Clinical and Experimental Optometry最新文献

{"title":"Building paediatric eyecare capability via Project ECHO tele-mentoring in Australia.","authors":"Melinda Toomey, Lisa Keay, Kerrie Ren, Ann Webber","doi":"10.1080/08164622.2025.2560975","DOIUrl":"10.1080/08164622.2025.2560975","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Effective paediatric eyecare requires up-to-date knowledge and skills. Effective tele-mentoring and continuous education can significantly improve clinical confidence and ensure comprehensive care for paediatric patients.</p><p><strong>Background: </strong>Project ECHO (Extension for Community Healthcare Outcomes) is a proven interactive case-based tele-mentoring for medical practitioners. A Paediatric Eyecare ECHO was implemented with Australian optometrists to evaluate its acceptability as an education modality and impact on self-reported confidence in clinical knowledge and competency.</p><p><strong>Methods: </strong>Eight weekly, hour-long ECHO sessions on paediatric eyecare topics, informed by a learning needs assessment survey, were conducted. Each session included a brief didactic lecture by an expert, case presentations by participating optometrists and interactive discussions. Participant engagement, satisfaction, likeliness to implement knowledge, and competence were evaluated. Online questionnaires (5-point scale) with open-ended questions were administered before, during, and after the programme. Quantitative data were analysed descriptively and inferentially, while qualitative data were thematically analysed.</p><p><strong>Results: </strong>Fifty-four optometrists registered for the ECHO with 98.1% attending at least one ECHO session. Forty-four of 54 ECHO programme registrants participated in the programme evaluation. Initial self-reported competencies showed knowledge deficits (score <3) in assessing and managing strabismus (72.1%), amblyopia (64.4%), and children with developmental delays (81.8%) and assessing and triaging paediatric ocular emergencies (63.6%). Most optometrists were satisfied with the ECHO format (>85%) and were likely to implement knowledge gained (>88.6%). Competence ratings increased significantly by +0.51 (Z = 4.3, <i>p</i> < .001). Qualitative feedback highlighted an appreciation for case-based presentations but a desire for more detailed clinical management and vision therapy information.</p><p><strong>Conclusion: </strong>The Paediatric Eyecare ECHO showed positive outcomes for optometrists in respect of engagement, satisfaction, likeliness to implement knowledge and self-assessed competency in treating paediatric patients. In addition to paediatric eye care case management, this model holds promise for interactive education in other ocular conditions managed by optometrists.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"708-719"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging roles of the immune microenvironment in glaucoma.","authors":"Xirui Yang, Songwei Li, Hao Guo, Siqi Wang, Huilan Sun, Jixue Wang, Xingxing Yuan","doi":"10.1080/08164622.2025.2525299","DOIUrl":"10.1080/08164622.2025.2525299","url":null,"abstract":"<p><p>Glaucoma is a common blinding eye disease characterised by chronic and progressive degeneration of the optic nerve. Recent studies have increasingly shown that the pathological process of glaucoma involves not only traditional factors such as elevated intraocular pressure (IOP) but also significant changes in the immune microenvironment surrounding the optic nerve. Immune cells within this microenvironment, including macrophages, microglia, and T cells, play crucial roles in the pathogenesis of glaucoma. The activation and infiltration of these immune cells, along with the accompanying neuroinflammatory responses, may exacerbate damage to retinal ganglion cells (RGC) through the release of pro-inflammatory cytokines and chemokines. The dysregulation of these immune factors not only promotes RGC apoptosis but also affects the outflow pathways of aqueous humour, leading to further elevation of IOP. This review summarises recent advances in the study of the immune microenvironment in glaucoma, explores its role in the disease pathogenesis, analyzes the immune regulatory networks associated with glaucoma, and discusses potential therapeutic strategies based on immune modulation. These studies offer new insights into the complex pathological mechanisms of glaucoma and provide novel targets for future treatments.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"572-578"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of ocular aberrations and pupil diameter on vision with four daily multifocal contact lenses.","authors":"Elena Martínez-Plaza, Ainhoa Molina-Martín, Kevin Mena-Guevara, Dolores de Fez, Violeta Gómez-Vicente, David P Piñero","doi":"10.1080/08164622.2025.2565457","DOIUrl":"10.1080/08164622.2025.2565457","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Understanding which ocular optical factors are clearly influencing the visual performance achieved with MFCLs is essential for conducting a more optimised procedure when fitting this type of lenses.</p><p><strong>Background: </strong>To assess and compare the induction of ocular higher-order aberrations by four daily multifocal contact lenses and evaluate the influence of pupil diameter on their performance.</p><p><strong>Methods: </strong>A randomised, crossover study evaluated four contact lenses in 20 presbyopic participants. Subjective refraction, distance/intermediate/near visual acuity and patient-reported visual satisfaction, and pupil diameter under four lighting conditions were assessed. Pupillary dynamic were calculated as the difference between mesopic and photopic pupil sizes. Primary coma, trefoil, spherical aberration, and higher-order aberration (HOA) root mean square were analysed.</p><p><strong>Results: </strong>A significant negative induction of primary spherical aberration was found with all lenses (<i>p</i> ≤ 0.04); being greater with MyDay than Moist in both eyes and with Total1 than Moist in non-dominant eyes (<i>p</i> ≤ 0.02). Coma and HOA increased significantly with all lenses (<i>p</i> ≤ 0.03), except for the Moist lens in dominant eyes; being greater with Total1 than Moist in dominant eyes (<i>p</i> ≤ 0.049). Odd aberrations showed inverse correlations with intermediate/near visual acuity and patient satisfaction (rho≤-0.58, <i>p</i> ≤ 0.04). Greater pupillary dynamic variation was significantly associated with better intermediate/near visual acuity for MyDay and Biotrue MCLs in dominant eyes (rho≤-0.59, <i>p</i> ≤ 0.04).</p><p><strong>Conclusions: </strong>Centre-near multifocal contact lenses induce negative primary spherical aberration. Interestingly, greater coma aberration correlates with improved visual acuity and patient satisfaction at intermediate and near distances. Additionally, larger pupillary dynamic variation may enhance visual acuity and satisfaction in certain presbyopic contact lens wearers.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"764-773"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caught at the edge: post-traumatic lens dislocation anchored by Weigert's ligament.","authors":"Vinayak S Gadad, Vaishali Tomar","doi":"10.1080/08164622.2025.2569598","DOIUrl":"10.1080/08164622.2025.2569598","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"804-805"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in peripapillary neurovascular structures in patients with intermittent claudication.","authors":"Gurcan Dogukan Arslan, Helin El Kılıc, Abdurrahman Alpaslan Alkan, Dilek Guven","doi":"10.1080/08164622.2025.2558750","DOIUrl":"10.1080/08164622.2025.2558750","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Peripapillary retina nerve fibre layer (RNFL) alterations in patients with peripheral artery disease (PAD) are hypothesised to share a pathway with the general pathophysiology of atherosclerosis. Depending on the severity of ischaemia in their extremities, these patients may be asymptomatic or have intermittent claudication.</p><p><strong>Background: </strong>This study aimed to evaluate structural and vascular alterations in the peripapillary region of asymptomatic patients with PAD and those with intermittent claudication.</p><p><strong>Methods: </strong>An observational cross-sectional study was conducted involving 68 patients with PAD who visited the cardiovascular surgery outpatient clinic and 40 age- and sex-matched healthy controls. One eye per participant was examined. Peripapillary RNFL thickness, radial peripapillary capillary density, and ankle-brachial index were assessed. Participants were categorised based on the Rutherford classification, with higher categories indicating more severe ischaemia: asymptomatic (Rutherford 0) in one group and mild to severe claudication (Rutherford 1-3) in another.</p><p><strong>Results: </strong>Average radial peripapillary capillary density was significantly reduced in patients with PAD and intermittent claudication compared to controls (<i>p</i> < 0.001), whereas no significant difference was found between asymptomatic patients and controls. Patients with PAD exhibited significantly lower peripapillary RNFL thickness in the inferonasal, nasal inferior, and nasal superior quadrants than the controls (<i>p</i> < 0.05), although average RNFL thickness was not associated with the Rutherford classification. Ankle-brachial index showed a weak positive association with average radial peripapillary capillary density in patients with PAD (<i>R</i> = 0.325, <i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>Decreased peripapillary vessel density was associated with a lower ankle-brachial index. Patients with PAD and intermittent claudication showed lower peripapillary vessel density than controls. These findings suggest that peripapillary microvascular impairments, likely linked to atherosclerosis, are more pronounced in patients with ischaemic limbs.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"755-763"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare bilateral diffuse orbital metastasis masquerading as inflammatory disease in breast cancer: a diagnostic challenge.","authors":"Batuhan Aksoy, Ahmet Murat Sarıcı, Senihe Rengin Yıldırım","doi":"10.1080/08164622.2025.2567971","DOIUrl":"10.1080/08164622.2025.2567971","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"801-803"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased near add power in pre-presbyopic glaucoma patients treated with medication.","authors":"Masahiko Ayaki, Akiko Hanyuda, Kazuno Negishi","doi":"10.1080/08164622.2025.2564693","DOIUrl":"10.1080/08164622.2025.2564693","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Near add power increases earlier in glaucoma patients than non-glaucoma subjects. Although many factors have been proposed to be implicated in this, the role of glaucoma medication in the progression of presbyopia remains unclear.</p><p><strong>Background: </strong>The aim of this work is to investigate whether glaucoma medication accelerates the progression of presbyopia in glaucoma patients by comparing with near add power in control subjects at pre-presbyopia ages.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was performed on consecutive subjects attending the Otake Eye Clinic, Kanagawa, Japan, and included bilateral phakic participants aged 30-39 years. The cohort comprised 187 controls (mean age 36.0 ± 2.7 years) and 106 patients with primary open-angle glaucoma (mean age 35.8 ± 2.7 years) who had been using topical glaucoma medication for over six months. The near add power and other ocular parameters were then compared between the two groups.</p><p><strong>Results: </strong>The mean near add power and the prevalence of near add power ≥ 1.50 D were 0.91 ± 0.74 D and 20.9% for controls, and 1.61 ± 0.71 D (<i>p</i> < 0.01) and 51.9% (<i>p</i> < 0.01) for glaucoma group, respectively. Univariable regression analysis of near add power and ocular parameters in the control group indicated that age, myopic errors, astigmatism, anisometropia, full macular thickness, ganglion cell complex thickness, and retinal nerve fibre layer thickness were significantly associated with near add power. Kaplan-Meier survival analysis showed that the glaucoma group reached the endpoint of near add power of + 1.50 D significantly earlier than controls (<i>p</i> < 0.01, log-rank test).</p><p><strong>Conclusion: </strong>Glaucoma patients aged 30-39 years exhibited higher near add power compared to controls. These findings could help improve the management of glaucoma patients with early presbyopia.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"660-669"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact lens practice in India: practitioner-reported challenges, barriers, and strategies for improvement.","authors":"Ankur Banik, Aditya Goyal","doi":"10.1080/08164622.2025.2596938","DOIUrl":"10.1080/08164622.2025.2596938","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Contact lenses offer effective refractive, cosmetic, and therapeutic options; however, their safe and successful use requires addressing barriers at the practitioner, patient, and healthcare system levels. Identifying and understanding these challenges are essential to improving clinical outcomes, enhancing patient satisfaction, and supporting broader global adoption.</p><p><strong>Background: </strong>Despite advancements in contact lens materials and designs, adoption rates in India remain constrained by discontinuation, affordability issues, and low public awareness. This study aimed to evaluate common challenges, barriers to contact lens uptake, and strategies implemented by practitioners across India.