Objectives: Determine the prevalence of refractive errors among school children comparing governmental and non-governmental schools. Patients and methods: This study was a school-based cross-sectional comparative study, conducted in Tanta city, Gharbia governorate in the middle of the Delta region, Egypt from January and April 2016. The study included 1075 students from Two groups of primary schools private and governmental. Sociodemographic data collected for all student and full ophthalmic examination were done. Results: The prevalence of refractive error in our study was 22.1% of all students, only 35.7% of RE students wore glasses before our screening and suspected amblyopia cases who were 31.1% of RE students (6.9% of all students). Distribution of different types of refractive error showed that astigmatism most common followed by myopia and lastly hyperopia (68.1%, 17.6%, and 14.3% respectively). Conclusion: About one-fourth of the students had a refractive error with high suspected amblyopia. Most of the refractive error cases especially in governmental school were first detected during our study.

AIMTo study the role of ultrasound biomicroscopy (UBM) in the assessment of the bleb function after trabeculectomy with mitomycin C (MMC).METHODSThis was a cross-sectional study including all cases had undergone trabeculectomy with MMC 0.2 mg/mL for 3min. Participants were recruited from the follow-up cases at Department of Ophthalmology, Tanta University in the period from August 2015 to August 2016. Full history taking and ophthalmological examination were performed. Intraocular pressure (IOP) was measured using Goldmann applanation tonometry and the history of prescribed postoperative antiglaucoma medications was recorded. Accordingly, the trabeculectomy blebs were divided clinically into successful blebs when the IOP post-operative was ≤18 mm Hg without medications. Scanning examination of the filtering bleb using UBM examination was performed at the period from 2 to 36mo after trabeculectomy (13.6±9.7mo).RESULTSThis study included 33 trabeculectomy filtering blebs of 25 patients (9 males and 16 females). The mean age of patients was 53.2±14.2y (range 25-71y). We had 20 eyes with complete success, 9 eyes with qualified success, and 4 eyes with failure after trabeculectomy with MMC. The blebs were classified into successful blebs (IOP ≤18 mm Hg without antiglaucoma medications), others were classified into qualified successful and failed blebs. There was a significant correlation between certain UBM findings (intra-bleb reflectivity, draining sub-scleral tract, bleb height, and intrableb fluid cysts) and cases with different grades of clinical functional success (P<0.01).CONCLUSIONUBM is an objective tool in the functional assessment of the post-trabeculectomy filtering bleb through a significant correlation between certain UBM parameters and the different grades of clinical functional success.

Purpose The aim of this study was to evaluate the role of ultrasound biomicroscopy (UBM) in diagnosis, decision of intervention, and follow-up monitoring of secondary iris cysts. Patients and methods This case series study included 17 patients diagnosed clinically of having secondary iris cysts. History and full ophthalmological examination included visual acuity testing and slit lamp examination. UBM and B-scan ultrasound were performed for all cases. The study cases were divided into two groups according to the management plan (surgical management group and follow-up group). The follow-up period was 1 year. Results The study included 17 cases with unilateral secondary iris cysts. They were five females and 12 males, with age range from 3.0 to 44 years and a mean of 9.01±10.76 years. The clinical presentations such as blurring of vision, uveitis, red eye, ocular pain, or disfiguring intraocular swelling were insignificantly related to the different management groups (P>0.05). Angle closure and corneal touch (detected by UBM) were significantly present in the surgically managed cases, with P values of 0.003 and 0.009, respectively. The cyst size dimensions and its relation to the visual axis were detected with an insignificant difference between both groups. Conclusion UBM had a great value in the diagnosis of secondary iris cysts. Certain UBM findings were very important in deciding the different management plans and follow-up monitoring.

Purpose: To evaluate the clinical value of rigid gas permeable contact lenses in children after traumatic corneal scarring. Methods: This comparative study included 15 children (age range: 5.7 to 14 years; mean ± standard deviation = 9.4 ± 2.9 years) with corneal scars and best corrected visual acuity (BCVA) of worse than 20/20, history of penetrating ocular trauma, and/or cataract extraction. All children were advised to wear spherical rigid gas permeable contact lenses for 6 months with a special regimen. Visual acuity was compared before and after fitting. The total and anterior surface aberrations of all children were measured using a corneal topographer before and after treatment. Results: There was a significant improvement in the BCVA after wearing rigid gas permeable contact lenses compared to spectacle visual acuity ( P = .001). There was also significant improvement of the keratometric astigmatism ( P = .001) and corneal aberrations such as higher order aberrations ( P = .008), lower order aberrations, root mean square, and point spread function ( P = .001). Conclusions: The optical performance of rigid gas permeable contact lenses has been demonstrated to be effective in the visual rehabilitation of children with traumatic corneal lacerations. Corneal topography was an objective tool for detecting optical disorders. [ J Pediatr Ophthalmol Strabismus. 2018;55(3):178–181.]

