Myopia, commonly referred to as shortsightedness, is the most common eye disease in the world with substantial social, educational, and economic impact. Some of the clinical features of Timira can be correlated with myopia. An open randomized clinical trial was conducted to evaluate the role of Tarpana with and without Nasya in patients suffering from myopia. In total, 41 patients were registered in two groups, out of which 30 patients completed the treatment. In Group A, Tarpana with Mahatriphaladya Ghrita and in Group B, Nasya with Abhijita taila followed by Tarpana with Mahatriphaladya Ghrita was administered. After enrollment of the patients in the study, the cardinal signs and symptoms of Timira — myopia, that is, visual acuity, clinical refraction, were evaluated before and after the treatment. Comparatively, more relief in the signs and symptoms were found in the Nasya group followed by the Tarpana group.
Timira; Myopia; Mahatriphaladya Ghrita; Abhijit Taila; Tarpana; Nasya
Timira is a disease that can be attributed to wide range of clinical conditions starting from mild blurring of vision and having potential risk of permanent vision loss. According to the involvement of Dhatus (body elements) the condition can be grouped into two stages. The initial stage or Uttana, where the involvement of Dhatus is limited to Rasa, Rakta (blood), and Mamsa Dhatu (muscle tissue). When the Doshas are localized in the first and second Patala refractive error do happen and in presbyopia more emphasis is given to Mamsa Dhatu. In this study only Uttana stage of Timira was considered. The clinical study was done on 66 patients of Timira in two groups of four sub groups each of myopia, hypermetropia, astigmatism, and presbyopia. Group A was subjected to eye exercises (Bates method) and Group B was subjected to Trataka Yoga Kriya. After the enrolment of patients for this study, signs and symptoms were assessed both subjectively and objectively before, during, and after treatment. The study indicates that subjectively there are significant results in both the groups but objectively there is not much improvement.
Eye exercises; refractive errors; Timira; Trataka Yoga Kriya
The present pharmacological investigation was undertaken to study the anti-pyretic activity of Guduchi ghrita formulations in albino rats against yeast induced pyrexia. Seven groups of six animals were used for the experiment. The yeast induced pyrexia method was standardized first by injecting 12.5% yeast suspension (s.c) followed by recording the rectal temperature at regular intervals. Then the evaluation of anti-pyretic activity of Guduchi ghrita formulations was carried out by using this standard procedure. Both the Guduchi ghrita samples including vehicle significantly attenuated the raise in temperature after three hours of yeast injection. After 6 and 9 hours of yeast injection also both the Guduchi ghrita samples attenuated the raise in temperature in a highly significant manner in comparison to both yeast control and vehicle control groups. The data generated during study shows that both the Guduchi ghrita formulations having significant anti-pyretic activity.
Guduchi Ghrita; pyrexia; Brewer's yeast; paracetamol; Tinospora cordifolia (Willd.) Miers. medicated ghee
Improper use of sense organs, violating the moral code of conduct, and the effect of the time are the three basic causative factors behind all the health problems. Computer, the knowledge bank of modern life, has emerged as a profession causing vision-related discomfort, ocular fatigue, and systemic effects. Computer Vision Syndrome (CVS) is the new nomenclature to the visual, ocular, and systemic symptoms arising due to the long time and improper working on the computer and is emerging as a pandemic in the 21st century. On critical analysis of the symptoms of CVS on Tridoshika theory of Ayurveda, as per the road map given by Acharya Charaka, it seems to be a Vata–Pittaja ocular cum systemic disease which needs systemic as well as topical treatment approach. Shatavaryaadi Churna (orally), Go-Ghrita Netra Tarpana (topically), and counseling regarding proper working conditions on computer were tried in 30 patients of CVS. In group I, where oral and local treatment was given, significant improvement in all the symptoms of CVS was observed, whereas in groups II and III, local treatment and counseling regarding proper working conditions, respectively, were given and showed insignificant results. The study verified the hypothesis that CVS in Ayurvedic perspective is a Vata–Pittaja disease affecting mainly eyes and body as a whole and needs a systemic intervention rather than topical ocular medication only.
