community-based study. Public Health 2019; 170:103-112. [DOI: 10.1016/j.puhe.2019.02.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 02/14/2019] [Accepted: 02/27/2019] [Indexed: 11/17/2022]
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23
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Wallace DK, Repka MX, Lee KA, Melia M, Christiansen SP, Morse CL, Sprunger DT. Amblyopia Preferred Practice Pattern®. Ophthalmology 2018; 125:P105-P142. [DOI: 10.1016/j.ophtha.2017.10.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022] Open
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24
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Darlow BA, Elder MJ, Kimber B, Martin J, Horwood LJ. Vision in former very low birthweight young adults with and without retinopathy of prematurity compared with term born controls: the NZ 1986 VLBW follow-up study. Br J Ophthalmol 2017; 102:1041-1046. [DOI: 10.1136/bjophthalmol-2017-311345] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/07/2017] [Accepted: 11/24/2017] [Indexed: 11/03/2022]
Abstract
ObjectiveThere are few data on visual outcomes in adulthood of former very low birthweight (VLBW; <1500 g) infants. We aimed to assess vision at 27–29 years in a national cohort of VLBW infants born in 1986 and assessed for retinopathy of prematurity (ROP) when no treatment was available, compared with term born controls.MethodsThe cohort and controls attended a 2-day assessment in Christchurch as part of a larger study. Visual assessment included glasses prescription measured by focimeter, logarithm of the minimum angle of resolution (logMAR) distance visual acuity (VA), contrast sensitivity, autorefraction, retinal photographs and a questionnaire on vision-related everyday activities. Rates of reduced VA and myopia in the VLBW cohort at 27–29 were compared with the results of vision testing at 7–8 years.Results250 VLBW adults (77% those alive) gave study consent and 229 (45 with a history of ROP) were assessed in Christchurch, plus 100 term born controls. VLBW adults with ROP had reduced VA compared with no ROP and controls (mean logMAR score (SD); 0.003 (0.19), –0.021 (0.16), –0.078 (0.09), P=0.001). There were no differences in myopia (>2 D) between the groups but high myopia (>5 D) was confined to those with ROP. VLBW adults with ROP drove a car less often and had higher difficulties with everyday activities scores due to eyesight. Between 7–8 and 27–29 years rates of reduced VA were stable but myopia increased.ConclusionFormer VLBW young adults with ROP have ongoing problems with vision affecting daily living and should continue in regular ophthalmological review.Trial registration numberACTRN12612000995875, Pre-results .
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Evidence for the need for vision screening of school children in Turkey. BMC Ophthalmol 2017; 17:230. [PMID: 29197362 PMCID: PMC5712108 DOI: 10.1186/s12886-017-0618-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 11/20/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND In many countries, access to general health and eye care is related to an individual's socioeconomic status (SES). We aimed to examine the prevalence of oculo-visual disorders in children in Istanbul Turkey, drawn from schools at SES extremes but geographically nearby. METHODS Three school-based vision screenings (presenting distance visual acuity, cover test, eye assessment history, colour vision, gross stereopsis and non-cycloplegic autorefraction) were conducted on 81% of a potential 1014 primary-school children aged 4-10 years from two private (high SES) schools and a nearby government (low SES) school in central Istanbul. Prevalence of refractive errors and school-based differences were analysed using parametric statistics (ANOVA). The remaining oculo-visual aspects were compared using non-parametric tests. RESULTS Of the 823 children with mean age 6.7 ± 2.2 years, approximately 10% were referred for a full eye examination (8.2% and 16.3% of private/government schools respectively). Vision had not been previously examined in nearly 22% of private school children and 65% of government school children. Of all children, 94.5% were able to accurately identify the 6/9.5 [LogMAR 0.2] line of letters/shapes with each eye and 86.6% the 6/6 line [LogMAR 0], while 7.9% presented wearing spectacles, 3.8% had impaired colour vision, 1.5% had grossly impaired stereo-vision, 1.5% exhibited strabismus, 1.8% were suspected to have amblyopia and 0.5% had reduced acuity of likely organic origin. Of the 804 without strabismus, amblyopia or organic conditions, 6.0% were myopic ≤ - 0.50DS, 0.6% hyperopic ≥ + 2.00DS, 7.7% astigmatic ≥1.00 DC and 6.2% anisometropic ≥1.00DS. CONCLUSIONS The results highlight the need for general vision screenings for all children prior to school entry given the varied and different pattern of visual problems associated with lifestyle differences in two populations raised in the same urban locale but drawn from different socioeconomic backgrounds.
