Clin Exp Optom [JOURNAL]
Sun
200 papers
Re: 'Enhancing eye care training: a comprehensive rubric for retinoscopy'.
Singh S, Tripathi A, Khan IJ … +1 more , Singh S
Clin Exp Optom · 2026 Mar · PMID 41865412 · Publisher ↗
Abstract loading — click title to view on PubMed.
Socioeconomic impact assessment of low vision and blindness on patients and households in Thailand.
Chotikavanich S, Phisalprapa P, Kositamongkol C … +10 more , Choopong P, Eiamsamarng A, Muneesri P, Yingyong R, Nujoi W, Dongngam S, Jai-Ai J, Sarinak N, Eksupapan E, Sagan S
Clin Exp Optom · 2026 Mar · PMID 41844146 · Publisher ↗
CLINICAL RELEVANCE: Services for patients with low vision and blindness aim to improve their well-being. This can be achieved by understanding the effects of vision loss on all aspects of life, thereby enabling clinician...
CLINICAL RELEVANCE: Services for patients with low vision and blindness aim to improve their well-being. This can be achieved by understanding the effects of vision loss on all aspects of life, thereby enabling clinicians to design appropriate rehabilitation models. BACKGROUND: This study explored the socioeconomic impact of low vision and blindness, mainly due to untreatable bilateral eye diseases, on individuals and their households. METHODS: A cross-sectional study conducted at a low-vision clinic, in which participants were interviewed regarding socioeconomic changes following visual impairment. Multivariable logistic regression was used to identify predictors of income reduction. RESULTS: A total of 110 patients (mean age 51.4 ± 14.6 years) were enrolled. Retinitis pigmentosa was the leading cause of visual impairment (35.4%), followed by optic atrophy, glaucoma, and age-related macular degeneration. Following vision loss, 41.8% of patients became unemployed. A significant occupational shift occurred, with many transitioning from professionals to having no occupation ( < 0.001). The primary monthly income of patients decreased significantly ( < 0.001), and the proportion of patients with no income increased (7.3-50.9%). Multivariable analysis showed significant associations between primary income reduction and age groups of 31-40 years (adjusted odds ratio [AOR] 10.7, 95% CI: 1.2-96.0, = 0.035), 51-60 years (AOR 8.4, 95% CI: 1.2-59.9, = 0.034), and over 60 years (AOR 46.5, 95% CI: 4.8-445.6, < 0.001). Although not significant, the income decline was greater in patients with poor visual acuity or large peripheral field loss than in those with central scotoma. Most patients had family caregivers who remained employed. CONCLUSION: Low vision and blindness due to incurable bilateral eye disease were associated with substantial income loss and transition out of paid employment, underscoring the need for integrated rehabilitation and social protection policies to address functional and socioeconomic needs.
A randomised controlled trial on the effect of a virtual three-dimensional eye model on patient satisfaction.
Tovey Crutchfield EC, McMahon MS, Ryan TG … +2 more , Meyer J, Chong EW
Clin Exp Optom · 2026 Jul · PMID 41785481 · Publisher ↗
CLINICAL RELEVANCE: Patients forget up to 80% of verbal communication. Visual aids improve understanding and information retention. A virtual, three-dimensional, interactive eye model (the One Right Eye model) is a new t...
CLINICAL RELEVANCE: Patients forget up to 80% of verbal communication. Visual aids improve understanding and information retention. A virtual, three-dimensional, interactive eye model (the One Right Eye model) is a new tool for eye care providers. The utility of three-dimensional models has been studied in other specialities, but never in ophthalmology. BACKGROUND: This study investigates whether the One Right Eye model improves patient satisfaction and understanding during ophthalmic outpatient appointments. METHODS: In a single-centre, open-label, randomised controlled trial, 92 patients were divided into two groups: a control group receiving a standard face-to-face consultation ( = 45) or an interventional group receiving the same consultation supplemented with a virtual eye model demonstration ( = 47). Key outcomes included patient satisfaction, understanding of their ocular condition, and rating of their explanation from their doctor. RESULTS: The interventional group rated their explanation from their doctor statistically significantly higher than the control group (89% versus 69% 'very good', = 0.03). Trends also indicated improved understanding (81% versus 62%, 'completely understood', = 0.05) and greater satisfaction (83% versus 69% 'very satisfied', = 0.12) in the interventional group compared to controls. While the latter two results did not reach statistical significance, the data suggest clinical improvements. CONCLUSION: The virtual three-dimensional eye model improved patients' perception of their explanation from their doctor and likely improved patient satisfaction and understanding of their ophthalmic condition. The One Right Eye, a virtual eyeball model, shows promise to enhance ophthalmic communication.
Statistics in the ophthalmic literature and the alignment with knowledge, attitudes and practices towards statistics.
