Optometry And Vision Science[JOURNAL]
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200 papers
Using artificial intelligence in research and writing publications.
Elliott DB
Optom Vis Sci · 2026 Mar · PMID 42014378 · Publisher ↗
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Delays in publication of 2026 papers.
Elliott DB
Optom Vis Sci · 2026 Feb · PMID 42003792 · Publisher ↗
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Uncorrected myopia affects the visual acuity of OFF-pathway more than ON-pathway.
Chen X, Pang Y, Li ZR … +5 more , Vricella M, Rutner D, Zhu X, Alonso JM, Wang J
Optom Vis Sci · 2026 Feb · PMID 42002698 · Publisher ↗
PURPOSE: The balance of responses between the ON and OFF pathways is believed to play an important role in myopia. This pilot study compared the difference in visual acuity under two contrast polarities between myopic ch...
PURPOSE: The balance of responses between the ON and OFF pathways is believed to play an important role in myopia. This pilot study compared the difference in visual acuity under two contrast polarities between myopic children (corrected and uncorrected) and emmetropic children. METHODS: Two groups of children aged 8-12 years were enrolled: a myopic group (spherical equivalent [SEQ] between -0.75 D and -6.00 D, N = 11) and a normal control group (N = 16). Visual acuities were measured using an Early Treatment Diabetic Retinopathy Study program, which presented either white letters against a black background or black letters against a white background. Visual acuity (corrected and uncorrected for the myopic group) under both polarities was tested in randomized order and repeated after a 30-min interval. Visual acuities were reported as letter scores. The ON/OFF ratios of visual acuity scores under the two polarity conditions were calculated and correlated with SEQ. RESULTS: When uncorrected, white-letter visual acuity was significantly better than black-letter visual acuity (p < 0.001) for the myopic group, with a difference of 6 letters (equivalent to 0.12 logMAR). No significant differences in visual acuity scores between the two polarities were found when the myopic group was corrected or in the control group. This suggests that uncorrected myopic eyes have greater difficulty in resolving the spatial resolution of black letters as compared to white letters. The ON/OFF ratio in the uncorrected myopic group was significantly higher than in the corrected myopic group and the control group (1.14 ± 0.09 vs. 0.99 ± 0.04, 1.00 ± 0.03, p < 0.001). When uncorrected, the ON/OFF ratio correlated with SEQ (R = 0.38, t = -2.4, p = 0.02), indicating that the ON/OFF imbalance increases with the magnitude of uncorrected myopic blur. CONCLUSIONS: Children with uncorrected myopic eyes had more difficulty in recognizing black letters compared to white letters, and the ON/OFF imbalance was correlated with the magnitude of uncorrected myopic blur.
Reduced visual acuity disrupts fixational stability but fails to fully capture amblyopic eye movements.
Kwon S, Belen JCA, Yeritsyan A … +1 more , Levi DM
Optom Vis Sci · 2026 Feb · PMID 41987537 · Publisher ↗
PURPOSE: Amblyopia is a neurodevelopmental disorder characterized by diminished visual acuity (VA) and aberrant fixational eye movements (FEMs), affecting both the amblyopic and fellow eyes. While previous studies have e...
PURPOSE: Amblyopia is a neurodevelopmental disorder characterized by diminished visual acuity (VA) and aberrant fixational eye movements (FEMs), affecting both the amblyopic and fellow eyes. While previous studies have established a strong correlation between impaired VA and increased fixational instability (FI), whether this reflects a causal relationship-or a shared downstream consequence of cortical dysfunction-remains unclear. We sought to determine whether reduced VA alone is sufficient to alter FEMs in the absence of developmental abnormalities. METHODS: To investigate whether reduced VA alone is sufficient to alter FEMs, we induced retinal defocus using convex lenses in neurotypical individuals (n = 5) and compared their FEM characteristics-microsaccade amplitude, latency, drift magnitude, and FI-with those of individuals with amblyopia (n = 7), under both monocular (nondominant eye only) and binocular viewing conditions. In addition to a control (0.0 logMAR), defocus was introduced using convex lenses to simulate interocular VA differences of 0.2, 0.4, 0.6, and 0.8 logMAR in both viewing conditions resulting in a total of 10 conditions. RESULTS: Retinal defocus in neurotypical observers increased drift magnitude and FI during monocular viewing, partially reproducing amblyopic oculomotor behavior. However, microsaccade amplitude and latency remained unchanged across all defocus levels. No significant effects of defocus were observed during binocular viewing. CONCLUSIONS: Reduced VA is sufficient to increase FI but does not reproduce the broader oculomotor abnormalities characteristic of amblyopia. These data suggest that FI in amblyopia arises from additional neurodevelopmental mechanisms beyond visual cortex, likely involving higher-order visuomotor circuits.
