Clinical Optometry最新文献

Purpose: To (1) assess rates of burnout in Fellows of the American Academy of Optometry and (2) assess associations among perceptions of workplace wellness support with lifestyle behaviors and health and wellness indicators (ie, anxiety, depression, stress, burnout, mattering to the workplace, and workplace is not stressful).

Methods: A survey collected sample characteristics and outcomes of interest from 321 Fellows.

Results: Thirty-two percent reported burnout. Females and those working in academia were significantly more likely to report being burned out at work. Compared to Fellows with low perceptions of workplace wellness support, Fellows with high perceptions of support were significantly more likely to report mattering to their workplace, a non-stressful workplace environment, and no burnout.

Conclusion: Promoting workplace wellness support may improve perceptions of mattering, stressful workplace environments, and rates of self-reported burnout in optometrists.

Purpose: Dry eye disease (DED) causes discomfort and potential damage to the surface of the eye, commonly managed with artificial tears. We assessed symptom relief, tolerability, and patient experience of a novel carboxymethyl-cellulose-based artificial tear formulation with trehalose and sodium hyaluronate (ABBV-444) in patients with DED.

Methods: This open-label, single-arm, single center study enrolled adult patients with baseline Ocular Surface Disease Index (OSDI) scores of ≥18 and ≤65. Patients were instructed to use ABBV-444 as often as needed but at least twice a day for 30 days. The primary endpoint was change from baseline in OSDI score at Day 30. Secondary endpoints were onset of action (change from baseline in current symptom survey [CSS] visual analog scale [VAS] scores over 5 minutes post administration on Day 1) and patients' experience (change from baseline in Patient Eye Drop Experience [PEDE] survey VAS scores at Day 30). Outcomes were assessed in the per-protocol (PP) population using descriptive statistics. A paired t-test was performed to calculate P-values.

Results: A total of 34 patients were included in the PP population. DED severity, measured by OSDI, significantly decreased by a mean (standard deviation; SD) score of 6.8 (15.0) points from baseline to Day 30 (P=0.006). Patients showed significant symptom improvement as early as 30 seconds after application, with mean (SD) CSS changes from baseline of -3.3 (10.3) points at 30 seconds (P=0.03) and -10.1 (10.6) points at 5 minutes post-dose (P<0.001). No adverse events were reported. PEDE scores averaged between 76.4 (36.7) and 85.7 (21.0) at Day 30.

Conclusion: Continuous daily treatment with ABBV-444 reduced DED symptom severity over 30 days and demonstrated rapid onset of action within 30 seconds post administration. These results suggest that ABBV-444 is a viable therapy for DED symptoms and support further investigation of longer-term treatment in multicenter trials.

Purpose: To determine the performance of TOTAL30 for Astigmatism (T30fA; Alcon; Fort Worth, TX, USA) contact lenses (CLs) in existing CL wearers who are also frequent digital device users.

Methods: This 1-month, 3-visit study recruited adult, 18- to 40-year-old subjects who were required to use daily digital devices for at least 8 hours per day. All subjects were refit into T30fA CLs. A text message visual analog scale (VAS) (±50 scale; positive being comfortable) evaluate at-home eye comfort across the day at 1 day, 1 week, and 1 month. Subjects were evaluated at 1 month with the Computer Vision Syndrome Questionnaire (CVS-Q), Impact of Dry Eye on Everyday Life (IDEEL) Quality of Life questionnaire, and a custom questionnaire.

Results: A total 48 subjects were analyzed (mean age = 28.8 ± 6.3 years; 75% female). At 1 month, IDEEL daily activities, feelings, and work domains scores were 96.7 ± 6.6, 96.4 ± 6.2, and 94.8 ± 8.6, respectively. CVS-Q scores were 3.48 ± 3.73. Most of the subjects indicated that they were satisfied with the overall performance of the study CLs (81.3%) and with their level of eye strain with the study CLs (87.3%). When evaluating CL comfort with the VAS, comfort did not differ across the month at each time point (all p-value ≥ 0.16), yet CL comfort did decrease minimally across the wear day (all p-value < 0.001).

Conclusion: These data suggest that the monthly study CLs can provide an excellent wearing experience for those with frequent digital device use.

Background: Diabetic retinopathy (DR) posed an adverse psychological impact among affected individuals.

Aim: This study evaluates the psychometric impact of Diabetic Retinopathy-induced visual impairment: A hospital-based study, Al Buraimi, Sultanate of Oman.

Settings: A hospital-based population having Diabetic Retinopathy, Al Buraimi, Sultanate of Oman.