Jalbert I, Alkhawajah S, Briggs N … +3 more , Lee J, Wei K, Challinor K
Clin Exp Optom · 2026 Mar · PMID 41775271 · Publisher ↗
CLINICAL RELEVANCE: The Entry-Level Competency Standards for Optometry 2022 explicitly state that optometrists must be able to 'find, appraise, analyse, interpret and integrate the best available research to inform clini...
CLINICAL RELEVANCE: The Entry-Level Competency Standards for Optometry 2022 explicitly state that optometrists must be able to 'find, appraise, analyse, interpret and integrate the best available research to inform clinical reasoning and professional decision-making'. BACKGROUND: To enumerate the statistical methods used in the ophthalmic literature and to measure the Knowledge, Attitude, and Practice (KAP) towards statistics in Australian optometrists. A secondary aim was to characterise statistical accessibility. METHODS: The most frequently used statistical methods in articles published in four highly ranked ophthalmic journals over a 12-month period were identified. Two reviewers independently audited articles and assigned analyses to 37 pre-defined categories. A cross-sectional 35-item purposely designed KAP survey was distributed to a random sample of registered Australian practitioners. Descriptive statistics, chi-square tests and odds ratios characterised the statistics used in the ophthalmic literature. KAP results were analysed using Cronbach's alpha and regression (linear, ordinal). RESULTS: The most frequently used category was descriptive statistics, followed by t-tests, contingency tables, nonparametric tests, other, and ANOVA and 77% of articles could be understood with knowledge of the top 10 statistical methods. Ninety-two of 706 (response rate 13%) optometrists (mean age 44 ± 12 years, 54% female) returned the survey. Optometrists demonstrated moderate knowledge (44% ± 20%) and attitude (47% ± 15%) and a poor practice (31% ± 31%) towards statistics. Females had a lower attitude score, practice, and total scores than males (all ≤ 0.02). Optometrists had best knowledge of T-test yet 75% had a little or no confidence in 'the knowledge and skills required to interpret all inferential statistics'. CONCLUSION: Optometrists must understand descriptive statistics and some basic inferential statistics to critically appraise the literature. The KAP can pinpoint gaps and indicate where and how education should be targeted. The validated KAP is available for use in other settings.
Impact of digital versus faxed e-referrals on triage decisions in a medical retina clinic.
McGuinness MB, Waugh M, Hickey DG … +3 more , van Wijngaarden P, Mancuso C, Larsen P
Clin Exp Optom · 2026 Mar · PMID 41775269 · Publisher ↗
CLINICAL RELEVANCE: Efficient triage is essential for managing increasing demand in resource-constrained ophthalmic services. Referral systems that enable structured clinical information and high-quality ocular imaging m...
CLINICAL RELEVANCE: Efficient triage is essential for managing increasing demand in resource-constrained ophthalmic services. Referral systems that enable structured clinical information and high-quality ocular imaging may support prioritisation according to clinical need and improve service efficiency. BACKGROUND: This study compared triage decisions made using traditional faxed referrals to those made using digital referrals with high-resolution retinal imaging in an Australian public hospital medical retina outpatient clinic. METHODS: Two ophthalmologists independently reviewed referrals for 100 patients ( = 73 for assessment of diabetic eye disease, = 27 for other medical retina conditions). Referrals were originally generated by optometrists using a digital referral platform with colour fundus photographs and/or optical coherence tomography images and were transmitted to the hospital via fax (2018-2021). Study assessors were masked to original triage decisions and post-referral clinical findings. Each assessor graded the urgency of an appointment using the faxed version of the referral prior to assessing the corresponding digital referral file via a five-level triage classification system. Medical records were retrospectively reviewed to evaluate the alignment between triage decisions and downstream clinical outcomes. RESULTS: At the time of original referral, 28% of patients were classified as requiring an appointment within a week, and 8% were deemed not to need an appointment. Agreement between assessors was moderate (exact match in triage level for 59.5% of cases across referral formats). Assessors were more likely to downgrade appointment urgency or reject referrals when grading digital files compared to when assessing the matched faxed referrals (45% downgraded urgency for Assessor 1, 13% Assessor 2). CONCLUSIONS: Digital referrals with high-resolution imaging may improve triage accuracy in medical retina clinics by better aligning appointment urgency with clinical need. Greater alignment between referring optometrists and specialist services through interoperable systems, structured referral protocols, and secure image sharing may further enhance efficiency and communication across care settings.
Effects of steam warming eye masks on choroidal perfusion, visual function, dry eye measures, and symptoms in children with myopia.
