Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)最新文献

{"title":"Epidemiology of Refractive Error in Ghana: A Systematic Review and Meta-Analysis.","authors":"Samuel Kyei, Randy Asiamah, Pious Tawiah Amoako, Hornametor Afake","doi":"10.1007/s44402-026-00202-4","DOIUrl":"https://doi.org/10.1007/s44402-026-00202-4","url":null,"abstract":"<p><strong>Purpose: </strong>To synthesise the population-based prevalence of myopia, hyperopia and astigmatism in Ghana and evaluate the methodological drivers of heterogeneity within the existing epidemiological literature.</p><p><strong>Recent findings: </strong>A systematic review and meta-analysis of nine eligible population-based cross-sectional studies (n = 7153 participants, age range 5-70 years) was conducted. Due to substantial inter-study heterogeneity, pooled estimates should be interpreted as weighted averages rather than definitive national prevalences. The pooled prevalence was approximately 3.1% (95% CI: 1.9% to 5.0%) for myopia, 2.2% (95% CI: 1.1% to 4.4%) for hyperopia and 1.7% (95% CI: 0.7% to 3.9%) for astigmatism. Prediction intervals were wide, reflecting extreme between-study variance. Subgroup analyses revealed that myopia prevalence was significantly higher in urban (3.1%) and mixed settings (4.7%) compared with rural areas (0.8%; 95% CI: 0.4% to 1.6%). Furthermore, studies omitting cycloplegia severely underestimated hyperopia prevalence (1.3%) compared to the single cohort utilising cycloplegic refraction (4.6%). Continuous meta-regression indicated a positive correlation between hyperopia and advancing age, while apparent temporal declines in hyperopia and astigmatism may reflect methodological shifts rather than true epidemiological trends. The findings suggest higher myopia prevalence in urban and mixed settings and indicate that cycloplegic use may influence reported hyperopia prevalence estimates. Future epidemiological studies would benefit from standardised cycloplegic protocols and harmonised refractive error definitions to improve comparability of prevalence estimates.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229825","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":"Diffractive Soft Contact Lenses for Modifying Ocular Longitudinal Chromatic Aberration.","authors":"Len Zheleznyak, Chang Liu, Lisen Xu","doi":"10.1007/s44402-026-00212-2","DOIUrl":"https://doi.org/10.1007/s44402-026-00212-2","url":null,"abstract":"<p><strong>Purpose: </strong>Childhood myopia prevalence is increasing rapidly worldwide, underscoring the need for effective strategies to slow its progression. Longitudinal chromatic aberration (LCA) has been identified as an optical cue for the sign of defocus that may guide childhood eye growth and emmetropisation. Reversing the sign of ocular LCA has been proposed as a myopia control strategy, yet no wearable devices have demonstrated this capability. Here, diffractive soft contact lenses fabricated using laser-induced refractive index change (LIRIC) are introduced to modify ocular LCA.</p><p><strong>Methods: </strong>Contact lenses were made with four diffractive powers (1.5, 2.0, 3.0 and 6.0 D) using LIRIC, a femtosecond laser writing technique that modifies the internal refractive index of a soft contact lens without altering external geometry. Lens LCA was characterised using a custom multi-wavelength Badal optical bench with narrow bandpass filters (470, 532, 550, 630 and 700 nm). LCA was defined as the linear slope of relative optical power versus wavelength (D/μm). Theoretical predictions were derived from a first-order thin lens model using the negative Abbe number of diffractive wavefronts (-3.45).</p><p><strong>Results: </strong>Measured LCA values of the lenses were 2.77, 3.78, 5.31 and 11.37 D/μm for LIRIC lenses of 1.5, 2.0, 3.0 and 6.0 D of diffractive power, respectively, in close agreement with theoretical predictions (2.73, 3.64, 5.45 and 10.91 D/μm). Theoretical modelling of a diffraction-limited eye with average human LCA predicted that the 1.5 and 2.0 D diffractive designs partially compensated the eye's native LCA, the 3.0 D design minimised it and the 6.0 D design reversed its sign.</p><p><strong>Conclusions: </strong>This study presents the first demonstration of a soft contact lens capable of manipulating ocular LCA, including sign reversal. LIRIC diffractive contact lenses offer a practical platform for tuning the eye's chromatic defocus cues and warrant further investigation as a novel myopia control strategy.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225784","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":"Progress in the Synthesis of Evidence in Glaucoma: What We Know and the Gaps that Remain.","authors":"Mapa Prabhath Piyasena, Gianni Virgili, Augusto Azuara-Blanco","doi":"10.1007/s44402-026-00218-w","DOIUrl":"https://doi.org/10.1007/s44402-026-00218-w","url":null,"abstract":"<p><strong>Purpose: </strong>Glaucoma is one of the leading causes of blindness worldwide, necessitating evidence-informed interventions and strategies to improve the quality of life of affected individuals. In this review, we examined progress in evidence over the past decade and discussed its implications and the ways forward for delivery of glaucoma care globally, embedded within a rapid evidence and gap-mapping exercise of systematic reviews and/or meta-analyses published between 2015 and 2025.