Problemas visuales en niños de edad escolar / Visual Impairment in School-Age Children

Introducción: A partir de su formación permanente y continuada, desde la educación en el trabajo, el tecnólogo de la salud en optometría y óptica desarrolla modos de actuación en la atención primaria de salud, mediante la interacción con escuelas de la comunidad, para identificar problemas visuales en niños y contribuir a su rehabilitación, al brindar educación especializada a familias y docentes. Objetivo: Exponer los resultados de una investigación sobre problemas visuales en niños en edad escolar atendidos en el Policlínico Mario Escalona para la socialización de datos que contribuyan a la educación especializada de familias y docentes en la rehabilitación visual. Métodos: Se realizó un estudio descriptivo, transversal, desde enero de 2020 hasta abril de 2022, para conocer la incidencia del uso de dispositivos electrónicos en niños en edad escolar atendidos en el Policlínico Mario Escalona. Conformaron el universo 1953 niños. Se valoró el defecto refractivo y el tiempo de uso de los dispositivos electrónicos. Resultados: El astigmatismo miópico fue la ametropía más frecuente, con una incidencia superior al 50 por ciento. En encuestas realizadas a los padres se corroboró el uso desmedido de dispositivos electrónicos. Conclusiones: Como acto de responsabilidad profesional, desde la atención primaria de salud, el tecnólogo de la salud en optometría y óptica debe identificar los problemas visuales en niños en edad escolar y brindar educación especializada a familias y docentes, que contribuya a la rehabilitación visual(AU)

Introduction: From his or her permanent and continuous training, from education at work, the health technologist in Optometry and Optics develops modes of action in primary health care, through interaction with community schools, to identify visual problems in children and contribute to their rehabilitation, by providing specialized education to families and professors. Objective: To present the results of a research on visual problems in school-age children treated at Mario Escalona Polyclinic for the socialization of data that contribute to the specialized education of families and teachers in visual rehabilitation. Methods: A descriptive, cross-sectional study was carried out from January 2020 to April 2022, in order to know the incidence of the use of electronic devices in school-age children attended at Policlínico Docente Dr. Mario Escalona Reguera. The universe consisted of 1953 children. The refractive defect and the time of use of electronic devices were assessed. Results: Myopic astigmatism was the most frequent ametropia, with an incidence higher than 50 percent. Surveys of parents corroborated an excessive use of electronic devices. Conclusions: As an act of professional responsibility, from primary health care, the health technologist in Optometry and Peptics should identify visual problems in school-age children, as well as provide specialized education to families and professors, contributing to visual rehabilitation(AU)

Impacto de la COVID-19 en la progresión de la miopía en niños / Impact of COVID-19 on myopia progression in children

Introducción: La Organización Mundial de la Salud considera a la miopía un problema de salud mundial debido a su prevalencia creciente. Se espera que afecte al 52 % de la población mundial en 2050. Objetivo: Determinar la progresión de la miopía durante la pandemia de COVID-19 con respecto al período previo al confinamiento. Métodos: Se realizó un estudio descriptivo y ambispectivo de una serie de 12 pacientes atendidos en la Consulta de Oftalmología Pediátrica del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" antes de la pandemia y que acudieron en el período de confinamiento por la COVID-19 para su seguimiento. Las variables evaluadas fueron edad, género, antecedentes patológicos familiares de miopía, horas pantalla, equivalente esférico y biometría. Resultados: El promedio de edad fue de 9,7 años y el 58,3 por ciento correspondió al sexo femenino. El 75 por ciento de los pacientes tenían antecedentes patológicos familiares de miopía y el tiempo estimado frente a pantalla fue de 5,3 ± 0,8 h diarias. La media de la biometría se incrementó en el tiempo de 23 mm en 2019 a 25,5 mm en 2021. La diferencia de la media del equivalente esférico previo a la COVID-19 fue -0,89 y -0,84 para ojo derecho y el ojo izquierdo, respectivamente. En la etapa epidémica se percibió un aumento hasta -1,97 y -1,72. Conclusiones: El incremento del uso de los medios digitales debido al confinamiento ha causado la progresión de la miopía(AU)

Introduction: Myopia is considered a global health problem by the World Health Organization due to its increasing prevalence and is expected to affect 52 percent of the world's population by 2050. Objective: To determine the progression of myopia during the COVID-19 pandemic with respect to the pre-confinement period. Methods: A descriptive and ambispective study of a series of 12 patients treated at the Pediatric Ophthalmology Clinic of the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" before the pandemic and who visited the hospital during the COVID-19 confinement period for follow-up, was carried out. The variables evaluated were age, gender, family history of myopia, screen hours, spherical equivalent and biometry. Results: The average age was 9.7 years and 58.3 percent of the patients were females. Seventy-five percent of the patients had a family history of myopia and the estimated time in front of the screen was 5.3 ± 0.8 h per day. The medium biometry increased over time from 23 mm in 2019 to 25.5 mm in 2021. The difference in medium pre-COVID-19 spherical equivalent was -0.89 and -0.84 for right eye and left eye, respectively. In the epidemic stage, an increase to -1.97 and -1.72 was perceived. Conclusions: Increased use of digital media due to confinement has caused myopia progression(AU)

