Optometry And Vision Science[JOURNAL]
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200 papers
Location of visual field defects and their impact on vision-related quality of life in glaucoma: A systematic review.
Higgins BE, Crabb DP, Jones PR … +1 more , Gardiner SK
Optom Vis Sci · 2026 Apr · PMID 42087071 · Publisher ↗
BACKGROUND: Regional patterns of visual field (VF) loss may affect vision-related quality of life (QoL) differently in people with glaucoma; yet evidence across studies remains inconsistent. OBJECTIVES: To identify and e...
BACKGROUND: Regional patterns of visual field (VF) loss may affect vision-related quality of life (QoL) differently in people with glaucoma; yet evidence across studies remains inconsistent. OBJECTIVES: To identify and evaluate studies comparing vision-related QoL, measured by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), with specific regions of VF loss in glaucoma. DATA SOURCES: MEDLINE, EMBASE, CINAHL, PsycINFO, and AMED were systematically searched from inception to April 2025. STUDY ELIGIBILITY CRITERIA: Eligible studies included adults with glaucoma that examined regional VF loss (e.g., central vs. peripheral, hemifield, or cluster analyses) and reported NEI-VFQ-25 outcomes. Studies using only global VF indices were excluded. STUDY APPRAISAL AND SYNTHESIS METHODS: Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute tools. Due to heterogeneity in VF metrics and NEI-VFQ-25 scoring approaches, the findings were synthesized narratively. RESULTS: Nine studies (n = 2626 participants) met the inclusion criteria. Most cohorts were relatively young (mean age mid-60s) with mild-moderate glaucoma; only two included participants with advanced loss. Despite methodological variation, a consistent pattern emerged: central and inferior VF loss were most strongly associated with poorer QoL, whereas superior and peripheral loss showed weaker or domain-specific effects. Associations were generally stronger when using better-eye or integrated VF measures. LIMITATIONS: The evidence base is limited by few studies, small sample sizes, predominance of mild disease, and variability in both VF and NEI-VFQ-25 methodologies. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Central and inferior VF loss appear most closely linked to reduced QoL; however, conclusions are constrained by the limited number and methodological heterogeneity of available studies. Larger, standardized investigations across disease stages are needed to clarify these relationships and guide patient-centered care. TRIAL REGISTRATION: PROSPERO CRD420251169334.
Assessment of the Dry Eye Questionnaire and a modified Ocular Surface Disease Index in children aged 6-17 years.
Pang Y, Ren LY, Ren DR … +1 more , Ernst J
Optom Vis Sci · 2026 Apr · PMID 42087069 · Publisher ↗
PURPOSE: The purpose of this study was to validate DEQ-5 and mOSDI in children using Rasch analysis and determine the optimal cutoff value for DEQ-5 to differentiate dry eye symptoms defined by mOSDI in children aged 6-1...
PURPOSE: The purpose of this study was to validate DEQ-5 and mOSDI in children using Rasch analysis and determine the optimal cutoff value for DEQ-5 to differentiate dry eye symptoms defined by mOSDI in children aged 6-17 years. In addition, the repeatability of mOSDI and DEQ-5 were investigated in children. METHODS: A total of 225 children were recruited. Both DEQ-5 and mOSDI were administered to participants in a randomized sequence. Retests of the two questionnaires were performed after 30 min in 72 participants. A receiver operating characteristic (ROC) curve was generated to determine the sensitivity and specificity of the DEQ-5 questionnaire for diagnosis of dry eye symptoms. Repeatability of both questionnaires was evaluated using coefficient of repeatability (CoR) and 95% limits of agreement. RESULTS: The median of mOSDI score was 11.4 (Inter-quartile range: 4.5-20.5). The median DEQ-5 score was 4.0 (Inter-quartile range: 2.0-7.0). The area under the curve of the ROC curve for DEQ-5 was 0.78 (p < 0.0001). A DEQ-5 threshold of 4.5 yielded maximum sensitivity (72.2%) and specificity (66.1%) to differentiate dry eye symptoms in children. Females had significantly higher OSDI scores than males. CoR was ±4.8 for DEQ-5 and ±16.6 for mOSDI. The 95% limits of agreement were 5.5 to -4.2 for DEQ-5 and 16.5 to -16.7 for modified OSDI. Rasch analysis demonstrated that the five-level response scales in both the mOSDI and DEQ-5 produced disordered item thresholds. Collapsing the response scales from five to three categories improved overall model fit. CONCLUSIONS: Although we identified a DEQ-5 cutoff value of ≥5 for differentiating dry eye symptoms in children, which is different from that used in adults (≥6), the five-level response scales of both the mOSDI and DEQ-5 may not be optimal for the pediatric population and certain items might not be adequate to measure dry eye symptoms, thus we do not recommend using DEQ-5 in children to measure dry eye symptoms. This underscores the need to develop a dry eye questionnaire specifically designed for children to ensure more accurate assessment.
Exploring the role of low-dose atropine in myopia management in children with inherited retinal diseases.
