Clin Exp Optom [JOURNAL]
Sun
200 papers
Identifying potential drug targets for seborrhoeic dermatitis and dry eye syndrome through mendelian randomisation analysis.
Zuo H, Zhou S, Feng Z
Clin Exp Optom · 2026 Jul · PMID 41543138 · Publisher ↗
CLINICAL RELEVANCE: Patients with seborrhoeic dermatitis frequently experience comorbid dry eye syndrome, which complicates clinical management. Identifying shared drug targets is a promising strategy for developing nove...
CLINICAL RELEVANCE: Patients with seborrhoeic dermatitis frequently experience comorbid dry eye syndrome, which complicates clinical management. Identifying shared drug targets is a promising strategy for developing novel therapies that concurrently address both conditionggs. BACKGROUND: Ocular involvement is common in seborrhoeic dermatitis and frequently leads to dry eye syndrome, underscoring the importance of identifying shared drug targets for dual-pathway therapy. METHODS: A two-sample Mendelian Randomisation (MR) analysis was conducted to identify potential drug targets. Sensitivity and colocalization analyses were performed to confirm shared targets. External replication and summary-data-based MR were used to validate target accuracy. Gene enrichment analysis and drug prediction were employed to explore functional pathways and potential therapeutics. RESULTS: MR analysis revealed 65 plasma proteins causally associated with seborrhoeic dermatitis ( < 0.05) and 68 with dry eye syndrome ( < 0.05). Colocalization and external replication demonstrated that KRT5 exhibited significant positive causal associations with both seborrhoeic dermatitis (OR = 1.535, 95%CI: 1.092-2.159, = 0.014) and dry eye syndrome (OR = 2.219, 95%CI: 1.267-3.887, = 0.005). Gene enrichment analysis indicated that target genes were primarily involved in keratinisation pathways. Drug prediction identified imipenem monohydrate as a potential therapeutic candidate. CONCLUSION: KRT5 is identified as a promising drug target for both conditions, with imipenem monohydrate as a potential treatment. These findings provide novel therapeutic avenues.
Recurrent cystoid macular oedema associated with high-dose cytarabine therapy.
Bezci Aygün F, Rustamova N, Kadayıfçılar S
Clin Exp Optom · 2026 Jan · PMID 41543136 · Publisher ↗
PURPOSE: To describe a rare case of recurrent, reversible cystoid macular oedema (CME) associated with high-dose cytarabine therapy in a patient with acute myeloid leukaemia (AML). CASE PRESENTATION: A 39-year-old woman...
PURPOSE: To describe a rare case of recurrent, reversible cystoid macular oedema (CME) associated with high-dose cytarabine therapy in a patient with acute myeloid leukaemia (AML). CASE PRESENTATION: A 39-year-old woman with AML developed recurrent bilateral visual disturbances following multiple cycles of high-dose cytarabine monotherapy. After each chemotherapy cycle, spectral-domain optical coherence tomography revealed cystoid intraretinal spaces predominantly involving the outer nuclear and outer plexiform layers. Fluorescein angiography demonstrated faint perifoveal leakage without the classic petaloid pooling pattern of CME. Macular oedema resolved spontaneously after the initial treatment cycles but showed progressively delayed regression after subsequent exposures. No systemic or ocular risk factors for CME were identified, and there was no evidence of inflammatory, vascular, or infectious retinal disease. CONCLUSION: High-dose cytarabine may rarely cause recurrent and reversible CME as a manifestation of posterior segment toxicity. The underlying mechanism is likely related to transient Müller cell dysfunction or retinal pigment epithelium impairment rather than disruption of the blood-retinal barrier. Awareness of this entity is essential to ensure prompt recognition and appropriate management, including consideration of treatment modification when clinically feasible.
Translational changes: evidence around efficacy of red-light therapy in myopia management.
Wood J, Dykgraaf J, Lallu J
Clin Exp Optom · 2026 Jan · PMID 41529261 · Publisher ↗
The global prevalence of myopia has continued to increase significantly over time. By 2050, it has been estimated that approximately half of the world's population will be myopic. Additionally, 10% of myopes will be high...