Expert consensus on stages of public health strategies for myopia prevention and control in children and adolescents / 中华预防医学杂志

Myopia has emerged as a public health issue with the increasing prevalence of myopia in children and adolescents in China. In the clinical diagnosis and treatment of myopia, there are clinical stages and classifications, but they are not suitable for the prevention and control of myopia at the public health level. At the public health level, because there is no staging standard for myopia, there is a lack of staging prevention and control guidance for different refractive errors. Therefore, the Public Health Ophthalmology Branch of the Chinese Preventive Medicine Association organized domestic experts in relevant fields to conduct literature searches and discuss based on the research data on myopia at home and abroad, put forward the stages of public health strategies for myopia prevention and control and corresponding group prevention and control measures for each stage to reached this experts consensus. This consensus first proposes a method for assessing myopia risk, in order to predict the occurrence and development of myopia in children and adolescents; From the perspective of public health, myopia prevention and control is further divided into four stages: myopia prodromal stage, myopia development stage, high myopia stage, and pathological myopia stage. According to this consensus, myopia prevention and control technology is targeted and implemented in different stages to provide guidance for myopia prevention and control from the perspective of public health.

Alertas en salud sobre el uso de los dispositivos electrónicos y su impacto en el bienestar visual / Health alerts on the use of electronic devices and their impact on visual well-being

Introducción: El incremento del empleo de los dispositivos electrónicos en las actividades de estudio, trabajo, entretenimiento e interacción social desde las plataformas digitales deriva numerosos riesgos y causas de problemas visuales y defectos refractivos. La prevalencia de estos puede conllevar a considerarlos como problemas de salud a nivel global. Objetivo: Describir los riesgos y las repercusiones del uso excesivo de los dispositivos electrónicos en la salud visual a cualquier edad. Métodos: El método de revisión bibliográfica y la sistematización de resultados investigativos de diversos autores posibilitan identificar los riesgos y la repercusión del uso excesivo de los dispositivos electrónicos sobre la salud visual, así como las recomendaciones para afrontar esa realidad. Resultados: La sistematización permite demostrar cómo incide el uso de los dispositivos electrónicos en la elevada prevalencia de trastornos oculares y visuales, como el síndrome visual informático y la miopía en la población mundial actualmente. Conclusiones: Entre los riesgos y las repercusiones del uso excesivo de los dispositivos electrónicos sobre la salud visual, señalados por varios autores, se describieron factores ópticos y ambientales que inciden en la aparición de trastornos como la visión tubular, el síndrome visual informático, además de los defectos refractivos como la miopía, considerados problemas de salud a nivel global en la actualidad(AU)

Introduction: The increase in the use of electronic devices in study, work, entertainment and social interaction activities from digital platforms derives numerous risks and causes of visual problems and refractive defects. The prevalence of these can lead to consider them as global health problems. Objective: To describe the risks and repercussions of excessive use of electronic devices on visual health to prevent eye problems at any age. Methods: The bibliographic review method and the systematization of research results from various authors make it possible to identify the risks and repercussions of the excessive use of electronic devices on visual health, as well as the recommendations to face this reality. Results: The systematization allows us to demonstrate how the use of electronic devices affects the high prevalence of eye and visual disorders, such as computer vision syndrome and myopia in the world population today. Conclusions: The excessive use of electronic devices has caused visual problems and refractive errors globally. An act of responsibility is imposed to inform and raise awareness about the damage to eye health and its harmful effects(AU)

Epidemiologia e prevalência da maculopatia miópica em centro de referência em oftalmologia / Epidemiology and prevalence of myopic maculopathy in an ophthalmology reference center

RESUMO Objetivo: Determinar a epidemiologia e a prevalência da maculopatia miópica e da miopia patológica e os fatores de risco associados. Métodos: Trata-se de estudo observacional transversal retrospectivo realizado em um serviço de oftalmologia, com 59 pacientes com idade entre 7 e 70 anos e equivalente esférico maior que -6 dioptrias. Suas retinografias foram laudadas segundo a classificação META-PM, por dois oftalmologistas e um retinólogo experiente. A análise estatística foi realizada conforme o Matlab R2010, com o Excel 2010 e o Statistical Package for the Social Sciences , versão 20.0, sendo utilizado o resultado da análise de regressão logística binária múltipla. Resultados: De acordo com a META-PM, a prevalência da maculopatia miópica nos cem olhos analisados foi de 19% para C0, 53% para C1,18% para C2,2% para C3 e 8% para C4. A prevalência da miopia patológica foi de 39%, sendo que 37% desses olhos possuíam maculopatia miópica C1 com lesões plus , C2 ou pior ou estafiloma posterior, e 2% apresentavam categoria menor que C2, sem lesões plus , porém com estafiloma posterior. A análise de regressão logística binária múltipla revelou associação entre idade e equivalente esférico com a presença da miopia patológica (p<0,05), evidenciando que o aumento de 1 ano na idade implicou em 1,05 vez (razão de chance de 1,05) mais chance de apresentar miopia patológica (p<0,001; intervalo de confiança de 95% de 1,02-1,08). O aumento de 1 dioptria no equivalente esférico maior que -6 dioptrias acarretou 1,19 vez (razão de chance de 1,19) maior risco de apresentar miopia patológica (p=0,001; intervalo de confiança de 95% de1,08-1,32). Por fim, não houve associação entre sexo e presença da miopia patológica (p=0,784). Conclusão: A classificação META-PM é uma ferramenta importante na padronização do estadiamento da lesão miópica, permitindo comparação entre estudos e normatização de condutas. O avançar da idade e o equivalente esféricomiópico estão relacionados à severidade da maculopatia miópica e à presença da miopia patológica.

