The role of parental health beliefs in seeking an eye examination for their child.

BACKGROUND: We aimed to explore the role of parental health beliefs in parent seeking of eye examinations for their children, using the Health Belief Model. METHODS: In this quantitative correlational survey study, 100 parents who presented to Barzilai University Medical Center in July 2021 to perform an eye examination to their child completed a questionnaire. RESULTS: Only 29.6% of the parents knew that a vision screening is performed in first grade, and 10% of the parents were unsure about where to find local eye care for their kids. Moreover, 19% of the parents indicated that they were concerned that their child would be prescribed glasses unnecessarily, and 10% believed that wearing glasses would weaken their child's eyes. Various parental health beliefs regarding children's eye examinations were found associated with parent seeking of eye examinations for their child. Thus, perceived susceptibility (r = 0.52, p < 0.01), perceived benefits (r = 0.39, p < 0.01), and perceived barriers (r=-0.31, p < 0.01) are associated with parent seeking of eye examinations for their child. Also, parents' level of knowledge was associated with seeking eye examinations for their child (r = 0.20, p < 0.01). CONCLUSION: Parent perceptions of the child's susceptibility to vision problems and perceived barriers to seeking eye examinations predicted parents seeking of eye examinations for their child. Interventions aimed at increasing timely eye examinations among children should focus on raising parent awareness of vision problems in childhood, dispelling misconceptions, and providing parents with practical information regarding available services.

An investigation of barriers and enablers to community eye care for children in England: A qualitative descriptive study.

PURPOSE: Research suggests that there are challenges in the accessibility of eye care for children in England. This study explores the barriers and enablers to eye examinations for children under 5 years of age from the perspective of community optometrists in England. METHODS: Optometrists working in community settings were invited to participate in virtual focus group discussions using an online platform based on a topic guide. The discussions were audio-recorded, transcribed and thematically analysed. Themes were derived from the focus group data based on the study aim and research question. RESULTS: Thirty optometrists participated in the focus group discussions. The overarching themes identified as barriers to eye examinations for young children in a community setting were as follows: 'Time and Money', 'Knowledge, Skills and Confidence', 'Awareness and Communication', 'Range of Attitudes' and 'Clinical Setting'. The key themes for enabling eye examinations for young children were as follows: 'Improving behaviour', 'Enhancing training and education', 'Enhancing eye care services', 'Raising awareness', 'Changes in professional bodies' and 'Balancing commercial pressures and health care'. CONCLUSION: Time, money, training and equipment are perceived by optometrists as key factors in providing an eye examination for a young child. This study identified a need for improved training and robust governance related to eye examinations for young children. There is a need for change within eye care service delivery such that all children, regardless of age and ability, are examined regularly, and by conducting these examinations, optometrists remain confident.

Validation of a simple-to-use, affordable, portable, wavefront aberrometry-based auto refractometer in the adult population: A prospective study.

BACKGROUND: Refraction is one of the key components of a comprehensive eye examination. Auto refractometers that are reliable and affordable can be beneficial, especially in a low-resource community setting. The study aimed to validate the accuracy of a novel wave-front aberrometry-based auto refractometer, Instaref R20 against the open-field system and subjective refraction in an adult population. METHODS: All the participants underwent a comprehensive eye examination including objective refraction, subjective acceptance, anterior and posterior segment evaluation. Refraction was performed without cycloplegia using WAM5500 open-field auto refractometer (OFAR) and Instaref R20, the study device. Agreement between both methods was evaluated using Bland-Altman analysis. The repeatability of the device based on three measurements in a subgroup of 40 adults was assessed. RESULTS: The refractive error was measured in 132 participants (mean age,30.53 ± 9.36 years, 58.3% female). The paired mean difference of the refraction values of the study device against OFAR was - 0.13D for M, - 0.0002D (J0) and - 0.13D (J45) and against subjective refraction (SR) was - 0.09D (M), 0.06 (J0) and 0.03D (J45). The device agreed within +/- 0.50D of OFAR in 78% of eyes for M, 79% for J0 and 78% for J45. The device agreed within +/- 0.5D of SR values for M (84%), J0 (86%) and J45 (89%). CONCLUSION: This study found a good agreement between the measurements obtained with the portable autorefractor against open-field refractometer and SR values. It has a potential application in population-based community vision screening programs for refractive error correction without the need for highly trained personnel.

Systematic review and meta-analysis on the agreement of non-cycloplegic and cycloplegic refraction in children.

