Home vision therapy and prism prescription in presbyopic persons with convergence insufficiency: study protocol for a randomized controlled trial.

BACKGROUND: Convergence insufficiency is a common issue in the field of binocular vision. Various treatment options have been suggested for managing this condition, but their efficacy in individuals with presbyopia remains unclear. The objective of this study is to compare the effectiveness of home-based vision therapy and prism prescription, in presbyopic patients with convergence insufficiency. METHODS/DESIGN: It is a randomized, prospective, double-blind clinical trial, with total of 150 participants randomly assigned to the three groups. The Control Group will receive a new near glasses as a conventional prescription, along with aimless and random eye movement exercises that do not have any convergence or accommodation effects. The Home Vision Therapy Group will receive new near glasses with accommodative and convergence eye exercises. The Prism Group will receive a near prismatic glasses prescribed using the Sheard's criterion. All treatments will be administered for a period of 2 months, and measurements of the modified convergence insufficiency symptoms survey (CISS), near point convergence, near phoria, and positive fusional vergence will be taken at baseline, one month later, and at the end of the treatment. DISCUSSION: We aim to identify which component - either the prism prescription or the home vision therapy - is more effective in improving binocular abilities and reducing patients' symptom scores. TRIAL REGISTRATION: ClinicalTrials.gov NCT05311917 with last update on 04/22/2023.

Acute spinal cord injury serum biomarkers in human and rat: a scoping systematic review.

STUDY DESIGN: Scoping systematic review. OBJECTIVES: To summarize the available experimental clinical and animal studies for the identification of all CSF and serum-derived biochemical markers in human and rat SCI models. SETTING: Tehran, Iran. METHODS: In this scoping article, we systematically reviewed the electronic databases of PubMed, Scopus, WOS, and CENTRAL to retrieve current literature assessing the levels of different biomarkers in human and rat SCI models. RESULTS: A total of 19,589 articles were retrieved and 6897 duplicated titles were removed. The remaining 12,692 studies were screened by their title/abstract and 12,636 were removed. The remaining 56 were considered for full-text assessment, and 11 papers did not meet the criteria, and finally, 45 studies were included. 26 studies were human observational studies comprising 1630 patients, and 19 articles studied SCI models in rats, including 832 rats. Upon reviewing the literature, we encountered a remarkable heterogeneity in terms of selected biomarkers, timing, and method of measurement, studied models, extent, and mechanism of injury as well as outcome assessment measures. CONCLUSIONS: The specific expression and distribution patterns of biomarkers in relation to spinal cord injury (SCI) phases, and their varied concentrations over time, suggest that cerebrospinal fluid (CSF) and blood biomarkers are effective measures for assessing the severity of SCI.

Refractive error and vision related quality of life.

BACKGROUND: To investigate and compare the vision-related quality of life (QOL) in different types of refractive error (RE). METHODS: This cross-sectional study was performed on 200 subjects, categorized into four groups of 50 each, consisting of subjects with myopia, hyperopia, astigmatism, and emmetropia, the latter being the control group. The mean age of the participants was 23.88 ± 5.87 (range, 15 to 38: 110 females and 90 males). RE was defined as myopia, spherical equivalent (SE) < -0.25 diopters (D), hyperopia, SE > + 0.25 D, astigmatism, cylinder < -0.25 D, and emmetropia (-0.25 ≤ SE(D) ≤ + 0.25, cylinder ≥ -0.25). Groups are subdivided into very low magnitudes of RE (0.50 and 0.75) and significant RE (1.00 ≤). Vision-related QOL was assessed using the Persian version of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The NEI-VFQ was scored as visual function and socioemotional scales using Rasch analysis. RESULTS: Corrected myopia, astigmatism, uncorrected myopia, and hyperopia had a lower vision-related QOL than emmetropes. (P < 0.001). Vision-related QOL in myopic subjects was lower than that in astigmatic participants. Very low myopes, who often do not use correction, had a significantly lower QOL than other groups. CONCLUSION: Individuals with refractive errors experience a lower QOL score than those without. Notably, the adverse impact on QOL score is significantly greater in myopic cases, particularly very low myopia, compared to other refractive errors. Therefore, it is strongly recommended not to neglect managing very low myopia since it may improve participants' QOL.

