bluuebunny/crossref_metadata_2025 huggingface dataset:
From EMI to CLIL
Authors: González Jesús Ángel , Andrés Javier Barbero
Published: May 2019

We report on a small-scale study carried out in the University of Cantabria, Spain, which investigated teaching strategies and methodology for CLIL at the tertiary level. The study was carried out in two stages: in the first one we designed a questionnaire for primary and secondary school teachers, and interviewed 10 CLIL teachers. The focus was on teaching strategies and methodology, with the explicit aim of collecting advice applicable to the tertiary level. In the second stage we have tested these tips in a university context through a second questionnaire and round of interviews. We have interviewed 10 EMI university lecturers and asked them about methodological strategies, and specifically about the advice suggested by their colleagues. Our findings suggest that CLIL teachers from lower levels are well acquainted with CLIL methodology and that EMI practitioners at university find their advice very useful, although they show reluctance towards deeper methodological changes.
,Rückkehr zur Natur' - wohin, nochmals gefragt? Die Rezeption des Natürlichkeitskonzepts im 19. Jahrhundert
Authors: Grund Vera
Published: May 2019

Der Beitrag behandelt anhand von Richard Wagners »Die Feen« und Jacques Offenbachs »Madame Favart«, welche Bedeutung dem Natürlichkeits-Ideal im Historismus zukam.
Land Grabbing and Home Country Development
Authors: Goetz Ariane
Published: May 2019

Since 2008, foreign land acquisitions have attracted international attention under the term »land grabbing.« Illustrated by rich and nuanced empirical accounts of forty Chinese and British investment projects in Sub-Saharan Africa, Ariane Goetz explains the phenomenon of »land grabbing« from the perspective of two investor countries. She reflects on Chinese and British public policy, state-society relations, national developmental contexts, ideologies, and international relations and thereby gives insights into the political economies that enable these investments as well as the development ambitions and institutionalized paradigms of which they form a part.
Die Gesellschaft des Zorns
Authors: Koppetsch Cornelia
Published: May 2019

Was noch in den 1990er Jahren undenkbar war, ist mittlerweile Alltag: Ganze Bevölkerungsgruppen verlassen den Boden der gemeinsamen Wirklichkeit, kehren etablierten politischen Narrativen zornig den Rücken oder bestreiten gar die Gültigkeit wissenschaftlichen Wissens. Der Aufstieg des Rechtspopulismus markiert nach Dekaden der Konsenskultur eine erneute Politisierung der Gesellschaft. Gängige Erklärungen für die Entstehung des Rechtspopulismus ziehen die Ereignisse der Fluchtmigration von 2015 oder vorgebliche Persönlichkeitsdefizite seiner Anhänger als Ursachen heran. Cornelia Koppetsch dagegen sieht die Gründe in dem bislang unbewältigten Epochenbruch der Globalisierung. Wirtschaftliche, politische oder kulturelle Grenzöffnungen werden als Kontrollverlust erlebt und wecken bisweilen ein unrealistisches Verlangen nach der Wiederherstellung der alten nationalgesellschaftlichen Ordnung. Konservative Wirtschafts- und Kultureliten sowie Gruppen aus Mittel- und Unterschicht, die auf unterschiedliche Weise durch Globalisierung deklassiert werden, bilden dabei eine klassenübergreifende Protestbewegung gegen die globale Öffnung der Gesellschaft.
Juegos de lenguaje y teoría crítica. Sobre la recepción de Wittgenstein en el pensamiento de Albrecht Wellmer
Authors: Robles Gustavo Matías
Published: May 2019

Este artículo intenta ofrecer una lectura de la recepción de la filosofía de Wittgenstein en la teoría crítica de Albrecht Wellmer siguiendo básicamente dos líneas de lecturas: una centrada en la cuestión del lugar de la crítica y la otra centrada en su diferencia con otros representantes de la llamada Escuela de Frankfurt, básicamente con Habermas, Apel y Adorno. De este modo se intentará mostrar que la filosofía de Wittgenstein le ofrece a Wellmer las herramientas conceptuales para restituir el suelo mundano a una teoría crítica escéptica de fundamentaciones últimas.
The Discrete Steklov–Poincaré Operator Using Algebraic Dual Polynomials
Authors: Zhang Yi , Jain Varun , Palha Artur , Gerritsma Marc
Published: May 2019

In this paper, we will use algebraic dual polynomials to set up a discrete Steklov–Poincaré operator for the mixed formulation of the Poisson problem. The method will be applied in curvilinear coordinates and to a test problem which contains a singularity. Exponential convergence of the trace variable in

H

1
/
2

{H^{1/2}}

-norm will be shown.
Cuspidal ℓ-modular representations of p-adic classical groups
Authors: Kurinczuk Robert , Stevens Shaun
Published: May 2019

For a classical group over a non-archimedean local
field of odd residual characteristic p, we construct all cuspidal representations over an arbitrary algebraically closed field of characteristic different from p, as representations induced from a cuspidal type. We also give a fundamental step towards the classification of cuspidal representations, identifying when certain cuspidal types induce to equivalent representations; this result is new even in the case of complex representations. Finally, we prove that the representations induced from more general types are quasi-projective, a crucial tool for extending the results here to arbitrary irreducible representations.
On sup-norm bounds part II: GL(2) Eisenstein series
Authors: Assing Edgar
Published: May 2019

In this paper we consider the sup-norm problem in the context of analytic Eisenstein series for

GL
2

{\mathrm{GL}_{2}}

over number fields. We prove a hybrid bound which is sharper than the corresponding bound for Maaß forms.
Our results generalize those of Huang and Xu where the case of Eisenstein series of square-free levels over the base field

