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

{"title":"A randomized clinical trial of full-time alternate patching therapy for intermittent exotropia in children.","authors":"Erin C Jenewein, Stephen P Christiansen, Yufeng Zhu, Raymond T Kraker, Adriana P Grigorian, Donny W Suh, Allison I Summers, Silvia Han, Bahram Rahmani, Katie S Connolly, Patricia L Davis, Jennifer H Fisher, Yasmin F Javed, Courtney L Kraus, Sudhi P Kurup, Stacy R Martinson, Morgan C Ollinger, Robert G Tauscher, Marilyn Vricella, Wesley T Beaulieu, Stacy L Pineles, Susan A Cotter, Jonathan M Holmes, Katherine K Weise","doi":"10.1002/ovs2.70015","DOIUrl":"10.1002/ovs2.70015","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether 3 months of prescribed full-time alternate patching is more effective than observation for intermittent exotropia (IXT) in children.</p><p><strong>Methods: </strong>We enrolled 73 children aged 3 to <9 years with mean IXT distance control score (3 measures) ≥2 points (on a 0-5 [phoria constant tropia] scale) with at least one score ≥3, 4, or 5 (indicating spontaneous XT over 30-s observation) and a distance exodeviation of 15-50 prism diopters (Δ) by prism and alternate cover test (PACT), with the near deviation not exceeding the distance by > 10Δ. Children were randomly assigned to 3 months full-time patching (all waking hours, 7 days per week, alternating eyes) or observation. The primary outcome was change in mean distance IXT control at 3 months.</p><p><strong>Results: </strong>Baseline mean (SD) distance control for children assigned to full-time patching (N = 36) and observation (N = 37) were 3.6 (0.9) and 3.6 (0.9) points; mean distance PACT was 27Δ (9) and 27Δ (8), respectively. The 3-month visit was completed by 33 (92%) of 36 and 35 (95%) of 37 children assigned to full-time patching and observation. Mean patching adherence was 4.1 h per day (95% CI: 2.8-5.5, N = 20) by participants who returned temperature sensor occlusion dose monitors and 7.4 h per day (95% CI: 5.8-8.9, N = 33) by review of at-home calendars and interviews with parent and child. At 3 months, children in the patching group had greater improvement in mean distance control than the observation group: 0.9 (1.3) versus 0.2 (1.1) points (difference = 0.62 points, 95% CI: 0.04-1.20, p = 0.04). There was also greater improvement in mean distance PACT: 6 (7) versus 2 (7) Δ, difference = 4Δ (95% CI: 1-8, p = 0.02).</p><p><strong>Conclusions: </strong>Three months of prescribed full-time alternate day patching improved distance control and magnitude of IXT in children 3-<9 years, despite mean adherence substantially less than the prescribed full-time regimen. Future studies should evaluate the durability of treatment effects and compare patching to other treatments.</p><p><strong>Trial registration: </strong>Clinicaltrials.Gov, registered 14 July 2022, NCT05462821.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70015"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611663","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":"Author's response.","authors":"Mark A Bullimore, Noel A Brennan","doi":"10.1002/ovs2.70035","DOIUrl":"https://doi.org/10.1002/ovs2.70035","url":null,"abstract":"","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70035"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635483","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":"Nonaxonal content of the circumpapillary retinal nerve fiber layer in experimental glaucoma.","authors":"Anish Kharal, Pratik Chettry, Nao Omi, Nimesh Bhikhu Patel","doi":"10.1002/ovs2.70038","DOIUrl":"10.1002/ovs2.70038","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the region-specific distribution of nonaxonal cells and capillaries within the circumpapillary retinal nerve fiber layer (RNFL) in a nonhuman primate experimental glaucoma model.</p><p><strong>Methods: </strong>Five rhesus macaques (age range: 4.5-9.0 years) with varying degrees of unilateral laser-induced experimental glaucoma were imaged with optical coherence tomography (OCT), euthanized and perfusion fixed for histological analysis. Eyes were enucleated, and six circumpapillary regions (60° apart), approximately 300-1000 µm from the optic disc margin, were dissected and prepared for serial block face scanning electron microscopy. A series of 400 images (0.098 µm/pixel) were obtained at 500 nm intervals to construct a volume of 200 × 200 × 200 µm. Inside the nerve fiber layer, nonaxonal nuclei and capillary lumen were manually outlined. The nearest vessel distance for each nonaxonal cell was determined as the Euclidean distance in 3-dimensional space from each nucleus center to the nearest capillary.