1
|
Nitzan I, Akavian I, Shmueli O, Erdinest N, Hanina Y, Twig G, Safir M. Body mass index and astigmatism: A nationwide study. Clin Exp Ophthalmol 2024. [PMID: 38803147 DOI: 10.1111/ceo.14406] [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: 03/01/2024] [Revised: 04/12/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Existing research on the relationship between body mass index (BMI) and astigmatism yields inconsistent results. This study analyses this association in a nationally representative sample of adolescents. METHODS This retrospective, cross-sectional study included Israeli adolescents who underwent medical assessments before mandatory military service between 2011 and 2022. BMI was categorised based on the US age- and sex-matched percentiles. Astigmatism was categorised by magnitude [low-moderate: 0.75 to <3.00 diopters (D), high: ≥3.00 D], and axis orientation [with-the-rule (WTR), against-the-rule (ATR), or oblique (OBL)]. Sex-stratified regression models adjusted for sociodemographic variables were used. RESULTS Of 935 989 adolescents evaluated, 887 325 were included [511 465 (57.6%) males, mean age 17.2 years]. Astigmatism was diagnosed in 123 675 (13.9%) adolescents, of whom 117 081 (13.2%) had low-moderate and 6594 (0.7%) had high astigmatism. WTR astigmatism was the most prevalent (8.2%), followed by ATR (4.1%) and OBL (1.6%) types. Compared with low-normal BMI (5th to 50th percentile), the adjusted ORs for total astigmatism increased with increasing BMI, peaking at 1.65 (1.57-1.74) in males and 1.74 (1.64-1.86) in females with severe obesity. ORs were accentuated for high astigmatism, reaching 3.51 (3.01-4.09) in males, and 3.45 (2.83-4.22) in females with severe obesity. WTR astigmatism demonstrated the strongest association with BMI, with ORs reaching 2.26 (2.13-2.40) in males and 2.04 (1.90-2.20) in females with severe obesity. The results persisted in a series of subgroup analyses. CONCLUSIONS Obesity is associated with higher odds of astigmatism in adolescence. Further investigation into the role of weight management in astigmatism development is warranted.
Collapse
Affiliation(s)
- Itay Nitzan
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Inbal Akavian
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Or Shmueli
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Nir Erdinest
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Yair Hanina
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Margarita Safir
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Department of Ophthalmology, Shamir Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
2
|
Gargallo D, Martinez-Espert A, Perches S, Victoria Collados M, Remón Martín L, Ares J. Multi-toric optical element to compensate ocular astigmatism with increased tolerance under rotation. OPTICS LETTERS 2024; 49:2289-2292. [PMID: 38691701 DOI: 10.1364/ol.518973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 05/03/2024]
Abstract
A new, to the best of our knowledge, optical element designed to compensate regular astigmatism while exhibiting increased tolerance to rotational misalignment is introduced. The element incorporates an optical design based on concentric annular regions with slightly different cylindrical axis angular positions. To assess visual quality performance as a function of rotation, retinal image simulation and clinical assessments with an adaptive optics visual simulator were carried out. The results demonstrate the superior performance of the newly proposed element in the presence of rotational errors when compared to traditional solutions.
Collapse
|
3
|
Chen X, Jiang Y, Gao N, Gao Y, Yang J, Bu S, Tian F. Effectiveness of toric intraocular lens implantation for correcting irregular corneal astigmatism in cataract eyes. Sci Rep 2024; 14:8868. [PMID: 38632326 PMCID: PMC11024119 DOI: 10.1038/s41598-024-59303-0] [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: 01/18/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
A retrospective cohort study was conducted to observe the correction effect of Toric intraocular lens (IOL) implantation in cataract eyes with specific types of irregular corneal astigmatism. Thirty-four eyes with either the "asymmetric bow-tie" pattern (Type I) or the "angled bow-tie" pattern (Type II) were included. Corneal topography was assessed using Pentacam HR, and changes in preoperative corneal astigmatism, visual acuity, manifest refraction, and objective visual quality were measured and compared. The average uncorrected distance visual acuity improved significantly from 0.86 ± 0.40 logMAR to 0.22 ± 0.15 logMAR (P < 0.001). Preoperative corneal astigmatism of 2.05 ± 0.90 D was corrected to a postoperative residual astigmatism of 0.78 ± 0.57 D (P < 0.001), with 32% of eyes within 0.50 D. The residual astigmatism prediction errors in Type I and Type II cases were (0.97 ± 0.68 D) and (0.66 ± 0.37 D), respectively (P = 0.100). The mean spherical equivalent prediction error in Type II cases (0.07 ± 0.36 D) was significantly smaller than that in Type I cases (- 0.29 ± 0.52 D) (P = 0.030). This study concludes that Toric IOL implantation effectively corrects specific types of irregular corneal astigmatism in cataract surgery. Eyes with the "angled bow-tie" pattern show higher accuracy in refractive predictions compared to eyes with the "asymmetric bow-tie" pattern.