Azmon R, Kreindler A, Ezra Kahtan B … +6 more , Knisbacher I, Mysler M, Ehrenberg M, Hendler K, Khateb S, Yahalom C
Optom Vis Sci · 2026 Apr · PMID 42087059 · Publisher ↗
PURPOSE: This study aimed to evaluate the effectiveness of low-dose atropine in slowing myopic progression in children with inherited retinal diseases (IRDs) and myopia. METHODS: Retrospective study of children with IRDs...
PURPOSE: This study aimed to evaluate the effectiveness of low-dose atropine in slowing myopic progression in children with inherited retinal diseases (IRDs) and myopia. METHODS: Retrospective study of children with IRDs, comparing myopia progression between those who received atropine drops and those who did not was conducted. Annual myopia progression rates were estimated from longitudinal spherical equivalent measurements. Progression was compared between groups using the Mann-Whitney U test and within groups using the Wilcoxon signed-rank test. RESULTS: A total of 27 children (262 refractive examinations) with IRDs and myopia were included (atropine group: 12 children and control group: 15 children). TRPM1 was the most common gene in both groups. Treatment with atropine was initiated at a mean age of 6.4 years. In the atropine group, mean annual myopic progression decreased from -1.01 D/year before treatment to -0.28 D/year after treatment initiation. In the control group, mean annual myopic progression decreased from -0.81 D/year before 6 years of age to -0.45 D/year thereafter. CONCLUSIONS: In children with IRDs, low-dose atropine treatment did not significantly alter myopia progression once age-related effects were accounted for. Early intervention might be required, suggesting the need for future studies exploring earlier treatment and alternative optical strategies for myopia management in this vulnerable pediatric population.
Systematic review: The ocular surface in the aircraft environment.
Mikhail E, Markoulli M
Optom Vis Sci · 2026 Apr · PMID 42086513 · Publisher ↗
BACKGROUND: The ocular surface is known to respond in certain ways in the aircraft environment, with subsequent symptomatic consequences for the individual. This has been found in several studies, which revealed symptoms...
BACKGROUND: The ocular surface is known to respond in certain ways in the aircraft environment, with subsequent symptomatic consequences for the individual. This has been found in several studies, which revealed symptoms of dry eye disease, while also demonstrating objective signs. Thus, with the increase in direct ultra long-haul flights, there needs to be a further understanding of the impact of flying on the eye and specifically, the ocular surface. PURPOSE: The aim of this review is to explore existing knowledge on the impact of the aircraft environment on the ocular surface, with the aim of guiding future advancements in this area. METHODS: Google Scholar, PubMed, and ScienceDirect electronic databases were used to identify studies conducted on the ocular surface in the aircraft environment. Terminology used for aircraft included "aeroplane," "airplane," "aircraft," "flying," "long flights," and "flights," and terminology used for ocular surface included "dry eye," "ocular surface," "ocular allergy," and "environmental exposures." RESULTS: Thirty studies were retrieved. It was found that the primary risk factors in the aircraft environment that affect the ocular surface include relative humidity, temperature, air velocity, atmospheric pressure, and air quality. CONCLUSIONS: The aircraft environment affects the ocular surface in a number of ways, and strategies to mitigate these effects should be explored in future studies.
Pathological suppression of binocular vision in stroke.
Houston KE, Labib M, Baker DH … +4 more , Ayturk D, McHenry A, Mortazavi S, Barrett AM
Optom Vis Sci · 2026 Apr · PMID 42062776 · Publisher ↗
PURPOSE: Two prior studies suggested a relationship between spatial neglect and reduced diplopia reporting. In spatial neglect with visual extinction phenomenon, the double image on the neglected side may be extinguished...
PURPOSE: Two prior studies suggested a relationship between spatial neglect and reduced diplopia reporting. In spatial neglect with visual extinction phenomenon, the double image on the neglected side may be extinguished from perception, representing a pathological binocular suppression. We retrospectively reviewed the binocular vision testing battery routinely performed at one inpatient rehabilitation hospital vision clinic to better understand reduced diplopia reporting and look for evidence of pathological suppression. METHODS: One hundred fifty-five consecutive patient charts were retrospectively reviewed. Significant predictors of denial of double vision in patients with recent stroke and strabismus (N = 55) or prism induced strabismus (N = 98) were identified with logistic regression. Additionally, three clinicians rated the likelihood (1 to 10) of suppression in each case and predictors of the rating were identified with a cumulative logit model. Cases with likelihood rating >7/10 were flagged and examined individually. RESULTS: Only 15 of 155 patients passed all suppression tests administered (9.7%). Fifty-three percent of patients with strabismus actively denied diplopia. When controlling for significant effects of age, patients with spatial neglect had 3.9 greater odds of denying diplopia (OR (95% CI) 3.91 (1.70, 8.96)). Inter-ocular acuity difference and hemianopia were not significant predictors. A high likelihood of suppression was associated with parietal lobe injury, (3.40 (1.22-9.30)). The side of the brain was not significant (α = 0.05). Five patients had a likelihood rating greater than 7 out of 10 and so were likely exhibiting pathological suppression. CONCLUSIONS: Denial of diplopia is associated with spatial neglect and age. In some cases, this likely represents a pathological suppression of binocular vision.
