bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
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.
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.
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.
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.