Remote Monitoring of Visual Function in Patients with Maculopathy: The Aphelion Study.

INTRODUCTION: Remote monitoring of vision, using tools such as the shape discrimination hyperacuity (SDH) test, can detect disease activity in patients with maculopathy. We determined the in-clinic accuracy and repeatability of three myVisionTrack expanded version (mVTx) tests for self-testing of visual acuity (VA) and contrast sensitivity. METHODS: Aphelion, a single-arm, prospective study conducted at two sites in the USA, included adults with any maculopathy and a baseline VA of 0.7 log of minimum angle of resolution (logMAR) (Snellen 20/100) or better. Participants completed the mVTx tests (tumbling E, Landolt C, contrast sensitivity, and SDH) and standard clinical tests (near and distance Early Treatment Diabetic Retinopathy Study [ETDRS] charts and the Pelli-Robson contrast sensitivity chart). Test-retest repeatability and agreement between the mVTx tests and the corresponding clinical test were assessed by Bland-Altman analyses. Participants also completed a usability survey. RESULTS: The mean age of the 122 participants was 67 years. The most common diagnosis was age-related macular degeneration (42% of patients). The tumbling E test had a test-retest 95% limit of agreement (LoA) of ± 0.18 logMAR; the Landolt C test, ± 0.23 logMAR; the SDH test, ± 0.24 logMAR; and the contrast sensitivity test, ± 0.32 log contrast threshold (logCT). Compared with the distance ETDRS chart, the LoA was ± 0.35 logMAR for the tumbling E test (mean difference, - 0.07 logMAR) and ± 0.39 logMAR for the Landolt C test (mean difference, 0.03 logMAR). For the contrast sensitivity test, the LoA compared with the Pelli-Robson chart was ± 0.30 logCT (mean difference, - 0.25 logCT). Most participants (85%) reported that they learned the tests quickly. The tumbling E test scored the highest on ease of use. CONCLUSION: The mVTx tests of VA are accurate and repeatable, supporting their potential use alongside the SDH test to detect disease progression remotely between clinic visits.

Repeatability of Brain Activity as Measured by a 32-Channel EEG System during Resistance Exercise in Healthy Young Adults.

Electroencephalography (EEG) is attracting increasing attention in the sports and exercise fields, as it provides insights into brain behavior during specific tasks. However, it remains unclear if the promising wireless EEG caps provide reliable results despite the artifacts associated with head movement. The present study aims to evaluate the repeatability of brain activity as measured by a wireless 32-channel EEG system (EMOTIV flex cap) during resistance exercises in 18 apparently healthy but physically inactive young adults (10 men and 8 women). Moderate-intensity leg press exercises are performed with two evaluations with 48 h. between. This intensity allows enough time for data analysis while reducing unnecessary but involuntary head movements. Repeated measurements of EEG during the resistance exercise show high repeatability in all frequency bands, with excellent ICCs (>0.90) and bias close to zero, regardless of sex. These results suggest that a 32-channel wireless EEG system can be used to collect data on controlled resistance exercise tasks performed at moderate intensities. Future studies should replicate these results with a bigger sample size and different resistance exercises and intensities.

Contribución de la priorización curricular de educación física y salud en la formación académica de los estudiantes / Contribution of the curricular prioritization of physical education and health in the academic training of students / Contribuição da priorização curricular de educação física e saúde na formação académica dos estudantes

RESUMEN Los procesos educativos han sufrido muchos cambios debido a la pandemia de Covid-19 intentando mantener la continuidad de los mismos a través de clases virtuales, para facilitar esta labor, el Ministerio de Educación de Chile establece la Priorización Curricular que tiene como propósito responder a las diversas dificultades y problemas del ámbito educativo que emergen debido a la paralización de las clases presenciales causado por la crisis sanitaria. El objetivo de este estudio fue conocer si la priorización curricular en Educación Física y Salud es una contribución para la formación académica de los estudiantes, para ello, se utilizó una metodología con enfoque cuantitativo, no experimental, a través de la cual se recogió información que permitió conocer la percepción de los profesores en ejercicio. Los resultados indican que su principal contribución es en el ámbito conceptual, sin embargo, presenta carencias en cuanto a algunos aspectos relevantes para un buen desarrollo del aprendizaje. Se concluye que esta organización de objetivos ha sido medianamente bien recibida por los profesores, aunque representa en su aplicación una contribución al proceso formativo.

