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At least 415 records · Page 23Linked to original sources
PubMed1998

Laser thermal keratoplasty for the treatment of photorefractive keratectomy overcorrections: a 1-year follow-up.

OBJECTIVE: To evaluate the results of holmium:YAG laser thermal keratoplasty (LTK) treatment for overcorrection of myopia after a photorefractive keratectomy (PRK) treatment. PARTICIPANTS: Thirty-six eyes (33 patients) were treated with a nontouch holmium:YAG laser (Sunrise Technologies, Model LTK, Freemont, CA) because of hyperopia (mean +/- standard deviation of +2.06 diopter [D] +/- 0.75, ranging from +1.0 to +3.5 D) following a PRK treatment. A control LTK group treated for primary hyperopia, who had preoperative refraction values not statistically different from the PRK + LTK group, was used for comparison. INTERVENTION: The number of spots applied varied from 8 to 24, and the energy used was 200 to 240 mJ. A maximum of three rings of four to eight spots were placed between 6 and 8 mm from the visual axis. RESULTS: Twelve months after the LTK retreatment for PRK patients, mean refraction was +1.14 D +/- 1.09. Regression from 1 to 12 months was 0.5 D +/- 1.1. At 12 months, 50% of eyes were within 1 D of emmetropia; 93% of eyes had uncorrected visual acuity (UCVA) of 20/40 or better; and 24% of eyes had UCVA of 20/20 or better. Refraction was not stable for 11 eyes (34%) that regained original sphere values or higher. Best-corrected visual acuity was not affected, and haze was not increased nor decreased by the procedure. CONCLUSIONS: Twelve months after an LTK retreatment for an initial PRK, two thirds of the retreated eyes did not need further retreatments. However, clinical data showed that LTK should be kept for +1 to +2 D of hyperopia for PRK overcorrection retreatments.

Adult↗
PubMed2001

Hyperopic laser in situ keratomileusis to treat overcorrected myopic LASIK.

PURPOSE: To evaluate the safety and efficacy of hyperopic laser in situ keratomileusis (LASIK) in treating hyperopia caused by overcorrected myopic LASIK and to evaluate a new technique to place the hyperopic treatment after lifting the initial myopic flap. SETTING: Open-access outpatient excimer laser surgical facility. METHODS: A retrospective analysis was performed of 54 eyes in 47 patients who had spherical hyperopic LASIK by 21 surgeons for the treatment of significant hyperopia after overcorrected LASIK for myopia. In 42 eyes, the initial LASIK flaps were lifted and in 12 eyes, new flaps were cut. The mean age of the 25 men (53%) and 22 women (47%) was 48.2 years +/- 8.4 (SD). Outcome measures included refractive error, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and complications. The mean follow-up was 2.97 months. RESULTS: In eyes in which postoperative emmetropia was attempted (n = 45), the mean spherical equivalent improved from +1.21 +/- 0.49 diopters (D) preoperatively to -0.38 +/- 0.50 D postoperatively (P <.001). The mean UCVA improved from 20/38.6 +/- 16.3 to 20/27.4 +/- 9.4 (P <.001). At the last follow-up, 69% of eyes were within +/-0.5 D and 96% were within +/-1.0 D of emmetropia; 42% had a UCVA of 20/20 and 96% had a UCVA of 20/40 or better. No eyes lost 2 or more lines of BSCVA. No vision-threatening complications occurred. Results in patients who had initial flaps lifted and those who had new flaps cut were statistically indistinguishable. On average, achieved hyperopic corrections were 18% greater than intended. CONCLUSION: Hyperopic LASIK was safe, predictable, and effective in the treatment of hyperopia caused by overcorrected myopic LASIK. Results were similar whether the original flap was lifted or a new one was cut.

Cornea↗
PubMed2002

Phakic refractive lens experience in Spain.