ABSTRACT Objective: To determine the epidemiology and prevalence of myopic maculopathy and pathologic myopia and associated risk factors. Methods: This is a retrospective cross-sectional observational study performed at an ophthalmology center, including 59 patients aged 7 to 70 years, and spherical equivalent higher than -6 diopters. Their retinographies were assessed by two ophthalmologists and an experienced retina specialist, using the META-PM study classification. Statistical analysis was performed using Matlab R2010, Excel 2010 and Statistical Package for the Social Sciences version 20.0, based on the result of multiple binary logistic regression analysis. Results: According to META-PM, the prevalence of myopic maculopathy in 100 eyes analyzed was 19% C0; 53% C1; 18% C2; 2% C3; 8% C4. The prevalence of pathologic myopia was 39%, and 37% of these eyes having myopic maculopathy category C1 with lesions plus, C2 or worse, or posterior staphyloma, and 2% in category smaller than C2, without lesions plus, but with posterior staphyloma. Multiple binary logistic regression analysis revealed an association between age and spherical equivalent inpathologic myopia (p<0.05), demonstrating the increase by 1 year in age implied in 1.05-fold (odds ratio=1.05) more likelyto present pathologic myopia (p<0.001; 95%CI 1.02-1.08). The increase by 1 diopter in the spherical equivalent higherthan -6 diopters, led to 1.19-fold (odds ratio=1.19) greater risk of presenting pathologic myopia (p=0.001; 95%CI 1.08-1.32). Finally, there was no association between sex and pathologic myopia (p=0.784). Conclusion: The META-PM study classification is an important tool to standardize myopic lesion staging, allowing comparison between studies and establishing management. Advanced age and myopic spherical equivalent are related to severity of myopic maculopathy and pathologic myopia.

Cirugía facorrefractiva en la alta miopía y sus complicaciones / Phaco-refractive surgery in high myopia and its complications

La miopía es un grave problema de salud pública por su alta y creciente prevalencia en distintas áreas geográficas. La cirugía facorrefractiva consiste en la extracción del contenido transparente o esclerosado del cristalino y el implante de una lente intraocular, con el objetivo posoperatorio de alcanzar o acercarse a la emetropía. Ha demostrado un resultado predecible y estable en el tiempo, pero no está exenta de complicaciones. Se presenta un paciente de 44 años de edad con antecedentes de oftalmológicos de miopía elevada, glaucoma secundario y cirugía facorrefractiva en ambos ojos, refracción dinámica de -3,50-100 x 200 con agudeza visual mejor corregida de 0,8 por cartilla de Snellen en el ojo derecho y -5,25 -1,25 x 1600 con agudeza visual mejor corregida de 0,6 en el ojo izquierdo. En el examen biomicroscópico se observó afaquia quirúrgica, opacidad de la cápsula posterior con capsulotomía láser central amplia y presencia de vítreo en la cámara anterior en ambos ojos con cifras de tensión ocular elevadas. Se realizó implante secundario de lente intraocular en ambos ojos. La refracción dinámica a los 3 meses fue para el ojo derecho de: -0,50 -0,50 x 400 con agudeza visual mejor corregida de 0,9 por cartilla de Snellen y para el ojo izquierdo de: -1,00 -0,75 x 1600 con agudeza visual mejor corregida de 0,6 por cartilla de Snellen. A los dos años presentó desprendimiento de retina subclínico en el ojo derecho, que fue tratado con terapia láser, y daño glaucomatoso en el ojo izquierdo. Se le realizó trabeculectomía, trabeculoplastia selectiva láser y posteriormente implante de drenaje valvulado en el ojo izquierdo(AU)

Myopia is a serious public health problem, due to its high and increasing prevalence in various geographic regions. Phaco-refractive surgery consists in extraction of the clear or sclerosed content of the crystalline lens and implantation of an intraocular lens with the postoperative objective of achieving or approaching emmetropia. The procedure has shown to obtain predictable results stable in time, but it is not exempt from complications. A case is presented of a male 44-year-old patient with an ophthalmologic history of high myopia, secondary glaucoma and phaco-refractive surgery in both eyes, dynamic refraction of -3.50-100 x 200 with best corrected visual acuity of 0.8 on the Snellen chart in the right eye and -5.25 -1.25 x 1600 with best corrected visual acuity of 0.6 in the left eye. Biomicroscopic examination found surgical aphakia, posterior capsule opacity with large central laser capsulotomy, presence of vitreous in the anterior chamber of both eyes and high ocular pressure values. Secondary intraocular lens implantation was performed in both eyes. Dynamic refraction at three months was -0.50 -0.50 x 400 for the right eye with best corrected visual acuity of 0.9 on the Snellen chart, and -1.00 -0.75 x 1600 for the left eye with best corrected visual acuity of 0.6 on the Snellen chart. At two years the patient experienced subclinical retinal detachment in the right eye, which was treated with laser therapy, and glaucomatous damage in the left eye, for which the treatment indicated was trabeculectomy, selective laser trabeculoplasty, and then valved drainage implantation in the left eye(AU)

