Demographic profiles of contact lens wearers and their association with lens wear characteristics in Trinidad and Tobago: A retrospective study.

PURPOSE: Contact lenses (CL) remain a popular mode of refractive error correction globally and in the Caribbean, mostly among young people. However, no data on the characteristics of the CL population wearers in the Caribbean is available. This study reported on the characteristics of CL wearers and the associated factors in Trinidad and Tobago (T&T). METHODS: This retrospective study reviewed the clinical records of 243 CL wearers who attended the University of the West Indies (UWI) optometry clinic between 2017 and 2018. Data on their demographic profiles, CL wearing characteristics including lens type, material, purpose of wear, replacement schedule and lens care systems were extracted and analyzed. The associations between the demographic characteristics and CL wearing characteristics were also determined. RESULTS: About half of the CL wearers used them for fashion (more among those aged 18 to 30 years, 61.0%), therapeutic (more among those <18 years, 43.8%, P = 0.001) and refractive error correction purposes (more in those >40 years, P = 0.001). Females were more likely to use CLs for fashion compared with males (67.0% versus 40.7%). Age (P<0.0005) and gender (P = 0.030) were associated with the lens materials. Those aged 18-30 years were more likely use hydrogels compared with the younger ones (64.1% versus 25.0%). Rigid gas permeable (RGP) CL use was more common in males than females (21.8% versus 10.9%, P = 0.031). Daily disposables were predominantly used by younger respondents (18-30 years old, 31.3%, P < 0.001) and more in females than males (66.7% vs 49.4%, P = 0.040). CONCLUSION: The study found that the CL appears to be more commonly worn for fashion in younger females and for refractive error correction in older males. Age, gender, and employment status were the main determinants of lens wear among respondents attending the university clinic in T&T.

Online e-learning during the COVID-19 lockdown in Trinidad and Tobago: prevalence and associated factors with ocular complaints among schoolchildren aged 11-19 years.

Background: The increase in online learning during the pandemic has been linked to various ocular complaints. This study determined the prevalence and factors associated with ocular complaints among schoolchildren aged 12-19 years during the COVID-19 lockdown in Trinidad and Tobago (T&T). Methods: A cross-sectional study was conducted between January and May 2021, during the COVID-19 lockdown in T&T among secondary school students studying remotely. A two-stage cluster sampling method was employed. A modified web-based Computer Vision Syndrome questionnaire was administered to students. Data on demography, duration of digital device use, and ocular complaints were collected, and multilevel logistic regression was used to determine factors associated with ocular complaints among school children, 12-19 years of age in T&T. Results: A total of 435 schoolchildren (mean age, standard deviation, 15.2 ± 1.9 years range 12-19 years) responded to the questionnaire. The prevalence of self-reported symptoms of headache, blurred vision, dry eyes, itchy eyes, and double vision were 75.0%, 65.1%; 56.8%; 46.4%; and 33.5%, respectively. Schoolchildren aged 18-19 years, those that used spectacles for correction of their refractive errors, and spent more than 6 h on average on digital devices, reported a high prevalence of any ocular complaints. Analysis also revealed that age (14-15 years) was associated with dry eyes, blurred vision, and headaches, while gender (more prevalently females) was associated with blurred vision and headache. Those that had an eye examination in the last year and schoolchildren that took action to resolve ocular complaints were more likely to experience nearly all ocular complaints. Conclusions: During the COVID-19 lockdown, over three in four students in T&T reported ocular complaints from digital devices for online learning. Tailored interventional messages to reduce all forms of ocular complaints should target older students, particularly females, those who laid down when learning online via their devices and people who regularly examine their eyes.

Choroidal Thickness Measured by Ocular Coherence Tomography (SD-OCT) and Body Mass Index in Healthy Saudi Women: A Cross-sectional Controlled Study.

