ABSTRACT.Purpose: This study describes the various ophthalmological conditions detected in the Swedish visual screening program for children. Methods: The study was longitudinal and retrospective. All children (3126) born in 1982 in three Swedish municipalities have been followed from birth to ten years of age. Visual acuity was examined at the ages of 4, 5.5, 7 and 10 years. Before the age of 4, a gross examination of the eyes was performed. Results: The prevalence of ametropia in the population was 7.7%, the prevalence of strabismus 3.1%, and the prevalence of organic lesions 0.6%. Seven children (0.2%) were visually handicapped (visual acuity AE0.3 in the better eye). Refractive errors and microtropias were mainly detected at the age of 4, when the first visual acuity test was performed, while manifest strabismus was in many cases detected before this age. With this screening and subsequent diagnosis and treatment, the prevalence of deep amblyopia (visual acuity AE0.3) has been reduced from 2% to 0.2%. With treatment, 47% of the amblyopic children achieved a visual acuity better than 0.7. Conclusion: Visual screening is effective in detecting visual and ocular disorders. Most conditions are discovered before the age of 6. Compared to an unscreened population, the prevalence of amblyopia is greatly reduced.

The SWEDROP, a quality register for ROP, has a national coverage (ie, participation) of 96%. Data from 2008 to 2009 show that it seems possible to reduce the upper limit for screening in Sweden by 1 week, including only infants with a GA of 30 weeks + 6 days or less. However, such a change should be combined with a strong recommendation to neonatologists to refer also severely ill and more "mature" infants.

Aims: To determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotising enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage ≥ 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusions: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted. Background and aims: Autism spectrum disorders (ASDs) are disorders of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. Previous studies investigating neonatal factors and ASDs have produced inconsistent results. We performed confirmatory analyses concerning various neonatal complications and a later diagnosis with ASDs, and infantile autism, specifically. Methods: A Danish population based cohort study, including all children born in Denmark from 1994, through 2002, a total of 604,140 children. Diagnoses of neonatal complications were retrieved from the Danish National Hospital Register. Children diagnosed with ASDs were identified using the Danish Psychiatric Central Register. Data was analyzed using Cox proportional hazards regression. Results: A total of 4,145 children were diagnosed with ASDs, of which 1,493 had infantile autism. We found an increased risk of ASDs after exposure to a variety of neonatal complications; respiratory distress: adjusted hazard ratio (HR)=1.24 [95% confidence interval (CI): 1.02-1.51], intracranial bleeding, cerebral edema or seizures: HR=1.94 [95% CI: 1.12-3.36], neonatal hypoglycemia: HR=1.46

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Huizinga's concept of a 'magic circle' has been used to depict computer games and gaming activities as something separate from ordinary life. In this view, games are special (magical) and they only come to life within temporal and spatial borders that are enacted and performed by the participants. This article discusses the concept of a 'magic circle' and finds that it lacks specificity. Attempts to use the concept of a magic circle create a number of anomalies that are problematic. This is not, as has been suggested earlier, primarily a matter of the genre of the game, or a discussion of what an appropriate definition of a 'game' might be. Rather, in this study with hardcore gamers, playing computer games is a routine and mundane activity, making the boundary between play and non-play tenuous to say the least. This article presents an alternative theoretical framework which should be explored further

IMPORTANCE This follow-up study of extremely preterm (EPT) children (<27 weeks' gestational age [GA] at birth) revealed major eye and visual problems in 37.9% (147 of 388) of all EPT infants and in 55.4% (67 of 121) of the most immature subgroups at 6.5 years of age. These major eye and visual problems were strongly associated with treatment-requiring retinopathy of prematurity (ROP). OBJECTIVES To investigate the ophthalmologic outcome of a national cohort of EPT children at 6.5 years of age and to evaluate the impact of prematurity and ROP. DESIGN, SETTING, AND PARTICIPANTS All surviving EPT children born in Sweden between April 1, 2004, and March 31, 2007, were included and compared with a matched term control group, as part of a prospective national follow-up study. MAIN OUTCOMES AND MEASURES Visual acuity, refraction in cycloplegia, and manifest strabismus were evaluated and compared with GA at birth and with treatment-requiring ROP. RESULTS The study cohort comprised 486 participants. The mean (SD) GA of the children who were included was 25 (1) weeks, and 45.7% (222 of 486) were female. At a median age of 6.6 years, 89.3% (434 of 486) of eligible EPT children were assessed and compared with 300 control group children. In the EPT group, 2.1% (9 of 434) were blind, 4.8% (21 of 434) were visually impaired according to the World Health Organization criteria, and 8.8% (38 of 434) were visually impaired according to the study criteria. Strabismus was found in 17.4% (68 of 390) and refractive errors in 29.7% (115 of 387) of the EPT children compared with 0% (0 of 299) and 5.9% (17 of 289), respectively, of the control children (P < .001). Altogether at 6.5 years of age, 37.9% (147 of 388) of the EPT children had some ophthalmologic abnormality compared with 6.2% (18 of 290) of the matched control group (95% CI of the difference, 26.1%-37.2%). When treatment-requiring ROP was adjusted for, no significant association between GA and visual impairment could be detected. For refractive errors, the association with GA remained after adjustment for treatment-requiring ROP (odds ratio, 0.72; 95% CI, 0.58-0.91 for each 1-week increment). CONCLUSIONS AND RELEVANCE In a Swedish national cohort of EPT children at 6.5 years of age, major eye and visual problems were frequently found. Treatment-requiring ROP was a stronger impact factor than GA on visual impairment and strabismus, but not on refractive errors, as a whole. In modern neonatal intensive care settings, ophthalmologic problems continue to account for a high proportion of long-term sequelae of prematurity.

A new approach designed to establish the most suitable area for eccentric viewing and to teach and train patients with severe age-related macular degeneration (AMD) to use the eccentric viewing technique is described. Using a computer and video display based system, as well as software written specifically for this purpose, we investigated and trained ten consecutive patients with AMD. The patients were 80.1 + or - 5.6 years old, on average. All of them had an absolute central scotoma. Mean visual acuity was 0.035 + or - 0.016. After 30 min of testing, instruction and reading on the screen, followed by 2.6 + or - 0.69 one-hour training sessions, on average, with the low vision therapist, reading newspaper and book texts with the aid of hyperoculars or aplanatic systems and a very short reading distance, the patients achieved a reading speed of 58.9 + or - 19.7 words/min, significantly (p<0.001) higher than the initial speed when reading on the screen, 11.5 + or - 4.5 words/min.