https://avehjournal.org/index.php/aveh/issue/feedAfrican Vision and Eye Health2024-03-01T13:02:05+01:00AOSIS Publishingsubmissions@avehjournal.orgOpen Journal Systems<a id="readmorebanner" href="/index.php/aveh/pages/view/journal-information" target="_self">Read more</a> <img style="padding-top: 2px;" src="/public/web_banner.svg" alt="" />https://avehjournal.org/index.php/aveh/article/view/869Heterophoria, fusional vergence, and near point of convergence in Sudanese hospital-based population2024-03-01T13:02:05+01:00Saif H. Alrasheeds.rasheed@qu.edu.saSulaiman Aldakhils.dakhil@qu.edu.sa<p><strong>Background:</strong> Fusional vergence amplitude is the amount of convergence and divergence that can be induced before fusion is lost and fusional vergence amplitude controls heterophoria.</p><p><strong>Aim:</strong> This study aimed to investigate the relationship between near heterophoria, near fusional vergence (NFV), and near point of convergence (NPC).</p><p><strong>Setting:</strong> Al-Neelain Eye Hospital Khartoum, Sudan.</p><p><strong>Methods:</strong> A hospital-based prospective study from February to October 2019, included 230 patients with age range of 15–30 years and mean age and standard deviation of 19.46 ± 3.33 years. The alternate cover test with prism was used to measure near heterophoria and a prism bar was used to measure quantity of fusional vergence. All measurements were taken at near heterophoria (0.33 m). Then the associations between near heterophoria, NFV and NPC were assessed.</p><p><strong>Results:</strong> The most common heterophoria at near among the participants was exophoria: 200 (87.0%). Reported complaints of asthenopia were commonly found among these exophoric patients: 106 (86.9%) (<em>P</em> = 0.735). Positive fusional vergence (PFV) to the break point varied according to the forms of heterophoria (<em>P</em> = 0.003). Esophoria had a higher PFV to break point than exophoria (30.83 ± 8.79Δ compared to 25.59 ± 10.07Δ). Negative fusional vergence at the break and recovery points were higher among those with exophoria and lower in esophoria (P ˃ 0.05). The NPC differed by the type of heterophoria (<em>P</em> = 0.01), with exophoria and slightly receded NPC (8.38 cm ± 3.33 cm) than for participants with esophoria (6.77 cm ± 1.52 cm).</p><p><strong>Conclusions:</strong> Exophoria was the most common type of near heterophoria, with asthenopia being the most reported complaint. Esophoria was found to be strongly associated with high PFV. Exophoria, on the contrary, is related to significant high NFV at the blur, beak, and recovery point. The NPC differed significantly by the type of near heterophoria, with exophoria having more receded NPC compared to those with esophoria.</p><p><strong>Contribution:</strong> This study provides information on the commonest type of near heterophorias among a sample of Sudanese adolescents and young adults, namely exophoria. Near point of convergence and NFV at break and recovery points were significantly different according to forms of near heterophoria.</p>2024-02-05T06:00:00+01:00Copyright (c) 2024 Saif H. Alrasheed, Sulaiman Aldakhilhttps://avehjournal.org/index.php/aveh/article/view/862The effect of 1% tropicamide on central corneal thickness and intraocular pressure2024-02-02T10:55:29+01:00Dimakatso G. Mashaladimakatso.mashala@ul.ac.zaBevily Nukerinukeribevily@gmail.comAlpheus S. Phakasellololo29@gmail.comAngela N. Mashabunhlamuk618@gmail.comMlungisi J. Fakudemlungisifakude63@gmail.comPhillip M. Seabiphillipseabi7@gmail.comMatome Mmakgahammakgahamashishi@gmail.comRamadimetja P. Sedibengramspheladi38@gmail.com<p><strong>Background:</strong> Dilating the eye with tropicamide may alter the intraocular pressure (IOP) because of an obstruction of the iridocorneal angle, resulting in decreased aqueous outflow drainage. Also, the repeated application of eyedrops and instrumentation could lead to increased central corneal thickness (CCT), consequently affecting IOP.