</p><p><strong>Methods: </strong>Using a predefined conceptual framework, ten domains were identified as relevant to evidence synthesis in glaucoma care. Within each domain, we assessed areas of strength and identified remaining evidence gaps. Findings were synthesised narratively and recommendations provided to inform future research priorities and advancement in glaucoma care.</p><p><strong>Recent findings: </strong>Across the systematic reviews published over the past decade, the majority focused on risk factors (15.6%), genetic factors (12.4%) and the effectiveness of various treatment modalities (44.4%). In the absence of a coordinated global approach, substantial duplication of effort across review groups was observed. In addition, several critical gaps remain in the evidence base, particularly regarding the cost-effectiveness of the interventions, improving equitable access to care and the availability of context-specific evidence for low- and middle-income countries. Improved rigour in the evidence from primary studies should be a key priority for future research. A substantial gap exists in the glaucoma care evidence base that limits its utility for informing clinical guidelines and policy development. Systematic reviewers should have a comprehensive understanding of the existing evidence landscape in glaucoma care prior to conceptualising and designing review projects. Strengthening the methodological quality of both systematic reviews and the underlying primary studies is essential to support the development of robust clinical guidelines and effective global policies in glaucoma care.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225786","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":"Global and Regional Risk Factors for Vision Impairment in 2020 and Multi-decadal Trends 1990-2020: A Meta-Analysis and Visual Display Based on Prevalence Data From the Global Burden of Disease study and Vision Loss Expert Group.","authors":"Michele Bottone, Jost Jonas, Jaimie Steinmetz, Tasanee Braithwaite, Robert Casson, Joshua Ehrlich, Hugh R Taylor, David Friedman, Nathan Congdon, John Kempen, Janet Leasher, Ningli Wang, Rohit Khanna, Tunde Peto, Joao M Furtado, Tien Y Wong, Mary E Hartnett, Maria V Cicinelli, Nina Tahhan, Van C Lansingh, Sophia Y Wang, Ian Tapply, Paul Briant, Theo Vos, Serge Resnikoff, Seth R Flaxman, Rupert R A Bourne","doi":"10.1007/s44402-026-00208-y","DOIUrl":"https://doi.org/10.1007/s44402-026-00208-y","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate global and regional risk factors for blindness and vision impairment pertaining to all geographical locations between 1990 and 2020.</p><p><strong>Methods: </strong>(1) Twenty-four covariates were selected with a potential link to vision impairment from the Global Burden of Disease Study (GBD) Covariates database as predictive factors. (2) From these, the linear association was investigated, with crude and age-standardised prevalence estimates of blindness and distance and near vision impairment in 2020 by using data for the whole population, sex and 5-year age groups, and by stratifying severity through mild, moderate, severe and total impairment. (3) Analysis investigated whether percentage rates of change in risk factors were associated with rates of change in prevalence in 1990-2020.</p><p><strong>Results: </strong>For adults (50+ years), for crude and age-standardised vision loss prevalence estimates for the year 2020, a significant negative association of smoking prevalence was found initially for all persons and for each sex, which appears to be due to ecological confounding and became a positive association using more granular regional and age group data. Maternal care and immunisation, sanitation proportion, Health Access and Quality Index and Socio-demographic Index were other significant age-standardised negative associations. Ophthalmologists/million population had a weak but significant protective effect, and positive associations were found for pollution (outdoor and indoor), stronger for greater vision impairment severities. Years in education per capita were weakly, negatively associated with vision loss prevalence, yet zero education proportion had a stronger but positive association for both sexes.</p><p><strong>Conclusions: </strong>This study confirmed associations at population level globally, which appear to be stable over decades. In addition, the study quantified the contribution of epidemiologically-based risk factors to vision loss at a GBD super-regional level, which is novel. This opens useful avenues for targeted intervention by policymakers. For example, reduction in sex inequity in blindness rates over 30 years has been positively associated with reducing overall prevalence of blindness.