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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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Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, Kollbaum P, Marcotte-Collard R, Montani G, Plainis S, Richdale K, Simard P, Wolffsohn JS. BCLA CLEAR presbyopia: Mechanism and optics. Cont Lens Anterior Eye 2024:102185. [PMID: 38796331 DOI: 10.1016/j.clae.2024.102185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2024]
Abstract
With over a billion adults worldwide currently affected, presbyopia remains a ubiquitous, global problem. Despite over a century of study, the precise mechanism of ocular accommodation and presbyopia progression remains a topic of debate. Accordingly, this narrative review outlines the lenticular and extralenticular components of accommodation together with the impact of age on the accommodative apparatus, neural control of accommodation, models of accommodation, the impact of presbyopia on retinal image quality, and both historic and contemporary theories of presbyopia.
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Affiliation(s)
- Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK.
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Fiona Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Jose J Estevez
- Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, Australia; Flinders Centre for Ophthalmology, Eye and Vision Research, Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Safal Khanal
- Department of Optometry and Vision Science, The University of Alabama at Birmingham, USA
| | | | | | | | - Sotiris Plainis
- Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | | | - Patrick Simard
- School of Optometry, Universite de Montreal, Montreal, Quebec, Canada
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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Ryu H, Ju U, Wallraven C. Decoding visual fatigue in a visual search task selectively manipulated via myopia-correcting lenses. Front Neurosci 2024; 18:1307688. [PMID: 38660218 PMCID: PMC11039808 DOI: 10.3389/fnins.2024.1307688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Visual fatigue resulting from sustained, high-workload visual activities can significantly impact task performance and general wellbeing. So far, however, little is known about the underlying brain networks of visual fatigue. This study aimed to identify such potential networks using a unique paradigm involving myopia-correcting lenses known to directly modulate subjectively-perceived fatigue levels. Methods A sample of N = 31 myopia participants [right eye-SE: -3.77D (SD: 2.46); left eye-SE: -3.75D (SD: 2.45)] performed a demanding visual search task with varying difficulty levels, both with and without the lenses, while undergoing fMRI scanning. There were a total of 20 trials, after each of which participants rated the perceived difficulty and their subjective visual fatigue level. We used representational similarity analysis to decode brain regions associated with fatigue and difficulty, analyzing their individual and joint decoding pattern. Results and discussion Behavioral results showed correlations between fatigue and difficulty ratings and above all a significant reduction in fatigue levels when wearing the lenses. Imaging results implicated the cuneus, lingual gyrus, middle occipital gyrus (MOG), and declive for joint fatigue and difficulty decoding. Parts of the lingual gyrus were able to selectively decode perceived difficulty. Importantly, a broader network of visual and higher-level association areas showed exclusive decodability of fatigue (culmen, middle temporal gyrus (MTG), parahippocampal gyrus, precentral gyrus, and precuneus). Our findings enhance our understanding of processing within the context of visual search, attention, and mental workload and for the first time demonstrate that it is possible to decode subjectively-perceived visual fatigue during a challenging task from imaging data. Furthermore, the study underscores the potential of myopia-correcting lenses in investigating and modulating fatigue.
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Affiliation(s)
- Hyeongsuk Ryu
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Uijong Ju
- Department of Information Display, Kyunghee University, Seoul, Republic of Korea
| | - Christian Wallraven
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
- Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
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Biswas V, Masihuzzaman M, Jha RK, Majumder R. Is there a relationship between somatic sensations, impaired vision, and cognitive performance using the factor structure of the convergence insufficiency symptoms survey questionnaire? Oman J Ophthalmol 2024; 17:32-36. [PMID: 38524337 PMCID: PMC10957034 DOI: 10.4103/ojo.ojo_67_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 12/22/2022] [Accepted: 01/02/2024] [Indexed: 03/26/2024] Open
Abstract
AIMS This study aims to evaluate the relationship between somatic sensations, impaired vision, and cognitive performance using the factor structure convergence insufficiency symptoms survey questionnaire in university undergraduate and post-graduate students. SETTINGS AND DESIGN Centre-based and questionnaire-based. SUBJECTS AND METHODS Subjects were recruited from a university. First, an e-Survey was conducted with the help of Google form and distributed through WhatsApp and Gmail to carry out the survey. The age group of participants was ranged from 18 to 30 years. A total number of 561 responses was received during the data collection period. As per the exclusion criteria, 230 responses were excluded from the study. Out of 331 students, 154 were male while 177 were female. Out of 331 participants, 213 were undergraduates and 118 were postgraduate's students. RESULTS A total of 331 participants took part in the study. The minimum age was 18 years and the maximum age was 30 years. The mean age of the participants was 23.40 ± 2.42. Among all students, 23.81% had somatic sensations followed by 10.49% had impaired vision, and 16.31% had a poor cognitive function. The correlation between somatic sensations-impaired visions was a moderate positive correlation and a strong positive correlation between somatic sensations-cognitive performance and impaired vision-cognitive performance. CONCLUSIONS A significant relationship between somatic sensations, impaired vision, and cognitive performance was found in the study. The students had more somatic sensations than impaired vision and cognitive performance.
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Affiliation(s)
- Vishal Biswas
- Department of Optometry, School of Allied Health Sciences, Noida International University, Greater Noida, Uttar Pradesh, India
| | - Mohammad Masihuzzaman
- Department of Optometry, School of Allied Health Sciences, Amity University, Gurgaon, Haryana, India
| | - Roshan Kumar Jha
- Department of Optometry, School of Allied Health Sciences, Amity University, Gurgaon, Haryana, India
| | - Roshni Majumder
- Department of Optometry, School of Allied Health Sciences, Noida International University, Greater Noida, Uttar Pradesh, India
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Lie AL, Pan X, Vaghefi E, White TW, Donaldson PJ. Alterations in Lens Free Water Distribution Are Associated with Shape Deformation in Accommodation. OPHTHALMOLOGY SCIENCE 2024; 4:100404. [PMID: 38027421 PMCID: PMC10654372 DOI: 10.1016/j.xops.2023.100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/05/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023]
Abstract
Objective To investigate whether a redistribution of water within the crystalline lens is associated with the shape deformation that occurs during accommodation. Design Observational, cross sectional study. Subjects Eleven young adults without presbyopia (aged 18-39 years) and 9 middle-aged adults with presbyopia (aged 40-55 years). Methods Magnetic resonance imaging (MRI) scans of the lens were acquired on a 3 Tesla clinical MRI scanner, without and with the presentation of a 3 Diopter accommodative stimulus. The MRIs were postprocessed using established methods to extract the geometric dimensions and spatial maps of water distribution of the lens. Main Outcome Measures Accommodative changes in the full 3-dimensional description of lens shape, the lens total-water distribution profile, and the lens free-water distribution profile. Results Viewing of an accommodative stimulus by young subjects elicited an elastic shape deformation of the lens consistent with accommodation that was associated with an elevated, smoother free-water distribution, primarily in the anterior region of the lens. In contrast, viewing of an accommodative stimulus by presbyopic subjects produced an atypical shape deformation of the lens that was instead associated with a lowered free-water distribution, primarily in the anterior region of the lens. No discernible changes to the lens total-water distribution were observed in response to the accommodative stimulus in either subject cohort. Conclusions The present study suggests that protein-mediated alterations in the free-water distribution of the anterior region of the lens influence the shape deformation in accommodation, presenting pharmacological modulation of free-water distribution as an attractive novel approach for treating presbyopia. Financial Disclosures The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Alyssa L. Lie
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Xingzheng Pan
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Ehsan Vaghefi
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Thomas W. White
- Department of Physiology and Biophysics, School of Medicine, Stony Brook University, Stony Brook, New York
| | - Paul J. Donaldson
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
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Usgaonkar UPS, Dessai SP, Shetty A. The effect of blue light filter on visual and task performance. Indian J Ophthalmol 2023; 71:3707-3710. [PMID: 37991308 PMCID: PMC10788743 DOI: 10.4103/ijo.ijo_534_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE This study aimed to determine the effect of the blue light (BL) filter on the different tasks performed on a laptop on a daily basis. METHODS Forty subjects were required to perform a 45-minute task on the laptop screen with or without the BL filter on two different days. In the first task, subjects were made to watch a video. In the second task, subjects were made to read a passage from the laptop for 3 minutes, and reading speed was calculated. In the third task, subjects were made to enter the data on the laptop. The time taken to fill in the data was recorded. After the completion of the task, questionnaires were administered. Pre- and post-task accommodative tests were performed. RESULTS Forty emmetropes with a mean age of 21 ± 2 were recruited. In visual performance, the subjective response showed a significant difference in visual fatigue level with and without the filter. A statistically significant difference was seen in reading speed and data entry during task performance with and without the filter. Pre- and post-task accommodative parameters showed variable responses. CONCLUSION This study showed that the use of a BL filter improves task performance, but subjectively, people experienced more visual fatigue while using the filter.
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Affiliation(s)
- Ugam P S Usgaonkar
- Department of Ophthalmology, Goa Medical College and Hospital, Goa, India
| | - Sailee P Dessai
- Optometry Intern, Goa Medical College and Hospital, Goa, India
| | - Aksha Shetty
- Lecturer in Optometry, Goa Medical College and Hospital, Goa, India
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Huang SY, Su HR, Hu YS, Lee CH, Tsai MS, Yeh SM, Chen YY, Tsai TH. Immediate Effects of Vergence Exercises Using Automatic Dual Rotational Risley Prisms on Accommodative Lag and Facility. Ophthalmol Ther 2023; 12:3361-3372. [PMID: 37853298 PMCID: PMC10640441 DOI: 10.1007/s40123-023-00832-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION This study evaluated novel automatic dual rotational Risley prisms (ADRRPs) as a vergence exercise tool for patients with myopia to improve accommodative lag and accommodative facility. METHODS Participants with myopia aged 20-24 years were recruited. After vergence exercises with prisms (treatment group) or plano lenses (control group) using ADRRPs for 10 min, measurements were taken using an open-field autorefractor (Grand Seiko WAM-5500) at viewing distances of 0.4 m and 6.0 m. We measured accommodative facility using a ± 2.00 D accommodative flipper. RESULTS A total of 56 participants (treatment group, 39; control group, 17) performed vergence exercises using ADRRPs. Participants in the treatment group showed improvements in accommodative lag at a 0.4 m viewing distance, with measurements of 0.57 D (right eye; OD) and 0.53 D (left eye; OS) and 0.21 D (OD) and 0.27 D (OS) before and after the exercises, respectively (p < 0.001). Over-refractions using an open-field autorefractor with spherical equivalent contact lenses at a 6.0 m viewing distance were - 0.01 ± 0.30 D (OD) and 0.03 ± 0.34 D (OS) and 0.15 ± 0.32 D (OD) and 0.19 ± 0.28 D (OS) before and after the exercises, respectively (difference + 0.16 D; p < 0.001). Accommodative facility values before and after exercises were 14.88 ± 3.36 and 15.59 ± 3.60 cpm, respectively (p < 0.01). No significant differences in accommodative lag, relaxation, and accommodative facility before and after exercise were observed in the control group. CONCLUSIONS Using ADRRPs in vergence exercises can improve accommodative lag, accommodative facility, and accommodative relaxation in adults with myopia. Further research to evaluate persistent and long-term effects is needed.