Factores asociados a la prevalencia de la miopía mundial y su impacto social / Factors associated to global myopia prevalence and its social impact

La miopía es una alteración visual que se encuentra entre las cinco condiciones cuya atención clínica ha sido calificada de prioridad inmediata para la Organización Mundial de la Salud. Esta afección ocular ya ha alcanzado proporciones epidémicas en todo el mundo y se estima que las cifras de prevalencia de miopía global continúen creciendo. Los adolescentes y jóvenes resultan los más afectados. Para realizar un acercamiento al tema se utilizaron metabuscadores en inglés y en español de PUBMED, INFOMED, EBSCO, SCIELO, PRISMA, y UPTODATE, con el objetivo de identificar los factores asociados, la prevalencia y el impacto social de la miopía. Los estudios revisados mostraron que mientras más temprano comience el desarrollo de este error refractivo, mayores serán las probabilidades de padecer miopía magna y complicaciones asociadas a ella con posterioridad. Múltiples factores propician su aparición, algunos de ellos totalmente evitables asociados a patrones de comportamiento y estilos de vida, por lo que teniendo en cuenta lo alarmante del incremento de la afección se hace necesario trazar estrategias que permitan frenar su aparición y/o progresión(AU)

Myopia is one the five conditions of the eye whose clinical care has been declared an immediate priority by the World Health Organization. This condition has already reached epidemic proportions worldwide, and its prevalence is expected to continue to increase in the future. Adolescents and young people are the most commonly affected groups. With the purpose of identifying the associated factors, prevalence and social impact of myopia, a search was conducted for articles about the topic published in English and Spanish in the databases PubMed, Infomed, EBSCO, SciELO, PRISMA and UpToDate. The studies retrieved showed that early development of the refractive error will result in a greater probability of suffering from myopia magna and related complications. Multiple factors may lead to the appearance of global myopia. Some of them are totally preventable, since they have to do with behavior patterns and lifestyles. Considering the alarming increase in the occurrence of this condition, it is necessary to devise strategies allowing to contain its appearance and/or progression(AU)

Analysis of visual disability in Buenos Aires, Argentina. Pathologic myopia is the leading cause in working age / Análisis de discapacidad visual en Buenos Aires, Argentina. La miopía patológica es la principal causa en edad laboral

Abstract This study assessed the causes of visual impairment over a decade in Buenos Aires City. This is a retrospective case series where we reviewed the database of visual disability certificates issued by the Buenos Aires City Ministry of Health between 2009 and 2017. In Argentina, visual disability is defined as a visual acuity ≤ 20/200 in the better eye, or a corresponding visual field of less than 20 degrees in the less impaired eye. The database included the following variables: year of issue, age, gender, and cause of visual disability. Between 2009 and 2017 a total of 7656 subjects were certified as legally blind. The mean age of the sample was 57 ± 21 years and 52.1% were females. The emission was near 700 certificates per year. The age distribution showed that 62.8% of certificates were from patients older than 50 years and that only 6.6% were given to subjects under 20. The leading causes of visual disability in Buenos Aires City were age-related macular degeneration (ARMD) with a rate of 15.5%, degenerative myopia (14.4%), primary open-angle glaucoma (11.3%) and diabetic retinopathy (6.6%). In subjects younger than 50, degenerative myopia was the first cause of visual disability. Interestingly in Argentina, where the prevalence of myopia is low, degenerative myopia is found to be the major cause of visual disability in middle-aged adult subjects. Population and clinical methods to avoid this preventable disease should need to be implemented as a matter of urgency.

Resumen Este trabajo estudia las causas de la discapacidad visual durante una década en la Ciudad de Buenos Aires. Se presenta una serie de casos retrospectiva donde se revisó la base de datos de certificados de discapacidad visual emitidos por el Ministerio de Salud de la Ciudad de Buenos Aires entre 2009 y 2017. En Argentina, la discapacidad visual se define como una agudeza visual ≤ 20/200 en el mejor ojo, o un campo visual correspondiente de menos de 20 grados en el ojo menos deteriorado. La base de datos incluyó las siguientes variables: año de emisión, edad, sexo y causa de la discapacidad visual. Entre 2009 y 2017 se certificaron un total de 7656 sujetos con ceguera legal. La edad media de la muestra fue de 57 ± 21 años y el 52.1% fueron mujeres. La distribución por edades mostró que el 62.8% de los certificados fueron dados a pacientes mayores de 50 años y que solo el 6.6% se otorgó a menores de 20 años. Las principales causas de discapacidad visual fueron la degeneración macular asociada a la edad (DMAE) (15.5%), la miopía degenerativa (14.4%), el glaucoma primario de ángulo abierto (11.3%) y la retinopatía diabética (6.6%). En los menores de 50 años, la miopía degenerativa fue la primera causa de discapacidad visual. Resulta interesante que, en Argentina, donde la prevalencia de miopía es baja, la miopía degenerativa sea la principal causa de discapacidad visual en adultos de mediana edad.

