Optometry And Vision Science[JOURNAL]
Sun
200 papers
Evaluating the initial and end-of-day wettability of contemporary daily disposable contact lenses using various in vitro methods.
Phan CM, Ho B, Hui A … +6 more , Walther H, Zheng Y, Subbaraman L, Shi XC, Wu J, Jones LW
Optom Vis Sci · 2025 Jun · PMID 40373200 · Full text
SIGNIFICANCE: Contact lens wettability is potentially correlated with friction, which is linked to lens comfort. However, measuring wettability can be highly variable. This study assessed wettability using three techniqu...
SIGNIFICANCE: Contact lens wettability is potentially correlated with friction, which is linked to lens comfort. However, measuring wettability can be highly variable. This study assessed wettability using three techniques for a more accurate profile. PURPOSE: To evaluate the wettability of contemporary daily disposable contact lenses after 16 hours on an in vitro model using the sessile drop, captive bubble, and a novel in vit ro noninvasive keratograph breakup time (NIKBUT) method. METHODS: The wettability of six contemporary silicone hydrogel contact lens materials (verofilcon A, delefilcon A, senofilcon A, kalifilcon A, stenfilcon A, and somofilcon A) and two conventional hydrogel materials (nesofilcon A and etafilcon A) were evaluated using an in vitro blink model at t = 0 and 16 hours. The blink rates of the eye model were 20 blinks per minute. Sessile drop and captive bubble angles were analyzed using the Optical Contact Analyzer. NIKBUT was assessed on a blink model in combination with the OCULUS Keratograph 5M. RESULTS: There were no significant differences in wettability for any lens types between 0 and 16 hours when assessed using the captive bubble or NIKBUT methods (p>0.05). For the sessile drop method, verofilcon A had the lowest contact angle values (36.5 ± 2.9°), and all lenses except for etafilcon A had similar wettability after 16 hours. All the lenses had similar wettability when assessed using the captive bubble method, suggesting that they had similar wettability under optimal wetting conditions. For NIKBUT, delefilcon A had the longest NIKBUT values (9.0 ± 1.0 s) after 16 hours. CONCLUSIONS: The sessile drop technique produced the most measurable differences in wettability between different lens types, whereas the captive bubble technique was not able to provide any measurable differences between lenses. NIKBUT measurements may provide a better measure of on-eye wettability, but variability in the results using the current eye model still needs to be addressed in future studies for improved repeatability. Although the contact lenses showed different contact angles and NIKBUT results, their in vitro wettability did not significantly change over the 16 hours of simulated wear in terms of the captive bubble or NIKBUT values.
Efficacy and factors influencing toric orthokeratology lenses in managing moderate to high astigmatic myopia.
Hong H, Long Y, Li L … +2 more , Lu H, Lin E
Optom Vis Sci · 2025 Jun · PMID 40343786 · Full text
SIGNIFICANCE: Toric orthokeratology lenses show potential in slowing myopia progression in adolescents with moderate to high astigmatic myopia. These findings support the broader application of toric orthokeratology in m...
SIGNIFICANCE: Toric orthokeratology lenses show potential in slowing myopia progression in adolescents with moderate to high astigmatic myopia. These findings support the broader application of toric orthokeratology in managing challenging refractive conditions and mitigating myopia-related complications. PURPOSE: This study seeks to probe the efficacy of toric orthokeratology lenses in controlling moderate to high astigmatic myopia in adolescents and to analyze the risk factors influencing treatment outcomes. METHODS: One hundred adolescent patients with moderate to high astigmatic myopia who were treated at our medical facility from January 2022 to January 2023 were randomly selected as the study subjects. All patients were allocated to either the experimental group (n = 50) or the control group (n = 50) using a random number table method. The control group was subjected to treatment with spherical orthokeratology lenses, whereas the experimental group was treated with toric orthokeratology lenses. Changes in uncorrected visual acuity, axial length, cylinder diopters, sphere diopters, and average corneal curvature before treatment and after 12 months of treatment were compared between the two groups. The logistic regression analysis was conducted to identify the factors influencing the efficacy of toric orthokeratology lenses in controlling moderate to high astigmatic myopia in adolescents. RESULTS: Both cohorts showed substantial improvements in uncorrected visual acuity, axial length, sphere, and average corneal curvature compared with their pre-treatment values, with the experimental cohort showing greater improvements than the control cohort (p=0.01, 0.03, 0.00, 0.00). There were no significant differences in cylinder between the two groups after treatment (p=0.56). Univariate analysis unraveled significant differences in age, baseline sphere, average corneal E value, baseline axial length, and central corneal thickness (p=0.00, 0.03, 0.04, 0.02, 0.05). Receiver operating characteristic curve analysis displayed that the area under the curve for the logistic regression model attained 0.82, with a 95% confidence interval of (0.69, 0.95), sensitivity of 88%, specificity of 72%, and a Youden index of 0.61. CONCLUSIONS: Toric orthokeratology lenses demonstrate potential efficacy for adolescents with moderate to high astigmatic myopia by slowing myopia progression. Patients who are older, severely nearsighted, and have longer baseline axial length experience more significant control over myopia progression.
