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Objective:To evaluate the effect of short-term topical administration of atropine eye drops with various concentrations and frequencies on eye safety in children.Methods:A double-blind randomized controlled trial was conducted.Sevevty-two children with ametropia or pre-myopia (72 eyes) were enrolled in Tianjin Medical University Eye Hospital from December 2020 to January 2022.The subjects were randomly divided into 0.01% atropine group, 0.02% atropine group and 0.04% atropine group according to a random number table, with 24 cases (24 eyes) in each group.Automatic refraction with an automatic computer optometry device, subjective refraction with a phoropter, intraocular pressure with a non-contact tonometer, axial length by optical biometrics, the amplitude of accommodation (AMP) by the push-up method, pupil diameter with pupilometer, near visual acuity at 33 cm with a standard logarithmic visual acuity chart, tear evaluation with Keratograph 5M and Ocular Surface Disease Index (OSDI) questionnaire survey were performed among all subjects.One drop of 0.01%, 0.02%, and 0.04% atropine was administrated to the study eye according to grouping, and the pupil diameter was measured every 10 minutes until the pupil did not enlarge three times, then the data after a single treatment of the three groups were recorded.After one-week application of the corresponding concentration of atropine eye drops once at night, the data after one-week treatment were recorded.For the next week, the application frequency of 0.01% and 0.02% atropine groups changed to once daily in the morning and evening, and 0.04% atropine group maintained once at night, then the data after two-week treatment were recorded.Data of the right eyes were analyzed.The changes in pupil diameter, AMP and other eye parameters before and after atropine eye drops of the three groups were compared.This study adhered to the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2020KY[L]-51). All subjects and their guardians were fully informed of the method and purpose of this study before entering the cohort.Written informed consent was obtained from guardians.Results:Pupil diameters of 0.01%, 0.02% and 0.04% atropine groups were (5.59±0.48), (5.35±0.76) and (5.65±0.43)mm before treatment respectively, (7.00±0.68), (7.17±0.58) and (8.40±1.71)mm after a single treatment, (6.67±0.62), (6.56±0.65) and (7.60±0.69)mm after one-week treatment, (6.96±0.49), (7.04±0.53) and (7.60±0.36)mm after two-week treatment.There were significant differences in pupil diameter at different time points after treatment among the three groups ( Fgroup=9.430, P<0.001; Ftime=156.620, P<0.001). The AMP of 0.01%, 0.02% and 0.04% atropine groups were (12.94±3.02), (13.25±2.81) and (13.42±2.60)D before treatment respectively, (11.62±2.61), (11.53±2.06) and (9.64±1.93)D after a single treatment, (11.14±2.61), (11.33±2.33) and (8.30±1.18)D after one-week treatment, (9.99±1.81), (8.72±1.25) and (8.76±2.12)D after two-week treatment.There was no significant difference in the AMP among the three groups ( Fgroup=2.800, P=0.063). In the three groups, the AMP at different time points after treatment were significantly lower than that before treatment ( Ftime=61.400, P<0.001). There was no difference in spherical equivalent refraction, intraocular pressure, near visual acuity, axial length, first none-invasive tear break-up time, average none-invasive tear break-up time, tear meniscus height and OSDI score among the three groups ( Fgroup=0.030, 0.630, 1.420, 0.580, 0.140, 0.120, 0.340, 0.142; all at P>0.05). There were significant differences in spherical equivalent refraction, intraocular pressure, first none-invasive tear break-up time, average none-invasive tear break-up time, tear meniscus height and OSDI score at different time points between before and after medication among the three groups ( Ftime=12.560, 4.730, 4.720, 5.220, 3.720; all at P<0.05). Conclusions:Varying pupil dilation and AMP reduction occur after the use of different concentrations of atropine and are more severe at higher concentrations.Increased administration frequency of atropine is associated with more pupil dilation and AMP reduction, but there is no intolerable adverse effect.
