Veldman MHJ, Adanç B, van Rens GHMB
… +2 more, van Nispen RMA, van der Aa HPA
Optom Vis Sci
· 2024 Nov · PMID 39499821
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SIGNIFICANCE: This research contributes to the concept of cognitive overload and the association between concentration and fatigue in individuals with visual impairment (VI). Gaining more insight into these and other fac...SIGNIFICANCE: This research contributes to the concept of cognitive overload and the association between concentration and fatigue in individuals with visual impairment (VI). Gaining more insight into these and other factors explaining cognitive overload is essential for a better understanding, prevention, and treatment of fatigue severity in individuals with VI. PURPOSE: Individuals with VI need to use additional cognitive resources to compensate for their loss of vision. These cognitive demands include increased concentration, which may put an extra burden on energy levels. This study aimed to expand upon previous research on the concept of cognitive overload by exploring the relationship between concentration and fatigue severity in individuals with VI. METHODS: A cross-sectional study was conducted based on data from the eligibility screening of the E-nergEYEze trial (n = 213). Concentration problems were measured with the Checklist of Individual Strengths subscale Concentration, and fatigue severity was measured with the Checklist of Individual Strengths subscale Fatigue Severity. Linear regression analyses were performed to investigate the association between concentration problems and fatigue severity. Potential effect modifiers (i.e., sociodemographic and vision-related characteristics) were considered, and associations were corrected for confounding. RESULTS: Concentration problems were directly and positively associated with fatigue severity ( β = 0.47; R2 = 0.10; 95% confidence interval, 0.28 to 0.66; adjusted model: β = 0.52; R2 = 0.16; 95% confidence interval, 0.32 to 0.72). No relevant effect modifiers were identified. However, other factors that were not included in this study were involved in this association. CONCLUSIONS: This study contributes to understanding the cognitive overload as experienced by adults with VI and highlights the importance of the association of concentration problems, as a reflection of the cognitive burden and perceived fatigue. It is recommended to identify and address concentration difficulties through suitable awareness and treatment strategies to prevent and reduce severe fatigue in this population.
Optom Vis Sci
· 2024 Nov · PMID 39485347
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PURPOSE: This study aimed to compare and analyze the efficacy of repeated low-level red-light therapy and orthokeratology lenses for myopia control in children. METHODS: Exactly 138 participants were enrolled in this ret...PURPOSE: This study aimed to compare and analyze the efficacy of repeated low-level red-light therapy and orthokeratology lenses for myopia control in children. METHODS: Exactly 138 participants were enrolled in this retrospective study. Comprehensive eye examinations were performed prior to treatment. The repeated low-level red-light therapy and orthokeratology lenses groups comprised 67 and 71 patients, respectively. The age range was between 6 and 14 years, with myopia of ≤-0.50 D and astigmatism of ≤2.50 D after cycloplegia. Follow-up data were collected during the initial visit and the treatment period. Changes in axial length over a 2-year period and associated factors were analyzed. RESULTS: Over the 2-year period, the repeated low-level red-light therapy group exhibited significantly less axial length growth compared with the orthokeratology lenses group (0.17 ± 0.40 vs. 0.50 ± 0.27 mm, p<0.001). In the first year, the axial length growth in the repeated low-level red-light therapy group was significantly less than that in the orthokeratology lenses group (0.03 ± 0.22 vs. 0.28 ± 0.18 mm, p<0.001), with no significant difference observed in the second year (0.14 ± 0.29 vs. 0.21 ± 0.14 mm, p=0.06). The repeated low-level red-light therapy group showed a 55% reduction in axial length after 1 month and a 42% reduction after 1 year, compared with 4% and 3% reductions in the orthokeratology lenses group, respectively. Linear mixed-effects model analysis indicated that the annual axial length change rate in the repeated low-level red-light therapy group was 0.10 mm (95% confidence interval [CI], 0.07 to 0.14), compared with 0.25 mm in the orthokeratology lenses group (95% CI, 0.24 to 0.27), with an average difference of 0.15 mm (95% CI, -0.17 to -0.12, p<0.001). CONCLUSIONS: Repeated low-level red-light therapy demonstrated slightly superior efficacy in controlling myopia progression in children compared with orthokeratology lenses.