Exploring eye care service delivery models for pediatric refraction and spectacle-dispensing in India and the United Kingdom: A scoping review.
Dhandapani K, Saravanan S, Sukumar S … +1 more , Narayanan A
Optom Vis Sci · 2026 Feb · PMID 41952081 · Publisher ↗
PURPOSE: To explore various service delivery models available for pediatric refraction and spectacle-dispensing in India and UK. METHODS: A scoping review was conducted following Preferred Reporting Items for Systematic...
PURPOSE: To explore various service delivery models available for pediatric refraction and spectacle-dispensing in India and UK. METHODS: A scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Review guidelines that included published literature (2010-2024) from MEDLINE (PubMed) and Cochrane Library, reports from government websites, annual reports of nongovernmental organizations, and private eyecare providers. Primary reports on refraction or spectacle-dispensing for children less than 18 years were included. Data related to the "5 Ps" influencing service delivery, namely, "Presence" (availability of refraction services), "Procurement" (availability of spectacle-dispensing), "Personnel," clinical "Protocol," and "Price" involved in the services, were qualitatively synthesized. RESULTS: From 1999 published articles screened by title and abstracts, 187 underwent full-text screening, and 60 were included in the review. Evidence also included 22 government reports, 13 annual reports, and 68 websites. A total of 13 and 9 pediatric eyecare service delivery models were identified in India and UK, respectively, and broadly categorized into community outreach, optical/optometry practices, hospitals/clinics, and online services. "Presence" and "Procurement" were evident in all models in India, whereas in UK, these were evident only in the optical/optometry practices and hospitals following referral from community outreach. "Personnel" included refractionists, ophthalmic assistants/vision-technicians, optometrists, opticians, or ophthalmologists in India, and orthoptists, optometrists, dispensing-opticians, or ophthalmologists with distinct regulatory roles in the UK. "Protocol" varied in community outreach in both countries. "Price" was free of charge at the point of delivery to patients through community outreach in India and all models in the UK, except online services. Evidence gaps exist under "Personnel," "Price" in optical/optometry practices in India, and "Protocol" in all models except community-outreach in both countries. CONCLUSIONS: This review highlights four broad models for pediatric refraction and spectacle-dispensing with varied "Personnel," "Protocol," and "Price" in both countries, identifying evidence gaps, benefits, and challenges to inform future research and global efforts to improve child eye care.
Letter to the Editor: The limitations of centile curves for evaluating myopic eye growth.
Flitcroft DI, Lingham G, Kneepkens S … +3 more , Polling JR, Klaver C, Loughman J
Optom Vis Sci · 2026 Feb · PMID 41947272 · Publisher ↗
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Bullimore MA, Brennan NA
Optom Vis Sci · 2026 Feb · PMID 41947267 · Publisher ↗
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Reduction of hyperopia and accelerated myopia progression in preschool children: A four-year longitudinal study.
Xu H, Zong C, Pu J … +5 more , Mi X, Bian S, Zhou Z, Chen W, Jiao Y
Optom Vis Sci · 2026 Feb · PMID 41947200 · Publisher ↗
PURPOSE: To investigate the association between reduced hyperopia and the increased risk of myopia onset in preschool children aged 3-6 years. METHODS: This study utilized data from the Beijing Hyperopia Reserve Research...
