Visual Screening with Welch Allyn Spot.

Objective: Analysis of refractive errors and strabismus deviations following the visual screening of patients with the Welch Allyn Spot device. Material and Methods: This paper is a prospective cross-sectional study of 4281 patients examined with the Welch Allyn Spot device acquired by Lions Club Romania - District 124. The study was conducted between May 2019 and August 2021 and was performed with the help of Lions Club Romania. Results: In the present study, 4281 patients were evaluated and divided into 5 age groups (6-12 months, 12-36 months, 3-6 years, 6-20 years, and 20-100 years). The most frequent age group was 6-20 years, being identified in 51,97% of participants. We found that the most common refractive error was astigmatism, followed by hyperopia and myopia. Thus, (RE) the refractive errors found in the right eye were: astigmatism 93.23%, hyperopia 4.63%, and myopia 1.05%, and in the left eye (LE): astigmatism 90.40%, hyperopia 6.68%, and myopia 0.84%. Of all participants, 8.81% had horizontal strabismus, esotropia being found in the RE in 4.56% of the participants and the LE in 4.74% of them. Conclusions: The pediatric population was the most affected by astigmatism and esotropia. Abbreviations: RE = right eye, LE = left eye, SD = strabismus deviation.

Smartphone-Based Artificial Intelligence for the Detection and Diagnosis of Pediatric Diseases: A Comprehensive Review.

In recent years, the use of smartphones and other wireless technology in medical care has developed rapidly. However, in some cases, especially for pediatric medical problems, the reliability of information accessed by mobile health technology remains debatable. The main aim of this paper is to evaluate the relevance of smartphone applications in the detection and diagnosis of pediatric medical conditions for which the greatest number of applications have been developed. This is the case of smartphone applications developed for the diagnosis of acute otitis media, otitis media with effusion, hearing impairment, obesity, amblyopia, and vision screening. In some cases, the information given by these applications has significantly improved the diagnostic ability of physicians. However, distinguishing between applications that can be effective and those that may lead to mistakes can be very difficult. This highlights the importance of a careful application selection before including smartphone-based artificial intelligence in everyday clinical practice.

Parental Awareness of the Preschool Orthoptics Visual Screening in Brunei-Muara District and Factors Contributing to Defaulters.

Background: The preschool orthoptics visual screening program began in Brunei Darussalam in 2004 to detect amblyopia, a common cause of treatable visual disorders in children. Amblyopia can be asymptomatic, easily missed, and cause permanent adverse visual consequences; hence, it is necessary to be screened. The parental role in ensuring timely visual screening is pivotal to their child's visual well-being and educational success. This study explored parental awareness and reasons for their nonattendance. Methods: A cross-sectional study of 401 parents was conducted in the Brunei-Muara district in private kindergarten schools and maternal and child health clinics. A self-designed and self-administered questionnaire was used. Data collected was analysed using RStudio in the form of descriptive and analytic statistics. Results: The study findings showed that 52.8% defaulted their screening and there was a significant association between parental awareness and the defaulters (p < 0.05). Only 39.9% of parents were aware of the screening service availability, and 50.1% had not taken their children for an eye check. The most significant sociodemographic factor that influenced awareness of the importance of vision screening was parental employment status (p = 0.013), revealing a 4.43 times higher likelihood of default if the father was unemployed. This study found that with each additional child, parents are 1.25 times less likely to seek eye screening (p < 0.05). Conclusions: The main reason for nonattendance was a lack of awareness of the situation and parents believed that their children were seeing well. Mitigating child visual screening defaults requires a community-focused approach.

[Bibliometric study and analysis of citation networks of visual screening in primary care]. / Estudio bibliométrico y análisis de redes de citación de los screening visuales en atención primaria.

