LASIK is a safe and effective method for treating refractive error and creating orthophoria in fRAE. In pRAE, it eliminates the refractive component of deviation safely and effectively.

Aim To investigate the effects of fibrovascular traction and the pooling of tears at the pterygium apex on the corneal topographic changes induced by pterygium. Methods A total of 16 eyes of 14 cases with primary pterygium were included in the study. A computerized corneal topography system was used for corneal topography examinations. Baseline keratographs were taken two times at straight gaze. A repeat corneoscope photograph was immediately obtained in temporal gaze. Then the tears at the pterygium apex were dried with a cellulose sponge, and a new corneoscope photograph was immediately obtained without allowing one to blink. Corneal topographic maps (numeric maps) were divided into 301 fields in 24 meridians. One colour was allocated to each field, representing its mean refractive power for all groups. In all eyes, keratometric astigmatism at the 3 mm central cornea and total mean corneal refractive power were found. Data were compared using pairedsamples two-tailed t-tests.Results Keratometric astigmatism at the 3 mm central cornea was significantly reduced at the temporal gaze (3.1072.34 D, t ¼ 3.40, P ¼ 0.027) and dried eyes (2.1271.01 D, t ¼ 4.74, P ¼ 0.001) according to the first baseline measurement (4.3171.91 D) of the total mean corneal refractive power was found to be 43.4571.28 D (39.29-45.87) at the first baseline measurement. There was no change at the temporal gaze (43.5471.06 D, P40.05). However, the total corneal refractive power was significantly higher in dried eyes (44.2670.93 D, t ¼ 34.92, Po0.001). The steepest region of corneal topography was a superior quadrant, and the flattest area was a nasal quadrant at the baseline. At the temporal gaze, the cornea was significantly flatter in the superior and inferior sides of the pterygium meridian. After dried pooling of tears, topographic abnormalities returned, and the cornea became more uniform and symmetric. Conclusion We conclude that the pooling of tears at the pterygium apex plays an important role, but fibrovascular traction has no effect on the corneal topographical changes induced by pterygium.

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Summary Background We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. Funding The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. Translations For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section.