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Vision (Basel, Switzerland) Sep 2023People with Down syndrome have more visual problems than the general population. They experience premature ageing, and they are expected to also have an acceleration in...
People with Down syndrome have more visual problems than the general population. They experience premature ageing, and they are expected to also have an acceleration in worsening visual function. A prospective observational study which includes visual acuity, refractive error, accommodation, binocular and colour vision was performed on young adults with ( = 69) and without ( = 65) Down syndrome and on a senior group ( = 55) without Down syndrome. Results showed significant differences in visual acuity between groups ( < 0.001), and it can be improved with a new prescription in 40% of the participants with Down syndrome. Regarding the accommodative state, no significant differences were found between groups of young people. Concerning binocular vision, 64.7% of strabismus was observed in the group with Down syndrome ( < 0.001). Visual abnormalities are significant in young adults with Down syndrome and are different from those of older people without Down syndrome, some of which can be improved by providing the optimal prescription as well as regular eye examinations.
PubMed: 37756134
DOI: 10.3390/vision7030060 -
Clinical Optometry 2023Presbyopia is an age-related progressive decrease of near vision, corrected by near addition glasses. These age-appropriate glasses, however, vary across different...
BACKGROUND
Presbyopia is an age-related progressive decrease of near vision, corrected by near addition glasses. These age-appropriate glasses, however, vary across different geographical locations and populations. But there is no existing information on the age-based addition for Asmara and high number of uncorrected presbyopes, so this study determined the required age-based addition for the presbyopes in Asmara.
METHODS
A cross-sectional study was conducted on patients aged 35-60 years who visited all eye centers in the city. Patients with best-corrected visual acuity in both eyes better than 6/9 were included in the study. Near add was calculated using Monocular Estimation Method (MEM) and amplitude of accommodation results. Data entry and analysis were performed using Statistical Package for the Social Sciences v. 20.
RESULTS
This study included 1310 participants of whom 48.5% were females and 51.5% were males. The prevalence of presbyopia was found to be 74.1% out of which 44% were females. There were 35.6% of the participants with a previous prescription for glasses, though only 24% of the participants presented with glasses on. Among the different occupational categories, laborers were the ones who had the highest number of presbyopes (79.5%), office workers (73%), and housewives (68.7%). The mean age of those with presbyopes was 49.5 ± 5.8 years. Multivariable analysis performed for presbyopia showed that older age and female sex were associated with a higher likelihood of presbyopia (<0.005). An addition table was prepared separately for males and females. On post-hoc tests, no significant association was found between the given and the different refractive status.
CONCLUSION
The study showed that there is a high level of uncorrected presbyopes in the city, so the availability of refraction sites and glasses accessibility needs to increase. The near addition demand for this population varies from the previously stated amount in other countries. Therefore, guidelines specifically prepared for a society are necessary.
PubMed: 37744317
DOI: 10.2147/OPTO.S421366 -
PloS One 2023This work aimed to comprehensively assess the risk factors affecting myopia in children to develop more effective prevention and treatment strategies. To this end, data... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
This work aimed to comprehensively assess the risk factors affecting myopia in children to develop more effective prevention and treatment strategies. To this end, data from database were employed to assess the relationship between the incidence of myopia and its risk factors.
METHODS
We searched eight databases online in June 2022. Cohort studies were included that measured the connection between risk factors and myopia. Eligibility was not restricted by language. The Newcastle-Ottawa Scale (NOS) was used to measure the risk of bias and conducted GRADE evaluation to determine the certainty of evidence. Potential risk factors with positive or negative results were seen. Inplasy Registration: https://inplasy.com/inplasy-2022-4-0109/.