Collapse
Affiliation(s)
- Xiteng Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300000, China
| | - Yuanfeng Jiang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300000, China
| | - Nan Gao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300000, China
| | - Yichen Gao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300000, China
| | - Jun Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300000, China
| | - Shaochong Bu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300000, China.
| | - Fang Tian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300000, China.
| |
Collapse
|
4
|
Morgan PB, Efron N, Papas E, Barnett M, Carnt N, Dutta D, Hepworth A, Little JA, Nagra M, Pult H, Schweizer H, Shen Lee B, Subbaraman LN, Sulley A, Thompson A, Webster A, Markoulli M. BCLA CLEAR Presbyopia: Management with contact lenses and spectacles. Cont Lens Anterior Eye 2024:102158. [PMID: 38631935 DOI: 10.1016/j.clae.2024.102158] [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: 04/19/2024]
Abstract
This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.
Collapse
Affiliation(s)
- Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom.
| | - Nathan Efron
- Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Eric Papas
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Nicole Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Debarun Dutta
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - Andy Hepworth
- EssilorLuxottica Europe North, Bristol, United Kingdom
| | - Julie-Anne Little
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
| | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Young Street, Cambridge, United Kingdom
| | - Heiko Pult
- Dr Heiko Pult - Optometry and Vision Research, Weinheim, Germany
| | - Helmer Schweizer
- CEO Helmer Schweizer Consulting Group (HSCG), Bassersdorf, Switzerland
| | - Bridgitte Shen Lee
- Vision Optique and Ocular Aesthetics dba Ocular Clinical Trials, Houston, TX, United States
| | | | - Anna Sulley
- CooperVision International Ltd, Chandlers Ford, United Kingdom
| | | | | | - Maria Markoulli
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| |
Collapse
|
5
|
Wang Y, Mu J, Yang Y, Li X, Qin H, Mulati B, Wang Z, Gong W, Zhao Y, Gao Y. Prevalence and risk factors for astigmatism in 7 to 19-year-old students in Xinjiang, China: a cross-sectional study. BMC Ophthalmol 2024; 24:116. [PMID: 38481203 PMCID: PMC10935971 DOI: 10.1186/s12886-024-03382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND To investigate the prevalence and risk factors for astigmatism in 7-19-year-old students in Xinjiang, China. METHODS A school-based, cross-sectional study was conducted on students who underwent refraction examination in Xinjiang, China, between May and December 2019. The prevalence of astigmatism was determined. Astigmatism was defined as cylinder power (C) ≤-0.75 D, undefined astigmatism as ≤-1.50 D, and high astigmatism as C ≤-3.00 D. Astigmatism types were: against-the-rule astigmatism (maximum refraction of the main meridian in 180° ± 30°), with-the-rule astigmatism (maximum refraction of the main meridian at 90°±30°), and oblique astigmatism (all other cases). RESULTS Of the 71,838 students examined (51.0% boys, 7 - 19 years old), 25,945 (36.1%, 95%CI: 35.52-36.68%) had astigmatism and 1267 (1.8%, 95%CI: 1.07-2.53%) had high astigmatism. The prevalence of astigmatism was greater in Han individuals (39.6%) compared with the Hui (34.0%), Kazakh (34.0%), Kyrgyz (32.1%), and Uyghur (26.4%) populations. Among the 25,945 students with astigmatism, 19,947 had with-the-rule astigmatism (76.9%), 3405 had against-the-rule astigmatism (13.1%), and 2593 had oblique astigmatism (10.0%). Multivariable logistic regression analysis showed that ethnicity (Han individuals more susceptible), male gender, age, and refractive errors (myopia and hyperopia) were independently associated with astigmatism, high astigmatism, and with-the-rule astigmatism (all P < 0.05). CONCLUSIONS The prevalence of astigmatism among children and adolescents in Xinjiang was 36.1%, including 1.8% of high astigmatism. In this population, astigmatism was mainly of the with-the-rule astigmatism type (76.9%). Han ethnicity, male gender, and myopia or hyperopia were independently associated with a high risk of astigmatism.