</p><p><strong>Results: </strong>At endpoint, OCT circumpapillary RNFL thickness in the experimental eyes ranged between 49 and 99 µm (control: 103-111 µm). In control eyes, the distribution of nonaxonal cells at the six circumpapillary regions was nonuniform (F_5,24 = 4.05 and p < 0.01). However, the total cell count was similar between the two eyes (control: 858 ± 173, experimental: 960 ± 245, and p = 0.51), and for each region (p > 0.05). Although capillary volume was reduced in experimental eyes (p = 0.02), the capillary volume density was similar between control (0.58 ± 0.31%) and experimental eyes (0.58 ± 0.32% and p = 0.99). Correspondingly, the nonaxonal cells had a shorter vessel distance in experimental compared to control eyes (15.92 ± 4.89 μm, 18.61 ± 5.48 μm, and p = 0.05).</p><p><strong>Conclusions: </strong>The number of nonaxonal cells and capillary volume density in the circumpapillary RNFL are similar for stable glaucomatous eyes compared to the healthy eyes. Regional differences and changes in nonaxonal contribution to the nerve fiber layer thickness should be considered when assessing clinical RNFL thickness measures.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70038"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13156695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611468","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":"Reduced visual acuity disrupts fixational stability but fails to fully capture amblyopic eye movements.","authors":"Sunwoo Kwon, Julien C A Belen, Artashes Yeritsyan, Dennis M Levi","doi":"10.1002/ovs2.70047","DOIUrl":"10.1002/ovs2.70047","url":null,"abstract":"<p><strong>Purpose: </strong>Amblyopia is a neurodevelopmental disorder characterized by diminished visual acuity (VA) and aberrant fixational eye movements (FEMs), affecting both the amblyopic and fellow eyes. While previous studies have established a strong correlation between impaired VA and increased fixational instability (FI), whether this reflects a causal relationship-or a shared downstream consequence of cortical dysfunction-remains unclear. We sought to determine whether reduced VA alone is sufficient to alter FEMs in the absence of developmental abnormalities.</p><p><strong>Methods: </strong>To investigate whether reduced VA alone is sufficient to alter FEMs, we induced retinal defocus using convex lenses in neurotypical individuals (n = 5) and compared their FEM characteristics-microsaccade amplitude, latency, drift magnitude, and FI-with those of individuals with amblyopia (n = 7), under both monocular (nondominant eye only) and binocular viewing conditions. In addition to a control (0.0 logMAR), defocus was introduced using convex lenses to simulate interocular VA differences of 0.2, 0.4, 0.6, and 0.8 logMAR in both viewing conditions resulting in a total of 10 conditions.</p><p><strong>Results: </strong>Retinal defocus in neurotypical observers increased drift magnitude and FI during monocular viewing, partially reproducing amblyopic oculomotor behavior. However, microsaccade amplitude and latency remained unchanged across all defocus levels. No significant effects of defocus were observed during binocular viewing.</p><p><strong>Conclusions: </strong>Reduced VA is sufficient to increase FI but does not reproduce the broader oculomotor abnormalities characteristic of amblyopia. These data suggest that FI in amblyopia arises from additional neurodevelopmental mechanisms beyond visual cortex, likely involving higher-order visuomotor circuits.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70047"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694567","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 ocular accommodation throughout the day in children using 0.05% low-dose atropine versus controls: A pilot study.","authors":"Kaylin M Maxwell, G Lynn Mitchell, Ann M Morrison, Heather A Anderson","doi":"10.1002/ovs2.70011","DOIUrl":"10.1002/ovs2.70011","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this pilot study was to assess the effect of 0.05% low-dose atropine on ocular accommodation (amplitude and accuracy) and how its effect changed throughout the day.</p><p><strong>Methods: </strong>Sixteen children aged 6-16 years using 0.05% atropine and 16 controls not using atropine were enrolled. Monocular accommodative amplitude was measured objectively using a Grand Seiko WAM-5500 open field autorefractor (formerly manufactured by RyuSyo Industrial Co.) and subjectively using the push-up method. Accuracy of accommodation was measured using monocular estimation (MEM) retinoscopy. All measures were taken at three study visits over a single day to assess change over time. Measures of accommodative amplitude and accuracy were compared using a 2-way analysis of variance (ANOVA). Nonparametric analyses were performed to compare MEM retinoscopy using the Mann-Whitney U-test and Friedman's test.