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

{"title":"Astigmatism Types Effects on Internal Astigmatism and Compensation in Children: Hong Kong Children Eye Study.","authors":"Ka Wai Kam, Arnold S H Chee, Yuzhou Zhang, Erica Shing, Alvin L Young, Clement C Tham, Chi Pui Pang, Li Jia Chen, Jason C S Yam","doi":"10.1007/s44402-026-00190-5","DOIUrl":"https://doi.org/10.1007/s44402-026-00190-5","url":null,"abstract":"<p><strong>Introduction: </strong>Astigmatism is highly prevalent among schoolchildren in Hong Kong. Children demonstrate distinct patterns of internal astigmatism (IA) to compensate for corneal astigmatism (CA). This study aims to investigate the associations among astigmatism subtypes, IA and compensation factors (CF) in schoolchildren with a minimum of 0.5 dioptre(D) of refractive astigmatism (RA).</p><p><strong>Methods: </strong>RA was assessed following cycloplegia and classified into simple myopic (SMA), compound myopic (CMA), mixed (MA), simple hyperopic (SHA) and compound hyperopic astigmatism (CHA) based on the location of the focal planes. IA was calculated through vector components. CF were determined by dividing IA by CA in respective vectors.</p><p><strong>Results: </strong>A total of 4027 children, mean age 7.6 ± 1.0 years, were analysed. CMA (n = 633) was associated with male sex (p = 0.02), older age (β = -0.143, 95% Confidence Interval (CI) -0.201 to -0.085, p < 0.001), longer axial length (β = -0.143, 95% CI -0.158 to -0.129, p < 0.001) and deeper anterior chamber (β = -0.019, 95% CI -0.022 to -0.015, p < 0.001). CHA (n = 1207) showed the greatest mean IA value whereas CMA and SMA (n = 104) had the smallest value. Some 56.1% of those with CHA displayed over-compensation as opposed to 7.9% and 7.6% in CMA and SMA, respectively. To the contrary, 55.6% and 52.9% of CMA and SMA had under-compensation of their astigmatism, compared with 8.2% in CHA.</p><p><strong>Conclusion: </strong>Children with hyperopic astigmatism over-compensate for their CA, whereas children with myopia are more likely to exhibit a greater amount of RA because of lower IA and under-compensation. The differential compensation between hyperopic and myopic children may play a determining role in the development of myopia in school children.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019518","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":"Comparison of Wavefront-optimised Refraction Determined Pre- and Post-cycloplegia in Individuals with Down Syndrome.","authors":"Ann M Morrison, Lan Chi Nguyen, Lauren V Schneider, Maureen D Plaumann, G Lynn Mitchell, Jason D Marsack, Heather A Anderson","doi":"10.1007/s44402-026-00189-y","DOIUrl":"10.1007/s44402-026-00189-y","url":null,"abstract":"<p><strong>Purpose: </strong>To compare metric-optimised refractions determined from wavefront aberration measures with the COAS-HD wavefront aberrometer pre- and post-dilation and the resultant visual acuity through each refraction in participants with Down syndrome (DS).</p><p><strong>Methods: </strong>Twenty-one adults (mean age = 31 ± 9 years) and 21 children (mean age = 11 ± 4 years) with DS had wavefront aberrations measured pre- and post-dilation. A mathematical programme applied a large range of sphero-cylindrical refractions to the uncorrected wavefront error for each eye and calculated the resultant visual Strehl ratio (VSX). The refraction providing the single best value of VSX was identified from both the pre- and post-dilation analyses. Participants returned for a second visit for in-office tests of visual acuity while viewing through pre- and post-dilation-optimised refractions. For analysis, refractions were converted to M, J₀ and J₄₅ vectors and the total dioptric difference between pre- and post-dilation refractions calculated. Visual acuity pre- and post-dilation was compared using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>The estimated median total dioptric difference (Q1, Q3) between pre- and post-dilation refractions was 0.66 D (0.47, 1.11) in the right and 0.80 D (0.44, 1.12) in the left eyes of children and 0.90 D (0.41, 1.43) and 0.74 D (0.42, 1.32) in the right and left eyes of adults. The M-value was significantly more hyperopic in both children and adults post-dilation (p = 0.001). There was no significant difference in the monocular or binocular distance visual acuity between the pre- and post-dilation acuity measures in adults and children (p > 0.14).</p><p><strong>Conclusions: </strong>Dilation status significantly affected the metric-optimised refractive outcomes but did not affect visual acuity significantly in adults and children with DS. While the median difference between pre- and post-dilation measures was around 0.66-0.90 D, some individual differences reached multiple dioptres, suggesting that dilation upon an initial visit is still important for a subset of individuals.