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Concept: Eyeglass prescription

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Many fields of basic and applied science require efficiently exploring complex systems with high dimensionality. An example of such a challenge is optimising the performance of plasma fusion experiments. The highly-nonlinear and temporally-varying interaction between the plasma, its environment and external controls presents a considerable complexity in these experiments. A further difficulty arises from the fact that there is no single objective metric that fully captures both plasma quality and equipment constraints. To efficiently optimise the system, we develop the Optometrist Algorithm, a stochastic perturbation method combined with human choice. Analogous to getting an eyeglass prescription, the Optometrist Algorithm confronts a human operator with two alternative experimental settings and associated outcomes. A human operator then chooses which experiment produces subjectively better results. This innovative technique led to the discovery of an unexpected record confinement regime with positive net heating power in a field-reversed configuration plasma, characterised by a >50% reduction in the energy loss rate and concomitant increase in ion temperature and total plasma energy.

Concepts: Fundamental physics concepts, Chemistry, Science, Research, Experiment, Theory, Eyeglass prescription, Complex system

148

Transepithelial photorefractive keratectomy (tPRK), where both the epithelium and stroma are removed in a single-step, is a relatively new procedure of laser refractive error correction. This study compares the 3-month results of myopia and compound myopic astigmatism correction by tPRK or conventional alcohol-assisted PRK (aaPRK).This prospective, nonrandomized, case-control study recruited 148 consecutive patients; 93 underwent tPRK (173 eyes) and 55 aaPRK (103 eyes). Refractive results, predictability, safety, and efficacy were evaluated during the 3-month follow-up. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and mean refractive spherical equivalent (MRSE).Mean preoperative MRSE was -4.30 ± 1.72 D and -4.33 ± 1.96 D, respectively (P = 0.87). The 3-month follow-up rate was 82.1% in the tPRK group (n = 145) and 86.4% in aaPRK group (n = 90), P = 0.81. Postoperative UDVA was 20/20 or better in 97% and 94% of eyes, respectively (P = 0.45). In the tPRK and aaPRK groups, respectively, 13% and 21% of eyes lost 1 line of CDVA, and 30% and 31% gained 1 or 2 lines (P = 0.48). Mean postoperative MRSE was -0.14 ± 0.26 D in the tPRK group and -0.12 ± 0.20 D in the aaPRK group (P = 0.9). The correlation between attempted versus achieved MRSE was equally high in both groups.Single-step transepithelial PRK and conventional PRK provide very similar results 3 months postoperatively. These procedures are predictable, effective, and safe for correction of myopia and compound myopic astigmatism.

Concepts: Visual acuity, Myopia, Lens, Eyeglass prescription, Refractive error, Photorefractive keratectomy

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OBJECTIVE: Because of the northern location of Denmark, the length of the day over the year varies from 7 to 17.5 hours. Experimental and clinical results suggest that the development of myopia may be related to ambient light exposure. The purpose of current study was to investigate whether axial eye growth, myopia progression, or corneal power change in Danish myopic children varies with the length of the day. DESIGN: Cross-sectional study. PARTICIPANTS: Two hundred thirty-five children 8 to 14 years of age found to have myopia during screening for a clinical trial (ClinicalTrial.gov identifier, NCT00263471; accessed December 6, 2005). All children found to have any value of spherical equivalent that was myopic (<0 diopters [D]) at the first of 2 visits were included. METHODS: Cycloplegic refraction was measured using an autorefractor, axial eye length, and corneal power using an automatic combined noncontact partial coherence interferometer and keratometer. The accumulated number of daylight hours during the measurement period was calculated for each participant using an astronomical table. MAIN OUTCOME MEASURES: Change over 6 months in axial length, refraction, and corneal power. RESULTS: Accumulated hours of daylight ranged from 1660 to 2804 hours. Significant correlations were found between hours of daylight and eye elongation (P = 0.00), myopia progression (P = 0.01), and corneal power change (P = 0.00). In children with an average of 2782±19 hours of daylight, axial eye growth was 0.12±0.09 mm, myopia progression was 0.26±0.27 D, and corneal power change was 0.05±0.10 D per 6 months, whereas in children with an average of 1681±24 hours of daylight, axial eye growth was 0.19±0.10 mm, myopia progression was 0.32±0.27 D, and corneal power change was -0.04±0.08 D per 6 months. CONCLUSIONS: Eye elongation and myopia progression seem to decrease in periods with longer days and to increase in periods with shorter days. Children should be encouraged to spend more time outside during daytime to prevent myopia. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Concepts: Cornea, Myopia, Refractive surgery, Lens, Astigmatism, Orthokeratology, Eyeglass prescription, Contact lens