ABSTRACT The educational processes have undergone many changes due to the Covid-19 pandemic, trying to maintain their continuity through virtual classes, to facilitate this work, the Ministry of Education of Chile establishes the Curricular Prioritization that aims to respond to the various difficulties and problems in the educational environment that emerge due to the paralysis of face-to-face classes caused by the health crisis. The objective of this study was to know if the curricular prioritization in Physical Education and Health is a contribution to the academic training of students, for this, a methodology with a quantitative, non-experimental approach was used, through which information was collected that allowed to know the perception of practicing teachers. The main results indicate that its main contribution is in the conceptual field; however, it presents deficiencies in terms of some relevant aspects for a good development of learning. It is concluded that this organization of objectives has been fairly well received by teachers, although in its application it represents a contribution to the training process.

RESUMO Os processos educacionais sofreram muitas mudanças devido à pandemia de Covid-19, tentando manter sua continuidade por meio de aulas virtuais. Para facilitar este trabalho, o Ministério da Educação do Chile estabelece a Priorização Curricular que visa responder às várias dificuldades e problemas no campo educacional que surgem devido à paralisação das aulas presenciais causadas pela crise da saúde. O objetivo deste estudo foi saber se a priorização curricular em Educação Física e Saúde é uma contribuição para a formação acadêmica dos alunos, para isso, foi utilizada uma metodologia com abordagem quantitativa, não experimental, por meio da qual foram coletadas informações que permitiu conhecer a percepção dos professores atuantes. Os resultados indicam que sua principal contribuição está no campo conceitual, porém, apresenta deficiências em alguns aspectos relevantes para um bom desenvolvimento da aprendizagem. Conclui-se que esta organização de objetivos tem sido moderadamente bem recebida pelos docentes, embora represente um contributo para o processo de formação na sua aplicação.

Enablers and Barriers to Deployment of Smartphone-Based Home Vision Monitoring in Clinical Practice Settings.

IMPORTANCE: Telemedicine is accelerating the remote detection and monitoring of medical conditions, such as vision-threatening diseases. Meaningful deployment of smartphone apps for home vision monitoring should consider the barriers to patient uptake and engagement and address issues around digital exclusion in vulnerable patient populations. OBJECTIVE: To quantify the associations between patient characteristics and clinical measures with vision monitoring app uptake and engagement. DESIGN, SETTING, AND PARTICIPANTS: In this cohort and survey study, consecutive adult patients attending Moorfields Eye Hospital receiving intravitreal injections for retinal disease between May 2020 and February 2021 were included. EXPOSURES: Patients were offered the Home Vision Monitor (HVM) smartphone app to self-test their vision. A patient survey was conducted to capture their experience. App data, demographic characteristics, survey results, and clinical data from the electronic health record were analyzed via regression and machine learning. MAIN OUTCOMES AND MEASURES: Associations of patient uptake, compliance, and use rate measured in odds ratios (ORs). RESULTS: Of 417 included patients, 236 (56.6%) were female, and the mean (SD) age was 72.8 (12.8) years. A total of 258 patients (61.9%) were active users. Uptake was negatively associated with age (OR, 0.98; 95% CI, 0.97-0.998; P = .02) and positively associated with both visual acuity in the better-seeing eye (OR, 1.02; 95% CI, 1.00-1.03; P = .01) and baseline number of intravitreal injections (OR, 1.01; 95% CI, 1.00-1.02; P = .02). Of 258 active patients, 166 (64.3%) fulfilled the definition of compliance. Compliance was associated with patients diagnosed with neovascular age-related macular degeneration (OR, 1.94; 95% CI, 1.07-3.53; P = .002), White British ethnicity (OR, 1.69; 95% CI, 0.96-3.01; P = .02), and visual acuity in the better-seeing eye at baseline (OR, 1.02; 95% CI, 1.01-1.04; P = .04). Use rate was higher with increasing levels of comfort with use of modern technologies (ß = 0.031; 95% CI, 0.007-0.055; P = .02). A total of 119 patients (98.4%) found the app either easy or very easy to use, while 96 (82.1%) experienced increased reassurance from using the app. CONCLUSIONS AND RELEVANCE: This evaluation of home vision monitoring for patients with common vision-threatening disease within a clinical practice setting revealed demographic, clinical, and patient-related factors associated with patient uptake and engagement. These insights inform targeted interventions to address risks of digital exclusion with smartphone-based medical devices.