Eleven years of orthokeratology contact lens wear for slowing myopia progression in children.
Santodomingo-Rubido J, Villa-Collar C, Gutiérrez-Ortega R … +3 more , Sugimoto K, Nishimura S, Newman S
Optom Vis Sci · 2025 May · PMID 40300181 · Full text
SIGNIFICANCE: The myopia control effect of orthokeratology accrues over time, with 11 years of lens wear providing a cumulative absolute reduction in axial elongation of -0.69 mm in comparison with spectacle lens wear. S...
SIGNIFICANCE: The myopia control effect of orthokeratology accrues over time, with 11 years of lens wear providing a cumulative absolute reduction in axial elongation of -0.69 mm in comparison with spectacle lens wear. Steeper corneas are likely to benefit from enhanced myopia control efficacy. PURPOSE: To compare axial length growth between a group of orthokeratology contact lens wearers and a control group of distance single-vision lens wearers over an 11-year period. METHODS: White European subjects 6 to 12 years old with myopia -0.75 to -4.00DS and astigmatism ≤1.00DC were prospectively allocated orthokeratology or distance single-vision spectacle correction for 2 years. Axial length measurements (Zeiss, IOLMaster) were taken at 6-month intervals during the initial 2 years of the study. Subjects were contacted approximately 5 and 9 years later (i.e., 7 and 11 years after the beginning of the study, respectively) and axial length measurements were repeated. RESULTS: Thirty-one orthokeratology and 30 control subjects were initially recruited, but only 10 orthokeratology and 15 control subjects attended the 11-year visit. In comparison with the control group, the change in axial length for the orthokeratology group was reduced by 0.04, 0.10, 0.14, 0.22, 0.45, and 0.69 mm after 0.5, 1, 1.5, 2, 7, and 11 years of lens wear, respectively. Significant differences between groups were found in mean unadjusted changes in axial length at the 1-, 1.5-, and 2-year time points (unpaired t -test, p < 0.05), whereas standard contrasts revealed statistical differences between groups in the estimated marginal means of the change in axial length at the 7- and 11-year time points (p < 0.05). CONCLUSIONS: Eleven years of orthokeratology lens wear provided a substantial slowing in the axial elongation of the eye, with a treatment effect of up to 0.69 mm after 11 years of lens wear in comparison with single-vision lens wear.
2024 Chew Sek Jin Memorial Lecture: "Are we there yet?".
Flitcroft I
Optom Vis Sci · 2025 May · PMID 40300116 · Publisher ↗
The journey from myopia being an intriguing scientific puzzle to part of clinical practice has been a long and varied path. Chew Sek Jin was one of the pioneers on this journey and, as director of the Singapore Eye Resea...
The journey from myopia being an intriguing scientific puzzle to part of clinical practice has been a long and varied path. Chew Sek Jin was one of the pioneers on this journey and, as director of the Singapore Eye Research Institute, initiated an ambitious research program that has helped us get to where we are today. His work was data-driven, embracing the power of epidemiological and longitudinal studies. He emphasized both the public health aspects and clinical management of myopia, pioneering the use of atropine in Singapore. With his work with Josh Wallman, he recognized the importance of research into the biological mechanisms of myopia.
Need for eyeglasses and prescription updates in students receiving a school-based eye exam.
Ambrosino CM, Collins ME, Nguyen A … +4 more , Kourgialis N, Repka MX, Friedman DS, Guo X
Optom Vis Sci · 2025 Jun · PMID 40266275 · Publisher ↗
SIGNIFICANCE: School-based vision programs can improve children's access to vision care in underserved areas. Little is known about the need for eyeglasses among students not wearing them compared with the need for presc...
SIGNIFICANCE: School-based vision programs can improve children's access to vision care in underserved areas. Little is known about the need for eyeglasses among students not wearing them compared with the need for prescription updates. A greater understanding of prescription trends will help identify gaps in care and inform resource allocation. PURPOSE: We aim to describe the baseline eyeglasses-wearing status and the need for new and updated eyeglasses prescriptions for students participating in a large school-based vision program. METHODS: This cross-sectional analysis examined retrospective data from the 2016-2022 operations of the Helen Keller Intl's United States Vision Program. Included students were pre-kindergarten to grade 12 and had received a school-based eye examination after a failed vision screening. Data extracted included student demographics, self-reported eyeglasses-wearing status, lensometer measurement, refractive error, and eyeglasses prescription. Multivariate logistic regression models were implemented to understand the factors associated with eyeglasses prescription and prescription change, defined as at least 0.50 D spherical equivalent change or 0.75 D cylindrical change between lensometer measurement and final prescription. RESULTS: Of the 97,069 students included in the analysis, 27.3% of students were self-reported current wearers of eyeglasses, 30.5% were inactive wearers of eyeglasses, and 42.2% were nonwearers. Overall, 72,784 (75%) students were prescribed eyeglasses. Among them, 48,600/72,784 (67%) were not current wearers. On multivariate logistic regression, students were more likely to be prescribed eyeglasses if they were in higher grade levels (grades 11 to 12 compared with grades 1 to 2, odds ratio: 2.39, 95% confidence interval: 2.17 to 2.64) and were current wearers (odds ratio: 8.82, 95% confidence interval: 8.24 to 9.43). Among current wearers, students with at least 6 D myopia and at least 3 D astigmatism had the greatest likelihood of spherical equivalent and cylindrical prescription change, respectively. CONCLUSIONS: Within a large sample of students enrolled in a school-based vision program, more than half reported having eyeglasses. However, two in three students who needed eyeglasses were not wearing them. The need for eyeglasses was notable across all age groups, especially among higher grade levels and those with more severe refractive error. Most students who failed a vision screening while wearing eyeglasses needed an eyeglasses prescription update.
