Ward Nieboer, Andrea Ghiani, Ralph de Vries, Eli Brenner, David L Mann
{"title":"Eye Tracking to Assess the Functional Consequences of Vision Impairment: A Systematic Review.","authors":"Ward Nieboer, Andrea Ghiani, Ralph de Vries, Eli Brenner, David L Mann","doi":"10.1097/OPX.0000000000002088","DOIUrl":"10.1097/OPX.0000000000002088","url":null,"abstract":"<p><strong>Background: </strong>Eye tracking is a promising method for objectively assessing functional visual capabilities, but its suitability remains unclear when assessing the vision of people with vision impairment. In particular, accurate eye tracking typically relies on a stable and reliable image of the pupil and cornea, which may be compromised by abnormalities associated with vision impairment (e.g., nystagmus, aniridia).</p><p><strong>Objectives: </strong>This study aimed to establish the degree to which video-based eye tracking can be used to assess visual function in the presence of vision impairment.</p><p><strong>Data sources: </strong>A systematic review was conducted using PubMed, EMBASE, and Web of Science databases, encompassing literature from inception to July 2022.</p><p><strong>Study eligibility criteria, participants, and interventions: </strong>Studies included in the review used video-based eye tracking, included individuals with vision impairment, and used screen-based tasks unrelated to practiced skills such as reading or driving.</p><p><strong>Study appraisal and synthesis methods: </strong>The included studies were assessed for quality using the Strengthening the Reporting of Observational Studies in Epidemiology assessment tool. Data extraction and synthesis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>Our analysis revealed that five common tests of visual function were used: (i) fixation stability, (ii) smooth pursuit, (iii) saccades, (iv) free viewing, and (v) visual search. The studies reported considerable success when testing individuals with vision impairment, yielding usable data from 96.5% of participants.</p><p><strong>Limitations: </strong>There was an overrepresentation of conditions affecting the optic nerve or macula and an underrepresentation of conditions affecting the anterior segment or peripheral retina.</p><p><strong>Conclusions and implications of key findings: </strong>The results offer promise for the use of eye tracking to assess the visual function of a considerable proportion of those with vision impairment. Based on the findings, we outline a framework for how eye tracking can be used to test visual function in the presence of vision impairment.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139080660","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}
María José Roig-Revert, Elena Arias-García, Carolina Ortega-Pérez, Cristina Peris-Martínez
{"title":"Case Report: Role of Anterior Segment Optical Coherence Tomography for Managing Failed Endothelial Keratoplasty Graft.","authors":"María José Roig-Revert, Elena Arias-García, Carolina Ortega-Pérez, Cristina Peris-Martínez","doi":"10.1097/OPX.0000000000002082","DOIUrl":"10.1097/OPX.0000000000002082","url":null,"abstract":"<p><strong>Significance: </strong>Some patients show poor visual outcomes after Descemet stripping automated endothelial keratoplasty. In such cases, secondary Descemet membrane endothelial keratoplasty can be performed to achieve complete visual recovery. Anterior segment optical coherence tomography (AS-OCT) is a valuable tool for the follow-up of posterior lamellar keratoplasty outcomes and complications.</p><p><strong>Purpose: </strong>This study aimed to report the clinical outcome of secondary Descemet membrane endothelial keratoplasty for managing poor visual results in a patient with graft failure after a previous Descemet stripping automated endothelial keratoplasty, highlighting the importance of AS-OCT in the follow-up of endothelial keratoplasty.</p><p><strong>Case report: </strong>A 38-year-old woman with high myopia underwent Descemet stripping automated endothelial keratoplasty for bullous keratopathy after explantation of an angle-supported phakic intraocular lens. Two years after keratoplasty, the patient experienced poor visual acuity (counting fingers), and significant corneal edema was observed on clinical examination hindering visualization of the anterior chamber structures. Anterior segment optical coherence tomography showed a failed and thickened graft adhering well to the recipient cornea in an anterior chamber without other comorbidities. Therefore, the graft was removed and replaced with a Descemet membrane endothelial keratoplasty graft without any complications. One year later, the clinical outcome was evaluated by comparing the pre-operative and post-operative best-corrected visual acuity, biomicroscopy findings, endothelial cell density, and corneal central thickness.