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Affiliation(s)
- Shuan-Yu Huang
- Department of Optometry, Central Taiwan University of Science and Technology, Taichung, 402, Taiwan
| | - Hui-Rong Su
- Ph.D. Program of Electrical and Communications Engineering, Feng Chia University, Taichung, 407, Taiwan
| | - Yun-Shao Hu
- Department of Optometry, Chung Shan Medical University, Taichung, 402, Taiwan
| | - Chi-Hung Lee
- Department of Electrical Engineering, Feng Chia University, Taichung, 407, Taiwan
| | - Ming-Shan Tsai
- Department of Electrophysics, National Chiayi University, Chiayi, 600, Taiwan
| | - Shang-Min Yeh
- Department of Optometry, Da-Yeh University, Changhua, 515, Taiwan
| | - Ya-Yu Chen
- Department of Optometry, Da-Yeh University, Changhua, 515, Taiwan
| | - Tzu-Hsun Tsai
- Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
- Department of Ophthalmology, National Taiwan University Hospital, Taipei City, 100225, Taiwan.
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Ortiz-Peregrina S, Ortiz C, Casares-López M, Martino F, Granados-Delgado P, Anera RG. The Relationship between Anxiety, Visual Function, and Symptomatology in University Students. J Clin Med 2023; 12:6595. [PMID: 37892731 PMCID: PMC10607452 DOI: 10.3390/jcm12206595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Mental health concerns have emerged at the university level, with the psychological well-being of students being increasingly affected. This cross-sectional study investigated the proportion of university students having anxiety, and its effects on their visual function and symptomatology. We included 41 students (26.1 ± 4.8 years), and their visual function was assessed through several tests to produce a general visual performance index (VPI). The visual symptomatology was studied using the Conlon Visual Discomfort Survey and the Quality of Vision (QoV) questionnaire. The students were classified into two groups according to the Generalized Anxiety Disorder Screener (GAD-7) test ("no anxiety" and "anxiety" groups). The visual function evaluation indicated significantly worse VPI in the anxiety group (p = 0.047). These students also showed significantly higher scores in the Conlon survey (p = 0.004) and two subscales of the QoV questionnaire: symptom severity (p = 0.041) and symptom bothersomeness (p = 0.013). Moreover, the multiple linear regression model showed a significant association between visual discomfort according to the Conlon questionnaire and the level of anxiety (r = 0.405; R2 = 0.164; B = 0.405; p = 0.012). It is important to study the influence of psychological factors on vision, not only for refractive error, but also for binocular and accommodative disorders.
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Affiliation(s)
- Sonia Ortiz-Peregrina
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
| | - Carolina Ortiz
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
| | - Miriam Casares-López
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
| | - Francesco Martino
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
| | - Pilar Granados-Delgado
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
| | - Rosario G Anera
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
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Chen YL, Chan YC. Neck and shoulder strains under various head flexing positions while standing and sitting with and without back support for male and female smartphone users. ERGONOMICS 2023:1-12. [PMID: 37824717 DOI: 10.1080/00140139.2023.2270651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023]
Abstract
This study recruited 30 young participants (15 men and 15 women) to examine the smartphone usage patterns in three postures (standing, supported sitting, and unsupported sitting) and at five head angle (HA) positions (0°-40°). Cervical erector spinae (CES) and upper trapezius (UTZ) muscle activity, neck flexion (NF), gaze angle (GA), viewing distance (VD), and discomfort scores were collected. Results showed that HA and posture almost affected all responses, while CES muscle activity, NF, and VD differed between sexes. Strain in the neck and shoulder region increased with HA increase. Particularly, when the HA exceeded 20°, the discomfort scores considerably increased. Unsupported sitting should be avoided during smartphone use because of relatively poor responses in all variables. However, both standing and supported sitting have their respective benefits. Sex-related differences were typically observed in the standing position, with women tending to have lower NF but higher CES muscle activity compared with men.Practitioner summary: Although smartphones have become daily necessities, the overall quantitative neck and shoulder strain of using smartphones in different postures is rarely evaluated. We suggest that maintaining the HA within 20° is recommended because of relatively low load on the neck and shoulders. An unsupported sitting should be avoided during smartphone use.
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Affiliation(s)
- Yi-Lang Chen
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei, Taiwan
| | - You-Chun Chan
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei, Taiwan
- Formosa Plastics Group, Taipei, Taiwan
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Shi JJ, Wang YJ, Lyu PP, Hu JW, Wen XS, Shi HJ. Effects of school myopia management measures on myopia onset and progression among Chinese primary school students. BMC Public Health 2023; 23:1819. [PMID: 37726699 PMCID: PMC10508019 DOI: 10.1186/s12889-023-16719-z] [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: 01/05/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Schools play an organizational role in managing myopia-related behavioral habits among students. We evaluated the effects of school myopia management measures on myopia onset and progression in a school-based prospective 1-year observational study. METHODS In total, 8319 children from 26 elementary schools were included. Online questionnaire completed by a parent, in which school myopia management experience including outdoor activities in recess or physical education class, teachers' supervision, and teaching facilities. Variables were defined as implemented well or poorly, according to the Comprehensive Plan to Prevent Myopia among Children and Teenagers. Children underwent ophthalmic examinations, and the incidence and progression of myopia from 2019 to 2020 were estimated. Multilevel logistic regression models were constructed to analyze the association between school management measures and myopia development in 8,9 years and 10,11 years students. RESULTS From 2019 to 2020, the incidence of myopia among primary school students was 36.49%; the mean difference of spherical equivalent in myopic children was - 0.29 ± 1.22 diopters. The risk of incident myopia was reduced by 20% in 8,9 years participants with well-implemented class recess compared with those with poorly implemented class recess (adjusted odds ratio [aOR]: 0.80, p = 0.032). PE outdoor time was significantly associated with myopia incidence in 10,11 years students (aOR: 0.76, p = 0.043). Compared with poorly implemented reading and writing posture, desk and chair height, 10,11 participants with well-implemented desk and chair height were less likely to have rapid myopic progression (p = 0.029, p = 0.022). CONCLUSION In Shanghai, children's myopia is associated with better implementation of school myopia management measures. The present findings suggest that outdoor activities during class recess or PE class, providing suitable desks and chairs, and adequate instruction in reading and writing postures might protect against pathological eye growth. An age-specific myopia prevention and control programs in school is of primary importance.
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Affiliation(s)
- Jiao- Jiao Shi
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Yu-Jie Wang
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Ping-Ping Lyu
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Jing-Wen Hu
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Xiao-Sa Wen
- Department of Immunizations, Minhang Centers for Disease Control and Prevention, Shanghai, 201100, China
| | - Hui-Jing Shi
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China.
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11
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Chen AM, Borsting EJ. Near work symptoms and measures of accommodation in children. Clin Exp Optom 2023; 106:675-680. [PMID: 35820772 DOI: 10.1080/08164622.2022.2097002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/16/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022] Open
Abstract
CLINICAL RELEVANCE Some children experience significant symptoms while doing near work, and accommodative deficits can be a contributory factor. However, studies investigating near work symptoms in children are sparse. BACKGROUND To investigate the association between clinical and objective measures of accommodation and near point symptoms. METHODS Twelve asymptomatic and 14 symptomatic children (mean age = 11.1 and 11.8 years, respectively) based on their Convergence Insufficiency Symptom Survey scores participated in the study. The clinical measures of accommodation were monocular amplitude of accommodation, monocular accommodative facility, and monocular estimation method. Objective measurements of the accommodative stimulus response function were recorded with a WAM-5500 autorefractor for two consecutive minutes at five viewing distances (0.33, 2, 3, 4, and 5 Dioptres [D]). Accommodative findings were compared between the groups using the Mann-Whitney U-tests. Spearman's rank correlation coefficient was used to assess the association between symptoms and clinical and objective measures of accommodation. RESULTS The mean CISS scores were 32.8 and 7.3 for the symptomatic and asymptomatic groups, respectively (p = <0.001). The symptomatic group showed a reduced accommodative functions compared to the asymptomatic group (p = 0.002 for accommodative facility, p = 0.04 for accommodative amplitude, p = 0.029 and 0.01 for objective measures of accommodation at 4D and 5D viewing distance, respectively). Clinical tests of accommodative amplitude and facility (correlation coefficient = -0.407 and -0.54, respectively) showed the highest correlation with the CISS scores, compared to the objective measures of accommodation. CONCLUSION Clinical tests of accommodation showed a greater association with symptoms than objective measures of accommodation in children aged 8-16 years. In children presenting with visual discomfort symptoms, measurement of accommodative amplitude and facility should be considered.
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Affiliation(s)
- Angela M Chen
- Southern California College of Optometry, Marshall B Ketchum University, Fullerton, CA, USA
| | - Eric J Borsting
- Southern California College of Optometry, Marshall B Ketchum University, Fullerton, CA, USA
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12
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Rueff EM. Visual discomfort and contact lens wear: A review. Cont Lens Anterior Eye 2023; 46:101872. [PMID: 37277259 DOI: 10.1016/j.clae.2023.101872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
The purpose of this manuscript is to describe how vision influences contact lens discomfort and review the evidence supporting the hypothesis that contact lens discomfort can be caused by vision and vision-related disorders. Contact lens discomfort is a misunderstood and difficult to manage clinical condition. Most treatments and strategies aimed at alleviating discomfort focus on optimizing the contact lens fit and its relationship with the ocular surface, but these strategies commonly fail at relieving discomfort symptoms. Many vision and vision-related disorders share symptoms with those reported by uncomfortable contact lens wearers. This paper will review evidence and literature that describes how these vision and vision-related disorders may influence comfort in contact lens wearers. Acknowledging how vision influences contact lens discomfort will improve future research intended to better understand the condition, allow for more effective clinical management, and reduce rates of discontinuation.