At-home visual acuity in children using a custom iPhone application compared with standardized in-office visual acuity testing.
Roberts TL, Bothun ED, Zhu Y … +27 more , Henderson RJ, Boyle NM, Leske DA, Hatt SR, Wernimont SM, Marino CE, Raghuram A, Manh VM, Youngerman JM, Qayum JN, Srinivasan G, Titelbaum JR, Crouch ER, Colburn JD, Esposito CA, Zeto VL, Connolly KS, Bhakta RM, Lorenzana IJ, McDowell PS, Beaulieu WT, Kraker RT, Holmes JM, Pineles SL, Weise KK, Cotter SA, Pediatric Eye Disease Investigator Group
Optom Vis Sci · 2026 Apr · PMID 42062237 · Publisher ↗
PURPOSE: To validate a custom smartphone application for at-home visual acuity (VA) measurement in children. METHODS: A total of 452 children aged 3-17.5 years participated. Certified examiners measured in-office test-re...
PURPOSE: To validate a custom smartphone application for at-home visual acuity (VA) measurement in children. METHODS: A total of 452 children aged 3-17.5 years participated. Certified examiners measured in-office test-retest VA (logMAR) using gold-standard Amblyopia Treatment Study HOTV (3-to-6-year-olds, younger cohort) or electronic Early Treatment of Diabetic Retinopathy Study (7-to-17.5-year-olds, older cohort) protocols at 3-4.5 m and app-based VA at 1.5 m. Caregivers measured at-home app-based VA at 1.5 m. RESULTS: Comparing at-home app-based with gold-standard VA, in eyes 20/40 or better, 95% (143/151) and 93% (91/98) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = -0.03, older = -0.04; 95% limits-of-agreement half-width (LOA): younger = ±0.26, older = ±0.22). In eyes 20/50 or worse, 66% (42/64) and 75% (76/101) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = 0.11, older = 0.13, LOA: younger = ±0.50, older = ±0.51). Comparing in-office app-based VA with gold-standard VA, in eyes 20/40 or better, 98% (160/164) and 94% (99/105) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = -0.03, older = -0.03; LOA: younger = ±0.22; older = ±0.24). In eyes 20/50 or worse, 85% (60/71) and 91% (101/111) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = 0.04; older = 0.04; LOA: younger = ±0.39; older = ±0.24). For gold-standard test-retest, in eyes 20/40 or better, 99% (163/164) and 99% (104/105) of the younger and older cohorts had retest within 2 lines, respectively (mean differences: younger = 0.00; older = 0.01; LOA: younger = ±0.17; older = ±0.11). For 20/50 or worse, 92% (66/72) and 100% (111/111) in the younger and older cohorts were within 2 lines, respectively (mean differences: younger = 0.01; older = 0.02; LOA: younger = ±0.35; older = ±0.15). CONCLUSIONS: Our app demonstrated good concordance with the gold standard at home and in the office for eyes with VA of 20/40 or better. However, concordance decreased considerably for eyes with VA 20/50 or worse, particularly at home.
Factors influencing glaucoma medication adherence: A qualitative study in the United Kingdom using the Theoretical Domains Framework.
Bott D, Subramanian A, Edgar DF … +2 more , Lawrenson JG, Campbell P
Optom Vis Sci · 2026 Apr · PMID 42056712 · Publisher ↗
PURPOSE: Long-term adherence to glaucoma medication is often suboptimal, compromising treatment efficacy and increasing the risk of glaucoma progression. Existing interventions have limited success. This study explored b...
PURPOSE: Long-term adherence to glaucoma medication is often suboptimal, compromising treatment efficacy and increasing the risk of glaucoma progression. Existing interventions have limited success. This study explored behavioral factors influencing adherence from the perspectives of United Kingdom (UK)-based patients with glaucoma and eye care professionals (ECPs), using the Theoretical Domains Framework (TDF). METHODS: Semi-structured interviews were conducted with adults prescribed intraocular pressure-lowering eyedrops whose adherence status was classified based on self-reported medication use and UK-registered ECPs involved in glaucoma care. Interview data were analyzed using deductive and inductive thematic analysis guided by the TDF to identify key barriers and enablers influencing adherence-related behaviors. RESULTS: Twenty-six participants were interviewed (13 patients and 13 ECPs). For patients, adherence was influenced by factors relating to knowledge and understanding of glaucoma, skills required to administer and obtain medication, memory and routine formation, beliefs about treatment necessity, social support, and healthcare system factors such as medication availability. ECPs identified time constraints, limited resources, and uncertainty in assessing adherence as key challenges, whereas communication skills, multidisciplinary support, and tailored decision-making were viewed as important enablers. CONCLUSIONS: Glaucoma medication adherence is shaped by a complex interplay of behavioral, professional and systemic factors. Applying the TDF highlights modifiable influences on adherence and supports the development of targeted, theory-informed interventions to improve glaucoma outcomes.
