Clinical Optometry最新文献

Purpose: To evaluate ocular motility (OM) disorders and strabismus in a sample of patients with retinitis pigmentosa (RP) and a control sample.

Methods: In this cross-sectional retrospective analysis, we studied a sample of RP patients with a mean age of 48.74 years and an average visual acuity of 7/10 based on Snellen optotype and a sample of control patients with similar mean age (49 years [men], 47 years [women]) and sex and an average visual acuity of 9.9/10, with the aim of assessing correlations between alteration of OM and strabismus in RP patients based on age, high refractive defect, or severely impaired binocular vision. The examination followed a protocol of testing for anamnesis and best-corrected visual acuity, as well as a complete eye examination, corneal reflex, cover test, OM, Hess screen, and Lang test.

Results: At the first orthoptic evaluation, 45.16% of patients showed strabismus, 41.93% exotropia (25% of cases intermittent), 3.22% esotropia, and 6.45% vertical deviation. Later evaluation showed strabismus in 25.80% of patients, exotropia in 19.35% (9.67% intermittent), esotropia in 3.22%, and vertical deviation in 3.22%. Assessment of eye motility study showed 51.6% overaction of the inferior oblique and hypofunction of the superior rectus, and 18% overaction of the lateral rectus and hypofunction of the medial rectus. According to our results, alterations in OM and strabismus in RP patients are not correlated with age or high refractive defect. Therefore, motility disorders and strabismus are attributed to a genetic factor to which men are more susceptible.

Conclusion: The incidence of OM disorder was 77.42%, and strabismus was present in 45.16% of patients.

Myopia control lenses have been shown to modify visual function; however, it is arguable if these changes are short-term or long-term. We investigated the changes in accommodative behaviour and binocular vision functions of Malay myopic children who participated in a myopia control trial utilising spectacle lenses (n = 40). This article presents baseline accommodation and binocular vision measurements. The mean (± SD) age, spherical equivalent measured by cycloplegic autorefraction, and axial length (AL) for the right eyes were 10.00 ± 1.47 years, -3.02 ± 1.20 D, and 24.42 ± 0.93 mm, respectively. All participants had good distance and near visual acuities with high-contrast charts (100%), which were significantly better than low-contrast charts (10%) (p < 0.001). The mean (± SD) accommodative lag at baseline was 1.14 ± 0.35 D, while monocular and binocular accommodative amplitudes were 15.35 ± 2.07 D and 16.82 ± 2.27 D, respectively. Malay schoolchildren in this study were more esophoric at near compared to distance, with an accommodative-convergence over accommodation (AC/A) ratio of 5.64 ± 0.66 ∆/D. A higher degree of myopia was found to be associated with a longer AL (r = -0.49, p < 0.05) and higher esophoria at near (r = -0.46, p < 0.05). These baseline measures are consistent with data from other studies showing that myopic children have a high accommodative lag, an elevated AC/A ratio, a longer AL, and are more esophoric at near. The measures reported herein will serve as a basis for examining changes that occur within 12 months of wearing myopia control spectacle lenses.

Purpose: To investigate changes in peripheral eye length (PEL) in myopic children undergoing orthokeratology (Ortho-K) treatment for 12 months using MRI. The results were compared to single vision spectacle wearers (SVS).

Patients and methods: A total of 70 children with myopia (aged 8-9 years old) were recruited. A total of 45 children were fitted with Ortho-K, and 25 were fitted with SVS. The PEL and axial length (AL) were measured by using MRI 3-Tesla, whereas central and peripheral refraction (PR) measurements were conducted at ±30 degrees horizontally with nasal (N) and temporal (T) intervals of 10°, 20°, and 30° and with an open field autorefractometer (WAM-5500 Grand Seiko). All the measurements were conducted at the baseline and 12 months.

Results: The MRI analysis indicates that at 12 months, the SVS group showed more elongation of the PEL and AL at all eccentricities than the Ortho-K group did (p < 0.05). The Ortho-K group only showed significant PEL elongation beyond 20 degrees at N20, N30, T20, and T30 (p < 0.05); however, a significant reduction in the AL was detected in the center AL, N10, and T10 (p < 0.05). All eccentricities in the relative PR of the Ortho-K group were significantly more myopic than at the baseline (p < 0.05), whereas in the SVS group, all eccentricities in the relative PR were shown to be significantly more hyperopic than at the baseline (p < 0.05). The PEL and PR showed negative correlations at 12 months in the Ortho-K group.

Conclusion: MRI analysis can be utilized to describe changes in PEL in myopic children. It appears that as myopia progressed in Ortho-K lens wearers, the PEL increased by a greater amount than the AL did; thus, the retina was reshaped to become increasingly oblate and to display peripheral myopic defocus.

In recent years, advanced diagnostic instruments have become widely available in optometric practices, offering various functions that optimize clinical information gathering. This article focuses on the Medmont Meridia™, a state-of-the-art multipurpose diagnostic device with corneal topography and cutting-edge features. Corneal topography is pivotal in the early diagnosis of corneal disorders, determining baseline ocular surface assessment, helping in contact lens fitting, and monitoring ocular health over time. The Medmont Meridia boasts Placido-disc-based imaging with extensive corneal coverage. Furthermore, the Meridia accurately measures the horizontal visible iris diameter, pupil diameter, and palpebral fissure width, which assists in making contact lens parameter decisions. Additionally, it offers sagittal height data for scleral lens design and first lens selection, streamlining the fitting process. Beyond its topography capabilities, the Meridia excels as a comprehensive dry eye assessment tool. With features like tear meniscus height, tear film surface quality, and meibography capabilities, it aids in diagnosing dry eye and monitoring its progression. The device also provides customizable dry eye reports with integrated grading scales and questionnaires, making dry eye management, patient education, and compliance more accessible. In conclusion, the Medmont Meridia consolidates a multitude of examination tools in a single instrument, enhancing practice efficiency and elevating patient care and communication. Its versatility and accuracy make it an invaluable asset in optometric practices worldwide.

Purpose: To examine the potential of different head-mounted displays in the rehabilitation of individuals with visual impairment.

Methods: This prospective explorative study conducted between September 2019 and August 2020 included participants with Stargardt disease with moderate to severe visual impairment and a relatively preserved peripheral visual field. AceSight, eSight 3, IrisVision Live, and Jordy were tested. After instruction and training, participants chose two head-mounted displays for home use for two weeks per device. The Canadian Occupational Performance Measure was used for evaluation.

Results: Twelve participants (aged 16-53 years) tested all head-mounted displays in the clinic. Distance visual acuity and reading distance improved with all head-mounted displays and eSight and Irisvision improved near visual acuity. Six participants decided not to test the head-mounted display at home due to lack of time or energy, dizziness and discomfort, double vision and peripheral visual field limitation, or aesthetics. After home use, the participants reported improved visual function at a distance with IrisVision, AceSight, and e-Sight, whereas only AceSight improved vision during near tasks. IrisVision and eSight improved reading ability, and none of the devices improved vision during tasks involving computers. Five participants used the devices sparingly, and five avoided public use owing to aesthetics.

Conclusion: We found an improvement in distance visual acuity and increased reading distance for all tested head-mounted displays. Additionally, IrisVision and eSight improved visual function at near and eSight also improved contrast vision at distance. Despite the possibility of improving vision, social stigma and device aesthetics kept the participants from using head-mounted displays in public and limited their use at home.