Methods: This cross-sectional, hospital-based study included 218 participants having diabetic retinopathy. The Vision Quality of Life Index (VisQoL) utility questionnaire was used to measure the psychometric status. Ordinal logistic regression analyses evaluated the significant factors from age, gender, visual acuity, duration of DM or DR, responsible for the psychometric status.

Results: Of the 218 participants, 114 (52.29%) were males and 104 (47.71%) were females. The mean diabetes mellitus (DM) and diabetic retinopathy duration was 17.21 ± 6.97 years and 5.15 ± 3.51 years respectively. The mean psychometric score was 2.21 ± 1.03. One-third (34.86%), 2.75% of the participants were extremely concerned, while 33.94% were observed to have a little concern. Visual impairment status (p = 0.00), higher age (p = 0.00), DR severity (p = 0.00) and individuals lacking support of the life partner (p = 0.00) were observed to have a significant negative psychometric impact.

Conclusion: Majority of the participants had proliferative diabetic retinopathy. A majority of the (34.86%) reported no concern, and a notable percentage (65.14%) expressed a minor-to-severe level of concern. Age, marital status, severity of diabetic retinopathy and level of visual impairment were the significant predictors for their psychometric scores.

[This corrects the article DOI: 10.2147/OPTO.S485270.].

Background: To compare the postoperative visual quality of patients undergoing small-incision lenticule extraction (SMILE) with spherical trial lens intervals of 0.05D and 0.25D in preoperative manifest refraction.

Methods: The study included 196 eyes of 101 patients with 0.05D intervals to perform manifest refraction and 194 eyes of 98 patients with 0.25D intervals. Intraoperative lenticule thickness was compared in patients with different myopic grades. Postoperative examinations, including uncorrected distance visual acuity (UDVA) and manifest refraction results, were compared at 1-day, 1-week and 1-month follow-up.

Results: At the one-month follow-up, there was no significant difference in UDVA and spherical equivalent (SE) between the two groups (P=0.602 and 0.898, respectively). But the proportion of patients with a UDVA of more than 0.0 one month postoperatively was higher in the 0.05D intervals group (P=0.067). In patients with moderate myopia, the corneas with 0.05D interval manifest refraction had thinner maximum lenticule thickness compared with those in the control group (P=0.019).

Conclusion: Compared with the 0.25D interval group, patients performed manifest refraction with 0.05D spherical lens interval obtained equally good postoperative visual quality. The moderate myopia patients in the 0.05D interval group had thinner cornea cut during SMILE.

Purpose: Retrospective study to review scleral lens outcomes in the pediatric population over a 21-year period, at a single clinical center.

Results: A total of 209 pediatric eyes (108 males and 101 females), distributed between 97 right and 112 left eyes, of which 147 eyes had ocular surface disease and 62 eyes had irregular cornea/refractive conditions, were treated with scleral lenses over a 21-year period. The mean age at the time of treatment initiation was 10.6 ± 2.6 years and at the time of the last evaluation recorded was 14.7 ± 4.0 years. One hundred and forty-seven eyes (70%) continued to wear scleral lenses at the time of review, with a mean duration of lens wear of 8.2 ± 4.6 years. Sixteen eyes (8%) discontinued lens wear, and of these, challenges with application and removal were the predominant reason for discontinuation. The lens wearing status of forty-six eyes (22%) was unknown. Mean LogMAR visual acuity at presentation for the entire cohort was 0.93 ± 0.74 and improved to 0.43 ± 0.58, p < 0.05 with scleral lens wear. LogMAR visual acuity at the last evaluation recorded was 0.4 ± 0.6, p < 0.05. The mean initial lens diameter of the full study cohort was 17.7 ± 1.2 mm, with a mean increase of 1.3mm (p = 0.0004) over the study period, to end with a mean final diameter of 18.2 ± 1.5 mm, at the time of the last evaluation recorded.

Conclusion: Scleral lenses are a viable option for therapeutic and visual rehabilitation applications in the pediatric population for both ocular surface disease and irregular cornea/refractive conditions. Most eyes continued to wear lenses over a 21-year review period. The mean final lens diameter was 18.2mm, suggesting that larger diameters do not appear to be a deterrent or obstacle for successful long-term outcomes in the pediatric population.

Purpose: The purpose of this work was to determine the comfort performance of a toric, monthly, silicon hydrogel CL (lehfilcon A; TOTAL30 for Astigmatism) over a long day of wear.