Gao K, Xu Y, Saita Y … +3 more , Liu H, Cai M, Xing G
Clin Exp Optom · 2026 Mar · PMID 41771265 · Publisher ↗
CLINICAL RELEVANCE: Innovative eye warming therapies may enhance comfort and ocular health in paediatric patients, potentially aiding in myopia management. Recognising the impact of ocular surface and perfusion improveme...
CLINICAL RELEVANCE: Innovative eye warming therapies may enhance comfort and ocular health in paediatric patients, potentially aiding in myopia management. Recognising the impact of ocular surface and perfusion improvements can guide optometrists in adopting non-invasive, supportive interventions to promote eye health and prevent progression of myopia in children. BACKGROUND: This study investigates the effects of steam-warming eye masks on the potential prevention and management of myopia in Chinese children. METHODS: A single-arm design was used, enrolling myopic and pre-myopic children at Shanghai Aier Puliang Eye Hospital from July 8 to 1 August 2024. All participants underwent treatment with steam-warming eye masks. RESULTS: The study included 127 eyes from 68 children, with 31 classified as pre-myopic and 37 as myopic. The application of the steam warming eye mask led to significant improvements in key ocular parametres. Choroidal perfusion in the central retina increased significantly in the 0-9 mm and 3-9 mm regions ( < 0.001). Symptom scores for eye strain, dryness, and soreness decreased by 60.75%, 22.96%, and 33.24%, respectively ( < 0.001). Ocular amplitude of accommodation and blink stability improved by 13.90% ( < 0.001) and 25.26% ( < 0.001), respectively. No significant changes were found in visual acuity or refractive error, nor in tear meniscus height ( = 0.117). CONCLUSION: Steam warming eye mask significantly improved ocular comfort, visual function, and choroidal perfusion in children, suggesting its potential as a practical tool for managing paediatric ocular health and controlling myopia.
An unusual foreign object on the intraocular lens.
Örnek K
Clin Exp Optom · 2026 Mar · PMID 41771264 · Publisher ↗
Abstract loading — click title to view on PubMed.
Blink rate self-regulation, tear volume and ocular symptoms in expert and naïve action video game players.
Argilés M, Ruiz-Sanchez P, Ballesteros-Sánchez A … +2 more , Valentino M, Cardona G
Clin Exp Optom · 2026 Mar · PMID 41764854 · Publisher ↗
CLINICAL RELEVANCE: Alterations in blink rate and dynamics are common during visually demanding tasks such as video gaming or digital device use, leading to tear film instability and ocular and visual symptoms. BACKGROUN...
CLINICAL RELEVANCE: Alterations in blink rate and dynamics are common during visually demanding tasks such as video gaming or digital device use, leading to tear film instability and ocular and visual symptoms. BACKGROUND: Sustained visual attention during gaming may reduce blink frequency and alter tear production, increasing ocular surface symptoms. The aim of this study was to determine whether experienced action video game (AVG) players exhibited adaptations in blink rate and tear volume compared with non-video game (NVG) players, and to explore the relationship between these adaptations and ocular symptoms. METHODS: Thirty participants (17 AVG and 13 NVG) were enrolled. All participants played Call of Duty: Modern Warfare® (Zombies mode) for 25 minutes under controlled conditions. Blink rate was recorded at baseline and during dynamic and non-dynamic scenes using the Pupil Core eye tracker. Tear volume was assessed with the Schirmer test before and after gameplay. Dry eye symptoms were evaluated using the SANDE questionnaire at baseline and the IOSS questionnaire every five minutes during gameplay. RESULTS: No significant group differences were observed at baseline in blink rate, tear volume, or SANDE scores (all > 0.05). During gameplay, AVG players exhibited significantly lower blink rates than NVG players in both dynamic (5.94 ± 2.61 vs. 7.88 ± 2.40 blinks/min, = 0.045) and non-dynamic scenes (10.44 ± 3.34 vs. 13.73 ± 3.82 blinks/min, = 0.018). Schirmer test values did not differ significantly pre - post session ( > 0.05). IOSS scores increased during gameplay in both groups ( < 0.0001), appearing earlier in NVG players. CONCLUSION: Expert AVG players demonstrate altered blink behaviour compared with NVG players, possibly reflecting adaptations that minimise visual information loss. These adaptations may influence ocular surface health during prolonged visual tasks. Further research is warranted to clarify the mechanisms underlying these changes.
Design and baseline characteristics of a prospective, longitudinal study of myopia progression in young adults (MAP).
Khan HA, Tran H, Naduvilath TJ … +3 more , Tahhan N, Ha T, Sankaridurg P
Clin Exp Optom · 2026 Mar · PMID 41764852 · Publisher ↗
CLINICAL RELEVANCE: Adult myopia is not well understood, with limited studies investigating the factors that influence its progression during and beyond adolescence. Understanding myopia progression and the associated ri...