Computer vision syndrome; Shatavaryaadi Churna; Tarpana
This study was undertaken to investigate the impact of formulation factors and adjuvants on the expression of biological activity of Tinospora cordifolia (Willd.) Miers. The adaptogenic effect of three samples of Guduchi ghrita, prepared using plain ghee (clarified butter) obtained from three different sources was studied in albino rats and compared with expressed juice of stem of Guduchi. The test preparations were evaluated against forced–swimming induced hypothermia, gastric ulceration and changes in the hematological parameters. The test drug given in the form of 'ghrita' produced better effect in comparison to the expressed juice. Among the three 'ghrita' preparations evaluated, only the 'Solapur Guduchi ghrita' (SGG) was found to produce significant inhibition of stress hypothermia and gastric ulceration. The other two preparations 'Nanded Guduchi ghrita' (NGG), and 'Wardha Guduchi ghrita' (WGG) could produce only a marginal effect. In hematological parameters 'Guduchi' juice produced better reversal of the stress-induced changes in comparison to the test 'ghrita' preparations. The present study provides evidence highlighting the importance of formulation factors for the expression of biological activity.
Ayurveda; adaptogenic activity; 'Guduchi ghrita'; 'rasaayana'; Tinospora cordifolia (Willd.) Miers
Jara Avastha (stage of old age) is the later phase of life in which maximum decline of bodily elements is observed. Paramanuvibhaga (cell division) takes place at every moment; particularly in old age, it will be fast in comparison with other phases of life. Some organ related changes also take place during this period, which are the decades of Balya, Vridhhi, Chhavi, Medha, Twak, etc., In this study, applied aspects of Medha Hani, Twak Hani, and Drishti Hani were evaluated subjectively as well as objectively. Patients were selected from the OPD of Department of Basic Principles, I.P.G.T. and R.A., Gujarat Ayurved University, Jamnagar, irrespective of their sex, caste, religion, etc., and randomly divided into two groups. Patients in Group A were treated with Panchagavya Ghrita and Group B with plain Go Ghrita for 90 days and the dose of drug was 10 g/day at Nirannakala (early morning with empty stomach). Both groups showed significant results, the difference in between the groups is statistically insignificant.
Aging; Drishti Hani; Jara; Medha Hani; Panchagavya; Twak Hani
The development and progression of early onset myopia is actively being investigated. While myopia is often considered a benign condition it should be considered a public health problem for its visual, quality of life, and economic consequences. Nearly half of the visually impaired population in the world has uncorrected refractive errors, with myopia a high percent of that group. Uncorrected visual acuity should be screened for and treated in order to improve academic performance, career opportunities and socio-economic status.
Genetic and environmental factors contribute to the onset and progression of myopia. Twin studies have supported genetic factors and research continues to identify myopia genetic loci. While multiple myopia genetic loci have been identified establishing myopia as a common complex disorder, there is not yet a genetic model explaining myopia progression in populations.
Environmental factors include near work, education levels, urban compared to rural location, and time spent outdoors. In this field of study where there continues to be etiology controversies, there is recent agreement that children who spend more time outdoors are less likely to become myopic.
Worldwide population studies, some completed and some in progress, with a common protocol are gathering both genetic and environmental cohort data of great value. There have been rapid population changes in prevalence rates supporting an environmental influence.
Interventions to prevent juvenile myopia progression include pharmacologic agents, glasses and contact lenses. Pharmacological interventions over 1–2 year trials have shown benefits. Peripheral vision defocus has been found to affect the emmetropization process and may be affected by wearing glasses or contacts. Accommodation accuracy also has been implicated in myopia progression.
Further research will aim to assess both the role and interaction of environmental influences and genetic factors.
Myopia; Refractive error; Emmetropization; Review
To characterize 24-hour variation of intraocular pressure (IOP) in healthy young adults based upon axial length of the eye.