Oviedo-Cáceres MDP, Arias-Valencia S, Hernández-Quirama A
Optom Vis Sci
· 2024 Oct · PMID 39480130
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SIGNIFICANCE: Low vision is a public health priority disability condition. People with this condition face multiple types of discrimination in a society that is not accustomed to diversity. PURPOSE: This study aimed to d...SIGNIFICANCE: Low vision is a public health priority disability condition. People with this condition face multiple types of discrimination in a society that is not accustomed to diversity. PURPOSE: This study aimed to describe the life experience of people with low vision from an intersectional perspective in Medellín, Colombia. METHODS: A qualitative ethnographic case study was conducted, considering the intersectional perspective as an analytical element to comprehend the everyday experience of people with low vision. Twenty-nine interviews were conducted with 10 participants, along with 16 participant observation exercises in their daily lives, with prior informed consent. RESULTS: Participants experienced discrimination due to their visual condition, which had negative implications for the development of their life projects. Three categories emerged: Discrimination in everyday contexts: ocularcentrism, gender challenges in the lives of people with low vision, and challenges in seeking vision rehabilitation services. CONCLUSIONS: The results of the study show that people experience discrimination, exclusion, and stigmatization in their daily activities, which vary according to the traditionally assigned roles of gender, social class, age, and educational level, among others. Given the complexity of the experience, it is important for health and visual rehabilitation professionals to broaden their perspective and transition toward vision rehabilitation models that address the various dimensions affected by this condition.
Weise KK, Repka MX, Zhu Y
… +24 more, Manny RE, Raghuram A, Chandler DL, Summers AI, Lee KA, Kehler LAF, Pang Y, Allen MS, Anderson HA, Erzurum SA, Golden RP, Koutnik CA, Kuo AF, Lenhart PD, Mokka PL, Petersen DB, Ticho BH, Wiecek EK, Yin H, Beaulieu WT, Kraker RT, Holmes JM, Cotter SA, Pediatric Eye Disease Investigator Group
Optom Vis Sci
· 2024 Oct · PMID 39480129
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PURPOSE: This study aimed to identify baseline factors associated with greater myopia progression and axial elongation in children with myopia. METHODS: This study performed a post hoc analysis of data from a 30-month ra...PURPOSE: This study aimed to identify baseline factors associated with greater myopia progression and axial elongation in children with myopia. METHODS: This study performed a post hoc analysis of data from a 30-month randomized trial of atropine 0.01% versus placebo in children 5 to <13 years old with baseline spherical equivalent refractive error (SER) of -1.00 to -6.00 D, astigmatism of ≤1.50 D, and anisometropia of <1.00 D SER. Data from atropine 0.01% and placebo groups were pooled given outcomes were similar. Baseline factors of age, SER, axial length, race, sex, parental myopia, and iris color were evaluated for association with changes in SER and with changes in axial length at 30 months (24 months on treatment and then 6 months off) using backward model selection. RESULTS: Among 187 randomized participants, 175 (94%) completed 30 months of follow-up. The mean change in SER was greater among younger children (-0.19 D per 1 year younger; 95% confidence interval [CI], -0.25 to -0.14 D; p<0.001) and children with higher myopia (-0.14 D per 1 D more myopia at baseline; 95% CI, -0.23 to -0.05 D; p=0.002). The mean change in axial length was also greater among younger children (0.13 mm per 1 year younger; 95% CI, 0.10 to 0.15 mm; p<0.001) and children with higher baseline myopia (0.04 mm per 1 D more myopia; 95% CI, 0.002 to 0.08; p=0.04). CONCLUSIONS: Younger children with higher myopia had greater myopic progression and axial elongation over 30 months than older children with lower myopia. Developing effective treatments to slow the faster myopic progression in younger children should be a target of further research.
