Journal of Optometry最新文献

{"title":"Validation and comparison of two commercial OCT systems for in vitro measurement of soft contact lens thickness","authors":"Maria Romaguera,&nbsp;Gonzalo Valdes-Soria,&nbsp;Laura Ximena Sierra-Buitrago,&nbsp;Carlos Carpena-Torres,&nbsp;Gonzalo Carracedo","doi":"10.1016/j.optom.2025.100607","DOIUrl":"10.1016/j.optom.2025.100607","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the in vitro measurement of central thickness (CT) in soft contact lenses using two commercial optical coherence tomography (OCT) systems by analyzing their repeatability and agreement.</div></div><div><h3>Methods</h3><div>A randomized, controlled, investigator-masked trial was conducted using 120 soft contact lenses made from eight different materials. Three examiners measured the CT of the soft contact lenses using two commercial OCT systems with a spherical support marked for correct lens centration. One system was a swept-source OCT, and the other a spectral-domain OCT. Intra- and inter-examiner repeatability were assessed. Comparisons between the OCT systems and the electronic thickness gauge, considered the gold standard, were analyzed. Agreement between the two OCT systems was evaluated using Bland–Altman plots.</div></div><div><h3>Results</h3><div>Both OCT systems showed a 95% confidence interval for intra-examiner repeatability of &lt;10.0 µm for most materials. Inter-examiner repeatability was worse than intra-examiner repeatability, exceeding 10.0 µm in some materials. The mean differences between the OCT devices and the electronic thickness gauge were &lt;10 µm. Swept-source OCT provided slightly lower CT values than spectral-domain OCT, although most differences were within ± 10 µm.</div></div><div><h3>Conclusion</h3><div>Both OCT systems demonstrate good repeatability and strong agreement with the electronic thickness gauge for measuring the central thickness of soft contact lenses, and can be used interchangeably. These findings support their use as a viable alternative in lens development, manufacturing, and quality control.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 2","pages":"Article 100607"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vision-related quality of life in Polish patients with keratoconus: A cross-sectional study using the KORQ questionnaire","authors":"Magdalena Nandzik ,&nbsp;Adam Wylęgała ,&nbsp;Magdalena Kijonka ,&nbsp;Julia Piekarska ,&nbsp;Dominika Szkodny ,&nbsp;Bartłomiej Markuszewski ,&nbsp;Edward Wylęgała","doi":"10.1016/j.optom.2025.100604","DOIUrl":"10.1016/j.optom.2025.100604","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of keratoconus on visual quality and quality of life among Polish patients by integrating subjective assessments using the Keratoconus Outcomes Research Questionnaire (KORQ) with objective clinical measurements.</div></div><div><h3>Methods</h3><div>A total of 100 patients (80% men, 20% women; median age: 39 years) with clinically diagnosed keratoconus completed the locally validated Polish version of the KORQ, including two subscales: Activity Limitation (18 items) and Symptoms (9 items). Objective data collected included best-corrected visual acuity (BCVA), corneal topography, pachymetry, and higher-order aberrations (HOA). Statistical analyses included biweight midcorrelations and robust linear regression models adjusted for age and gender.</div></div><div><h3>Results</h3><div>The mean Activity Limitation score was 51.53 (SD = 17.19) and the Symptoms score was 55.60 (SD = 16.14), indicating moderate functional impairment and symptom burden. The most challenging activities were night driving (mean = 2.06), seeing small distant objects (mean = 2.09), and coping with poor lighting (mean = 2.05). The most bothersome symptoms were distorted vision (mean = 1.84), sensitivity to smoke (mean = 2.05), and dusty environments (mean = 2.01). Higher-order aberrations, especially in the worse-seeing eye, showed the strongest associations with KORQ scores across both subscales (e.g., for Symptom subscale: HOA: β = 2.84; <em>p</em> = 0.004; vertical coma: β = 5.83; <em>p</em> = 0.019), while BCVA in the better-seeing eye was significantly associated with both lower symptom burden (<em>β</em> = -9.83; <em>p</em> = 0.047) and functional limitation (<em>β</em> = -12.13; <em>p</em> = 0.042). Traditional structural parameters, such as Kmax and corneal thickness, showed no significant predictive value.