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Magnitude and determinants of refractive error in Omani school children.

OBJECTIVE: To estimate the magnitude and determinants of refractive error in school children, a study was undertaken to review the school screening and refraction data. METHODS: Trained physicians screened 416,157 students to evaluate their visual status and identified 28,765 students with defective vision. Refractionists refracted 25,733 (89.5%) of them, determined the refractive error and prescribed spectacles. Students with ocular co-morbidity and visual disability were re-examined and treated by the ophthalmologists. This study was conducted between June 2003 and December 2003 in the Ministry of Health, Muscat, Sultanate of Oman. RESULTS: The prevalence of myopia was 4.1% (95% confidence interval [CI] 4.06-4.18). It was higher among female than male students [rate ratio (RR) 1.69 (95% CI 1.64-1.74)]. The rate was more in students of higher age groups (chi2 = 11,179 degrees of freedom = 2 p<0.00001). Regional variation in myopic trend was marked. The prevalence of hypermetropia was 0.4% (95% CI 0.37-0.41). However, it could be an underestimation as presence of accommodative spasm was not taken into account. The risk of low vision disability was significantly higher in male students than female students. The prevalence of ambiopia was 0.3%. It was significantly higher in male than female students. First primary students had strabismus of 0.5%. CONCLUSION: The study enabled to understand trends of refractive error in Omani children (Arabic tribe) and demonstrated the importance of vision screening in providing timely eye care and identifying visually disabled school children.

Adolescent↗

Prescribing spectacles for aviators: USAF experience.

This special report was written for USAF vision specialists to use as a guide when prescribing spectacles for military aviators and to extend to the civilian sector the knowledge gained from the USAF experience. Visual correction in aviators presents some unique problems, especially for presbyopes. The demands of each individual aircraft environment need to be well understood. Ophthalmologists and optometrists must consider all pertinent aeromedical factors before prescribing spectacles for ametropic aviators.

Adult↗

Ablation design in relation to spatial frequency, depth-of-focus, and age.

PURPOSE: To consider factors relevant to the design of wavefront-aberration-based customized ablations. METHODS: Review. RESULTS: Ablations that seek to eliminate all wavefront aberrations, both second- and higher-order, may not be optimal for all patients. This is particularly the case for presbyopes. Their main requirement will normally be for extended binocular depth-of-focus to yield adequate distance and near vision with good retinal contrast at lower spatial frequencies, rather than the highest levels of acuity and modulation transfer function at a single distance. For many presbyopes, this can be achieved by aiming for monovision correction or low myopic astigmatism, with reasonable but not necessarily complete correction of higher-order aberrations. This compromise allows a range of everyday tasks to be carried out, including face recognition and reading. CONCLUSION: The targeted correction of wavefront aberration should take into account the visual needs and preferences of the individual patient.

Accommodation, Ocular↗

Magnification in a restorative dental practice: from loupes to microscopes.

Dentistry requires precise motor skills guided by keen visual acuity. Many options are available to improve visual acuity--from simple loupes to surgical microscopes. Each has inherent advantages and limitations, but they all help improve precision beyond unaided vision. Data suggests that every dental professional is at risk for an occupational musculoskeletal injury. Clearly, there is a correlation between seeing clearly and maintaining good posture. Using the appropriate visual enhancement should be considered for all dental professionals to make the practice of dentistry more precise, easier, and more enjoyable and to reduce the risk of musculoskeletal injury.

Age Factors↗

Ophthalmic topics for the non-ophthalmologist.

This article provides information for the medical practitioner who deals with patients receiving care for eye disease. It is written for the non-ophthalmologist physician. The goal is to update the practitioner by discussing common ophthalmic issues that are encountered in everyday interactions with patients. Glaucoma, age-related macular degeneration, and treatment of refractive errors are emphasized in this summary article.

Adrenergic beta-Antagonists↗

Clinical evaluation of fitting presbyopic patients with contact lenses.

This clinical investigation was performed to determine the success of using a system designed as a flow chart to fit presbyopic patients with contact lenses. The value of this type of system is to provide practitioners with a simple step-by-step approach to fitting presbyopic patients and reducing the costs of several trial fitting sets. Patients were fit with monovision, simultaneous vision bifocal, alternating vision bifocal or diffractive bifocal contact lenses. The patients were fit first with monovision, and, if unsuccessful with this or any of the above lens designs, they proceeded to the next stage. Stage 2 used the simultaneous lens design, Stage 3 the alternating lens design and Stage 4 the diffractive lens design. Of the 22 patients enrolled in the study, 17 (77.3 percent) were successful through Stage 3 and 18 (81.8 percent) were successful through Stage 4. The first three stages are those proposed by Bausch & Lomb as the Presbyopic Fitting System. The Presbyopic Fitting System was found to be simple to follow and successful in fitting presbyopic patients.

Adult↗

Dynamic retinoscopy and accommodation.

The added positive lens power required for low and high neutrals at a distance of 1/3 m is determined as a function of age for a sample of 221 clinically normal subjects, aged between 10 and 80 years. These dynamic retinoscopy results are compared with corresponding laser optometer measurements of the levels of accommodation under each condition. Dark focus (tonic accommodation) measurements are carried out on a further sample of 58 subjects. Although the mean results of dynamic retinoscopy agree with those found by earlier authors, on the basis of our sample it is concluded that the considerable scatter in neutral values found in normal subjects at any age limits the usefulness of the technique as an indication of abnormality in near responses. Much of this scatter in pre-presbyopic subjects appears to be related to individual variation in the level of tonic accommodation, although near phoria may also play some role.

Accommodation, Ocular↗

Photographic cockpit model for prescribing multifocals.

Recent interest in the relevancy of near vision tests for presbyopic aircrew members has led to the development of a photographic cockpit model. This model is used to prescribe more accurately for flying personnel. Prescriptions can be evaluated by use of trial lenses. This allows the aircrew members to experience the effect of viewing instruments in the cockpit of a C-130 aircraft.

Aircraft↗

An evaluation of four multifocal contact lenses in young monocular aphakic patients.

To evaluate the efficacy of multifocal contact lenses in the correction of presbyopic symptoms we fit six young monocular aphakic patients with four different bifocal contact lenses (ACC, Tangent Streak, VFL, and Constavu). Each patient had 20/20 uncorrected vision and normal accommodation in the other eye. We evaluated both subjective and objective parameters of comfort and vision for all four lenses. We found no significant overall performance advantage among the four lenses based on comfort, visual satisfaction, visual acuity, contrast sensitivity, or wear-related corneal complications.

Adolescent↗

Accommodative intraocular lenses for age-related cataracts.

The standard intraocular lens (IOL) that is used to replace a cataractous lens cannot change focus from distant to near objects, so most patients need glasses for near vision after cataract surgery. Limited evidence suggests that accommodative IOLs provide better near vision than monofocal IOLs, but not better than multifocal IOLs. Long-term follow-up is needed to confirm patient outcomes, and determine whether the benefits justify the additional cost.

Accommodation, Ocular↗