Abstract Objective: Maculopathies are more and more frequent. For the follow-up of its evolution and therapy, it seems important for us to determine the baseline in normal subjects by Optical Coherence Tomography (OCT). The goal here is to determine the acceptable range of macular thickness in normal black sub jects in Lomé. Methodology: This is a retrospective study over a 6-month period. It did not include all patients with retinopathy of any cause, maculopathy, and glaucoma. The analyzed variables were the average macular thickness, the central macular thickness, and the total macular volume. Results: Out of the 433 macular OCT performed, 191 patients were selected; a total of 338 eyes. These included 96 men and 95 women. A sex ratio was 1.01. The median age was 44.1 years with extremes ranging from 10 to 70 years. The average macular thickness was 263.4 µm for the right eye and 263.7 µm for the left eye. The central macular thickness was 174.1 µm for the right eye and 173.3 µm for the left eye. The total macular volume was 7.4 in both eyes. Discussion: No significant statistical difference existed between the two sexes. The average macular thickness found in this study was within the range of normality observed in the literature, which is between 216 and 288 µm. Conclusion: The average macular thickness of the normal subject in Lomé was 263.4 µm.

Abstract The case studies are about atypical bilateral, postoperative Cystoid Macular Edema (CME) in two patients who underwent bilateral uncomplicated pha coemulsification surgery with a trifocal Intraocular Lens (IOL). In postopera tive follow-up, both the cases presented with complaints of bilateral blurring of vision. Irvine-Gass syndrome has been diagnosed after evaluation of the ret ina by fundoscopy and OCT macula. Posterior subtenon steroid injection has been prescribed and given. Regular OCT examinations indicated substantial ede ma improvement. Subsequent improvement in visual acuity was also noted in both cases. Cystoid macular edema can happen in any case irrespective of the quality of IOL. The visual outcome is satisfactorily responsive towards steroid medication.

Abstract Introduction: Patient satisfaction is defined as the extent of agreement be tween what a patient expects to receive from his or her health experience and the perception of the level of care he or she actually receive. With the COVID-19 pandemic, many practices have to adapt to provide health ensuring patients’safety in first instance. Eye care procedures may be delayed during the pandemic, so eye safety is more important than ever, and it doesn’t only focus on the examination room, all the clinic compartments must be adjusted to ensure that no patient is infected by COVID-19 within the clinic. The aim of this study was to assess the satisfaction of patients who attended the Lúrio University Clinic for eye care during COVID-19. Material and Methods: This is a quantitative, descriptive and cross-sectional study conducted from December 30th, 2020 to April 30th, 2021. A systematic random sampling method was used to enroll173 participants. Data were collected using an identification form and the patient satisfaction survey. Ethical clearance was obtained from the Lúrio University Bioethical Committee review board, and informed consent term was also received from the participants before data collection. Results: 173 participants (84 women, 48.6% and 89 men, 51.4%) completed the survey with the mean age of 31.14 and standard deviation of ±14.6 years. We found that 98.3% of the participants were satisfied (63.6% satisfied and 34.7% extremely satisfied) with the eye care provided in Lúrio University Clinic. Conclusion: Most of the patients were satisfied with the eye health examination provided in Lúrio University clinic, thus the directions for future research of the study are now opened.

Abstract Purpose: To evaluate axial length before and after the photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). Setting: Alhokama Eye Center, Riyadh Saudi Arabia. Design: A cross-sectional study. Methods: The study sample was comprised of 106 eyes of 54 patients. Patients were divided into 2 groups based on whether they had photorefractive surgery (PRK group) or laser in situ keratomiluesis (LASIK group). The intra-group comparison was performed of the changes in axial length before and after surgery using IOLMaster. P < 0.05 was considered statistically significant. Results: There were 76 eyes (39 patients) in the PRK group with the mean age of 25.10 ± 3.47 years, the mean preoperative spherical equivalent of −3.16 ± 1.75 D, and the mean preoperative axial length of 24.79 ± 1.02 mm. In the LASIK group, there were 30 eyes (15 patients) with the mean age of 25.13 ± 4.91 years and the mean preoperative spherical equivalent of −5.58 ± 1.98 D and the mean preoperative axial length of 25.67 ± 1.35 mm. Postoperatively, the mean axial length was 24.70 ± 1.14 mm in the PRK group and 25.60 ± 1.33 mm in the LASIK group. The mean change between the preoperative and postoperative axial length was statically significant in both groups (P < 0.00001, both intra-group comparisons). Conclusion: There was a statically significant decrease in the axial length measurements after PRK or LASIK for myopia.