Twenty-four-hour IOP data from 9 healthy young adults with hyperopia, ages 18 to 25, were collected in a sleep laboratory. Every two hours, measurements of IOP were taken after 5 min in the supine and 5 min in the sitting positions during the 16-hour diurnal/wake period as well as supine in bed during the 8-hour nocturnal/sleep period. Variations in 24-hour IOP in this hyperopia group were analyzed together with previously collected data under the same laboratory conditions from 32 age-matched subjects with emmetropia or mild myopia (emmetropia group) and 34 subjects with moderate to severe myopia (myopia group).
Average diurnal sitting IOP was lower in the hyperopia group than in the other two groups. The difference between the diurnal sitting and diurnal supine IOP was larger in the hyperopia group than in the myopia group. In all three groups, the nocturnal supine IOP was higher than the diurnal sitting IOP. This elevation in habitual IOP was most significant in the hyperopia group. The hyperopia group also presented a significant IOP elevation within the nocturnal period. Simulated 24-hour rhythms of supine IOP were detected in all groups with different phase timings, but simulated 24-hour IOP variations were not different. The 24-hour habitual IOP fluctuation (peak minus trough) was inversely correlated to axial length.
Shorter eyes had a larger 24-hour IOP variation than longer eyes in healthy young adults.
24-hour; axial length; fluctuation; intraocular pressure; posture; refraction
BACKGROUND—Laser intrastromal keratomileusis (LASIK) is an evolving technique which enables high degrees of myopia (>8.0 dioptres) and myopic astigmatism to be corrected. This paper describes initial experience with this procedure. It also details the methodology, the results, the problems encountered, and discusses retreatment procedures.
METHODS—51 eyes (48 primary cases and three retreatments) underwent LASIK for simple myopia or compound myopic astigmatism. After the keratotomy was fashioned with a Chiron corneal shaper, the ablation was performed with either a Summit or Meditec excimer laser. The actual preoperative astigmatism ranged from −0.5 D to −6.0 D (in the astigmatic myopic LASIK (AML) series), while the range of preoperative myopia in the combined myopic LASIK (ML) and AML series was −8.0 D to −37.0 D. Of the ML cases, group 1 (−8.0 to −15.0 D (dioptres)), group 2 (> −15.0 to −20.0 D), and group 3 (> −20.0 D) had mean preoperative myopia values (spherical equivalent) of −11.26 D, −16.84 D and −27.78 D. The same groupings (1, 2, and 3) for the AML cases had respective values of −9.702, −17.4, and −23.08. In the AML series the mean preoperative astigmatism was −2.109 D. Follow up ranged from 8 to 27 months (mean 15.8 months). Six of the cases required retreatment.
RESULTS—There was a reduction in best corrected visual acuity (BCVA) (of 1 Snellen line) in seven of the primary cases (14.5 %) (three in the ML group and four in the AML group), and in one of the retreatment cases. The BCVA improved in 28 cases (58%) in the primary treatment group. The mean correction attempted (spherical equivalent) for the ML groups 1, 2, and 3 was 10.51 D, −14.5 D, and −27.78 D, versus a mean correction achieved of −9.445 D, −15.625 D, and −21.571 D. Similarly, for the AML groups, attempted correction values were −9.702 D, −17.4 D, and −23.08 D, while the values achieved were −6.95 D, −51.425 D, and −15.708 D. Regression was minimal and stabilisation of the refractive result was achieved in all groups, except group 3 of the ML series, by the 3 month examination period. The mean postoperative astigmatism in the AML series was −0.531 D. Vector analysis of the AML series showed that the mean surgically induced astigmatism was +0.93 D. The most common complication encountered was undercorrection, which occurred in 35 cases—23 cases in the ML group and 12 cases in the AML series. Twenty eight per cent of the ML cases, and 25% of the AML cases were within plus or minus 1.5 D of the attempted refraction.
CONCLUSION—For the correction of high myopia and myopic astigmatism, LASIK results in less postoperative pain and relatively little subepithelial haze compared with high myopic photorefractive keratectomy. Furthermore, a stable refraction and reasonably predictable outcome occurs much earlier. High myopia up to −37.0 D can be corrected, albeit with some limitations at the extremes of myopia—in terms of the amount of myopia correctable; this represents a limitation of the technique. Retreatment is a technically straightforward and effective way to treat undercorrection. Undercorrection, the main complication seen in our series, should become less common when the ablation algorithms are further refined.
