Geoffrey W. Goodfellow

Effect of Amblyopia Treatment on Macular Thickness in Eyes With Myopic Anisometropic Amblyopia.

PURPOSE To determine whether abnormal macular thickness in myopic anisometropic amblyopia differed after amblyopia treatment. Furthermore, to investigate whether effect of treatment on macular thickness was associated with subject age or improvement in stereoacuity. METHODS Seventeen children (mean age: 9.0 [±3.0] years, ranging from 5.7-13.9 years) with myopic anisometropic amblyopia (visual acuity [VA] in amblyopic eyes: 20/80-20/400) were recruited and treated with 16-week refractive correction, followed by an additional 16-week refractive correction and patching. Macular thickness, best-corrected VA, and stereoacuity were measured both before and after amblyopia treatment. Factorial repeated-measures analysis of variance was performed to determine whether macular thickness in amblyopic eyes changed after amblyopia treatment. RESULTS Mean baseline VA in the amblyopic eye was 1.0 ± 0.3 logMAR and improved to 0.7 ± 0.3 after amblyopia treatment (P < 0.0001). The interaction between eye and amblyopia treatment was statistically significant for average foveal thickness (P = 0.040). There was no treatment effect on fellow eyes (P = 0.245); however, the average foveal thickness in the amblyopic eye was significantly reduced after amblyopia treatment (P = 0.049). No statistically significant interactions were found for the other macular thickness parameters (P > 0.05). CONCLUSIONS Abnormal central macula associated with myopic anisometropic amblyopia tended to be thinner following amblyopia treatment with no significant changes in peripheral macular thickness.

Optic nerve heads in pediatric African Americans using retinal tomography.

Purpose. To characterize optic nerve head (ONH) parameters including symmetry between the eyes in healthy African American children using the Heidelberg retinal tomograph II, and to determine if there are associations between these parameters and age, refractive error, or gender. Methods. The ONHs of 146 African American children aged 6 to 17 years without ocular disease were imaged with the Heidelberg retinal tomograph II. Mean values for 11 ONH parameters were determined as was their relationship to age, gender, and refractive error. Interocular symmetry of the parameters was determined. Results. The mean (±standard deviation) disc area, rim area, and cup area were 2.18 ± 0.57 mm2, 1.63 ± 0.40 mm2, and 0.52 ± 0.37 mm2, respectively. The mean linear cup-to-disc (C/D) ratio was 0.45 ± 0.15, and mean cup depth was 0.22 ± 0.10 mm. The mean retinal nerve fiber layer thickness was 0.26 ± 0.07 mm. The ONH parameters were not related to age or refractive error. With the exception of the C/D area ratio and linear C/D ratio, which were greater in boys than in girls, ONH parameters were not related to gender. Most parameters were strongly correlated between the right and left eyes. The average interocular differences in disc area, cup area, rim area, linear C/D ratio, and mean retinal nerve fiber layer thickness were 0.09 ± 0.31 mm2, 0.04 ± 0.22 mm2, 0.06 ± 0.40 mm2, 0.02 ± 0.11, and 0.00 ± 0.06 mm, respectively. Conclusions. ONH parameters were not related to age and refractive error, and only C/D area ratio and linear C/D ratio were greater in boys than girls in a clinical sample of African American children. These measures of normative ONH parameters and range of interocular differences may be helpful in clinical pediatric eye care to facilitate identification of African American children with abnormal optic discs.

Patient literacy levels within an inner-city optometry clinic.

BACKGROUND This study compares the literacy levels of patients seeking primary optometric care at the Illinois Eye Institute, located in a Chicago inner-city neighborhood, to the literacy demands of available near point cards and patient educational materials. METHODS The revised large print Slosson Oral Reading Test was administered to 100 primary care patients 10 to 15 minutes after the instillation of mydriatic eye drops. In addition, the Flesch-Kincaid Grade Level was calculated using the Spelling and Grammar component of the Microsoft Word software package 2003 (Microsoft, Redmond, Washington) for available near point testing cards and patient education materials used in this clinic from the American Optometric Association and the National Eye Institute. RESULTS A total of 37.4% of patients read 1 standard deviation or more below their age-expected levels. A total of 46.5% of patients read at or below an eighth-grade level. The literacy demands of the tested near point cards ranged from 2nd grade to 12th grade. The literacy demands of patient education materials ranged from 7th grade to 12th grade. CONCLUSIONS About one third to almost one half of the 100 patients in this sample from the Illinois Eye Institute optometry clinic read below their age-expected level. Therefore, near point testing materials and patient education materials may not be written at a suitable reading level to be effective in this population. Clinicians who provide eye care for patients in inner city settings should consider communicating important information using nonwritten methods to those patients with low literacy levels.