AIM: Screenings make it possible to detect anomalies that can be treated and identify patients who require referral to a specialist. The objective is to identify the different areas of research and determine the most cited publications on screening in primary care. METHODS: An analysis of publications and visualization of citation networks has been carried out using the Citation Network Explorer software. The bibliographic search was carried out with the Web of Science (WOS) database using the search term: "screening AND (vision OR eye OR ocular OR visual)". RESULTS: We analyzed 16707 publications in all fields, 23919 citation networks have been found. The number of publications has increased, with 2021 being the year with the highest number. The majority are scientific articles and the predominant language is English. The most cited article is a global meta-analysis on the prevalence of glaucoma, showing the importance of screening for its early detection since it is essential to avoid blindness. Using the clustering function we found 8 groups with a significant number of publications where we have bibliography on certain eye diseases: glaucoma, diabetic retinopathy, pediatric amblyopia, keratoconus and dry eye. CONCLUSIONS: The main areas of study in relation to screening are the detection of diseases such as glaucoma, retinopathy of prematurity, keratoconus and dry eye. As well as the detection through visual analysis of childhood amblyopia and vision loss in elderly patients. It also gives importance to performing ocular motility tests in problems of acquired brain damage.

Improving detection of oral lesions: Eye tracking insights from a randomized controlled trial comparing standardized to conventional approach.

BACKGROUND: Early detection of oral cancer (OC) or its precursors is the most effective measure to improve outcome. The reasons for missing them on conventional oral examination (COE) or possible countermeasures are still unclear. METHODS: In this randomized controlled trial, we investigated the effects of standardized oral examination (SOE) compared to COE. 49 dentists, specialists, and dental students wearing an eye tracker had to detect 10 simulated oral lesions drawn into a volunteer's oral cavity. RESULTS: SOE had a higher detection rate at 85.4% sensitivity compared to 78.8% in the control (p = 0.017) due to higher completeness (p < 0.001). Detection rate correlated with examination duration (p = 0.002). CONCLUSIONS: A standardized approach can improve systematics and thereby detection rates in oral examinations. It should take at least 5 min. Perceptual and cognitive errors and improper technique cause oral lesions to be missed. Its wide implementation could be an additional strategy to enhance early detection of OC.

Early Detection of Refractive Errors by Photorefraction at School Age.

Early detection and treatment of refractive defects during school age are essential to avoid irreversible future vision loss and potential school problems. Previously, vision screening of preschool children used methods based on subjective visual acuity; however, technologies such as photorefraction have promoted the detection of refractive errors quickly and easily. In this study, 1347 children from 10 schools in Madrid aged 4 to 12 years participated in a program of early detection of visual problems, which consisted of visual screening composed of anamnesis and photorefraction with a PlusOptix A12R. The prevalence of refractive errors was analyzed in terms of spherical equivalent, cylinder and its orientation, and potential cases of development of high myopia or amblyopia. Hyperopia predominates in the early years, but the number of myopic subjects is higher than that of hyperopic subjects from the age of ten onwards. At all ages, the predominant orientation of astigmatism was with-the-rule. On average, 80% of the myopic subjects were uncorrected. Potential high myopia increased with age, from 4 to 21% of the measured population. Potential amblyopia cases decreased across age groups, from 19 to 13.7%. There is a need to raise awareness of the importance of vision screening at school age to address vision problems.

Simple and reliable in situ CRISPR-Cas9 nuclease visualization tool is ensuring efficient editing in Streptomyces species.

CRISPR-Cas9 technology has emerged as a promising tool for genetic engineering of Streptomyces strains. However, in practice, numerous technical hurdles have yet to be overcome when developing robust editing procedures. Here, we developed an extension of the CRISPR-Cas toolbox, a simple and reliable cas9 monitoring tool with transcriptional fusion of cas9 nuclease to a beta glucuronidase (gusA) visual reporter gene. The Cas9-SD-GusA tool enables in situ identification of cells expressing Cas9 nuclease following the introduction of the plasmid carrying the CRISPR-Cas9 machinery. Remarkably, when the Cas9-SD-GusA system was applied under optimal conditions, 100% of the colonies displaying GusA activity carried the target genotype. In contrast, it was shown that the cas9 sequence had undergone major recombination events in the colonies that did not exhibit GusA activity, giving rise to "escaper colonies" carrying unedited genotype. Our approach allows a simple detection of "escaper" phenotype and serves as an efficient CRISPR-Cas9 optimisation tool.

Development and validation of a new method for visual acuity assesment on tablet in pediatric population: eMOVA test.