</p><p><strong>Results: </strong>Objectively measured accommodative amplitude was significantly lower in the 0.05% atropine group (morning: 5.99 ± 2.28D, midday: 6.17 ± 2.06D, afternoon: 7.08 ± 1.82D) compared to the control group (morning: 7.68 ± 1.59D, midday: 7.62 ± 1.93D, afternoon: 7.63 ± 1.48D) at the morning and midday visits (p = 0.01, 0.03). There was no difference between groups at the afternoon visit (p = 0.40). In the 0.05% atropine group, objectively measured amplitudes were greater at the afternoon visit compared to those of the morning and midday visits (p < 0.01). There were no significant differences throughout the day in the push-up amplitude of accommodation or MEM retinoscopy.</p><p><strong>Conclusions: </strong>When measured objectively, accommodative amplitude in children using 0.05% low-dose atropine was reduced compared to controls during the morning and midday visits and increased over the day reaching a level comparable to that of the control group by the afternoon visit. Common clinical measures of accommodative ability, including subjective amplitude of accommodation using the push-up test and accommodative accuracy using MEM retinoscopy, did not demonstrate these same differences.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70011"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597726","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":"Reduction of hyperopia and accelerated myopia progression in preschool children: A four-year longitudinal study.","authors":"Huaying Xu, Chenxi Zong, Jianing Pu, Xuejing Mi, Shimeng Bian, Zhen Zhou, Wei Chen, Yonghong Jiao","doi":"10.1002/ovs2.70028","DOIUrl":"10.1002/ovs2.70028","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between reduced hyperopia and the increased risk of myopia onset in preschool children aged 3-6 years.</p><p><strong>Methods: </strong>This study utilized data from the Beijing Hyperopia Reserve Research (BHRR) prospective cohort, including 941 children aged 3-6 years who completed baseline and 3-year follow-up assessments (2021-2024). Cross-sectional analyses compared ocular biometry among children with different baseline refractive statuses, followed by longitudinal analyses evaluating the relationship between reduced hyperopia and myopia onset. Children were categorized into pre-myopia and hyperopia groups based on spherical equivalent refraction (SER). The predictive ability of SER for myopia onset was evaluated using receiver operating characteristic analysis, with optimal cutoffs determined by the Youden index. Age-stratified (3-6 years) analyses identified age-specific SER thresholds.</p><p><strong>Results: </strong>The baseline cross-sectional analysis revealed that there were no significant differences in anterior chamber depth (ACD) or corneal radius (CR) in the pre-myopia group compared to the hyperopia group despite having a significantly lower SER (p < 0.001) and longer AL (p < 0.001). Over 3 years, both groups showed decreasing SER, increasing AL, and deepening anterior chambers (all p < 0.05). Furthermore, in the 5- and 6-year-old groups, the pre-myopia group demonstrated significantly higher rates of change in SER and AL compared to the hyperopia group (all p < 0.05). The optimal SER cut-off value for predicting myopia onset in preschool children was +0.90 D. This cut-off value showed a decreasing trend with age, corresponding to +1.04 D, +0.95 D, +0.87 D, and +0.82 D for children aged 3, 4, 5, and 6 years, respectively.</p><p><strong>Conclusions: </strong>Preschool children with lower levels of hyperopia, especially those aged 5 and 6, show a significantly higher rate of myopic drift, and AL growth compared to those with greater hyperopia. Enhanced early monitoring and interventions are essential to prevent excessive loss of hyperopia that may accelerate myopia development.</p><p><strong>Trial registration: </strong>The registration database and the registration number: Chinese Clinical Trial Registry: ChiCTR2000031142.