Clinical and Experimental Optometry最新文献

Clinical relevance: Attention-deficit/hyperactivity disorder (ADHD) has been associated with visual symptoms that may impact daily activities such as near-work tasks and social interactions. Addressing these visual issues is important for improving the overall quality of life and functional outcomes in individuals with ADHD, particularly in academic and social settings.

Purpose: To investigate the relationship between vision-related quality of life and near-work visual symptoms in patients with ADHD patients.

Methods: A cohort of 37 individuals with ADHD was compared to age- and sex-matched healthy controls (n = 37). The 25-Item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Convergence Insufficiency Symptoms Survey (CISS) were used to assess vision-related quality of life and near-work visual symptoms.

Results: Mean NEI VFQ-25 scores were not significantly different between the ADHD and control groups. However, individuals with ADHD scored lower on the near activities (p = 0.032; Cohen's d = -0.511), social functioning (p = 0.045; Cohen's d = -0.481) and driving (p = 0.007; Cohen's d = -0.124) subscales. The CISS scores were significantly higher in the ADHD group (23.43 ± 11.22) than in the control group (14.02 ± 9.36; p < 0.001; Cohen's d = 0.910), indicating a significant relationship between ADHD and the presence of symptomatic subjects (p < 0.001; Cramer's V = 0.541). Medication did not affect NEI VFQ-25 or CISS scores. Female gender was associated with an increased number of symptomatic subjects based on their CISS scores (p = 0.043; Cramer's V = 0.396). Symptomatic ADHD individuals had lower NEI VFQ-25 scores (85.02 ± 12.68 vs. 96.02 ± 4.63, p = 0.008; Cohen's d = -0.969), indicating compromised vision-related quality of life.

Conclusions: Patients with ADHD experienced a reduced vision-related quality of life and increased near-work visual symptoms, suggesting potential repercussions on academic performance and social adaptability. This study underscores the importance of addressing visual issues in the ADHD population to enhance their overall well-being and functional outcomes.

Clinical relevance: Clinical skills training is essential in optometry curricula to develop core graduate entry competencies, including self-directed learning to facilitate life-long learning. Efficient and efficacious approaches are required to optimise student and educator time and resources.

Background: A video library of optometric clinical skills was created in 2012 to support self-directed student learning and face-to-face training. Use of videos in higher education generally increased during the COVID-19 pandemic and has remained above pre-pandemic levels. This study aimed to capture and evaluate student access patterns in the library to determine which videos were accessed most, and if this changed with training stage and following the pandemic.

Methods: Data on student viewing and critique submission were extracted for 71 videos from a clinical skills video library from 2018 to 2023. The number of videos viewed by students was analysed by year, cohort, video type (gold standard, scripted errors, summary, and student generated) and video category (history, screening, refraction, anterior segment, posterior segment and tonometry).

Results: First-year students viewed the most videos, and this decreased significantly during and following the pandemic. Overall, the number of videos viewed decreased with increasing course stage. Video access, by category, aligned with the curriculum. Views were highest for gold standard and student videos. Viewing of scripted error videos and submission of critiques of procedural videos was low for all course stages and years.

Conclusion: A web-based video library of optometric clinical skills was used for self-directed learning, mostly by students early in their training. Similar resources developed in the future should align with curriculum and include exemplar and student-based videos. Exploration of student and educator perspectives regarding factors that impact engagement with the online library warrants investigation to facilitate optimal integration in post-pandemic times.

Clinical relevance: Angle closure glaucoma is one of the most common blinding diseases encountered mainly in older age groups, although it may also occur at a younger age. Identifying the underlying cause of angle closure helps in designing specific treatment strategies essential for effective disease management.

Background: Primary angle closure disease, caused due to pupillary block (PB) and plateau iris configuration (PIC), necessitates different management strategies. This study assessed the potential utility of anterior segment optical coherence tomography (ASOCT) and optical biometry in distinguishing PIC from PB in primary angle closure disease of the young (PACDy).

Methods: Patients aged 20-40 years with PACDy and age-matched healthy controls were recruited. Ophthalmic examinations included gonioscopy, ultrasound biomicroscopy, ASOCT, and biometry. Anterior chamber depth, lens thickness, axial length, central corneal thickness, lens position, relative lens position, vitreous cavity length, lens vault, relative lens vault and angle opening distance, trabecular iris space area, and trabecular iris angle were measured. Receiver operating characteristics curve analysis evaluated the discriminative ability of these parameters.

Results: Of the 280 eyes, 128 were normal and 152 had PACDy. Of 128 PACDy, 88 had PIC, and 64 had PB. Both PIC and PB had significantly smaller ASOCT and biometric parameters than normal eyes. However, PIC had intermediate biometric values that fell between normal eyes and PB. All the aforementioned parameters, except central corneal thickness, showed excellent discriminating ability of PIC and PB from normal eyes; however, no single parameter can strongly differentiate PB from PIC. Axial length and relative lens vault had the highest, although weak, power for discriminating PB from PIC.

Conclusion: ASOCT and biometry effectively distinguish PIC and PB from normal eyes, but no single parameter reliably differentiates PIC from PB. Comprehensive gonioscopy and ultrasound biomicroscopy may be necessary for accurate diagnosis in PACDy.