Evaluating quality of patient-reported outcome measures in keratitis: A systematic review.
Alemu HW, Kumaran SE, Carnt N … +3 more , Assaye AK, Baral P, Pesudovs K
Optom Vis Sci · 2026 Apr · PMID 42056444 · Publisher ↗
PURPOSE: To evaluate the quality of existing patient-reported outcome measures (PROMs) used to assess the impact of keratitis on the quality of life (QoL). METHODS: A literature search was conducted using Embase, PubMed,...
PURPOSE: To evaluate the quality of existing patient-reported outcome measures (PROMs) used to assess the impact of keratitis on the quality of life (QoL). METHODS: A literature search was conducted using Embase, PubMed, Scopus, Web of Science, CINAHL, and PsycINFO. The review included PROMs used to assess the impact of keratitis on QoL. Data on the content development and psychometric properties were extracted. Quality assessment was performed using the established criteria for ophthalmic PROMs. RESULTS: A total of seven articles met our inclusion criteria. The study populations in the reviewed articles consist of individuals diagnosed with different types of microbial keratitis. Ten unique PROMs were reviewed. Nine were ophthalmic and one was generic. Only the impact of vision impairment PROM has undergone psychometric validation in keratitis. Although the validation indicated acceptable unidimensionality (grade B), both the eigenvalue and item-person targeting demonstrated misfit to the Rasch model. Psychometric appraisal showed that keratitis patients were not involved in PROM content development, leading to misalignment and inconsistencies between the constructs outlined by the instruments and evaluation findings. Limited available literature constrains the depth of this review. CONCLUSIONS: Initiating psychometric validation of the PROM in keratitis conditions is a good starting point. All evaluated PROMs lack psychometric validation and are not specific to keratitis. The findings of this review underscore the need to create a psychometrically robust, keratitis-specific PROM. The systematic review registration number is CRD42023449213.
Malpractice payments by optometrists in the United States: An analysis of the National Practitioner Data Bank from 1996 to 2023.
Duszak RS, Phan MS, Duszak R
Optom Vis Sci · 2026 Apr · PMID 42045747 · Publisher ↗
PURPOSE: To analyze trends in malpractice payments made on behalf of U.S. optometrists from 1996 to 2023 using National Practitioner Data Bank (NPDB) data, and to assess whether state-level scope-of-practice expansions a...
PURPOSE: To analyze trends in malpractice payments made on behalf of U.S. optometrists from 1996 to 2023 using National Practitioner Data Bank (NPDB) data, and to assess whether state-level scope-of-practice expansions are associated with increased liability risk. METHODS: Publicly available NPDB data were reviewed for malpractice payments involving optometrists between 1996 and 2023. Variables included number and value of payments, provider age, patient demographics, geographic distribution, and allegation category. Nationwide trends were analyzed using the Mann-Kendall test; pre- and post-scope expansion comparisons in 11 states were evaluated using the Mann-Whitney rank-sum test. All monetary values were inflation adjusted to 2023 U.S. dollars. RESULTS: A total of 1040 malpractice payments were recorded (mean 38.5 cases/year). Mean payment was $220,918 (SD $311,395; range $300-$2.95 million). The average provider age was 43 years; 56% of patients were >50 years old. 'Failure to diagnose' accounted for 40% of primary allegations. Inflation-adjusted total payments demonstrated a significant upward trend (p = 0.008) that became nonsignificant after excluding 2021-2023 (p = 0.15). No significant change in annual case numbers was observed (p = 0.28). Among 11 states with expanded optometric authority, no statistically significant increase in malpractice cases occurred post-expansion except in Indiana (p = 0.049). Expanded-scope states mirrored national trends in both payment frequency and amount. CONCLUSIONS: Malpractice payments involving optometrists remain infrequent and financially modest compared with other health professions, with most claims arising from diagnostic rather than procedural issues. There is no evidence that expanding optometric privileges, including lasers, injections, or oral medications, has increased malpractice risk. Advances in education, technology, and interprofessional collaboration likely underpin this stability. Ongoing monitoring of NPDB data will help ensure that optometry's growing clinical role continues to align with patient safety and professional accountability.
Online circular contrast perimetry: Tablet validation study against desktop test and standard automated perimetry.
Abdul R, Khoder AA, Gong A … +2 more , Busija L, Skalicky SE
Optom Vis Sci · 2026 Apr · PMID 42045136 · Publisher ↗
PURPOSE: To assess correlation, agreement and diagnostic accuracy of a new tablet-based 24-degree, 52-point online circular contrast perimetry application (OCCP), compared to computer-based OCCP and standard automated pe...