Vincenz (Wincenty) Fukala, was born in 1847 in Zolkiew at Galicia in Poland, studied medicine and ophthalmology in Vienna in 1871. He was a pioneer in systematically extracting the clear crystalline lens in young patients with high myopia. He demonstrated the benefit to this group of increased visual acuity which enabled them to work and ophthalmologists gradually began to carry out surgery in high myopes worldwide. He persisted in operating despite the vigorous opposition of several authorities but, through sheer determination he convinced skeptics of the efficacy of his surgical method of lens dissection. He performed the first lens discission in 1887 and in 1894, he had successfully treated 44 patients. The late complication of retinal detachment, which was not understood until years later, eventually led surgeons to abandon the procedure until the recent improvements in both lenticular and retinal surgery techniques that led to better prognosis.
Fukala’s operation; Clear-lens extraction; Cataract surgery; Refractive surgery; History of ophthalmology; Fukala; High myopia; Retinal detachment
During myopia development and recovery, remodeling of the scleral extracellular matrix (ECM) alters the axial elongation rate. Proteins involved in cell-ECM adhesions and the cytoskeleton change in abundance, possibly altering slippage of scleral layers across each other.
During the development of, and recovery from, negative lens-induced myopia there is regulated remodeling of the scleral extracellular matrix (ECM) that controls the extensibility of the sclera. Difference gel electrophoresis (DIGE) was used to identify and categorize proteins whose levels are altered in this process.
Two groups of five tree shrews started monocular lens wear 24 days after eye opening (days of visual experience [VE]). The lens-induced myopia (LIM) group wore a −5 D lens for 4 days. The recovery (REC) group wore a −5 D lens for 11 days and then recovered for 4 days. Two normal groups (28 and 39 days of VE; n = 5 each) were also examined, age-matched to each of the treatment groups. Refractive and A-scan measures confirmed the effect of the treatments. Scleral proteins were isolated and resolved by DIGE. Proteins that differed in abundance were identified by mass spectrometry. Ingenuity pathway analysis was used to investigate potential biological pathway interactions.
During normal development (28–39 days of VE), eight proteins decreased and one protein increased in relative abundance. LIM-treated eyes were myopic and longer than control eyes; LIM-control eyes were slightly myopic compared with 28N eyes, indicating a yoking effect. In both the LIM-treated and the LIM-control eyes, there was a general downregulation from normal of proteins involved in transcription, cell adhesion, and protein synthesis. Additional proteins involved in cell adhesion, actin cytoskeleton, transcriptional regulation, and ECM structural proteins differed in the LIM-treated eyes versus normal but did not differ in the control eyes versus normal. REC-treated eyes were recovering from the induced myopia. REC-control eye refractions were not significantly different from the 39N eyes, and few proteins differed from age-matched normal eyes. The balance of protein expression in the REC-treated eyes, compared with normal eyes and REC-control eyes, shifted toward upregulation or a return to normal levels of proteins involved in cell adhesion, cell division, cytoskeleton, and ECM structural proteins, including upregulation of several cytoskeleton-related proteins not affected during myopia development.
The DIGE procedure revealed new proteins whose abundance is altered during myopia development and recovery. Many of these are involved in cell-matrix adhesions, cytoskeleton, and transcriptional regulation and extend our understanding of the remodeling that controls the extensibility of the sclera. Reductions in these proteins during minus lens wear may produce the increased scleral viscoelasticity that results in faster axial elongation. Recovery is not a mirror image of lens-induced myopia—many protein levels, decreased during LIM, returned to normal, or slightly above normal, and additional cytoskeleton proteins were upregulated. However, no single protein or pathway appeared to be responsible for the scleral changes during myopia development or recovery.
