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Shah R, Hassan N, Harris S. Impact of a Vision Photoscreener in Very Young Children in an Inner-City Pediatric Clinic in Detroit. Clin Pediatr (Phila) 2024; 63:625-632. [PMID: 37568267 DOI: 10.1177/00099228231191950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Pediatric vision screening is important because approximately 80% of visual impairments, including amblyopia, can be prevented or cured, especially if caught early. This retrospective study aims to determine whether the implementation of a machine photoscreener improves vision outcomes in 1- to 4-year-old children in an urban clinic. Before the vision screener, 91 patients were seen (control group), while 205 were seen following its implementation (study group). The number of children screened increased by 27.4% after implementing the photoscreener (57.1% study, 29.7% control, P < .001). All patients who failed the screening, 14.6% in the study period, were referred to ophthalmology (n = 30); 40% (n = 12) were evaluated, and 9 were diagnosed with a true vision abnormality. Instrument vision screening allows children as young as 1 year to be screened and allows for early intervention for potential vision-threatening pathologies in a vulnerable urban population.
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Affiliation(s)
- Riya Shah
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Nimra Hassan
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Susan Harris
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
- Wayne Pediatrics, Detroit, MI, USA
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Bui A, Mitchell GL, McDaniel C, Morrison A, Toole A, Buckland M, Kulp MT. Detection of significant vision conditions in children using QuickSee wavefront autorefractor. Ophthalmic Physiol Opt 2024; 44:501-513. [PMID: 38504505 DOI: 10.1111/opo.13301] [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: 10/26/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE This study evaluated the ability of QuickSee to detect children at risk for significant vision conditions (significant refractive error [RE], amblyopia and strabismus). METHODS Non-cycloplegic refraction (using QuickSee without and with +2 dioptre (D) fogging lenses) and unaided binocular near visual acuity (VA) were measured in 4- to 12-year-old children. Eye examination findings (VA, cover testing and cycloplegic retinoscopy) were used to determine the presence of vision conditions. QuickSee performance was summarised by area under the receiver operating characteristic curve (AUC), sensitivity and specificity for various levels of RE. QuickSee referral criteria for each vision condition were chosen to maximise sensitivity at a specificity of approximately 85%-90%. Sensitivity and specificity to detect vision conditions were calculated using multiple criteria. Logistic regression was used to evaluate the benefit of adding near VA (6/12 or worse) for detecting hyperopia. A paired t-test compared QuickSee without and with fogging lenses. RESULTS The mean age was 8.2 (±2.5) years (n = 174). RE ranged up to 9.25 D myopia, 8 D hyperopia, 5.25 D astigmatism and 3.5 D anisometropia. The testability of the QuickSee was 94.3%. AUC was ≥0.92 (excellent) for each level of RE. For the detection of any RE, sensitivity and specificity were 84.2% and 87.3%, respectively, using modified Orinda criteria and 94.5% and 78.2%, respectively, using the American Academy for Pediatric Ophthalmology and Strabismus (AAPOS) guidelines. For the detection of any significant vision condition, the sensitivity and specificity of QuickSee were 81.1% and 87.9%, respectively, using modified Orinda criteria and 93% and 78.6%, respectively, using AAPOS criteria. There was no significant benefit of adding near VA to QuickSee for the detection of hyperopia ≥+2.00 (p = 0.34). There was no significant difference between QuickSee measurements of hyperopic refractive error with and without fogging lenses (difference = -0.09 D; p = 0.51). CONCLUSIONS QuickSee had high discriminatory power for detecting children with hyperopia, myopia, astigmatism, anisometropia, any significant refractive error or any significant vision condition.
