Ophthalmic and Physiological Optics最新文献

{"title":"Effect of low-level light therapy in individuals with dry eye disease.","authors":"Antoinette Antwi, Alexander W Schill, Rachel Redfern, Eric R Ritchey","doi":"10.1111/opo.13371","DOIUrl":"10.1111/opo.13371","url":null,"abstract":"<p><strong>Introduction: </strong>Low-level light therapy (LLLT) or photobiomodulation, the application of red light to the eye, is used for the treatment of dry eye. Limited studies have investigated the efficacy of LLLT as a stand-alone treatment. The investigation aimed to evaluate the effect of LLLT on signs and symptoms of dry eye.</p><p><strong>Methods: </strong>Participants with mild to moderate dry eye were recruited for this three-visit study. Visits were 7 (±3) days apart and all participants received 633 nm LLLT (eye-light®) for 15 min at each visit. Clinical measures including first and average non-invasive keratograph tear break-up time (NIKBUT), tear meniscus height (TMH), meibomian gland (MG) loss for upper and lower eyelids, ocular surface disease index (OSDI) score, tear film lipid layer thickness, meibum quality score, Schirmer's test, corneal fluorescein staining and eyelid temperature for external upper (EUL) and external lower (ELL) eyelids were measured from the right eye of participants before and after treatment.</p><p><strong>Results: </strong>Thirty participants (mean [SD] age: 31.1 [9.5] years) completed the study. Treatment with LLLT resulted in significant differences in first and average NIKBUT, TMH, tear film lipid layer thickness, OSDI score, Schirmer's test, meibum quality score and eyelid temperature over time (all p < 0.05). Compared to baseline, TMH, tear film lipid layer thickness and eyelid temperature significantly increased by 0.06 mm (95% CI: 0.01-0.11), 12.9 nm (95% CI: 1.18-24.55), and 7.0°C, respectively, for both EUL (95% CI: 6.17-7.84) and ELL (95% CI: 6.17-7.73). The respective decrease in the OSDI score and Schirmer's test was 10.2 (95% CI: -15.15 to -5.26) and 4.4 mm (95% CI: -7.31 to -1.42; all p < 0.05). There was no significant difference in corneal fluorescein staining and MG loss after LLLT.</p><p><strong>Conclusion: </strong>Low-level light therapy treatment significantly improved signs and symptoms of dry eye in the early phases of treatment, suggesting its efficacy for dry eye management.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1464-1471"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the subjective response during the measurement of fusional reserves affect the clinical diagnosis?","authors":"Cristina Rovira-Gay, Marc Argilés, Clara Mestre, Valldeflors Vinuela-Navarro, Jaume Pujol","doi":"10.1111/opo.13384","DOIUrl":"10.1111/opo.13384","url":null,"abstract":"<p><strong>Introduction: </strong>Fusional reserves differ with the method of measurement. The goal of this study was to compare the subjective and objective responses during the measurement of positive and negative fusional reserves using both step and ramp methods.</p><p><strong>Methods: </strong>A haploscopic system was used to measure fusional reserves. Eye movements were recorded using an EyeLink 1000 Plus eye tracker (SR Research). The stimulus disparity was changed to either mimic a prism bar (steps) or a Risley prism (ramp). Subjective responses were obtained by pressing a key on the keyboard, whereas objective break and recovery points were determined offline using a custom algorithm coded in Matlab.</p><p><strong>Results: </strong>Thirty-three adults participated in this study. For the ramp method, the subjective and objective responses were similar for the negative (break and recovery points (t(32) = -0.82, p = 0.42) and (t(32) = 0.42, p = 0.67), respectively) and positive fusional reserves (break and recovery points (U = -1.34, p = 0.18) and t(19) = -0.25, p = 0.81), respectively). For the step method, no significant differences in positive fusional reserves were observed when measured subjectively and objectively for the break (t(32) = 1.27, p = 0.21) or the recovery point (U = -2.02, Bonferroni-adjusted p = 0.04). For the negative fusional reserve, differences were not significant for either the break or recovery points (U = -0.10, p = 0.92 and t(19) = 1.17, p = 0.26, respectively).</p><p><strong>Conclusion: </strong>Subjective and objective responses exhibited good agreement when measured with the ramp and step methods.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1354-1362"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental eye movement test results of Hebrew-speaking children with cross-linguistic comparisons.","authors":"Hadas Ben-Eli, Hadas Blique, Mitchell Scheiman, Rachel Eichler","doi":"10.1111/opo.13409","DOIUrl":"https://doi.org/10.1111/opo.13409","url":null,"abstract":"<p><strong>Introduction and purpose: </strong>The developmental eye movement (DEM) test is designed to assess saccadic eye movements and visual-verbal automaticity in children. This study aimed to assess whether there is a need for independent DEM Hebrew norms and to compare DEM results for Hebrew-speaking children with eight other language norms.