Clinical and Experimental Optometry最新文献

{"title":"Validity of keratoconus screening tests.","authors":"Zahra A Rashid, Khathutshelo P Mashige, Vanessa R Moodley","doi":"10.1080/08164622.2025.2530535","DOIUrl":"https://doi.org/10.1080/08164622.2025.2530535","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Knowledge of reliable cut-off values for screening tests can facilitate early disease identification and referral.</p><p><strong>Background: </strong>This study compared the validity of clinical tests used to screen for keratoconus in high school students.</p><p><strong>Methods: </strong>In this population-based, prospective, cross-sectional study, multistage cluster sampling was used to select participants who underwent visual acuity assessment, auto-refraction, retinoscopy and corneal topography. Students were classified into three groups: non-keratoconus, keratoconus suspect and keratoconus.</p><p><strong>Results: </strong>A total 3051 students, mean age of 17.4 ± 1.6 years ranged from 13 to 25 years participated in this study. Of the 51 (1.7%) students diagnosed with keratoconus, one-third (31.4%) had a binocular visual acuity of ≤0.2 logMAR. The median visual acuity was worse, the spherical equivalent refractive error was more myopic and the astigmatism was higher in the keratoconus group compared to the non-keratoconus group (all <i>p</i> values < 0.05). However, there was a considerable overlap when comparing these parameters between the three groups, making it difficult to establish a reliable cut-off. Asymmetry was a feature of a large proportion of the students with keratoconus. When using scissor reflex on retinoscopy, maximum anterior corneal curvature or astigmatism individually as referral criteria, retinoscopy yielded the highest Youden Index (0.44). However, combining the use of all three parameters where either of them is positive: a scissors reflex or maximum anterior corneal curvature > 46.5 D or astigmatism >2.50 D was the most effective (Youden index 0.46).</p><p><strong>Conclusion: </strong>Monocular visual acuity, retinoscopy, keratometry and refraction should be included in keratoconus screening protocols with the inclusion of corneal topography to increase effectiveness. A combined referral criterion of a scissors reflex on retinoscopy or maximum anterior corneal curvature > 46.5 D or astigmatism > 2.50 D is recommended.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689075","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":"Frequency and causes of visual impairment in people attending outreach clinics in Zambia.","authors":"Cheralynn Saunders, Neema Ghorbani-Mojarrad, Brendan T Barrett, Alexander G Swystun, Christopher J Davey","doi":"10.1080/08164622.2025.2530533","DOIUrl":"https://doi.org/10.1080/08164622.2025.2530533","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Preventable visual impairment and blindness represent significant global public health challenges. Expanding access to high-volume eye care services in underserved areas may reduce visual impairment and blindness.</p><p><strong>Background: </strong>Visual impairment negatively impacts quality of life, education, and employability, but is often treatable with management following a basic eye examination. Access to basic eyecare in Zambia is limited. Vision Action, a UK-based non-governmental organisation, facilitates eyecare services in Zambia to reduce rectifiable visual impairment by supporting government outreach clinics in underserved communities. This study examines the frequency of presenting visual impairment, uncorrected refractive error, and ocular pathology among outreach clinic attendees in Zambia.</p><p><strong>Methods: </strong>A retrospective analysis of outreach clinic records between 2012 and 2015 was performed. The available data include patient demographics, presenting symptoms, presenting level of vision, and classification of any ocular pathology present. Levels of visual impairment were categorised according to the World Health Organization's classification for blindness and visual impairment.</p><p><strong>Results: </strong>Data from 5809 patients were collected (58.5% female, mean age = 41.9 years, SD = 20.7 years). Presenting vision, in the better eye, was classified as 'moderate visual impairment' in 14.2% (<i>n</i> = 766), 'severe visual impairment' in 0.3% (<i>n</i> = 15) and 'blind' in 4.3% (<i>n</i> = 234) of individuals. Uncorrected refractive error was responsible for 62.4% and 57.0% of blindness and severe visual impairment, respectively. Cataract, corneal scarring, and glaucoma were the most common non-refractive ocular pathologies associated with visual impairment.</p><p><strong>Conclusion: </strong>Uncorrected refractive error is the leading cause of blindness and visual impairment in patients presenting to outreach clinics in Zambia and is particularly significant in a predominantly working-age population. Outreach clinics are an effective method of detecting and treating correctable visual impairment in this population. However, there is a need to expand and enhance primary eyecare services to reduce the burden of visual impairment, through management of uncorrected refractive error.