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Background and Objective: It is well accepted that accommodation system is characterized by steady state error in focus. Usually near addition lenses are prescribed to prepresbyopic individual for treatment of binocular motor problems such as convergence excess and accommodative disorder. The purpose of this study was to evaluate the near addition lenses in accommodative and vergence responses at three viewing distances. Materials and Methods: This semi-experimental study was done on 42 students of 17-25 years old in Zahedan, South-Eastern Iran during 2009. After correction of refractive error, phoria states with APCT and binocular and monocular lag of accommodation by MEM method with and without +2.00 lenses in three difference distances (30, 40, 50 cm) was measured. Data analyzed by ANOVA, t-student and paired t-tests. Results: There was significant difference between average of lag of accommodation and phoria at various distances, with and without lens (P<0.05). Also, there was significant difference between mean of lag in 3 fixation distance (P<0.017). There was no significant difference between average of lag of accommodation and phoria at various distances in three group of refractive error. Conclusion: Our results showed that, near addition lens reduce the lag of accommodation. It is proposed, therefore, according to near emmetropization theory addition lenses may be effective in reducing of the myopia progression.

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Background and Objective: Floater is defined as dark and vague spots and lines, which presents in visual fields of patients. Etiologies are various and life threatening, due to the serious complications resulted from floaters, this study was designed to assess ophthalmic disorder among patients with floater Gorgan, Iran (2009). Materials and Methods: This cross-sectional study,was done on 164 patients (105 female, 59 male) with floater or photopsia in Gorgan, North of Iran during 2009. Findings of ophthalmic examination and demographic characteristics were recorded in a questionnaire for each patients. Results: The prevalency of floater was higher among patients over sixty years old. 57.2% women with floater were during monopausal period. Myopia (32.9%) and cataract (32.9%) were the most associated ophthalmic diseases. Posterior vitreous detachment and retinal bleeding in patients with floater was 84.1% and 6.1%, respectively. Retinal detachment was not seen in patients. Conclusion: This study showed that posterior retinal detachment is the most frequent associated ophthalmic disorder in patients with floater. Older age, gender, myopia and cataract are considered to be the related risk factors in floater.

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Background and Objective: Glaucoma is one of the most important cause of blindness wordwide. Exact determination of intra ocular pressure is important for the diagnosis and decision making about glaucoma treatment. Central corneal thickness is considered as effective factor on intra ocular pressure and visual field defect. This study was carried out to determine the relationship between central corneal thickness, intra ocular pressure and visual field in normal tension and primary open angle glaucoma. Materials and Methods: This descriptive study was carried out on 45 eyes with normal tension glaucoma and 45 eyes with primary open angle glaucoma in Al-Zahra ophthalmology hospital in Zahedan, Iran during 2010. Intra ocular pressure and central corneal thickness were measured by Goldman tonometer and pachymeter and visual field exanimated by Humphrey perimeter. Data were analyzed using SPSS-16, paired t-test, ANOVA, Mann–Whitney and Pearson corlateion tests. Results: There was significant correlation between central corneal thickness and intra ocular pressure (r=0.309, P<0.05). A significant difference was detected in intra ocular pressure between two type of glaucoma (P<0.05). Mean value of central corneal thickness in patient with mild visual field defect was higher than severe visual field defect but there was not significant statistical difference between central corneal thickness and visual field defect in subjects with glaucoma. Conclusion: This study indicated that increasing corneal thickness is accompanied with intra occular presure.

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Red eye is the most common sign of ocular inflammation. Serious cases of red eye need diagnosis and proper treatment by ophthalmologist but many other from of red eye can be managed primarily by health care personals. If General practioners were able to diagnose and differentiate the causes of red eye the serious complication have not been observed and the patients were have been treated on due time. Some of the causes of red eye are: blepharitis, corneal erosion, sub conjunctival hemorrhage, glaucoma, episcleritis and scleritis.

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Background and Objective: Pterygium is a fibrovascular lesion of the ocular surface with unknown origin, decrease in the vision. This study was done to evaluate the possible role of Epstein-Barr virus (EBV) in the formation of pterygia. Methods: This case-control study was done on 50 tissue specimens of pterygium from the patients who underwent pterygium surgery as the case group and 10 conjunctival biopsy specimens of individuals without pterygium including the patients whom underwent cataract surgery, as controls. The evidence of EBV infection was tested by polymerase chain reaction (PCR). Results: EBV was detected in three (6%) patients with pterygia. EBV was not detected in controls. There was not any significant correlation between pterygium and the presence of EBV. Conclusion: According to this study, EBV virus is not associated with pterygium formation.

