Aim: Our study aims to produce an estimation of the keratoconus disease epidemiology and important demographic factors in disease presentation in Najran city in the south of Saudi Arabia. Methods: Keratoconus patients between 9 and 29 years of age at the eye clinic of King Khaled General Hospital in Najran Province with a confirmed diagnosis of keratoconus were recruited over one year period. Visual acuity, keratometry, corneal thickness and demographic data were collected and analysed. Results: The keratoconus prevalence in Najran Province was found to be 87.3 cases per 100,000 people with an incidence of 28.47 per 100,000 cases. The disease presented more frequently in male patients (67.9%) with a statistically significant difference in the mean age between genders (p=0.014). Most cases presented at a moderate stage, and almost half of the cases reported a family history of the disease. There were statistically significant differences in best visual acuity and corneal thickness between genders (p< 0.05). The majority of the cases were managed with contact lenses (56.08%). Conclusion: Genetic and environmental factors could have a substantial role in the increased rate of keratoconus presentation in Najran Province. Screening programmes should dedicate more attention to late presentation to improve prevention and early detection. More studies on keratoconus epidemiology in Saudi Arabia are needed.

The aim of this study was to standardize and investigate the changes in corneal clarity with age. Densitometry software for the Oculus Pentacam was used to examine corneal clarity at different age groups. A total of 192 eyes from 97 healthy participants were included in this cohort comparative nonrandomized, cross-sectional study. An Oculus Pentcam was used to image the cornea of healthy participants grouped by age (between 10 and 70 years old). Data from the densitometry output have been used to determine clarity in concentric zones and different depths of the cornea. Corneal densitometry (CD) across all ages showed significant differences between groups when divided into the following layers: anterior, central, and posterior or divided into 0 to 2, 2 to 6, and 6 to 10 mm concentric zones (P < .05). The most striking decrease in clarity occurred with age in all 3 layers of the periphery (6–10 mm) (P < .05). In addition, we showed that the 10 to 19-year age group had lower clarity than the 20 to 30-age group (P < .05), and after 30 years, the cornea shows a steady progression of increased or decreased clarity. The values for CD, as well as for separate subdivisions based on layer and surface area, might provide a standard for use in further studies and clinical practice. This study established that relation between CD and age is differed when the cornea is divided into layers and zones. This study suggests that there are other factors that may play an essential role in corneal clarity as well as age.

Purpose: To compare the corneal clarity measurement between penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK) in patients with keratoconus, using densitometry software for the Oculus Pentacam. Methods: A retrospective comparative study was carried out at Manchester Royal Eye Hospital. Data were collected 12–18 months after corneal transplantation for keratoconus, including postoperative corneal densitometry, best corrected visual acuity (BCVA), central corneal thickness (CCT), and other relevant clinical details. Results: Analysis of 37 keratoconus eyes from 36 patients found there was a significantly higher corneal densitometry measurement after DALK than PK. This was predominantly in the posterior layer of the concentric zone 0–2 mm of the cornea (P=0.0004). A significant correlation was found between postoperative BCVA and corneal densitometry in DALK groups at full thickness (P=0.03). This correlation was seen in the central 0–2 mm (P=0.03) and posterior 0–2 mm (P=0.04) zones. In addition, within the DALK group, a correlation was found between central corneal thickness and densitometry at full thickness 2–6 mm (P=0.007), central 0–2 (P=0.04), central 2–6 mm (P=0.01), and at posterior 2–6 mm (P=0.01) zones. Conclusion: This study showed that corneal densitometry measurement differs depending on the type of corneal transplantation used to treat keratoconus patients. Densitometry may have an important role to play in the final BCVA achieved by patients undergoing corneal transplantation for keratoconus. Analysis of Oculus Pentacam images provides an objective evaluation to monitor the cornea status after the surgery.