</div></div><div><h3>Conclusions</h3><div>Keratoconus significantly impairs visual functioning and causes a high symptom burden among Polish patients. Best-corrected visual acuity and higher-order aberrations, especially in the worse-seeing eye, are the strongest predictors of reduced vision-related quality of life. These findings emphasize the need to focus clinical management on improving optical quality, rather than solely correcting structural corneal features.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 2","pages":"Article 100604"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of iris color on corneal densitometry","authors":"Ana R. Arizcuren,&nbsp;Alejandra Consejo","doi":"10.1016/j.optom.2025.100595","DOIUrl":"10.1016/j.optom.2025.100595","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether iris pigmentation introduces a measurable bias in corneal densitometry (CD) values obtained via Scheimpflug imaging, and to develop an objective metric for iris color quantification.</div></div><div><h3>Methods</h3><div>This observational study included 91 eyes from 47 healthy adults. CD was assessed as mean pixel intensity (MPI) from 25 Scheimpflug images per eye. Brightness artefacts from the iris were quantified using automated image processing. Iris color was objectively characterized from slit-lamp photographs using an objective single-value metric (<em>IrisColor</em>) derived from normalized CIELAB components. Associations among CD, iris brightness, and iris pigmentation were evaluated using Pearson correlation and linear mixed-effects models (LMMs).</div></div><div><h3>Results</h3><div>CD correlated positively with iris brightness artefacts (<em>r</em> = 0.47, <em>β</em> = 1.49, <em>p</em> &lt; 0.001), which in turn showed a strong negative correlation with <em>IrisColor</em> (<em>r</em> = –0.83, <em>β</em> = –1.11, <em>p</em> &lt; 0.001). Lighter-colored irises (lower <em>IrisColor</em> values) exhibited statistically significantly higher CD values equivalent to a 6.6% relative overestimation. Groupwise comparisons confirmed that iris pigmentation significantly influences both CD and overall image brightness.</div></div><div><h3>Conclusion</h3><div>Iris pigmentation induces a measurable bias in Scheimpflug-based CD estimates, primarily through increased brightness artefacts in light-colored eyes. The proposed <em>IrisColor</em> metric enables objective, continuous classification of iris color and could support future corrections for pigmentation-induced bias in CD-based diagnostics.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 2","pages":"Article 100595"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term astigmatism progression and its interaction with spherical equivalent in Chinese school-age children: A hospital-based cohort study","authors":"Zhuoer Qin ,&nbsp;Qiaolan Zheng ,&nbsp;Yuanyuan Liu ,&nbsp;Ying Chen ,&nbsp;Xinping Yu ,&nbsp;Jie Chen ,&nbsp;Dan Xu ,&nbsp;Wuhe Chen","doi":"10.1016/j.optom.2025.100606","DOIUrl":"10.1016/j.optom.2025.100606","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize longitudinal astigmatism changes and their interaction with spherical equivalent (SE) progression in Chinese school-age children.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed medical records of patients with long-term follow-up data from 2008 to 2022. Patients aged 6–10 years at initial visit and 16 years at last assessment, with a cylinder refraction of 0.75 D or greater, were selected. Astigmatism was analyzed in clinical notation and vector notation (J0, J45). Factors related to annual changes in astigmatism and SE and their interaction were analyzed.</div></div><div><h3>Results</h3><div>A total of 2946 patients (mean age 8.72 ± 1.21 years at initial visit) were followed up for 7.40 ± 1.23 years. In low astigmatism (≤1.50 D), cylinder power increased by 0.018 D/y with age, whereas in high astigmatism (≥3.00 D), it decreased by 0.048 D/y (<em>p</em> &lt; 0.001). Oblique astigmatism (J45) increased by 0.008 D/y, and with-the-rule (WTR) astigmatism (J0) decreased by 0.005 D/y (<em>p</em> &lt; 0.001). A more negative baseline SE at initial visit was associated with greater increase in astigmatism magnitude (β = -0.004, <em>p</em> &lt; 0.001), and higher baseline astigmatism magnitude was associated with less SE progression (β = 0.047, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In this large longitudinal cohort of Chinese school-age children, astigmatism progression exhibited a baseline-dependent pattern. Myopia was associated with a modest acceleration of astigmatism progression, whereas higher astigmatism conferred a slight protective effect against myopic shift. This study demonstrates these refractive interactions, though their clinical applicability is limited by small effect sizes.