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Prevalence of refractive errors in Colombia: MIOPUR study
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  • Published on: 10 January 2019
    Inclusion criteria and non-cycloplegyc examinations in study of refractive errors in Colombia
    • Virgilio Galvis, Ophthalmologist Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia.
    • Other Contributors:
      • Alejandro Tello, Ophthalmologist
      • Johana Otero, Epidemiologist
      • Andres A Serrano, Medical doctor
      • Luz M Gómez, Ophthalmology Resident
      • Paul A Camacho, Epidemiologist
      • José P López-Jaramillo, Researcher

    We thank Dr. Tobon for his comments regarding our recently published article on refractive errors frequency in Colombia.1
    Initially he referred to the exclusion of the participants with less than 20/40 of distance corrected vision. The explanation of the application of this criterium was that, since as it has been shown, reproducibility of manifest refraction is less in patients with bad distance corrected visual acuity, and in this study we needed to have a very reliable manifest refraction examination.2
    However, we believe that Dr. Tobon highlights a very interesting point, which is worth analyzing in more detail. Ours and other studies that have analyzed the prevalence of refractive errors in a population have excluded eyes with other ocular conditions, including amblyopia. For example, in the study conducted in Mexico by Gomez-Salazar et al, which included a very large sample (more than 670,000 patients), they excluded patients with amblyopia.3 This made it impossible to analyze the frequency of amblyopia or anisometropia.
    In our study we excluded those patients with less than 20/40 of distance corrected visual acuity in any eye. Unfortunately, we did not keep the information on those patients excluded, and therefore we cannot determine the exact number or diagnosis of those cases. For future studies we will record such information.
    With regard to the second query of Dr. Tobon, we decided not to use cyclopegic refraction in this study, performed...

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    Conflict of Interest:
    None declared.
  • Published on: 3 January 2019
    Concerns about the inclusion criteria
    • Camilo A Tobon, Retina specialist Clinica Oftalmologica del Café- Universidad de Caldas

    Best regards,

    I have read with great interest the article of Galvis et al about Prevalence of refractive errors in Colombia: MIOPUR study. It is a great effort and it might be the first study of its type in our country. In the discussion section, the inclusion criteria needs to be better explained.

    1: Why did they exclude the participants with less than 20/40 corrected vision?
    2: Is the vision exclusion criteria based on any eye or the better eye?
    3: Why didn’t they use cyclopegic medication for the refraction exam?

    These concerns affect the results because all of the amblyopic patients are excluded from the study and the hyperopic patients and those with an astigmatism that induce amblyopia are underreported, as seen in the table that shows a very low incidence in those refractive errors.

    Conflict of Interest:
    None declared.