Survey of Australian primary eyecare management of choroidal nevus patients.
Conway RM, Trang TMT, Tang EJ … +3 more , Challinor KL, Jalbert I, Madigan MC
Optom Vis Sci · 2025 Jul · PMID 40266266 · Full text
SIGNIFICANCE: Our survey found that clinical imaging is widely utilized by many Australian eyecare practitioners for detecting and monitoring choroid nevus and highlighted knowledge gaps for risk factors and features of...
SIGNIFICANCE: Our survey found that clinical imaging is widely utilized by many Australian eyecare practitioners for detecting and monitoring choroid nevus and highlighted knowledge gaps for risk factors and features of choroid nevus and early primary eye melanoma. Continuing education related to early detection could improve multidisciplinary management of these patients. PURPOSE: The aim is to survey Australian primary eyecare practitioners on their management of patients with choroidal nevus. METHODS: A random sample of optometrists and ophthalmologists registered to practice in Australia was surveyed using a purpose-designed questionnaire including demographics, types of imaging techniques used, and practitioner choroid nevus knowledge (K), attitude (A), and practice (P). RESULTS: Ninety-three optometrists and 82 ophthalmologists responded. More than 50% practiced independently, most in metropolitan centers (n = 113/175). Multiple imaging techniques were used to detect and monitor choroidal nevus; >72% of practitioners routinely used optical coherence tomography and color fundus photography. KAP scores indicated moderate knowledge about choroid nevus risk factors and clinical features (mean = 5.2/9, standard deviation [SD] = 1.8). Clinical mnemonics that summarized signs of risk for nevus-to-melanoma transformation were used by <50% of practitioners overall. Scores indicated a very positive attitude to nevus management (mean = 6.5/8, SD = 1.2) but a moderate practice score (mean = 13.9/25, SD = 2.9). A significant difference between optometrists and ophthalmologists was found for knowledge, but not for attitude or practice scores. Choroid nevus patients were referred to a specialist ophthalmologist by ~30% of all practitioners. CONCLUSIONS: The majority of Australian primary eyecare practitioners used multiple imaging techniques to detect and monitor choroidal nevi. There were, however, gaps in knowledge associated with identifying risk factors for choroidal nevus growth. Our findings align with recent UK studies that highlight the importance of diligent screening and review, timely referral for potential melanoma-related risks, and encourage multidisciplinary care for choroidal nevus patients.
Perceptions of providers and unhoused patients on access to eye care in Santa Clara County: A qualitative study.
Liu JM, Chang M, Liu FM … +2 more , Patel B, Chang DS
Optom Vis Sci · 2025 Jul · PMID 40261685 · Publisher ↗
SIGNIFICANCE: Perspectives on eye care barriers differ between low-income patients and vision care providers. Comparing these views provides valuable insight into strategies for addressing disparities in underserved comm...
SIGNIFICANCE: Perspectives on eye care barriers differ between low-income patients and vision care providers. Comparing these views provides valuable insight into strategies for addressing disparities in underserved communities, especially in regions with significant income inequality and opportunity gaps. PURPOSE: The aim is to identify obstacles that prevent individuals who are unhoused, have low income, or are publicly insured in Santa Clara County from accessing basic refractive eye exams and corrective glasses. METHODS: Patients aged ≥18 years with low income presenting to a free vision care clinic in Northern California (n = 15) and vision care providers who primarily work with underserved patients in Santa Clara County, California (n = 11) participated in one-on-one phone interviews. Interviews were transcribed and analyzed. RESULTS: Most participants (87% patients and 82% providers) say that basic vision care (refractive eye exam and eyeglasses) in Santa Clara County is unaffordable and that in-person eye exams can be physically inaccessible (67% patients and 91% providers) due to busy work schedules or limited access to transportation. However, patient and provider perspectives on intrinsic barriers to accessing eye care diverge. In total, 73% of providers stated that limited health literacy contributed to lower utilization of routine vision care, while 47% of patients cited limited empathy from providers as responsible for their negative experiences and dissatisfaction with care. CONCLUSIONS: In Santa Clara County, patients with low income and their providers both identify similar external barriers to basic vision care: high costs, inadequate insurance coverage, and limited services. However, patients and providers may disagree on intrinsic barriers to accessing care. Suggestions for improving access to vision care include more help from healthcare coordinators, better information about affordable services, improved vision insurance, and mobile healthcare options.