Collapse
Affiliation(s)
- Yan Wang
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Jingyu Mu
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Yining Yang
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Xiaolong Li
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Han Qin
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Batima Mulati
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Zhen Wang
- School of Public Health, Xinjiang Medical University, No. 393 Xinyi Road, Xinshi District, Ürümqi, Xinjiang, China
| | - Wei Gong
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Shanghai, China
| | - Yong Zhao
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China.
| | - Yunxian Gao
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China.
| |
Collapse
|
6
|
Gal E, Gispets J, Wilkins A, Zyroff M, Netanya E, Gantz L. Assessment of a Clinical Test for Detection of Alteration in Visual Perception Due to Astigmatism. Clin Ophthalmol 2024; 18:723-733. [PMID: 38468915 PMCID: PMC10926918 DOI: 10.2147/opth.s447627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/18/2023] [Indexed: 03/13/2024] Open
Abstract
Purpose Astigmatism blurs the retinal image of a circular spot along a particular orientation rendering it an elliptical shape. Astigmatic patients demonstrate adaptation to residual astigmatic blur that may affect their discrimination between oval and circular targets. The Wilkins Egg and Ball Test (WEBT) was created to detect altered visual perception due to residual astigmatic blur by discriminating a circle within a row of oval elements. This prospective, cross-sectional study examined the utility of WEBT in detecting uncorrected residual astigmatism on the perception of form symmetry in astigmatic and keratoconic participants as well as normal participants with induced astigmatism at four primary meridians. Methods The mean search time (sT) and number of errors (noE) of 33 non-astigmatic controls (mean age: 24±5, range: 18-43, 6 males), 23 astigmatic participants (mean age: 36±12, range: 18-43, 6 males) and 13 keratoconic participants (N=22 eyes, mean age: 36±12, range: 18-58, 6 males) were measured under baseline, and 2.00 DC induced cylinder at four primary meridians, and for uncorrected, spherical-correction only, and fully corrected conditions, respectively. Mean sT and noE were converted to Z-scores, combined for each condition, and compared using repeated measures ANOVA with post-hoc analysis. Results Combined Z-scores for the controls were significantly worse (p<0.001) for all induced cylinder conditions. The induced 180° condition was significantly better than 45° and 90° conditions (p=0.04), but not the 135° condition. For both astigmatic and keratoconic cohorts, Z-scores of the uncorrected condition were significantly worse than the fully corrected condition (both p<0.01), but the fully corrected and spherical-only conditions did not differ significantly (p=0.06 and p=0.05, respectively). Conclusion In accommodating young adults, WEBT detected altered visual perception due to overall blur, and moderate-high amounts of uncorrected induced astigmatism and keratoconus, but is not useful as a tool for detection of altered visual perception due to small residual astigmatic blur.
Collapse
Affiliation(s)
- Eyal Gal
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
- University Vision Centre, Universitat Politècnica de Catalunya, Terrassa, Barcelona, Spain
| | - Joan Gispets
- University Vision Centre, Universitat Politècnica de Catalunya, Terrassa, Barcelona, Spain
| | - Arnold Wilkins
- Department of Psychology, University of Essex, Colchester, UK
| | - Meira Zyroff
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
| | - Efrat Netanya
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
| | - Liat Gantz
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
| |
Collapse
|
7
|
Liang Y, Kang BS, Kee CS, Leung TW. Compensatory Interactions between Corneal and Internal Astigmatism despite Lifestyle Changes. CHILDREN (BASEL, SWITZERLAND) 2024; 11:154. [PMID: 38397266 PMCID: PMC10887046 DOI: 10.3390/children11020154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/21/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
This study explores whether children's refractive errors and visual behaviors reverted to pre-COVID-19 levels a year after normal schooling resumed in Hong Kong as well as the impact of corneal and internal astigmatism on refractive astigmatism development. Vision survey data and questionnaire results collected in 2022 (n = 119) and 2020 (n = 173) were compared. Cross-sectional data showed similar proportions of astigmatism (cylindrical power ≥ 0.75 D) in the 2020 (49.1%) and 2022 cohorts (55.5%). Despite a 0.28 D increase in corneal astigmatism, a compensatory 0.24 D increase in internal astigmatism of opposite direction kept refractive astigmatism relatively stable. The questionnaire data showed that children spent an additional 0.5 h/day outdoors on weekends post-resumption of normal schooling but engaged in more near-work activities, especially non-screen near-work, by approximately 1 h/day on both weekdays and weekends. These findings were supported by longitudinal data from 72 children who participated in both surveys. This study highlights the significant role of corneal and internal astigmatism in refractive astigmatism changes. Despite the return to in-person classes, children's total near-work time increased and astigmatism remained high. These findings underscore the need for comprehensive strategies to reduce the high environmental risks for refractive error development in children.