The correlation between myopia and intraocular inflammation has rarely been explored. The aim of this article is to review myopic changes induced by inflammatory diseases and inflammatory diseases related to myopia, followed by a discussion on inflammatory choroidal neovascularization. Clinical cases are used to illustrate these conditions. The review does not include inflammatory conditions caused by surgical interventions employed for treatment of myopia. Uveitic conditions that can induce a myopic shift include sclero-choroidal inflammation, lens induced myopia due to steroid cataracts, juvenile idiopathic arthritis (JIA) induced myopia, and transient drug induced myopia due to sulfonamides and acetazolamide used for treatment of ocular toxoplasmosis and inflammatory cystoid macular edema, respectively. Most inflammatory conditions related to myopia are conditions involving the choriocapillaris. These include multifocal choroiditis and/or punctate inner choroiditis, multiple evanescent white dot syndrome and acute idiopathic blind spot enlargement. It can be hypothesized that fragility of the choriocapillaris due to particular anatomic changes due to myopia, together with unknown immunogenetic factors predispose myopic eyes to primary inflammatory choriocapillaropathies.
Myopia; Inflammation; Choriocapillaritis; Multifocal Choroiditis; Multiple Evanescent White Dot Syndrome; Vogt-Koyanagi-Harada Disease
AIMS: To compare the refractive error 1 to 3 years after cryotherapy or diode laser treatment for threshold retinopathy of prematurity. METHODS: Twenty six infants treated with diode laser and 17 infants treated with cryotherapy underwent cycloplegic refraction during follow up. RESULTS: After 3 years of follow up, 94.1% of patients had myopia (right eye if bilateral) following cryotherapy and 45.5% of patients had myopia following diode laser treatment. The difference between the two proportions was 48.7% (95% confidence interval 17.8 to 80.1, p = 0.004). In the cryotherapy group 55% of patients were highly myopic (> -6.00 dioptres) while in the laser group there were no high myopes. CONCLUSIONS: In the diode laser group there were significantly fewer myopes than in the cryotherapy group up to 3 years after the procedure. There was no trend towards increasing myopia in the laser treated group and the refraction in these eyes stabilised after 1 year. In the cryotherapy group there was a significant increase in the degree of myopia between year 1 and year 3 of follow up (p = 0.02). Diode laser treatment is thought to be as effective as cryotherapy, and has the added benefit of reducing myopia, in the treatment of ROP.
Extracellular matrix proteins have been implicated in protein remodelling of the sclera in refractive error. The matrix metalloproteinases (MMPs) falling into the collagenase (MMP1, MMP8, MMP13), gelatinase (MMP2, MMP9) and stromelysin (MMP3, MMP10, MMP11) functional groups are particularly important. We wished to assess their association with myopia, refractive error and ocular biometric measures in an Australian cohort. A total of 543 unrelated individuals of Caucasian ethnicity were genotyped including 269 myopes (≤−1.0D) and 274 controls (>−1.0D). Tag single nucleotide polymorphisms (SNPs) (n = 53) were chosen to encompass these eight MMPs. Association tests were performed using linear and logistic regression analysis with age and gender as covariates. Spherical equivalent, myopia, axial length, anterior chamber depth and corneal curvature were the phenotypes of interest. Initial findings indicated that the best p values for each trait were 0.02 for myopia at rs2274755 (MMP9), 0.02 for SE at both rs3740938 (MMP8) and rs131451 (MMP11), 0.01 for axial length at rs11225395 (MMP8), 0.01 for anterior chamber depth at rs498186 (MMP1) and 0.02 at rs10488 (MMP1). However, following correction for multiple testing, none of these SNPs remained statistically significant. Our data suggests that the MMPs in the collagenase, gelatinase and stromelysin categories do not appear to be associated with myopia, refractive error or ocular biometric measures in this cohort.
Of the 745 available members of the population of Nain in Labrador 650 (87%) were screened for refractive errors and ocular disease. Refraction by retinoscopy was done in 553 and axial length measured by an optical method in 514. The results showed that the incidence of low degrees of myopia was higher in Inuit (Eskimos) and those of Mixed Inuit-Caucasian blood in the age groups 10 to 40 than in those over 40. 75% of the myopes came from 20 families in which myopia was present in 2 or more generations. Although there was no significant correlation between the refraction of parents and offspring, there were significant correlations between them for axial length. The axial lenths of the myopic eyes of the Inuit and Mixed populations were significantly longer than emmetropic and hypermetropic eyes. The younger memebers of the population were taller than their parents, and except in female Caucasians axial length showed a significant positive correlation with height. More myopes than emmetropes and hypermetropes achieved grade 8 or more in school. It is suggested that the increased incidence of myopia in the younger age groups might be due to environmental factors interfering with the process of emmetropisation in eyes with a genetic predisposition to myopia by virtue of inheriting a slightlt longer eye. Better nutrition resulting in an increase in stature may also have had some influence.
