The annual meeting of the American Academy of Ophthalmology (AAO) was held virtually this year from Nov. 13 to 15 and attracted more than 8,000 participants from around the world, including ophthalmologists, optometrists, opticians, and other eye health care professionals. The conference featured presentations focusing on the latest advances in comprehensive eye care, including medical, surgical, and optical care.

In one study, Ali Poostchi, M.D., of the University Hospitals of Derby and Burton NHS Foundation Trust in the United Kingdom, and colleagues found that small standard slit-lamp breath shields offer some protection against COVID-19 infection transmission but are not as effective as larger slit-lamp breath shields, especially against coughs.

The researchers evaluated the effectiveness of barrier shields at reducing the COVID-19 infection transmission risk and found that the larger face shields were effective at reducing particle transmission from simulated coughs across a slit lamp.

“We looked at this in various ways, through direct visualization of sprayed dye and previously through the use of a laser particle counter, which detects aerosols that are not visible to the naked eye,” Poostchi said. “Our results were consistent across studies. We found that shielding (and face masks) were effective at reducing particle transmission.”

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In a longitudinal analysis of national Medicare-based supplemental survey data during eight years of follow-up, Suzann Pershing, M.D., of the Stanford University School of Medicine in California, and colleagues found a strong bidirectional association between self-reported visual impairment and dementia over time.

The authors used longitudinal data on 10,676 Medicare-enrolled participants aged 65 years and older from the National Health and Aging Trends Study 2011 to 2018 cycles to assess the likelihood of developing functional visual impairment over time given baseline dementia, and vice versa. The researchers found that participants with visual impairment were twice as likely to develop subsequent dementia and participants with baseline dementia were twice as likely to develop subsequent visual impairment over time, even after adjusting for potentially confounding factors.

“These findings suggest that vision screening in cognitively impaired patients and cognitive assessments in the visually impaired may allow for earlier detection and intervention,” Pershing said. “Specifically, referrals to geriatrics/neurology from ophthalmology clinics for older patients with visual impairment may enable at-risk patients to seek timely cognitive assessment and care, and vision screening among the cognitively impaired may identify treatable vision loss and prompt referral for ophthalmic evaluation.”

Abstract No. PO242

Richard L. Abbott, M.D., of the University of California at San Francisco, and colleagues discussed how the AAO has developed a task force to combine resources, knowledge, and communication in a collaborative effort to find ways to slow the progression to “high” myopia.

The task force is reviewing the results of current global clinical trials and other studies addressing the progression to high myopia. Recommendations are based on these reviews as well as the task force members’ own extensive clinical expertise. Myopia prevalence and high myopia are significant public health problems both internationally and in the United States. The AAO recommends a multipronged approach, including increasing efforts in education, advocacy, research, and public health, to delay the age of onset and slow the progression to vision-threatening high myopia.

“We need to raise the awareness of all ophthalmologists, optometrists, and other health care professionals to the risk and potential dangers of permanent vision-threatening conditions in children developing high myopia,” Abbott said. “More studies need to be done, especially in populations outside of Asia, to obtain additional data regarding the overall effect of the various recommended interventions to slow down the progression of myopia. It is possible that a combination of therapies may be most effective. These include the use of special contact lenses and spectacles, increased time spent outdoors, and use of topical low-dose atropine drops.”

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