Eye health is everyone’s responsibility: China’s first Western-style eye hospital improves in the prevention of blindness

AIM: To investigate the relationship between China’s first Western-style eye hospital development and the prevention of blindness in China and determine the main factor influencing eye health today.METHODS: Data about eye health, blindness and cataract surgery rate of China from public website of World Health Organization (WHO), ORBIS International, Ministry of Health (MOH) of China, Pubmed center and Historical Archives of Zhongshan Ophthalmic Center (ZOC) were reviewed and analyzed.RESULTS: ZOC is China’s first Western-style eye hospital. In 2012, the ORBIS Flying Eye Hospital has chosen ZOC once again as one of its destinations, 30 years after ORBIS expanded internationally to train eye care professionals and treat underserved patients in developing countries in 1982. During the past 30 years, cataract surgery rate and public awareness of blindness prevention were improved greatly in China, in which ZOC plays a very important role.CONCLUSION: ZOC, as China’s first Western-style eye hospital,has improved in the prevention of blindness. Eye health has become everyone’s responsibility.     

Choriocapillaris’ alterations in the presence of reticular pseudodrusen compared to drusen: study based on OCTA findings

Purpose

To evaluate the qualitative changes of choriocapillaris in the presence of reticular pseudodrusen (RPD) and compare them with conventional small drusen due to dry age-related macular degeneration (AMD).

Procedures

Participants in this study were 59 patients with non-neovascular AMD, presenting either RPD (23 patients) or drusen (36 patients) of similar size. All patients underwent best-corrected visual acuity, slit-lamp examination, spectral domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography.

Results

The morphology of RPD in SD-OCT was depicted either as conical or as amorphous in shape. Both types were found to affect the ellipsoid zone. The presence of RPD was associated with choriocapillaris’ reduced blood flow signal (non-perfusion), while the same but less intense choriocapillaris’ non-perfusion appearance was noticed in the presence of drusen of the same size. In 13% of patients with RPD, ghost-like vessels were observed in the non-perfusion area of choriocapillaris, while in none patients with drusen ghost vessels were present. In all 23 patients with RPD, the choriocapillaris non-perfusion was correspondent to the location of RPD. Additionally, in about 35% of them, choriocapillaris’ impairment was also observed, covering areas outside RPD.

Conclusions

Morphological impairment of choriocapillaris was more intense in patients with RPD than in those with conventional drusen of the same size. The existence of ghost vessels in the area of choriocapillaris’ density defect suggested that choriocapillaris’ alterations may occur in patients with RPD.

     

Response to the letter to the editor: “Coronal plane OCT imaging and vision in macular pucker”

Graefe's Archive for Clinical and Experimental Ophthalmology -     

Ophthalmology and vision science research: part 2: How to commence research--Eureka or that's a little unusual?

Understanding the key elements that increase the likelihood of project success is fundamental for those embarking on research. The first article in this series placed scientific journals in perspective in relation to Journal Impact Factors and citation indices. This second article in a series primarily aimed at those commencing research, particularly in the area of ophthalmology and vision science, delineates the interrelated components that are required to complete a research project. Successful research projects seldom emerge from serendipitous observation, and most evolve through a combination of inspiration, careful planning, and a great deal of industry. Beginning researchers must first be clear about their reason(s) for pursuing research and should identify potential mentors and collaborators at the outset. This article discusses methods of identifying suitable projects and mentors. Ten component areas necessary to complete a research project are addressed, with reference to relevant published literature, under the following topic areas: mentors and collaborators; finding a research topic; confirming suitability of the topic; defining the research question; developing the hypothesis; key considerations in study design; threats to study validity; study sample size; benefits and limitations of clinical science; completing to publication. This guide is intended to be applicable to all embarking on research, but particularly to those with an interest in the visual system. The final 3 articles in this series will deal with writing a research paper to publication standard, working successfully with the journal review process, and refining electronic literature searches.     

Evaluation of ��vision screening�� program for three to six-year-old children in the Republic of Iran

Background:

Since 1996, vision screening of three to six-year-old children is conducted every year in Iran. We present outcomes of project review held in August 2006.

Materials and Methods:

Kindergarten teachers examined vision by using Snellen''s illiterate ‘E’ chart. They used torchlight to detect strabismus. On a repeat test, if either eye had vision <20/30, the child was referred to the optometrist. A pediatric ophthalmologist examined and managed children with strabismus or amblyopia. Provincial managers supervised the screening program. The evaluator team assessed the coverage, yield, quality and feasibility, and cost-effectiveness of vision screening, as well as magnitude of amblyopia, and its risk factors.

Result:

In 2005, 1.4 million (67%) children were examined in all provinces of Iran. Opticians examined 90,319 (61%) children with defective vision that were referred to them. The prevalence of uncorrected refractive error, strabismus and amblyopia was 3.82% (95% CI 3.79 – 3.85), 0.39% (95% CI 0.38 – 0.40) and 1.25% (95% CI 1.24 – 1.26) respectively. Validity test of 7,768 children had a sensitivity of 74.5% (95% CI 72.7 – 76.3) and specificity of 97.2% (95% CI 96.7 – 97.7). The cost of amblyopia screening was US $ 1.5 per child. While the cost of screening and treating one child with amblyopia was US $ 245.