</p><p><strong>Methods: </strong>The DEM test was administered to 224 Hebrew-speaking children aged 6-13 years who met the inclusion criteria and read the numbers in Hebrew. Test C of the DEM was performed twice, once from right (R) to left (L) and once from L to R, in random order. Age group and language comparisons, including vertical and horizontal reading speeds, errors and horizontal/vertical (H/V) ratios in both directions were analysed.</p><p><strong>Results: </strong>The participants were almost evenly distributed between the sexes (46.8% female). Statistically significant differences were found between age groups (6-9 and 10-13 years) for vertical and horizontal reading speeds and H/V ratios in both directions (p < 0.001). Older children, as compared to younger children, exhibited faster vertical and horizontal times, with fewer errors, as well as lower ratios (p < 0.001). No significant difference was noted between reading directions for horizontal time and H/V ratio within both age groups (6-9 year olds: p = 0.27 and p = 0.06; 10-13 year olds: p = 0.89 and p = 0.49, respectively). Comparison of DEM norms across languages showed significant differences, with post-hoc analysis revealing specific language-related variations. DEM results for Hebrew-speaking children had similar outcomes to both original English and French values.</p><p><strong>Conclusions: </strong>This study compared DEM results of Hebrew-speaking children and scores across nine languages. DEM test values for Hebrew-speaking children aligned with norms from other languages, particularly the French and original English norms, with consistent ratio scores. It is recommended for practitioners who test Hebrew-speaking children to continue using the original English norms and to enable the children to read using their preferred reading direction.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Convergence insufficiency prevalence in attention deficit and hyperactivity disorder children depends on the diagnosis criteria.","authors":"Laura Clavé, Aurora Torrents","doi":"10.1111/opo.13411","DOIUrl":"https://doi.org/10.1111/opo.13411","url":null,"abstract":"<p><strong>Purpose: </strong>Attention deficit and hyperactivity disorder (ADHD) is a neurodevelopmental condition commonly seen in children and adolescents, characterised by an increase in distractibility or inattention. Several studies have noted a higher rate of visual problems in this group, especially convergence insufficiency (CI), but when using different diagnostic criteria. The aim of this study was to evaluate visual function in ADHD children and non-ADHD controls to compare the different signs for diagnosis of CI.</p><p><strong>Method: </strong>In this prospective case-control study, a group of children aged 7-17 years, diagnosed with ADHD before the start of pharmacological treatment and matched for age and gender with non-ADHD controls were examined. Visual acuity (VA), objective and subjective refraction, accommodative amplitude and facility, heterophoria, positive and negative fusional vergences (PFV and NFV) and stereopsis were assessed.</p><p><strong>Results: </strong>Sixty participants (30 ADHD and 30 non-ADHD controls) were evaluated. There was no significant difference between the two groups for VA, refraction and accommodative abilities. There were significant differences in PFV and NFV: PFV break/recovery values for the ADHD and control groups were 18.9/16.2∆ and 26.9/22.1∆, respectively. Respective values for NFV were 15.7/13∆ and 19.3/15.9∆. Using the three signs of receded near point of convergence (NPC), decreased PFV and exophoria 4∆ greater at near than distance, the prevalence of CI was equivalent for the ADHD and controls (p = 0.34) If only two signs were considered for the CI diagnosis, (i.e., receded NPC and decreased PFV), then prevalence was significantly greater for the ADHD group (p < 0.01).</p><p><strong>Conclusions: </strong>These results show a higher prevalence of binocular vision problems in the ADHD group. This suggests a relationship between vergence problems and ADHD, but the direction of this link remains unclear. Further studies with specific samples may be needed to understand fully the association between binocular vision disorders and ADHD.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viewing distance, font size and symptoms of eyestrain in non-presbyopic and presbyopic smartphone users.","authors":"Shivani Naipal, Nqobile Khumalo, Muhammad Rahmtoola, Sinoxolo Chagi, Luyanda Didi, Sandile Mthethwa, Simmy Ndhlovu, Bhavna Persadh, Nishanee Rampersad","doi":"10.1111/opo.13410","DOIUrl":"https://doi.org/10.1111/opo.13410","url":null,"abstract":"<p><strong>Purpose: </strong>Smartphones are the most frequently used digital devices globally with ~6.80 billion users. Despite the ubiquitous use of smartphones, limited information is known on the preferred viewing distance and font size of smartphone users. This study investigated viewing distance, font size and symptoms of eyestrain in non-presbyopic and presbyopic smartphone users.</p><p><strong>Methods: </strong>In this quantitative research study, viewing distance and font size were measured in a group of non-presbyopes (n = 107) and presbyopes (n = 53), whilst participants viewed a text message and a web page on their own smartphone. Subjects also responded to a verbal questionnaire related to the characteristics of their smartphone and the computer vision syndrome questionnaire to assess symptoms of eyestrain. Data were analysed using descriptive and inferential statistics.