DaF, COVID-19, and newer technologies: Experiences from an Indian University

[...]flexibility ensures that students feel included and stay interested in learning. [...]dealing with varied genres allows students to get acquainted with different registers of the language. [...]the lack of physical classes also resulted in a lack of group activities. [...]as part of its policy of inclusion, JNU offers admission to students with visual impairment and also offers extra classes for them. [...]for overcoming the impersonal nature of online teaching, I made sure to get each student to speak in the class. The purpose was to ensure that students were active during the entire class. [...]I had to make sure that whilst recording the teaching session, I started recording only after having played the DW video.

Prevalence of Glaucoma in Cataract Patients - a Comparison between Pre-Covid and Post-Covid Periods

Objectives: Globally, cataract and glaucoma are the predominant causes of blindness. Screening glaucoma in patients referred for cataract surgery is a convenient tool for detecting glaucoma cases in rural population. The COVID period has adversely affected eye care as the routine screening and follow-ups at hospital were substantially reduced owing to pandemic restrictions. We aim to study the impact of COVID on detection of glaucoma in patients with cataract. Method(s): It was a retrospective study conducted to compare the prevalence of glaucoma in rural patients presenting with cataract pre- and post-COVID. Details of 975 consecutive patients each were taken prior to March 2020 (pre-COVID) and after October 2021 (post-COVID) from hospital database and patient case files. Result(s): The prevalence of glaucoma was higher during the pre-COVID time (3.8%) as compared to pre-COVID (3.8%), but the result was not statistically significant. In both the groups, primary open-angle glaucoma was the pre-dominant form of glaucoma, with prevalence being 1.5% and 2.2% in the pre-COVID and post-COVID groups, respectively. The mean intraocular pressure and mean VCDR values were higher in the post-COVID group as compared to the pre-COVID group, and the result was statistically significant. Conclusion(s): This was the first study to compare the prevalence of glaucoma in patients with cataract in rural population in the pre-COVID and post-COVID periods. In the aftermath of the pandemic, the present study emphasizes the role of screening and follow-ups in glaucoma management to prevent irreversible loss of vision.Copyright © 2023 The Authors.

The precariousness of teaching in the Covid-19 pandemic: impacts on the inclusion of visually impaired university students

This article aims to explain the challenges and barriers imbricated in teaching practice regarding the inclusion of visually impaired university students in times of the Covid-19 pandemic. It follows the foundations of Socio-Historical Psychology and Dialectical Historical Materialism. Six university students with visual impairments from different undergraduate courses at a public university in the Northeast of the country, participated in the research. The data were produced through a semi-structured interview, which was carried out individually by Google Meet. For data analysis we used the meaning nuclei. The results showed that the lack of knowledge about the inclusion of people with visual impairment, combined with the lack of appropriation of digital tools and the multiple demands contributed to an excluding pedagogical practice that is guided by an ideological bias of the normative body. However, we consider that remote teaching enhanced the precariousness of teaching practice, and that it exacerbated the exclusion of students with visual impairments.

Development of an integrated telerehabilitation model in children with cerebral visual impairment in South India during the COVID-19 pandemic - A pilot study.

Purpose: Coronavirus disease 2019 (COVID-19) pandemic affected the in-person rehabilitation/habilitation services in families with children with cerebral visual impairment (CVI) in India. This study aimed to develop a structured and family-centered telerehabilitation model alongside conventional in-person intervention in children with CVI to observe its feasibility in the Indian population. Methods: This pilot study included 22 participants with a median age of 2.5 years (range: 1-6) who underwent a detailed comprehensive eye examination followed by functional vision assessment. The visual function classification system (VFCS) was administered to the children and the structured clinical question inventory (SCQI) to the parents. Every participant underwent 3 months of telerehabilitation including planning, training, and monitoring by experts. At 1 month, the parental care and ability (PCA) rubric was administered to the parents. After 3 months, in an in-person follow-up, all the measures were reassessed for 15 children. Results: After 3 months of Tele-rehabilitation there were significant improvements noted in PCA rubric scores (P<0.05). Also, statistically significant improvements were noted in functional vision measured using SCQI and VFCS scores (P<0.05) compared to baseline. Conclusion: The outcomes of the study provide the first steps towards understanding the use of a novel tele-rehabilitation model in childhood CVI along-side conventional face-to-face intervention. The added role of parental involvement in such a model is highly essential.

