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Chen W, Fu J, Sun A, Li L, Sun Y, Meng Z. Paediatric vision screening in Urban Lhasa from the Tibetan Plateau of Southwest China. Eye (Lond) 2023; 37:1336-1341. [PMID: 35668139 PMCID: PMC10170070 DOI: 10.1038/s41433-022-02126-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/05/2022] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Few studies of vision screening in school-aged children were reported in Tibetan Plateau. We herein summarize the results of a mandatory vision screening conducted in young children in the Tibetan Plateau of Southwest China. METHODS The Lhasa Childhood vision Screening (LCVS) performed uncorrected distant visual acuity (UCVA) test on primary school students in urban Lhasa from July to September 2019. Pin-hole corrected VA (PCVA) was obtained for individuals with the UCVA less than 20/25. Decreased VA was defined for UCVA based on the American Academy of Pediatrics guidelines 2016 (UCVA < 20/32 for over 60 months). Visual impairment (VI), Mild VI, and moderate VI to blindness, defined as a PCVA less than 20/40, less than 20/40 to 20/63 and less than 20/63 in the better eye, respectively. RESULTS Overall, 34,848 children aged 9.03 ± 1.87 years fulfilled the screening with a response rate of 98.5%. 18,412 (52.8%) of the participants were males, and 30,531(87.6%) were Tibetan. The prevalence of decreased VA, VI, Mild VI, and moderate VI to blindness was 35.6%, 4.4%, 3.5%, and 1.0%, respectively. The prevalence of decreased VA in grade 1-6 students was 28.8%, 20.8%, 26.9%, 40.7%, 50.8%, 59.5%, respectively. The prevalence of VI in grade 1 to 6 students was 1.5%, 1.4%, 2.4%, 5.6%, 7.7% and 9.9%, respectively. CONCLUSION This study documented a relatively low prevalence of decreased VA and VI in Tibetan primary school students than other urban populations in China. An increasing trend of poor vision with grades was found.
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Affiliation(s)
- Weiwei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
| | - Ali Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Yunyun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Zhaojun Meng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
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Pinhole does not increase screening accuracy of detecting decreased best corrected visual acuity in schoolchildren. BMC Ophthalmol 2021; 21:416. [PMID: 34856946 PMCID: PMC8638540 DOI: 10.1186/s12886-021-02150-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Decreased best corrected visual acuity among children should be treated early in life, and vision screening in schoolchildren is an efficient and feasible selection for developing countries. Thus, the screening accuracy of different visual acuity tests is the key point for making vision screening strategies. The present study aims to explore the screening accuracy of uncorrected visual acuity (UCVA) and pin-hole corrected visual acuity (PCVA) using different vision chart in the detection of decreased best-corrected visual acuity (BCVA) among schoolchildren. Methods Grade one primary schoolchildren in urban Lhasa with data of UCVA using tumbling E chart (UCVAE), PCVA using tumbling E chart (PCVAE), UCVA using Lea Symbols chart (UCVAL), PCVA using Lea Symbols chart (PCVAL) and BCVA using Lea Symbols chart were reviewed. Decreased BCVA was defined as BCVA≤20/32(≥0.2 logMAR). Difference, reliability, and diagnostic parameters in the detection of decreased BCVA of different visual acuity results were analyzed. Results Overall, 1672 children aged 6.58 ± 0.44 years fulfilling the criteria. The prevalence of decreased BCVA was 6.8%. Although no significant differences were found between UCVAE vs UCVAL (p = .84, paired t-test) as well as PCVAE vs PCVAL (p = .24), the ICC between them was low (0.68 and 0.57, respectively). The average difference between BCVA and UCVAE, UCVAL, PCVAE, PCVAL was logMAR -0.08 (− 0.37, 0.21), − 0.08 (− 0.29, 0.17), − 0.05 (− 0.30, 0.19), − 0.06 (− 0.23, 0.12) using Bland–Altman method. The area under the receiver operating characteristic curve of UCVAE, PCVAE, UCVAL, PCVAL for the detection of decreased BCVA was 0.78 (0.73, 0.84), 0.76 (0.71, 0.82), 0.95 (0.94, 0.96), 0.93 (0.91, 0.95), respectively. Conclusion Pinhole does not increase the screening accuracy of detecting decreased BCVA in grade one primary schoolchildren. Visual acuity test using Lea Symbols is more efficient than Tumbling E in the screening of that age. Trial registration Data were maily from the Lhasa Childhood Eye Study which has finished the clinical registration on (ChiCTR1900026693).
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Malaika R, Raffa L, Algethami M, Alessa S. Pediatric spectacle prescription: Understanding practice patterns among ophthalmologists and optometrists in Saudi Arabia. Saudi J Ophthalmol 2021; 34:278-283. [PMID: 34527872 PMCID: PMC8409352 DOI: 10.4103/1319-4534.322608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 08/22/2020] [Accepted: 10/05/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE This study aims to understand the approach to prescribing spectacles for children and the interpretation of refractive errors among ophthalmologists/optometrists in Saudi Arabia. METHODS A cross-sectional survey was conducted between September and November 2018 using a database of online registrants for ophthalmologists and optometrists practicing in Saudi Arabia. The survey included 10 multiple-choice questions designed to elicit information about how ophthalmologists and optometrists deal with commonly encountered case scenarios covering different practical aspects of pediatric refraction. The responses were compared using the proportion of pediatric clientele received in the respondents' practices (Group A: <25%, Group B: 25%) and drawing upon concepts from the published literature. RESULTS One hundred and three participants, including ophthalmologists, specialists/registrars, and optometrists from across Saudi Arabia, participated in this survey. Approximately 25% were classified as Group A. Large discrepancies were observed between the participants' responses and actual practices based on guideline recommendations. Responses varied significantly between Groups A and B on certain issues pertaining to pseudomyopia (P < 0.001), anisometropia (P = 0.033), and high astigmatism (P = 0.023). CONCLUSION Practice patterns regarding pediatric spectacle prescription varied among ophthalmologists and optometrists in Saudi Arabia. The approach to managing refractive errors in children was better among ophthalmologists/optometrists servicing a larger pediatric clientele, suggesting the need to increase awareness among all groups of ophthalmologists/optometrists.