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Mansoor N, Mansoor T, Ahmed M. Eye pathologies in neonates. Int J Ophthalmol 2016; 9:1832-1838. [PMID: 28003988 DOI: 10.18240/ijo.2016.12.22] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 08/15/2016] [Indexed: 12/25/2022] Open
Abstract
In the United Kingdom, newborn assessment incorporates a screening eye examination for any structural abnormalities, observation of neonate's visual behaviour and direct ophthalmoscopy examination looking for red reflex. Early identification and immediate management of eye related pathologies should commence soon after birth as early diagnosis and prompt intervention may have significant impact on the prognosis for many potentially blinding but treatable disorders such as congenital cataracts and retinoblastoma. If left undetected and untreated, such problems may potentially lead to irreversible damage to the vision which persists into adulthood resulting in lack of self-confidence together with difficulties in educational attainment and job opportunities.
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Affiliation(s)
- Nyaish Mansoor
- Leeds School of Medicine, University of Leeds, LS2 9JT, United Kingdom
| | - Tihami Mansoor
- Leeds School of Medicine, University of Leeds, LS2 9JT, United Kingdom
| | - Mansoor Ahmed
- Queen's Hospital, Burton Upon Trent, DE13 0RB, United Kingdom
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Scheetz J, Koklanis K, Long M, Morris ME. Accuracy and Efficiency of Orthoptists in Comprehensive Pediatric Eye Examinations. THE AMERICAN ORTHOPTIC JOURNAL 2016; 66:98-106. [PMID: 27799583 DOI: 10.3368/aoj.66.1.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION AND PURPOSE To investigate the level of agreement between orthoptists and medical practitioners in the comprehensive eye examination of children seen in an orthoptist-led triage clinic. PATIENTS AND METHODS Patient records over a 6-month period were retrospectively reviewed. Those with a presenting complaint related to vision or ocular motility were triaged into the orthoptist-led clinic and included in the study. Patients who did not meet the triage protocol and those who were not assessed by a medical practitioner at a subsequent appointment were excluded from analysis. The clinical findings from the orthoptist and medical practitioner were collected and compared. RESULTS In total, sixty-three patients were reviewed during the 6-month period and met the inclusion criteria. After the initial comprehensive eye examination with an orthoptist, thirty-two were discharged from hospital and thirty-one were asked to return for a review appointment with a medical practitioner. Agreement between the orthoptists and medical practitioners for the diagnosis of strabismus and/or amblyopia was 84.6% (κ = 0.649, P < 0.001). There was strong agreement between orthoptists and medical practitioners for refractive error of the right eye [τ (19) = 0.352, P = 0.729] and left eye [τ (19) = 1.785, P = 0.090]. Fundus examination comparisons between the orthoptists and medical practitioners showed very high agreement (95.7%). CONCLUSIONS Orthoptists have the skills necessary to provide comprehensive care of children referred for ocular motility and/or vision related disorders. There was close agreement between orthoptists and medical practitioners when performing comprehensive eye examinations.
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Affiliation(s)
- Jane Scheetz
- From the School of Allied Health, La Trobe University, Victoria, Australia.