Perceptions of telemedicine in specialist outpatient services

Introduction/Aim: COVID-19 has fast-tracked changes to healthcare delivery, including the introduction of a broad range of telehealth services. Work is needed to assess the ongoing suitability of telemedicine for the post-pandemic era. We sought to explore perceptions of telemedicine amongst patients and providers (clinicians and health administrators) who had appointments in cardiology, respiratory, neurology, rheumatology and gastroenterology services in hospital specialist outpatient clinics in Sydney Local Health District. Method(s): Semi-structured interviews explored perceptions of consultations undertaken virtually compared to in-person, seeking perspectives on the benefits, limitations and risks of outpatient telemedicine consultations. The 37 participants comprised 16 patients, 14 specialists, 3 Clinical Nurse Consultants and 4 administrators. Result(s): Patients indicated satisfaction with telemedicine consultations, especially during the pandemic. They valued saving on travel time and costs, and being able to access care from their homes, thereby minimising risk of COVID exposure. The chief disadvantage perceived by patients was inability to receive a physical examination. They noted greater challenges for people with hearing and visual impairments, limited digital skills and/or computer access. Providers' perceptions were more ambivalent. Although telehealth was understood to help meet demands during the pandemic, mis- and under-diagnoses were considered major concerns arising from the inability to perform physical examination. Most regarded telemedicine as an effective tool for review appointments but mentioned an associated increased workload. All participants mentioned the need for relevant education and training, better integration of telemedicine platforms into existing infrastructure and the need for a hybrid model of care. Conclusion(s): Telemedicine played a unique role in meeting patients' needs during the pandemic and its convenience was valued by patients. Clinicians expressed concerns about missed diagnoses, uncertain clinical outcomes, lack of administrative and technological infrastructure. The ultimate test of telemedicine will be its impact on clinical outcomes versus longstanding models of in person care.

Risk of Retinal Vascular Occlusion among Patients with Covid-19 and Influenza A: A Multi-Centered Analysis

Purpose of Study: Severe COVID-19 infection has been associated with a hypercoagulable state, contributing to the formation of clots. Retinal vascular occlusion (RVO) is a common cause of vision impairment and is due to blockage of the retinal arteries and veins. There have been reported cases of patients with previous history of COVID-19 presenting with new RVO. Given the minimal research delving into this relationship, the purpose of this study was to investigate the short-term prevalence and risk for RVO following infection by COVID-19 compared to Influenza A. Methods Used: Two cohorts were created using TrinetX, a national federated electronic health record (EHR). The two cohorts consisted of patients with a history of COVID-19 (n=2,352,475) and patients with a history of Influenza A (n=67,065). Both cohorts were balanced using 1:1 propensity score matching (PSM) addressing demographics and medical comorbidities. Outcomes between the two cohorts were compared using adjusted risk ratios (aRR), with a confidence interval of 95%. Summary of Results: After PSM, two cohorts of 67,063 patients each were compared. Patients in the COVID-19 cohort had an average age of 41.4+/-23.0 years compared to 34.4+/-27.7 years in the Influenza cohort. Between the two cohorts, there was no significant difference in risk of developing retinal vascular occlusion (aRR [95% CI] = 0.72 [0.49,1.06];p=0.097) and patients with COVID-19 had a significantly lower risk for developing retinal vein occlusion (aRR [95% CI] = 0.45 [0.27,0.77];p=0.03). Incidence of retinal vascular occlusion was 0.1% between both cohorts. Retinal artery occlusion was excluded from analysis due to obfuscation of the data by the EHR. Conclusion(s): Between the two cohorts, there was no significant difference in risk for developing RVO within 120 days. However, while there was no significant difference, vascular occlusions were found at a relatively younger age than the general population. Although incidence of RVO was low between the two cohorts, both viruses could be considered a risk factor for development of RVO, particularly in younger patients lacking classic risk factors for the disease.

