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1.
J Pediatr Ophthalmol Strabismus ; 56(5): 297-304, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545863

RESUMO

PURPOSE: To detect eye tracking abnormalities in children with strabismus in the absence or presence of amblyopia. METHODS: A total of 100 patients aged 7 to 17 years were enrolled prospectively for 2 years from the pediatric ophthalmology clinic of the American University of Beirut Medical Center: 50 children with strabismus (including 24 with amblyopia) and 50 age- and gender-matched controls. Eye tracking with different paradigms was performed. RESULTS: Mean age was 10.66 ± 2.90 years in the strabismus group and 10.02 ± 2.75 years in the control group. Demographic characteristics were similar with respect to vision, gender, and refraction. Four paradigms were tested using the eye tracker: (1) distance/near paradigm: patients with strabismus showed a lower fixation count and longer fixation at both distances and a tendency for decreased latency and percentage of fixation in distant elements; (2) reading paradigm: the strabismus group had a higher fixation count and duration, especially those without amblyopia; (3) location identification paradigm: strabismus group without amblyopia fixated less and with shorter duration on the most flagrant element; and (4) video paradigm: no differences in eye movements were noted. CONCLUSIONS: Significant eye movement deficits were demonstrated in patients with strabismus compared to controls while reading text and identifying prominent elements in a crowded photograph. This was significant in the non-amblyopic subgroup. [J Pediatr Ophthalmol Strabismus. 2019;56(5):297-304.].


Assuntos
Ambliopia/fisiopatologia , Movimentos Oculares/fisiologia , Estrabismo/fisiopatologia , Acuidade Visual , Adolescente , Distribuição por Idade , Ambliopia/complicações , Ambliopia/epidemiologia , Criança , Feminino , Seguimentos , Humanos , Incidência , Masculino , Estudos Prospectivos , Estrabismo/complicações , Estrabismo/epidemiologia , Estados Unidos/epidemiologia , Visão Binocular/fisiologia
2.
BMC Ophthalmol ; 19(1): 137, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248388

RESUMO

BACKGROUND: Uveitis in the pediatric population is uncommon, accounting for 2 to 14% of all uveitis cases, yet resulting in significant ocular morbidity. A number of studies have focused on patterns and complications of uveitis in the pediatric age group (≤ 16 years). In this report, we studied children with uveitis syndromes focusing on demographics, anatomic distribution, etiologies, treatment, and complications. We additionally divided subjects into two age groups to look into any differential characteristics pertaining to the younger age group and the role of amblyopia as a cause of visual loss. METHODS: Retrospective chart review of 80 eyes of 49 uveitis patients aged ≤16 years. Subjects were categorized by age of onset into visually immature (≤8 years) and visually mature group (> 8 years). Data compared between the two age groups included demographics, disease characteristics, visual outcomes and complications. RESULTS: Idiopathic uveitis was the most common diagnosis (51%). Anterior uveitis complications (posterior synechiae and band keratopathy) were more common in the younger group (p = 0.002 and p = 0.03 respectively) while posterior uveitis manifestations (vitreous haze and vasculitis) were more common in the older age group (p = 0.04 and p < 0.001 respectively). Amblyopia was the most common cause of vision loss in the visually immature versus cataract in the visually mature. CONCLUSION: Anterior uveitis and its complications were more common in visually immature group in our cohort. Amblyopia was identified as the main cause of visual loss in the younger population.


Assuntos
Ambliopia/etiologia , Catarata/etiologia , Doenças da Córnea/etiologia , Medição de Risco/métodos , Centros de Atenção Terciária/estatística & dados numéricos , Uveíte/epidemiologia , Acuidade Visual , Distribuição por Idade , Fatores Etários , Ambliopia/epidemiologia , Catarata/epidemiologia , Criança , Pré-Escolar , Doenças da Córnea/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Líbano/epidemiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Uveíte/complicações , Uveíte/fisiopatologia
3.
Acta Med Port ; 32(3): 179-182, 2019 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-30946787