Effect of corneoscleral lenses on visual acuity and corneal parameters in patients with keratoconus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of wearing corneoscleral contact lens on visual acuity, and corneal parameters in keratoconus patients.METHODS:In this prospective study, 43 cases(83 eyes)with keratoconus were included and examined. A corneoscleral contact lens was fitted, and thorough exams were carried out at baseline, 3 and 6 mo after wearing lenses, including slit lamp examination, objective and subjective refraction, uncorrected visual acuity(UCVA), and best-corrected visual acuity(BCVA), keratometry(Kmax, K1 and K2), central corneal thickness and endothelial cells count.RESULTS: Mean BCVA(LogMAR)improved from 0.34±0.23 with the spectacles to 0.03±0.05 with the corneoscleral contact lenses in 6 mo(P&#x003C;0.001). Kmax changed from 52.80±5.93 D to 51.51±5.64 D in 6 mo(P&#x003C;0.001), central corneal thickness changed from 483.84±34.69 μm to 476.28±35.38 μm(P&#x003C;0.001), and endothelial cell count changed from 2559.18±275.7 cells/mm2 to 2572.73±274.3 cells/mm2 after wearing corneoscleral contact lens for 6 mo(P&#x003C;0.001).CONCLUSION: Corneoscleral lenses could significantly increase visual acuity, since there were no clinical noticeable changes in the corneal parameters, this lenses can be used safely in patients with keratoconus.

Effect of changing mesopic and photopic light conditions on visual functions.

AIM: To determine the effects of change in light conditions on refractive error and visual functions including visual acuity, stereopsis and contrast sensitivity. METHODS: This cross-sectional study was conducted in the optometry clinic of the Shahid Beheshti School of Rehabilitation on 48 students in 2021-2022. All of them had eye health and normal visual function and could have refractive errors or not. Light intensity of 4 lx was considered equivalent to photopic light condition and light intensity of 1 lx was considered to be equivalent to mesopic light condition. The amount of refractive error was checked by auto refractometer and its changes in mesopic light condition were subjectively measured. Also, visual acuity, stereopsis and contrast sensitivity (in five spatial frequencies of 1.5, 3, 6, 12, and 18 cycles per degree), were measured first in photopic light condition and then in mesopic light condition, by Snellen control vision chart, stereo butterfly test and the M&S technology monitor test respectively. RESULTS: In the 48 student subjects with an average age of 22.69±3.56y, mean of refractive error as sphere equivalent, visual acuity and stereopsis were -1.25±1.74 diopters, 0 logMAR, 44.37±13.03 seconds of arc, respectively in photopic light condition while in mesopic light was equal to -1.56±1.75 diopters, 0.12±0.09 logMAR and 50.62±33.35 seconds of arc, respectively. The mean of contrast sensitivity measured at spatial frequencies of 1.5, 3, 6, 12, and 18 cycles per degree in photopic condition was equal to 2.38±0.04, 2.37±0.07, 2.04±0.21, 1.27±0.32, 0.82±0.27 logarithm of contrast sensitivity, respectively and in mesopic lighting condition was equal to 2.34±0.12, 2.30±0.16, 1.84±0.28, 1.02±0.28, 0.63±0.24 logarithm of contrast sensitivity, respectively. Statistical analysis showed a significant difference between the two lighting conditions in all evaluated variables [refractive error (P<0.001), visual acuity (P<0.001), stereopsis (P=0.008) and contrast sensitivity (P<0.001)]. CONCLUSION: The refractive error of the student subjects in mesopic light condition change towards myopia, and its amount is clinically significant. Also, the examination and comparison of the factors of visual acuity, stereopsis and contrast sensitivity in these two lighting conditions show that the decrease in brightness level to the mesopic level causes a decrease in the aforementioned visual functions.

Clinico-cytopathological subcategorization in thyroid nodules of atypia of undetermined significance/follicular lesion of undetermined significance using the TIRADS and Bethesda classifications.