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682076","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":"Multiple Descemet membrane splits in a neonate with Sturge weber syndrome.","authors":"Arnav Panigrahi, Shikha Gupta, Viney Gupta","doi":"10.1080/08164622.2025.2519890","DOIUrl":"https://doi.org/10.1080/08164622.2025.2519890","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682079","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":"The evolving landscape of retinitis pigmentosa: clinical trials and regulatory advances.","authors":"Youran Cai, Qing Zhou","doi":"10.1080/08164622.2025.2526081","DOIUrl":"https://doi.org/10.1080/08164622.2025.2526081","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-2"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682080","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":"Coloured filters and lenses for reading discomfort and difficulty: an Australian and New Zealand perspective.","authors":"Maree Flaherty, Manjushree Bhate, Amanda K Lea, Glen A Gole","doi":"10.1080/08164622.2025.2526082","DOIUrl":"https://doi.org/10.1080/08164622.2025.2526082","url":null,"abstract":"<p><p>Children who struggle with learning to read, and those who experience reading discomfort, are faced with varied and conflicting opinions regarding appropriate interventions. They commonly present to eye care practitioners for an examination and advice, often after a referral from school. Eye care practitioners have a responsibility to understand and to convey the current state of evidence about any proposed treatment plan to affected individuals who find themselves vulnerable due to a lack of expertise. Non-beneficial therapies for reading difficulty and discomfort may contribute to the delay of appropriate interventions, a critical issue for children learning to read, and one which may have health, economic and educational implications. This perspective and review examines the historical context, proposed causal theories, and current state of the evidence regarding the use of coloured filters for children with reading difficulties, and people of all ages with reading discomfort, and concludes that such use cannot be recommended or promoted based on literature published to date.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682074","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":"Vision rehabilitation of patients with retinitis pigmentosa.","authors":"Mufarriq Shah, Yumna Tariq","doi":"10.1080/08164622.2025.2522178","DOIUrl":"https://doi.org/10.1080/08164622.2025.2522178","url":null,"abstract":"<p><strong>Clinical relevance: </strong>The goal of low vision rehabilitation is to help patients make the most of their remaining vision with the use of low vision devices so they can lead independent lives. Vision rehabilitation is an efficient way to improve the remaining vision of people with low vision due to retinitis pigmentosa.</p><p><strong>Background: </strong>Retinitis pigmentosa is a common inherited retinal disease causing vision impairment and blindness. This study aimed to investigate the role of low-vision devices in managing low vision associated with retinitis pigmentosa.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 50 consecutive retinitis pigmentosa cases assessed for low vision rehabilitation in a tertiary care hospital between January 2022 and June 2024. Each participant underwent a thorough ocular examination, including history, visual acuity assessment, and evaluation for low vision devices (LVDs). The paired samples T-test, with a significance level of <i>p</i> < 0.05, was used to look for statistical differences between visual acuity before and after the provision of LVDs.</p><p><strong>Results: </strong>Of the 50 participants, 68% (<i>n</i> = 34) were male. The mean age was 26.10 (±12.96) years. At the time of presentation, the mean visual acuity of the better-seeing eye was 1.04 ± 0.46 (range: 0.10 to 1.60) log MAR for distance and 3.60 ± 2.46 (1.00-12.00) M for near. There was a significant improvement of 0.27 ± 0.25 logMAR in the mean best corrected visual acuity after careful refraction (<i>p</i> < 0.001). The mean visual acuity was improved to 0.77 ± 0.46 logMAR for distance 1.46 ± 1.25 M for near with LVDs. Monocular telescopes were the most common LVDs for distance vision, and Fonda glasses (high plus up to + 10.00D with base-in prisms) for near vision. Fifteen (30%) of participants needed more than one type of LVD for different tasks.</p><p><strong>Conclusion: </strong>The use of low vision devices can enhance the functional independence of people with low vision associated with retinitis pigmentosa by maximising residual vision according to their specific needs.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682082","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":"Chemotherapy-associated retinal ischaemia and silent macular oedema: a docetaxel-oxaliplatin-induced case.","authors":"Ece Ozal, Serhat Ermis, Murat Karapapak, Ozgu Canbolat Kaplan, Sadik Altan Ozal","doi":"10.1080/08164622.2025.2528359","DOIUrl":"https://doi.org/10.1080/08164622.2025.2528359","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682137","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":"Clinical experience gained by optometry students during placement: analysis by geographic location.","authors":"Jacqueline M Kirkman, Ryan J Wood-Bradley, Sharon A Bentley, Craig A Woods, James A Armitage","doi":"10.1080/08164622.2025.2523447","DOIUrl":"https://doi.org/10.1080/08164622.2025.2523447","url":null,"abstract":"<p><strong>Clinical relevance: </strong>A variety of training opportunities is key to ensuring optometry graduates are competent to practice optometry at its fullest scope. It is therefore important to understand how the geographic location of placements contributes to the volume and diversity of clinical experience gained by students.