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208443","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":"Subtype-Specific Efficacy of Adrenoceptor Agonists in Inhibiting Lens-Induced Myopia in Chicks.","authors":"Mezbah Uddin, Fengjuan Yu, Rachel Ka Man Chun, Bing Zuo, King Kit Li, Chi Ho To, Dennis Yan-Yin Tse","doi":"10.1007/s44402-026-00207-z","DOIUrl":"https://doi.org/10.1007/s44402-026-00207-z","url":null,"abstract":"<p><strong>Purpose: </strong>Alpha-adrenergic receptors (ARs) may potentially play a critical role in controlling myopia, with subtype-specific signalling pathways mediating distinct effects. This study systematically investigated the efficacy of three subtype-specific pharmacological agents in myopia control and dose-response relationships in lens-induced myopia (LIM) chick models.</p><p><strong>Methods: </strong>White Leghorn chicks were randomised to a phosphate-buffered saline (PBS) control group or treated groups receiving metaraminol (α1-AR agonist), lofexidine (α2-AR agonist) or cirazoline (a dual α1‑AR agonist and α2‑AR antagonist) at low (3 nmol), medium (30 nmol) or high (300 nmol) doses. A -10 D single-vision lens was fitted to the right eye for 7 days to induce myopia, with intravitreal injections administered at baseline and on days 2, 4 and 6. Natural ocular recovery was allowed for another 7 days. Interocular differences (IOD) in spherical equivalent refraction (SER) and ocular biometrics were compared.</p><p><strong>Results: </strong>After 7 days of lens wear, all drug groups exhibited lower myopia progression than the control group. Lofexidine showed potent and consistent myopia-inhibiting effects. The IOD in SER, vitreous chamber depth (VCD) and axial length (AL) were significantly reduced at three doses compared with PBS control (all p < 0.05). Metaraminol and cirazoline exhibited significant efficacy mainly at medium and high doses. All three α-AR modulators alleviated choroidal thinning at both 30 and 300 nmol doses. During recovery, all treatment groups trended toward emmetropia, without significant differences from the PBS group.</p><p><strong>Conclusions: </strong>This first head-to-head in vivo comparison of three subtypes of α-AR modulators in the chick LIM model demonstrates the potent myopia-suppressive effects of α2-AR agonist lofexidine at low dose. α1-AR agonist metaraminol required a distinct threshold dose to achieve efficacy and blockade of α2-AR with cirazoline may counteract anti-myopic protection. These findings provide crucial subtype-specific preclinical insights for the rational development of future drugs for myopia.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208439","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 Visual Impact of Uncorrected Astigmatism in Eyes Fitted with Dual Focus Myopia Control Lenses.","authors":"Dawn Meyer, Matt Jaskulski, Martin Rickert, Myhanh Nguyen, Paul Chamberlain, Arthur Bradley, Pete Kollbaum","doi":"10.1007/s44402-026-00204-2","DOIUrl":"https://doi.org/10.1007/s44402-026-00204-2","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify the impact of uncorrected astigmatism in myopic eyes fitted with dual focus (DF) myopia control contact lenses.</p><p><strong>Methods: </strong>The right eyes of 10 young adult myopes were corrected with standard single vision (SV, Proclear 1 day, CooperVision, Inc.) and DF (MiSight 1 day, CooperVision, Inc.) contact lenses. SV and DF contact lens powers were determined from SV over-refractions and any ocular astigmatism was corrected using cylindrical trial lenses. Visual acuity and subjective vision were measured through added cylindrical trial lenses (0.00DC, 0.75DC, 1.25DC, 1.75DC and 2.25DC) with spherical equivalent adjustments. With the 2.25D astigmatic lenses, spherical trial lenses were also used to focus the front edge, centre and back edge of the interval of Sturm. Data were analysed using linear mixed-effects regression models.</p><p><strong>Results: </strong>High illumination visual acuity was similar for both lens types (zero astigmatism model-estimated intercept: -0.25 logMAR for SV; -0.24 logMAR for DF), and visual acuity decreased linearly with increasing astigmatism, similarly with both SV (0.27 logMAR/D) and DF (0.23 logMAR/D) lenses. Under low room illumination and in the absence of astigmatism, SV acuity was slightly superior to DF (mean logMAR -0.03 and +0.06 for SV and DF, respectively) and the rate of visual acuity decline with increasing astigmatism was less for DF (0.21 logMAR/D) than for SV lenses (0.26 logMAR/D; p = 0.04). Subjective quality of vision ratings were higher for SV lenses compared to DF lenses (model-estimated intercept: 93 vs. 86). Quality of vision ratings decreased linearly with increasing astigmatism at nearly identical rates for both lens types (~19 rating units/D). LogMAR acuity and subjective ratings were similar when the edges or the centre of the interval of Sturm were focused.