ABSTRACT
RESUMO A acurácia do cálculo da lente intraocular não é perfeita, podendo ser comuns erros refrativos pós-operatórios, especialmente em pacientes submetidos à cirurgia refrativa prévia ou na presença de córneas assimétricas. O poder corneano após cirurgia refrativa pode ser medido com maior acurácia utilizando o mapa de poder óptico total na zona central de 4mm, com Orbscan II ou pelo mapa equivalent keratometric reading disponível no pentacam, com medidas centrais de 1,0, 2,0, 3,0 e 4,5mm. O objetivo desta série de casos é demonstrar a abordagem de quatro olhos em condições especiais corneanas, por meio do equivalent keratometric reading do pentacam para mensuração do poder corneano e o utilizando na biometria, em comparação com possíveis resultados obtidos com outras estratégias. Os quatro olhos foram submetidos a procedimentos refrativos prévios, e a lente intraocular escolhida a partir do uso do poder corneano calculado pelo equivalent keratometric reading mostrou excelentes resultados pós-operatórios.
ABSTRACT The accuracy of the intraocular lens calculation is not perfect, and postoperative refractive errors are common, especially in patients who have undergone previous refractive surgery or in presence of asymmetric corneas. Corneal power after refractive surgery can be more accurately measured using the total optical power map in the 4-mm central zone, by means of Orbscan II or equivalent keratometric reading map available on pentacam, with central measurements of 1.0, 2.0, 3.0 and 4.5 mm. The purpose of this case series is to demonstrate four approaches performed in special corneal conditions, using pentacam equivalent keratometric reading to measure corneal power and biometrics, and comparing with possible results obtained with other strategies. The four eyes were submitted to previous refractive procedures, and the intraocular lens chosen from the use of the corneal power calculated by equivalent keratometric reading showed excellent postoperative results.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Biometry/methods , Lens Implantation, Intraocular , Refractive Surgical Procedures , Refraction, Ocular/physiology , Refractive Errors/diagnosis , Refractive Errors/physiopathology , Cataract/diagnosis , Visual Acuity , Corneal Topography , Slit Lamp Microscopy , Lenses, IntraocularABSTRACT
RESUMO Objetivos: Avaliar a sensibilidade, especificidade e acurácia da refratometria obtida através do aparelho photoscreener 2WIN® como método de rastreio de ametropias com indicação de prescrição de óculos pelos critérios da Sociedade Brasileira de Oftalmopediatria em crianças assintomáticas, de origem extra-hospitalar, de 6 a 36 meses de idade, e determinar se a cicloplegia influencia a capacidade de rastreio do aparelho. Métodos: Cento e setenta e oito (178) de crianças com idades entre 6 e 36 meses tiveram sua refratometria mensurada pelo método padrão-ouro, a retinoscopia manual sob cicloplegia, e pelo método em teste, o photoscreener 2WIN®, antes e após a cicloplegia. Resultados: O photoscreener 2WIN® é capaz de identificar aqueles pacientes que deveriam receber prescrição de óculos pelos critérios da Sociedade Brasileira de Oftalmopediatria com sensibilidade de 100%, especificidade de 93,18% e acurácia de 93,26%, quando comparado a retinoscopia estática. Sob cicloplegia, o 2WIN® mantém sensibilidade de 100%, porém aumenta sua especificidade para 96,59% e a acurácia para 96,63%. Conclusão: O photoscreener 2WIN® se mostrou altamente sensível, específico e acurado para uso como equipamento de triagem daqueles pacientes de 6 a 36 meses que se beneficiariam do uso de óculos pelos critérios da Sociedade Brasileira de Oftalmopediatria, com discreto aumento da especificidade e acurácia quando aplicado em pacientes cicloplegiados.
ABSTRACT Objective: Evaluate the sensitivity, specificity e accuracy of the ocular refraction measured by the 2WIN® photoscreener as a screening method to identify children in need of spectacles prescription according to the criteria published by the Brazilian Society of Pediatric Ophthalmology (BSPO) in asymptomatic children, 6 to 36 months old, and determine the impact of cycloplegia in the sensitivity, specificity and accuracy of this method. Methods: One hundred seventy-eight (178) eyes of asymptomatic children between the ages of 6 and 36 months have been submitted to ocular refraction measurements by the gold-standard method, the manual retinoscopy under cycloplegia, and the method been tested, the 2WIN® photoscreening, both before and under cycloplegia. Results: The 2WIN® photoscreener before cycloplegia was able to identify those patients in need of spectacles prescription according to the criteria published by the BSPO with 100% sensitivity, 93.18% specificity and 93.26% accuracy, when compared to the manual retinoscopy under cycloplegia. The 2WIN® photoscreener under cycloplegia maintained a sensitivity of 100%, but increased specificity to 96.59% and accuracy to 96.63%. Conclusion: The 2WIN® photoscreener before cycloplegia showed high sensitivity, specificity, and accuracy in detection of patients in need of spectacles prescription according to the criteria published by the BSPO in the tested population, with minor increase in specificity and accuracy when the measurements were performed under cycloplegia.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Refraction, Ocular , Refractive Errors/diagnosis , Refractometry/methods , Retinoscopy/methods , Eyeglasses , Cross-Sectional Studies , Sensitivity and Specificity , Observational Study , Data AccuracyABSTRACT
RESUMO Objetivo Verificar a prevalência e as principais causas de baixa acuidade visual encontradas em estudantes; resolver as alterações refracionais por meio de correção óptica e estabelecer uma relação entre visão e desempenho escolar. Métodos Estudo transversal, quantitativo, de ação social realizada em uma escola pública de ensino fundamental e médio de Araçatuba (SP). A avaliação especializada foi indicada aos estudantes que, em triagem visual, apresentaram acuidade visual ≤0,7 em um ou em ambos os olhos, com ou sem correção óptica prévia. Foram entregues óculos a todos que necessitavam, para melhorar visão. Foi realizada análise pela ficha de atendimento e pela nota escolar dos alunos, pelos programas Excel e BioEstat. Resultados Dos 503 alunos triados, 75 (15%) apresentaram baixa de acuidade visual. Compareceram à consulta agendada 66 (88%), e 50 (80,65%) receberam óculos prontos. A média de idade foi de 152 anos, e houve predominância do sexo feminino (64,5%). As alterações refracionais foram a principal causa da baixa visual (90,3%), e miopia, associada ou não a astigmatismo, foi a mais prevalente (63%). Dentre os casos, 13 (21%) tinham anisometropia. Não houve diferença estatisticamente significativa (p=0,5479) entre as médias anuais dos alunos com baixa de acuidade visual e aqueles com visão normal. Conclusão Projetos sociais de triagem visual são facilmente executáveis, têm baixo custo e alta resolutividade, uma vez que os transtornos refracionais são a principal causa e facilmente corrigidos com óculos. A baixa de acuidade visual detectada nos alunos não interferiu no desempenho escolar.