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axial Length to Corneal Curvature Ratio is Insufficient for Detecting Pseudomyopia in Children: A Multi-Cohort Study.","authors":"Huyen T Bui, Dirk J van Hemert, Tianli Peng, Shuhui Yang, Hai-Yen T Nguyen, Hannah Noor, Siofra C Harrington, Sander C M Kneepkens, Lene A Hagen, Craig S Walker, Edward Mallen, Matthew Cufflin, Rigmor C Baraas, Neema Ghorbani-Mojarrad, Olavi Pärssinen, Louise Terry, Shi-Ming Li, Amanda N French, Jason C Yam, Caroline C W Klaver, Jeremy A Guggenheim","doi":"10.1007/s44402-026-00185-2","DOIUrl":"https://doi.org/10.1007/s44402-026-00185-2","url":null,"abstract":"<p><strong>Purpose: </strong>Pseudomyopia is an accommodative disorder that can be identified by the difference between pre- and post-cycloplegic refractive error. The current study aimed to evaluate whether the axial length to corneal curvature (AL/CR) ratio, in conjunction with non-cycloplegic refractive error, can reliably identify pseudomyopia in children, thus avoiding the need for cycloplegia.</p><p><strong>Methods: </strong>Refractive error and biometry data from longitudinal studies based in Denmark (n = 645; age 7-17 years) and China (Anyang Childhood Eye Study; n = 2487; age 6-13 years) were used to train separate linear mixed models for children of European or East Asian ancestry, respectively, with AL/CR ratio as outcome and cycloplegic spherical equivalent refractive error (SER), age and sex as predictors. The models could be used to calculate the AL/CR 95% prediction interval in a child of known age, sex and non-cycloplegic SER; if the child's AL/CR fell below the lower limit of the AL/CR 95% prediction interval, then the child was classified as pseudomyopic. The European and East Asian models were externally validated using data from participants of the Ireland Eye Study (IES; n = 92) and Sydney Myopia Study (SMS; n = 686) cohorts, and the Hong Kong Children Eye Study (HKCES; n = 9519) and Vietnam (n = 1165) cohorts, respectively.</p><p><strong>Results: </strong>The European model demonstrated moderate detection accuracy for pseudomyopia: sensitivity = 0.82 (IES) and 0.81 (SMS); specificity = 0.75 in both cohorts. By contrast, the East Asian model performed poorly: sensitivity = 0.22 (HKCES) and 0.13 (Vietnam); specificity = 0.99 in both cohorts.</p><p><strong>Conclusions: </strong>Despite moderate diagnostic performance in European samples, the current AL/CR-based models lacked sufficient accuracy for screening and performed poorly in East Asian children, suggesting that AL/CR is not a reliable non-cycloplegic marker of pseudomyopia. Further studies incorporating additional ocular biometric parameters and employing a more rigorous definition of pseudomyopia may build on these initial findings.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003302","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":"Living Well with Keratoconus: Implications for Person-Centred Eye Care.","authors":"Eilin Lundanes, Espen Andreas Brembo, Lena Leren, Vibeke Sundling","doi":"10.1007/s44402-026-00188-z","DOIUrl":"https://doi.org/10.1007/s44402-026-00188-z","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence from patient-reported outcome measures demonstrate that keratoconus adversely impacts quality of life. However, qualitative research exploring the life experiences of persons living with keratoconus remains limited. Gaining insights to these experiences is valuable for eye health care professionals, as it enhances understanding about life beyond the clinic and supports person-centred care. The aim of this study is to explore how persons living with keratoconus experience vision-related quality of life.</p><p><strong>Methods: </strong>This study employed a qualitative design, using semi-structured individual interviews with persons with keratoconus guided by a framework of vision-related quality of life. Participants were recruited through self-selection in response to an invitation posted on Keratokonus Norge (Facebook group) and through purposive sampling by optometrists in private practice. Data were analysed using inductive Systematic Text Condensation.</p><p><strong>Results: </strong>Thirteen participants with keratoconus, six women and seven men, representing all age decades from 20 to 70 years, were interviewed. All participants had been diagnosed with keratoconus for at least 5 years and represented a range of medical treatment histories and optical correction modalities. The inductive analysis through Systematic Text Condensation resulted in five main concepts: (1) A good life with keratoconus, (2) Contact lenses - a game changer, (3) Persistent symptoms and emotional impact, (4) Coping strategies and (5) Eye care is key.</p><p><strong>Conclusion: </strong>Although keratoconus affects daily functioning and vision-related quality of life, participants' experiences show that living well with the condition is possible through appropriate eye care, personal acceptance and the use of various coping strategies. These insights provide valuable perspectives for person-centred care and offer reassurance and encouragement for individuals newly diagnosed.