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Coq R, Neveu P, Plantier J, Legras R. Accommodative response and visual fatigue following a non-congruent visual task in non-asthenopic and asthenopic individuals. Ophthalmic Physiol Opt 2024; 44:925-935. [PMID: 38533853 DOI: 10.1111/opo.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Asthenopia is related to near vision activities or visual tasks that dissociate accommodation from vergence. Since the results of previous studies using objective measures to diagnose asthenopia are inconsistent, this study compared optometric tests and objective metrics of accommodation in non-asthenopic and asthenopic young adults before and after a visual fatigue task. METHODS The accommodative response was recorded objectively for 6 min at a 3.33 D accommodative demand using an autorefractor, before and after a 5-min non-congruent visual task. Accommodation was disassociated from vergence with a ±2.00 D accommodative flipper while reading at the same distance. Optometric tests and subjective evaluations of asthenopia were performed before and after the task. Twenty-six non-presbyopic adults (23.15 ± 2.56 years) were included and identified as asthenopic (n = 14) or non-asthenopic (n = 12) based on their score on the Computer Vision Syndrome Questionnaire. RESULTS A mixed ANOVA found no significant difference between the groups for objective (accommodative response) or subjective metrics (feeling of fatigue, optometric tests), although all participants reported greater visual fatigue after the task. A significant effect of time (before and after the non-congruent task) was identified for the overall sample for mean accommodative lag (+0.10 D, p = 0.01), subjective visual fatigue (+1.18, p < 0.01), negative relative accommodation (-0.20 D, p = 0.02) and near negative fusional reserve (blur: +2.46Δ, p < 0.01; break: +1.89Δ, p < 0.01; recovery: +3.34Δ, p = 0.02). CONCLUSIONS The task-induced asthenopia, measured both objectively and subjectively, was accompanied by a change in accommodative lag, greater visual fatigue and a decrease in negative relative accommodation. Conversely, near negative fusional reserves seem to adapt to the task. No significant differences were found between the two groups with respect to accommodative metrics (objective) or subjective and optometric tests.
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Affiliation(s)
- Rémi Coq
- French Armed Forces Biomedical Research Institute, Bretigny-sur-orge, France
- LuMIn, CNRS, ENS Paris-Saclay, CentraleSupelec, Université Paris-Saclay, Orsay, France
| | - Pascaline Neveu
- French Armed Forces Biomedical Research Institute, Bretigny-sur-orge, France
| | - Justin Plantier
- French Armed Forces Biomedical Research Institute, Bretigny-sur-orge, France
| | - Richard Legras
- LuMIn, CNRS, ENS Paris-Saclay, CentraleSupelec, Université Paris-Saclay, Orsay, France
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Guo L, Fan L, Tao J, Hua R, Yang Q, Gu H, Yu S, Li L, Zhao X. Use of Topical 0.01% Atropine for Controlling Near Work-Induced Transient Myopia: A Randomized, Double-Masked, Placebo-Controlled Study. J Ocul Pharmacol Ther 2019; 36:97-101. [PMID: 31800355 DOI: 10.1089/jop.2019.0062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: To investigate the efficacy and safety of topical low-concentration (0.01%) atropine for controlling near work-induced transient myopia (NITM) in a young Chinese population. Methods: This was a randomized, double-blinded, placebo-controlled study. The participants were randomly divided into the 0.5% hydroxypropyl-methylcellulose-treated group (control group) or 0.01% atropine-treated group (study group). Participants' pulse rate, respiration rate, intraocular pressure, pupil diameter, and magnitude of initial NITM were evaluated at baseline and on day 7 and 14 during treatment. In addition, ocular discomfort and adverse effects were recorded. Results: Of the initial 176 participants, 145 (82.4%) completed the 14-day treatment and all evaluations. At baseline, no difference in the magnitude of initial NITM was observed between the control and study groups (P = 0.826). However, the magnitude of initial NITM of the study group was significantly lower at both day 7 (-0.11 ± 0.227 D) and day 14 (0.076 ± 0.183 D) after treatment initiation, compared with the magnitude of initial NITM in the control group (P < 0.001). No serious complications were observed. However, significantly larger pupil diameters were noted on day 7 and 14 in the study group than in the control group (P < 0.001). Conclusions: We speculate that daily topical 0.01% atropine application effectively reduced the magnitude of initial NITM, without any serious complications. The minimal pupil dilation induced by the treatment was acceptable. Low-concentration atropine may be useful in clinical settings as treatment for young patients with NITM.