</p><p><strong>Conclusion: </strong>Uncorrected astigmatism had an almost identical impact on visual acuity and vision quality in eyes fitted with DF myopia control and SV contact lenses.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198837","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 Custom Ocular Prosthesis on Self-esteem, Appearance and Quality of Life in Adults: A Prospective Study.","authors":"Vijaya K Gothwal, Tarjani V Dave, Yashwant G Marupakula, Dharani Tripuraneni","doi":"10.1007/s44402-026-00210-4","DOIUrl":"https://doi.org/10.1007/s44402-026-00210-4","url":null,"abstract":"<p><strong>Purpose: </strong>To assess changes in self-esteem, appearance and vision-related quality of life (VRQoL) following custom ocular prosthesis wear and its relationship with demographic characteristics and clinical factors.</p><p><strong>Methods: </strong>Three hundred and twenty-one first-visit adults (≥18 years of age) visiting the ocular prosthesis clinic for a custom ocular prosthesis between 2019 and 2021 completed four questionnaires: the self-esteem rating scale (SERS), facial appearance (FA) of the negative physical self-scale, Impact of Vision Impairment (IVI) scale (measure of VRQoL) and Derriford Appearance scale before and 3-4 months following ocular prosthesis wear. Rasch analysis optimised the measurement properties of questionnaires and generated interval-level estimates of the corresponding latent trait at both time points, anchoring the instruments to their baseline measurement characteristics. Primary outcome measures included changes in self-esteem, FA, VRQoL and social anxiety and avoidance. Correlational analysis determined associations between outcome measures and sociodemographic variables.</p><p><strong>Results: </strong>Mean age was 34.6 years (71% male). The majority were married (49%), working (60%) and had obtained at least secondary school education (77%). Minor modifications in questionnaires enabled adequate fit to the Rasch model. Following prosthesis wear, patients reported significantly large improvements in self-esteem (effect size: 0.88; p < 0.001), FA (0.94; p < 0.001), VRQoL (0.36-0.38; p < 0.001) and social anxiety and avoidance (0.93; p < 0.001). Females reported larger improvements in self-esteem (p = 0.02), while younger age was related to greater levels of social anxiety and avoidance (r = -0.15, p = 0.01). Participants reported a significant reduction in feelings of shame, sadness, preoccupation with hiding the disfigured eye, insecurity, inferiority and anger after ocular prosthesis wear.</p><p><strong>Conclusions: </strong>Custom ocular prosthesis wear is associated with significant large improvements in psychological functioning and VRQoL in adults. Additionally, it reduces social anxiety and avoidance. These findings support early prosthetic rehabilitation as a critical component of holistic anophthalmic care, particularly in younger patients at higher psychosocial risk.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198814","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":"Digital Eye Behaviour Phenotypes and Their Association with Axial Length and High Myopia in Chinese Adolescents.","authors":"Jiawei Xu, Hua Zhao, Chengjun Liu, Bin Cao","doi":"10.1007/s44402-026-00205-1","DOIUrl":"https://doi.org/10.1007/s44402-026-00205-1","url":null,"abstract":"<p><strong>Purpose: </strong>Screen exposure is often summarised as total duration, although this aggregate measure obscures important differences in how devices are used. This study sought to identify digital eye behaviour phenotypes and evaluate their associations with axial length (AL) and high myopia.</p><p><strong>Methods: </strong>A school-based cross-sectional study of 898 high school students in Shanghai was conducted. The four-class latent class analysis (LCA) used eight questionnaire-derived indicators of device use. Regression models evaluated exploratory cross-sectional associations with AL and high myopia, adjusting for demographic, familial, sleep and school covariates.</p><p><strong>Results: </strong>LCA identified four phenotypes differing by screen purpose, weekday-weekend patterns, viewing distance and visual-break behaviour. The entertainment-dominant, weekend-heavy phenotype (11.5%) had the highest entertainment ratio and weekend concentration. The lower-screen, study-oriented phenotype (15.4%) had the lowest total screen time and the highest study ratio. Adjusted AL point estimates relative to the reference phenotype ranged from -0.25 to -0.02 mm. The lower-screen, study-oriented phenotype had nominally higher odds of high myopia (adjusted odds ratio = 1.90; 95% CI, 1.06 to 3.39; p = 0.03). This association was attenuated in the attention-check-correct subset. Mean AL was 24.83 ± 1.20 mm; mean worse-eye spherical equivalent was -3.35 ± 2.36 D and 115 students (12.8%) had high myopia.