Abstract Stickler syndrome (SS) is an autosomal dominant inherited genetic disorder that presents with hearing loss, a cleft palate, epiphyseal dysplasia, and degeneration, similar to arthritis and well known to be associated with rhegmatogenous retinal detachments. A particular group of physical features called Pierre Robin sequence is also common in people with stickler syndrome. Pierre Robin sequence includes a cleft palate, glossoptosis, and micrognathia. We describe a case report of a family diagnosed with stickler syndrome presenting with Pierre Robin sequence and share some universal management steps for rhegmatogenous retinal detachment in stickler syndrome. Genetic testing is important to support the diagnosis and conduct screenings of family members.

Abstract Introduction: Refractive error is recognized as one of the most important causes of correctable visual impairment and affects people of all ages, socioeconomic levels, and ethnic groups. The World Health Organization (WHO) estimated 285 million people globally were visually impaired, with 39 million blinds. The aim of this study is to access the knowledge, attitudes, and practices of health sciences students about the refractive error in Nampula, Mozambique. Material and Methods: Descriptive cross-sectional study including health sciences students of Lúrio University in Nampula, applying a questionnaire to access their knowledge, attitudes, and practices concerning the refractive error. The collected data were entered into SPSS version 22.0 for analysis. Frequency distribution and central tendency measures (mean, median) were used to summarize the descriptive part of the study. Results were described using tables and running text. Sample students were included after obtaining informed consent. Results: A total of 298 students participated in the study, 50.3% female, with average age of 24 ± 5.4 years. 69.8% had an eye exam and 54.7% believe they have good vision, 58.1% say that wearing glasses is the main method of correcting refractive errors. 92.3% refer to the Central Hospital as the best place to provide eye health services. The main reason for not purchasing the glasses was their cost (47.3%) and the alternative method for spectacle users was contact lenses (81.0%). The students’ attitudes were positive towards the use of glasses.Conclusion: Visual health education about the knowledge, attitudes and practices regarding refractive errors among students must be intensified to ensure good dissemination of information in the surrounding communities enrolled in the health promotion program “One Student, One Family” implemented by Lúrio University in Nampula.

Abstract Aim: To describe the socio-demographic profile of the participants and the ocular pathologies seen during a 3-day free eye screening and cataract surgical camp, to identify the groups we need to create awareness to, and to improve access in subsequent outreaches. Method: A retrospective cross-sectional descriptive study was carried out among 552 participants that attended a cataract surgical outreach camp in New Karu Local Government Area (L.G.A.), Nasarawa State from 10th to 14th September 2013. Data were analyzed using SPSS Version 20 using descriptive analysis such as frequencies and cross-tabulation. P < 0.05 was considered statistically significant. Results: Six hundred and sixty-six people registered and 552 were examined comprising of 205 males and 347 females. The majority (81.7%) were younger than 60 years old, accounting for 4.5 times more than those older than 60. Females were in the majority (63%). Amongst those older than 60 years, males were slightly higher as compared to those younger than 60 years, where females were twice as much. Most of the participants (71.3%) reside within the L.G.A. Amongst those that reside within the L.G.A., females were twice the men and there was a fairly even distribution of both sexes amongst those that reside outside the L.G.A. The majority of the screened participants (41%) required presbyopic correction. Cataract was the second commonest ocular pathology (22.6%) and 53 (9.6%) participants with VA ≤ 6/60 were offered the free cataract surgery. Conclusion:There was an increase in female participation and those younger than 60 years.Amongst those younger than 60 years and those that reside within New Karu L.G.A., female participation was twice as much as males. When the barrier of distance is eliminated, it increases female participation.