</p><p><strong>Aim:</strong> This study aimed to determine the effect of 1% tropicamide on CCT and IOP post-mydriasis among the University of Limpopo optometry students.</p><p><strong>Setting:</strong> The data were collected at the optometry clinic of the University of Limpopo.</p><p><strong>Methods:</strong> A within-subject experimental study was conducted on 59 healthy subjects aged 18 years – 28 years. A computer assisted simple random probability sampling was used to identify a sample of participants from the study population (<em>N</em> = 200). Baseline and post-mydriasis IOP (20 min, 30 min, and 45 min intervals) were measured with a Goldmann applanation tonometer. Central corneal thickness and IOP were analysed using means, correlations and paired <em>t</em>-tests.</p><p><strong>Results:</strong> The mean CCT pre-mydriasis was 504.68 <em>μ</em>m, and post-dilation was 507.90 <em>μ</em>m, 510.08 <em>μ</em>m and 509.25 <em>μ</em>m at 20 min, 30 min, and 45 min, <em>P</em> = 026, <em>p</em> = 0.033, <em>P</em> = 0.004, respectively. Moreover, the mean IOP pre-mydriasis was 15.97 mmHg, and post-dilation was 16.85 mmHg, 16.46 mmHg and 16.85 mmHg over 20 min, 30 min, and 45 min of followed-up time, <em>p</em> = 0.140, <em>p</em> = 0.432, and <em>p</em> = 0.183, respectively.</p><p><strong>Conclusion:</strong> Measuring IOP post-dilation is still valid; however, CCT should be measured before the instillation of tropicamide.</p><p><strong>Contribution:</strong> This study analysed the effect of 1% tropicamide on CCT and IOP post-mydriasis in a clinical South African context.</p>2024-01-31T11:11:00+01:00Copyright (c) 2024 Dimakatso G. Mashala, Bevily Nukeri, Alpheus S. Phaka, Angel N. Mashabu, Mlungisi J. Fakude, Phillip M. Seabi, Matome Mmakgaha, Ramadimetja P. Sedibenghttps://avehjournal.org/index.php/aveh/article/view/857Advanced ring melanoma of the choroid and ciliary body with extrascleral extension2024-02-01T12:32:07+01:00Sara Alattarsaraalattar@aun.edu.egSana S. Krooshs.kroosh@aun.edu.eg<p><strong>Introduction:</strong> Ring melanoma is a rare form of uveal melanomas that is characterized by circumferential growth pattern. The diagnosis of ring melanomas may be delayed because of their initial hidden location and non-specific symptoms. In addition, ring melanomas may be misdiagnosed and treated as refractory glaucoma or retinal detachment because of their atypical presentation. Such tumours are usually large and extensive at the time of diagnosis, thus associated with worse prognosis.</p><p><strong>Patient presentation:</strong> This case report presents a case of a 70-year-old female presenting with blurring of vision of 1 month duration. Examination revealed a pigmented subconjunctival mass just inferior to the lower limbus that the patient reported to appear 1 year before. Dilated fundus and ultrasonographic examination were suggestive of ciliochoroidal melanoma with associated retinal detachment.</p><p><strong>Management and outcome:</strong> The patient underwent enucleation, and histopathology confirmed the diagnosis of ciliochoroidal melanoma of mixed cell type.</p><p><strong>Conclusion and Contribution:</strong> This article aims to report a rare and advanced case of a deadly tumour emphasizing on the importance of routine fundus examination in patients over the age of 40 years.</p>2024-01-31T07:00:00+01:00Copyright (c) 2024 Sara Alattar, Sana S. Krooshhttps://avehjournal.org/index.php/aveh/article/view/834Relationship between biometry, fovea, and choroidal thickness in Nigerian children with myopia2024-02-01T12:32:07+01:00Chukwuemeka Junior Obinwannezugusjay@gmail.comKovin S. Naidookovinn@gmail.comKhathutshelo P. Mashigemashigek@ukzn.ac.za<p><strong>Background:</strong> Understanding the relationship between biometric and structural changes in childhood myopia is necessary to effectively manage myopia progression.