RESULTS
Evidence that risk factors for myopia are mixed, comprising both positive (20) and null (17) findings. In 19 cohort studies on 3578 children, girls were more likely to develop myopia (RR: 1.28 [1.22-1.35]). Myopia can occur at any age, from early childhood to late adulthood. Children whose parents had myopia were more likely to develop myopia. Longer outdoor activities time (RR: 0.97 [0.95-0.98]) and less near-work time (RR: 1.05 [1.02-1.07]) appeared to be significantly decrease the incidence of myopia. Children with lower SE, longer AL, a lower magnitude of positive relative accommodation, worse presenting visual acuity, deeper anterior chamber, and thinner crystalline lens may be related to myopia onset. The burden of myopia in underprivileged countries is higher than in developed countries (RR: 5.28 [2.06-13.48]). The quality of evidence for the evaluated factors was moderate to low or very low.
CONCLUSIONS
Genetic factors, environmental factors (such as excessive use of electronic products, and poor study habits) and lifestyle factors (such as lack of outdoor activities, poor nutrition, etc.) are the main risk factors for myopia in children. Myopia prevention strategies should be designed based on environmental factors, gender, parental myopia and eye indicators in order to explore a lifestyle that is more conducive to the eye health of children.
Topics: Child, Preschool; Female; Humans; Child; Adult; Risk Factors; Accommodation, Ocular; Databases, Factual; Factor Analysis, Statistical; Myopia
PubMed: 37729320
DOI: 10.1371/journal.pone.0291470 -
Cancer Research Communications Sep 2023Financial hardship (FH), defined as adverse patient effects due to cancer costs, is experienced by approximately half of individuals diagnosed with cancer. Many...
Association of Employment Disruptions and Financial Hardship Among Individuals Diagnosed with Cancer in the United States: Findings from a Nationally Representative Study.
UNLABELLED
Financial hardship (FH), defined as adverse patient effects due to cancer costs, is experienced by approximately half of individuals diagnosed with cancer. Many individuals diagnosed with cancer also experience disruptions with their employment. This study examines associations of employment disruptions and FH among a nationally representative sample of individuals diagnosed with cancer in the United States. We utilized 2016/2017 Medical Expenditure Panel Survey Experiences with Cancer data from individuals who worked for pay following cancer diagnosis. Employment disruption included taking extended paid time off work; switching to part-time/less demanding jobs; and/or retiring early due to cancer diagnosis/treatment. FH domains included: material (e.g., borrowing money/financial sacrifices); psychologic (e.g., worrying about medical bills/income); and behavioral (delaying/forgoing healthcare services because of cost). Multivariable logistic regression analyses determined associations of employment disruption and FH. Among 732 individuals with a cancer history, 47.4% experienced employment disruptions; 55.9% experienced any FH. Any FH was significantly more common among individuals with versus without employment disruptions across multiple measures and domains (68.7% vs. 44.5%; value of difference <0.0001). Individuals with employment disruptions were more likely to have any FH [OR, 2.38; 95% confidence interval (CI), 1.62-3.52] and more FHs (OR, 2.76; 95% CI, 1.96-3.89]. This study highlights that employment disruptions are common and significantly associated with multiple domains of FH among individuals with a cancer history. Employer workplace accommodation, physician discussions regarding potential impacts of cancer care on employment, and other policies to minimize employment disruptions among individuals diagnosed with cancer may reduce FH in this vulnerable population.
SIGNIFICANCE
Individuals diagnosed with cancer may have employment disruptions; they may also develop FHs. People with cancer who have employment changes are more likely to also have FHs. Physicians and employers can help individuals with cancer through advancing planning, workplace assistance, and improved medical leave and insurance policies.
Topics: Humans; United States; Financial Stress; Neoplasms; Employment; Workplace; Accommodation, Ocular; Drug-Related Side Effects and Adverse Reactions
PubMed: 37705562
DOI: 10.1158/2767-9764.CRC-23-0157 -
JMIR Pediatrics and Parenting Sep 2023The Structured E-Parenting Support (STEPS) app provides support for parents of children with elevated hyperactivity, impulsivity, inattention, and conduct problems who...