RESUMO

INTRODUCTION: Amblyopia requires a timely diagnosis and treatment to attain maximum vision recovery. Specialty literature is lacking on how early amblyopia is referred. We aimed to understand if there are mean age differences at first referral for ophthalmologic tertiary center consultation among non-amblyopic and different types of amblyopia, in a context of lack of population screening. MATERIAL AND METHODS: In this retrospective model, the sample corresponded to all children born in Braga Hospital during 1997 - 2012 (3 - 18 years-old), with an ophthalmologic consultation in 2014. Data was collected from the clinical records and children were divided in a non-amblyopic versus amblyopic group. The amblyopic group was subdivided in strabismic versus refractive (anisometropic/bilateral). RESULTS: The sample had a total of 1665 participants, 1369 (82.2%) without amblyopia and 296 (17.8%) with amblyopia. Among amblyopia: 67.9% (n = 201) refractive, 32.1% (n = 95) strabismic. Within refractive amblyopia: 63.7% (n = 128) anisometropic and 36.3% (n = 73) bilateral. The mean age at first consultation was 6.24 ± 3.90 years-old: 6.39 ± 3.98 for non-amblyopic and 5.76 ± 3.58 for amblyopic. Among amblyopia subgroups, there were significant differences in mean age at first consultation (F3,1250 = 8.45; p < 0.001; Î·2 = 0.020). Strabismic and bilateral refractive amblyopia were referred earlier, when compared to non-amblyopia or anisometropic amblyopia (p < 0.05). Anisometropic amblyopia had the highest first consultation mean age: 6.92 ± 3.57 years-old. DISCUSSION: Without specific pre-school screening, children with amblyopia were referred to their first ophthalmologic evaluation significantly later than desired, especially anisometropic amblyopia, with a postschool mean age for first consultation. CONCLUSION: Recognizing high-risk children is essential for earlier referral and helps minimize future visual handicap.


Assuntos
Ambliopia/diagnóstico , Anisometropia/diagnóstico , Encaminhamento e Consulta/estatística & dados numéricos , Estrabismo/diagnóstico , Adolescente , Fatores Etários , Ambliopia/epidemiologia , Anisometropia/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Portugal/epidemiologia , Estudos Retrospectivos , Estrabismo/epidemiologia , Fatores de Tempo , Tempo para o Tratamento
4.
J Pediatr Ophthalmol Strabismus ; 56(2): 88-94, 2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-30889262

RESUMO

PURPOSE: To determine the incidence of amblyopia risk factors during the first 3 years of life in premature children. METHODS: This prospective cohort included 145 premature children (gestational age of less than 37 weeks) who were evaluated for amblyopia risk factors every 6 months until age 3 years. The incidence rate, cumulative incidence, and prevalence of any amblyopia risk factor were assessed in retinopathy of prematurity (ROP) and non-ROP screened groups. Multivariate logistic regression was performed to evaluate variables associated with the development of an amblyopia risk factor. RESULTS: The 3-year incidence rates of amblyopia risk factors were similar between the non-ROP and ROP screened groups (18 versus 19 cases per 1,000 person-years, respectively). The 3-year cumulative incidence was also similar: 32% (95% confidence interval [CI]: 18 to 47) in the non-ROP and 14% (95% CI: 5 to 28) in the ROP screened group (P > .05). In the ROP screened group, the prevalence rates were 20% or greater at most time points. In the non-ROP screened group, the prevalence rates were 11% to 14% during the first 18 months and increased to more than 20% at 24 months and thereafter. Astigmatism was the most prevalent amblyopia risk factor in both groups (7% to 18%). CONCLUSIONS: The incidence of amblyopia risk factors was not significantly different between non-ROP and ROP screened children in our cohort. The prevalence of refractive errors among premature non-ROP screened children was higher than that reported in childhood in the literature. It may be appropriate to screen all children with a history of prematurity for refractive errors around 24 months of age. [J Pediatr Ophthalmol Strabismus. 2019;56(2):88-94.].


Assuntos
Ambliopia/epidemiologia , Doenças do Prematuro/epidemiologia , Recém-Nascido Prematuro , Retinopatia da Prematuridade/complicações , Medição de Risco/métodos , Ambliopia/etiologia , California/epidemiologia , Pré-Escolar , Feminino , Seguimentos , Idade Gestacional , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos Prospectivos , Retinopatia da Prematuridade/epidemiologia , Fatores de Risco
5.
Acta Ophthalmol ; 97(5): 486-490, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30390373

RESUMO

PURPOSE: Anterior polar cataract is an opacity in the anterior capsule of the lens. Anterior polar cataract has historically been considered as a relatively benign condition. The purpose of this study was to estimate the prevalence of anterior polar cataract, to identify the risk factors for amblyopia and to estimate the risk of developing amblyopia in children with anterior polar cataract. METHODS: The medical records for patients with congenital cataracts at the Eye Clinic Rigshospitalet, Rigshospitalet-Glostrup and Kennedy Center covering a ten year period from 2007 to 2016 (both metres  years included) were reviewed. RESULTS: A total of 54 patients with anterior polar cataract were identified. The majority had unilateral anterior polar cataract (72%). Family history of childhood cataracts was frequent (27%) of patients with bilateral anterior polar cataract. There was an overrepresentation of female patients (70%). Amblyopia was found in 55% of the patients. The causes were primarily hypermetropic anisometropia (70%) and astigmatism (52%). Axial length was on average 0.88 mm (SD 0.44) shorter in the eye with anterior polar cataract compared to fellow eyes. CONCLUSION: Anterior polar cataract is a highly amblyogenic condition not because of a visually obstructing lens opacity but because of refractive errors, primarily hypermetropic anisometropia and astigmatism. Anterior polar cataract seems to represent an anomaly in global eye development resulting in reduced axial length. Patients with anterior polar cataract should be monitored to detect and treat amblyopia in time.


