-
Journal of Clinical Medicine Nov 2022Purpose: To analyze the correlation between eye movements and asthenopia so as to explore the possibility of using eye-tracking techniques for objective assessment of...
Purpose: To analyze the correlation between eye movements and asthenopia so as to explore the possibility of using eye-tracking techniques for objective assessment of asthenopia. Methods: This prospective observational study used the computer visual syndrome questionnaire to assess the severity of asthenopia in 93 enrolled college students (age 20−30) who complained about asthenopia. Binocular accommodation and eye movements during the reading task were also examined. The correlations between questionnaire score and accommodation examination results and eye movement parameters were analyzed. Differences in eye movement parameters between the first and last reading paragraphs were compared. The trends in eye movement changes over time were observed. Results: About 81.7% of the subjects suffered from computer visual syndrome. Computer visual syndrome questionnaire total score was positively correlated with positive relative accommodation (p < 0.05). In the first reading paragraph, double vision was positively correlated with unknown saccades (all p < 0.05). Difficulty focusing at close range was positively correlated with total fixation duration, total visit duration, and reading speed (all p < 0.05). Feeling that sight was worsening was positively correlated with regressive saccades (p < 0.05). However, visual impairment symptoms were not significantly correlated with any accommodative function. In a total 20 min reading, significantly reduced eye movement parameters were: total fixation duration, fixation count, total visit duration, visit count, fixation duration mean, and reading speed (all p < 0.01). The eye movement parameters that were significantly increased were: visit duration mean and unknown saccades (all p < 0.001). Conclusion: Eye tracking could be used as an effective assessment for asthenopia. Among the various eye movement parameters, a decrease in fixation duration and counts may be one of the potential indicators related to asthenopia.
PubMed: 36498619
DOI: 10.3390/jcm11237043 -
Asia-Pacific Journal of Ophthalmology...The purpose of this study was to assess the dose-response effects of low-dose atropine on myopia progression and safety in pediatric subjects with mild-to-moderate... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The purpose of this study was to assess the dose-response effects of low-dose atropine on myopia progression and safety in pediatric subjects with mild-to-moderate myopia.
METHODS
This phase II, randomized, double-masked, placebo-controlled study compared the efficacy and safety of atropine 0.0025%, 0.005%, and 0.01% with placebo in 99 children, aged 6-11 years, with mild-to-moderate myopia. Subjects received 1 drop in each eye at bedtime. The primary efficacy endpoint was change in spherical equivalent (SE), while secondary endpoints included changes in axial length (AL) and near logMAR (logarithm of the minimum angle of resolution) visual acuity and adverse effects.
RESULTS
The mean±SD changes in SE from baseline to 12 months in the placebo and atropine 0.0025%, 0.005%, and 0.01% groups were -0.55±0.471, -0.55±0.337, -0.33±0.473, and -0.39±0.519 D, respectively. The least squares mean differences (atropine-placebo) in the atropine 0.0025%, 0.005%, and 0.01% groups were 0.11 D ( P =0.246), 0.23 D ( P =0.009), and 0.25 D ( P =0.006), respectively. Compared with placebo, the mean change in AL was significantly greater for atropine 0.005% (-0.09 mm, P =0.012) and 0.01% (-0.10 mm, P =0.003). There were no significant changes in near visual acuity in any of the treatment groups. The most common ocular adverse events were pruritus and blurred vision, each occurring in 4 (5.5%) atropine-treated children. Changes in mean pupil size and amplitude of accommodation were minimal.
CONCLUSIONS
Atropine doses of 0.005% and 0.01% effectively reduced myopia progression in children but no effect was noted with 0.0025%. All doses of atropine were safe and well tolerated.
Topics: Humans; Child; Administration, Topical; Ophthalmic Solutions; Atropine; Myopia; Refraction, Ocular; Axial Length, Eye; Disease Progression
PubMed: 37523428
DOI: 10.1097/APO.0000000000000609 -
Indian Journal of Medical Ethics 2020The opening quote by Alexandra Adams, the first deaf-blind medical student in the United Kingdom, is a response to naysayers on her decision to join medicine. The cover...
The opening quote by Alexandra Adams, the first deaf-blind medical student in the United Kingdom, is a response to naysayers on her decision to join medicine. The cover page of this issue of IJME also highlights the underrepresented in medicine: portraying a healthcare professional with an acquired visual impairment who works with full professional rigour and dedication.
Topics: Disabled Persons; Female; Humans; Morals; Standard of Care; Students, Medical; Students, Nursing; United Kingdom
PubMed: 34018950
DOI: 10.20529/IJME.2020.109 -
BMC Ophthalmology Mar 2022To assess dynamic visual acuity (DVA) under different defocus statuses and explore the assessment of dynamic vision accommodation.
