Reducing visual deficits caused by refractive errors in school and preschool children: results of a pilot school program in the Andean region of Apurimac, Peru

Background: Refractive error is defined as the inability of the eye to bring parallel rays of light into focus on the retina, resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is associated with increased morbidity and reduced educational opportunities. Vision screening (VS) is a method for identifying children with visual impairment or eye conditions likely to lead to visual impairment. Objective: To analyze the utility of vision screening conducted by teachers and to contribute to a better estimation of the prevalence of childhood refractive errors in Apurimac, Peru. Design: A pilot vision screening program in preschool (Group I) and elementary school children (Group II) was conducted with the participation of 26 trained teachers. Children whose visual acuity was<6/9 [20/30] (Group I) and≤6/9 (Group II) in one or both eyes, measured with the Snellen Tumbling E chart at 6 m, were referred for a comprehensive eye exam. Specificity and positive predictive value to detect refractive error were calculated against clinical examination. Program assessment with participants was conducted to evaluate outcomes and procedures. Results: A total sample of 364 children aged 3–11 were screened; 45 children were examined at Centro Oftalmológico Monseñor Enrique Pelach (COMEP) Eye Hospital. Prevalence of refractive error was 6.2% (Group I) and 6.9% (Group II); specificity of teacher vision screening was 95.8% and 93.0%, while positive predictive value was 59.1% and 47.8% for each group, respectively. Aspects highlighted to improve the program included extending training, increasing parental involvement, and helping referred children to attend the hospital. Conclusion: Prevalence of refractive error in children is significant in the region. Vision screening performed by trained teachers is a valid intervention for early detection of refractive error, including screening of preschool children. Program sustainability and improvements in education and quality of life resulting from childhood vision screening require further research.

Minimizing the IOL Power Error Induced by Keratometric Power

Purpose. To evaluate theoretically in normal eyes the influence on IOL power (PIOL) calculation of the use of a keratometric index (nk) and to analyze and validate preliminarily the use of an adjusted keratometric index (nkadj) in the IOL power calculation (PIOLadj). Methods. A model of variable keratometric index (nkadj) for corneal power calculation (Pc) was used for IOL power calculation (named PIOLadj). Theoretical differences ($PIOL) between the new proposed formula (PIOLadj) and which is obtained through Gaussian optics (PIOL Gauss) were determined using Gullstrand and Le Grand eye models. The proposed new formula for IOL power calculation (PIOLadj) was prevalidated clinically in 81 eyes of 81 candidates for corneal refractive surgery and compared with Haigis, HofferQ, Holladay, and SRK/T formulas. Results. A theoretical PIOL underestimation greater than 0.5 diopters was present in most of the cases when nk = 1.3375 was used. If nkadj was used for Pc calculation, a maximal calculated error in $PIOL of T0.5 diopters at corneal vertex in most cases was observed independently from the eye model, r1c, and the desired postoperative refraction. The use of nkadj in IOL power calculation (PIOLadj) could be valid with effective lens position optimization nondependent of the corneal power. Conclusions. The use of a single value of nk for Pc calculation can lead to significant errors in PIOL calculation that may explain some IOL power overestimations with conventional formulas. These inaccuracies can be minimized by using the new PIOLadj based on the algorithm of nkadj.

Error induced by the estimation of the corneal power and the effective lens position with a rotationally asymmetric refractive multifocal intraocular lens

AIM: To evaluate the prediction error in intraocular lens (IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP). METHODS: Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany). In all cases, an adjusted IOL power (PIOLadj) was calculated based on Gaussian optics using a variable keratometric index value (nkadj) for the estimation of the corneal power (Pkadj) and on a new value for ELP (ELPadj) obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal) and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay). RESULTS: PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05). In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D) and limits of agreement (of 1.47 and -1.61 D) when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01) and was found to be dependent on axial length, anterior chamber depth and Pkadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.