BACKGROUND
The Structured E-Parenting Support (STEPS) app provides support for parents of children with elevated hyperactivity, impulsivity, inattention, and conduct problems who are awaiting clinical assessment. STEPS will be evaluated in a randomized controlled trial (RCT) within the Online Parent Training for the Initial Management of ADHD Referrals (OPTIMA) research program in the United Kingdom. Phase 1 of the OPTIMA tested the feasibility of participants' recruitment and the app's usability.
OBJECTIVE
This study aimed to adapt a digital routine clinical monitoring system, myHealthE, for research purposes to facilitate waitlist recruitment; test using remote methods to screen and identify participants quickly and systematically; pilot the acceptability of the recruitment and assessment protocol; and explore the usability of STEPS.
METHODS
myHealthE was adapted to screen patients' data. Parents' and clinicians' feedback on myHealthE was collected, and information governance reviews were conducted in clinical services planning to host the RCT. Potential participants for the observational feasibility study were identified from new referrals using myHealthE and non-myHealthE methods. Descriptive statistics were used to summarize the demographic and outcome variables. We estimated whether the recruitment rate would meet the planned RCT sample size requirement (n=352). In addition to the feasibility study participants, another group of parents was recruited to assess the STEPS usability. They completed the adapted System Usability Scale and responded to open-ended questions about the app, which were coded using the Enlight quality construct template.
RESULTS
Overall, 124 potential participants were identified as eligible: 121 (97.6%) via myHealthE and 3 (2.4%) via non-myHealthE methods. In total, 107 parents were contacted, and 48 (44.9%) consented and were asked if, hypothetically, they would be willing to participate in the OPTIMA RCT. Of the 28 feasibility study participants who provided demographic data, 21 (75%) identified as White. Their children had an average age of 8.4 (SD 1.7) years and 65% (31/48) were male. During the primary recruitment period (June to July 2021) when 45 participants had consented, 38 (84%) participants agreed hypothetically to take part in the RCT (rate of 19/mo, 95% CI 13.5-26.1), meeting the stop-go criterion of 18 participants per month to proceed with the RCT. All parents were satisfied or very satisfied with the study procedures. Parents (n=12) recruited to assess STEPS' usability described it as easy to navigate and use and as having an attractive combination of colors and visual design. They described the content as useful, pitched at the right level, and sensitively presented. Suggested improvements included adding captions to videos or making the recorded reflections editable.
CONCLUSIONS
Remote recruitment and study procedures for testing a parenting intervention app are feasible and acceptable for parents. The parents felt that STEPS was a useful and easy-to-use digital parenting support tool.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.1186/s40814-021-00959-0.
PubMed: 37695667
DOI: 10.2196/47035 -
ELife Sep 2023Crowding occurs when the presence of nearby features causes highly visible objects to become unrecognizable. Although crowding has implications for many everyday tasks...
Crowding occurs when the presence of nearby features causes highly visible objects to become unrecognizable. Although crowding has implications for many everyday tasks and the tremendous amounts of research reflect its importance, surprisingly little is known about how depth affects crowding. Most available studies show that stereoscopic disparity reduces crowding, indicating that crowding may be relatively unimportant in three-dimensional environments. However, most previous studies tested only small stereoscopic differences in depth in which disparity, defocus blur, and accommodation are inconsistent with the real world. Using a novel multi-depth plane display, this study investigated how large (0.54-2.25 diopters), real differences in target-flanker depth, representative of those experienced between many objects in the real world, affect crowding. Our findings show that large differences in target-flanker depth increased crowding in the majority of observers, contrary to previous work showing reduced crowding in the presence of small depth differences. Furthermore, when the target was at fixation depth, crowding was generally more pronounced when the flankers were behind the target as opposed to in front of it. However, when the flankers were at fixation depth, crowding was generally more pronounced when the target was behind the flankers. These findings suggest that crowding from clutter outside the limits of binocular fusion can still have a significant impact on object recognition and visual perception in the peripheral field.