Optom Vis Sci
· 2025 Feb · PMID 39471355
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SIGNIFICANCE: Evaluating the visual challenges and refractive correction solutions of presbyopic orienteers identifies features of relevance to optometric management of the visual needs of active presbyopes. PURPOSE: Ori...SIGNIFICANCE: Evaluating the visual challenges and refractive correction solutions of presbyopic orienteers identifies features of relevance to optometric management of the visual needs of active presbyopes. PURPOSE: Orienteering is a unique sport requiring visual clarity at a range of viewing distances and has a high proportion of presbyopic participants. This study evaluates the vision corrections used by presbyopic orienteers, specifically aiming to characterize the prevalence of different vision correction options used and to explore the strengths and limitations of different vision correction solutions. METHODS: Orienteers 40 years or older completed an online questionnaire consisting of multiple-choice questions covering personal demographics, orienteering participation, and visual corrections worn in everyday life and for orienteering. Free-text questions asked for further information about the corrections used and advice received from eye care practitioners were analyzed using content analysis. RESULTS: There were 469 respondents (195 women, 274 men; median age category, 55 to 59 years). For the 187 people without distance refractive correction, the most frequent corrections for orienteering were "off the shelf" reading spectacles (n = 95) or use of a compass magnifier (n = 24), and for the 277 people with distance refractive correction, they were progressive addition spectacles (n = 96) and monovision contact lenses (n = 63). The main visual challenges faced by orienteers were seeing map detail, lens obstruction from fogging and rain, and difficulty orienteering in low light in the daytime. An ideal correction needed to provide visual clarity for both map and terrain. No visual correction type consistently addressed all challenges. Orienteers valued personalized discussion with eye care practitioners to address their needs. CONCLUSIONS: Optimal visual corrections for presbyopic orienteers are individual, but higher reading additions to clarify map detail, contact lenses to avoid lens obstruction, additional light, and solutions that provide clear vision at all viewing distances while avoiding the reading add blurring the ground at the orienteer's feet should be considered. Personalized care is necessary to optimize visual correction solutions.
PURPOSE: The central lower TMH is used as a clinical measure of tear volume in the assessment of contact lens candidates and patients with dry eyes. Ethnic differences in eyelid morphology may influence the measurement o...PURPOSE: The central lower TMH is used as a clinical measure of tear volume in the assessment of contact lens candidates and patients with dry eyes. Ethnic differences in eyelid morphology may influence the measurement of the TMH. Furthermore, with the advent of larger contact lenses, such as scleral lenses, it would be of clinical value to assess the TMH centrally and peripherally. The purpose of this study was to evaluate and compare the TMH at different positions along the palpebral margin between Caucasian and Asian eyes. METHODS: This prospective study evaluated the lower TMH in five positions (central, temporal and nasal limbus and temporal and nasal periphery) of the right eye using the Keratograph 5M (Oculus) instrument in Caucasian and Asian participants between 10 am and 12 pm . The TMH at each position was taken three times and averaged and analyzed using a 5 × 2 repeated-measures analysis of variance. RESULTS: Central TMH did not differ significantly ( F = 0.02, p=0.88) in Caucasians (n = 20, aged 24.45 [2.30] years, TMH 0.320 [0.052] mm) and Asians (n = 20, aged 22.25 [3.43] years, TMH 0.325 [0.048] mm). A difference was noted with respect to TMH positions along the lid margin ( F = 64.17, p<0.001), independent of ethnicity ( F = 2.15, p=0.15). A post hoc analysis revealed a significantly higher TMH temporally when compared with centrally or nasally (p<0.001). CONCLUSIONS: This study demonstrated the similarity of the central TMH and the differences in the peripheral TMH within Caucasian and Asian eyes. This may be clinically relevant when using the Tear Film & Ocular Surface Society Dry Eye Workshop II diagnostic algorithm for dry eyes and when fitting scleral contact lenses. Future studies need to consider that ethnic differences may exist for certain tests in order to personalize the care and management of each patient.