Although a myopia susceptibility gene has not yet been elucidated, ten candidate regions (MYP1–MYP10) have been associated with myopia by linkage analysis employing large pedigrees. We report herein on the results of our analysis pertaining to polymorphisms of LAMA1 (alpha subunit of laminin), a promising candidate gene for high myopia present in the MYP2 region of Japanese subjects with high myopia. Three hundred and thirty Japanese subjects with high myopia at a level of greater than −9.25 D and ethnically and sex matched 330 normal controls without high myopia was enrolled in this study. The thirteen SNPs located on the LAMA1 gene were analyzed using PCR and SNP-specific fluorogenic probes. Two of the SNPs were monomorphic and none of the 11 SNPs showed statistically significant association with high myopia in the Japanese population. There is no convincing evidence to prove a connection between nucleotide sequence variations in LAMA1 and high myopia. The pairwise linkage disequilibrium (LD) mapping disclosed a strong value (D' > 0.8) and narrow ranged block within these SNPs.
Before the onset of myopia, children's near work activities did not differ from those of emmetropes. Those who became myopic had fewer sports and outdoor activity hours than emmetropes had, before, at, and after myopia onset.
To investigate visual activities before and after the onset of juvenile myopia.
The subjects were 731 incident myopes (−0.75 D or more myopia on cycloplegic autorefraction in both meridians) and 587 emmetropes (between −0.25 and +1.00 D) in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. Parents supplied visual activity data annually. Data from myopic children 5 years before through 5 years after myopia onset were compared to data from age-, sex-, and ethnicity-matched models of children who remained emmetropic.
Hours per week spent reading or using a computer/playing video games did not differ between the groups before myopia onset; however, hours per week for both activities were significantly greater in myopes than in emmetropes at onset and in 4 of the 5 years after onset by 0.7 to 1.6 hours per week. Hours per week spent in outdoor/sports activities were significantly fewer for children who became myopic 3 years before onset through 4 years after onset by 1.1 to 1.8 hours per week. Studying and TV watching were not significantly different before myopia onset.
Before myopia onset, near work activities of future myopic children did not differ from those of emmetropes. Those who became myopic had fewer outdoor/sports activity hours than the emmetropes before, at, and after myopia onset. Myopia onset may influence children's near work behavior, but the lack of difference before onset argues against a major causative role for near work. Less outdoor/sports activity before myopia onset may exert a stronger influence on development than near work.
To investigate 5-hydroxytryptamine (5-HT) function and 5-HT receptor 2A (5-HT2A) mRNA expression in the formation of lens-induced myopia (LIM).
Lens-induced myopia construction method was applied to generate myopia on guinea pig right eye (LIM eye).
LIM eyes formed significant myopia with longer axial length. 5-HT level in retina, choroids and sclera from LIM eyes was significantly higher than that in control group. 5-HT2A mRNA expression was also significantly up-regulated.
Refraction lens could induce myopia in guinea pig and 5-HT may play an important role in the formation of myopia by binding with 5-HT2A receptor.
guinea pig; high performance liquid chromatography/electrochemical detection; lens-induced myopia; 5-hydroxytryptamine; 5-HT receptor 2A
To determine whether previously reported loci predisposing to nonsyndromic high myopia show linkage to common myopia in pedigrees from two ethnic groups: Ashkenazi Jewish and Amish. We hypothesized that these high myopia loci might exhibit allelic heterogeneity and be responsible for moderate /mild or common myopia.
