{"title":"Binocular vision parameters in keratoconic eyes wearing scleral lenses.","authors":"Krishna Shah, Praveen Kumar P, Ayisha Atiya, Asif Iqbal","doi":"10.1080/08164622.2025.2530540","DOIUrl":null,"url":null,"abstract":"<p><strong>Clinical relevance: </strong>Binocular vision anomalies are common in individuals with keratoconus (KC) corneas and can significantly impact visual function, comfort, and quality of life. Understanding how ocular conditions influence accommodative and vergence parameters is essential for accurate assessment and effective management, especially in patients requiring speciality contact lenses such as scleral lenses (SL) for visual rehabilitation.</p><p><strong>Background: </strong>The aim of this work is to evaluate the changes in binocular vision parameters in eyes with KC wearing SLs.</p><p><strong>Methods: </strong>Binocular vision parameters (accommodative and vergence) were assessed at baseline, after 6 h and 1 month of SL wear in 16 KC participants. Convergence insufficiency symptom survey (CISS) was employed to assess binocular vision disorder-related symptoms.</p><p><strong>Results: </strong>A statistically significant improvement in visual acuity was observed after 6 h and 1 month of SL wear (<i>p</i> < 0.05). Stereopsis showed a significant improvement after 6 h (<i>p</i> = 0.002) and 1 month (<i>p</i> = 0.001) of SL wear compared to baseline. Near point of convergence break showed significant improvement after 1 month (<i>p</i> = 0.002) when compared to baseline and between 6 h and 1 month (<i>p</i> = 0.003) SL wear. Near point of convergence recovery showed significant improvement after 1 month of SL wear (<i>p</i> = 0.005). Positive fusional vergence improved at distance recovery (<i>p</i> = 0.01) and near break and recovery (<i>p</i> = 0.03, <i>p</i> = 0.01) after 6 h and 1 month of SL wear. Vergence facility at near improved significantly after 6 h and 1 month of SL wear compared to baseline (<i>p</i> < 0.001). Statistically significant improvement was observed for the binocular amplitude of accommodation (<i>p</i> = 0.009) and negative relative accommodation (<i>p</i> = 0.003) after 1-month SL wear. Binocular accommodative facility also showed significant improvement after 6 h (<i>p</i> = 0.009) and 1 month (<i>p</i> = 0.003) of SL wear. CISS scores significantly improved after 1 month of SL wear (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>SLs effectively enhance vision, help maintain proper eye alignment, improve binocular function, and reduce asthenopia symptoms in KC patients. Comprehensive orthoptic examinations are crucial for addressing these issues in KC.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-10"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Optometry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08164622.2025.2530540","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Clinical relevance: Binocular vision anomalies are common in individuals with keratoconus (KC) corneas and can significantly impact visual function, comfort, and quality of life. Understanding how ocular conditions influence accommodative and vergence parameters is essential for accurate assessment and effective management, especially in patients requiring speciality contact lenses such as scleral lenses (SL) for visual rehabilitation.
Background: The aim of this work is to evaluate the changes in binocular vision parameters in eyes with KC wearing SLs.
Methods: Binocular vision parameters (accommodative and vergence) were assessed at baseline, after 6 h and 1 month of SL wear in 16 KC participants. Convergence insufficiency symptom survey (CISS) was employed to assess binocular vision disorder-related symptoms.
Results: A statistically significant improvement in visual acuity was observed after 6 h and 1 month of SL wear (p < 0.05). Stereopsis showed a significant improvement after 6 h (p = 0.002) and 1 month (p = 0.001) of SL wear compared to baseline. Near point of convergence break showed significant improvement after 1 month (p = 0.002) when compared to baseline and between 6 h and 1 month (p = 0.003) SL wear. Near point of convergence recovery showed significant improvement after 1 month of SL wear (p = 0.005). Positive fusional vergence improved at distance recovery (p = 0.01) and near break and recovery (p = 0.03, p = 0.01) after 6 h and 1 month of SL wear. Vergence facility at near improved significantly after 6 h and 1 month of SL wear compared to baseline (p < 0.001). Statistically significant improvement was observed for the binocular amplitude of accommodation (p = 0.009) and negative relative accommodation (p = 0.003) after 1-month SL wear. Binocular accommodative facility also showed significant improvement after 6 h (p = 0.009) and 1 month (p = 0.003) of SL wear. CISS scores significantly improved after 1 month of SL wear (p < 0.001).
Conclusion: SLs effectively enhance vision, help maintain proper eye alignment, improve binocular function, and reduce asthenopia symptoms in KC patients. Comprehensive orthoptic examinations are crucial for addressing these issues in KC.
期刊介绍：
Clinical and Experimental Optometry is a peer reviewed journal listed by ISI and abstracted by PubMed, Web of Science, Scopus, Science Citation Index and Current Contents. It publishes original research papers and reviews in clinical optometry and vision science. Debate and discussion of controversial scientific and clinical issues is encouraged and letters to the Editor and short communications expressing points of view on matters within the Journal''s areas of interest are welcome. The Journal is published six times annually.
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