PURPOSE: To evaluate the efficacy, predictability, and safety of a phakic refractive lens (PRL) for high myopia and hyperopia. SETTING: Instituto Oftalmológico Hoyos, Barcelona, Spain. METHODS: A PRL was implanted in 31 eyes (17 myopic, 14 hyperopic) with a mean preoperative spherical equivalent (SE) of -18.46 diopters (D) (range -11.85 to -26.00 D) for myopia and +7.77 D (range +5.25 to +11.00 D) for hyperopia. All eyes had a thorough ophthalmologic examination before and after surgery. The follow-up was at least 12 months. RESULTS: At 1 year, the mean postoperative SE in the myopic group was -0.22 D +/- 0.87 (SD) and 82% were within +/-1.00 D of the desired refraction. The mean postoperative SE in the hyperopic group was -0.38 +/- 0.82 D, and 79% were within +/-1.00 D. Snellen lines of visual acuity were gained in 65% of the myopic eyes (8 eyes gained 1 line, 3 eyes gained 2 lines), and no eye lost lines. In the hyperopic group, 1 eye gained 1 line of acuity and 1 eye lost 1 line. In the hyperopic group, complications included pupillary block in 2 eyes and pigment dispersion signs without intraocular hypertension in 1 eye. In the myopic group, 1 eye had a corticosteroid-induced intraocular pressure rise, 1 eye had a spot of anterior cortical lens opacity immediately after surgery that did not progress, and 3 eyes with the PRL model 100 had decentration that required replacement of the lens. Four patients (2 myopic, 2 hyperopic) reported night halos in both eyes. CONCLUSIONS: Results indicate that PRL implantation to correct high myopia and hyperopia is a relatively rapid, safe, predictable, and stable method that in many cases also improves the best corrected visual acuity. Complications such as visually significant progressive cataract and pigmentary glaucoma were not observed.

Adult↗
PubMed1991

Hyperopic thermokeratoplasty: clinical evaluation.

A new procedure, hyperopic thermokeratoplasty (HTK), developed in the Soviet Union for the correction of hyperopia, uses controlled thermal burns of the corneal stroma with a retractable probe tip preset to penetrate the cornea at 95% depth. The coagulations are applied in a radial pattern for spherical hyperopia. Only the peripheral cornea is treated and the effect is titrated by varying the optical zone and number of rays. The thermal effect flattens the peripheral cornea and steepens the central cornea. In this report, we prospectively evaluated the refractive results of a group of 61 HTK patients. Mean preoperative spherical equivalent was 3.9 diopters (D). Mean follow-up to date is 5.2 months, with 44% of cases evaluated at six months and 31% at one year. The initial effect of surgery (at one day) was a mean decrease in hyperopia of 6.0 D (standard error of the mean [S.E.] = 0.3 D), resulting in a mean spherical equivalent of -2.1 D (S.E. = 0.2 D). There was a steep regression of effect between one day and two months at which point average refraction was close to emmetropia. After two months, there was a gradual but continuing regression of effect, leveling off after six months. At five to six months, 63% of cases were undercorrected by at least a diopter; at 9 to 12 months, 83% of cases were undercorrected. The overall change in spherical equivalent at each time increased as optical zone size decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Laser in situ keratomileusis after automated lamellar keratoplasty and penetrating keratoplasty.

We present three patients who had laser in situ keratomileusis (LASIK) after corneal surgery as follow: 15 months after automated lamellar keratoplasty (ALK) for hyperopia, 6 months after ALK for hyperopia, and 2 years after penetrating keratoplasty (PKP). Although the first case was uneventful, intraoperative complications arose in the second case because the connection of the ALK-related flap to its stromal bed was insufficient. In the third case, the refractive error caused by PKP was corrected as shown by corneal topography and visual acuity measurement. In conclusion, LASIK after PKP can be considered a precise and safe procedure if 2 to 3 years pass between the procedures. An interval of 6 months between ALK and LASIK was too short, whereas 15 months after ALK for hyperopia, LASIK was performed without problems and delivered a good result.

Adult↗
PubMed1999

Corneal iron ring after hyperopic photorefractive keratectomy.