ℚ

{\operatorname{\mathbb{Q}}}

had been considered.
On classification of typical representations for GL3(F)
Authors: Nadimpalli Santosh
Published: May 2019

Let F be any non-Archimedean local field with residue field of
cardinality

q
F

{q_{F}}

. In this article, we obtain a classification of
typical representations for the Bernstein components associated to
the inertial classes of the form

[

GL
n

⁡

(
F
)

×

F
×

,

σ
⊗
χ

]

{[\operatorname{GL}_{n}(F)\times F^{\times},\sigma\otimes\chi]}

with

q
F

>
2

{q_{F}>2}

, and for
the principal series components with

q
F

>
3

{q_{F}>3}

. With this we complete
the classification of typical representations for

GL
3

⁡

(
F
)

{\operatorname{GL}_{3}(F)}

, for

q
F

>
2

{q_{F}>2}

.
Effect of Aging on Characteristics of Bitumen Modified with Waste Lime Sludge
Authors: Kanoungo Abhishek , Kanwar Varinder S. , Shukla Sanjay Kumar
Published: May 2019

The design of pavement must be carried out to make it capable of evenly transferring the wheel load to the subgrade soil without exceeding its bearing capacity. However, failure occurs before the design life because of structural defects shown by pavements, such as low skid resistance, fatigue, and rutting. Because low-temperature cracking is more predominant in cold-temperature regions, this aspect of failure is considered within the future scope of study. To address this concern, waste lime sludge was added to improve the properties of bitumen in the present research work. In order to examine the effect of aging, the rolling thin-film oven test was conducted to replicate the short-term aging process, and pressure aging vessel test was used to resemble long-term aging. The viscosity test, softening point test, and penetration test were carried out to assess the physical properties, whereas the dynamic shear rheometer test was conducted to investigate the rheological properties of aged and unaged bitumen binders. It is observed that sludge acts as an aging inhibitor. The complex modulus was enhanced as a result of addition of sludge up to 20 %, which also lowered the values of phase angle, depicting high resistance to permanent deformation. The rutting and fatigue resistances of the binder improved, and soft grade bitumen was converted to hard grade bitumen.
FEATURES OF PROJECTING THE HIGHER EDUCATIONAL ENVIRONMENT IN THE CONTEXT OF TRAINING TEACHERS TO THE ORGANIZATION OF DIALOGUE EDUCATION OF PRIMARY SCHOOL PUPILS
Authors: FOMIN KATERYNA
Published: May 2019

The article substantiates the urgency of the problem of professional training of future teachers to organize the dialogue training of primary school students in the context of integration into the European educational space and the conceptual foundations of the New Ukrainian school. The main methodological foundations of the study are defined: philosophical and pedagogical anthropology, philosophical and pedagogical hermeneutics and philosophical and pedagogical synergetics. The author substantiates the essence of the educational dialogue and its advantages, in contrast to the traditional teaching methods at primary school. The contents of dialogue communication and its components are determined. The principles of organization of dialogue training for junior pupils are described. The indicative model of forming the readiness of the future teacher of elementary school for the dialogue education is presented, in which the main components of this readiness (motivational, cognitive, socially-communicative and operational-technological) are singled out. It is emphasized that the effectiveness of projecting the educational environment for the implementation of the idea of dialogue education for junior pupils depends to a large extent on the level of the teacher's communicative culture and the components of this culture (communicative settings, knowledge, communicative skills, etc.) are described.
Complaint of blood running out of eye leads to discovery of elevated choroidal mass
Authors: Robertson Russell
Published: May 2019

Complaint of blood running out of eye leads to discovery of elevated choroidal mass
Competency Corner, Part Three: Practice-based Weightings of the CBPS
Authors: Winslade T. , Winslade N , Chou R , Cyr B , Hawkins B
Published: May 2019

The ﬁrst two articles in this series outlined the task, research, terminology and processes the Competence Committee used to develop the Competency-based Performance Standards (CBPS). These standards were designed as a framework for revision of the Canadian Standard Assessment in Optometry (CSAO) to directly link the exam and practice requirements of Canadian Optometrists. This linkage required determination of the relative weight to be assigned to each of the various competencies. Working groups of practising optometrists rated the frequency and criticality of performance of each of the competencies using a standardized rating system. Results indicated that the majority of a revised CSAO would focus on providing comprehensive eye and vision care (78%), followed by management (11%) and collaboration (10%). The ratings also allowed calculation of the appropriate weighting of the underlying general attributes. The heaviest weighting was assigned to candidates’ professional optometric knowledge and the ability to apply this knowledge (41%), followed by communication (27%), planning (13%), ethics (11%) and self-directed learning (8%). The last article in this series will describe work to evaluate the competence-based weightings of the current CSAO and to describe plans for future versions of the CSAO.
Clinical Diagnosis
Authors: Chiarelli C
Published: May 2019

Congenital Hypertrophy of the Retinal Pigment Epithelium
Optometry’s role in the care of patients with Diabetes
Authors: Lee Richard
Published: May 2019

Optometry’s role in the care of patients with Diabetes
Les soins en optométrie au patient atteint de diabète 2008 : Un document central de l’Association canadienne des optométristes
Authors: Koltun Len
Published: May 2019