Emmetropization in highly hyperopic infants: A randomized clinical trial of partial refractive correction.
Morrison AM, Robich ML, Jordan LA … +2 more , Sinnott LT, Mutti DO
Optom Vis Sci · 2025 May · PMID 40261678 · Publisher ↗
SIGNIFICANCE: Highly hyperopic infants are at greater risk for not undergoing emmetropization and later developing conditions such as strabismus, amblyopia, and early literacy and reading problems. An early intervention...
SIGNIFICANCE: Highly hyperopic infants are at greater risk for not undergoing emmetropization and later developing conditions such as strabismus, amblyopia, and early literacy and reading problems. An early intervention consisting of partial hyperopic correction and encouragement of accommodation may influence the rate of emmetropization in these high-risk infants. PURPOSE: This study aimed to determine if moderate spectacle partial correction (3.00 D cut from cycloplegic) and visual exercises to promote accommodation enhance emmetropization (reaching ≤+3.00 D) in highly hyperopic (≥+5.00 D to ≤+7.00 D) 3-month-old infants compared with no treatment (observation). METHODS: Thirty-five highly hyperopic 3-month-old infants (57% female) were randomized to observation or treatment ( clinicaltrials.gov ; NCT03669146). Primary analysis compared the mean hyperopia at 18 months of age in treated versus untreated participants. Data were also modeled using proportional hazards survival analysis (time to reach ≤+3.00 D). RESULTS: There was no significant difference in refractive error at 18 months of age between infants in the treated (+1.6 ± 0.6 D) and observation groups (+1.2 ± 0.7 D; p = 0.23) but treatment affected the rate of emmetropization depending on baseline hyperopia (p = 0.01). At 12 months of age, treated infants had similar refractive errors regardless of baseline hyperopia but untreated infants at 12 months underwent faster emmetropization if their baseline hyperopia was <+5.50 D and slower emmetropization if it was >+5.50 D. CONCLUSIONS: Partial hyperopic refractive correction with accommodative exercises in highly hyperopic infants did not affect average refractive error at 18 months. However, treatment affected the rate of emmetropization and how long it took to reach ≤+3.00 D. Treatment slowed the rate of emmetropization at lower levels of initial hyperopia but may enhance emmetropization at higher levels.
Visual performance of single-vision contact lenses utilizing opaque, nonrefractive features for potential myopia management.
Tilia D, Diec J, Sha J … +4 more , Lahav-Yacouel K, Ehrmann K, Fedtke C, Bakaraju RC
Optom Vis Sci · 2025 May · PMID 40261677 · Publisher ↗
SIGNIFICANCE: Contact lenses (CLs) utilizing opaque, nonrefractive features may purposefully modulate retinal ganglion cell activity away from the baseline activity. This is a nonrefractive mechanism that may reduce myop...
SIGNIFICANCE: Contact lenses (CLs) utilizing opaque, nonrefractive features may purposefully modulate retinal ganglion cell activity away from the baseline activity. This is a nonrefractive mechanism that may reduce myopia progression. However, the visual performance of CLs with opaque features is unknown. PURPOSE: This study aimed to compare the visual performance and binocular/accommodative function of CLs with opaque features (test) against MiSight (control-1) and single-vision (control-2) CLs. METHODS: This was a prospective, randomized, unmasked, cross-over study where 35 myopic CL wearers (18 to 39 years) wore each design for at least 5 days. Visual performance was subjectively assessed using 1 to 10 numeric ratings comprising clarity of vision, lack of ghosting, vision when driving, overall vision satisfaction, and willingness to purchase (yes/no: based on vision and myopia efficacy). Visual acuity measurements comprised monocular and binocular high and low contrast visual acuity at 6 m, and binocular high contrast visual acuity at 70 and 40 cm. Binocular function was assessed using heterophorias at 3 m and 40 cm. Accommodative function was assessed using monocular accommodative facility (MAF) at 40 cm and dynamic monocular accommodative response (AR: 6 m, 70 cm, and 40 cm). RESULTS: Test was rated higher than control-1 (p<0.001) and control-2 was rated higher than test (p≤0.0052) for all subjective ratings. More participants were willing to purchase test compared with control-1 for vision and myopia efficacy (p<0.001), while there was no difference between test and control-2 for either question (p>0.7). Both controls were better than test for all acuity-based measurements (p≤0.0013). MAF at 40 cm was better with test compared with control-1 (p=0.010) and not different to control-2 (p>0.99). AR was higher with test than both controls at 70 cm (p<0.0001), higher than control-1 at 40 cm (p<0.0001), and not different to control-2 at 40 cm (p=0.12). There were no differences between CLs for AR at 6 m or heterophorias at 3 m or 40 cm (p>0.1). CONCLUSIONS: Compared with control-1, the test offered better visual performance, a higher proportion of participants willing to purchase, and better MAF. Compared with control-2, the test offered worse visual performance, but the proportion of participants willing to purchase was not different, and accommodative function was comparable.
