Optometry and vision science : official publication of the American Academy of Optometry最新文献

{"title":"Quality of refractive error care in Malaysia: An unannounced standardized patient study.","authors":"Duratul Ain Hussin, Ling Lee, Suit May Ho, Nor Azizah Ismail, Juhaida Zahri, Arini Hanim Alias, Putri Nurliyana Zulkafli, Mageswary Lapchmanan, Puteri Norhidayah Nordin, Diana Mohamed, Azrin Esmady Ariffin, Anthea Burnett","doi":"10.1002/ovs2.70100","DOIUrl":"10.1002/ovs2.70100","url":null,"abstract":"<p><strong>Purpose: </strong>Quality of refractive error services is an outcome for effective refractive error coverage for people requiring vision correction. Optical legislation has regulated optometrists and opticians providing refractive care in Malaysia since 1991. This study aims to evaluate the quality of refractive error care (Q.REC) in Malaysia by estimating the proportion of dispensed spectacles meeting optimal spectacle quality standards and factors associated with spectacle quality.</p><p><strong>Methods: </strong>Using the Q.REC Protocol, 18 recruited unannounced standardized patients (USPs) from Klang Valley, Malaysia received a baseline refraction and completed training on refractive care standards. Dispensed spectacles were compared with the baseline refraction to determine the proportion meeting quality indicators, and associations between practice characteristics and spectacle quality were analyzed using logistic regression. USPs also reported visual symptoms.</p><p><strong>Results: </strong>Eighty-six practices comprising 257 visits and 253 spectacles were assessed. The analysis indicated that the quality of dispensed spectacles were 30.8% (95% CI: 24.9%-37.4%) and 78.8% (95% CI: 73.7%-83.4%) for optimal and adequate indicators, respectively. The most frequent error observed was the cylindrical axes outside of the tolerance limits (56.6%). Focimetry was inversely associated with quality, with spectacles more likely to be suboptimal when performed (OR 0.48, 95% CI: 0.27-0.85, and p = 0.013). USPs who experienced symptoms with their dispensed spectacles were 41.1% of emmetropes, 21.4% of simple myopes, and 26.6% of astigmats/myopic astigmats.</p><p><strong>Conclusions: </strong>Despite established optical legislation, refractive error care quality in Malaysia appears suboptimal. This study underscores the importance of strengthening regulatory mechanisms to address the possibility of unqualified refractive care practitioners, adherence to standard operating procedure and continuous education for higher-quality refractive care in Malaysia.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 9","pages":"e70100"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019538","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":"Huge AI-linked increases in submissions and effects on triaging.","authors":"David B Elliott","doi":"10.1002/ovs2.70105","DOIUrl":"https://doi.org/10.1002/ovs2.70105","url":null,"abstract":"","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 9","pages":"e70105"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027490","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":"Near and distance vergence facility provides complementary clinical information in concussion-related convergence insufficiency.","authors":"Mitchell Scheiman, Tara L Alvarez, Farzin Hajebrahimi, Melissa Noble, Matthew L Robich, Rebecca Baro, Josie A Bachman, Christina L Master, Arlene Goodman","doi":"10.1002/ovs2.70097","DOIUrl":"10.1002/ovs2.70097","url":null,"abstract":"<p><strong>Purpose: </strong>To compare near and distance vergence facility testing in adolescents and young adults with concussion-related convergence insufficiency and evaluate changes following office-based vergence/accommodative therapy (OBVAM).</p><p><strong>Methods: </strong>This secondary analysis of the CONCUSS randomized clinical trial evaluated vergence facility at near (40 cm) and distance (4 m) using a 12Δ base out/3Δ base in prism flipper. Participants aged 11-25 years with concussion-related convergence insufficiency were randomized to immediate or 6 weeks delayed OBVAM. Vergence facility was assessed at baseline, outcome time 1 assessment (after 12 therapy sessions for the immediate group and 6 weeks of watchful waiting for the delayed group), and outcome time 2 assessment (after both groups completed 16 therapy sessions). Agreement between near and distance vergence facility classifications was evaluated, and treatment-related changes were compared between groups.</p><p><strong>Results: </strong>Of the 106 enrolled participants, 102 completed all study visits. At baseline, the near and distance vergence facility classifications demonstrated substantial discordance. Among 101 participants with both measures available, 49 demonstrated reduced distance vergence facility despite normal near vergence facility, whereas only two showed the opposite pattern (Cohen's κ = 0.12; p < 0.0001). Vergence facility improved following therapy in both treatment groups, with larger early improvements in the immediate-treatment group.</p><p><strong>Conclusions: </strong>Near and distance vergence facility testing provided complementary rather than interchangeable clinical information in adolescents and young adults with concussion-related convergence insufficiency. Both measures improved following vergence/accommodative therapy, supporting consideration of both testing distances in clinical assessment.