PURPOSE: To assess correlation, agreement and diagnostic accuracy of a new tablet-based 24-degree, 52-point online circular contrast perimetry application (OCCP), compared to computer-based OCCP and standard automated perimetry (SAP). METHODS: Seventy-five participants (26 controls, 49 glaucomatous) were tested via SAP using Humphrey field analyzer (Zeiss), then by computer OCCP on a 24-inch monitor, followed by two OCCP tests on a tablet (iPad Air 5th gen). Key outcome measures included pattern standard deviation (PSD), mean deviation (MD), mean sensitivity per point, and visual field index (VFI)/visual index (VI). RESULTS: Agreement and correlation of VFI, PSD, and MD between OCCP tablet and SAP were very strong, with spearman's ρ and intra-class correlation coefficients between 0.81-0.86 and 0.80-0.93, respectively. MD Bland-Altman bias was greater for OCCP tablet against SAP-0.53 to 0.68 dB-compared to OCCP computer against SAP at 0.05 dB. 95% limits of agreement were comparable for OCCP versus SAP. Point-by-point Bland-Altman bias demonstrated tighter agreements between OCCP tablet and OCCP personal computer (PC) compared to OCCP generally and SAP. Receiver-operating-characteristic curves were comparable across outcomes between all OCCP tests, SAP, and cirrus optical coherence tomography parameters with no significant differences. Test duration was longer for OCCP tablet than SAP, whereas OCCP PC was shorter than SAP (p < 0.001). CONCLUSIONS: OCCP tablet has strong correlation, agreement, and similar area-under-curve in identifying glaucomatous eyes from controls to both SAP and OCCP computer, demonstrating prospect as a tool for glaucoma perimetry testing in low-resource settings, with further enhancements to reduce test duration.
Psychometric evaluation of the Copenhagen Burnout Inventory: Rasch analysis of burnout among optometrists.
Retallic N, Davey CJ, Elliott DB
Optom Vis Sci · 2026 Apr · PMID 42045135 · Publisher ↗
PURPOSE: The purpose of this paper is to validate the Copenhagen Burnout Inventory (CBI) using Rasch analysis and to generate Rasch-calibrated scores for use in future research. Despite its widespread use, the CBI has un...
PURPOSE: The purpose of this paper is to validate the Copenhagen Burnout Inventory (CBI) using Rasch analysis and to generate Rasch-calibrated scores for use in future research. Despite its widespread use, the CBI has undergone limited psychometric evaluation, predominantly using classical test theory. METHODS: CBI data were collected online in a cross-sectional study involving 1303 UK-based, patient-facing optometrists. Rasch analysis was used to assess the psychometric properties of the CBI, including item fit, response category functioning, personal reliability, and unidimensionality. Model refinement opportunities were explored, and differential item functioning (DIF) was evaluated across gender and age. RESULTS: The three subscales of the CBI: personal, work-related, and patient-related burnout demonstrated strong psychometric properties, with good discrimination, appropriate response category functioning, and unidimensionality, respectively. Limitations included a small number of items across all subscales displaying minor misfit, though these had minimal impact on the overall model fit and a floor effect (22%) was observed across the patient-related scale. No significant DIF was found for gender or age, supporting the cross-group validity and measurement invariance of the instrument. CONCLUSIONS: This study indicates that the CBI is a psychometrically valid instrument for measuring burnout, although additional validation in other populations would be beneficial. Rasch-derived interval-level scores improve the precision and comparability of measurement, providing advantages over traditional ordinal methods. The CBI is a valuable tool for detecting burnout, guiding targeted interventions, and informing strategies to address burnout among healthcare professionals.
Case series: The value of fundus autofluorescence in inherited macular disease.
Guro M, Wang H, Phu J … +4 more , Patel NB, Sapoznik KA, Shah H, Kalloniatis M
Optom Vis Sci · 2026 Mar · PMID 42020924 · Full text
PURPOSE: To evaluate the diagnostic utility of fundus autofluorescence (FAF) imaging in identifying and characterizing phenotypically classified inherited macular dystrophies. In this way, we aim to provide methods by wh...
PURPOSE: To evaluate the diagnostic utility of fundus autofluorescence (FAF) imaging in identifying and characterizing phenotypically classified inherited macular dystrophies. In this way, we aim to provide methods by which eye care practitioners can link FAF imaging and other clinical results or imaging modalities to aid their clinical decision-making. CASE REPORTS: Phenotypically identified inherited macular dystrophies, including Stargardt disease and related ABCA4 mutations, Best vitelliform dystrophy, pattern dystrophies, and cone and cone-rod dystrophies, are discussed. CONCLUSIONS: We provide evidence that the use of FAF alone and in combination with other clinical results and imaging modalities can assist in the diagnosis of a range of inherited macular dystrophies.
Landscape analysis of school-based vision programs in the United States: A survey study.
Rahmeh SM, Guo X, Kallem M … +1 more , Collins ME
Optom Vis Sci · 2026 Mar · PMID 42020923 · Publisher ↗
PURPOSE: Currently, there are neither guidelines for school-based vision program operations nor a registry of programs that exist in the United States. We aim to describe the characteristics of school-based vision progra...