The limitations of centile curves for evaluating myopic eye growth.
Bullimore MA, Cheng X, Brennan NA
Optom Vis Sci · 2025 May · PMID 40261673 · Full text
SIGNIFICANCE: Pediatric growth charts are widely used to track height and weight. Recently, axial length growth charts have been developed. Unfortunately, they underestimate the rate of normal myopic eye growth, making i...
SIGNIFICANCE: Pediatric growth charts are widely used to track height and weight. Recently, axial length growth charts have been developed. Unfortunately, they underestimate the rate of normal myopic eye growth, making it challenging to evaluate the benefits of myopia control interventions, due to the conflation of myopes and nonmyopes. PURPOSE: The aim is to assess the value of axial length centile curves in the management of childhood myopia. METHODS: Papers reporting centile curves were identified by searching PubMed. For comparison, axial length values for a representative selection of baseline values (21 to 24 mm at 6 years) were calculated as a function of age and ethnicity using published meta-analyses of myopic and emmetropic eye growth data. RESULTS: Six published centile curves, largely based on cross-sectional data, were identified: three from European populations, two from China, and one from India. The trajectory of the emmetropic eye growth model generally tracks the European and Indian centile curves at lower centiles. This is not the case for the Chinese centile curves, likely due to the significant numbers of myopic children even at lower centiles. In contrast, the trajectory of the myopic eye growth model is steeper than that of the centile curves, even at higher centiles. This suggests that the higher centiles contain substantial numbers of nonmyopic children. Only in the centile curves for Chinese children, who have a higher prevalence of myopia, do they approach myopic eye growth, and then only for older children and at higher centiles. CONCLUSIONS: Centile curves do not accurately represent myopic eye growth, are not the best tool to monitor myopia progression and treatment, do not accurately represent growth in incident myopes, and are not the best way to predict myopia onset. Separate centile curves for myopic eyes do not alleviate the problem because of incident myopia. Annualized growth models may provide a better approach to assessing axial elongation relative to population norms.
Contact lens masks to improve the visual image quality in best-corrected keratoconic eyes.
Francis SM, Koppen C, Rozema JJ
Optom Vis Sci · 2025 Jun · PMID 40209207 · Publisher ↗
SIGNIFICANCE: Abnormalities or irregularities in the cornea, whether it is from scarring or an ectatic disease like keratoconus can significantly affect vision. Correcting such eyes with rigid gas-permeable (RGP) contact...
SIGNIFICANCE: Abnormalities or irregularities in the cornea, whether it is from scarring or an ectatic disease like keratoconus can significantly affect vision. Correcting such eyes with rigid gas-permeable (RGP) contact lenses can help regularize the cornea and improve vision. However, some aberrations persist despite wearing the best RGP contact lens correction. PURPOSE: This investigation looks into improving contact lenses by designing a customized mask on the contact lens plane. The image quality of keratoconic eyes can be improved by blocking light rays that stray too far from the best focus using a binary mask. METHODS: Corneal tomography and biometry data of 20 keratoconic SyntEyes were generated using a stochastic eye model and the best toric RGP contact lens corrections were calculated and applied to these eyes. Custom MATLAB software was used to perform ray tracing through the eye and determine ray coordinates on the retinal plane. Circular zones with radii of 0.015, 0.025, 0.05, and 0.1 mm were created on the image plane that acted as a virtual pinhole. Finally, masks in four regions were designed to block light rays that did not converge inside these virtual pinholes. RESULTS: A region 4 mask significantly reduces the average root-mean-square wavefront error from 1.82 ± 0.50 to 0.32 ± 0.06 µm ( t test, p<0.05), while blocking 53.87 ± 4.68% of the incoming light. For masks of regions 3, 2, and 1, the root-mean-square wavefront error increases to 0.51 ± 0.01, 1.25 ± 0.36, and 1.81 ± 0.50 μm, respectively, and the amount of blocked light decreases to 30.35 ± 5.09, 8.49 ± 3.70, and 0.47 ± 0.63%, respectively. CONCLUSIONS: Contact lens masks designed to filter out skewed light rays can increase the image quality in contact lens-corrected keratoconic eyes, but this must be balanced with minimal light loss.
Technical report: Calculation and interpretation of corneal transference maps.
Evans T, Rozema JJ
Optom Vis Sci · 2025 Apr · PMID 40207392 · Full text
SIGNIFICANCE: Transference matrices are interesting tools for optical analysis of an eye alongside ray tracing. To explore possible interpretations of the ABCD entries of the transference, this article applies them to th...