Silent Thyroiditis as a Complication of Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine

Introduction: Silent autoimmune thyroiditis, a type of chronic autoimmune thyroiditis, as an adverse effect of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is infrequently reported in the literature. We hereby describe a case of silent thyroiditis followed by Grave's orbitopathy after vaccination against SARS-CoV2. Case Description: An 84-year-old male presented to clinic with a 10-pound weight loss with no other symptoms of hyperthyroidism, no personal history of thyroid illnesses, or recent viral infections. He had normal thyroid function 3 months prior to presentation. He had received 3 doses of SARS-CoV2 Pfizer-BioNTech vaccine with the last dose 5 months prior to presentation. Thyroid exam was normal. Laboratory testing revealed thyroid stimulating hormone (TSH) level of 0.005 IU/ml (0.45-4.5 IU/ml), total T4 14.4 g/dl (4.5-12.1 g/dl), and total T3 1.22 nmol/l (0.6-1.81 nmol/l). Thyroid Ultrasound revealed a heterogeneous atrophic thyroid gland with no nodules or hypervascularity. He was started on Methimazole by primary care provider. Four months later, he was seen in the Endocrinology clinic and reported no hyperthyroidism symptoms. His TSH level at that time was 65.9 IU/ml, free T4 0.47 ng/dl (normal: 0.82-1.77 ng/dl), total T3 level 75 ng/dl (normal: 71-180 ng/dl), thyroid stimulating immunoglobulin 2.05 IU/l (0-0.55 IU/L), thyrotropin receptor antibody level 2.8 (0-1.75). Methimazole was discontinued. At 6 months after initial presentation laboratory testing showed TSH 5.010 IU/ml, free T4 1.2 ng/dl, thyroid peroxidase antibody of 148 IU/ml (normal 0-34 IU/ml), thyroglobulin antibody 131.6 IU/ml (normal 0.0-0.9 IU/ml). He was diagnosed with silent autoimmune thyroiditis. A few weeks later, the patient presented to an ophthalmologist with bilateral eye bulging and impaired vision. He was diagnosed with acute Graves' orbitopathy and started on pulse-dose of intravenous Methylprednisolone 250 mg twice daily and urgently referred to a tertiary ophthalmology center for teprotumumab infusion. His thyroid function tests were normal at that time on no thyroid medications. Discussion(s): The underlying mechanisms of thyroid impairment following SARS-CoV2 vaccination are not completely understood. There is a role of molecular mimicry between SARS-CoV2 antigens and thyroid antigens that may help to hasten the emergence of autoimmunity in vulnerable individuals. Our patient developed multiple thyroid-related antibodies following vaccination. Silent painless thyroiditis is a self-limiting condition, characterized by temporary thyrotoxicosis, followed by a brief period of hypothyroidism and then a complete return to normal thyroid function. A radioactive iodine uptake scan can help differentiate between the different causes of thyrotoxicosis in the acute thyrotoxic phase. Development of severe Graves orbitopathy following silent autoimmune thyroiditis after SARS COV2 vaccination has not been previously reported.Copyright © 2023

Bilateral optic neuritis and myocarditis after the first dose of COVID-19 vaccine

Since the introduction of COVID-19 vaccine, various adverse events have been reported including injection site pain, fatigue, headaches, and myocarditis. Cranial neuropathies and optic neuritis, have been also rarely reported, however, the significance of these autoimmune manifestations after the administration of COVID-19 vaccine remain controversial. In this report we present a case of myocarditis and bilateral optic neuritis that occurred in a young healthy male patient after the administration of first dose of mRNA-1273 vaccine (Moderna).Copyright © 2022 The Author(s)

Side Effects of the Sinopharm/BBIBP COVID-19 Vaccine among Iranian Healthcare Workers: A Gender Assessment

