PURPOSE. To determine the most appropriate analysis technique for the differentiation of multifocal intraocular lens (MIOL) designs by using defocus curve assessment of visual capability.METHODS. Four groups of 15 subjects were implanted bilaterally with either monofocal intraocular lenses, refractive MIOLs, diffractive MIOLs, or a combination of refractive and diffractive MIOLs. Defocus curves between À5.0 D and þ1.5 D were evaluated by using an absolute and relative depth-of-focus method, the direct comparison method, and a new ''area-offocus'' metric. The results were correlated with a subjective perception of near and intermediate vision. RESULTS.Neither depth-of-focus method of analysis was sensitive enough to differentiate between MIOL groups (P > 0.05). The direct comparison method indicated that the refractive MIOL group performed better at þ1.00 diopter (D), À1.00 D, and À1.50 D and worse at À3.00 D, À3.50 D, À4.00 D, and À5.00 D than did the diffractive MIOL group (P < 0.05). The area-of-focus intermediate zone was greater with the refractive than with the diffractive MIOL group (P ¼ 0.005) and the near zone was better with the diffractive (P ¼ 0.020) and ''mix and match'' (P ¼ 0.039) groups than with the refractive MIOL group. The subjective perception of intermediate and near vision agreed best with the area-of-focus metric for the intermediate (r s ¼ 0.408, P ¼ 0.010) and near zone (r s ¼ 0.484, P < 0.001).CONCLUSIONS. Conventional depth-of-focus metrics provide a single value to quantify the useful range of vision; however, they fail to provide sufficient detail to differentiate between MIOL designs. The direct comparison method provides a large amount of information, although the results can be complex to interpret. The proposed area-of-focus metric provides a simple, but differentiating method of evaluating MIOL defocus curves. (Invest Ophthalmol Vis Sci. 2012;53:3920-3926 Previous in vivo MIOL studies have examined the visual range of MIOLs by using measurements of visual acuity (VA) either at varying distances 4-6 or through different levels of spectacle lens defocus.7-9 However, the more physical method of measuring VA at varying distances is often impractical owing to the need to control angular image size and luminance.Measuring VA through a range of spectacle lenses creates a defocus curve profile. A previous study has suggested that VA measured with this method provides an underestimation of the true VA at the corresponding distance owing to the magnification effects of lenses in the spectacle plane (although this can be compensated for mathematically 10 ) and the disrupted natural associated convergence and pupil response. 11The two focal points created by the conventional bifocal MIOL result in a distinctive defocus curve profile with two peaks of optimum acuity: one at the distance focal point and the other at the near focus. 6 Hence, defocus curves demonstrate the strength of the near addition (the separation in diopters between the distance and near peak) as well as the quality of vis...

PRPF8-retinitis pigmentosa is said to be severe but there has been no overview of phenotype across different mutations. We screened RP patients for PRPF8 mutations and identified three new missense mutations, including the first documented mutation outside exon 42 and the first de novo mutation. This brings the known RP-causing mutations in PRPF8 to nineteen. We then collated clinical data from new and published cases to determine an accurate prognosis for PRPF8-RP. Clinical data for 75 PRPF8-RP patients were compared, revealing that while the effect on peripheral retinal function is severe, patients generally retain good visual acuity in at least one eye until the fifth or sixth decade. We also noted that prognosis for PRPF8-RP differs with different mutations, with p.H2309P or p.H2309R having a worse prognosis than p.R2310K. This correlates with the observed difference in growth defect severity in yeast lines carrying the equivalent mutations, though such correlation remains tentative given the limited number of mutations for which information is available. The yeast phenotype is caused by lack of mature spliceosomes in the nucleus, leading to reduced RNA splicing function. Correlation between yeast and human phenotypes suggests that splicing factor RP may also result from an underlying splicing deficit.

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Background: Adjustable sutures have revolutionized strabismus surgery. Numerous techniques have been described that aim to facilitate postoperative adjustment. Nevertheless, some sort of procedure is always necessary following adjustable suture surgery and has to be arranged within 24 hours. Where no adjustment is required, the muscle needs to be secured at the existing position and the conjunctiva, sometimes left on a loop, has to be tidied up and sutured. Methods: As fewer than half of the operated on eyes need a final adjustment, we describe a technique whereupon the muscle is left on a loop and the conjunctiva is closed over it with two interrupted polyglactin 910 sutures. If an adjustment is deemed necessary, one of the sutures has to be cut and replaced at the end of the procedure. When the result of squint surgery is satisfactory and no muscle movement is needed, no further manipulation of the conjunctiva is required. Conclusions: In a series of 17 patients, we have found this technique to be excellent for patient comfort and time efficiency. We have not encountered any muscle slippage. We think that the ease of postoperative management may tend to bias the surgeon against adjustment. J Pediatr Ophthalmol Strabismus 2004;41:226-229 .

Both ectopic cilia and nail-patella syndrome (NPS) are rare entities. To our knowledge we report the first case of the two anomalies coexisting in one patient. We present the case of a 2-year-old girl, with no other ophthalmic complication of NPS, who had an excellent cosmetic outcome and no lesion recurrence following surgical excision of ectopic cilia.

RNFL thickness measurements obtained with OCT and SLP-VCC correlate well only in eyes with more advanced glaucomatous damage. The nerve fiber indicator parameter derived by SLP correlated best with mean deviation.

Table 1 Clinical characteristics Age Sex VA Visual fields Visual hallucinations 79 F RE 20/20 Humphrey 24-2; constriction to 15 degrees; MD −16.68 dB "like dreaming while awake. . .water dripping from the ceiling" LE 20/25 Humphrey 24-2; complete loss of inferior nasal field; MD −12.61 dB 82 F RE 20/80 Humphrey 81-3 zone; 51/81 points not seen "A changing visual panorama. . .halls green with diamond-like pattern. . .blue flowers covering the bathroom. . .small red and grey tiles on the carpet. . .the walls looked like they were made of brick" LE FC Confrontation; FC ability in all but inferior nasal field 78 M RE 20/25 Humphrey 81-3 zone; 55/81 points not seen "I saw images of my bedroom wallpaper all over my house. . ." LE 5/200 Humphrey 81-3 zone; 50/81 points not seen 89 F RE 20/40 Humphrey 24-2; MD −3.14 People in the room that were not there. . .people or shadows standing near the elevator LE 20/40 Humphrey 24-2; MD −11.66 Dense inferior field defect VA = visual acuity; MD = mean deviation; FC = finger counting.