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Affiliation(s)
- Erin M Rueff
- The Southern California College of Optometry at Marshall B Ketchum University, 2575 Yorba Linda Blvd, Fullerton, CA 92831, USA.
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Ma LU, Yu X, Gong L, Wei L, Peng Z, Wang K, Li Y, Zhou J, Zhao M. Evaluating the optimised font size and viewing time of online learning in young children: a multicentre cross-sectional study. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001835. [PMID: 37185652 PMCID: PMC10151978 DOI: 10.1136/bmjpo-2022-001835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/14/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES Near viewing distance (VD) and longer viewing times are associated with myopia. This study aimed to identify the font size and viewing time that guarantee the appropriate VD and pixels per degree (PPD) for children's online learning. DESIGN This cross-sectional study comprised two experiments. In experiment A, participants read text in five font sizes on three backlit displays (a personal computer, a smartphone and a tablet), an E-ink display and paper for 5 min per font size. In experiment B, participants watched videos for 30 min on three backlit displays. SETTING The Peking University People's Hospital in Beijing (China) and the School of Ophthalmology and Optometry, Wenzhou Medical University (Zhejiang Province, China). PARTICIPANTS Thirty-five participants completed experiment A. Ten of them participated in experiment B. PRIMARY AND SECONDARY OUTCOME MEASURES VDs were measured by Clouclip. The corresponding PPD was calculated. RESULTS In experiment A, font size and display type significantly affected VD (F(4840)=149.44, p<0.001, ES (Effect size)=0.77; F(4840), p<0.001, ES=0.37). VDs were >33 cm for all five font sizes on the PC, the tablet and paper and for 18-pt on the smartphone and 16-pt on E-ink. PPD for 16-pt on the PC, 14-pt on the tablet and all five font sizes on the phone were >60. In experiment B, VD increased over the four previous 5 min periods but decreased slightly on tablets and PCs in the fifth 5 min period. PPD was >60. CONCLUSION Children demonstrated different VDs and PPDs based on font size and display type. To ensure a 33 cm VD and 60 PPD, the minimum font size for online reading should be 18-pt on smartphones, 16-pt on PCs and E-ink, 10.5-pt on tablets and 9-pt on paper. More attention should be given to children's VD with continuous video viewing of more than 25 min. TRIAL REGISTRATION NUMBER ChiCTR2100049584.
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Affiliation(s)
- L U Ma
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Xi Yu
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ling Gong
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lili Wei
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
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Mihelčič M, Podlesek A. Cognitive workload affects ocular accommodation and pupillary response. JOURNAL OF OPTOMETRY 2023; 16:107-115. [PMID: 35764479 PMCID: PMC10104792 DOI: 10.1016/j.optom.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/14/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
SIGNIFICANCE Cognitive involvement in reading causes variations in the tonus of autonomic nerve system. The aim of this study was to examine the effect of short-term cognitive load on accommodation and pupils' absolute values and temporal variability in test persons performing three different types of tasks. PURPOSE We aimed to show how cognitive tasks of different type and difficulty level affect accommodation and pupil behavior during a short time interval. METHODS Participants (n = 58; mean age 16.4 years, SD = 0.56) performed reading from a 10-inch LCD screen placed at 40 cm distance. Three different types of tasks (numerical, textual, and the Stroop task), each at three different levels of cognitive load were introduced. Participants had 90 s to complete each task. Accommodative and pupillary responses were measured with videoretinoscope Power Refractor 3 at 50 Hz. RESULTS Pupil size was largest in the Stroop task (M = 5.20 mm, SD = 0.75 mm), followed by the numerical tasks (M = 5.02 mm, SD = 0.72 mm) and textual tasks (M = 4.78 mm, SD = 0.71 mm). Accommodative fluctuations - measured as accommodation SD - were largest in the textual tasks (M = 0.67 D, SD = 0.34 D), followed by the numerical tasks (M = 0.61 D, SD = 0.40 D) and the Stroop task (M = 0.52 D, SD = 0.21 D). CONCLUSIONS In our experiment, short-term cognitive load was associated with altered pupillary and accommodative response to near tasks. In conflicting tasks (Stroop) or in performing continuing calculations, the pupils were larger; in tasks requiring logical reasoning, the accommodative fluctuations were greater. These effects can potentially be associated with current near-point stress and myopia growth models.
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Affiliation(s)
| | - Anja Podlesek
- Department of Psychology, University of Ljubljana, Slovenia
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Vera J, Redondo B, Galan T, Machado P, Molina R, Koulieris GA, Jiménez R. Dynamics of the accommodative response and facility with dual-focus soft contact lenses for myopia control. Cont Lens Anterior Eye 2023; 46:101526. [PMID: 34674953 DOI: 10.1016/j.clae.2021.101526] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To assess the impact of using dual-focus soft contact lenses for myopia control on the dynamics of the accommodative response and facility. METHODS 24 young adult myopes were fitted with dual-focus soft contact lenses for myopia control (MiSight®) and single-vision soft contact lenses (Proclear®). The WAM-5500 open-field autorefractor was used to measure the dynamics of the accommodative response (magnitude and variability) in binocular conditions, with accommodative data being gathered from the dominant eye, at three viewing distances (500 cm, 40 cm, and 20 cm) during 90 s. Also, the binocular accommodative facility was assessed with the WAM-5500 autorefractor. All participants performed the same experimental protocol with the dual-focus (MiSight) and single-vision (Proclear) soft contact lenses, with both experimental sessions being carried in two different days and following a counterbalanced order. RESULTS This study showed greater lags of accommodation with the MiSight than the Proclear lenses at near distances (40 cm: 1.27 ± 0.77 vs. 0.68 ± 0.37 D, corrected p-value = 0.002, Cohen-d = 0.90; and 20 cm: 1.47 ± 0.84 vs. 1.01 ± 0.52 D, corrected p-value = 0.007, Cohen-d = 0.75), whereas a higher variability of accommodation was observed with the dual-focus than the single-vision lenses at 500 cm (0.53 ± 0.11 vs. 0.23 ± 0.10 D), 40 cm (0.82 ± 0.31 vs. 0.68 ± 0.37 D), and 20 cm (1.50 ± 0.56 vs. 1.15 ± 0.39 D) (corrected p-value < 0.001 in all cases, and Cohen-ds = 0.67-2.33). Also, a worse quantitative (27.75 ± 8.79 vs. 34.29 ± 10.08 cycles per minute, p = 0.029, Cohen-d = 0.48) and qualitative (23.68 ± 7.12 vs. 28.43 ± 7.97 score, p = 0.039, Cohen-d = 0.45) performance was observed with the MiSight when compared to the Proclear lenses. CONCLUSIONS The use of dual-focus soft contact lenses for myopia control alters the dynamics of accommodative response and facility in the short-term. Although this optical design has demonstrated its effectiveness for myopia control, eye care specialists should be aware of the acute effects of these lenses on accommodation performance.
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Affiliation(s)
- Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Beatriz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain.
| | - Tomás Galan
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Pedro Machado
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain; Department of Computer Science, Durham University, UK
| | - Rubén Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | | | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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Redondo B, Vera J, Molina R, Jiménez R. Less is more: optimal recording time for measuring the steady-state accommodative response. Clin Exp Optom 2023; 106:20-28. [PMID: 34839788 DOI: 10.1080/08164622.2021.2003692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Clinical Relevance Background: Steady-state accommodation is frequently evaluated with open-field autorefractors; however there is no consensus regarding the optimal test duration. Our results allow us to standardise the procedure followed for the assessment of the steady-state accommodative response in clinical and laboratory settings and may be of great relevance in time-constrained situations. BACKGROUND The present study aims to determine the optimal recording time to assess the magnitude and variability of the accommodative response with a binocular open-field autorefractor. METHODS The steady-state accommodative response of 84 healthy undergraduate students was dynamically measured using the Grand Seiko WAM-5500 autorefractor at 500 cm, 40 cm and 20 cm for 90 s while participants maintained focus on a stationary target. We examined the reliability and level of agreement between four time intervals (the first 10-s, 30-s, 60-s and 90-s) at three accommodative demands (0.2D, 2.5D and 5D). RESULTS The magnitude of accommodation showed an excellent level of reliability (intraclass correlation coefficient [ICC]> 0.90) for the comparisons between the 90-s, 60-s and 30-s time intervals at the three viewing distances tested. However, when including the 10-s interval, there was a moderate reduction of the reliability indices and an increase of the mean difference between two time intervals (intra-class correlation [ICC] ranging from 0.89 to 0.97; and ESs ranging from 0.16 to 0.42). For the variability of accommodation, we observed an excellent reliability for the comparisons of the 90-s and 60-s measures at the three accommodative demands (ICC: 0.95-0.96), whereas for the rest of comparisons we observed from moderate to good levels of reliability. CONCLUSION Our data indicate that of 30-s and 60-s are enough to accurately assess the magnitude and variability of the accommodative response with the WAM-5500 autorefractor, respectively.