BACKGROUND: Amblyopia is a major public health concern. Its screening and management require reliable methods of visual acuity assessment. New technologies offer nowadays many tests available on different app stores for smartphone or tablet but most of them often lack of scientific validation for a medical use. The aim of our study was to attempt validating a tablet-based near visual acuity test adapted to the pediatric population: the eMOVA test (electronic Measurement Of Visual Acuity) by comparing visual acuity measured with more conventional test. METHODS: A cohort of 100 children aged 3 to 8 attending the ophthalmic-pediatric for eye examination between September 2016 and June 2017 were included in the study. Near visual acuity was assessed on participants using both the eMOVA test and a Standard test (Rossano-Weiss test). Duration of each test, its comprehension, its acceptability and the attention of the child during the test was also investigated. RESULTS: The eMOVA test overestimated near visual acuity by 0.06 logMAR. This difference, statistically significant, was not clinically relevant. The duration of the eMOVA test was longer than the reference test, but less discomfort and preferred by children and their parents compared to standard tests. CONCLUSION: The eMOVA test appears as a reliable test to assess near visual acuity in children. By its portability and efficiency, this application proved to be a relevant tool to be used for children eye examination in daily routine at the hospital.

An office-based fix-and-follow grading system assessing visual function in preverbal children.

BACKGROUND: Assessing visual function in infants is usually challenging. Fix-and-Follow is a simple and popular method for assessing early development of visual perception in infants, currently however, there is no formal reproducible method for grading the capacity of fix-and-follow. This study was to develop and validate a new fix-and-follow grading system for assessing visual function development in preverbal children. METHODS: In this cross-sectional study, the fix-and-follow grades was evaluated in 21 consecutive preverbal children. Fixation was categorised as grade 1 if there was no response to the target and grade 2 if there was a response but only for < 3 s. Grades of 3 and 4 were assigned based capacities to (1) fix on a moving target for ≥3 s, and (2) shift fixation from one target to another. If only one of these two criteria was met, grade 3 was assigned. If both were met, grade 4 was assigned. Following was evaluated using smooth pursuit movement, where grade 1 indicated no movement, grade 2 partial movement, and grade 3 complete movement. Two ophthalmologists independently applied the grading method in all patients. Then one of two examiners repeated the examinations to investigate the intra-observer agreement of the grading system. RESULTS: Intra-observer agreement was excellent (Kappa coefficient = 0.823) and inter-observer agreement was good (Kappa coefficient = 0.625). All patients who exhibited abnormal ocular movement had score discrepancy between a new fix-and-following grading examination. CONCLUSIONS: The new fix-and-follow grading scale can be applied easily in preverbal children in an office setting, and it proved reliable and reproducible.

Evaluation of the red reflex: An overview for the pediatrician.

BACKGROUND: Red reflex test (RRT) is a simple, non-invasive method that can be performed easily by pediatricians during the clinical examination in neonatal period, infancy and childhood. Abnormal reflexes can lead to prompt diagnosis of several ocular disorders, with potentially severe consequences on patient's vision, cognitive function and even life. AIM: To underline the contribution of pediatricians to early detection of vision and life threatening diseases by using RRT effectively. METHODS: For the present systematic review, PubMed searches were performed using the key words "red reflex and newborn"; "red reflex and neonate"; "red reflex and complications"; "red reflex and necessity"; "red reflex and retinoblastoma"; "red reflex and congenital cataract"; "red reflex and glaucoma"; "red reflex and prematurity"; "red reflex and leukocoria"; "red reflex and blindness"; "red reflex sensitivity and specificity"; "red reflex and differential diagnosis"; "red reflex and guidelines". The relevant articles were selected without language restrictions. When a full-text publication was not available, their English abstracts were used. In some cases, studies from the reference lists of the selected articles provided useful information. The research took place in September 2020, in the Ophthalmology Department of University Hospital of Alexandroupolis. RESULTS: A total of 45 articles were selected according to the used key words. After reviewing data from these articles, it is supported that red reflex remains an effective tool of undeniable importance for early detection of severe eye conditions, such as cataract, retinoblastoma, retinopathy of prematurity and glaucoma. Although literature reports some limitations of RRT, including a notable percentage of false positive tests, the inability to detect small, peripheral retinoblastomas and the lower sensitivity for posterior segment pathology, it is widely accepted that the benefits from the regular evaluation of the test on public health are significant. Therefore, RRT has been established by international guidelines and should be an essential component of pediatricians clinical practice. Red reflex implementation should be incorporated in pediatricians educational programs, so that they would be able to provide quality services and safe diagnoses. CONCLUSION: The implementation of RRT should be encouraged in all neonatal/pediatric departments. Prompt education of pediatricians should be empowered in order to achieve careful vision screening, according to current guidelines.