Ce document a pour but de présenter une vue d’ensemble de l’épidémie de diabète à laquelle fait actuellement face le Canada, ainsi que de la morbidité et de la mortalité associées à ce fardeau croissant des soins de santé. On y présentera spécifiquement le rôle de l’optométriste dans les soins oculovisuels des Canadiens diabétiques, rôle rentable, axé sur le patient et basé sur des résultats cliniques et scientifiques.
Bioart: Biotechnology and Art
Authors: Backman Howard
Published: May 2019

Art has been historically associated with cultural and technological changes in society. Recently imaging, genetics and new biological sciences have been utilized in what is known as Bioart. Visual science digital imaging, photonics, genomics, tissue engineering, and cloning utilize colored pixels. The visual scientist, biologist, geneticist, eyecare practitioner and artist work with a variety of bio-technology images. These images may be considered as an inspiration for Bioart. Internet references to some ophthalmic digital technology sites are provided. The Optometrist may view digital ocular diagnostic and therapeutic images with an appreciation of its aesthetics.
Nutrition and Behavior as it Applies to Systemic and Ocular Disease
Authors: Alexander Larry
Published: May 2019

Nutrition and Behavior as it Applies to Systemic and Ocular Disease
Aboriginal preschool vision screening in BC – closing the health gap
Authors: Atkinson Donna L
Published: May 2019

Aboriginal preschool vision screening in BC – closing the health gap
Vision, neurosciences et réadaptation
Authors: Giasson Claude J , Casanova Christian
Published: May 2019

Vision, neurosciences et réadaptation
Soins oculovisuels pour vos patients diabétiques — dépistage, diagnostic et options de traitement
Authors: Beatty Margaret
Published: May 2019

Soins oculovisuels pour vos patients diabétiques — dépistage, diagnostic et options de traitement
Le prix à payer : le coût de la perte de vision au Canada
Authors: Gordon Keith
Published: May 2019

Le prix à payer : le coût de la perte de vision au Canada
Présentation d'une maladie ophthalmique liée au SIDA chez un patient sévèrement immunodéprimé
Authors: Chetrit Sally
Published: May 2019

Contexte : La rétinopathie liée au virus de l’immunodéficience humaine (VIH) est la manifestation oculaire la plus courante du syndrome d’immunodéficience acquise (SIDA), servant de marqueur important chez les patients présentant un état immunitaire fortement déprimé qui sont à risque de contracter des infections oculaires opportunistes sévères qui menacent la vision. Le présent rapport de cas décrit une présentation d’une rétinopathie à VIH et d’une rétinite à cytomégalovirus (CMV) et examine les options de prise en charge actuellement utilisées.

Rapport de cas : Un homme de race noire de 40 ans se présente pour un examen complet de la vue afin d’exclure la possibilité d’une maladie ophtalmique liée au VIH. À ses premières visites, un examen du fond de l’œil à pupilles dilatées révèle une rétinopathie au VIH à l’œil gauche. Après d’autres examens et du fait que sa capacité immunitaire diminuait, le patient contracte une rétinite à CMV dans l’œil droit. On administre avec succès au patient un traitement antirétroviral hautement actif (HAART) et du valgancyclovir par voie orale.

Conclusion : La rétinite à CMV est l’infection oculaire opportuniste la plus courante associée au SIDA. Un traitement systémique HAART et une thérapie concomitante contre le CMV permettent de reconstituer le système immunitaire et de faire régresser la rétinite.
Lignes directrices sur la prise en charge concertée des personnes qui ont le diabète sucré par des professionnels des soins oculovisuels
Authors: (CSOO) Conseil de la santé de l'oeil de ON
Published: May 2019

Lignes directrices sur la prise en charge concertée des personnes qui ont le diabète sucré par des professionnels des soins oculovisuels
One optometrist’s personal experience with age-related macular degeneration (AMD) and nutritional supplementation
Authors: Richer Stuart , Licup Albert , Porter Tere , Collison Frederick
Published: May 2019

Background: Age-related macular degeneration (AMD) is the leading cause of blindness in ageing western societies and accounts for greater than 50% of all US visual disability. This report describes the 25-year history of a 66-year-old optometrist who has successfully endured AMD. 

Case Report: Visual acuity and serial retinal photographs from 1983 to 2009 as various nutritional modalities and non-dietary lifestyle changes were introduced. After starting lutein-based nutritional supplements beginning at approximately 15 years from diagnosis, the optometrist’s Snellen visual acuity improved in his right eye from 20/40 to 20/25 with a subjective improvement in distortion, but eventually regressed to 20/70-20/80 with some increase in metamorphopsia. The left eye, initially 20/30, improved to 20/15 and has remained stable at 20/20 with complete resolution of metamorphopsia and near complete resolution of a parafoveal scotoma. Fundus photographs demonstrate a reduction in soft and hard drusen count over time in each retina and possible parafoveal repigmentation of atrophic areas with later addition of higher dose zeaxanthin.

Conclusions: AMD is a nutritionresponsive disease. The carotenoids, lutein and zeaxanthin appear to be particularly robust therapeutic components of nutritional supplement formulations.
Contact lens prescribing in Canada 2011
Authors: Jones Deborah , Woods Craig , Efron Nathan , Morgan Philip
Published: May 2019

The annual survey to collect data on the contact lens prescribing preferences of practitioners has continued for 12 years in Canada. Practitioners were surveyed for information on the first 10 patients they fitted with contact lenses immediately after receipt of said survey. A total of 121 completed surveys were returned, detailing contact lens fittings for 1,184 patients.