Introduction: Bethesda category III - atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) is a heterogeneous class of the Bethesda system for thyroid nodules. In order to clarify the therapeutic road for clinicians, this category was subclassified based on the cytopathological features. In this study, we evaluated the risk of malignancy, surgical outcome, demographic characteristics, and correlation of ultrasound features with the final outcome in patients with thyroid nodules based on AUS/FLUS subclassification. Method: After evaluating 867 thyroid nodules from three different centers, 70 (8.07%) were initially diagnosed as AUS/FLUS. The cytopathologists re-interpreted the FNA samples and subclassified them into five subcategories: architectural atypia, cytologic atypia, cytologic and architectural atypia, and Hürthle cell AUS/FLUS, and atypia, which was not specified. Based on the suspicious ultrasound features, an appropriate ACR TI-RADS score was allocated to each nodule. Finally, the malignancy rate, surgical outcomes, and ACR TI-RADS scores were evaluated among Bethesda category III nodules. Results: Among the 70 evaluated nodules, 28 (40%) were subclassified as Hürthle cell AUS/FLUS, 22 (31.42%) as cytologic and architectural atypia, 8 (11.42%) as architectural atypia, 7 (10%) as cytologic atypia, and 5 (7.14%) as atypia which was not specified. The overall malignancy rate was 34.28%, and the architectural atypia and Hürthle cell nodules displayed lower malignancy compared to other groups (P-Value<0.05). Utilizing ACR TI-RADS scores showed no statistical significance between Bethesda III subcategorization and ACR TI-RADS scores. However, ACR TI-RADS can be a reliable predictor for Hürthle cell AUS/FLU nodules. Conclusion: ACR TI-RADS helps evaluate malignancy only in the Hürthle cell AUS/FLUS subcategory of AUS/FLUS. Besides, cytopathological reporting based on the suggested AUS/FLUS subclassification could help clinicians take appropriate measures to manage thyroid nodules.

Prevalence and risk factors of keratoconus (including oxidative stress biomarkers) in a cohort study of Shiraz university of medical science employees in Iran.

BACKGROUND: To determine the prevalence of keratoconus in Shiraz University of Medical Sciences Employees and the related risk factors including oxidative stress biomarkers. METHODS: 2546 subjects' mean age ± SD, 40.35 ± 6.70 (46% male) were recruited. All participants underwent objective refraction using auto-refractometer and retinoscopy, followed by subjective refraction, and bio-microscopy. Pentacam imaging was performed for the detected keratoconus patients. The prevalence of keratoconus and frequency of the visual impairment among keratoconus cases were evaluated. Potential risk factors of sex, age, family history of keratoconus, body mass index ≥ 30 kg/m2, serum levels of glucose ≥ 100 mg/d, low-density-lipoprotein-cholesterol (LDL) ≥ 110 mg/dL, high-density-lipoprotein-cholesterol ≤ 40 mg/d, and triglycerides ≥ 150 mg/dL in the blood were evaluated. RESULTS: The prevalence of keratoconus at least in one eye was 0.98% (95% CI: 0.6- 1.4%). The best corrected visual acuity in the keratoconus group was 0.06 ± 0.1 and the rest of the population was 0.01 ± 0.07 logMAR (p < 0.001). The frequency of visual impairment in the keratoconus group was zero. Odds ratios of the family history of keratoconus (21.00, 95% CI: 9.00-48.00, p < 0.001) and LDL ≥ 110 mg/dL (3.00, 95% CI: 1.20-6.40, p = 0.01) were significant. CONCLUSIONS: Keratoconus is rare and is not considered a risk factor for visual impairment. A family history of keratoconus and elevated serum LDL levels are contributing risk factors, suggesting an inflammatory background for the disease. Serum levels of LDL ≥ 110 mg/dL in the blood increased the risk of keratoconus three folds.

Investigating the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic.

BACKGROUND: Pre-hospital emergency staffs as the frontline forces fighting against COVID -19 have been affected by this pandemic. Today, the occupational and mental health of these individuals is particularly important to the health care system. Death anxiety is one of the inevitable things in this job, and not paying attention to it can cause unwanted effects such as changing the level of job satisfaction of the personnel. The purpose of this study was to determine the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic. METHODS: This cross-sectional descriptive study was conducted among pre-hospital emergency staffs in Qazvin Province, Iran in 2021-2022. Among the bases chosen by the census method, 198 samples were included in the study by the available method. Data collection tools included the Demographic Checklist, Templer's Death Anxiety scale, and the Minnesota Job Satisfaction Questionnaire. The data were analyzed with descriptive and inferential statistics and SPSS 20 software. RESULTS: The mean age of the samples was (33.14 ± 6.77). 167 persons were male and the others were female. The average job satisfaction and death anxiety of the personnel were 55.07 ± 11.50 and 8.18 ± 1.96, respectively. Pearson's correlation coefficient between the two variables was r = -0.126 And a null correlation coefficient hypothesis has been confirmed with p-value = 0.077. CONCLUSIONS: The results showed a high level of death anxiety and average job satisfaction. Although these two variables do not have a significant relationship with each other, considering that they do not have the appropriate level, it needs more investigation and consideration.