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Affiliation(s)
- Beatríz Redondo
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Jesús Vera
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Rubén Molina
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Raimundo Jiménez
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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Association between ADHD and vision problems. A systematic review and meta-analysis. Mol Psychiatry 2023; 28:410-422. [PMID: 35931758 PMCID: PMC9812778 DOI: 10.1038/s41380-022-01699-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/23/2022] [Accepted: 07/01/2022] [Indexed: 01/11/2023]
Abstract
AIM To conduct the first systematic review and meta-analysis assessing whether attention-deficit/hyperactivity disorder (ADHD) is associated with disorders of the eye, and/or altered measures of visual function. METHOD Based on a pre-registered protocol (PROSPERO: CRD42021256352), we searched PubMed, Web of Knowledge/Science, Ovid Medline, Embase and APA PsycINFO up to 16th November 2021, with no language/type of document restrictions. We included observational studies reporting at least one measure of vision in people of any age meeting DSM/ICD criteria for ADHD and in people without ADHD; or the prevalence of ADHD in people with and without vision disorders. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Random effects meta-analyses were used for data synthesis. RESULTS We included 42 studies in the narrative synthesis and 35 studies in the meta-analyses (3,250,905 participants). We found meta-analytic evidence of increased risk of astigmatism (OR = 1.79 [CI: 1.50, 2.14]), hyperopia and hypermetropia (OR = 1.79 [CI: 1.66, 1.94]), strabismus (OR = 1.93 [CI: 1.75, 2.12]), unspecified vision problems (OR = 1.94 [CI: 1.38, 2.73]) and reduced near point of convergence (OR = 5.02 [CI: 1.78, 14.11]); increased lag (Hedge's g = 0.63 [CI: 0.30, 0.96]) and variability (Hedge's g = 0.40 [CI: 0.17, 0.64]) of the accommodative response; and increased self-reported vision problems (Hedge's g = 0.63 [CI: 0.44, 0.82]) in people with ADHD compared to those without ADHD (with no significant heterogeneity). We also found meta-analytic evidence of no differences between people with and without ADHD on retinal nerve fiber layer thickness (Hedge's g = -0.19 [CI: -0.41, 0.02]) and refractive error (Hedge's g = 0.08 [CI: -0.26, 0.42]) (with no significant heterogeneity). DISCUSSION ADHD is associated with some self-reported and objectively ascertained functional vision problems, but not with structural alterations of the eye. Further studies should clarify the causal relationship, if any, between ADHD and problems of vision. TRIAL REGISTRATION PROSPERO registration: CRD42021256352.
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Vera J, Redondo B, Ocaso E, Martinez‐Guillorme S, Molina R, Jiménez R. Manipulating expectancies in optometry practice: Ocular accommodation and stereoacuity are sensitive to placebo and nocebo effects. Ophthalmic Physiol Opt 2022; 42:1390-1398. [PMID: 35959593 PMCID: PMC9804873 DOI: 10.1111/opo.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION There is scientific evidence that an individual's beliefs and/or expectations play a role in the behavioural and physiological response to a given treatment. This study aimed to assess whether the dynamics of the accommodative response and stereoacuity are sensitive to experimentally induced placebo and nocebo effects. METHODS Nineteen healthy university students performed three experimental sessions (placebo, nocebo and control) in randomised order, with the dynamics of the accommodative response (magnitude and variability), stereoacuity and subjective measures being assessed in all sessions. For the experimental manipulation, participants ingested an inert capsule that was alleged to have positive (white capsule, placebo condition) or negative (yellow capsule, nocebo conditions) effects on the human physiology. In the control condition, participants did not ingest a capsule. RESULTS The data revealed that the variability of accommodation was sensitive to experimentally induced placebo and nocebo effects, showing a more stable accommodative response for the placebo compared with the nocebo condition (corrected p-value = 0.04, Cohen's d = 0.60). In addition, better stereoacuity was found with the placebo, compared with the nocebo (corrected p-value = 0.01, Cohen's d = 0.69) and control (corrected p-value = 0.03, Cohen's d = 0.59) conditions. Successful experimental manipulation was confirmed by the analysis of subjective perceptions. CONCLUSIONS These findings provide evidence that manipulating expectations about the efficacy of an inert treatment affect the dynamics of the accommodative response (variability of accommodation) and stereoacuity. The results have important applications in both clinical and research outcomes, where individuals´ beliefs/expectations could modulate the visual function.
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Affiliation(s)
- Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of SciencesUniversity of GranadaGranadaSpain
| | - Beatriz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of SciencesUniversity of GranadaGranadaSpain
| | - Elena Ocaso
- Óptica del Penedes Optometry CenterZaragozaSpain
| | | | - Rubén Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of SciencesUniversity of GranadaGranadaSpain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of SciencesUniversity of GranadaGranadaSpain
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Yu H, Li W, Chen Z, Chen M, Zeng J, Lin X, Zhao F. Is Ocular Accommodation Influenced by Dynamic Ambient Illumination and Pupil Size? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10490. [PMID: 36078207 PMCID: PMC9518590 DOI: 10.3390/ijerph191710490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE We investigated ocular accommodative responses and pupil diameters under different light intensities in order to explore whether changes in light intensity aid effective accommodation function training. METHODS A total of 29 emmetropic and myopic subjects (age range: 12-18 years) viewed a target in dynamic ambient light (luminance: 5, 100, 200, 500, 1000, 2000 and 3000 lux) and static ambient light (luminance: 1000 lux) at a 40 cm distance with refractive correction. Accommodation and pupil diameter were recorded using an open-field infrared autorefractor and an ultrasound biological microscope, respectively. RESULTS The changes in the amplitude of accommodative response and pupil diameter under dynamic lighting were 1.01 ± 0.53 D and 2.80 ± 0.75 mm, respectively, whereas in static lighting, those values were 0.43 ± 0.24 D and 0.77 ± 0.27 mm, respectively. The amplitude of accommodation and pupil diameter change in dynamic lighting (t = 6.097, p < 0.001) was significantly larger than that under static lighting (t = 16.115, p < 0.001).The effects of light level on both accommodation and pupil diameter were significant (p < 0.001). CONCLUSION Accommodation was positively correlated with light intensity. The difference was about 1.0 D in the range of 0-3000 lux, which may lay the foundation for accommodative training through light intervention.
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Affiliation(s)
- Hanyang Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Wentao Li
- Huizhou Third People’s Hospital, Guangzhou Medical University, Huizhou 516000, China
| | - Ziping Chen
- Guangdong Wlight Visual Health Research Institute, Guangzhou 510150, China
| | - Mengzhen Chen
- Guangdong Wlight Visual Health Research Institute, Guangzhou 510150, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xijiang Lin
- Educational Equipment Center of Guangdong Province, Guangzhou 510240, China
| | - Feng Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
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Stasiak K, Zyskowska M, Głowinkowska I, Kowalczuk K, Lewkowicz R. Influence of night vision goggles with white and green phosphor screens on selected parameters of the eye and fatigue. ERGONOMICS 2022; 65:999-1014. [PMID: 34787060 DOI: 10.1080/00140139.2021.2008019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
In modern aviation, in particular in the military context, increasingly many aviation tasks are performed at night. To improve the safety of night flights, night vision goggles (NVGs) are commonly used. This study aimed to examine whether changes in ophthalmic parameters during NVGs use vary depending on phosphor screen type (green or white coded as P43 and P45 respectively). Thirteen participants were studied during a 2-h visual task in a night vision laboratory. Before and after NVGs use, we examined visual acuity, pachymetry, critical flicker-frequency thresholds, stereoscopic and contrast vision. During the use of NVGs, visual acuity, intra-ocular pressure and eye refraction were measured. We found no difference in visual performance between NVGs with green and white phosphor screens; however, NVGs use in general may lead to subjective eye fatigue, neck pain and headaches associated with the time of wearing and the weight of the helmet with additional equipment attached. Practitioner summary Night vision goggles (NVGs), widely used to improve the safety of night flights, were examined according to the applied type of the phosphor screen. There was no difference in visual performance between a white and green phosphor screens; however, NVGs and helmet manufacturers should strive to design these devices to be as lightweight as possible. Abbreviations: ANOVA: analysis of variance; CCT: central corneal thickness; CFF: critical flicker frequency; CNS: central nervous system; CS: contrast sensitivity; FOV: field-of-view; I2: image intensifier; IOP: intra-ocular pressure; NVGs: night vision goggles; SV: stereoscopic vision; VA: visual acuity; VAS: visual analog scale.
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Affiliation(s)
- Karol Stasiak
- Department of Ophthalmology, Military Institute of Aviation Medicine, Warsaw, Poland
| | - Małgorzata Zyskowska
- Department of Ophthalmology, Military Institute of Aviation Medicine, Warsaw, Poland
| | - Ilona Głowinkowska
- Department of Ophthalmology, Military Institute of Aviation Medicine, Warsaw, Poland
| | - Krzysztof Kowalczuk
- Simulator Study and Aeromedical Training Division, Military Institute of Aviation Medicine, Warsaw, Poland
| | - Rafał Lewkowicz
- Simulator Study and Aeromedical Training Division, Military Institute of Aviation Medicine, Warsaw, Poland
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Singh S, McGuinness MB, Anderson AJ, Downie LE. Interventions for the management of computer vision syndrome: a systematic review and meta-analysis. Ophthalmology 2022; 129:1192-1215. [PMID: 35597519 DOI: 10.1016/j.ophtha.2022.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
TOPIC To evaluate the efficacy and safety of interventions for treating eye strain related to computer use relative to placebo or no treatment. CLINICAL RELEVANCE Computer use is pervasive and often associated with eye strain, referred to as "computer vision syndrome" (CVS). Currently, there are no clinical guidelines to help practitioners provide evidence-based advice about CVS treatments, many of which are directly marketed to patients. This systematic review and meta-analysis will help inform best practice for eye care providers. METHODS Eligible randomized controlled trials (RCTs) were identified in Ovid MEDLINE, EMBASE, CENTRAL, and trial registries, searched from inception to November 23, 2021. Eligible studies were appraised for risk of bias, and synthesized. The certainty of the body of evidence was judged using GRADE. Standardized mean differences (SMD) were used when differently scaled measures were combined. RESULTS Forty-five RCTs, involving 4497 participants, were included. Multifocal lenses did not improve visual fatigue scores compared to single-vision lenses (three RCTs, SMD: 0.11; 95% confidence interval (CI) -0.14 to 0.37; p=0.38). Visual fatigue symptoms were not reduced by blue-blocking spectacles (three RCTs), with evidence judged to be of low certainty. Relative to placebo, oral berry extract supplementation for 4 to 12 weeks did not improve visual fatigue (seven RCTs, SMD: -0.27; 95%CI -0.70 to 0.16; p=0.22), and dry eye symptoms (four RCTs, SMD: -0.10; 95%CI -0.54 to 0.33; p=0.65). Likewise, berry extract supplementation had no effect on critical flicker-fusion frequency (CFF) or accommodative amplitude. Oral omega-3 fatty acid supplementation for 45 days to 3 months improved dry eye symptoms (two RCTs, mean difference, MD: -3.36 units out of 18; 95%CI -3.63 to -3.10; p<0.00001) relative to placebo. Oral carotenoid supplementation improved CFF (two RCTs, MD: 1.55 Hz; 95%CI 0.42 to 2.67; p=0.007) relative to placebo, although the clinical significance of this finding is unclear. CONCLUSIONS We found no high certainty evidence supporting the use of any of the therapies analyzed. There was low certainty evidence that oral omega-3 supplementation reduces dry eye symptoms in symptomatic computer users.