Of the patients fitted with contact lenses, the results indicated that the majority were prescribed soft lenses. The preferred modality was monthly planned replacement and over 67 per cent of the soft lens fits were made of silicone hydrogel materials. Of the rigid lens fits, the majority were prescribed for daily wear, as the overnight use of rigid lenses appears to be mainly for orthokeratology. Practitioners are recommending multipurpose solutions for the majority of their soft lens patients (85.6%).
An unusual case of myopic shift post acquired brain injury
Authors: Sunderji Farrah F , Heyman Catherine
Published: May 2019

Background Ocular and visual problems are frequent consequences of an acquired brain injury (ABI). The literature suggests that many patients demonstrate a myopic shift in refractive error after a traumatic brain injury (TBI), a form of an ABI. Three reported courses are suggested. Most commonly the myopia resolves under cycloplegic conditions, secondly the shift is transient, and least commonly the myopia increases over time. This case report, although not due to a TBI, is an example of the least common subgroup.

Case Report The patient, a 63 year-old male, presented with a history (15 months prior to initial evaluation) of an excised right frontal temporal lobe tumour. The history included dexamethasone 4mg QD pre- and post-surgery which caused blood glucose levels to fluctuate between 5.72-22.2 mmol/l; a stroke occured postsurgery causing hemiparesis on his left side; and shunt surgery to decrease swelling to the area of excision and the optic nerves. Medications included: Cartia, lisinopril, Toprol XL, prednisone, Reglan, and Temodar. The patient was receiving chemotherapy to treat remnants of the tumour. His last eye exam in 2004 indicated a refractive error of -2.50-1.25X080 in his right eye and -3.000.75X080 in his left eye with visual acuity of 6/7.5 in both the right and left eye. He presented to our clinic with an aided visual acuity of 8/100 (6/110) in both the right and left eye and a left homonymous hemianopsia on finger counting fields. Cycloplegic retinoscopy revealed -6.003.00X090 in his right eye and -6.002.00X090 in his left eye. Dilated fundus exam showed mild swelling of both optic nerves. The patient reported blood glucose levels of 103-140. At a one-month follow-up, his best corrected visual acuity at a distance improved to 6/60 in both the right and left eye through the new prescription. His cycloplegic retinoscopy did not show any change in myopia or astigmatism and the disk edema was resolved. 

Conclusion This case illustrates an unusual presentation of myopic shift post ABI. The patient’s condition continued to deteriorate eventually taking his life. It remains unclear whether the myopia and astigmatism continued to increase or remained stable. Although, the cause of this change is not fully understood and needs further investigation, providing appropriate optical correction did improve the patient’s quality-of-life.
Importance of Optimizing Visual Acuity in Vulnerable Seniors Living in an Institution
Authors: Chriqui Estefania , Champoux Nathalie , Kergoat Hélène
Published: May 2019

Visual acuity is an important measurement taken during an eye exam for checking an individual’s ability to see properly and to guide the adjusting of ocular refraction. It is a routine test usually done in a few minutes and with no particularly difficulty. However, this measurement can be more difficult to do in seniors with cognition or communication disabilities. For example, this may be true for a senior with dementia or suffering from aphasia following a stroke. The purpose of this article is to present certain aspects of population aging, data connected with institutionalization of seniors, various conditions that are more prevalent with age, as well as specific factors demonstrating the importance of optimizing vision in seniors. Lastly, this article will provide an overview of various scales available for measuring visual acuity.
Importance d’optimiser l’afférence visuelle chez la personne âgée vulnérable vivant en institution
Authors: Chriqui Estefania , Champoux Nathalie , Kergoat Hélène
Published: May 2019

L’acuité visuelle est une mesure importante effectuée lors de l’examen visuel afin de vérifier la capacité d’une personne à bien voir et guider l’ajustement de la réfraction oculaire. Il s’agit d’un test de routine qui s’effectue généralement en quelques minutes et sans difficulté particulière. Cette mesure peut par contre être plus difficile à obtenir chez la personne âgée atteinte de troubles de la cognition ou de la communication. Ceci pourrait être le cas par exemple chez la personne âgée atteinte de démence ou celle souffrant d’aphasie suite à un accident vasculaire cérébral. Le but de cet article est de présenter certains aspects du vieillissement de la population, des données liées à l’institutionnalisation de la personne âgée, diverses conditions plus prévalentes liées à l’âge, ainsi que des facteurs particuliers démontrant l’importance d’optimiser la vision chez les personnes âgées. Finalement, cet article fera un survol de diverses échelles disponibles pour mesurer l’acuité visuelle.
Eye See Eye Learn The Benefit of Comprehensive Eye Examinations for Preschoolers
Authors: Jones Deborah A , Chiarelli Catherine A , Robinson Barbara E , MacDonald Karen E
Published: May 2019

Objective: Undetected vision problems in children can lead to permanent vision loss, a condition known as amblyopia. Early detection and treatment of the causes of amblyopia may prevent this vision loss. The objective of this paper is to look for evidence that comprehensive eye examinations upon entry to junior Kindergarten are an effective way to identify and treat vision problems early.

methods: Relevant peer-reviewed publications on amblyopia and the importance of comprehensive eye examinations were reviewed. Specific areas investigated include: the prevalence and causes of amblyopia; impact of vision problems on child development and education; impact of amblyopia and/or strabismus on quality of life; and the cost effectiveness of treating amblyopia. The validity of vision screening compared to a comprehensive eye examination was also reviewed.

Synthesis:The review suggests that without a complete eye examination many eye or vision problems remain undetected at school entry. Left uncorrected these problems negatively impact child development, education and quality of life. Reduced vision due to amblyopia also restricts future employment opportunities and increases the risk of bilateral visual impairment in adulthood. Examination procedures with high sensitivity and specificity are required to accurately detect these problems. Studies show that amblyopia treatment initiated at an early age is one of the most cost-effective of all health interventions.