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Affiliation(s)
- Lei Guo
- Ophthalmology and Optometry Center, First Hospital of China Medical University, Shenyang, China
| | - Liying Fan
- Department of Ophthalmology, The 4th People's Hospital of Shenyang, Shenyang, China
| | - Jun Tao
- Department of Ophthalmology, The 4 People's Hospital of Shenyang, Shenyang, China
| | - Rui Hua
- Department of Ophthalmology, First Hospital of China Medical University, Shenyang, China
| | - Qiang Yang
- Department of Ophthalmology, Shenyang Xingqi Eye Hospital, Shenyang, China
| | - Hong Gu
- Department of Ophthalmology, Shenyang Xingqi Eye Hospital, Shenyang, China
| | - Shiyuan Yu
- Department of Ophthalmology, Shenyang Xingqi Eye Hospital, Shenyang, China
| | - Linwei Li
- Department of Ophthalmology, Shenyang Xingqi Eye Hospital, Shenyang, China
| | - Xin Zhao
- Department of Ophthalmology, Shenyang Xingqi Eye Hospital, Shenyang, China
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The influence of age, refractive error, visual demand and lighting conditions on accommodative ability in Malay children and adults. Graefes Arch Clin Exp Ophthalmol 2019; 257:1997-2004. [PMID: 31273509 DOI: 10.1007/s00417-019-04405-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/30/2019] [Accepted: 06/25/2019] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Near work, accommodative inaccuracy and ambient lighting conditions have all been implicated in the development of myopia. However, differences in accommodative responses with age and refractive error under different visual conditions remain unclear. This study explores differences in accommodative ability and refractive error with exposure to differing ambient illumination and visual demands in Malay schoolchildren and adults. METHODS Sixty young adults (21-25 years) and 60 schoolchildren (8-12 years) were recruited. Accommodative lag and accommodative fluctuations at far (6 m) and near (25 cm) were measured using the Grand Seiko WAM-5500 open-field autorefractor. The effects of mesopic room illumination on accommodation were also investigated. RESULTS Repeated-measures ANOVA indicated that accommodative lag at far and near differed significantly between schoolchildren and young adults [F(1.219, 35.354) = 11.857, p < 0.05]. Post hoc tests using the Bonferroni correction showed that at near, there was a greater lag in schoolchildren (0.486 ± 0.181 D) than young adults (0.259 ± 0.209 D, p < 0.05). Repeated-measures ANOVA also revealed that accommodative lag at near demands differed statistically between the non-myopic and myopic groups in young adults and schoolchildren [F(3.107, 31.431) = 12.187, p < 0.05]. Post hoc tests with Bonferroni correction showed that accommodative lag at near was significantly greater in myopic schoolchildren (0.655 ± 0.198 D) than in non-myopic schoolchildren (0.202 ± 0.141 D, p < 0.05) and myopic young adults (0.316 ± 0.172 D, p < 0.05), but no significant difference was found between myopic young adults (0.316 ± 0.172 D) and non-myopic young adults (0.242 ± 0.126 D, p > 0.05). Accommodative lag and fluctuations were greater under mesopic room conditions for all ages [all p < 0.05]. CONCLUSION Greater accommodative lag was found in myopes than in emmetropes, in schoolchildren than in adults, and under mesopic conditions than under photopic conditions. Accommodative fluctuations were greatest in myopes and in mesopic conditions. These results suggest that differences exist in the amount of blur experienced by myopes and non-myopes at different ages and under different lighting conditions.
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Guo F, Zhang Q, Fan MN, Ma L, Chen C, Liu XH, Jiang H, Liu Y. Fruit and vegetable consumption and its relation to risk of asthenopia among Chinese college students. Int J Ophthalmol 2018; 11:1020-1027. [PMID: 29977818 DOI: 10.18240/ijo.2018.06.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/12/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the associations between fruit and vegetable consumption and risk of asthenopia among Chinese college students. METHODS A total of 1022 students were selected from five universities by a multi-stage stratified cluster sampling method. They were surveyed via a self-administered questionnaire including socio-demographic features, dietary and lifestyle habits, eye-related symptoms, eye care habits and history of diseases. Ascertainment of asthenopia was based on participants' subjectively reported symptoms. The associations between fruit and vegetable intake with asthenopia risk were assessed using multivariate logistic regression analysis. RESULTS There were no significant associations between total fruit and vegetable, total vegetable, or fruit and the risk of asthenopia. Higher intake of dark-green leafy vegetable was likely to be inversely associated with asthenopia risk [odd ratio (OR): 0.60; 95%CI: 0.37-0.97; Ptrend=0.21] after controlling for nondietary and dietary risk factors. Stratified analysis showed that the inverse association between dark-green leafy vegetable intake and asthenopia risk was limited to participants with suboptimal eyesight (OR: 0.45; 95%CI: 0.25-0.82; Ptrend=0.05), wearing glasses (OR: 0.35; 95%CI: 0.17-0.72; Ptrend=0.03) or using computer ≥3h/d (OR: 0.48; 95%CI: 0.25-0.93; Ptrend=0.08). CONCLUSION A higher consumption of dark-green leafy vegetable is associated with a lower asthenopia risk among college students with suboptimal eyesight and poor eye care habits.
