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Contact Lens & Anterior Eye : the... Apr 2021The most fundamental aspect of a contact lens is its optics; the manner in which the refraction of light is managed to optimise vision to the clinical benefit of the...
The most fundamental aspect of a contact lens is its optics; the manner in which the refraction of light is managed to optimise vision to the clinical benefit of the lens wearer. This report presents contemporary information on the optical structure of the eye and the optical models employed to understand the correction of refractive error. The design, measurement and clinical assessment of spherical, aspheric, toric, multifocal and myopia control contact lenses are described. The complexity and variety of multifocal lenses is recognised and detailed information is provided for alternating, simultaneous, diffractive, annular, aspheric and extended depth of field lens designs. In terms of clinical assessment, a contemporary review is provided for the measurement of: visual acuity, contrast sensitivity, through focus curves, reading performance, peripheral refraction, toric displacement realignment and patient reported outcomes. Overall, the paper aims to serve as a resource for the prescribing clinician, who can optimise contact lens corrections for patients by building on the optical rationale of these devices; and also highlights future opportunities for research innovation.
Topics: Contact Lenses; Contrast Sensitivity; Humans; Myopia; Vision Tests; Visual Acuity
PubMed: 33775378
DOI: 10.1016/j.clae.2021.02.005 -
International Ophthalmology Mar 2023To analyze the top 100 most cited papers related to amblyopia. (Review)
Review
AIM
To analyze the top 100 most cited papers related to amblyopia.
METHODS
A bibliographic search in the Institute for Scientific Information Web of Knowledge across 55 years was performed.
RESULTS
Eighty-nine of the 100 papers were published in first-quartile journals. Half (50) of the senior authors were from the USA. Most papers dealt with clinical science (72) and included original research (84). Forty-two of the articles related to all three types of amblyopia (refractive, strabismic and deprivation). Thirty-four related to both strabismic and refractive amblyopia. Around two-thirds of the papers dealt with treatment (34) and pathophysiology (30). Almost a quarter (23%) of the papers were multicenter studies. Nearly half (48) of the papers were published between 2000 and 2010. The Pediatric Eye Disease Investigator Group (PEDIG) published the highest number of studies (11), which dealt more with treatment (p = 0.01) and had higher average number of citations per years (p = 0.05). A larger number of articles on the treatment of amblyopia are newer (p = 0.01). There was no correlation between the time of their publication and the number of citations (p = 0.68, r = 0.042).
CONCLUSIONS
Half of the papers were published between 2000 and 2010 and were spearheaded by PEDIG. Most papers dealt with treatment and pathophysiology. This study provides an important historical perspective, emphasizing the need for additional research to better understand this preventable and curable childhood vision impairment.
Topics: Child; Humans; Amblyopia; Refraction, Ocular; Vision Tests
PubMed: 36057007
DOI: 10.1007/s10792-022-02487-z -
JAMA Ophthalmology May 2022Visual acuity (VA) is one of the most important clinical data points in ophthalmology. However, few options for validated at-home VA assessments are currently available. (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Visual acuity (VA) is one of the most important clinical data points in ophthalmology. However, few options for validated at-home VA assessments are currently available.
OBJECTIVE
To validate 3 at-home visual acuity tests in comparison with in-office visual acuity.
DESIGN, SETTING, AND PARTICIPANTS
Between July 2020 and April 2021, eligible participants with VA of 20/200 or better were recruited from 4 university-based ophthalmology clinics (comprehensive, cornea, glaucoma, and retina clinics). Participants were prospectively randomized to self-administer 2 of 3 at-home VA tests (printed chart, mobile phone app, and website) within 3 days before their standard-of-care clinic visit. Participants completed a survey assessing usability of the at-home tests. At the clinic visit, best-corrected Snellen distance acuity was measured as the reference standard.
MAIN OUTCOMES AND MEASURES
The at-home VA test results were compared with the in-office VA test results using paired and unpaired t tests, Pearson correlation coefficients, analysis of variance, χ2 tests, and Cohen κ agreement. The sensitivity, specificity, positive predictive value, and negative predictive value of each at-home test were calculated to detect significant VA changes (≥0.2 logMAR) from the in-office baseline.