CLINICAL RELEVANCE: Adult myopia is not well understood, with limited studies investigating the factors that influence its progression during and beyond adolescence. Understanding myopia progression and the associated risk factors in adulthood would help clinicians identify young adult myopes at greater risk of progression, ensuring they receive appropriate clinical attention. BACKGROUND: Myopia progression in young adults (MAP) is a 1-year prospective, longitudinal, multicentre study to document the progression of myopia and associated risk factors in young adults. The aim of this article is to report the baseline characteristics of the study population. METHODS: Participants between 18 and 26 years of age and spherical equivalent refractive error (SER) between -0.50 and -6.00 D were recruited at two sites: Sydney and Ho Chi Minh (HCM). Data, including central and peripheral cycloplegic refractive errors, central and peripheral axial length (AL), and myopia-related lifestyle factors, were recorded at baseline and will be collected every 6 months. RESULTS: One-hundred and twenty-six young adults (63 participants at Sydney and HCM, respectively) aged 21.3 ± 2.3 years (20.6 ± 2.3 vs 22.0 ± 2.0, < 0.001), SER of -2.8 ± 0.8D (-2.7 ± 1.3 vs -3.0 ± 1.1, = 0.17), and AL 24.8 ± 0.8 mm (25.0 ± 0.8 vs 24.7 ± 0.8, = 0.033) were enrolled.The overall sample included 98 (77.8%) Asians, with 35 (79.4%) in Sydney and 63 (100%) in HCM. Myopes in HCM reported an older age at the onset than myopes in Sydney ( < 0.001). In HCM, greater time was spent on screens ( = 0.030) and less time spent outdoors than in Sydney ( < 0.001). Multivariate analysis indicated that younger age at onset was associated with a longer baseline AL, a more myopic baseline SER and females had a shorter baseline AL. CONCLUSION: The design and baseline characteristics of MAP are reported. Baseline analyses indicate that younger age at onset is associated with more myopic SER and longer AL in young adults.
Anterior polar cataract with type 2 persistent pupillary membrane.
Nadeem S
Clin Exp Optom · 2026 Feb · PMID 41734775 · Publisher ↗
Abstract loading — click title to view on PubMed.
Apps for people with vision impairment: an international review of practitioner suggestions and app availability.
Gothwal VK, Miller A, Boon MY … +3 more , Subramanian A, Malkin A, Bittner AK
Clin Exp Optom · 2026 Feb · PMID 41734772 · Publisher ↗
CLINICAL RELEVANCE: Assistive smartphone apps play an integral role in supporting people with vision impairment (VI). Low vision rehabilitation (LVR) professionals need an understanding of these tools to provide effectiv...
CLINICAL RELEVANCE: Assistive smartphone apps play an integral role in supporting people with vision impairment (VI). Low vision rehabilitation (LVR) professionals need an understanding of these tools to provide effective, up-to-date guidance to help patients identify options that can improve daily functioning. BACKGROUND: Smartphones and assistive apps are widely used by people with VI, offering versatile and portable tools which support daily activities and promote independence. However, the volume and variability of apps create challenges for practitioners particularly as apps are updated frequently and artificial intelligence is gaining prominence. The purpose of this study is to describe how practitioners identify and make app recommendations. METHODS: An international cross sectional survey of LVR professionals was conducted to identify commonly recommended visual assistive apps. Responses were categorised by country income level and professional group of respondents. A concurrent search of English-language app stores, using predefined terms was performed to identify and compare assistive app availability with practitioner recommendations. RESULTS: App recommendation patterns varied by practitioner role and region. Optometrists frequently recommended magnifier apps, while therapists tended to suggest computer vision and sighted guide apps. Most commonly recommended apps were Seeing AI and Be My Eyes in high-income countries, and weZoom Magnifying glass and Be My Eyes in lower-income countries. Only two of ten most frequently recommended apps, Seeing AI and Be My Eyes, appeared consistently in app store searches across all four countries and both Android and iOS operating systems. CONCLUSION: Comparing practitioner recommendations reflects potential differences in access, awareness, training, device availability, and patient needs. Understanding these insights helps to inform clinical decision-making and encourage more consistent and tailored support to diverse patient populations. Given the rapid pace of app development, regular review of the most suitable apps and clear dissemination of reliable information to practitioners are essential for informed evidence-based decision making.
Implementation and evaluation of an optometry-led satellite outpatient clinic for patients with diabetes.
Warren J, Khadka J, Chipchase L … +3 more , Lake S, Chakraborty R, Anstice N
Clin Exp Optom · 2026 Feb · PMID 41734770 · Publisher ↗
CLINICAL RELEVANCE: Collaborative models involving optometrists and ophthalmologists can provide safe, evidence-based, quality care, enhance access to diabetic eye care services, and alleviate pressure on hospital-based...