Prevalence of refractive errors and color vision deficiency in a population of industry-workers in Abhar, Iran.

ABSTRACT: Visual impairment due to refractive errors and color vision deficiency (CVD) can affect the visual abilities of workers in workplace. Identifying the prevalence of common visual problems helps us to prevent and treat occupational ocular problems.This study was conducted on 2600 males referring from companies for a routine medical exam to Occupational Medicine Center. In all subjects, visual acuity and refraction were measured. Assessment of color vision was performed by Ishihara color test. In present study, right eyes of subjects were selected to statistical analysis.The mean spherical equivalent was -0.19 ±â€Š1.39 diopter with a range of -11.00 to +10.00 diopter. Whereas 71% of persons were emmetropic, 20% and 9% of them were myopic and hypermetropic, respectively. From a total subjects, 164 of them had CVD with prevalence of color blindness of 6.3%. In comparison with normal subjects, CVD had no significant effect on refractive findings of our subjects (P > .05).Our data present the prevalence of refractive errors and color blindness among Iranian industry-workers. Compared with other studies, our subjects have a lower prevalence of refractive errors, and similar rate of prevalence of color blindness.

A new glaucoma drainage implant with the use of Polytetrafluoroethylene (PTFE). A pilot study.

Purpose: To investigate the implantation of Polytetrafluoroethylene (PTFE) as a glaucoma drainage device. Methods: This study has been done in two steps. First, the constructed implants have been used in 4 rabbits and the histopathologic response was evaluated. In the second step, the implants were used in the 6 eyes of 6 patients with end-stage glaucoma with uncontrolled IOP and poor visual acuity. The tube was made of two-layer of PTFE membrane measuring 8 * 6 mm with a thickness of 1.8 mm and a silicone tube. The rabbits and the human eyes underwent surgical implantation of the tube in the anterior chamber. The histopathologic evaluation was done using H&E staining. Visual acuity, intraocular pressure and the number of glaucoma medications were assessed before and after the surgery. Results: In the histopathologic evaluation, subconjunctival polarizing fibers of a synthetic mesh infiltrated by fibrovascular septa was seen. A granulomatous inflammatory reaction composed of histiocytes, lymphocytes, and multinucleated giant cells were seen around and between the synthetic bundles. The average age of patients was 63 ± 5.5 years. The mean IOP reached from 36.6 ± 5.7 mmHg at baseline to 16.2 ± 8.9 mmHg at the final follow-up. Patients were followed for an average of 6.6 ± 4.5 months. One patient found hypotony refractory to medical and surgical treatment, which led to implant removal. One patient had uncontrolled IOP and finally led to phthisis bulbi following slow CPC. The remaining four eyes did well during the follow-up. Conclusion: The use of PTFE as a new polymer in tube shunt construction was reported. Larger studies, modification of the PTFE membranes like changing the porosity amount, and size of PTFE membranes might result in different conclusions.

An analysis of factors associated with graft topographic outcomes after deep anterior lamellar keratoplasty.

PURPOSE: To investigate the correlations between preoperative, operative, and postoperative factors and corneal graft topographic parameters after deep anterior lamellar keratoplasty (DALK) performed in keratoconus-affected eyes. METHODS: This prospective, interventional study enrolled 44 eyes. Graft topographic parameters, including keratometric astigmatism and the surface regularity index (SRI), were assessed after complete suture removal. Univariate analyses were used to evaluate the effects of preoperative factors (donor quality, donor and recipient age, keratoconus severity), operative factors (graft size, donor button roundness, roundness and centration of the donor-recipient junction), and postoperative factors (time point of suture removal) on postoperative topographic parameters. RESULTS: The roundness of the donor-recipient junction after complete suture removal had a significant association with the roundness of the donor button after trephination (P = 0.04) and the amount of graft decentration relative to the limbus (P = 0.03). A significant correlation was found between the value of graft decentration relative to the limbus and postoperative keratometric astigmatism (P = 0.001) and between the roundness of the donor-recipient junction and the postoperative SRI (P = 0.02). The flat axis of the keratometric astigmatism and the longer axis of the graft lay in the direction of graft displacement. Other investigated factors had no significant association with postoperative topographic indices. CONCLUSION: Graft displacement relative to the limbus and roundness of the donor-recipient junction were the main predictors of graft astigmatism and regularity, respectively, after DALK. Noncircularity of the donor button after trephination could increase the graft surface irregularity indirectly by influencing the roundness of the surgical wound.