</p><p><strong>Results: </strong>For the total sample, the mean viewing distance for a text message was 37.13 ± 8.82 cm (median 36.00 cm), and for a web page was 36.11 ± 7.98 cm (median 36.00 cm). Presbyopes had longer median viewing distances compared with non-presbyopes for a text message (41 cm vs. 34 cm, p < 0.001) and web page (40 cm vs. 34 cm, p < 0.001). The font size for non-presbyopes were <1.0 M whilst for presbyopes were >1.2 M. More than twice the percentage of non-presbyopes were classified with digital eyestrain (DES) compared with presbyopes.</p><p><strong>Conclusions: </strong>Non-presbyopes used shorter viewing distances, smaller font sizes and were more predisposed to DES than presbyopes. The viewing distances adopted by presbyopes were similar to the conventional near-working distance of 40 cm. Eye care practitioners should consider viewing distances when assessing near-visual functions and prescribing a near refractive correction, particularly in non-presbyopes. There should be greater awareness of the importance of adopting appropriate viewing distances when using smartphones.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accommodating version of a schematic eye for emmetropia and myopia.","authors":"David A Atchison, W Neil Charman","doi":"10.1111/opo.13406","DOIUrl":"https://doi.org/10.1111/opo.13406","url":null,"abstract":"<p><strong>Aim: </strong>To develop an accommodating, wide-angle, schematic eye for emmetropia and myopia in which spectacle refraction and accommodation level are input parameters.</p><p><strong>Method: </strong>The schematic eye is based on an earlier unaccommodated refraction-dependent eye for myopia developed by Atchison in 2006. This has a parabolic gradient index lens and parameters derived from biometric and optical measurements on young adults. Several parameters are linearly dependent upon spectacle refraction (anterior radius of curvature of the cornea, axial length and vertex radii of curvature and conic asphericities of a biconic retina). The new accommodated schematic eye incorporates accommodation-dependent changes in several lens-related parameters. These changes are based on literature values for anterior chamber depth, lens thickness, vitreous chamber depth, lens surface radii of curvature and lens front surface asphericity. A parabolic variation of refractive index with relative distance from the lens centre is retained, with the same edge and centre refractive indices as the earlier model, but the distribution has been manipulated to maintain focus near the retina for the emmetropic case at 0 and 4 D accommodation. The asphericity of the lens back surface is changed so that spherical aberration and peripheral refraction approximately match typical literature trends. The model is used to compare spherical aberration and peripheral refraction in eyes with up to 4 D of myopia and 4 D of accommodation.</p><p><strong>Results: </strong>The levels of spherical aberration in the unaccommodated schematic eyes are similar to literature values for young adults, but the changes in spherical aberration with accommodation are approximately two-thirds of that found in an experimental study. As intended, peripheral refractions in the accommodated schematic eyes are similar to those of their unaccommodated counterparts.</p><p><strong>Conclusion: </strong>The wide-angle model extends the range of schematic eyes to include both refraction and accommodation as variable input parameters. It may be useful in predicting aspects of retinal image quality.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you to our 2024 reviewers.","authors":"Mark Rosenfield","doi":"10.1111/opo.13407","DOIUrl":"https://doi.org/10.1111/opo.13407","url":null,"abstract":"","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between ON-OFF function and OCT structural and angiographic parameters in early diabetic retinal disease.","authors":"Vanessa T S Tang, Robert C A Symons, Spiros Fourlanos, Daryl Guest, Allison M McKendrick","doi":"10.1111/opo.13394","DOIUrl":"https://doi.org/10.1111/opo.13394","url":null,"abstract":"<p><strong>Purpose: </strong>This study measured associations between ON and OFF functional indicators and structural optical coherence tomography (OCT) and OCT angiography (OCTA) markers in diabetic retinal disease.</p><p><strong>Methods: </strong>Fifty-four participants with type 1 or type 2 diabetes (mean age = 34.1 years; range 18-60) and 48 age-matched controls (mean age = 35.4 years, range 18-59) underwent visual psychophysical testing, OCT and OCTA retinal imaging. Psychophysical tasks measuring (A) contrast increment and decrement sensitivity and (B) response times to increment and decrement targets were assessed as surrogate measures of ON and OFF retinal ganglion cell function.</p><p><strong>Results: </strong>The group with diabetes had worse foveal contrast increment and decrement thresholds (p = 0.04) and were slower to search for increment and decrement targets relative to controls (p = 0.009). Individuals with diabetes had a less circular foveal avascular zone (FAZ) (p < 0.001) but did not differ from controls in foveal vessel density and FAZ area. Functional and structural outcome measures related to the peripheral retina were also comparable between those with and without diabetes. Functional responses to increments and decrements were not significantly correlated with FAZ circularity or vessel density in individuals with diabetes.