Abstract Background: As a cause of blindness, ocular injury constitutes 1.5% of all causes of blindness. In the developed world, trauma is also the leading cause of unilateral blindness and is preceded only by the cataract as a cause for vision impairment. Males are much more likely than females to sustain ocular trauma. The ocular effects of trauma can be far-reaching, so timely intervention is of prime importance to improve the visual outcome. General Objective: To evaluate the visual outcome after ocular injury. Methods: This study was conducted at Nagri Eye Hospital, Ahmadabad. In total, 68 eyes of 68 patients with eye injury were included in this study. Detail history was taken from the entire patient and a detailed ocular examination was done. Results: The mean age of incidence of the patients was 25.39 ± 16.89. The commonest age group presented with ocular trauma was <10 yrs followed by the 2nd decade, i.e., 11 - 20 yrs. A great majority of patients were male with the mean age of 25.89 ± 16.55 accounting for 83.82%. The majority of the patients have visited the hospital in between the time period of 24 hrs - 1 wk (57.35%), followed by 23.52% within the time period of <24 hrs. The majority of the patients got their eyes traumatized during industrial work (27.94%) followed by domestic work (26.47%). 19.11% of patients have got the trauma during agricultural activity. The commonest type of ocular trauma was with wooden material (19) followed by metallic (13). The blunt types of trauma were most frequent accounting for 42.64% followed by combined blunt and perforating 32.35%. A comparative study of visual recovery was also done between the presenting visual acuity and the final visual outcome after 3 months by using paired t-test, which showed marked visual improvement from 1st visit to the final visit (p-value < 0.005).Conclusions: The majority of cases were youth males with the age group of 25 yrs. All the cases with ocular trauma were unilateral. The trauma was common in industrial workers with the majority of the cases of blunt type. There was satisfactory visual improvement in patients who followed-up well.

Abstract The management of retinoblastoma is challenging and complex. Preservation of the eyeball as well as vision, with minimum morbidity, is the aim in the initial stages. This has been made possible by the use of chemotherapy that is targeted to the eye in the form of selective intravitreal and intra-arterial chemotherapy which has shown promising results. The efficacy and safety of intraarterial chemotherapy have been reported by many specialized centers. The aim of this article was to review the role of intraarterial chemotherapy in the management of retinoblastoma and its clinical outcomes. In addition, we will review the possible complications of the procedure. We were able to collect articles relevant to our research objectives by reviewing the title and abstract of each article. Irrelevant articles and those that did not meet the inclusion criteria were excluded. This yielded a total of 19 studies. The results indicated that intraarterial chemotherapy is an effective and new modality of treatment for retinoblastoma to salvage the eyeball and helps in the prevention of enucleation with minimal local and systemic complications that are mostly transient. For future work, we recommend conducting more prospective studies with large samples and the long duration of follow-up. Also, we recommend future studies focusing on assessing visual acuity, as most of the currently available studies did not assess the visual acuity, making the judgment on vision preservation with IAC difficult.

Abstract Objectives: The study aimed to compare stereopsis, aniseikonia, and associated symptoms in bilateral pseudophakia with and without anisometropia.Methods: Patients with senile cataracts, previously scheduled for phacoemulsification with an IOL implant in both eyes were included in this cross-sectional study. Patients were divided into two groups: control group (n = 69) with an interocular post-surgical refraction difference in Spherical Equivalent (SE) < 1.0 D and anisometropia group (n = 42) with an interocular post-surgical difference in SE ≥ 1.00 D. Aniseikonia was evaluated by Aniseikonia InspectorTM 3 and stereopsis by Randot® Stereotest. Ten symptoms related to aniseikonia were evaluated with a questionnaire. Statistical evaluation of data included models of univariate, multivariate, and regression analyses. Results: Cataract surgery-induced aniseikonia was 0.64% ± 1.41% in control group and 0.62% ± 1.76% in anisometropia group with an insignificant difference (p = 0.766). Measured stereoacuity was 1.95 ± 0.17 log10 seconds of arc in the control group and 2.12 ± 0.22 log10 seconds of arc in the anisometropia group with a significant difference (p < 0.0001). The mean score of symptoms associated with aniseikonia was 1.41 ± 0.46 in the control group and 1.47 ± 0.45 in the anisometropia group, with an insignificant difference (p = 0.387). The contribution of independent variables in predicting stereopsis in the anisometropia group was the following: axial length difference (18.06%); refractive error difference (SE) (44.53%), aniseikonia (25.71%), and IOL power difference (11.71%). Conclusions: The study showed that stereopsis, aniseikonia, and associated symptoms did not stand for a substantial problem for visual comfort of bilateral pseudophakia with anisometropia less than 3D.

