RESUMO
Objective: An international survey evaluated the opportunities and threats related to contact lens practice reported by eye care professionals worldwide. This study reports on the results specifically found in Spain and how these compare with those from other regions of the world. Methods: A questionnaire was distributed to eye care practitioners around the world through professional associations. The questionnaire consisted of 9, 5 and 12 questions about opportunities, interventions, and potential threats related to contact lens practice, respectively. Results: A total of 2,408 responses were obtained from practitioners worldwide, of which 436 responses were obtained from Spanish practitioners. Spain was found among the regions with the highest perception of opportunities (median: 6.5/10) along with Australasia, North America, Europe, and South America. Spanish (median: 7.3/10), along with South American practitioners, also reported the highest perception of threats. Continuously updating of knowledge/skills, recommending contact lens wearing options to potential patients, creating an efficient recall system for follow-up examinations and being competent in managing contact lens-related complications were reported as important interventions for contact lens practice growth by Spanish eye care practitioners. Conclusions: Spain is one of the regions in the world with the highest perception of both opportunities and threats regarding future contact lens practice. As such, Spanish practitioners consider it important to continuously update knowledge/skills and to recommend and educate patients on the benefits of contact lens wear. Online sales were found to be one of the most important concerns reported by both Spanish and eye care practitioners worldwide.(AU)
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Humanos , Olho , Lentes de Contato , Visão Ocular , Oftalmologistas , Marketing , Inquéritos e Questionários , EspanhaRESUMO
Purpose: Evaluate the performance of a photochromic contact lens in various lighting conditions throughout the day, including those indoor and outdoor environments where the photochromic contact lens is in a less active or inactive state. Methods: Data from two clinical trials of a photochromic contact lens were analyzed to evaluate its performance in various light environments. Both studies involved a photochromic test lens (ACUVUE® OASYS with Transitions Light Intelligent Technology) and a similar non-photochromic control lens (ACUVUE® OASYS 2-week with HYDRACLEAR® PLUS). The studies were both multi-visit, multi-site, 2-treatment by 3-period randomized crossover (i.e., Test/Control/Control or Control/Test/Test) dispensing studies, with follow-up visits after each 2-week dispensing period. Results: A total of 250 subjects were dispensed lenses across both studies, of which 237 total subjects completed. In situations where exposure to an activating light source is common (e.g., outdoors), the Test lens was preferred nearly 6:1 over the control lens. In situations where exposure to an activating light source is less common indoors, driving at night, using digital devices , the Test lens was still preferred over the control lens by margins of 4:1, nearly 4:1, and over 3:1 respectively. The Test lens was superior with respect to quality of vision, ability to see comfortably, clarity of vision, reduction of squinting while using computers and reduction of bright light while driving at night. Conclusion: The photochromic test contact lens was rated superior to a non-photochromic control lens in environmental situations where the lens is in a less active or inactive state.(AU)
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Humanos , Masculino , Feminino , Lentes de Contato , Luz , Visão Ocular , Olho , Testes Visuais , Optometria , OftalmologiaRESUMO
This article summarizes scientific and practical results of hybrid femtosecond laser-assisted phacoemulsification (HFE) including study of clinical and technical aspects of the intervention and evaluation of post-surgical functional state of the eye on the basis of clinical, morphological and biomechanical data. The HFE technology should be considered the method of choice for microinvasive phaco surgery, its main advantage being the possibility of controlled handling of such important surgical stages as anterior circular continuous capsulorhexis and nucleus fragmentation on a closed eyeball, which significantly reduces the risk of complications and decreases of effective ultrasound time.
Assuntos
Extração de Catarata , Terapia a Laser , Facoemulsificação , Humanos , Facoemulsificação/efeitos adversos , Facoemulsificação/métodos , Capsulorrexe/métodos , Lasers , Olho , Terapia a Laser/métodosRESUMO
Ophthalmic rehabilitation consists of improving or maintaining the functions of the visual analyzer within the possibilities of the "therapeutic window". Ophthalmic rehabilitation involves physiotherapeutic methods, as well as additional ones that improve the condition of the body and indirectly affect the organ of vision. This article presents schematic algorithms of physiotherapeutic ophthalmic stimulation in neurodystrophic diseases of the visual organ and the main results of their multifactorial objective and subjective analysis. It was shown that even with the consistent visual resolution, treatment courses can help get positive changes at the level of nerve structures lasting for three to six months. This allows us to recommend physiotherapeutic ophthalmic stimulation for maintaining the therapeutic effects obtained after the main medical or surgical treatment.