Background: Since the outbreak of COVID-19, vaccination has been considered as an important measure against it. Side effects have always been an inseparable component of vaccination, which in this study, Sinopharm vaccine, its side effects and the differences of their manifestation amongst men and women have been investigated. Objective(s): This study aimed to compare the side effects of the Sinopharm vaccine among men and women working in some medical centers in Tehran, Iran. Method(s): This cross-sectional descriptive-analytical study on 890 healthcare workers of 7 medical centers in Tehran within 2 months, from late June to late August 2021. The samples were selected by the complete enumeration method, and the required data were collected using a questionnaire. Only those who received the Sinopharm vaccine at least 10 days before the study were included. Result(s): Of 890 participants, 22.96% and 77.30% were women and men, respectively, and 65.8% of women and 78.1% of men were in the age range of 20-29 years. It was revealed that 74.75% of women and 26.16% of men had at least one side effect. The incidence of at least one side effect was significantly higher in women than in men (P<0.001). It was also found that 12 side effects were significantly higher in women than in men. Most men and women had side effects within the first 24 h after vaccination. There was no significant difference in taking therapeutic measures to reduce or minimize the post-vaccination complications between men and women;however, 9.4% of men and 27.2% of women reported a decline in their ability to perform daily activities as they were unable to do their everyday tasks the day after vaccination which was significantly different between the two groups (P<0.001). Conclusion(s): The results showed that the occurrence rate of side effects after receiving the Sinopharm vaccine was significantly higher in women than in men. Moreover, women were significantly less able to perform daily routines than men.Copyright © 2022, Author(s).

Neurological Symptoms Common in Covid-19 Patients: A Retrospective Observational Study

In December 2019, a novel coronavirus outbreak spread rapidly all over the world. The virus is known to be neuroinvasive, but much is still unknown. In this study, we aimed to pres-ent the main neurologic symptoms in patients who were diagnosed with coronavirus disease 2019 (COVID-19). The study was conducted retrospectively by phoning 156 patients in Turkey diagnosed with COVID-19 through real-time polymerase chain reaction;only 100 patients could be reached. Data about their demographics, initial symptoms, neurological symptoms, and sleeping habits were collected. During the disease process, 66% had at least one neurological symptom, 55% had central nervous system symptoms, 42% had peripheral nervous system symptoms, and 64% had sleep disturbances and myalgia. Impaired consciousness, smell and taste impairments, and sleep disturbances were significantly higher in patients with positive chest computed tomography imaging (p < 0.05). Neurological symptoms were observed in COVID-19, as in other coronaviruses. Headache in particular was the most common symptom in our population. In patients with respiratory system findings, the detec-tion of certain neurological symptoms such as smell-taste impairments, impaired consciousness, and sleep disorders were more common. We concluded that COVID-19 patients should be approached in a more holistic way, taking the nervous system into account.Copyright © 2022, Dr. Mladen Stojanovic University Hospital. All rights reserved.

New-onset neuromyelitis optica spectrum disorder in a patient with COVID-19 and chronic Hepatitis B co-infection

Background: Neurological autoimmune disorders are often triggered by bacterial and viral infections, with growing evidence supporting coronavirus disease 2019 (COVID-19) infection precipitation of these disorders. COVID-19 is already implicated in causing discrete para-infectious neurological syndromes: acute disseminated encephalomyelitis (ADEM), transverse myelitis, neuromyelitis optica spectrum disorders (NMOSD), Guillain-Barre syndrome (GBS), and is also associated with encephalopathy, acute cerebrovascular disease, neuromuscular disorders, and seizures. Case Presentation: We describe a case of a 43-year-old Asian woman with chronic Hepatitis B (HBV) co-infected acutely with COVID-19, presenting with urinary retention, bilateral blindness, thoracic sensory level, and quadriparesis. Extensive workup narrowed down her diagnosis as seronegative NMOSD. She had complete resolution of symptoms after treatment with concurrent plasma exchange (PLEX), high dose corticosteroids, and emtricitabine-tenofovir. Follow-up visit showed no seroconversion at 6 months and no relapses. Conclusion(s): Our literature review highlights the likely link between COVID-19 infection and the development of neurologic autoimmune diseases. Our literature review supports a virus-triggered immune-mediated process rather than neuro-invasion. Many viral illnesses have been linked to the development of NMOSD and anti-AQP4 antibody-related myelitis. Additionally, there is limited literature linking chronic HBV infection with the development of optic neuritis and speculation thatcross-reactivity between HBsAg and myelin antigens may lead to the development of demyelinating diseases in the CNS and PNS. We observed remarkable clinical improvement after treatment with alternating days of IV methylprednisolone and therapeutic PLEX.Copyright © 2022