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Affiliation(s)
- Anh Bui
- The Ohio State University College of Optometry, Columbus, Ohio, USA
| | - G Lynn Mitchell
- The Ohio State University College of Optometry, Columbus, Ohio, USA
| | | | - Ann Morrison
- The Ohio State University College of Optometry, Columbus, Ohio, USA
| | - Andrew Toole
- The Ohio State University College of Optometry, Columbus, Ohio, USA
| | | | - Marjean T Kulp
- The Ohio State University College of Optometry, Columbus, Ohio, USA
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Oszczędłowski P, Raczkiewicz P, Więsyk P, Brzuszkiewicz K, Rapa M, Matysik-Woźniak A, Zieliński G, Onyszkiewicz M, Rękas KM, Makosz I, Latalska M, Czarnek-Chudzik A, Korulczyk J, Rejdak R. The Incidence and Severity of Myopia in the Population of Medical Students and Its Dependence on Various Demographic Factors and Vision Hygiene Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4699. [PMID: 36981608 PMCID: PMC10049007 DOI: 10.3390/ijerph20064699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Myopia is one of the leading causes of visual impairment. Visual work and usage of electronic devices are known risk factors of myopia. Many education systems were forced to apply online and hybrid teaching methods, to reduce the number of new cases of COVID-19. Medical students are a population well-known for intense visual work in the form of learning; (2) Methods: Visual acuity and refractive error were measured in the population of medical students. Participants also filled out the survey that included their population characteristic and their habits related to the hygiene of vision; (3) Results: We found a correlation between the age of the first diagnosis of myopia and current values of refractive error. The majority of participants believe that the COVID-19 pandemic had an impact on the health of their vision. Among methods of studying, usage of the computer screen was less preferred by myopic students; (4) Conclusions: In the population of medical school students in Eastern Poland, visual acuity was lower than 1.0 in 232 (52.97%) in the right eye and 234 (53.42%) in the left eye. Early recognition of refractive error has influenced its current values. Among methods of studying, usage of the computer screen was less preferred by myopic students. More population-based studies should focus on the impact of the COVID-19 pandemic on the health of vision.
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Affiliation(s)
- Paweł Oszczędłowski
- Students’ Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Przemysław Raczkiewicz
- Students’ Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Piotr Więsyk
- Students’ Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Kinga Brzuszkiewicz
- Students’ Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Maria Rapa
- Students’ Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Anna Matysik-Woźniak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland
| | - Maksymilian Onyszkiewicz
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Krzysztof Marek Rękas
- Students’ Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Inga Makosz
- Students’ Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Małgorzata Latalska
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Aleksandra Czarnek-Chudzik
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Jan Korulczyk
- Department of Didactics and Medical Simulation, Medical University of Lublin, 20-093 Lublin, Poland
| | - Robert Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
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Matsumura S, Dannoue K, Kawakami M, Uemura K, Kameyama A, Takei A, Hori Y. Prevalence of Myopia and Its Associated Factors Among Japanese Preschool Children. Front Public Health 2022; 10:901480. [PMID: 35812505 PMCID: PMC9257008 DOI: 10.3389/fpubh.2022.901480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the prevalence of myopia and factors associated with spherical equivalent (SE), axial length (AL), and axial length to corneal radius of curvature (AL/CR) ratio among Japanese preschool children. Study Design Prospective observational study. Methods This cross-sectional study evaluated subjects aged 4–6 years from a preschool. Non-cycloplegic autorefraction was measured using the Spot Vision Screener, while AL and corneal radius (CR) were measured using the Myopia Master. Parental myopia and environmental factors were investigated using the myopia-related factor questionnaire. The worse eye with higher myopic SE was chosen for analysis, and multiple linear regression models was performed using AL, SE, and AL/CR ratio as dependent variables. Results A total of 457 out of 514 participants (239 males, 52.3%) aged 4–6 years (mean 4.77 ± 0.65 years) were included. The mean SE was 0.13 ± 0.63 D, AL was 22.35 ± 0.67 mm, CR was 7.76 ± 0.25 mm, and AL/CR ratio was 2.88 ± 0.72. The overall prevalence of myopia and high myopia were 2.9 and 0.2%, respectively. Multiple regression analysis showed that myopic SE was significantly associated with male sex (β = −0.14, p = 0.02) and parental myopia (β = −0.15, p = 0.04). Meanwhile, longer AL was significantly associated with older age (β = 0.13, p = 0.02), male sex (β = 0.44, p < 0.001), parental myopia (β = 0.24, p = 0.01), and screen time (including smartphones, tablets, and computers) (>1 h, β = 0.14, p = 0.04). A higher AL/CR was significantly associated with older age (β = 0.02, p < 0.001), male sex (β = 0.03, p < 0.001), ratio and parental myopia (β = 0.03, p = 0.02). Conclusion The prevalence of myopia and high myopia were 2.9 and 0.2%, respectively, among Japanese preschool children in 2021. Longer AL was associated with older age, male sex, parental myopia, and screen time in children aged 4–6 years. Children with a high risk of myopia can be identified early based on parental myopia information for early prevention.
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Affiliation(s)
- Saiko Matsumura
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
- *Correspondence: Saiko Matsumura
| | | | - Momoko Kawakami
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
| | | | | | | | - Yuichi Hori
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
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Álamo-Martín MTD, Pérez-Curiel MDH, Vallelado-Álvarez AI. Psychosocial needs of Spanish schoolchildren with visual impairment: a mixed methods research. SAUDE E SOCIEDADE 2022. [DOI: 10.1590/s0104-12902022210446en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract This study investigates the psychosocial needs of a group of schoolchildren with visual impairments. Based on a CUAN+CUAL mixed methods, it analyzed 26 children, with and without visual impairment, who attended a pediatric ophthalmology consultation with their parents. Several descriptive, mean and variance tests of independence between variables were performed using Pearson’s Chi-square (χ²) and Mann-Whitney U tests. The interviews conducted with the children and/or parents on the impact of their visual impairment on education, leisure activities and peer interaction, as well as the feelings derived from the impairment, underwent discourse analysis. Results show that schoolchildren with severe visual impairments experience greater difficulties regarding physical and emotional well-being, school performance, and peer interaction when compared with those without. These findings suggest the importance of developing comprehensive and joint health and socio-educational interventions to improve these areas.
