Purpose: To document the prevalence of vision impairment among children in a resource-poor community in Peru. Methods: Cross-sectional study of children 5 to 18 years old in Puente Piedra, Peru from March to April, 2011. Participants underwent standard vision screening exam, consisting of distance visual acuity (VA), stereopsis, external eye exam, and color vision testing and completed a socio-demographic and health risk factor questionnaire. Results: 380 children were examined. The mean uncorrected VA was 0.07 ± 0.13 Log Mar. Children wearing eyeglasses were 3.7%. Visual impairment was found in both eyes in 8.9% and in one eye in 26.3%. Severe visual impairment (<20/200) was found in both eyes in one child (0.3%) and in the worse eye of 3 (0.7%) children. Thirteen (3.5%) children failed the stereopsis exam and 20 (5.5%) boys and 7 (1.9%) girls failed the color vision exam. Overall, 37.3% of children met the criteria for referral to an ophthalmologist. Major factors for referral included the history of eyeglasses use, previous eye exam, or parental concern about the child's vision. Factors for untreated vision impairment included not having seen a physician regularly, no previous eye exam, and having a blind family member. Conclusion: There is a high prevalence of vision impairment in children living in Puente Piedra, Peru. Few children wore glasses or have ever been examined before. Basic eye care is needed for this underprivileged population.

Purpose: Determine if anterior stromal puncture (ASP) has a more effective decrease in symptomatology (pain, photophobia, and foreign body sensation) than annular keratotomy (AK) in patients with painful bullous keratopathy (PBK) and poor visual prognosis. Methods: Patients with PBK, refractory to combined medical treatment and poor visual prognosis were randomly assigned to one of two surgical procedures. Symptomatology, central corneal thickness (CCT), visual acuity (VA), and best corrected (BCVA) were evaluated with a 12-month follow up. Results: From 78 patients with PBK, 13 met inclusion criteria; ASP was performed to 7 and AK to 6 of them. There was improvement in the magnitude of symptoms in both groups; however, there was no difference when groups were compared. CCT showed in the 7-month follow-up a significant reduction of 10.4% in the ASP group compared with a 9.6% increase in the AQ group (p=0.05). Twelve-month-follow up CCT presented a non-significant reduction of 9.3% in the ASP group compared with a 3.3% increase in the AQ group. VA and BCVA in both groups were not modified. None of the groups presented complications related to the surgical procedures. Conclusion: In this clinical trial, we documented that ASP and AQ produce a similar improvement in the symptomatology of patients with PBK refractory to combined medical treatment and poor VA potential. The ASP group additionally presented a significant decrease in CCT at 7 months of follow up, which looses statistical significance at 12 months of follow up, but maintains a clinical reduction of 9.3%. A longer follow-up period would be required to evaluate if this CCT reduction is able to modify the frequency of bullae development and symptoms relapse. Furthermore, the material used for ASP has a lower cost than the one used for AQ, which could represent an economic advantage for patients that attend our Hospital.

Purpose: To compare the prevalence of angle closure disease (ACD) diagnoses in a glaucoma department of an ophthalmology teaching hospital at two cut points, before and after encouragement of a supervised, mandatory gonioscopy for all patients, during all visits as well as to profile patients with angle closure disease in terms of age, gender, intraocular pressure, visual acuity, cup-to-disc ratio and refractive error parameters when divided by Foster's classification. Study design: Retrospective, two cut-point observational study. Material and methods: A 1-month sample of electronic medical records from 2010 and from 2013 was analyzed. Between those two cut points, gonioscopy was encouraged as a mandatory procedure and execution was supervised systematically. The prevalence of angle closure disease was obtained from the diagnosis of electronic medical records and patients with ACD were divided according to Foster's ACD classification in order to profile them. Results: A total of 2112 medical records from 2010 and 2549 medical records from 2013 were included. Angle closure disease prevalence went from 7.29% (n=154) in 2010 to 20.36% (n=519) in 2013. Prevalence of primary open angle glaucoma (POAG) decreased from 23.20% to 10.84% in the same time period. Conclusions: A comparison between the prevalence of angle closure disease between these two cut points showed a considerable increase. Angle closure disease was diagnosed 1.79 times more as opposed to when gonioscopy was not previously encouraged or supervised. ACD patients are generally women, with decreasing low hyperopia and intraocular pressure within normal ranges.