SIGNIFICANCE: This study establishes an increased risk of developing dry eye disease (DED) in patients with diabetic peripheral neuropathy using validated diagnostic criteria for both conditions. PURPOSE: The disruption...SIGNIFICANCE: This study establishes an increased risk of developing dry eye disease (DED) in patients with diabetic peripheral neuropathy using validated diagnostic criteria for both conditions. PURPOSE: The disruption of ocular surface homeostasis has been associated with diabetes. However, it remains unclear if this association is independently influenced by peripheral neuropathy secondary to diabetes. This study aimed to investigate the clinical signs and symptoms of DED and their association with the severity of peripheral neuropathy in participants with type 2 diabetes. METHODS: This prospective cross-sectional study recruited 63 participants with type 2 diabetes. All participants underwent a detailed assessment of DED using dry eye questionnaires (Ocular Surface Disease Index, Dry Eye Questionnaire-5), tear osmolarity, lipid layer thickness, noninvasive keratographic tear breakup time, phenol red thread test (PRT), and ocular surface staining. Corneal nerve morphology was imaged using corneal confocal microscopy. Based on the Total Neuropathy Scale, participants were stratified into no/mild (n = 48) and moderate/severe (n = 15) neuropathy groups. RESULTS: Dry eye disease was diagnosed in 31 participants (50%) of the total cohort, and the odds of developing DED in the moderate/severe neuropathy group were four times (95% confidence interval, 1.10 to 13.80; p=0.030) higher compared with the no/mild neuropathy group. The Dry Eye Questionnaire-5 scores were significantly higher (p=0.020), and PRT values (p=0.048) and corneal nerve fiber length (p<0.001) were significantly reduced in the moderate/severe neuropathy group compared with the no/mild neuropathy group. In regression analysis, neuropathy scores were independently associated with PRT measurements ( β = -0.333, p=0.023) and nerve fiber length ( β = -0.219, p=0.012) while adjusting for age, gender, hemoglobin A 1c , and duration of diabetes. CONCLUSIONS: Type 2 diabetic patients with peripheral neuropathy have a risk of developing DED, which increases with the severity of neuropathy. The observation that worsening peripheral neuropathy is associated with reduced tear secretion suggests that it may contribute to aqueous insufficiency.
SIGNIFICANCE: Symptoms of dryness and discomfort are the main reasons for contact lens dropout. Clinical tests for this purpose are invasive or subjective. Ocular thermography may help to assess the ocular discomfort and...SIGNIFICANCE: Symptoms of dryness and discomfort are the main reasons for contact lens dropout. Clinical tests for this purpose are invasive or subjective. Ocular thermography may help to assess the ocular discomfort and dryness in a noninvasive and objective manner. PURPOSE: This study aimed to investigate the relationship of ocular thermography with clinical measurements in habitual symptomatic and asymptomatic soft contact lens wearers. METHODS: Forty habitual contact lens wearers were evaluated in two age- and gender-matched asymptomatic and symptomatic groups (Contact Lens Discomfort Questionnaire scores ≤8 and ≥14, respectively). Clinical measurements took place during visit 1 (with contact lens in situ and after contact lens removal) and at baseline after a 2-week washout period (visit 2). The Ocular Surface Disease Index (OSDI) questionnaire, noninvasive tear breakup time, bulbar conjunctival hyperemia, and corneal staining were assessed. Thermal cooling rate was computed in the central and lower cornea during natural blinking (30 s) and sustained eye opening (10 s). RESULTS: Dry eye symptoms (OSDI score) were significantly higher in the symptomatic group during contact lens wear (p<0.001) and at baseline (p = 0.001). Thermal cooling rate was significantly higher in the symptomatic group in the lower cornea (10 s, p=0.013) with the contact lens in situ and in the central cornea (30 s, p=0.045) after contact lens removal. At baseline, dry eye symptoms (OSDI score) significantly correlated with cooling rate in the central cornea region for the symptomatic group (30 s: r = -0.5, p=0.03; 10 s: r = -0.63, p=0.005). Noninvasive tear breakup time correlated with cooling rate in the central cornea region at baseline in the symptomatic group (30 s, r = 0.6, p=0.005; 10 s, r = 0.55, p=0.018). Cooling rate in the central cornea region (10-s duration, p<0.0001) and noninvasive tear breakup time (p<0.0001) were identified as significant predictor variables for dry eye symptoms at baseline. CONCLUSIONS: Noninvasive tear breakup time and thermal cooling rate were identified as significant predictor variables for contact lens-induced dry eye. These findings may suggest the potential for the additional application of ocular thermography in the evaluation of contact lens discomfort.