ABSTRACT Objective To verify the prevalence and the main causes of low visual acuity among students, to correct refractive errors with eyewear, and to establish a relation between vision and school performance. Methods This is a cross-sectional, quantitative study of a social action carried out in a public elementary and high school in the city of Araçatuba (SP). Specialized evaluation was indicated to students who presented visual acuity ≤0.7 in one or both eyes, with or without prior optical correction, upon triage. Glasses were delivered to everyone who needed better vision. The analysis was performed based on screening record and student's school grade, using Excel and BioEstat software. Results Out of 503 students screened, 75 (15%) presented low visual acuity. Sixty-six (88%) attended the scheduled visit and 50 (80.65%) received ready-made glasses. The mean age was 15±2 years, and there was a predominance of females (64.5%). Refractive errors were the main cause of visual impairment (90.3%) and myopia, associated or not to astigmatism, was the most prevalent condition (63%). Thirteen (21%) students had anisometropia. There was no statistically significant difference (p=0.5479) in annual average grade of students with low visual acuity and those with normal vision. Conclusion Social projects for visual triage are carried out without effort, have a low cost and high problem-solving capacity, since refractive errors are the most frequent diagnoses and easily corrected with glasses. The low visual acuity detected in students did not interfere in their school performance.
Subject(s)
Humans , Male , Female , Child , Adolescent , Refractive Errors/complications , Refractive Errors/diagnosis , School Health Services , Vision Disorders/diagnosis , Visual Acuity , Eye Health , Vision Disorders/rehabilitation , Vision Tests , Vision Screening , Student Health , Cross-Sectional Studies , Early Diagnosis , Eyeglasses , Observational StudyABSTRACT
OBJECTIVES: Uncorrected refractive errors are the leading cause of visual impairment in children. In this cross-sectional retrospective study, we analyzed a social visual screening program for school children in São Paulo, Brazil, evaluated its impact on the prevention and treatment of children's visual disabilities, and assessed its epidemiological outcomes to outline suggestions for its improvement. METHODS: First-grade children from public schools were submitted to prior visual screening by their teachers. Selected children were forwarded to the hospital's campaigns for a second screening by ophthalmologists and treatment if needed. Data were analyzed for age, sex, visual acuity, biomicroscopy, refractive errors, ocular movement disorders, amblyopia, number of donated spectacles, and number of children forwarded to specialized care. RESULTS: A total of 1080 children were included with mean age of 6.24±0.45 years. Children with normal ophthalmological exam, 591 (54.7%; 95% confidence interval [CI]: 51.7%-57.7%) were dismissed and considered false-positives. Myopia, hyperopia, and astigmatism components were found in 164 (15.2%; CI: 13.1%-17.4%), 190 (17.6%; CI: 15.3%-20.0%), and 330 (30.5%; CI: 27.8%-33.4%) children, respectively. Amblyopia was diagnosed in 54 (5%; CI: 3.5%-6.4%) children, and 117 (10.8%; CI: 9.8%-12.8%) presented ocular movement disorders. A total of 420 glasses were donated. CONCLUSION: Epidemiological findings for amblyopia and refractive errors are consistent with those of similar studies. The expressive number of diagnoses performed and number of glasses donated to underprivileged children depict the importance of such projects. New guidelines to improve their cost-effectiveness, such as professional training and community sensitization, are imperative.
Subject(s)
Humans , Child, Preschool , Child , Refractive Errors/diagnosis , Refractive Errors/therapy , Refractive Errors/epidemiology , Schools , Vision Disorders/diagnosis , Vision Disorders/prevention & control , Vision Disorders/epidemiology , Brazil , Prevalence , Cross-Sectional Studies , Retrospective StudiesABSTRACT
ABSTRACT Purpose: The aim of this study was to evaluate the effect of anterior chamber depth and axial length on clinical performance of the Spot Vision Screener in detecting amblyopia risk factors in children aged 3-10 years. Methods: A total of 300 eyes from 150 patients aged 3-10 years were prospectively tested with Spot Vision Screener (firmware version 3.0.02.32, software version 3.0.04.06) and a standard autorefractometer (Nidek ARK-1). The anterior chamber depth and axial length were measured with an optical biometer (Nidek AL-Scan). The sensitivity and specificity values for detecting significant refractive errors using the referral criteria of the American Association for Pediatric Ophthalmology and Strabismus were determined. Pearson's correlation analysis was employed to evaluate the relationship between the Spot Vision results and the anterior chamber depth and axial length. Results: Compared with the standard autorefractometer results, the Spot Vision Screener's sensitivity and specificity was 59% and 94%, respectively. The differences between the cycloplegic autorefractometer and the Spot Vision Screener spherical equivalents were negatively correlated with anterior chamber depth (r=-0.48; p<0.001) and axial length (r=-0.45; p<0.001). Conclusion: The Spot Vision Screener has moderate sensitivity and high specificity, using the criteria of the American Association for Pediatric Ophthalmology and Strabismus. The anterior chamber depth and axial length affect the Spot Vision results.