BACKGROUND
To assess dynamic visual acuity (DVA) under different defocus statuses and explore the assessment of dynamic vision accommodation.
METHODS
Twenty subjects (6 males and 14 females) aged 18 to 35 were recruited. Nonmydriatic subjective refraction (sphere and cylinder) and accommodative tests including negative relative accommodation (NRA), positive relative accommodation (PRA), binocular cross cylinder (BCC) and accommodative facility using a flipper were performed. Binocular static visual acuity (SVA) and DVA at 40 degrees per second (dps) were measured under different defocus statuses (+1.5D to -4D in -0.5D steps) based on the refractive error fully corrected. Static and dynamic defocus curves were plotted. The area under the curve (AUC) and corrected dynamic vision accommodation (CDVAc) were calculated.
RESULTS
The study showed that the dynamic defocus curve fitted the cubic curve properly (p<0.001). DVA was significantly worse than SVA at all defocused statuses (p<0.001), and the difference was more significant at greater defocus diopters. Single factor analysis indicated that CDVAc was significantly correlated with NRA-PRA (p=0.012) and AUC (p<0.001). Significant associations were observed between AUC and PRA (p=0.013) as well as NRA-PRA (p=0.021). Meanwhile, DVA was positively correlated with PRA at 0D, -1.0D, -1.5D, -2.5D and -3.0D (p<0.05) and with NRA-PRA at 0D, -1.0D, -1.5D, -2.0D and -2.5D (p<0.05). Multiple factor regression analysis indicated that CDVAc (0D ~ -3.5D) and SVA (+1.5D ~ +1.0D & -2.5D ~ -4.0D) were significant influential factors for defocused DVA (p<0.05).
CONCLUSIONS
Our study demonstrated that DVA had a defocus curve similar to that of SVA. CDVAc was feasible for the assessment of dynamic vision accommodative function. The dynamic defocus curve test could efficiently be applied in the evaluation of dynamic visual performance under different defocus statuses.
Topics: Accommodation, Ocular; Adolescent; Adult; Female; Humans; Male; Refractive Errors; Vision Tests; Vision, Binocular; Visual Acuity; Young Adult
PubMed: 35248018
DOI: 10.1186/s12886-022-02335-9 -
Eye and Vision (London, England) Sep 2022To investigate the short- and long-term effects of myopia control spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) on visual...
OBJECTIVES
To investigate the short- and long-term effects of myopia control spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) on visual function and visual quality using data obtained from a randomized controlled clinical trial.
METHODS
This was a prospective, randomized, controlled, and double-blinded study; 170 myopic children aged 8-13 years were randomly assigned to the HAL, SAL, or single-vision spectacle lenses (SVL) groups. Distance and near visual acuity (VA) at high (100%) and low (10%) contrast in photopic and scotopic conditions, near phoria, stereoacuity, and accommodative lag, microfluctuations (AMFs), amplitude (AA) were measured after wearing lenses for 10 min, 6 months, and 12 months.
RESULTS
In total, 161 subjects completed all follow-up in 12 months and were included in the analysis. After 10 min of wearing, the HAL and SAL groups had lower scotopic and low-contrast VA than the SVL group (decreased 0.03-0.08 logMAR and 0.01-0.04 logMAR in different VAs in the HAL and SAL groups, respectively, all P < 0.05). The reduction in VA was recovered at 12 months as the HAL and SAL groups exhibited significant VA improvements, and the VA was not different among the three groups (all P > 0.05). The HAL and SAL groups had significantly larger AMFs than the SVL group (HAL vs. SAL vs. SVL: 0.21 ± 0.08 D vs. 0.16 ± 0.05 D vs. 0.15 ± 0.06 D at baseline, 0.19 ± 0.07 D vs. 0.17 ± 0.05 D vs. 0.13 ± 0.07 D at 12 months, all P < 0.05). There were no significant differences in accommodative lag, AA, or phoria between the groups (all P > 0.05). The HAL and SAL groups had reduced stereoacuity compared to the SVL group at baseline (70' vs. 60' vs. 50', P = 0.005), but no difference was observed at 12 months (70' vs. 70' vs. 70', P = 0.11).
CONCLUSIONS
HAL and SAL have no significant influence on accommodation and phoria except had larger AMF than SVL. Scotopic VA and low-contrast VA are reduced with short-term HAL and SAL use but recovered to be at same level with the SVL after 1 year of use. Trial registration Chinese Clinical Trial Registry: ChiCTR1800017683. Registered on 9 August 2018. http://www.chictr.org.cn/showproj.aspx?proj=29789.
PubMed: 36045391
DOI: 10.1186/s40662-022-00304-3 -
Journal of Optometry 2022Several studies have suggested that accommodative and non-strabismic binocular dysfunctions are commonly encountered in optometric practice. This study aims to verify...