Optom Vis Sci
· 2024 Oct · PMID 39259703
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SIGNIFICANCE: This study brings awareness of racial/ethnic difference of refractive error characteristics in clinics. PURPOSE: This study aimed to assess longitudinal change in refractive errors over a 36-month period in...SIGNIFICANCE: This study brings awareness of racial/ethnic difference of refractive error characteristics in clinics. PURPOSE: This study aimed to assess longitudinal change in refractive errors over a 36-month period in Hispanic and Black children. METHODS: Children (2.4 to 15 years old) were studied. Cycloplegic refraction was measured annually. Spherical equivalent was calculated. Astigmatism was evaluated by magnitude of cylinder and power vector (J 0 and J 45 ). Absolute value of interocular spherical equivalent difference was used to calculate anisometropia. Mixed-linear model was used to analyze longitudinal annual change in spherical equivalent, cylinder, J 0 , and J 45 over 36 months. RESULTS: A total of 485 participants (310 Black, 175 Hispanic) met the criteria. At the baseline examination, prevalence of myopia, emmetropia, and hyperopia was 39% (n = 187), 31% (n = 150), and 30% (n = 148), respectively. Spherical equivalent of Black children was not significantly different from that in Hispanic children (0.10 ± 2.92 vs. -0.37 ± 2.05 D, p=0.06); however, the Hispanic children had a significantly higher cylinder compared with Black children (Hispanic: 1.46 ± 1.57 D vs. Black: 0.92 ± 1.07 D; p<0.001). Both J 0 (p<0.001) and J 45 (p=0.01) were significantly different between two groups; the Hispanic children had more with-the-rule astigmatism and oblique astigmatism than the Black children. Prevalence of anisometropia (≥1 D) was higher in Black children (14%) compared with Hispanic children (5%, p=0.006). Over 36 months, spherical equivalent significantly decreased an average of 0.69 D (0.23 D/y, p<0.001) for both groups; neither astigmatism nor anisometropia changed significantly (p>0.05). CONCLUSIONS: Astigmatism in the Hispanic children was significantly higher than in Black children. However, the Black children had a higher prevalence and degree of anisometropia than the Hispanic children.
Optom Vis Sci
· 2024 Aug · PMID 39259701
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SIGNIFICANCE: This is one of the first reports to summarize the enrollment metrics for ophthalmology trials completed in the United States (US). PURPOSE: This study aimed to describe US ophthalmology clinical trial enrol...SIGNIFICANCE: This is one of the first reports to summarize the enrollment metrics for ophthalmology trials completed in the United States (US). PURPOSE: This study aimed to describe US ophthalmology clinical trial enrollment metrics to facilitate planning and budgeting of US Food and Drug Administration-regulated ophthalmological drugs trials. METHODS: A GlobalData PLC search was conducted on or before February 27, 2024, to evaluate the clinical trial landscape for completed ophthalmology clinical trials conducted in the US. The primary search contained only the term "ophthalmology," which was restricted to trials that were completed and were conducted within the US. Trials were classified as multicenter when trials included three sites or more, and when the enrollment search resulted in ≥30 multicenter trials for an individual indication, enrollment data were further broken down by Food and Drug Administration trial phase. RESULT: The search yielded 2229 trials, which analyzed 980 different drugs produced by 854 different sponsors. The most common indications evaluated in US trials were macular degeneration, glaucoma, macular edema, allergies, and keratoconjunctivitis. Multicenter trials by indication had an overall median enrollment period range of 4.8 to 35.1 months; number of subjects enrollment, range of 36 to 518 subjects; number of sites utilized, range of 4 to 74 sites; and enrollment rate, range of 0.11 to 4.04 subjects/sites per month. There were 17 indications with ≥30 multicenter trials, which allowed for enrollment metric calculation by trial phase. CONCLUSIONS: This study provides sponsors with an understanding of the number of subjects and sites needed to complete a trial while also setting realistic enrollment timelines. Although this work represents the US market, more work is needed to better understand other countries given that country-specific guidelines and subject beliefs may impact enrollment metrics.