RESUMO Objetivo: O objetivo deste estudo foi avaliar o efeito da profundidade da câmara anterior e do comprimento axial sobre o desempenho clínico do Spot Vision Screener, na deteção de fatores de risco para a ambliopia em crianças de 3 a 10 anos de idade. Métodos: Um total de 300 olhos de 150 pacientes de 3-10 anos de idade foram prospectivamente testados com o Spot Vision Screener (firmware: 3.0.02.32, software: 3.0.04.06) e com autorefratómetro padrão (Nidek ARK-1). Todas as medições de profundidade e comprimento axial da câmara anterior dos pacientes foram realizadas através de Nidek AL Scan. A sensibilidade e especificidade para a deteção de erros refrativos significativos foram determinadas de acordo com os critérios de referência da Associação Americana de Oftalmologia e Estrabismo Pediátricos. A análise da Correlação de Pearson foi utilizada para avaliar a correlação entre os resultados do Spot Vision e a profundidade ou comprimento axial da câmara anterior dos pacientes. Resultados: Em comparação com os resultados do autorefratómetro padrão, a sensibilidade do Spot foi de 59% e a especificidade de 94%. As diferenças entre os equivalentes esféricos do autorefratómetro cicloplégico e o Spot Vision Screener foram correlacionados negativamente com a profundidade (r=-0,48; p<0,001) e o comprimento axial (r=-0,45; p<0,001) da câmara anterior dos casos. Conclusão: O Spot Vision Screener possui uma sensibilidade moderada e uma especificidade elevada utilizando os critérios da Associação Americana de Oftalmologia Pediátrica e Estrabismo; a profundidade da câmara anterior e o comprimento axial dos pacientes afetam os resultados do Spot Vision.
Subject(s)
Humans , Child, Preschool , Child , Vision Screening/instrumentation , Amblyopia/diagnosis , Refractive Errors/diagnosis , Amblyopia/etiology , Strabismus , Prospective Studies , Risk Factors , Sensitivity and Specificity , Retinoscopy , Axial Length, Eye , Anterior ChamberABSTRACT
ABSTRACT Fabry disease is a rare X-linked disorder caused by an alpha-galactosidase enzyme deficiency, which leads to a progressive lysosomal glycosphingolipids accumulation, mainly globotriaosylceramide, in multiple organism tissues including the eye. This case series describes the first ophthalmological Colombian report of Fabry disease highlighting the importance of ocular signs as markers of the disease, useful in diagnosis and treatment to avoid long-term complications that lead to a morbi-mortality increment. We describe five cases of Fabry disease from Bogotá, Colombia, including a complete clinical history, ophthalmologic, optometric examination, and photographs. We found that all patients had refractive defects and that in all cases corneal verticillata pattern was found. Four patients presented with posterior capsule lens brown-beige deposits and four patients had conjunctival and retinal tortuous vessels. A complete ophthalmologic examination is important for prompt diagnosis, which is key to starting a multidisciplinary treatment and reducing morbi-mortality.
RESUMEN La enfermedad de Fabry es un raro trastorno ligado al cromosoma X causado por deficiencia de la enzima alfa-galactosidasa y la consiguiente y progresiva acumulación lisosómica de glucoesfingolípidos, especialmente la globotriaosilceramida, en múltiples tejidos del organismo, incluido el ojo. En este reporte se presenta la primera serie de casos de manifestaciones oculares de la enfermedad de Fabry en Colombia, resaltando la importancia de los signos oculares como ayuda para el diagnóstico temprano. Se presentan cinco casos de la enfermedad en Bogotá y se da cuenta de las historias clínicas y los exámenes oftalmológicos y de optometría, y se incluyen fotografías. En todos los pacientes se hallaron errores de refracción y se evidenció el patrón de córnea verticillata. Cuatro pacientes presentaban depósitos de color café y castaño claro en la cápsula posterior del cristalino, y cuatro tenían tortuosidad vascular conjuntival y retiniana. El examen oftalmológico completo es importante para hacer un diagnóstico oportuno con el fin de iniciar el tratamiento multidisciplinario y reducir la morbimortalidad.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Fabry Disease/complications , Eye Diseases/diagnosis , Refractive Errors/diagnosis , Retinal Vessels/abnormalities , Cataract/diagnosis , Amblyopia/diagnosis , Fabry Disease/genetics , Colombia , Conjunctiva/abnormalities , Conjunctiva/blood supply , Heterozygote , Lacrimal Apparatus/abnormalitiesABSTRACT
Resumo Objetivo: Avaliar a prevalência de crianças com dificuldade visual em triagens realizadas em 3 escolas públicas de Aracaju-SE, estimar a distribuição dos erros refrativos e usar os dados para planejamento de uma ação social mais extensa em todas as escolas públicas da cidade. Métodos: Estudo transversal, com medida da acuidade visual (AV), na forma de triagem. Foram analisados idade, gênero, AV, frequência dos principais erros refrativos, médias de equivalente esférico e cilindro das crianças com AV pior ou igual a 0,7 em qualquer olho, diferença superior a 0,2 entre os olhos, sinais de doenças oculares ou se já fizessem uso de óculos. Resultados: Foram avaliadas 510 crianças nas 3 escolas. A idade média foi 9,1 ± 1,6 anos. Gênero masculino correspondeu a 50,4%. Das 154 crianças (30%) que necessitaram de consulta mais detalhada, 97 se dirigiram à consulta. Destas, 51 tiveram indicação de uso de óculos. Míopes corresponderam a 44,1% dos olhos, hipermetropia a 15,6% e astigmatismo a 82,3%. A idade média das crianças com indicação de uso de óculos foi 9,5 ± 1,7 anos. Considerando-se que há em torno de 15 mil crianças entre o 1º e o 3º anos do ensino fundamental matriculadas nas escolas públicas de Aracaju, pode-se estimar que aproximadamente 30% delas necessitarão de consulta oftalmológica, correspondendo a 4500 atendimentos (2000 a 2500 destas deverão precisar de óculos). Conclusão: Conclui-se que aproximadamente um terço das crianças em idade escolar neste estudo apresentou dificuldade visual durante a triagem. Após avaliação oftalmológica, foram prescritos óculos para pouco mais da metade. Astigmatismo foi o erro de refração mais prevalente. Os dados obtidos foram utilizados para o planejamento de importante ação social a ser desenvolvida pela Sociedade Sergipana de Oftalmologia.
