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- Corneal tomography in osteogenesis imperfectaPublication . Barão, R.; Marques, R. E.; Mano, S. S.; Firmino, Patrícia; Poças, Ilda Maria; Rodrigues, W.; Fonseca, A. C.; Guerra, P.Osteogenesis Imperfecta (OI) is a rare genetic disorder with musculoskeletal manifestations and some ocular features, such as the presence of blue sclerae, corneal thinning, altered corneal biomechanics, and rare reports of keratoconus (KC). Corneal tomography is essential for KC screening and a BAD_D score over 1,6 and 2,6 is highly sensitive and specific for the detection of subclinical KC and keratoconic corneas, respectively. This study aims to explore the corneal tomographic characteristics of OI patients.
- Perceptions of online teaching in the academic community at a higher education health institutionPublication . Poças, Ilda Maria; Grilo, Ana; Silva, Carina; Homem, Ana; Rodrigues, Carolina; Francisco, Inês; Nogueira, PatríciaPurpose: Faced with the COVID-19 pandemic situation, higher education institutions needed to adapt, moving from face-to-face teaching to distance learning online. The aim is to analyze the perception of the academic community in a higher education health institution (students' and lecturers' perception; and lecturers' perception of students) in the face of transition, emotional states, and visual changes.
- Ocular repercussions in COVID-19 patients: structural changes of the retina and choroidPublication . Poças, Ilda Maria; Cunha, João Paulo; Camacho, Pedro; Silva, Carina; Ribeiro, Edna; Brito, Miguel; Mendonça, Paula; Barroqueiro, Olga; Lino, Pedro Miguel; Condado, Patrícia; Nicho, Inês; Carmo, Rita; Castelhano, Mariana; Carvalho, Francisca; Almeida, Júlio Costa; Prieto, IsabelPurpose: In March 2022, after 1 year of the emergence of the pandemic by Covid-10 in Portugal, 3413013 positive cases were recorded. The eye can be not only the gateway for coronaviruses (CoV) but also one of their target organs. Conjunctivitis, uveitis, vasculitis, retinitis, and optic neuritis have been documented in animal models. Although most studies focus on respiratory tract involvement, ocular surface involvement such as tears are also reported in other CoVs and their relationship should be valued and studied as a form of treatment, contagion, and transmission. Also, the neurotropism of CoVs, not only through hematogenous dissemination but also through the retrograde neuronal route, associated or not with vascular/ischemic compromise of COVID-19 and its brain sequela may justify the use of non-invasive methodologies to characterize the retina and choroid of patients infected with COVID-19. The possible neurodegeneration associated with the coronavirus will be important to assess the thickness of the innermost layers of the upper hemiretin, with involvement described in other neurodegenerative diseases.
- Visual results with the use of prismatic lenses in the treatment of congenital nystagmus: a clinical casePublication . Poças, Ilda Maria; Lima, PedroPurpose: It is important to establish a differential diagnosis between the different types of nystagmus, in order to give the appropriate clinical approach to every situation and to improve visual acuity. The nystagmus is normally blocked when the eyes are positioned in a particular way. This makes the child adopt a posture of ocular torticollis that reduces the nistagmiformes movements, improving the vision in this position. A way to promote the blocking of the nystagmic movements is by using prismatic lenses with opposite bases, to block or minimize the oscillatory movements. This results in a vision improvement and it reduces the anomalous head position. There is limited research on the visual results in children with nystagmus after using prisms with opposing bases. Our aim is to describe the impact on the visual acuity (VA ) of theprescription prism lenses in a nystagmus patient starting at 3 months of age. Methods: Case report on thirty month old caucasian male infant, with normal growth and development for their age, with an early onset of horizontal nystagmus at 3 months of age. Ophthalmic examination included slit lamp examination, fundus, refractive study, electrophysiological and magnetic resonance tests, measurement of VA over time with the Teller Acuity Cards (TAC ) in the distance agreed for the age. At age ten months, the mother noted a persistent turn to the right of the child’s head, which became increasingly more severe along the months. There’s no oscillopcia. At 24 months, an atropine refraction showed the following refractive error: 0D.: -1,50, OS: -0,50 and prismatic lens adapting OD 8 Δ nasal base and OE 8 Δ temporal base. Results: Thirty month old child, with