The Sound Sense™ hearing conservation program improved earplug use practices in elementary school children in the short and long term. The development, implementation and evaluation of a community-based health promotion project around hearing loss can serve as a tremendous opportunity for students to develop their knowledge and skills in health advocacy.

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irritation. Using AMT with MOSR relieves symptoms and decreases surgical time.Recently, several sutureless amniotic graft implantation procedures have been described. The Prokera ring (Bio-Tissue, Inc, Doral, Fla.) is an FDA-approved device that consists of a cryopreserved amniotic membrane circle clamped into a dual-polycarbonate ring. However, it has a relatively high cost. Liang et al. created a modified symblepharon ring using a polymethylmethacrylate ring to apply the amniotic membrane for patients with ocular chemical burns. 4 They showed that sutureless AMT using MOSR had better efficacy than the conventional sutured AMT in the treatment of acute ocular burns.Symblepharon formation is one of the most challenging problems in severe ocular surface diseases. Various procedures have been evaluated to prevent symblepharon formation, such as the conformer or conventional symblepharon ring combined with AMT. Commercially available amniotic bandage tissues such as the Prokera ring cover just the corneal and limbal surfaces, leaving the deep fornix unreachable, and fail to prevent symblepharon formation. AMT with the MOSR procedure expands the effective coverage of the amniotic graft to the entire ocular surface, including the cornea, bulbar conjunctiva, fornices, and palpebral conjunctiva, and prevents significant ocular surface scarring and symblepharon formation. Compared with other options, the MOSR is an inexpensive and an easily accessible option. It can also be customized for each individual. As the MOSR is placed into fornices, it does not have any cosmetic effects. The central aperture of the MOSR allows oxygen and drops to reach the ocular surface and allows examination of the ocular surface during the postoperative period. Postoperatively, the MOSR can be easily removed from the ocular surface in the office.This study demonstrates a simple, effective, and safe technique using AMT combined with MOSR for ocular surface rehabilitation without the need for suturing. This modified technique is economically advantageous and may be an alternative to conventional symblepharon ring or other sutureless AMT techniques.

Background and Objective Patients with migraine frequently report ocular or visual symptoms including aura, photophobia, and eye pain. Using validated instruments, our group previously reported that due to these symptoms, patients have marked reductions in visual quality of life. In chronic migraine, these reductions can be as substantial as those reported for other neuro‐ophthalmic diseases such as multiple sclerosis with optic neuritis and idiopathic intracranial hypertension. Because the instruments take several different dimensions into account, we were unable to determine which ocular symptom(s) contributed to reduced visual quality of life. The purpose of this investigation was to attempt to determine which ocular symptom(s) were driving the observed reduction in visual quality of life. Methods We designed a cross‐sectional survey‐based study to assess visual quality of life, headache impact, aura, dry eye, and photophobia in migraine patients. Subjects were recruited from the Headache Clinic and General Neurology Clinic at a tertiary teaching hospital. Subjects completed validated questionnaires including: The visual functioning questionnaire‐25 (VFQ‐25), the headache impact test (HIT‐6), the visual aura rating scale (VARS), the ocular surface disease index (OSDI), and the Utah photophobia score (UPSIS‐17). Associations between VFQ‐25 and OSDI, VFQ‐25 and VARS, VFQ‐25 and UPSIS‐17, HIT‐6 and OSDI, HIT‐6 and VARS, and HIT‐6 and UPSIS‐17 were calculated. Results Of the 62 patients who completed all questionnaires, 17 had episodic migraine and 45 had chronic migraine. Twenty‐three patients experienced aura and 39 did not report aura. The most striking correlations were observed between the VFQ‐25 and the OSDI (−0.678; P < .001), between the HIT‐6 and UPSIS‐17 (0.489; P < .001), and between the HIT‐6 and OSDI (0.453; P < .001). Conclusions Dry eye seems to be the most important symptom that reduces visual quality of life and worsens headache impact. This symptom may be a form of allodynia, a well‐known feature of chronic migraine. Photophobia appears to have modest effects on headache impact. In the future, we hope to determine whether treatment of dry eye symptoms can improve visual quality of life and reduce headache impact.