OBJECTIVE: To determine the diagnostic agreement of non-cycloplegic and cycloplegic refraction in children. METHOD: The study methodology followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases were searched for comparative studies exploring refraction performed on children under non-cycloplegic and cycloplegic conditions. There was no restriction on the year of publication; however, only publications in the English language were eligible. Inclusion criteria consisted of children aged ≤12 years, any degree or type of refractive error, either sex and no ocular or binocular co-morbidities. The QUADAS-2 tool was used to evaluate the risk of bias. Meta-analysis was conducted to synthesise data from all included studies. Subgroup and sensitivity analyses were undertaken for those studies with a risk of bias. RESULTS: Ten studies consisting of 2724 participants were eligible and included in the meta-analysis. The test for overall effect was not significant when comparing non-cycloplegic Plusoptix and cycloplegic autorefractors (Z = 0.34, p = 0.74). The pooled mean difference (MD) was -0.08 D (95% CI -0.54 D, +0.38 D) with a prediction interval of -1.72 D to +1.56 D. At less than 0.25 D, this indicates marginal overestimation of myopia and underestimation of hyperopia under non-cycloplegic conditions. When comparing non-cycloplegic autorefraction with a Retinomax and Canon autorefractor to cycloplegic refraction, a significant difference was found (Z = 9.79, p < 0.001) and (Z = 4.61, p < 0.001), respectively. DISCUSSION: Non-cycloplegic Plusoptix is the most useful autorefractor for estimating refractive error in young children with low to moderate levels of hyperopia. Results also suggest that cycloplegic refraction must remain the test of choice when measuring refractive error ≤12 years of age. There were insufficient data to explore possible reasons for heterogeneity. Further research is needed to investigate the agreement between non-cycloplegic and cycloplegic refraction in relation to the type and level of refractive error at different ages.

Analgesia for retinopathy of prematurity screening: A systematic review.

BACKGROUND AND AIMS: Premature neonates require regular ophthalmological examination, generally indirect ophthalmoscopy, to screen for retinopathy of prematurity (ROP). Conventional analgesia is provided with topical anesthetic eyedrops and oral sugar solution, but neonates still experience significant pain. Here, the literature base was examined to evaluate the usefulness of other pharmacological analgesics. MATERIALS AND METHODS: A systematic review was undertaken, adhering to a PROSPERO preregistered protocol in accordance with PRISMA guidelines (identifier CRD42022302459). Electronic databases were searched for primary research articles on pharmacological pain interventions used for ROP screening in neonates. The primary outcome measure was pain scores recorded using validated pain scoring tools, with and without pharmacological interventions in neonates during eye examination. For analysis, studies were separated into two categories: topical anesthesia and alternative pharmacological treatments. RESULTS: Eleven studies met the inclusion criteria. Topical analgesia, oral paracetamol, and intranasal fentanyl were found to be effective in reducing the pain of eye examination. Oral morphine and inhaled nitrous oxide had no significant effect on premature infant pain profile (PIPP) scores during indirect ophthalmoscopy. DISCUSSION: In addition to topical anesthesia, premedication with oral paracetamol is recommended during screening examination for ROP. The routine use of fentanyl is not recommended due to the risk of potential side effects. Non-pharmacological measures, such as sweet oral solutions and comfort techniques should also be employed. Further research is required to determine whether the use of nitrous oxide has a role, and to develop a safe and effective analgesic strategy to fully ameliorate the pain of ROP screening.

How accessible is primary eye care for children in England?

PURPOSE: Good vision during childhood is vital for visual, educational, and social development. Previous research highlights challenges in the accessibility of eye care for children. This study investigates the accessibility of primary eye care for young children with typical development and those with autism in England. METHODS: A telephone survey was conducted using four hypothetical scenarios (a child aged 1, 3, 5 years and a 13-year-old with autism). Four hundred community optometric practices (100 different practices for each scenario) were contacted to explore the availability of an eye examination. The caller acted as a parent, asking about the availability of an eye examination for their child and raising concerns regarding the child. Key barriers and enablers to the accessibility of primary eye care were identified through an analysis of qualitative information. RESULTS: Of the 400 practices, only three (<1%) stated that they do not perform eye examinations on children. Fifty-six practices (14%) stated that they would examine a child at any age, the remainder (n = 341, 85%) specifying a minimum age at which they would perform eye examinations on children. Lack of 'communication' from the child and 'equipment' were identified as barriers to accessing eye care for young children. Eye care for children with autism was enabled by factors related to adaptability and appointment time. CONCLUSION: Our results suggest that communication and a lack of appropriate equipment for examining children are potential barriers to accessing primary eye care. No clear barriers were identified for an older child with autism. Eye examinations are more accessible for older children in these scenarios (aged 5 with typical development and 13 years with autism) than younger children (aged 1 and 3 years old). While the UK General Ophthalmic Services (GOS) terms do not permit contract holders to exclude categories of patients from a GOS eye exam, our findings suggest this is taking place.

