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

{"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}

{"title":"Efficacy and Safety of Specialty-Designed Orthokeratology Lenses with a Reduced Corneal Central Zone Moulding Area in Children with Low Myopia: A Prospective, Randomised, Controlled Trial.","authors":"Qi Zhang, Changliang Peng, Yishu Wang, Chen Chu, Tao Yu, Jianfeng Zhu","doi":"10.1007/s44402-026-00194-1","DOIUrl":"https://doi.org/10.1007/s44402-026-00194-1","url":null,"abstract":"<p><strong>Purpose: </strong>Orthokeratology (ortho-k) is widely used for myopia control in children. Specialty-designed ortho-k lenses with a modified corneal reshaping profile may offer an alternative approach for myopia control through altered lens design characteristics. This study aimed to evaluate the efficacy and safety of this lens design in slowing axial elongation and myopia progression in children with low myopia, and to explore ocular structural predictors of the treatment response.</p><p><strong>Methods: </strong>This prospective, randomised, double-masked clinical trial enroled 80 children aged 8-14 years with low myopia (-1.00 to -3.00 D). Participants were randomly assigned (1:1) to wear either standard-design ortho-k lenses or specialty-designed ortho-k lenses designed to produce a reduced corneal central zone moulding area for 12 months. Axial length was measured at baseline and at 1, 3, 6, 9 and 12 months. The primary outcome was the change in axial length (ΔAL) over time. Secondary outcomes included changes in spherical equivalent refraction (SER) and adverse events.</p><p><strong>Results: </strong>The mean base curve squared (BC²), representing the estimated corneal central zone moulding area, was 8.73 ± 5.59 mm² in the test group, which was significantly smaller than that in the control group (11.21 ± 5.17 mm^2; t = 2.685, p = 0.008). Compared with the control group, the values of ΔAL at month 6 (0.103 ± 0.14 vs. 0.047 ± 0.11, p = 0.01), month 9 (0.141 ± 0.16 vs. 0.060 ± 0.12, p = 0.002) and month 12 (0.168 ± 0.20 vs. 0.077 ± 0.14, p = 0.004) were significantly smaller. No significant difference in severe adverse events was observed between the two groups.</p><p><strong>Conclusion: </strong>Orthokeratology effectively slowed axial elongation in children with low myopia. Specialty-designed ortho-k lenses with altered corneal reshaping characteristics demonstrated greater inhibition of axial elongation.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2500113706, retrospectively registered on 2 December 2025.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122848","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":"Age-Related Changes in Differential Corneal Thickness and Their Correlation with With-the-Rule and Against-the-Rule Corneal Astigmatism.","authors":"Dandan Liao, Xiangjie Zeng, Shuangfeng Liang, Chunyang Zhou","doi":"10.1007/s44402-026-00200-6","DOIUrl":"https://doi.org/10.1007/s44402-026-00200-6","url":null,"abstract":"<p><strong>Objective: </strong>To analyse age-related changes in differential corneal thickness (DCT) and curvature (DCC) between the two principal meridians and between the vertical and horizontal meridians, and to examine their relationship with with-the-rule (WTR) and against-the-rule (ATR) astigmatism.</p><p><strong>Methods: </strong>This retrospective study included 400 patients (100 per age group: 6-20, 21-40, 41-60 and ≥61 years). The left eye was analysed for each participant. Corneal thickness (CT) and curvature (CC) were measured within the central 3 mm zone along the two principal, vertical and horizontal meridians. The mean differential thickness (DCT1) and curvature (DCC1) between the two principal meridians, as well as the mean differential thickness (DCT2) and curvature (DCC2) between the vertical and horizontal meridians were calculated and compared across age groups. To account for axis orientation, power vector transformation was applied to DCC1, decomposing it into DCC1₀ (WTR/ATR component) and DCC1₄₅ (oblique component). Subgroup analyses restricted to WTR astigmatism were performed to control for axis orientation in the thickness analysis.</p><p><strong>Results: </strong>DCT1 decreased with age but showed no significant change in the WTR subgroup (p = 0.14), indicating the apparent decline was driven by age-related shifts in axis composition. DCT2 remained stable across age groups (p = 0.19). DCC1₀ decreased significantly with age, from -2.09 to -0.08 D (p < 0.05), while DCC1₄₅ did not change significantly (p = 0.30). DCC2 also decreased significantly with age (p < 0.05). No significant age-by-sex interactions were observed (all p > 0.05).</p><p><strong>Conclusions: </strong>After controlling for axis orientation in the WTR subgroup, DCT1 and DCT2 did not vary with age. The significant age-related decreases in DCC1₀ and DCC2 confirm that anterior CC changes are the primary drivers of the WTR-to-ATR astigmatic shift. These age-related changes were consistent between sexes.