The global prevalence of myopia has continued to increase significantly over time. By 2050, it has been estimated that approximately half of the world's population will be myopic. Additionally, 10% of myopes will be highly myopic, which greatly increases the risk of sight-threatening ocular complications including retinal detachments and myopic maculopathies. Significant global efforts have been invested in the development of interventions and strategies to prevent myopia onset and progression. Several different myopia control treatments are now available to clinicians for this purpose. Additionally, evidence has suggested that increased outdoor time and illuminance may have protective effects against myopia progression. Recently, the use of repeated low-level red-light therapy devices has become an emerging novel intervention for myopia. While current research surrounding red light therapy, mostly occurring in China, has suggested promising results for myopia management, there is still limited long-term research into the efficacy and safety of red-light therapy. This review aims to present a comprehensive overview of the current evidence surrounding the efficacy and safety of red-light therapy as a myopia control treatment, and to highlight the importance for further global research efforts for this novel treatment.
Comparing conventional and 3D semi-automated lighting slit lamps for anterior segment examinations in a remote eye care setting.
Sattarpanah Karganroudi S, Samet MR, Amaniss Y … +2 more , Michaud L, Hanssens JM
Clin Exp Optom · 2026 Jul · PMID 41525496 · Publisher ↗
CLINICAL RELEVANCE: Accurate and timely assessment of the anterior segment of the eye is vital for the early detection and management of ocular conditions, like cataracts, keratitis, and other corneal diseases. BACKGROUN...
CLINICAL RELEVANCE: Accurate and timely assessment of the anterior segment of the eye is vital for the early detection and management of ocular conditions, like cataracts, keratitis, and other corneal diseases. BACKGROUND: This study compares two methods for examining the anterior segment of the eye: conventional slit lamp examination, the gold standard, and a novel three-dimensional semi-automated lighting slit lamp examination. The objectives are to evaluate the correlation between grading scores of ocular signs using standardised scales and determine the sensitivity and specificity of the novel approach to diagnosis. METHODS: A randomised, prospective, and repeated-measures design was employed. Participants, candidates for cataract surgery, were recruited from an ophthalmology clinic and included pre-operative and short-term post-operative groups. The pre-operative group was assessed for cataracts and iridocorneal angles, while the post-operative group was evaluated for anterior chamber reactions, keratitis, and corneal opacities. Standardised grading scales, like Contact Lens Complications Report, Standardisation of Uveitis Nomenclature, Van Herrick grading, and Lens Opacities Classification System III, were applied to categorise ocular diseases by morbidity levels, from 1 (low) to 5 (high). RESULTS: A total of 95 participants (72.17 ± 7.62 years; 59% F, 41% M) were included, with 43% in the pre-operative (phakic) and 57% in the post-operative (pseudo-phakic) patients. The intra-class correlation coefficient demonstrated good to excellent correlation (≥0.75) for most clinical findings, with moderate correlation (0.5 to 0.75) for the iridocorneal angle. Sensitivity ranged from 65% to 67% for low-morbidity diseases and 87% to 95% for moderate-morbidity diseases. Specificity was high for low-morbidity diseases (96% to 100%) and moderate for moderate-morbidity diseases (73% to 87%). CONCLUSION: A good to great correlation exists between the two methods, and the novel method shows potential as a reliable alternative to the conventional method, with good sensitivity to moderate diseases and high specificity across all conditions.
Normative visual performance standards in male professional football players: a comprehensive assessment of visual acuity, binocular function, and visuo-cognitive abilities.
Jorge J, Fuste R, Sousa R
Clin Exp Optom · 2026 Jul · PMID 41525494 · Publisher ↗
CLINICAL RELEVANCE: Visual performance plays a fundamental role in sports, contributing to decision-making, spatial awareness, and object tracking. Establishing normative values for key visual functions supports performa...
CLINICAL RELEVANCE: Visual performance plays a fundamental role in sports, contributing to decision-making, spatial awareness, and object tracking. Establishing normative values for key visual functions supports performance assessment and training optimisation in athletes. BACKGROUND: This study aimed to evaluate visual acuity, refractive error, binocular function, and Visuo-cognitive abilities in professional football players to establish normative visual performance standards across different levels of athletic ability. METHODS: Visual assessments included static and dynamic visual acuity, refractive error, binocular vision (phoria, fusional vergence, vergence facility, and accommodative facility), and stereopsis. Visuo-cognitive abilities, such as multiple object tracking, reaction time, and peripheral perception, were also evaluated. The results were classified into five performance levels: Elite (10th percentile), Proficient (25th percentile), Average (50th percentile), Insufficient (75th percentile), and Dysfunctional (90th percentile). Statistical analyses were performed to determine normative thresholds and identify significant differences across these performance levels. RESULTS: A total of 262 male professional football players (mean age 24.6 ± 4.8 years) were assessed. Visual acuity averaged 1.09 ± 0.20, with Elite-level performance at 1.26 (6/4.8) and Dysfunctional-level at 0.90 (6/6.7). Dynamic visual acuity was 0.72 ± 0.17, with thresholds at 0.62 (6/9.5) (insufficient) and 0.52 (6/11.5) (Dysfunctional). Refractive error showed minimal anisometropia (0.20 ± 0.41D). Phoria status was orthophoric at distance (0.0 ± 2.1Δ) and exophoric at near (2.2 ± 4.7Δ). Accommodative facility averaged 11.7 ± 4.6 cpm. Stereopsis at distance averaged 1.85 ± 0.16 log arcsec, with Elite performance at 1.78 log arcsec and Dysfunctional at 2.00 log arcsec. Peripheral span averaged 40.7 ± 11.9, while multiple objects tracking and visual reaction time averaged 1623.3 ± 430.5 ms and 327.4 ± 37.8 ms, respectively. CONCLUSION: Normative visual data is provided for male professional football players, including visual acuity, binocular vision parameters, and visuo-cognitive skills, offering a reference for assessing and optimising performance in football.