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Color vision deficiency (CVD) is a defect of vision with disability to distinguish colors. Color vision deficiency can be divided into the two categories, congenital and acquired. Congenital color vision deficiency divided into anomalous trichromacy, dichromacy and monochromacy. The most common congenital CVD was deuteranomalous that mode of inheritance is X linked recessive occurring mostly in males. Acquired CVD can occur as a direct result of illness or any related medicine. Color perception changes in acquired CVD may be secondary to primary ocular disease, drug side effect, or serious systemic disease such as diabetes. Dystrophy of cone, types of maculopathy, crystalline lens changes associated with aging, diabetes, glaucoma, optic nerve diseases and traumatic brain injuries can cause CVD. For acquired CVD, type of defect may not be easy to classify; nevertheless, predominantly is tritanopia and type and severity of the defect fluctuates during of disease. It has been suggested that human evolution to industrialized civilization has led to an increased prevalence of CVD in most population. An acquired CVD can reflect a deficiency in color information processing at anywhere along the related visual pathway, from the photoreceptors to the cortex. Sometimes, assessment of color vision can be helpful to detect a visual impairment in early stages.

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Background and Objective: Age-related cataract is one of the most important causes of blindness. Early detection of cataracts can help alleviate the problems caused by this disease. This study was performed to evaluate the visual acuity and contrast sensitivity of patients with early cataract.
Methods: This descriptive-analytical study was performed on 54 patients (108 eyes) in the age range of 35 to 50 years with early stage cataract referred to Alzahra Ophthalmology Hospital in Zahedan, souh-west of Iran. The ethnicity of all the participants was Baluchi and Sistani. After correcting the refractive errors if the inclusion criteria were met, visual acuity with E chart at 6 m and Pelli Robson contrast sensitivity chart at 3 m were measured as monocular.
Results: There was a significant correlation between visual acuity and contrast sensitivity (P=0.033, r²=0.205). The mean of visual acuity and contrast sensitivity were not significantly different in the two Baluchi and Sistani ethnicities. But visual acuity and contrast sensitivity were significantly different in the two genders (P<0.05).
Conclusion: Early cataract, although having a minor effect on visual acuity, can reduce contrast sensitivity. Therefore, measuring of contrast sensitivity in normal light condition in patients with early cataract who complain of blurred vision despite normal visual acuity can more accurately assess their visual function.

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Background and Objective: Any factor that disrupts the tear duct can cause epiphora, one of the most prevalent causes for patients to go to ophthalmology clinics. Nasolacrimal duct obstruction can be congenital or acquired. Dacryocystorhinostomy (DCR) surgery, which can be operated using external or endonasal approaches, is the standard treatment for nasolacrimal duct obstruction. This study was carried out to assess the success rate of endoscopic dacryocystorhinostomy surgery for patients with nasolacrimal duct obstruction.
Methods: This descriptive study was carried out on 38 patients (29 females and 9 males), aged over 18 with an average age of 43.07±13.83, suffering from epiphora referring to 5 Azar Hospital in Gorgan (Iran) between 2015 and 2018. The success rate of endoscopic dacryocystorhinostomy surgery for epiphora treatment was evaluated 6 months after the surgery. Furthermore, from the viewpoint of the complications of the surgery and the connection to the CT scan results, endoscopic dacryocystorhinostomy surgery was assessed.
Results: The surgery was successful for 36 patients (94.74%). The extent of the nasolacrimal duct obstruction of the right eye and the left eye was measured at 63.2% and 36.8%, respectively. Slight and heavy bleeding during the surgery was observed in 76.3% and 7.9% of the cases, respectively. Cerebrospinal fluid leakage and orbital injury during the surgery were not seen in the patients. According to the CT scan findings, deviation of the septum was seen in 76.3% of the patients, while septoplasty was operated on in 41.37% of the patients during the surgery. Moreover, half of the patients were suffering from chronic sinusitis for whom, the involved sinuses were opened and sinuses drainage was performed.
Conclusion: Endoscopic dacryocystorhinostomy surgery is an acceptable and successful method for treating epiphora, especially for patients with sinusitis or nasal septum deviation.
 

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The rise in patients seeking corneal refractive surgery, despite having systemic autoimmune diseases, underscores the need for special considerations when treating these individuals. Recent studies have expanded our knowledge in identifying and evaluating autoimmune disorders and their potential side effects in the results of corneal refractive surgery with laser. This study briefly examines the pathogenic factors, clinical aspects, and possible complications in patients with systemic autoimmune disorders subjected to these surgeries. In total, 132 articles were selected for this research among the reviewed studies. Considering that the release of various cytokines caused by systemic autoimmune disorders can lead to destructive corneal consequences, the need for early diagnosis before any laser surgery for refractive errors seems essential. Although procedures such as LASIK and PRK are commonly performed on patients with autoimmune disorders, important considerations must be made. Studies have not yet confirmed definitive contraindications to laser refractive surgery for autoimmune disorders.