PURPOSE: To investigate the association between reduced hyperopia and the increased risk of myopia onset in preschool children aged 3-6 years. METHODS: This study utilized data from the Beijing Hyperopia Reserve Research (BHRR) prospective cohort, including 941 children aged 3-6 years who completed baseline and 3-year follow-up assessments (2021-2024). Cross-sectional analyses compared ocular biometry among children with different baseline refractive statuses, followed by longitudinal analyses evaluating the relationship between reduced hyperopia and myopia onset. Children were categorized into pre-myopia and hyperopia groups based on spherical equivalent refraction (SER). The predictive ability of SER for myopia onset was evaluated using receiver operating characteristic analysis, with optimal cutoffs determined by the Youden index. Age-stratified (3-6 years) analyses identified age-specific SER thresholds. RESULTS: The baseline cross-sectional analysis revealed that there were no significant differences in anterior chamber depth (ACD) or corneal radius (CR) in the pre-myopia group compared to the hyperopia group despite having a significantly lower SER (p < 0.001) and longer AL (p < 0.001). Over 3 years, both groups showed decreasing SER, increasing AL, and deepening anterior chambers (all p < 0.05). Furthermore, in the 5- and 6-year-old groups, the pre-myopia group demonstrated significantly higher rates of change in SER and AL compared to the hyperopia group (all p < 0.05). The optimal SER cut-off value for predicting myopia onset in preschool children was +0.90 D. This cut-off value showed a decreasing trend with age, corresponding to +1.04 D, +0.95 D, +0.87 D, and +0.82 D for children aged 3, 4, 5, and 6 years, respectively. CONCLUSIONS: Preschool children with lower levels of hyperopia, especially those aged 5 and 6, show a significantly higher rate of myopic drift, and AL growth compared to those with greater hyperopia. Enhanced early monitoring and interventions are essential to prevent excessive loss of hyperopia that may accelerate myopia development. TRIAL REGISTRATION: The registration database and the registration number: Chinese Clinical Trial Registry: ChiCTR2000031142.
Effect of peripheral refractive correction on retinal sensitivity in phakic and pseudophakic glaucoma patients and healthy subjects.
João CAR, Scanferla L, Jansonius NM
Optom Vis Sci · 2026 Feb · PMID 41926913 · Publisher ↗
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Nonaxonal content of the circumpapillary retinal nerve fiber layer in experimental glaucoma.
Kharal A, Chettry P, Omi N … +1 more , Patel NB
Optom Vis Sci · 2026 Feb · PMID 41926912 · Full text
PURPOSE: This study aimed to determine the region-specific distribution of nonaxonal cells and capillaries within the circumpapillary retinal nerve fiber layer (RNFL) in a nonhuman primate experimental glaucoma model. ME...
PURPOSE: This study aimed to determine the region-specific distribution of nonaxonal cells and capillaries within the circumpapillary retinal nerve fiber layer (RNFL) in a nonhuman primate experimental glaucoma model. METHODS: Five rhesus macaques (age range: 4.5-9.0 years) with varying degrees of unilateral laser-induced experimental glaucoma were imaged with optical coherence tomography (OCT), euthanized and perfusion fixed for histological analysis. Eyes were enucleated, and six circumpapillary regions (60° apart), approximately 300-1000 µm from the optic disc margin, were dissected and prepared for serial block face scanning electron microscopy. A series of 400 images (0.098 µm/pixel) were obtained at 500 nm intervals to construct a volume of 200 × 200 × 200 µm. Inside the nerve fiber layer, nonaxonal nuclei and capillary lumen were manually outlined. The nearest vessel distance for each nonaxonal cell was determined as the Euclidean distance in 3-dimensional space from each nucleus center to the nearest capillary. RESULTS: At endpoint, OCT circumpapillary RNFL thickness in the experimental eyes ranged between 49 and 99 µm (control: 103-111 µm). In control eyes, the distribution of nonaxonal cells at the six circumpapillary regions was nonuniform (F = 4.05 and p < 0.01). However, the total cell count was similar between the two eyes (control: 858 ± 173, experimental: 960 ± 245, and p = 0.51), and for each region (p > 0.05). Although capillary volume was reduced in experimental eyes (p = 0.02), the capillary volume density was similar between control (0.58 ± 0.31%) and experimental eyes (0.58 ± 0.32% and p = 0.99). Correspondingly, the nonaxonal cells had a shorter vessel distance in experimental compared to control eyes (15.92 ± 4.89 μm, 18.61 ± 5.48 μm, and p = 0.05). CONCLUSIONS: The number of nonaxonal cells and capillary volume density in the circumpapillary RNFL are similar for stable glaucomatous eyes compared to the healthy eyes. Regional differences and changes in nonaxonal contribution to the nerve fiber layer thickness should be considered when assessing clinical RNFL thickness measures.
Ocular misalignment and unmet eye care needs among students with special education needs in Hong Kong.