Frequency of incidental ocular findings during pre-employment screening at a tertiary care Eye hospital.

OBJECTIVE: To highlight the prevalence of incidentally discovered ocular findings harvested amongst candidates of different age groups presented for pre-employment screening in a tertiary care eye hospital. METHODS: This Cross sectional prospective study was conducted in Armed Forces Institute of Ophthalmology, Rawalpindi, from Jun 2018 to Dec 2019. Data was collected using non-probability consecutive sampling technique. All candidates who appeared for medical fitness examination were included. Candidates belonged to various regions of Pakistan. Complete ophthalmic checkup including visual acuity, best corrected visual acuity, anterior and posterior segment examination was performed. The data analysis was done by IBM SPSS 2.0 software. RESULTS: One thousand and five hundred (1500) candidates underwent ophthalmic medical fitness examination during Jun 2018 to Dec 2019, out of these 86% (1290) were males and 14% (210) were females. Mean age of the candidates was 23.14 ± 5.66 years. The most common incidental ocular findings were amblyopia 24.6% (369), strabismus 10% (150), cataract 7.3% (110), macular scar 6.5% (100) and colour vision deficiencies 5.5% (82). CONCLUSION: The study demonstrates that out of total patients, 77% (1095) were found to be asymptomatic and 23% (405) were symptomatic. The study provides frequency for prevailing diseases and can help in improvement of eye care screening.

Use of Ocular Point-of-Care Ultrasound in a Difficult Pediatric Examination: A Case Report of an Emergency Department Diagnosis of Retinoblastoma.

BACKGROUND: Eye examination in distressed young children can be challenging in a busy emergency department. A full, detailed evaluation is, however, often needed in ocular emergencies. CASE REPORT: A 2-year-old boy presented to our pediatric emergency department with refusal to open his left eye for 1 day. Eye examination was difficult and yielded limited findings, despite analgesia and parental facilitation. Under such circumstances, this might require sedation or forcibly everting the child's eyelids for the eye evaluation. A rapid ocular point-of-care ultrasound was performed, which revealed sonographic findings suggestive of a retinoblastoma in the left eye. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The use of ocular point-of-care ultrasound facilitated the diagnosis of retinoblastoma in a child who was highly distressed and difficult to examine. Its use under such circumstances facilitated the patient's prompt evaluation and subsequent management.

Self-reported confidence with ocular examination and management of eye diseases by general medical practitioners.

AIMS: The aim of the study is to determine the confidence of general practitioners (GPs) with ophthalmic exam and management of eye diseases. MATERIALS AND METHODS: Using self-administered questionnaire, information on sociodemographics, medical practice experience, confidence with eye exam, and management of eye diseases was obtained from GP at the General Outpatient Department. Responses on level of confidence were ranked with Likert scale and analyzed with the Statistical Package for Social Science, version 23. RESULTS: Twenty-two GPs with mean medical practice experience of 17.4 ± 8.5 years participated. Twelve (54.5%) GPs routinely examined patients' eyes. Pen torch assessment of ocular surface was most commonly performed eye exam, 1 (4.6%) did visual acuity, while none performed ophthalmoscopy. Seventeen (77.3%) GPs rated themselves average or higher in interpreting pen torch examination of ocular surface. Expressed diagnostic confidence was highest for pterygium, 19 (86.4%), and low for interpreting visual acuity, 8 (36.4%); 13 (59.1%) were confident with diagnosing cataract. While all GPs (100.0%) were not confident with diagnosing and managing posterior segment diseases, 19 (86.4%) felt that they could confidently manage allergic and bacterial conjunctivitis, respectively. Seventeen (77.3%) GPs thought their undergraduate exposure in ophthalmology was inadequate and 21 (95.5%) felt that update courses in ophthalmology were necessary. CONCLUSIONS: Half of the GPs performed eye examination. Self-reported confidence in ophthalmoscopy, diagnosis, and management of posterior segment diseases was low among GPs. Diagnostic confidence was highest for pterygium. Continuing ophthalmic education and provision of basic ophthalmic equipment are recommended to improve confidence of GP in management of ocular disorders.