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 9","pages":"e70097"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922597","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":"Artificial intelligence in a commercial clinical decision support tool: Insightful or dominated by heuristics?","authors":"Jack Phu, Henrietta Wang","doi":"10.1002/ovs2.70098","DOIUrl":"10.1002/ovs2.70098","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically evaluate a commercially available myopia risk artificial intelligence (AI) supported clinical decision support screening tool in pediatric patients and to determine the additional insights provided by the AI component.</p><p><strong>Methods: </strong>Eighteen synthetic images of myopic-appearing and 18 non-myopic-appearing pediatric 'subjects' were generated using three commercially available AI software (ChatGPT, Google Gemini, and Reve), and uploaded to Magnifeye, which performs AI-guided image analysis and assessment of environmental risk factors to evaluate output myopia risk. The first analysis was image-based, where we assessed each image but modified the environmental risk to the lowest possible and the highest possible level. The second analysis was scenario-based, where we assessed two 'subjects', and systematically evaluated all combinations of environmental risk.</p><p><strong>Results: </strong>There were significant differences in eye aspect ratio between myopic and non-myopic groups (squinting). Under low environmental risk conditions, both myopic and non-myopic groups were regarded as low overall risk of myopia. Conversely, high environmental risk led to a high overall risk of myopia. Systematically adjusting the environmental risk factors demonstrated a gradual uptitration of overall myopia risk. Family history of myopia and proximity behaviors represented the highest environmental risk. A non-myopic appearance moderated the overall myopia risk, decreasing it slightly in some situations.</p><p><strong>Conclusions: </strong>A simple clinical problem with a small number of outcomes in a low-stakes situation could be crudely reverse-engineered. This highlights the notion that some clinical issues may not necessarily require a complex AI system, which may be no more effective than conventional clinical heuristics.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 9","pages":"e70098"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003334","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":"Advances in low vision research: An upcoming feature issue.","authors":"David B Elliott","doi":"10.1002/ovs2.70095","DOIUrl":"https://doi.org/10.1002/ovs2.70095","url":null,"abstract":"","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 8","pages":"e70095"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805375","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":"Case series: The role of retinal ischemia in the pathogenesis and clinical manifestation of diabetic retinopathy.","authors":"Marina Guro, Henrietta Wang, Jack Phu, Kaitlyn A Sapoznik, Hamza Shah, Maggie L Zhang, Michael Kalloniatis","doi":"10.1002/ovs2.70090","DOIUrl":"10.1002/ovs2.70090","url":null,"abstract":"<p><strong>Purpose: </strong>To highlight retinal ischemia as an important component of diabetic retinopathy (DR) pathogenesis, a significant prognostic factor, and a driver of various DR complications, including neovascularization. We aim to describe the main features of ischemic areas that can be identified through fundoscopy, color fundus photography, optical coherence tomography (OCT), and OCT angiography and provide clinicians with a step-by-step approach to identifying prognostically unfavorable markers of DR and accurately staging DR to improve management and prevent severe proliferative DR.</p><p><strong>Case reports: </strong>Cases of DR with subtle but significant retinal findings that are not readily identifiable unless a systematic multimodal imaging approach is used. We emphasize the presence of retinal ischemia in each case and show how to identify retinal vascular nonperfusion and its complications.</p><p><strong>Conclusions: </strong>Advanced stages of DR may lack prominent fundus findings and may be easily misdiagnosed as milder DR without a comprehensive multimodal imaging diagnostic approach.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 8","pages":"e70090"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623306","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":"Outcomes of wavefront-guided scleral lenses in keratoconus patients.","authors":"Omar H Masoud, Clark Y Chang, Beeran B Meghpara, Zeba A Syed","doi":"10.1002/ovs2.70092","DOIUrl":"https://doi.org/10.1002/ovs2.70092","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the change in higher order aberrations (HOAs) and visual acuity with wavefront-guided scleral lenses (WFGSLs) in the management of patients with keratoconus.</p><p><strong>Methods: </strong>A total of 22 eyes from 13 patients with keratoconus were fit with WFGSLs utilizing a commercially available aberrometer to further reduce residual HOAs uncorrected via traditional scleral lenses (tSLs). The outcomes for total higher order root mean square (HORMS) and individual Zernike terms at various pupil sizes (maximal, 5 mm, 3 mm), best corrected visual acuity (BCVA), tomography, and subjective patient preference at the most recent visit, representing a minimum of 48 weeks of WFGSL adaptation, were compared to the prior traditional SLs.