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Affiliation(s)
- Sumeer Singh
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia 3010
| | - Myra B McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne Australia 3010
| | - Andrew J Anderson
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia 3010
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia 3010.
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Redondo B, Vera J, Molina R, Galán T, Machado P, Jiménez R. Changes in accommodation and behavioural performance with a contact lens for myopia management: A comparison between a dual-focus and a single-vision soft contact lens. Ophthalmic Physiol Opt 2022; 42:753-761. [PMID: 35305040 PMCID: PMC9313609 DOI: 10.1111/opo.12978] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 12/02/2022]
Abstract
Introduction Dual‐focus soft contact lenses for myopia management have demonstrated to be an effective strategy to reduce myopia progression. However, this optical design has been shown to alter visual quality and accommodative function. The aim of this study was to examine the accommodative and behavioural performance during the execution of a psychomotor vigilance task (PVT) while wearing dual‐focus and single‐vision soft contact lenses. Methods The steady‐state accommodative response was recorded with the WAM‐5500 binocular open‐field autorefractor during the execution of a 10‐min PVT at 50 cm either with the dual‐focus (MiSight 1‐day) or single‐vision (Proclear 1‐day) soft contact lenses, using a sample of 23 healthy young adults. Each experimental session was performed on two different days in a counterbalanced order. Results A greater lag of accommodation, variability of accommodation and reaction time was found while wearing dual‐focus in comparison with single‐vision soft contact lenses (mean differences during the 10‐min PVT were 0.58 ± 0.81 D, p < 0.001; 0.31 ± 0.17 D, p < 0.001 and 15.22 ± 20.93 ms, p = 0.002, respectively). Also, a time‐on‐task effect was found for the variability of accommodation and reaction time (p = 0.001 and p < 0.001, respectively), observing higher values over time. However, the lag of accommodation did not change significantly as a function of time‐on‐task (p = 0.33). Conclusion Dual‐focus soft contact lens wear influences the steady‐state accommodative response and behavioural performance during the execution of a visual vigilance task in the short‐term. Eye care practitioners should be aware of these effects when prescribing these lenses for myopia management, and provide specific recommendations according to the individual visual needs.
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Affiliation(s)
- Beatriz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Rubén Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Tomás Galán
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Pedro Machado
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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Huang Y, Li M, Shen Y, Liu F, Fang Y, Xu H, Zhou X. Study of the Immediate Effects of Autostereoscopic 3D Visual Training on the Accommodative Functions of Myopes. Invest Ophthalmol Vis Sci 2022; 63:9. [PMID: 35113140 PMCID: PMC8819359 DOI: 10.1167/iovs.63.2.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Stereoscopic viewing has an impact on ocular dynamics, but its effects on accommodative functions are not fully understood, especially for autostereoscopic viewing. This study aimed to investigate the changes in dynamic accommodative response, accommodative amplitude, and accommodative facility of myopes after autostereoscopic visual training. Methods We enrolled 46 adults (men = 22 and women = 24; age = 21.5 ± 2.5 [range = 18–25] years, spherical equivalent: −4.52 ± 1.89 [−8.88 to −1.75] diopters [D]) who visited the Eye & ENT Hospital of Fudan University. The study population was randomly divided into three-dimensional (3D) and two-dimensional (2D) viewing groups to watch an 11-minute training video displayed in 3D or 2D mode. Dynamic accommodative response, accommodative facility, and accommodative amplitude were measured before, during, and immediately after the training. Accommodative lag and the variability of accommodation were also analyzed. Visual fatigue was evaluated subjectively using a questionnaire. Results Accommodative lag decreased from 0.54 ± 0.29 D to 0.42 ± 0.32 D (P = 0.004), whereas accommodative facility increased from 10.83 ± 4.55 cycles per minute (cpm) to 13.15 ± 5.25 cpm (P < 0.001) in the 3D group. In the 2D group, there was no significant change in the accommodative lag (P = 0.163) or facility (P = 0.975), but a decrease in accommodative amplitude was observed (from 13.88 ± 3.17 D to 12.71 ± 2.23 D, P = 0.013). In the 3D group, the accommodative response changed with the simulated target distance. Visual fatigue was relatively mild in both groups. Conclusions The immediate impact of autostereoscopic training included a decrease in the accommodative lag and an increase in the accommodative facility. However, the long-term effects of autostereoscopic training require further exploration.
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Affiliation(s)
- Yangyi Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Meiyan Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yang Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fang Liu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yong Fang
- Shanghai EVIS Technology Co. Ltd., Shanghai, China
| | - Haipeng Xu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Jiménez R, Redondo B, Galán T, Machado P, Molina R, Vera J. Impact of dual-focus soft contact lens wear on near work-induced transient myopia. Clin Exp Optom 2022; 106:296-302. [PMID: 35073496 DOI: 10.1080/08164622.2022.2029684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CLINICAL RELEVANCE Dual-focus soft contact lenses are effective in slowing myopia progression; however, their influence on near work-induced transient myopia (NITM) remains unknown. When performing a 5-min near task at 20 cm, we observed that dual-focus soft contact lens wear induced greater lags of accommodation and a lower initial NITM than single-vision soft contact lenses, which provides relevant information for better understanding the impact of using this optical design on the accommodative function. BACKGROUND NITM has been proposed as a myogenic factor, although it is a matter of debate by the scientific community. The main objective of this study was to assess the short-term effect of wearing dual-focus soft contact lenses for myopia control on the steady-state accommodative response and NITM. METHODS Twenty-four young myope adults wore, on two different days, dual-focus and single-vision soft contact lenses, while the accommodative response was dynamically measured with an open-field autorefractor during the execution of the NITM task. The shift and the time required to recover baseline levels in the refractive state after performing the 5-min near task (20 cm) were the main dependent variables. RESULTS We found a lower magnitude of accommodation during the execution of the near task with the dual-focus in comparison to the single-vision soft contact lenses (p < 0.001). There was a lower initial NITM with the dual-focus when compared to the single-vision lenses (corrected p-value = 0.003, Cohen's d = 0.68), but no statistically significant differences were observed for decay duration (p = 0.984). CONCLUSIONS Dual-focus soft contact lens wear causes a reduced accommodative response during a near task, and an initial small myopic shift at distance after a 5-min period of near viewing. The current findings may help to understand the mechanisms involved in myopia control with this optical strategy.
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Affiliation(s)
- Raimundo Jiménez
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Beatriz Redondo
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Tomás Galán
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Pedro Machado
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Rubén Molina
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Jesús Vera
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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25
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Devenier M, Hansraj R, Rasengane TA. The response of the accommodation system to digital and print images. AFRICAN VISION AND EYE HEALTH 2021. [DOI: 10.4102/aveh.v80i1.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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26
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Vera J, Redondo B, Koulieris GA, Molina R, Jiménez R. Examining the Validity of a New Method for the Objective Assessment of Binocular Accommodative Facility (2Q-AF Test): A Comparison with ± 2.00 DS Lens Flippers. Curr Eye Res 2021; 47:62-68. [PMID: 34612106 DOI: 10.1080/02713683.2021.1962359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Recent technological advances have permitted to objectively record the accommodative response while shifting between two different levels of accommodation. This study is aimed at examining the concurrent validity of a new objective method for the qualitative and quantitative assessment of binocular accommodative facility, which is named 2Q-AF test, in comparison to the ±2.00 DS lens flippers. METHODS Fifty-six individuals took part in this study (36 healthy young adults [24.4 ± 3.2 years] and 20 children [12.2 ± 0.4 years]). Participants randomly performed the 2Q-AF and the ±2.00 DS lens flipper tests. For the 2Q-AF test, a binocular open-field autorefractor was used to record the magnitude of accommodative response during a 60-sec period, while participants repeatedly changed fixation from a 5 m to a 40 cm chart when clarity of vision was achieved at each level. Due to the advantages of the proposed method, we have determined the number of cycles and the 2Q-AF score, with the latter also considering the accuracy of changes in accommodation. A standard procedure was followed for the ±2.00 DS flipper test. RESULTS Our data exhibited a moderate association between the number of cycles with the ±2.00 DS lens flippers and the number of cycles in the 2Q-AF test in the group of young adults (p = .005, r = 0.46 [0.15-0.68]) and children (p = .007, r = 0.58 [0.19-0.81]), whereas a stronger relationship was observed when considering the number of cycles with the ±2.00 DS lens flippers and the 2Q-AF score (young adults: p < .001, r = 0.83 [0.69-0.91]; and children: p < .001, r = 0.78 [0.52-0.91]). CONCLUSIONS The current findings show that the 2Q-AF test is a valid method for accommodative facility assessment, as suggested by its good levels of reliability and validity. This method allows to examine the accommodative facility in qualitative terms and solve most of the limitations associated with the ±2.00 DS lens flipper test.
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Affiliation(s)
- Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Beatriz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | | | - Rubén Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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Ong ACH, Cruickshank FE, Sheppard AL, Davies LN. The efficacy of multifocal soft contact lenses for the alleviation of asthenopic symptoms in myopes with accommodative lag. Cont Lens Anterior Eye 2021; 45:101514. [PMID: 34511307 DOI: 10.1016/j.clae.2021.101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the efficacy of multifocal soft contact lenses to reduce asthenopic symptoms in myopes with accommodative lag. METHODS Twenty-four myopic participants, aged 18-35 years, with mean spherical equivalent (MSE) of ≤ -0.75D, were recruited in a randomised, double-blind crossover study. All participants were existing contact lens wearer with near orthophoria or esophoria, presenting with subjective asthenopic symptoms at baseline [Convergence Insufficiency Symptom Survey (CISS) score ≥ 21] and a lag of accommodation ≥ +0.75 D. All participants were initially fitted with single vision contact lenses for a one month period. Participants were then randomly assigned 1:1 to wear low add or high add multifocal soft contact lenses for a further month. After this period, the groups were reversed. Data were collected at baseline and following one month's wear of each lens. Change in CISS score was evaluated as the primary outcome measure, while secondary outcome measures were changes in accommodative lag and heterophoria status. RESULTS Baseline CISS score was (mean ± SD) 25.04 ± 4.58. Post-intervention scores were as follows: single vision: 24.46 ± 4.59, low add: 12.17 ± 6.89, high add: 13.71 ± 7.23. Both low add and high add multifocal soft contact lens wear was associated with an improvement in CISS score compared to baseline CISS and single vision (all p < 0.01). No significant difference was found between the CISS score for the baseline CISS and single vision (p = 1.00). No significant difference was found in lag of accommodation between lens conditions (all p > 0.05), however, there was an exophoric shift in near heterophoria between single vision and both multifocal contact lenses (low add: (mean difference 1.33 Δ, p = 0.02; high add: mean difference 1.23 Δ, p = 0.02) but not between habitual spectacle or any other modality (all p > 0.05). CONCLUSIONS The use of multifocal soft contact lenses for a one-month period was associated with reduced severity of asthenopic symptoms in pre-presbyopic myopes with accommodative lag. Whilst improvement of symptoms does not appear to be mediated by a significant reduction in accommodative lag, changes in heterophoria may play a role in reducing asthenopic symptoms.
