Background Refraction is one of the key components of a comprehensive eye examination. Auto refractometers that are reliable and affordable can be beneficial, especially in a low-resource community setting. The study aimed to validate the accuracy of a novel wave-front aberrometry-based auto refractometer, Instaref R20 against the open-field system and subjective refraction in an adult population. Methods All the participants underwent a comprehensive eye examination including objective refraction, subjective acceptance, anterior and posterior segment evaluation. Refraction was performed without cycloplegia using WAM5500 open-field auto refractometer (OFAR) and Instaref R20, the study device. Agreement between both methods was evaluated using Bland-Altman analysis. The repeatability of the device based on three measurements in a subgroup of 40 adults was assessed. Results The refractive error was measured in 132 participants (mean age,30.53 ± 9.36 years, 58.3% female). The paired mean difference of the refraction values of the study device against OFAR was − 0.13D for M, − 0.0002D (J0) and − 0.13D (J45) and against subjective refraction (SR) was − 0.09D (M), 0.06 (J0) and 0.03D (J45). The device agreed within +/− 0.50D of OFAR in 78% of eyes for M, 79% for J0 and 78% for J45. The device agreed within +/− 0.5D of SR values for M (84%), J0 (86%) and J45 (89%). Conclusion This study found a good agreement between the measurements obtained with the portable autorefractor against open-field refractometer and SR values. It has a potential application in population-based community vision screening programs for refractive error correction without the need for highly trained personnel.
Purpose: Amblyopia is a significant public health problem. Photoscreeners have been shown to have significant potential for screening; however, most are limited by cost and display low accuracy. The purpose of this study was validate a novel artificial intelligence (AI) and machine learning–based facial photoscreener “Kanna,” and to determine its effectiveness in detecting amblyopia risk factors. Methods: A prospective study that included 654 patients aged below 18 years was conducted in our outpatient clinic. Using an android smartphone, three images of each the participants’ face were captured by trained optometrists in dark and ambient light conditions and uploaded onto Kanna. Deep learning was used to create an amblyopia risk score based on our previous study. The algorithm generates a risk dashboard consisting of six values: five normalized risk scores for ptosis, strabismus, hyperopia, myopia and media opacities; and one binary value denoting if a child is “at-risk” or “not at-risk.” The presence of amblyopia risk factors (ARF) as determined on the ophthalmic examination was compared with the Kanna photoscreener. Results: Correlated patient data for 654 participants were analyzed. The mean age of the study population was 7.87 years. The algorithm had an F-score, 85.9%; accuracy, 90.8%; sensitivity, 83.6%; specificity, 94.5%; positive predictive value, 88.4%; and negative predictive value, 91.9% in identifying amblyopia risk factors. The P value for the amblyopia risk calculation was 8.5 × 10 −142 implying strong statistical significance. Conclusion: The Kanna photo-based screener that uses deep learning to analyze photographs is an effective alternative for screening children for amblyopia risk factors.
Aim: The study was done to identify causes, demographic and clinical profile and to evaluate factors influencing visual outcome in paediatric ocular trauma patients (up to 15 years). Study Design: It was a prospective interventional study Place and Duration of the Study: The study was done in a tertiary eye care centre of eastern India between January 2019 to February 2020. Materials and Methods: The study was done from January 2019 to February 2020 on children between 1 year to 15 years of either sex with ocular trauma. Demographic details, cause of injury, presenting visual acuity were noted. Follow up was done till 2 months after carrying out appropriate intervention. Results: A total 106 eyes of 106 patients were evaluated and it was observed that children who were of 7 yrs and above were more affected (67%) than below (33%). Male children (59%) were more affected than female (41%). Injuries to Adnexa were found in 52% eyes, 40% injury cases were due to closed injury while open globe injuries comprised 8% of total cases. Common causes of injury were found to be mainly blunt objects and projectile objects. Maximum correction in visual acuity (VA) of more than 6/18 was achieved in 66% eyes, 6/18-6/60 in 11% eyes, <6/60-counting finger at 1 meter in 10% eyes. Conclusion: Late reporting, poor initial visual acuity, involvement of posterior segment, and no immediate primary intervention at time of injury adversely affect visual outcome. Early intervention and globe salvaging repair should be done in all eyes of trauma.
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