</p><p><strong>Results: </strong>WFGSLs resulted in significant reductions of HORMS and individual Zernike terms (Z7, Z8, Z11, Z17, and Z18) for all pupil sizes (p < 0.05 for all). When analyzing data from a 5 mm pupil, mean HORMS improved 53% (0.59 ± 0.30 μm vs. 0.28 ± 0.14 μm, p < 0.001). BCVA was significantly improved by 2 Snellen lines (0.18 ± 0.16 vs. -0.040 ± 0.090 logMAR, p < 0.001). All patients subjectively preferred WFGSLs over the traditional SLs. No adverse events were observed.</p><p><strong>Conclusions: </strong>WFGSLs provide effective management for residual HOAs as evidenced by the significant reductions observed in HORMS and individual Zernike terms (Z7, Z8, Z11, Z17, and Z18) for various pupil sizes. Correspondingly, WFGSLs significantly improve BCVA and are preferred over traditional SLs by all patients in this cohort. Therefore, WFGSL provides a valid alternative vision rehabilitation solution to help diminish the need for surgery in keratoconus patients who do not achieve adequate visual outcomes via traditional SLs.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 8","pages":"e70092"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763430","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":"Progressive binocular visual alterations associated with increasing myopic anisometropia in spectacle-corrected children.","authors":"Ningxin Dou, Xiaodan Dong, Jiayan Li, Yunfan Li, Jiaqi Chen, Guoming Zhang, Yanling Zhang","doi":"10.1002/ovs2.70093","DOIUrl":"https://doi.org/10.1002/ovs2.70093","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the severity-dependent pattern of accommodative and binocular visual alterations in spectacle-corrected children with myopic anisometropia, normal best-corrected visual acuity (BCVA), and no clinically significant binocular vision-related symptoms.</p><p><strong>Methods: </strong>This hospital-based cross-sectional study included 153 myopic anisometropic and 104 myopic isometropic children. Cycloplegic refraction, axial length, ocular dominance, accommodative function, fusional vergence, heterophoria, Worth Four-Dot Test responses, and stereoacuity were assessed. All binocular vision examinations were performed under full spectacle correction. Anisometropia severity was quantified using vector dioptric distance (VDD). Multivariable regression models were used to evaluate associations between VDD and selected accommodative and binocular visual outcomes.</p><p><strong>Results: </strong>With increasing anisometropia severity, amplitude of accommodation in the nondominant eye decreased from 10.73 ± 3.10 D in the mild group to 9.05 ± 3.12 D in the high group (p-trend = 0.007), and accommodative facility decreased from 8.3 ± 4.4 to 5.5 ± 4.4 cpm (p-trend = 0.005). Interocular accommodative imbalance increased progressively. The prevalence of clinically meaningful near esophoria increased from 5.9% to 33.3% (p-trend = 0.009) and reduced near base-in vergence increased from 10.2% to 42.9% (p-trend = 0.001). Near Worth Four-Dot diplopia increased from 13.7% to 28.0% (p-trend = 0.05). Near stereoacuity worsened progressively across severity strata (p-trend < 0.001). After adjustment for age, binocular mean spherical equivalent, and relevant binocular covariates, increasing VDD remained independently associated with greater interocular accommodative imbalance, reduced near base-in vergence, a higher likelihood of diplopia on the near Worth Four-Dot Test, a more esophoric near phoria value, and poorer near stereoacuity.</p><p><strong>Conclusions: </strong>Increasing myopic anisometropia was associated with a severity-dependent pattern of subclinical alterations in accommodative balance, ocular alignment, fusional vergence, sensory fusion, and stereoacuity in spectacle-corrected children with normal BCVA. These findings support a multifactorial interpretation involving accommodative, optical, vergence, and sensory factors; however, their relative contributions and causal sequence cannot be determined from this cross-sectional study. Longitudinal and interventional studies are needed to clarify the mechanisms and clinical significance of these alterations.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 8","pages":"e70093"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805348","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 longitudinal association between perceived stress and dry eye symptoms: A cross-lagged panel study.","authors":"Reut Ifrah, Liat Gantz, Avi Besser","doi":"10.1002/ovs2.70091","DOIUrl":"https://doi.org/10.1002/ovs2.70091","url":null,"abstract":"<p><strong>Purpose: </strong>Dry eye disease is a multifactorial condition in which symptom burden may reflect ocular surface alterations together with broader psychophysiological processes. Previous studies have reported associations between dry eye symptoms and psychological distress, but most relied on cross-sectional designs and could not clarify temporal directionality. This study examined the longitudinal association between perceived stress and dry eye symptoms using a two-wave cross-lagged panel design.