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AIM: To report 5 cases with drug-induced bilateral acute ciliochoroidal effusion(DBACE)and myopic shift, with or without ocular hypertension(OHT), summarize patients' clinical characteristics and recovery process of DBACE, and investigate the possible pathophysiological mechanism.METHODS:A retrospective observational case study conducted from June 2017 to February 2021. The included patients were subjected to a series of ocular examinations listed as follows: 1)best corrected visual acuity; 2)intraocular pressure(IOP); 3)slit-lamp microscopy; 4)fundus photography; 5)ultrasound biomicroscopy(UBM); 6)subjective optometry; 7)axial length and anterior chamber depth. All patients were followed up every 2d until the diopters were completely restored to the state before the disease onset.RESULTS:In total, 5 patients aged 10-45 years old, including 3 female and 2 male patients, were enrolled in this study. All patients were bilaterally involved(5/5), and had myopic shift(5/5), of whom 3 patients had OHT(3/5). With the increase of age, myopic shift decreased, while OHT increased. Based on OHT, the dynamic aggravation process of DBACE was subdivided into 2 stages, stage 1(myopic shift without OHT)and stage 2(myopic shift with OHT). With the deterioration of DBACE, when myopic shift approached or exceeded the minimum amplitude of accommodation(MAA), IOP gradually rose, and DBACE progressed from stage 1 to stage 2. With the recovery of DBACE after discontinuing the suspicious drugs, DBACE in stage 2 first returned to stage 1, and then returned to normal.CONCLUSION:Pathophysiological mechanism of DBACE was subdivided into 2 stages, including stage 1(myopic shift without OHT)and stage 2(myopic shift with OHT). The transition between the two stages depends on the imbalance between myopic shift and MAA.
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The study aimed to examine the distribution of Accommodative Facility (AF) and Amplitude of Accommodation (AA) and compare the findings with established guidelines.Place and Duration of Study: Mzuzu University, Malawi. Between May and July 2022.Methods: This cross-sectional study was conducted among students at Mzuzu university in Malawi. We recruited 77 students using a stratified random sampling technique. The participants' age ranged from 16 to 35 years of age. We measured AA using the push-up method while AF was measured using +/- 1.50 Diopters (D) flippers. Both techniques utilized black reading material on white background held at 40 centimeters (cm). Next, we measured the accommodation facility by counting the number of Cycles per Minute (c/m). We utilized the Pearson correlation test and the One-way ANOVA where appropriate. The value of p< 0.05 was considered statistically significant. Results: The participants comprised 44 (57.1%) males and 33 (42.9%) females. Monocular AA was 10.04D (SD=2.71) and Binocular AA was 10.51 (3.641). The difference was statistically significant (p=0.04). While Monocular AF and Binocular AF were 9 c/m (SD= SD=1.84) and 8.96 (SD=1.539) respectively but the difference was non-significant (p=0.868). AF and AA were not significantly different between males and females. All the parameters decreased with age. The measured AA was significantly higher than using Hofstetter’s formula.Conclusion: The study provides a cut-off value for practitioners diagnosing Accommodation anomalies. However, indices in the study differ from the well-established guidelines hence practitioners should endeavor to perform the clinical assessment instead of relying on equations.
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@#AIM: To observe the visual quality after segmental Refractive multifocal intraocular lens(IOL)implantation.<p>METHODS: Totally 50 cases(83 eyes)of cataract patients who receiving phacoemulsification and IOL implantation in our hospital from June 2016 to February 2017 were selected as the study object. Based on the IOL types, the patients were divided into two groups: 22 cases(37 eyes)in observation group implanted segmental refractive multifocal IOL, 28 cases(46 eyes)in control group implanted monofocal IOL. Three months after surgery, the uncorrected visual acuity was recorded. A double-pass optical quality analysis system(OQAS II)was used to evaluate the visual quality. The near spectacle independence, satisfaction, and symptoms of visual disturbance were assessed by a questionnaire.<p>RESULTS: Three months after surgery, there were no statistical differences in uncorrected distance visual acuity(UCDVA)between the observation group and control group(<i>P</i>=0.273). The uncorrected intermediate visual acuity(UCIVA)and uncorrected near acuity(UCNVA)of observation group was better than control group(<i>P</i><0.05). There were no statistical differences in MTF cutoff; contrast visual acuity between the groups. The OSI in the observation and control groups was 2.64±0.68 and 1.52±0.47, respectively; objective amplitude of accommodation was(2.91±0.71)D and(1.32±0.41)D, respectively; near spectacle independence was 91% and 7%, respectively. There were statistical differences between the groups(<i>P</i><0.05). There were no statistical differences between the groups for visual disturbances(glare, ghosting)and satisfaction(<i>P</i>>0.05).<p>CONCLUSION: Segmental refractive multifocal intraocular lens provides wider objective amplitude of accommodation and good overall visual acuity, reduces spectacle dependency and provides high patient satisfaction.