Assuntos
Ambliopia/etiologia , Catarata/congênito , Cristalino/anormalidades , Refração Ocular/fisiologia , Medição de Risco , Acuidade Visual , Adolescente , Ambliopia/epidemiologia , Ambliopia/fisiopatologia , Catarata/complicações , Catarata/diagnóstico , Catarata/epidemiologia , Criança , Pré-Escolar , Dinamarca/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos Retrospectivos , Fatores de Risco , Tomografia de Coerência Óptica
6.
Acta Ophthalmol ; 97(1): 29-35, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30280496

RESUMO

PURPOSE: To evaluate the prevalence of amblyopia and associated biometric factors in Danish children. METHODS: Determination of best-corrected visual acuity (BCVA) using ETDRS charts, non-cycloplegic subjective refractioning guided by automated refractometry, axial length and corneal curvature, fundus photography and optical coherence tomography (OCT) in 1335 children from the population-based Copenhagen Child Cohort 2000 (CCC2000) Eye Study. Birth data were obtained from the Danish Medical Birth Registry. RESULTS: The mean (±SD) age of children was 11.7 (±0.4) years, and 47% were boys. Amblyopia prevalence was 1.5 (95% CL 0.8-2.2) %. Unilateral amblyopic eyes [BCVA < 80 ETDRS letters (0.8 snellen) and ≥2 lines difference between the eyes] was 0.6 (95% CL 0.3-1.0) mm shorter, 1.34 (95% CL 0.30-2.37) D more hyperopic and had 0.79 (95% CL 0.14-1.44) D more astigmatism compared with fellow eyes. Compared with the right eyes of the non-amblyopic children, unilateral amblyopic eyes were 1.0 (95% CL 0.5-1.6) mm shorter, 2.48 (95% CL 1.11-3.86) D more hyperopic, 1.09 (95% CL 0.43-1.75) D more astigmatic and had a 47 (95% CL 13-81) µm thicker subfoveal choroid. CONCLUSION: Amblyopia was found in 1.5% of Danish children born 22 years after the inception of the nationwide preschool visual screening programme. Amblyopia was associated with anisometropia, astigmatism, a thicker subfoveal choroid and a history of childhood strabismus.


Assuntos
Ambliopia/epidemiologia , Vigilância da População , População Urbana , Acuidade Visual , Ambliopia/diagnóstico , Ambliopia/fisiopatologia , Criança , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Tomografia de Coerência Óptica
7.
Acta Ophthalmol ; 97(2): 158-164, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30280519

RESUMO

PURPOSE: To evaluate the current vision screening criteria regarding amblyopia and refractive errors, with emphasis on screening limits and retesting, in Region Västra Götaland (VGR), Sweden. Visual acuity (VA) screening is performed by nurses at primary healthcare centres (PHCs) in 4-year-old children and at school in 6- or 7-year-old children. Children with VA <0.65 (>0.19 logMAR) at either eye are referred. If VA is 0.65 in one or both eyes, a retest is performed by nurses at PHCs and schools, the children are then referred if VA is <0.8 (>0.10 logMAR). METHODS: We included all children aged ≥5 and <8 years referred between October 2014 and June 2015 from PHCs and schools to the four eye clinics in VGR, with VA ≥0.65 in one or both eyes. At the eye clinic, children underwent assessment of VA, refraction in cycloplegia, eye motility, cover test, stereo test and a slit lamp examination. RESULTS: Among the 259/295 children (139 female) participating, median age was 5.7 years (5.0-7.8 years) at referral. Glasses were prescribed due to subnormal VA with refractive errors in 20% of the children, 22% displayed heterophoria, none had heterotropia and one younger child had amblyopia. Accurate retesting gave fewer false-positive referrals. CONCLUSION: Our results showed that a vision screening referral cut-off limit of VA <0.65 would leave undetected refractive errors. Residual amblyopia was uncommon. Accurate referral criteria, retesting and training of those performing the screening as well as re-evaluation of the screening programme are all important.