Collapse
Affiliation(s)
- Yuanyuan Liang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong; (Y.L.); (B.-S.K.); (C.-S.K.)
| | - Byung-Soo Kang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong; (Y.L.); (B.-S.K.); (C.-S.K.)
| | - Chea-Su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong; (Y.L.); (B.-S.K.); (C.-S.K.)
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong
| | - Tsz-Wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong; (Y.L.); (B.-S.K.); (C.-S.K.)
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong
| |
Collapse
|
8
|
Beesley J, Elliott DB. Changes in ocular astigmatism with age: A longitudinal study. Ophthalmic Physiol Opt 2024; 44:71-77. [PMID: 37743700 DOI: 10.1111/opo.13234] [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: 06/01/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE To investigate changes in astigmatism with age. Are changes from with-the-rule (WTR) in younger ages to against-the-rule (ATR) in older patients mediated through oblique astigmatic axes or spherical prescriptions, and at what ages do these changes occur? METHODS Prescription data were gathered retrospectively from one optical practice belonging to a large multiple group in the UK. Longitudinal assessments were made of the changes in astigmatism for 326 patients (mean age at first prescription 46 years, range 28-69 years) and 640 eyes through their recorded prescription history (median 20 years of prescription data per participant, IQR 19-22 years, range 18-29 years). RESULTS Changes in small degrees of astigmatism (0.25 or 0.50 DC) from WTR to ATR were more than three times more likely to pass through an oblique cylinder axis as through a spherical prescription (56 vs. 16,χ 1 2 = 22.2, p < 0.0001). For patients aged 28-40 years at their first recorded eye examination, 55% (92/167) of eyes had an onset of astigmatic changes at a mean of 44 years (SD 6.2) and 41% (68/167) of eyes had no change until after a mean of 54 years (SD 4.6). Compared with a measured prevalence of oblique astigmatism in the literature of 11%-19%, 36% (232/640) of the eyes in this study had an oblique cylinder prescribed at least once in their refraction history and of these oblique cylinders, 78% were transient in nature. CONCLUSIONS The change in ocular astigmatism with age, from WTR to ATR, was more than three times more likely (56 vs. 16) to pass through oblique cylinder axes as through a spherical prescription. Changes in oblique astigmatism have been implicated in complaints with new spectacles, so given this prevalence of oblique cylinder axes (232/640, 36%), continuing professional development is needed regarding reconciling these oblique changes with previous prescriptions.
Collapse
Affiliation(s)
- Jeremy Beesley
- Bradford School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - David B Elliott
- Bradford School of Optometry and Vision Science, University of Bradford, Bradford, UK
| |
Collapse
|
9
|
Gong W, Wang J, Zhang B, Xu X, Zou H, Liu K, Xu X, He X, Huang J. Cylinder power progression associated with axial length in young children: a two-year follow-up study. Graefes Arch Clin Exp Ophthalmol 2024; 262:295-303. [PMID: 37410179 PMCID: PMC10806115 DOI: 10.1007/s00417-023-06149-3] [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: 11/24/2022] [Revised: 05/06/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE To describe the association of refraction development and axial length (AL) in young children and provide new insights into the progression of cylinder power. METHODS Children (2-3 grades) were enrolled from primary schools in Shanghai and followed up for two years. Cycloplegic refraction, AL, and corneal curvature radius were measured. Refraction parameters were compared among groups with different AL, AL1 (AL < 23.5 mm), AL2 (23.5 mm ≤ AL < 24.5 mm), and AL3 (AL ≥ 24.5 mm). Multiple regression analysis was used to explore risk factors of diopter of cylinder (DC) progression. RESULTS In total, out of 6891 enrolled children, 5961 participants (7-11 yrs) were included in the final analysis. Over the two-year period, the cylinder power significantly changed, and those with longer AL had more rapid DC progression over the two years (AL1, -0.09 ± 0.35 D; AL2, -0.15 ± 0.39 D; AL3, -0.29 ± 0.44 D) (P < 0.001). The change in DC was independently associated with AL at baseline (P < 0.001). The proportion of with-the-rule astigmatism increased from 91.3% to 92.1% in AL1 group, from 89.1% to 91.8% in AL2 group and from 87.1% to 92.0% in AL3 group. CONCLUSIONS Young children with long AL experienced rapid progression of cylinder power. Both the control of myopia progression and attention to the correction of astigmatism are necessary in the health management of children with long AL. The significantly increased AL in participants might contribute to both the extent and direction of astigmatism.