Investigating the impact of COVID-19 on individuals with visual impairment

We present a comprehensive review of the various challenges that individuals with visual impairment (VI) face during the COVID-19 pandemic. A structured review was done using online databases PubMed, EMBASE, and grey literature databases between 19 April 2021 and 4 August 2021, using search terms ‘COVID-19', ‘SARS-CoV-2', ‘Coronavirus', or ‘pandemic' combined with ‘visually impaired', ‘visual impairment', or ‘Blind'. Studies included were written in English, published after the World Health Organization (WHO) declaration of the COVID-19 Pandemic (11 March 2020), and focused on the VI population during the pandemic. The initial search yielded 702 publications, of which 20 met our inclusion criteria and were included in analysis. Emotional distress from deteriorating mental health and social isolation were considerably higher in the VI population. For a community that relies on spatial awareness and touch, regulations related to social distancing and avoiding contact were considerable barriers. Further challenges were noted in accessing healthcare, care, receiving timely health information and changes in regulations, adequately sanitizing, using technology, and completing activities of daily living. In the unprecedented times of the COVID-19 pandemic, the VI community has faced unique challenges. A more holistic and inclusive approach needs to be adopted to ensure that more vulnerable populations are adequately cared for. © The Author(s) 2023.

Very simple PDF-based online ageing game equivalent enhances medical students' understanding of elderly patients

Background: Aging simulation games are established tools in undergraduate medical education aiming to provide medical students with insights into elderly patient's everyday life and raise awareness for age-related difficulties. At Leipzig University, a 90-min ageing simulation game is part of a compulsory geriatric medicine course in the fifth study year (of six). In the course of online teaching during the COVID-19 pandemic, we replaced the classroom-based simulation with an elementary online version based on four PDF documents containing audio and video links, directives for 'do it yourself' experiences and prompts for reflection. Research question: Is a simple, self-directed online ageing game able to provide students with relevant experiences and insights to enhance their understanding of elderly patients? Methods: Anonymous post-hoc survey among 277 fifthyear medical students eligible for the course in 2020. Descriptive statistical analysis and qualitative analysis of students' free-text responses regarding their main insights from the course. Result(s): Response rate was 92.4% (n=256, ;age =26 years, 60% women). 88% of the students enjoyed working on the course, and 83% perceived it as practice-orientated. 75% reported having gained new personal insights and 60% new professional knowledge. Although 92% reported an enhanced understanding of elderly patients, 85% disagreed that online simulations may generally replace realworld ageing games. PDF documents containing audio and video links directly imitating conditions (visual or hearing impairment) were rated best. Students' main insights from the course (qualitative data) most frequently referred to aspects of professional interaction with geriatric patients, knowledge about conditions/diseases, role reversal, and enhanced empathy. Conclusion(s): Very simple online ageing game equivalents can provide students with relevant insights and raise awareness for elderly patients' needs. They might be alternatively implemented into the education of health professionals where resource-intensive real-world simulations are unfeasible.