</p><p><strong>Methods: </strong>Seventy-one young adults (60 females; mean age 22 ± 3 years) completed the Perceived Stress Scale-14 (PSS-14) and the Ocular Surface Disease Index (OSDI) at two time points approximately 7.5 months apart. The second assessment took place under conditions of heightened regional threat. Paired-samples t tests, Pearson correlations, bootstrap confidence intervals, and cross-lagged panel modeling were applied. The prespecified directional path from perceived stress at Time 1 to dry eye symptoms at Time 2 was evaluated using a one-tailed test; all other significance tests were two-tailed.</p><p><strong>Results: </strong>Both perceived stress and dry eye symptoms increased significantly over the approximately 7.5-month follow-up period. Perceived stress increased by 4.2 points, t(70) = 6.20, p < 0.001, dz = 0.74, and dry eye symptoms increased by 7.5 points, t(70) = 3.46, p < 0.001, dz = 0.41. Perceived stress and dry eye symptoms were positively associated within each wave and showed substantial rank-order consistency across waves. In the cross-lagged model, the prospective path from perceived stress at Time 1 to dry eye symptoms at Time 2 was small and positive (β = 0.18) but did not reach the conventional two-tailed significance threshold (p = 0.084); it reached statistical significance only under the prespecified directional one-tailed test (p = 0.042). The reverse cross-lagged path was small and not statistically significant (β = 0.09).</p><p><strong>Conclusions: </strong>These findings provide suggestive, but not confirmatory, evidence of a small prospective association between earlier perceived stress and later dry eye symptom burden in a sample of predominantly young adult women. However, the finding should be interpreted cautiously given the modest sample size, the two-wave design, and its dependence on a directional one-tailed test. Further longitudinal studies are needed.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 8","pages":"e70091"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687524","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":"Randomized comparison of lipid-containing and non-lipid-containing artificial tears on tear film dynamics over a 3-month period.","authors":"Jennifer E Ding, Anisha Pradhan, Dorothy K Ma, Andrea J FazioLiu, Sarah M Chang, Andrew D Graham, Devin J Leung, Ryan S Wu, Yixiu Zhou, Tatyana Svitova, Thao N Yeh, Meng C Lin","doi":"10.1002/ovs2.70084","DOIUrl":"10.1002/ovs2.70084","url":null,"abstract":"<p><strong>Purpose: </strong>To study the effects of a lipid-containing artificial tear (AT) and a non-lipid-containing AT on tear film dynamics over a 3-month period.</p><p><strong>Methods: </strong>Subjects with low lipid layer thickness were randomized to lipid-containing or non-lipid-containing ATs for 3 months. At each visit Ocular Surface Disease Index (OSDI), LipiView, non-invasive and fluorescein tear breakup times, tear lipid layer and aqueous film recordings with EasyTear View+, and corneal staining assessment were performed. Lipid layer thickness and tear thinning rate were calculated using custom LabView programs. Mixed effects models were used to analyze relationships among variables.</p><p><strong>Results: </strong>Thirty nine subjects completed the study. Mean EasyTear View+ lipid layer thickness with non-lipid-containing AT decreased from baseline (65.1 [61.0, 69.2] nm) to 3 months (58.0 [53.4, 62.7] nm, p = 0.012), whereas mean lipid layer thickness with the lipid-containing AT remained stable (baseline = 59.0 [53.6, 64.4] nm, 3 months = 62.4 [56.1, 68.7] nm, p = 0.30). There was a significant difference in lipid layer thickness change from baseline to 3 months between the lipid-containing (3.4 nm) and non-lipid-containing ATs (-7.1 nm, p = 0.014). Tear thinning rate with the non-lipid-containing AT was faster at 3 months (baseline = 3.01 [2.21, 3.81]%/sec, 3 months = 4.78 [3.62, 5.94]%/sec, p = 0.008), but remained stable with the lipid-containing AT (baseline = 2.84 [1.93, 3.76]%/sec, 3 months = 2.93 [2.15, 3.70]%/sec, p = 0.84). The increase in tear thinning rate from baseline was greater with the non-lipid-containing (1.77%/sec) than the lipid-containing AT (0.09%/sec, p = 0.019). Fluorescein tear breakup time with the non-lipid-containing AT remained stable at 3 months (4.70 [4.14, 5.25] sec) versus baseline (4.23 [3.48, 4.99] sec, p = 0.26), whereas fluorescein tear breakup time with the lipid-containing AT was longer at 3 months (6.33 [4.85, 7.82] sec) versus baseline (4.44 [3.66, 5.22] sec, p = 0.029). There were no significant changes in OSDI score, LipiView lipid layer thickness, non-invasive tear breakup time or corneal staining grade over the 3-month period.</p><p><strong>Conclusions: </strong>Patients with lipid deficiency may benefit from lipid-containing AT over the non-lipid-containing AT to stabilize tear lipid thickness and minimize tear thinning while increasing tear breakup time.</p><p><strong>Trial registration: </strong>This study was registered at ClinicalTrials.gov (#NCT05705518) on the date of January 20, 2023.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 7","pages":"e70084"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407871","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}