CLINICAL RELEVANCE: Collaborative models involving optometrists and ophthalmologists can provide safe, evidence-based, quality care, enhance access to diabetic eye care services, and alleviate pressure on hospital-based ophthalmology services. BACKGROUND: Australian hospital-based ophthalmology services face high demand, far exceeding supply. However, many patients with non-sight threatening pathologies may be safely assessed in community settings. This study explored the safety, effectiveness and patient satisfaction of a collaborative diabetic eye care model between a university optometry-led clinic and a public ophthalmology department. METHODS: The program implemented a collaboratively developed clinical protocol that minimised the need for direct ophthalmology oversight. Following implementation, a retrospective review of clinical data, post-visit patient satisfaction surveys and a randomised audit of clinical records assessing adherence to care protocols was undertaken. Data were evaluated to determine the models effectiveness in ensuring timely access to care, maintaining clinical safety and patient satisfaction. RESULTS: Over 18 months, 770 appointments (522 first visits, 248 reviews) were completed. Eighty-one (10.5%) appointments required virtual ophthalmology review and a further 24 (3.1%) required transfer to tertiary ophthalmology. Most (98%) of patients were satisfied with the care they received and adherence to minimum clinical recording, clinical testing and management was 98.7%, 98.9% and 100%, respectively. At the first visit, only 36 (17.5%) patients were seen within 30 days of their recommended review time, compared to 187 (91.2%) at the time of their second visit. Among the 20 patients referred to the hospital for further evaluation and treatment, there was an 85% agreement (K = 0.80) in clinical diagnosis between the optometrist and ophthalmologist. CONCLUSION: The model demonstrated that a primary-tertiary care partnership can maintain high standards while improving service efficiency. A collaborative model with reduced dependence on direct ophthalmology oversight can deliver quality care, improve timely access and follow-up for patients with diabetes, with good patient satisfaction.
Using low-dose atropine in control of intermittent exotropia.
Dehghanian Nasrabadi F, Mirzajani A, Soltan Sanjari M … +2 more , Jafarzadehpur E, Abolghasemi J
Clin Exp Optom · 2026 May · PMID 41734769 · Publisher ↗
CLINICAL RELEVANCE: There are a variety of non-surgical methods to control and correct intermittent exotropia. Identifying the effectiveness of an alternative method that carries minimal risk and ocular symptoms can guid...
CLINICAL RELEVANCE: There are a variety of non-surgical methods to control and correct intermittent exotropia. Identifying the effectiveness of an alternative method that carries minimal risk and ocular symptoms can guide clinicians in optimising patient care. BACKGROUND: The aim of this work is to evaluate the efficacy of 0.05% atropine eye drops on exotropia control in children with intermittent exotropia. METHODS: This parallel-group, controlled, randomised clinical trial was conducted on children aged 2-8 years with intermittent exotropia who had been admitted at the Paediatric Ophthalmology and Strabismus Clinic of Rasoul Akram Hospital, Tehran, Iran. Participants were randomly assigned in a 1:1 ratio to the low dose (0.05%) atropine or overminus lens groups and followed for 3 months. Deviation control was evaluated using 3-point and 6-point control scales. RESULTS: A total of 21 participants in each group (mean (SD) age, 5.1 (2.34) years; 14 males [33.3%]) were included in this study. According to both 3- and 6-point control scales, deviation control 1 and 3 months after the intervention was significantly better than before in each group ( < 0.05). According to the 3-point control scale, in the low-dose atropine group, the distance deviation control at 3 months was significantly improved than at 1 month ( = 0.031). According to the 6-point control scale, distance and near deviation controls at 3 months were significantly improved than at 1 month in the overminus lens group ( = 0.005 and = 0.005, respectively). In the low-dose atropine group, near deviation control at 3 months was significantly better than at 1 month ( = 0.007). CONCLUSION: Low dose atropine appears to have the same level of effectiveness as overminus lenses, and induces good control in intermittent exotropia. Therefore, it may be an efficient alternative to overminus lenses.
Assessing facial asymmetry before and after early treatment of abnormal head posture caused by ocular problems.
Khorrami-Nejad M, Akbari MR, Shakor YA … +1 more , Kangari H
Clin Exp Optom · 2026 Feb · PMID 41730263 · Publisher ↗
CLINICAL RELEVANCE: Identifying and managing ocular causes of abnormal head posture (AHP) in children is crucial, as early intervention may not only improve visual function but also prevent the development and progressio...