Saccadic eye movements in amblyopia: a systematic review and meta-analysis.
Atiya A, Mani R, Webber A … +2 more , Narayanan A, Khuu SK
Clin Exp Optom · 2026 Jan · PMID 41525492 · Publisher ↗
A systematic review and meta-analysis were conducted to understand the extent to which saccadic latency is impacted by different types of aetiologies. Nine studies were included in the meta-analysis, from 232 amblyopes a...
A systematic review and meta-analysis were conducted to understand the extent to which saccadic latency is impacted by different types of aetiologies. Nine studies were included in the meta-analysis, from 232 amblyopes and 140 controls. Longer saccadic latencies occurred in amblyopes compared to controls. A large and significant effect size (ES) was found when viewing with the amblyopic eye (g = 1.17, I = 43.69%, < 0.0001), followed by binocular viewing (g = 0.70, I = 25.87%, < 0.0001). However, no significant ES was found with fellow eye viewing (g = 0.12, I = 42.86%, = 0.320). Largest ES was noted for mixed amblyopia in the amblyopic eye (g = 1.79, I = 0%, Q = 0.05, 95% CI = 1.70 to 1.87), followed by strabismic and anisometropic amblyopia, indicating that deficits in saccadic latency are dependent on the amblyopia type ( < 0.001). A positive association was found between saccadic latency and increasing hyperopic refractive error for the amblyopic eye ( = 0.004). A significant increase in saccadic latency ES with age was found for the fellow eye ( = 0.048) and binocular viewing ( = 0.004) conditions, but not for the amblyopic eye viewing ( = 0.077). Saccadic latency is most delayed in the amblyopic eye, particularly in mixed amblyopia, with smaller delays under binocular viewing condition. An increase in saccadic latency is observed with higher levels of hyperopia and as age progresses. These findings highlight the utility of measures of saccadic latency as a way of distinguishing between different types and severities of amblyopia, which may be useful in its diagnosis and treatment.
Improving eye care access for autistic people: applying the autistic SPACE framework.
Edwards C, Love AMA, Cai RY … +6 more , Constable PA, Love DC, Parmar K, Gowen E, Doherty M, Gibbs V
Clin Exp Optom · 2026 Jul · PMID 41520361 · Publisher ↗
Abstract loading — click title to view on PubMed.
Bibliometric mapping of the contribution of African optometry researchers to ophthalmic literature.
Owusu P, Amoako PT, Asiamah R … +5 more , Owusu G, Sa-Ambo JM, Agyiri PE, Boadi-Kusi SB, Kyei S
Clin Exp Optom · 2026 Mar · PMID 41494690 · Publisher ↗
CLINICAL RELEVANCE: The theoretical basis and evidence-based clinical practice of optometry and vision science are expressed primarily in refereed journals of academic and professional repute. These journals serve as the...