[Vision screening for children: Recommended practices from AFSOP]. / Le dépistage visuel chez l'enfant : les recommandations de l'Association Francophone de Strabologie et d'Ophtalmologie Pédiatrique (AFSOP).

In light of the international literature, a workgroup of experts from the AFSOP met in February 2019 to formulate updated recommendations for visual screening in children. An ophthalmologic examination during the first month of life is recommended for children at risk of developing infantile organic amblyopia. An ophthalmologic examination including cycloplegic refraction between 12 and 15 months of age is recommended for children at risk of developing functional amblyopia. At any age, a prompt ophthalmologic examination is recommended for a child suspected of functional or organic ocular pathology. In children without risk factors or warning signs, a systematic orthoptic screening examination is recommended during the third year of life, including a monocular visual acuity test, a cover-test and a refraction by photoscreener. The child is referred to the ophthalmologist only in the case of an abnormal screening result, according to the following criteria: visual acuity <5/10, or >1 difference between eyes, abnormal cover test, photodetection refraction values <-3D or>+2.5D for the sphere,>1.5D for astigmatism and>1D for anisometropia. Finally, we review normal childhood refractive errors as a function of age as well as the correct use of photo screening devices.

Reduced visual acuity in children from 5 to 6 years old, with LEA chart.

PURPOSE: To assess visual acuity in 5-year-old children with LEA chart and to estimate the frequency of reduced visual acuity in this age. METHOD: Study aimed at children attending the last year of preschool education in Public Kindergartens and Private Social Solidarity Institutions (IPSS) under the influence Regional Health Administration of the Médio Tejo, in Portugal. The 15-line LEA charts at 3 m were used and the presentation visual acuity was measured monocularly starting with the right eye. The ETDRS-fast methodology was used. RESULTS: A total of 3072 children participated, being 51% male and 54% from rural area. A rate of 13.7% children with a reduced level of visual acuity was found, that is, visual acuity worse or equal to 0.2 logMAR in at least one eye, or an interocular difference greater than two lines. CONCLUSION: This research shows that reduced VA frequency rate in children between 5 and 6 years old is high. The literature presents amblyopia (refractive and/or strabismic) and uncorrected refractive errors without amblyopia as the main cause of reduced VA in childhood, and these anomalies negatively affect child development, especially at the educational level. Reduced VA interferes with performance on a number of key tasks in the learning process. Thus, it is important to preserve the running program to identify these deficits and lead to their correction before the beginning of the school stage.

Ophthalmology examination during well-child visits in primary care health centres: Knowledge and difficulties experienced by health workers. / Examen oftalmológico durante el control del niño sano en atención primaria: conocimiento y dificultades de los miembros del equipo de salud.

INTRODUCTION: The red reflex examination (RRE) and visual acuity testing (VA) is a mandatory part of the examination during the well-child visits (WCV) in primary health care centres of the public system of health in Chile. The eye examination is aimed at the early detection of severe eye diseases in children, such as retinoblastoma, congenital cataracts, and amblyopia. The knowledge and difficulties experienced by health workers in primary care health centres for evaluating the red reflex during WCV in Chile is unknown. MATERIAL AND METHODS: A survey was performed in primary community health centres of XXX Santiago de Chile. RESULTS: The WCV were mainly performed by physicians (45.2%) and nurses (35.8%). Only 34% of health workers performed the red reflex test, and 42.3% checked VA during the WCV. The main reasons for not doing it include the lack of direct ophthalmoscopes and VA charts (55.2% and 43.9%, respectively) at their centres, and not having the knowledge or skills (29.3% and 22%, respectively) to properly perform these clinical tests. CONCLUSION: In this series, the eye examination of children attending WCV was unfrequently performed. A better implementation of the health centres and training of the health workers are needed in order to improve the access and quality of the paediatric eye examination in primary health care institutions in Chile.