Conclusion: There is good evidence in the literature that a full eye examination is critical to detect all cases of amblyopia. This and other visual problems can be detected and managed at an early age, which leads to better visual quality of life and economical outcomes. The Eye See Eye Learn program offers the “gold standard” of eye care.
Cas atypique d’uvéite associée à l’antigène HLA-B27 avec hypopyon et atteinte du segment postérieur
Authors: Xie Thomas , Bitton Etty
Published: May 2019

La présence d’un hypopyon et l’atteinte du segment postérieur sont des signes cliniques peu fréquents dans les cas d’uvéite associée à l’antigène HLA-B27. De plus, les premières attaques sont rares chez les personnes âgées. Ce rapport décrit un cas atypique d’uvéite chez une personne âgée qui s’est présentée à la fois avec un hypopyon visible et une uvéite intermédiaire sévère dans un œil.

Un homme caucasien de 60 ans a consulté à cause d’un œil rouge et douloureux avec baisse subite de la vision au niveau de la perception de la main dans l’œil atteint. Ses antécédents oculaires et systémiques ne présentaient rien de remarquable. Un examen de la chambre antérieure de l’œil a révélé la présence de cellules inflammatoires importantes et un hypopyon flagrant. Un examen du segment postérieur a révélé la présence d’une vaste hyalite, entravant toute visibilité de la rétine. En dépit de l’âge et des signes oculaires atypiques du patient, un diagnostic d'une uvéite liée à l’antigène HLA-B27 à la suite d’une évaluation approfondie des signes cliniques et des résultats d’analyses de laboratoire a été proposé. L ’inflammation a été traitée avec succès au moyen d’une combinaison de corticostéroïdes administrés par voies intraveineuse, topique et orale dont la dose a diminué progressivement en quelques semaines. L ’acuité visuelle s’est rétablie à 20/30.

Ce cas constitue un rappel important du fait que des signes atypiques comme un hypopyon ou une uvéite intermédiaire peuvent apparaître et constituer un signe important d’uvéite liée à l’antigène HLA-B27. Les cliniciens doivent connaître les différentes manifestations de l’uvéite associée à l’antigène HLA-B27 et agir avec prudence en incluant une évaluation complète des segments antérieur et postérieur face à un œil rouge et douloureux associé à une baisse de vision.
Beyond Eye Care – Low Vision Rehabilitation of a Patient with Recent-Onset Leber’s Hereditary Optic Neuropathy: A Case Report
Authors: Poon Teresa , Labreche T.
Published: May 2019

Leber’s hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial deoxyribonucleic acid (DNA) mutation that results in painless, sudden-onset, bilateral central vision loss and dyschromatopsia. Currently, there are no proven treatments to prevent or reverse the optic neuropathy in LHON. Accordingly, individualized rehabilitation services and assistive devices for low vision are crucial for helping people with LHON to regain independence and quality of life. This report describes the impact of multidisciplinary low vision rehabilitation on a young man with recent-onset LHON and emphasizes the importance of the provision of emotional support through counselling for low vision.
Overview of the Main Types of Contact Lenses for Aphakic Children Under 5
Authors: Corbeil Marie-Eve , Ganivet Amélie , Michaud Langis
Published: May 2019

Contact lenses are often the first choice for visual correction of aphakic children. There are several types of lens that can successfully be fitted to correct ametropia, stimulate visual selecting, and maintain ocular health. Several factors are important for choosing the type of lens. Usually, the first lens fitted is made of silicone (Elasofilcon A, Bausch & Lomb, Rochester, Ny) with an evolution to a custom silicone hydrogel lens over time. Although fitting in young aphakic children presents many challenges, contact lenses often remain the best option for the correction of refractive errors after congenital cataract surgery. An overview of the main types of contact lens available for aphakic children and their characteristics are presented.
Refining Decisions for Identifying Primary Care Patients Who Require A Work-Up for Glaucoma: Intraocular Pressure Changes with Central Corneal Thickness
Authors: Gall Ronald , Wick Bruce
Published: May 2019

Purpose: The factors associated with the increased risk of glaucoma include intraocular pressure (IoP), central corneal thickness (CCT), vertical cup-to-disc ratio, visual field index, age, and diabetes mellitus. We have investigated the relation of IoP with CCT in normal, healthy pre-presbyopic persons.

Methods: A total population of 698 normal patients (1396 eyes), aged 4 to 40 years, were evaluated in two separate clinics, one in Houston, Texas, USA and the second in oakville, ontario, Canada. IoP was measured using a noncontact tonometry (nCT 20 Topcon). In Houston, CCT was determined by using the Pentacam (occulus Pentacam – Belinea) and an optical pachymetry that utilized optical low-coherence reflectometry (oLCR) technology, and in oakville, a Hagg-Streit slit lamp–mounted pachymeter was used.

Results: of the total number of eyes tested, 1226 eyes had IoP of 21 millimetres of mercury (mm Hg) or lower and 134 eyes had IoP greater than 21 mm Hg. For the normal IoP group (n = 1226 eyes), the overall IoP mean was 15.63 +/– 2.87 mm Hg; the overall CCT mean was 550.21 +/– 39.64 micrometres (µm). In the normal IoP group, for every 10 µm change in CCT, IoP changed a statistically significant amount of 2.49 mm Hg (p <0.05 to <0.001), except for the 10 nm CCT bins above and below the 550 µm mean.