PurposeWe sought to study the potential effects of child behavior disorders as well as the psychological profile and parenting style in children with ocular trauma and evaluate their effects with other traumatic associates on the visual outcome.SettingThis study was conducted at Tanta University Eye Hospital, Middle Delta.Study designThis was a nonrandomized cohort study.Patients and methodsThis study included all children at least 6 years with ocular trauma admitted to the Ophthalmology Department, Tanta University, from June 2015 to January 2016. Children were evaluated with regard to age, sex, time of seeking treatment, type, site of injury, and causative agent of trauma. Psychological assessment was carried out at the child psychiatry unit objectively using Western Psychological Services programs after trauma. Best-corrected visual acuity was detected at the last follow-up visit after trauma and was correlated to the behavioral disorders of children and the traumatic associates.ResultsIn this study, we included 62 children aged 6–16 with an average±SD of 9.45±2.8 years. Among them, 71% were boys and 29% were girls (P<0.0001). Open globe injury was found in 37 eyes (59.7%), closed in 22 eyes (35.5%), and adnexal in three (4.8%). Single entry was a significant type of injury (P=0.0001), and sharp causative agents were many and variable. Certain psychiatric and parenting style problems were significantly associated with moderate and severe vision loss such as inattention, aggressive behaviors, attention deficit hyperactivity disorder (P=0.01), and oppositional defiant disorder with P=0.03.ConclusionChild behavior disorders and abnormal parenting style were significantly associated with ocular trauma in children. In addition, certain types and characters of trauma were effective in the visual outcome.

The study aimed to identify different factors responsible for long term successful surgical outcome for intermittent exotropia in children.

ObjectiveOcular trauma is a serious problem in children and adolescents that can be troubling for them and their families. Psychosocial risk factors for eye trauma are understudied, especially in Arab and Egyptian populations. The current study aimed to evaluate the probable role of child psychopathology and parenting discipline styles in the predisposition for eye trauma in Egyptian children and adolescents. MethodsForty patients aged 3–18 years with accidental eye trauma and 40 controls of the same age range were recruited. A validated Arabic version of the Child Behavior Check List (CBCL) and an Arabic translated and validated version of the conflict tactic scale-parent child version were applied to evaluate the sample. ResultsAfter statistical adjustment for differences in socioeconomic status, youth with eye trauma showed higher rates of rule breaking behavior and attention deficit hyperactivity disorder (ADHD) as compared with the control group. Families of children with eye trauma reported a tendency to use less nonviolent discipline and more current and lifetime physical punishment as compared with the control group. ConclusionsChildhood behavioral disorders, such as ADHD, and parental tendency to use physical punishment as a pattern of discipline might predispose to serious accidental injuries, including eye trauma. Proper evaluation, diagnosis, and treatment for ADHD, together with community program that enhances nonviolent discipline techniques, will help in both primary and secondary prevention of ocular trauma.

Purpose This is a prospective investigational study that was performed at Tanta University Eye Hospital, Tanta, Egypt to evaluate the role of ultrasound biomicroscopy (UBM) in planning secondary implantation of intra ocular lens (IOL) in aphakia. Methods Preoperative UBM was performed for the assessment of anterior segment of 30 aphakic eyes admitted for secondary IOL implantation with special attention to central corneal thickness (CCT), anterior chamber depth (ACD), ciliary sulcus (CS), anatomical changes, and posterior capsular (PC) integrity which had been assessed by measuring the remnants of PC with special attention to the 12, 3, 5, 6, 7, and 9 o'clock meridians. Results This study involved 30 eyes in 27 patients; 16 males and 11 females. The mean age was 8.39 ± 2.36 years. The causes of aphakia were: congenital cataract extraction in14 eyes (46.7 %); trauma in 14 eyes (46.7 %); and after extracapsular cataract extraction in 2 eyes (6.6 %). The mean CCT was 0.61 + 0.35 mm and the mean ACD was 3.03 + 0.41 mm. The ciliary sulcus was patent in 28 eyes (93.4 %). Posterior synechia was observed in 8 eyes (26.7 %), lens remnants in 11 eyes (36.7 %), corneal scars in 11 eyes (36.7 %), and vitreous in anterior chamber in 1 eye (3.3 %). The integrity of PC was illustrated with a diagram. Conclusions UBM is a useful device to evaluate aphakic eyes before secondary IOL implantation through good evaluation of the anterior segment with special attention to the posterior capsular integrity, ciliary sulcus, anterior chamber depth, corneal thickness, and detection of any structural changes in the anterior segment resulting from the remote cause of aphakia.