SIGNIFICANCE: Transference matrices are interesting tools for optical analysis of an eye alongside ray tracing. To explore possible interpretations of the ABCD entries of the transference, this article applies them to the corneal surfaces to find a surprising link to a corneal biomechanics parameter that may help with keratoconus detection. PURPOSE: The transference matrix used in linear optics has four entries, dilation A, disjugacy B, divergence C, and divarication D. Entry C is the negative of the power of the system. However, the remaining three entries are somewhat difficult to relate to. This work explores how the four fundamental properties of the corneal transference relate to familiar corneal variables such as radii of curvature, thickness, surface powers, and total refractive power. METHODS: The cornea is treated as a thick lens, and a transference is obtained for the cornea at approximately 12,000 points, as well as point-by-point corneal maps of A, B, C, and D are obtained based on Scheimpflug tomography data (Pentacam HR, Wetzlar, Germany). The trace of the transference is also obtained. RESULTS: The four corneal maps of A, B, C, and D resemble familiar clinical maps, albeit at different scales. Pachymetry is represented by B, and total corneal power is represented by C, and A represents a new variable, resembling the corneal contribution to stress (CCS), a new variable used in detecting early keratoconus. D seems to represent a CCS-like variable applied to the posterior corneal surface. In keratoconus, the trace appears as a ring-shaped pattern around the cone. CONCLUSIONS: The A, B, C, and D maps relate information from known clinical maps such as pachymetry, corneal power, and CCS. The trace of the transference provides a new corneal map representing the combination of CCS and a related posterior parameter that may be useful in the detection and follow-up of keratoconus.
Evidence-based optometry: Is the von Graefe method still the standard?
Elliott DB
Optom Vis Sci · 2025 Apr · PMID 40207391 · Publisher ↗
Abstract loading — click title to view on PubMed.
Topical review: Potential mechanisms of atropine for myopia control.
Horn D, Salzano AD, Jenewein EC … +4 more , Weise KK, Schaeffel F, Mathis U, Khanal S
Optom Vis Sci · 2025 May · PMID 40168189 · Publisher ↗
Atropine is effective at slowing myopia progression in children, but the mechanism of action by which it controls myopia remains unclear. This article is an evidenced-based review of potential receptor-based mechanisms b...
Atropine is effective at slowing myopia progression in children, but the mechanism of action by which it controls myopia remains unclear. This article is an evidenced-based review of potential receptor-based mechanisms by which atropine may act to slow the progression of myopia.The rising number of individuals with myopia worldwide and the association between myopia and vision-threatening ocular pathologies have made myopia control treatments one of the fastest growing areas of ophthalmic research. High-concentration atropine (1%) is the most effective treatment for slowing myopia progression to date; low concentrations of atropine (≤0.05%) appear partially effective and are currently being used to slow myopia progression in children. While significant progress has been made in the past few decades in understanding fundamental mechanisms by which atropine may control myopia, the precise characterization of how atropine works for myopia control remains incomplete. It is plausible that atropine slows myopia via its affinity to muscarinic receptors and influence on accommodation, but animal studies suggest that this is likely not the case. Other studies have shown that, in addition to muscarinic receptors, atropine can also bind, or affect the action of, dopamine, alpha-2-adrenergic, gamma-aminobutyric acid, and cytokine receptors in slowing myopia progression. This review summarizes atropine's effects on different receptor pathways of ocular tissues and discusses how these effects may or may not contribute to slowing myopia progression. Given the relatively broad array of receptor-based mechanisms implicated in atropine control of myopia, a single mode of action of atropine is unlikely; rather atropine may be exerting its myopia control effects directly or indirectly via several mechanisms at multiple levels of ocular tissues, all of which likely trigger the response in the same direction to inhibit eye growth and myopia progression.
Eye growth and myopia progression following cessation of myopia control therapy with a dual-focus soft contact lens.
Chamberlain P, Hammond DS, Bradley A … +5 more , Arumugam B, Richdale K, McNally J, Hunt C, Young G
Optom Vis Sci · 2025 May · PMID 40132119 · Full text
SIGNIFICANCE: This 7-year clinical study assessed the impact of age and number of years of myopia control treatment with MiSight 1 day (omafilcon A; CooperVision, Inc., Pleasanton, CA) dual-focus contact lenses on post-t...