CLINICAL RELEVANCE: The theoretical basis and evidence-based clinical practice of optometry and vision science are expressed primarily in refereed journals of academic and professional repute. These journals serve as the reference and access point for advances and innovations in the field of optometry. BACKGROUND: Africa has the highest global burden of visual impairment, yet the contribution of African optometry researchers to ophthalmic research has not been assessed. This study examines the scholarly output and publication outlets of the leading African optometry academics to evaluate their contribution to ophthalmic literature. METHODS: A bibliometric analysis was undertaken using Scopus-indexed publications authored by the leading African optometry researchers. The Scopus records for each of the fifty scholars were extracted and deduplicated, yielding metadata on document types, language, citation counts, journal titles, and metrics (h-index, Impact Factor, Cite Score). The Bibliometrix package in R was used to analyse the research output and publication trends. The Kruskal-Wallis and Mann-Whitney U tests were used to assess the associations between African contributions and global journal metrics. RESULTS: African optometry researchers published 1319 papers across 341 journals, accumulating 86,218 citations with an overall h-index of 72. Original research articles comprised 84.4%. Though open access articles had a higher volume (58.7%), subscription-based articles (41.3%) showed a higher citation impact than open access articles (mean rank:641.18 vs 686.73; U = 225,481.50, = 0.032). Publications were concentrated in 27 core journals. No significant correlations were found between African-authored article counts and Impact Factor (r = -0.069, = 0.738) or between African h-index and journal quartile (χ (2) = 4.58, = 0.101). CONCLUSIONS: African optometry researchers have demonstrated increasing productivity and contribution to ophthalmic research. However, relevance and accessibility drive journal selection more than impact metrics alone, highlighting the need to bridge the gap between research visibility and global recognition.
Translational changes: evidence for low-dose atropine and myopia control.
Backhouse S, Robinson L, Law C
Clin Exp Optom · 2026 Jan · PMID 41494685 · Publisher ↗
Myopia control, as opposed to myopia correction, is emerging as the new standard of care for clinical management of paediatric myopia by optometrists. The prevalence of myopia, and high myopia, is increasing worldwide, w...
Myopia control, as opposed to myopia correction, is emerging as the new standard of care for clinical management of paediatric myopia by optometrists. The prevalence of myopia, and high myopia, is increasing worldwide, while the prevalence of pathologies associated with myopia increases with increasing axial length. With increasing global prevalence, preventing the axial elongation and pathologies associated with higher levels of myopia is therefore of paramount importance. Pharmacological management with atropine is one of the key myopia control options available to practitioners. Management with 1% atropine shows positive control effects but induces significant visual side effects in paediatic patients due to cycloplegia and mydriasis. The initial studies on the efficacy of low-dose atropine (<0.1%) have led to a significant increase in both publications (50% of all atropine myopia control papers having been published in the past 4 years) and practitioner prescribing. In this review, the advantages and disadvantages of low-dose atropine are explored to provide practitioners with an evidence-based approach to use in their practice.
Cost-effectiveness analysis of early versus late switching in treatment-naïve patients with refractory diabetic macular oedema in the Turkish population: real-world data from the Bosphorus DME study group, report number 5.
Karataş G, Çakır A, Yıldız D … +20 more , Arıcı M, Korkmaz A, Ermiş S, Çiloğlu Hayat Ş, Karapapak M, Özal E, Özal SA, Erdoğan M, Koçak İ, Sayın N, Karabaş VL, Önder Tokuç E, Öztürk M, Tiryaki Demir S, Karataş ME, Uçak T, Demirayak B, Onur İU, Hepokur M, Özkaya A
Clin Exp Optom · 2026 Jul · PMID 41490741 · Publisher ↗
CLINICAL RELEVANCE: Diabetic macular oedema (DME) is a leading cause of visual impairment worldwide. Real-world evidence is essential for understanding treatment effectiveness and guiding practical decision-making in rou...
CLINICAL RELEVANCE: Diabetic macular oedema (DME) is a leading cause of visual impairment worldwide. Real-world evidence is essential for understanding treatment effectiveness and guiding practical decision-making in routine clinical care. BACKGROUND: The aim of this work is to evaluate the cost-effectiveness of early versus late switching to intravitreal aflibercept or ranibizumab in eyes with DME refractory to intravitreal bevacizumab loading treatment. METHODS: This multicentre retrospective study included treatment-naïve refractory DME eyes that initiated bevacizumab between 2021 and 2023. Eyes were divided into three groups: no switch, early switch (3-6 months), and late switch (after 6 months). Public healthcare costs from 2021-2023 were used to calculate the cost per 0.1 improvement in best-corrected visual acuity (BCVA) and per 100 μm reduction in central macular thickness. Cost-effectiveness ratio and incremental cost-effectiveness ratio analyses were performed. RESULTS: A total of 229 eyes in the no-switch group, 328 eyes in the early-switch group, and 63 eyes in the late-switch group were analysed. At month 12, the greatest BCVA gain was observed in the early-switch group ( = 0.02). Mean injection numbers were 5.7 ± 1.4 (no-switch), 7.2 ± 1.5 (early-switch), and 6.6 ± 1.4 (late-switch) ( < 0.001). Cost-effectiveness ratio for visual acuity improvement was €4,838, €10,395, and €10,848 for the no-switch, early-switch, and late-switch groups, respectively. Incremental cost-effectiveness ratio analysis showed additional costs of €15,654 for early switching and €54,856 for late switching compared with no switching. Central macular thickness reduction was greatest in the no-switch group and lowest in the late-switch group ( = 0.05). CONCLUSION: Although early switching yields the greatest visual improvement and faster rehabilitation, it incurs higher costs. The no-switch strategy provided modest visual improvement at the lowest cost, resulting in the most favourable cost-effectiveness ratio. Late switching produced limited benefit at high cost, rendering it an unfavourable option. Treatment decisions should balance clinical efficacy and cost-effectiveness on an individual basis.