Birds eye view of trolley routes in New England, 1904 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Trolley wayfinder, birds eye view of trolley routes in New England, published by the New England Street Railway Club, 1904. This is a perspective map not drawn to scale. Covers eastern portion of New England from Lewiston, Maine, to Newport, Rhode Island. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Massachusetts State Plane Coordinate System, Mainland Zone (in Feet) (Fipszone 2001). All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, or other information associated with the principal map. This map shows features such as steam railroads, electric railroads, parks, buildings, drainage, and more. Relief and some features are shown pictorially. Includes 7 insets. This layer is part of a selection of digitally scanned and georeferenced historic maps of Massachusetts from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of regions, originators, ground condition dates (1755-1922), scales, and purposes. The digitized selection includes maps of: the state, Massachusetts counties, town surveys, coastal features, real property, parks, cemeteries, railroads, roads, public works projects, etc.

Northeastern United States, 1799 : showing township grants and land purchases in New York (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Map of the middle states of North America : shewing the position of the Geneseo country comprehending the counties of Ontario & Steuben as laid off in townships of six miles squar[e] each, Maverick, sculpt. It was printed by T. & J. Swords for Charles Williamson's Description of the settlement of the Genesee country, in the state of New-York, 1799. Scale [ca. 1:2,250,000]. Partial cadastral map showing large land purchases and township grants in New York State. Covers New York, Pennsylvania, Vermont, Massachusetts, Connecticut, New Jersey, Washington, D.C. and portions of Maryland, Delaware, and West Virginia. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Universal Transverse Mercator (UTM) Zone 18N NAD83 projection. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as roads, drainage, major cities and towns, land purchases, township grants, state boundaries, and more. Includes key to "principal villages in Ontario & Steuben counties." This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

Zwey Abhandlungen über Frachtwägen und Strassen und über die Frage, ob, und in welchen Fällen der Bau schiffbarer Kanäle, Eisenwege, oder gemachter Strassen vorzuziehen sey : nach einer Untersuchung, ob die Moldau mit der Donau durch einen Schiffahrtkanal zu vereinigen sey /

Errata: 2 p. (at end).

The law of charitable uses, rev. and much enl.; with many cases in law both antient and modern: whereunto is now added,the learned reading of Sr Francis Moor, Kt. ... upon the statute of 43 Eliz. concerning charitable uses, (who was a member of that Parliament when that statute was made, and the penner thereof.) Abridged by himself, and now printed by his own original manuscript. Together, with the manner of proceedings in Chancery, by information, in the name of the King's attorney-general, for relief, on divers cases, wherein the aid of this statute is not required ... Methodically digested,

Error in paging: p. 183-184 repeated in numbering.

Elizabethan England in gentle and simple life.: Being I. England's address to her three daughters, the Universities of Cambridge and Oxford, and Lincoln's Inn: from Polimanteia, 1595. II. A quest of enquirie by women to know whether the tripe-woman was trimmed, 1595.

The dedication to Polimanteia is signed W.C., and the work has been ascribed to William Clerke or Clarke.

Reports of cases argued and determined in the Court of Exchequer, from Easter term, 32 George III. to [Trinity term 37 George III.] ... both inclusive. [1792-1797]

Includes index.

A general catalogue of valuable and rare old books, in the ancient and modern languages, and various classes of literature; which are now on sale at the prices affixed to each,

Error in paging: 289 numbered 298.

The Irishman in London; or, The happy African. A farce. In two acts. Performed at the Theatre-Royal, Covent-Garden.

Error in paging: no. 32-37 repeated.

Eustratiou kai allōn tinōn episēmōn hypomnēmata eis ta deka tōn tou Aristotelous Ēthikon Nikmacheiōn biblia meta tou hypokeimenou = Evstratii et aliorvm insignivm peripateticorvm commentaria in libros decem Aristotelis De moribvs ad Nicomachvm, vna dvm textv svis in locis adiecto.

Guide letters.

The light of truth : and pleasure of light ; in four books. Great is truth, and it shall prevail.

Error in paging: 95 numbered 59.

A few weeks in Paris, during the residence of the Allied sovereigns in that metropolis.

Lyman is stated to have been the author in Memorial biographies of the New England Historic Genealogical Society, v.l (1880) p. 172.

An arrangement of the Psalms, hymns, and spiritual songs of the Rev. Isaac Watts : to which is added a Supplement, being a selection of more than three hundred hymns from the most approved authors, on a great variety of subjects ; among which are all the hymns of Dr. Watts, adapted to public and private worship, not published in the common editions ; with indexes, very much enlarged and improved, to facilitate the use of the whole in finding Psalms and hymns, suited to particular subjects or occasions /

Error in paging: xxv-xxviii repeated.