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Olho , Modalidades de Fisioterapia , HumanosRESUMO
Purpose: An intraocular hemorrhage is an adverse event that can lead to visual acuity impairment. Antithrombotic therapy with antiplatelet agents and anticoagulants may increase intraocular hemorrhage. However, since their frequency is low, studies on the risk of intraocular hemorrhage with these drugs, especially under combination therapy, are limited. This study aimed to investigate the occurrence of intraocular hemorrhages under monotherapy and combination therapy with antiplatelets and anticoagulants by analyzing a large pharmacovigilance database. Methods: Intraocular hemorrhage signals with oral antiplatelets and anticoagulants were evaluated by calculating reporting odds ratios and information components using the Japan Adverse Drug Reactions Report database from April 2004 to March 2022. In addition, differences in signals between younger and elderly patients, affecting factors, and time-to-onset from initial antiplatelet and anticoagulant treatments were analyzed. Results: Aspirin, clopidogrel, warfarin, apixaban, and rivaroxaban, but not ticagrelor, ticlopidine, prasugrel, dabigatran, and edoxaban showed intraocular hemorrhage signals under monotherapy. In combination therapy, dual therapy (aspirin + P2Y12 inhibitors, warfarin, direct oral anticoagulants, and P2Y12 inhibitors + warfarin) and triple therapy (aspirin + P2Y12 inhibitors + warfarin) resulted in intraocular hemorrhage signals. Intraocular hemorrhage signals were observed in younger patients receiving monotherapy with aspirin and in elderly patients receiving monotherapy and combination therapy with warfarin. Affecting factors were diabetes mellitus in patients with prasugrel, use of medications for intravitreal injections, and posterior sub-Tenon injections with some antiplatelets and anticoagulants. The median period of intraocular hemorrhage occurrence after starting monotherapy with aspirin, clopidogrel, warfarin, or rivaroxaban was within 90 days. Conclusion: In addition to monotherapy with several antiplatelets and anticoagulants, combination therapy using aspirin, P2Y12 inhibitors, and warfarin has the potential risk of intraocular hemorrhage. Particular attention should be paid to the occurrence of intraocular hemorrhages in younger patients taking aspirin, in elderly patients taking warfarin, and within the first 90 days of antiplatelet and anticoagulant use.
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Anticoagulantes , Olho , Hemorragia , Idoso , Humanos , Anticoagulantes/efeitos adversos , Aspirina/efeitos adversos , Clopidogrel/efeitos adversos , Quimioterapia Combinada , Hemorragia/induzido quimicamente , Inibidores da Agregação Plaquetária/efeitos adversos , Cloridrato de Prasugrel/efeitos adversos , Rivaroxabana/efeitos adversos , Varfarina/uso terapêutico , Japão , Sistemas de Notificação de Reações Adversas a Medicamentos , Olho/patologiaRESUMO
Infectious uveitis is a vision-threatening condition that requires prompt clinical diagnosis and proper treatment. However, rapid and proper diagnosis in infectious uveitis remains challenging. Several examination tests, including polymerase chain reaction (PCR) tests, are transitioning from laboratory-based basic research-level tests to bedside clinical tests, and recently tests have changed to where they can be performed right next to clinicians. In this review, we introduce an updated overview of recent studies that are representative of the current trends in clinical microbiological techniques including PCR tests for infectious uveitis.
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Doenças Transmissíveis , Infecções Oculares Bacterianas , Uveíte , Humanos , Olho , Reação em Cadeia da Polimerase/métodos , Uveíte/diagnóstico , Uveíte/microbiologia , Doenças Transmissíveis/diagnóstico , Transtornos da VisãoRESUMO
There is a growing consensus in the global health community that the use of communication technologies will be an essential factor in ensuring universal health coverage of the world's population. New technologies can only be used profitably if their accuracy is sufficient. Therefore, we explore the feasibility of using Apple's ARKit technology to accurately measure the distance from the user's eye to their smartphone screen. We developed an iOS application for measuring eyes-to-phone distances in various angles, using the built-in front-facing-camera and TrueDepth sensor. The actual position of the phone is precisely controlled and recorded, by fixing the head position and placing the phone in a robotic arm. Our results indicate that ARKit is capable of producing accurate measurements, with overall errors ranging between 0.88% and 9.07% from the actual distance, across various head positions. The accuracy of ARKit may be impacted by several factors such as head size, position, device model, and temperature. Our findings suggest that ARKit is a useful tool in the development of applications aimed at preventing eye damage caused by smartphone use.