adequate development for their age, with onset of idiopatic horizontal nystagmus, at 3 months of age. Normal ocular fundus and magnetic ressoance without alterations, sub-normal results in electrophysiological tests and VA with values below normal for age. At 6 months OD 20/300; OE 20/400; OU 20/300. At 9 months OD 20/250; OE 20/300; OU 20/150 (TAC a 38 cm). At 18 months OD 20/200; OE 20/100; OU 20/80 (TAC at 38 cm), when the head is turned to the right and the eyes in levoversão, the nystagmus decreases in a “neutral” area. At 24 month, with the prismatic glasses, OD 20/200 OE 20/100, OU20/80 (TAC at 54 cm, reference value is 20/30 – 20/100 para OU e 20/40 – 20/100 monocular), there was an increase in the visual acuity. The child did visual stimulation with multimedia devices and using glasses. After adaptation of prisms: at 30 months VA (with Cambridge cards) OD e OE = 6/18. The child improved the VA and reduced the anomalous head position. There is also improvement in mobility and fine motricity. Conclusion: Prisms with opposing bases., were used in the treatment of idiopathic nystagmus. Said prisms were adapted to reduce the skewed position of the head, and to improve VA and binocular function. Monitoring of visual acuity and visual stimulation was done using electronic devices. Following the use of prismatic, the patient improved significantly VA and the anomalous head position was reduced.
- Peters’ anomaly – Strabismus and amblyopia: a case reportPublication . Poças, Ilda Maria; Lino, Pedro Miguel; Abrantes, InêsPeter’s Anomaly, first described by Albert Peter in 1906, consists of a central corneal opacity related to a malformation of the anterior segment of the eye. It’s a disease in a constellation of diseases that causes corneal opacity, iridocorneal adhesions due to dysgenesis of the anterior segment during development. Peters’ Anomaly can cause devastating corneal opacity in an infant leading to severe amblyopia. It frequently occurs with associated strabismus, usually convergent (sensorial type), having also dissociated vertical deviation (DVD). The exact prevalence of Peters’ Anomaly is unknown. This condition is one of a group of disorders known as congenital corneal opacities, which affect three to six individuals per 100,000. Physiopathology: Peter’s Anomaly is a rare dramatic finding at birth, manifests in utero during the first trimester of pregnancy (10-16 weeks of gestation), and can be associated with other systemic malformations. It is classified in two types, which are distinguished by their signs and symptoms. Peters’ Anomaly Type I is characterized by an incomplete separation of the cornea and iris and mild to moderate corneal opacity. Type II is characterized by an incomplete separation of the cornea and lens and severe corneal opacity that may involve the entire cornea. Type II is more associated with systemic alterations and tends to be bilateral. During development of the eyes, the elements of the anterior segment form separate structures. However, in Peters’ Anomaly, development of the anterior segment is abnormal, leading to incomplete separation of the cornea from the iris or the lens. As a result, the cornea is cloudy (opaque), which causes blurred vision. The opaque area (opacity) of the cornea varies in size and intensity from a small, faint streak to a large, white cloudy area that covers the front surface of the eye. Additionally, the location of the opacity varies, the cloudiness may be at the center of the cornea or off-center. Large, centrally located opacities tend to cause poorer vision than smaller, off-center ones. It is important a binocular vision evaluation in order to identify, qualify and quantify the type of ocular deviation, characterize the real and potential binocular single vision and the amblyopia. The motor and sensorial tests must be appropriate to the case in question, in particular, visual acuity and fixation. The treatment involves a corneal transplant which is often complicated due to the young age of the affected. To prevent amblyopia and provide visual rehabilitation a penetrating keratoplasty (PKP) was recommended. Many children with PKP for Peters’ Anomaly Type I can experience good or functional vision in their operated eye. After keratoplasty is very important to improve visual acuity and do amblyopia treatment. Children with glaucoma have a poorer visual prognosis. The treatment of strabismus in cases of Peters’ Anomaly follows the general rules of treatment of concomitant strabismus. The first step should be the best optical correction possible. The surgical proposal must be made after achieving visual acuities between the two eyes. In congenital strabismus, late surgery will only have aesthetic value.