Optom Vis Sci
· 2024 Aug · PMID 39259700
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SIGNIFICANCE: High-energy visible (HEV) light-filtering spectacle lenses are being widely promoted despite limited evidence to support their use. The spectral transmission properties of commercially available lenses vari...SIGNIFICANCE: High-energy visible (HEV) light-filtering spectacle lenses are being widely promoted despite limited evidence to support their use. The spectral transmission properties of commercially available lenses varied, particularly in the HEV light region, and they do not perform in the same way for transmission of ultraviolet (UV)-A and HEV light. PURPOSE: Although HEV light is important for several visual and nonvisual functions, there are concerns over the potential adverse effects of increased HEV light exposure. High-energy visible light-filtering spectacle lenses are being widely marketed to promote ocular health and improve sleep by reducing exposure to HEV light. This study reports on the spectral transmission characteristics of commercially available HEV light-filtering spectacle lenses based on the recommendations of the Spectral Bands Task Force technical report. METHODS: The spectral transmission of light through nine afocal plastic lenses, including eight commercially available HEV light-filtering lenses and one clear uncoated control lens, was evaluated using a Cary 5000 UV-Vis-NIR spectrophotometer (Agilent Technologies, Johannesburg, South Africa) for wavelengths 250 to 780 nm. The percentage transmission values are reported for UV radiation and visible light, with emphasis for HEV light (380 to 500 nm) and the three subbands therein. RESULTS: All lenses blocked UV-C and UV-B radiation (250 to 315 nm). For UV-A radiation (315 to 380 nm), six lenses showed optimal 100% absorption, whereas three lenses allowed ≤12%. The transmission values for the HEV light-filtering lenses ranged from 55 to 90% and 75 to 95% for HEV light of wavelengths 400 to 455 nm and 455 to 500 nm, respectively. In contrast, the control lens showed 92 (400 to 455 nm) and 93% (455 to 500 nm) transmission. CONCLUSIONS: The HEV light-filtering spectacle lenses varied in their transmission properties and do not necessarily perform in the same way for transmission of UV-A and HEV light. Optometric personnel should consider these transmission properties, particularly for HEV light, when making recommendations to patients about HEV light-filtering spectacle lenses.
Brennan NA, Shamp W, Maynes E
… +2 more, Cheng X, Bullimore MA
Optom Vis Sci
· 2024 Aug · PMID 39259699
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PURPOSE: Axial elongation is the basis of progression in primary myopia and the preferred metric to monitor its evolution. We conducted a meta-regression to model axial elongation and its associated factors in children w...PURPOSE: Axial elongation is the basis of progression in primary myopia and the preferred metric to monitor its evolution. We conducted a meta-regression to model axial elongation and its associated factors in children with low to moderate myopia. METHODS: A comprehensive electronic systematic search was performed using Ovid Medline, EMBASE, and Cochrane Central Register of Controlled Trials of studies conducted up until October 2021. The mean rate of axial elongation was analyzed using a multivariate linear mixed-effects meta-regression model, with backward stepwise elimination of nonsignificant covariates. The model included three levels of random effects, allowing both prediction and confidence intervals to be estimated. RESULTS: A total of 64 studies with 83 subpopulations and 142 evaluations of mean axial change from baseline met our inclusion criteria and had no missing significant covariates in the final model. A separate analysis including all populations with axial length data (202 evaluations) but missing variance or covariate data produced a similar model to that for the analysis with complete data. The mean axial elongation is 38% greater in Asian children (95% confidence interval, 19 to 61%; p<0.01) compared with non-Asians, but both groups show a 15% decline per year as age increases (95% confidence interval, 12 to 17% p<0.0001). Prediction intervals indicate substantial variability around the axial elongation estimates. CONCLUSIONS: This analysis provides mean values of axial elongation for evaluation of efficacy of myopia control. The broad prediction intervals emphasize the large range of individual axial elongation rates in the population, illustrating the challenge in managing individual children. Interpretation of the analysis is limited by the use of aggregated data rather than individual subject data.