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70028"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635502","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":"Assessment of eye movement endurance using the OculoMotor Assessment Tool: A replication study on young Indian adults.","authors":"Shrikant R Bharadwaj, PremNandhini Satgunam, Preetirupa Devi, Chang Yaramothu, Tara L Alvarez","doi":"10.1002/ovs2.70024","DOIUrl":"10.1002/ovs2.70024","url":null,"abstract":"<p><strong>Purpose: </strong>This replication study sought to determine (1) the frequency of horizontal/vertical saccades, vergence jumps, and horizontal/vertical vestibulo-ocular reflexes (VORs) elicited per minute in young Indian adults using the OculoMotor and Vestibular Endurance Screening (MoVES) protocol with the OculoMotor Assessment Tool (OMAT) and (2) the association between the participant's MoVES values and routine clinical binocular vision status.</p><p><strong>Methods: </strong>Two hundred twenty-two healthy participants (17-33 years) repeatedly generated the aforesaid eye movements using the OMAT as a target for 60 s. A subset (n = 75) also underwent binocular vision assessment using standard optometric protocols. Eye movement frequency of participants with a near point of convergence ≤ 6 cm, stereoacuity ≤ 70 arcsec, and BIVSS score ≤ 31 constituted the normative cohort.</p><p><strong>Results: </strong>Eye movement responses of 153 participants who formed the replication cohort showed a higher frequency in the last 30 s compared to the initial 30 s (p < 0.01). The overall frequency of vergence jumps was lower in those who failed these criteria, vis-à-vis, the pass cohort (p < 0.01). These values were lower than previously published data from USA (p ≤ 0.05), but the differences diminished when matched with participants in organized sports activities. The clinical binocular vision parameters did not show a strong correlation with oculomotor frequency (r ≤ 0.3).</p><p><strong>Conclusions: </strong>The endurance values of eye movements established here allow screening for oculomotor dysfunctions in young Indian adults. These values may be impacted significantly by the level of organized physical activity engaged by the participant. Routine binocular vision evaluation does not correlate with eye movement endurance values, reflecting the need for dedicated assessments of the latter functions using standardized techniques and tools.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70024"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611664","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":"Visual performance of phase alteration utilizing sub-elements lenses for potential myopia management.","authors":"Karen Lahav-Yacouel, Daniel Tilia, Darrin Falk, Jennie Diec, Jennifer Sha, Cathleen Fedtke, Klaus Ehrmann, Ravi C Bakaraju","doi":"10.1002/ovs2.70023","DOIUrl":"10.1002/ovs2.70023","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the visual performance (VP) of P.A.U.S.E. spectacle lenses (tests) against defocus incorporated multiple segments (DIMS; control).</p><p><strong>Methods: </strong>This randomized, single-masked study included 48 participants aged 18-41 years who wore five tests (T1, T2, T4, T5, T6) and DIMS. VP was assessed through the full-lens and inferior treatment zone. Full-lens visual-acuity (VA) based measurements comprised monocular high- and low-contrast VA (HCVA/LCVA) at 6 m and binocular HCVA at 6 m and 40 cm. Assessments through the treatment zone comprised HCVA at 40 cm and subjective ratings (1-10 scale) of near vision-clarity and ease-of-reading. VP was assessed after 3 days of wear (full-lens) using subjective ratings of vision-clarity, night-vision, vision-while-walking, eyestrain, overall-vision-satisfaction, and willingness-to-purchase (yes/no: based on vision and myopia management efficacy). Analyses were performed using linear mixed models and the X² test. Significance was set at 5%.</p><p><strong>Results: </strong>Full-lens binocular HCVA at 40 cm was significantly better with three tests (T2, T4, T5) compared to DIMS (p ≤ 0.022), whereas there were no differences between any test and DIMS for monocular or binocular HCVA at 6 m (p > 0.5). Full-lens monocular LCVA at 6 m was significantly better with DIMS compared to T4 (p = 0.0057). Through the treatment zone, four tests (T2, T4, T5, T6) were significantly better than DIMS for binocular HCVA at 40 cm (p < 0.0001), near vision-clarity (p ≤ 0.0011) and ease-of-reading (p ≤ 0.0014). T2 was rated significantly higher than DIMS for night-vision (p = 0.0085) and overall-vision-satisfaction (p = 0.0495), whereas DIMS was rated higher than T1 for vision-clarity (p = 0.0001). There were no significant differences between DIMS and any test for other subjective ratings (p > 0.07), nor willingness-to-purchase based on vision (p > 0.2) or myopia management efficacy (p > 0.6).