Superficial and deep capillary plexus as structural surrogates for early glaucoma detection via pattern deviation.
Belbase U, Subedi A, Chhetri S … +2 more , Cantó-Cerdán M, Suwal R
Clin Exp Optom · 2026 May · PMID 41378774 · Publisher ↗
CLINICAL RELEVANCE: Quantitative analysis of macular capillary plexuses using optical coherence tomography angiography (OCTA) may improve diagnosis and monitoring of glaucoma. Identifying vascular patterns linked to loca...
CLINICAL RELEVANCE: Quantitative analysis of macular capillary plexuses using optical coherence tomography angiography (OCTA) may improve diagnosis and monitoring of glaucoma. Identifying vascular patterns linked to localised and global visual field loss could enhance clinical decision-making and understanding of disease mechanisms. PURPOSE: To investigate the relationship between macular vessel density, measured by OCTA, and visual field loss quantified by pattern standard deviation and mean deviation; and to determine whether perfusion metrics from the superficial and deep capillary plexus correlate with functional deficits using OCTA and visual field analysis. METHODS: This cross-sectional study included 114 participants: 38 with glaucoma, 38 glaucoma suspects, and 38 healthy controls. Macular vessel density of the superficial and deep capillary plexus was measured using 6 × 6 mm OCTA scans, while functional loss was assessed with Humphrey visual field parameters including pattern standard deviation, mean deviation, and the visual field index. Linear regression was performed to analyse associations between vascular metrics, visual field indices, and structural measures such as retinal nerve fibre layer and ganglion cell complex thickness. RESULTS: Deep capillary plexus vessel density showed strong correlations with global functional loss (mean deviation, R² = 0.88, < 0.001) and focal loss (pattern standard deviation, R² = 0.83, < 0.001). Superficial capillary plexus vessel density was significantly associated with pattern standard deviation (R² = 0.51, < 0.001). Glaucoma eyes showed higher pattern standard deviation (7.87 ± 3.11) than suspects (2.76 ± 1.45) and controls (2.37 ± 0.67) ( < 0.001), along with reduced macular perfusion in both plexuses. CONCLUSION: Macular vessel density, particularly in the deep capillary plexus, is strongly associated with focal and global visual field loss in glaucoma. Superficial plexus metrics show a moderate but significant correlation with focal loss, supporting OCTA as a non-invasive biomarker for early glaucoma detection and monitoring.
Establishing the operating conditions of 'Ocula AI' in capturing the pupillary light reflex.
Khuu SK, He R, O'Brien B
Clin Exp Optom · 2026 May · PMID 41378386 · Publisher ↗
CLINICAL RELEVANCE: Pupillary light reflex testing via mobile apps offers a low-cost, and accessible method for assessing eye and neurological function. Its use may enable rapid screening and monitoring of eye disease, b...
CLINICAL RELEVANCE: Pupillary light reflex testing via mobile apps offers a low-cost, and accessible method for assessing eye and neurological function. Its use may enable rapid screening and monitoring of eye disease, brain injury and neurological disorders, supporting early detection, telemedicine applications, and clinical decision-making in and outside clinical environments. BACKGROUND: Rapid advances in technology have made it possible to assess human brain health with personal handheld devices through quantification of visual reflexes such as the pupillary light reflex (PLR). The study examined the effectiveness of a cutting-edge smartphone application, Ocula AI (Equinox), to capture and quantify the PLR compared to an established clinical-standard device, the PLR-3000 pupillometer (NeurOptics). METHODS: Both Ocula AI and the PLR-3000 device captures the PLR waveform providing estimates of key metrics such as latency, maximum and minimum pupils, and constriction and dilation velocities. The ability of Ocula AI to capture the PLR was assessed under different indoor illumination conditions (indicated by illuminance levels ranging from 0 to 1000 lux) in 16 healthy young adults and key metrics were compared to the outputs of the PLR-3000 device. RESULTS: Ocula AI was capable of capturing the PLR up to approximately 1000 lux, at which point the pupils are maximally constricted. Comparison and Bland-Altman plot analyses showed that Ocula AI captured the PLR and estimated key metrics of the PLR waveform to a similar standard (and were not significantly different) to the PLR-3000 device. CONCLUSIONS: The present study provided preliminary evidence demonstrating that nascent technologies now available on mobile devices are capable of providing accurate and easy estimation of the PLR. The development of such technologies offers a cost-effective solution and expands the scope of PLR testing (as a measure of neural function) to a range of environments and situations not limited to laboratory or clinical settings.