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 2","pages":"Article 100606"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of different spectacle designs on the European visual field requirements for driving","authors":"Thea Melsen Sudmann ,&nbsp;Anne Kathinka Jeber ,&nbsp;Anne Brækhus ,&nbsp;Ole Klungsøyr ,&nbsp;Fiona J. Rowe ,&nbsp;Øystein Kalsnes Jørstad","doi":"10.1016/j.optom.2025.100582","DOIUrl":"10.1016/j.optom.2025.100582","url":null,"abstract":"<div><h3>Purpose</h3><div>Spectacles can obstruct the peripheral visual field (VF) and interfere with formal requirements for driving. The European VF standards can be assessed with perimetry using the European Driving Test (EDT). This study aimed to evaluate the impact of different spectacles on the EDT, and their compliance with the European VF standards for driving.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 30 participants (15 males and 15 females) with normal VF. Participants underwent binocular EDT perimetry with three different spectacles. The number of missed test points were recorded and the vertex distance (VD), pupillary distance, and eye dominance were measured. Statistical comparisons were conducted using a generalized linear mixed model, with significance set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Peripheral VF loss was observed in 11 (37 %) participants (10 males) with spectacle B and in six (20 %) participants (five males) with spectacle C, whereas only one participant had a single missed test point with spectacle A. Participants with spectacle-related VF loss had significantly greater VD than those without. Moreover, there were a higher number of missed test points on the side of the dominant eye.</div></div><div><h3>Conclusions</h3><div>Spectacles with thin frames and temples had a negligible impact on the peripheral VF, whereas thicker frames and temples could compromise compliance with the VF standards. VF loss was associated with greater VD, which can explain why male participants exhibited more artefacts. These findings emphasize the need to consider spectacle design in fitness-to-drive assessments with perimetry and raise awareness of potential VF restrictions associated with certain eyewear.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 1","pages":"Article 100582"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opto-biomechanical simulation of keratoconus development in emmetropic eyes","authors":"Hosna Ghaderi ,&nbsp;Marta Jiménez García ,&nbsp;Carina Koppen ,&nbsp;Jos Rozema","doi":"10.1016/j.optom.2025.100587","DOIUrl":"10.1016/j.optom.2025.100587","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess how different corneas respond to a standardized structural weak spot in different sizes and locations using the finite element method depending on their initial geometry.</div></div><div><h3>Method</h3><div>The corneal meshes of <em>5</em> randomly selected emmetropic SyntEyes with different biometry and optical properties were generated using MATLAB and ANSYS. To simulate keratoconus development, a local stiffness reduction of up to <em>60</em> % of the original value was implemented in three locations (central, <em>1</em> <em>mm</em>, and <em>2</em> <em>mm</em> inferior) with a diameter of <em>2</em> <em>mm</em> for each cornea. From this, tangential corneal power maps were calculated.</div></div><div><h3>Results</h3><div>Local weakening causes the formation of a conical deformation at the site of the weak spot and, for an inferior weak spot, a superior flattening. At the center of the weak spot, the cornea becomes thinner by <em>50</em> <em>μm</em>, while the maximum anterior curvature increased by an average <em>of 51.76</em> <em>±</em> <em>1.38D</em> and the posterior curvature by an average of -<em>7.45</em> <em>±</em> <em>0.15D</em> for the central keratoconus. The anterior surface area increases by <em>0.88</em> <em>±</em> <em>0.29 mm²</em> and <em>0.85</em> <em>±</em> <em>0.03 mm²</em> for a central and inferior keratoconus, respectively. The corresponding values for the posterior surface were <em>1.10</em> <em>±</em> <em>0.03 mm²</em> and <em>1.06</em> <em>±</em> <em>0.03 mm²</em>.</div></div><div><h3>Conclusion</h3><div>The shape of a keratoconic cornea is not only determined by the response to a local structural weakening, but also by its original corneal shape. This understanding may help enhance early detection and monitoring techniques for keratoconus progression.