Collapse
Affiliation(s)
- Wei Gong
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Jingjing Wang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Bo Zhang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xian Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Haidong Zou
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Kun Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xun Xu
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xiangui He
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
| | - Jiannan Huang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
| |
Collapse
|
10
|
Zhou J, Wang X, Wei Y, Li X, Rui Y, Mao K, Cai J. The Efficacy of Paired Opposite Clear Corneal Incisions Correcting Preexisting Low-to-Moderate Astigmatism in Implantable Collamer Lens Surgery. J Refract Surg 2024; 40:e20-e29. [PMID: 38190562 DOI: 10.3928/1081597x-20231212-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE To evaluate the efficacy of paired opposite clear corneal incisions (OCCIs) in Implantable Collamer Lens (ICL; STAAR Surgical) implantation surgery for correcting preexisting low-to-moderate astigmatism and observe their influence on corneal aberration. METHODS This prospective controlled randomized study included 123 eyes: 73 eyes in the ICL surgery group (control group) and 50 eyes in the ICL combined with OCCI group (OCCI group). All patients had corneal astigmatism between 0.50 and 3.00 D. Parameters considered included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, keratometry, slit-lamp biomicroscopy, indirect ophthalmoscopy, corneal topography, and higher order aberrations (HOAs). The Alpins method was used to analyze the correction of astigmatism. The follow-up period lasted for 12 months. RESULTS Both groups showed a statistically significant improvement in mean UDVA and CDVA after surgery. At 1 and 12 months, the OCCI group had statistically better UDVA than the control group (P = .021 and .01). The OCCI group showed a significant reduction in mean refractive astigmatism from -0.835 ± 0.274 to -0.535 ± 0.353 and -0.450 ± 0.346 D postoperatively (P < .05) after 1 and 12 months. No significant change was observed in the control group (P > .05). The average magnitude of surgically induced astigmatism (SIA) was 0.911 ± 0.442 and 0.811 ± 0.397 D at 1 and 12 months postoperatively, respectively, in the OCCI group, which was slightly lower than the target induced astigmatism. The difference in SIA between the OCCI and control groups was significant by the end of 1 and 12 months postoperatively (P < .0001). The mean correction index was below 1, suggesting an undercorrection effect caused by clear corneal incisions in the opposite direction. HOAs increased in both the control and OCCI groups after surgery (t = 5.668, P < .0001, t = 3.773, P = .0003, respectively), with oblique trefoil only significantly increasing in the OCCI group. CONCLUSIONS This study demonstrated that OCCIs represent a secure, efficient, reliable, and long-term technique for reducing preexisting low-to-moderate corneal astigmatism during ICL surgery. However, OCCIs did not show any advantageous impact in terms of wavefront aberrations when compared to the traditional single-incision method. The presence of oblique trefoil may be the main contributor to the alteration of HOAs during OCCI surgery. [J Refract Surg. 2024;40(1):e20-e29.].