Lau KH, Wan K, Leung TW
Optom Vis Sci · 2026 Feb · PMID 41926788 · Publisher ↗
PURPOSE: To determine the prevalence of ocular misalignment among students with special educational needs (SEN) in Hong Kong and to investigate their access to eye care services. METHODS: This cross-sectional study was c...
PURPOSE: To determine the prevalence of ocular misalignment among students with special educational needs (SEN) in Hong Kong and to investigate their access to eye care services. METHODS: This cross-sectional study was conducted between 2023 and 2024 in three special education schools. Students with mild to moderate intellectual disabilities received vision screenings evaluating ocular alignment, visual acuity, and stereopsis. A questionnaire collected data on eye care history, caregiver awareness of vision problems, and access to financial support of eye care services. RESULTS: A total of 334 students (mean age 13.5 ± 5.0 years; 73.7% male) participated. The prevalence of tropia (strabismus) was 8.1% (95% confidence interval [CI]: 5.6%-11.5%), with exotropia being the predominant type (6.3%). Clinically significant phoria was present in 10.5% (95% CI: 7.6%-14.3%). Tropia was associated with significantly worse visual acuity (p < 0.01) and stereoacuity (p < 0.01) compared to phoria and orthophoria. Alarmingly, major gaps in care were identified: 24% of students with tropia had never received a vision assessment, and 32% of their caregivers were unaware or unsure of their child's condition. Although vision screenings were the most common source of care, 80.6% of families reported receiving no financial support for comprehensive eye examinations. CONCLUSIONS: Strabismus is common and functionally impactful in Hong Kong students with SEN, yet significant systemic barriers, including limited caregiver awareness and inadequate support, prevent access to essential care. These findings highlight an urgent need for public health reforms, including the implementation of integrated, 'closed-loop' referral systems and enhanced collaboration across health and education sectors, linking schools with eye care providers, to ensure timely and equitable eye care for this vulnerable population.
Visual performance of phase alteration utilizing sub-elements lenses for potential myopia management.
Lahav-Yacouel K, Tilia D, Falk D … +5 more , Diec J, Sha J, Fedtke C, Ehrmann K, Bakaraju RC
Optom Vis Sci · 2026 Feb · PMID 41926787 · Publisher ↗
PURPOSE: To compare the visual performance (VP) of P.A.U.S.E. spectacle lenses (tests) against defocus incorporated multiple segments (DIMS; control). METHODS: This randomized, single-masked study included 48 participant...
PURPOSE: To compare the visual performance (VP) of P.A.U.S.E. spectacle lenses (tests) against defocus incorporated multiple segments (DIMS; control). METHODS: This randomized, single-masked study included 48 participants aged 18-41 years who wore five tests (T1, T2, T4, T5, T6) and DIMS. VP was assessed through the full-lens and inferior treatment zone. Full-lens visual-acuity (VA) based measurements comprised monocular high- and low-contrast VA (HCVA/LCVA) at 6 m and binocular HCVA at 6 m and 40 cm. Assessments through the treatment zone comprised HCVA at 40 cm and subjective ratings (1-10 scale) of near vision-clarity and ease-of-reading. VP was assessed after 3 days of wear (full-lens) using subjective ratings of vision-clarity, night-vision, vision-while-walking, eyestrain, overall-vision-satisfaction, and willingness-to-purchase (yes/no: based on vision and myopia management efficacy). Analyses were performed using linear mixed models and the X test. Significance was set at 5%. RESULTS: Full-lens binocular HCVA at 40 cm was significantly better with three tests (T2, T4, T5) compared to DIMS (p ≤ 0.022), whereas there were no differences between any test and DIMS for monocular or binocular HCVA at 6 m (p > 0.5). Full-lens monocular LCVA at 6 m was significantly better with DIMS compared to T4 (p = 0.0057). Through the treatment zone, four tests (T2, T4, T5, T6) were significantly better than DIMS for binocular HCVA at 40 cm (p < 0.0001), near vision-clarity (p ≤ 0.0011) and ease-of-reading (p ≤ 0.0014). T2 was rated significantly higher than DIMS for night-vision (p = 0.0085) and overall-vision-satisfaction (p = 0.0495), whereas DIMS was rated higher than T1 for vision-clarity (p = 0.0001). There were no significant differences between DIMS and any test for other subjective ratings (p > 0.07), nor willingness-to-purchase based on vision (p > 0.2) or myopia management efficacy (p > 0.6). CONCLUSIONS: Most of the test lenses achieved better VP through the treatment zone compared to the DIMS control. T2 showed better overall VP compared to DIMS, whereas DIMS showed better overall VP compared to T1.