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 1","pages":"Article 100587"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A feasibility study of 3D printing technology for simulating rigid gas permeable contact lens fitting","authors":"Nerea Tolón Zardoya,&nbsp;Diana Gargallo Yebra,&nbsp;Francisco J. Ávila Gómez,&nbsp;Jorge Ares García","doi":"10.1016/j.optom.2025.100583","DOIUrl":"10.1016/j.optom.2025.100583","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the feasibility of a novel method for simulating a Rigid Gas Permeable Contact Lenses (RGP-CL) fitting using 3-D printed sclero-corneal surfaces (SCSs).</div></div><div><h3>Methods</h3><div>The experiment involved the fabrication of two resin SCSs with biconic corneal geometry and the participation of 22 optician-optometrists as observers. Participants compared the fluorescein patterns of three RGP-CL fitted on each SCS with theoretical patterns generated through computer simulation. To standardize visualization, comparisons were conducted through a multiple-choice questionnaire composed of 6 questions. Each question presented one main fluorescein pattern (either theoretical or experimental) and four additional patterns obtained using the other technique. Optometrists were required to select the fluorescein pattern more similar to the main pattern. A statistical analysis was performed to evaluate the accuracy of the comparison between the two methods.</div></div><div><h3>Results</h3><div>The surface quality of the printed SCSs was sufficient to produce consistent and interpretable fluorescein patterns. In all questions, at least 70 % of optometrists selected the correct pattern. In four questions, more than 90 % identified the correct pattern, and in one question accuracy reached 100 %. The correct option was always the most frequently chosen, with a significantly higher rate than the second most selected option (p = 0.05).</div></div><div><h3>Conclusions</h3><div>The ability of most optometrists to correctly identify patterns suggests that, even without polishing, 3-D printed SCSs can simulate fluorescein patterns closely resembling theoretical ones. This approach shows promise as a supportive tool for training in RGP-CL fitting.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 1","pages":"Article 100583"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in randomized controlled trials on slowing myopia: A systematic review","authors":"Yiyang Xu ,&nbsp;Nan Chen ,&nbsp;Fei Zhang ,&nbsp;Xuanling Zeng ,&nbsp;Tianlin Wang ,&nbsp;Wanying Xia ,&nbsp;Xingyue Yang","doi":"10.1016/j.optom.2025.100562","DOIUrl":"10.1016/j.optom.2025.100562","url":null,"abstract":"<div><h3>Introduction</h3><div>This review aims to analyse the application of the measure methods and measure contents of the outcomes reported in studies on slowing myopia, and the associations between outcomes and study characteristics.</div></div><div><h3>Methods</h3><div>Publications were identified by a search of seven electronic databases including China National Knowledge Infrastructure, China Biology Medicine, Wanfang database, CQVIP database, PubMed, Cochrane Library and Excerpta Medica Database, for relevant terms like myopia and randomized controlled trial from construction to Sept. 15th, 2023. The basic information of studies was extracted, including publishing time, region, intervention duration, sample size, intervention and outcome. Additionally, the measurements of outcomes were explored. The risk of bias of all studies included were assessed.</div></div><div><h3>Results</h3><div>Altogether, 599 randomized controlled trials were included, including vision (52.75 %), refraction (64.94 %), eye axial length (47.25 %) and response rate (38.23 %). Since 478 studies (79.80 %) were published in Chinese, the included studies were divided into subgroups according to the study language. The number of research published in Chinese was surged since 2005. The rate of refraction was gradually increased from 27.27 % before 2005 to 71.08 % in the past 2 years. 121 studies in English were included in this study. The usage frequency of refraction was ≥75 % in each period and that of eye axial length kept at more than half. In the studies lasting &gt;6 months, the usage frequencies of refraction and axial length were &gt;90 %. They accounted for 91.30 % and 82.61 % in the studies using contact lenses, and both 94.12 % in the studies using spectacles.</div></div><div><h3>Conclusion</h3><div>More and more attention is paid in slowing myopia, and the reported outcomes are diverse. Based on the analysis of the outcomes, there is a lack of an agreed-upon standardised set of outcomes in clinical trials for slowing myopia.