| | | | - Maureen Long
- From the School of Allied Health, La Trobe University, Victoria, Australia
| | - Meg E Morris
- From the School of Allied Health, La Trobe University, Victoria, Australia
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Amblyopia: Can Laser Acupuncture be an Option? J Acupunct Meridian Stud 2016; 9:267-274. [PMID: 27776766 DOI: 10.1016/j.jams.2016.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 11/23/2022] Open
Abstract
This paper describes the results of the treatment of amblyopia in young patients using an unconventional laser-acupuncture technique. After obtaining satisfactory results in the treatment of a 14-year-old amblyopic girl, the treatment was applied to 13 amblyopic children aged 3-11 years, with an encouraging outcome. An ultralow-light-intensity laser with a square-wave modulated emission was applied over a sequence of acupuncture points. Each session lasted < 15 minutes, and the treatment was performed once a week in 6-week cycles. Patients were followed for several years to evaluate the long-term results and/or to extend the treatment. All except two of the treated patients showed a rapid increase in visual acuity after several treatment sessions. Some required retreatment for regressions in visual acuity. The need for medium-term treatment cycles seems, however, to suggest that results may not be stable for all individuals. Although acupuncture has already been proved to be effective in the treatment of amblyopia, the results reported in this paper suggest that laser acupuncture at ultra-low-light-intensity levels can provide similar, if not better, results to conventional acupuncture stimulation, but with higher patient compliance.
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Latorre-Arteaga S, Gil-González D, Bascarán C, Núñez RH, Morales MDCP, Orihuela GC. Visual health screening by schoolteachers in remote communities of Peru: implementation research. Bull World Health Organ 2016; 94:652-659. [PMID: 27708470 PMCID: PMC5034634 DOI: 10.2471/blt.15.163634] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 03/05/2016] [Accepted: 03/06/2016] [Indexed: 11/27/2022] Open
Abstract
Objective To describe the adaptation and scaling-up of an intervention to improve the visual health of children in the Apurimac region, Peru. Methods In a pilot screening programme in 2009–2010, 26 schoolteachers were trained to detect and refer visual acuity problems in schoolchildren in one district in Apurimac. To scale-up the intervention, lessons learnt from the pilot were used to design strategies for: (i) strengthening multisector partnerships; (ii) promoting the engagement and participation of teachers and (iii) increasing children’s attendance at referral eye clinics. Implementation began in February 2015 in two out of eight provinces of Apurimac, including hard-to-reach communities. We made an observational study of the processes and outcomes of adapting and scaling-up the intervention. Qualitative and quantitative analyses were made of data collected from March 2015 to January 2016 from programme documents, routine reports and structured evaluation questionnaires completed by teachers. Findings Partnerships were expanded after sharing the results of the pilot phase. Training was completed by 355 teachers and directors in both provinces, belonging to 315 schools distributed in 24 districts. Teachers’ appraisal of the training achieved high positive scores. Outreach eye clinics and subsidies for glasses were provided for poorer families. Data from six districts showed that attendance at the eye clinic increased from 66% (45/68 children referred) in the pilot phase to 92% (237/259) in the implementation phase. Conclusion Adaptation to the local context allowed the scaling-up of an intervention to improve visual health in children and enhanced the equity of the programme.
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Affiliation(s)
- Sergio Latorre-Arteaga
- Public Health Research Group, University of Alicante, Campus San Vicente del Raspeig, Ap. 99 CP 03080, San Vicente del Raspeig, Alicante, Spain
| | - Diana Gil-González
- Public Health Research Group, University of Alicante, Campus San Vicente del Raspeig, Ap. 99 CP 03080, San Vicente del Raspeig, Alicante, Spain
| | - Covadonga Bascarán
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, England
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Rewri P, Nagar CK, Gupta V. Vision Screening of Younger School Children by School Teachers: A Pilot Study in Udaipur City, Western India. J Ophthalmic Vis Res 2016; 11:198-203. [PMID: 27413502 PMCID: PMC4926569 DOI: 10.4103/2008-322x.183920] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 01/16/2016] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To assess the reliability of school teachers for vision screening of younger school children and to study the pattern of vision problems. METHODS In this cross-sectional study, trained school teachers screened 5,938 school children aged 3 to 8 years for vision and ocular disorders. Children were cross screened by professionals to assess the reliability of the teachers in vision screening and detecting ocular disorders in these children. The pattern of visual acuity, ametropia and ocular disorders was studied. RESULTS Sensitivity and specificity of the vision screening by school teachers was 69.2% (95% CI: 66.8-71.5%) and 95.3% (95% CI: 94.5-95.8%), respectively. The positive predictive value was 83.5% (95% CI: 81.4-85.6%) and negative predictive value was 89.8% (95% CI: 88.8-90.6%). The kappa statistic was 0.68 (95% CI: 0.66-0.7). CONCLUSION School teachers could effectively screen younger school children for vision assessment and ocular disorders.