Características de los pacientes pediátricos con miopía por encima de 6 dioptrías / Characteristics of pediatric patients with greater than 6 diopter myopia

RESUMEN Objetivo: Identificar las características de los pacientes pediátricos con miopías por encima de 6 dioptrías. Métodos: Se realizó un estudio descriptivo y observacional, de corte longitudinal, en 43 niños entre 3 y 15 años de edad con diagnóstico de miopía igual o mayor de 6 dioptrías en uno o ambos ojos (72 ojos), quienes acudieron a la consulta del Servicio de Oftalmología Pediátrica y Estrabismo del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" durante el periodo comprendido entre enero y diciembre del año 2018. Las variables del estudio fueron la edad, el sexo, el color de la piel, la miopía (isometrópica y anisometrópica), la longitud axial, la agudeza visual con corrección, el tipo de corrección óptica, la presencia y el grado de estereopsia. Resultados: Predominó el grupo de 3 a 5 años (34,4 por ciento), el sexo femenino y el color de la piel blanca. La longitud axial aumentó junto con el equivalente esférico de los pacientes. La corrección más usada correspondió a los cristales, aunque se demostró estadísticamente que con los lentes de gas permeables los pacientes presentaban mejor agudeza visual (p= 0,016), donde se registró también la media más alta de equivalente esférico. De 43 pacientes, 20 (46,5 por ciento) no presentaron estereopsia. Los pacientes con anisometropías (64 por ciento) no presentaron estereopsia, lo que fue estadísticamente significativo. Conclusiones: Con los lentes de gas permeables los pacientes presentan mejor agudeza visual y mayor equivalente esférico. La mayor cantidad de pacientes sin estereopsia corresponde a las miopías por anisometropías(AU)

ABSTRACT Objective: Identify the characteristics of pediatric patients with greater than 6 diopter myopia. Methods: An observational descriptive longitudinal study was conducted of 43 children aged 3-15 years diagnosed with myopia equal to or greater than 6 diopters in one or both eyes (72 eyes) who attended the Pediatric Ophthalmology and Strabismus Service at Ramón Pando Ferrer Cuban Institute of Ophthalmology from January to December 2018. The variables considered were age, sex, skin color, myopia (isometropic or anisometropic), axial length, corrected visual acuity, type of optical correction, and presence and degree of stereopsis. Results: A predominance was found of the 3-5 years age group (34.4 percent), female sex and white skin color. Axial length increased with spherical equivalent. The most common correction was glasses, but it was statistically demonstrated that gas permeable lenses provided better visual acuity (p= 0.016) and the highest spherical equivalent mean. Of the 43 patients evaluated, 20 (46.5 percent) did not present stereopsis. Patients with anisometropia (64 percent) did not present stereopsis, which constituted a statistically significant fact. Conclusion: Gas permeable lenses provide better visual acuity and a greater spherical equivalent. Most of the patients without stereopsis have anisometropic myopia(AU)

Avaliação e triagem da acuidade visual em escolares da primeira infância / Evaluation and screening of visual acuity in early childhood schoolchildren

Resumo Objetivo: Identificar a prevalência de alterações visuais em crianças de cinco anos em escolas públicas de Curitiba-PR. Métodos: As escolas foram selecionadas aleatoriamente dentro do município de Curitiba. As crianças com cinco anos completos em 2017 foram avaliadas com a tabela de Snellen, através de distância mínima correta para nitidez de imagem e teste de Hirschberg. Os pais responderam um questionário sobre uso de telas, sintomas oculares e histórico familiar da criança. Os resultados das avaliações foram analisados estatisticamente considerando nível de significância p≤0,05. Resultados: Em uma população de 459 crianças triadas, 219 (47,7%) pertenciam ao sexo feminino e 240 (52,3%) masculino, sendo que do total, 100 foram encaminhadas para avaliação oftalmológica especializada. A partir da triagem observou-se a prevalência de miopia de 10,7%, hipermetropia de 17,6% e estrabismo de 0,9%. Houve relação entre genitores com miopia e filhos míopes (p<0,05). Dentre as queixas oftalmológicas predominaram cefaleia (30,4%) e franzir de testa (10%). Conclusão: A prevalência de alterações visuais encontrada foi de 21,8%. A relação entre distúrbios visuais e o histórico familiar se mostrou estatisticamente significativa. Entretanto, apenas o tempo médio em frente à televisão apresentou influência, dentre os hábitos de vida, sobre as alterações da AV (p=0,028). Queixas oftalmológicas apesar de frequentes, não apresentaram correlação expressiva com a diminuição da acuidade visual.