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 1","pages":"Article 100562"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of an algorithm-based combination device for objective and subjective refraction: accuracy and efficiency across examiner experience levels","authors":"Antonia Roth ,&nbsp;Katharina Breher ,&nbsp;Niklas Domdei ,&nbsp;Jonas Müller ,&nbsp;Siegfried Wahl","doi":"10.1016/j.optom.2025.100580","DOIUrl":"10.1016/j.optom.2025.100580","url":null,"abstract":"<div><h3>Purpose</h3><div>A novel combination device for objective and subjective refraction was assessed regarding repeatability, reproducibility, validity, vision quality, and timing for experienced and untrained examiners.</div></div><div><h3>Methods</h3><div>Six examiners (each three trained optometrists and untrained examiners) examined 33 healthy participants for objective and subjective refraction. The ZEISS VISUCORE 500 (VC) objective and subjective refraction combination device with an algorithm-based guided and regular custom mode was compared to a conventional control procedure (wavefront aberrometer and phoropter).</div></div><div><h3>Results</h3><div>For the objective measurement of spherical equivalent refractive error (SE), VC shows good repeatability (≤ ±0.29 D) and reproducibility (≤ ±0.28 D) across all examiners versus control (±0.34 D and ≤ ±0.30 D, respectively), measured only by trained examiners. VC measures slightly negative objective refractions for SE with a mean difference (MD) and 95% limits of agreement (LoA) of -0.07 ± 1.24 D analyzed for a trained examiner. Subjective refraction for VC guided and custom mode showed good repeatability (≤ ±0.64 D) and reproducibility (≤ ±0.59 D) regarding SE for the examiner level. The results were similar to control (±0.54 D and ±0.51 D, respectively) with MD and LoA of +0.12 ± 0.67 D and +0.14 ± 0.66 D for VC guided and custom for trained examiner level. No significant differences were observed in best-corrected visual acuity across the three refraction workflows (all p &gt; 0.05). The VC guided procedure was the most time-efficient, requiring less than 5 min of chair time.</div></div><div><h3>Conclusions</h3><div>The tested combination refraction device provides reliable and efficient objective and subjective refraction measurements across trained and untrained examiners.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 1","pages":"Article 100580"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing early diagnosis and treatment of acanthamoeba keratitis through corneal scraping","authors":"Wen-Hui Chang ,&nbsp;Yu-Wei Kuo ,&nbsp;Yu-Chih Hou","doi":"10.1016/j.optom.2025.100566","DOIUrl":"10.1016/j.optom.2025.100566","url":null,"abstract":"<div><h3>Purpose</h3><div>Acanthamoeba keratitis (AK) is a sight-threatening disease, commonly associated with contact lens use. Early diagnosis is challenging due to its varied clinical presentation. This study aimed to describe the clinical characteristics of AK and evaluate the utility of corneal scraping for early diagnosis.</div></div><div><h3>Methods</h3><div>This retrospective study included 14 eyes from 13 AK patients diagnosed by detecting Acanthamoeba cysts in corneal scrapings between July 2019 and August 2023. Clinical history, presentation, treatment, and outcomes were analyzed.</div></div><div><h3>Results</h3><div>The mean age of the 13 patients was 28 ± 13 years. Ten patients used soft contact lenses and 3 patients used orthokeratology lenses. The mean time from symptom onset to diagnosis was 18.2 ± 12.9 days. The most common sign was elevated superficial punctate keratitis (SPK), followed by dot infiltrates, radial perineuritis, pseudodendrites, stromal edema, and ring infiltrates. Nine eyes were treated with polyhexamethylene biguanide (PHMB) eye drops, while the remaining five eyes received a combination of two or three anti-amoebic agents. Thirteen eyes improved with treatment, but one eye—initially misdiagnosed and treated with steroids—required therapeutic keratoplasty. LogMAR visual acuity in eleven eyes improved from an initial 0.51 ± 0.44 to 0.11 ± 0.10 after treatment.</div></div><div><h3>Conclusion</h3><div>Elevated SPK is the most frequent early feature of AK and may mimic contact lens-related sterile keratitis. Corneal scraping is a valuable diagnostic tool that enables earlier detection and improved outcomes. PHMB monotherapy is effective in early AK, while delayed diagnosis and prior steroid use may lead to disease progression and necessitate surgical intervention.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"19 1","pages":"Article 100566"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}