conferenceseries.com JOINT EVENT

4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and August 22-23, 2019 Vienna, Austria Scientific Tracks & Abstracts Day 1

Euro Optometry 2019 & Visionscience 2019 Page 21 Day-1

Sessions

An Ayurvedic Guide to better Vision & Eye Health | | Ocular Diseases | Clinical Optometry Eye care and Prevention |

Chair: David Berkow, Ulster University, Isreal

Session Introduction

Title: An Appraisal of Methods to Protect and Preserve Eye Health in Āyurveda Aravind Kumar, Sreedhareeyam Ayurvedic Research and Development Institute, India

Title: is associated with allergic in children who attend an urban school exposed to air pollution Yangho Kim, University of Ulsan College of Medicine, South Korea

Title: The importance of routine eye examination in asymptomatic patients in tertiary eye care centres in Northern India Milan Rai, Dr Om Parkash Eye Institute, India

Title: Tears and fears-influence of contact wear on the tear film David Berkow, Ulster University, Isreal

Title: Effects of ocular hypotensives on ocular surface and cornea Manik Gupta, Rotary Narayana Eye Hospital, India

Title: Comparison of the corneal densitometry using Pentacam in individuals with healthy, subclinical and early Mohammad Sadegh Mirdehghan, Ahvaz Jundishapur University of Medical Science , Iran

Title: Nanophthalmic eyes and its associated complications with correction using rgp contact lens- a case study Milan Rai, Dr Om Parkash Eye Institute, India conferenceseries.com Aravind Kumar, Clin Exp Ophthalmol 2019, Volume: 10 JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria

An appraisal of methods to protect and preserve eye health in āyurveda Aravind Kumar Sreedhareeyam Ayurvedic Eye Hospital and Research Center.India

Statement of Problem: Ayurveda, India’s ancient holistic science of life, proclaims that the eyes are most important among the sense organs. Through a set of intricately related parts, the eyes enable perception of the world through vision. Any affliction of the eye invariably results in improper function of these parts and impaired vision in the long run. Hence, ocular health needs to be constantly maintained. ayurveda defines health as the equilibrium of dosa (humors), Agni (gastric fire), dhātu (tissue), and mala (excretory products); and pleasantness of atma (soul), indriya (sensory organs), and mana (mind). Different methods to preserve and protect health are explained by ayurveda, viz., dinacarya (daily regime), rātricarya (nocturnal regime), rtucarya (seasonal regime), and pathyāpathya (wholesome and unwholesome habits). The purpose of this study is to analyze these methods in the light of ocular health. Methodology: A comprehensive review of available literature, including Samhitās (Ayurvedic texts) and published material was undertaken. Findings: Aspects such as abhyanga (massage) with oil over the head and feet, snāna (bath), añjana (collyrium), nasya (nasal medication), regular śodhana (purification), śarat rtucarya (autumnal regime), consuming triphala (fruits of Terminalia chebula Retz., Terminalia bellerica Linn., and Emblica officinalis Gaertn.), ghee (clarified butter), and honey at night, regular intake of foods such as pomegranate, old barley and wheat, green gram, and other foods that pacify kapha and pitta and a pleasant and calm mind are useful to promote and preserve eye health. Conclusion and Significance: Proper eye health ensures good vision. The aspects of promoting health described by ayurveda that have a role in eye health perform such actions as increase circulation, remove excess Dosas from the body, provide requisite nutrients to the eye, and eventually cool the body down. The delicate balance of heat and cold in the body enables the eye to function effectively and allows for more nutrition to reach the eye. Intraocular pressure can be maintained and the refractive media can be clear. In the end, the eye enables proper vision to see the world and its myriad of colors.

Biography Aravind Kumar completed his Postgraduation (M S (Ay)) in Salakya Tantra (Ayurvedic Ophthalmology) at Amrita School of Ayurveda, Kerala, India. His Postgraduate dissertation was on analysing the prevalence of age-related in different Prakrti (body constitution) populations. Currently, he works as a Research Coordinator with Sreedhareeyam Ayurvedic Research and Development Instutue, a premier Ayurvedic institution in India specializing in Ophthalmology. He is interested in Research on Preventive Ophthalmology and applying Ayurvedic principles to promote eye health.