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Álamo-Martín MTD, Pérez-Curiel MDH, Vallelado-Álvarez AI. Identificación de necesidades psicosociales de un grupo de escolares españoles con problemas visuales: un estudio con metodología mixta. SAUDE E SOCIEDADE 2022. [DOI: 10.1590/s0104-12902022210446es] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Resumen Este estudio presenta un análisis de las necesidades psicosociales de un grupo de escolares españoles que padecen problemas visuales. La investigación utiliza metodología mixta aplicada en una muestra de 26 menores que acuden con sus progenitores a una consulta de oftalmología pediátrica con y sin problemas visuales. Se realizan entrevistas a los niños, adolescentes y/o progenitores sobre las repercusiones de su problema visual en el ámbito educativo, en la realización de actividades de ocio y tiempo libre y en la interacción con sus iguales, además de los sentimientos que les produce su problema visual. A los datos obtenidos se aplican análisis descriptivos, de medias, de varianza y pruebas de independencia entre variables, mediante las pruebas de chi-cuadrado de Pearson (χ²) y de U de Mann-Whitney. Los resultados encontrados indican que el grupo de escolares con problemas visuales graves tienen mayores dificultades que los que no los tienen en el bienestar físico y emocional, en el rendimiento escolar y en la interacción con los otros. Estos resultados sugieren la importancia de programar intervenciones integrales y conjuntas de carácter sanitario y socioeducativo que incidan en la mejora en cada una de las áreas de necesidad.
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Guler Alis M, Alis A. Photoscreener results with and without cycloplegia and their reliability according to biometric parameters. J Fr Ophtalmol 2021; 45:65-73. [PMID: 34924211 DOI: 10.1016/j.jfo.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Our goal in this study is to compare the results of a photoscreener (Plusoptix A12C) with and without cycloplegia and to investigate its reliability as a function of biometric parameters. METHODS In total, 250 eyes of 125 children with a mean age of 6.77±1.59years were included in the study. The results of cycloplegic and noncycloplegic Plusoptix A12C measurements and autorefractometer with cycloplegia (CA) were compared. The spherical equivalent (SE) differences between CA and noncycloplegic Plusoptix A12C measurements (NPO) with CA and cycloplegic Plusoptix A12C measurements (CPO) were compared with axial length (AL), anterior chamber depth (ACD), corneal radius of curvature (CR), mean keratometry (meanK) and axial length/corneal radius of curvature ratio (AL/CR) values. The relationships between these were examined. RESULTS According to amblyopia risk factors (ARFs) based on the criteria in the 2013 AAPOS guidelines, 33 eyes (13%) in the NPO results and 34 eyes (13.6%) in the CPO results were found to be at risk for amblyopia. According to the CA results, the NPO had 67.3% sensitivity and 94.5% specificity, and the CPO 69.4% sensitivity and 89.1% specificity in detecting the values of refractive amblyopia factors determined by the AAPOS. In regard to refraction values determined by the AAPOS for amblyopia, according to CA results, the NPO had 71.4% sensitivity and 88.4% specificity in detecting myopia; 33.3% sensitivity and 93.6% specificity in detecting hyperopia; and 79.4% specificity and 71.2% sensitivity in detecting astigmatism. With regard to refraction values determined by the AAPOS for amblyopia, according to CA results, the CPO had 80.9% sensitivity and 90% specificity in detecting myopia; 13.3% sensitivity and 89.2% specificity in detecting hyperopia; and 44.9% sensitivity and 30.8% specificity in detecting astigmatism. When the SE differences between the CA and NPO values were compared with biometric parameters, a negative correlation was observed with ACD, AL, and especially AL/CR ratio. CONCLUSION Both the NPO and CPO showed moderate sensitivity and high specificity in detecting ARFs based on the criteria in the 2013 AAPOS guidelines. Sensitivity for detecting hyperopic risk factors was lower than for myopia and astigmatism. The CPO has no additional clinical advantage. A negative correlation was found between biometric parameters and NPO results. Thus, the NPO is more reliable in myopic children with higher axial lengths, deeper anterior chambers, and increased AL/CR ratios.
