Clinical and Experimental Optometry最新文献

Clinical relevance: Access to high-quality educational resources is essential for patients with low vision. Providing curated recommendations for reliable materials can help ensure patients receive accurate information for effective visual health management.

Background: Visual impairment is a global issue affecting millions. The internet serves as a significant source of information, but the quality and reliability of this information can vary greatly.

Methods: An online search on YouTube was conducted using keywords such as 'Low Vision', 'Vision Impairment', 'Low Vision Aids', and 'Low Vision Rehabilitation'. Videos were screened based on inclusion criteria, and those that did not meet these criteria were excluded. The selected videos were assessed using three evaluation tools: modified DISCERN criteria (mDISCERN), JAMA benchmark criteria, and Global Quality Score (GQS). Three low-vision optometrists independently performed the assessments, and video popularity was measured using the video power index (VPI).

Results: A total of 116 videos were included in the analysis. The Kruskal-Wallis test indicated significant differences between the results of the three video evaluation tools and video quality (p < .001). The comparison between videos produced by universities vs. professional organisations vs. private companies showed no significant differences between groups and VPI (p = .522), but a significant difference was found with mDISCERN (p < .001), JAMA (p < .001), and GQS (p = .014). No significant differences in quality were found in gender analysis.

Conclusions: YouTube can be a valuable source of information for low vision patients, but healthcare providers need to guide patients towards high-quality resources while ensuring oversight of the content.

Clinical relevance: Assessing visual and cognitive performance in athletes is important for optimising training strategies and preventing visual strain in both esports and traditional sports.

Background: This study compared visual acuity, refractive error, binocular functions, and cognitive perception measures between esports and soccer players to optimise visual performance strategies.

Methods: Twenty-eight male esports athletes and 38 male soccer players were assessed. Visual acuity was measured using an ETDRS chart, and refractive error was assessed with retinoscopy. Phoria was evaluated with the Modified Thorington Technique at distance and near. Fusional vergence ranges and vergence facility were measured using prism bars and a prism flipper. Monocular accommodative facility at near was tested with ± 2.00D flipper lenses. Stereopsis was assessed using the Randot Stereo Test. Perception span, multiple object tracking, and visual reaction time, were evaluated using the Senaptec Sensory Station.

Results: Soccer players had significantly better visual acuity than esports athletes. For the right eye, the soccer group had an average decimal visual acuity of 1.1 ± 0.2 compared to 0.9 ± 0.1 in the esports group (p < 0.001). Refractive error analysis showed that esports athletes had more myopia (M =-0.67 ± 1.70D) and higher astigmatism (J0 = 0.47 ± 0.53D) than soccer players (M = 0.6 ± 1.06D, J0 = 0.09 ± 0.43D; p < 0.001). Soccer players demonstrated better negative fusional vergence at distance (p = 0.049) and superior near-accommodative facility (12.4 ± 4.2 cpm vs. 9.4 ± 5.2 cpm; p = 0.025). Soccer players also outperformed esports athletes in multiple object tracking (1811.3 ± 391.3 vs. 1523.4 ± 528.7; p = 0.013). No significant differences were observed in stereopsis or other binocular vision parameters.

Conclusion: Soccer players showed superior visual acuity and performance in tasks such as negative fusional vergence and near-accommodative facility compared to esports players. Esports athletes had more myopia and astigmatism, indicating a need for targeted visual interventions.

The relationship between the gut microbiome and ocular health has garnered increasing attention within the scientific community. Recent research has focused on the gut-eye axis, examining whether imbalances within the gut microbiome can influence the development, progression and severity of ocular diseases, including dry eye disease, uveitis, and glaucoma. Dysbiosis within the gut microbiome is linked to immune dysregulation, chronic inflammation, and epithelial barrier dysfunction, all of which contribute to ocular pathology. This review synthesises current evidence on these associations, exploring how gut microbiome alterations drive disease mechanisms. Furthermore, it examines the therapeutic potential of microbiome-targeted interventions, including antibiotics, prebiotics, probiotics, and faecal microbiota transplantation, all of which aim to restore microbial balance and modulate immune responses. As the prevalence of these conditions continues to rise, a deeper understanding of the gut-eye axis may facilitate the development of novel, targeted therapies to address unmet needs in the management of ocular diseases.

Clinical relevance: Waste management strategies are well documented for employee safety, legal compliance and infection control measures; however, appropriate waste disposal is equally important to minimise adverse environmental impacts. Knowledge on best practices related to the disposal of healthcare-generated waste is crucial for environmental sustainability.

Background: Global healthcare contributes significantly to greenhouse gas emissions, thereby extending the pervasiveness of climate change. Urgent action is required by the healthcare sector to minimise these impacts. Proper waste management is an alleviation measure that can be easily implemented in healthcare practice. The aim of this study was to calculate the approximate mass of plastic waste generated through lens wear and develop an easy-to-use decision-making tree to support optometrists with sustainable waste management.

Methods: Data were analysed, from an online survey directed to ophthalmic lens wearers, to determine the mass of annual plastic waste associated with lens wear. Information collated from published studies and clinical experience of the researchers, supplemented by a literature search from online databases, EBSCOhost, Google Scholar, ScienceDirect and PubMed, were used to develop the waste decision-making tree.