Feasibility and accuracy of school-led vision screening in primary and secondary school students within the United Kingdom.
Saunders C, Davey CJ, Ghorbani-Mojarrad N … +1 more , Barrett BT
Optom Vis Sci · 2026 Feb · PMID 41926785 · Publisher ↗
PURPOSE: Vision screening occurs once in United Kingdom (UK) children on school entry, but has recently been withdrawn in some areas. Consequently, significant refractive error and/or vision problems may go undetected. S...
PURPOSE: Vision screening occurs once in United Kingdom (UK) children on school entry, but has recently been withdrawn in some areas. Consequently, significant refractive error and/or vision problems may go undetected. School-led vision checking, where school staff assess vision, is increasingly advocated by the International Agency for the Prevention of Blindness. This study investigates the accuracy of school-led vision checking in UK school students. METHODS: School personnel were trained to conduct vision checks on their students. These involved external observation of the eyes for obvious abnormalities, as well as monocular distance (3 m) and near vision assessments (33 cm), equivalent to 0.2 logMAR. Equipment required to complete the checks was provided to schools. Optometrists repeated the assessments on average within 3 weeks to determine the accuracy of the school-led checks. Failure criteria were habitual vision >0.20 logMAR (<4 of 5 letters correct) in one or both eyes, at distance or near, and/or the presence of any ocular abnormality. RESULTS: One thousand and one children (45.7% female) from eight primary (6-8 years n = 233) and three secondary (11-13 years n = 768) schools participated. Overall sensitivity and specificity of distance vision and ocular abnormality checks were 87.2% and 88.9%, respectively. Corresponding values for sensitivity and specificity were 95.8% and 88.1% for primary schoolchildren and 84.3% and 89.2% for secondary schoolchildren. High negative predictive values in both primary (99.3%) and secondary (97.4%) schools indicate school staff correctly identified most children with distance vision problems. With near vision results included, sensitivity and specificity reduced to 80.6% and 82.2%, respectively, in the whole cohort (87.1% and 83.2% in primary schoolchildren and 78.5% and 81.6% for secondary schoolchildren) because of an increase in false positives. CONCLUSIONS: The vision screening assessment battery utilized within this study requires refinement; however, school-led vision screening is feasible and can correctly identify UK school children with and without vision problems with sensitivity and specificity of >80%.
Assessment of eye movement endurance using the OculoMotor Assessment Tool: A replication study on young Indian adults.
Bharadwaj SR, Satgunam P, Devi P … +2 more , Yaramothu C, Alvarez TL
Optom Vis Sci · 2026 Feb · PMID 41926784 · Publisher ↗
PURPOSE: This replication study sought to determine (1) the frequency of horizontal/vertical saccades, vergence jumps, and horizontal/vertical vestibulo-ocular reflexes (VORs) elicited per minute in young Indian adults u...
PURPOSE: This replication study sought to determine (1) the frequency of horizontal/vertical saccades, vergence jumps, and horizontal/vertical vestibulo-ocular reflexes (VORs) elicited per minute in young Indian adults using the OculoMotor and Vestibular Endurance Screening (MoVES) protocol with the OculoMotor Assessment Tool (OMAT) and (2) the association between the participant's MoVES values and routine clinical binocular vision status. METHODS: Two hundred twenty-two healthy participants (17-33 years) repeatedly generated the aforesaid eye movements using the OMAT as a target for 60 s. A subset (n = 75) also underwent binocular vision assessment using standard optometric protocols. Eye movement frequency of participants with a near point of convergence ≤ 6 cm, stereoacuity ≤ 70 arcsec, and BIVSS score ≤ 31 constituted the normative cohort. RESULTS: Eye movement responses of 153 participants who formed the replication cohort showed a higher frequency in the last 30 s compared to the initial 30 s (p < 0.01). The overall frequency of vergence jumps was lower in those who failed these criteria, vis-à-vis, the pass cohort (p < 0.01). These values were lower than previously published data from USA (p ≤ 0.05), but the differences diminished when matched with participants in organized sports activities. The clinical binocular vision parameters did not show a strong correlation with oculomotor frequency (r ≤ 0.3). CONCLUSIONS: The endurance values of eye movements established here allow screening for oculomotor dysfunctions in young Indian adults. These values may be impacted significantly by the level of organized physical activity engaged by the participant. Routine binocular vision evaluation does not correlate with eye movement endurance values, reflecting the need for dedicated assessments of the latter functions using standardized techniques and tools.