PURPOSE: To report the incidence and course of corneal iron deposition after hyperopic photorefractive keratectomy (PRK). SETTING: Gazi University, Medical School, Department of Ophthalmology, Ankara, Turkey. METHODS: Between January 1995 and December 1997, 62 eyes had PRK to correct hyperopia. RESULTS: Nine eyes developed corneal iron ring 5 to 8 months (mean 6.25 months +/- 1.3 [SD]) after PRK for hyperopia. The rings persisted during the mean follow-up of 19 +/- 11.09 months. CONCLUSION: The ring-shaped iron deposition after PRK for hyperopia must be differentiated from the Fleischer ring. Our results suggest that the slitlamp findings of peripheral corneal iron deposition in hyperopic PRK patients correlate with achieved correction.

Adult↗
PubMed2002

[In kinetic perimetry high refractive errors also influence the isopter position outside the central 30 degrees].

BACKGROUND: In kinetic perimetry, refractive errors are usually only corrected within the central 30 degrees of the visual field. In this study, we determined whether refractive errors have an influence on the peripheral visual field. PATIENTS AND METHODS: The peripheral visual field was determined with and without contact lens correction always by the same examiner in 58 myopic in 30 hyperopic eyes (range of refractive errors - 25 D to + 17.25 D). If the average of an isopter position determined without contact lens was outside its 95 % confidence interval, a significant influence of the corresponding refractive error was postulated. STUDYDESIGN: Experimental, clinical study. RESULTS: In uncorrected myopias > 11 D and uncorrected hyperopias > 9 D, we observed a significant inward displacement of the I4e isopter. In uncorrected myopias > 18 D and uncorrected hyperopias > 13 D, we observed a significant inwards displacement of the I3e isopter. No influence of refractive errors could be found on the V4e isopter. CONCLUSIONS: In myopias > 11 D and hyperopias > 9 D kinetic perimetry of the peripheral visual field should be performed only after correcting the refractive error with a contact lens. No refractive correction is needed if only the boundaries are determined.

Contact Lenses↗
PubMed2003

Clinical features predictive of successfully weaning from spectacles those children with accommodative esotropia.

PURPOSE: It has been reported that most children with accommodative esotropia are not able to discontinue spectacle wear as they become older. We conducted a prospective study to determine which factors are predictive of successfully weaning children from spectacles. METHODS: Beginning in 1995, children with fully accommodative esotropia with a baseline refractive error of + 1.50 to + 5.00 diopters (D) were gradually weaned from their hyperopic correction. Patients with amblyopia or who had previously undergone strabismus surgery were excluded. Children were weaned in 0.50 D increments until spectacles were discontinued or they developed esotropia, asthenopia, or decreased vision. A multivariate analysis was performed to assess the association between successful weaning and various clinical characteristics. RESULTS: Twelve of 20 children (60%) were successfully weaned from spectacles. Spectacles were prescribed at a mean age of 4.2 +/- 1.5 years, and weaning was initiated at a mean age of 8.0 +/- 1.1 years. The spherical equivalent of the least hyperopic eye when spectacles were prescribed was 2.99 +/- 1.06 D. The clinical characteristic most clearly associated with successful weaning was the refractive error at the time glasses were prescribed. Whereas 10 of 11 (91%) patients with < 3 D of hyperopia were weaned from spectacles, only 2 of 9 (22%) patients with 3 to 5 D of hyperopia were successfully weaned from their spectacles (P =.005). CONCLUSIONS: Many children with fully accommodative esotropia can be weaned out of spectacles during the grade school years. The degree of baseline hyperopia appears to be one of the best predictors of success.

Accommodation, Ocular↗
PubMed2002

Assessment of applanation tonometry after hyperopic laser in situ keratomileusis.