Abstract Purpose: To evaluate the prevalence of visually impaired children at screening in three public schools in Aracaju-SE, to estimate the distribution of refractive errors and to use the data to develop a more comprehensive social project in all public schools of town. Methods: Cross-sectional study with visual acuity (VA) measurement at screening. Age, gender, VA, frequency of the main refractive errors, spherical equivalent and cylinder of those children with VA lower than or equal to 0.7 in any eye, difference greater than 0.2 between the eyes, signs of eye diseases or if they already wore glasses. Results: A total of 510 children were evaluated in 3 schools. Mean age was 9.1 ± 1.6 years. Males were 50.4%. Of the 154 children (30%) who required a more detailed examination, 97 went to the office. Of these, 51 had a prescription of glasses. Myopes accounted for 44.1% of the eyes, hypermetropia to 15.6% and astigmatism to 82.3%. Mean age of children with glasses was 9.5 ± 1.7 years. Considering that there are 15 thousand children between the 1st and 3rd years of elementary school, it can be estimated that approximately 30% will require ophthalmological consultation, corresponding to 4500 consultations (2000 to 2500 of these should need glasses). Conclusion: We conclude that approximately one-third of school-age children in this study had visual impairment during screening. After ophthalmological evaluation, glasses were prescribed for just over half. Astigmatism was the most prevalent refractive error in the 3 schools of the study. The data obtained were used for the planning of important social project to be developed by Sergipe's Society of Ophthalmology.
Subject(s)
Humans , Male , Female , Child , Vision Disorders/diagnosis , Vision Disorders/epidemiology , Visual Acuity , Vision Screening/methods , Refractive Errors/diagnosis , Refractive Errors/epidemiology , Schools , Students , Eye Health , Prevalence , Cross-Sectional StudiesABSTRACT
Resumo Objetivo: Avaliar a acuidade visual de crianças de 6 a 10 anos de idade em duas escolas públicas do município de Patos, Paraíba. Métodos: Estudo transversal, quantitativo, nas escolas E.M.E.F. Dom Expedito Eduardo de Oliveira e CIEP II Anésio Leão/Miguel Mota, que envolveu um total de 195 alunos. A coleta dos dados foi realizada com o auxílio de um instrumento para a coleta das informações, realização de entrevista com os alunos e a acuidade visual foi aferida pela utilização do Teste de Snellen. O estudo foi realizado entre os meses de janeiro e maio de 2018. Os dados provenientes dos instrumentos de coleta utilizados, foram compilados no Programa Statistical Package for the Social Sciences (SPSS - versão 21.0), em que foi feita uma análise estatística do tipo descritiva. Resultados: Do total de 195 alunos das escolas selecionadas, 154 participaram dos testes de acuidade visual realizados por meio da Tabela de Snellen e 28 destes apresentaram baixa acuidade visual e foram encaminhados para a consulta com o oftalmologista. Conclusão: Os principais erros de refração foram encontrados: miopia, astigmatismo e hipermetropia. Além disso, foi observado que a prevalência de baixa acuidade e teve um decréscimo bastante relevante de acordo com os estudos publicados entre 2003 e 2017.
Abstract Objective: To evaluate the visual acuity of children from 6 to 10 years of age in two public schools in the city of Patos, Paraíba. Methods: Cross-sectional, quantitative study in schools E.M.E.F. Dom Eduardo Expedito de Oliveira and CIEP II Anésio Leão / Miguel Mota, which involved a total of 195 students. The data collection was performed with the aid of an instrument to collect information, conduct interviews with the students and visual acuity was measured using the Snellen Test. The study was carried out between January and May of 2018. Data from the collection instruments used were compiled in the Statistical Package for Social Sciences (SPSS - version 21.0), and a descriptive statistical analysis was done. Results: Of the total of 195 students from the selected schools, 154 participated in the visual acuity tests performed through the Snellen Table and 28 of them presented low visual acuity and were referred to the ophthalmologist. Conclusion: The main refractive errors found were myopia, astigmatism and hypermetropia. In addition, it was observed that the prevalence of low acuity had a significant decrease according to studies published since 2003 to 2017.
Subject(s)
Humans , Male , Female , Child , Refractive Errors/epidemiology , Students/statistics & numerical data , Vision Tests/methods , Visual Acuity , Refractive Errors/diagnosis , Schools/statistics & numerical data , Vision Screening , Cross-Sectional Studies , EyeglassesABSTRACT
Resumo Objetivo: Avaliar o perfil epidemiologico de disfuncao da acuidade visual (AV), possiveis disturbios oculares e a frequencia ao atendimento oftalmologico, de escolares do municipio de Itauna, Minas Gerais, Brasil. Posteriormente objetivou-se o encaminhamento ao especialista para correcao das anormalidades. Métodos: Estudo transversal, com populacao avaliada de 432 alunos da rede publica de ensino. Os individuos foram avaliados pelo metodo Snellen e a faixa etaria da amostra variou de 4 a 17 anos. Os dados foram colhidos e sistematizados. Foram encaminhados para o servico de Oftalmologia aqueles que possuiam AV ≤ 0,7 em pelo menos um dos olhos. Resultados: Dos 432 alunos avaliados neste estudo 14,5% apresentaram baixa AV, quando avaliados pelo teste de Snellen. Destes, 61,9 % pertenciam ao sexo feminino. A faixa etaria em que houve maior prevalencia de baixa visao foram escolares de 15 a 17 anos. A maioria apresentou alteracao em ambos os olhos e 60% dos alunos avaliados declararam nunca terem passado por uma consulta oftalmologica. Dos alunos que compareceram as consultas, a maioria foi diagnosticada com erros de refracao e necessitou de correcao otica. Conclusão: Os resultados encontrados demonstram que a parcela significativa dos individuos avaliados apresentou baixa visao e necessitou de encaminhamento oftalmologico. Alem disso, observou-se a inexistencia de consultas oftalmológicas anteriores em grande parte dos escolares. Esse fato reforca, diante dos orgaos publicos de saude, a necessidade de implantar sistemas de triagem visual nas escolas e oferecer assistencia a esses estudantes, objetivando melhorias em seu aprendizado e qualidade de vida.