Conclusions: Although many investigators have described a positive correlation between IoP and CCT, this relationship has not been demonstrated in normal, healthy pre-presbyopic persons. There is a significant change of IoP with CCT (2.49 mm Hg IoP change per 100 µm of CCT). These normative data allow primary eye care clinicians to accurately determine normal and abnormal IoP and refine the index of suspicion for identifying patients who need to be worked up for glaucoma.
Vernal Keratoconjunctivitis and its Management Challenges
Authors: Collins Onyeahiri
Published: May 2019

Vernal keratoconjunctivitis (VKC) is an allergic, bilateral, recurrent inflammatory disorder of the conjunctiva and the cornea that has a seasonal incidence. It affects young males more than females in age bracket of 3 to 16. In the majority of cases, symptoms resolve at puberty, but some may run into adulthood. Diagnosis is based typically on clinical signs and symptoms. The cause of the disease is not clearly known, but it is often associated with atopic diseases such as asthma or eczema and is probably due to a longstanding allergic reaction.

The disease consists clinically of the palpebral, limbal and mixed types. Its management has been a great challenge to eye care providers because of its recurrent nature, the large number of individuals who are affected, wrong diagnoses, and lack of judicious drug administration. The disease has the potential of producing serious vision-threatening complications if not adequately managed. This case report also reviews the diagnosis and management options for patients with mixed VKC and demonstrates the importance of the clinician’s role in taking a careful case history and in modifying treatment when necessary throughout care.
Wavefront Aberrations in Subjects Wearing Soft Aspheric Contact Lenses and Those Wearing Spherical Ones
Authors: Fraser Alexandra , Fontaine Nicolas , Lambert Valérie
Published: May 2019

Purpose: To measure the level of higher order aberrations (HOA) when wearing a soft aspheric contact lens (CL), compared to a spherical CL, in myopic subjects.

Method: Fifteen myopic subjects aged 20-30 years were tested for the presence of dry eye. Aberrometry measurements were done without a contact lens as well as with a spherical CL and an aspheric CL. Root mean square error (RMS) of HOA, spherical aberration (SA) and coma were measured five times in an interval of 15 seconds without blinking for each of the 3 conditions.

Results: Wearing a spherical CL produced a significant increase of SA and horizontal coma compared to an eye without a contact lens. When wearing an aspheric CL, there was a trend towards a smaller increase of these aberrations. However, the difference between both types of lens was not statistically significant. In terms of total HOA, these were higher when wearing the spherical CL, while they tended to be less with the aspheric CL. As for the variations between blinks, there was a similar increase in total HOA and individual modes with time for the three conditions.

Conclusion : Wearers of aspheric CL seem to show a tendency towards smaller amounts of SA, horizontal coma and HOA in general in comparison with wearers of SCL. However, total HOA increases during a long interval between blinks, no matter the condition.
Ocular Prosthesis: Indications to Management
Authors: Cafiero-Chin Malinda , Marques Cathy , Danz Heather J
Published: May 2019

Caring for patients with a prosthetic eye can be a challenge to clinicians. Regardless of the circumstances leading to eye removal, inspection of the underlying tissue should be part of a comprehensive eye exam. Maintaining the overall health of the anophthalmic socket is critical in patient comfort and optimal prosthetic fit. Discussions will focus on anophthalmic procedures and preparation of the socket for prosthetic fitting. Care and management of the prosthesis and the anophthalmic socket, including associated ocular tissue disorders will be emphasized. the article will enhance the clinician’s comfort level managing patients wearing ocular prosthesis.
Mes tatouages ont causé ma sécheresse oculaire?
Authors: Morrison Caitlin J , Stamm Joseph M
Published: May 2019

But. Le présent rapport de cas décrit les répercussions potentielles d’un tatouage de contour des yeux sur la structure et le fonctionnement des paupières, soit des symptômes accrus de sécheresse oculaire et d’autres anomalies.

Rapport de cas. Une femme de 59 ans d’origine hispanique, aux prises depuis longtemps avec des symptômes de sécheresse oculaire peu soulagés par des larmes artificielles, a consulté pour une évaluation. Les examens d’imagerie ont révélé une perte de glandes de Meibomius, probablement causée par le tatouage de contour des yeux. L’application de compresses chaudes, le massage palpébral et l’utilisation de larmes artificielles à base de lipides ont permis d’atténuer les symptômes et d’améliorer les mesures objectives.

Conclusions. Un contour des yeux tatoué de façon permanente peut accroître la sécheresse oculaire par deux mécanismes principaux : perturbation de l’architecture des paupières et inflammation chronique due aux granules de pigments dans l’encre de tatouage. Reconnaître ces possibles effets chez les patientes ayant le contour des yeux tatoué peut aider à offrir un traitement adapté à l’étiologie de la sécheresse oculaire : stimuler les glandes de Meibomius restantes par des compresses chaudes et un massage palpébral, et utiliser des larmes artificielles à base de lipides pour pallier l’absence de sécrétion de lipides par les glandes de Meibomius qui manquent.
Canadian Optometric Low Vision: Predictive Factors and Regional Comparisons
Authors: Lam Norris , Leat Susan J
Published: May 2019

Purpose: To investigate the regional differences in low vision (LV) provision across Canada and to identify predictive factors for the provision of more extensive low vision services (LVS).

Methods: Practising optometrists across Canada were invited to participate in a questionnaire that investigated personal and practice demographics, levels of LVS offered, patterns of referrals and barriers to provision of LVS.