Cost-Utility Analysis of Extending Public Health Insurance Coverage to Include Diabetic Retinopathy Screening by Optometrists.

BACKGROUND: Diabetic retinopathy (DR) is one of the leading causes of vision loss and blindness in Canada. Eye examinations play an important role in early detection. However, DR screening by optometrists is not always universally covered by public or private health insurance plans. This study assessed whether expanding public health coverage to include diabetic eye examinations for retinopathy by optometrists is cost-effective from the perspective of the health care system. METHODS: We conducted a cost-utility analysis of extended coverage for diabetic eye examinations in Prince Edward Island to include examinations by optometrists, not currently publicly covered. We used a Markov chain to simulate disease burden based on eye examination rates and DR progression over a 30-year time horizon. Results were presented as an incremental cost per quality-adjusted life year (QALY) gained. A series of one-way and probabilistic sensitivity analyses were performed. RESULTS: Extending public health coverage to eye examinations by optometrists was associated with higher costs ($9,908,543.32) and improved QALYs (156,862.44), over 30 years, resulting in an incremental cost-effectiveness ratio of $1668.43/QALY gained. Sensitivity analysis showed that the most influential determinants of the results were the cost of optometric screening and selected utility scores. At the commonly used threshold of $50,000/QALY, the probability that the new policy was cost-effective was 99.99%. CONCLUSIONS: Extending public health coverage to eye examinations by optometrists is cost-effective based on a commonly used threshold of $50,000/QALY. Findings from this study can inform the decision to expand public-insured optometric services for patients with diabetes.

Content Design and System Implementation of a Teleophthalmology System for Eye Disease Diagnosis and Treatment and Its Preliminary Practice in Guangdong, China.

BACKGROUND: We have developed a new telemedicine system for comprehensive eye examination, diabetic retinopathy (DR) screening, and eye disease diagnosis and treatment. The novel points of the system include a tablet application for facilitating doctor's examination and diagnosis process, a comprehensive eye examination component, and integrated treatment planning and recording. METHODS: The system provided a new service model through one ophthalmological center linking with multiple remote and rural hospitals for eye care in Guangdong province, China. RESULTS: The early stage of the project study also undertook the responsibility of educations for remote-area doctors and image graders for DR grading and glaucoma grading and research on the effectiveness of short message service (SMS) reminder for patient revisit. Some other research, such as the comparison of the accuracy of graders' DR grading with the gold standard, and doctor's tentative diagnosis with final diagnosis and related statistical information, has been implemented in the system. In the preliminary practice, we summarized the outcomes related to presenting system performance and made an initial analysis. CONCLUSION: From the practice, the project has shown the telemedicine system and associated contents have satisfied our initial goal and demonstrated their effectiveness and efficiency.

Will the Affordable Care Act (ACA) Improve Racial/Ethnic Disparity of Eye Examination Among US Working-Age Population with Diabetes?

This study aimed to examine the racial/ethnic disparity of eye examination rates among US adults with diabetes before and after the ACA. Working-age adults (18-64 years) with diabetes for years 2014-2017 were simulated by bootstrapping from the working-age diabetes patient sample of Medical Expenditure Panel Survey (MEPS) Household Component 2011. Insurance coverage rates were separately predicted for each racial/ethnic group based on the Congressional Budgeting Office (CBO) report in 2014 and the proportions of Medicaid eligibility. Eye examination rates were weighted to national estimates and compared between racial/ethnic groups. Confidence intervals were estimated using the bootstrap percentile method. Health insurance coverage after the ACA is projected to increase from 90.23 % in 2011 to 98.33 % in 2014 among non-Hispanic Whites (NHW), reaching 98.96 % in 2017. Minorities are forecasted to have about 15 % expansion of insurance coverage from 2011 (80.65 %) to 2014 (96.00 %), reaching 97.25 % in 2017. In 2011, 63.01 % of NHW had eye examinations with forecasted increase to 65.83 % in 2014 and 66.05 % in 2017, while the eye examination rate in the minorities will increase from 55.75 % in 2011 to 59.23 % in 2014 and remain at 59.48 % in 2017. Therefore, racial disparity in eye examination rates is forecasted to persist (ranging from 6.57 % in 2017 to 6.69 % in 2016). The ACA is projected to improve the eye examination rate along with the expansion in insurance coverage. Although predicted racial/ethnic disparities will improve, some differences will persist. Comprehensive strategies need to be developed to eliminate the disparity.