Accessibility for Virtual Tours: On Designing a Prototype for People with Visual Impairments

Virtual tours are tools that could be effectively used in many different contexts. The COVID-19 pandemic has let emerge how they can be useful and efficacy in those situations where it is not possible to access physical places and attend events. Besides that, they can be used for several goals in different contexts. In fact, in simple words, virtual tours are essentially based on using 3D images and videos, letting the users interact with the virtual environment and its points of interest through them, emphasizing the need for navigation and orienteering mechanisms within the virtual environment. Due to these characteristics, virtual tours represent digital barriers affecting users with disabilities, in particular those people with visual impairments. This paper presents an innovative solution we have adopted by designing and developing a prototype devoted to exploring a University Campus, with accessibility in mind. A preliminary evaluation has been conducted, and the obtained results are presented in the paper, which discusses some potentialities and limitations that emerged, © 2023 IEEE.

Risks of Visual Impairment and Its Progression in Children and Adolescents under Modern Conditions of Education and Upbringing: A Scientific Review

Introduction: Intensive introduction of digital technologies and educational tools poses risks of visual impairment in children and adolescents as the most active users of the digital space. Objective: To assess risks of visual impairment in children and adolescents in the context of active dissemination of digital technologies in education and everyday life based on a literature review in order to choose directions for pediatric prevention of eye diseases. Materials and methods: We did a review of Russian and English language scientific literature published in 2007-2021, found on eLIBRARY.ru, PubMed, Web of Science, and Scopus information portals and platforms. We selected 48 articles containing an evidence-based assessment of risks of eye diseases related to e-learning and long screen time in children and adolescents, especially during the COVID-19 pandemic and associated lockdown. Results: We observed combined risks of visual impairment and musculoskeletal disorders due to violation of hygienic requirements for illumination, working posture, distance to the screen, and screen time when using various gadgets. Concom-itant risk factors for eye diseases related to vitamin D deficiency were evaluated. Conclusions: We identified groups at risk of visual impairment based on health indicators and the intensity of using the digital environment. We also specified basic methodological and regulatory documents, the compliance with which could reduce the risks of visual impairment in children, adolescents, and students, and proposed up-to-date directions of research on the topic of the review for maintenance of eye health. © 2022, Federal Center for Hygiene and Epidemiology. All rights reserved.

A fractured system: have existing problems in health and social care for visually impaired people been exacerbated by COVID-19?

Visually impaired people in the UK have been adversely impacted during the COVID-19 pandemic due to an inconsistent approach between agencies and a failure to effectively manage key data. In this paper, fractures in the system already evident, particularly around the transition between health and social care, and the ways in which the COVID-19 pandemic has further starkly highlighted them, are presented. Key recommendations are proposed to improve the system and prevent such failings being repeated.

Neuro-Behcet's disease in the setting of active COVID-19 infection

Background: Cases of SARS-COV-2 triggering or exacerbating autoimmune responses has been described in the literature, and it has shown that use of steroids in non-severe COVID-19 may potentially increase mortality. Case presentation: A 22 year-old African-American man presented with headache, weight, loss, and oral/scrotal ulcerations. Case report: Neurological exam revealed somnolence and right hemiplegia. MRI was remarkable multiple enhancing lesions involving the brainstem and left hemisphere. He was found to have a positive SARS-CoV-2 test. Work-up was unrevealing, and he was diagnosed with Neuro-Behcet's disease (NBD) based on the International Criteria for Behcet's Disease (ICBD)ackspaceD)BackspaceBackspacep. The patient was treated with systemic steroids, which resulted in both clinical and radiological improvement of his disease without exacerbation of his SAR-CoV-2 infection. Conclusion(s): This case presentation suggests that IV steroids may be safe in the treatment of NBD in adult patients presenting with SARS-CoV-2 infection.Copyright © 2021

Design and Validation of a Novel Smartphone-Based Visual Acuity Test: The K-VA Test.