Cycloplegic and manifest refraction were performed on 38 Jewish and 40 Amish families. Individuals with at least -1.00 D in each meridian of both eyes were classified as myopic. Genomic DNA was genotyped with 12 markers on chromosomes 12q21-23 and 18p11.3. Parametric and nonparametric linkage analyses were conducted to determine whether susceptibility alleles at these loci are important in families with less severe, clinical forms of myopia.
There was no strong evidence of linkage of common myopia to these candidate regions: all two-point and multipoint heterogeneity LOD scores were < 1.0 and non-parametric linkage p-values were > 0.01. However, one Amish family showed slight evidence of linkage (LOD>1.0) on 12q; another 3 Amish families each gave LOD >1.0 on 18p; and 3 Jewish families each gave LOD >1.0 on 12q.
Significant evidence of linkage (LOD> 3) of myopia was not found on chromosome 18p or 12q loci in these families. These results suggest that these loci do not play a major role in the causation of common myopia in our families studied.
To analyze the risk factors of age, sex, course, best corrected visual acuity (BCVA), diopter and fundus features of high myopes with progressive high myopia.
A total of 167 patients with high myopes were categorized into four groups: group 1, age 10-29 years; group 2, age 30-49 years; group 3, age 50-69 years and group 4, age 70-89 years. The refractive errors of all patients were measured without cycloplegia with an autorefractometer. Data of the spherical equivalent (SE) of the refractive errors in diopters (D) and fundus examined by direct ophthalmoscope were used in statistical analysis.
The number of female was statistically larger than that of male (P<0.01), also the disease course was correlated to the age. The visual acuity of high myopes significantly decreased as they grew older including the higher incidence of lacquer cracker, submacular hemorrhage, Fuchs spots, chorioretinal atrophy.
Female maybe a risk factor of high myopia, advanced age is an important factor of visual acuity decreased. High myopes ought to be treated early to delay the progress of myopia and development of macular degeneration.
high myopia; sex; age; diopter; fundus
Eye morbidities with or without symptoms delineate a significant morbidity among adolescent schoolgirls in India. The study was undertaken to assess the extent of visual impairment and ocular morbidity to identify influencing factors and the impact on scholastic performance.
Materials and Methods:
A population-based cross-sectional study was undertaken among 3002 urban girl students of Surat in Gujarat, India. Overall prevalence of refractive error was found to be 15.22%; myopia affected 91.47%, hyperopia 4.60%, and astigmatism 0.04%. The prevalence of myopia and astigmatism was more in higher age groups, while hyperopia was more in lower age groups; even students with good vision reported ophthalmic symptoms. Of all spectacle users, in 29.73% cases the eyesight was not found to be with the best possible corrections. Refractive error was observed to be higher among the general caste (50.98%) and among Muslims (54.05%). Still, among those with problems of eyesight, 75.93% students had good academic performance. Associated ocular morbidity was noted in 20.35% participants along with the refractive error.
This study highlighted the load of eye morbidities of adolescent Indian urban girls.
Refractive errors; Schoolgirls; visual impairments
To identify whether parental history of myopia and/or parent-reported children’s visual activity levels can predict juvenile-onset myopia.
Survey-based data from Orinda Longitudinal Study of Myopia subjects from 1989 to 2001 were used to predict future myopia. Univariate and multiple logistic regression analyses were performed, and receiver operator characteristic (ROC) curves were generated. Differences among the areas under the ROC curves were compared using the method of multiple comparison with the best.
Of the 514 children eligible for this analysis, 111 (21.6%) became myopic. Differences in the third grade between eventual myopes and nonmyopes were seen for the number of myopic parents (P < 0.001) and for the number of sports and outdoor activity hours per week (11.65 ± 6.97 hours for nonmyopes vs. 7.98 ± 6.54 hours for future myopes, P < 0.001). Analysis of the areas under the ROC curves showed three variables with a predictive value better than chance: the number of myopic parents, the number of sports and outdoor activity hours per week, and the number of reading hours per week. After controlling for sports and outdoor hours per week and parental myopia history, reading hours per week was no longer a statistically significant factor. The area under the curve for the parental myopia history and sports and outdoor activities model was 0.73. A significant interaction in the logistic model showed a differential effect of sport and outdoor activity hours per week based on a child’s number of myopic parents.