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Affiliation(s)
- Fang Guo
- The First Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China.,Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China
| | - Qiang Zhang
- The First Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China.,Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China
| | - Meng-Nan Fan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China
| | - Le Ma
- The First Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China.,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an 710061, Shaanxi Province, China
| | - Chu Chen
- Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Xiao-Hong Liu
- The First Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China
| | - Hong Jiang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China
| | - Yan Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi Province, China
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Imaizumi S, Koyama S, Tanno Y. Development of the Japanese version of the Visual Discomfort Scale. PLoS One 2018; 13:e0191094. [PMID: 29324819 PMCID: PMC5764345 DOI: 10.1371/journal.pone.0191094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 12/28/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Visual stimuli, such as stripes and texts, can induce "visual discomfort" including perceptual and somatic symptoms. Individuals reporting high levels of visual discomfort might experience migraine headache and may have reduced reading efficiency due to visual perceptual difficulties. This study aimed to develop and validate the Japanese version of the Visual Discomfort Scale, which measures proneness to visual discomfort. METHODS AND RESULTS In Survey 1, 428 adults completed the Japanese version and a questionnaire assessing migraine morbidity. Rasch analysis revealed that the Japanese version is a unidimensional scale with a high amount of unexplained variance due to random noise rather than another dimension, and has high person and item reliabilities. Participants with migraine exhibited high scores in the Japanese version, indicating the construct validity of the scale. Survey 2 with 118 adults revealed a strong test-retest correlation for the Japanese version, indicating the stability of the scale. CONCLUSION The Japanese version of the Visual Discomfort Scale is a sufficiently reliable and valid scale for assessing visual discomfort, although its unidimensionality leaves room for further improvements.
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Affiliation(s)
- Shu Imaizumi
- Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- * E-mail:
| | - Shinichi Koyama
- Graduate School of Engineering, Chiba University, Chiba, Japan
| | - Yoshihiko Tanno
- Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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Zheng K, Han T, Zhou X. Accommodative changes after SMILE for moderate to high myopia correction. BMC Ophthalmol 2016; 16:173. [PMID: 27716112 PMCID: PMC5050588 DOI: 10.1186/s12886-016-0352-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/23/2016] [Indexed: 11/12/2022] Open
Abstract
Background To investigate accommodative response and accommodative lag changes after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction. Methods A total of 32 eyes of 32 patients with no strabismus who underwent SMILE were enrolled in this prospective clinical study. The accommodative response was obtained viewing monocularly with spherical equivalent refractive error corrected, using an open-field autorefractor at different stimulus levels (2.00D, 2.50D, 3.00D, 4.00D and 5.00D) for the right eye before a standard SMILE surgery and at 1-month follow-up after surgery. Results The mean age of the patients were 23.34 ± 2.90 years and the mean preoperative manifest refraction spherical equivalent was −5.74 ± 1.98 diopters. Significant differences were detected in both preoperative and postoperative accommodative responses to different stimulus levels (P < 0.001). Multiple linear regression model analysis revealed preoperative manifest refractive spherical equivalent (P = 0.006) and preoperative accommodative lag (P = 0.04) showed a significant impact on postoperative accommodative lag. Conclusions This is the first report of accommodative changes after SMILE. Our preliminary results showed that a decrease in postoperative accommodative lag that might be related to the relief of the visual discomfort symptom.
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Affiliation(s)
- Ke Zheng
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 19 Baoqing Road, Shanghai, 200031, China
| | - Tian Han
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 19 Baoqing Road, Shanghai, 200031, China
| | - Xingtao Zhou
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 19 Baoqing Road, Shanghai, 200031, China.
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Abstract
PURPOSE To determine the relationship between binocular vision (BV) disorder and dry eye symptoms and the frequency of BV disorders in subjects with contact lens-induced dry eye symptoms. METHODS Subjects recruited for a larger dry eye study (n = 104) completed the Ocular Surface Disease Index (OSDI) and Convergence Insufficiency Symptom Survey (CISS) to determine if symptoms assessed on these two surveys were related. Also, myopic soft contact lens wearers (n = 29) with self-reported dry eye symptoms were recruited. Subjects completed the OSDI and CISS to assess severity of dry eye and BV disorder symptoms. Basic BV and dry eye testing was performed on each subject. RESULTS Severity of symptoms assessed on the OSDI and CISS was found to be significantly correlated in the larger subject group (ρ = 0.68, p = 0.0001). This significant correlation warranted further investigation of both symptoms and clinical signs. In the group of myopic soft contact lens wearers, 48.3% had a BV disorder. This proportion appeared to be higher than previously reported prevalence estimates of BV disorders. Accommodative lag greater than or equal to 1.00 diopter was the most common BV disorder sign encountered (48.3%), and pseudo-convergence insufficiency was the most common BV disorder (31.0%). CONCLUSIONS Symptoms related to dry eye and BV disorders overlap. Subjects with symptoms of discomfort while wearing soft contact lenses may be experiencing a concurrent or stand-alone BV disorder. Accommodative insufficiency and pseudo-convergence insufficiency were common in the sample of myopic soft contact lens wearers. Clinicians should screen symptomatic contact lens-induced dry eye patients for BV disorders. Dry eye studies should assess basic BV function.
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