INTRODUCTION: Visual acuity (VA) testing is a critical screening examination for the assessment of visual function. This study describes the development and validation of a smartphone-based VA test: the K-VA test. METHODS: A total of 171 patients with various ocular diseases were examined in our outpatient unit at Aristotle University of Thessaloniki, School of Medicine in Greece. Participants underwent VA examination using the standard Early Treatment Diabetic Retinopathy Study (ETDRS) charts and the K-VA smartphone-based test. The K-VA test was performed by participants themselves. The Bland-Altman method was employed to assess the agreement between the ETDRS charts and the new test for the examination of VA at 1 m and 40 cm. Test-retest reliability was also calculated. A questionnaire regarding the participants' feedback on the K-VA test was completed. RESULTS: No significant bias was observed between the gold standard ETDRS charts and the K-VA test measurements. The mean difference (95% limits of agreement, LoA) between the K-VA test at 1 m and the ETDRS chart at 4 m was -0.006 (95% LoA -0.129 to 0.117) logarithm of the minimal angle of resolution (logMAR). The agreement of the K-VA test at 40 cm with the near ETDRS chart was also high with a mean difference of -0.007 (95% LoA -0.105 to 0.090) logMAR. Test-retest reliability was found to be high with a mean difference of 0.003 (95% LoA -0.045 to 0.033) logMAR and 0.005 (95% LoA -0.065 to 0.076) logMAR for the K-VA test at 1 m and 40 cm, respectively. A total of 97 participants answered the questionnaire and 71 (73.2%) stated that the test was easy to very easy to use for self-performance. CONCLUSIONS: The study demonstrated that the K-VA application performed well compared with the ETDRS charts and provides reliable and repeatable measurements of VA across a wide range of VA.

Visual acuity (VA) is the most significant measure of visual function and an accurate examination of VA is of high importance for clinicians. Traditionally, the Snellen and the Early Treatment Diabetic Retinopathy Study (ETDRS) acuity charts are the most commonly used VA tests. However, the examination requires physical presence, which is not always feasible for elderly, mobility-impaired, rural patients, or patients in quarantine due to coronavirus disease 2019 (COVID-19) pandemic. Currently, there are hundreds of vision-testing applications available, with only a few having been validated, especially against the standard ETDRS chart. This study describes the development and investigates the validity of a new smartphone application, the K-VA test, for VA testing in 171 participants with various ocular diseases. Participants performed the K-VA test themselves with the supervision of a healthcare provider. The K-VA test was shown to perform well when compared with the ETDRS charts. We also showed that the test is well accepted by patients familiar with the Android operating system. The test should be performed following the instructions of the attending physician. The K-VA application provides repeatable and reliable measurements of VA across a wide range of VA. This tool offers users a secure system for the tele-transmission of results to physicians for further consultation.

Prevalence and Factors Associated with Suicidal Ideation Among Older People with Visual Impairments Attending an Eye Center During the COVID-19 Pandemic: A Hospital-Based Cross-Sectional Study.

Purpose: To evaluate the prevalence of suicidal ideation and associated factors among older people with visual impairments attending an eye center during the COVID-19 pandemic. Patients and Methods: A total of 314 older people aged 60 and above with visual impairments who attended an eye center were included in this study. This was a hospital-based cross-sectional study conducted from February to July, 2022. Data were collected in person. Suicidal ideation was measured using the Columbia-Suicide Severity Rating Scale (C-SSRS). Multivariable logistic regression analysis was used to explore associations between related factors and suicidal ideation. Results: Of 314 older people with visual impairments, the prevalence of suicidal ideation was 32.5%. Suicidal ideation was independently associated with diabetic retinopathy (adjusted odds ratio (AOR)=2.4, 95% confidence interval (CI): 1.0-5.8; p=0.038) and depression (AOR=6.3, 95% CI: 3.5-11.2; p<0.001). Conclusion: This study found a relatively high prevalence of suicidal ideation among older people with visual impairments. There was also a significant association between depression and suicidal ideation among these individuals. Visual impairments can lead to negative émotions. This underscores the importance of addressing the mental health needs of older individuals with visual impairments, including suicide prevention efforts tailored to their needs. Ophthalmologists should be equipped with the skills necessary to identify the early signs of suicidal ideation and refer patients to mental healthcare specialists for appropriate treatment.