PURPOSE: Currently, there are neither guidelines for school-based vision program operations nor a registry of programs that exist in the United States. We aim to describe the characteristics of school-based vision programs across the United States through a survey. METHODS: We identified 10 organizations that operated one or more school-based vision programs during the 2022-2023 school year. We developed and distributed an online survey form to collect information on program demographics, program components, and protocols for vision screenings and eye exams, as well as procedures for obtaining consent, dispensing glasses, and funding resources. Organizations were asked to complete a survey for each school district in which they operated, which we defined as an individual program. Programs that did not complete the survey were excluded. We used descriptive statistics to describe program characteristics. We compared grade levels that received vision screening by school-based vision programs and their respective screening mandate in the state where the programs operated. RESULTS: Seven organizations participated and provided data about 184 unique school-based vision programs. These programs operated in 19 states and the District of Columbia. All 184 programs provided vision screenings, eye exams, and eyeglasses. 94.6% of programs included instrument-based screening, with 46.7% using it exclusively. School-based vision programs most frequently screened elementary school grades. For eye exams, 81% of programs utilized opt-out consent; 21.7% of programs included dilation. Vision screenings were mostly conducted by program staff (164/184, 89.1%), and eye exams were performed by optometrists (183/184, 99.5%). Nine programs (5.0%) reported providing additional care beyond eyeglasses provision, while 135 (73.4%) reported having an established relationship with community eye care providers for students referred for additional evaluation and care. CONCLUSIONS: Many school-based vision programs operate in the United States. These programs focus on vision screening, eye exams, and eyeglasses provision. Establishing a registry of programs would help to disseminate lessons learned and track outcomes data. Future programs will benefit from guidelines to ensure they are operating according to best practices.
Small areas of damage due to glaucoma are less likely to be identified by SITA-Faster than SITA-Standard.
Turpin A, Muthusamy V, Morgan WH … +2 more , Chan G, McKendrick AM
Optom Vis Sci · 2026 Mar · PMID 42020862 · Publisher ↗
PURPOSE: To examine if clusters of colocated damaged locations repeatedly found during prior SITA-Standard (SS) visual field tests are not replicated in a subsequent SITA-Faster (SFR) test. METHODS: Visual field series f...
PURPOSE: To examine if clusters of colocated damaged locations repeatedly found during prior SITA-Standard (SS) visual field tests are not replicated in a subsequent SITA-Faster (SFR) test. METHODS: Visual field series from the Lions Eye Institute, Perth, Australia were extracted if they had at least 4 SS fields followed by a SFR field and all fields had false positive rates and fixation losses less than 15%. Clusters of damaged locations were defined as either an isolated location with no damaged neighbors or a group of connected 24-2 points (not crossing the horizontal) that all had Pattern Deviation (PD) probability values below 1% of normal in all 3 SS tests immediately preceding the SFR test. For each cluster, the number of locations that were damaged in the SFR field that overlapped the established and repeatable SS clusters was computed and reported. We compare this proportion of overlap against the same calculations using the last SS as the final field. We also examine the effect of relaxing the PD criteria for damage in the final field on the proportion of overlap. RESULTS: 2519 eyes were included. For established, repeatable, and clusters of size 1, 2, 3, and 4 locations, the follow-up SFR field completely missed 46%, 26%, 11%, and 14% of the clusters whereas SS missed significantly less 26%, 11%, 4% and 1% (t-test with mixed paired and unpaired observations and p < 0.05). Relaxing the criteria for damage in the final field to PD < 5% reduced the miss rates for both methods, but SFR was still significantly worse than SS (SFR: 24%, 8%, 3%, and 6% vs. SS: 13%, 3%, 1%, and 1%). CONCLUSIONS: SITA-Faster tends to miss established clusters of damaged locations of size 4 or fewer locations in follow up visits at a higher rate than SITA-Standard.
Bioptic driving: Historical milestones, current landscape, and future directions.
Deffler RA, Raasch TW, Dougherty BE
Optom Vis Sci · 2026 Mar · PMID 42020686 · Publisher ↗
A bioptic telescope is a small telescope mounted in the upper portion of a pair of eyeglasses that, when used for driving, allows a driver with central vision loss to briefly spot through the telescope to gain a magnifie...
A bioptic telescope is a small telescope mounted in the upper portion of a pair of eyeglasses that, when used for driving, allows a driver with central vision loss to briefly spot through the telescope to gain a magnified view of the roadway scene ahead. This paper summarizes the various ways bioptic driving has been studied, provides an update on bioptic driving research, and suggests future areas of work related to bioptic drivers. As the number of jurisdictions permitting bioptic driving increases, this review provides context regarding the history of bioptic driving, characteristics of bioptic drivers, and the safety of these drivers with vision impairment. Recent research has incorporated naturalistic recording methods that allow for study of specific safety events, the measurement of collision and near collision behavior on open roads, and adjustment for driving exposure in ways not previously possible. Still, studies of bioptic driving safety have been limited to North America, and small sample sizes and inadequate control groups remain challenges to interpretation, and more work should be done to determine what characteristics of bioptic drivers and other factors are related to safety. Suggestions for future research include study of the effects of newer advanced driver assistance systems on bioptic driving and development of evidence-based training programs.
Compensation for axial elongation during multifocal soft contact lens wear: Results from the BLINK study.