Abstract Background: Trabeculectomy does not always work as long as necessary to control glaucoma. This study aimed to describe the initial outcomes of a surgical technique for restoring failed trabeculectomies. Methods: We reviewed patients with failed trabeculectomy with mitomycin (MMC) who underwent limbus-based revision. After the dissection of the subconjunctival area through a smaller incision (3 mm), MMC was applied and episcleral fibrosis was excised. Each criterion was classified as complete or qualified for glaucoma medication. Results: Nineteen patients (19 eyes) were included in this study. The mean follow-up was 9.4 ± 8.6 months. At the last follow-up visit, the mean intraocular pressure was reduced from 20.9 ± 8.4 (range, 12 - 44 mmHg) to 11.6 ± 3.6 mm Hg (range, 6 - 19 mmHg) (p < 0.01). The mean number of glaucoma medications was reduced from 2.6 ± 0.8 to 0.4 ± 0.7 during the same period (p < 0.01). At 6 months postoperatively, the qualified success rate was 68% and 85% for stricter and less strict criteria, respectively. Two cases of transient leakage and reoperation were required in three eyes. No sight-threatening complications were noted. Conclusions: Our initial results suggest that limbus-based revision is an effective alternative to restoring failed trabeculectomies with minor postoperative complications.

Abstract Objective: The current study aimed to assess the association between the type of anisometropia and its effects on monocular and binocular best-corrected vision acuity (BCVA), aniseikonia, and stereopsis in the absence of strabismus. Methods: In total, 162 individuals with anisometropia and healthy eyes and without a previous history of amblyopia therapy and eye surgery were included in the analysis. According to spherical and cylindrical components and spherical equivalent, they were divided into the spherical hyperopic anisometropia (SHA, n = 31), spherical myopic anisometropia (SMA, n = 45), astigmatic or cylindrical hyperopic anisometropia (CHA, n = 22), and astigmatic or cylindrical myopic anisometropia (CMA, n = 64) groups. Patients without anisometropia (NA, n = 188) were classified under the control group. The effects of anisometropia on monocular and binocular BCVA, aniseikonia, and stereoacuity were examined. Results: The NA group had a significantly lower LogMAR of BCVA of the right eye (RE), left eye (LE), worse eye than the SHA, SMA, CMA, and CHA groups. Moreover, the SMA group had significantly lower LogMAR of BCVA than the CHA group (p < 0.05). However, there was no significant difference between the groups in terms of the descriptive values of aniseikonia (p = 0.052). The NA group had significantly lower stereoacuity values in log10 arc seconds than the CHA (p < 0.05), CMA (p < 0.05), and SMA (p < 0.05) groups. The SMA groups had significantly lower stereoacuity values in log10 arc seconds than the CMA (p < 0.05) and SHA (p < 0.05) groups. There was a significantly positive correlation in the anisometropia group between aniseikonia and stereoacuity values in log10 arc seconds (r = 0.160; p = 0.041). Conclusion: Worse visual levels of the RE, LE, worse eye, BCVA difference, and lower stereopsis werevidenced in each type of anisometropia defined in this study. Cylindrical hyperopic anisometropia (CHA) resulted in a statically significant worsening VA level and stereopsis than cylindrical myopic (CMA) or spherical myopic anisometropia.