PURPOSE: To determine the reliability and identify pitfalls in intraocular pressure measurement by Goldmann applanation tonometry after hyperopic laser in situ keratomileusis (LASIK). METHODS: Prospective non-masked case series at University of Valencia, Faculty of Medicine and Rahhal Ophthalmology Clinic, Valencia, Spain. One hundred three patients (103 eyes) treated with hyperopic LASIK were evaluated. The main treatment was hyperopic LASIK using a microkeratome Chiron Hansatome (Chiron Vision Corp, Claremont, CA) and the excimer laser Chiron Technolas 217-C LASIK (Chiron Technolas GmbH, Dornack; Germany). Central Goldmann applanation tonometric readings before surgery and 1, 3, and 6 months after surgery were analyzed. RESULTS: After hyperopic LASIK, a significant decrease in intraocular pressure was observed in the postoperative controls. In the low hyperopia patients (range: 1.00-3.00 D) a decrease of 2.43 mmHg was observed at the 6-month follow-up (p < 0.001). In the moderate hyperopia group (range: 3.25-6.00 D) a decrease of 2.05 mmHg was observed at the 6-month follow-up (p < 0.001). There were no significant differences between low and moderate hyperopia (p = 0.812). There was no statistically significant correlation between the magnitude of decrease in tonometry and gender, age, treated spherical equivalent, pachymetry, and anterior chamber depth (ACD). CONCLUSIONS: This clinical study displays that postoperative tonometry after hyperopic LASIK was significantly lower than the preoperative, hence modifying the reliability of Goldmann tonometry, and causing an intraocular pressure underestimation. A correcting factor should be applied when using applanation tonometry to measure postoperative intraocular pressure in patients who have undergone hyperopic LASIK.

Adult↗
PubMed1998

Clinical course of accommodative esotropia.

PURPOSE: To report the clinical course of patients having accommodative esotropia and to determine whether the strabismus resolves during the adolescent years. METHODS: Patients diagnosed with accommodative esotropia from 1983 to 1991 were recalled to the clinic for re-examination. For all patients, the clinical records indicated that the esotropia had begun in early childhood and was controllable at some time during the follow-up period with plus power single vision glasses and/or bifocals. Re-examination included assessment of patient history, visual acuity, ocular alignment, versions, sensory fusion, and refractive error. The ocular alignment status with and without any current plus single vision and/or bifocal correction, and the refractive error at recall, were compared to the same findings taken at the patient's initial clinic visit. These findings were compared to determine whether the accommodative esotropia had resolved, improved, remained the same, or increased in amount. RESULTS: Thirty-nine patients participated in the study. At the time of recall their average age and follow-up period were 16.8 and 9.5 years, respectively. Before treatment, the mean eso deviation was 14.5 delta at distance and 21.6 delta at near. At recall, 15 patients used single vision glasses, 9 used glasses with bifocals, 11 used contact lenses, and 4 patients used no optical correction. Five patients (12.8%) had best corrected acuity in one eye of 20/30 or poorer. Twenty patients (57.1%) were not strabismic with their current refractive correction, whereas 15 patients (42.8%) continued to be esotropic (intermittent or constant) at distance and/or near. When assessing ocular alignment without the current plus power correction, 26 patients (82%) were esotropic and 4 patients (15.6%) were heterophoric. The mean deviation without the optical correction was 18.6 delta at distance and 19 delta at near. Of the 4 patients presenting without an optical correction, 3 were esotropic at distance and/or near and 1 patient was heterophoric. Six patients (15.3%) also had inferior oblique overaction, 2 which occurred with superior oblique palsy. Thirty-three patients (86.8%) fused the Worth dot test at distance and/or near, and 35 patients (89.7%) had stereopsis (mean, 84 sec arc). The mean spherical equivalent refractive error changed for the group from 2.77 D hyperopia at the initial evaluation to 1.95 D hyperopia at recall (mean refractive shift = -0.08 D/year). CONCLUSIONS: Accommodative esotropia persists for most patients into adolescence and early adulthood. These patients need to be carefully monitored during this period because most do not outgrow their hyperopia and some can again become esotropic.

Accommodation, Ocular↗
PubMed1988

Refractive changes from use of silicone oil in vitreous surgery.