</p><p><strong>Aim:</strong> To determine the relationship between ocular biometry, fovea and sub-fovea choroidal thickness in school-aged children with myopia of Nigerian descent.</p><p><strong>Setting:</strong> Abuja, Nigeria.</p><p><strong>Methods:</strong> This study involved 189 children (117 girls and 72 boys), and myopia was defined as cycloplegic spherical equivalent refraction (SER) of ≤ −0.50 D. Keratometry values, biometry data, fovea and sub-foveal choroidal thickness (SFChT) values were obtained from medical records retrospectively and analysed.</p><p><strong>Results:</strong> The median age was 13 years (interquartile range [IQR]: 5). The median SER, fovea and SFChTs were −2.63 D (IQR: 3.38), 249 <em>μ</em>m (IQR: 118) and 225 <em>μ</em>m (IQR: 341), respectively. Male children had flatter corneas, thicker fovea and thinner SFChT compared to female children. The vitreous chamber and axial length were longer and sub-fovea choroid was thinner in children with high myopia. There was a weak but significant positive correlation between myopia and sub-fovea choroidal thickness (<em>r</em> = 0.270 respectively, <em>P</em> < 0.01). A moderate negative correlation was found between myopia and vitreous chamber depth (<em>r</em> = −0.536, <em>P</em> < 0.001), and a strong negative correlation was found between myopia and axial length (<em>r</em> = −0.706, <em>P</em> < 0.001).</p><p><strong>Conclusion:</strong> Myopia in school-aged Nigerian children is associated with sub-fovea choroidal thinning, increased vitreous chamber depth and axial elongation.</p><p><strong>Contribution:</strong> This study provides data on the relationship between ocular biometry, fovea and sub-foveal choroidal thickness in school-aged Nigerian children with myopia.</p>2024-01-25T15:00:00+01:00Copyright (c) 2024 Chukwuemeka Junior Obinwanne, Kovin S. Naidoo, Khathutshelo P. Mashigehttps://avehjournal.org/index.php/aveh/article/view/790Expert multistakeholder engagement informing content of advanced diploma in visual impairment studies2024-02-01T12:32:07+01:00Maesala Manispm.thabe@gmail.comMaximus M. Sefothomsefotho@uj.ac.zaRonél Ferreiraronel.ferreira@up.ac.za<p><strong>Background:</strong> This study evaluates the interface between expert multistakeholder engagement and the development of Advanced Diploma in Visual Impairment Studies (VIS). Additionally, the study validates the content included in the modules of this training programme for teachers of learners with visual impairment (VI).</p><p><strong>Aim:</strong> The aim of the study was to anchor on one of the objectives of a broader main study, namely to establish a network of experts that could provide input in terms of suitable content to include in the VI qualification.</p><p><strong>Setting:</strong> The study setting was the University of Pretoria, South Africa.</p><p><strong>Methods:</strong> Snowball sampling was used to identify 56 stakeholders from different organisations working in or having interest in visual impairment field. Two-phase Participatory Reflection and Action (PRA)-guided workshops and focus groups were utilised to generate data. Subsequestly, member checking was conducted with the stakeholders during a follow-up workshop, validating results.</p><p><strong>Results:</strong> Stakeholder partnerships were identified as a prominent theme. Sub-themes included the identification of potential stakeholders, collaboration and networking, maintaining partnerships, and community outreach.</p><p><strong>Conclusion:</strong> The establishment of networks with key stakeholders was found to be important, however, the necessary care had to be taken to continuously engage stakeholders in content reviews and efforts to accommodate learners with VI through learnerships and entrepreneurial developments.</p><p><strong>Contribution:</strong> Teachers feel ill-equipped to work with learners with VI. This article attempts to highlight the benefit of involving the perspectives of multiple stakeholders when developing a programme informing the learning, teaching and supporting system in schools of learners with VI.</p>2024-01-22T06:00:00+01:00Copyright (c) 2024 Maesala Manis, Maximus M. Sefotho, Ronél Ferreirahttps://avehjournal.org/index.php/aveh/article/view/860Impact of the COVID-19 pandemic on ophthalmic surgery at a tertiary hospital in South Africa2024-01-22T15:20:22+01:00Ismail Makdaismailymakda@icloud.comAubrey Makgotloeaubrey.makgotloe@wits.ac.zaNaseer Allynaseerally@gmail.com<p><strong>Background:</strong> The coronavirus disease 2019 (COVID-19) pandemic impacted the provision of ophthalmic care.</p><p><strong>Aim:</strong> This study aimed to quantify the pandemic on the number of ophthalmic surgeries.</p><p><strong>Setting:</strong> The study was conducted at a South African tertiary academic hospital.</p><p><strong>Methods:</strong> A retrospective comparative analysis of eye surgeries 1 year pre- and post- onset of the COVID-19 lockdown (27 March 2019 to 26 March 2021) was conducted. Theatre surgical records were analysed 1-year pre- and post-lockdown. All surgical procedures were recorded and subcategorised into cataract, cornea, glaucoma, oncologic, orbital, oculoplastic, strabismus, trauma, vitreoretinal, and other. Trauma surgeries in the post-pandemic year were sub-analysed based on the level alcohol restriction level.</p><p><strong>Results:</strong> Total surgeries decreased from 3521 to 1551 (<em>P</em> < 0.001). Using multivariate analysis, the incidence rate ratio (IRR) for all surgeries during the pandemic was 0.47 (<em>P</em> < 0.001) with a significantly reduced IRR during the first wave of 0.427 (<em>P</em> = 0.003) and a non-significant change during wave two; IRR 1.25 (<em>P</em> = 0.36). All surgical subgroups decreased significantly except oncology, insignificant decrease from 211 to 180 (<em>P</em> = 0.12). Trauma significantly decreased during periods of total alcohol bans; IRR of 0.50 (<em>P</em> < 0.001). An insignificant decrease was found during periods of partial ban with an IRR of 0.83 (<em>P</em> = 0.06) compared with periods without alcohol restrictions.</p><p><strong>Conclusion:</strong> Post lockdown, the total number of surgeries decreased in all subgroups except oncology. Alcohol bans significantly decreased trauma surgeries.</p><p><strong>Contribution:</strong> This article provides valuable insight, which may inform public health policy.</p>2023-12-19T08:00:00+01:00Copyright (c) 2023 Ismail Makda, Aubrey Makgotloe, Naseer Allyhttps://avehjournal.org/index.php/aveh/article/view/844An intracameral combination of tropicamide, phenylephrine and lidocaine in phacoemulsification2024-01-22T15:21:34+01:00Dhruvil Nayakdhruvilnayak96@gmail.comHarish Triveditrivedi_harish@yahoo.co.inRuchi Prabtaniruchibarot25@gmail.com<p><strong>Background:</strong> Although the benefits of intracameral mydriatics have been established in healthy patients, their safety and efficacy in difficult subjects have yet to be determined.</p><p><strong>Aim:</strong> The aim of the study is to assess the safety and efficacy of topical and intracameral application of a combination of tropicamide, phenylephrine and lidocaine during phacoemulsification surgery.</p><p><strong>Setting:</strong> The study was done at the Department of ophthalmology at the University of Bhavnagar, Gujarat, India.