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Affiliation(s)
- Alex C H Ong
- Ong's Optics, Singapore; School of Optometry, Aston University, Birmingham, UK.
| | | | | | - Leon N Davies
- School of Optometry, Aston University, Birmingham, UK
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28
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Ortiz-Peregrina S, Ortiz C, Martino F, Castro-Torres JJ, Anera RG. Dynamics of the accommodative response after smoking cannabis. Ophthalmic Physiol Opt 2021; 41:1097-1109. [PMID: 34382240 DOI: 10.1111/opo.12851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Cannabis is the most widely consumed illicit drug worldwide. It has been suggested that cannabis could generate blurred vision during reading tasks. The goal of this study was to objectively assess the acute effects of smoking cannabis on the dynamics of ocular accommodation. The influence of other factors, including target distance and the direction of accommodation, as well as personal characteristics, were also analysed. METHODS Nineteen young people who were occasional cannabis users participated in the study (mean age 22.53 [3.12] years). Their usage profiles were evaluated by means of the Cannabis Use Disorders Identification Test-revised (CUDIT-r). The dynamics of the accommodative response were evaluated using an open-field auto refractor (Grand Seiko WAM-5500). The participants completed two different experimental sessions, one week apart, and in random order (baseline session and after smoking cannabis). During these sessions, the amplitude of the response (D), mean velocity (D/s), peak velocity (D/s), response time (s), accommodative lag (D) and accommodation variability (D) were measured. RESULTS The results indicated that cannabis use had a significant main effect on the mean accommodation/disaccommodation velocity (F1,13 = 7.21; p = 0.02; η p 2 = 0.396). Cannabis consumption also interacted significantly with other factors. Response time showed a significant two-way interaction between condition × target distance (F1,13 = 11.71; p = 0.005; η p 2 = 0.474) and condition × accommodation direction (F1,13 = 8.71; p = 0.01; η p 2 = 0.401). For mean velocity, two-way interactions were found between condition × age (F1,13 = 6.03; p = 0.03; η p 2 = 0.354), condition × CUDIT-r score (F1,13 = 6.03; p = 0.03; η p 2 = 0.356) and condition × target distance (F1,13 = 7.20; p = 0.02; η p 2 = 0.396). CONCLUSIONS These findings suggest that cannabis use can alter the accommodation process, although further studies should be carried out to explore the role of attention deficits. According to these results, certain daily activities that depend on an accurate accommodative function may be affected by cannabis use.
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Affiliation(s)
- Sonia Ortiz-Peregrina
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, Spain
| | - Carolina Ortiz
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, Spain
| | - Franceso Martino
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, Spain
| | - José J Castro-Torres
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, Spain
| | - Rosario G Anera
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, Spain
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Alsaqr AM, AlShareef H, Alhajri F, Abusharha A, Fagehi R, Alharbi A, Alanazi S. Accommodative Response in Patients with Central Field Loss: A Matched Case-Control Study. Vision (Basel) 2021; 5:vision5030035. [PMID: 34287385 PMCID: PMC8293396 DOI: 10.3390/vision5030035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose: This study was conducted to evaluate the accommodative response in young participants with visual impairment in comparison with visually normal participants. Methods: Fifteen participants with confirmed visual impairment and 30 visually normal participants aged 12–15 years were recruited. Accommodative response was measured using autorefractor (Grand Seiko WV500) at distances of accommodative demand of 33, 25, and 20 cm. The targets were one-line-above participant threshold acuity. The participants’ accommodative responses were compared between both groups after calibration for refractive errors and the vertex distance of the glasses. Visual acuity and refractive status were also assessed. Results: The age was not significantly different between both participant groups. The visual acuity of visually impaired patients was 6/30 to 6/240, and that of visually normal participants was 6/7.5 or better. Ten of the visually impaired patients and 29 of visually normal participants were myopic. In total, 61–73% of visually impaired patients showed an accommodative lead. Five subtypes of accommodative response were observed. In general, the accommodative inaccuracy increased with increasing accommodative demand. However, the visually normal participants largely exhibited an accommodative lag. A mild-to-moderate relationship was observed between visual acuity and accommodative response (r = 0.3–0.5, p < 0.05). Conclusion: Accommodative response in young visually impaired patients can be variable and on an individual basis. Low vision specialists should anticipate accommodative response outside the normal range. Therefore, we shall consider evaluating each patient’s accommodative response before prescribing any near addition lenses. Accommodation inaccuracy is often more complex than predicted due to increased depth of focus caused by reduced visual acuity.
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Fogt JS, Onate J, Emerson A, Kraemer W, Fogt N. Visual and Ocular Characteristics of eSports Participants. Optom Vis Sci 2021; 98:771-776. [PMID: 34328456 DOI: 10.1097/opx.0000000000001725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE The popularity of competitive video game play is growing rapidly. Little is known about the ocular characteristics of esports participants. Refractive error and binocular measures in young adult gamers were similar to population norms. However, tear breakup time was lower, and accommodative lag was higher. PURPOSE In a recent report, very young video game players were found to have greater levels of refractive error and heterophoria and reduced stereopsis. The purpose of this study was to assess the visual and ocular characteristics of a group of recreational esports athletes to determine if the findings in young children were similar to findings in a group of young adult video game players. METHODS Vision tests were performed on 36 college students during a video game combine event. Testing included high- and low-contrast visual acuity, autorefraction at distance and at 33 cm, stereoacuity, near heterophoria, and tear breakup time. Participants also indicated their level or rank in the game Overwatch. RESULTS Fifteen participants were myopic, and 21 did not wear vision correction. The mean local stereopsis was 31.9 seconds. The mean of the esophoric value was 3.2 prism diopters, and the mean of the exophoric value was 5.7 prism diopters. The mean lag of accommodation was 0.81 D. The mean tear breakup time was 5.8 seconds. Average hours of play did not differ between those who wore vision correction and those who did not. There were no significant relationships between the hours of play and the ocular findings. CONCLUSIONS The prevalence of refractive error and the mean heterophoria were similar to population norms, and the mean stereoacuity was normal. However, accommodative lag was slightly higher, and the tear breakup time was lower than expected. Differences in these latter values were also noted between high- and low-level Overwatch players.
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Affiliation(s)
| | | | - Angela Emerson
- Human Performance Collaborative, The Ohio State University, Office of Research, Columbus, Ohio
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Redondo B, Vera J, Koulieris GA, Molina-Romero R, Jiménez R. Short-term effects of caffeine intake on binocular accommodative facility: a quantitative and qualitative analysis. Clin Exp Optom 2021; 105:534-538. [PMID: 34134591 DOI: 10.1080/08164622.2021.1935218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
CLINICAL RELEVANCE Caffeine intake has been demonstrated to influence several physiological measures, including some related to eye physiology. The ability to focus at different distances is of paramount importance in real-world situations, and thus, the possible impact of caffeine intake on accommodative facility may have important clinical implications. BACKGROUND This placebo-controlled, double-blind, balanced crossover study aimed to assess the acute effects of caffeine ingestion on the frequency and precision of the binocular accommodative facility. METHODS Twenty university students (21.9 ± 3.4 years) ingested a capsule of caffeine (4 mg/kg) or placebo (300 mg of corn-starch) on two different days and counterbalanced order. The binocular accommodative facility was objectively assessed, using the WAM-5500 binocular open-field autorefractometer, after 60 min of capsule ingestion (caffeine/placebo). Perceived levels of activation was also assessed in each experimental condition. RESULTS The ingestion of a single administration of caffeine (~ 4 mg/kg) causes an increase in the number of cycles performed per minute (p = 0.023, Cohen's d = 0.55), whereas no effects were observed for the mean magnitude of accommodative change between the far and near targets (p = 0.794), and the percentage of incorrect cycles of accommodation and dis-accommodation (p = 0.271 and 0.396, respectively). Participants reported a perceived level of activation of 6.8 ± 1.5 and 7.6 ± 1.8 in the placebo and caffeine conditions, respectively (p = 0.059). CONCLUSION Caffeine intake improves quantitative, but not qualitative, measures of accommodative facility. These results corroborate the impact of caffeine on visual function and suggest that this ergogenic effect of caffeine may be used to enhance visual performance in applied situations.
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Affiliation(s)
- Beatriz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | | | - Rubén Molina-Romero
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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Molina R, Redondo B, Molina-Carballo A, García JA, Muñoz-Hoyos A, Vera J, Jiménez R. Capturing attention improves accommodation: An experimental study in children with ADHD using multiple object tracking. Vision Res 2021; 186:52-58. [PMID: 34051609 DOI: 10.1016/j.visres.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/15/2022]
Abstract
The present study was aimed at assessing the impact of manipulating the attentional load using a multiple object tracking (MOT) task on the dynamics of the accommodative response in children with attention deficit hyperactivity disorder (ADHD). The pupil size was recorded to assess the effectiveness of the experimental manipulation, and the role of ADHD medication was also explored. The accommodative and pupil dynamics (magnitude and variability) were monitored with an open-field autorefractometer (WAM-5500) in 41 children with ADHD (24 non-medicated and 17 medicated) and 21 non-ADHD controls, while they performed the MOT task with four different levels of complexity (i.e., tracking zero, one, two, or three targets). We found that increasing the attentional load caused a heightened accommodative response, showing a negative association between MOT complexity and accommodative lag in children with ADHD and non-ADHD controls. Complementarily, the pupil size increased as a function of task complexity, confirming a successful experimental manipulation. The stability of accommodation was insensitive to the attentional manipulation, but it differed between groups. Specifically, non-medicated children with ADHD exhibited a greater variability of accommodation in comparison to controls. Increasing the attentional load is associated with a reduction in the accommodative lag in children with ADHD and controls. Our findings show that the allocation of attention plays an important role in the dynamics of the accommodative response, which may be of relevance in the diagnosis and treatment of accommodative deficits in children with and without ADHD.