Purpose: In this study densitometry software for the Oculus Pentacam was used to investigate the treatment outcomes of corneal cross linking (CXL) in adult and juvenile keratoconus (KCN) patients. Densitometry measurements were taken before and after treatment and followed up for one year. Methods: A comparative study was carried out at Manchester Royal Eye Hospital. Corneal densitometry measurements collected before and after CXL treatment for 32 eyes from KC patients, aged between 12 and 39, were divided to 2 groups 13-18 years (juvenile group) and 19-39 years (adult group) and analysed and compared to pre and post treatment at 3, 6 and 12 months for each group and between both groups. Results: Analysis of densitometry measurements found higher corneal densitometry after CXL which peaks at three months post treatment in both groups. There was significant diversity in corneal densitometry measurements in the stromal zone 0-2 and 2-6 mm for all layers except the posterior layer for both groups (P<0.05). Significantly increased densitometry value was found higher in the juvenile group at six months in the central (P=0.006) and posterior (P=0.004) layers for zone 0-2 mm. The same layers differed significantly also in the 2-6 mm zone in all layers (P=0.01). One year post treatment the same significant increased densitometry level was seen in the juvenile group in the 0-2 mm zone of the central (P=0.007) and posterior layers (P=0.01), as was the 2-6 mm zone (P=0.04). However, no significant difference was found between pre and post treatment for best corrected visual acuity (BCVA), central corneal thickness (CCT) and thinnest area between both groups. A significant difference was found between pre and post treatment for best corrected visual acuity (BCVA), in the adult group at 6 and 12 months post-treatment from pre-treatment (P=0.02, P=0.16) respectively. Conclusion: Corneal clarity post CXL treatment in the juvenile group differed significantly from the adult group. Both groups showed increased haze at 3 months post treatment but the adults showed improvement over the next 9 months. In contrast, the juvenile group showed higher densitometry readings at both 6 and 12 months post treatment in comparison to adult group. The reasons for this remain unclear.

Background: The rapid increase increased, in using of video display terminals during the COVID-19 pandemic predisposes users to a variety of health problems restricted to visual problems and including various musculoskeletal problems, collectively known as computer vision syndrome (CVS) or computer vision syndrome. Aim: This study aims to ascertain university students’ awareness of computer vision syndrome at Al-Baha University, including the nature, sources, accuracy, and completeness of information, as well as the attitudes towards CVS, and mitigative practices. Methods: This study used a descriptive cross-sectional design and a convenient sample of 310 (80.0% male) students drawn from Al Baha University campuses. Data were collected using self-administered questionnaires. Results: The mean age of the participants was 23.51 years (SD=5.42). The results show that 78.7%, 66.1%, and 11.6% received CVS information from social media, mass media, and family, respectfully. Despite 70% of respondents being aware of CVS manifestations, between 42% to 67% of those sampled had accurate and complete information about the meaning, causes, prevention, and management of the syndrome. More than a third of the participants had either a good (62.9%) or average (29%) total knowledge of CVS. Less than 15% had incorrect information. On average, 62.5% of respondents engaged in preventive or mitigative behaviours/activities as opposed to 37.5% who did not, but only 44% believed CVS was a serious health threat. 65.2% of the studied students had a satisfactory total practice score. The regression analysis showed that the coefficients of marital status and faculty were a statistically significant association with the total knowledge score. Conclusion: CVS awareness is acceptably high, but there is a low preventive/mitigative behaviors as well as a low realization of CVS’ long-term health problems. This is why increasing CVS awareness and implementing interventions such as the 20-20-20 rule could be effective at Al Baha University.

Aim: The aim of this study was to compare the pre- and posttreatment corneal densitometry and corneal thickness value of keratoconus (KCN) patients managed via contact lenses (CLs) or by both intrastromal corneal rings and contact lenses. Patients and methods: This prospective study was performed at the Manchester Royal Eye Hospital, UK. Patients were recruited before treatment and followed up for 12 months. Data of corneal densitometry and corneal thickness were collected using the Oculus Pentacam at the pretreatment visit and posttreatment visit at 12 months. Results: Corneal clarity significantly differs between both groups at pre treatment at zone 0–2 mm for the anterior layer (P=0.002). The same diversity is present at zone 2–6 mm for the anterior layer (P=0.003) and posterior layer (P=0.008). The corneal clarity diversity found was not statistically significant at 12 months post treatment (P>0.05). Corneal thickness was found to be statistically significantly different between pre treatment and post treatment for the CL group for central corneal thickness (CCT) and thinnest area (P=0.01 and P=0.02), respectively. Discussion: This study shows that KCN management with Intacs was found to be effective in maintaining corneal clarity for a longer time than that with CL alone. On the other hand, corneal clarity reduces with disease progression in cases managed with CLs only. Analysis of Oculus Pentacam images provides an objective evaluation to monitor the corneal status after these different pathways of management.