Vision for the Future Project: Screening impact on the prevention and treatment of visual impairments in public school children in São Paulo City, Brazil

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.

Análise da prevalência dos pacientes que necessitam de óculos em um Hospital Oftalmológico em Goiânia, Goiás, Brasil. Projeto Olhar Brasil / Analysis of the prevalence of patients in need eyeglasses in Ophthalmologic Hospital in Goiânia, Goiás, Brazil: Projeto Olhar Brasil

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.

Guía de Práctica Clínica ​(GPC) para la detección temprana, el diagnóstico, el tratamiento y el seguimiento de los defectos refractivos en menores de 18 años: guía para profesionales de la salud / Clinical Practice Guideline on prevention, early detection, diagnosis and treatment of refractive errors in children under 18 years of age

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.

Facoemulsificación del cristalino transparente en pacientes con alta miopía / Phacoemulsification applied to transparent crystalline lens in high myopic patients

Objetivo: evaluar los resultados de la facoemulsificación del cristalino transparente en pacientes con alta miopía. Métodos: se realizó un estudio descriptivo, longitudinal y prospectivo en el Hospital Enrique Cabrera, entre agosto del año 2006 y agosto de 2009. El universo estuvo constituido por pacientes altos miopes (³ 6 dioptrías) quienes acudieron a la consulta de Oftalmología durante el período señalado. La muestra fue de 110 ojos de 61 pacientes a quienes se le realizó extracción del cristalino transparente por la técnica de facoemulsificación con implante de lente intraocular, igual o mayores de 40 años, que cumplían con los criterios de inclusión y exclusión y que dieron su consentimiento informado. Resultados: el 60 por ciento de los ojos intervenidos mejoraron la agudeza visual sin corrección. De los 110 ojos intervenidos, 108 conservaron una mejor agudeza visual corregida posoperatoria igual o superior a la preoperatoria. El equivalente esférico obtenido en más del 95 por ciento de los ojos quedó en el rango esperado, lo que demostró una elevada predictibilidad de la fórmula (SRK/T) utilizada para el cálculo de la potencia del lente intraocular implantado. El astigmatismo inducido fue mínimo. No se registraron complicaciones transoperatorias y las posoperatorias fueron pocas. Conclusión: la facoemulsificación del cristalino transparente en pacientes con alta miopía es una alternativa de tratamiento quirúrgico segura y eficaz(AU)

Objective: to evaluate the results of phacoemulsification technique in treating high myopic patients. Methods: a prospective, longitudinal and descriptive study was conducted in Enrique Cabrera hospital in the period of August 2006 to August 2009. The universe was made up of high myopic patients (³ 6 dioptries), who went to the ophthalmology service in this period. The sample was 110 eyes from 61 forty years-old and older patients who had undergone transparent crystalline lens extraction by the phacoemulsificación technique with intraocular lens implantation, met the inclusion criteria and given their informed consent. Results: sixty percent of surgical eyes improved their uncorrected visual acuity. Of 110 operated eyes, 108 kept best corrected visual acuity equal or better than preoperative one after the surgery. The spheral equivalent obtained in more than 95 percent of the eyes was within expected range, showing high predictability of the formula (SRK/T) used for the calculation of the intraocular lens power. Induced astigmatism was minimal. No perioperative complications were reported whereas postoperative ones were few. Conclusions: it can be concluded that phacoemulsification in high myopic patients is a safe and effective surgical treatment option(AU)

Síndrome de visión de la computadora en trabajadores de dos bancos metropolitanos de un área de salud / Computer vision syndrome observed in employees from two Metropolitan Banks in a health area