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122814","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":"Prevalence of Myopia in Europe: An Umbrella Review of Systematic Reviews and Meta-Analyses.","authors":"Miguel Angel Sanchez-Tena, Wei Pan, Weizhong Lan, Cristina Alvarez-Peregrina","doi":"10.1007/s44402-026-00195-0","DOIUrl":"https://doi.org/10.1007/s44402-026-00195-0","url":null,"abstract":"<p><strong>Purpose: </strong>Myopia is a growing public health concern worldwide. Although several systematic reviews and meta-analyses have evaluated its prevalence in Europe, findings remain inconsistent due to methodological differences. This umbrella review critically synthesised the available evidence and provided a pooled prevalence estimate based on non-overlapping primary studies.</p><p><strong>Methods: </strong>PubMed, Web of Science and Embase were searched systematically up to February 2026 for systematic reviews and meta-analyses reporting myopia prevalence in Europe. Methodological quality was assessed using AMSTAR 2. Overlap of primary studies across reviews was mapped, and a secondary random-effects meta-analysis including only unique studies was performed to avoid double counting. Subgroup analyses were conducted by age group and refractive assessment method (cycloplegic vs non-cycloplegic).</p><p><strong>Results: </strong>Five systematic reviews and meta-analyses were included. Four recent reviews demonstrated high methodological quality according to the AMSTAR 2 criteria. Considerable overlap of primary studies was identified across reviews, supporting the need for an umbrella review approach. The secondary meta-analysis included 40 unique primary studies comprising 200,127 participants and 33,153 myopia cases. Most included studies defined myopia as a spherical equivalent refraction of ≤-0.50 D, although some studies used alternative thresholds. The pooled prevalence of myopia among European children and adolescents was 12% (95% CI: 9-15%). Age-stratified analyses showed a prevalence of 8% (95% CI: 6-12%) in children <12 years and 23% (95% CI: 13-33%) in individuals ≥12 years of age. Studies using non-cycloplegic refraction reported slightly higher prevalence estimates (14%) than those using cycloplegic refraction (12%); however, the difference was not significant (p = 0.45).</p><p><strong>Conclusion: </strong>Approximately one in eight European children and adolescents is myopic, and prevalence increases substantially with age. Differences related to refractive assessment methodology should be interpreted cautiously, as no significant differences were observed between cycloplegic and non-cycloplegic studies.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083762","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":"Who Gets Referred for What? Large Scale Analysis of Clinical, Socioeconomic and Demographic Drivers Within Electronic Optometry Referrals.","authors":"Abdullah F Alotaibi, Matthew Jinkinson, Ketan R Parmar, Glen P Martin, Philip B Morgan, Robert A Harper","doi":"10.1007/s44402-026-00198-x","DOIUrl":"https://doi.org/10.1007/s44402-026-00198-x","url":null,"abstract":"<p><strong>Objective: </strong>To provide the first large-scale analysis of Electronic Eyecare Referral System (EeRS) data, examining referral patterns, demographic differences and geographical variation by socioeconomic deprivation overall.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of 104,190 referrals submitted via the National Health Service (NHS) England North West's EeRS between June 2022 and May 2024. Descriptive analyses summarised referral destinations and putative optometric diagnoses. Chi-squared tests with Bonferroni correction examined sex differences across referral endpoints. Multivariable logistic regression assessed associations between deprivation (Index of Multiple Deprivation (IMD) decile) and condition-specific referral odds, adjusting for age, sex and ethnicity.</p><p><strong>Results: </strong>Most referrals were directed to ophthalmology in secondary care (71.6%). The most common referral endpoints were glaucoma (12.2%), other medical retina (11.6%) and YAG laser capsulotomy (11.1%). Referrals within primary care accounted for 18.2%, predominantly referrals to general practice (15.0%), while referrals to glaucoma referral filtering comprised 3.0% of all referrals. Significant sex differences in referral distribution across several subspecialty endpoints were observed (p < 0.003). Deprivation-related and geographical variation was evident, with higher odds of cataract (Odds Ratio (OR) per IMD decile 0.97, 95% CI 0.97-0.98) and paediatric binocular vision referrals (OR 0.96, 95% CI 0.94-0.98) in more deprived areas, whereas vitreoretinal, adult binocular vision and other medical retina referrals were more common in less deprived areas.</p><p><strong>Conclusions: </strong>Electronic optometry referrals showed substantial variation by condition and area-level socioeconomic context. Linking referral data to deprivation measures may help identify variation in referral activity and support strategies to improve eye examination uptake and optimise referral pathways.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067281","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}