ABSTRACT Objective: To evaluate the epidemiological profile of visual acuity (VA) dysfunction, the possible ocular disorders and the frequency of ophthalmologic care of school children from the city of Itaúna, Minas Gerais, Brazil. Methods: A cross-sectional study with a population of 432 students in the public schools. The individuals were evaluated by the Snellen method and the sample age ranged from 4 to 17 years. Data were collected and systematized. Those who had VA ≤ 0.7 in at least one eye were referred to the ophthalmology service. Results: Of the 432 students evaluated in this study, 14.5% presented low VA, when evaluated by the Snellen test. Of these, 61.9% were female. The age group with the highest prevalence of low vision were schoolchildren aged 15 to 17 years. The majority presented alteration in both eyes and 60% of the evaluated students stated that they had never had an ophthalmological consultation. Of the students who attended the consultations, most were diagnosed with refractive errors and needed optical correction. Conclusion: The results showed that a significant portion of the individuals evaluated had low vision and required ophthalmologic referral. In addition, there was no previous ophthalmological consultation in most of the schoolchildren. This fact reinforces to public health agencies, the need to implement visual screening systems in schools and offer assistance to these students, with the aim of improvements in their learning and quality of life
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Refractive Errors/diagnosis , Vision Disorders/diagnosis , Visual Acuity , Vision Screening , Schools , Students , Vision Tests , Prevalence , Cross-Sectional StudiesABSTRACT
Abstract Purpose: To present the design and implementation of an amblyopia risk factors screening project, in a large based Portuguese population. Methods: Two referral centers have been enrolled to assess all children aged 2 under their direct referral area. The photoscreener used was PlusOptix ® A09. At this age, the cut-off defined for referral was: ≥1 Diopter (D) of anisometropia, ≥1.5D of astigmatism, ≥2D of myopia and ≥1.5D of hyperopia. The results were reported to a reading platform that allowed the ophthalmologist to see all exams, and provide timely appointment with a complete ophthalmologic assessment for those who needed. Results: A total of 2867 photo screens were made to the population eligible to both referral centers, which comprises a coverage rate of 55%. Out of 2611 children under one of the referral area, 53% (n=1395) adhered to the screening. Within these children, 17.5% (n=245) were referred and 15.3 % (n=214) appointments were performed. The comparison of refraction between PlusOptix ® and cycloplegic refraction showed a strong correlation regarding the sphere and cylinder values. From the 214 children observed in consultation, glasses were prescribed in 25.7% (n=55), corresponding to 3.9% of all screened children under one of the referral area. This screening method showed a positive predictive value of 58.4%. Conclusion: This screening program may be highly relevant to eradicate untreated amblyopia from our population. The results may lead to the implementation of this project to the whole country.
Resumo Objetivo: Apresentação da implementação de um projeto de rastreio de fatores de risco de ambliopia, numa população alargada portuguesa. Métodos: dois centros de referência foram selecionados para avaliar todas as crianças de 2 anos, na sua área de referenciação direta. Para o foto rastreio foi utilizado o PlusOptix ® A09. Nesta idade, os valores definidos para referenciação foram: ≥1 Dioptria (D) de anosimetropia, ≥1.5 D de astigmatismo, ≥2 D de miopia e ≥1.5 D de hipermetropia. Os resultados foram reportados a uma plataforma de leitura que permitiu ao oftalmologista ver todos os exames e providenciar uma consulta oportuna com uma avaliação oftalmológica completa para aqueles que precisavam. Resultados: Foram realizados 2867 foto rastreios na população elegível para ambos os centros de referência, perfazendo uma taxa de cobertura de 55%. Das 2611 crianças sob uma área de referência, 53% (n = 1395) aderiram ao rastreio. Dentro desse grupo, 17,5% (n = 245) foram referenciadas e 15,3% (n = 214) consultas foram realizadas. Verificou-se uma forte correlação entre a refração do PlusOptix® e a refração cicloplégica. Das 214 crianças observadas em consulta, foram prescritos óculos em 25,7% (n = 55), correspondendo a 3,9% de todas as crianças sob uma área de referência. Este método de triagem mostrou um valor preditivo positivo de 58,4%. Conclusão: Este programa de rastreio pode ser altamente relevante para erradicar a ambliopia não tratada na nossa população. Os resultados podem levar à implementação deste projeto em todo o país.
Subject(s)
Humans , Male , Female , Child, Preschool , Refractive Errors/diagnosis , Vision Tests/instrumentation , Vision Screening/instrumentation , Amblyopia/diagnosis , Portugal , Visual Acuity , Amblyopia/epidemiology , Predictive Value of Tests , Risk FactorsABSTRACT
RESUMO Objetivo: Avaliar a Prevalência de ametropias e anisometropias em crianças no ensino fundamental nas escolas de 14 municípios do estado de Alagoas. Métodos: Realizado um Estudo retrospectivo com dados de 40.873 alunos na faixa etária de 7 a 15 anos. Os pacientes com qualquer erro refrativo foram considerados ametropes e erros maiores que - 0,75D ou + 2,00D esféricos ou maiores que -0,75D cilíndricos com queixas visuais significativas tiveram óculos prescritos e anisometropia considerada com a diferença maior de duas dioptrias. Resultados: Encontrado prevalência, 5,2% de ametropias. Astigmatismo miópico composto (28,99%), seguido de astigmatismo hipermetrópico composto (20,39%). E anisometropia, de 10.38%. Conclusão: Conhecer a prevalência infanto-juvenil de ametropias e anisometropia na população é fundamental para a adoção de estratégias para diagnóstico e tratamento correto de causas evitáveis de baixa visão.
ABSTRACT Objective: Evaluate a prevalence of ametropias and anisometropias in elementar school children from 14 cities in the state of Alagoas. Methods: A retrospective study, total of 40.873 students, between 7 and 15 years of age, were examined. Patients presenting any refractive error were considered ametropic. Only patients claiming eye complaints with spherical errors greater than -0.75D or +2.00D and cylinder error greater than -0.75D were prescribed eyeglasses. Anisometropia was considered when the refractive difference between the two eyes was of 2 diopters or more. Results: 5.2% presented ametropia. Compound myopic astigmatism (28.99%) and compound hyperopic astigmatism (20.39%). And anisometropias was 10.38%. Conclusions: Understanding the prevalence of ametropias and anisometropias among children is essential to implement strategies for the correct diagnosis and treatment of avoidable visual impairment causes.