El ordenador, si no se utiliza adecuadamente, produce trastornos en la salud. La causa de estas alteraciones está relacionada con factores ergonómicos visuales del entorno de trabajo y la exacerbación de problemas visuales ya existentes. Objetivo: describir características clínicas del síndrome de visión de la computadora en trabajadores de dos bancos metropolitanos de un área de salud. Métodos: se realizó un estudio descriptivo transversal. La muestra la conformaron 40 trabajadores que refirieron sintomatología asociada al uso del ordenador y que cumplieron los criterios de inclusión. Se estudiaron las variables: edad, sexo, síntomas, signos biomicroscópicos, afecciones oculares asociadas y tipo de defecto refractivo. Resultados: el 82,5 por ciento de los pacientes tenían más de 30 años, con edad media de 41,7 años. Por cada 12,3 mujeres diagnosticadas con síndrome de visión de la computadora se diagnosticó un hombre. Ojo rojo intermitente y visión borrosa resultaron los síntomas más frecuente y la inyección conjuntival el signo. Las afecciones oculares más frecuentes fueron las ametropías con 87,5 por ciento y ojo seco con 57,5 por ciento. Dentro de las ametropías predominó el astigmatismo con 43 por ciento de casos. Conclusiones: el síndrome de visión de la computadora es un problema de salud real en la actualidad. Las personas que pasan muchas horas frente al ordenador generalmente presentan antecedentes de afecciones oculares como ametropías y ojo seco, por lo que deben asistir al oftalmólogo(AU)

The computer, if not properly used, may cause health disorders. The cause is already related with visual ergonomic factors of the work environment and the exacerbation of already existing visual problems. Objective: to describe the clinical characteristics of the computer vision syndrome in employees from two metropolitan banks in a health area. Method: a cross-sectional descriptive study was carried out. The sample made up of 40 workers who had symptoms associated to the use of computer and met the inclusion criteria. The study variables were age, sex, symptoms, biomicroscopy signs, other eye pathologies and type of refractive defect. Results: in the study group, 82,5 percent of the patients were older than 30 years old, being the mean age of 41,7 years. One man per 12,3 women was diagnosed with the computer vision syndrome. Intermittent red eye and blurred vision were the most frequent symptoms and the conjunctival injection was the sign. The most frequent ocular pathologies turned to be the ametropia with 87,5 percent and dry eye with 57,5 percent of cases. Astigmatism prevailed in 43 percent of the group. Conclusions: the computer vision syndrome is a real health problem at the present time people that spend many hours working with computer generally show eye alterations as ametropia and dry eye, and they should go to the ophthalmologist(AU)

Refractive surgery in systemic and autoimmune disease

Patients with underlying systemic disease represent challenging treatment dilemma to the refractive surgeon. The refractive error in this patient population is accompanied by a systemic disease that may have an ocular or even a corneal component. The literature is rather sparse about the use of laser refractive surgery [LRS] and such procedure is not approved by the United States Food and Drug Administration [FDA] in this patient population. Patients with collagen vascular disease, diabetes mellitus [DM], allergic and atopic disease, or human immunodeficiency virus [HIV] are never ideal for LRS. Patients with uncontrolled systemic disease or ocular involvement of the disease should not undergo LRS. However, a patient with well-controlled and mild disease, no ocular involvement, and not on multidrug regimen may be a suitable candidate if they meet stringent criteria. There is a need for a large, multicenter, controlled trial to address the safety and efficacy of LRS in patients with systemic disease before such technology can be widely adopted by the refractive surgery community

Spectacle compliance amongst rural secondary school children in Pune district, India.