CLINICAL RELEVANCE: Identifying and managing ocular causes of abnormal head posture (AHP) in children is crucial, as early intervention may not only improve visual function but also prevent the development and progression or even resolve facial asymmetry. BACKGROUND: The effect of early AHP treatment on halting the development of facial asymmetry, or even eliminating or decreasing it with age, has not yet been evaluated. METHODS: In this prospective observational study, the quantitative and qualitative facial asymmetry of paediatric patients with superior oblique palsy ( = 8, 53.3%) and Duane retraction syndrome ( = 7, 46.7%), who had AHP and underwent strabismus surgery, was assessed before and five years after the operation. Captured photographs of the face were analysed by CorelDRAW Graphics Suite X7 software to calculate the relative facial size (RFS) and facial angle as well as evaluate hemihypoplasia, columella deviation, one-side cheek and nostril compression. RESULTS: The median preoperative age was 4.5 years (IQR 2.5; range 1-5 years). Preoperative facial asymmetry in 14 (93.3%) patients decreased to 10 (66.7%) postoperatively. On evaluating quantitative facial asymmetry parameters pre- and postoperatively, the median facial angle changed from 0.36° (IQR 1.96°) to 0.00° (IQR 1.37°), and the median RFS changed from 1.006 (IQR 0.031) to 1.000 (IQR 0.019). Before surgery, hemihypoplasia, one-side cheek and nostril compression, and columella deviation were observed in 10 (66.7%), 8 (53.3%), 9 (60.0%), and 2 (13.3%) cases, respectively. Following surgery, there was a reduction of 20.1% in one-side face, 46.6% in cheek, and 46.7% in nostril compression. The frequency of one-side cheek and nostril compression was significantly decreased following surgery ( = 0.011 and = 0.012, respectively). CONCLUSION: Timely strabismus intervention for the treatment of AHP may help enhance facial symmetry in children. However, as this was an observational study without a control group, a causal relationship cannot be established.
Pupil size as a predictor of visual outcomes with an enhanced monofocal intraocular lens.
Lee SH, Chun YS, Kim KW
Clin Exp Optom · 2026 Feb · PMID 41702642 · Publisher ↗
CLINICAL RELEVANCE: Pupil size plays a critical role in the optical performance of modern intraocular lenses, including enhanced monofocal intraocular lens. BACKGROUND: Enhanced monofocal aspheric intraocular lenses, suc...
CLINICAL RELEVANCE: Pupil size plays a critical role in the optical performance of modern intraocular lenses, including enhanced monofocal intraocular lens. BACKGROUND: Enhanced monofocal aspheric intraocular lenses, such as the Tecnis Eyhance ICB00, are designed to provide improved intermediate vision without compromising distance acuity. However, visual outcomes may vary among patients, and pupil size has been proposed as a contributing factor. Accurate assessment of pupil size using anterior segment swept-source optical coherence tomography (AS SS-OCT) devices may help identify patients who would benefit most from these intraocular lenses. METHODS: This retrospective study included 64 eyes from 45 patients who underwent uncomplicated cataract surgery with implantation of the Tecnis Eyhance ICB00 intraocular lens. Preoperative pupil size was measured using both the Anterion® and IOLMaster 700 AS SS-OCT devices; postoperative measurements at one month were obtained with Anterion. UCDVA was analysed based on pupil size thresholds of 3.5 mm and 4.0 mm. intraocular lens thickness profiles of Eyhance and a conventional monofocal intraocular lens (Tecnis ZCB00) were compared. RESULTS: Postoperative pupil size ≥4.0 mm (Anterion) was associated with significantly better UCDVA (LogMAR 0.08 ± 0.08) compared to <4.0 mm (LogMAR 0.19 ± 0.08; < 0.001). A similar trend was found for preoperative pupil size measured by Anterion, while IOLMaster 700 measurements did not correlate with visual outcomes. Anterion consistently yielded larger pupil sizes than IOLMaster 700 (mean difference: 0.56 mm, < 0.001). The Eyhance intraocular lens exhibited a steeper curvature within the central 2.0 mm zone compared to the ZCB00. CONCLUSION: Preoperative and postoperative pupil size ≥4.0 mm, as measured by Anterion, was associated with better UCDVA with enhanced monofocal intraocular lenses. However, further research is needed to confirm if this results from the lens design or physiological confounders like diffraction. Measurement discrepancies between AS SS-OCT devices highlight the need for standardisation.
Children's Eye Screening South Australia (CESSA): diagnostic performance of a vision screening programme for 7-9-year-olds.
Haines C, Anstice NS, Chakraborty R
Clin Exp Optom · 2026 Feb · PMID 41702628 · Publisher ↗
CLINICAL RELEVANCE: Standardised paediatric vision screening programmes enable timely detection of refractive errors and other amblyopia risk factors. School-based programmes that use appropriate referral thresholds for...
