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

{"title":"Saccadic Reaction Times and Computational Modelling Reveal Heterogeneous Binocular Summation in Glaucomatous Visual Fields.","authors":"Ashwini Venkat Reddy Chanakya, Johan Jm Pel, Ronnie George, Peter Bremen","doi":"10.1007/s44402-026-00100-9","DOIUrl":"https://doi.org/10.1007/s44402-026-00100-9","url":null,"abstract":"<p><p>Binocular summation enhances visual performance. This enhancement may be disrupted in visual conditions that introduce interocular asymmetries, e.g., glaucoma. Reaction times provide a direct index of visual processing efficiency. However, they have not been studied systematically under binocular conditions in glaucoma. This investigation quantified monocular and binocular saccadic reaction times (RTs) across the visual field using eye-movement perimetry (EMP), compared binocular summation between healthy and glaucoma participants and evaluated correspondence with computational models. Saccadic RTs were measured monocularly/binocularly at 54/56 visual-field locations in seven healthy participants and eight participants with glaucoma of varying severity. Each location was tested with six to ten repetitions under low (74%) and high (155%) contrast conditions. Data were analysed using reciprobit plots, estimation statistics and linear mixed-effects modelling. Binocular RTs were compared with statistical facilitation (Race model) and variance-weighted neural integration predictions. Healthy participants consistently demonstrated a binocular advantage, with RTs faster by ~20 ms relative to monocular viewing, closely matching statistical facilitation predictions. Glaucoma participants showed greater heterogeneity, ranging from preserved summation (~40 ms faster than monocular) to binocular RT being slower than the fastest monocular RT. Computational modelling indicated that most glaucoma cases were compatible with statistical facilitation, but some exhibited deviations suggestive of inhibitory interactions, monocular dominance or faster responses than predicted by statistical facilitation. Binocular RTs provide a sensitive index of visual processing and reveal heterogeneous binocular summation mechanisms in glaucoma. EMP under binocular conditions offers a promising approach for studying functional visual impairment beyond traditional monocular testing.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864890","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":"Retrospective Comparative Analysis of Myopia Control Efficacy: Orthokeratology, Defocus-Incorporated Soft Contact Lenses and Their Combination with 0.01% Atropine in Chinese Children and Adolescents.","authors":"Jiaqi Wang, Yi-Ming Guo, Junhan Wei, Guanchen Liu, Yijin Han, Lu Ye","doi":"10.1007/s44402-026-00104-5","DOIUrl":"https://doi.org/10.1007/s44402-026-00104-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacies of orthokeratology (OK), defocus-incorporated soft contact lenses (DISC) and their combination with 0.01% atropine in slowing myopia progression in Chinese children and adolescents.</p><p><strong>Methods: </strong>This retrospective study analysed 336 myopic participants aged 6-15 years, including 144 males (42.9%) and 192 females (57.1%). The participants were divided into 4 groups: OK (n = 89), OK combined with 0.01% atropine (OKA, n = 84), DISC (n = 82) and DISC combined with 0.01% atropine (DISCA, n = 81). Axial length (AL) was measured at baseline and after 3, 6, 9 and 12 months. Differences in AL changes among the groups were compared and subgroup analyses were conducted based on the initial age and spherical equivalent to explore the effectiveness of interventions across age and refractive error.</p><p><strong>Results: </strong>After 12 months, OKA had less axial elongation than OK (-0.08, 95% CI [-0.11, -0.05]), DISC (-0.07, 95% CI [-0.10, -0.04]) and DISCA (-0.06, 95% CI [-0.10, -0.04]). Subgroup analyses revealed significant differences between the OK and OKA groups at three follow-up time points in the aged 6-9 year (0.04, 95% CI [0.003, 0.08], 0.05, 95% CI [0.008, 0.09], 0.08, 95% CI [0.04, 0.12]) and 0 to -2.75 dioptre (D) subgroups (0.04, 95% CI [0.001, 0.08], 0.06, 95% CI [0.02, 0.09], 0.10, 95% CI [0.06, 0.13]), with significant differences being observed at 12 months in the aged 10-15 year (0.07, 95% CI [0.01, 0.13]) and -3.00 to -6.00 D subgroups (0.08, 95% CI [0.01, 0.14]). Significant differences between OK and DISC were limited to the 0 to -2.75D subgroup at 3 months (0.05, 95% CI [0.009, 0.09]) and 12 months (0.04, 95% CI [0.001, 0.08]).