Assuntos
Ambliopia/diagnóstico , Refração Ocular , Erros de Refração/diagnóstico , Acuidade Visual , Ambliopia/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Masculino , Estudos Prospectivos , Erros de Refração/epidemiologia , Reprodutibilidade dos Testes , Suécia/epidemiologia , Seleção Visual
8.
Br J Ophthalmol ; 103(4): 517-522, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29986946

RESUMO

PURPOSE: To evaluate the effectiveness of Spot photoscreener and SW800 vision screener in detecting amblyopia risk factors in Chinese children between 4 and 6 years of age. METHODS: One hundred and thirteen children (226 eyes) underwent complete ophthalmologic examination, cycloplegic retinoscopy refraction, prism cover tests and photoscreen using both Spot (v2.1.4) and SW800 (v1.0.1.0) photoscreeners. The agreement of results obtained from photoscreener and retinoscopy was evaluated by paired t-test as well as Pearson correlation test. The sensitivity and specificity of detecting amblyopia risk factors were calculated based on the American Association of Pediatric Ophthalmology and Strabismus 2013 guidelines. The overall effectiveness of detecting amblyopia risk factors by using either photoscreener was analysed by receiver operating characteristic (ROC) curves. RESULTS: A strong linear agreement was observed between Spot and retinoscopy (p<0.01) in aspects of spherical equivalent (SE, Pearson's r=0.95), dioptre sphere (DS, r=0.97), dioptre cylinder (DC, r=0.84) and horizontal deviation (Hdev, r=0.91), with overall -0.17 D myopic shift of SE. Significant correlation was also shown between SW800 and retinoscopy (p<0.01) in aspects of SE (r=0.90), DS (r=0.93), DC (r=0.82) and Hdev (r=0.80), with overall -0.12 D myopic shift of SE. The overall sensitivity and specificity in detecting amblyopia risk factors were 94.0% and 80.0% for Spot and 88.8% and 81.1% for SW800. CONCLUSION: The measurements of Spot and SW800 photoscreener showed a strong agreement with cycloplegic retinoscopy refraction and prism cover tests. The performance of both screeners in detecting individual amblyopia risk factors is satisfactory. ROC analysis indicates that the Spot and SW800 performed very similarly in detecting amblyopia risk factors.


Assuntos
Ambliopia/diagnóstico , Refração Ocular/fisiologia , Retina/diagnóstico por imagem , Retinoscópios , Seleção Visual/instrumentação , Acuidade Visual/fisiologia , Ambliopia/epidemiologia , Ambliopia/fisiopatologia , Criança , Pré-Escolar , China/epidemiologia , Desenho de Equipamento , Feminino , Humanos , Incidência , Masculino , Curva ROC , Reprodutibilidade dos Testes
9.
Medicina (Kaunas) ; 54(1)2018 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-30344237

RESUMO

Background and objective: Amblyopia is the leading cause of visual impairment in children and adults and is very common during childhood. The aim of this study was to identify the prevalence and the risk factors of amblyopia in a pediatric population with refractive errors from an Eastern European country. Materials and methods: A total of 1231 children aged 5⁻16 years, who had refractive errors and were examined from January to August 2017, were enrolled in a cross-sectional population-based study. Every child underwent a complete ophthalmological exam. Amblyopia was defined as a visual acuity (VA) of less than 0.63. The study respected the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS) criteria for defining amblyopia (MEPEDS, 2008). Parents participated in a face-to-face interview. The questionnaire contained details about their family history of amblyopia; the child's maternal nutritional status in the preconception period; their history of maternal smoking or work in a toxic environment; the child's birth, and the child's history of congenital naso-lacrimal duct obstruction (CNLDO). Results: Amblyopia was identified in 2.8% of the participants. The ocular conditions hyperopia (p = 0.0079), astigmatism (p = 0.046), anisometropia (p < 0.001), esotropia (p < 0.001), exotropia (p = 0.0195), and CNLDO (p < 0.001), as well as a family history of amblyopia (p < 0.001), were associated with amblyopia. The non-ocular risk factors for amblyopia that were found in the study included low birth weight (p < 0.0009), prematurity (p < 0.001), an Apgar score under 7 (p = 0.0008), maternal age, maternal smoking history or work in toxic environment (p < 0.001), and maternal body mass index in the preconception period (p < 0.003). Conclusions: Some of the risk factors we identified for amblyopia are modifiable factors. This is an important observation as an adequate health education program can provide the relevant information for future mothers that will allow for a better management of the condition. We also wanted to highlight the need for amblyopia screening starting from the age of 3 years in case of significant parental refractive errors, strabismus, prematurity, and maternal risk factors.