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Affiliation(s)
- Parveen Rewri
- Department of Ophthalmology, Maharaja Agrasen Medical College, Hisar, Haryana, India
- Department of Ophthalmology, Ravinder Nath Tagore Medical College, Udaipur, Rajasthan, India
| | - Chandra Kant Nagar
- Department of Ophthalmology, Ravinder Nath Tagore Medical College, Udaipur, Rajasthan, India
- Department of Ophthalmology, Geetanjali Medical College, Udaipur, Rajasthan, India
| | - Vijay Gupta
- Department of Ophthalmology, Ravinder Nath Tagore Medical College, Udaipur, Rajasthan, India
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Michaeline I, Sheriff A, Bimbo A. Paediatric Refractive Errors in an Eye Clinic in Osogbo, Nigeria. Ethiop J Health Sci 2016; 26:145-52. [PMID: 27222627 PMCID: PMC4864343 DOI: 10.4314/ejhs.v26i2.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Paediatric ophthalmology is an emerging subspecialty in Nigeria and as such there is paucity of data on refractive errors in the country. This study set out to determine the pattern of refractive errors in children attending an eye clinic in South West Nigeria. METHODS A descriptive study of 180 consecutive subjects seen over a 2-year period. Presenting complaints, presenting visual acuity (PVA), age and sex were recorded. Clinical examination of the anterior and posterior segments of the eyes, extraocular muscle assessment and refraction were done. The types of refractive errors and their grades were determined. Corrected VA was obtained. Data was analysed using descriptive statistics in proportions, chi square with p value <0.05. RESULTS The age range of subjects was between 3 and 16 years with mean age = 11.7 and SD = 0.51; with males making up 33.9%.The commonest presenting complaint was blurring of distant vision (40%), presenting visual acuity 6/9 (33.9%), normal vision constituted >75.0%, visual impairment20% and low vision 23.3%. Low grade spherical and cylindrical errors occurred most frequently (35.6% and 59.9% respectively). Regular astigmatism was significantly more common, P <0.001. The commonest diagnosis was simple myopic astigmatism (41.1%). Four cases of strabismus were seen. CONCLUSION Simple spherical and cylindrical errors were the commonest types of refractive errors seen. Visual impairment and low vision occurred and could be a cause of absenteeism from school. Low-cost spectacle production or dispensing unit and health education are advocated for the prevention of visual impairment in a hospital set-up.
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Affiliation(s)
- Isawumi Michaeline
- Department of Surgery, College of Health Sciences, Osun State University, Osogbo, Nigeria
| | - Agboola Sheriff
- Department of Ophthalmology, LAUTECH Teaching Hospital, Osogbo, Nigeria
| | - Ayegoro Bimbo
- Department of Ophthalmology, LAUTECH Teaching Hospital, Osogbo, Nigeria
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Maitre NL. Neurorehabilitation after neonatal intensive care: evidence and challenges. Arch Dis Child Fetal Neonatal Ed 2015; 100:F534-40. [PMID: 25710178 PMCID: PMC4784692 DOI: 10.1136/archdischild-2013-305920] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/21/2015] [Indexed: 01/28/2023]
Abstract
Neonatologists and paediatric providers of developmental care have documented poor neurodevelopmental outcomes of infants who have received neonatal intensive care due to prematurity, perinatal neurological insults such as asphyxia or congenital anomalies such as congenital heart disease. In parallel, developmental specialists have researched treatment options in these high-risk children. The goal of this review is connect the main categories of poor outcomes (sensory and motor function, cognition, communication, behaviour) studied by neonatal intensive care follow-up specialists to the research focused on improving these outcomes. We summarise challenges in designing diagnostic and interventional approaches in infants <2 years of age and review the evidence for existing therapies and future treatments aimed at improving functionality.