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Face , Smartphone , Olho , Atenção à SaúdeRESUMO
PURPOSE: To provide a summary of the research advances on ocular images-based artificial intelligence on systemic diseases. METHODS: Narrative literature review. RESULTS: Ocular images-based artificial intelligence has been used in a variety of systemic diseases, including endocrine, cardiovascular, neurological, renal, autoimmune, and hematological diseases, and many others. However, the studies are still at an early stage. The majority of studies have used AI only for diseases diagnosis, and the specific mechanisms linking systemic diseases to ocular images are still unclear. In addition, there are many limitations to the research, such as the number of images, the interpretability of artificial intelligence, rare diseases, and ethical and legal issues. CONCLUSION: While ocular images-based artificial intelligence is widely used, the relationship between the eye and the whole body should be more clearly elucidated.
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Inteligência Artificial , Aprendizado Profundo , Olho/diagnóstico por imagem , Face , RimRESUMO
Biologics are almost exclusively administered systemically, but localized delivery is preferable as it minimizes off-target exposure and allows more aggressive treatments. Topical application of biologics to epithelia is generally ineffective because most are covered with fluids and biologics are washed out too quickly to have significant therapeutic effects. Here we explore the idea that attaching a binding domain can serve as an "anchor" to extend the residency time of biologics on wet epithelia, allowing their effective use even with infrequent applications. We use topical application to the ocular surface as a challenging test since foreign substances are washed out especially efficiently by tear flow and blinking. Our results demonstrate that conjugation of antibodies to wheat germ agglutinin, which binds GlcNAc and sialic acid that are ubiquitously present in tissues, increases their half-life 350-fold upon application to the ocular surface in a mouse model of dry eye, a common and onerous disease in humans. Importantly, antibodies to IL-17A, IL-23, and IL-1ß conjugated to the agglutinin reduces manifestations of dry eye, even when applied just once daily. In contrast, unconjugated antibodies are ineffective. Attaching an anchor to biologics is a simple means to overcome washout and to extend their therapeutic use.
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Produtos Biológicos , Síndromes do Olho Seco , Humanos , Camundongos , Animais , Produtos Biológicos/farmacologia , Produtos Biológicos/metabolismo , Olho , Síndromes do Olho Seco/tratamento farmacológico , Síndromes do Olho Seco/metabolismo , Lágrimas/metabolismo , Mucosa/metabolismoRESUMO
The ocular micro-dissection of the rodent eye involves the segmentation of the enucleated eyeball with the attached nictitating membrane, or third eyelid, to obtain the anterior and posterior eyecups. With this technique, the sub-parts of the eye, including the corneal tissue, neural tissue, retinal pigment epithelial (RPE) tissue, and lens, can be obtained for wholemounts, cryo-sectioning, and/or single-cell suspensions of a specific ocular tissue. The presence of the third eyelid presents unique and significant advantages, as it benefits the maintenance of the orientation of the eye, which is important for understanding eye physiology following any localized intervention or in studies involving ocular analysis relating to the eye's spatial topography. In this method, we enucleated the eyeball at the socket along with the third eyelid by carefully and slowly cutting through the extraocular muscles and severing the optic nerve. The eyeball was pierced through the corneal limbus using a microblade. The incision was used as the point of entry, allowing for cutting along the corneal-scleral junction by inserting micro-scissors through the incision point. Small and continuous cuts along the circumference were made until the cups separated. These could be further dissected by gently peeling the translucent layer of the neural retina using Colibri suturing forceps to obtain the neural retina and RPE layers. Further, three/four equidistant cuts were made from the periphery perpendicularly to the optic center until the optic nerve was reached. This opened the hemispherical cups into a floret shape so that they fell flat and could be easily mounted. This technique has been used in our lab for corneal wholemounts and retinal sections. The presence of the third eyelid delineates the nasal-temporal orientation, which allows for the study of various cell therapy interventions post-transplantation and, thus, the targeted physiological validation vital for visualization and accurate representation in such studies.