</p><p><strong>Conclusions: </strong>Anterior segment optical coherence tomography is an important tool when deciding on the surgical technique to be applied and for the post-surgical monitoring of endothelial corneal grafts. This case demonstrates the successful management of Descemet stripping automated endothelial keratoplasty graft failure with Descemet membrane endothelial keratoplasty graft, highlighting the importance of AS-OCT in detecting complications such as graft dislocation and primary graft failure. In addition, corneal thickness measured using AS-OCT serves as a critical predictor of graft failure, as observed in this case.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61564511","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":"Comparison of Two Printed Pseudoisochromatic Tests for Color Vision Assessment.","authors":"Reema Alduhayan, Ali Almustanyir","doi":"10.1097/OPX.0000000000002087","DOIUrl":"10.1097/OPX.0000000000002087","url":null,"abstract":"<p><strong>Significance: </strong>The Waggoner PIP24 is a pseudoisochromatic test with a pattern similar to the Ishihara test. This study determined that the W-PIP24 can be used clinically to yield screening results (or sensitivity and specificity) comparable with the Ishihara.</p><p><strong>Purpose: </strong>This study aimed to determine whether the W-PIP24 is equivalent to the Ishihara 38 edition pseudoisochromatic test in detecting red-green color vision defects. Also, the performance of each plate of the W-PIP24 in detecting the color vision defects relative to the Ishihara test was determined.</p><p><strong>Methods: </strong>Sixty-three individuals with congenital red-green color vision defects and 57 with normal trichromacy were recruited. Participants were tested with both the Ishihara and W-PIP24. The first-order agreement coefficients were calculated for the Ishihara and W-PIP24. The results were also analyzed using specificity, sensitivity, efficiency, and predictive pass and fail values.</p><p><strong>Results: </strong>The agreement between the W-PIP24 and Ishihara test using the recommended criterion of using all plates was perfect. The sensitivity, specificity, predictive pass, and predictive fail were 1.00 (95% confidence interval, 0.94 to 1.00).</p><p><strong>Conclusions: </strong>This study showed that the W-PIP24 using a failure criterion of three or more errors on screening plates 1 to 15 is equivalent to the Ishihara test while screening for red-green color vision deficiency using a failure criterion of three or more errors on screening plates 1 to 17 of the Ishihara 38 edition.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461445","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":"Relationship of Low-luminance Visual Acuity with Ocular Aberrations in Older Participants.","authors":"Tatsuya Iizuka, Takushi Kawamorita, Tomoya Handa, Hitoshi Ishikawa","doi":"10.1097/OPX.0000000000002093","DOIUrl":"10.1097/OPX.0000000000002093","url":null,"abstract":"<p><strong>Significance: </strong>This study highlights the importance of twilight adaptation for reliable assessment of low-luminance visual acuity and understanding the relationship between low-luminance visual acuity and ocular aberrations.</p><p><strong>Purpose: </strong>The human eye experiences reduced visual acuity as luminance decreases owing to reduced retinal and optical resolutions; however, the details are unclear. This study aimed to quantify the effects of refraction, pupil diameter, and ocular aberrations on visual acuity during the transition from high- to low-light environments, thereby contributing to the standardization of low-luminance visual acuity measurements.</p><p><strong>Methods: </strong>In total, 27 older participants with a mean age of 70.0 ± 4.1 years were included in this study. Visual acuity was measured according to the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol with three luminance conditions: high luminance (300 cd/m 2 ), low luminance (10 cd/m 2 ), and low luminance with short-term (15-minute) twilight adaptation (10 cd/m 2 ).</p><p><strong>Results: </strong>The mean logarithm of minimum angle of resolution values of visual acuity were -0.09 ± 0.09, 0.10 ± 0.13, and 0.03 ± 0.09 at 300, 10, and 10 cd/m 2 with twilight adaptation, respectively. Multiple regression analysis determined that spherical aberration ( P < .005) and tetrafoil ( P < .005) were significant factors associated with low-luminance visual acuity after twilight adaptation, with an adjusted R2 value of 0.35 for this model ( P < .005).</p><p><strong>Conclusions: </strong>Although the influence of ocular aberrations on low-luminance visual acuity may be relatively modest compared with neural effects, it remains a crucial factor that should not be overlooked. The absence of twilight (or dark) adaptation can cause ocular aberrations and neural effects, potentially leading to inaccuracies in the measurement of low-luminance visual acuity.