Background: Refractive errors (RE) are the most common cause of avoidable visual impairment in children. But benefits of visual aids, which are means for correcting RE, depend on the compliance of visual aids by end users. Aim: To study the compliance of spectacle wear among rural school children in Pune district as part of the sarva siksha abhiyan (education for all scheme) after 6 - 12 months of providing free spectacles. Settings and Design: Cross-sectional follow-up study of rural secondary school children in western India. Materials and Methods: The students were examined by a team of optometrists who collected the demographic details, observed if the child was wearing the spectacles, and performed an ocular examination. The students were asked to give reasons for non-wear in a closed-ended questionnaire. Statistical Analysis: Chi-square test and multiple logistic regression used for data analysis. Results: Of the 2312 students who were dispensed spectacles in 2009, 1018 were re-examined in 2010. 523 students (51.4%) were female, the mean age was 12.1 years 300 (29.5%) were wearing their spectacles, 492 (68.5%) students claimed to have them at home while 211 (29.4%) reported not having them at all. Compliance of spectacle wear was positively associated to the magnitude of refractive error (P < 0.001), father's education (P = 0.016), female sex (P = 0.029) and negatively associated to the visual acuity of the better eye (P < 0.001) and area of residence (P < 0.0001). Of those that were examined and found to be myopic (N = 499), 220 (44%) wore their spectacles to examination. Factors associated with compliance to spectacle usage in the myopic population included increasing refractive error (P < 0.001), worsening visual acuity (P < 0.001), and higher academic performance (P < 0.001). The causes for not wearing spectacles were ‘lost spectacles’ 67(9.3%), ‘broken spectacles’ 125 (17.4%), ‘forgot spectacles at home’ 117 (16.3%), ‘uses spectacles sometimes’ 109 (15.2%), ‘teased about spectacles’ 142 (19.8%) and ‘do not like the spectacles’ 86 (12%). Conclusion: Spectacle compliance was poor amongst school children in rural Pune; many having significant vision loss as a result.

impact of spectacle wear compliance on the visual function related quality of life of Omani students: a historical cohort study

Eye screening and refractive services to students are part of a school health initiative in Oman. We evaluated the impact of the compliance of spectacle wear on the vision related quality of life [VFQ] among 12-13 years old and 15-16 years old Omani students with refractive error. This historical cohort study was conducted in 2012. Students using spectacles and those not using spectacles after 1 year of prescribing/ providing spectacles were interviewed to assess their VFQ. The VQ 20 questionnaire with 5 graded close-ended responses was adopted for this purpose. The responses for the VFQ related to different visual functions of students who were/were not spectacle wear compliant, were compared. Our cohort had 124 students in each group. The overall VFQ was significantly higher among the compliant spectacle wearers [compliant group] compared with the non-complaint wearers [non-compliantgroup] [relative risk [RR] =4.7% [95%of the confidence interval [CI]: 2.8-6.6]]. The association of gender and the grade level was not significant [P > 0.05]. However, the variation of governorate was significantly associated to the difference of VFQ in both groups [x[2] = 16.6, degrees of freedom = 4, P = 0.0003]. The VFQ related to the near work [RR = 1.3] and school related activities [RR =1.3] was better in the compliant group. VFQ was better among those students who were spectacle wear compliant compared with those who were not. VFQ related to near work and school related activities seem to be the most influenced by spectacle wear compliance

Laser in-situ keratomileusis for refractive error following radial keratotomy.

Aim: To evaluate the safety and efficacy of laser in-situ keratomileusis (LASIK) in eyes with residual/induced refractive error following radial keratotomy (RK). Design: Retrospective study. Materials and Methods: A retrospective analysis of data of 18 eyes of 10 patients, who had undergone LASIK for refractive error following RK, was performed. All the patients had undergone RK in both eyes at least one year before LASIK. Parameters like uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), contrast sensitivity, glare acuity and corneal parameters were evaluated both preoperatively and postoperatively. Statistical Software: STATA-9.0. Results: The mean UCVA before LASIK was 0.16±0.16 which improved to 0.64 ± 0.22 (P < 0.001) after one year following LASIK. Fourteen eyes (out of 18) had UCVA of ≥ 20/30 on Snellen's acuity chart at one year following LASIK. The mean BCVA before LASIK was 0.75 ± 0.18. This improved to 0.87 ± 0.16 at one year following LASIK. The mean spherical refractive error at the time of LASIK and at one year after the procedure was –5.37 ± 4.83 diopters (D) and –0.22 ± 1.45D, respectively. Only three eyes had a residual spherical refractive error of ≥ 1.0D at one year follow-up. In two eyes, we noted opening up of the RK incisions. No eye developed epithelial in-growth till 1 year after LASIK. Conclusion: LASIK is effective in treating refractive error following RK. However, it carries the risk of flap-related complications like opening up of the previously placed RK incisions and splitting of the corneal flap.

