Spontaneous resolution of unilateral vitreomacular traction

Vitreomacular traction (VMT) caused visual symptoms in two healthy young adults but spontaneously resolved within four weeks without any sequelae. Optical coherence tomography (OCT) and fundus photographs proved vital in documenting the rare complete resolution of VMT. It is prudent to monitor for spontaneous resolution of VMT in young healthy adults. Disclosure The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Factors affecting accuracy in the Developmental Eye Movement Test measurement for Cantonese‐speaking children

Background: This study aims to determine the factors affecting the accuracy in the Developmental Eye Movement (DEM) test measurement for Cantonese‐speaking children. Method: The voices of 10 Cantonese‐speaking children (aged between six and eight years) undertaking the vertical test (40 numbers) of the DEM test were recorded on a digital audio recorder. These voice clips were assessed by an experienced examiner to give the DEM test times. The examiner repeated the measurement five times for each voice clip and completed all 10 voice clips from the 10 children. The average of a single measurement, the mean of two, the mean of three and the mean of five repeated measurements were then compared. Five experienced and five inexperienced examiners of the DEM test were asked to record the results from five Cantonese‐speaking children by listening to the playback of prerecorded audio clips. The deviation of the results from the preset values between the two groups was compared. Results: There is no difference between the single measurement and those obtained by mean of two, three, four or five. Both experienced and inexperienced examiners obtained a higher deviation from the preset values in the adjusted compared with the non‐adjusted times in both vertical and horizontal times. Experienced examiners measured the vertical times and adjusted vertical times significantly closer to the preset values than the inexperienced examiners (paired t‐test, p < 0.05). Conclusion: The DEM test needs to be measured only once for an accurate time measurement. Inaccurate assessment of ‘reading errors’ in the DEM test can increase the inaccuracy of the adjusted times. It is suggested that an audio recording of the test be made to allow reassessment of reading errors. Experience in using the DEM test yields a more accurate DEM measurement as errors are detected more easily.     

Evaluation of various methods in the detection of protein calorie malnutrition (PCM) of early childhood

3 different anthropometric methods and clinical assessment were carried out on 82 children aged 1–5 years, to diagnose protein calorie malnutrition.The anthropometric methods used include measurements of weight-for-age, weight-for-height, mid-arm circumference and the use of a Quac stick. The results obtained showed close agreement between two methods, namely weight-for-height and mid-arm circumference measurements.The mid-arm circumference measurement proved to be the easiest, simplest and fastest method to employ in detecting protein calorie malnutrition among a population of children below the age of 5 years. A combination of mid-arm circumference and weight-for-height measurements is recommended for better and more accurate results.     

Laser in situ keratomileusis with a scanning excimer laser for the correction of low to moderate myopia with and without astigmatism

PURPOSE: To evaluate the safety and effectiveness of and patient satisfaction with laser in situ keratomileusis (LASIK) performed with a scanning excimer laser by experienced surgeons to correct low and moderate levels of myopia and astigmatism. SETTING: Clinique Laservue, Montreal, Quebec, Canada. METHODS: A consecutive series of 125 patients (236 eyes) with myopia of -0.5 to -7.0 diopters (D) and cylinder less than 2.5 D were enrolled in this single-center prospective clinical trial. The patients were treated with LASIK and followed for 6 months. The System-ALK Automated Corneal Shaper microkeratome (Bausch & Lomb Surgical) with a 180 microm thickness plate and the Technolas 217 excimer laser (Bausch & Lomb Surgical) with PlanoScan software for the stromal ablation were used in all procedures. Since this version of PlanoScan tended to undercorrect, a mean of 14.7% was added to the standard nomogram. Patient satisfaction was assessed by questionnaires administered preoperatively and 1 and 6 months postoperatively. Retreatments for enhancement were not performed during the 6-month follow-up. RESULTS: Six months after LASIK (86.4% follow-up), the mean postoperative manifest spherical equivalent was +0.02 D +/- 0.64 (SD) compared with a preoperative mean of -4.01 +/- 1.59 D. The uncorrected visual acuity was 20/40 or better in 94.6% of eyes and 20/20 or better in 81.9%. A total of 91.2% were within +/-1.0 D of emmetropia and 73.0% were within +/-0.5 D. Only 2 eyes were overcorrected by >1.0 D. Of the eyes with astigmatic myopia, 86.8% were within +/-1.0 D of the intended cylinder correction (by vector analysis) and 73.0% were within +/-0.5 D. The refractions were generally stable after 1 month, and the change in refraction between postoperative examinations was within +/-0.5 D in 88.0% of eyes. A 1-line decrease in best spectacle-corrected visual acuity was seen in 11.3% of eyes, and no eye lost more than 1 line. An increase of 1 or 2 lines was seen in 45.1%. No intraoperative problems occurred, and the interface was clear in all eyes. At 6 months, most symptoms present significantly more frequently than preoperatively were "mild"; none were "marked" or "severe." A total of 90.5% of eyes were reported with marked to extreme improvement in the overall quality of vision, and 99.0% of patients said they would choose LASIK surgery again. CONCLUSIONS: Mild to moderate myopia, with and without astigmatism, was corrected safely, effectively, and predictably with a high degree of patient satisfaction using LASIK with a scanning excimer laser and the System-ALK Automated Corneal Shaper.     

Clinical outcomes following the dispensing of ready‐made and recycled spectacles: A systematic literature review

Uncorrected refractive error is the leading cause of global visual impairment. Given resource constraints in developing countries, the gold standard method of refractive error correction, custom‐made spectacles, is unlikely to be available for some time. Therefore, ready‐made and recycled spectacles are in wide use in the developing world. To ensure that refractive error interventions are successful, it is important that only appropriate modes of refractive error correction are used. As a basis for policy development, a systematic literature review was conducted of interventional studies analysing visual function, patient satisfaction and continued use outcomes of ready‐made and recycled spectacles dispensed to individuals in developing countries with refractive errors or presbyopia. PubMed and CINAHL were searched by MESH terms and keywords related to ready‐made and recycled spectacle interventions, yielding 185 non‐duplicated papers. After applying exclusion criteria, eight papers describing seven studies of clinical outcomes of dispensing ready‐made spectacles were retained for analysis. The two randomised controlled trials and five non‐experimental studies suggest that ready‐made spectacles can provide sufficient visual function for a large portion of the world's population with refractive error, including those with astigmatism and/or anisometropia. The follow‐up period for many of the studies was too short to confidently comment on patient satisfaction and continued‐use outcomes. No studies were found that met inclusion criteria and discussed recycled spectacles. The literature also notes concerns about quality and cost effectiveness of recycled spectacles, as well as their tendency to increase developing countries' reliance on outside sources of help. In light of the findings, the dispensing of ready‐made spectacles should be favoured over the dispensing of recycled spectacles in developing countries.