Abstract Objective: To identify the incidence of visual impairment in 5-year-old children in public schools from Curitiba-PR. Methods: A selection of schools has been choosen randomly from Curitiba. The children, with completed 5 years at end of 2017 have been evaluated using Snellen table, trough minimum distance for image sharpness and Hirschberg test. Parents answered a questionnaire about the use of screens, ocular symptoms and family history of the child. Significance levels were defines as begin p≤0,05. Results: The results have shown that four hundred fifty-nine children were screened. Two hundred nineteen are female (47,7%) and two hundred fourty (52,3%), male. From all screened patients, one hundred were refered to specialized oftalmic evaluation. After trial completing, has been attained a prevalence value of 10,7% for myopia, 17,6% of hyperopia and 0,9% of strabismus. Strong correlation between parents and children has been undiscovered (p<0,05). From listed oftalmic complaints, headache (30,4%) and frown (10%) where most prevalent. Conclusion: It has been attained that the prevalence of visual acuity is 21,8%. The relation between visual acuity alteration and familiar history has been shown to be significant related. On the other side, the average time in front of television has been shown the only habit that has correlation with visual acuity reduction (p=0,028). Vision complaints, although very frequent, doesn't translate into increased probability of visual acuity alteration.

Aumento da prevalência de miopia em um serviço oftalmológico de referência em Goiânia - Goiás / Increased prevalence of myopia in a ophthalmologic hospital in Goiânia - Goiás

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.

Descripción de la función de sensibilidad al contraste en pacientes miopes e hipermétropes / Contrast sensitivity function in myopic and hyperopic patients

Objetivo: describir la Función de Sensibilidad al Contraste (FSC) en pacientes con miopía, astigmatismo miópico, hipermetropía y astigmatismo hipermetrópico. Diseño del estudio: serie de casos, descriptivo. Métodos: se incluyeron sujetos con miopía, astigmatismo miópico, hipermetropía y astigmatismo hipermetrópico, candidatos para cirugía refractiva y evaluados en la Unidad de Cirugía Refractiva de la Clínica de Oftalmología de Cali, con agudeza visual mejor corregida (AVMC) >=20/20, menores de 50 años de edad y sin antecedente de cirugía refractiva. La función sensibilidad al contraste se midió con el sistema OPTEC® 6500 (Stereo Optical Co, Inc., Chicago, USA) en frecuencias espaciales de 1.5, 3.0, 6.0, 12 y 18 ciclos/grado en condiciones fotópicas (85 cd/m2) y mesópicas (3 cd/m2). Se aplicaron las prueba no paramétrica de Wilcoxon y de Mann-Whitney para comparar diferencias entre la FSC entre los grupos de miopía/astigmatismo miópico e hipermetropía/astigmatismo hipermetrópico en las diferentes frecuencias espaciales. Resultados: se incluyeron 188 ojos de 95 sujetos con miopía y astigmatismo miópico (promedio de edad = 30,6 ± 7,6 años, 51% hombres) y 121 ojos de 64 sujetos con hipermetropía y astigmatismo hipermetrópico (promedio de edad = 43 ± 6,1 años, 62 % mujeres). La sensibilidad al contraste en los pacientes de ambos grupos fue mayor significativamente en condiciones fotópicas que en condiciones mesópicas, excepto en la frecuencia espacial de 3 ciclos/grado del grupo de miopía/astigmatismo miópico. Se encontró diferencia estadísticamente significativa del valor de la FSC entre los grupos de miopía/astigmatismo miópico e hipermetropía/astigmatismo hipermetrópico en condiciones fotópicas en casi todas las frecuencias espaciales, excepto en 3 ciclos/grado y en condiciones mesópicas en las frecuencias espaciales de 1.5, 3 y 6 ciclos/grado. Conclusiones: los valores de FSC son mayores en el grupo de pacientes con miopía y astigmatismo miópico que en los del grupo de hipermetropía y astigmatismo hipermetrópico. Estos valores podrían usarse como referencia en estos grupos de pacientes en nuestra población.

Purpose: to describe the contrast sensitivity function (CSF) in patients with myopia, hyperopia and astigmatism. Study design: descriptive case series study. Methods: subjects with myopia/myopic astigmatism and with hyperopia/hyperopic astigmatism looking for refractive surgery, and evaluated at the Unit of Refractive Surgery in the Clínica de Oftalmología de Cali were included. Their Best Spectacle Corrected Visual Acuity (BSCVA) was >=20/20, age less than 50 years and no previous refractive surgery. The CSF was measured using the OPTEC® 6500 (Stereo Optical Co, Inc, Chicago, USA) system for spatial frequencies 1.5, 3.0, 6.0, 12 and 18 cycles/degree in photopic (85 cd/m2) and mesopic (3 cd/m2) conditions. Statistical analysis was done using the Wilcoxon and Mann-Whitney tests for non-parametric samples, comparing the myopia/myopic astigmatism and the hyperopia /hyperopic astigmatism groups. Results: 188 eyes of 95 subjects with myopia/myopic astigmatism (age = 30,6 ± 7.6 years, 51% men) and 121 eyes of 64 subjects with hyperopia/hyperopic astigmatism (age = 43± 6.1 years, 62% women) were analyzed. The CSF was higher in both groups in photopic conditions except in 3 cycles per degree in myopia/myopic astigmatism group. Significant differences in the CSF were found between the two groups in photopic conditions excluding the 3 cycles per degree. In mesopic conditions diff erences were found for the spatial frequencies 1.5, 3 and 6 cycles per degree. Conclusions: The patients of the myopia/myopic astigmatism group had a contrast sensitivity function higher than those of hyperopia/hyperopic astigmatism group. These values could be used as reference for these patients in our population.