Evaluación del cambio refractivo en escolares de Chile / Evaluation of refractive changes in Chilean schoolchildren

Objetivo: Evaluar cambios de refracción en escolares beneficiarios de JUNAEB. Material y Métodos: Se analizan 120 escolares (240 ojos) con prescripción de lentes, evaluados por un oftalmólogo desde 2001 por periodo de cuatro años. Resultados: 72 eran mujeres (59,5 por ciento) y 87 tenían entre 5 y 7 años en primer control (71,9 por ciento). 53 niños (43,8 por ciento) eran miopes (EE<0,5 Dp) 37 (30,6 por ciento) hipermétropes (EE>2,0 DP) constatándose 17 casos (14 por ciento) de ambliopía y 4 (3,3 por ciento) estrabismo. 13 usaban lentes (10,7 por ciento) y una visión menor a 0,3 en 100 ojos (41.3 por ciento). En último control, 97,5 por ciento refiere haber usado lentes con visión corregida mayor 0,5 en 217 ojos (89,7 por ciento) y menor 0,3 en 7 (2,9 por ciento) asociado a estrabismo o alta miopía. La miopía aumento en -0,9 dioptrías en 4 años, siendo mayor en miopía alta (-1,7 Dp). Conclusión: beneficio visual de corrección excepto mala visión final asociado alta miopía y estrabismo detectados tardíamente. Mayor progresión en alta miopía.

Objective: Evaluate refractive changes in students beneficiary of JUNAEB program. Material and methods: We studied 120 schoolchildren (240 eyes) with lenses prescription, evaluated by one ophthalmologist since 2001, for a four years period. Results: 72 were women (59.5 percent) and 87 had between 5 and 7 years in the first control (71.9 percent). 53 children (43.8 percent) were myopic (EE<0.5 Dp) 37 (30.6 percent), hyperopia (SE> 2.0 Dp). Found 17 cases (14 percent) of amblyopia and 4 (3.3 percent) strabismus. 13 used lenses (10.7 percent) and a vision of less than 0.3 in 100 eyes (41.3 percent). At last check, 97.5 percent reported having used lenses with corrected vision increase 0.5 in 217 eyes (89.7 percent) and less than 0.3 in 7 (2,9 percent) associated with strabismus or high myopia. Myopia increase -0.7 diopter in four years, being higher in high myopia (-1.7 diopter). Conclusion: Benefit visual correction except poor vision associated high myopia and strabismus detected late. Increased high in myopia progression.

Subclinical keratoconus among patients visiting laser unit - Hilla Teaching Hospital in Iraq

Subclinical Keratoconus is a term used to indicate a patient with inferior or central steepening of cornea on topography where the clinician suspects that it may progress to keratoconus. Diagnosis of sub-clinical keratoconus among myopic patients seeking for correction of their refractive errors by excimer laser, to avoid surgery for those patients and consider them at risk of developing post operative corneal ectasia which is the most severe post operative complication in photorefractive surgery. One thousand and two hundred myopic patients who attended laser unit/ Hilla Teaching Hospital, during a 1.5 year duration, seeking for correction of their refractive errors. Many investigations were done including visual acuity, slit lamp examination, corneal topography, keratometry and pachymetry. The present results indicating that 49 [4%] of patients diagnosed as having subclinical keratoconus. Out of these cases, 27 [55%] were males and 22 [45%] were females. Forty one of them [83.6%] were less than 25 years old. Sub-clinical keratoconus is one of the challenging problems facing refractive surgeons and is one of the most important and preventable causes of corneal ectasia following photorefractive surgeries

Refractive error changes in children with intermittent exotropia under overminus lens therapy / Alterações nos vícios refracionais em crianças com exotropia intermitente submetidas ao tratamento por meio da hipercorreção com lentes negativas