Abstract Introduction: Refractive disturbances have been observed during hyperglycemia. However, there remains controversy as to the types of disturbances that it induces. Objective: To determine the types of refractive disturbances observed during hyperglycemia in humans. Population and Methods: This was an observational and cross-sectional study with an analytical purpose conducted from July to November 2021. Emmetropia, hypermetropia, and myopia as well as blood glucose levels were compared between day 0 (D0) and day 30 (D30) after initiation of hypoglycemic therapy in 222 people (444 eyes) with recently discovered hyperglycemia (Chi-2; p < 0.05). Results: At D0, the mean of blood glucose was 18.1 mmol/L ± 8.2 vs 6.9 mmol/L ± 3.0 at D30 (p = 0.001). At day 0, 80% (n = 355) of eyes were hypermetropic compared to 73.9% (n = 328) at D30 (p = 0.02). At D0, 14.2% of eyes (n = 63) were myopic compared to 11.3% (n = 50) at D30 (p = 0.02). Refraction improved from 0.75 to 1.5D for 34.5% (n = 18) of hypermetropic eyes and 10.2% (n = 2) of myopic eyes. Conclusion: Our results show that hypermetropia is the most common ametropia during hyperglycemia. Moreover, these data suggest that the normalization of blood glucose improves refraction.

Abstract Aim: To analyze the clinical characteristics and the surgical outcomes of external dacryocystorhinostomy (DCR) in patients with nasolacrimal duct obstruction (NLDO). Methods: We retrospectively reviewed the clinical record of 62 patients who underwent external DCR for NLDO between November 2015 and November 2019 at CHU-IOTA in Mali. The preoperative clinical findings and the postoperative outcomes after a minimum follow up of 3 months were analyzed. Results: epiphora, discharges and canthal swelling weremain symptoms of the 62 patients (68% women, 32% men), with the mean age of 47 years (10 - 76). Among them, 36 had chronic dacryocystitis, 12 had a traumatic NLDO and 8 followed a septal deviation. The majority (77%) were operated on under local anesthesia with sedation. Bicanalicular intubation was performed in 29% of patients. After postoperative follow up of at least 3 months, only 8 patients had persistent watering, thus a subjective functional success of 87%. Conclusion: In the nasolacrimal duct obstruction, most often secondary to chronic dacryocystitis, external dacryocystorhinostomy remains a technique of choice with very good success.

Abstract Purpose of Review: Amblyopia is the reduction in the best-corrected visual acuity of one or both eyes and the most common cause of the loss of vision in children. Previously, amblyopia was thought to have no organic lesions. However, the latest “Amblyopia Preferred Practice Pattern” of 2017 points out that in amblyopia, the eye structure is abnormal with a defective eye function, with few differences from the structure of contralateral non-amblyopic eyes. With the development of optical coherence tomography and optical coherence tomography angiography, it has been observed that even the ocular structure of amblyopic eyes is different from that of normal eyes. Here, we review studies investigating the changes in amblyopic eye structure upon treatment. Review Findings: The pathogenesis of amblyopia is controversial and not well-understood. The retina, choroid, and blood vessels of amblyopic eyes are different from those of normal eyes. Further, the various types of amblyopia are affected differently upon treatment. Because of the scarcity of studies and long-term follow-up observations, the underlying reason for such differences is unclear. Age, gender, and axial length are the influencing factors of the retina and choroid, and the relationship of these factors with amblyopia needs to be investigated further. Conclusion: This review will help us understand the pathogenesis of amblyopia and the underlying mechanism for the changes that occur upon treatment. Further, knowledge of the changes in ocular structure summarized here will be helpful for the diagnosis and treatment of amblyopia.