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461447","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":"Diurnal Variation in Accommodation, Binocular Vergence, and Pupil Size.","authors":"Beatríz Redondo, María Serramito, Jesús Vera, Marina Alguacil-Espejo, Mercedes Rubio-Martínez, Rubén Molina, Raimundo Jiménez","doi":"10.1097/OPX.0000000000002091","DOIUrl":"10.1097/OPX.0000000000002091","url":null,"abstract":"<p><strong>Significance: </strong>Our results show significant diurnal variations in accommodative function and the magnitude of the phoria. Therefore, when comparing visual measures in clinical or laboratory settings, performing the visual examination at the same time of day (±1 hour) is encouraged.</p><p><strong>Purpose: </strong>The aim of this study was to evaluate the accommodation, binocular vergence, and pupil behavior on three different times during the day.</p><p><strong>Methods: </strong>Twenty collegiate students (22.8 ± 2.1 years) participated in this study. Participants visited the laboratory on three different days at 2-hourly intervals (morning, 9:00 to 11:00 am ; afternoon, 2:00 to 4:00 pm ; evening, 7:00 to 9:00 pm ). The binocular vergence and accommodative function were measured using clinical optometric procedures, and the accommodative response and pupil function were evaluated in binocular conditions using the WAM-5500 autorefractometer.</p><p><strong>Results: </strong>The accommodative amplitude for the right and left eyes showed statistically significant differences for the time interval ( P = .001 and P = .02, respectively), revealing higher accommodative amplitude in the morning and afternoon in comparison with the evening. Participants were more esophoric when assessed in the morning in comparison with the evening at far and near ( P = .02 and P = .01, respectively) and when assessed in the afternoon in comparison with the evening at far distance ( P = .02). The magnitude of accommodative response was higher in the morning, and it decreased throughout the day at 500 ( P < .001), 40 ( P = .05), and 20 cm ( P < .001). No statistically significant differences were obtained for any other variable.</p><p><strong>Conclusions: </strong>This study shows small diurnal variations in some accommodative and binocular vergence parameters, but no effects were observed for the pupil response. These outcomes are of special relevance for eye care specialists when performing repeated accommodative or binocular vergence measures. However, the diurnal variations were modest and may not influence a routine orthoptic examination.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461446","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}
Ailin Song, Rami Gabriel, Omar Mohiuddin, Diane Whitaker, C Ellis Wisely, Terry Kim
{"title":"Automated Eye Tracking Enables Saccade Performance Evaluation of Patients with Concussion History.","authors":"Ailin Song, Rami Gabriel, Omar Mohiuddin, Diane Whitaker, C Ellis Wisely, Terry Kim","doi":"10.1097/OPX.0000000000002090","DOIUrl":"10.1097/OPX.0000000000002090","url":null,"abstract":"<p><strong>Significance: </strong>Automated eye tracking could be used to evaluate saccade performance of patients with concussion history, providing quantitative insights about the degree of oculomotor impairment and potential vision rehabilitation strategies for this patient population.</p><p><strong>Purpose: </strong>To evaluate the saccade performance of patients with concussion history based on automated eye-tracking test results.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients with concussion history, primarily from sports participation, who underwent oculomotor testing based on an eye-tracking technology at the Duke Eye Center vision rehabilitation clinic between June 30, 2017, and January 10, 2022. Patients' saccade test results were reviewed, including saccade fixation and saccade speed/accuracy ratio. The outcomes were compared with age-matched normative population data derived from healthy individuals. Multiple linear regression analyses were performed to identify factors associated with saccade performance among patients with concussion history.</p><p><strong>Results: </strong>On hundred fifteen patients with concussion history were included in the study. Patients with concussion, on average, had fewer fixations on self-paced horizontal and vertical saccade tests and lower horizontal and vertical saccade speed/accuracy ratios compared with normative ranges. Among patients with concussion history, multiple linear regression analyses showed that older age was associated with fewer fixations on horizontal and vertical saccade tests, whereas male sex was associated with more fixations on horizontal and vertical saccade tests (all P < .01). In addition, older age was associated with lower horizontal saccade speed/accuracy ratio, after adjusting for sex, number of concussion(s), and time from most recent concussion to oculomotor testing ( P < .001).