PURPOSE:Studying the role of ultrasound biomicroscopy (UBM) in detection of anterior segment changes in infants with primary congenital glaucoma (PCG). METHODS:Cross-sectional study that included 25 eyes of 15 patients suffering from PCG and a control group of 15 eyes of ten age- and sex-matched participants. Diagnosis of PCG was based on clinical data (intraocular pressure, corneal diameter, fundus examination and amplitude-modulation scan measurement of axial length). UBM examination was done for all participants for measurement of central corneal thickness, anterior chamber depth, lens thickness, iris thickness (measured 2 mm from the iris root and again at the thickest point near the pupil), zonular length, posterior chamber depth, and angle of anterior chamber. Qualitative evaluation was done for abnormal angle membranes, iris insertion level, and ciliary processes position and configuration. RESULTS:Mean age ± standard deviation was 10.32±3.59 months in the study group and 14.54±5.9 months in the control group. The central corneal thickness, anterior chamber depth, zonular length, and angle of anterior chamber were significantly larger in the study group than in the control group, with mean values 700±190 μm, 3.55±0.32 mm, 1.02±0.15 mm, and 58.47°±5.57°, respectively. The posterior chamber depth had a mean of 0.33±0.06 mm, which was significantly smaller than that of the control group. In the study group, the mean iris thickness 2 mm from the iris root was 0.32±0.04 mm, the mean iris thickness at the thickest point near the pupil was 0.38±0.08 mm, and the mean lens thickness was 3.32±0.18 mm. These three parameters were smaller than the control group but the difference was insignificant. Loss of normal iris configuration was detected in all eyes of the study group. Anterior iris insertion was detected in 56% of the eyes in the study group, and abnormal angle membrane was found in 12%. CONCLUSION:UBM is a useful tool for detection of anterior segment changes in PCG, which is helpful especially in cases with opaque cornea or cases with borderline clinical findings.

Ultrasound biomicroscopy as a diagnostic tool in infants with primary congenital glaucoma Tarek r hussein said M shalaby Molham a elbakary rabab M elseht rania e gad Purpose: Studying the role of ultrasound biomicroscopy (UBM) in detection of anterior segment changes in infants with primary congenital glaucoma (PCG). Methods: Cross-sectional study that included 25 eyes of 15 patients suffering from PCG and a control group of 15 eyes of ten age-and sex-matched participants. Diagnosis of PCG was based on clinical data (intraocular pressure, corneal diameter, fundus examination and amplitude-modulation scan measurement of axial length). UBM examination was done for all participants for measurement of central corneal thickness, anterior chamber depth, lens thickness , iris thickness (measured 2 mm from the iris root and again at the thickest point near the pupil), zonular length, posterior chamber depth, and angle of anterior chamber. Qualitative evaluation was done for abnormal angle membranes, iris insertion level, and ciliary processes position and configuration. Results: Mean age ± standard deviation was 10.32±3.59 months in the study group and 14.54±5.9 months in the control group. The central corneal thickness, anterior chamber depth, zonular length, and angle of anterior chamber were significantly larger in the study group than in the control group, with mean values 700±190 μm, 3.55±0.32 mm, 1.02±0.15 mm, and 58.47°±5.57°, respectively. The posterior chamber depth had a mean of 0.33±0.06 mm, which was significantly smaller than that of the control group. In the study group, the mean iris thickness 2 mm from the iris root was 0.32±0.04 mm, the mean iris thickness at the thickest point near the pupil was 0.38±0.08 mm, and the mean lens thickness was 3.32±0.18 mm. These three parameters were smaller than the control group but the difference was insignificant. Loss of normal iris configuration was detected in all eyes of the study group. Anterior iris insertion was detected in 56% of the eyes in the study group, and abnormal angle membrane was found in 12%. Conclusion: UBM is a useful tool for detection of anterior segment changes in PCG, which is helpful especially in cases with opaque cornea or cases with borderline clinical findings.