BACKGROUND: Obesity is one of the major public health problems globally, especially among women. Obesity is associated with glaucoma, cataract, age-related macular degeneration and diabetic retinopathy. Although it is clear that the anatomy and physiologic functions of the choroid may be affected by obesity, data investigating the effect of obesity on the choroid is limited and/or unavailable for the Saudi population. OBJECTIVE: To assess Choroidal Thickness (CT) changes in a sample of healthy Saudi Arabian women with different Body Mass Index (BMI) using Spectral-domain Ocular Coherence Tomography (SD-OCT). METHODS: A total of 140 healthy women aged 18-29 years (mean age ± standard deviation SD, 24.5 ± 1.7 years) with different BMI, axial length (AL) ≤ 24 ± 1.0 mm, and spherical equivalent refraction (SER) of ≤ ±2.0 dioptres were enrolled for the study. The participants were age and refractionmatched, and grouped into underweight (BMI ≤ 18.0 kg/m2) (n = 30), normal (control group) (18.5-24.9 kg/m2) (n = 43), overweight (25.0-29.9 kg/m2) (n=37), and obese study groups (≥ 30.0 kg/m2) (n = 30). SD-OCT imaging was performed on one eye of each participant. Comparisons among groups for all locations and the associations between CT and other variables were examined. RESULTS: The mean CT at the subfoveal region (285 ± 31 µm, range: 203 µm to 399 µm) was significantly greater, and it was the lowest in the nasal region (248 ± 26 µm, range 154 to 304) compared with other locations, across all the groups (p < 0.05). Compared with the control, the subfoveal choroid was thinner in the obese group (mean difference: 22.6 µm, 95% Confidence Interval; CI: 8.6 µm to 36.6 µm; p = 0.02) and across all locations (p < 0.05) but thicker at the temporal location in the underweight group (12.4 µm, 95% CI: -23.7 µm to -1.04 µm; p = 0.01). No significant association of subfoveal CT with any of the measured parameters, including age (p-values ranged from 0.10 to 0.90), was found. CONCLUSION: BMI may have an influence on the CT of healthy individuals and could be a cofounder in research studies on CT. It is, therefore, recommended that BMI should be evaluated in the clinical diagnosis and management of conditions associated with choroid in healthy individuals.

A survey on knowledge and attitude of Saudi female students toward refractive correction.

BACKGROUND: To assess the general knowledge and attitude of refractive error correction methods among female Saudi university students. METHODS: One thousand, one hundred and sixty-five female university students, between 17 and 32 years of age were randomly interviewed using self-administered questionnaires with open and closed-ended questions. The questions collected information on demographics (gender, age, educational status, college of study, and occupation), addressed general knowledge/perception of the difference between the professions of ophthalmology and optometry, and attitudes toward spectacle, contact lens (CL) usage, including coloured prescription CLs, and refractive surgery for correcting refractive errors. RESULTS: The response rate was 90 per cent (1,052/1,165). Fifty-two per cent had never had an eye examination and only 28 per cent correctly identified the difference between an 'ophthalmologist' and 'optometrist'. Eighty-one per cent knew that CLs instead of spectacles (81.8 per cent), and coloured CLs (89.7 per cent) can be used for correcting refractive errors. Concerning refractive surgery, although a majority (90 per cent) knew that the technique corrects refractive error and reduces dependency on spectacles/CLs, only five per cent had experienced refractive surgery. Approximately, 46 per cent and 47 per cent used spectacles and CLs, respectively, and while the optometrist was the main source of CL prescriptions (41 per cent), most people visited the ophthalmologist for their eye examination (68 per cent). Surprisingly, 52 per cent had never had an eye examination, or had only had one or two eye examinations (50 per cent) in their lifetime. While 23 per cent of spectacle wearers chose to continue with spectacles at the end of the study, 64 per cent and 12 per cent preferred refractive surgery and CLs, respectively, for refractive correction. Lack of information and fear of complications, but not cost, hindered most people from uptake of CLs and refractive surgery. CONCLUSION: The students demonstrated high levels of knowledge and awareness of refractive correction methods, especially for refractive surgery. Although many consulted the optometrist or ophthalmologist for their eye examinations and corrective devices, many remain uncorrected and unaware of the main difference between both professions. The lack of information about correction methods and fear of complications may have affected their interest in uptake of eye services and should be addressed to increase uptake and prevent avoidable vision loss.

