Surgical correction of refractive errors after penetrating keratoplasty.
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Cycloplegic refraction of 1-year-old children is technically possible and is acceptable to mothers as a method for screening children for visual defects. The range of refractions found in a sample of 186 1-year-old children is reported. Prediction of which children are significantly at risk for squint and/or amblyopia is possible on the basis of refractions at age 1 year according to the criteria selected for an 'abnormal' refraction. Bilateral hypermetropia and/or astigmatism or anisometropia at age 1 year was significantly (P less than 1 in 10 000) associated with a child eventually being found to have squint or amblyopia. Both the age of screening and criteria of abnormality will probably need modification. +2.50 or more D hypermetropia in any one meridian of either eye at age 1 year was even more significantly (P = 0.000 000 05%) associated with squint and/or amblyopia. The possibility that meridional hypermetropia could be the basic defect in squint and amblyopia is discussed.
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PURPOSE: To estimate gender- and age-specific prevalence of myopia and identify risk indicators for myopia in a population-based sample of Latino adults aged 40 years and older in La Puente, California. METHODS: Noncycloplegic automated refraction with supplemental standardized subjective refraction was performed for presenting visual acuity worse than 20/20. Potential risk indicators for myopia were evaluated by questionnaire and clinical examination. The gender- and age-specific prevalence of spherical equivalent myopia in phakic eyes was calculated. Multiple logistic regression identified independent risk indicators for myopia. RESULTS: Refractive error was analyzed for the worse eye of 5927 of 6357 participating Latinos. The overall prevalence of myopia < or = -1.0 D was 16.8%, and of high myopia < or = -5.0 D, 2.4%. When participants were stratified by age, myopia initially decreased with age and then increased in the oldest groups in association with nuclear opacification. Risk indicators for myopia were: oldest and youngest age groups, presence of diabetes mellitus, high acculturation, high school or higher education, and birth in the United States. The latter two were also predictors of high myopia. CONCLUSIONS: Risk indicators for myopia in adult Latinos include higher education, birth in the United States, high acculturation, and diabetes. The burden of myopia in older Latinos exceeds that in African Americans and non-Hispanic whites in the United States.
OBJECTIVE: To present a case of photorefractive keratectomy (PRK) with adjunctive topical mitomycin C (MMC) in an anisometropic hyperopic patient after penetrating keratoplasty (PKP) for keratoconus. METHODS: Interventional case report, chart review, and literature review. RESULTS: A 43-year-old man with a refraction of +7.00 -4.75 x 125 in the right eye underwent PRK 10 months after PKP for keratoconus. The patient had sutures removed for 3 months and was intolerant of contact lenses. After photoablation, 0.02% MMC was applied to the corneal stromal bed. The patient was followed up daily until the epithelium closed and at 1 week, 1 month, 3 months, and 6 months postoperatively. CONCLUSIONS: To our knowledge, this represents the first reported case of the use of MMC to prevent postoperative haze after PRK for PKP in an eye with keratoconus. MMC (0.02%) applied topically to the cornea immediately after PRK is safe and effective to treat a hyperopic refractive error after PKP and prevent postoperative corneal haze formation without the risks of performing a lamellar flap into an ectatic corneal bed.
An historical analysis of discoveries related to the treatment of defects of vision is described. Opinions on visual processes, optics and methods of treating myopia, hypermetropia and astigmatism from ancient times through the Middle Ages, the renaissance and the following centuries are presented in particular. The beginning of the usage of glasses is discussed. Examples of the techniques which have been used to improve the subjective and objective methods of measuring refractive errors are also presented.
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Kittens reared in the dark with their eyelids sutured postnatally on one side have developed hypermetropia in the closed eye (average: +2.75 D for the horizontal meridian). This was significantly different (0.01 greater than p greater than 0.005) from the results of the open eye (+1.67 D; 180 degrees). The closed eye of light-reared kittens had similar refractive error (+0.33 D) to that of their open eye (+0.50 D), and to that of kittens light-reared with both eyes open (+0.75 D). Axial length of the closed eye in the dark-reared kittens and its corneal refractive power were smaller in comparison to the results for the open eye. It was concluded that in kittens lid closure during development in the dark induces hypermetropia.
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