</p><p><strong>Conclusions: </strong>Patients with concussion history had lower saccade performance based on eye tracking compared with healthy individuals. We additionally identified risk factors for lower saccade performance among patients with concussion history. These findings support the use of saccade test results as biomarkers for concussion and have implications for post-concussion rehabilitation strategies.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461441","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":"Case Report: Remote Scleral Lens Fitting for High Toric Scleras in a Keratoconus Patient.","authors":"Daddi Fadel, Cian Gildea","doi":"10.1097/OPX.0000000000002085","DOIUrl":"10.1097/OPX.0000000000002085","url":null,"abstract":"<p><strong>Significance: </strong>Technology plays a crucial role in customizing scleral lenses and improving lens alignment, especially in challenging scleral shapes. In addition, remote fitting technology allows optometrists to extend their expertise globally, empowering patients to access to customized lenses without travel expenses.</p><p><strong>Purpose: </strong>The objective of this study was to document the difficulties encountered in fitting a scleral lens in a patient with keratoconus and pronounced scleral toricity. In addition, the study aimed to present the successful remote fitting achieved by using advanced technology.</p><p><strong>Case report: </strong>An Irish male patient diagnosed with keratoconus exhibited high scleral toricity. Generally, keratoconus eyes often exhibit significant scleral asymmetry associated with cone decentration and disease severity. Improperly aligned scleral lenses can lead to regional changes in scleral shape, lens decentration, discomfort, and visual disturbances. Indeed, previous scleral lens fits were unsuccessful because of these issues. Corneoscleral profilometry was acquired in Ireland and then used in Italy to design customized lenses, which were then delivered to the patient's optometrist in Ireland. The first lenses designed and delivered demonstrated excellent overall performance without requiring adjustments.</p><p><strong>Conclusions: </strong>This report highlights the importance of corneoscleral profilometry to increase efficiency and reduce lens reorders and chair time, and the remote fitting in overcoming barriers to accessing specialized lens fitting.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461442","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}
Aaron D Salzano, Safal Khanal, Nathan L Cheung, Katherine K Weise, Erin C Jenewein, Darryl M Horn, Donald O Mutti, Timothy J Gawne
{"title":"Repeated Low-level Red-light Therapy: The Next Wave in Myopia Management?","authors":"Aaron D Salzano, Safal Khanal, Nathan L Cheung, Katherine K Weise, Erin C Jenewein, Darryl M Horn, Donald O Mutti, Timothy J Gawne","doi":"10.1097/OPX.0000000000002083","DOIUrl":"10.1097/OPX.0000000000002083","url":null,"abstract":"<p><strong>Significance: </strong>Exposure to long-wavelength light has been proposed as a potential intervention to slow myopia progression in children. This article provides an evidence-based review of the safety and myopia control efficacy of red light and discusses the potential mechanisms by which red light may work to slow childhood myopia progression.The spectral composition of the ambient light in the visual environment has powerful effects on eye growth and refractive development. Studies in mammalian and primate animal models (macaque monkeys and tree shrews) have shown that daily exposure to long-wavelength (red or amber) light promotes slower eye growth and hyperopia development and inhibits myopia induced by form deprivation or minus lens wear. Consistent with these results, several recent randomized controlled clinical trials in Chinese children have demonstrated that exposure to red light for 3 minutes twice a day significantly reduces myopia progression and axial elongation. These findings have collectively provided strong evidence for the potential of using red light as a myopia control intervention in clinical practice. However, several questions remain unanswered. In this article, we review the current evidence on the safety and efficacy of red light as a myopia control intervention, describe potential mechanisms, and discuss some key unresolved issues that require consideration before red light can be broadly translated into myopia control in children.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61564515","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":"Passing the Torch.","authors":"Michael D Twa","doi":"10.1097/OPX.0000000000002099","DOIUrl":"10.1097/OPX.0000000000002099","url":null,"abstract":"","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139080661","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":"Thought Processes as Data in Eye Care Education and Research.","authors":"Babu Noushad","doi":"10.1097/OPX.0000000000002074","DOIUrl":"10.1097/OPX.0000000000002074","url":null,"abstract":"","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41140116","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}