Background: Diabetic retinopathy (DR) is a leading cause of visual impairment globally among working-aged individuals. This study aims to update data on DR prevalence in Bulgaria. Methods: The present cross-sectional study was conducted between 1 January 2022 and 1 January 2023, using a local diabetes registry from the city of Varna as a sampling framework. In total, 587 diabetic patients underwent DR examination. Data included demographics, diabetes type/duration, treatment, and ophthalmic history. DR status was assessed using indirect slit-lamp biomicroscopy or digital fundus photography, graded by the International Clinical Diabetic Retinopathy Scale. Results: Of 587 participants, 13 were excluded due to cataract-related ungradable images. The median age was 65 years (IQR 56–73), with a slight female predominance (54%). The overall prevalence of any DR was 39.9% (95% CI 35.9–44.0), with non-proliferative DR (NPDR) at 27.5%, proliferative DR (PDR) at 7.3%, and macular edema (DME) at 5%. Type 1 diabetes patients had significantly higher DR prevalence (68.8%) than type 2 (34.1%, p < 0.001). Men exhibited higher DR prevalence. Age and diabetes duration correlated positively with DR prevalence. Insulin treatment was associated with higher DR prevalence (55.6%) than oral antidiabetic treatment (22.5%, p < 0.001) for type 2 diabetes patients. Among those diagnosed with DR, 70.9% received treatment, mainly laser therapy. Conclusions: These findings provide epidemiological insights for future research and emphasize the need for a comprehensive national DR screening program in Bulgaria. Technological advancements enable proactive measures to mitigate DR-related visual impairment and blindness, including widespread screening, even in rural areas.

Background: The World Health Organization defines myopia as a global epidemic. Its growing prevalence and the increasingly early age onset all raise a major concern for public health due to the elevated risk of loss and deterioration of visual function as a result of myopia-related ocular pathological complications. However, it remains unclear whether the vision-related quality of life of patients with myopia is the same as in healthy individuals. The aim of the present study is to assess the quality of life in children and adolescents with myopia between the ages of 8 and 16 years, who underwent observation at USBOBAL-Varna. Methods: This study prospectively included 190 patients with myopia between −1.00 and −5.50 D, corrected with different optical aids. After a thorough physical ocular examination and inquiry into the best visual acuity with and without distance correction, specially designed questionnaires were completed by the patients and their parents/guardians for the purpose of the study. The data from the questionnaires was statistically processed. The mean age of the patients in the study was 11.65 years, 101 were female and 89 were male. Of these, 83 wore monofocal glasses, 50 were monofocal and 47 were multifocal contact lenses, and 10 wore ortho-K lenses. Results: No significant difference in best corrected visual acuity (BCVA) was found among the three types of optical correction (p-value > 0.05). Cronbach’s alpha of the questionnaire for all 10 factors was higher than 0.6, indicating acceptable internal consistency. Significantly higher scores were reported for overall, near, and distance vision, symptoms, appearance, attitude, activities and hobbies, handling, and perception for soft contact lens wearers than for spectacle wearers (p-value < 0.05). Ortho-K wearers performed better than spectacle wearers in all aspects except for pronounced symptoms (p = 0.74). No significant difference was found between ortho-K wearers and soft contact lens wearers for any factor (p > 0.05). Conclusions: Patients wearing spectacles and with myopia above −5.00 D had the highest anxiety scores and lower quality of life among all myopic participants. The research on the quality of life in children with myopia with different refractive errors and optical correction devices is crucial for improving corrective devices and meeting the needs of patients.

Background: To evaluate the association between glaucomatous visual field loss and self-reported driving limitation, and to explore potential threshold ranges of visual field loss associated with an increased likelihood of driving restriction. Methods: In this cross-sectional study, 100 patients with primary open-angle glaucoma underwent standard automated perimetry. Visual function was assessed using Mean Deviation (MD) and Visual Field Index (VFI) from the better eye. Driving status, driving limitation, and self-reported driving difficulties were assessed using a structured questionnaire. Multivariable logistic regression was performed to determine independent associations between visual field parameters and driving limitation, adjusting for age, sex, cataract status, and systemic comorbidities. Because MD and VFI are closely related indices of visual field loss, separate multivariable models were constructed for each parameter. Receiver operating characteristic (ROC) analysis was used to explore threshold values associated with driving limitation. Results: Driving limitation increased progressively with worsening functional severity, affecting 17% of participants with preserved function, 48% of those with borderline impairment, and 72% of those with definite impairment (p < 0.001). Reduced VFI was independently associated with driving limitation (OR = 0.972, 95% CI: 0.948–0.996; p = 0.021). In a separate model, more negative MD was also independently associated with driving limitation (OR = 0.924, 95% CI: 0.875–0.976; p = 0.004). Male sex was associated with a lower likelihood of driving limitation. ROC analysis identified threshold values of VFI ≤ 71% (AUC = 0.663) and MD ≤ −13.36 dB (AUC = 0.650), both characterized by high specificity but limited sensitivity. Participants who had ceased driving demonstrated worse visual field indices than active drivers, whereas never-drivers showed no consistent association with visual field loss. Conclusions: Glaucomatous visual field loss was significantly associated with self-reported driving limitation and behavioural self-regulation. Objective perimetric parameters, particularly VFI and MD in the better eye, may help identify patients more likely to report driving difficulties. The reported threshold values should be interpreted as exploratory reference points rather than clinically actionable criteria and require further validation before clinical application.