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PURPOSE: To assess the repeatability and accuracy of optical biometry (Lenstar LS900 optical low-coherence reflectometry [OLCR] and IOLMaster partial coherence interferometry [PCI]) and applanation ultrasound biometry in highly myopic eyes. SETTING: Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China. DESIGN: Comparative evaluation of diagnostic technology. METHODS: Biometric measurements were taken in highly myopic subjects with a spherical equivalent (SE) of -6.00 diopters (D) or higher and an axial length (AL) longer than 25.0 mm. Measurements of AL and anterior chamber depth (ACD) obtained by OLCR were compared with those obtained by PCI and applanation A-scan ultrasound. Right eyes were analyzed. Repeatability was evaluated using the coefficient of variation (CoV) and agreement, using Bland-Altman analyses. RESULTS: The mean SE was -11.20 D ± 4.65 (SD). The CoVs for repeated AL measurements using OLCR, PCI, and applanation ultrasound were 0.06%, 0.07%, and 0.20%, respectively. The limits of agreement (LoA) for AL were 0.11 mm between OLCR and PCI, 1.01 mm between OLCR and applanation ultrasound, and 1.03 mm between PCI and ultrasound. The ACD values were 0.29 mm, 0.53 mm, and 0.51 mm, respectively. These repeatability and agreement results were comparable in eyes with extreme myopia (AL ≥27.0 mm) or posterior staphyloma. The mean radius of corneal curvature was similar between OLCR and PCI (7.66 ± 0.24 mm versus 7.64 ± 0.25 mm), with an LoA of 0.12 mm. CONCLUSION: Optical biometry provided more repeatable and precise measurements of biometric parameters, including AL and ACD, than applanation ultrasound biometry in highly myopic eyes. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Concepts: Cornea, Ophthalmology, Accuracy and precision, Myopia, Refractive surgery, Presbyopia, Eyeglass prescription, Staphyloma

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Purpose: To determine the prevalence of anisometropia and its determinants in the population of Mashhad. Methods: In a cross-sectional study in 2008, 4453 residents of Mashhad city between the ages of 1 and 90 years were selected using stratified cluster sampling, of which 70.4% participated in the study. All respondents had visual acuity and refraction testing. Anisometropia was defined as the absolute interocular difference in the spherical equivalent based on non-cycloplegic refraction. The prevalence rates and 95% confidence intervals (CI) of anisometropia were determined based on cut points of 0.5 diopter (D), 1.0 D, and 2.0 D or more, and we used the 1.0 D cut point to examine associations. Results: After applying exclusion criteria, data from 2947 participants were used in the analyses. Based on cut points of 0.5 D, 1.0 D, and 2.0 D or more, the prevalence of anisometropia was 17.0% (n = 451) (95% CI, 15.1-18.8), 5.6% (n = 148) (95% CI, 4.6-6.6), and 1.7% (n = 50) (95% CI, 1.2-2.2), respectively. The odds of anisometropia showed a significant increase of 2.8% with every year of aging (P < 0.001); 2.6% and 2.8% were anisomyopic and anisohyperopic, respectively. The prevalence of anisometropia was directly associated with myopia (P < 0.001) as well as a history of ocular trauma (P < 0.001). The prevalence of anisoastigmatism was 5.6% and significantly increased with age (P < 0.001). Conclusion: The prevalence of anisometropia in the studied population, compared to studies conducted in the Middle Eastern Region and East Asia, is in the midrange. The prevalence of anisometropia is higher at older age, however, children should receive more attention due to the risk of amblyopia. A history of ocular trauma is a risk factor for anisometropia.

Concepts: Sample, Epidemiology, Sampling, Middle East, Asia, Eyeglass prescription, Iran, Cluster sampling

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Comparison between treatment with wavefront optimized and custom-Q laser-assisted in situ keratomileusis (LASIK) ablations. Our study included 400 eyes of 200 patients divided into two equal groups. All patients were treated for myopia and myopic astigmatism with LASIK. The first group was treated with wavefront optimized ablation and the second group with custom-Q ablation. They were examined preoperatively and postoperatively to assess asphericity, image quality, and other classical outcome parameters. The wavefront optimized ablation group comprised 200 eyes with a mean spherical equivalent refraction (SE) of -5.2188 diopters (D) (range: -1.15 to -10.50 D); the mean Q-value changed from 0.30 preoperatively to 0.06 postoperatively. The custom-Q ablation group also comprised 200 eyes with a mean SE of -5.1575 D (range: -1.35 to -9.00 D); the mean Q-value changed from 0.32 preoperatively to 0.03 postoperatively. A statistically significant difference in postoperative change in Q-values (P = 0.02) and in postoperative visual acuity (P = 0.42) between the two groups was noted. There was no difference between the two groups regarding refractive correction. There was a marginally significant change in BSCVA (best spectacle-corrected visual acuity) between the two groups, and less impairment in the corneal asphericity in the custom-Q group.