The Influence of Noise in the Neurofeedback Training Sessions in Student Athletes.

Considering that athletes constantly practice and compete in noisy environments, the aim was to investigate if performing neurofeedback training in these conditions would yield better results in performance than in silent ones. A total of forty-five student athletes aged from 18 to 35 years old and divided equally into three groups participated in the experiment (mean ± SD for age: 22.02 ± 3.05 years). The total neurofeedback session time for each subject was 300 min and were performed twice a week. The environment in which the neurofeedback sessions were conducted did not seem to have a significant impact on the training's success in terms of alpha relative amplitude changes (0.04 ± 0.08 for silent room versus 0.07 ± 0.28 for noisy room, p = 0.740). However, the group exposed to intermittent noise appears to have favourable results in all performance assessments (p = 0.005 for working memory and p = 0.003 for reaction time). The results of the study suggested that performing neurofeedback training in an environment with intermittent noise can be interesting to athletes. Nevertheless, it is imperative to perform a replicated crossover design.

Preditores da síndrome de Burnout em técnicos de enfermagem de unidade de terapia intensiva durante a pandemia da COVID-19 / Predictors of Burnout syndrome in nursing technicians in an intensive care unit during the COVID-19 pandemic

RESUMO Objetivo: Avaliar a prevalência e a existência de fatores preditores da síndrome de Burnout em técnicos de enfermagem que atuam em unidade de terapia intensiva (UTI) durante a pandemia da COVID-19. Métodos: Trata-se de um estudo descritivo, de caráter transversal e abordagem quantitativa com 94 técnicos de enfermagem de terapia intensiva. Os instrumentos utilizados foram: um formulário de coleta de dados sociodemográficos, ocupacionais e comportamentais e o Maslach Burnout Inventory (MBI) em sua versão Human Services Survey (HSS). A associação entre as variáveis estudadas e a prevalência da síndrome de Burnout foi verificada por análise bivariada seguida de regressão de Poisson hierarquizada, com variância robusta. Resultados: Observou-se uma prevalência da síndrome em 25,5% da amostra analisada. As variáveis que, após análise múltipla, se mostraram como preditores associados a maior prevalência de síndrome de Burnout foram: idade > 36 anos, realizar hora extra, considerar a carga horária de trabalho rígida e ser etilista. Conclusão: Conclui-se que a prevalência da síndrome de Burnout em técnicos de enfermagem que atuam em UTIs e que estão na linha de frente na pandemia da COVID-19 foi alta e fatores sociodemográficos, ocupacionais e comportamentais se mostraram como preditores da síndrome.

ABSTRACT Objective: To evaluate the prevalence and existence of predictive factors for Burnout syndrome in nursing technicians who work in an intensive care unit during the COVID-19 pandemic. Methods: This is a descriptive, cross-sectional study with a quantitative approach with 94 intensive care nursing technicians. The instruments used were: a form for collecting sociodemographic, occupational, behavioral data and the Maslach Burnout Inventory (MBI) in its Human Services Survey (HSS) version. The association between the variables studied and the prevalence of Burnout syndrome was verified by bivariate analysis followed by hierarchical Poisson regression, with robust variance. Results: It observed a prevalence of the syndrome in 25.5% of the analyzed sample. The variables that, after multiple analysis, showed themselves as predictors associated with the higher prevalence of Burnout syndrome were: age > 36 years, working overtime, considering the workload as rigid and being alcoholic. Conclusion: It is concluded that the prevalence of Burnout syndrome in nursing technicians who work in intensive care units and who are in the front line in the COVID-19 pandemic was high and sociodemographic, occupational and behavioral factors were shown as predictors of the syndrome.

Trail-Traced Threshold Test (T4) With a Weighted Binomial Distribution for a Psychophysical Test.

