Validity and Reliability of the Student Refractive Error and Eyeglasses Questionnaire-Revised Version in Myopic Children.

SIGNIFICANCE: Multiple vision-related quality of life (VRQol) instruments exist, but questionnaires designed specifically for myopic children that are appropriate for assessing the impact of refractive error are rare. PURPOSE: This study aimed to assess the validity and reliability of the Student Refractive Error and Eyeglasses Questionnaire - Revised (SREEQ-R) in school-aged children with myopia in the United Kingdom. METHODS: Community optometrists in the United Kingdom invited children up to the age of 18 years presenting for an eye examination with current or previous reported use of eyeglasses for myopia to complete the SREEQ-R, which consists of 20 specific items divided into two sections each with three response categories. The "without glasses" section relates to perceptions of uncorrected vision/not wearing glasses, and the "with glasses" relates to corrected vision/wearing glasses. Rasch analysis was used to explore the psychometric performance (content, construct validity, and reliability) of the questionnaire items and scale using Winsteps software (Winsteps.com. Portland, OR). RESULTS: A total of 125 eligible children with a mean ± standard deviation age of 12.7 ± 2.9 years completed the SREEQ-R. All items fit the Rasch model and were retained, and the scale was found to be unidimensional. All children and item infit and outfit mean square statistics fell within the recommended fit criteria. As per the Rasch analysis, the person reliability coefficients were 0.84 and 0.91, whereas item reliabilities were 0.99 and 0.80 for the without glasses and with glasses sections, respectively. The internal consistency for the SREEQ-R was good; Cronbach α values were 0.84 for without glasses and 0.91 for with glasses. CONCLUSIONS: The SREEQ-R had satisfactory validity and reliability evidence. Construct validity of the scale was supported to measure the impact of uncorrected and corrected refractive error on vision-related quality of life in myopic school-aged children in the United Kingdom. The SREEQ-R could be used in future studies to evaluate vision-related quality of life in children with myopia.

Rate of Strabismus Detection on Digital Photographs Increases by Using Off-center Near Target.

PURPOSE: To increase the detection rate of strabismus on digital photographs, with the ultimate aim of developing a new automated strabismus detection algorithm. METHODS: In this prospective case series, the authors acquired digital face photographs of 409 children with manifest or latent strabismus, using a 14-million-pixel camera with CCD image sensor. Of the last 52 enrolled, 34 image sets were selected for this study: 29 with manifest and 5 with latent strabismus. Images were taken at a distance of 40 to 70 cm in primary position, with the camera lens as the fixation target and in slight off-center fixation, and using a novel target of small light-emitting diodes mounted onto the camera case. The location of the corneal light reflection was manually calculated in relation to the center of the pupil in both eyes and ocular deviation as the difference in corneal light reflection location between the two eyes. In orthotropia, the expected deviation is zero. RESULTS: In children with phorias, the mean corneal light reflection location difference between the eyes was -0.10 ± 0.14 mm in primary position and -2.02 ± 0.39 mm in off-center fixation. Using a threshold of ±0.5 mm on either side of zero for central and of 2 mm for off-center fixation, sensitivity to detect strabismus increased from 65.6% in central to 79.3% in off-center fixation, respectively. The calculation of specificity will require inclusion of a population of individuals without strabismus. CONCLUSIONS: Off-center fixation onto a near target ensures that participants are actively looking at the target and may increase accommodative effort, thereby increasing the detection rate of strabismus. [J Pediatr Ophthalmol Strabismus. 2017;54(2):90-96.].

Prevalence of choroidal naevi using scanning laser ophthalmoscope.

PURPOSE: To determine the prevalence of choroidal naevi in a healthy population using an ultra-wide scanning laser ophthalmoscope which can capture up to a 200° field of view of the retina, without pupil dilation. METHODS: Subjects were recruited from a college population. Each subject underwent an eye examination that included retinal and choroidal imaging using the Optos scanning laser ophthalmoscope and completed a self-administered questionnaire. Univariate and multivariate regression analysis were performed to identify associated factors with choroidal naevi. RESULTS: The Optomap images of 406 participants (mean age 23.5 ± 4.4) were analysed. Thirty-nine subjects (10%) presented with at least one naevus in one eye, and multiple naevi were observed unilaterally in eight subjects. Drusen were noted in only one eye. The mean naevus diameter was 2.38 mm (± 2.07). Prevalence was not associated with either eye colour, time spent outdoors, visual impairment, or ethnic group, but was significantly associated with male gender (OR 2.41, p = 0.009), blond/red hair colour (OR 2.42, p = 0.037), skin that neither burns nor tans (OR 2.8, p = 0.02) and habitual sunglasses use (OR 0.33, p = 0.002). CONCLUSIONS: A higher prevalence of choroidal naevi was detected in this college population compared to other population-based studies. This is likely due to the use of an ultra-wide field scanning laser ophthalmoscope which provides up to 200° of the fundus. The naevi were associated with several factors.