Building paediatric eyecare capability via Project ECHO tele-mentoring in Australia.
Toomey M, Keay L, Ren K … +1 more , Webber A
Clin Exp Optom · 2026 May · PMID 41368687 · Publisher ↗
CLINICAL RELEVANCE: Effective paediatric eyecare requires up-to-date knowledge and skills. Effective tele-mentoring and continuous education can significantly improve clinical confidence and ensure comprehensive care for...
CLINICAL RELEVANCE: Effective paediatric eyecare requires up-to-date knowledge and skills. Effective tele-mentoring and continuous education can significantly improve clinical confidence and ensure comprehensive care for paediatric patients. BACKGROUND: Project ECHO (Extension for Community Healthcare Outcomes) is a proven interactive case-based tele-mentoring for medical practitioners. A Paediatric Eyecare ECHO was implemented with Australian optometrists to evaluate its acceptability as an education modality and impact on self-reported confidence in clinical knowledge and competency. METHODS: Eight weekly, hour-long ECHO sessions on paediatric eyecare topics, informed by a learning needs assessment survey, were conducted. Each session included a brief didactic lecture by an expert, case presentations by participating optometrists and interactive discussions. Participant engagement, satisfaction, likeliness to implement knowledge, and competence were evaluated. Online questionnaires (5-point scale) with open-ended questions were administered before, during, and after the programme. Quantitative data were analysed descriptively and inferentially, while qualitative data were thematically analysed. RESULTS: Fifty-four optometrists registered for the ECHO with 98.1% attending at least one ECHO session. Forty-four of 54 ECHO programme registrants participated in the programme evaluation. Initial self-reported competencies showed knowledge deficits (score <3) in assessing and managing strabismus (72.1%), amblyopia (64.4%), and children with developmental delays (81.8%) and assessing and triaging paediatric ocular emergencies (63.6%). Most optometrists were satisfied with the ECHO format (>85%) and were likely to implement knowledge gained (>88.6%). Competence ratings increased significantly by +0.51 (Z = 4.3, < .001). Qualitative feedback highlighted an appreciation for case-based presentations but a desire for more detailed clinical management and vision therapy information. CONCLUSION: The Paediatric Eyecare ECHO showed positive outcomes for optometrists in respect of engagement, satisfaction, likeliness to implement knowledge and self-assessed competency in treating paediatric patients. In addition to paediatric eye care case management, this model holds promise for interactive education in other ocular conditions managed by optometrists.
Effect of mire spacing on the subjective non-invasive break-up time measurement: a comparison of instruments.
Lortie-Milner E, Bitton E
Clin Exp Optom · 2026 May · PMID 41344684 · Publisher ↗
CLINICAL RELEVANCE: Non-invasive break-up time (NIBUT) has become the measurement of choice to evaluate stability of the tear film. Tear film stability is essential in the diagnosis and follow-up of dry eye disease. BACK...
CLINICAL RELEVANCE: Non-invasive break-up time (NIBUT) has become the measurement of choice to evaluate stability of the tear film. Tear film stability is essential in the diagnosis and follow-up of dry eye disease. BACKGROUND: Instruments used to measure NIBUT have different spacing of luminous mires, but the influence of this characteristic on the measurement of NIBUT is poorly understood. This study aimed at comparing the characteristics of five different instruments used to measure NIBUT and to determine if the mire spacing had an impact on the measured NIBUT. METHODS: Mire spacing of the instruments was assessed using a calibration sphere. Two raters then measured the NIBUT of 20 participants (20 eyes) with normal ocular surfaces three consecutive times with five different instruments (Oculus Placido Disk, Keeler Tearscope Plus with the Coarse and the Fine Grid, Medmont E300 Topographer and Oculus Keratograph 5M). A two-way repeated measure analysis of variance was performed to compare the NIBUT data and correlation values (intra-class and Spearman) were computed for intra-rater agreement and test-retest reliability. RESULTS: The Tearscope Plus with the Fine Grid was the instrument that presented the finest mire spacing. Two instruments, the Medmont E300 and the Keratograph gave shorter NIBUTs compared to the Tearscope Plus with the Fine Grid. All instruments had good inter-rater agreement. The Medmont E300 had a less good test-retest reliability for one of the raters. Bland-Altman plots were used to compare all the instruments with the one having the finest mire spacing. A positive proportional bias between the Tearscope Plus using the Fine Grid and the Coarse Grid was found. CONCLUSION: The topography-based instruments had shorter subjective NIBUT values in non-dry eye participants compared to the other instruments. Mire spacing is not the most definitive factor that impacts the NIBUT value.