Reflex maintenance of vergence eye alignment to small natural images is at risk for adults and young children.
Bentz A, Mestre C, Marella BL … +1 more , Candy TR
Optom Vis Sci · 2026 Feb · PMID 41926783 · Publisher ↗
PURPOSE: Typical human adults make reflex eye movements and computations to support stable binocular vision in milliseconds. The current project was designed to determine the impact of visual field extent on reflex verge...
PURPOSE: Typical human adults make reflex eye movements and computations to support stable binocular vision in milliseconds. The current project was designed to determine the impact of visual field extent on reflex vergence performance of adults and six- to eight-year-old children for images of natural scenes. METHODS: Twenty-two typical adults (23-55 years) and 12 typical six- to eight-year-old children were presented with dichoptic natural scenes in continuous tracking and step disparity formats while vergence realignment responses were recorded. The images had radii varying from 1° to 16° and either moved smoothly at random disparity velocities (≥30 s) or stepped in disparity to 0-6° in 1.5 s trials. RESULTS: Peak correlations and latencies between stimulus and vergence velocities were computed for continuous tracking trials, and response amplitudes after 1.25 s were computed for step trials. Continuous tracking responses of both adults and children were unaffected by reductions in image radii from 16° to 3°, but their vergence response amplitudes to step changes and the range of disparities over which a stimulus-driven response was generated decreased with decrease in stimulus radius. The participants moved to their dissociated heterophoria position for disparity stimuli that exceeded their reflex vergence response range for these limited duration stimuli. CONCLUSIONS: Patients with peripheral visual field loss needing to align their eyes to a new depth plane and patients provided with virtual binocular images in clinical therapy or assistive devices must use disparity over a limited field extent to realign their eyes. Performance to natural image content here suggests that reflex maintenance of eye alignment is at risk for moderate disparities when the stimulus radius falls below approximately eight degrees. This is of particular concern for patients with limited binocular function resulting from amblyopia or strabismus, for example.
Attention to text and pictures during storybook reading in preschool children with moderate hyperopia.
Oechslin TS, Fogt N, Ciner E … +2 more , Candy TR, Kulp MT
Optom Vis Sci · 2026 Feb · PMID 41926782 · Full text
PURPOSE: Uncorrected, moderate hyperopia has been associated with poor emergent literacy skills. However, the eye movements of preschoolers have not yet been used to determine how well young, hyperopic children attend to...
PURPOSE: Uncorrected, moderate hyperopia has been associated with poor emergent literacy skills. However, the eye movements of preschoolers have not yet been used to determine how well young, hyperopic children attend to text and pictures during storybook reading compared to emmetropic children. In this study, the percentage of visual on-task time during storybook reading for 4- and 5-year-old children with uncorrected, moderate hyperopia was compared to that of their emmetropic peers. The relationship between percentage visual on-task time and near visual function was also assessed. METHODS: Children received an eye exam with cycloplegic refraction to identify hyperopia (+3.00D to +6.00D with astigmatism ≤1.50D and anisometropia ≤1.00D) or emmetropia (hyperopia ≤1.0D; astigmatism, anisometropia, and myopia<|1.0|D) and to rule out amblyopia, strabismus, and ocular health concerns. Infrared video eye tracking systems were used to monitor eye position during storybook reading. Fixations were "on-task" if the child was looking at text or a picture in the story. Statistical comparisons of percentage visual on-task time between the emmetropic and hyperopic children were performed, and correlations between the percentage visual on-task time and the participants' near visual skills (visual acuity, stereoacuity, accommodative lag) were determined. RESULTS: Fifty-five of 72 eligible children provided analyzable data. The average percentage visual on-task time for hyperopic children was 20% less than that of emmetropic children (Mann-Whitney U test, p = 0.02). Further, for all children combined, the percentage visual on-task time was moderately correlated with accommodative lag (Spearman, r = -0.32, p = 0.02) while there was no significant correlation between percentage visual on-task time and near acuity or near stereoacuity (p > 0.05). CONCLUSIONS: Moderately hyperopic, uncorrected 4- and 5-year-old children showed a significantly lower percentage of visual on-task time during shared storybook reading compared to their emmetropic peers. The percentage on-task time was moderately correlated with increased accommodative lag for the combined group of emmetropic and hyperopic children.