</p><p><strong>Conclusions: </strong>Four digital eye-behaviour phenotypes captured multidimensional exposure heterogeneity beyond total duration. These profiles provide a framework for prospective studies of whether behaviour combinations relate to refractive development beyond total duration.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198785","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":"Effect of Lens Shape and Thickness on the Accommodative Range in Adults Aged 40-50 Years.","authors":"Evelien Janssen, Sarah Hershko, Barbara K Pierscionek, Carina Koppen, Jos J Rozema","doi":"10.1007/s44402-026-00206-0","DOIUrl":"https://doi.org/10.1007/s44402-026-00206-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the influence of lens shape on accommodative range in individuals aged 40-50 years, a period during which accommodative loss becomes clinically relevant.</p><p><strong>Methods: </strong>Accommodation was measured in 40 participants aged 40-50 years using the RAF Convergence Rule and the Negative Lens Test. Crystalline lens geometry and power, as well as corneal power, axial length and anterior chamber depth, were assessed under cycloplegia using an autorefractor, Pentacam, Lenstar and Casia II OCT. Associations between accommodative range and lenticular parameters were analysed through correlation analysis, with and without corrections for age, sex and refractive error.</p><p><strong>Results: </strong>No significant correlation was observed between the lenticular dimensions and the accommodative range. The change in accommodative amplitude with age was correlated with corneal power and axial length. After correcting for sex and age, these latter two correlations were no longer significant. An additional correction for the spherical equivalent refractive error did not change this result.</p><p><strong>Conclusions: </strong>The geometry of the crystalline lens does not affect the accommodative range in early presbyopic eyes, suggesting that changes in baseline lens shape are not the primary contributor to presbyopia. In contrast to expectations based on geometrical considerations, thicker or more curved lenses did not exhibit reduced accommodation.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187675","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":"Association Between Binocular Vision Disorders and Contact Lens Discomfort During Soft Contact Lens Wear: A Systematic Review.","authors":"Prithwis Manna, Ankit Raj, Ankita Kumari, Mark Willcox, Fiona Stapleton, James S Wolffsohn, Mukesh Kumar","doi":"10.1007/s44402-026-00203-3","DOIUrl":"https://doi.org/10.1007/s44402-026-00203-3","url":null,"abstract":"<p><strong>Purpose: </strong>To synthesise and critically evaluate the evidence regarding accommodative and binocular vision dysfunction systematically in relation to visual discomfort during soft contact lens wear in non-presbyopic individuals, and to examine the association between soft contact lens optical designs and objective measures of accommodation and vergence.</p><p><strong>Recent findings: </strong>A systematic search of PubMed, Scopus and Google Scholar (inception to 13 May 2026) identified 403 records, of which 23 studies met the inclusion criteria, including 16 randomised trials, five non-randomised studies and two cross-sectional studies. Evidence demonstrated consistently that centre-distance multifocal, dual-focus and extended-depth-of-focus (EDOF) soft contact lenses increased accommodative lag (1.0-1.7 D), accommodative variability (0.36-0.86 D) and near exophoria (1.8-2.4Δ), while reducing accommodative facility (4.5-9 cpm) compared with single-vision designs. Similar effects were observed across a broad range of myopic refractive errors (-1.00 to -9.25 D). In contrast, centre-near multifocal lenses were associated with lower accommodative lag and reduced near exophoria relative to single-vision and centre-distance multifocal designs. Toric soft contact lenses demonstrated improvements in near point of convergence (NPC) and subjective visual performance. Across studies evaluating symptomatic wearers, binocular vision dysfunction was reported in 23%-48% of participants and was associated with significantly greater symptom severity, as reflected by higher Ocular Surface Disease Index (OSDI) and Convergence Insufficiency Symptom Survey (CISS) scores (p < 0.001). Collectively, these findings indicate that alterations in accommodative and vergence function associated with specific soft contact lens optical designs may be associated with visual discomfort during lens wear. Given the high prevalence of binocular vision dysfunction among symptomatic contact lens wearers, a brief binocular vision screening, including accommodative facility, near heterophoria, NPC and fusional vergence testing may assist clinicians in identifying underlying causes of visual discomfort and guiding targeted management strategies.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187752","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}