Methods: This was a 1-month, 3-visit, prospective, single-arm study. Adult, 18- to 45-year-old CL wearers with good vision who were minimally symptomatic (CLDEQ-8 scores ≤12) were enrolled. Subjects were required to have astigmatism ranging from -0.75 D to -2.50 D in each eye and were required to wear the study CLs from about 8:00 AM until 12:00 AM each day. Comfort data with the study CL throughout the wear day were collected via text messaging.

Results: A total of 47 subjects who had a mean ± SD age of 29.5 ± 7.0 years were analyzed. Within a specified time point across the month of wear, CL comfort did not vary (all p-value ≥ 0.82), yet CL comfort did decrease across the wear day for all days evaluated (all p-value <0.001). Most subjects found their CLs to be comfortable with only 1.8% of subjects reporting an uncomfortable score at CL application and only 8.5% of subjects reporting an uncomfortable score after 16 hours of CL wear.

Conclusion: A high level of consistency and predictability in comfort was found within the first month of wearing lehfilcon A CLs. This suggests that patients with minimal CL-related discomfort at initial fitting of a lehfilcon A CL may likely tolerate longer wear time with minimal discomfort across the entire month of wear.

Clinical trialsgov id: NCT06052046.

Purpose: The use of mobile phone applications (apps) in the health sector, including in eye care, is increasing. This study aimed to compare interpupillary distance (IPD) measurements using common clinical techniques (pupillometer, PD ruler, and autorefractor), which are contact procedures, with measurements from a non-contact mobile phone application.

Methods: Forty participants were recruited (mean age 25.65±3.72 years, 21 male and 19 female). Binocular distance and near IPD measurements from four instruments were compared: pupillometer (TOPCON PD-5, Japan), PD ruler, auto-refractor (KR-8100P, TOPCON, Japan), and Mobile Application (Eye Measure, 1.22). Two consecutive measurements were performed. The pupillometer measurement was used as the gold standard measurement for the Bland-Altman analysis, and two analyses were conducted: repeated measures ANOVA and Bland- Altman plots to analyze mean differences (MD) and 95% confidence intervals (CI) calculated as MD±1.96* standard deviation (SD).

Results: The measurement method affected IPD distance (F(3, 117)=15.74, p<0.01). The mobile apps resulted in significantly smaller distance IPD measurements than other methods. The PD ruler method yielded significantly larger distance IPD measurements than the pupillometer. For binocular near IPD, there was a significant difference among the methods (F(2, 78)=15.06, p<0.01). Pairwise comparison revealed that IPD ruler measurement was greater than with the other two methods (pupillometer and mobile application), while no difference was found between the pupillometer and mobile application. For consistency of measurement, correlation of two consecutive measurements was carried out, and it was found to be strongly correlated for all methods (r=0.9; p.<01).

Conclusion: Measurement by different tools showed difference of IPD measurement although induced prism due to discrepancy were within the allowed tolerance of less than 0.33 prism diopter (ISO 16034:2002) for all methods. Therefore, mobile App can be efficiently used for screening purposes for many people where limited services are available. However, caution should be exercised when mobile apps are used, such as in complex and for eyes which are misaligned.

Introduction: Following the formal launch of the AAO-African Chapter in October 2023, there was a renewed interest among African Optometrists to obtain the Fellowship of the American Academy of Optometry (FAAO). This paper investigates the awareness of the FAAO process among African optometrists and their perception of the newly established African Chapter's role in advancing the profession on the continent. The survey addresses a critical gap in understanding and highlights the pivotal role the African Chapter can play in advancing the optometry profession on the continent, contributing valuable insights for shaping strategies to enhance awareness, promote professional development, and foster a sense of belonging among African optometrists within the global optometry community.

Methods: A self-administered web-based cross-sectional survey was conducted from October 25 to 30, 2023, targeting African Optometrists who had joined the candidate for AAO WhatsApp group, created by the African Chapter. The survey aimed to collect data on the participants' knowledge, perceptions, and attitudes toward the FAAO process and the newly established African Chapter.

Results: The majority of the 302 African optometrists that participated in the survey, were under 40 years old and predominantly from Nigeria or Ghana. Despite a high intention to apply for the FAAO (77.2%), a significant proportion (82.1%) were unaware of the process. Nevertheless, nearly half of the respondents perceived benefits from the fellowship with regard to enhancing professional development and status. While one-third of respondents were aware of the African Chapter before joining, nearly all expressed a desire to become official members.

Conclusion: The critical gap in awareness regarding the FAAO process among African optometrists suggests the need for targeted strategies to increase awareness, promote professional development, and foster a sense of belonging among African optometrists within the global optometry community.