CLINICAL RELEVANCE: Standardised paediatric vision screening programmes enable timely detection of refractive errors and other amblyopia risk factors. School-based programmes that use appropriate referral thresholds for distance visual acuity, combined with photorefraction, can improve detection of amblyopia and refractive errors in children. BACKGROUND: The Children's Eye Screening South Australia study evaluated the performance of a vision screening protocol for detecting common vision disorders in a school-based sample of children aged 7-9 years, while characterising prevalent vision conditions in this population. METHODS: A total of 159 children from 15 schools underwent school-based screening, including distance and near vision, retinoscopy, photorefraction, stereoacuity, heterophoria and ocular alignment. All children who failed screening, and 10% of those who passed, underwent a comprehensive cycloplegic eye examination to establish a clinical diagnosis against which screening outcomes were compared. Screening test accuracy was evaluated using predefined fail criteria and diagnostic performance using the area under the curve (AUC) of Receiver Operating Characteristic curves. RESULTS: Twenty-eight children (17.6%) failed screening, and cycloplegic eye examination confirmed a vision disorder in 27 children (17.0% of the total sample), 16.4% had significant refractive errors and 2.5% had suspected amblyopia. Standard distance vision fail criteria (≥0.26 logMAR) demonstrated low sensitivity (33.3%), but improved to 59.3% using > 0.04 logMAR. Retinoscopy and photorefraction showed high screening test accuracy (AUC, 0.91 and 0.86). Combining distance vision with photorefraction significantly improved accuracy (AUC, 0.87, < 0.001), with modest, non-significant gains from adding stereoacuity or heterophoria. CONCLUSIONS: Seventeen percent of a school-based sample of South Australian children aged 7-9 years were identified as having vision disorders, such as refractive errors and amblyopia risk factors, effectively detected using a combination of vision measurement and photorefraction. These findings support improved vision surveillance in children in South Australia, which could include an instrument-based vision screening programme with appropriate thresholds.
A comparison of water drinking test among normotensive and ocular hypertensive eyes with pseudoexfoliation.
Sofi RA, Tripathi VK, Dar MY … +4 more , Najeeb R, Qureshi T, Gupta V, Panigrahi A
Clin Exp Optom · 2026 Feb · PMID 41678957 · Publisher ↗
CLINICAL RELEVANCE: In pseudoexfoliation, the Water Drinking Test (WDT) can unmask Intraocular pressure (IOP) behaviour not evident at baseline. Normotensive and ocular hypertensive pseudoexfoliation eyes need to be segr...
CLINICAL RELEVANCE: In pseudoexfoliation, the Water Drinking Test (WDT) can unmask Intraocular pressure (IOP) behaviour not evident at baseline. Normotensive and ocular hypertensive pseudoexfoliation eyes need to be segregated based on their risk profile. BACKGROUND: Pseudoexfoliation is associated with elevated and fluctuating IOP and a heightened risk of glaucoma. While WDT is used to reveal peak IOP and fluctuation, comparative data between normotensive and ocular hypertensive PEX eyes are limited. WDT responses were compared across these subgroups to identify high-risk phenotypes. METHODS: In this cross-sectional observational study, 137 treatment-naïve pseudoexfoliation eyes without glaucomatous optic neuropathy underwent WDT (1 L water over 10 min). IOP was measured at baseline, 15, 30, 45, and 60 min. Eyes were classified as normotensive (≤21 mmHg; = 95) or hypertensive (>21 to < 30 mmHg; = 42). Derived metrics included IOPΔ, IOPnet, IOPrange, and IOPfluct; WDT positivity was predefined (Δ≥8 mmHg or ≥30%). Group comparisons used t-tests/χ as appropriate. RESULTS: Both groups showed significant post-WDT IOP elevation. Hypertensive eyes had higher IOP at every time point (all < 0.001) and more frequently reached IOPmax ≥30 mmHg (48% vs 11%, < 0.001). Normotensive eyes more often exhibited IOPnet > 2 mmHg at 60 min (64% vs 40%, = 0.04). WDT positivity was comparable (25% vs 36%, = 0.30). Derived fluctuation metrics (IOPΔ, IOPnet, IOPrange, IOPfluct) were not statistically different between groups (all > 0.05). CONCLUSION: Despite similar fluctuation amplitudes, normotensive PEX eyes demonstrate delayed recovery (greater IOPnet), whereas hypertensive PEX eyes are prone to extreme peaks (IOPmax ≥30 mmHg). WDT provides complementary risk stratification in PEX, supporting tailored follow-up and earlier intervention in eyes exhibiting high-risk response patterns.
Impact of occupational visual demands on the progression of presbyopia in civilian pilots.
Turkoglu C
Clin Exp Optom · 2026 Feb · PMID 41662831 · Publisher ↗
CLINICAL RELEVANCE: Presbyopia, an age-related decline in near vision, significantly impacts daily functioning and work performance in visually demanding professions. Understanding occupational factors influencing presby...