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Notes:

Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 23 conferenceseries.com Yangho Kim et al., Clin Exp Ophthalmol 2019, Volume: 10 JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria

Astigmatism is associated with in children who attended an urban school exposed to air pollution Yangho Kim and Ju-Hyang Lee University of Ulsan College of Medicine, South Korea

e first examined the association of ocular refractive error with allergic conjunctivitis in school children and then examined this association in children attending a suburban school and an urban school. We enrolled 426 Wchildren attending a primary school in a suburban area and 550 children attending a primary school in an urban area which had a higher level of air pollution. Allergic conjunctivitis was defined as the diagnosis of this condition at any time during a child’s life. The ophthalmic examinations included measurements of visual acuity and refraction and a slit lamp examination. Skin prick tests were also performed at each school during 2018. The significance of associations was determined by calculation of odds ratios (ORs) and 95% confidence intervals (CIs). Astigmatism (increase of 1 cylindrical diopter) was associated with allergic conjunctivitis in children overall (OR = 1.287, 95% CI = 1.010 to 1.642) and in children attending the urban school (OR = 1.440, 95% CI = 1.056 to 1.964), but not in children attending the suburban school (OR = 1.031, 95% CI = 0.671 to 1.548). Allergic conjunctivitis also had a higher prevalence among children attending the urban school. The urban school had higher levels of air pollutants than the suburban school. Skin prick tests indicated that the major allergens in children with allergic conjunctivitis were house dust mites and various types of pollen. Astigmatism is associated with allergic conjunctivitis in children attending an urban school, but not a suburban school. This result may be explained by a higher level of air pollution at the urban school.

Biography Yangho Kim is a Professor in Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine in Korea. He graduated from College of Medicine, Kumamoto University, Japan in Occupational Medicine as a PhD. He is also a family medicine specialist. He has main research interest in environmental health issues, particularly environmental effects of air pollution on children’s health problems such as allergic disease.

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Notes:

Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 24 conferenceseries.com Milan Rai, Clin Exp Ophthalmol 2019, Volume: 10 JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria

The importance of routine eye examination in asymptomatic patients in tertiary eye care centres in Northern India Milan Rai Dr. Om Parkash Eye Institute, Amritsar, India

Purpose: To evaluate the visual and ocular conditions in asymptomatic patients. Background: There is a trend of having ophthalmic eye examinations only when the individuals perceive some disturbances in their sight. The ways to ophthalmic centers are almost neglected by them until they feel that their weak or decreased vision has started to interfere with their tasks. This trend is more common in developing nations. The quality of life is greatly affected by the visual and ophthalmic conditions. The existence of some silent killer diseases which do not show any symptoms but considerably decrease the vision and in some cases if remain untreated will irreversibly damage the eye resulting in permanent loss of vision. In such circumstances, the comprehensive eye examination can play preventive role in vision loss thereby screening such silent diseases. Diagnosis of some diseases at advanced stage will just be an informative confirmation. In such cases, there is no alternative except to accept the conditions. So, routine eye examinations are equally important for both symptomatic and asymptomatic patients. Methodology: In our study, data of 150 asymptomatic patients who came for routine eye examination from July 15 2018 to November 15 2018 were collected at the end of each day for 4 months from the Medical Record Department of the Hospital. The data consisted of Medical Record Department Number of patient, age, gender, complaints of patients, any ocular and systemic diseases history, previous glass prescription (spectacle wearer), and its duration, visual acuity with PGP, unaided visual acuity, pinhole visual acuity, new prescription values, Diagnosis and managements. The microsoft excel sheets of above mentioned information were formed. Results: 22 were emmetropes. 110 patients out of 150 were found to have different types of refractive errors. 26 patients were found to have . 12 patients were diagnosed with senile cataract. Non Proliferative Diabetic (NPDR), Dry eye, , Nanophthalmos and Pseudophakia were diagnosed in 1, 2, 2, 1 and 10 patients respectively. The Phacoemulsification surgery was done in one patient. Lubricant eye drops were prescribed in 2 patients and 80 patients were prescribed new glasses. 20 patients were advised for same treatment. Conclusion: It is important for each asymptomatic individual to have routine eye examinations.

Biography Milan Rai works at Dr. Om Parkash Eye Institute PVT LTD and Dr Om Parkash eye institute.He is working as an Intern Optometrist.

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Notes:

Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 25 conferenceseries.com David Berkow, Clin Exp Ophthalmol 2019, Volume: 10 JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria

Tears and fears-influence of contact lens wear on the tear film David Berkow Ulster University, Israel

Background: When a contact lens is placed on the eye the normal structure of the tear film is altered. This leads to a change in the evaporation rate of the tears and ultimately has an effect on the wearing time and comfort of the contact lenses. Content: The tear film dynamics and the mechanism of tear film rupture will be described in detail as well as the tear exchange process. We will try to answer the question why do some patients experience discomfort and dryness which increases with time, whilst others wear their lenses for long periods without any complaints. A detailed explanation on how to clinically evaluate lens-tear interaction will also be given.