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957792","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":"Effects of Spatial Ambient Illumination on Pupil Diameter and Visual Acuity.","authors":"Pham Hong Duong, Pham Hoang Minh, Nguyen Tri Duc, Nguyen Van Quan, Hoang Thu Thuy, Tran Minh Anh, Duong Thi Giang","doi":"10.1007/s44402-026-00187-0","DOIUrl":"https://doi.org/10.1007/s44402-026-00187-0","url":null,"abstract":"<p><strong>Purpose: </strong>Although chart luminance is carefully standardised in visual acuity (VA) testing, the luminance and spatial distribution of the surrounding illumination are less clearly defined. This study investigated how central luminance, peripheral field illumination and ambient room illumination influence pupil diameter and VA during small-field visual tasks.</p><p><strong>Methods: </strong>A programmable light-emitting diode (LED) illumination system was developed to manipulate central chart luminance, peripheral field illumination and ambient room illumination surrounding a central Early Treatment of Diabetic Retinopathy Study (ETDRS) chart independently. VA and pupil diameter were measured in 201 participants under multiple lighting conditions. Relationships among illumination parameters, pupil diameter and VA were evaluated using paired comparisons and regression analysis.</p><p><strong>Results: </strong>Increasing central luminance from 20 to 640 cd/m² reduced mean pupil diameter from 5.93 to 3.61 mm and improved VA from 0.02 to -0.13 logMAR. At constant central luminance (160 cd/m²), increasing peripheral field extent and ambient illumination produced additional pupil constriction and modest improvements in VA. Changes in pupil diameter were significantly associated with changes in VA (r = 0.67, p < 0.001).</p><p><strong>Conclusion: </strong>The spatial distribution of illumination significantly influences pupil diameter and VA, even when central chart luminance remains unchanged. Both peripheral field illumination and ambient room lighting were associated with pupil constriction and modest improvements in VA. These findings highlight the importance of spatial illumination in visual performance and suggest that ambient lighting conditions should be considered in visual acuity assessment and visual environment design.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957795","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":"Differences in Contrast Sensitivity Measurement With Letters and Gratings.","authors":"Assunta Di Vizio, Riccardo Rolandi, Alessandro Duse, Giulia Carlotta Rizzo, Roberta Daini, Marialuisa Martelli, Marco Barbieri, Gabriele Vestri, Silvia Tavazzi, Fabrizio Zeri","doi":"10.1007/s44402-026-00191-4","DOIUrl":"https://doi.org/10.1007/s44402-026-00191-4","url":null,"abstract":"<p><strong>Purpose: </strong>To compare contrast sensitivity function (CSF) measurements obtained with either Gabor gratings or Sloan letters using the same LCD-based device, to evaluate the reliability of letter-based CSF testing and to establish normative values in a young healthy population.</p><p><strong>Methods: </strong>A new computerised chart for psychophysical measurements in clinical settings was used (Vision Chart, CSO). Three related investigations were conducted. In Study 1 (n = 44), a randomised crossover design measured monocular CSF with gratings and letters at four spatial frequencies (1.5, 3.0, 6.0 and 12.0 cycles/degree) in dominant and non-dominant eyes. In Study 2 (n = 31), letter-based CSF was measured in the dominant eye across three consecutive trials and reassessed in a second session to evaluate intra- and intersession reliability. A two-way repeated-measures ANOVA evaluated stimulus type and spatial frequency effects in Study 1. Reliability in Study 2 was assessed using repeatability and agreement statistics. In Study 3, normative data were derived by pooling findings from Studies 1 and 2 (dominant eyes n = 75; non-dominant eyes n = 44).</p><p><strong>Results: </strong>In Study 1, CSF measurements were significantly higher for gratings than for letters at all spatial frequencies tested in both eyes (Holm-corrected p < 0.001). Significant main effects of stimulus type and spatial frequency, as well as a significant interaction, were observed (all p < 0.001). Grating measurements clustered near the upper measurable limit, indicating a ceiling effect. In Study 2, letter-based CSF showed good within-session reliability (intraclass correlation coefficient (ICC) 0.69-0.88) and moderate-to-good test-retest reliability (ICC 0.56-0.75). Bland-Altman analysis indicated good repeatability. Normative percentiles for letter-based CSF were established.</p><p><strong>Conclusions: </strong>CSF outcomes depend on stimulus type when measured on the same investigated LCD system. Grating stimuli are susceptible to ceiling effects, whereas letters demonstrate good reliability and provide clinically useful normative data, supporting their use in routine functional vision assessment.