- Result of prismatic lenses in the treatment of congenital nystagmus: case reportPublication . Poças, Ilda Maria; Lino, Pedro MiguelIntroduction: Nystagmus is characterized by an involuntary shaking or jerking of the eyes idiopathic or associated with defects of the visual afferent system, which usually results in some degree of visual loss. Congenital motor nystagmus onset is typically between 6 weeks and 3 months of age. Patients with nystagmus often hold their heads in a head abnormal position (HAP), in an effort to maintain a null point - a position whereby eye movement is minimized that reduces the nystagmiform movements. They turn the head to the left while looking to the right or to right, while looking to the left, improving the vision in this position. The use of prismatic lenses with opposite bases placed in the opposite direction to the direction of the look in which the nystagmus decreases, reduces the HAP, and improves visual acuity (VA). The power must be in accordance with the patient's fusional ability to avoid diplopia. Aim of the study: To describe the evolution and impact on VA and HAP, of the use of opposing base prisms for 5 years, in a child with congenital motor nystagmus.
- Perimetria de hiperacuidade preferencial no estudo do edema macular diabéticoPublication . Matos, Ana Cláudia Rebelo; Gaspar, Cristiana Gomes Ferreira; Duarte, Marisa Alexandra da Eira; Marques, Patrícia Alexandra Valado; Poças, Ilda Maria; Silva, Carina; Queirós, Luísa; Bivar, AnaIntrodução – A diabetes é uma das maiores epidemias do último século. Mais de 250 milhões de pessoas, em todo o mundo, sofrem de diabetes. Das complicações derivadas da diabetes são as principais causas de cegueira, de insuficiência renal e de amputação de membros inferiores, derivando estes, predominantemente, da disfunção vascular. Quando surge perda de pericitos na parede vascular ocorrem uma série de alterações da microcirculação que levam ao aparecimento de microaneurismas e outras alterações vasculares que possibilitam a passagem de componentes sanguíneos para o tecido retiniano adjacente que, em situação de normalidade, não ocorreriam, sendo esta uma das causas do edema macular exsudativo diabético. A perimetria de hiperacuidade preferencial (PHP) é um teste psicofísico que pretende detetar metamorfopsias na Degenerescência Macular ligada à Idade (DMI). Uma vez que o edema macular diabético (EMD) se destaca como uma das principais causas de deficiência visual e baixa visão, pretende-se verificar a eficácia do PHP no estudo do edema macular diabético, respondendo à seguinte questão: “Qual a capacidade do perímetro de hiperacuidade preferencial em detetar metamorfopsias em pacientes com edema macular diabético?“ Metodologia – Estudo quantitativo, do tipo descritivo e correlacional. Selecionou-se uma amostra de 33 pacientes, onde se analisou um total de 60 olhos. Resultados – A sensibilidade do PHP na deteção de metamorfopsias associadas ao EMD na tomografia de coerência ótica (OCT) foi de 70,6%, a especificidade foi de 11,5% e a eficiência global do teste de 45%. Comparando os resultados encontrados no PHP e no OCT, constatou-se a existência de uma correlação inversa fraca (Phi = -0,215). Conclusões – Este novo método de diagnóstico revela-se sensível, contudo pouco específico e eficaz na deteção de metamorfopsias consequentes da existência de EMD. - ABSTRACT - Introduction – Preferential hyperacuity perimeter (PHP) is a new psychophysical test, which principle is based on the detection of metamorphopsia in age-related macular degeneration (AMD). It is intended to verify its effectiveness in the study of diabetic macular edema (DME). When there is loss of pericytes in the vascular wall occur a number of microcirculatory changes that lead to the appearance of microaneurysms and other vascular changes that allow the passage of blood components to the surrounding retinal tissue than in normal situation does not occur, this being one of the causes exudative diabetic macular edema. Methodology – It was performed a quantitative study, using descriptive and correlational analysis. A sample of 33 patients was selected, and 60 eyes were analyzed. Results – The sensitivity of PHP on the detection of metamorphopsia associated to EMD was 70.6%, the specificity was 11.5% and the global efficiency of the test was 45%. It was found a weak negative correlation (Phi= -0.215) between the PHP and optical coherence tomography (OCT). Conclusions – This new method of diagnosis was sensitive, but not very specific and effective on the detection of metamorphopsia, due to the DME.