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Objective To observe the adverse effects of 0.01％ atropine sulfate eye drops on myopic children.Methods A prospective non-randomized controlled trial was conducted.Ninety-nine myopic children (99 right eyes) were randomly assigned to experimental group(55 cases) and control group(44 cases).Myopic children of experimental group wore completely corrected frame glasses,while 0.01％ atropine sulfate eye drop was dropped into each eye once a day before going to bed.Myopic children in control group only wore completely corrected frame glasses.The follow-up time was 4 months.Best corrected visual acuity (BCVA),intraocular pressure (IOP),change of pupil diameter (PD) and amplitude of accommodation,symptoms of discomfort after medication were observed.This study followed the Helsinki declaration and was approved by Ethic Committee of the First Affiliated Hospital of Zhengzhou University.Informed consent was signed by the parents of each patient.Results No significant differences were found in best corrected distance visual acuity (BCDVA),best corrected near visual acuity(BCNVA) and IOP between the two groups before and 4 months after treatment (BCDVA:Fgroup =3.880,P =0.112;Ftime =27.220,P =0.413;BCNVA:Fgroup =5.200,P =0.311;Ftime =38.200,P =0.116,IOP:Fgroup =12.350,P=0.214;Ftime =22.300,P =0.146).After 4 months treatment,the PD was (6.99 ±0.64) mm in the experimental group,which was significantly higher than that before treatment(P＜0.001).The PD of the experimental group was higher than that of the control group after 4 months treatment,and the difference was statistically significant (P＜0.01).The amplitude of accommodation in the experimental group was 14.01 ±3.98 after 4 months treatment.which was 1.20 D lower than that before treatment,the difference was statistically significant (P＜0.01).The amplitude of accommodation of the experimental group was lower than that of the control group after 4 months treatment,the difference was statistically significant (P ＜ 0.01).Four cases (8％) appeared photophobia symptoms.Two cases and 2 cases appeared photophobia for 1 week or 2 weeks,respectively.However this symptom would relieve after wear sunglasses or sunshade caps in outdoor activities.One case (2％) appeared ocular itching and swelling after 1 month treatment,but disappeared after withdrawal.There were no other uncomfortable symptoms such as near sight blurring.Conclusions In mainland of China,the BCDVA,BCNVA and IOP of myopic children are stable;the PD is dilated and the amplitude of accommodation is decreased slightly after 4 months treatment of 0.01％ atropine,and 10％ children appear photophobia,but do not affect their study and life.
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AIM:To analyse visual modifications such as amplitude of accommodation, near point of convergence (NPC) reopsis and near phoria associated with asthenopic symptoms after 3D viewing at varying distances. METHODS: A prospective study. Thirty young adults were randomly selected. Each individual was exposed to 3D viewing thrice in a day for a fixed distance and the distance was varied on three consecutive days. Same video of equal duration and different screen sizes were used for every distance. Cyclic 3D mode of K-multimedia (KM) player was used for projecting the 3D video. Different variables like stereopsis, amplitude of accommodation, near point of accommodation, near phoria and asthenopic symptoms were recorded immediately after 3D video viewing. Stereopsis was measured with "Toegepast Natuurwetenschappelijk Onderzoek冶 or"Netherlands Organisation for Applied Scientific Research 冶 ( TNO test ), amplitude of accommodation and NPC were measured using RAF ruler, near phoria was measured using prism bar and a closed ended sample questionnaire was used to know the occurrence of asthenopic symptoms. Statistical analyses were performed using descriptive statistics, paired t-test etc. Qualitative data was analyzed using Chi-square test. RESULTS: For every distance of 40 cm, 3 m and 6 m, amplitude of accommodation was significantly reduced by 0.66 D,1.12 D and 1.44 D. NPC got significantly receded by 0.63 cm, 0.93 cm and 1.23 cm, and the near phoria was significantly increased by 0. 87, and 2. 2 prism dioptres (PD) base-in respectively. It was found that most of the subjects got pain around the eyes, headache and irritation for each viewing distance. This study also revealed that 3D video viewing in theaters may increase the symptoms of headache, watering and irritation. Symptoms like headache,watering,fatigue,irritation and nausea may increase considerably at home environment and symptoms such as headache and watering may cause significant discomfort by 3D viewing using a laptop. CONCLUSION: There was a significant difference in amplitude of accommodation, NPC, near phoria and asthenopic symptoms before and after viewing a 3D video and also at three viewing distances. There was a predominant occurrence of asthenopic symptoms after 3D video viewing at different distances.