Collapse
|
11
|
Jin T, Yu L, Li J, Zhou Y. Refractive outcomes of toric intra-ocular lens implantation in cases of high posterior corneal astigmatism. Indian J Ophthalmol 2023; 71:2967-2971. [PMID: 37530266 PMCID: PMC10538836 DOI: 10.4103/ijo.ijo_3385_22] [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] [Indexed: 08/03/2023] Open
Abstract
Purpose To evaluate whether the toric intra-ocular lens (IOL) power calculation based on total corneal astigmatism (TCA) in eyes with high posterior corneal astigmatism (PCA) could result in a systematic over-correction or under-correction after operation. Methods The present study included a mono-centric retrospective study design. The data were collected from 62 consecutive eyes during uncomplicated cataract surgery by a single surgeon with a measured PCA of 0.50 diopters (D) or higher. Toric IOL calculations were made using TCA measurements. The eyes were grouped as either "with-the-rule" (WTR) or "against-the-rule" (ATR) on the basis of the steep anterior corneal meridian. The post-operative refractive astigmatic prediction error was analyzed 1 month post-operatively using the vector analysis by the Alpins method and double-angle plots method. Results The correction indexes were 1.14 ± 0.29 in the ATR eyes and 1.25 ± 0.18 for the WTR eyes, indicating a tendency toward over-correction. The mean over-correction was 0.22 ± 0.52D in the ATR group and 0.65 ± 0.60D in the WTR group. The magnitude of error (ME) values were significantly different from the ideal value of zero in both groups (ATR: P = 0.03; WTR: P = 0.00). No significant difference in mean absolute error (MAE) in predicted residual astigmatism was found between ATR and WTR groups (0.61 ± 0.42 D versus 0.64 ± 0.39 D; P = 0.54). The ATR group yielded better results, with 48% <0.50D prediction error in the main analysis. Conclusions The results suggested that in cases of high PCA, the toric IOL calculation, which was performed using TCA, may cause a potential over-correction in the ATR and WTR eyes. For ATR eyes, over-correction led to slight disruption of post-operative visual quality because of the "with-the-rule" residual astigmatism after operation. Therefore, we suggested using TCA for toric IOL calculation in ATR eyes.
Collapse
Affiliation(s)
- Tianru Jin
- Department of Cataract Surgery, Shenyang Aier Eye Optometry Hospital, Shenyang, China
| | - Lan Yu
- Department of Cataract Surgery, Shenyang Aier Eye Optometry Hospital, Shenyang, China
| | - Jingjing Li
- Department of Cataract Surgery, Shenyang Aier Eye Optometry Hospital, Shenyang, China
| | - Yanwen Zhou
- Department of Cataract Surgery, Shenyang Aier Eye Optometry Hospital, Shenyang, China
| |
Collapse
|
12
|
Gil P, Farcas A, Benito A, Tabernero J. Functional visual tests to evaluate the effect of small astigmatism correction with toric contact lenses. BIOMEDICAL OPTICS EXPRESS 2023; 14:2811-2820. [PMID: 37342708 PMCID: PMC10278640 DOI: 10.1364/boe.487410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/31/2023] [Accepted: 04/26/2023] [Indexed: 06/23/2023]
Abstract
The prescription of daily contact lenses does not often include a full astigmatic correction. We question here whether this full astigmatic correction (for low to moderate astigmatism) provides a substantial improvement in the overall visual performance compared to a more conservative approach based only on the prescription of spherical contact lenses. The visual performance of 56 contact lens neophytes divided in two contact lens fitting groups (toric versus spherical lens fit) was assessed using standard visual acuity and contrast sensitivity tests. A new set of functional tests simulating everyday tasks was also used. Results showed that subjects with toric lenses had significantly better visual acuity and contrast sensitivity than those with spherical lenses. Functional tests did not render significant differences between groups, which was explained by several factors like i) the visual demand of the functional tests, ii) the dynamic blur due to misalignments and iii) small misfits between the available and measured axis of the astigmatic contact lens.
Collapse
Affiliation(s)
- Pedro Gil
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Alexandra Farcas
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Antonio Benito
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Juan Tabernero
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| |
Collapse
|
13
|
Tang VTS, Symons RCA, Fourlanos S, Guest D, McKendrick AM. Contrast Increment and Decrement Processing in Individuals With and Without Diabetes. Invest Ophthalmol Vis Sci 2023; 64:26. [PMID: 37083950 PMCID: PMC10132322 DOI: 10.1167/iovs.64.4.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Purpose Animal models suggest that ON retinal ganglion cells (RGCs) may be more vulnerable to diabetic insult than OFF cells. Using three psychophysical tasks to infer the function of ON and OFF RGCs, we hypothesized that functional responses to contrast increments will be preferentially affected in early diabetes mellitus (DM) compared to contrast decrement responses. Methods Fifty-two people with DM (type 1 or type 2) (mean age = 34.8 years, range = 18-60 years) and 48 age-matched controls (mean age = 35.4 years, range = 18-60 years) participated. Experiment 1 measured contrast sensitivity to increments and decrements at four visual field locations. Experiments 2 and 3 measured visual temporal processing using (i) a response time (RT) task, and (ii) a temporal order judgment task. Mean RT and accuracy were collected for experiment 2, whereas experiment 3 measured temporal thresholds. Results For experiment 1, the DM group showed reduced increment and decrement contrast sensitivity (F (1, 97) = 4.04, P = 0.047) especially for the central location. For experiment 2, those with DM demonstrated slower RT and lower response accuracies to increments and decrements (increments: U = 780, P = 0.01, decrements: U = 749, P = 0.005). For experiment 3, performance was similar between groups (F (1, 91) = 2.52, P = 0.137). Conclusions When assessed cross-sectionally, nonselective functional consequences of retinal neuron damage are present in early DM, particularly for foveal testing. Whether increment-decrement functional indices relate to diabetic retinopathy (DR) progression or poorer visual prognosis in DM requires further study.