Prevalence; Distribution and Determinants of Myopia in Owerri; Nigeria

Background: Uncorrected myopia is a significant cause of visual impairment and avoidable blindness. Incidence of open-angle glaucoma has been shown to occur more often in myopia. This cross-sectional analytical study determined the prevalence; distribution and determinants of myopia in the adult population of Imo State; Nigeria with a view to establish a reference data for research purposes and future intervention in this locality. Materials and Method: A total of 3451 adults living in Owerri consisting of 2606 persons as test group and 845 persons as controls were randomly selected using standard optometric methods including subjective refraction. Results: Refractive error (ametropia) was found in 79.5 study and 76.8 control. Myopia was found in 23.4 study and 19.6 control. Highest prevalence of myopia was observed in females aged 40-49 years. Fifty percent of study and 68.1 of control group had myopia of -0.50DS to -3.00DS while 4.0 and 2.4 of study and control group respectively had myopic astigmatism. In all; 27.7 study and 16.2 control had myopia 5.00DS. The highest degree of myopia found in this study was - 24.00DS. Conclusion: This study provided information on the prevalence; distribution and determinants of myopia in Owerri; Nigeria and the data could be a basis for improved visual health care in the south-eastern sub-region of Nigeria

Prevalence of myopic shifts among patients seeking cataract surgery / Prevalencia de cambios miópicos en pacientes con catarata

Modern cataract surgery by phacoemulsification is a widely accepted procedure with a rapid recovery time. The prescription of specific intraocular lens, implanted during surgery, makes it possible to anticipate whether the patient will need reading glasses after the procedure. The present study analyses a sample of cataract surgery patients to show the frequency of myopic shifts related to nuclear opacity, which can result in clear near vision before surgery. A non-selected sample of consecutive patients who underwent elective cataract surgery in a private clinic was studied retrospectively. The myopic shift in refraction was assessed by comparing the old prescription with the spectacle correction at the time of interviewing.The mean age of the 229 subjects studied was 71.5 ± 10.4 years (109, 47.6%, males). A myopic shift in refraction, defined as at least - 0.5 diopters, was present in 37.1% of subjects (95% CI: 30.8%-43.4%). The mean change in refraction in these subjects was -2.52 ± 1.52 diopters. The percentage of subjects who had developed a myopic shift was significantly greater in those who presented greater nuclear opalescence. There were also differences in the mean myopic shift by refractive group, with the emmetropes having the greatest myopic shift. In this study of patients seeking cataract surgery in a clinical setting, more than one third had myopic shifts in refraction. This must be taken into account in order that patients maintain the benefit of clear near vision after surgery.

La cirugía moderna de facoemulsificación del cristalino tiene una recuperación muy rápida. La elección correcta del lente intraocular que se coloca en la cirugía permite, muchas veces, anticipar si el paciente va a precisar anteojos luego de la cirugía. Este estudio analiza una muestra de pacientes con catarata, mostrando la frecuencia relativa de cambios miópicos que permiten a los pacientes ver de cerca sin lentes antes de la cirugía. Se estudiaron retrospectivamente una serie de pacientes consecutivos que realizaron cirugía electiva de catarata. El cambio refractivo miópico fue documentado comparando las prescripciones antiguas con la medición subjetiva al momento del estudio. Los sujetos fueron agrupados de acuerdo a la presencia o ausencia de cambios miópicos, y se estudiaron las proporciones con respecto a su grado de opacidad nuclear. La edad promedio de los 229 sujetos estudiados fue de 71.5 ± 10.4 años, 109 (47.6%) varones. Se halló un cambio miópico, definido como un cambio mayor de - 0.5 dioptrías, en 85 (37.1%, IC95%: 30.8-43.4%). El porcentaje de sujetos con cambio miópico fue significativamente mayor en aquellos que tenían mayor opacidad nuclear al tiempo del examen. En este estudio de pacientes no seleccionados que buscaban realizar cirugía de catarata, más de un tercio tuvo cambios miópicos en la refracción. Si el paciente lograba ver bien de cerca antes de la cirugía, esto debería ser tenido en cuenta a la hora de elegir un correcto lente intraocular para que el sujeto no pierda este beneficio de la catarata.

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.