</p><p><strong>Conclusion: </strong>OKA demonstrated superior myopia control efficacy than OK, DISC and DISCA. The synergistic effect of 0.01% atropine combined with OK was more pronounced in younger age and low myopia subgroups. Notably, DISC showed significantly better efficacy than OK in children with low 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":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849155","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":"Reversibly Desensitising the Human Retina to Delay Saccadic Reaction Time for Diagnostic Prototyping.","authors":"Suzanna M L Janssens, Johan J M Pel, Peter Bremen","doi":"10.1007/s44402-026-00090-8","DOIUrl":"https://doi.org/10.1007/s44402-026-00090-8","url":null,"abstract":"<p><p>Glaucoma is a progressive retinal disease and a leading cause of blindness. Early detection is crucial but challenging due to subtle symptoms and the burden of standard clinical tests. Standard Automated Perimetry, though the gold standard for detecting glaucomatous functional deficits, is time-consuming and demanding for patients. Eye-movement perimetry (EMP) offers a promising alternative by using saccadic reaction times as indirect markers of visual-field integrity. However, EMP development is impeded by the need for large trial numbers due to inherent reaction-time variability and ethical constraints on patient involvement in early-stage prototyping. To address these limitations, this study employed photopigment bleaching to develop a method for generating reaction-time delays typically associated with glaucoma. Specific retinal regions in healthy participants were desensitised transiently using non-harmful light patterns displayed on a standard monitor. Participants performed an oculomotor task with targets presented at locations across the visual field either with or without desensitisation. Saccadic reaction times (target onset to movement onset) were measured to quantify the behavioural effect of desensitisation. Localised desensitisation significantly increased the mean (50-130 ms) and variability (20-60 ms) of saccadic reaction times in desensitised regions, and could lead to detection deficits resembling scotomas. These effects were more pronounced at greater eccentricities, consistent with retinal heterogeneity in photoreceptor density and receptive-field size, and decayed within hundreds of milliseconds (250-600 ms). This approach offers a safe, transient and spatially specific method for inducing reaction-time delays across the visual field in healthy individuals, enabling efficient prototyping of EMP paradigms prior to patient testing.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849165","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":"Tear Dynamics During Fenestrated Scleral Lens Wear: A Pilot Study.","authors":"Damien Fisher, Asif Iqbal, David Alonso-Caneiro, Michael J Collins, Stephen J Vincent","doi":"10.1007/s44402-026-00102-7","DOIUrl":"https://doi.org/10.1007/s44402-026-00102-7","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a Scheimpflug-based image analysis technique to quantify tear exchange during scleral lens wear and investigate fluid reservoir tear dynamics during fenestrated lens wear.</p><p><strong>Methods: </strong>Nine healthy participants wore a scleral lens (KATT™, Capricornia Contact Lenses) with a single 0.3 mm diameter limbal fenestration in one eye for 90 min. Central (0-2.5 mm from the corneal apex) and peripheral (-1.0 to 0 mm from the scleral spur) stromal cornea oedema was measured using optical coherence tomography. Scheimpflug images were obtained during lens wear at multiple time points following the application of sodium fluorescein to the bulbar conjunctiva. These images were exported and annotated manually to select the region of interest (the fluid reservoir) from which the intensity of each pixel was extracted to provide a measure of fluorescent intensity (in arbitrary units [AU] on a scale of 0-255) throughout lens wear across the central 10 mm.