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Affiliation(s)
- Rubén Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Beatriz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain.
| | - Antonio Molina-Carballo
- Faculty of Medicine, University of Granada, Neuropediatric and Neurodevelopment Unit of Clinico San Cecilio University Hospital, Spain
| | - José Antonio García
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Antonio Muñoz-Hoyos
- Faculty of Medicine, University of Granada, Neuropediatric and Neurodevelopment Unit of Clinico San Cecilio University Hospital, Spain
| | - Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
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Jaiswal S, Asper L, Long J, Lee A, Harrison K, Golebiowski B. Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know. Clin Exp Optom 2021; 102:463-477. [DOI: 10.1111/cxo.12851] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/06/2018] [Accepted: 10/07/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sukanya Jaiswal
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Lisa Asper
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Jennifer Long
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Abigail Lee
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Kirsten Harrison
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Blanka Golebiowski
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
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Monger LJ, Shah D, Wilkins AJ, Allen PM. The effect of viewing distance on responses to the pattern glare test. Clin Exp Optom 2021; 99:47-50. [DOI: 10.1111/cxo.12364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 04/01/2015] [Accepted: 04/06/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Laura J Monger
- Department of Vision and Hearing Sciences and Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK,
| | - Dhruvi Shah
- Department of Vision and Hearing Sciences and Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK,
| | - Arnold J Wilkins
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester, UK,
| | - Peter M Allen
- Department of Vision and Hearing Sciences and Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK,
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Kang JW, Chun YS, Moon NJ. A comparison of accommodation and ocular discomfort change according to display size of smart devices. BMC Ophthalmol 2021; 21:44. [PMID: 33461518 PMCID: PMC7814593 DOI: 10.1186/s12886-020-01789-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 12/22/2020] [Indexed: 12/01/2022] Open
Abstract
Background To evaluate the change of accommodation and ocular discomfort according to the display size, using quantitative measurements of accommodation and ocular discomfort through subjective and objective metrics. Methods Forty six subjects without any ophthalmic disease history were asked to watch the documentary movie, using two different sizes of smart devices; smartphones and tablets. Before and after using devices, the near point accommodation (NPA) and the near point convergence (NPC) were measured, and objective accommodation was measured using an auto refractometer/keratometer. The subjective ocular discomfort was assessed through a survey. Results Both devices showed a decrease in post-use NPA and NPC, and the change after use of the smartphone was significantly severe, 1.8 and 2.5 folds respectively, compared to tablet (p = 0.044, p = 0.033, respectively). Neither smartphone nor tablet showed significant changes in the accommodative response induced by dynamic accommodative stimulus of auto refractometer/keratometer (p = 0.240 and p = 0.199, respectively). Subjects showed a more severe increase in ocular discomfort after using smartphones (p = 0.035) and reported feeling tired even with shorter use times (p = 0.012). Conclusions Both devices showed significant decreases in NPA and NPC, and the larger changes were seen when using the small display smartphone. Even within 20minutes of using, subjects start to feel ocular discomfort, and it was more severe and faster after smartphones than tablets. Therefore, the smaller the display size, the greater the adverse impact on eyes, and thus, appropriate display size will need to be selected depending on the time and purpose of use.
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Affiliation(s)
- Jeong Woo Kang
- Department of Ophthalmology, Airforce 16th Fighter Wing Medical Squadrone, Yecheon, Gyeongsangbuk-Do, South Korea
| | - Yeoun Sook Chun
- Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, 06974, Seoul, South Korea
| | - Nam Ju Moon
- Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, 06974, Seoul, South Korea.
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Redondo B, Vera J, Ortega-Sánchez A, Molina R, Jiménez R. Effects of a blue-blocking screen filter on accommodative accuracy and visual discomfort. Ophthalmic Physiol Opt 2020; 40:790-800. [PMID: 33001489 DOI: 10.1111/opo.12738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The prescription of blue-blocking (B-B) filters for the management of visual symptoms and signs associated with the use of electronic devices is routinely performed by eye care specialists. However, the utility of B-B filters is a matter of debate and discussion by the scientific community due to the lack of evidence supporting their use. Here, we aimed to determine the effects of using B-B filters on the dynamics of the accommodative response and pupil size and perceived levels of visual discomfort, while performing a 30-min reading task at a close distance in subjects who routinely use electronic devices. METHODS Nineteen healthy young adults (22.0 ± 2.7 years) read two 30-min passages on a computer screen placed at 50 cm, either while using a commercially available B-B filter or without any filter on two different days. The magnitude and variability of both the accommodative response and pupil size were dynamically measured for 60 s using the WAM-5500 open field autorefractometer at 4-5, 9-10, 14-15, 19-20, 24-25, and 29-30 min into the trial. The perceived levels of visual discomfort were also obtained. RESULTS The lag and variability of accommodation were insensitive to the blue light level (p = 0.34 and 0.62, respectively). There was a time-on-task effect for the variability of accommodation, showing greater instability over time regardless of the blue light level. The use of the B-B filter was associated with improved reading speed (p = 0.02), with an increase of 16.5 words per minute. However, it was not associated with any significant change in pupil dynamics or the perceived levels of visual discomfort (p> 0.05 in both cases). CONCLUSIONS Our data showed that the use of a B-B filter had no effect on accommodative dynamics or visual symptomatology. Based on these findings, there is no support for the prescription of B-B filters to attenuate the visual symptoms and signs associated with the use of electronic devices in healthy young adults.
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Affiliation(s)
| | - Jesús Vera
- Department of Optics, University of Granada, Granada, Spain
| | | | - Rubén Molina
- Department of Optics, University of Granada, Granada, Spain
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Redondo B, Vera J, Molina R, Garcia JA, Catena A, Muñoz-Hoyos A, Jimenez R. Accommodation and pupil dynamics as potential objective predictors of behavioural performance in children with attention-deficit/hyperactivity disorder. Vision Res 2020; 175:32-40. [DOI: 10.1016/j.visres.2020.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 02/05/2023]
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Accommodative Behavior, Hyperopic Defocus, and Retinal Image Quality in Children Viewing Electronic Displays. Optom Vis Sci 2020; 97:628-640. [DOI: 10.1097/opx.0000000000001543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Yoon HJ, Kim J, Park SW, Heo H. Influence of virtual reality on visual parameters: immersive versus non-immersive mode. BMC Ophthalmol 2020; 20:200. [PMID: 32448140 PMCID: PMC7245896 DOI: 10.1186/s12886-020-01471-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/13/2020] [Indexed: 11/10/2022] Open
Abstract
Abstract Background To investigate the differences in refraction, accommodative factors, visual parameters, and subjective symptoms after using two types of virtual reality (VR) content with different depths of perception. Methods Twenty-three volunteers, who played VR games in two modes (immersive and non-immersive) for 30 min, were enrolled. Visual parameters were examined before and after using VR. Accommodative factors were measured using static and dynamic methods. Subjective symptoms were assessed using a questionnaire. Differences according to VR content were compared, and correlations between each visual parameter were analyzed. Results There were no changes in refraction or accommodative factors after use of the VR. However, there was a significant increase in the near point of accommodation (NPA), the near point of convergence (NPC), and subjective symptom scores after using the immersive mode. Correlation analysis revealed a positive correlation between baseline values of near exophoria and mean accommodative lag of the dominant eye, and also revealed a negative correlation between NPA and mean accommodative lag in the non-dominant eye. Conclusions The use of VR for 30 min increased NPA and NPC, especially after the immersive mode was used. In addition, higher exophoria and smaller NPA is associated with increased accommodative lag after using VR.
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Affiliation(s)
- Hyeon Jeong Yoon
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Jonghwa Kim
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Sang Woo Park
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hwan Heo
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
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Redondo B, Vera J, Molina R, Davies LN, Jiménez R. Accommodative dynamics and attention: the influence of manipulating attentional capacity on accommodative lag and variability. Ophthalmic Physiol Opt 2020; 40:510-518. [DOI: 10.1111/opo.12690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 01/31/2023]
Affiliation(s)
| | - Jesús Vera
- Department of Optics University of Granada Granada Spain
| | - Rubén Molina
- Department of Optics University of Granada Granada Spain
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Accommodative response in children with attention deficit hyperactivity disorder (ADHD): the influence of accommodation stimulus and medication. Graefes Arch Clin Exp Ophthalmol 2020; 258:1299-1307. [DOI: 10.1007/s00417-020-04645-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/05/2020] [Accepted: 03/04/2020] [Indexed: 12/14/2022] Open
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Nunes AF, Monteiro PL, Nunes AS. Factor structure of the convergence insufficiency symptom survey questionnaire. PLoS One 2020; 15:e0229511. [PMID: 32092119 PMCID: PMC7039507 DOI: 10.1371/journal.pone.0229511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/09/2020] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study is to analyze the factorial structure of the Convergence Insufficiency Symptom Survey questionnaire with 15 items, in order to identify latent dimensions that can contribute to a more focused implementation. The questionnaire was self-administered in paper by 183 university students, in the age span of 18 to 30. Both Kaiser-Meyer-Olkin measure and Bartlett's sphericity test were performed to ensure the validity of the factorization. In order to analyze the principal components, factors which obtained eigenvalues greater than 1 were chosen. The extraction of factors was performed after computing a Promax rotation and a Kaiser criterion. In each extracted factor, the internal consistency was used to prove its reliability. Bartlett's sphericity test was statistically significant (p <0.001), and the Both Kaiser-Meyer-Olkin test was 0.89, confirming the factorization of this instrument. Exploratory factor analysis followed by a Promax rotation and scree plots graphic, extracted three factors that explained 62.1% of the total variance. The composition of each factor suggests the following meanings: Factor 1 (somatic sensation) includes 8 of 15 items; Factor 2 (impaired vision) includes 3 of 15 items; Factor 3 (cognitive performance) includes 4 of 15 items. Cronbach's alpha coefficient demonstrated good internal consistency (α> 0.75) in three dimensions. The multivariate statistical analysis of the Convergence Insufficiency Symptom Survey revealed a three-factor structure, so new forms of questionnaire analysis can be designed in order to obtain gains in the management of a symptomatic patient, using 3 subscores, one for each factor, instead of a total score. The factorial structure of the questionnaire can be used with a high level of confidence in future investigations, which aim to assess which dimensions are most affected in each type of visual changes and develop more targeted therapeutic performances.