Clinical visual field testing is performed with commercial perimetric devices and employs psychophysical techniques to obtain thresholds of the differential light sensitivity (DLS) at multiple retinal locations. Current thresholding algorithms are relatively inefficient and tough to get satisfied test accuracy, stability concurrently. Thus, we propose a novel Bayesian perimetric threshold method called the Trail-Traced Threshold Test (T4), which can better address the dependence of the initial threshold estimation and achieve significant improvement in the test accuracy and variability while also decreasing the number of presentations compared with Zippy Estimation by Sequential Testing (ZEST) and FT. This study compares T4 with ZEST and FT regarding presentation number, mean absolute difference (MAD between the real Visual field result and the simulate result), and measurement variability. T4 uses the complete response sequence with the spatially weighted neighbor responses to achieve better accuracy and precision than ZEST, FT, SWeLZ, and with significantly fewer stimulus presentations. T4 is also more robust to inaccurate initial threshold estimation than other methods, which is an advantage in subjective methods, such as in clinical perimetry. This method also has the potential for using in other psychophysical tests.

Antimicrobial Activity and Antiadherent Effect of Peruvian Psidium guajava (Guava) Leaves on a Cariogenic Biofilm Model.

AIM: Phytomedicine has been commonly practiced as a form of traditional medicine in various cultures for the treatment of oral diseases. Recently, it has gained importance as an alternative to conventional treatment. Several extracts of plants and fruits have been recently evaluated for their potential activity against microorganisms involved in the development of dental caries. The purpose of this study was to evaluate the antimicrobial activity and antiadherent effect of the crude organic extract (COE) and three partitions (aqueous, butanolic, and chloroformic) of Psidium guajava (guava) leaves on a cariogenic biofilm model. MATERIALS AND METHODS: Guava leaves were obtained from the mountains of northern Peru, where they grow wild and free of pesticides. The antimicrobial activity of the COEs and partitions against Streptococcus mutans and Streptococcus gordonii was determined by measuring the inhibition halos, while the effect on biofilm adhesion was determined by measuring the optical density using spectrophotometry. RESULTS: An antibacterial effect of the COE and chloroformic partition against S. gordonii (p < 0.05) was found, as was a significant effect on biofilm adherence, with a minimum inhibitory concentration (MIC) of 0.78 mg/mL, which was maintained throughout the 7 days of evaluation. CONCLUSION: We conclude that the COEs and their chloroformic partition have antimicrobial and antibiotic effects against this strain of S. gordonii, making them of particular interest for evaluation as a promising alternative for the prevention of dental caries. CLINICAL SIGNIFICANCE: By knowing the antimicrobial effect of Psidium guajava, this substance can be effectively used in products aimed to prevent dental caries and periodontal disease.

Example of monitoring measurements in a virtual eye clinic using 'big data'.

AIM: To assess the equivalence of measurement outcomes between patients attending a standard glaucoma care service, where patients see an ophthalmologist in a face-to-face setting, and a glaucoma monitoring service (GMS). METHODS: The average mean deviation (MD) measurement on the visual field (VF) test for 250 patients attending a GMS were compared with a 'big data' repository of patients attending a standard glaucoma care service (reference database). In addition, the speed of VF progression between GMS patients and reference database patients was compared. Reference database patients were used to create expected outcomes that GMS patients could be compared with. For GMS patients falling outside of the expected limits, further analysis was carried out on the clinical management decisions for these patients. RESULTS: The average MD of patients in the GMS ranged from +1.6dB to -18.9dB between two consecutive appointments at the clinic. In the first analysis, 12 (4.8%; 95% CI 2.5% to 8.2%) GMS patients scored outside the 90% expected values based on the reference database. In the second analysis, 1.9% (95% CI 0.4% to 5.4%) GMS patients had VF changes outside of the expected 90% limits. CONCLUSIONS: Using 'big data' collected in the standard glaucoma care service, we found that patients attending a GMS have equivalent outcomes on the VF test. Our findings provide support for the implementation of virtual healthcare delivery in the hospital eye service.

Development of a Pediatric Visual Field Test.