CLINICAL RELEVANCE: Presbyopia, an age-related decline in near vision, significantly impacts daily functioning and work performance in visually demanding professions. Understanding occupational factors influencing presbyopia is crucial for optimizing vision screening and management strategies. BACKGROUND: This study aimed to compare the prevalence and progression of presbyopia in civilian pilots aged 40 and above with an age-matched control group lacking aviation experience. METHODS: A retrospective cross-sectional study involved 1124 participants (159 females, 965 males). The study group comprised civilian aviators aged 40+ with at least five years of flying experience, while controls had no aviation history. Comprehensive visual assessments were performed. RESULTS: Civilian aviators exhibited significantly lower near addition values compared to controls (mean +0.59 ± 0.71 D vs. +1.61 ± 0.71 D; < 0.01). Gender-specific analysis revealed a more pronounced difference in female pilots versus female controls ( < 0.01). CONCLUSION: Civilian pilots aged 40 and above may experience delayed onset or slower progression of presbyopia. These findings suggest that aviation-related visual demands and proactive ocular health practices might mitigate presbyopia development. Further research is needed to validate these findings and assess long-term occupational visual influences.
Changes in inflammatory blood parameters in patients with radiation-related complications due to radiotherapy for uveal melanoma.
Algedik Tokyürek MÖ, Koç İ, Öztürk E … +2 more , Yazıcı G, Kıratlı H
Clin Exp Optom · 2026 Feb · PMID 41662828 · Publisher ↗
CLINICAL RELEVANCE: Radiation retinopathy is a common cause of visual impairment following ocular radiotherapy, and systemic inflammatory activity may contribute to retinal vascular damage. Understanding inflammatory mec...
CLINICAL RELEVANCE: Radiation retinopathy is a common cause of visual impairment following ocular radiotherapy, and systemic inflammatory activity may contribute to retinal vascular damage. Understanding inflammatory mechanisms may support earlier identification of patients at risk and improve clinical monitoring strategies. BACKGROUND: Radiation retinopathy is a vision-threatening complication of radiotherapy for uveal melanoma and has traditionally been considered a localised microvascular disorder. However, the potential contribution of systemic inflammation to its development remains unclear. METHODS: A retrospective review was undertaken of hospital records of patients diagnosed with radiation retinopathy after stereotactic photon radiotherapy for uveal melanoma. Demographic characteristics, tumour features, and systemic inflammatory blood parameters were evaluated before and after the onset of retinopathy. RESULTS: A total of 97 patients were included, with 52.6% female participants. Most tumours were classified as T1 or T2. The median time to retinopathy diagnosis was 24 months. All systemic inflammatory blood parameters showed significant increases after the development of radiation retinopathy (all < 0.05). CONCLUSION: It is concluded that radiation retinopathy is associated with systemic inflammatory activation, suggesting that inflammatory processes may extend beyond localised retinal injury, and therefore may serve as accessible biomarkers for disease monitoring.
Enhancing eye care training: a comprehensive rubric for retinoscopy.
Yelagondula VK, Dutta S, Rizwan M … +3 more , Madhukuri S, Reddy SP, Pathengay A
Clin Exp Optom · 2026 Jul · PMID 41662769 · Publisher ↗
CLINICAL RELEVANCE: Retinoscopy is an important ophthalmic technique for objectively assessing refractive errors and detecting ocular abnormalities, especially in patients unable to undergo subjective refraction. The dev...
CLINICAL RELEVANCE: Retinoscopy is an important ophthalmic technique for objectively assessing refractive errors and detecting ocular abnormalities, especially in patients unable to undergo subjective refraction. The development and standardisation of retinoscopy rubrics foster a more equitable and consistent learning experience for trainees, ultimately leading to improved patient care. BACKGROUND: Retinoscopy is an essential skill in ophthalmic examination. Despite the use of various rubrics in eye care, standardised rubric for retinoscopy is still unavailable. This study aims to develop and validate a comprehensive rubric for retinoscopy, addressing the lack of standardised assessment tools in optometric and ophthalmic education. METHODS: The authors developed a retinoscopy rubric, which was assessed for face and content validity by an international group of optometry educators. Cohen's alpha was calculated to determine interobserver reliability. RESULTS: The final rubric consists of 19 individual items for performance criteria. The revised rubric demonstrated face validity, with an overall percentage of agreement of 95.71%. The content validity index (S-CVI/Ave) was 0.99. Most of the individual rubric items showed moderate to strong interobserver reliability. CONCLUSION: The retinoscopy rubric, a validated evaluation tool for objective refraction, demonstrates strong validity and reliability. It holds significant potential to enhance ophthalmic education by providing a consistent and effective framework for assessing retinoscopy skills.
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