</p><p><strong>Results: </strong>The coefficient of repeatability for central fluid reservoir intensity measurements was 7 AU (on a scale of 0-255 AU). Fluid reservoir fluorescent intensity varied with measurement location (p < 0.001), being greater towards the periphery (4 and 5 mm from the centre). On average, intensity differences between the peripheral and central fluid reservoir diminished within 10 min of sodium fluorescein application. Two patterns of tear dynamics were observed and were classified as low and high flow. Low flow participants (n = 6) exhibited greater central (3.72× more) and peripheral (2.25× more) corneal oedema, but the difference was not statistically significant.</p><p><strong>Conclusions: </strong>The ingress and mixing of sodium fluorescein within the fluid reservoir stabilised between central and peripheral locations after 10 min of fenestrated scleral lens wear. Two patterns of tear dynamics were observed (low and high flow), with low flow participants exhibiting greater corneal oedema. Future research utilising the developed technique may provide further insights into tear exchange during scleral lens wear with different fenestration sizes and configurations.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849246","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 Role of Visual Perception in Reading Across Fonts and Similar Words in Children with Reading Disabilities.","authors":"Marc Argilés, Cristina Rovira-Gay, Liat Gantz, Luis Pérez-Mañá, Bernat Sunyer-Grau, Joan Gispets","doi":"10.1007/s44402-026-00094-4","DOIUrl":"https://doi.org/10.1007/s44402-026-00094-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined associations between visual perceptual skills and reading performance in children aged 6-12 years, focusing on reading similar words and words in different fonts.</p><p><strong>Methods: </strong>Forty-six children (mean age 8.3 ± 0.9 years; 24 and 22 with and without reading disabilities, respectively) were assessed. Visual discrimination, visual memory and form constancy were examined with the TVPS-3 (Test of Visual Perceptual Skills, 3rd version). Reading speed was measured using the TALEC test (Test d'Anàlisi de la Lectoescriptura en Català). Additionally, the reading speed and accuracy of reading lists of similar words, as well as words presented in six different fonts, were recorded.</p><p><strong>Results: </strong>Children with reading disabilities scored significantly lower for visual discrimination, visual memory and form constancy (all p < 0.01) and showed slower reading speed and higher error rates for both word list tasks (all p < 0.01). In this group, visual discrimination and visual memory correlated significantly with reading similar words, while visual memory correlated significantly with reading different fonts. In children without reading disabilities, form constancy correlated strongly with both tasks and TALEC performance (p = 0.002).</p><p><strong>Conclusion: </strong>Visual perceptual skills influence reading performance differently in children with and without reading disabilities. While these skills are important to assess, low scores on visual perception tests such as the TVPS-3 do not necessarily predict reading between similar words and different fonts, highlighting the need for a more comprehensive evaluation in clinical optometry.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849274","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":"Is My Eye Examination Really Evidenced-Based?","authors":"Mark Rosenfield","doi":"10.1007/s44402-026-00098-0","DOIUrl":"https://doi.org/10.1007/s44402-026-00098-0","url":null,"abstract":"","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849193","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":"Incidence and Risk Factors of Refractive Error in Children in Spain: CISViT Project.","authors":"Alba Galdón, Laura Guisasola, Mariam El Gharbi, Valldeflors Vinuela-Navarro, Joan Pérez-Corral, Núria Vila-Vidal","doi":"10.1007/s44402-026-00086-4","DOIUrl":"https://doi.org/10.1007/s44402-026-00086-4","url":null,"abstract":"<p><strong>Background: </strong>The incidence of refractive errors (RE), particularly myopia, has increased in recent years, presenting significant geographic variations. This prospective longitudinal cohort study aims to assess the incidence of RE in a school-based cohort in northeastern Spain and identify associated risk factors.</p><p><strong>Methods: </strong>The study followed up 1189 children with an ~1-year interval (mean age: 8.74 years at visit 1 and 10.00 years at visit 2) from a school-based cohort in northeast Spain (2021-2024). RE was measured using an autorefractometer and retinoscopy without cycloplegia. A preliminary questionnaire was used to collect data on potential risk factors such as visual habits and socioeconomic status.