Subject(s)
Humans , Male , Female , Child , Adolescent , Refractive Errors/epidemiology , Schools/statistics & numerical data , Students , Anisometropia/epidemiology , Refractive Errors/diagnosis , Anisometropia/diagnosis , Vision Screening , Eye Health , Prevalence , Retrospective StudiesABSTRACT
Resumo Objetivo: Avaliar o projeto Olhar Brasil sob um olhar crítico, examinando a prevalência dos pacientes encaminhados para consulta oftalmológica, pós-triagem, que realmente apresentem vícios de refração não corrigidos. Métodos: Revisão de prontuários entre Março de 2014 e Agosto de 2016, totalizando 339 pacientes entre 6 e 18 anos de idade, sendo 5 pré-escolares (2 - 6 anos e 11 meses), 124 escolares (2 - 6 anos e 11 meses) e 210 adolescentes (10-20 anos) entre os quais 156 do sexo masculino e 183 do feminino , em um hospital oftalmológico em Goiânia, Goiás, Brasil. Resultados: No total dos 339 pacientes examinados 143 (42,1 %) necessitaram de correção e 196 (57,8%) não. Entre os 156 pacientes do sexo masculino 74 (47,4%) apresentaram necessidade de uso de óculos contra 82 (52,5%) que não precisaram, em relação ao sexo feminino os números foram de 69 (37,7%) que tiveram alteração ao exame e 114 (62,2%) que não apresentaram alterações refrativas. Em relação a faixa etária, os adolescentes, escolares, e pré-escolares apresentaram em números absolutos e porcentagem respectivamente 102 (48,5%), 40 (32,2%) e 2 (40%) de indicação de lentes corretivas. Conclusão: O projeto Olhar Brasil tem importância relevante para sociedade em geral, com diminuição da evasão escolar, melhor rendimento escolar e consequentemente da qualidade de vida dos beneficiários, embora necessite melhor treinamento e aperfeiçoamento dos profissionais da Atenção Básica em Saúde, professores do ensino fundamental e os alfabetizadores que são responsáveis pela triagem.
Abstract Objective: Measure the "Projeto Olhar Brasil" under a critic point of view, examining the prevalence of patients referred for ophthalmological appointment, post-screening, that show refractive errors uncorrected. Methods: Review of records between March 2014 and August 2016, in totality of 339 patients between 6 and 18 years old, 5 preschools (2 - 6 years and 11 months) 124 school (7 - 9 years and 11 months) and 210 teenagers (10 - 20 years old). There were 156 males and 183 females, in an Ophthalmologic Hospital in Goiânia, Goiás, Brazil. Results: In total of 339 patients examined, 143 (42.1%) needed optical correction against 196 (57.8%) that not benefiting from the same. There were 74 (47.4%) males patients who required the use of eyeglasses, against 69 (37.7%) of females gender who obtained eyes test alterations. In relation to age, the teenagers, school and preschool showed in absolute numbers and percentage respectively 102 (48.5%), 40 (32.2%) and 2 (40%) indications of corrective lenses. Conclusion: The "Projeto Olhar Brasil" has great importance for society in general reducing the loss of students in school, improving school performance and consequently the quality of life of the beneficiaries, although it needs better training and improvement of professionals in primary health care, elementary school teachers and educators that are responsible for screening.
Subject(s)
Humans , Male , Female , Child , Adolescent , Refractive Errors/diagnosis , Refractive Errors/therapy , Eyeglasses/statistics & numerical data , Refractive Errors/prevention & control , Visual Acuity , Vision Screening , Medical Records , Eye Health , Epidemiology, Descriptive , Prevalence , Cross-Sectional Studies , Retrospective Studies , Diagnostic Techniques, Ophthalmological , Prescriptions/statistics & numerical dataABSTRACT
RESUMO Objetivo: Avaliar o aumento da prevalência de miopia entre pacientes atendidos em períodos diferentes em um serviço oftalmológico de Goiânia. Métodos: Foram comparados dados coletados em dois estudos científicos realizados em um serviço de oftalmologia, em diferentes períodos de tempo, que avaliaram dentre outros fatores, os erros refracionais dos participantes a partir destes dados comparou-se a porcentagem de pacientes portadores de miopia presentes nos estudos. Resultados: Observou-se um aumento na prevalência de Miopia dentre os participantes dos dois estudos. Na avaliação realizada entre 1995 e 2000 a porcentagem de pessoas com miopia representou 3,6% do total, já no estudo realizado no ano de 2014 a prevalência de pacientes com miopia foi de 9%. Dentre os pacientes com erros refracionais a prevalência de miopia no primeiro estudo foi de 9,97%, já no segundo a prevalência foi de 22%. Conclusão: Observou-se um aumento na prevalência de miopia entre os dois estudos, dados esses que corroboram com análises feitas que mostram um aumento da prevalência de miopia em todo mundo nos últimos 30 anos. Porém em uma proporção menor do que a observada em outros estudos populacionais.
ABSTRACT Objective: To evaluate the increased prevalence of myopia among patients in different periods in an ophthalmologic hospital in Goiânia. Methods: There were compared data collected in two scientific studies carried out in the same ophthalmologic hospital in different periods of time, they evaluated among other factors, the refractive errors of the participants, from this data there were compared the percentage of patients with myopia between the two studies. Results: There was an increase in the prevalence of myopia among the participants of the studies, in the evaluation carried out between 1995 and 2000 the percentage of people with myopia accounted for 3.6% of the total, in the study carried out in 2014 the prevalence of patients with myopia was 9%. Only among patients with refractive errors the prevalence of myopia in the first study was 9.97%, in the second study the prevalence was 22%. Conclusion: There was an increase in the prevalence of myopia between the two studies, these data corroborate with tests that shows an increasing prevalence of myopia in the world in the last 30 years. However, in a smaller proportion than in other population studies.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Refractive Errors/epidemiology , Myopia/epidemiology , Refractive Errors/diagnosis , Students , Visual Acuity , Vision Screening , Prevalence , Eye Health Services , Myopia/diagnosisABSTRACT
La presente guía de práctica clínica aborda la detección temprana, el diagnóstico, el tratamiento y el seguimiento de los defectos refractivos en pacientes menores de 18 años miopía, astigmatismo e hipermetropía. Se considera pertinente aclarar que la guía ofrece recomendaciones específicas frente a las preguntas definidas y excede el alcance de la misma, definir las competencias profesionales del equipo involucrado en el manejo de esta patología.