Mutti DO, Sinnott LT, Jones-Jordan LA … +6 more , Berntsen DA, Giannoni AG, Orr DJ, Holmberg DM, Walline JJ, BLINK Study Group
Optom Vis Sci · 2026 Mar · PMID 42020655 · Publisher ↗
PURPOSE: To determine the effect of +2.50 D add multifocal soft contact lenses (MFSCLs) compared to +1.50 D add and single vision contact lenses (SVCLs) on the relationship between axial elongation and myopia progression...
PURPOSE: To determine the effect of +2.50 D add multifocal soft contact lenses (MFSCLs) compared to +1.50 D add and single vision contact lenses (SVCLs) on the relationship between axial elongation and myopia progression. METHODS: Individual estimates of D/mm were derived from the CLEERE Study, then applied to data from 289 participants in the BLINK Study to determine the portion of axial elongation that either contributed (uncompensated elongation) or did not contribute to myopia progression (compensated elongation). BLINK participants had myopia between -0.75 D and -5.00 D and were 7-11 years of age when enrolled in a 3-year clinical trial of multifocal contact lens myopia control. Cycloplegic refractive error was measured under tropicamide cycloplegia with the Grand Seiko WAM-5500 Binocular Autorefractor/Keratometer and axial length was measured using the Lenstar LS 900. RESULTS: The majority of the inhibition of axial elongation during myopia control with +2.50 D add MFSCLs was inhibition of uncompensated elongation. Over 3 years, axial elongation was less in +2.50 D add MFSCLs (0.39 mm) compared to SVCLs (0.62 mm) by 0.23 mm (95% CI: 0.14, 0.33), split between 0.17 mm (95% CI: 0.091, 0.26) of uncompensated elongation and 0.055 mm (95% CI: 0.013, 0.097) of compensated elongation. Inhibition of compensated elongation only occurred in the first year of the study. Total axial elongation over 3 years would need to be reduced to 0.17 mm (0.45 mm less than 0.62 mm) to result in no myopia progression. CONCLUSIONS: Optical myopia control with multifocal contact lenses has a small but significant effect on the compensation for elongation from changes in the optical components of the eye. As a result, myopia control must set an aggressive therapeutic target if the goal is slowing axial elongation to the point of no net myopia progression.
Interocular mismatches of high-order wavefront aberrations impair stereoacuity following refractive surgeries by reducing the disparity signal quality.
Tang J, Bharadwaj SR, Schor CM … +3 more , Sarkar S, Vaddavalli PK, Metlapally S
Optom Vis Sci · 2026 Mar · PMID 42020351 · Publisher ↗
PURPOSE: (1) To investigate if binocular cross-correlation metrics derived from the aberrated monocular retinal images can explain the deterioration of stereoacuity following keratorefractive surgeries. (2) To investigat...
PURPOSE: (1) To investigate if binocular cross-correlation metrics derived from the aberrated monocular retinal images can explain the deterioration of stereoacuity following keratorefractive surgeries. (2) To investigate if the quality of binocular metrics improves with improved monocular retinal image quality and pupil miosis. METHODS: High-order aberrations (HOAs) were obtained over 6 mm pupil diameter from 99 young adults undergoing photorefractive keratectomy (PRK) (n = 26), laser-assisted in situ keratomileusis (LASIK) (n = 38), and ReLEx small-incision lenticule extraction (SMILE; n = 35) for myopia correction. Point spread functions derived from HOAs were convolved with random-dot stereo pairs and cross-correlated to obtain four binocular metrics-signal width, signal height, signal-to-noise ratio, and height-to-width ratio-that signified the quality of the disparity signal. These metrics were derived pre-operatively and at 1-week, 1-month, 3-month, and 6-month after surgeries, and correlated with the subject's stereoacuity for 6 mm pupil diameters. Binocular metrics were also derived for 4 mm pupil diameters and compared with the 6 mm data. RESULTS: Larger interocular differences in retinal image quality led to reduced disparity signal quality and less optimal values of the binocular metrics. These trends were strongly correlated with the subject's stereoacuity across refractive surgeries (ρ ≥ 0.71; p < 0.001). Relative to pre-operative values, post-operative metrics worsened at 1-week followed by a recovery period (p < 0.001). All post-operative metrics for PRK and LASIK surgeries were similar (p ≥ 0.67), but worse than SMILE surgery (p < 0.001). The binocular metrics derived for the 4 mm pupil diameters were superior to those of the 6 mm pupil diameters (p < 0.001). CONCLUSIONS: Binocular cross-correlation metrics derived from the aberrated monocular retinal images signify the strength of the disparity signal, and capture much of the stereoacuity losses following keratorefractive surgeries for myopia. Binocularity may be better preserved after SMILE surgery owing to the smaller interocular mismatches in optical quality, relative to PRK and LASIK surgeries for comparable pupil diameters.
Control of myopia progression by low-dose atropine (0.01%, 0.025% and 0.05%), defocus incorporated multiple segments/highly aspherical lenslets spectacles, and combined therapy in European children: A 3-year retrospective study.