BACKGROUND
Several studies have suggested that accommodative and non-strabismic binocular dysfunctions are commonly encountered in optometric practice. This study aims to verify whether these findings apply to a Portuguese clinical population.
METHODS
This study included consecutive nonpresbyopic subjects that came to two Portuguese optometric clinics over a period of six months. A complete visual exam was conducted and included the measurement of visual acuity (VA), refraction, near point of convergence (NPC), distance and near phoria, near and distance fusional vergences, amplitude of accommodation (AA), monocular accommodative facility (MAF), relative accommodation and lag of accommodation.
RESULTS
156 subjects with a mean age of 24.9 ± 5.3 years (from 18 to 35 years old) participated in the study. Of all subjects, 32 % presented binocular vision and/or accommodative disorders accompanied or not by refractive errors. Moreover, 21.1 % had accommodative disorders, and 10.9 % had a binocular vision dysfunction. Accommodative insufficiency (11.5 %) was the most prevalent disorder, followed by convergence insufficiency (7.1 %) and accommodative infacility (5. 8 %).
CONCLUSIONS
Clinicians should be aware that about one third of the optometric clinical population could have accommodative and/or non-strabismic binocular disorders. Accommodative insufficiency was the most prevalent dysfunction presented in the studied population, followed by accommodative infacility and convergence insufficiency.
Topics: Accommodation, Ocular; Adolescent; Adult; Humans; Ocular Motility Disorders; Portugal; Presbyopia; Vision Disorders; Vision Tests; Vision, Binocular; Young Adult
PubMed: 34852966
DOI: 10.1016/j.optom.2021.10.002 -
Medical Journal of the Islamic Republic... 2022Pregnancy-induced changes in the physiological responses during the gestational period can affect the eye. This study aimed to evaluate the effect of pregnancy on...
Pregnancy-induced changes in the physiological responses during the gestational period can affect the eye. This study aimed to evaluate the effect of pregnancy on visual, refractive, vergence, and accommodative status. In this cross-sectional study, twenty-five healthy pregnant women with a mean age of 29±3.1 were examined. All of the subjects underwent comprehensive ophthalmologic examinations, including anterior segment and fundus examinations and tonometry. Refractive error was determined in each trimester using Autokeratometer. Furthermore, near the point of convergence (NPC), best-corrected visual acuity (BCVA), and near the point of accommodation (NPA) were measured. Data analysis was performed using SPSS version 22. To compare the data during pregnancy, repeated measures analysis of variance (ANOVA) was performed. During pregnancy, in the right and left eye, spherical equivalent (SE) had a myopic shift from -0.13 to -0.35 D and +0.096 to -0.23 D, respectively (=0.049 and =0.020, respectively). Also, in the right and left eyes BCVA significantly decreased from -0.13 to 0.00 and -0.14 to 0.00 LogMAR, respectively (=0.039 and =0.045, respectively). NPA and NPC did not change statistically significantly during pregnancy (=0.385, and =0.801, respectively). Due to the unstable hormonal status, a myopic shift and decrease in BCVA occur during pregnancy. So, any change in their spectacle prescription, fitting of contact lenses, performing refractive surgeries, etc., during this period should be postponed.
PubMed: 36447546
DOI: 10.47176/mjiri.36.102 -
Eye & Contact Lens Feb 2023The objective of this study was to compare the visual performance and binocular/accommodative function of two novel S.T.O.P. design (F2 and DT) contact lenses against... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The objective of this study was to compare the visual performance and binocular/accommodative function of two novel S.T.O.P. design (F2 and DT) contact lenses against MiSight when worn by myopic, young adults.
METHOD
This was a prospective, randomized, cross-over, single-masked study. Each lens was worn daily wear with overnight peroxide disinfection for approximately 7 days. Visual performance was assessed with subjective ratings (0-100): clarity of vision and lack of ghosting (far away, intermediate, and near), vision when driving, overall vision satisfaction, and with monocular high-contrast and low-contrast visual acuity (HCVA/LCVA) at 6 m, binocular HCVA (6 m, 70 cm, 50 cm, and 40 cm), binocular LCVA (6 m and 70 cm). Binocular function was assessed with heterophorias (3 m and 40 cm). Accommodative function was assessed with monocular accommodative facility (AF: 40 cm) and dynamic monocular accommodative response (AR: 6 m, 70 cm, and 40 cm).
RESULTS
F2 was rated higher than MiSight for clarity of vision (near and intermediate) and lack-of-ghosting ( P <0.001), while MiSight was rated higher than DT for clarity of vision (near, P <0.001). MiSight was better than F2 and DT for monocular HCVA (6 m) and binocular HCVA (6 m and 40 cm, P ≤0.02), but the maximum difference was ≤2 letters. There were no differences between designs for heterophoria ( P =0.61) nor were there any differences between DT and MiSight for any accommodative measure ( P >0.1). F2 was higher for monocular-AF ( P =0.007) and lower for AR (70 cm and 40 cm; P ≤0.007) compared with MiSight.