Assuntos
Ambliopia/epidemiologia , Erros de Refração/epidemiologia , Adolescente , Ambliopia/etiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Erros de Refração/complicações , Fatores de Risco , Romênia/epidemiologia
10.
Indian J Ophthalmol ; 66(7): 924-928, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29941732

RESUMO

Purpose: To compare the efficacy of Lea symbols (LS) chart and Sheridan Gardiner (SG) chart for vision screening among preschool children, in a semi-urban district of South India. Methods: Vision screening was conducted among 260 preschool children aged 3-5 years in cluster sampled kindergartens using LS chart and SG chart. Pass/fail scores and time taken for visual acuity (VA) estimation were compared. VA scores and time taken were compared using unpaired t-test. Sensitivity, specificity, and positive and negative predictive values were compared between the charts. Results: There was a significant difference between LS and SG charts in the VA score in both the eyes (P = 0.04). LS showed 76.09% pass score and 23.90% fail score, whereas SG showed 87.65% pass score and 12.35% fail score with a cutoff value of > 0.3 log MAR. Time for screening using LS was higher, when compared to SG, both for the right eyes (P < 0.001) and the left eyes (P < 0.001). The sensitivity of the LS was 94.74% (95% confidence interval [CI]: 70.13%-81.06%) and that of SG was 52.63% (95% CI: 45.29%-59.8%). The specificity of LS was 66.67% (95% CI: 90.26%-97.30%) and SG was 83.33% (95% CI: 70.12%-91.30%). Conclusion: LS chart showed better sensitivity and negative predictive value when compared to SG chart. However, SG chart showed better specificity and positive predictive value, and screening was less time-consuming. Considering the high sensitivity and negative predictive value, LS is the preferred tool, when compared to SG chart in preschool vision screening in our population.


Assuntos
Ambliopia/diagnóstico , Instituições Acadêmicas , Seleção Visual/métodos , Acuidade Visual , Ambliopia/epidemiologia , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Morbidade/tendências , Reprodutibilidade dos Testes , Testes Visuais
11.
Indian J Ophthalmol ; 66(7): 940-944, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29941736

RESUMO

Purpose: To study the prevalence, determine the magnitude, and cause of amblyopia among the children aged 6 months to 16 years in Kamrup district, Assam, India. Methods: Among a total of 39,651 children between 6 months and 16 years of age, door-to-door screening was conducted by trained workers. For children above 5 years of age who failed to read the 6/9 line, camps were conducted in the nearby schools. Children below 5 years of age were directly referred to the tertiary eye care institute. After visual acuity assessment at the institute, cycloplegic refraction and complete ophthalmic examination were done to rule out other causes of diminution of vision. Axial length measurement and corneal topography were performed in children with high refractive errors. Results: Of the total 39,651 children screened, 469 were diagnosed to have amblyopia at the camp and 223 were diagnosed at the institute. The prevalence of amblyopia was 1.75%. Amblyopia was more common among the males (52.50%) as compared to females. Maximum number of patients were found in the age group of 11-16 (63.58%). Refractive amblyopia was found to be the most common cause of amblyopia (45.29%). In children below 5 years, deprivation amblyopia and strabismic amblyopia were more common. Conclusion: Awareness of amblyopia among the parents is essential for early detection and treatment of the disease, which will, in turn, reduce the burden of childhood visual impairment.


Assuntos
Ambliopia/epidemiologia , Relações Comunidade-Instituição , Instituições Acadêmicas , Seleção Visual/métodos , Adolescente , Ambliopia/diagnóstico , Ambliopia/fisiopatologia , Criança , Pré-Escolar , Feminino , Humanos , Índia/epidemiologia , Lactente , Masculino , Prevalência , Estudos Prospectivos , Acuidade Visual
12.
Med J Malaysia ; 73(1): 25-30, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29531199

RESUMO

INTRODUCTION: Little is known regarding the extent of visual impairment amongst pre-school children in Malaysia. OBJECTIVE: To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children. METHODOLOGY: A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria. RESULTS: A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia. CONCLUSION: Our study highlights an urgent need for initiation of preschool vision screening in Malaysia.


Assuntos
Ambliopia/epidemiologia , Transtornos da Visão/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Malásia/epidemiologia , Masculino , Prevalência , Seleção Visual , Acuidade Visual
13.
J Coll Physicians Surg Pak ; 28(3): 210-213, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29544578

RESUMO

OBJECTIVE: To evaluate the state of refraction in children with bilateral congenital nasolacrimal duct obstruction (CNLDO). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from April 2014 to April 2016. METHODOLOGY: Children with bilateral CNLDO were studied. Patients' refractive status were evaluated by performing cycloplegic refraction, followed by appropriate management plan. The refractive errors of both eyes were noted and compared for any significant anisometropia. RESULTS: One hundred and seventeen (n=117) children with median age (IQR) of 32 (12) months having bilateral CNLDO were enrolled. Children with bilateral CNLDO had insignificant interocular difference in terms of spherical equivalent (SE) and cylindrical refractive errors (p>0.05). The rate of the anisometropia (>1 D difference between the two eyes) was 5.98% (n=7) in children with bilateral CNLDO. CONCLUSION: Performing cycloplegic refraction routinely in patients with bilateral CNLDO is not as urgent as compared to ones with unilateral CNLDO. Further, avoidance of early surgical intervention in children with bilateral CNLDO will spare the parents from the emotional trauma and positively influence the health economics worldwide.