Results: 459 optometrists responded. Predictive factors for providing more extensive LVS included: optometrists with >15 years of practice, having a local LV optometrist/ophthalmologist within one day’s travel, not having a multi-disciplinary LV clinic within one-day’s travel, working in a practice in a population of <50,000, and having 2+ optometrists in the same practice. Regional differences were found in the following variables: the presence of an optometrist offering LVS within the respondent’s primary practice, referral criteria, the type of LV provider receiving the referral, and the perceived quality of LVS.

Conclusions: LVS are provided differently across Canada and the availability of government-funded LVS appeared to enhance optometric referrals to multidisciplinary low vision clinics. Optometrists who were in a group practice setting, who had practiced for >15 years and who worked in a less populated area were more likely to provide more extensive LVS.
Bilateral Anterior Ischemic Optic Neuropathy During Treatment with Pegylated Interferon and Ribavirin
Authors: Rinehart Jason , Stottlemyer Lisa
Published: May 2019

Hepatitis C virus (HCV) is a blood-borne pathogen that often results in chronic liver infection leaving patients at risk for cirrhosis, liver decompensation and hepatocellular carcinoma. The goal of therapy is to eliminate the virus in order to minimize morbidity and mortality from HCV infection. Traditional treatment has utilized a combination of pegylated-interferon (IFN) and ribavirin that often causes both systemic and ocular side effects. The most common ocular side effects are retinal hemorrhages and cotton wool spots, although in rare circumstances more significant ophthalmic adverse events have been attributed to IFN therapy.

Here we discuss a case of bilateral anterior ischemic optic neuropathy (AION) that occurred during treatment with IFN and ribavirin for HCV genotype 1. We review the proposed pathogenesis of ocular side effects associated with this regimen, as well as the pathogenesis and risk factors associated with AION itself. Finally, we will offer clinical recommendations for screening for more than retinopathy should a patient present with ophthalmic complications.
Editorial
Authors: Chou B. Ralph
Published: May 2019

Having attended both the CAO Congress and the American Academy of Optometry Annual Meeting this year, just like I did 38 years ago when I entered practice, I can look back across this time to see how our profession’s interests have developed and changed.
Éditorial
Authors: Chou B. Ralph
Published: May 2019

L’été 2017 a été riche en événements. Tout d’abord, il y a eu le congrès de l’ACO, qui s’est déroulé à Ottawa durant la dernière semaine de juin. En plus du grand nombre de séances instructives de qualité supérieure, des événements sociaux ont été tenus, durant lesquels j’ai pu m’entretenir avec plusieurs anciens étudiant [...]
Editorial
Authors: Chou B. Ralph
Published: May 2019

Our lead article this issue discusses a model for the multidisciplinary management of allergic conjunctivitis.
Gestion interprofessionnelle de la conjonctivite allergique
Authors: Prokopich C. Lisa , Lee-Poy Michael , Kim Harold
Published: May 2019

Les allergies oculaires touchent un nombre important et croissant de gens en Amérique du Nord. Les statistiques du Canada sont probablement analogues à celles des États-Unis, pays où jusqu’à 40 % de la population souffre d’allergies oculaires. Les symptômes et les signes de ces allergies peuvent avoir un effet considérable sur la productivité et la qualité de vie en général. Au fil des ans, on a mis au point de nombreux traitements ef caces pour la prise en charge des allergies oculaires. Dans le cas de la conjonctivite allergique, les agents ophtalmiques topiques comprennent les antihistaminiques, les stabilisateurs mastocytaires, les agents à double activité, les stéroïdes, les anti-inflammatoires non stéroïdiens et d’autres médicaments à modulation immunitaire. Les patients choisissent souvent des antihistaminiques oraux pour toutes les formes d’allergie, y compris la conjonctivite allergique. Nous récapitulerons ici les formes d’allergies oculaires en mettant particulièrement l’accent sur les symptômes et les signes, le diagnostic, les options de traitement actuelles et l’incidence sur la qualité de vie. Plus important encore, nous proposerons, grâce à la collaboration multidisciplinaire, un algorithme de traitement simplifié pour la pratique clinique au Canada. Cet algorithme fournit aux praticiens les meilleures stratégies de gestion possibles fondées sur la présentation individuelle du patient et propres à optimiser l’efficacité du traitement et à réduire au minimum les effets sur les tâches de tous les jours et la qualité de vie.
Canadian Association of Optometrists/Canadian Ophthalmological Society Joint Position Statement
Authors: Optometrists Canadian Association of , Society Canadian Ophthalmological
Published: May 2019

The prevalence of electronic screen-related ocular symptoms in adult users is estimated to be as high as 50–90%. While the corresponding statistic in children is not known, the use of electronic screens by children has become more commonplace (at both home and school), begins earlier in childhood than in the past, and can last for long periods of time.

The prevalence of electronic-screen symptoms in adults and the resultant guidelines for safe use should not be automatically applied to children. The visual and physical systems of children are different than those of adults, and still developing. In addition, children use screens differently and for different tasks. This policy reviews the current literature on ocular and visual symptoms related to electronic-screen use in children and provides evidence-based guidelines for safe use. The effect of screen-time on other cognitive and developmental milestones is beyond the scope of this statement.
The Future – Disruptive Optometry
Authors: Angle Daryan , Larsen Grant , Ulsifer Alan , Lacoste Patrice
Published: May 2019