</p><p><strong>Conclusions: </strong>Diabetic retinal disease results in impaired performance on measures of inferred ON and OFF pathway function in addition to vascular deficits measurable with OCTA. Future longitudinal studies may determine the temporal relationship between these deficits, and whether they predict future diabetic retinopathy.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-orthogonal spectacle correction for irregular astigmatism.","authors":"Adela Hulpus, Ritchie Henry, Lynn White, Bernardo T Lopes, Vito Romano, Ahmed Abass","doi":"10.1111/opo.13405","DOIUrl":"https://doi.org/10.1111/opo.13405","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the potential improvement in visual acuity and subjective perception of image quality in patients with keratoconus using non-orthogonal correction (NOC) cylinder trial lenses where the steep and flat power meridians are set at angles less or greater than 90°.</p><p><strong>Methods: </strong>A set of NOC plano/cylindrical trial lenses, where the axes between the power meridians were set at a range of non-orthogonal angles, were used to refract 18 participants with keratoconus in whom 23 eyes were used for testing. Corneal elevation data were processed by bespoke MATLAB code from Pentacam Scheimpflug tomographer scans. Each participant first underwent subjective refraction using standard orthogonal cylinder trial lenses, and the monocular best-corrected visual acuity (BCVA, logMAR) was recorded for each eye. They then underwent a second subjective refraction using NOC cylinder trial lenses created for the study and completed a questionnaire to elicit their subjective appraisal of letter clarity and ghosting.</p><p><strong>Results: </strong>Fourteen (61%) eyes demonstrated an increase in objective BCVA with the NOC versus the orthogonal correction; seven (30%) eyes showed no change and in two (9%) eyes, the BCVA was slightly worse. Further, 87% and 79% experienced an increase in letter clarity and a reduction in ghosting, respectively, independent of changes in BCVA. The majority of non-orthogonal angles were in the range of 80°-85°, and it was possible to refine the cylinder and axis of the NOC further compared with the orthogonal correction. All but one of the participants said they would be interested in trying non-orthogonal spectacles if the opportunity arose.</p><p><strong>Conclusions: </strong>Correcting irregular astigmatism in keratoconic individuals with non-orthogonal spectacle correction may provide benefit in terms of increased visual acuity, improvements in letter clarity and a reduction of ghosting effects. This type of correction has the potential to improve the overall quality of life for patients with keratoconus.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomised trial of three treatments for amblyopia: Vision therapy and patching, perceptual learning and patching alone.","authors":"Rosa Hernández-Andrés, Miguel Ángel Serrano, Adrián Alacreu-Crespo, María José Luque","doi":"10.1111/opo.13395","DOIUrl":"https://doi.org/10.1111/opo.13395","url":null,"abstract":"<p><strong>Background: </strong>Active vision therapy for amblyopia shows good results, but there is no standard vision therapy protocol. This study compared the results of three treatments, two combining patching with active therapy and one with patching alone, in a sample of children with amblyopia.</p><p><strong>Methods: </strong>Two protocols have been developed: (a) perceptual learning with a computer game designed to favour the medium-to-high spatial frequency-tuned achromatic mechanisms of parvocellular origin and (b) vision therapy with a specific protocol and 2-h patching. The third treatment group used patching only. Fifty-two amblyopic children (aged 4-12 years), were randomly assigned to three monocular treatment groups: 2-h patching (n = 18), monocular perceptual learning (n = 17) and 2-h patching plus vision therapy (n = 17). Visual outcomes were analysed after 3 months and compared with a control group (n = 36) of subjects with normal vision.</p><p><strong>Results: </strong>Visual acuity (VA) and stereoacuity (STA) improved significantly after treatment for the three groups with the best results for patching plus vision therapy, followed by monocular perceptual learning, with patching only least effective. Change in the interocular difference in VA was significant for monocular perceptual learning, followed by patching. Differences in STA between groups were not significant. For VA and interocular differences, the final outcomes were influenced by the baseline VA and interocular difference, respectively, with greater improvements in subjects with poorer initial values.</p><p><strong>Conclusions: </strong>Visual acuity and STA improved with the two most active treatments, that is, vision therapy followed by perceptual learning. Patching alone showed the worst outcome. These results suggest that vision therapy should include monocular accommodative exercises, ocular motility and central fixation exercises where the fovea is more active.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}