Assessment of Emergency Department Eye Examinations in Patients Presenting with Mid-Face Injury.

BACKGROUND: One-fifth of patients with severe facial trauma suffer ophthalmic injury. Currently, patients presenting with mid-face injury to the emergency department (ED) undergo visual examination and then further assessment by ophthalmologists and with computed tomography (CT) scanning. The utility of the initial visual examination in the ED, performed by nonophthalmologists, remains unclear. OBJECTIVE: We aimed to objectively identify whether a more thorough initial visual assessment, performed by nonophthalmologists in the ED, was associated with improved ophthalmic outcomes. METHODS: Patients (n = 100) were retrospectively recruited from a tertiary craniomaxillofacial center. Visual examinations performed in the ED were scored objectively and measured against defined management and prognostic outcomes. RESULTS: There was no significant difference between more thorough initial visual examination and reduced time to ophthalmology assessment or reduced visual complications. There was no correlation between more comprehensive examination and incidence of CT scanning. CONCLUSIONS: We identified no significant difference between a comprehensive visual examination performed by nonophthalmologists in the ED, and improved ophthalmic outcomes. Physicians assessing patients with mid-face trauma in the ED should rule out eye emergencies, including retrobulbar hemorrhage and penetrating globe injury, and initiate expeditious CT scan and assessment by specialist ophthalmologists.

Fundus Photography in the 21st Century--A Review of Recent Technological Advances and Their Implications for Worldwide Healthcare.

BACKGROUND: The introduction of fundus photography has impacted retinal imaging and retinal screening programs significantly. LITERATURE REVIEW: Fundus cameras play a vital role in addressing the cause of preventive blindness. More attention is being turned to developing countries, where infrastructure and access to healthcare are limited. One of the major limitations for tele-ophthalmology is restricted access to the office-based fundus camera. RESULTS: Recent advances in access to telecommunications coupled with introduction of portable cameras and smartphone-based fundus imaging systems have resulted in an exponential surge in available technologies for portable fundus photography. Retinal cameras in the near future would have to cater to these needs by featuring a low-cost, portable design with automated controls and digitalized images with Web-based transfer. CONCLUSIONS: In this review, we aim to highlight the advances of fundus photography for retinal screening as well as discuss the advantages, disadvantages, and implications of the various technologies that are currently available.

Bilateral Concurrent Eye Examination with a Head-Mounted Perimeter for Diagnosing Functional Visual Loss.

The authors here report a case series where bilateral concurrent eye examination, using a head-mounted perimeter (imo®), was employed to facilitate diagnosis of functional visual loss, as regular ophthalmological tests were ineffective. Subjects (11-year-old female, 15-year-old male, and 24-year-old male) were diagnosed with unilateral functional visual loss by using the imo®, at the Kitasato University hospital. The results of the imo® and those of Goldmann perimetry or Humphrey Field Analyzer II differed for all subjects, which is indicative of potential functional visual loss. Bilateral concurrent examination with the imo® may become a standard for future diagnosis of unilateral functional visual loss.

Performing red reflex eye examinations increases the rate of neonatal conjunctivitis.

AIM: Red reflex eye examinations often require opening the eyelids, risking infection. We evaluated links between this procedure and neonatal conjunctivitis. METHODS: We divided 18 872 neonates of more than 35 weeks of gestation into two birth periods, 2008-2009 and 2010-2011, before and after red reflex examinations were carried out by our facility. The rates of clinical conjunctivitis, bacterial conjunctivitis and bacterial growth percentage were compared between the two periods. RESULTS: The 2010-2011 period included more Caesarean deliveries and longer lengths of stay (LOS) than the 2008-2009 period. The clinical conjunctivitis rate increased significantly during 2010-2011 (p = 0.029), but the bacterial conjunctivitis and bacterial growth percentages did not differ between the two periods. Variables that were independently and significantly associated with clinical conjunctivitis included being born in 2010-2011, with an odds ratio (OR) of 1.22, male gender (OR 1.31) and LOS (OR 1.19). Bacterial conjunctivitis was associated with vaginal delivery (OR 3.65), males delivered by Caesarean (OR 2.68) and LOS (OR 1.37). CONCLUSION: Clinical conjunctivitis was significantly associated with the later study period, male gender and LOS. Conjunctival swab sampling increased significantly following the implementation of red reflex examinations, but without changes in the bacterial conjunctivitis rate and the bacterial growth percentage.

Why don't younger adults in England go to have their eyes examined?