SIGNIFICANCE: This 7-year clinical study assessed the impact of age and number of years of myopia control treatment with MiSight 1 day (omafilcon A; CooperVision, Inc., Pleasanton, CA) dual-focus contact lenses on post-treatment eye growth and myopia progression. Growth and progression after treatment were ceased and returned to age-normal levels retaining prior accrued treatment gains. PURPOSE: This study aimed to assess eye growth and refractive changes after cessation of prolonged myopia control treatment with a dual-focus contact lens. METHODS: Eighty-three subjects completing a 6-year clinical trial of a dual-focus myopia control contact lens (MiSight 1 day) continued into a follow-on 1-year "wash-out" phase in which all subjects were fit with a single-vision contact lens (Proclear 1 day, omafilcon A; CooperVision, Inc.). Right and left eye data were analyzed from 38 subjects with 6 years of prior treatment (T6) and 40 receiving treatment during study years 4 to 6 (T3). Axial length and cyclopleged spherical equivalent refractive errors were monitored annually for 7 years. Expected axial growth and myopia progression during years 4 to 7 if treatment had not been started were estimated by extrapolating growth of untreated myopic control eyes collected during years 1 to 3 using population-based estimates of age effects on growth rates. RESULTS: During the untreated year 7, annualized axial growth and refractive changes were 0.09 ± 0.09 (T3) and 0.10 ± 0.10 mm/y (T6), and -0.23 ± 0.36 (T3) and -0.21 ± 0.40 D/y (T6), respectively, each slightly greater than observed during the previous year of treatment (0.07 ± 0.12 [T3] and 0.08 ± 0.07 mm [T6], and -0.04 ± 0.34 [T3] and -0.13 ± 0.42 D [T6]). Year 7 progression was less for the older (11 to 12 at baseline, -0.17 ± 0.40 D/0.05 ± 0.07 mm) than the younger (8 to 10 at baseline, -0.26 ± 0.36 D/0.13 ± 0.10 mm) subgroup. Years in treatment (3 vs. 6) did not influence post-treatment growth or progression. CONCLUSIONS: A cessation study following 3 or 6 years of myopia control treatment with the dual-focus myopia control contact lens found axial growth and myopia progression rates similar to those expected of untreated myopic eyes at these ages. This finding reveals that accrued treatment gains were retained and neither amplified nor diminished after cessation of treatment.
Cognitive demand, concurrent viewing distances, and digital eyestrain.
Sharvit E, Rosenfield M
Optom Vis Sci · 2025 Apr · PMID 40117477 · Publisher ↗
SIGNIFICANCE: Digital devices are ubiquitous in modern daily life. Although a high prevalence of digital eyestrain has been reported, the mechanisms underlying digital eyestrain have not been fully elucidated, and there...
SIGNIFICANCE: Digital devices are ubiquitous in modern daily life. Although a high prevalence of digital eyestrain has been reported, the mechanisms underlying digital eyestrain have not been fully elucidated, and there is currently no proven treatment. PURPOSE: This study aimed to evaluate the relationship between the cognitive demand of a near task, mode of presentation (digital or paper), working distance, and symptoms of digital eyestrain. METHODS: Thirty young participants completed four 30-minute reading tasks. The four conditions (performed in randomized order) entailed (1) a cognitively demanding task performed on a tablet computer and (2) a less cognitively demanding task performed on the same device. Trials (3) and (4) were identical to (1) and (2) except that the tasks were performed on paper. Subjects could hold the reading task at any distance they felt comfortable. Before and immediately following each task, subjects completed a digital eyestrain symptom survey. For all four conditions, a spectacle-mounted device (Clouclip) was used to measure the working distance objectively. RESULTS: Although all four tasks induced significant symptoms, there was a significant difference between the four conditions, with the increase being greatest for the cognitively demanding task on the tablet computer. There was no significant difference in working distance for the four conditions, and all tasks showed a similar reduction in working distance (p=0.001), on average, from 31.6 to 28.9 cm, over the first 10 minutes, with the working distance remaining stable after this initial period. CONCLUSIONS: Task-induced symptoms varied with both cognitive demand and mode of presentation. However, working distance did not vary significantly with these factors. The wording distance decreased during the first 10 minutes of each trial and was markedly closer than 40 cm for all conditions. The closer working distances being adopted should be considered during routine clinical testing.
Case series: Switching myopia management therapies in a real-world academic clinic.
Tomiyama ES, Rickert M, Kollbaum P … +1 more , Ritchey ER
Optom Vis Sci · 2025 May · PMID 40117476 · Publisher ↗
SIGNIFICANCE: Slowing myopia progression is quickly becoming the clinical standard of care, but little is known about how changing treatment alters treatment effect. This case series provides insight on how changing trea...
SIGNIFICANCE: Slowing myopia progression is quickly becoming the clinical standard of care, but little is known about how changing treatment alters treatment effect. This case series provides insight on how changing treatment modality may affect treatment outcomes in myopia management. PURPOSE: Aiming to control myopia progression in children is becoming the clinical standard of care. Little is known about the effect of changing treatment on myopic progression. We present a case series of real-world myopia management patients who underwent a change in treatment method and report the observed effect on axial length. METHODS: Clinical records from the University of Houston Myopia Management Service were reviewed to identify children who underwent a change in treatment. The analyzed dataset consisted of 44 clinic assessments from seven children including two who were switched from peripheral defocus soft contact lenses to orthokeratology, two who were switched from orthokeratology to peripheral defocus soft contact lenses, and three who received combination therapy following an initial period of treatment with either orthokeratology, peripheral defocus soft contact lenses, or atropine alone. Axial length measurements were adjusted by subtracting central corneal thickness from the raw axial length value and then converted to an annualized rate (mm/y) by subtracting the previous corneal thickness-adjusted from the current corneal thickness-adjusted axial length and dividing by elapsed time between the successive clinic visits. RESULTS: Age at initial assessment ranged from 6.6 to 12.6 years (M = 9.3 ± 2.4) with follow-up times ranging between 26 and 78 months (M = 43 ± 18.5). Each individual had a minimum of two clinical visits per treatment type. The mean (SD) for central corneal thickness-annualized adjusted axial length growth in both the eyes and chronological age at the beginning of each treatment type was calculated. Estimated progression rates are summarized separately for each individual and treatment. Data are grouped by patients who switched treatments for either lack of efficacy or other clinical issues. CONCLUSIONS: In a real-world setting, there are various reasons that necessitate a change in treatment. In this sample, change in treatment continued to show slowing of myopia progression, regardless of reason for change.