</p><p><strong>Methods:</strong> A total of 50 patients were recruited patients who were operated with phacoemulsification surgery. During the intraoperative period, pupil seize was studied and eventual adverse events have been monitored. Also, comfort reported by patients and surgeons has been investigated.</p><p><strong>Results:</strong> It was observed that the intracameral drug combination did not have any impact on blood pressure, pulse rate as well as did not affect the Intra Ocular Pressure (IOP) dynamics and was successful in maintaining pupil size after its application during surgery.</p><p><strong>Conclusion:</strong> The combination also proved effective as an anaesthetic agent, which was proven by pain score findings, as the patients were comfortable and compliant enough to tolerate cataract surgery.</p><p><strong>Contribution:</strong> The mydriatic and anaesthetic combination is efficient enough used topically and intracamerally to carry out phacoemulsification surgery and has a better safety profile when compared with current practices.</p>2023-12-18T05:00:00+01:00Copyright (c) 2023 Dhruvil Nayak, Harish Trivedi, Ruchi Prabtanihttps://avehjournal.org/index.php/aveh/article/view/853Optical coherence tomography profile of macular structure and ocular dominance in young adults2024-01-22T15:20:22+01:00Salma I.E. Hagarsalmahagar17@hotmail.comAtif B.M Aliatfbm@yahoo.comAbd Elaziz M. Elmadinaa.alkhalil@qu.edu.saSaif H. AlrasheedS.rasheed@qu.edu.saRaghda F. Mutwalir.mutwaly@qu.edu.sa<p><strong>Background:</strong> Ocular dominance is used clinically for decisions on monovision in contact lens wear and treating binocular vision anomalies.</p><p><strong>Aim:</strong> This study aimed to investigate the association between macular structure and ocular dominance in normal-sighted young adult Sudanese by using optical coherence tomography (OCT).</p><p><strong>Setting:</strong> The study was conducted at Al-Neelain eye hospital, Faculty of optometry and visual sciences, Khartoum, Sudan.</p><p><strong>Methods:</strong> A prospective, cross-sectional and comparative study was conducted in 160 eyes of 80 healthy young adults. Central macular thickness (CMT), peripapillary retinal nerve fibre layer (NFL) thickness and inner retinal layers were investigated in each subject using OCT. Hole-in-the-card was used to detect ocular dominance.</p><p><strong>Results:</strong> The findings showed that the mean value of CMT for dominant eyes was slightly thicker (224.53 ± 17.18 <em>μ</em>m) than in non-dominant eyes (224.36 ± 16.18 <em>μ</em>m; <em>P</em> = 0.947). Whereas NFL thickness for dominant eyes was thicker at 31.87 ± 10.43 <em>μ</em>m than in non-dominant 130.83 ± 10.30 <em>μ</em>m with <em>P</em> = 0.528. In general, there were no highly significant differences between dominant eyes and non-dominant eyes found in macular parameters (<em>P</em> > 0.05).</p><p><strong>Conclusion:</strong> Central macular thickness, NFL, ganglion cell layer and retinal pigmented epithelium may have some impact on determining ocular dominance in healthy adults. We believe that the exact mechanism and effects of ocular dominance remain unclear. Thus, further evaluation is needed.</p><p><strong>Contribution:</strong> This study observed slight thicker in macular parameters for the dominant eye, particularly in CMT and NFL thickness.</p>2023-12-12T07:00:00+01:00Copyright (c) 2023 Salma I.E. Hagar, Atif B.M Ali, Abd Elaziz M. Elmadina, Saif H. Alrasheed, Raghda F. Mutwalihttps://avehjournal.org/index.php/aveh/article/view/891Acknowledgement to reviewers2024-01-22T15:20:22+01:00Editorial Officepublishing@aosis.co.zaNo abstract available.2023-12-01T16:45:00+01:00Copyright (c) 2023 Editorial Officehttps://avehjournal.org/index.php/aveh/article/view/882African vision eye health2024-01-22T15:20:22+01:00Alan Rubineditor@avehjournal.orgNo abstract available.2023-11-24T06:00:00+01:00Copyright (c) 2023 Alan Rubin