Impact of uncorrected hyperopia on visual function and academic performance in preschool and school-age children.
Kulp MT, Ciner EB, Candy TR … +4 more , Ying GS, Hall C, Quinn G, Moore B
Optom Vis Sci · 2026 Feb · PMID 41926780 · Full text
Many children with a moderate amount of farsightedness do not see as well up close as children who are not farsighted, and they often have significantly more problems with near visual function (near visual acuity, stereo...
Many children with a moderate amount of farsightedness do not see as well up close as children who are not farsighted, and they often have significantly more problems with near visual function (near visual acuity, stereoacuity, and accommodation), early literacy skills, reading, and attention. Problems with early literacy skills often lead to difficulties with reading in first grade and beyond. Controversy exists among eye care providers regarding whether moderately hyperopic children have adequate visual function without correction or whether correction provides benefit. Furthermore, the effect of correction is unclear, and further research is needed to determine whether hyperopic correction allows farsighted children to overcome deficits in near visual function, early literacy, reading, and attention.
A randomized clinical trial of full-time alternate patching therapy for intermittent exotropia in children.
Jenewein EC, Christiansen SP, Zhu Y … +22 more , Kraker RT, Grigorian AP, Suh DW, Summers AI, Han S, Rahmani B, Connolly KS, Davis PL, Fisher JH, Javed YF, Kraus CL, Kurup SP, Martinson SR, Ollinger MC, Tauscher RG, Vricella M, Beaulieu WT, Pineles SL, Cotter SA, Holmes JM, Weise KK, Pediatric Eye Disease Investigator Group
Optom Vis Sci · 2026 Feb · PMID 41926779 · Publisher ↗
PURPOSE: To determine whether 3 months of prescribed full-time alternate patching is more effective than observation for intermittent exotropia (IXT) in children. METHODS: We enrolled 73 children aged 3 to <9 years with...
PURPOSE: To determine whether 3 months of prescribed full-time alternate patching is more effective than observation for intermittent exotropia (IXT) in children. METHODS: We enrolled 73 children aged 3 to <9 years with mean IXT distance control score (3 measures) ≥2 points (on a 0-5 [phoria constant tropia] scale) with at least one score ≥3, 4, or 5 (indicating spontaneous XT over 30-s observation) and a distance exodeviation of 15-50 prism diopters (Δ) by prism and alternate cover test (PACT), with the near deviation not exceeding the distance by > 10Δ. Children were randomly assigned to 3 months full-time patching (all waking hours, 7 days per week, alternating eyes) or observation. The primary outcome was change in mean distance IXT control at 3 months. RESULTS: Baseline mean (SD) distance control for children assigned to full-time patching (N = 36) and observation (N = 37) were 3.6 (0.9) and 3.6 (0.9) points; mean distance PACT was 27Δ (9) and 27Δ (8), respectively. The 3-month visit was completed by 33 (92%) of 36 and 35 (95%) of 37 children assigned to full-time patching and observation. Mean patching adherence was 4.1 h per day (95% CI: 2.8-5.5, N = 20) by participants who returned temperature sensor occlusion dose monitors and 7.4 h per day (95% CI: 5.8-8.9, N = 33) by review of at-home calendars and interviews with parent and child. At 3 months, children in the patching group had greater improvement in mean distance control than the observation group: 0.9 (1.3) versus 0.2 (1.1) points (difference = 0.62 points, 95% CI: 0.04-1.20, p = 0.04). There was also greater improvement in mean distance PACT: 6 (7) versus 2 (7) Δ, difference = 4Δ (95% CI: 1-8, p = 0.02). CONCLUSIONS: Three months of prescribed full-time alternate day patching improved distance control and magnitude of IXT in children 3-<9 years, despite mean adherence substantially less than the prescribed full-time regimen. Future studies should evaluate the durability of treatment effects and compare patching to other treatments. TRIAL REGISTRATION: Clinicaltrials.Gov, registered 14 July 2022, NCT05462821.
Test-retest reliability of clinical accommodative measures in adolescents.
