Treatment of Anisometropic Amblyopia with a Dichoptic Digital Platform in Argentinian Children and Adults.

PURPOSE: To evaluate and compare the results of dichoptic training in Argentinian children and adults with anisometropic amblyopia. METHODS: Prospective non-comparative study enrolling 41 subjects with anisometropic amblyopia (age, 6-60 years old). Two groups were differentiated according to age, children (6-16 years, 24 subjects) and adults (>17 years, 17 subjects). All patients were treated with the Bynocs® platform (Kanohi Eye Pvt. Ltd, India) following a protocol of 30 sessions of training of 30 min daily 5 times a week for 6 weeks. Changes in corrected distance visual acuity (CDVA) and binocular function (BF) score with treatment were analyzed. RESULTS: In the whole sample, CDVA in the amblyopic eye improved significantly, with a mean change of 0.30 logMAR (p < .001). Likewise, a significant improvement was also found in BF score (p < .001), with a mean change of 1.14 log units. The change achieved in CDVA was significantly correlated with the baseline CDVA in the amblyopic eye (r=-0.568, p < .001). Furthermore, no significant differences were found between age groups in the change achieved in CDVA (p = .431) and BF with therapy (p = .760). CONCLUSIONS: Dichoptic training with the digital platform evaluated provides an effective improvement of visual acuity and binocular function in children and adults with anisometropic amblyopia.

Intracorneal Ring Segment Implantation for the Management of Keratoconus in Children.

The short-term safety and efficacy of intracorneal ring segment (ICRS) implantation in keratoconus eyes of children are investigated in this study. A retrospective interventional case series study including a total of 33 keratoconus eyes (age 8 to 17 years) that had undergone ICRS (Keraring segments, Mediphacos) implantation was conducted. Information about visual, refractive, pachymetric, corneal topographic and aberrometric, and corneal endothelial changes during a 3-month follow-up were extracted and analysed. A significant improvement was observed in logMAR corrected distance visual acuity (p = 0.005), combined with a statistically significant reduction in keratometric readings (p < 0.001). A reduction in the magnitude of corneal astigmatism of ≥1 D was observed in 52.8% of eyes. No significant changes were observed in corneal endothelial density (p = 0.317). Significant changes were found in the anterior vertical coma component (p = 0.002) as well as in the spherical aberration of the posterior corneal surface (p = 0.004). Only two relevant complications were described: one corneal microperforation with penetration of the ring segment into the anterior chamber (1 eye, 2.8%), and a case of ring extrusion (1 eye, 2.8%). ICRS implantation in children keratoconus eyes allows a reduction of corneal astigmatism, irregularity, and aberrations, leading to a significant visual improvement.

Prevalence of visual impairment and refractive errors in an urban area of Mexico.

AIM: To determine the distribution of refractive errors in a school-age population in Quintana Roo (Mexico) in the framework of an international cooperation campaign for the prevention of blindness. METHODS: A sample of 2647 school-age children (ranging from 5 to 14 years old) with a mean age of 9.1±1.9 years old were tested by trained volunteers for distance visual acuity (VA) and refractive errors. The first screening examination included uncorrected distance visual acuity (UDVA) and VA with a +2.00 D lens. Inclusion criteria for a second complete cycloplegic eye examination performed by an optometrist were UDVA <20/25 (0.10 logMAR or 0.8 decimal) and/or VA with +2.00 D ≥20/25. RESULTS: A total of 633 (23.9%) children underwent the second complete eye examination. Mean logMAR UDVA was 0.035±0.094 (range 1.00 to 0.00 logMAR) for the right eyes and 0.036±0.160 (range 1.00 to 0.00 logMAR) for the left eyes. Bilateral amblyopia was found in 17 children (2.7% of refracted eyes; 0.64% of the total). The main reason for visual impairment (VI) in the sample analyzed was found to be refractive errors. In 12 children (1.9% of refracted eyes; 0.45% of the total) the VI was bilateral and 9 (1.4% of refracted eyes; 0.34% of the total) achieved a corrected distance visual acuity of 20/25 or better in both eyes. Mean magnitude of sphere and refractive cylinder was +0.20±0.96 D and -0.43±0.85 D in right eyes, and +0.24±1.08 and -0.43±0.83 D in left eyes. The proportion of myopic eyes [standard equivalent (SE) ≤-0.50 D] was 4.6% of the whole sample (5290 eyes). The mean magnitude of myopia was -0.84±3.44 D for the right eyes and -0.82±5.21 D for the left eyes. The proportion of hyperopic patients (SE≥+2.00 D) was 2.4% (15/633), which corresponded to 0.60% of the whole sample (32/5290 eyes). No statistically significant correlation of age to manifest sphere or cylinder was found. CONCLUSION: VI due to uncorrected refractive errors can be easily corrected with glasses but it is still a burden to be treated. Myopia is prevalent in this sample. More efforts towards correcting uncorrected refractive errors are needed.

Refractive error study in young subjects: results from a rural area in Paraguay.

AIM: To evaluate the distribution of refractive error in young subjects in a rural area of Paraguay in the context of an international cooperation campaign for the prevention of blindness. METHODS: A sample of 1466 young subjects (ranging from 3 to 22 years old), with a mean age of 11.21±3.63 years old, were examined to assess their distance visual acuity (VA) and refractive error. The first screening examination performed by trained volunteers, included visual acuity testing, autokeratometry and non-cycloplegic autorefraction. Inclusion criteria for a second complete cycloplegic eye examination by an optometrist were VA <20/25 (0.10 logMAR or 0.8 decimal) and/or corneal astigmatism ≥1.50 D. RESULTS: An uncorrected distance VA of 0 logMAR (1.0 decimal) was found in 89.2% of children. VA <20/25 and/or corneal astigmatism ≥1.50 D was found in 3.9% of children (n=57), with a prevalence of hyperopia of 5.2% (0.2% of the total) in this specific group. Furthermore, myopia (spherical equivalent ≤-0.5 D) was found in 37.7% of the refracted children (0.5% of the total). The prevalence of refractive astigmatism (cylinder ≤-1.50 D) was 15.8% (0.6% of the total). Visual impairment (VI) (0.05≤VA≤0.3) was found in 12/114 (0.4%) of the refracted eyes. Main causes for VI were refractive error (58%), retinal problems (17%, 2/12), albinism (17%, 2/12) and unknown (8%, 1/12). CONCLUSION: A low prevalence of refractive error has been found in this rural area of Paraguay, with higher prevalence of myopia than of hyperopia.