Contact lens practice in India: practitioner-reported challenges, barriers, and strategies for improvement.
Banik A, Goyal A
Clin Exp Optom · 2026 May · PMID 41344682 · Publisher ↗
CLINICAL RELEVANCE: Contact lenses offer effective refractive, cosmetic, and therapeutic options; however, their safe and successful use requires addressing barriers at the practitioner, patient, and healthcare system le...
CLINICAL RELEVANCE: Contact lenses offer effective refractive, cosmetic, and therapeutic options; however, their safe and successful use requires addressing barriers at the practitioner, patient, and healthcare system levels. Identifying and understanding these challenges are essential to improving clinical outcomes, enhancing patient satisfaction, and supporting broader global adoption. BACKGROUND: Despite advancements in contact lens materials and designs, adoption rates in India remain constrained by discontinuation, affordability issues, and low public awareness. This study aimed to evaluate common challenges, barriers to contact lens uptake, and strategies implemented by practitioners across India. METHODS: A cross-sectional survey was conducted among contact lens practitioners across six Indian zones (North, South, East, West, Central, and North-East) between January and May 2025. A structured questionnaire, assessed challenges in contact lens practice, barriers to uptake, and improvement strategies. Responses were recorded on a 5-point numerical scale. Data were analysed, employing descriptive statistics and Kruskal-Wallis tests to evaluate regional differences. RESULTS: A total of 338 (96.5%) out of 350 practitioners completed the survey. Limited availability of trial lenses and high material costs were the most frequently reported challenges (median score: 3/5, IQR: 2.0-4.0). Key barriers to contact lens uptake included lack of awareness (median: 3/5, IQR: 2.0-4.0), discomfort-related dropout (median: 3/5, IQR: 2.0-4.0), and unsupervised online purchases (median: 3/5, IQR: 2.0-5.0). High consensus was observed for improvement strategies, with practitioner education, patient awareness initiatives, affordability, and proactive contact lens recommendations scoring a median of 4/5, IQR: 3.0-5.0. No statistically significant regional differences were found ( > 0.05). CONCLUSIONS: Indian contact lens practitioners face consistent challenges nationwide, with affordability, trial lens availability, and public awareness identified as primary concerns. Practitioner-driven education, patient counselling, and affordability measures are essential to enhancing contact lens practice and promoting the safe and wider adoption of contact lenses in India.
Axial length/corneal radius ratio for the diagnosis of myopia in children and adolescents: a meta-analysis.
Song D, Zhang P, Meng T … +2 more , Yao J, Sheng M
Clin Exp Optom · 2026 Jul · PMID 41344681 · Publisher ↗
CLINICAL RELEVANCE: Accurate and objective tools for myopia screening in children and adolescents are crucial to retard progression and avert vision-endangering complications. BACKGROUND: This study aims to investigate t...
CLINICAL RELEVANCE: Accurate and objective tools for myopia screening in children and adolescents are crucial to retard progression and avert vision-endangering complications. BACKGROUND: This study aims to investigate the diagnostic performance of the axial length/corneal radius (AL/CR) ratio for myopia in children and adolescents. METHODS: The literature search encompassed major electronic databases, key academic websites, and grey literature from inception to April 2025. Inclusion criteria were restricted to studies evaluating the diagnostic accuracy of AL/CR for myopia, with spherical equivalent (SE) ≤ -0.50 D as the gold standard for myopia diagnosis. The meta-analysis adhered to the Cochrane Handbook guidelines and PRISMA reporting standards. RESULTS: A total of 9 studies involving 24,030 children and adolescents were included in the meta-analysis. The summary sensitivity, specificity, and area under the curve of AL/CR for diagnosing myopia were 0.88 [95% CI: 0.86-0.90], 0.89 [95% CI: 0.86-0.91], and 0.93 [95% CI: 0.91-0.95], respectively. Meta-regression analysis revealed that the sensitivity of AL/CR remained independent of sample size, SE, myopia prevalence, age, or recruitment setting (school-based vs. hospital-based) (all > 0.05). Notably, increased diagnostic specificity was significantly associated with older age ( = 0.01). The combination of AL/CR with non-cycloplegic autorefraction demonstrated significantly higher sensitivity and specificity in detecting myopia compared to AL/CR alone (Sensitivity: 0.93 [95% CI: 0.92-0.95] VS 0.88 [95% CI: 0.86-0.90]; Specificity: 0.94 [95% CI: 0.94-0.95] VS 0.89 [95% CI: 0.86-0.91]). AL/CR cut-off value exhibited significant correlations with age. CONCLUSION: AL/CR ratio demonstrates robust diagnostic efficacy for myopia in paediatric and adolescent populations, particularly when utilised in conjunction with non-cycloplegic autorefraction. However, the selection of age-specific AL/CR cut-off points is essential to maximise diagnostic precision.