RESULTS
A total of 121 participants with a mean (SD) age of 63.8 (13.0) years completed the study. The mean in-office VA was 0.11 logMAR (Snellen equivalent 20/25) with similar numbers of participants from the 4 clinics. Mean difference (logMAR) between the at-home test and in-office acuity was -0.07 (95% CI, -0.10 to -0.04) for the printed chart, -0.12 (95% CI, -0.15 to -0.09) for the mobile phone app, and -0.13 (95% CI, -0.16 to -0.10) for the website test. The Pearson correlation coefficient for the printed chart was 0.72 (95% CI, 0.62-0.79), mobile phone app was 0.58 (95% CI, 0.46-0.69), and website test was 0.64 (95% CI, 0.53-0.73).
CONCLUSIONS AND RELEVANCE
The 3 at-home VA test results (printed chart, mobile phone app, and website) appeared comparable within 1 line to in-office VA measurements. Older participants were more likely to have limited access to digital tools. Further development and validation of at-home VA testing modalities is needed with the expansion of teleophthalmology care.
Topics: COVID-19; Humans; Middle Aged; Ophthalmology; Telemedicine; Vision Tests; Visual Acuity
PubMed: 35357405
DOI: 10.1001/jamaophthalmol.2022.0396 -
Clinical & Experimental Optometry Sep 2023Spherical aberration is an imperfection of the optical system of the human eye. The role of spherical aberration of the human eye in the quality of vision and... (Review)
Review
Spherical aberration is an imperfection of the optical system of the human eye. The role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation is reviewed. Spherical aberration is an imperfection of the optical system of the human eye. In most cases, due to well-developed neuroadaptation, it is insignificant for the perception of the image. Nevertheless, its role in modern ophthalmology is far from straightforward. On the one hand, there are clinical scenarios in which an excess of spherical aberration degrades the retinal image and leads to a high dissatisfaction rate among patients.©Recently, there is a growing interest in the modulation of spherical aberration in the clinical setting. Modern intraocular lenses as well as laser refractive procedures are aimed at interfering with spherical aberrations of the optical system in order to increase range of pseudoaccommodation. Here, we review the role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation.
Topics: Humans; Ophthalmology; Lenses, Intraocular; Refraction, Ocular; Vision, Ocular; Vision Tests
PubMed: 36822601
DOI: 10.1080/08164622.2022.2160235 -
Optometry and Vision Science : Official... Jan 2021Quality refractive error care is essential for reducing vision impairment. Quality indicators and standardized approaches for assessing the quality of refractive error...
SIGNIFICANCE
Quality refractive error care is essential for reducing vision impairment. Quality indicators and standardized approaches for assessing the quality of refractive error care need to be established.
PURPOSE
This study aimed to develop a set of indicators for assessing the quality of refractive error care and test their applicability in a real-world setting using unannounced standardized patients (USPs).
METHODS
Patient outcomes and three quality of refractive error care (Q.REC) indicators (1, optimally prescribed spectacles; 2, adequately prescribed spectacles; 3, vector dioptric distance) were developed using existing literature, refraction training standards, and consulting educators. Twenty-one USPs with various refractive errors were trained to visit optical stores across Vietnam to have a refraction, observe techniques, and order spectacles. Spectacles were assessed against each Q.REC indicator and tested for associations with vision and comfort.
RESULTS
Overall, 44.1% (184/417) of spectacles provided good vision and comfort. Of the spectacles that met Q.REC indicators 1 and 2, 62.5 and 54.9%, respectively, provided both good vision and comfort. Optimally prescribed spectacles (indicator 1) were significantly more likely to provide good vision and comfort independently compared with spectacles that did not meet any indicator (good vision: 94.6 vs. 85.0%, P = .01; comfortable: 66.1 vs. 36.3%, P < .01). Adequately prescribed spectacles (indicator 2) were more likely to provide good comfort compared with spectacles not meeting any indicator (57.7 vs. 36.3%, P < .01); however, vision outcomes were not significantly different (85.9 vs. 85.0%, P = .90). Good vision was associated with a lower mean vector dioptric distance (P < .01) but not with comfort (P = .52).
CONCLUSIONS
The optimally prescribed spectacles indicator is a promising approach for assessing the quality of refractive error care without additional assessments of vision and comfort. Using USPs is a practical approach and could be used as a standardized method for evaluating the quality of refractive error care.