Chen AM, Koutures C, Sinnott LT … +9 more , Morrison A, Wu C, Lew C, Vaughn M, Wiecek EK, Scheiman M, Jordan LA, Roberts TL, EPICC Study Group
Optom Vis Sci · 2026 Feb · PMID 41922925 · Publisher ↗
PURPOSE: To determine long-term (3 months) test-retest reliability of accommodative testing in adolescents with normal accommodative amplitude. METHODS: Participants aged 12 years to <17.5 years with normal accommodative...
PURPOSE: To determine long-term (3 months) test-retest reliability of accommodative testing in adolescents with normal accommodative amplitude. METHODS: Participants aged 12 years to <17.5 years with normal accommodative amplitude (minimum of 11 diopters [D]) and binocular vision were enrolled. Three trials of monocular accommodative amplitude using the push-up method and one trial of monocular accommodative facility with ±2.00 D flipper lenses were performed at the initial and 90-day retest visits. Bland-Altman analyses of within-participant differences between initial and 90-day retest visits were performed. RESULTS: Ninety-three participants (mean age 14.3 ± 1.6 years; 51% female) were enrolled, and 91 of 93 (98%) participants completed both visits. At the initial visit, the mean accommodative amplitude was 13.95 D and 14.32 D in the right and left eyes, respectively, and the mean accommodative facility was 10.16 and 10.19 cycles per minute (cpm) in the right and left eyes, respectively. Although no significant difference was observed in accommodative amplitude between the initial and retest visits, a significant but clinically small difference was observed in facility. The 95% limits of agreement were large for amplitude (right eye -3.96 to 3.63 D and left eye -4.92 to 4.13 D), particularly in those with initial amplitude exceeding 14 D, and for facility (right eye -6.43 to 9.44 cpm and left eye -7.54 to 10.8 cpm). CONCLUSIONS: In adolescents with normal accommodative amplitude and binocular vision, test-retest differences in accommodative amplitude and facility were small; however, the variability was high, especially for accommodative facility.
Comparison of ocular accommodation throughout the day in children using 0.05% low-dose atropine versus controls: A pilot study.
Maxwell KM, Mitchell GL, Morrison AM … +1 more , Anderson HA
Optom Vis Sci · 2026 Feb · PMID 41922924 · Publisher ↗
PURPOSE: The purpose of this pilot study was to assess the effect of 0.05% low-dose atropine on ocular accommodation (amplitude and accuracy) and how its effect changed throughout the day. METHODS: Sixteen children aged...
PURPOSE: The purpose of this pilot study was to assess the effect of 0.05% low-dose atropine on ocular accommodation (amplitude and accuracy) and how its effect changed throughout the day. METHODS: Sixteen children aged 6-16 years using 0.05% atropine and 16 controls not using atropine were enrolled. Monocular accommodative amplitude was measured objectively using a Grand Seiko WAM-5500 open field autorefractor (formerly manufactured by RyuSyo Industrial Co.) and subjectively using the push-up method. Accuracy of accommodation was measured using monocular estimation (MEM) retinoscopy. All measures were taken at three study visits over a single day to assess change over time. Measures of accommodative amplitude and accuracy were compared using a 2-way analysis of variance (ANOVA). Nonparametric analyses were performed to compare MEM retinoscopy using the Mann-Whitney U-test and Friedman's test. RESULTS: Objectively measured accommodative amplitude was significantly lower in the 0.05% atropine group (morning: 5.99 ± 2.28D, midday: 6.17 ± 2.06D, afternoon: 7.08 ± 1.82D) compared to the control group (morning: 7.68 ± 1.59D, midday: 7.62 ± 1.93D, afternoon: 7.63 ± 1.48D) at the morning and midday visits (p = 0.01, 0.03). There was no difference between groups at the afternoon visit (p = 0.40). In the 0.05% atropine group, objectively measured amplitudes were greater at the afternoon visit compared to those of the morning and midday visits (p < 0.01). There were no significant differences throughout the day in the push-up amplitude of accommodation or MEM retinoscopy. CONCLUSIONS: When measured objectively, accommodative amplitude in children using 0.05% low-dose atropine was reduced compared to controls during the morning and midday visits and increased over the day reaching a level comparable to that of the control group by the afternoon visit. Common clinical measures of accommodative ability, including subjective amplitude of accommodation using the push-up test and accommodative accuracy using MEM retinoscopy, did not demonstrate these same differences.
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