PURPOSE: Intermittent exotropia may be decreased by stimulation of accommodative convergence. Once excessive accommodation has been related to myopia, our objective was to evaluate refractive errors changes in children under overcorrecting minus lens therapy. METHODS: A retrospective chart review of 21 children with intermittent exotropia was performed. All patients were treated with occlusion, and a 13-patient subset of them received overminus lens therapy (group A). Eight children received spectacles as necessary (group B). Initial age, age interval, initial spherical equivalent (SE), and magnitude of overcorrection were considered as co-variables of the mean variation in refractive error (SE of each eye) between groups, through a multivariate analysis. RESULTS: Overcorrection used in group A ranged from 0.5 D to 3.5 D (2.46 ± 0.87 D). Although initial SE of each eye was significant different between group A and B (OD - p=0.02; OS - p=0.01), initial age (p=0.69), age interval (p=0.90), and mean variation in refractive errors (p=0.36) did not differ between groups. Multivariate analysis with linear regression showed no significantly difference regarding all co-variables enrolled. CONCLUSIONS: Treatment of intermittent exotropia with overcorrecting minus lens did not induce refractive errors changes, even considering age, treatment period, initial spherical equivalent and overcorrection magnitude used.

OBJETIVO: A exotropia intermitente pode ser diminuída pela estimulação da convergência acomodativa. Uma vez que uma acomodação excessiva tem sido relacionada à miopização, o objetivo deste trabalho foi o de avaliar alterações nos vícios de refração de crianças submetidas à hipercorreção com lentes negativas. MÉTODOS: Foi realizada revisão dos prontuários de 21 crianças com exotropia intermitente. Todos os pacientes foram tratados com oclusão, sendo que 13 deles foram submetidos à hipercorreção com lentes negativas (grupo A). As 8 crianças restantes receberam prescrições ópticas conforme necessário pelas suas ametropias (grupo B). A idade inicial, tempo de tratamento, equivalente esférico (EE) inicial e magnitude da hipercorreção foram considerados como covariáveis na análise das diferenças das médias de erro refrativo (EE de cada olho) entre os grupos, pela análise multivariada. RESULTADOS: A hipercorreção utilizada no grupo A variou entre 0,5 D e 3,5 D (2,46 ± 0,87 D). Embora o EE inicial de cada olho ter sido significativamente diferente entre os grupo A e B (olho direito - p=0,02; olho esquerdo - p=0,01), a idade inicial (p=0,69), o tempo de tratamento (p=0,90) e a variação média nos erros refrativos (p=0,36) não diferiram entre os grupos. A análise multivariada com regressão linear não mostrou diferença significativa, considerando as covariáveis em questão. CONCLUSÕES: O tratamento de crianças com exotropia intermitente por meio de hipercorreção óptica com lentes negativas não induziu alterações nos vícios de refração, mesmo considerando fatores como idade inicial, o tempo de tratamento, equivalente esférico inicial e a magnitude da hipercorreção utilizada.

Pattern of use of contact lens among college students: A cross-sectional study in coastal Karnataka.

The use of contact lens (CL) for the correction of refractive errors, cosmetic use and their usage as a therapeutic modality for corneal pathologies has increased tremendously over the years. The present study was conducted with the aim to find a pattern of CL use amongst college students with a focus on the rationale for CL use and problems related to their use. This study includes 371 college students who were current users of CL at the time of the study. Results showed that 96.8% of the CL users use the ‘daily wear type’ of CL. Most quoted reasons of usage were comfort and convenience (61.2%) with cosmetic benefit (42.9%) as the next most common reply. Common complaints were that of general discomfort (foreign body sensation), dry eyes and watering eyes. Educated use of CLs amongst its users is advised in view of the symptoms and associated complications that may occur.

School eye screening and the national program for control of blindness.