Topics: Adult; Delivery of Health Care; Eyeglasses; Female; Humans; Male; Middle Aged; Prescriptions; Quality Indicators, Health Care; Refraction, Ocular; Refractive Errors; Standard of Care; Vietnam; Vision Tests; Visual Acuity; Young Adult
PubMed: 33394928
DOI: 10.1097/OPX.0000000000001629 -
Translational Vision Science &... Mar 2023To propose new methods for eye selection in presbyopic monovision corrections.
PURPOSE
To propose new methods for eye selection in presbyopic monovision corrections.
METHODS
Twenty subjects with presbyopia performed two standard methods of binary eye dominance identification (sensory with +1.50 diopters [D ]and +0.50 D and sighting with "hole-in-the-card") and two psychophysical methods of perceived visual quality: (1) the Preferential test, 26 natural images were judged with the near addition in one eye or in the other in a 2-interval forced-choice task, and the Eye Dominance Strength (EDS) defined as the proportion of trials where one monovision is preferred over the other; (2) the Multifocal Acceptance Score (MAS-2EV) test, the perceived quality of a natural images set (for 2 luminance levels and distances) was scored and EDS defined as the score difference between monovision in one eye or the other. Left-eye and right-eye dominance are indicated with negative and positive values, respectively. Tests were performed using a Simultaneous Vision Simulator, which allows rapid changes between corrections.
RESULTS
Standard sensory and sighting dominances matched in only 55% of subjects. The Preferential EDS (ranging from -0.7 to +0.9) and MAS-2EV EDS (ranging from -0.6 to +0.4) were highly correlated. Selecting the eye for far in monovision with the MAS-2EV, sensory, or sighting tests would have resulted in 79%, 64%, and 43% success considering the Preferential test as the gold standard.
CONCLUSIONS
Tests based on perceptual preference allow selection of the preferred monovision correction and measurement of dominance strength.
TRANSLATIONAL RELEVANCE
The binocular visual simulator allows efficient implementation of eye preference tests for monovision in clinical use.
Topics: Humans; Vision, Monocular; Visual Acuity; Dominance, Ocular; Vision, Ocular; Vision Tests
PubMed: 36939712
DOI: 10.1167/tvst.12.3.18 -
Endocrinology, Diabetes & Metabolism Jan 2023The aim of this study was to investigate the effects of hypothyroidism on visual functions such as visual acuity, refractive errors, colour vision, and contrast...
INTRODUCTION
The aim of this study was to investigate the effects of hypothyroidism on visual functions such as visual acuity, refractive errors, colour vision, and contrast sensitivity, among hypothyroid adults.
METHODS
Forty-three patients with clinical hypothyroidism along with 43 age- and sex-matched healthy individuals underwent visual examinations, including visual acuity, refractive errors, eye deviations with the cover test, colour vision with the D15 test, and contrast sensitivity with Pelli-Robson test.
RESULTS
It was indicated that visual acuity, refractive errors, phoria, and colour vision had no significant difference between the hypothyroid and control groups. Contrast sensitivity decreased in hypothyroid subjects as compared with controls. The mean values of binocular contrast sensitivity were 1.85 ± 0.09 log in the hypothyroid group and 1.93 ± 0.09 log in controls, which showed a statistically significant difference (p = .03).
CONCLUSIONS
Our findings illustrated a reduced contrast sensitivity in adult hypothyroidism. Since CS is related to functioning and quality of life, a comprehensive and detailed eye examination may be beneficial for hypothyroidism patients.
Topics: Humans; Adult; Iran; Vision Tests; Quality of Life; Refractive Errors; Hypothyroidism
PubMed: 36519206
DOI: 10.1002/edm2.393 -
Ophthalmic & Physiological Optics : the... Nov 2023Colour vision deficiencies (CVDs) indicate potential genetic variations and can be important biomarkers of acquired impairment in many neuro-ophthalmic diseases....
