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Case Reports Showing Improved Macular Pigment and Visual Function in Patients Using a Carotenoid-rich Dietary Supplement

Herman JP, Kleiner-Goudey SJ, Davis RL, Pizzimenti JJ.


Purpose. These case reports demonstrate visual, retinal, and macular pigment optical density (MPOD) improvements achieved in patients using a specific, carotenoid-based dietary supplement.

Methods. We performed a comprehensive history, along clinical examination, MPOD testing, visual function testing, and spectral domain optical coherence tomography (SD-OCT) of the central retina. We prescribed a carotenoid-rich antioxidant supplement and conducted follow-up visits at appropriate intervals over a 2-year period.

Results. We noted improvements in MPOD and various visual function parameters. We also noted stabilization or improvement in macular appearance, SD-OCT findings, and patient self-reported parameters, including improvement in metamorphopsia.

Conclusions. Our four patient cases suggest that a lutein/zeaxanthin/fish oil/antioxidant dietary supplement with zinc improved MPOD and visual function. Patient education about sun protection, nutrition and lifestyle may benefit those at risk for and/or showing signs of age-related macular degeneration (AMD).

Relationships between blink rate, tear break up time and corneal changes among contact lens users.

Ammer R.


Purpose. Use of contact lenses is thought to reduce the oxygen supply to ocular tissues and many studies found that contact lens wear lead to various adverse ocular changes among contact lens users. The purpose of study was to rule out associations among ocular changes (blink rate, tear film break-up time and corneal changes) in contact lens users, those used contact lenses for more than 1 year.

Methods. It was a cross-sectional study and convenient sampling was used to collect the sample of 100 contact lens users. This study was conducted in 4 months from 05-04-2016 to 05-08-2016 and sample was recruited from Madinah Teaching Hospital Faisalabad, E Plomer Optics and Punjab Optics Lahore. Tear film break up time (TBUT) and corneal changes were determined by using slit lamp and blink rate was recorded by direct observation and counting. SPSS version 23 was used for data analysis. Inferential statistics was reported for variables.

Results. A highly significant (p = .000) negative correlation was found between blink rate and tear film break up time (TBUT). A significant (p = .000) association was found between blink rate and corneal changes. A significant (p = .000) association was found between tear film break up time (TBUT) and corneal changes.

Conclusions. It was concluded that ocular changes induced by contact lens use are interrelated. A cascade of changes started with the use of contact lens wear.

Knowledge Attitude and Practices Regarding Red Reflex in Neonatology Units of Lahore.

Takmeel S.


Purpose: The purpose of the study was to estimate the Knowledge, Attitude and Practices (KAP) of the red reflex test in the neonatology units of Lahore. The article would brief about the significance of Red reflex test, an ophthalmic screening test, probably expected to be carried out at every neonatology unit in most part of the developed world. The presence of red reflex can indicate to normal eye or otherwise it is an indication towards many ophthalmic problems and pathologies like ROP, cataracts, Retinoblastoma, squints and vitreous opacities.

Methodology: Knowledge, Attitude and Practices (KAP) study was conducted in the neonatology units, to assess the practice of red reflex in new born screening. Self-made questionnaires were used to assess the knowledge, attitude and practices of practitioners in nurseries. Sample size was 100 on duty practitioners and data was analyzed on SPSS version 20. The place of study was Lady Atchison Hospital and Lady Willingdon Hospital of Lahore. Duration of the study was from 5th September 2015 to 1st of November 2015.

Results: Results were found highly significant and different from the expected ranges. i-e the p value (p<0.05).Results were representing very little knowledge and attitudes regarding the red reflex test in neonatology screening units. Same was true for practices i-e negligible amount of practices were found regarding the performance of red reflex test.

Improvement in Visual Acuity with Refraction in Low vision Patients at Low Vision Clinic.

Saifullah, Ahmad Z, Shah M, Islam SB, Safi SK, Samiuddin.



Improvement in visual acuity with refraction in low vision patients at low vision clinic

 Materials and Methods:

Nineteen patients that include 13 males (68.42%) and 6 females (31.58%), with low vision visiting the low vision clinic were examined where after the reception and verbal consent, visual acuity was tested using standard log MAR chart. Retinoscopy was performed using the standard technique at a 67cm working distance. In the case of dimmer reflexes, Radical Retinoscopy at a 10cm working distance was performed and verified through subjective refraction. The study was conducted at Low Vision clinic Ophthalmology Department, Hayatabad Medical Complex, Peshawar and the duration of the study was 6months.

Results: Median presenting visual acuity was 1.16 log MAR, with an interquartile range of 2.1-0.6 log MAR. There was an improvement of 7 or more lines of visual acuity in 5 patients (26.32%), with 8 patients (42.11%) improving by 2-4 lines, 3 patients (15.79%) improving by 1 line. There was no significant improvement in 3 patients (15.79%). A higher rate of improvement was attained in age groups 23-30 years and 80-95 years. When stratified by diagnosis, a higher rate of improvement in visual acuity (up to 13 lines) was attained in patients with Age-related macular degeneration. Other patients that also significantly improved (up to 7 lines) had nystagmus or optic atrophy. No improvement in visual acuity was seen in a patient with retinitis pigmentosa, one patient with Nystagmus, and one with Stargardt’smaculopathy. A patient who was falsely categorized into low vision attained a visual acuity of 0.2 log MAR after proper refraction.

Conclusions: A significant improvement in visual acuity was attained from the total low vision patients. With proper refraction, the practitioner may take out a falsely categorized low vision patient from low vision category or may improve the visual acuity from severe to a moderate level.