</p><p><strong>Conclusions: </strong>Most of the test lenses achieved better VP through the treatment zone compared to the DIMS control. T2 showed better overall VP compared to DIMS, whereas DIMS showed better overall VP compared to T1.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70023"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611593","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":"Impact of uncorrected hyperopia on visual function and academic performance in preschool and school-age children.","authors":"Marjean Taylor Kulp, Elise B Ciner, T Rowan Candy, Gui-Shuang Ying, Colby Hall, Graham Quinn, Bruce Moore","doi":"10.1002/ovs2.70018","DOIUrl":"10.1002/ovs2.70018","url":null,"abstract":"<p><p>Many children with a moderate amount of farsightedness do not see as well up close as children who are not farsighted, and they often have significantly more problems with near visual function (near visual acuity, stereoacuity, and accommodation), early literacy skills, reading, and attention. Problems with early literacy skills often lead to difficulties with reading in first grade and beyond. Controversy exists among eye care providers regarding whether moderately hyperopic children have adequate visual function without correction or whether correction provides benefit. Furthermore, the effect of correction is unclear, and further research is needed to determine whether hyperopic correction allows farsighted children to overcome deficits in near visual function, early literacy, reading, and attention.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70018"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611439","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":"Exploring eye care service delivery models for pediatric refraction and spectacle-dispensing in India and the United Kingdom: A scoping review.","authors":"Kalaiyarasi Dhandapani, Swetha Saravanan, Subash Sukumar, Anuradha Narayanan","doi":"10.1002/ovs2.70016","DOIUrl":"10.1002/ovs2.70016","url":null,"abstract":"<p><strong>Purpose: </strong>To explore various service delivery models available for pediatric refraction and spectacle-dispensing in India and UK.</p><p><strong>Methods: </strong>A scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Review guidelines that included published literature (2010-2024) from MEDLINE (PubMed) and Cochrane Library, reports from government websites, annual reports of nongovernmental organizations, and private eyecare providers. Primary reports on refraction or spectacle-dispensing for children less than 18 years were included. Data related to the \"5 Ps\" influencing service delivery, namely, \"Presence\" (availability of refraction services), \"Procurement\" (availability of spectacle-dispensing), \"Personnel,\" clinical \"Protocol,\" and \"Price\" involved in the services, were qualitatively synthesized.</p><p><strong>Results: </strong>From 1999 published articles screened by title and abstracts, 187 underwent full-text screening, and 60 were included in the review. Evidence also included 22 government reports, 13 annual reports, and 68 websites. A total of 13 and 9 pediatric eyecare service delivery models were identified in India and UK, respectively, and broadly categorized into community outreach, optical/optometry practices, hospitals/clinics, and online services. \"Presence\" and \"Procurement\" were evident in all models in India, whereas in UK, these were evident only in the optical/optometry practices and hospitals following referral from community outreach. \"Personnel\" included refractionists, ophthalmic assistants/vision-technicians, optometrists, opticians, or ophthalmologists in India, and orthoptists, optometrists, dispensing-opticians, or ophthalmologists with distinct regulatory roles in the UK. \"Protocol\" varied in community outreach in both countries. \"Price\" was free of charge at the point of delivery to patients through community outreach in India and all models in the UK, except online services. Evidence gaps exist under \"Personnel,\" \"Price\" in optical/optometry practices in India, and \"Protocol\" in all models except community-outreach in both countries.</p><p><strong>Conclusions: </strong>This review highlights four broad models for pediatric refraction and spectacle-dispensing with varied \"Personnel,\" \"Protocol,\" and \"Price\" in both countries, identifying evidence gaps, benefits, and challenges to inform future research and global efforts to improve child eye care.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70016"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641262","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}