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932469","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":"Contamination Rates and Economic Evaluation of Reusing Medicated, Preservative-Free, Single-Use Eye Drops.","authors":"Ahmed M Y Osman, Ahmed Gamal Tahoun, Nourhan Abdalkader, Mohammed Aljarousha, Alaa Mahmoud Zawrah, Hanzada T Nour El-Din","doi":"10.1007/s44402-026-00184-3","DOIUrl":"https://doi.org/10.1007/s44402-026-00184-3","url":null,"abstract":"<p><strong>Introduction: </strong>Preservative-free eye drops are commonly packaged in single-dose vials, so it is recommended to discard the vial upon first use, even if some solution remains. This study aims to examine the risk of infection associated with repeated use of these eye drops and evaluate the economic impact of such practice.</p><p><strong>Methods: </strong>Eighty vials were divided into three test groups and one control group (C). Group A comprised sterile installation; in group B the vial tip touched the volunteers' eyelid while in group D the volunteers' fingertip touched the vial tip. The vials were then recapped and kept in the refrigerator for 24 h. Next, the remaining solution in each vial was cultured, as well as group C vials and contamination and infection rates were compared between each group against the control. The infection probabilities were applied to a decision tree model to compare the cost of reusing the vials.</p><p><strong>Results: </strong>Group A pathogenic contamination was detected in four out of 20 individual vials tested (20%), p = 0.11, while group B had only a single contamination (5%), p > 0.99; finally, group D demonstrated five contamination incidents (25%), p < 0.04. This was the only group that showed a significantly higher rate of infection (pathogenic rate) as an indicator of the importance of the instillation technique. The cost and savings ratio ranged from Egyptian Pounds (EGP) 20.1 to EGP 20.4 for the base case (i.e., assuming that both opportunistic and pathogenic bacteria were infectious, while commensal bacteria were not) according to the different instillation techniques.</p><p><strong>Conclusion: </strong>Within this hypothetical economic model, reusing single-use vials within 24 h demonstrated potential cost savings independent of the instillation technique. Further real-world studies are warranted as actual experienced patients are expected to provide pragmatic conclusions.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922536","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":"Migraine and Reduced Binocular Vision in Adolescents: A Cross-Sectional Study.","authors":"Hanne Mari Schiøtz Thorud, Cecilie Onshuus Bjørset, Inger Helene Hallan Minsås, Stuart J Gilson, Trine Langaas, Tina R Johansen, Gro Horgen, Lene A Hagen, Hilde R Pedersen, Ellen Svarverud, Rigmor C Baraas","doi":"10.1007/s44402-026-00180-7","DOIUrl":"https://doi.org/10.1007/s44402-026-00180-7","url":null,"abstract":"<p><strong>Purpose: </strong>Headache disorders and untreated vision problems are both common among adolescents. This study aimed to examine headache characteristics in adolescents and potential associations with untreated vision problems.</p><p><strong>Methods: </strong>As part of a school vision testing programme, 230 Norwegian adolescents aged 15.5 ± 0.5 years (mean ± SD) completed a structured questionnaire including questions that allowed for classification according to The International Classification of Headache Disorders, 3rd edition. The Wong-Baker FACES Pain Rating Scale was used for registration of pain intensity. The questionnaire also registered general health, pain/discomfort in the upper body, screen time and physical activity.</p><p><strong>Results: </strong>A total of 190 (83%) adolescents reported experiencing headache, while frequent tension-type headache was classified in 42 (18%) and migraine in 25 (11%) of the adolescents. Adolescents with an untreated vision problem [n = 74 (32%)] were more likely to be classified with a migraine diagnosis (20 vs. 8%, p = 0.009) and reported more arm pain/discomfort (68 vs. 49%, p = 0.007) compared with adolescents with normal vision. Adolescents classified with migraine more often had an untreated vision problem due to reduced binocular vision (37 vs. 16%, p = 0.008), reduced accommodation amplitude (15 vs. 2%, p = 0.009) and reduced near point of convergence (19 vs. 2%, p < 0.001), compared with adolescents without a migraine diagnosis. Adolescents who reported arm pain/discomfort more often had reduced near point of convergence (12 vs. 3%, p = 0.02), compared with adolescents without arm pain/discomfort.</p><p><strong>Conclusions: </strong>The results of this study indicate an association between migraine characteristics, upper body musculoskeletal pain and reduced near visual function. However, as the study design prevents causal interpretation, further research is needed. A comprehensive eye examination may offer significant benefits and should be considered an integral part of the management strategy for patients with headaches.