</p><p><strong>Results: </strong>The spherical equivalent (SE) at the initial visit was +0.29 ± 0.03 D, decreasing to +0.14 ± 0.04 D at follow-up. The prevalence of myopia increased from 12.3% at baseline to 17.1% at follow-up. A total of 56 incident cases were identified, corresponding to a cumulative incidence of 5.4%. In multivariable logistic regression, baseline SE ≤ +1.00 D was associated with a clinically significant myopic shift (odds ratio (OR) = 1.67, 95% CI 1.29-2.16; p < 0.001). Parental myopia was strongly associated with the outcome (maternal: OR = 23.36, 95% CI 8.33-65.49; p < 0.001; paternal: OR = 4.25, 95% CI 1.74-10.38; p < 0.001). Lower outdoor exposure was also associated with higher odds of a clinically significant myopic shift (low vs. high: OR = 9.33, 95% CI 5.89-14.79; p < 0.001). Parental education was not significantly associated, whereas parental unemployment was associated with higher odds of myopic shift in the fully adjusted model.</p><p><strong>Conclusions: </strong>The incidence of myopia and progression of RE (change in SE) in this school-based cohort of northeastern Spanish schoolchildren was significant over 1 year. Factors such as paternal/maternal myopia, reduced outdoor time and both paternal and maternal unemployment were associated with a higher risk of a clinically significant myopic shift (ΔSE ≤ -0.50 D).</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849160","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 Evolving Landscape of Vision Rehabilitation: Current Status and Future Directions.","authors":"Amritha Stalin, Andrew Miller, Hilde van der Aa, Simona Turco, Tammy Labreche, Stefania Fortini, Carlotta Lalla, Filippo Amore, Michael Crossland, Gianni Virgili, Benjamin Thompson, Ruth van Nispen","doi":"10.1007/s44402-026-00088-2","DOIUrl":"https://doi.org/10.1007/s44402-026-00088-2","url":null,"abstract":"<p><p>Vision impairment is increasingly recognised as a complex condition shaped not only by ocular pathology but also by cognitive, psychological, social and environmental factors that influence participation and quality of life. In line with the United Nations Convention on the Rights of Persons with Disabilities and the International Classification of Functioning, Disability and Health, contemporary vision rehabilitation frameworks adopt a biopsychosocial perspective that extends beyond treatment of the eye condition alone toward holistic support to improve the lives of individuals with vision loss. An overview of the effectiveness and future directions of multidisciplinary vision rehabilitation in clinical practice is presented, and a summary of the findings concerning the international standards of vision rehabilitation, focusing on adults. Furthermore, some examples of achievements in emerging fields are presented, such as neuroplasticity and visual system recovery, technological interventions and psychosocial support, including their future directions. Multidisciplinary models are widely supported but remain difficult to implement because of limited resources, workforce constraints and differences in culture and health policy. Overcoming these barriers is critical to expanding and strengthening multidisciplinary vision rehabilitation. The evidence highlights the need for implementation-focused research, closer collaboration across disciplines and core outcome measures that capture participation, mental health and quality of life, not just impairment. The overview also points to the importance of structured models that integrate neurorehabilitation (artificial intelligence-based) technology and mental healthcare while adapting to regional and cultural contexts. Embedding multidisciplinary vision rehabilitation within health systems is both a clinical necessity and a prerequisite for advancing global commitments to inclusion and equity for people with vision impairment. As population ageing and global demographic change are expected to increase the absolute numbers of adults with vision loss, strengthening collaboration between research, clinical practice and service delivery will be essential to further improve the quality of life of individuals with vision loss.