Correlations between Magnitude of Refractive Error and Other Optical Components in Korean Myopes

PURPOSE: We evaluated ocular optical components and their interrelationships in myopic Korean patients. METHODS: In this prospective observational study, 1,011 consecutive patients were recruited from a refractive surgery clinic. The best-corrected visual acuity was >20 / 20 in all patients. The refractive error, axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and vitreous chamber depth (VCD) were measured by an autorefractor and partial coherence laser interferometry (IOL Master). Central corneal thickness (CCT) was measured by ORBscan II topography. RESULTS: The refractive errors had a positive correlation with LT but negative correlations with AL, ACD, VCD, and CCT. As the axial length increased, the ACD, VCD, and CCT increased but the LT decreased. The CCT had a positive correlation with gender, refractive errors, ACD, VCD, and AL but no correlation with age. The mean CCT was increased in proportion to the increase in AL. CONCLUSIONS: In myopic Korean patients, as axial elongation progressed, the VCD and ACD deepened and the CCT thickened but the LT decreased. The CCT had a positive correlation with the degree of myopia and the AL.

Structural sequelae and refractive outcome 1 year after laser treatment for type 1 prethreshold retinopathy of prematurity in Asian Indian eyes.

Aim: The aim was to study the structural sequelae and refractive outcome after laser treatment for Type 1 prethreshold retinopathy of prematurity (ROP) in Asian Indian eyes. Materials and Methods: A retrospective chart review of infants with Type 1 prethreshold ROP (defined according to the Early Treatment for Retinopathy of Prematurity study) undergoing laser treatment at a tertiary center between January 2004 and December 2008 was done. The 1-year outcome of infants was analyzed. Results: Sixty-nine eyes of 36 infants were included. The mean birth weight was 1121.69 ± 254.81 g and the gestational age was 28.99 ± 2.03 weeks. Sixty-five eyes (94.2%) had zone 2 and 4 (5.8%) had zone 1 disease. Forty-four (63.77%) eyes had stage 2 ROP with plus disease and 25 (36.23%) eyes had prethreshold (fewer than five contiguous or eight cumulative clock hours) stage 3 ROP with plus disease. None of the eyes developed retinal structural sequelae. On cycloplegic retinoscopy, 59.4% eyes had nonsignificant hyperopia [spherical equivalent (SE) ≤ 4 D], 14.5% eyes had no refractive error (SE 0 D), 24.7% eyes had low myopia (SE < 5 D), and 1.4% eyes had high myopia (SE > 5.0 D). Eyes developing myopia were associated with a greater number of clock hours of ROP, greater number of laser spots used, and a longer time to disease regression. Two infants (5.6%) had esotropia and one (2.8%) had exotropia. Conclusion: Asian Indian infants treated for Type 1 prethreshold ROP did not develop retinal structural sequelae. Myopia was seen in nearly one-fourth of the eyes.The risk factors for myopia were a greater number of clock hours of ROP, greater number of laser spots, and a longer time to regression of ROP.

Efectividad de la combinación del LASEK y el implante del lente fáquico Artisan en la corrección de la alta miopía / Effective combination of LASEK and Artisan phakic lens implantation in high myopia correction

OBJETIVO: Determinar la efectividad del tratamiento combinado de lentes fáquicos Artisan y la técnica LASEK en la corrección de la alta miopía. MÉTODOS: El estudio se realizó en el Instituto Cubano de Oftalmología Ramón Pando Ferrer en el período 2007-2009. El universo estuvo constituido por los 24 ojos a los cuales se les implantó el lente Artisan. El defecto refractivo residual se corrigió con la técnica de LASEK seis meses después de implantados los lentes. Se analizaron como variables la esfera y el cilindro refractivo, la mejor agudeza visual sin corrección y corregida, las complicaciones transoperatorias y posoperatorias, la paquimetría y la densidad celular. RESULTADOS: La esfera refractiva se corrigió a 0,25 ± 0,25, el cilindro refractivo a -0,25 ± 0,25 y la mejor agudeza visual sin corrección y corregida mejoró a 0,9. El grosor corneal central se redujo en relación al defecto refractivo corregido con valores por encima de 480. La pérdida celular endotelial fue baja después de la colocación de los lentes fáquicos y del LASEK. CONCLUSIONES: El uso combinado del lente fáquico Artisan y el LASEK resultó efectivo, seguro y preciso como alternativa en la corrección de la alta miopía

OBJECTIVE: To determine the effectiveness of the combined treatment of Artisan phakic intraocular lenses and the surgical technique LASEK in high myopia correction. METHODS: The study was conducted at Ramón Pando Ferrer Cuban Institute of Ophthalmology from 2007 to 2009. The universe of study was 24 eyes implanted with the Artisan phakic lens and the residual refractive defect was corrected with the LASEK technique 6 months after the implantation. The sphere and the refractive cylinder, the best uncorrected visual acuity and the best corrected visual acuity, the transoperative and postoperative complications, the pachymetry and the cell density were all analyzed as variables. RESULTS: The refractive sphere was corrected to 0,25 ± 0.,5, the refractive cylinder to -0,25 ± 0,25 and the best uncorrected and corrected visual acuity improved by 0,9. The central corneal thickness decreased with respect to the corrected refractive defect, yielding figures over 480 Ám. There was low endothelial cell loss after placing the phakic lens and the LASEK application. CONCLUSIONS: The combined use of the Artisan phakic IOLs and the LASEK technique proved to be effective, safe and accurate as an option for high myopia correction