Challenges faced by women in optometry while delivering community eye care services.
Chande PK, Citek K, Wang-Harris S … +1 more , Radoiu M
Optom Vis Sci · 2025 Apr · PMID 40117464 · Publisher ↗
SIGNIFICANCE: India has a population of more than 1.40 billion with a humongous need for community eye health services. Understanding challenges faced by female optometrists in community eye care will help us address the...
SIGNIFICANCE: India has a population of more than 1.40 billion with a humongous need for community eye health services. Understanding challenges faced by female optometrists in community eye care will help us address the needs and eventually improve eye and vision care services. The study also aims to give recommendations to policymakers and to leadership in hospitals that provide community eye health services and employ female optometrists. PURPOSE: The study aimed to understand the challenges faced by women in optometry while delivering community eye care services. METHODS: Optometrists working in community eye health were invited to participate in this study. In-depth interviews were conducted using a semistructured questionnaire. The interviews were recorded, and the audio files were transcribed to text and analyzed using the MAXQDA-10 software. Data analysis was performed based on thematic codes and responses received from the participants. RESULTS: Eighteen optometrists completed the interviews, and the average age of the female optometrists who participated in the study was 36.4 ± 6.5 years. The average experiences in overall optometry work and community eye health were 14.3 ± 5.9 and 9.5 ± 5.3 years, respectively. The qualitative analysis revealed that women faced several challenges from basic logistics to gender bias, from the communities they served, and from within the organization's peers. Their work-life balance also faced challenges including their social lives. The enablers and motivating factors were job satisfaction, learning experience, and career growth. CONCLUSIONS: The study describes several challenges faced by female optometrists in community eye health, from the lack of basic facilities to gender bias among peers and challenging work-life balance. Despite this, women are happy to contribute to community work, as they find the experience rewarding, both emotionally and professionally.
Parental influences on contact lens uptake among school-aged individuals with myopia in Kenya.
Kololi G, Okenwa-Vincent EE, Sum TJ
Optom Vis Sci · 2025 May · PMID 40117463 · Publisher ↗
SIGNIFICANCE: With the global rise in myopia among school-aged children, effective management strategies, such as contact lenses (CLs), are essential. In Kenya, where myopia prevalence is increasing, understanding parent...
SIGNIFICANCE: With the global rise in myopia among school-aged children, effective management strategies, such as contact lenses (CLs), are essential. In Kenya, where myopia prevalence is increasing, understanding parental influence on CL uptake is critical because of parents' key role in healthcare decisions involving their children. This study addresses this significant gap by exploring the parental factors that either promote or hinder CL uptake among school-aged children in Kenya. PURPOSE: This study investigated the parental factors influencing CL uptake among school-aged children with myopia in selected Kenyan eye clinics. This study specifically examined the factors that promote or hinder parents' choice of CLs as a myopia correction method for their children. METHODS: This cross-sectional study involved 85 parents or caregivers of children and teenagers aged 8 to 18 years with significant myopia, defined as a spherical equivalent refraction value of ≤-0.50 D in one or both eyes. Data were gathered using a pre-validated questionnaire distributed at selected eye clinics. The questionnaire assessed parental knowledge, attitudes, and the factors affecting CL uptake. Descriptive statistics were used to summarize the key variables, and multivariate logistic regression was used to assess the influence of parental factors on CL uptake. RESULTS: The study found that 35% of parents approved CL use for their children, with academic performance (odds ratio [OR], 106; p = 0.01) and discomfort with spectacles (OR, 41; p = 0.02) being significant positive influencers. The major barriers identified were concerns about the child being too young (OR, 62; p = 0.03) and not careful enough (OR, 84; p = 0.02) to handle CLs. Other barriers include the perceived high cost of CLs and a lack of professional advice. CONCLUSIONS: Parental CL uptake decisions are significantly influenced by perceived academic benefits and concerns regarding the child's ability to manage CLs. These findings highlight the need for targeted educational interventions and professional guidance to address parental concerns, improve CL uptake, and enhance myopia management in school-aged Kenyan children.
Letter to the editor: ISO 7921:2024-A new international standard for measurement of reading acuity.
Citek K, Radner W
Optom Vis Sci · 2025 Mar · PMID 40100086 · Publisher ↗
Abstract loading — click title to view on PubMed.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe