Clinical and Experimental Optometry最新文献

{"title":"Genetics and eye health: research advances and implications for primary eyecare.","authors":"Alexis Ceecee Britten-Jones, Lachlan Sw Knight, Sena A Gocuk, Parker Truong, Elise Cichello, Sumudu Sc Amarasekera, Bao N Nguyen, Lauren N Ayton","doi":"10.1080/08164622.2025.2580576","DOIUrl":"10.1080/08164622.2025.2580576","url":null,"abstract":"<p><p>Ocular genetics research has seen tremendous growth in the last two decades. Understanding the genetic basis of eye diseases helps researchers comprehend their heritability, uncover disease mechanisms, and develop targeted gene therapies. This evolving knowledge is changing the clinical management of many eye conditions, from diagnostics and gene-based therapies for patients with previously untreatable monogenic eye diseases, to risk stratification and personalised management of complex conditions. Despite the limited role of genetics in primary eyecare today, the integration of genetics into optometry practice holds promise for enhancing patient outcomes. Optometrists, as primary eyecare practitioners, play a key role in detecting and managing eye conditions. Therefore, increased engagement from optometrists can assist in identifying patients with genetic eye conditions within the community, supporting shared care and multidisciplinary teams, enhancing participation in research and clinical trials, and providing ongoing monitoring and patient education. Integrating genetics into eyecare requires clinicians to have a clear understanding of the role of genetics in rare and common eye diseases, genomic literacy education for primary care practitioners, and multidisciplinary networks for improved communication and coordinated care. This review aims to provide an evidence-based update on recent advances in genetic technologies for eye diseases. It discusses current evidence on the role of genetics in monogenic and polygenic eye diseases, and examines the applications of genetics in eyecare, including diagnosis, risk stratification, and emerging treatments. Additionally, it highlights the role of primary eyecare professionals within a multidisciplinary approach.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1197-1214"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534312","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":"A review of technological advances in the management of bacterial, fungal, viral, and <i>Acanthamoeba</i> keratitis.","authors":"Tanzina Akter, Shyam Mishra Baishnab, Meseret Damtie, Srikanth Dumpati, Teshome Belachew Eshete, Suleman Irfan, Mukesh Kumar, Manjulatha Sara, Umme Laila Urmi, Mark Willcox","doi":"10.1080/08164622.2025.2579169","DOIUrl":"10.1080/08164622.2025.2579169","url":null,"abstract":"<p><p>Microbial keratitis is a major cause of monocular blindness worldwide. Trauma and contact lens wear are major risk factors. Bacteria are a major cause, but fungi, viruses, and <i>Acanthamoeba</i> can also cause the disease. Therapeutic options are dwindling with the rise of antimicrobial resistance in all of these microbes, but especially bacteria. Infection with resistant strains results in worse clinical outcomes. New antimicrobial therapies are being developed but most have yet to be either used to treat ocular infections or become commercially available. For bacterial keratitis, antimicrobial peptides (AMPs) are a potential new option, as are bacteriophages and even bacteria that eat other bacteria or maggot secretions. For fungal keratitis, ocular natamycin, with oral ketoconazole or voriconazole treatments, offer improved outcomes for severe cases. For viral keratitis, AMPs again offer hope as new therapeutics, as do RNA interference and CRISPR-Cas systems. The recent release of a commercially available polyhexamethylene biguanide eye drop is a step forward, but new therapies that can kill both <i>Acanthamoeba</i> trophozoites and cysts are still needed. Beyond antibiotics, photoactivated chromophores for keratitis-corneal collagen cross-linking and photodynamic therapy have been successfully used. Therapies for large ulcers or scarring include corneal gluing, tissue scaffolds such as amniotic membrane or conjunctival flaps, and tissue replacement through penetrating or lamellar keratoplasty.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1102-1112"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534331","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":"Translational changes: evidence around efficacy of red-light therapy in myopia management.","authors":"Jessica Wood, Josephine Dykgraaf, Jagrut Lallu","doi":"10.1080/08164622.2025.2606171","DOIUrl":"10.1080/08164622.2025.2606171","url":null,"abstract":"<p><p>The global prevalence of myopia has continued to increase significantly over time. By 2050, it has been estimated that approximately half of the world's population will be myopic. Additionally, 10% of myopes will be highly myopic, which greatly increases the risk of sight-threatening ocular complications including retinal detachments and myopic maculopathies. Significant global efforts have been invested in the development of interventions and strategies to prevent myopia onset and progression. Several different myopia control treatments are now available to clinicians for this purpose. Additionally, evidence has suggested that increased outdoor time and illuminance may have protective effects against myopia progression. Recently, the use of repeated low-level red-light therapy devices has become an emerging novel intervention for myopia. While current research surrounding red light therapy, mostly occurring in China, has suggested promising results for myopia management, there is still limited long-term research into the efficacy and safety of red-light therapy. This review aims to present a comprehensive overview of the current evidence surrounding the efficacy and safety of red-light therapy as a myopia control treatment, and to highlight the importance for further global research efforts for this novel treatment.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1142-1156"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965308","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":"Quality of refractive error care in China - a cross-sectional unannounced standardised patient study.","authors":"Ling Lee, Ziyin Zhao, Anthea Burnett, Suit May Ho, Yiwen Huang, Cairui Li, Ming Ni, Mediya Rangi, Xiaochen Ma","doi":"10.1080/08164622.2026.2642319","DOIUrl":"10.1080/08164622.2026.2642319","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Understanding the quality of care provided by existing refractive error services and aspects that influence quality enables educators and the workforce to develop interventions for delivering high-quality services.</p><p><strong>Background: </strong>High-quality eye care services are required not only to address uncorrected refractive error but also maintain the needs of those wearing spectacles. This study aims to evaluate the quality of refractive error care in China by estimating the proportion and assessing factors associated with receiving optimal spectacles.</p><p><strong>Methods: </strong>This cross-sectional study utilised trained unannounced standardised patients with various refractive error profiles to attend optical services in 2024 in Dali, China. Patients requested an eye examination, ordered and collected spectacles and a written prescription, and recorded testing provided. Baseline refractions were averaged from measurements conducted by three qualified refractionists. Spectacles and prescriptions were compared against the baseline and optimal criteria, and then against each other to assess appropriateness of spectacles made. Proportions for quality outcomes were calculated with robust standards errors to account for intra-service correlation. Univariable and multivariable logistic regression explored potential associations between spectacle quality and visit factors.</p><p><strong>Results: </strong>Fourteen unannounced standardised patients visited 67 optical services completing 259 visits with 249 spectacles dispensed (181 single vision distance, 68 single vision near). Overall, 25.7% (95%CI:20.0-32.4%) and 38.8% (95%CI:33.5-44.5%) of spectacles and prescriptions, respectively, met the optimal criteria. Regression analyses indicated that males (OR:0.42, 95%CI:0.19-0.92, <i>p</i> = 0.03) were at reduced odds of receiving optimal spectacles, whereas those attending rural services were at significantly increased odds of receiving optimal spectacles (OR:2.82, 95%CI:1.40-5.69, <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>The quality of refractive error care in Dali, China, shows a distinct need for improvement. The observed gender disparity in care requires further investigation, while understanding the systems and structures of rural services may provide insights to foster and improve urban services.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1338-1348"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721867","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":"Recurrent cystoid macular oedema associated with high-dose cytarabine therapy.","authors":"Figen Bezci Aygün, Nargız Rustamova, Sibel Kadayıfçılar","doi":"10.1080/08164622.2025.2612189","DOIUrl":"10.1080/08164622.2025.2612189","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a rare case of recurrent, reversible cystoid macular oedema (CME) associated with high-dose cytarabine therapy in a patient with acute myeloid leukaemia (AML).</p><p><strong>Case presentation: </strong>A 39-year-old woman with AML developed recurrent bilateral visual disturbances following multiple cycles of high-dose cytarabine monotherapy. After each chemotherapy cycle, spectral-domain optical coherence tomography revealed cystoid intraretinal spaces predominantly involving the outer nuclear and outer plexiform layers. Fluorescein angiography demonstrated faint perifoveal leakage without the classic petaloid pooling pattern of CME. Macular oedema resolved spontaneously after the initial treatment cycles but showed progressively delayed regression after subsequent exposures. No systemic or ocular risk factors for CME were identified, and there was no evidence of inflammatory, vascular, or infectious retinal disease.</p><p><strong>Conclusion: </strong>High-dose cytarabine may rarely cause recurrent and reversible CME as a manifestation of posterior segment toxicity. The underlying mechanism is likely related to transient Müller cell dysfunction or retinal pigment epithelium impairment rather than disruption of the blood-retinal barrier. Awareness of this entity is essential to ensure prompt recognition and appropriate management, including consideration of treatment modification when clinically feasible.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1386-1391"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988388","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":"Pupil size as a predictor of visual outcomes with an enhanced monofocal intraocular lens.","authors":"Seung Hyeun Lee, Yeoun Sook Chun, Kyoung Woo Kim","doi":"10.1080/08164622.2026.2629452","DOIUrl":"10.1080/08164622.2026.2629452","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Pupil size plays a critical role in the optical performance of modern intraocular lenses, including enhanced monofocal intraocular lens.</p><p><strong>Background: </strong>Enhanced monofocal aspheric intraocular lenses, such as the Tecnis Eyhance ICB00, are designed to provide improved intermediate vision without compromising distance acuity. However, visual outcomes may vary among patients, and pupil size has been proposed as a contributing factor. Accurate assessment of pupil size using anterior segment swept-source optical coherence tomography (AS SS-OCT) devices may help identify patients who would benefit most from these intraocular lenses.</p><p><strong>Methods: </strong>This retrospective study included 64 eyes from 45 patients who underwent uncomplicated cataract surgery with implantation of the Tecnis Eyhance ICB00 intraocular lens. Preoperative pupil size was measured using both the Anterion® and IOLMaster 700 AS SS-OCT devices; postoperative measurements at one month were obtained with Anterion. UCDVA was analysed based on pupil size thresholds of 3.5 mm and 4.0 mm. intraocular lens thickness profiles of Eyhance and a conventional monofocal intraocular lens (Tecnis ZCB00) were compared.</p><p><strong>Results: </strong>Postoperative pupil size ≥4.0 mm (Anterion) was associated with significantly better UCDVA (LogMAR 0.08 ± 0.08) compared to <4.0 mm (LogMAR 0.19 ± 0.08; <i>p</i> < 0.001). A similar trend was found for preoperative pupil size measured by Anterion, while IOLMaster 700 measurements did not correlate with visual outcomes. Anterion consistently yielded larger pupil sizes than IOLMaster 700 (mean difference: 0.56 mm, <i>p</i> < 0.001). The Eyhance intraocular lens exhibited a steeper curvature within the central 2.0 mm zone compared to the ZCB00.</p><p><strong>Conclusion: </strong>Preoperative and postoperative pupil size ≥4.0 mm, as measured by Anterion, was associated with better UCDVA with enhanced monofocal intraocular lenses. However, further research is needed to confirm if this results from the lens design or physiological confounders like diffraction. Measurement discrepancies between AS SS-OCT devices highlight the need for standardisation.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1274-1283"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212396","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":"Transformational changes in optometry research and practice.","authors":"Kalika Bandamwar, James Armitage","doi":"10.1080/08164622.2026.2699984","DOIUrl":"https://doi.org/10.1080/08164622.2026.2699984","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":"109 6","pages":"1099-1101"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629481","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":"Perspectives on screening in retinopathy of prematurity: new algorithms and AI tools.","authors":"Helen Kearns, Sarah Hull","doi":"10.1080/08164622.2025.2589393","DOIUrl":"10.1080/08164622.2025.2589393","url":null,"abstract":"<p><p>Retinopathy of prematurity (ROP) is a vasoproliferative blinding disorder of the retina, unique to premature infants and a leading cause of preventable childhood blindness globally. Screening of premature babies aims to identify disease reaching a threshold for treatment needed in 6-10% of babies screened. Current screening criteria are based on birth weight (BW) and gestational age (GA) with an additional third criteria for babies deemed at risk by the neonatologist due to an unstable postnatal course or prolonged use of oxygen. These lack specificity and could potentially miss babies at risk. With increased survival rates of premature and extreme premature babies, ROP screening numbers are rising with associated clinical and economic burden. Several alternative algorithms have been proposed based on postnatal weight gain and in this review, the application and pitfalls of these will be discussed as well as the potential role of artificial intelligence in improving accuracy, efficiency, and equity in Australasia and low-middle-income countries.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1170-1182"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630719","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":"Children's Eye Screening South Australia (CESSA): diagnostic performance of a vision screening programme for 7-9-year-olds.","authors":"Cassandra Haines, Nicola S Anstice, Ranjay Chakraborty","doi":"10.1080/08164622.2026.2629449","DOIUrl":"10.1080/08164622.2026.2629449","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Standardised paediatric vision screening programmes enable timely detection of refractive errors and other amblyopia risk factors. School-based programmes that use appropriate referral thresholds for distance visual acuity, combined with photorefraction, can improve detection of amblyopia and refractive errors in children.</p><p><strong>Background: </strong>The Children's Eye Screening South Australia study evaluated the performance of a vision screening protocol for detecting common vision disorders in a school-based sample of children aged 7-9 years, while characterising prevalent vision conditions in this population.</p><p><strong>Methods: </strong>A total of 159 children from 15 schools underwent school-based screening, including distance and near vision, retinoscopy, photorefraction, stereoacuity, heterophoria and ocular alignment. All children who failed screening, and 10% of those who passed, underwent a comprehensive cycloplegic eye examination to establish a clinical diagnosis against which screening outcomes were compared. Screening test accuracy was evaluated using predefined fail criteria and diagnostic performance using the area under the curve (AUC) of Receiver Operating Characteristic curves.</p><p><strong>Results: </strong>Twenty-eight children (17.6%) failed screening, and cycloplegic eye examination confirmed a vision disorder in 27 children (17.0% of the total sample), 16.4% had significant refractive errors and 2.5% had suspected amblyopia. Standard distance vision fail criteria (≥0.26 logMAR) demonstrated low sensitivity (33.3%), but improved to 59.3% using > 0.04 logMAR. Retinoscopy and photorefraction showed high screening test accuracy (AUC, 0.91 and 0.86). Combining distance vision with photorefraction significantly improved accuracy (AUC, 0.87, <i>p</i> < 0.001), with modest, non-significant gains from adding stereoacuity or heterophoria.</p><p><strong>Conclusions: </strong>Seventeen percent of a school-based sample of South Australian children aged 7-9 years were identified as having vision disorders, such as refractive errors and amblyopia risk factors, effectively detected using a combination of vision measurement and photorefraction. These findings support improved vision surveillance in children in South Australia, which could include an instrument-based vision screening programme with appropriate thresholds.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1359-1369"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212339","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":"Models of multidisciplinary team-based care involving optometrists in Australia and New Zealand: narrative review and synthesis of implementation issues.","authors":"Jessie Huang-Lung, Sheela Kumaran, Philip Rk Turnbull, Ann L Webber, Joel Rhee, Margo Barr, Jacqueline Ramke, Lisa J Keay","doi":"10.1080/08164622.2026.2624750","DOIUrl":"10.1080/08164622.2026.2624750","url":null,"abstract":"<p><strong>Clinical relevance: </strong>There is potential to expand the number of collaborative care and multidisciplinary team-based care models that optometrists are involved in, working at full scope to deliver high quality patient care. Ongoing work to generate research evidence, change policy and secure long-term funding is needed to support implementation.</p><p><strong>Background: </strong>Implementation of new models of multidisciplinary team-based care or collaborative care can support quality healthcare delivery and the sustainability of future health systems.</p><p><strong>Methods: </strong>This narrative review synthesises research on models of multidisciplinary team-based care or collaborative care that involve optometrists in Australia and New Zealand. Outcomes related to patient health and experience, health service delivery including costs, and practitioner experience including workforce satisfaction were extracted from published evaluations. Additionally, barriers and facilitating factors to implementation were synthesised from identified studies.</p><p><strong>Results: </strong>In total, 12 models of care were identified, most were task shifting or task sharing models between optometry and hospital-based ophthalmology for managing eye conditions. These collaborative models were developed to address long waiting lists for hospital-based ophthalmology services, and their implementation resulted in a corresponding decrease in waiting times for appointments. However, patient health outcomes, patient, and practitioner experiences were seldom reported. In primary care settings, models of multidisciplinary team-based care (<i>n</i> =3) were generally well-received by patients and practitioners. However, more objective measures may help quantify the social and economic benefits of these models.</p><p><strong>Conclusion: </strong>Despite the impetus for multidisciplinary team-based care, barriers to wider implementation persist. Implementation science can help identify strategies to overcome barriers to adopting evidence-based models of care. Future studies should incorporate economic evaluations, to inform advocacy and policy, to generate system-level change that support health organisations to deliver multidisciplinary team-based care. Finally, future work should consider embedding the patient perspective from outset to ensure that models of care are people-centred.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1239-1253"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670883","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}