Topics: Histological Techniques; Visual Perception
PubMed: 37665324
DOI: 10.7554/eLife.85143 -
Scientific Reports Sep 2023This study investigated the accuracy and stability of accommodative and vergence functions in children with and without hyperopia while engaged in two sustained near...
This study investigated the accuracy and stability of accommodative and vergence functions in children with and without hyperopia while engaged in two sustained near tasks. The sustained accommodative and vergence characteristics of participants without refractive correction (n = 92, aged 5-10 years) with and without hyperopia (defined as cycloplegic retinoscopy ≥ + 1.00D and less than + 5.00D) were measured using eccentric infrared photorefraction (PowerRef 3; PlusOptix, Germany). Binocular measures of accommodation and eye position were recorded while participants engaged in 2 tasks at 25 cm for 15 min each: (1) reading small print on an Amazon Kindle and (2) watching an animated movie on liquid crystal display screen. Comprehensive visual assessment, including measurement of presenting visual acuity, amplitude of accommodation, and stereoacuity was conducted. The magnitude of accommodative and vergence responses was not related to refractive error (P > 0.05). However, there were inter-task differences in the accuracy and stability of the accommodative responses across refractive groups (P < 0.05). The relationship between accommodation and vergence was not significant in both tasks (P > 0.05). However, increased accommodative and vergence instabilities were associated with total accommodative response (P < 0.05). Despite having greater accommodative demand, uncorrected hyperopes accommodate comparably to emmetropic controls. However, uncorrected hyperopes have increased instabilities in their accommodative and vergence responses, which may adversely impact their visual experience.
Topics: Child; Humans; Hyperopia; Accommodation, Ocular; Refractive Errors; Refraction, Ocular; Visual Acuity
PubMed: 37658084
DOI: 10.1038/s41598-023-41244-9 -
Investigative Ophthalmology & Visual... Aug 2023The mechanical properties of the crystalline lens are related to its optical function of accommodation, and their changes with age are one of the potential causes for...
PURPOSE
The mechanical properties of the crystalline lens are related to its optical function of accommodation, and their changes with age are one of the potential causes for presbyopia. We estimated the mechanical parameters of the crystalline lens using quantitative optical coherence tomography (OCT) imaging and wavefront sensing data from accommodating participants and computer modeling.
METHODS
Full-lens shape data (from quantitative swept-source OCT and eigenlens representation) and optical power data (from Hartmann-Shack wavefront sensor) were obtained from 11 participants (22-30 years old) for relaxed accommodation at infinity and -4.5 D accommodative demand. Finite element models of lens, capsular bag, zonulae, and ciliary body were constructed using measured lens geometry and literature data, assuming a 60-mN radial force. An inverse modeling scheme was used to determine the shear moduli of the nucleus and cortex of the lens, such that the simulated deformed (maximally stretched) lens matched the participant's lens at -4.5 D.
RESULTS
The shear moduli of the nucleus and cortex were 1.62 ± 1.32 and 8.18 ± 5.63 kPa, on average, respectively. The shear modulus of the nucleus was lower than that of the cortex for all participants evaluated. The average of the two moduli per participant was statistically significantly correlated with age (R2 = 0.76, P = 0.0049).
CONCLUSIONS
In vivo imaging and mechanical modeling of the crystalline lens allow estimations of the crystalline lens' mechanical properties. Differences between nuclear and cortical moduli and their dependency with age appear to be critical in accommodative function and likely in its impairment in presbyopia.
Topics: Humans; Male; Female; Lens, Crystalline; Accommodation, Ocular; Finite Element Analysis; Presbyopia; Tomography, Optical Coherence; Computer Simulation; Healthy Volunteers; Adult
PubMed: 37639248
DOI: 10.1167/iovs.64.11.31