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Affiliation(s)
- Rawan Malaika
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Lina Raffa
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | | | - Sara Alessa
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Chan VF, Yong AC, Azuara-Blanco A, Gordon I, Safi S, Lingham G, Evans J, Keel S. A Systematic Review of Clinical Practice Guidelines for Infectious and Non-infectious Conjunctivitis. Ophthalmic Epidemiol 2021; 29:473-482. [PMID: 34459321 DOI: 10.1080/09286586.2021.1971262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To systematically review and critically appraise clinical practice guidelines (CPGs) and summarise the recommendations for non-infectious and infectious conjunctivitis. METHODS CPGs published on non-infectious and infectious conjunctivitis between 2010 and March 2020 were reviewed, evaluated, and selected using nine items from the Appraisal of Guidelines for Research and Evaluation II tool (4, 7, 8, 10, 12, 13, 15, 22 and 23). CPGs with an average score for items 4, 7, 8, 12, or 22 below 3 and/or a sum of the two researchers' average score for all nine items less than 45 were excluded. Two authors independently extracted and validated the data using standardised forms. RESULTS Fifteen CPGs from five sources remained for data extraction. CPGs consistently recommended non-pharmacological interventions (artificial tears, cold compress, avoidance or removal of allergens) for non-infectious conjunctivitis and pharmacological interventions (topical anti-histamine, mast-cell stabiliser and dual-acting agent) for allergy types. Observation without treatment was strongly recommended for non-herpetic viral and bacterial infections. Systemic and topical anti-viral was consistently recommended for herpetic viral conjunctivitis, while systemic and topical antibiotics were recommended for chlamydial and gonorrhoeal conjunctivitis. The methods used to assess the level of evidence and the strength of recommendation varied among CPGs. CONCLUSIONS There are a number of high-quality CPGs for non-infectious and infectious conjunctivitis. While there were a number of consistencies in the recommendations provided within these CPGs, several inconsistencies were also identified. Many of which related to the scope of practise of the targeted end-user of the particular guideline.
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Affiliation(s)
- Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK.,College of Health Sciences, University KwaZulu Natal, Durban, South Africa
| | - Ai Chee Yong
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK
| | | | - Iris Gordon
- Cochrane Eyes and Vision, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Sare Safi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Who Collaborating Centre for the Eye Care and Prevention of Blindness, Iran
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Jennifer Evans
- Cochrane Eyes and Vision, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Stuart Keel
- Department of Noncommunicable Diseases, Vision and Blindness Prevention Programme, World Health Organization, Geneva, Switzerland
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Chen W, Fu J, Meng Z, Li L, Su H, Dai W, Yao Y. Lhasa childhood eye study: the rationale, methodology, and baseline data of a 5 year follow-up of school-based cohort study in the Tibetan plateau region of Southwest China. BMC Ophthalmol 2020; 20:250. [PMID: 32571250 PMCID: PMC7310065 DOI: 10.1186/s12886-020-01522-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/17/2020] [Indexed: 11/26/2022] Open
Abstract
Background Tibetan Plateau is a highland area with special geographical location, time zone, and ethnic composition. We herein report the rationale, methodology and baseline data of the school-based childhood cohort study named Lhasa Childhood Eye Study (LCES), with the primary objective to pursue a comprehensive understanding on the longitudinal trends of refractive error as well as other ocular diseases and to address the differences between Tibetan Plateau and other parts of the world. Methods Grade one students from primary schools in Lhasa were cluster randomly selected. They were examined and would be conducted with follow-up annually for 5 years. The examination procedures for LCES consisted of standardized ocular, systematic examinations, and questionnaires, identical to the Anyang Childhood Eye Study (ACES) conducted in central China. Results One thousand nine hundred two Grade one students eligible for the LCES, 1856 (97.58%) participated in the study, with a mean age of 6.83 ± 0.46 years (range 5.89–10.32 years), and the proportions of male to be 53.02%. 1762 (94.93%) of the 1856 participants in the baseline exam were Tibetans. 1837 (98.98%) of the students examined had cycloplegic autorefraction performed. The numbers of hyperopia, emmetropia, myopia, and high myopia were 127 (6.91%), 1639 (89.22%), 71 (3.86%) and 3 (0.16%) respectively. Compared with ACES, students from LCES baseline had a younger age (p < 0.001), lower cycloplegic spherical equivalent (p < 0.001), similar myopia prevalence (p = 0.886), lower hyperopia prevalence (p < 0.001), and a higher emmetropia prevalence (p < 0.001). Conclusions LCES was a school-based cohort study in Tibetan Plateau with a high baseline response rate. A higher emmetropic trend was found in LCES compared with ACES. Continuous documentation of this cohort might potentially provide useful reference information for the areas of China which was previously not well studied. Trial registration The study has finished the clinical registration on Chinese Clinical Trial Registry. (ChiCTR1900026693).
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Affiliation(s)
- Weiwei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China.,Beijing Institute of Ophthalmology, Beijing, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China.
| | - Zhaojun Meng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Han Su
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Wei Dai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Yao Yao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
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