Parental history of myopia was an important predictor in univariate and multivariate models, with a differential effect of sports and outdoor activity hours per week based on the number of myopic parents. Lower amounts of sports and outdoor activity increased the odds of becoming myopic in those children with two myopic parents more than in those children with either zero or one myopic parent. The chance of becoming myopic for children with no myopic parents appears lowest in the children with the highest amount of sports and outdoor activity, compared with those with two myopic parents.
To investigate the characteristics of retinal function in myopia using full-field electroretinogram (ERG) and multifocal ERG (MF-ERG) and to determine the correlation among MF-ERG, ocular axis length, retinal thickness and degree of myopia.
Twenty emmetropes (20) and sixty-eight myopes (68) underwent manifest refraction, A- and B-scan, fundus examination, fluorescein angiography (FA), optical coherence tomography (OCT), full field ERG and MF-ERG. The amplitudes and implicit times of ERG were determined. The results were further analyzed by comparing ocular axis length, refraction, retinal thickness, and macular function detected by ERG parameters.
There was a significant difference in implicit times of MF-ERG of an emmetrope and a moderate and high myopia whereas implicit times of mild myopia patients and emmetropes were similar. There was a statistically significant difference in amplitude densities of first positive peak of MF-ERG P1 wave between an emmetrope and a moderate and high myopia. In central ring and four quadrants, amplitude densities showed negative correlation to ocular axis length and diopter of myopia. There was no statistically significant difference between the average retinal thickness in emmetropic and physiological myopic eyes (low, medium, high), but there was significant difference between physiological and pathological myopia.
Decreased foveal function as determined by MF-ERG is associated with high degree of myopia. Retinal function impairment is correlated with increase in the diopter of myopia, decrease of corrected visual acuity (VA), elongation of ocular axis and increased macular degeneration.
ERG; Myopia; OCT
Myopia is a common ocular disorder. Prevalence data with regard to myopia is scarce in India and almost nonexistent in Kashmir.
To determine the prevalence of myopia in Srinagar City and to evaluate risk factors associated with the disease.
38 schools in the Srinagar were selected randomly and students were examined by our optometrist team. Children with refractive error of −0.25 D to −5.9 D were considered myopic, while those with −6 D and above were considered high myopic.
Statistical analysis used:
χ2 Tests were used as appropriate to test whether potential risk factors were significantly associated with myopia. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated for risk factors that were independently associated with myopia in this population.
A total of 4,360 students of mean age 12.11 (95% confidence interval [CI] = 11.99 – 12.22: range, 7–18) participated in the study. Myopia was found in 4.74% students. Increasing age was associated with the increased risk of having myopia. Girl students were more likely to have myopia than boys (OR = 1.52). The prevalence of myopia among girls was more than that of boys. Students from low socioeconomic conditions were having higher prevalence of myopia than their counterparts from higher socioeconomic counterparts.
Reduced vision because of myopia is an important health problem in students in Srinagar City. Most of these students do not have the necessary correction spectacles. Effective strategies are needed to eliminate the cause of a significant visual problem.
Myopia; Prevalence; Kashmiri population
A 34-year-old man with severe myopia, presented with acute visual loss in his right eye. This occurred 3 hours after a posterior chamber phakic (PCP) intraocular lens (IOL) implantation, and was associated with a rhegmatogenous retinal detachment. Retinal retachment surgery was performed without complications, with the outcome showing good anatomical and functional results during a 2-year follow-up period.
Despite the fact that several authors have described retinal detachments following PCP IOL implantation in highly myopic patients, there is no evidence that this procedure increases the risk of retinal detachment in these patients. The occurrence of the retinal detachment immediately after the phakic IOL implantation supports the hypothesis that the surgical procedure could induce iatrogenic changes in patients with high myopia, which could increase the incidence of retinal detachment. In contrast to other reports, the interval between the PCP IOL implantation and the retinal detachment was only 3 hours in our patient. We believe this demonstrates the importance of performing a complete preoperative vitreoretinal examination in patients with severe myopia.
retinal detachment; phakic intraocular lens; myopia