Conclusion:

A review of the vision screening of children in Iran showed it with screening and useful exercise and had a yield of 1:21. The coverage of vision screening was low and the management of children with amblyopia, low vision and refractive error needed strengthening.     

Learning to identify crowded letters: Does the learning depend on the frequency of training?

Performance for many visual tasks improves with training. The magnitude of improvement following training depends on the training task, number of trials per training session and the total amount of training. Does the magnitude of improvement also depend on the frequency of training sessions? In this study, we compared the learning effect for three groups of normally sighted observers who repeatedly practiced the task of identifying crowded letters in the periphery for six sessions (1000 trials per session), according to three different training schedules—one group received one session of training everyday, the second group received a training session once a week and the third group once every 2 weeks. Following six sessions of training, all observers improved in their performance of identifying crowded letters in the periphery. Most importantly, the magnitudes of improvement were similar across the three training groups. The improvement was accompanied by a reduction in the spatial extent of crowding, an increase in the size of visual span and a reduction in letter-size threshold. The magnitudes of these accompanied improvements were also similar across the three training groups. Our finding that the effectiveness of visual perceptual learning is similar for daily, weekly and biweekly training has significant implication for adopting perceptual learning as an option to improve visual functions for clinical patients.     

Through our children's eyes—The public health impact of the vision screening requirements for Indiana school children

BackgroundThe vision screening of preschool and school children is a widely accepted procedure to detect vision problems that can interfere with learning. The Indiana General Assembly requires the annual vision screening with the Modified Clinical Technique (MCT) of all children upon their enrollment in either kindergarten or the first grade, with the exception of schools that apply for and receive waivers to conduct only a distance Snellen chart screening.MethodsIn association with the Indiana State Department of Health, the Indiana University School of Optometry conducted an analysis of statewide school screening data on 36,967 grade 1 children from 139 of the 294 Indiana school corporations that submitted data for the 2000–2001 school year to examine differences in referral rate by screening method, the socioeconomic status of children screened, and academic performance.ResultsThe MCT was used by 125 of the school corporations, and some other technique was used by 14 school corporations. Significant differences were seen when comparing the mean referral rates of school corporations that conduct the MCT against school corporations that do not conduct the MCT (P = 0.001) and in the rate of referral by median family income of the children screened (P = 0.050). A median family income of $46,500 was identified as the level at which the income-specific difference in referral rates ceased to be significant (P = 0.074). In spite of an observed tendency toward a higher referral rate for children who performed below average on the standardized Indiana Statewide Testing for Educational Progress Plus (ISTEP+) exam, results were found to be not significant (P = 0.116) when comparing the percentage of grade 1 children referred to an eye care provider in 2000–2001 with their percentages of passing both the English/language arts and mathematics components of the 2002–2003 ISTEP+ exam (in grade 3).ConclusionSchools using the highly sensitive and specific MCT identified more visually at-risk children than schools using alternative, less sensitive vision screening techniques, and the percentage of grade 1 children referred to an eye care provider was higher for school corporations with lower median family incomes. Although statistically insignificant, the results indicate that students who fail the vision screening in grade 1 tend to be more at risk for poorer academic performance on standardized testing in grade 3.     

Kinesin-2 motors transport IFT-particles,dyneins and tubulin subunits to the tips of Caenorhabditis elegans sensory cilia: Relevance to vision research?

The sensory outer segments (OS) of vertebrate retinal photoreceptors, which detect photons of light, resemble the distal segments of Caenorhabditis elegans sensory cilia, which detect chemical ligands that influence the chemotactic movements of the animal. Based on fluorescence microscopy assays performed in sensory cilia of living, transgenic “wild type” and mutant C. elegans, combined with in vitro motility assays using purified motors, we have proposed that two types of kinesin-2 motor, heterotrimeric kinesin-II and homodimeric OSM-3, cooperate to build amphid and phasmid sensory cilia on chemosensory neurons. Specifically, we propose that these motors function together in a redundant manner to build the axoneme core (aka middle segments (MS)), whereas OSM-3 alone serves to build the distal segments (DS). Furthermore, our data suggest that these motors accomplish this by driving two sequential steps of anterograde transport of cargoes consisting of IFT-particles, retrograde dynein motors, and ciliary tubulin subunits, from the transition zone to the tips of the axonemal microtubules (MTs). Homologs of kinesin-II (KIF3) and OSM-3 (KIF17) are also proposed to contribute to the assembly of vertebrate photoreceptors, although how they do so is currently unclear. Here I review our work on kinesin-2 motors, intraflagellar transport (IFT) and cilium biogenesis in C. elegans sensory cilia, and comment on its possible relevance to current research on vertebrate photoreceptor cilia assembly and function.