Refractive errors in children: analysis among preschool and school children in Tuzla city, Bosnia and Herzegovina.

Aim To establish the prevalence of refractive errors in preschool and school children between 4 and 15 years of age, living in Tuzla, Bosnia and Herzegovina. Methods Children from all elementary schools in the city of Tuzla and as well from eight day-care centres were screened for refractive errors in the period 2015-2019. Any child, who failed to pass the screening examination, was referred to an ophthalmologist for complete ophthalmological evaluation. The obtained data were analysed using non-parametric statistics. Results The highest number of children who were tested after the screening process was during 2015. A total of 7415 children (3790 males and 3625 females), in the age range of 4-15 were screened. In the total sample of children who were completely evaluated (n=145; 290 eyes) the most common refractive error was astigmatism, in 152 (52.4%) eyes. In the preschool children (n=18; 36 eyes), the most common refractive error was astigmatism, in 19 (52.8%) eyes, followed by hyperopia, in 9 (25%) eyes. In the school children (n=127) (254 eyes), the most common refractive error was astigmatism, in 133 (52.4%) eyes, followed by myopia, in 92 (36.2%) eyes. The overall prevalence of refractive errors was 1.95% (145 with refractive error out of 7415 screened). Conclusion Prevalence of refractive errors is high enough to justify a school eye screening programme.

Vision for the Future Project: Screening impact on the prevention and treatment of visual impairments in public school children in São Paulo City, Brazil

OBJECTIVES: Uncorrected refractive errors are the leading cause of visual impairment in children. In this cross-sectional retrospective study, we analyzed a social visual screening program for school children in São Paulo, Brazil, evaluated its impact on the prevention and treatment of children's visual disabilities, and assessed its epidemiological outcomes to outline suggestions for its improvement. METHODS: First-grade children from public schools were submitted to prior visual screening by their teachers. Selected children were forwarded to the hospital's campaigns for a second screening by ophthalmologists and treatment if needed. Data were analyzed for age, sex, visual acuity, biomicroscopy, refractive errors, ocular movement disorders, amblyopia, number of donated spectacles, and number of children forwarded to specialized care. RESULTS: A total of 1080 children were included with mean age of 6.24±0.45 years. Children with normal ophthalmological exam, 591 (54.7%; 95% confidence interval [CI]: 51.7%-57.7%) were dismissed and considered false-positives. Myopia, hyperopia, and astigmatism components were found in 164 (15.2%; CI: 13.1%-17.4%), 190 (17.6%; CI: 15.3%-20.0%), and 330 (30.5%; CI: 27.8%-33.4%) children, respectively. Amblyopia was diagnosed in 54 (5%; CI: 3.5%-6.4%) children, and 117 (10.8%; CI: 9.8%-12.8%) presented ocular movement disorders. A total of 420 glasses were donated. CONCLUSION: Epidemiological findings for amblyopia and refractive errors are consistent with those of similar studies. The expressive number of diagnoses performed and number of glasses donated to underprivileged children depict the importance of such projects. New guidelines to improve their cost-effectiveness, such as professional training and community sensitization, are imperative.

A convenient, rapid and efficient method for establishing transgenic lines of Brassica napus.

BACKGROUND: Brassica napus is an important oilseed crop that offers a considerable amount of biomass for global vegetable oil production. The establishment of an efficient genetic transformation system with a convenient transgenic-positive screening method is of great importance for gene functional analysis and molecular breeding. However, to our knowledge, there are few of the aforementioned systems available for efficient application in B. napus. RESULTS: Based on the well-established genetic transformation system in B. napus, five vectors carrying the red fluorescence protein encoding gene from Discosoma sp. (DsRed) were constructed and integrated into rapeseed via Agrobacterium-mediated hypocotyl transformation. An average of 59.1% tissues were marked with red fluorescence by the visual screening method in tissue culture medium, 96.1% of which, on average, were amplified with the objective genes from eight different rapeseed varieties. In addition, the final transgenic-positive efficiency of the rooted plantlets reached up to 90.7% from red fluorescence marked tissues, which was much higher than that in previous reports. Additionally, visual screening could be applicable to seedlings via integration of DsRed, including seed coats, roots, hypocotyls and cotyledons during seed germination. These results indicate that the highly efficient genetic transformation system combined with the transgenic-positive visual screening method helps to conveniently and efficiently obtain transgenic-positive rapeseed plantlets. CONCLUSION: A rapid, convenient and highly efficient method was developed to obtain transgenic plants, which can help to obtain the largest proportion of transgene-positive regenerated plantlets, thereby avoiding a long period of plant regeneration. The results of this study will benefit gene functional studies especially in high-throughput molecular biology research.