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890115","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":"Objective Assessment of Intermittent Exotropia Magnitude and Control Using the Binocular Eye Alignment Monitor.","authors":"Erin C Jenewein, Christopher J Morris, Mitchell Scheiman, Tara L Alvarez","doi":"10.1007/s44402-026-00179-0","DOIUrl":"https://doi.org/10.1007/s44402-026-00179-0","url":null,"abstract":"<p><strong>Purpose: </strong>To compare an objective assessment of intermittent exotropia (IXT) control and deviation size using the binocular eye alignment monitor (BEAM) to standard clinical assessments.</p><p><strong>Methods: </strong>IXT control and deviation size were evaluated in 15 participants aged 8-35 years. Participants completed two visits that included a 90-min BEAM eye movement recording at a distance (6 m) to evaluate distance IXT size and control of the deviation objectively. IXT control was assessed using the mean of three measurements of the IXT Office Control Scale, and the deviation size was measured with the prism alternate cover test (PACT).</p><p><strong>Results: </strong>The mean IXT control score in the IXT participants was 2.2 ± 1 points, which was weakly correlated with the percentage of time strabismic as measured by the BEAM (Spearman's correlation coefficient = 0.29; p = 0.30). Distance PACT and mean BEAM deviation size demonstrated a moderate, non-significant association (ρ = 0.47, p = 0.08). BEAM measurements were consistently smaller than PACT measurements. IXT distance control (0.44; 95% CI: 0.04-0.80; p = 0.03) and the median deviation size measured by the BEAM (z = -2.1, p = 0.03) were significantly different between visits 1 and 2 (z = -2.1, p = 0.03); however, the percentage of time deviated (BEAM) was not significantly different between the two study visits (z = -0.63; p = 0.50).</p><p><strong>Conclusions: </strong>The notable differences in control observed with the BEAM compared to current clinical measures suggest that office control scores and prolonged objective monitoring may capture different aspects of IXT control. Objective monitoring over extended periods may be a valuable complement to traditional clinical assessment in both research and clinical 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":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889016","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":"Residual Astigmatism With Toric Versus Light-Adjustable Intraocular Lenses: A Power-Vector Model of the Effect of Alignment Uncertainty.","authors":"Henry Bair","doi":"10.1007/s44402-026-00166-5","DOIUrl":"10.1007/s44402-026-00166-5","url":null,"abstract":"<p><strong>Purpose: </strong>To identify when postoperative cylinder adjustment with a light-adjustable lens (LAL) is expected to reduce residual astigmatism more than a toric intraocular lens (IOL), whose effect depends on axis placement and rotational stability.</p><p><strong>Methods: </strong>Power-vector analysis was used to derive a closed-form expected squared residual cylinder for a non-toric IOL, toric IOL and LAL. The toric model included a cylinder-dependent axis-error term and a cylinder-independent RMS floor; the LAL model included a cylinder-independent floor up to a platform-specific deliverable ceiling. Parameters were informed by published biometric, toric-alignment and LAL data. Closed forms were checked by Monte Carlo simulation, with sensitivity analyses across residual floors and axis-error distributions.</p><p><strong>Results: </strong>The toric RMS residual comprised a floor plus a misalignment term that increased with corneal cylinder and combined axis-error variance. The LAL residual remained near its floor within its deliverable range. With floors of 0.30 and 0.29 D for toric and LAL, respectively, the LAL advantage was essentially the toric misalignment penalty. At 2.00 D of cylinder, RMS reduction was 0.17, 0.77 and 1.06 D at alignment standard deviations of 5°, 15° and 20°, respectively. Below about 2 D on a stable platform, the gain was generally smaller than 0.50 D; with high cylinder and high combined alignment uncertainty, it could exceed a 0.50-D cylinder step. The comparison was robust across plausible floors and the non-Gaussian error distributions tested. Above the LAL ceiling, LAL monotherapy leaves residual astigmatism from a cylinder beyond the deliverable range.</p><p><strong>Conclusion: </strong>Postoperative adjustability has the most astigmatic value when cylinder and alignment uncertainty are both high. For routine eyes, lens choice is more likely to be governed by cost, treatment burden and target refraction than by residual cylinder accuracy alone.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"1142-1146"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805410","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}