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Aim and Background: This study was designed to compare four standard procedures, for determining the monocular accommodative amplitudes. Materials and Methods: Fifty‑two students participated in this analytical–descriptive study. Accommodative amplitudes were measured using four common clinical techniques, namely: Push‑up, push‑down, minus lens, and modified push‑up. Results: The highest amplitude was obtained using the push‑up method (11.21 ± 1.85 D), while the minus lens technique gave the lowest finding (9.31 ± 1.61 D). A repeated‑measures Analysis of Variance (ANOVA) showed a significant difference between these methods (P < 0.05), further analysis showed that this difference was only between the minus lens and other the three methods (the push-up (P < 0.001), the push-down (P < 0.001) and the modified push-up (P < 0.001)). The highest and the lowest mean difference was related to the push‑up with the minus lens, and the push‑down with the modified push‑up, while the highest and the lowest 95% limits of agreement were related to the push‑up with the modified push‑up and the push‑up with the push‑down methods. There was almost a perfect agreement between the push‑up and the push‑down method, whereas, a poor agreement was present between the modified push‑up and the minus lens technique, and a fair agreement existed between the other pairs. Conclusions: The quick and easy assessment of the amplitude using the push‑up and the push‑down methods compared to other methods, and the obtained perfect agreement between these two methods can further emphasize their use as a routine procedure in the clinic, especially if a combination of the two techniques is used to offset their slight over‑ and underestimation.
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Aim: To study the relationship between ocular parameters and amplitude of accommodation (AA) in the peri-presbyopic age group (35–50 years). Materials and Methods: Three hundred and sixteen right eyes of consecutive patients in the age group 35–50 years, who attended our outpatient clinic, were studied. Emmetropes, hypermetropes and myopes with best-corrected visual acuity of 20/20, J1 in both eyes were included. The AA was calculated by measuring the near point of accommodation. The axial length (AL), central anterior chamber depth (CACD) and lens thickness (LT) were also measured. Results: There was moderate correlation (Pearson’s correlation coefficient r = 0.56) between AL and AA as well as between CACD and AA (r = 0.53) in myopes in the age group 35–39 years. In the other age groups and the groups taken as a whole, there was no correlation. In hypermetropes and emmetropes, there was no correlation between AA and the above ocular parameters. No significant correlation existed between LT and AA across different age groups and refractive errors. Conclusion: There was no significant correlation between AA and ocular parameters like anterior chamber depth, AL and LT.
Subject(s)
Accommodation, Ocular , Adult , Anterior Chamber/anatomy & histology , Anterior Chamber/pathology , Female , Humans , Male , Middle Aged , Refractive Errors/pathology , Refractive Errors/physiopathology , Visual AcuityABSTRACT
Son pocos los estudios sobre valores normales de amplitudde acomodación realizados en Colombia. En este trabajo se tuvo como objetivo determinar el promedio de la amplitud de acomodación por grupos de edad en la población entre los 5 y 39 años de edad de Santa Fe de Bogotá, con base en datos tomados en 1991.Materiales y métodos: se realizó una revisión de los datos reportados en un trabajo de grado sobre 620 sujetos (1240 ojos), hombres y mujeres con defecto refractivo entre +1.50 y -1.50 D, poder cilíndrico de -0.25 a -1.00 D, agudeza visual en visión lejana mayoro igual a 20/30, agudeza visual de cerca mayor o igual a 0.75 M.Se realizó la determinación de los criterios de inclusióny exclusión de la base de datos, se tomaron los valores de la amplitud de acomodación determinandoel promedio de la amplitud de acomodación para los diferentes grupos de edad seleccionados, se compararon los resultados obtenidos con los valores encontrados por Duane, Hofstteter y Kragha, y finalmentese realizó un análisis de los cambios de la amplitudde acomodación con el transcurso de la edad.Resultados: el promedio de la amplitud de acomodaciónde todos los sujetos fue de 9.10 D para el ojo derecho y 9.09 D para el ojo izquierdo y no se hallarondiferencias estadísticamente significativas entre ambos ojos. La amplitud de acomodación disminuye en 0.50 D desde los 5 a los 14 años y en 1.0 a 1.3 D hasta los 39 años.Conclusiones: los resultados de amplitud de acomodaciónobservados demuestran que Hofstteter encontróvalores superiores a los de Duane, Kragha y este estudio (mayor en 4,2 D entre los 5 y 9 años), sobre todo en edades más tempranas. Con respecto a Duane, se encontró una diferencia de 1.7 D entre los 5 y los 30 años, y de 1.35 D después de los 30 años. La menor diferencia se halló con respecto a Kragha, encontrando valores ligeramente mayores entre 0.50 D y 1.2 D.