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Affiliation(s)
- Nathalie L Maitre
- Department of Pediatrics, Division of Neonatology, Vanderbilt University, Nashville Tennessee, USA
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee, USA
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Hobday R. Myopia and daylight in schools: a neglected aspect of public health? Perspect Public Health 2015; 136:50-5. [DOI: 10.1177/1757913915576679] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A century ago, it was widely believed that high levels of daylight in classrooms could prevent myopia, and as such, education departments built schools with large windows to try to stop children becoming short-sighted. This practice continued until the 1960s, from which time myopia was believed to be an inherited condition. In the years that followed, less emphasis was placed on preventing myopia. It has since become more common, reaching epidemic levels in east Asia. Recent research strongly suggests that the amount of light children get as they grow determines whether they will develop short sight; however, evidence that daylight in classrooms prevents myopia is lacking. Given the rapid increase in prevalence among school children worldwide, this should be investigated.
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Lenake M, du Toit N. Paediatric ophthalmology at primary healthcare level. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786190.2014.977017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Latorre-Arteaga S, Gil-González D, Enciso O, Phelan A, García-Muñoz A, Kohler J. Reducing visual deficits caused by refractive errors in school and preschool children: results of a pilot school program in the Andean region of Apurimac, Peru. Glob Health Action 2014; 7:22656. [PMID: 24560253 PMCID: PMC3925804 DOI: 10.3402/gha.v7.22656] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 01/01/2014] [Accepted: 01/16/2014] [Indexed: 11/20/2022] Open
Abstract
Background Refractive error is defined as the inability of the eye to bring parallel rays of light into focus on the retina, resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is associated with increased morbidity and reduced educational opportunities. Vision screening (VS) is a method for identifying children with visual impairment or eye conditions likely to lead to visual impairment. Objective To analyze the utility of vision screening conducted by teachers and to contribute to a better estimation of the prevalence of childhood refractive errors in Apurimac, Peru. Design A pilot vision screening program in preschool (Group I) and elementary school children (Group II) was conducted with the participation of 26 trained teachers. Children whose visual acuity was<6/9 [20/30] (Group I) and≤6/9 (Group II) in one or both eyes, measured with the Snellen Tumbling E chart at 6 m, were referred for a comprehensive eye exam. Specificity and positive predictive value to detect refractive error were calculated against clinical examination. Program assessment with participants was conducted to evaluate outcomes and procedures. Results A total sample of 364 children aged 3–11 were screened; 45 children were examined at Centro Oftalmológico Monseñor Enrique Pelach (COMEP) Eye Hospital. Prevalence of refractive error was 6.2% (Group I) and 6.9% (Group II); specificity of teacher vision screening was 95.8% and 93.0%, while positive predictive value was 59.1% and 47.8% for each group, respectively. Aspects highlighted to improve the program included extending training, increasing parental involvement, and helping referred children to attend the hospital. Conclusion Prevalence of refractive error in children is significant in the region. Vision screening performed by trained teachers is a valid intervention for early detection of refractive error, including screening of preschool children. Program sustainability and improvements in education and quality of life resulting from childhood vision screening require further research.
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Affiliation(s)
- Sergio Latorre-Arteaga
- Entretodos Foundation, Zaragoza, Spain; Public Health Research Group, University of Alicante, Alicante, Spain
| | - Diana Gil-González
- Public Health Research Group, University of Alicante, Alicante, Spain; Department of Community Nursing, Preventive Medicine and Public Health, and History of Science, Faculty of Health Sciences, University of Alicante, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Observatory of Public Policies and Health (OPPS), University of Alicante, Alicante, Spain;
| | - Olga Enciso
- Centro Oftalmológico Monseñor Enrique Pelach, Abancay, Peru
| | | | - Angel García-Muñoz
- Public Health Research Group, University of Alicante, Alicante, Spain; Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
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Post-Newborn: A New Concept of Period in Early Life. LECTURE NOTES IN ELECTRICAL ENGINEERING 2014. [PMCID: PMC7120469 DOI: 10.1007/978-94-007-7618-0_143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Post-newborn infants refer to infants from >28 days to <100 days after birth. During this period, infants are still completely dependent on breast milk or/and formula milk for feeding. Up to now, the concept of post-newborn has not been mentioned in classic textbooks. With the development of perinatal medicine, mortality rate of diseases in neonates such as premature infants, asphyxia, infectious diseases have decreased significantly, and consequently, issues of the quality of life for these survivors have aroused widespread concerns. The post-newborn infants have some important characteristics differing from both newborn infants and infants after the period: (1) different fatal diseases and mortality rate; (2) the diseases inherited from newborn period requiring early and prompt treatments; (3) some peculiar diseases during this period requiring much attention; (4) either similar or different immune function; (5) rapid growth and uneven development of organ systems. Establishment of the new concept of post-newborn will further reveal the nature of life, reduce the mortality rate of infants, and improve the quality of life.