Biography David Berkow (Israel) qualified as an Optometrist at the Teknikon in Johannesburg, Republic of South Africa and returned to Israel to start practicing in Optometry. At the time there was no optometry law in Israel until 1991 where he submitted his qualifications and was issued with the certificate from the Ministry of Health (1992).

In 1983, he was awarded Fellowship of The American Academy of Optometry. He has been a member of The British Contact Lens Association for over 25 years. In 1984, he went to London to register as an Optometrist in England. As a foreign Optometrist, he attended the course at the London Refraction Hospital and sat the examinations in order to qualify to register with the G.O.C. After passing, he registered with the G.O.C. keeping up registration until December 2005. He also became a member of The British College of Optometrists and has been a member since. He practices general optometry and has a special interest in contact lenses. Recently he was awarded Fellowship of The British Contact Lens Association

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Notes:

Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 26 conferenceseries.com Manik Gupta et al., Clin Exp Ophthalmol 2019, Volume: 10 JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria

Effects of ocular hypotensives on ocular surface and cornea Manik Gupta, Sushma David and Iqram Khan Rotary Narayana Eye Hospital, India

Aims & Objectives: To study the effects of ocular hypotensive on ocular surface and cornea. Methods & Materials: The proposed study is a prospective randomized interventional study to be conducted in patients having open angle (primary and secondary) and . A total of 60 eyes will be divided into 4 groups (15 each) according to type of topical hypotensive therapy four groups are formed. The group 1 is beta blocker – timolol/betaxolol; group 2 is brimonidine; group 3 is dorzolamide/timolol+dorzolamide combination and group 4 is PG analogues latanoprost, travoprost and bimatoprost. After proper clinical diagnosis all the patients have to undergo clinical tests (IOP, Schirmers test, TUBT, endothelial cell count, pachymetry at 0,1,3,6 months. Result: Patients in group 1, 2 and 3 showed significant decrease in the values of Schirmers and TUBT from the baseline over six months. In patients of group 4 there was decrease in mean values of Schirmer’s test and TBUT from the baseline but that were not significant. Mean corneal thickness and endothelial cell count did not change significantly from the baseline mean value in all the four groups. Conclusion: On the basis of above study changes were seen in Schirmer’s test, tear film function and staining pattern of conjunctival and ocular surface with use of antiglaucoma medication. These all factors can cause ocular surface disorders which can affect the quality of life as well compliance of the patient. There was no effect seen on corneal thickness as well as endothelial cell count in these patients.

Biography Manik Gupta has studied in Rotary Narayana Eye Hospital MBBS in ophthalmologist from 2011-2014.Present he is an ophthalmologist at MI Eye Clinic And Opticals.

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Notes:

Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 27 conferenceseries.com Mohammad Sadegh Mirdehghan et al., Clin Exp Ophthalmol 2019, Volume: 10 JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria

Comparison of the corneal densitometry using Pentacam in individuals with healthy, subclinical and early keratoconus eyes Mohammad Sadegh Mirdehghan, MD Farshad Ostadian, MD Fereydoun Farrahi and MD Atefeh Mahdian Rad Ahvaz Jundishapur University of Medical Science, Iran

eratoconus is a type of ectatic corneal disorder that affects the central and paracentral region of the cornea and as a result, causes due to astigmatism. This non-inflammatory disease progressively affects eyes Kbilaterally. Investigating the corneal layers is an essential factor in the diagnosis of keratoconus. Corneal topography is a non-invasive method for evaluating the corneal morphology, which can reveal the malformations of the corneal surface before the demonstration of clinical symptoms of ectatic corneal disorders .This study aimed to compare the corneal densitometry using Pentacam in individuals with healthy, subclinical and early keratoconus eyes. Materials and methods: The epidemiologic survey was conducted on patients who were refractive surgery candidates. Also, we obtained corneal, stromal, epithelial thickness mapping using SPECTRALIS OCT. According to the Amsler-Krumeich classification, patients were classified as normal, subclinical and early stage of keratoconus. Results: In the early keratoconus group, the anterior layer at the 0-2 mm and 2-6 mm zones had higher values compared to the subclinical keratoconus and control groups (P <0.001 and P <0.001, respectively). At the 2-6 mm zone, the early keratoconus group had higher values compared to the control group (P <0.001). in the central layer at the 0-2 mm and 2-6 mm zones, the early keratoconus group revealed higher densitometry values compared to the control group (P <0.001 and P = 0.01, respectively). In the total corneal thickness at the 0-2 mm zone, densitometry values in the early keratoconus group was more than control group (P = 0.01). Conclusion: Densitometry with Pentacam could be useful in discriminating early keratoconus from subclinical keratoconus and normal individuals.