Assuntos
Obstrução dos Ductos Lacrimais/congênito , Obstrução dos Ductos Lacrimais/fisiopatologia , Ducto Nasolacrimal/anormalidades , Ducto Nasolacrimal/fisiopatologia , Refração Ocular/fisiologia , Ambliopia/epidemiologia , Anisometropia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Erros de Refração , Testes Visuais
14.
J AAPOS ; 22(2): 145.e1-145.e6, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29555516

RESUMO

PURPOSE: To estimate the prevalence and causes of visual impairment and other ocular comorbidities among tribal children in an urban school population in eastern India. METHOD: In this cross-sectional study, vision screening tests were administered to tribal school children. Demographic data, including name, age, sex, home district, height, and weight of each child, and examination data, including unaided and pinhole visual acuity, external eye examination with a flashlight, slit-lamp examination, intraocular pressure (IOP) measurement, and undilated fundus photography, were collected. Children with visual acuity of less than 20/20, abnormal anterior or posterior segment findings, and IOP of >21 mm Hg were referred for further evaluation. RESULTS: Of 10,038 children (5,840 males [58.2%]) screened, 335 (median age, 9 years; range, 6-17 years) were referred. Refractive error was the most common cause of visual impairment (59.52%; 95% CI, 51.97-66.65) followed by amblyopia (17.2%; 95% CI, 12.3-23.6) and posterior segment anomaly (14.88%; 95% CI, 10.2-21.0). The prevalence of best-corrected visual acuity of 20/40 was 0.13%. The prevalence of blindness was 0.03%. CONCLUSIONS: Visual impairment among tribal children in this residential school is an uncommon but important disability.


Assuntos
Ambliopia/epidemiologia , Grupos Étnicos/estatística & dados numéricos , Erros de Refração/epidemiologia , População Urbana/estatística & dados numéricos , Baixa Visão/epidemiologia , Pessoas com Deficiência Visual/estatística & dados numéricos , Adolescente , Ambliopia/diagnóstico , Criança , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Pressão Intraocular/fisiologia , Masculino , Prevalência , Erros de Refração/diagnóstico , Microscopia com Lâmpada de Fenda , Seleção Visual , Acuidade Visual/fisiologia
15.
Acta Ophthalmol ; 96(4): 379-383, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29369530

RESUMO

PURPOSE: To report normative data on visual acuity (VA) for near and distance, refraction, ocular alignment, ocular motility and stereo acuity in a cohort of children aged 4.5-7 years. METHODS: A total of 950 children with normal development from the municipality of Roskilde, Denmark, were invited to participate in an ophthalmic cross-sectional population-based survey, of which 445 children in the age of 54-87 months participated with a complete ocular examination including cycloplegia. Visual acuity (VA) was tested using Kay Picture charts and notified in logMAR units. RESULTS: Mean distance VA was 0.010 logMAR [standard deviation (SD): 0.048] in right eye, and near VA in right eye was 0.012 logMAR (SD: 0.054), with a nonsignificant difference between right and left eye in both parameters (paired t-test, p = 0.15 and p = 0.08, respectively). Amblyopia was found in 12 children (2.7%), mainly related to refractive errors. The mean refractive error of right eye was +1.75 D, and significant hyperopia (greater than +3.0 D) was found in 7.9%. No myopia (greater than or equal to -0.5 D) was found, astigmatism (>1 D) was seen in 4.3%. Manifest strabismus was present in 1.6%, and heterophoria in 4.0%. Reduced or absent stereo acuity was present in 35 children (7.9%) and was related to a reduced VA, refractive error and strabismus. CONCLUSION: Ophthalmic data of 445 normally developed children are presented, supplementing previous reported normative data in children. We found a relatively high prevalence of amblyopia and of hyperopia, while myopia was not found, confirming previous studies that myopia is not developing at early age in Danish children.