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Assistive Technology for Students with Visual Impairments and Blindness. AUTISM AND CHILD PSYCHOPATHOLOGY SERIES 2014. [DOI: 10.1007/978-1-4899-8029-8_5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Netson KL, Conklin HM, Wu S, Xiong X, Merchant TE. Longitudinal investigation of adaptive functioning following conformal irradiation for pediatric craniopharyngioma and low-grade glioma. Int J Radiat Oncol Biol Phys 2013; 85:1301-6. [PMID: 23245284 PMCID: PMC3685870 DOI: 10.1016/j.ijrobp.2012.10.031] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/17/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Children treated for brain tumors with conformal radiation therapy experience preserved cognitive outcomes. Early evidence suggests that adaptive functions or independent-living skills may be spared. This longitudinal investigation prospectively examined intellectual and adaptive functioning during the first 5 years following irradiation for childhood craniopharyngioma and low-grade glioma (LGG). The effect of visual impairment on adaptive outcomes was investigated. METHODS AND MATERIALS Children with craniopharyngioma (n=62) and LGG (n=77) were treated using conformal or intensity modulated radiation therapy. The median age was 8.05 years (3.21-17.64 years) and 8.09 years (2.20-19.27 years), respectively. Serial cognitive evaluations including measures of intelligence quotient (IQ) and the Vineland Adaptive Behavior Scales (VABS) were conducted at preirradiation baseline, 6 months after treatment, and annually through 5 years. Five hundred eighty-eight evaluations were completed during the follow-up period. RESULTS Baseline assessment revealed no deficits in IQ and VABS indices for children with craniopharyngioma, with significant (P<.05) longitudinal decline in VABS Communication and Socialization indices. Clinical factors associated with more rapid decline included females and preirradiation chemotherapy (interferon). The only change in VABS Daily Living Skills correlated with IQ change (r=0.34; P=.01) in children with craniopharyngioma. Children with LGG performed below population norms (P<.05) at baseline on VABS Communication, Daily Living Indices, and the Adaptive Behavior Composite, with significant (P<.05) longitudinal decline limited to VABS Communication. Older age at irradiation was a protective factor against longitudinal decline. Severe visual impairment did not independently correlate with poorer adaptive outcomes for either tumor group. CONCLUSIONS There was relative sparing of postirradiation functional outcomes over time in this sample. Baseline differences in functional abilities before the initiation of irradiation suggested that other factors influence functional outcomes above and beyond the effects of irradiation.
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Affiliation(s)
- Kelli L. Netson
- Department of Psychiatry & Behavioral Sciences, Kansas University School of Medicine – Wichita, KS, USA
| | - Heather M. Conklin
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Shengjie Wu
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Xiaoping Xiong
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Thomas E. Merchant
- Division of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
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Unmet Visual Needs of Children with down Syndrome in an African Population: Implications for Visual and Cognitive Development. Eur J Ophthalmol 2012; 23:394-8. [DOI: 10.5301/ejo.5000222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2012] [Indexed: 11/20/2022]
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Avery RA, Ferner RE, Listernick R, Fisher MJ, Gutmann DH, Liu GT. Visual acuity in children with low grade gliomas of the visual pathway: implications for patient care and clinical research. J Neurooncol 2012; 110:1-7. [DOI: 10.1007/s11060-012-0944-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 07/13/2012] [Indexed: 10/28/2022]
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