Spectacles utilization and its impact on health-related quality of life among rural Chinese adolescents.

PURPOSE: The aims of the study were to assess the magnitude and predictors of the unmet need for spectacles utilization and to quantify its impact on health-related quality of life (HRQOL) among rural Chinese adolescents. METHODS: This school-based survey of 2346 grade-7 students (mean age: 13.8 years) was conducted in Southwestern China in 2016. Spectacles need was defined as uncorrected visual acuity (VA) of 20/40 or worse but correctable to 20/40 or better in the better-seeing eye, together with the presence of myopia of less than -0.5 diopters (D), hyperopia of more than +2.0 D, or astigmatism of more than 0.75 D in both eyes. The HRQOL was measured using self-reported versions of 23-item Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales (PedsQL 4.0). RESULTS: Among 579 (24.7%) adolescents with an uncorrected VA of 20/40 or less, 483 (83.4%) needed vision corrections and 172 (35.6%) used them. Higher parental education levels (odds ratio (OR) = 2.73; 95% CI, 1.29-5.77), negative attitude regarding spectacles (OR = 0.49; 95% CI, 0.25-0.97), and poorer uncorrected VA (OR = 31.27; 95% CI, 3.76-260.23) were independent determinants for spectacles utilization. Adolescents not using spectacles had a lower HRQOL score compared to those using spectacles in terms of psychosocial health (65.91 vs. 70.59; P = 0.028), emotional health (56.85 vs. 63.24; P = 0.012), and social functioning (72.99 vs. 78.60; P = 0.036). CONCLUSIONS: The rate of spectacles utilization in rural China was low. Adolescents were not accustomed to use spectacles had a worse HRQOL score.

Portable electronic vision enhancement systems in comparison with optical magnifiers for near vision activities: an economic evaluation alongside a randomized crossover trial.

PURPOSE: To determine the incremental cost-effectiveness of portable electronic vision enhancement system (p-EVES) devices compared with optical low vision aids (LVAs), for improving near vision visual function, quality of life and well-being of people with a visual impairment. METHODS: An AB/BA randomized crossover trial design was used. Eighty-two participants completed the study. Participants were current users of optical LVAs who had not tried a p-EVES device before and had a stable visual impairment. The trial intervention was the addition of a p-EVES device to the participant's existing optical LVA(s) for 2 months, and the control intervention was optical LVA use only, for 2 months. Cost-effectiveness and cost-utility analyses were conducted from a societal perspective. RESULTS: The mean cost of the p-EVES intervention was £448. Carer costs were £30 (4.46 hr) less for the p-EVES intervention compared with the LVA only control. The mean difference in total costs was £417. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of £736 (95% CI £481 to £1525) for a 7% improvement in near vision visual function. Cost per quality-adjusted life year (QALY) ranged from £56 991 (lower 95% CI = £19 801) to £66 490 (lower 95% CI = £23 055). Sensitivity analysis varying the commercial price of the p-EVES device reduced ICERs by up to 75%, with cost per QALYs falling below £30 000. CONCLUSION: Portable electronic vision enhancement system (p-EVES) devices are likely to be a cost-effective use of healthcare resources for improving near vision visual function, but this does not translate into cost-effective improvements in quality of life, capability or well-being.

The p-EVES study design and methodology: a randomised controlled trial to compare portable electronic vision enhancement systems (p-EVES) to optical magnifiers for near vision activities in visual impairment.

PURPOSE: To describe the study design and methodology for the p-EVES study, a trial designed to determine the effectiveness, cost-effectiveness and acceptability of portable Electronic Vision Enhancement System (p-EVES) devices and conventional optical low vision aids (LVAs) for near tasks in people with low vision. METHODS: The p-EVES study is a prospective two-arm randomised cross-over trial to test the hypothesis that, in comparison to optical LVAs, p-EVES can be: used for longer duration; used for a wider range of tasks than a single optical LVA and/or enable users to do tasks that they were not able to do with optical LVAs; allow faster performance of instrumental activities of daily living; and allow faster reading. A total of 100 adult participants with visual impairment are currently being recruited from Manchester Royal Eye Hospital and randomised into either Group 1 (receiving the two interventions A and B in the order AB), or Group 2 (receiving the two interventions in the order BA). Intervention A is a 2-month period with conventional optical LVAs and a p-EVES device, and intervention B is a 2-month period with conventional optical LVAs only. RESULTS: The study adopts a mixed methods approach encompassing a broad range of outcome measures. The results will be obtained from the following primary outcome measures: Manchester Low Vision Questionnaire, capturing device 'usage' data (which devices are used, number of times, for what purposes, and for how long) and the MNRead test, measuring threshold print size, critical print size, and acuity reserve in addition to reading speed at high (≈90%) contrast. Results will also be obtained from a series of secondary outcome measures which include: assessment of timed instrumental activities of daily living and a 'near vision' visual functioning questionnaire. A companion qualitative study will permit comparison of results on how, where, and under what circumstances, p-EVES devices and LVAs are used in daily life. A health economic evaluation will provide results on: the incremental cost-effectiveness of p-EVES compared to optical magnifiers; cost-effectiveness; and cost-utility. CONCLUSIONS: The evidence base in low vision rehabilitation is modest and further high quality clinical trials are required to inform decisions on healthcare provision. The p-EVES study findings are anticipated to contribute to this broader evidence requirement, with the methodological issues evident here being relevant to other trials within the field.

[Ophthalmological assessment of professionally significant functions in persons undergone laser myopia correction].

Professionally significant functions (visual acuity, color vision and its parameters, and dark adaptation and its parameters) were determined in moderate and severe myopia before and after its excimer laser correction by the LASIK method: in early (1, 3 months) and late (6, 12 months) periods after surgery to decide where the operated persons are allowed to have the jobs associated with railway traffic safety. Sixty-one patients with moderate and severe myopia and 23 control individuals were examined at the Moscow Research and Technological Complex "Eye Surgery". The examinations have demonstrated that the values of visual acuity, color vision, and dark adaptation considerably improved. Whether the persons undergone excimer laser myopia correction are allowed to have the jobs associated with railway transport safety should be individually decided, by taking into account the postoperative recovery of professionally significant visual functions.