Childhood blindness and visual impairment are as important and perhaps more devastating and disabling than adult onset blindness, because of the long span of life still remaining to be lived. Refractive errors and more particularly myopia, place a substantial burden on the individual and society. School-age children constitute a particularly vulnerable group where uncorrected refractive errors may have a dramatic impact on learning capability and educational potential. This article provides an overview of school eye screening from the perspective of National Program for Control of Blindness (NPCB), Government of India; and challenges, future directions and thrust area envisaged under the program for amelioration of childhood blindness.

Laser in situ keratomileusis to correct residual or induced refractive error following cataract surgery

To study the safety, efficacy and predictability of laser in situ keratomileusis [LASIK] as a refractive procedure to correct residual or induced refractive error following cataract surgery. 10 eyes of 10 patients suffering from unilateral ametropia following uneventful cataract surgery due to myopia and/or myopic astigmatism in the operated eye consequently leading to significant anisometropia and visual troubles. Seven eyes underwent cataract surgery by phacoemulsification and the remaining three by extra capsular cataract extraction. The mean un-corrected visual acuity improved from 0.09 +/- 5.73 to 0.64 +/- 0.26 postoperatively. 70% of the patients had a postoperative spherical equivalent within +/- 1.00D. The only striking complication was the occurrence of macular edema in the first postoperative day in a patient that underwent extra capsular cataract extraction followed few months later by YAG laser capsulotomy to treat posterior capsular opacification. LASIK safely and effectively corrected post cataract surgery ametropia. The safety of LASIK following cataract surgery in patients previously treated by YAG capsulotomy needs to be properly evaluated

Patterns of detection and optical correction among ophthalmologists

OBJECTIVE: To verify age of first ophthalmic evaluation and optical prescription along with present optical correction among ophthalmologists of different age groups. METHODS: A cross-sectional study was conducted with a nonprobabilistic sample (n = 578) of ophthalmologists and resident physicians using a self-administered questionnaire. RESULTS: The first ophthalmologic exam was undergone before age 7 for 33.3 percent of the ophthalmologists aged between 23 and 30 years, for 25.8 percent of those aged from 31 to 42 , and for 15.8 percent of those aged from 43 to 76 years (P < 0.0005). The first ophthalmologic exam was undergone at 8 to 22 years of age for 60.7 percent of the ophthalmologists aged between 23 and 30, for 54.9 percent of those aged between 31 and 42, and for 47.4 percent of those aged from 43 to 76 years of age. Use of the first optical prescription (eyeglasses) between 0 and 7 years was reported by 10.0 percent, from 8 to 20 years of age by 59.6 percent, from 21 to 40 years by 18.1 percent, and 41 years or older by 12.3 percent . Present use of optical correction was reported by 69.0 percent. Concerning type of corrective device chosen, 63.7 percent wore only eyeglasses, 29.8 percent wore eyeglasses and contact lenses, and 6.5 percent wore contact lenses only. CONCLUSION: Among the sample of opthalmologists, the first ophthalmic evaluation and corresponding optical correction usually occurred relatively late (8 to 20 years of age). However, in the younger group of ophthalmologists, there was a highly significant increase in the number of subjects who had undergone an ophthalmologic exam before age 7. Eyeglasses were reported as the correction of choice by those in all age groups.