Assuntos
Ambliopia/epidemiologia , Transtornos da Motilidade Ocular/epidemiologia , Refração Ocular/fisiologia , Erros de Refração/epidemiologia , Seleção Visual/métodos , Acuidade Visual , Adolescente , Ambliopia/diagnóstico , Ambliopia/fisiopatologia , Criança , Pré-Escolar , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Transtornos da Motilidade Ocular/diagnóstico , Transtornos da Motilidade Ocular/fisiopatologia , Prevalência , Erros de Refração/diagnóstico , Erros de Refração/fisiopatologia , Fatores de Risco
16.
Middle East Afr J Ophthalmol ; 25(3-4): 156-160, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30765954

RESUMO

BACKGROUND/AIMS: To evaluate the refractive status, axial length, and prevalence of amblyopia among Saudi children with unilateral congenital nasolacrimal duct obstruction (UCNLDO) compared to the unaffected fellow eye. METHODS: A retrospective chart review was performed for children with UCNLDO at two eye institutes in Eastern Saudi Arabia from 2009 to 2015. The outcomes of syringing determined UNCLDO. The risk factors for amblyopia were defined as anisometropia of (spherical equivalent) >1.5 D, hyperopia >3.5 D, myopia >3.0 D, astigmatism >1.5 D at 90° or 180°, >1.0 D, any manifest strabismus, any media opacity >1 mm, or ptosis 1 mm or less margin reflex distance 1 along with blunting of vision in that eye. Matched-pair analysis was performed to correlate variables. P < 0.05 was considered statistically significant. RESULTS: We included 39 children with UNCLDO. The mean axial length was 21.4 ± 1.3 mm for the eyes with UCNLDO and 21.6 ± 1.0 mm for the fellow eye (P = 0.4). Hyperopia >+2 D was present in 17 (44%) eyes with UCNLDO and none of the fellow eyes. None of the participants had strabismus. CONCLUSION: Axial length and risk factors of amblyopia such as anisometropia, hyperopia, and strabismus were not associated with UCNLDO. UCNLDO is likely an isolated defect.


Assuntos
Ambliopia/etiologia , Obstrução dos Ductos Lacrimais/complicações , Ducto Nasolacrimal/anormalidades , Ambliopia/epidemiologia , Pré-Escolar , Feminino , Humanos , Lactente , Obstrução dos Ductos Lacrimais/epidemiologia , Masculino , Prevalência , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita/epidemiologia , Testes Visuais
17.
Int Ophthalmol ; 38(1): 29-34, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29236204

RESUMO

PURPOSE: To assess the proportion of pure anisometropic amblyopia in a sample Iranian (white) population. METHODS: A total of 2800 consecutive individuals who presented at a referral eye clinic for any reason were examined for the presence of pure anisometropic amblyopia. Anisometropia was reported when a spherical equivalent refraction difference of at least 1.0 D with or without a cylinder refraction difference of at least 1.0 D was present between the two eyes. Amblyopia was defined as the best-corrected visual acuity of 20/30 or worse or a two-line interocular visual acuity difference between eyes that could not be attributed to any structural ocular pathology or visual pathway abnormality. RESULTS: Subjects were 1528 females and 1272 males with a mean age of 30.25 ± 14.93 years (range, 5-65). Amblyopia was diagnosed in 192 cases (6.9%), significantly more frequent among females (7.9 vs. 5.7%, p = 0.02). Pure anisometropic amblyopia was present in 6.1% of the study population, significantly more common in patients with spherical hyperopic anisometropia (37.7%) compared to patients with spherical myopic anisometropia (21.3%), cylindrical myopic anisometropia (4.1%), and cylindrical hyperopic anisometropia (15%) (p < 0.001). CONCLUSIONS: Pure anisometropic amblyopia is a common finding in Caucasians seeking eye care, particularly when anisometropia is of spherical hyperopic subtype.


Assuntos
Ambliopia/epidemiologia , Anisometropia/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Acuidade Visual , Adulto Jovem
18.
J Autism Dev Disord ; 48(5): 1530-1536, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29170942

RESUMO

Amblyopia risk factors in children with autism spectrum disorders (ASD) are usually hard to detect in early childhood due to poor cooperation and has not been reported in the Chinese population. We screened 168 Chinese children with ASD, aged between 3 and 8 years, and 264 age-matched neurotypical children with Spot photoscreener and basic ophthalmologic examinations. Children with ASD were found to have normal refractive status but significantly higher incidence of strabismus (16.1%), compared with control children (1.5%) (p < 0.01). Most of the cases of strabismus found in children with ASD were classified as esodeviation. Strabismus in children with ASD should be considered more seriously as an amblyopia risk factor by ophthalmologists and other healthcare professionals.