Results: Approximately 48 kg of plastic waste was generated from annual lens wear, of which approximately 83% of recyclable materials were landfilled. The waste management decision-making tree was created to guide optometrists regarding sustainable waste management practices.

Conclusion: Although this study focused on Optometry, its findings and recommendations have applicability across the healthcare field. Environmental stewardship is a joint responsibility of all healthcare professionals. This study highlighted the importance of incorporating and promoting sustainable clinical measures as well as the embedding and regular updating of clinical evidence on waste management best practices into healthcare training programmes. In doing so, the broader healthcare sector can contribute significantly towards reducing healthcare waste and associated emissions and improving health outcomes, thereby safeguarding the planet and its inhabitants.

Clinical relevance: Knowing the changes in corneal sensitivity according to age and gender is important for the correct evaluation of pathologies.

Background: The aim of this work was to analyse variability of corneal sensitivity according to age and gender in the healthy population in Turkey.

Methods: Healthy volunteers between the ages of 20 and 84, who applied to outpatient clinic due to routine examination, were included. Exclusion criteria were any ocular diseases other than refractive error, any systemic disease, contact lens use, chronic ocular and systemic drug use, and previous ocular surgery. Central and 4 quadrants (superior, inferior, nasal, temporal) corneal sensitivity measurements were performed with a Cochet-Bonnet esthesiometer (Luneau Ophthalmology, France). The patients were divided into 5 groups according to their ages (Group 1:20-29, Group 2:30-39, Group 3:40-49, Group 4:50-59, Group 5 ≥ 60). The data were evaluated in terms of groups and gender.

Results: The right eyes of 324 volunteers were included. The mean age was 44.31 ± 15.65 (20-84) and the female/male ratio was 165/159. The mean central, superior, inferior, nasal, and temporal sensitivities were 50.15 ± 9.7,48.62 ± 10.3,48.59 ± 10.3,47.73 ± 10.2,47.71 ± 10.3 mm, respectively. Sensitivities in all quadrants decreased significantly depending on age (p = 0.001 for all, central, superior, inferior, nasal and temporal correlation coefficients,r = -0.783, -0.791, -0.789, -0.760, -0.775, respectively). The decrease accelerated in Group 4 and 5. Gender-related changes were detected as significant in central and temporal quadrants (p = 0.038, p = 0.019). When sensitivity according to gender was evaluated within each decade, significant difference was detected in Group 2 and 4 (p < 0.05).

Conclusion: Corneal sensitivity decreases with age, most significantly in 5^th and 6^th decades. Sensitivity differs between genders in central and temporal quadrants. Geographic location, gender, and ethnicity may affect sensitivity values. The present study defines normal values in aTurkish population and may guide the evaluation of pathologies that impair corneal sensitivity.

Clinical relevance: Myopia control is a prominent area of global research, with multifocal contact lenses identified as an effective intervention for adolescents.

Background: This study aims to evaluate the visual performance and vision-related quality of life (QoL) of myopic adolescents when corrected with pupil-optimised multifocal soft contact lenses (MFSCLs) versus single-vision contact lenses (SVCLs), with each participant serving as their own control.

Methods: Thirty-five myopic adolescents, habitually wearing SVCLs and fitted with pupil-optimised MFSCL with mid-addition power, were recruited. The assessment included distance visual acuity (DVA), near visual acuity (NVA), maximum reading speed (MRS), reading acuity (RA), contrast sensitivity (CS), and stereoacuity (SA) in photopic conditions for both types of lenses. Vision-related QoL was quantified twice for both lens types using the National Eye Institute Visual Function Questionnaire (NEI VFQ-42), covering 13 vision-specific domains.

Results: Comparisons of visual outcomes between MFSCLs and SVCLs for the same subjects revealed statistically significant differences in DVA (p = 0.010), NVA (p = 0.014), MRS (p = 0.044), and RA (p < 0.001), with SVCLs outperforming in DVA only. No significant difference in CS and SA was observed between the two lens types. According to the NEI VFQ-42, scores for clarity of vision, far vision, glare, and satisfaction with correction were higher with SVCLs, while the score for near vision was higher with MFSCLs. When fitted with MFSCLs, no significant correlations were found between pupil size and age of the patient with any visual examination parameters. However, there was a significant negative correlation between the DVA, NVA and the spherical equivalent of the lens.

Conclusion: MFSCLs with mid-add power significantly improve NVA, MRS, and RA, albeit with a reduction in DVA compared to SVCLs. While SVCLs were associated with better clarity of vision, far vision, and satisfaction with correction, MFSCLs offered superior performance in near vision tasks, according to the NEI VFQ-42 scores.

Oxygen delivery and tear exchange are considered essential to maintain corneal homoeostasis during contact lens wear. Since the 1940s, fenestrations and back surface channels have been utilised in scleral, corneal rigid, and soft contact lenses in an attempt to enhance corneal oxygen transmission, facilitate the removal of carbon dioxide from the post-lens tear layer, minimise corneal oedema and prevent post-lens tear stagnation. This review examines the use of contact lens fenestrations and channels in both clinical and laboratory settings, and the effect of these modifications upon tear exchange and corneal oedema. Despite almost a century of modifying contact lenses to alter tear dynamics and promote corneal health, the evidence regarding the efficacy of fenestrations and channels is mixed.