When silicone oil fills the vitreous cavity of the phakic eye or the entire aphakic eye, the refractive correction can be expected to change by 5-9 diopters and sometimes as much as 14 diopters. Aphakic eyes become less hyperopic when filled with silicone oil, whereas phakic eyes become more hyperopic when the vitreous cavity is filled with silicone oil. Previously emmetropic aphakic eyes that are filled with silicone oil have only 4-6 diopters of hyperopia, whereas the same eyes have 10-12 diopters of hyperopia before insertion or after removal of silicone oil. Phakic eyes develop 5-7 diopters of hyperopia when the vitreous cavity is filled with silicone oil, and this puts them in the same range as the silicone oil filled aphakic eyes. High myopia, incomplete silicone oil filling, and several other factors influence the final optical outcome. The vitreoretinal surgeon must anticipate significant changes in refractive error when silicone is introduced into an eye or removed from the eye. Careful retinoscopy and refraction is essential for obtaining optimal vision in these patients.

Adult↗
PubMed2001

Hyperopic refractive surgery.

Although the first attempts at hyperopia correction were made more than 100 years ago, it is only in the past several years that the success of hyperopic refractive surgery has begun to approach the efficacy of myopia surgery. Corneal surgery for the correction of hyperopia includes older lamellar techniques such as automated lamellar keratoplasty and epikeratophakia, and more recently photorefractive keratectomy and laser in situ keratomileusis. The latter two procedures have shown the most success. Using large diameter laser ablations and improved keratomes, laser in situ keratomileusis has become a realistic alternative for corrections of up to 4 or 5 diopters with astigmatic corrections. Laser thermal keratoplasty using the Holmium or diode laser and contact techniques also have gained popularity and shown some potential. Collagen shrinkage procedures are easy to perform and have relatively few complications, but over correction and regression are problems. Crystalline lens surgery and phakic intraocular lenses are being investigated actively and are promising; however, safety issues persist. The surgical treatments of hyperopia present a significant challenge and reward for the ophthalmic surgeon.

Cornea↗
PubMed2004

Sources of normal and anomalous motion in retinoscopy.

PURPOSE: Besides the classic "with," "against," and "neutral" absence of motion, retinoscopic reflexes can display anomalous "with" motion in myopia. A model is presented that explains the source of this anomalous motion, as well as quantifies the appearance of retinoscopic motion in myopia and hyperopia. METHODS: Various 2 x 2 matrices were created to describe schematic eyes for a +20 D trial lens, a Gullstrand #1 schematic eye, and an infant schematic eye. Rays from the retinoscope were traced paraxially through these matrices over a full transit of the retinoscope beam across the pupil. Retinal position of the edge of the reflex visible to the observer was plotted as a function of pupil sizes from 2 mm to 16 mm for -5.00 D and +2.00 D refractive errors for the +20 D trial lens. RESULTS: The edge of the retinoscopic reflex could be formed by one of two sources: the edge of the retinoscope beam itself, or the shadow cast by the beam against the edge of the pupil. Anomalous "with" motion arose in myopia when the edge of the reflex was formed by the edge of the beam. The edge of the beam was also visible in hyperopia but did not create anomalous motion. The retinoscope peephole was not involved in the formation of the edge of the reflex. The degree of anomalous motion increased with greater myopia and pupil size. Measured pupil sizes needed to completely eliminate anomalous motion agreed well with those predicted by the model, except at the largest pupil sizes. The limit for anomalous motion depended only on pupil size, refractive error, and working distance but not on whether the system matrix represented the trial lens, a Gullstrand #1 eye, or an infant eye. CONCLUSIONS: Seeing the edge of the beam at large pupil sizes during retinoscopy creates anomalous "with" motion in myopia but may make the reflex easier to see in hyperopia. Anomalous "with" motion in myopia can be managed by adjustment of pupil size, working distance, or net corrected refractive error. Aside from possible effects of aberrations, retinoscopic motion appears to be consistent across various paraxial optical systems for a given refractive error and pupil size.

Artifacts↗
PubMed2005

Aberrations and myopia.

It has been suggested that high levels of axial aberration or specific patterns of peripheral refraction could play a role in myopia development. Possible mechanisms involving high levels of retinal image blur caused by axial aberrations include form deprivation through poor retinal image quality in distance vision, enhanced accommodative lags favouring compensatory eye growth, and an absence of adequate directional cues to guide emmetropization. In addition, in initially emmetropic eyes, hyperopia in the retinal periphery may result in local compensatory eye growth, which induces axial myopia. Evidence in support of these ideas is reviewed and it is concluded that, for any fixed pupil diameter, evidence for higher levels of axial aberration in myopes in comparison with other refractive groups is weak, making involvement of axial aberrations in myopization through image degradation at the fovea unlikely. If, however, some potential myopes had unusually large pupil diameters, their effective aberration levels and associated retinal blur would be larger than those of the rest of the population. There is stronger evidence in favour of differences in patterns of peripheral refraction in both potential and existing myopes, with myopes tending to show relative hyperopia in the periphery. These differences appear to be related to a more prolate eyeball shape. Longitudinal studies are required to confirm whether the retinal defocus associated with the peripheral hyperopia can cause patterns of eyeball growth which lead to axial myopia.

Accommodation, Ocular↗
PubMed1979

A clinical study on the detection of strabismus, anisometropia or ametropia of children by simultaneous photography of the corneal and the fundus reflexes.

Twenty two strabismus and 106 straight eyed patients with anatomically normal eyes were first photographed with a conventional camera equipped with a weak 100 mm teleobjective and coaxial flashlight and then examined clinically. The possibility of detecting strabismus, anisometropias and ametropias in the photographs by noting the localisation of the corneal reflexes and examining the appearance and lightness of the fundus reflexes and their possible asymmetry were tested in a double blind study. Even small angled strabismus cases could be found because of the asymmetrical localisation of the corneal reflexes. In 18 of the 22 strabismus cases (82%) there was asymmetrical lightness of the fundus reflexes and the fundus reflex of the deviating eye was lighter than that of the fixating eye. All the straight eyed anisometropias of 3.0 diopters or more (five cases) were observed in the photographs because of the asymmetrical appearance of the fundus reflexes. In straight eyed anisometropias of under 3.0 diopters, the fundus reflexes were symmetrical in 90 cases and asymmetrical in 11 cases (11%). Only three out of eight hyperopias of fomr +4.5 to +6.0 diopters were found because of the light crescent in the low part of the pupil. All myopias of over -4.0 diopters (14 cases) were observed because of the light crescent appearance in the upper part of the pupil. No pupillary crescents appeared with refractions of less than -1.75 diopters myopia or less than +4.5 diopters hyperopia; 172 eyes came within this range. Even a technician can perform, without premedication, the method tested here for rapid and simple screening to detect strabismus and straight eyed anisometropias of 3.0 diopters or more in small children or other patients who do not co-operate well in normal clinical examination. Over -4.0 diopters myopias can also be found. The method was rather unreliable for finding hyperopias, presumably because no cycloplegic drops were used.

Astigmatism↗
PubMed2000

Anterior chamber depth measured by two methods in myopic and hyperopic phakic IOL implant.

AIM: To evaluate the accuracy and reliability of the optical versus ultrasonic measurement of anterior chamber depth (ACD) in a group of patients affected by high myopia or hyperopia, before phakic IOL implant. METHODS: 18 consecutive patients (34 eyes) were enrolled in this study, and asked to undergo phakic IOL implant to correct high myopia or hyperopia. The mean age was 29.5 (SD 3.4) years, the male/female ratio was 10/8. 13 patients (24 eyes) were myopic (mean myopia -16.17 (4.39) D, range -9 to -24 D), whereas five patients (10 eyes) were hyperopic (mean hyperopia 7.4 (2.01) D, range 5.5-11 D). For each patient, ACD was evaluated comparing an optical system (Orbscan topograph system) with a standard A-scan ultrasound system. To evaluate the reliability of the two methods, the average of three optical and 10 ultrasonic consecutive measurements were considered. Statistical analysis was performed by means linear regression. RESULTS: The average difference between optical and ultrasound values was 0.17 (0.1) mm (4.68% (2.52%)). There was a constant underestimation of the ACD with the optical system compared with the ultrasound measurement, more evident in the hyperopic eyes (5.20% (1. 95%)) than in myopic ones (4.46% (2.72%)). The reliability of measurements, as showed by the standard deviation values, was higher in the optical system (0.03 (0.02)) than in the ultrasound (0.1 (0. 05)), with a statistical difference (p<0.001). The linear regression analysis between optical and ultrasound measurements was 0.8992 (p<0. 0001). CONCLUSIONS: The optical measurement of ACD is an accurate and reliable technique in high myopic and hyperopic eyes. It gives a small underestimation of the ACD values, but it could be preferable to the ultrasound technique, because it demonstrates more repeatability and has the advantages of a non-contact technique.

Adult↗
PubMed2003

Relationship between refraction and prevalent as well as incident age-related maculopathy: the Rotterdam Study.

PURPOSE: To study the relationship between baseline spherical equivalents (SphE) of refraction and prevalent as well as incident age-related maculopathy (pARM and iARM, respectively). METHODS: The study was performed as part of the Rotterdam Study, a population-based, prospective cohort study. The SphE (in diopters), measured with autorefraction and subjective optimization, was recorded in 6209 subjects aged 55 years or more. Aphakic or pseudophakic eyes at baseline were excluded. Stereoscopic transparencies of the macular region were graded according to the International Classification and Grading System. ARM was defined as large soft drusen with pigmentary changes, or indistinct drusen, or atrophic or neovascular age-related macular degeneration (AMD). For the prevalence analyses, ARM was classified into no, p(early)ARM, or pAMD, and in each subject the eye with the most advanced ARM and the corresponding refraction was selected. After a mean 5.2 years of follow-up, 4935 subjects had complete data for these incidence analyses. In each subject, the eye with iARM was selected. RESULTS: The age- and gender-adjusted odds ratio (OR) of pARM (n = 536) for every diopter of progress toward hyperopia was 1.09 (95% confidence interval [CI]1.04-1.13). For p(early)ARM (n = 440) the OR was 1.09 (1.04-1.14) and for pAMD (n = 96) the OR was 1.09 (1.00-1.19). Baseline refraction was significantly associated with increased risk of iARM (n = 497). For each diopter of progress toward hyperopia the OR was 1.05 (95% CI 1.01-1.10). Additional adjustments for smoking, atherosclerosis, and blood pressure did not alter the relationship. CONCLUSIONS: These population-based incidence data confirm results from prevalence and case-control studies that there is an association between hyperopia and ARM.

Aged↗
PubMed2004

Prevalence of refractive errors in a rural South Indian population.

PURPOSE: To report the prevalence of refractive errors in a rural south Indian population. METHODS: Four thousand eight hundred subjects (age, >39 years) from rural south India were enumerated for a population-based study. All participants underwent complete ophthalmic evaluation. Subjects who were phakic in the right eye with best corrected visual acuity of 20/40 or better were included for analysis. Association of refractive errors with age, sex, cataract, and diabetes mellitus were analyzed. RESULTS: Of the 3924 responders, 2508 were eligible. The unadjusted prevalence of emmetropia (spherical equivalent [SE], -0.50 to +0.50 diopter sphere [DS]), myopia (SE < -0.50 DS), high myopia (SE < -5.00 DS), and hyperopia (SE > 0.50 DS) were 50.60%, 26.99%, 3.71%, and 18.70% and age and gender adjusted for the rural Tamil Nadu population were 46.77%, 30.97%, 4.32%, and 17.94%, respectively. The prevalence of emmetropia decreased significantly with age (P < 0.0001), and the prevalence of myopia and high myopia increased significantly with age (P < 0.001) and were significantly associated with nuclear sclerosis (P < 0.001). The prevalence of hyperopia increased until 60 years of age and then decreased. Hyperopia was more common among women than men (P < 0.001) and was negatively associated with nuclear sclerosis (P < 0.001) and positively with diabetes mellitus (P = 0.008). Of the participants with astigmatism (cylindrical error greater than 0.50 DC), 9.80% had with-the-rule (WTR) and 77.44% against-the-rule (ATR) astigmatism. The prevalence of WTR and ATR astigmatism significantly decreased (P < 0.001) and increased (P = 0.006) with age, respectively. CONCLUSIONS: The pattern of refractive errors in this rural south Indian population is similar to those reported in other tropical regions of the world.

Adult↗