PURPOSE: We describe a pediatric visual field (VF) test based on a computer game where software and hardware combine to provide an enjoyable test experience. METHODS: The test software consists of a platform-based computer game presented to the central VF. A storyline was created around the game as was a structure surrounding the computer monitor to enhance patients' experience. The patient is asked to help the central character collect magic coins (stimuli). To collect these coins a series of obstacles need to be overcome. The test was presented on a Sony PVM-2541A monitor calibrated from a central midpoint with a Minolta CS-100 photometer placed at 50 cm. Measurements were performed at 15 locations on the screen and the contrast calculated. Retinal sensitivity was determined by modulating stimulus in size. To test the feasibility of the novel approach 20 patients (4-16 years old) with no history of VF defects were recruited. RESULTS: For the 14 subjects completing the study, 31 ± 15 data points were collected on 1 eye of each patient. Mean background luminance and stimulus contrast were 9.9 ± 0.3 cd/m2 and 27.9 ± 0.1 dB, respectively. Sensitivity values obtained were similar to an adult population but variability was considerably higher - 8.3 ± 9.0 dB. CONCLUSIONS: Preliminary data show the feasibility of a game-based VF test for pediatric use. Although the test was well accepted by the target population, test variability remained very high. TRANSLATIONAL RELEVANCE: Traditional VF tests are not well tolerated by children. This study describes a child-friendly approach to test visual fields in the targeted population.

Capacitação a Distância em Saúde, Desastres e Desenvolvimento [versão 1]

O Curso de Capacitação a Distância em Saúde, Desastres e Desenvolvimento do IESC/UFRJ tem um enfoque teórico-prático. A estratégia pedagógica escolhida para o curso se baseia na associação de textos teóricos com o estudo de casos. Visa oferecer conhecimentos e ferramentas que permitam formular e implementar planos e programas de redução do risco de desastres, assim como proporcionar ao profissional que atua em desastres uma visão mais ampla de atuação e das conseqüências de um desastre. Pretende-se que o aluno Entenda as responsabilidades do Setor Saúde em situações de desastres, e fortaleça sua capacidade técnica, especialmente nos âmbitos municipal e estadual frente a uma demanda crescente desses eventos.

Gestão de acidentes com produtos químicos (APQ): prevenção e preparação

A Unidade do 02 do módulo 02 do Curso de Capacitação a Distância em Saúde, Desastres e Desenvolvimento, visa oferecer conhecimentos e ferramentas que permitam formular e implementar planos e programas de redução do risco de desastres. Pretende-se que o aluno entenda as responsabilidades do Setor Saúde em situações de desastres, e fortaleça sua capacidade técnica, especialmente nos âmbitos municipal e estadual, frente a demanda crescente desses eventos. O conteúdo desta Unidade aborda a classificação e identificação de produtos químicos perigosos, os riscos associados aos produtos químicos, a informação como ferramenta de gestão de acidentes químicos, o mapeamento de ameaças, recursos e vulnerabilidades, bem como trata de ações de prevenção de APQ e preparação para resposta para APQ.

Introdução a acidentes com produtos químicos [unidade 08]

O Curso de Capacitação a Distância em Saúde, Desastres e Desenvolvimento do IESC/UFRJ tem um enfoque teórico-prático. A estratégia pedagógica escolhida para o curso se baseia na associação de textos teóricos com o estudo de casos. Visa oferecer conhecimentos e ferramentas que permitam formular e implementar planos e programas de redução do risco de desastres, assim como proporcionar ao profissional que atua em desastres uma visão mais ampla de atuação e das conseqüências de um desastre. Pretende-se que o aluno Entenda as responsabilidades do Setor Saúde em situações de desastres, e fortaleça sua capacidade técnica, especialmente nos âmbitos municipal e estadual frente a uma demanda crescente desses eventos.

Gestão de Acidentes com Produtos Químicos: Prevenção e Preparação [unidade 09]

O Curso de Capacitação a Distância em Saúde, Desastres e Desenvolvimento do IESC/UFRJ tem um enfoque teórico-prático. A estratégia pedagógica escolhida para o curso se baseia na associação de textos teóricos com o estudo de casos. Visa oferecer conhecimentos e ferramentas que permitam formular e implementar planos e programas de redução do risco de desastres, assim como proporcionar ao profissional que atua em desastres uma visão mais ampla de atuação e das conseqüências de um desastre. Pretende-se que o aluno Entenda as responsabilidades do Setor Saúde em situações de desastres, e fortaleça sua capacidade técnica, especialmente nos âmbitos municipal e estadual frente a uma demanda crescente desses eventos.

Gestão de acidentes com produtos químicos (APQ): resposta

A Unidade 03 do módulo 02 do Curso de Capacitação a Distância em Saúde, Desastres e Desenvolvimento do IESC/UFRJ é a última unidade deste módulo e abordará as ações de resposta aos acidentes com produtos químicos (APQ) e o papel do setor de saúde nestas ações.

