No abstract

Our data showed that the Oculus Pentacam provides repeatable measures of corneal thickness when measured within a few seconds, after 1 h, and 1 week.

IMPORTANCETelemedicine is accelerating the remote detection and monitoring of medical conditions, such as vision-threatening diseases. Meaningful deployment of smartphone apps for home vision monitoring should consider the barriers to patient uptake and engagement and address issues around digital exclusion in vulnerable patient populations.OBJECTIVE To quantify the associations between patient characteristics and clinical measures with vision monitoring app uptake and engagement. DESIGN, SETTING, AND PARTICIPANTSIn this cohort and survey study, consecutive adult patients attending Moorfields Eye Hospital receiving intravitreal injections for retinal disease between May 2020 and February 2021 were included.EXPOSURES Patients were offered the Home Vision Monitor (HVM) smartphone app to self-test their vision. A patient survey was conducted to capture their experience. App data, demographic characteristics, survey results, and clinical data from the electronic health record were analyzed via regression and machine learning.MAIN OUTCOMES AND MEASURES Associations of patient uptake, compliance, and use rate measured in odds ratios (ORs). RESULTSOf 417 included patients, 236 (56.6%) were female, and the mean (SD) age was 72.8 (12.8) years. A total of 258 patients (61.9%) were active users. Uptake was negatively associated with age (OR, 0.98; 95% CI, 0.97-0.998; P = .02) and positively associated with both visual acuity in the better-seeing eye (OR, 1.02; 95% CI, 1.00-1.03; P = .01) and baseline number of intravitreal injections (OR, 1.01; 95% CI, 1.00-1.02; P = .02). Of 258 active patients, 166 (64.3%) fulfilled the definition of compliance. Compliance was associated with patients diagnosed with neovascular age-related macular degeneration (OR, 1.94; 95% CI, 1.07-3.53; P = .002), White British ethnicity (OR, 1.69; 95% CI, 0.96-3.01; P = .02), and visual acuity in the better-seeing eye at baseline (OR, 1.02; 95% CI, 1.01-1.04; P = .04). Use rate was higher with increasing levels of comfort with use of modern technologies (β = 0.031; 95% CI, 0.007-0.055; P = .02). A total of 119 patients (98.4%) found the app either easy or very easy to use, while 96 (82.1%) experienced increased reassurance from using the app.CONCLUSIONS AND RELEVANCE This evaluation of home vision monitoring for patients with common vision-threatening disease within a clinical practice setting revealed demographic, clinical, and patient-related factors associated with patient uptake and engagement. These insights inform targeted interventions to address risks of digital exclusion with smartphone-based medical devices.

These findings may indicate that the viscoelastic properties of the cornea are altered to a minor extent in myopia. However, in this normal population, any overall systematic changes in CH and CRF with refractive error were small in comparison with the considerable inter-subject scatter at any level of refraction.

Background: Both Shack-Hartmann aberrometry (IRX3, Imagine Eyes, Orsay, France) and Scheimpflug photography (Oculus Pentacam, Oculus Inc Wetzlar, Germany) are known to provide repeatable measurements. The variability in measurements of corneal and ocular aberrations obtained with these instruments over one week had not been assessed. The aim was to study the variability in corneal and ocular aberrations in the human eye over one week and to determine the impact of age on corneal and crystalline lens aberrations and on the variability of these measurements. Methods: Monochromatic ocular aberrations were measured with the IRX3 and monochromatic corneal aberrations were measured using Scheimpflug photography on one eye of 23 normal subjects at periods of a few seconds, one hour and one week after the initial measurement. Results: No significant differences were found between the initial aberrations and aberrations measured at 59 Ϯ 24 seconds, 1.10 Ϯ 0.24 hours and 7.11Ϯ 0.31 days later. Analysis with Bland and Altman plots showed that measurements with both instruments were highly repeatable over the times studied. There was no relationship between age and the variance of corneal and ocular aberrations (higher order, spherical and coma aberrations). Corneal spherical aberration did not show a significant correlation with age, whereas the lens aberrations changed from being negative in the younger age groups to positive in the older age group, however, these differences failed to reach statistical significance (p > 0.05). Conclusion:The variability found in all the measurements was small and not clinically significant and could be attributable to instrument noise, changes in the tear film and to small fixational eye movements.

The Oculus Pentacam provides repeatable measures of the metrics derived from corneal topography over the tested time scales. In subjects aged from 19 to 40 years, topography measurements and their respective variability did not seem to change significantly with age.

Using 'big data' collected in the standard glaucoma care service, we found that patients attending a GMS have equivalent outcomes on the VF test. Our findings provide support for the implementation of virtual healthcare delivery in the hospital eye service.

Cementoblastoma is a rare benign tumor that almost always occurs in the premolar or molar region and more commonly in the mandible than in the maxilla. We present a unique incisor maxillary cementoblastoma in an 11-year-old child not previously described. To our knowledge, only 2 maxillary cases, both related to canine teeth, were described in the international literature. Thus, the aim of this article was to discuss the clinical presentation, diagnosis, and subsequent treatment of a patient with a cementoblastoma in the anterior maxillary region.