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Cristalino , Microdissecção , Animais , Olho , Retina/cirurgia , Epitélio Pigmentado da Retina , Córnea/cirurgiaAssuntos
Glaucoma de Ângulo Aberto , Glaucoma , Hipertensão Ocular , Humanos , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Inibidores da Anidrase Carbônica/uso terapêutico , Inibidores da Anidrase Carbônica/farmacologia , Olho , Pressão Intraocular , Soluções OftálmicasRESUMO
After the global COVID-19 pandemic, there has been an alarming concern with the monkeypox (mpox) outbreak, which has affected more than 110 countries worldwide. Monkeypox virus is a doublestranded DNA virus of the genus Orthopox of the Poxviridae family, which causes this zoonotic disease. Recently, the mpox outbreak was declared by the World Health Organization (WHO) as a public health emergency of international concern (PHEIC). Monkeypox patients can present with ophthalmic manifestation and ophthalmologists have a role to play in managing this rare entity. Apart from causing systemic involvement such as skin lesions, respiratory infection and involvement of body fluids, Monkeypox related ophthalmic disease (MPXROD) causes varied ocular manifestations such as lid and adnexal involvement, periorbital and lid lesion, periorbital rash, conjunctivitis, blepharocounctivitis and keratitis. A detailed literature review shows few reports on MPXROD infections with limited overview on management strategies. The current review article is aimed to provide the ophthalmologist with an overview of the disease with a spotlight on ophthalmic features. We briefly discuss the morphology of the MPX, various modes of transmission, an infectious pathway of the virus, and the host immune response. A brief overview of the systemic manifestations and complications has also been elucidated. We especially highlight the detailed ophthalmic manifestations of mpox, their management, and prevention of vision threatening sequelae.
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Líquidos Corporais , COVID-19 , Varíola dos Macacos , Humanos , Varíola dos Macacos/diagnóstico , Varíola dos Macacos/epidemiologia , Pandemias , OlhoRESUMO
Glaucoma is a series of linked optic diseases resulting in progressive vision loss and total blindness due to the acquired loss of retinal ganglion cells. This harm to the optic nerve results in visual impairment and, ultimately, total blindness if left untreated. Primary open-angle glaucoma (POAG) is the most frequent variety within the large family of glaucoma. It is a multifaceted and heterogeneous condition with several environmental and genetic variables aiding in its etiology. By 2040, there will be 111.8 million glaucoma patients globally, with Asia and Africa accounting for the vast majority. The goal of this review is to elaborate on the role of genes (nuclear and mitochondrial) as well as their variants in the pathogenesis of POAG. PubMed and Google Scholar databases were searched online for papers until September 2022. Prevalence and inheritance patterns vary significantly across different ethnic and geographic populations. Numerous causative genetic loci may exist; however, only a few have been recognized and characterized. Further investigation into the genetic etiology of POAG is expected to uncover novel and intriguing causal genes, allowing for a more precise pathogenesis pattern of the disease.
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Glaucoma de Ângulo Aberto , Humanos , Glaucoma de Ângulo Aberto/genética , Transtornos da Visão , Olho , Cegueira , Biologia MolecularRESUMO
Amblyopia is a monocular or binocular reduction in visual acuity that results from prolonged visual deprivation in the early years of life. It is second only to refractive error as a cause of poor vision in children. The gold standard treatment of amblyopia includes patching and, less commonly, atropine penalization and filters. These therapies are aimed at improvements in the visual acuity of the amblyopic eye alone. They have compliance and psychosocial issues and gains are accrued after prolonged periods. Experimental studies have demonstrated the presence of binocular cortical communication even in amblyopes and neural plasticity in late childhood as well as adulthood. On this basis, binocular vision therapy aimed at the stimulation of both eyes rather than forced use of the amblyopic eye was developed. Such therapies involve visual tasks designed in such a way that they can be completed only by binocular viewing. These tasks vary from simple game play using red-green glasses, to engaging 3D games and movie viewing. Preliminary data suggest that binocular vision therapy has led to lasting improvements in visual acuity and can be a useful adjunct, if not replacement, to the conventional treatment of amblyopia. In this article, we aim to describe the various binocular vision therapies and review the available literature on the same.