Gestão de Acidentes com produtos químicos: Resposta [unidade 10]

O Curso de Capacitação a Distância em Saúde, Desastres e Desenvolvimento do IESC/UFRJ tem um enfoque teórico-prático. A estratégia pedagógica escolhida para o curso se baseia na associação de textos teóricos com o estudo de casos. Visa oferecer conhecimentos e ferramentas que permitam formular e implementar planos e programas de redução do risco de desastres, assim como proporcionar ao profissional que atua em desastres uma visão mais ampla de atuação e das conseqüências de um desastre. Pretende-se que o aluno Entenda as responsabilidades do Setor Saúde em situações de desastres, e fortaleça sua capacidade técnica, especialmente nos âmbitos municipal e estadual frente a uma demanda crescente desses eventos.

Thrombosis and acute coronary syndrome.

Acute coronary syndromes (ACS) represent the main clinical manifestation of atherosclerotic progression in the coronary district. Thrombosis plays a critical role in the patho-anatomical of ACS, as disruption of an atherosclerotic plaque exposes flowing blood to subendothelial collagen, tissue factor, and other procoagulant molecules that trigger activation of platelets and formation of fibrin within the vessel lumen. Endothelial damage/dysfunction, inflammation and coagulation are closely related to the pathophysiology of ACS and may be inter-related. Platelets play key roles in both the formation of the atheromatous plaque and clinical presentation of acute atherothrombotic events following plaque rupture. In the pathogenesis of the ACS, blood clotting activation has a crucial role and thrombin generation and TF may represent useful markers for the identification of patients at high risk of vascular events. Lipoprotein-associated phospholipase A2 (Lp-PLA2) represents the crossroads between lipid metabolism and inflammatory response.

Corneal biomechanical properties and their correlates with refractive error.

PURPOSE: The aim was to study the link between refractive error and corneal biomechanical properties. METHODS: Corneal hysteresis and corneal resistance factor were measured using the Ocular Response Analyser in 117 participants. The spherical equivalent refractive error of the participants ranged between -9.00 and +3.00 D. RESULTS: Corneal hysteresis and corneal resistance factor showed a considerable degree of variability between individuals. Corneal hysteresis was not found to correlate significantly with refractive error (p = 0.82). Corneal resistance factor showed a weak but significant correlation with spherical equivalent refractive error (r(2) = 0.04; p = 0.03), with myopic participants exhibiting a higher corneal resistance factor compared with non-myopes. CONCLUSIONS: Refractive error accounted for four per cent of the variance in corneal resistance factor measurements, indicating that patients with mild to moderate myopia have higher corneal resistance compared with non-myopes.

Corneal biomechanical properties measured with the Ocular Response Analyser in a myopic population.

PURPOSE: To explore the possible association between myopia and corneal biomechanical properties in a Caucasian population, and the correlations between the properties of right and left eyes. METHODS: Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using the Ocular Response Analyser (ORA) in both eyes of 95 normal adult subjects aged between 19 and 48 years. The spherical equivalent refractive errors of the participants ranged from 0.25 to -14.00 D. The mean CH and CRF values for the right and left eyes were recorded for each subject. CH and CRF data were compared between different refractive groups. RESULTS: CH was found to be slightly lower in high myopes (>-6.00 D, mean CH 10.0 ± 1.2 mmHg) in comparison to moderate myopes (>-3.00 to -6.00 D, 10.1 ± 1.4 mmHg) and emmetropes and low myopes (+0.25 to -2.75 D, 10.9 ± 1.5 mmHg). The decrease in CH with the degree of myopia was about 0.13 mmHg per D or roughly 1% per D (r(2) = 0.084, p < 0.001). Inter-subject variations were much greater than any systematic changes. CRF was not correlated with refractive error (r(2) = 0.001, p = 0.66). Although the refractive error was highly correlated between the two eyes (r(2) = 0.89, p < 0.001), CH and CRF showed a lower inter-ocular correlation (r(2) = 0.68, p < 0.001 and r(2) = 0.77, p < 0.001 respectively). CONCLUSIONS: These findings may indicate that the viscoelastic properties of the cornea are altered to a minor extent in myopia. However, in this normal population, any overall systematic changes in CH and CRF with refractive error were small in comparison with the considerable inter-subject scatter at any level of refraction.