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Affiliation(s)
- M Guler Alis
- Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey.
| | - A Alis
- Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey
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Kapoor V, Shah SP, Beckman T, Gole G. Community based vision screening in preschool children; performance of the Spot Vision Screener and optotype testing. Ophthalmic Epidemiol 2021; 29:417-425. [PMID: 34423736 DOI: 10.1080/09286586.2021.1962918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Children's vision screening children commonly uses optotype-based visual acuity or instrument-based methods measuring amblyogenic risk factors (ARFs). OBJECTIVE To compare the performance of the Spot Vision Screener (SVS) (PediaVision, Welch Allyn, NY) and a nurse-administered visual acuity screen (NVAS) in identifying ARFs and decreased visual acuity. METHODS A prospective, cross-sectional population-based study of preschool children in South-East Queensland, Australia. Eligible participants had both forms of screening by trained community nurses. All children with an abnormal result by either method as well as a cohort of randomly selected children who passed both assessments were assessed at a tertiary paediatric ophthalmology clinic. RESULTS Over a 10 month period, 2237 children (mean age; 64.4 ± 4.0 months) were screened from 38 schools. 6.4% of children failed SVS and 8.3% failed NVAS (with 3.8% overlap, failing both). The positive predictive value (PPV) in identifying either ARFs and/or reduced VA for the SVS and NVAS was 70.4% (95% Confidence Interval (CI): 61.6%-78.2%) and 60.5% (95% CI: 52.6%-67.9%) respectively. Highest PPV to detect either ARFs and/or reduced VA was achieved by a 'hybrid' method by combining failed NVAS and failed SVS: 91.0% (95% CI: 82.4 to 96.3) but this would risk children with sight impairment being missed in the community. CONCLUSION To our knowledge, this is the first population-based study providing detailed comparative measures of diagnostic accuracy for NVAS and SVS in preschool children. One in ten preschool children failed one or both screens. A number of children who required ophthalmic intervention were missed if only one screening method was utilized.
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Affiliation(s)
- Vishal Kapoor
- Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Australia.,Department of Paediatric Medicine, QLD Children's Hospital, Brisbane, Australia
| | - Shaheen P Shah
- Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Australia.,Department of Ophthalmology, QLD Children's Hospital, Brisbane, Australia
| | - Timothy Beckman
- Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Australia.,Department of Ophthalmology, QLD Children's Hospital, Brisbane, Australia
| | - Glen Gole
- Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Australia.,Department of Ophthalmology, QLD Children's Hospital, Brisbane, Australia
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Bosque LE, Yamarino CR, Salcedo N, Schneier AJ, Gold RS, Blumenfeld LC, Hunter DG. Evaluation of the blinq vision scanner for detection of amblyopia and strabismus. J AAPOS 2021; 25:214.e1-214.e7. [PMID: 34246763 DOI: 10.1016/j.jaapos.2021.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/26/2021] [Accepted: 02/24/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To report the results of a clinical study designed to evaluate the accuracy of the blinq pediatric vision scanner, which detects amblyopia and strabismus directly by means of retinal polarization scanning, unlike other vision screening devices, which infer possible disease based on detection of refractive risk factors. METHODS Subjects 1-20 years of age were prospectively enrolled in this cross-sectional diagnostic accuracy study with planned enrollment of 200. All enrolled subjects were tested by individuals masked to the diagnosis, followed by complete ophthalmologic examination by pediatric ophthalmologists masked to the screening result. Patients previously treated for amblyopia or strabismus were analyzed separately. RESULTS The study cohort comprised 193 subjects, 53 of whom had been previously treated, leaving 140 treatment-naïve subjects, including 65 (46%) with amblyopia or strabismus, 11 (8%) with risk factors/suspected binocular vision deficit without amblyopia/strabismus, and 64 (46%) controls. Sensitivity was 100%, with all 66 patients with referral-warranted ocular disease referred. Five patients with intermittent strabismus receiving pass results were deemed "acceptable pass" when considering patient risk factors and amblyogenic potential. Specificity was 91%, with 7 incorrect referrals. Subanalysis of children aged 2-8 years (n = 92) provided similar results (sensitivity 100%; specificity 89%). CONCLUSIONS In this study cohort, the blinq showed very high sensitivity and specificity for detecting referral-warranted unilateral amblyopia and strabismus. Implementation of the device in vision screening programs could lead to improved rates of disease detection and reduction in false referrals.
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Affiliation(s)
| | | | | | | | - Robert S Gold
- Eye Physicians of Central Florida, Maitland, Florida
| | | | - David G Hunter
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Rebion Inc, Boston, Massachusetts.
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