Change is the only constant. How our profession embraces, and indeed leads, disruption will be the key to our collective successful future. The pace of disruption, both in our world and in our industry, is accelerating, forcing independent optometrists to examine their practices with a view to meeting changing patient needs and embracing technology, while also ensuring patient safety. This opportunity allows the profession of optometry to get ahead of the curve and lead change, rather than be a victim of it. The Canadian Association of Optometrists invited four leaders in the industry to provide their perspectives on disruptive optometry and how optometrists can be the disruptor, rather than the disrupted.
Innovations and Emerging Therapies in Glaucoma
Authors: Wroten Chris
Published: May 2019

It’s unclear when the progressive optic neuropathy that is glaucoma was first discovered, but it has been described in medical writings since ancient times. Hippocrates wrote of a blindness in the elderly that he called “glaykoseis.” Much later, the English ophthalmologist Richard Banister first discovered a correlation with high intraocular pressure (IOP). The invention of the ophthalmoscope by Hermann von Helmholtz in the mid-1800’s allowed the in vivo visualization of glaucomatous changes to the optic nerve for the first time, and in 1862 Franciscus Donders coined the term “Glaukoma simplex” to describe blindness resulting from elevated IOP. Shortly thereafter, the invention of the tonometer, the development of perimetry, and the use of cocaine as an anesthetic all further advanced the diagnosis of glaucoma.
Pituitary Tumor Associated with Situs Inversus of the Optic Nerve Head
Authors: Williams T. David
Published: May 2019

This report present further developments in a patient with an unusual vas-cular pattern on both optic nerve heads: the trunks of the central retinal vessels appear on the temporal side of the nerve head (situs inversus of the blood vessels of the nerve head). This vascular pattern was also present (to only slightly varying degrees) in all six of his children (two girls and four boys). Twenty-one years after the first presentation of this patient, he de-veloped a non-secretory pituitary tumor. This case suggests that congeni-tal nerve head anomalies may be markers for potential intracranial tumors later in life.
Glaucome primitif à angle ouvert précoce
Authors: Lifferth Austin L.
Published: May 2019

Le glaucome est la principale cause de cécité irréversible dans le monde et devrait toucher plus de 79,6 millions de personnes d’ici 2020, dont plus de 10 % seront atteintes de cécité bilatérale.1Cette neuropathie optique progressive multifactorielle provoque des lésions caractéristiques à la couche de fibres nerveuses rétiniennes qui finiront par entraîner des lacunes glaucomateuses du champ visuel s’ils ne sont pas traités. Malheureusement, ces lacunes du champ visuel sont difficiles à détecter pour le patient avant les stades plus avancés et, par conséquent, le glaucome précoce est habituellement asymptomatique.2Cet article présente un cas qui concorde avec les études des populations selon lesquelles jusqu’à la moitié des personnes atteintes de glaucome ne savent pas qu’elles ont contracté la maladie.3
Le PHQ-2 comme outil de dépistage de la dépression clinique dans une clinique de soins oculovisuels de première ligne
Authors: DellaBella Matias , Schwartz Steven H. , Nehmad Leon
Published: May 2019

Objet : Les tests de dépistage de la dépression clinique, une maladie très répandue et souvent invalidante, n’ont pas été étudiés dans les établissements de soins oculovisuels de première ligne. L’objet de la présente étude était de déterminer le pourcentage de patients d’une clinique de soins oculovisuels de première ligne en milieu urbain qui répondent positivement à l’outil de dépistage PHQ-2. Le PHQ-2 est un outil de dépistage ultra-court composé de deux questions concernant l’humeur et l’anhédonie.

Méthodes : Les deux questions du PHQ-2 ont été posées (dans le cadre d’un questionnaire plus vaste qui comprenait des données sur le sexe, l’âge et l’origine ethnique) aux patients assis à la clinique de soins de première ligne du College of Optometry de la SUNY [University Eye Center] à Manhattan (New York). Au total, 739 questionnaires ont été remplis sur une période de deux mois, avec un pourcentage de réponse de 69 %. Tous les questionnaires ont été remplis de façon anonyme, et les questionnaires inachevés n’ont pas été inclus dans l’ensemble de données final.

Résultats : Les données démographiques recueillies dans le cadre de cette étude reflètent celles de la population desservie par cette clinique; très diversifiée dans l’ensemble, avec une bonne représentation de chaque groupe d’âge. Treize pour cent de l’échantillon a reçu une cote de 3 ou plus, soit le seuil standard pour un résultat positif au PHQ‑2.

Conclusions : Le taux de résultats positifs au PHQ-2 obtenu chez la population urbaine en soins oculovisuels de première ligne s’approche de celui que l’on trouve en médecine générale, ce qui suggère des taux semblables de dépression clinique. Par conséquent, le PHQ‑2 peut être un outil utile pour le dépistage de la dépression, mais il est important de faire un suivi en aiguillant les personnes vers un spécialiste de la santé mentale.
Risque et gestion des saignements intraoculaires associés aux anticoagulants oraux
Authors: Koh Len V. , Gosnell Chad E. , Well Anna R
Published: May 2019

La thrombose veineuse profonde, l’embolie pulmonaire, l’AVC ischémique et l’infarctus du myocarde sont d’importantes maladies thromboemboliques qui touchent des millions de Nord-Américains. La plupart de ces patients sont pris en charge à long terme avec des anticoagulants oraux qui peuvent accroître le risque de saignement, y compris les hémorragies intraoculaires. L’interruption de l’anticoagulation augmente temporairement le risque de thromboembolie et l’anticoagulation continue augmente le risque de saignement; les deux scénarios nuisent à la santé globale du patient. Cet article présente une revue générale et une mise à jour des anticoagulants oraux et traite des façons pour les optométristes de gérer les saignements oculaires associés aux anticoagulants oraux.