Ensure your paper gets published: ten tips for responding effectively to reviewer comments.
Efron N
Clin Exp Optom · 2025 Nov · PMID 41320237 · Publisher ↗
Abstract loading — click title to view on PubMed.
Emerging research on non-neovascular age-related macular degeneration treatments.
Ju X, Ramke J, Turnbull PR
Clin Exp Optom · 2025 Nov · PMID 41312773 · Publisher ↗
Age-related macular degeneration (AMD) is a common condition that causes vision impairment in the elderly, significantly impacting their physical and psychosocial well-being. Historically, treatment options to slow or pr...
Age-related macular degeneration (AMD) is a common condition that causes vision impairment in the elderly, significantly impacting their physical and psychosocial well-being. Historically, treatment options to slow or prevent atrophic AMD progression have been limited but are recently increasing in number. This scoping review aims to provide an overview of the research (both preclinical and clinical) on non-neovascular AMD (including early, intermediate, and geographic atrophy) treatments published in the past decade. Our study protocol was prospectively registered on the Open Science Framework.Searches were conducted on MEDLINE, Embase, ProQuest, and CINAHL for studies investigating treatments for atrophic AMD (including early, intermediate, and geographic atrophy stages) published between 1 January 2014 and 14 July 2024, the search date. Data screening, full-text review, and extraction were independently performed by two researchers. Study characteristics and outcomes were summarised, and the results were synthesised narratively. The search identified 1,211 studies, of which 132 were included in this review. Studies were most often conducted in the United States ( = 92, 68.7%) or Europe ( = 25, 18.5%) and most frequently investigated antioxidant or anti-inflammatory treatments ( = 30, 22.7%) or complement pathway inhibitors ( = 25, 18.9%) as potential therapies. Over three quarters ( = 101, 76.5%) of the included studies reported positive outcomes. Across the decade, the number of studies published increased at an annual rate of 24.0%.This review highlights the growing body of research on atrophic AMD treatments over the past decade, with antioxidant and anti-inflammatory treatments emerging as prominent, promising avenues. However, more phase III human clinical trials are needed to ensure that future therapies effectively serve the global AMD population.
Teresa Puthussery: optometrist and MacArthur Fellow at the cutting edge of visual neurobiology.
Efron N
Clin Exp Optom · 2026 Jan · PMID 41298076 · Publisher ↗
Abstract loading — click title to view on PubMed.
Perspectives on screening in retinopathy of prematurity: new algorithms and AI tools.
Kearns H, Hull S
Clin Exp Optom · 2025 Nov · PMID 41298074 · Publisher ↗
Retinopathy of prematurity (ROP) is a vasoproliferative blinding disorder of the retina, unique to premature infants and a leading cause of preventable childhood blindness globally. Screening of premature babies aims to...
Retinopathy of prematurity (ROP) is a vasoproliferative blinding disorder of the retina, unique to premature infants and a leading cause of preventable childhood blindness globally. Screening of premature babies aims to identify disease reaching a threshold for treatment needed in 6-10% of babies screened. Current screening criteria are based on birth weight (BW) and gestational age (GA) with an additional third criteria for babies deemed at risk by the neonatologist due to an unstable postnatal course or prolonged use of oxygen. These lack specificity and could potentially miss babies at risk. With increased survival rates of premature and extreme premature babies, ROP screening numbers are rising with associated clinical and economic burden. Several alternative algorithms have been proposed based on postnatal weight gain and in this review, the application and pitfalls of these will be discussed as well as the potential role of artificial intelligence in improving accuracy, efficiency, and equity in Australasia and low-middle-income countries.
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