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826301","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 Rise of Independent Prescribing by Optometrists in Wales 2020-2024: Number of Practices, Drugs and Costs.","authors":"David Grant Robinson, Hannah Thomas, Barbara Ryan","doi":"10.1007/s44402-026-00097-1","DOIUrl":"https://doi.org/10.1007/s44402-026-00097-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the growth and prescribing patterns of community-based independent prescribing (IP) optometrists managing acute eye conditions in Wales between 2020 and 2024, a period that saw the introduction and subsequent commissioning of National Health Service (NHS) funded acute eye care with prescribing in primary care optometry throughout Wales.</p><p><strong>Methods: </strong>Monthly prescribing data from NHS Wales Shared Services Partnership were analysed for all IP optometrists in Wales from 1st February 2020 to 31st January 2024. Data included drug name, British National Formulary classification, quantity, cost and health board location. Descriptive and correlational statistics were used to assess prescribing activity, regional distribution and cost trends.</p><p><strong>Results: </strong>The number of active IP optometry practices increased from eight in February 2020 to 68 in January 2024, with 20,980 prescriptions (49,162 items) issued at a total cost of £339,426. Corticosteroids, anti-infective agents and ocular lubricants were the most frequently prescribed drug classes. Ocular lubricants accounted for 34.0% of the total spend. Regional variation in prescribing activity was observed, with positive correlations between the number of active practices and both prescription volume and cost. Generic prescribing accounted for 47.0% of prescriptions, lower than national averages.</p><p><strong>Conclusion: </strong>NHS commissioning of IP services in Wales has significantly expanded the role of optometrists in managing acute eye conditions in primary care. The findings highlight the potential of IP optometry to reduce pressure on general medical practice and hospital eye services. Further research is needed to evaluate clinical outcomes, cost-effectiveness and the broader therapeutic use of ocular lubricants in acute 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":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826310","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":"Smartphone Addiction and Dry Eye Disease in Children: Exploring the Mediating Role of Sleep Disturbance.","authors":"Ruixin Li, Qing He, Yafang Zheng, JunTing He, Lin Liu, Ruihua Wei","doi":"10.1007/s44402-026-00072-w","DOIUrl":"https://doi.org/10.1007/s44402-026-00072-w","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the relationship between dry eye disease (DED) and smartphone addiction, and to explore the mediating effect of sleep disturbance on this relationship.</p><p><strong>Methods: </strong>A total of 375 participants were recruited and surveyed using demographic questionnaires, 5-Item Dry Eye Questionnaire (DEQ-5), Sleep Disturbance Scale for Children (SDSC) and Smartphone Addiction Scale-Short Version (SAS-SV). Additionally, they were assessed for DED using the Keratograph 5M and corneal fluorescein staining. Regression analysis and the bootstrap method were used to investigate the influence of sleep disturbance on the relationship between DED and smartphone addiction.</p><p><strong>Results: </strong>Among the 375 participants, 247 (65.9%) spend less than 2 h on screens, while 66 (17.6%) spend 2-4 h and 62(16.5%) spend more than 4 h. The effects of smartphone addiction, dry eye and sleep disturbance were positively correlated with one another (all p < 0.01). Model fit indices were all within acceptable ranges, indicating an adequate fit to the data. The total effect of smartphone addiction on dry eye is significant (β = 0.30, p = 0.002). Further, smartphone addiction has a significant indirect effect on the dry eye via sleep disturbance (β = 0.04, p = 0.045). The results suggest that the severity of DED symptoms was affected by smartphone addiction directly and sleep disturbance indirectly.</p><p><strong>Conclusions: </strong>A significant correlation was found between DED and smartphone addiction. Moreover, sleep disturbance was a mediator of the relationship between DED symptoms and smartphone addiction, which aligns with the direct and indirect effects identified in the results.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795688","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}