Collapse
Affiliation(s)
- Vanessa Thien Sze Tang
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia
| | - Robert Charles Andrew Symons
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia
- Department of Surgery, The University of Melbourne, Parkville, Australia
- Centre for Eye Research Australia, East Melbourne, Australia
- Department of Surgery, Alfred Hospital, Monash University, Australia
| | - Spiros Fourlanos
- Department Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Australia
- Department Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia
- Australian Centre for Accelerating Diabetes Innovations, The University of Melbourne, Parkville, Australia
| | - Daryl Guest
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia
| | - Allison Maree McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia
- Division of Optometry, University of Western Australia, Perth, Australia
- Lions Eye Institute, Nedlands, Australia
| |
Collapse
|
14
|
Zhang J, Wu Y, Sharma B, Gupta R, Jawla S, Bullimore MA. Epidemiology and Burden of Astigmatism: A Systematic Literature Review. Optom Vis Sci 2023; 100:218-231. [PMID: 36749017 PMCID: PMC10045990 DOI: 10.1097/opx.0000000000001998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/15/2023] [Indexed: 02/08/2023] Open
Abstract
SIGNIFICANCE This is the first literature review to report the epidemiology, patient burden, and economic burden of astigmatism in the general adult population. The unmet needs of astigmatism patients with coexisting ocular conditions (cataract, glaucoma, dry eye, presbyopia, or macular degeneration) and risks associated with untreated astigmatism are also reviewed and reported. PURPOSE This study aimed to identify, report, and summarize the published literature on epidemiology, patient burden, and economic burden of astigmatism using a systematic literature review. METHODS MEDLINE, EMBASE, and Cochrane Library databases were searched (January 1996 to May 2021). Search results were limited to the English language. Proceedings (2018 to 2021) from ophthalmology congresses were searched along with gray literature using the Google Scholar platform. RESULTS The literature search yielded 6804 citations, of which 125 met the inclusion criteria (epidemiology, 68; patient burden, 60; economic burden, 6). Astigmatism prevalence in the general population varied from 8 to 62%, with higher rates in individuals 70 years or older. The prevalence of with-the-rule astigmatism was higher in individuals 40 years or younger, whereas rates of against-the-rule and oblique astigmatism increased with age. Astigmatic patients experienced decreased vision quality, increased glare (53 to 77%), haloes (28 to 80%), night-time driving difficulties (66%), falls, and spectacle dependence (45 to 85%). Astigmatic patients performed vision-related tasks slower (1 D, 9% slower; 2 D, 29% slower) and made more errors (1 D, 38% more errors; 2 D, 370% more errors) compared with fully corrected individuals. In cataract patients with astigmatism, the annual mean per-patient productivity loss costs ranged from €55 ($71) to €84 ($108), and mean informal care costs ranged from €30 ($39) to €55 ($71) with a mean of 2.3 to 4.1 hours spent on informal care. CONCLUSIONS Uncorrected astigmatism decreases patients' vision-related quality of life, decreases productivity among working-age adults, and poses an economic burden on patients and their families.