PURPOSE: Most research on attitudes to eye health has focussed on older people, reflecting the higher prevalence of eye diseases in older age groups. Little is known about younger people's attitudes to eye health. This paper explores young adults understanding of eye health and the purpose of eye examinations and the reasons why they do or do not attend for eye examinations. The aim is to provide evidence to inform policy on recommendations relating to eye health for individuals at low risk of visual impairment. METHODS: Six focus-group meetings were held in Leeds with 43 people aged 18-35 (mean age 22 years). Focus group participants were recruited using a snowballing approach from an initial group of young adults. Focus groups were transcribed and a thematic analysis approach was used. RESULTS: Children who wore spectacles were often bullied. As people grew up it became more socially acceptable to wear spectacles. Practicalities, aesthetics and fashion were important issues. Knowledge about eye disease and the eye examination were generally poor. Many claimed to value vision, but recognised that young people do not have eye examinations as often as they should. Eye examinations were only perceived to be needed for younger people experiencing problems or to update prescriptions. Eye health was seen as issue for older people. Some had no idea or were shocked about how much spectacles cost. Optometrists were seen differently to other healthcare professionals. The retail aspect of optometry was seen as too dominant. More information was wanted from the NHS on eye health. CONCLUSION: While young adults are at low risk of sight threatening disease, many do benefit from correction of refractive error. There is an argument for reducing the recommended frequency of eye examinations for low risk individuals from the 2 years currently advised. Nevertheless, young adults need to be made more aware of eye health issues, so that optometrists are seen as more than somewhere that sell spectacles. Increasing awareness of eye health in younger adulthood will also be important to ensure that services are appropriately accessed as they get older.

Why don't older adults in England go to have their eyes examined?

PURPOSE: Preventable sight loss is one of the Public Health Outcome Indicators in England. Despite availability of NHS-funded eye examinations, many people do not take up their entitlement. This paper explores older adults understanding of eye health and the purpose of eye examinations and the reasons why they do or do not attend for eye examinations. The aim is to provide evidence to inform policy on increasing uptake of eye examinations among older people who have increased risk of preventable sight loss. METHODS: 10 focus-group meetings were held with people living in deprived areas of Leeds, recruited via community groups and neighbourhood networks. Focus groups were transcribed and a thematic analysis approach was used. RESULTS: The majority of participants were aged over 60, wore spectacles, and had regular eye examinations. Most were eligible for a NHS-funded eye examination. There was poor knowledge about eye disease and the purpose of different elements of the eye examination. Participants felt very vulnerable about getting the tests 'wrong' and looking foolish. Wearing of spectacles was associated with appearing old and frail. Many did not trust the veracity of optometrists, and perceived opticians to be expensive places, where it was difficult to control spending. Many had experienced 'hard sell' and opaque pricing. Most, but not all, were happy with the optometric services received. Participants indicated a preference for utilising a local optometrist located alongside other familiar health care services. CONCLUSION: Not-for-profit services co-located with other public services are needed to address concerns about cost of spectacles, lack of trust in optometrists, and poor access to eye examinations in local settings. It will also be important to raise public understanding about the purpose of eye examinations in terms of other causes of preventable sight loss and not just refractive error and need for spectacles.

Oral sucrose and non-nutritive sucking goes some way to reducing pain during retinopathy of prematurity eye examinations.

AIM: To evaluate the efficacy of oral sucrose combined with non-nutritive sucking for reducing pain associated with retinopathy of prematurity screening. METHODS: This was a randomised controlled study of 64 infants undergoing eye examination for retinopathy of prematurity screening. Topical anaesthetic (Proparacaine; Alcaine(®) drop 0.5%: ALCON CANADA Inc., Mississauga, Canada) was applied 30 sec before the eye examination in all infants. The infants in intervention group (Group 1, n = 32) received 0.5 mL/kg of 24% sucrose with a pacifier. The control group (Group 2, n = 32) received 0.5 mL/kg of sterile water with a pacifier. RESULTS: The groups had similar gestational ages (28.5 ± 2.8 weeks), mean birthweight (1304 ± 466 g) or corrected gestational age (35.4 ± 3.7 weeks) at examination. The intervention group had a significantly lower mean Premature Infant Pain Profile score during examination of the first eye, following insertion of the speculum (Group 1:13.7 ± 2.1 vs. Group 2:16.4 ± 1.8, p = 0.001). CONCLUSION: Although sucrose combined with non-nutritive sucking modestly reduces pain scores during eye examinations, there is need to further studies to explore significant pain relief for infants undergoing retinopathy of prematurity screening.