Vitamin A-Related Policies in Iran: Document Analysis.

BACKGROUND: There are one-third of children in the world with Vitamin A deficiency. The prevalence of vitamin deficiency in children aged 15-23 months in Iran has increased 18 times and in rural areas. The present article aims to an analysis of related documents to the existing policies on this vitamin in our country. MATERIALS AND METHODS: This study is a descriptive study using a quantitative content analysis approach to analyze nutritional policy documents. RESULTS: We extracted six themes at the first stage of analysis (based on common policies in the world), which were reduced to two final themes: "Direct interventions" and "Indirect interventions." There were also six subthemes and eight issues. CONCLUSIONS: It seems that policymaking must revise these documents and also making new policy decision with more emphasis on micronutrient.

Histopathologic Evaluation of Polymer Supports for Pintucci-type Keratoprostheses: An Animal Study.

PURPOSE: To report histopathological findings for different types of polymers proposed as support for a Pintucci-type keratoprosthesis. METHODS: Six polymers, including three types of polyesters ( # 1-3), one type of polytetrafluoroethylene (PTFE, # 4), polyethylene ( # 5), and expanded polytetrafluoroethylene (ePTFE, # 6) were evaluated. Four samples of each material were placed under the orbicularis oculi muscles of 12 rabbits. After five weeks, the samples were removed and evaluated histopathologically. Fibrovascular tissue ingrowths were investigated in terms of tissue penetration depth into the materials (graded as none, mild, moderate, and intense) and fibrovascular ingrowth area at the ultimate level of tissue penetrance. ImageJ software was used to calculate fibrovascular tissue area between the material fibers, and the mean area values were compared between the materials. RESULTS: Polyester materials # 1 and # 3 demonstrated intense fibrovascular tissue penetration with a large fibrovascular ingrowth area; no overt tissue ingrowth was observed into material #6. The mean area of penetrated fibrovascular tissues was significantly different between materials ( P < 0.001). Materials # 2, # 4, and # 5 showed moderate fibrovascular tissue ingrowth and the area of presented fibrovascular tissue at the paracentral parts of material # 4 was significantly smaller than that of materials # 1 ( P = 0.02) and # 3 ( P = 0.01). CONCLUSION: Two polyester materials that had relatively large pore sizes demonstrated a deep and large area of fibrovascular ingrowth. Given that material #3 is thicker and more consistent than material # 1, the former can be used as the appropriate material for supporting the Pintucci-type keratoprosthesis.

Vision Rehabilitation with a Native Pintucci-type Keratoprosthesis.

PURPOSE: To report visual rehabilitation with a native Pintucci keratoprosthesis (KPro) after a severe ocular surface chemical burn in a male patient. CASE REPORT: A 41-year-old man experienced a bilateral severe chemical burn 5 years previously. Earlier penetrating keratoplasty and keratolimbal allografts were unsuccessful in both eyes, and neither of the eyes had vision better than light perception. Both corneas were opaque and conjunctivalized. Because of severe dry eye and total limbal stem cell deficiency, the left eye was considered for a Pintucci-type KPro. In the first stage, the ocular surface was reconstructed with an oral mucus membrane graft, and a KPro was placed under the skin and orbicularis oculi muscle. Three months later, the KPro was removed and implanted in the left eye. During seven months after the KPro implantation, the anatomical position was acceptable, and his best corrected visual acuity was 2/10. CONCLUSION: Bearing in mind the successful results of the native Pintucci KPro in this case of severe acid burn, using this type of keratoprosthesis in patients with total limbal stem cell deficiency and severe dry eye is recommended.

Refractive Stability After Deep Anterior Lamellar Keratoplasty for Keratoconus.