Biography Mohammad Sadegh Mirdehghan has his expertise in ocular surface, corneal disorders and electrophysiology research. He was in cooperation with biophysics department (IAUTM,Iran) from 2005 to 2010 and during that time he attended several international conferences to present their researches specially in the field of electrophysiology study. At the Johann Wolfgang Goethe University of Frankfurt he underwent one year fellowship research in interventional radiology during2011-2012.He joined the ophthalmology department of Vydehi hospital, RGUHS, Bangalore, India on 2012 to 2016 and during that time he has done several researches and publications with his colleagues, specially in ocular surface disorder. From 2016 he is doing completion course and research at AJUMS, Iran , his recent focus of research is on corneal disorders and methods to improve the diagnosis and management of the same. Eventually, his goal is to improve the quality and quantity of researches from ophthalmologic departments which will lead to helping patients have better quality of vision/quality of life.

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Notes:

Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 28 conferenceseries.com Milan Rai, Clin Exp Ophthalmol 2019, Volume: 10 JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria

Nanophthalmic eyes and its associated complications with refractive error correction using rgp contact lens- a case study Milan Rai Om Parkash Eye Institute, India

anophthalmos is a rare genetic disease characterized by the abnormally small eyes secondary to compromised growth inducing high degree of hypermetropia.It is very often associated with primary angle closure glaucoma, Nuveal effusion, absence of foveal pit, shallow anterior chamber, diffuse macular thickening ,rudimentary foveal avascular zone, scleral collagen fibers abnormalities etc. It may be present with familial or sporadic disorder with autosomal-dominant or recessive inheritance. Five and two loci have been implicated in familial forms. The five genes are MFRP, TMEM9, PRSS56, BEST1 and CRB1.The refractive error can be corrected by the spectacles as well as with contact lens despite having their few limitations. However due to high power, optical aberrations are associated with the use of spectacle is comparatively more than aberrations associated with the contact lens. Usually the total dioptric power of eye is about 60D.However, in this case the total power of the optical system of eye is almost 73D in both eyes even if the power of crystalline lens is not considered when RGP is fitted. Case Presentation: A 26 years old patient came to our OPD for LASIK opinion. His Chief complaints were redness, itching and watering since last 2 days. He had no history of ocular and systemic illness . He used spectacle for the time when he was 5 years old and continued the same spectacle till he became 12 years old .At the age of 12, his spectacle prescription became+13.00DS (OD) and +13.50 (OS) .He continued the same spectacle for 6 years. At the age of 18,he began to use soft contact lens for 2 years and since last 6 years he had been using the spectacle of +15.00DS(OD) and +16.00DS(OS).The visual acuities with PGP were 6/18 in both eyes. The dry acceptance were +15.25DS/-0.25DC*180 and +15.50DS/-0.50DC *140 in right and left eye respectively with visual acuity of 6/12 in both eyes. The slit lamp examination was done .Mild swelling on upper , few SPKs on nasal side of cornea and mild congestion on were seen through slit lamp examination in right eye. However, anterior segment of left eye was within normal limit. Antibiotic and lubricant eye drops were prescribed for 3 days. Follow Up After 3 Days: Non-Contact Tonometry values were 11 mmHg(OD) and 13mmHg(OS). The cycloplegic refraction was done using Tropicamide. The cycloplegic refraction revealed +18.00DS (OD) and +18.50 DS (OS).The visual acuity of each eye was same i.e.6/12. The fundus exam showed hypermetropic fundus with absence of foveal pit in both eyes. However peripheral retinal was ok.The patient was called for follow up after 2 days. Follow Up After 2 Days: The Dry acceptance values were +16.50DS (OD) and +16.50DS/-0.50DC*140 (OS). The Near Vision was N12 at 30cm (OU). The biometry was done using IOL MASTER 700. The axial lengths were 15.18mm(OD) and 15.24mm (OS).The central Anterior chamber depth were 2.93mm(OD) and 2.89mm(OS).The lens thickness is considerably less in right eye (1.39mm) but in left eye it was 2.30mm.Central Corneal Thickness were 497 micrometer (OD) and 499micrometer (OS).The keratometric values were 49.94Dat 0 and 50.30D at 90 in right eye and 49.84D at 119 and 50.14 D at 29 in left eye. The gonioscopy revealed that none of the angle structure were visible indicating the close to zero angle grading. The anterior segment OCT (angular) was done which confirmed the gonioscopy findings. The patient was advised for all glaucoma work up but he denied. The patient was called for follow up after 2 days.