- Contributo de vídeos no ensino prático na área disciplinar de Ortóptica na ESTeSLPublication . Miguel, Ângela; Pardal, Bruna; Leal, Catarina; Jerónimo, Rita; Abreu, Renato; Poças, Ilda MariaIntrodução – O desenvolvimento tecnológico levou à necessidade de adquirir novos métodos de aprendizagem complementares aos tradicionais. Assim, surge o mobile learning como um método de educação à distância em que se usam dispositivos móveis para ensinar e aprender. Na área disciplinar de Ortóptica ainda não existem conteúdos visuais credíveis em português nas plataformas digitais. Objetivos: Facultar aos estudantes da licenciatura em Ortóptica e Ciências da Visão vídeos da execução prática de diversos exames de avaliação clínica, facilitadores do processo de aprendizagem na prática clínica da avaliação da motilidade ocular e da visão binocular. Método – Estudo de paradigma quantitativo, descritivo observacional com uma amostra de 108 estudantes (n=108). Foram gravados 13 vídeos da prática clínica de avaliação clínica de ortóptica e publicados no YouTube. Para avaliar a perceção dos estudantes na visualização de vídeos como contributo facilitador do processo de aprendizagem prática aplicou-se um questionário previamente validado aos estudantes da licenciatura em Ortóptica e Ciências da Visão da Escola Superior de Tecnologia da Saúde de Lisboa. Resultados e Discussão – A maioria da amostra é do género feminino (n=108; 80,56%) e a idade variou entre os 18 e 37 anos, com média de 21,12±2,96. Obtiveram-se 29 respostas do 1º ano (26,85%), 26 do 2º ano (24,07%), 18 do 3º ano (16,67%) e 35 do 4º ano (32,41%). Toda a amostra considera os vídeos uma forma complementar de estudo ao ensino tradicional; 98,14% (n=106) afirmam que os vídeos estimulam o interesse pela área abordada; 96,30% (n=104) refere adquirir mais rapidamente os conhecimentos através dos vídeos; 92,59% (n=100) pensam utilizá-los no seu estudo. Conclusão – Os vídeos são considerados uma boa forma complementar ao estudo individual, existindo interesse na expansão do canal do YouTube a outras áreas das ciências da visão e na realização de vídeos de avaliação clínica de ortóptica de indivíduos com diferentes patologias da motilidade ocular e da visão binocular.
- Face-to-face versus distance learning: perception of the academic community at ESTeSLPublication . Poças, Ilda Maria; Grilo, Ana; Silva, Carina; Homem, Ana Pinto; Rodrigues, Carolina; Francisco, Inês; Dragão, Mariana; Nogueira, PatríciaIntroduction: Facing the pandemic situation of COVID 19, which reached Portugal in 2020, higher education institutions needed to adapt, transitioning from face-to-face learning to distance emergency learning, and therefore, in an online format. Objectives: To analyze the academic community's perception of a higher school of health facing the learning transition, focusing mainly on the preference and satisfaction for the type of learning, adaptation difficulties, motivation, changes in emotional states, academic performance, acquired skills, and visual changes.
- The Erasmus+ mobility programme at the Lisbon School of Health Technology: characteristics and motivations of participants from 2009-2019Publication . Dolan, Ana; Vasco, Helena; Poças, Ilda MariaThe Erasmus+ Mobility Programme (EMP) was established in 1987. It aims to promote both intercultural cooperation and communication and the development of higher education at a European level. The program has had over 4 million participants, but the rates of participation by Portuguese students are low. This is also the case for STEM students across the EU member states. Therefore, it is pertinent to analyze the profile of these students. The first EMP for Orthoptics and Vision Sciences (OVS) students at the Lisbon School of Health Technology (ESTeSL) took place in 2003. The Países de Língua Oficial Portuguesa Mobility Programme (PMP), mobility between ESTeSL and Portuguese-speaking African countries, began in 2016. Aims of the study: to characterize the participants in the EMP and PMP mobility programs between 2009/10 and 2019/20; to identify participants’ preferred fields of study; to emphasize the advantages of EMP and PMP for OVS students at ESTeSL according to students; to understand the students' motivations for selecting ESTeSL as their destination university; to determine the student’s satisfaction.