Colour vision deficiencies (CVDs) indicate potential genetic variations and can be important biomarkers of acquired impairment in many neuro-ophthalmic diseases. However, CVDs are typically measured with tests which possess high sensitivity for detecting the presence of a CVD but do not quantify its type or severity. In this study, we introduce Foraging Interactive D-prime (FInD), a novel computer-based, generalisable, rapid, self-administered vision assessment tool and apply it to colour vision testing. This signal detection theory-based adaptive paradigm computed test stimulus intensity from d-prime analysis. Stimuli were chromatic Gaussian blobs in dynamic luminance noise, and participants clicked on cells that contained chromatic blobs (detection) or blob pairs of differing colours (discrimination). Sensitivity and repeatability of FInD colour tasks were compared against the Hardy-Rand-Rittler and the Farnsworth-Munsell 100 hue tests in 19 colour-normal and 18 inherited colour-atypical, age-matched observers. Rayleigh colour match was also completed. Detection and discrimination thresholds were higher for atypical than for typical observers, with selective threshold elevations corresponding to unique CVD types. Classifications of CVD type and severity via unsupervised machine learning confirmed functional subtypes. FInD tasks reliably detect inherited CVDs, and may serve as valuable tools in basic and clinical colour vision science.
Topics: Humans; Color Vision Defects; Color Vision; Vision Tests; Machine Learning; Cardiovascular Diseases; Color Perception
PubMed: 37589437
DOI: 10.1111/opo.13210 -
Graefe's Archive For Clinical and... Sep 2021Stereopsis is a fundamental skill in human vision and visual actions. There are many ways to test and quantify stereoacuity: traditional paper and new digital...
PURPOSE
Stereopsis is a fundamental skill in human vision and visual actions. There are many ways to test and quantify stereoacuity: traditional paper and new digital applications are both valid ways to test the stereoacuity. The aim of this study is to compare the results obtained using standard tests and the new Stereoacuity Test App developed by the University of Bergamo.
METHODS
A group of 497 children (272 males), aged between 6 and 11 years old, were tested using different tests for the quantification of stereopsis at near. These tests were TNO, Weiss EKW, and the new developed Stereoacuity Test App.
RESULTS
A one-way repeated measure ANOVA showed that the three tests give different thresholds of stereoacuity (p < 0.0001). Post hoc analyses with Bonferroni correction showed that all tests showed different thresholds (p < 0.0001). The lower threshold was obtained by Titmus Stereo Test followed by Stereoacuity App, Weiss MKW, and TNO.
CONCLUSION
The stereoacuity based on global stereopsis showed that the better values were obtained in order by Stereoacuity Test App, TNO, and Weiss EKW. However, the clinical significance of their values is similar. The new digital test showed a greater compliance by the child, showing itself in tune with the digital characteristics of today's children.
Topics: Child; Depth Perception; Humans; Male; Mobile Applications; Vision Tests; Vision, Binocular; Visual Acuity
PubMed: 33907883
DOI: 10.1007/s00417-021-05195-z -
Translational Vision Science &... Mar 2023To describe two new stereoacuity tests: the eRDS v6 stereotest, a global dynamic random dot stereogram (dRDS) test, and the Vivid Vision Stereo Test version 2 (VV), a...
PURPOSE
To describe two new stereoacuity tests: the eRDS v6 stereotest, a global dynamic random dot stereogram (dRDS) test, and the Vivid Vision Stereo Test version 2 (VV), a local or "contour" stereotest for virtual reality (VR) headsets; and to evaluate the tests' reliability, validity compared to a dRDS standard, and learning effects.
METHODS
Sixty-four subjects passed a battery of stereotests, including perceiving depth from RDS. Validity was evaluated relative to a tablet-based dRDS reference test, ASTEROID. Reliability and learning effects were assessed over six sessions.
RESULTS
eRDS v6 was effective at measuring small thresholds (<10 arcsec) and had a moderate correlation (0.48) with ASTEROID. Across the six sessions, test-retest reliability was good, varying from 0.84 to 0.91, but learning occurred across the first three sessions. VV did not measure stereoacuities below 15 arcsec. It had a weak correlation with ASTEROID (0.27), and test-retest reliability was poor to moderate, varying from 0.35 to 0.74; however, no learning occurred between sessions.
CONCLUSIONS
eRDS v6 is precise and reliable but shows learning effects. If repeated three times at baseline, this test is well suited as an outcome measure for testing interventions. VV is less precise, but it is easy and rapid and shows no learning. It may be useful for testing interventions in patients who have no global stereopsis.
TRANSLATIONAL RELEVANCE
eRDS v6 is well suited as an outcome measure to evaluate treatments that improve adult stereodepth perception. VV can be considered for screening patient with compromised stereovision.
Topics: Adult; Humans; Reproducibility of Results; Vision Tests; Depth Perception; Dystonic Disorders
PubMed: 36857068
DOI: 10.1167/tvst.12.3.1