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Ambliopia , Baixa Visão , Criança , Humanos , Adulto , Ambliopia/terapia , Visão Binocular/fisiologia , Acuidade Visual , OlhoRESUMO
Purpose: The main objective of this study is to explore the efficacy of olopatadine 0.1% treatment in the resolution of symptoms of vernal keratoconjunctivitis (VKC) among the Indian population. Methods: This single-center, prospective cohort study involved 234 patients with VKC. Patients were treated with olopatadine 0.1%, twice daily for a period of 12 weeks and then followed up in 1st week, 4th week, 3rd month, and 6th month. The extent of relief in the symptoms of VKC was measured using total ocular symptom score (TOSS) and ocular surface disease index (OSDI). Results: In the present study, the dropout rate was 5.6%. Total of 136 males and 85 females with a mean age of 37.68 ± 11.35 years completed the study. TOSS score reduced from 58.85 to 5.06 and the OSDI score reduced from 75.41 to 11.2 with statistical significance (P < 0.01) from 1st week to 6th week after olopatadine 0.1% treatment. The data showed relief in subjective symptoms of itching, tearing, and redness, and relief in discomfort in functions related to ocular grittiness, visuals like reading, and environmental like tolerability in dry conditions. Further, olopatadine 0.1% was effective in both males and females, and patients across ages 18-70 years. Conclusion: Based on TOSS and OSDI scores, the findings of this study validate safety and tolerability as revealed by low adverse effects and moderate efficacy of olopatadine 0.1% in reducing VKC symptoms in a broader age group (18-70 years) of both genders.
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Conjuntivite Alérgica , Dibenzoxepinas , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Idoso , Cloridrato de Olopatadina , Conjuntivite Alérgica/diagnóstico , Conjuntivite Alérgica/tratamento farmacológico , Conjuntivite Alérgica/induzido quimicamente , Estudos Prospectivos , Dibenzoxepinas/efeitos adversos , Olho , Soluções OftálmicasRESUMO
Purpose: To investigate the change in ocular parameters of anisomyopic children treated with 0.01% atropine. Methods: This retrospective study analyzed the data of anisomyopic children who underwent comprehensive examination at a tertiary eye center in India. Anisomyopic subjects (difference of ≥1.00 D) of age 6-12 years who were treated with 0.01% atropine or prescribed regular single vision spectacle and had follow-ups of more than 1 year were included. Results: Data from 52 subjects were included. No difference was observed in the mean rate of change of spherical equivalent (SE) of more myopic eyes between 0.01% atropine (-0.56 D; 95% confidence interval [CI]: -0.82, -0.30) and single vision lens wearers (-0.59 D; 95% CI: -0.80, -0.37; P = 0.88). Similarly, insignificant change in the mean SE of less myopic eyes was noted between the groups (0.01% atropine group, -0.62 D; 95% CI: -0.88, -0.36 vs. single vision spectacle wearer group, -0.76 D; 95% CI: -1.00, -0.52; P = 0.43). None of the ocular biometric parameters showed any difference between the two groups. Though anisomyopic cohort treated with 0.01% atropine revealed a significant correlation between the rate of change of mean SE and axial length in both eyes (more myopic eyes, r = -0.58; P = 0.001 and less myopic eyes, r = -0.82; P < 0.001) compared to single vision spectacle wearer group, the change was not significant. Conclusion: Administration of 0.01% atropine had minimal effect on reducing the rate of myopia progression in anisomyopic eyes.
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Atropina , Miopia , Humanos , Criança , Midriáticos , Estudos Retrospectivos , Olho , Refração Ocular , Miopia/diagnóstico , Miopia/tratamento farmacológico , Progressão da Doença , Comprimento Axial do OlhoRESUMO
PURPOSE: To demonstrate the practicability of a portable instrument in assessing tear film breakup time (TFBUT): a lens attachment for smartphones (LAS). METHODS: By applying LAS in combination with the iPhone 12 pro, and a recordable slit-lamp microscope, we obtained TFBUT videos from 58 volunteers. The comparison between the conventional slit-lamp microscope and LAS by an experienced ophthalmologist. Moreover, we also invited an ophthalmic postgraduate student and an undergraduate student with no clinical experience to assess TFBUT in those videos. The inter-observer reliability was assessed using intraclass correlation coefficients (ICC). RESULTS: The TFBUT of 116 eyes in total was recorded. Reliability indexes were adequate. The Spearman's correlation analysis and the intraclass correlation coefficient suggested a strong correlation between the 2 modalities (Right eye: Spearman's r = 0.929, 95% confidence interval (CI) = 0.847-0.963, ICC = 0.978, p < 0.001; Left eye: Spearman's r = 0.931, 95% CI = 0.866-0.964, ICC = 0.985, p < 0.001;). Between instruments, the majority of TFBUT measurements showed good agreement on Bland Altman plot. A high concordance was observed in TFBUT, when assessed by an ophthalmologist and an ophthalmic postgraduate student (Left eye: LAS ICC = 0.951, p < 0.001; Left eye: slit-lamp microscope ICC = 0.944, p < 0.001). CONCLUSIONS: Compared with the conventional slit-lamp microscope, the LAS has sufficient validity for evaluating TFBUT in clinics or at home.