SIGNIFICANCE: This is the first study to evaluate the retention time of lubricating eye drops containing various concentrations of sodium hyaluronate using fluorophotometry in a symptomatic dry eye population. Informatio...SIGNIFICANCE: This is the first study to evaluate the retention time of lubricating eye drops containing various concentrations of sodium hyaluronate using fluorophotometry in a symptomatic dry eye population. Information regarding eye drop retention may be useful for eye care practitioners to assist in the selection of more effective treatments for managing dry eye. PURPOSE: This study aimed to use fluorophotometry to compare retention time on the ocular surface of three commercially available lubricating eye drops, each containing varying concentrations of sodium hyaluronic acid (HA), and their effects on tear film stability post-instillation in a population with symptoms of dry eye. METHODS: Adults with symptoms of dry eye (Ocular Surface Disease Index score, >12) were enrolled in this prospective, double-masked comparison of eye drops containing 0.15% HA-hydroxypropyl guar (HPGuar), 0.2% HA, and 0.1% HA. Participants were randomized to the eye drop order and the study eye under evaluation. Each eye drop was admixed with a fluorescent tracer (70-kDa fluorescein isothiocyanate-dextran) at 10% wt/vol, and 10 μL volume was instilled for each evaluation. A fluorophotometer was used to measure the time for the tracer signal to return to baseline. Fluorescein tear breakup time was measured following fluorophotometry assessment. RESULTS: Retention time for 0.15% HA-HPGuar and 0.2% HA was significantly longer compared with 0.1% HA (p=0.02 and p=0.03). Fluorescein tear breakup time was significantly longer for the 0.15% HA-HPGuar eye drop compared with both the 0.1% HA eye drop (p=0.01) and 0.2% HA eye drop (p=0.003). CONCLUSIONS: Retention time on the ocular surface of the two eye drops containing higher concentrations of HA was longer than the eye drop with the lowest concentration of HA. The tear film was also more stable with the 0.15% HA-HPGuar eye drop compared with the eye drops containing HA alone, which may be attributable to the other components in the 0.15% HA-HPGuar eye drop.
SIGNIFICANCE: When using lissamine green for bulbar conjunctival evaluation, the most staining was observed with two applications of the same strip in the same eye, wetted with a drop of saline. The first application was...SIGNIFICANCE: When using lissamine green for bulbar conjunctival evaluation, the most staining was observed with two applications of the same strip in the same eye, wetted with a drop of saline. The first application was 5 seconds after wetting the strip, and the second was 1 minute later, followed by immediate viewing. This suggests that bulbar staining should be viewed before the lid wiper region. PURPOSE: This study aimed to optimize the assessment of lissamine green staining of the bulbar conjunctiva by investigating the application technique and subsequent observation period. METHODS: Twenty-two participants with dry eye (as defined by the Tear Film and Ocular Surface Society Dry Eye Workshop II) were recruited to trial five application methods in randomized order: (1) application immediately after wetting a single strip, (2) application 5 seconds after wetting a single strip, (3) application 10 seconds after wetting a single strip, (4) consecutive single application of sodium fluorescein followed by lissamine green 5 seconds after wetting, and (5) two applications using the same lissamine green strip 5 seconds after wetting, 1 minute apart. Slit-lamp photography of the conjunctiva was performed immediately following application and at 30, 60, 90, and 300 seconds after application. Three experienced (masked) practitioners independently quantified the visible punctate spots and graded the staining intensity within the images in a random order. RESULTS: Values for punctate spot count ( F = 6.29, p<0.0001) and lissamine green staining intensity ( F = 6.29, p<0.0001) varied significantly between the different application methods. Using two applications of the same lissamine green strip, 1 minute apart, in the same eye resulted in the greatest values for both punctate spot count and lissamine green staining intensity. Lissamine green staining decreased with time for both spot count ( F = 18.87, p<0.0001) and lissamine green staining intensity ( F = 11.33, p<0.0001), with the most staining found immediately after application followed by a gradual decline. There was no evidence of any interaction effect between time and application method for either measure (p>0.05 for both). CONCLUSIONS: The optimal approach for assessing bulbar conjunctival lissamine green staining involves two applications of a whole infused drop resting on the same strip for 5 seconds, applied 1 minute apart. The ocular surface should be viewed immediately after application to maximize the conjunctival staining observed.