Visual impairment among adults in Saudi Arabia.

BACKGROUND: To estimate the prevalence of visual impairment, and identify its causes and associated factors among adults aged 40 years and over, attending for eye examination at a Riyadh public hospital in Saudi Arabia. METHODS: This was a retrospective cross-sectional study conducted among 195 consecutive older adults who attended the outpatient ophthalmology clinic of King Abdul-Aziz University Hospital between 1 February and 30 June 2018. All participants underwent comprehensive ophthalmic examination: visual acuity, refraction (objective and subjective), fundus photography and automated visual field assessment. Classification of visual impairment was based on the World Health Organization criteria: mild visual impairment if best-corrected distance visual acuity < 6/12-6/18 in the better eye; moderate visual impairment if best-corrected visual acuity < 6/18-6/60 in the better eye; and severe visual impairment if best-corrected visual acuity < 6/60-3/60. Regression analysis was used to identify the factors associated with visual impairment. RESULTS: The study participants included 107 (54.9 per cent) females, and the mean (SD) age was 61.1 ± 10.9 years. The overall prevalence of visual impairment (14.9 per cent, 29 cases), consisting of severe (0.5 per cent), moderate (9.7 per cent) and mild (4.6 per cent) forms, correlated significantly with age (R2 = 0.023, p = 0.04). The main causes of visual impairment were glaucoma (48.3 per cent), cataract (31.0 per cent), refractive error, and diabetic retinopathy (24.1 per cent each). The odds of having visual impairment increased by 22 per cent and eight per cent respectively in participants who had diabetic retinopathy (adjusted odds ratio 1.22, 95% confidence interval [CI] 1.05, 1.95) and glaucoma (1.08, CI 1.02, 1.40). CONCLUSIONS: The prevalence of visual impairment among older adults attending the ophthalmology clinic in Riyadh city was high and driven by the high rate of diabetic retinopathy and glaucoma in this region. As part of their routine checks, there is need to make dilated fundus examination and intraocular pressure measurement mandatory tests in addition to refraction and visual acuity testing, when examining Saudi adults attending the hospital eye clinics in Riyadh province.

Changes in retinal nerve fiber layer and optic disc algorithms by optical coherence tomography in glaucomatous Arab subjects.

PURPOSE: To assess the difference in retinal nerve fiber layer (RNFL) and optic disc algorithms between glaucomatous and normal Arab subjects using optical coherence tomography (OCT). METHODS: RNFL thickness and optic disc parameters were obtained in 65 patients aged 50.1 ± 7.7 years. Percentage differences in all parameters were calculated and analyzed between groups. RESULTS: The mean RNFL thickness around the disc and at all quadrants was significantly thinner in glaucomatous eyes than in normal eyes (P < 0.01). The greatest decrease in RNFL thickness was observed at the inferior (39.5%) and superior (39.3%) quadrants and at 1 o'clock (43%) and 5 o'clock (40%) hour sectors. Significant differences were observed between glaucomatous and control eyes in all disc parameters (P < 0.005) assessed. The disc area, cup area, mean cup/disc ratio, and vertical and horizontal cup/disc ratios were significantly larger (P < 0.01), whereas the vertical integrated rim area, horizontal integrated rim width, and rim area were significantly smaller (P < 0.001) in glaucomatous eyes than in normal eyes. CONCLUSION: Stratus OCT is still a valuable tool in the diagnosis of early glaucoma changes and, as such, its use should be encouraged in glaucoma clinics in Saudi Arabia. The best OCT parameters for detecting early glaucoma change were RNFL thickness in the inferior, superior, and 1 o'clock hour sector; the cup area; and the vertical integrated rim area of the optic disc.