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Background and Objective: The therapeutic outcomes of amblyopia after the age range of 8-10 years are poor, and amblyopia in older individuals is resistant to treatment. Repetitive Transcranial Magnetic Stimulation (rTMS), among the efforts intended to modulate cortical excitability in the treatment of psychiatric disorders, has been believed to be associated with a specific disease. This study aimed to determine the effect of rTMS on the treatment of treatment-resistant amblyopia in adult patients.
Methods: This clinical trial was conducted on 16 patients (12 males and 4 females) with unilateral amblyopia, with a mean age of 30±5 years referring to the clinics of Khatam al-Anbia Eye Hospital, Mashhad, Iran, during 2016-17. Patients were randomly selected from those with unilateral amblyopia (refractive, strabismic, or mixed) who had not responded to conventional treatments (patching or penalization). The healthy eye was considered a control. The therapeutic intervention consisted of four rTMS sessions at two-week intervals. Visual acuity and contrast sensitivity were measured and compared three times: Before the intervention, at the first session of intervention, and at the fourth session of intervention.
Results: The mean visual acuity at baseline (0.36±0.19) was not significantly different compared to the first treatment session (0.41±0.1); however, a significant increase was observed compared to the fourth session (0.45±0.23) (P<0.05). The mean contrast sensitivity at baseline (2.02±0.74) was not significantly different compared to the first (1.97±0.63) and the fourth (2.16±0.94) treatment sessions.
Conclusion: In most follow-ups, improvement in contrast was not observed in patients with treatment-resistant amblyopia at older ages using rTMS. Only an improvement in visual acuity was observed in the last follow-up compared to the baseline in the patient group.

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Background and Objective: Intermittent exotropia is the most common form of exotropia in children. Non-surgical treatments include refractive error correction, occasional patching of the normal eye in young children, prism therapy, and orthoptic exercises. This study aimed to compare the effects of wearing overminus spectacles versus patch therapy in 3- to 8-year-old children with intermittent exotropia.
Methods: This clinical trial was conducted on 30 children (9 boys and 21 girls) with intermittent exotropia aged 3 to 8 years with no previous treatment history referring to the strabismus clinic of Khatam-al-Anbia Hospital in Mashhad. Patients were randomly assigned to two groups: Patch therapy (n=20) and overminus (n=10). In the patch therapy group, the patient’s healthy eye was patched for 2 to 4 hours a day for 6 months. Overminus spectacles were selected based on cycloplegic refraction between 2 and 4 diopters. Astigmatism was fully prescribed. Patient follow-up time was 3 months and then 6 months. Finally, data, including the size of the deviation and the degree of deviation control, were collected and analyzed.
Results: The median spherical error of patients before intervention in the overminus group was +1 diopter in the right eye and +0.75 diopter in the left eye, and in the patch therapy group, +0.75 diopter in both the right and left eyes. Six months after the intervention, the median spherical error in the overminus group was +0.62 diopters in both the right and left eyes, and in the patch therapy group, +0.75 diopters and +0.62 diopters in the right and left eyes, respectively. No significant statistical difference was found between the study groups. The median deviation size of patients in the overminus group before intervention was +25 prism in distance vision and +25 prism in near vision, and 6 months after intervention, it was +22.5 prism in distance vision and +20 prism in near vision. Also, the median deviation size of patients in the patch therapy group before intervention was +25 prism in distance vision and +25 prism in near vision, and 6 months after intervention, it was +25 prism in distance vision and +25 prism in near vision. No significant statistical difference was found between the study groups. The median deviation control based on the Newcastle Scale Score (NSS) of patients before intervention was 3.5 in the overminus group and 4 in the patch therapy group, which was 1.5 in the overminus group and 3 in the patch therapy group 6 months after the intervention. Although there was a greater improvement in control based on the NSS in the overminus group compared to the patch therapy group.
Conclusion: Both overminus and patch therapy are effective in treating patients with intermittent exotropia. In patients using the overminus method, deviation control is higher compared to the patch therapy method.
 

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Background and Objective: Evaluating the agreement among various corneal imaging devices is crucial due to their varying technologies in diagnosing corneal parameters. This study aimed to assess the agreement of Advanced Corneal Explorer (ACE) with Pentacam and Orbscan in myopic individuals with healthy corneas.
Methods: This descriptive-analytical study was conducted on 45 myopic individuals (25 women and 20 men; mean age=30.37±6.13 years) referring to Al-Zahra Ophthalmology Hospital in Zahedan, Iran, during 2023. Anterior segment imaging was performed using three devices: ACE, Pentacam, and Orbscan. Corneal parameters, including topography, tomography, and corneal aberrations, were examined. The intraclass correlation coefficient (ICC) and 95% limits of agreement (LoA) were used to evaluate the agreement of ACE data with the data obtained from the other two devices.
Results: ACE exhibited good agreement with Pentacam for the mean power (ICC=0.97), maximum power (ICC=0.98), and minimum power of the anterior corneal surface (ICC=0.97) (P<0.05). Additionally, ACE exhibited good statistical agreement with Orbscan for the mean power of the anterior corneal surface due to an ICC of 0.98 (P<0.05). The ICC values for central corneal thickness and thinnest corneal thickness with the ACE and Pentacam devices were 0.99 and 0.95, respectively, indicating significant statistical agreement (P<0.05). White-to-white distance, pupil size, and corneal aberrations did not show good agreement among the three devices (ICC<0.75).
Conclusion: Topography values and corneal thickness measured with ACE showed good agreement with Pentacam; therefore, they can be used interchangeably. Other measured variables from ACE did not show good agreement with Pentacam and Orbscan and are not interchangeable.