Assuntos
Ambliopia/diagnóstico , Ambliopia/epidemiologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Testes Visuais/métodos , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Masculino , Exame Físico/métodos , Fatores de Risco , Estrabismo/diagnóstico , Estrabismo/epidemiologia
19.
J Pediatr Ophthalmol Strabismus ; 55(3): 189-193, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29257184

RESUMO

PURPOSE: To determine the validity of the OPTEC 5500 vision screener (Stereo Optical Co., Inc., Chicago, IL) in assessing visual acuity and amblyopia in pediatric patients between the ages of 3 and 17 years by comparing it statistically to gold standard comprehensive ophthalmic examinations. METHODS: A cross-sectional study was conducted of 64 patients between the ages of 3 and 17 years who underwent a vision screening test at a pediatric ophthalmology office using the OPTEC 5500 vision screener, followed by traditional visual acuity testing via the Snellen or Lea optotypes. After data were collected, the results of the OPTEC 5500 vision screener were compared to the Snellen and Lea visual acuity tests and statistical analysis was subsequently performed for the right and left eyes separately. Patients were considered to have risk factors for amblyopia based on the American Association for Pediatric Ophthalmology and Strabismus referral criteria guidelines. RESULTS: The results of the OPTEC 5500 vision screener for the right eye of participants of all ages were a sensitivity of 77.4%, specificity of 100.0%, positive predictive value of 100.0%, negative predictive value of 50.0%, and accuracy of 81.5%. Results for the left eye were a sensitivity of 81.0%, specificity of 87.0%, positive predictive value of 91.9%, negative predictive value of 71.4%, and accuracy of 83.1%. CONCLUSIONS: Although the specificity and positive predictive value were acceptable, the sensitivity and negative predictive value of the OPTEC 5500 vision screener were below average when compared to other available devices, exhibiting some of the weaknesses of the device. Additional studies of the OPTEC 5500 vision screener with a larger population are necessary to assess the device in the general pediatric population, such as in general pediatric clinics and public schools. Additionally, other options for pediatric vision screening devices should be explored. [J Pediatr Ophthalmol Strabismus. 2018;55(3):189-193.].


Assuntos
Ambliopia/diagnóstico , Encaminhamento e Consulta , Seleção Visual/instrumentação , Acuidade Visual , Ambliopia/epidemiologia , Ambliopia/fisiopatologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Nebraska/epidemiologia , Fatores de Risco
20.
Eur J Ophthalmol ; 28(2): 229-233, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28967080

RESUMO

PURPOSE: To assess the role of risk factors for amblyopia, such as family history and neonatal background, for the prediction of either strabismic amblyopia or refractive amblyopia. METHODS: In this retrospective case-control model, the study population included all children born at the Hospital de Braga during 1997-2012 (3 to 18 years old) with ophthalmologic consultation in 2014. Data collection was performed from the clinical database and through telephone questionnaire surveys. RESULTS: A total of 298 (50%) controls and 298 (50%) cases (120 [40.3%] strabismic amblyopia and 178 [59.7%] refractive amblyopia) were analyzed. A significantly lower birthweight was detected in patients with strabismic amblyopia (mean 2,961 g [95% confidence interval (CI) 2,827-3,096]) compared to controls (mean 3,198 g [95% CI 3,125-3,271]) (p = 0.002). Five-minute Apgar was significantly lower in patients with strabismic amblyopia (mean 9.57 [95% CI 9.37-9.77]) than in controls (mean 9.83 [95% CI 9.77-9.90]) (p = 0.004) or patients with refractive amblyopia (mean 9.79 [95% CI 9.69-9.89]) (p = 0.031). Family history of either amblyopia or strabismus was associated with amblyopia (χ2 [2, n = 562] = 12.66; p = 0.002; Cramer V = 0.150; χ2 [2, n = 561] = 11.0; p = 0.004; Cramer V = 0.140), but was significantly more associated with strabismic amblyopia (p = 0.0023 and p = 0.0032) than with refractive amblyopia (p = 0.48 and p = 0.015, respectively). Multinomial logistic regression model explained 50.8% of the variance in amblyopia development. Low 5-minute Apgar had a relevant odds ratio (OR) for either strabismic amblyopia (OR 3.44; p = 0.066) or refractive amblyopia (OR 3.30; p = 0.077). CONCLUSIONS: This division in amblyopia subtypes gives a new perspective of the risk factors for amblyopia, with family history and some obstetrician/neonatal outcomes appearing to be more relevant in strabismic amblyopia. Educating health care providers to recognize these risk factors can result in an early ophthalmologic referral.


Assuntos
Ambliopia/epidemiologia , Erros de Refração/epidemiologia , Estrabismo/epidemiologia , Adolescente , Ambliopia/fisiopatologia , Peso ao Nascer , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Anamnese , Erros de Refração/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Estrabismo/fisiopatologia , Inquéritos e Questionários , Testes Visuais , Acuidade Visual/fisiologia
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