The employment rate in this Swiss cohort before and after successful kidney transplantation is high compared with the literature. A high number of living donors, of pre-emptive transplantations, and short dialysis vintages contribute to this observation.

The development of myopia as a refractive disorder seems to hold multifactorial causes. Among others, increased time exposed to natural light outdoors is regarded as possible effective preventive measure against myopia development. The objective of this review is to analyse and summarize the evidence investigating the association between time outdoors and myopia prevalence and progression. Methods: A review, restricted to articles published in the last ten years, was conducted. The literature search for the included articles was performed in the following databases: PubMed, the Cochrane Library, Web of Science and Scopus. If predefined inclusion criteria were met, the studies were further categorized and data were summarized and individually evaluated. Results: Two cross-sectional studies, 7 prospective cohort studies and 3 intervention studies were reported in this review, representing the data of a total of 32,381 participants. The majority of the studies found an inverse association between myopia incidence/prevalence and increased time outdoors. The association between time outdoors and myopia progression on the other hand remains debatable; one recent randomized controlled trial indicating a protective value of increased time outdoors for further progression in myopic children. Conclusion: In summary, increasing time exposed to outdoor light seems to be a simple and effective preventive measure to decrease myopia prevalence. Also, contrasting previous review work, it may represent a potential strategy for myopia progression control. Future investigation is necessary to better define and quantify outdoor time and its effects on myopia.

Purpose The goal of this study was to investigate the use of spectacles in everyday life after bilateral cataract surgery with a preoperative refractive target of emmetropia in both eyes. In addition, we analyzed the total cost of spectacles and the patientʼs visual satisfaction at least 6 months after surgery. Methods Patients after bilateral cataract surgery with implantation of an aspheric monofocal IOL (Tecnis 1, Johnson & Johnson) with a preoperative refractive target of emmetropia in both eyes and a documented refractive outcome were included in this prospective observational study. In a phone interview ≥ 6 months after surgery, the following items were assessed: type of spectacles purchased and overall cost, type of activity with and duration of spectacle wear, and satisfaction with the visual situation. Results Seventy patients were included in this study. Depending on their postoperative refraction, patients were divided into group A (n = 27) with perfect emmetropia in both eyes (i.e., spherical equivalent [SE] of ≥ − 0.25 D to ≤ + 0.25 D), group B (n = 21) with achieved emmetropia in one eye (i.e., SE of ≥ − 0.25 D to ≤ + 0.25 D) and a myopic refraction in the other eye (< − 0.25 D), and group C (n = 22) with bilateral myopic results (SE of < − 0.25 D). Overall, 84% of patients had purchased new spectacles, mostly varifocals (59%) or reading glasses (24%) at the median cost of 980 Swiss Francs (mean: CHF 912 ± 746). Despite patientsʼ initial reasoning for their lens choice to require reading glasses only, varifocal glasses were worn for more than 50% or all of awake time by 48% of patients in group A, 43% in group B, and 68% in group C. Despite their regular spectacles use, patientsʼ visual satisfaction was very high in all three groups. Conclusions Most patients who achieve perfect bilateral emmetropia after implantation of monofocal aspheric lenses buy varifocal spectacles within 6 months, and more than half of all patients use their varifocal spectacles for more than 50% of their awakening time. The costs for such spectacles are high.

Zusammenfassung Hintergrund Das therapeutische Management von Motilitätseinschränkungen und begleitender Kopfzwangshaltung (KZH) stellt oft eine Herausforderung dar. Wir berichten über unsere Erfahrungen mit der Prismenapplikation. Patienten und Methoden Retrospektive Fallserie von 3 Patienten mit Augenmotilitätsstörungen und begleitender KZH, bei denen eine Behandlung mittels Prismenkorrektur erfolgte. Ergebnisse Ein 37-jähriger Mann mit traumatischer Okulomotoriusparese links mit leichter residueller Senkungseinschränkung und deutlicher Hebungseinschränkung zeigte nach Prismenausgleich der Hypotropie links (OS: 10^ Basis oben) ein Feld binokularen Einfachsehens (BES-Feld) nur im Abblick. Erst unter zusätzlicher Vorgabe von beidseits 10^ Basis oben gelang eine Verlagerung des BES-Feldes in die Primärposition. Ein 45-jähriger Mann mit Parinaud-Syndrom infolge eines Schädel-Hirn-Traumas und beidseitiger Hebungseinschränkung beklagte erhebliche Nackenbeschwerden bei ausgeprägter Kinnhebung. Zudem bestand bei Amaurose rechts eine sekundäre Exotropie. Unter Vorgabe von OS: 8^ Basis oben war der Patient bei Aufgabe der KZH auch subjektiv beschwerdefrei. Bei einer 69-jährigen Frau mit Abduzensparese links bestand eine Kompensation der Schielabweichung nur im äußersten Rechtsblick unter Einnahme einer ausgeprägten Linksdrehung von 20°. Mit OS: 20^ Basis temporal resultierte Doppelbildfreiheit ohne KZH in Primärposition. Schlussfolgerung Neben der Schielkorrektur kann auch die Blickverlagerung durch Prismen in verschiedenen klinischen Konstellationen therapeutisch hilfreich sein. Zur Reduktion der KZH erfolgt die prismeninduzierte Blickverlagerung prinzipiell in Richtung des Motilitätsdefizits.

Purpose Assessment of diagnostic and therapeutic strategies currently used in routine practice for myopia management in Europe. Methods Online survey study including 11 main questions. The questionnaire was sent to members of the European Paediatric Ophthalmology Society (EPOS). The following items and questions were surveyed: I. Profession and workplace of the survey participants. II. Preventive measures and recommendations for myopia management, a) regarding reading distance and near work, b) optical tools, i.e., application of Defocus Incorporated Multiple Segments (DIMS) glasses, near additions, or contact lenses, and c) the application of atropine eye drops. III. Application of additional diagnostic tools. Results Forty-eight individuals completed the survey. Of the respondents, 88% (n = 42) affirmed that they generally gave advice on strategies for myopia prevention and management strategies. Almost all study participants (n = 41; 85%) recommend outdoor time as a preventive measure. The recommendation on near distance is given less frequently, with 28 (58%) participants confirming that they do recommend a “safe” reading distance, and 15 (31%) negating this. Eight (17%) survey participants recommend using near addition glasses, while 36 (75%) do not. Similarly, 35 (73%) respondents do not apply DIMS glasses and 8 (17%) apply them. Fourteen (29%) participants recommend myopia-reducing contact lenses while 30 (63%) do not, and 29 (60%) confirmed that they applied atropine eye drops to slow myopia progression while 14 (29%) do not prescribe these eye drops. The majority of respondents (n = 25; 86%) who prescribe atropine eye drops use atropine 0.01% eye drops. Conclusions Prevention and therapeutic management of childhood myopia is an essential part in the daily routine of pediatric ophthalmologists. Substantial agreement was found for the protective role of outdoor time (85%). The only common therapeutic approach is the administration of atropine eye drops (60%).