Concepts: Ophthalmology, Refractive surgery, Lens, Presbyopia, Eyeglass prescription, Contact lens, Refractive error, Hyperopia

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BACKGROUND: To assess the role of Spectral Domain Optical Coherence Tomography (SD-OCT) measurements as prognostic factors in myopic macular hole (MMH) surgery. METHODS: In a retrospective cohort study, we evaluated 42 eyes of 42 patients (Spherical equivalent > -6.00 D) who underwent pars plana vitrectomy with internal limiting membrane peeling for MMH without foveoschisis. Statistical analysis was performed to correlate postoperative best corrected visual acuity (BCVA) with preoperative BCVA, age, degree of myopia and seven preoperative OCT measurements: macular hole (MH) base, MH minimum diameter, MH height, Hole Form Factor (HFF), Macular Hole Index (MHI), Diameter Hole Index (DHI) and Tractional Hole Index (THI). RESULTS: Primary and final anatomical success rate were 83.3 % (35/42) and 90.5 % (38/42), respectively. Four patients deferred reoperation and three underwent a second surgical approach to achieve MH closure. A posterior staphyloma was observed in 27 of 42 patients, and in three of them the MH was located in the apex of the staphyloma. Two of these three cases showed an open MH after the first surgery. Postoperative visual acuity improved in 22/42 (52.4 %) patients, worsened in 7/42 (16.7 %) and remained unchanged in 13/42 (30.9 %). Only MH minimum diameter (P = 0.03) and HFF (P = 0.02) correlated significantly with postoperative BCVA. CONCLUSIONS: Minimum diameter and HFF are strongly correlated with postoperative visual outcomes in cases of MMH. Since analyzing MH configuration seems to improve the anatomical success rate after vitreous surgery in highly myopic patients, these parameters should be preoperatively evaluated by SD-OCT.

Concepts: Cohort study, Retina, Ophthalmology, Vitrectomy, Optical coherence tomography, Myopia, Eyeglass prescription, Staphyloma

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BACKGROUND AND OBJECTIVE:Macular anatomic abnormalities in high myopia are more frequent in the presence of posterior staphyloma. The objective was to determine the prevalence of foveoschisis, foveal detachment, vascular traction, epiretinal membrane (ERM), and macular hole (MH) in eyes with high myopia by spectral-domain optical coherence tomography. PATIENTS AND METHODS:Prospective, observational study. Eyes with myopia greater than 8 diopters (D) were included. Results were analyzed using chi-square and Student’s t tests. RESULTS:The study included 116 eyes of 72 patients. Mean spherical equivalent: -15.04 ± 5.33 D. Mean axial length: 28.88 ± 2.31 mm. Foveoschisis was observed in 17 eyes (14.65%), vascular traction in 17 (14.65%), ERM in 13 (11.2%), lamellar MH in two (1.72%), and posterior staphyloma in 41 (35.34%). Presence of foveoschisis, vascular traction, and ERM was more frequent in eyes with posterior staphyloma (P = .0001). CONCLUSION:Macular anatomic abnormalities were observed in 22.41% of eyes with high myopia and in 53.65% of eyes with posterior staphyloma.

Concepts: Scientific method, Optics, Eye, Ophthalmology, Normal distribution, Myopia, Eyeglass prescription, Staphyloma

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To estimate the prevalence of refractive error in adults across Europe. Refractive data (mean spherical equivalent) collected between 1990 and 2013 from fifteen population-based cohort and cross-sectional studies of the European Eye Epidemiology (E(3)) Consortium were combined in a random effects meta-analysis stratified by 5-year age intervals and gender. Participants were excluded if they were identified as having had cataract surgery, retinal detachment, refractive surgery or other factors that might influence refraction. Estimates of refractive error prevalence were obtained including the following classifications: myopia ≤-0.75 diopters (D), high myopia ≤-6D, hyperopia ≥1D and astigmatism ≥1D. Meta-analysis of refractive error was performed for 61,946 individuals from fifteen studies with median age ranging from 44 to 81 and minimal ethnic variation (98 % European ancestry). The age-standardised prevalences (using the 2010 European Standard Population, limited to those ≥25 and <90 years old) were: myopia 30.6 % [95 % confidence interval (CI) 30.4-30.9], high myopia 2.7 % (95 % CI 2.69-2.73), hyperopia 25.2 % (95 % CI 25.0-25.4) and astigmatism 23.9 % (95 % CI 23.7-24.1). Age-specific estimates revealed a high prevalence of myopia in younger participants [47.2 % (CI 41.8-52.5) in 25-29 years-olds]. Refractive error affects just over a half of European adults. The greatest burden of refractive error is due to myopia, with high prevalence rates in young adults. Using the 2010 European population estimates, we estimate there are 227.2 million people with myopia across Europe.

Concepts: Epidemiology, Statistics, Ophthalmology, Myopia, Refractive surgery, Presbyopia, Eyeglass prescription, Refractive error

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To examine the associations of near work related parameters with spherical equivalent refraction and axial length in Chinese children.

Concepts: Eyeglass prescription