OBJETIVO: Verificar em oftalmologistas de diferentes faixas etárias a idade do primeiro exame oftalmológico, dos primeiros óculos e tipos e correlação óptica em uso, a fim de substituir estudos sobre a evolução dos cuidados oftalmológicos nas últimas décadas. MÉTODOS: Foi realizado estudo transversal em amostra prontamente acessível formada por oftalmologistas e residentes (n = 578), por meio da aplicação de questionário. RESULTADOS: Submeteram-se ao primeiro exame oftalmológico até os 7 anos de idade, 33,3 por cento dos oftalmologistas na faixa etária de 23 a 30 anos; 25,8 por cento na faixa etária de 31 a 42 anos e 15,8 por cento de 43 a 76 anos (teste exato de Fischer P < 0,0005). O primeiro exame oftalmológico ocorreu entre 8 e 20 anos de idade em 60,7 por cento dos oftalmologistas na faixa etária de 23 a 30 anos; 54,9 por cento na faixa etária de 31 a 42 anos e 47,4 por cento na de 43 a 76 anos. Manifestaram terem usado os primeiros óculos entre 0 e 7 anos 10,0 por cento, entre 8 e 20 anos 59,6 por cento, entre 21 e 40, 18,1 por cento; e de 41 anos ou mais, 12,3 por cento. Dos 69,0 por cento que mencionaram uso de correção óptica, 63,7 por cento usavam apenas óculos, 29,8 por cento intercalavam o uso de óculos e de lentes de contato e 6,5 por cento usavam apenas lentes de contato. CONCLUSÕES: A época do primeiro exame oftalmológico e da correção óptica ocorreu tardiamente (entre 8 e 20 anos). Porém na faixa etária mais jovem houve um aumento altamente significativo dos indivíduos submetidos a exeme oftalmológico até os 7 anos de idade. Registrou-se preferência por uso de óculos em todos os grupos etários.

[Comparison of different invasive types of refractive errors operation]

The methods of ammetropia of human eye correction are divided into invasive and non invasive methods. Each method has its own advantages and disadvantages. Each method has limitations due to the type of compensation; therefore it is difficult to make a straight forward decision. In this study we tried to compare the results of methods to find out their predictability, Uncorrected Visual Acuity, safety and stability. We investigated data of 24012 patients of different operation types in published papers by using the following keywords: Conductive Keratoplasty [CK], Hyperopic Thermokeratoplasty [HTK], Diode Laser Thermal Keratoplasty [DTK], Laser Thermal Keratoplasty [LTK], Photorefractive Keratectomy [PRK], Laser In Situ Keratomileusis [LASIK], Laser SubEpithelial Keratomileusis [LASEK]. The criteria for selection of papers were safety, predictability, stability and uncorrected visual acuity. Data were analyzed with Chi-square test. For those patients with hypermetropia less than 3.5 diopter, CK and LTKhave best correction results, respectively. Then the results of PRK and LASEK were the same. For all range of myopia, LASEK provided the best results and then LASIK was proper for moderate and higher myopia refractive errors, and PRK was useful in low myopia refractive anomalies

Comparação da função visual e do índice de qualidade de vida com uso de óculos ou de lente de contato progressiva / Comparative analysis of visual function and the quality of life index with eyeglasses or a progressive contact lens

OBJETIVO: Comparar a função visual e a resposta dos pacientes ao índice de qualidade de vida quando estes são corrigidos com óculos com lentes progressivas ou lente de contato progressiva. MÉTODOS: Foram selecionados 35 pacientes présbitas, usuários de óculos com acuidade visual igual, ou melhor, a logMAR zero (longe) e J1 (perto), para adaptarem a lente de contato Focus Progressive®. Foram comparadas medidas de acuidade visual para longe, perto e sensibilidade ao contraste com a lente de contato e com os óculos. Os resultados do questionário de avaliação de qualidade de vida NEI VFQ-25 dos mesmos pacientes corrigidos com os óculos e com a lente de contato progressiva foram comparados, levando-se em consideração o tipo de ametropia e a idade. RESULTADOS: A acuidade visual para longe, perto e a sensibilidade ao contraste foram significantemente piores com lente de contato progressiva do que com os óculos. As respostas do questionário não diferiram quanto à forma de correção quando se analisou o tipo de ametropia, entretanto foram significantemente piores com a lente de contato nos grupos míope e hipermétrope abaixo das suas respectivas medianas da idade e maiores no hipermétrope acima de sua mediana. CONCLUSÃO: As funções visuais foram significantemente piores com a lente de contato e o tipo de ametropia não influenciou nas respostas ao índice de qualidade de vida quanto à forma de correção, mas sim, quanto à idade.