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Concept: Optometry

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Diseases involving the macula and posterior pole are leading causes of visual impairment and blindness worldwide and may require prompt ophthalmological care. However, access to eye-care and timely patient management may be limited due to inefficient and inappropriate referrals between primary eye-care providers and ophthalmology. Optometrists with a special interest in macular disease may be useful as a community aid to better stratify and recommend best-practice management plans for suitable patients. This study assesses such a notion by appraising the optometric referral patterns of patients with suspected macular disease to an intermediate-tier optometric imaging clinic.

Concepts: Medicine, Visual perception, Ophthalmology, Eye examination, Optometry

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To investigate the choroidal and retinal thickness in myopic, emmetropic, and hyperopic Chinese children by swept-source longer-wavelength optical coherence tomography.

Concepts: Optics, Lens, Presbyopia, Optometry

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IMPORTANCE Individuals with age-related eye disease (ARED) need to use eye care services for detection, assessment, and care at regular intervals. OBJECTIVE To explore the association between socioeconomic position (SEP) and use of eye care services among US adults with self-reported ARED during 2002 and 2008. DESIGN Data were from the National Health Interview Survey 2002 and 2008. We used multiple logistic regression to estimate predictive margins, controlling for other factors, and we used the slope index of inequality to measure the relationship between SEP and use of eye care services across the entire distributions of poverty-income ratio (PIR) and educational attainment. SETTING A cross-sectional, nationally representative sample of adults, with prevalence estimates weighted to represent the civilian, noninstitutionalized US population. PARTICIPANTS The sample included US participants in the 2002 (n = 3586) and the 2008 (n = 3104) National Health Interview Survey who were at least 40 years old and reported any ARED (age-related macular degeneration, cataract, diabetic retinopathy, or glaucoma). MAIN OUTCOMES AND MEASURES Use of eye care services; SEP was measured by the PIR and educational attainment. RESULTS In 2002, persons with ARED and a PIR of less than 1.50 were significantly less likely than those with a PIR of at least 5 to report visiting an eye care provider (62.7% vs 80.1%; P < .001) or undergoing a dilated eye examination in the past 12 months (64.3% vs 80.4%; P < .001), after adjustment for other factors. Similarly, persons with less than a high school education were less likely than those with at least a college education to report a visit to an eye care provider (62.9% vs 80.8%; P < .001) or dilated eye examination (64.8% vs 81.4%; P < .001). In 2002, the slope index of inequality showed statistically significant differences for eye care provider visits across the levels of education (24.4; P = .006), and in 2008, it showed a significant difference for eye care provider visits across the levels of educational attainment (25.2; P = .049) and PIR (21.8; P = .01). CONCLUSIONS AND RELEVANCE Significant differences in the use of eye care services by SEP persist among US adults with eye diseases.

Concepts: Regression analysis, Statistics, Statistical significance, Retina, Eye, Ophthalmology, Macular degeneration, Optometry

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Purpose To determine the incidence of ophthalmologic disorders in children with autism and related disorders. Design Retrospective chart review. Four hundred and seven children diagnosed with autism or a related disorder between 1998 and 2006. one hundred and fifty-four of these children completed a comprehensive ophthalmology exam by a pediatric ophthalmologist. Results Ophthalmologic pathology was found in 40% of patients with autism or a related disorder with 29% having significant refractive errors, 21% demonstrating strabismus, and 10% having amblyopia. Conclusions Children with autism or a related disorder will frequently have an ophthalmologic abnormality. Since cooperation with vision screening is understandably limited in these children, a comprehensive eye examination by a pediatric ophthalmologist is recommended for all such children.

Concepts: Visual acuity, Ophthalmology, Medical school, Strabismus, Eye examination, Eye surgery, Optometry, Pediatric ophthalmology

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Background: To investigate the distribution of refractive errors and their characteristics in older adults from a Polish population. Methods: The study design was a cross-sectional study. A total of 1107 men and women were interviewed and underwent detailed ophthalmic examinations, 998 subjects underwent refraction. Myopia was defined as spherical equivalent (SER) refraction ≤-0.5 dioptres (D) and hyperopia was defined as SER ≥+0.5 dioptres (D). Results: Among those who were refracted the distribution of myopia and hyperopia was 24.1% (95% CI 21.4-26.7) and 37.5% (95% CI 34.5-40.5), respectively. Myopia decreased from 28.7% in subjects aged 35-59 years to 19.3% in those aged 60 years or older and hyperopia increased from 21.8% at 35-59 years of age to 53.3% in subjects aged ≥60 years. Multiple regression analysis showed decreasing age (OR 0.98, 95% CI 0.96-1.00), female gender (OR 1.87, 95% CI 1.18-2.95) and presence of cataract (OR 2.40, 95% CI 1.24-4.63) were independent risk factors associated with myopia. Conclusions: The distribution of refractive errors found in our study is similar to those reported in other Caucasian populations and differs from Asian populations. Myopia was positively associated with younger age, female gender and presence of cataract.

Concepts: Regression analysis, Population, Refraction, Econometrics, Lens, Eyeglass prescription, Refractive error, Optometry

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Multifocal or multi-zone contact lenses are increasingly being fit to young eyes in an attempt to control myopia progression. However, success in achieving this aim may depend on how much the eye accommodates. The purpose of the current work was to evaluate the ability of an open-field clinical autorefractor to measure on-axis refractive state and accommodation in eyes fit with multifocal contact lenses (CLs).

Concepts: Eye, Cornea, Myopia, Lens, Contact lens, Corrective lens, Optometry, Glasses

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Approximately 5% of the patients in the ophthalmological practice suffer from non-organic vision loss. In children non-organic vision loss has been observed from the age of 6 years. In order to be able to make a rapid diagnosis knowledge of the relevant clinical tests is decisive. If a patient shows signs of non-organic visual loss, diagnostic externalization of the visual function is crucial. Depending on the symptoms there are various tests, which can be used to differentiate between organic and non-organic disorders. For therapeutic and economic reasons an early diagnosis of a non-organic visual loss is crucial. Ophthalmologists need to differentiate between malingering and augmentation, where the patient is aware of the fraud and tries to gain personal benefit from it, and somatoform disorders. In the latter, a more sensitive approach is recommended.

Concepts: Medicine, Optics, Patient, Visual perception, Ophthalmology, Cataract, Optometry, Hypochondriasis

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To evaluate wide-field laser ophthalmoscopy (Optomap 200Tx) for screening retinal lesions before myopic refractive surgery.

Concepts: Surgery, Ophthalmology, Myopia, Optometry

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To investigate whether initial assessment of contact lenses prescribed for myopia control (MC) predicts short-term visual performance.

Concepts: Myopia, Contact lens, Corrective lens, Optometry

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To create a formula to predict refractive correction of autologous lenticule implantation for correction of hyperopia (with myopia in one eye and hyperopia in the contralateral eye).

Concepts: Lens, Refractive error, Optometry