Follow Up After 2 Days: The patient came to Contact lens unit. The best corrected visual acuities with RGP contact lens (FP90,blue tinted with lenticular design) were 6/12 in both eyes. The Base curves of Contact were 6.75(OD)

Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 29 conferenceseries.com JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria and 6.80(OS) with total diameter of 9.8mm.The final powers of contact lens with best corrected Visual acuity of 6/12 in both eyes were +21.50DS (OD) and +22.00DS(OS).There was sufficient corneal coverage by the lens with well centration with lid fit. The overall fitting of contact lens was visually, optically and mechanically optimal. . The patient was called for follow up after 1 week.

Follow Up After 1 Week: The patient was comfortable with the contact lens. The contact lens was well centered with sufficient corneal coverage. The visual acuities with contact lens were 6/12 in both eyes.

Discussion: Due to natural increase in size of the crystalline lens inside the small eye ball in patients with nanophthalmos, there is always a high risk of developing chronic angle closure painless glaucoma in middle age. The central Anterior Chamber Depth is not informative in nanophthalmic eyes regarding glaucomatous changes. Peripheral ACD is of utmost importance. Retinal changes include the macular hypoplasia, ocular cystinosis, retinal cysts, , cystoid macular oedema and pseudopapilloedema etc. The hyperopic eye is due to short axial length (15-20)mm .Nanophthalmos occurs very often bilaterally. The contact lens has widely increased the field of view and its reduced weight in comparison to the thick lens has increased its use especially while using for high refractive error correction.

Biography Milan Rai works at Dr. Om Parkash Eye Institute PVT LTD and Dr Om Parkash eye institute.He is working as an Intern Optometrist.

[email protected]

Notes:

Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 30 conferenceseries.com JOINT EVENT

4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria Video Presentation Day 1

Euro Optometry 2019 & Visionscience 2019 Page 31 conferenceseries.com Kristine Mackare, Clin Exp Ophthalmol 2019, Volume: 10 JOINT EVENT 4th International Conference & Expo on Euro Optometry and Vision Science & 29th International Congress on VisionScience and Eye August 22-23, 2019 Vienna, Austria

Improving users reading comfort and vision health by e-material formatting Kristine Mackare Liepaja University, Latvia

Statement of the Problem: Based on large-scale studies, more recent data shown that by 2015 - more than 30%. As the trend continues, it is expected that by the year 2050, at least half of the world's population will be myopic. The size of the is also increasing and the age at which the myopia starts, continuing to development and progress. Responsiveness for the progression of myopia is the high near work load and its impact on vision that is occurring today daily, especially by development of technology. All near work, especially viewing texts and images, reading, learning both print media and computer screen, are making effects on vision. Such smart and digital devices as computers (both desktop computers and laptop computers), tablets, smartphones, book readers, etc. and internet directly or indirectly are used in both formal and non-formal education. To successfully participate in e-learning and e-studies, users need both good e-skills and well-designed e-learning materials: high-quality content, comfortable, easy-to-understand and comprehensible text, suitable formatting parameters of text. Methodology: As research content of several parts methodology are wide and content of literature research, several e-surveys, statistical data research, patient data analysis. Findings: Most respondents chose a larger font size; even young people Important founding is that nearly a half of respondents use smart devices almost continuously all-day long as well as that at least 96,2% respondents use smart devices for getting knowledges in different ways. For computer users under 40 years of age, an average change of 0.45D was detected within 1-2 years. Conclusion & Significance: Analysing more than 100 literary sources, it was found that there is no unambiguity about all formatting parameters. Based on all information, research and survey, recommendations for different target groups were made. Good formatted e-materials could improve users reading comfort and vision health

Biography KRISTINE MACKARE, MSc is optometrist originally from Latvia, but currently from Norway. She studied science and clinical optometry and obtained her BD and MD at University of Latvia. She is doctoral student in E-study technologies and management at Liepaja University since 2016. Her research interests include vision science, public-health, on-screen reading, e-study, and technologies. Her research creates new pathways for improving users vision comfort and health by digital reading. She is working on methodology and recommendations for e-material formatting based on Vision Science. Also, there are new program for e-material formatting in progress. The research is conducted in collaboration with Liepaja University, University of Latvia and Riga Technical University. For a practical point of view on nowadays problem, she worked as professional optometrist in OC Vision (Latvia) for 5 years and now she works in Salten Synssenter (Norway).

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Journal of Clinical & Experimental Ophthalmology Euro Optometry 2019 Volume 10 ISSN: 2155-9570 Visionscience 2019 August 22-23, 2019 Page 32