PURPOSE: To evaluate the long-term stability of subjective refraction after deep anterior lamellar keratoplasty (DALK) performed in keratoconus-affected eyes. METHODS: This retrospective, comparative interventional case series analyzed the data of 73 eyes in 69 patients with keratoconus who underwent DALK. Only patients with clear grafts who had all sutures removed for at least 12 months were enrolled. The corrected distance visual acuity (CDVA) and manifest refraction were measured several months after all sutures were removed. The CDVA, spherical equivalent refraction, refractive astigmatism, and vector components of refractive astigmatism (J0 and J45) were recorded and compared at different time points. RESULTS: Mean age of patients was 28.3 ± 8.3 years at the time of keratoplasty. No significant changes in the CDVA were observed during the follow-up period. Spherical equivalent refraction measured at 1 month (-3.18 ± 3.41 D) and 3 months (-4.29 ± 4.26 D) after complete suture removal differed significantly from that measured at the last examination (-4.70 ± 3.75 D; P = 0.001 and 0.03, respectively). This measurement stabilized from 6 months after complete suture removal onward. Refractive astigmatism and its vector components (J0 and J45) did not change over time after complete suture removal. CONCLUSIONS: Refraction stabilized 6 months after complete DALK suture removal. Therefore, postponing refractive surgery until this time is advisable to manage post-DALK refractive errors.

Intravitreal Injection of Anti-vascular Endothelial Growth Factor Agents for Ocular Vascular Diseases: Clinical Practice Guideline.

PURPOSE: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases including diabetic macular edema, neovascular age-related macular degeneration, myopic choroidal neovascularization, retinal vein occlusion and central serous chorioretinopathy. METHODS: Twenty clinical questions were developed by the guideline technical committee. Relevant websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations. RESULTS: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases. CONCLUSION: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients.

A Stakeholder Perspective on Diabetes Mellitus and Diabetic Retinopathy Care in Iran; A Qualitative Study.

OBJECTIVE: To assess the national health system for management of diabetes mellitus (DM) in Iran, with particular focus on diabetic retinopathy (DR). MATERIALS AND METHODS: In this qualitative study, the national stakeholders related to DR and DM management system were invited to participate. Two researchers performed interview using a semi-structured questionnaire recommended by the World Health Organization titled "Tool for Assessment of Diabetic Retinopathy and DM Management Systems". The questionnaire contains seven different sections, each consisting of closed and open-ended questions, and a final Likert-type score, ranging from 1 indicating the worst to 4 indicating the best status. Inconsistencies were resolved through a collective decision of the research team, followed by a focus group discussion with stakeholders at the Ministry of Health. RESULTS: Fourteen stakeholders out of 15 total invitees were interviewed (response rate: 93.3%). There were national priorities, defined policies, and running programs (score = 3), but the care system should be strengthened in terms of implementation of clinical guidelines, with specific reference to the availability of regular screenings for DR (score = 2). The network of care providers, health information systems, and promotional programs were insufficient (score = 2). The health workforce and technology for DR and DM were acceptable (scores 4 and 3, respectively); however, there were concerns about the appropriate distribution and utilization of resources and out-of-pocket costs paid by patients. CONCLUSION: The existence of national policies, programs, a qualified workforce, and modern technology is promising. Nevertheless, other aspects of the health system need to be improved to ensure access to health and eye care for people with DM and achieve universal health coverage.

Do UV-blocking Soft Contact Lenses Meet ANSI Z80.20 Criteria for UV Transmittance?

PURPOSE: To compare ultraviolet (UV) ray transmission in four UV-blocking soft contact lenses with Z80.20 standards set by the American National Standards Institute (ANSI). METHODS: Four soft contact lenses including Acuvue Oasys (Johnson & Johnson, Ireland), Acuvue 2 (Johnson & Johnson, Ireland), Zeiss CONTACT Day 30 (Zeiss, Germany), and Sauflon 55 UV (Sauflon, UK) were evaluated for UV transmission. One-way ANOVA testing was performed to compare mean values of UVA and UVB transmission for the contact lenses. RESULTS: Acuvue Oasys, Acuvue 2, Zeiss CONTACT Day 30 and Sauflon 55 UV showed UV-B transmittance values of 0.24%, 1.46%, 10.37%, and 2.52%, respectively. Corresponding values for UV-A transmittance were 20.81%, 33.49%, 44.03% and 42.53%, respectively. One-way ANOVA showed a statistically significant difference among the tested contact lenses in terms of UV-B (P < 0.001) and UV-A (P < 0.001) transmission. CONCLUSION: Acuvue Oasys met the ANSI criteria for UV transmission and may thus be a good choice for eye and vision care specialists and contact lens wearers seeking UV protection.