Abstract Purpose: The purpose of this case report is to share and spread the awareness of diagnosing and managing idiopathic intracranial hypertension in atypical scenarios as in this case, who presented with multiple other medical conditions, and had no papilloedema. The presenting signs and symptoms of mere headache were misleading. The other medical conditions could have explained the patient’s headache. These included cervical spine osteoporosis, and middle ear otolith disease. This case is unique because she was found to have IIH without papilloedema, and despite having multiple cancers in the uterus, breasts, and recently the thyroid, she had no malignant cells in the CSF. The patient was treated for IIH, and her malignancies were treated separately by the corresponding physicians. Method: The patient was assessed in 2019, and was followed up closely till 2021, in collaboration with her neurologist, oncologist, and orthopedist. Result: The patient had IIH after her neurologist attempted a lumbar puncture, which showed high CSF pressure. Conclusion:Headache is a common symptom presented by patients of different ages and backgrounds. The absence of papilloedema does not exclude the diagnosis of IIH. When possible etiologies for headache are ruled out (e.g. middle and inner ear infections, anemia, intracranial tumors, glaucoma, etc.), chronic headaches that do not respond to medications, and present with visual field changes may require a lumbar puncture.

Abstract Background: Information on the long-term perfusion status of patients after successful surgery for giant retinal tear (GRT) macula-off rhegmatogenous retinal detachment (RRD) is limited. Purpose: To examine long-term structural, functional, and perfusion outcomes in normal control eyes and eyes treated for different degrees of GRT-associated extensions of RRD. Methods:One emmetropic normal eye (control), one healthy highly myopic eye (control myopic), and three eyes surgically treated for GRT (surgical), were included in the study for a long-term comparison of study outcomes. The surgical eyes were classified based on the degree of GRT-associated RRD extension as follows: one eye with GRT-associated RRD extension < 180˚; one eye with GRT-associated RRD extension between 180˚ - 270˚; and one eye with GRT-associated RRD extension > 270˚. Structural, functional, and perfusion outcomes were compared with those of the control eyes. Results: All three eyes were phakic and the condition was monocular. The mean age of the patients was 48.67 ± 8.50 years (range, 39 - 55 years). All three eyes had GRT macula-off RRD. The mean preoperative time for GRT surgery was 1.2 weeks. The mean pre- and postoperative best corrected visual acuities (BCVA) were 1.87 logMAR and 0.46 logMAR, respectively. The mean postoperative followup period was 19.67 ± 5.69 months. Proliferative vitreoretinopathy resulted in multiple surgeries in one eye (31.5%). Long-term ostoperative optical coherence tomography (OCT) showed abnormal retinal thickness, ellipsoid zone disruption, and external limiting membrane line discontinuities in one eye. OCT angiography yielded abnormal perfusion indices in the surgically treated eyes. Conclusions: Our data showed multiple structural alterations in spectral-domain OCT biomarkers. One eye that developed secondary epiretinal membrane (ERM) proliferation showed a significantly improved BCVA after proliferation and internal limiting membrane were removed. Perfusion findings were correlated with the final BCVA. Despite a fully reattached retina without ERM proliferation, GRT-associated RRD has a guarded functional prognosis.

Abstract Background: Hard brunescent nuclei are difficult to chop with traditional techniques, because leathery tough strands may connect the posterior surface and span across the fragments, which poses a challenge to completely divide the nuclei. The ultra-chopping technique was designed to mitigate this issue.Purpose: To compare the intraoperative parameters between Ultra-Chopper and Divide & Conquer Techniques. Setting: This study was performed at Hospital Oftalmológico de Brasília, Brasília, DF, Brazil. Patients and Methods:A prospective, randomized and comparative study. Patients with the diagnosis of dense cataract and surgical extraction programmed were divided into two groups: Ultra-Chopper and Divide & Conquer. Intraoperative data were collected and submitted for the statistical analysis. Results: 36 eyes were included, 19 eyes with Ultra-Chopper and 17 eyes with Divide & Conquer. Groups were statistically equivalent in age and nucleus density. There were no surgical complications. Torsional time and cumulative dissipated energy were significantly reduced in the ultra-chopper group. The ultra-chopper group had less total case time, fluid usage and aspiration (ASP) time. Conclusion: The ultra-chopper technique can reduce ultrasound energy dissipation during cataract surgery, and decrease case time, fluid usage and ASP time.