Subject(s)
Humans , Child, Preschool , Child , Adolescent , Refractive Errors/diagnosis , Refractive Errors/therapy , Early DiagnosisABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the accuracy of Spot Vision ScreeningTM as an autorefractor by comparing refraction measurements to subjective clinical refractometry results in children and adult patients. METHODS: One-hundred and thirty-four eyes of 134 patients were submitted to refractometry by Spot and clinical refractometry under cycloplegia. Patients, students, physicians, staff and children of staff from the Hospital das Clínicas (School of Medicine, University of São Paulo) aged 7-50 years without signs of ocular disease were examined. Only right-eye refraction data were analyzed. The findings were converted in magnitude vectors for analysis. RESULTS: The difference between Spot Vision ScreeningTM and subjective clinical refractometry expressed in spherical equivalents was +0.66±0.56 diopters (D), +0.16±0.27 D for the vector projected on the 90 axis and +0.02±0.15 D for the oblique vector. CONCLUSIONS: Despite the statistical significance of the difference between the two methods, we consider the difference non-relevant in a clinical setting, supporting the use of Spot Vision ScreeningTM as an ancillary method for estimating refraction.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Refraction, Ocular , Refractive Errors/diagnosis , Vision Tests/instrumentation , Vision Tests/methodsABSTRACT
ABSTRACT Objective To describe retinal diseases found in patients who were waiting for treatment at a tertiary care hospital in Rio Branco, Acre, Brazil. Methods Patients underwent slit lamp biomicroscopy, dilated fundus exam and ocular ultrasound. Patients were classified according to phakic status and retinal disease of the most severely affected eye. Results A total of 138 patients were examined. The mean age was 51.3 years. Diabetes was present in 35.3% and hypertension in 45.4% of these patients. Cataract was found in 23.2% of patients, in at least one eye. Retinal examination was possible in 129 patients. The main retinal diseases identified were rhegmatogenous retinal detachment (n=23; 17.8%) and diabetic retinopathy (n=32; 24.8%). Out of 40 patients evaluated due to diabetes, 13 (32.5%) had absent or mild forms of diabetic retinopathy and did not need further treatment, only observation. Conclusion Diabetic retinopathy was the main retinal disease in this population. It is an avoidable cause of blindness and can be remotely evaluated, in its initial stages, by telemedicine strategies. In remote Brazilian areas, telemedicine may be an important tool for retinal diseases diagnosis and follow-up.
RESUMO Objetivo Descrever as doenças de retina encontradas em pacientes que aguardavam tratamento para doenças retinianas em um hospital terciário de Rio Branco, Acre, Brasil. Métodos Foi realizado um exame oftalmológico compreendendo biomicroscopia com lâmpada de fenda, mapeamento de retina e ultrassonografia ocular. Os pacientes foram classificados de acordo com o status fácico e a doença retiniana que acometia o olho de maior gravidade. Resultados Foram atendidos 138 pacientes. A média de idade foi de 51,3 anos. A distribuição de diabetes foi de 35,3% e de hipertensão arterial foi de 45,5%. Catarata esteve presente em pelo menos um dos olhos em 23,2%. Tiveram o exame da retina possibilitado 129 pacientes. As principais doenças retinianas detectadas foram descolamento de retina regmatogênico (n=23; 17,8%) e retinopatia diabética (n=32; 24,8%). Dos 40 pacientes avaliados em função do diabetes, 13 (32,5%) apresentavam retinopatia ausente ou estágios iniciais de retinopatia e necessitavam apenas de acompanhamento. Conclusão A principal doença retiniana foi a retinopatia diabética, uma causa de cegueira evitável que pode ser acompanhada à distância, nos estágios iniciais, por meio de estratégias de telemedicina. A telemedicina pode ser uma importante ferramenta no acompanhamento de doenças retinianas em localidades remotas no Brasil.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Diabetic Retinopathy/epidemiology , Fundus Oculi , Retinal Detachment/epidemiology , Tertiary Care Centers/statistics & numerical data , Brazil/epidemiology , Cataract/epidemiology , Cities/epidemiology , Diabetes Mellitus/epidemiology , Eye , Hypertension/epidemiology , Refractive Errors/diagnosis , Retinal Diseases/epidemiology , Slit Lamp , TelemedicineABSTRACT
Marco conceptual:El manejo y detección de ametropías en la niñez es multidisciplinario. Los programas de tamizaje incluyen maestros, pediatras, oftalmólogos y optometristas, con el fin de corregir y prevenir la ambliopía. Objetivo: Evaluar la efectividad del tamizaje realizado por maestros que fueron capacitados en la toma de agudeza visual. Metodología: Se realizó estudio de concordancia en donde el universo lo constituyeron 33 maestros de las Escuelas primarias República de Nicaragua, Reino de los Países Bajos y República de Paraguay del sector público del municipio del Distrito Central de Honduras.El estudio se llevó a cabo en el año lectivo 2015 entre los meses de mayo a julio. Se evaluaron 840 estudiantes matriculados de primero a sexto grado. La medición de la agudeza visual se realizó utilizando la Cartilla Snellen, tomando como punto de corte mediciones menores a 20/30 en el mejor ojo. Los estudiantes con dicha agudeza visual fueron examinados por los médicos residentes cuya evaluación fue considerada el gold estándar del estudio para determinar la sensibilidad y especificidad de las mediciones realizadas por los maestros. Resultados: La sensibilidad y especificidad del tamizaje ejecutado por los maestros fue de 100% y 74% respectivamente. El resultado de índice de Kappa de Cohen fue de 0.65. Conclusiones: los resultados del presente estudio indican que el tamizaje de agudeza visual realizado por los maestros presenta validez aceptable para identificar casos positivos de disminución de agudeza visual y que es mejor elegir una prueba muy sensible si se prefiere obtener falsos positivos en lugar de falsos negativos...(AU)
Subject(s)
Humans , Amblyopia/diagnosis , Faculty , Refractive Errors/diagnosis , Visual AcuityABSTRACT
ABSTRACT Purpose: To evaluate the difference in terms of refractive errors and anterior segment parameters between schizophrenic patients and healthy volunteers. Methods: This study compared 70 patients (48 men) who were diagnosed with schizophrenia with a control group of 60 (35 men) who were similar in terms of age, gender, education, and socioeconomic level. Anterior segment examination was performed using a Scheimflug system. Axial length and lens thickness (LT) were measured using optic biometry. The following tests were administered to the psychiatric patient group: Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), and Scale for the Assessment of Positive Symptoms (SAPS). Results: Mild myopia was detected in both the schizophrenic and control groups, with no statistically significant difference (p>0.005). Corneal volume (CV), anterior chamber volume (ACV), anterior chamber depth (ACD), and central corneal thickness (CCT) values were lower in the schizophrenic group, and there was a statistically significant between-group difference (p=0.026, p=0.014, p=0.048, and p=0.005, respectively). LT was greater in schizophrenics, and the difference was found to be statistically significant (p=0.006). A statistically significant negative correlation was found between SAPS and cylinder values (p=0.008). The axial eye length, cylinder value, pupil diameter, mean keratometric value, and anterior chamber angle revealed no statistically significant difference between the groups (p>0.05). Conclusion: No statistically significant difference was detected in terms of refraction disorders between schizophrenics and the healthy control group, while some differences in anterior chamber parameters were present. These results demonstrate that schizophrenics may exhibit clinical and structural differences in the eye. .