Grégoire M, Dormegny L, Gaucher D … +3 more , Solecki L, Bourcier T, Sauer A
Optom Vis Sci · 2026 Mar · PMID 42020349 · Publisher ↗
PURPOSE: Myopia control is crucial for pediatric eye care professionals. Although various treatments exist, their comparative efficacy, particularly in European populations, remains unclear. In real-life conditions, this...
PURPOSE: Myopia control is crucial for pediatric eye care professionals. Although various treatments exist, their comparative efficacy, particularly in European populations, remains unclear. In real-life conditions, this study aimed to compare different strategies to slow myopia progression. METHODS: This retrospective, nonrandomized study evaluated the efficacy of 0.01%, 0.025%, and 0.05% atropine, defocus incorporated multiple segments/highly aspherical lenslets (DIMS/HAL) spectacles, combined atropine and DIMS/HAL, and single vision spectacles in 288 European children (aged 5-12 years) with myopia progression (≥0.75 D in the past 12 months). Primary outcomes were changes in spherical equivalent refraction (SER) and axial length measured every 6 months for 3 years. RESULTS: The mean cumulative 3-year SER progressions were -0.75 ± 0.49, -0.92 ± 0.52, and -1.31 ± 0.75 D for the 0.05%, 0.025%, and 0.01% atropine groups, respectively, -1.31 ± 0.76 D for the DIMS/HAL group, and -1.11 ± 0.65 D for the 0.01% atropine + DIMS/HAL group, showing better myopia progression control compared to those of the control group (-2.14 ± 0.72 D). Atropine exhibited a dose-dependent effect, with 0.05% atropine achieving the greatest reduction in myopia progression and axial elongation. CONCLUSIONS: This study demonstrates the efficacy of low-dose atropine and DIMS/HAL spectacles in slowing myopia progression in European children. The 0.05% atropine exhibited the most pronounced myopia control effect.
Case series: A possible association of relative peripheral refraction and lattice degeneration in patients with high myopia.
Antony M, Takkar B, Narula R … +1 more , Verkicharla PK
Optom Vis Sci · 2026 Mar · PMID 42020347 · Publisher ↗
PURPOSE: This case series aims to assess the potential relationship between relative peripheral hyperopia and the presence of lattice degeneration in individuals with myopia. CASE REPORTS: We present three cases of indiv...
PURPOSE: This case series aims to assess the potential relationship between relative peripheral hyperopia and the presence of lattice degeneration in individuals with myopia. CASE REPORTS: We present three cases of individuals with high myopia, aged 11 and 52 years, who were diagnosed with lattice degeneration. The areas of relative peripheral hyperopia were found to correlate with the quadratic location of lattice degeneration lesions. CONCLUSIONS: These observations suggest a potential association between relative peripheral refraction and the development of lattice degeneration in the retina. Relative peripheral hyperopia may serve as a potential marker to detect early pathological changes associated with myopia, particularly lattice degeneration. Longitudinal studies are warranted to validate these findings and further explore their clinical implications.
Peripheral retinal findings in a pediatric primary care optometry clinic and their associations with myopia: A 3-year retrospective review.
Ollinger MC, Bodack MI, Bromley MI
Optom Vis Sci · 2026 Mar · PMID 42020344 · Publisher ↗
PURPOSE: This study aims to detail the frequency of peripheral retinal findings seen in pediatric patients in a primary care optometry clinic, and evaluate the relative frequency of abnormal and pathological peripheral r...
PURPOSE: This study aims to detail the frequency of peripheral retinal findings seen in pediatric patients in a primary care optometry clinic, and evaluate the relative frequency of abnormal and pathological peripheral retinal findings based on myopia magnitude. METHODS: An observational retrospective cross-sectional study analyzed records for 874 patients aged 6-17 years who received routine eye exams at an academic eye care clinic in Memphis, TN between January 2020 and July 2023. Demographic data, refractive error, and peripheral retinal findings, both pathological and non-pathological, were evaluated. Overall frequencies of retinal findings were assessed, and further contrasted between levels of myopia. RESULTS: Abnormal retinal findings were present in 177 participants (20.2%). Pathology was diagnosed in a total of 55 participants (6.3%). The frequency of abnormal peripheral retinal findings increased with myopia severity, with nearly half (44.8%) of patients with 3 or more diopters of myopia having at least one abnormal finding. Significant associations were found between myopia category and the presence of abnormal retinal findings (p < 0.0001), and between myopia category and retinal pathology (p < 0.0001), suggesting that children with 3 or more diopters of myopia have an elevated risk of peripheral retinal pathology detection compared to children with no myopia (odds ratio of 11.5, 95% CI: 4.8-27.8). CONCLUSIONS: These findings highlight the notable frequency of retinal findings in pediatric primary eye care patients. Peripheral retinal pathology is more common in pediatric patients with 3 or more diopters of spherical equivalent myopia, and present across all refractive error statuses. These results underscore the importance of a comprehensive dilated retinal evaluation in children, particularly those with myopia.
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