Optom Vis Sci
· 2024 Aug · PMID 39163120
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SIGNIFICANCE: People with peripheral field loss report colliding with other pedestrians on their blind side(s). We show that, in dyadic collision scenarios between persons, one with field loss, such as homonymous hemiano...SIGNIFICANCE: People with peripheral field loss report colliding with other pedestrians on their blind side(s). We show that, in dyadic collision scenarios between persons, one with field loss, such as homonymous hemianopia, and the other normally sighted pedestrian, collisions occur only if the persons with homonymous hemianopia are overtaking the pedestrians, and the collision risk is concentrated at farther bearing angles than previously suggested. PURPOSE: Prior work computed the risk of collision while simulating both pedestrians as points and did not consider the ability of the other pedestrian's normal vision to avoid the collision. We extended the model to better characterize the open space collision risk posed for persons with homonymous hemianopia by normally sighted pedestrians where both have volume. METHODS: We computed the risk of collision with approaching pedestrians using a model that simulates approaching pedestrians as volumetric entities without vision, volumetric entities with vision, and as points for comparison with the prior work. Collision risk of approaching pedestrians is characterized for all three conditions through spatial collision risk maps and collision risk densities as a function of bearing and radial distances. RESULTS: The collision risk for volumetric pedestrians is slightly different from that of point pedestrians. For volumetric pedestrians simulated with normal vision, the risk of collision was reduced substantially, as the other pedestrians could detect and avoid most impending collisions. The remaining collision risk is from pedestrians approaching at higher bearing angles (>50°) and from shorter radial distances (<2 m). Thus, collisions occurred when the pedestrians started in front of the person with homonymous hemianopia that was overtaking the pedestrian. CONCLUSIONS: The probability of collisions between pedestrians and the person with peripheral field loss is low and occurs only when the person with peripheral field loss is walking from behind the pedestrian at faster speed, thereby overtaking them. Such collisions occur with pedestrians at higher bearing angles, which should be monitored by assistive aids to avoid collisions. The same collision risk applies not only in homonymous hemianopia but also in other peripheral field loss such as monocular vision loss or concentric field loss, as common in retinitis pigmentosa and glaucoma.
Skerswetat J, He J, Shah JB
… +3 more, Aycardi N, Freeman M, Bex PJ
Optom Vis Sci
· 2024 Jul · PMID 39110980
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SIGNIFICANCE: Angular Indication Measurement (AIM) is an adaptive, self-administered, and generalizable orientation-judgment method designed to interrogate visual functions. We introduce AIM Visual Acuity (VA) and show i...SIGNIFICANCE: Angular Indication Measurement (AIM) is an adaptive, self-administered, and generalizable orientation-judgment method designed to interrogate visual functions. We introduce AIM Visual Acuity (VA) and show its features and outcome measures. Angular Indication Measurement VA's ability to detect defocus was comparable with that of an Early Treatment of Diabetic Retinopathy Study (ETDRS) letter chart and showed greater sensitivity to astigmatic blur. PURPOSE: This proof-of-concept study introduces Angular Indication Measurement and applies it to VA. METHODS: First, we compared the ability of AIM-VA and ETDRS to detect defocus and astigmatic blur in 22 normally sighted adults. Spherical and cylindrical lenses in the dominant eye induced blur. Second, we compared repeatability over two tests of AIM-VA and ETDRS. RESULTS: A repeated-measure analysis of variance showed a main effect for defocus blur and test. For the astigmatism experiment, an interaction between blur and orientation was found. Pairwise comparisons showed that AIM was more sensitive to astigmatic-induced VA loss than ETDRS. Bland-Altman plots showed small bias and no systematic learning effect for either test type and improved repeatability with more than two adaptive steps for AIM-VA. CONCLUSIONS: Angular Indication Measurement VA's ability to detect defocus was comparable with that of an ETDRS letter chart and showed greater sensitivity to induced astigmatic blur, and AIM-VA's repeatability is comparable with ETDRS when using two or more adaptive steps. Angular Indication Measurement's self-administered orientation judgment approach is generalizable to interrogate other visual functions, e.g., contrast, color, motion, and stereovision.