</p><p><strong>Background: </strong>Research suggests optometry students and rural-based supervisors believe that rural placements offer students exposure to a wider variety of clinical experiences compared with metropolitan placements. However, to date there has been no formal analysis of whether students on rural placement gain a more diverse experience. This study aimed to compare the clinical experience gained by optometry students on rural versus metropolitan placement.</p><p><strong>Methods: </strong>Clinical experiences recorded in student electronic logbooks from 203 Deakin University optometry students undertaking a 26-week clinical placement were analysed. Differences between the numbers of patients seen, skills performed, and ocular conditions managed by students were compared by geographic location.</p><p><strong>Results: </strong>Students experienced 12.2% more patient encounters on a rural placement than on metropolitan placement (mean ± SD, 341 ± 123 vs 304 ± 109, <i>p</i> < 0.002). On average, during rural placement, students encountered 49.6% more patients presenting with sore eyes (56.1 ± 37.5 vs 37.5 ± 24.6, <i>p</i> < 0.001) and 61.0% more instances of urgent, potentially sight-threatening eye conditions (8.5 ± 6.4 vs 5.9 ± 4.9, <i>p</i> < 0.001). Students on metropolitan placement encountered 33.2% more patients presenting for reasons related to contact lenses (26.1 ± 14.7 vs 19.6 ± 11.2, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Students encountered a greater total count of conditions on rural placement than metropolitan placements. However, there were some opportunities metropolitan placements offered which were limited on rural placements. It is important students are exposed to practice in both rural and metropolitan locations to ensure a breadth of clinical experience is encountered.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682138","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":"The importance of nutritional status in NAION: risk assessment with PNI and CONUT scores.","authors":"Ahmet Özdemir, Muhiddin Fatih Bodur, İnci Güngör","doi":"10.1080/08164622.2025.2527820","DOIUrl":"https://doi.org/10.1080/08164622.2025.2527820","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Nutritional and immune status are emerging as systemic factors that may influence the onset and course of optic nerve disorders. Recognising their potential role in neuro-ophthalmology can enhance preventive strategies and support holistic patient management in clinical practice.</p><p><strong>Background: </strong>Non-arteritic anterior ischaemic optic neuropathy (NAION) is a common cause of sudden, painless vision loss in older adults. Although vascular and systemic risk factors such as diabetes mellitus and hypertension are well-documented, emerging evidence suggests that nutritional and immune status may also play a role in its development.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted involving 50 NAION patients and 50 age-matched ophthalmologically healthy controls. The Prognostic Nutritional Index (PNI) was calculated as 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm³). Controlling Nutritional Status (CONUT) scores were derived from serum albumin, total cholesterol, and lymphocyte counts. Group differences were assessed using the Mann-Whitney U and Chi-square tests. Logistic regression identified independent predictors of NAION, with significance set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>PNI values were significantly lower in NAION patients than in controls (42.32 ± 5.05 vs. 46.87 ± 1.95, <i>p</i> < 0.001), while CONUT scores were significantly higher (1.24 ± 1.62 vs. 0.22 ± 0.50, <i>p</i> < 0.001). Both PNI (OR = 0.657, 95% CI: 0.531-0.812, <i>p</i> < 0.001) and CONUT (OR = 3.102, 95% CI: 1.236-7.789, <i>p</i> = 0.009) independently predicted NAION. Diabetes mellitus and hypertension were also more prevalent in the NAION group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>PNI and CONUT scores may serve as non-invasive, independent biomarkers for assessing NAION risk. These findings underscore the contribution of systemic nutritional and immune factors to NAION pathogenesis and support their integration into comprehensive patient evaluations. Prospective studies are needed to confirm these results and explore clinical applications.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682081","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":"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":"https://doi.org/10.1080/08164622.2025.2530540","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":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682136","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}