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among contact lens practitioners across six Indian zones (North, South, East, West, Central, and North-East) between January and May 2025. A structured questionnaire, assessed challenges in contact lens practice, barriers to uptake, and improvement strategies. Responses were recorded on a 5-point numerical scale. Data were analysed, employing descriptive statistics and Kruskal-Wallis tests to evaluate regional differences.</p><p><strong>Results: </strong>A total of 338 (96.5%) out of 350 practitioners completed the survey. Limited availability of trial lenses and high material costs were the most frequently reported challenges (median score: 3/5, IQR: 2.0-4.0). Key barriers to contact lens uptake included lack of awareness (median: 3/5, IQR: 2.0-4.0), discomfort-related dropout (median: 3/5, IQR: 2.0-4.0), and unsupervised online purchases (median: 3/5, IQR: 2.0-5.0). High consensus was observed for improvement strategies, with practitioner education, patient awareness initiatives, affordability, and proactive contact lens recommendations scoring a median of 4/5, IQR: 3.0-5.0. No statistically significant regional differences were found (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Indian contact lens practitioners face consistent challenges nationwide, with affordability, trial lens availability, and public awareness identified as primary concerns. Practitioner-driven education, patient counselling, and affordability measures are essential to enhancing contact lens practice and promoting the safe and wider adoption of contact lenses in India.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"614-622"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pituitary adenoma with unilateral three-quadrant visual field defect.","authors":"Christopher J Borgman","doi":"10.1080/08164622.2025.2533296","DOIUrl":"10.1080/08164622.2025.2533296","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"809-814"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of retinopathy of prematurity and preterm birth on childhood visual outcomes.","authors":"Myra Leung, Joanna Black, Tina Y Gao, Benjamin Thompson, Jane M Alsweiler","doi":"10.1080/08164622.2025.2561861","DOIUrl":"10.1080/08164622.2025.2561861","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Late-childhood visual outcomes in children born preterm, with or without retinopathy of prematurity (ROP), are not well understood, limiting the opportunities for preventative and early interventions.</p><p><strong>Background: </strong>This observational study investigated how ROP and preterm birth may affect late-childhood visual outcomes.</p><p><strong>Methods: </strong>Children born at gestational age <30 weeks or birth weight <1250 grams and screened for ROP, and at full-term (gestational age ≥ 37 weeks) were assessed at 8-10 years corrected age. The primary outcome, favourable overall visual outcome (good presenting vision in the better eye [≤0.30 logMAR], no strabismus, passing stereoacuity, not requiring spectacles), and other outcomes were compared using generalised linear regression models.</p><p><strong>Results: </strong>The study included 111 children (ROP <i>n</i> = 47 [stages: 1 = 23, 2 = 19, 3 = 4, 4 or worse = 1; 3 laser photocoagulation treatment]; preterm birth and no ROP <i>n</i> = 17; and term <i>n</i> = 37), aged 8.9 (interquartile range 8.6, 9.4) years. There were no significant differences in favourable overall visual outcome (composite measure) between the groups (ROP, 21/44 (48%); preterm birth and no ROP, 8/14 (57%); term, 20/32 (63%); <i>p</i> = 0.43). Children with ROP had shorter axial length (<i>p</i> = 0.01) and steeper corneal curvature (<i>p</i> = 0.001) than the term group; both preterm groups had thicker central retinas than the term group (<i>p</i> < 0.0001). The term group had better visuomotor integration scores than the ROP group (<i>p</i> = 0.01). No group differences in global motion or electrophysiology were observed.</p><p><strong>Conclusion: </strong>In this small observational cohort, children with mainly mild ROP had similar visual outcomes to children born preterm without ROP and at full-term but remain at risk of reduced visuomotor integration in late childhood. Children born preterm are at risk of ocular structural changes, but further investigation is required to understand the long-term implications.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"743-754"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}