CONCLUSIONS
The visual performance and binocular/accommodative function of S.T.O.P. designs F2 and DT were comparable with MiSight. F2 outperformed MiSight in some aspects of subjective visual performance and monocular accommodative function.
Topics: Young Adult; Humans; Visual Acuity; Prospective Studies; Contact Lenses, Hydrophilic; Presbyopia; Accommodation, Ocular; Vision, Binocular
PubMed: 36282205
DOI: 10.1097/ICL.0000000000000950 -
Arquivos Brasileiros de Oftalmologia 2021To investigate the effects of pharmacological accommodation and cycloplegia on ocular measurements.
PURPOSE
To investigate the effects of pharmacological accommodation and cycloplegia on ocular measurements.
METHODS
Thirty-three healthy subjects [mean (±SD) age, 32.97 (±5.21) years] volunteered to participate in the study. Measurement of the axial length, macular and choroidal thickness, refractive error, and corneal topography, as well as anterior segment imaging, were performed. After these procedures, pharmacological accommodation was induced by applying pilocarpine eye drops (pilocarpine hydrochloride 2%), and the measurements were repeated. The measurements were repeated again after full cycloplegia was induced using cyclopentolate eye drops (cyclopentolate hydrochloride 1%). The correlations between the measurements were evaluated.
RESULTS
A significant increase in subfoveal choroidal thickness after applying 2% pilocarpine was identified (without the drops, 319.36 ± 90.08 µm; with pilocarpine instillation, 341.60 ± 99.19 µm; with cyclopentolate instillation, 318.36 ± 103.0 µm; p<0.001). A significant increase in the axial length was also detected (without the drops, 23.26 ± 0.83 mm; with pilocarpine instillation, 23.29 ± 0.84 mm; with cyclopentolate instillation, 23.27 ± 0.84 mm; p=0.003). Comparing pharmacological accommodation and cycloplegia revealed a significant difference in central macular thickness (with pilocarpine instillation, 262.27 ± 19.34 µm; with cyclopentolate instillation, 265.93 ± 17.91 µm; p=0.016). Pilocarpine-related miosis (p<0.001) and myopic shift (p<0.001) were more severe in blue eyes vs. brown eyes.
CONCLUSION
Pharmacological accommodation may change ocular measurements, such as choroidal thickness and axial length. This condition should be considered when performing ocular measurements, such as intraocular lens power calculations.
Topics: Accommodation, Ocular; Adult; Cyclopentolate; Eye; Eye Color; Humans; Mydriatics; Refraction, Ocular; Refractive Errors
PubMed: 33567004
DOI: 10.5935/0004-2749.20210015 -
Investigative Ophthalmology & Visual... Nov 2021Peripheral refraction and accommodation are intrinsic factors that were once hypothesized to trigger myopia but are now controversial. Previously, home nearwork...
PURPOSE
Peripheral refraction and accommodation are intrinsic factors that were once hypothesized to trigger myopia but are now controversial. Previously, home nearwork environment (i.e., extrinsic factor) was reported to be associated with myopia progression. In this study, we aimed to evaluate the potential interaction between extrinsic and intrinsic factors with juvenile refractive development.
METHODS
Nearwork environmental parameters were measured for 50 children (aged 9.3 ± 1.2 years), including net amount and dispersion of defocus. Refraction was measured at near distances and in central field (±30° horizontal) at 3m. The relative peripheral refraction (RPRE) was obtained and presented in a vectoral approach. The linear regression coefficient was extracted (mAcc) from the accommodative stimulus-response curve. RPRE was quadratically regressed against field eccentricity, and the first coefficients (aM, aJ0, aP90, and aP180) were extracted. Relationships between RPRE, baseline accommodation, and 1-year myopia progression (∆M), controlled for the nearwork environment, were evaluated.
RESULTS
Coefficients of RPRE were independent of ∆M. However, additional nearwork environmental parameters significantly improved the variance in ∆M explained by aM and aP180 (P < 0.03). The relationship between intrinsic factor and ∆M was stronger when the extrinsic risk was low (P ≤ 0.01), whereas the relationship was abolished when extrinsic risk was high. For mAcc, it also significantly improved the variance in ∆M explained by nearwork environmental parameters.
CONCLUSIONS
The interaction between extrinsic (environment) and intrinsic (RPRE and accommodation) factors is speculated to contribute to juvenile myopia progression. Our findings may also explain the inconsistencies of such intrinsic factors in the literature.
Topics: Accommodation, Ocular; Child; Eye; Female; Humans; Intrinsic Factor; Male; Myopia; Refraction, Ocular; Visual Acuity
PubMed: 34797905
DOI: 10.1167/iovs.62.14.21