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Affiliation(s)
- Amélia Fernandes Nunes
- Universidade da Beira Interior, Covilhã, Portugal
- Health Sciences Research Centre (CICS-UBI), UBIMedical, Covilhã, Portugal
- * E-mail:
| | - Pedro Lourenço Monteiro
- Universidade da Beira Interior, Covilhã, Portugal
- Health Sciences Research Centre (CICS-UBI), UBIMedical, Covilhã, Portugal
| | - António Santos Nunes
- Universidade da Beira Interior, Covilhã, Portugal
- Research Unit in Business Sciences (NECE), Covilhã, Portugal
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Short-term effects of text-background color combinations on the dynamics of the accommodative response. Vision Res 2020; 166:33-42. [DOI: 10.1016/j.visres.2019.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/26/2019] [Accepted: 11/29/2019] [Indexed: 11/21/2022]
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Effect of Vision Therapy on Accommodative Lag in Myopic Children: A Randomized Clinical Trial. Optom Vis Sci 2019; 96:17-26. [PMID: 30575616 DOI: 10.1097/opx.0000000000001316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
SIGNIFICANCE Accommodative dysfunction has been suggested to be related to the development and progression of myopia. Office-based accommodative/vergence therapy (OBAVT) improved accommodative facility in Chinese myopic children, but it is unclear if such improvement has a role in decreasing myopic progression. PURPOSE The purpose of this study was to compare the effects of OBAVT with home reinforcement and office-based placebo therapy (OBPT) as a treatment to improve accommodative functions (i.e., lag, amplitude, and facility) in myopic children with poor accommodative accuracy. METHODS This was a prospective, single-masked, randomized clinical trial. Thirty-four Chinese children 8 to 12 years old with myopia and at least 1 diopter of lag of accommodation measured by autorefraction were enrolled. The participants were randomly assigned to the OBAVT or OBPT group. The primary outcome measure was the change in the monocular lag of accommodation from the baseline visit to the 13-week visit measured by a Shin-Nippon open-field autorefractor. Secondary outcome measures were changes in accommodative amplitude and monocular accommodative facility. RESULTS A total of 33 participants completed the study. After 12 weeks of treatment, there were significant improvements in the lag of accommodation in both the OBAVT and OBPT groups (OBAVT: -0.30 ± 0.29 diopters [P < .001; Cohen's d effect size, 1.29]; OBPT: -0.24 ± 0.30 diopters [P = .005; Cohen's d effect size, 1.24]). There was no statistically significant difference between the improvements in the two groups (P = .50). There was statistically significant improvement in monocular accommodative facility only in the OBAVT group (OBAVT: 7.7 ± 4.7 cycles per minute [P < .001; Cohen's d effect size, 2.20]; OBPT: 1.9 ± 4.4 cycles per minute [P = .072]). The change in the OBAVT group was statistically significantly larger than that in the OBPT group (P < .001). CONCLUSIONS Office-based accommodative/vergence therapy was no more effective than OBPT in reducing the lag of accommodation in children 8 to 12 years old with low to moderate myopia. It did improve accommodative facility in Chinese myopic children, but it is unclear if such an improvement has a role in decreasing myopic progression.
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Wang Y, Zhai G, Chen S, Min X, Gao Z, Song X. Assessment of eye fatigue caused by head-mounted displays using eye-tracking. Biomed Eng Online 2019; 18:111. [PMID: 31729983 PMCID: PMC6858717 DOI: 10.1186/s12938-019-0731-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 11/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Head-mounted displays (HMDs) and virtual reality (VR) have been frequently used in recent years, and a user's experience and computation efficiency could be assessed by mounting eye-trackers. However, in addition to visually induced motion sickness (VIMS), eye fatigue has increasingly emerged during and after the viewing experience, highlighting the necessity of quantitatively assessment of the detrimental effects. As no measurement method for the eye fatigue caused by HMDs has been widely accepted, we detected parameters related to optometry test. We proposed a novel computational approach for estimation of eye fatigue by providing various verifiable models. RESULTS We implemented three classifications and two regressions to investigate different feature sets, which led to present two valid assessment models for eye fatigue by employing blinking features and eye movement features with the ground truth of indicators for optometry test. Three graded results and one continuous result were provided by each model, respectively, which caused the whole result to be repeatable and comparable. CONCLUSION We showed differences between VIMS and eye fatigue, and we also presented a new scheme to assess eye fatigue of HMDs users by analysis of parameters of the eye tracker.
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Affiliation(s)
- Yan Wang
- Institute of Image Communication and Network Engineering, Shanghai Key Laboratory of Digital Media Processing and Transmissions, Shanghai Jiao Tong University, Shanghai, China.
| | - Guangtao Zhai
- Institute of Image Communication and Network Engineering, Shanghai Key Laboratory of Digital Media Processing and Transmissions, Shanghai Jiao Tong University, Shanghai, China
| | - Sichao Chen
- Institute of Ophthalmology and Vision Science of Beijing, Beijing, China
| | - Xiongkuo Min
- Institute of Image Communication and Network Engineering, Shanghai Key Laboratory of Digital Media Processing and Transmissions, Shanghai Jiao Tong University, Shanghai, China
| | - Zhongpai Gao
- Institute of Image Communication and Network Engineering, Shanghai Key Laboratory of Digital Media Processing and Transmissions, Shanghai Jiao Tong University, Shanghai, China
| | - Xuefei Song
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.,Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Vera J, Redondo B, Molina R, Koulieris GA, Jiménez R. Validation of an Objective Method for the Qualitative and Quantitative Assessment of Binocular Accommodative Facility. Curr Eye Res 2019; 45:636-644. [DOI: 10.1080/02713683.2019.1688837] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jesús Vera
- Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Beatríz Redondo
- Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Rubén Molina
- Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | | | - Raimundo Jiménez
- Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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Kaphle D, Atchison DA, Schmid KL. Multifocal spectacles in childhood myopia: Are treatment effects maintained? A systematic review and meta-analysis. Surv Ophthalmol 2019; 65:239-249. [PMID: 31622629 DOI: 10.1016/j.survophthal.2019.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/25/2019] [Accepted: 10/04/2019] [Indexed: 12/22/2022]
Abstract
We evaluate the impact of duration on the treatment effect of multifocal spectacle lenses used to inhibit myopia progression in children. A systematic literature search identified randomized controlled trials where multifocal lenses were prescribed as the intervention, with single-vision lenses as the control. Nine randomized control trials involving 1,701 children aged 8-13 years were included in the meta-analysis. Treatment effects, that is, differences in spherical equivalent refraction between intervention and nonintervention groups, were analyzed over both 6- and 12-month intervals. As treatment duration increased, effectiveness reduced. In 6-month intervals, treatment effects were 0.07 D (95 % CI 0.02, 0.13), 0.03 D (95% CI -0.02, 0.08), and 0.02 D (95% CI -0.05, 0.11) for baseline to 6, 6-12, and 12-18 months, respectively. For 12-month intervals, treatment effects were 0.21 D (95% CI 0.12, 0.29), 0.11 D (95% CI 0.03, 0.19), and 0.12 D (95% CI -0.01, 0.25) for baseline to 12, 12-24, and 24-36 months, respectively. Even during the second 6 months of wear, the ability of multifocal spectacle lenses to inhibit myopia progression was reduced. It is not appropriate to extrapolate the treatment effect observed in the first 6 months or 12 months to estimate the likely future benefit of treatment.
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Affiliation(s)
- Dinesh Kaphle
- School of Optometry and Vision Sciences and Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
| | - David A Atchison
- School of Optometry and Vision Sciences and Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Katrina L Schmid
- School of Optometry and Vision Sciences and Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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Redondo B, Vera J, Luque-Casado A, García-Ramos A, Jiménez R. Associations between accommodative dynamics, heart rate variability and behavioural performance during sustained attention: A test-retest study. Vision Res 2019; 163:24-32. [PMID: 31374236 DOI: 10.1016/j.visres.2019.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 12/19/2022]
Abstract
This study evaluated the time-on-task effect of a sustained attention task on the accommodative response, explored the link between ocular accommodation, cardiac autonomic regulation and behavioral performance, and tested the inter-session repeatability of these results by performing the same experimental procedure on different days. The accommodative response was measured in 25 university students using a WAM-5500 autorefractor, while participants performed a 10-minute psychomotor vigilance task at 50 cm. There were no time-on-task effects for the lag of accommodation, whereas the microfluctuations of accommodation and reaction time were modulated as a function of time-on-task, observing a progressive increment of both variables over time. Multiple regression analysis revealed that the microfluctuations of accommodation were a reasonably good predictor of behavioral performance. Analysis of inter-session repeatability showed that ocular accommodation, heart rate variability and reaction time had a low to moderate level of repeatability between two measurements. The microfluctuations of accommodation were sensitive to time-on-task effects during sustained attention, with a lower stability of accommodation being linked to reduced behavioral performance. The predictive capacity of the variability of accommodation for behavioral performance might be explained by the brain mechanisms shared by the ocular dynamics and attentional state; however, future studies would be required to elucidate this association. The low to moderate inter-session repeatability indicated that results in two measurement periods cannot be considered interchangeable, and therefore, the results of this study should be interpreted cautiously in this regard.
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Affiliation(s)
- Beatriz Redondo
- Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Jesús Vera
- Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain.
| | - Antonio Luque-Casado
- Center for Sport Studies, King Juan Carlos University, Madrid, Spain; Mind, Brain and Behaviour Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Amador García-Ramos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain; Department of Sports Sciences and Physical Conditioning, Faculty of Education, CIEDE, Catholic University of Most Holy Concepción, Concepción, Chile
| | - Raimundo Jiménez
- Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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Caffeine alters the dynamics of ocular accommodation depending on the habitual caffeine intake. Exp Eye Res 2019; 185:107663. [DOI: 10.1016/j.exer.2019.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/06/2019] [Accepted: 05/08/2019] [Indexed: 11/23/2022]
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50
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Dynamics of the accommodative response under artificially-induced aniseikonia. Exp Eye Res 2019; 185:107674. [DOI: 10.1016/j.exer.2019.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 02/01/2023]
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