Evaluation of the Spot Vision Screener in comparison with the orthoptic examination in visual screening in 3-5 year-old schoolchildren.

PURPOSE: To evaluate the Spot Vision Screener (SVS) compared with the orthoptic examination for detection of amblyopia risk factors in preschools. METHODS: This prospective study included children with a visual screening organized by the department of "le" (PMI) in Côte d'Or (Burgundy, France), between June 2017 and April 2018. All children were evaluated with the SVS followed by a clinical orthoptic examination. Results with the SVS were compared with those obtained by clinical orthoptic examination. RESULTS: A total of 1236 subjects were included in the study from 100 preschools. The mean age of the children was 3.6±0.7 years, and 627 were female (50.7%). The orthoptic examination detected 308 (24.9%) children with subnormal visual acuity for age in one eye or both. In children with a history of prematurity, the orthoptic examination was more frequently abnormal (P=0.002), which was not seen with the SVS (P=0.050). The SVS screened 20 (1.6%) children with strabismus, while 40 (3.2%) were detected by orthoptic examination. At the end of the screening, the SVS detected 182 (14.7%) suspect patients while 311 (25.1%) suspect patients were detected after the orthoptic examination. Comparing SVS with orthoptic examination, agreement was fair (κ=0.4). CONCLUSION: The SVS can be a useful device for visual screening, but agreement with the orthoptic examination was only fair. The Spot vision screener should be used in conjunction with a clinical orthoptic examination.

Development and Validation of an Effective CRISPR/Cas9 Vector for Efficiently Isolating Positive Transformants and Transgene-Free Mutants in a Wide Range of Plant Species.

The CRISPR/Cas9 technique is a highly valuable tool in creating new materials for both basic and applied researches. Previously, we succeeded in effectively generating mutations in Brassica napus using an available CRISPR/Cas9 vector pKSE401, while isolation of Cas9-free mutants is laborious and inefficient. Here, we inserted a fluorescence tag (sGFP) driven by the constitutive 35S promoter into pKSE401 to facilitate a visual screen of mutants. This modified vector was named pKSE401G and tested in several dicot plant species, including Arabidopsis, B. napus, Fragaria vesca (strawberry), and Glycine max (soybean). Consequently, GFP-positive plants were readily identified through fluorescence screening in all of these species. Among these GFP-positive plants, the average mutation frequency ranged from 20.4 to 52.5% in Arabidopsis and B. napus with stable transformation, and was 90.0% in strawberry and 75.0% in soybean with transient transformation, indicating that the editing efficiency resembles that of the original vector. Moreover, transgene-free mutants were sufficiently identified in Arabidopsis in the T2 generation and B. napus in the T1 generation based on the absence of GFP fluorescence, and these mutants were stably transmissible to next generation without newly induced mutations. Collectively, pKSE401G provides us an effective tool to readily identify positive primary transformants and transgene-free mutants in later generations in a wide range of dicot plant species.