RESUMO Objetivo: Avaliar se existem diferenças em relação aos erros refracionais e parâmetros do segmento anterior entre pacientes com esquizofrenia e voluntários saudáveis. Métodos: Este estudo comparou 70 pacientes diagnosticados com esquizofrenia (48 homens) com um grupo controle de 60 pacientes, semelhantes em relação à idade, sexo, escolaridade e nível socioeconômico (35 homens). O exame do segmento anterior foi realizado com o sistema Scheimflug; os comprimentos axiais do olho e a espessura do cristalino foram avaliadas por meio de biometria óptica. Os seguintes testes foram aplicados ao grupo de pacientes psiquiátricos: Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), e Scale for the Assessment of Positive Symptoms (SAPS). Resultados: Miopia leve foi detectada em ambos os grupos de esquizofrenia e de controle, sem diferença estatisticamente significativa (p>0,005). Volume de córnea (CV), volume da câmara anterior (ACV), profundidade da câmara anterior (ACD) e paquimetria central da córnea (CCT) apresentaram valores menores no grupo de esquizofrênicos e houve diferença estatisticamente significativa entre os dois grupos (p=0,026, p=0,014, p=0,048 e p=0,005, respectivamente). A espessura do cristalino (LT) foi maior em esquizofrênicos e a diferença foi estatisticamente significativa (p=0,006). Foi encontrada uma correlação negativa estatisticamente significativa entre SAPS e os valores cilíndricos (p=0,008). O comprimento axial do olho, o valor do cilindro, o diâmetro pupilar, a ceratometria média e o ângulo da câmara anterior não revelaram nenhuma diferença estatística entre os grupos (p>0,05). Conclusões: Não foi detectada diferença estatisticamente significativa em relação aos transtornos de refração entre os esquizofrênicos e o grupo controle, enquanto algumas diferenças nos parâmetros de câmara anterior estavam presentes. Estes resultados demonstram que esquizofrénicos podem ...
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Anterior Eye Segment , Biometry/methods , Refractive Errors , Schizophrenia , Anterior Eye Segment/physiopathology , Axial Length, Eye/pathology , Cross-Sectional Studies , Cornea/anatomy & histology , Lens, Crystalline/pathology , Myopia/complications , Myopia/diagnosis , Psychiatric Status Rating Scales , Pupil/physiology , Refractive Errors/diagnosis , Refractive Errors/physiopathology , Socioeconomic Factors , Surveys and Questionnaires , Schizophrenia/drug therapy , Schizophrenia/physiopathology , Time FactorsABSTRACT
Objective: The objective of this study was to determine the prevalence of uncorrected refractive error among students in three selected secondary schools in Birnin Kebbi metropolis as many children with poor vision due to refractive error remain undiagnosed and perform poorly in schools. Materials and Methods: This was a cross-sectional study that was conducted over a period of 2 months (May-June 2014). A total of 614 students were included from three randomly chosen secondary schools in Birnin Kebbi; Nigeria. Subjects were selected using random sampling technique from the list of students available through the help of their class teachers. Visual acuity (VA) was measured with a Snellen chart; while students with subnormal vision (VA = 6/9) were examined using pinhole; and subsequently referred for detailed eye examination and retinoscopy evaluation. Results: The age range was from 11 to 20 years comprising 50.8 (n = 312) males and 48.2 (n = 302) females. Refractive error in either eye was present in 30 (4.8) children. Of these; myopia was diagnosed in 18 (60) children; and then hyperopia in 7 (23.3); and astigmatism in 5 (16.7) subjects. Spectacle coverage was low as only three pupils were found to be using glasses with lack of awareness and lack of access to eye care services as major barriers. Conclusions: Uncorrected refractive error is found among secondary schools students in Birnin Kebbi; and there is a need for the establishment of regular and effective school vision screening program to detect and refer patients for treatment
Subject(s)
Cross-Sectional Studies , Mass Screening , Refractive Errors/diagnosis , Schools , Vision, OcularABSTRACT
PURPOSE: To evaluate the performance of the hand-held and table-top autorefractokeratometer in measuring refractive errors by comparing them with cycloplegic retinoscopy. METHODS: Included in the study were 112 eyes of 112 pediatric patients whose mean age was 6.78 +/- 2.61 years (range, 2 to 12 years). The refractive errors of all the eyes were measured with and without cycloplegia using a hand held autorefractokeratometer (Retinomax K-plus 3), table top autorefractokeratometer (Canon RK-F1) and performing cycloplegic retinoscopy. The spherical equivalent, cylindrical axis and keratometer values were statistically compared. RESULTS: The mean spherical equivalent obtained from the Retinomax K-plus 3 was significantly less hyperopic than that of Canon RK-F1 (p = 0.004) before cycloplegia. When the Bland Altman analysis was performed in comparisons of spherical equivalent values measured with the Retinomax K-plus 3, Canon RK-F1 and cycloplegic retinoscopy, it was seen that almost all of the differences between the measurements remained within the range of +/-2 standard deviation. Good agreement was found between Retinomax K-plus 3 and Canon RK-F1 for the Jackson cross-cylinder values at axis 0degrees and 45degrees; keratometer values respectively. CONCLUSIONS: The refractive error components were highly correlated between the two instruments and cycloplegic retinoscopy.