In Colombia are few studies on normal values amplitude of accommodation. This work has as its main objective to determine the average extent of accommodation by age groups in the population between 5 to 39 years old in the city of Santa Fe Bogota-based data taken in 1991.Methodology: a review of the data reported in a paper grade on 620 subjects (1240 eyes) to which they assessed the extent of accommodation taken into men and women of the city of Bogota in 1991 with refractive error between -1.50 And +1.50 D cylindrical power to -1.00 from -0.25 D, visual acuity in distant vision greater than or equal to 20/30, near visual acuity of greater than or equal to 0.75 M. We performed determining the criteria for inclusion and exclusion from the database, took the values of the breadth of accommodation determining the average extent of accommodation for the different age groups selected, the results were compared with the values found by Duane, and Kragh Hofstteter and finally an analysis of changes in the breadth of accommodation with the passage of age. Results: the average extent of accommodation of all subjects was 9.10 D for the right eye and 9.09 D for the left eye and we found no statistically significant differences between both eyes. The extent of accommodation decreases by 0.50 D of 5 to 14 years of age and 1.0 to 1.3 D to 39 years old.Conclusions: the results of breadth of accommodation observed show that Hofstteter found values superior to those of Duane, Kragh and this study (4.2 higher in D between 5 to 9 years) especially in the younger ages. Regarding Duane was a difference of 1.7 D between 5 and 30 years and 1.35 D after 30 years. The minor difference is hallo regarding Kragh found slightly higher values between 0.50 and 1.2 D D.
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Accommodation, Ocular , Visual AcuityABSTRACT
We studied on change of lens accommodation and pupil light reflex caused by VDT work in six women and compared them with those of other office works. The results were as follows. 1. In VDT work group, the accommodation contraction velocity decreased during the first 2-hr VDT task, then recovered markedly by the end of the one-hour lunch break, and then decreased again by the end of the 2nd 2-hr VDT task. Changes of relaxation velocity showed similar pattern although it was less typical than that of contraction velocity. 2. There was no marked change in accommodation contraction velocity and amplitude of accommodation in general office work group and near-distance office work group, and in the near-distance office work accommodation relaxation velocity decreased according to work load without recovery after lunch break. 3. Initial pupil diameter, initial pupil area of light reflex decreased significantly during VDT task only in VDT work group, and didn't recover after lunch break. These results suggest possibility that changes of accommodation contraction velocity, accommodation relaxation velocity, near point distance, and pupil diameter and area are useful in evaluating characteristics of VDT work. For this, more research adjusted individual differences, circadian rhythm, emotional stress needs.
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Female , Humans , Accommodation, Ocular , Circadian Rhythm , Individuality , Lunch , Pupil , Reflex , Relaxation , Stress, PsychologicalABSTRACT
Scopolamine Patch is transdermal drug delivery system that contains 1.5mg of scopolamine This agent is used for prevention of motion sickness, but a few partients note dilated pupils and complain of difficulty in near work in the use of the patches. The cause of pupil dilation and cycloplegia from scopolamine patches has been thought to be a result of ocular contamination from handling of the patches, but there was no definitive proof. Moreover, the duration and amplitudes of mydriasis and cycloplegia from this patches have not been fully described. The authors studied the effects of the scopolamine patches on pupil size and accommodative amplitude. The results were as follows: 1. Mydriasis and cycloplegia from scopolamine patchs were not results of systemic absorption, but of ocular contamination from finger which already touched to the patches. 2. The maximal pupil dilation was observed in all age groups between 1+1/2 and 4 hours after contamination, and its effect lasted 3 to 5 days. 3. The maximal reduction of the accommodative amplitude was observed at 4 hours after contamination and the reduction of the accommodative amplitude was statistically significant in older age group(p>0.05). 4. Return to original pupil size or miosis and recovery from the reduction of the accomodative amplitude were observed in 40%, 50%, and 71%, respectively by the first day on instillation of 1%, 2% and 4% pilocarpine.