Prevalencia de baixa acuidade visual em escolares / Prevalence of visual disorders in school children

Resumo Objetivo: Avaliar o perfil epidemiologico de disfuncao da acuidade visual (AV), possiveis disturbios oculares e a frequencia ao atendimento oftalmologico, de escolares do municipio de Itauna, Minas Gerais, Brasil. Posteriormente objetivou-se o encaminhamento ao especialista para correcao das anormalidades. Métodos: Estudo transversal, com populacao avaliada de 432 alunos da rede publica de ensino. Os individuos foram avaliados pelo metodo Snellen e a faixa etaria da amostra variou de 4 a 17 anos. Os dados foram colhidos e sistematizados. Foram encaminhados para o servico de Oftalmologia aqueles que possuiam AV ≤ 0,7 em pelo menos um dos olhos. Resultados: Dos 432 alunos avaliados neste estudo 14,5% apresentaram baixa AV, quando avaliados pelo teste de Snellen. Destes, 61,9 % pertenciam ao sexo feminino. A faixa etaria em que houve maior prevalencia de baixa visao foram escolares de 15 a 17 anos. A maioria apresentou alteracao em ambos os olhos e 60% dos alunos avaliados declararam nunca terem passado por uma consulta oftalmologica. Dos alunos que compareceram as consultas, a maioria foi diagnosticada com erros de refracao e necessitou de correcao otica. Conclusão: Os resultados encontrados demonstram que a parcela significativa dos individuos avaliados apresentou baixa visao e necessitou de encaminhamento oftalmologico. Alem disso, observou-se a inexistencia de consultas oftalmológicas anteriores em grande parte dos escolares. Esse fato reforca, diante dos orgaos publicos de saude, a necessidade de implantar sistemas de triagem visual nas escolas e oferecer assistencia a esses estudantes, objetivando melhorias em seu aprendizado e qualidade de vida.

ABSTRACT Objective: To evaluate the epidemiological profile of visual acuity (VA) dysfunction, the possible ocular disorders and the frequency of ophthalmologic care of school children from the city of Itaúna, Minas Gerais, Brazil. Methods: A cross-sectional study with a population of 432 students in the public schools. The individuals were evaluated by the Snellen method and the sample age ranged from 4 to 17 years. Data were collected and systematized. Those who had VA ≤ 0.7 in at least one eye were referred to the ophthalmology service. Results: Of the 432 students evaluated in this study, 14.5% presented low VA, when evaluated by the Snellen test. Of these, 61.9% were female. The age group with the highest prevalence of low vision were schoolchildren aged 15 to 17 years. The majority presented alteration in both eyes and 60% of the evaluated students stated that they had never had an ophthalmological consultation. Of the students who attended the consultations, most were diagnosed with refractive errors and needed optical correction. Conclusion: The results showed that a significant portion of the individuals evaluated had low vision and required ophthalmologic referral. In addition, there was no previous ophthalmological consultation in most of the schoolchildren. This fact reinforces to public health agencies, the need to implement visual screening systems in schools and offer assistance to these students, with the aim of improvements in their learning and quality of life

The development of the visual screening tool for anxiety disorders and depression: Addressing barriers to screening for depression and anxiety disorders in hypertension and/or diabetes.

BACKGROUND:  There is a lack of screening tools for common mental disorders that can be applied across cultures, languages and levels of education in people with diabetes and hypertension. Aim: To develop a visual screening tool for depression and anxiety disorders that is applicable across cultures and levels of education. Setting: Participants were purposively recruited from two not-for-profit organisations and two public health facilities - a maternal mental health unit and a primary health care centre. Method: This was a qualitative cross-sectional study. Thirteen drawings based on the Hospital Anxiety and Depression Scale depicting symptoms of anxiety disorders and depression were drawn. Participants described emotions and thoughts depicted in the drawings. Data were analysed through content analysis. Results: Thirty-one women (66%) and 16 men (34%) participated in the development of the visual screening tool. The mean age was 34 (standard deviation [SD] 12.46). There were 32 (68%) black participants, 11 (23%) mixed race participants and 4 (9%) white participants. Two participants (4%) had no schooling, 14 (31%) primary schooling, 8 (18%) senior schooling, 13 (29%) matric qualification and 8 (18%) had post-matric qualification. Participants correctly described 10 out of the 13 visual depiction of symptoms as associated with depression and anxiety disorders, with no differences between levels of education and cultural groups. Conclusion: Ten drawings were appropriate for inclusion in the visual screening tool for anxiety disorders and depression (VISTAD). The VISTAD will be validated against the mini international neuropsychiatric interview (MINI) in a primary care population with hypertension and/or diabetes.