ABSTRACT
Objectives: Determining the accuracy of cycloplegic refractive error measurements made with the Spot Vision Screener (SVS, Welch Allyn Inc, Skaneateles Falls, NY, USA) is important for refractive assessment of uncooperative patients during optometric examinations. This study compared cycloplegic refractive errors measured by SVS and tabletop autorefractometer to cycloplegic retinoscopy in children. Materials and Methods: Eighty-eight eyes of 44 subjects were examined in the study. Refractive error measurements were obtained under cycloplegia using retinoscopy, SVS, and Nidek ARK-530 tabletop autorefractometer (ARK-530, Nidek, Japan). Spherical and cylindrical values, spherical equivalents (SE), and Jackson cross-cylinder values at axes of 0° (J0) and 45° (J45) were recorded. Correlations between methods were analyzed using intraclass correlation coefficient (ICC) and Bland-Altman analysis. Results: The mean age was 7 years (range: 6 months-17 years). Sixteen (36%) of the subjects were female and 28 (64%) were male. For SE there was excellent agreement between retinoscopy and SVS (ICC: 0.924) and between retinoscopy and tabletop autorefractometer (ICC: 0.995). While there was a moderate correlation between retinoscopy and SVS for cylindrical values (ICC: 0.686), excellent correlation was detected between retinoscopy and autorefractometer (ICC: 0.966). J0 and J45 crosscylinder power values were not correlated between retinoscopy and SVS (ICC: 0.472) or retinoscopy and tabletop autorefractometer (ICC: 0.442). Retinoscopy was correlated with both SVS and tabletop autorefractometer for all parameters within ±1.96 standard deviations in Bland-Altman analysis. Conclusion: Cycloplegic retinoscopy is the gold standard for refractive error measurement in the pediatric population. However, it requires time and experienced professionals. This study revealed moderate to good agreement between SVS and retinoscopy, with better agreement in spherical errors than cylindrical errors. Although the SVS is intended for screening programs, it may also be useful in the pediatric eye office to estimate spherical refractive error in uncooperative patients.
Subject(s)
Refraction, Ocular , Refractive Errors , Retinoscopy , Vision Screening , Humans , Female , Male , Child , Retinoscopy/methods , Adolescent , Child, Preschool , Refraction, Ocular/physiology , Refractive Errors/diagnosis , Refractive Errors/physiopathology , Infant , Reproducibility of Results , Vision Screening/instrumentation , Vision Screening/methods , Mydriatics/administration & dosageABSTRACT
PURPOSE: To evaluate the impact of soft contact lens (CL) wear on the morphology and function of the meibomian glands (MG). METHODS: One hundred seventy-three eyes of 87 soft CL wearers and 103 eyes of 55 age-matched healthy volunteers were included into this study. The patients were divided into 3 groups according to the total duration of lens wear: less than 3 years, 3 to 7 years, and more than 7 years. Ocular Surface Disease Index (OSDI) scores, slitlamp biomicroscopy findings, fluorescein staining of the ocular surface, tear film break-up time (BUT), Schirmer I test, and meibography findings were recorded in all patient eyes and were compared with controls. RESULTS: The mean meiboscores of the upper and lower eyelids were significantly higher in CL wearers compared with controls (P<0.05). The mean BUT and the mean MG expressibility were significantly lower, whereas the mean OSDI score, corneal staining scores, percentage of partial/complete gland loss, and percentage of thickened and curled MG in upper/lower lids were statistically significantly higher in CL wearers (P<0.05). Meiboscores were significantly higher in patients with a total lens wear duration of more than 3 years compared to those with less than 3 years of lens wear for both upper/lower lids (P<0.05). The earliest morphological change in the MG of CL wearers was MG thickening, and this parameter was the only meibography finding that had the highest diagnostic ability for MG dysfunction. CONCLUSION: Soft CL wear causes significant morphological and functional changes in MG with thickening of MG presenting an early diagnostic finding of MG dysfunction on meibography.
Subject(s)
Contact Lenses, Hydrophilic/adverse effects , Eyelid Diseases/etiology , Hyperopia/therapy , Meibomian Glands/pathology , Myopia/therapy , Adult , Cross-Sectional Studies , Eyelid Diseases/diagnosis , Eyelid Diseases/physiopathology , Female , Humans , Male , Staining and Labeling , Tears/physiologyABSTRACT
Anterior segment optical coherence tomography (AS-OCT) is a relatively new imaging modality that allows assessment of anterior segment structures. AS-OCT enables the differentiation of benign and malignant tumors through the evaluation of lesion size, internal structure, degree of vascularity, and anterior and posterior surfaces. Herein, we discuss the AS-OCT findings of a patient with spindle type iridociliary melanoma diagnosed in pathologic examination.