Collapse
Affiliation(s)
| | - Yifei Wu
- Alcon Vision LLC, Fort Worth, Texas
| | - Bhavna Sharma
- Skyward Analytics Pvt. Ltd., Gurugram, Haryana, India
| | - Ritu Gupta
- Skyward Analytics Pvt. Ltd., Gurugram, Haryana, India
| | | | | |
Collapse
|
15
|
Wu Z, Hu Y, Xu Z, Sun W, Wang Y, Shao Z, Liu Y, Yu M, Si P, Huo H, Wang X, Bi H. Characteristics of full compensation and its association with total astigmatism: A cross-sectional study. Front Public Health 2023; 11:1119654. [PMID: 36815152 PMCID: PMC9939449 DOI: 10.3389/fpubh.2023.1119654] [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: 12/09/2022] [Accepted: 01/16/2023] [Indexed: 02/09/2023] Open
Abstract
Objective To evaluate the characteristics of full compensation and its association with the prevalence of total astigmatism (TA), and to analyze the effects of TA on uncorrected distance visual acuity (UDVA). Methods With random cluster sampling based on a school-based cross-sectional design, children aged 4 to 18 years were recruited in September 2020, Shandong Province, China. TA, anterior corneal astigmatism (ACA), and ocular residual astigmatism (ORA) were converted to vectorial components (J0, J45), followed by an assessment of the compensatory effect of ACA by ORA. Astigmatism was defined as a cylinder that was better than or equal to 0.75 diopters (D). Logistic regression analysis was used to assess the related factors for children with full compensation, and the generalized linear model was used to assess the influence of TA on UDVA. Results Out of 4,494 eligible children, data of 4,145 children (92.3%, 9.23 ± 3.15 years, 50.4% boys) were included in the statistical analysis. The prevalence of TA (27.9%) increased significantly with age (Ptrend < 0.001). The distribution of full compensation in J0 and J45 components were similar (22.1% and 25.6%, respectively), which decreased with age (Ptrend < 0.001). The closer the refractive status was to emmetropization, the higher the proportion of full compensation and the lower the prevalence of TA were. Shorter axial length (J0: Odds Ratio (OR) = 0.76, 95% confidence interval (CI): 0.61 to 0.94, P = 0.010), better UDVA (J0: OR = 0.37, 95% CI: 0.21 to 0.65, P < 0.001; J45: OR = 0.34, 95% CI: 0.20 to 0.59, P < 0.001), and longer average corneal curvature radius (J0: OR = 3.72, 95% CI: 2.18 to 6.34, P < 0.001; J45: OR = 2.82, 95% CI: 1.67 to 4.76, P < 0.001) were associated with full compensation. Higher TA was associated with a worse UDVA (β = 0.03, 95% CI: 0.02 to 0.04, P < 0.001). Conclusions The prevalence of TA gradually increased with age, and showed a U-shaped distribution with increased refraction. Full compensation was associated with smaller TA and better UDVA. This indicated that considering the compensatory effect of ORA is vital for astigmatism correction in clinical work, which may improve the visual quality.
Collapse
Affiliation(s)
- Ziyun Wu
- Shandong University of Traditional Chinese Medicine, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuanyuan Hu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Zihang Xu
- Shandong University of Traditional Chinese Medicine, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wei Sun
- Shandong University of Traditional Chinese Medicine, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Yirong Wang
- Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Zhen Shao
- Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Yi Liu
- Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Mingkun Yu
- Shandong University of Traditional Chinese Medicine, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Peiran Si
- Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - HuanHuan Huo
- Shandong University of Traditional Chinese Medicine, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xingrong Wang
- Shandong University of Traditional Chinese Medicine, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Xingrong Wang ✉
| | - Hongsheng Bi
- Shandong University of Traditional Chinese Medicine, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,*Correspondence: Hongsheng Bi ✉
| |
Collapse
|
16
|
Liang D, Leung TW, Kee CS. Measuring Retinal Thickness and Visual Acuity in Eyes with Different Types of Astigmatism in a Cohort of Hong Kong Chinese Adults. Invest Ophthalmol Vis Sci 2023; 64:2. [PMID: 36595274 PMCID: PMC9819738 DOI: 10.1167/iovs.64.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Purpose The purpose of this study was to investigate optical coherence tomography (OCT)-measured retinal thickness (RT) and best-corrected distance visual acuity (BCDVA) in eyes with different types of astigmatism. Methods This is a case-control study of 101 participants stratified into With-The-Rule (WTR; n = 41), Against-The-Rule (ATR; n = 25), and control (n = 35) groups by noncycloplegic subjective refraction. Inclusion criteria were ages between 18 and 45 years, spherical-equivalent (SE) refraction ≥-10.00 diopters (D), negative cylindrical power (CYL) ≤-0.75 D with axes of 0 to 30 degrees/150 to 180 degrees for WTR and 60 to 120 degrees for ATR, or CYL ≥-0.25 D for controls. Participants suffering from ocular diseases related to retinal defects, having a history of ocular surgery, with BCDVA >0.10 LogMAR, or poor OCT imaging quality were excluded. Fovea-centered scans were performed using spectral-domain OCT (SD-OCT), and RT automatically measured by the inbuilt software. Only right eyes were analyzed. Groups were matched for age, gender, SE, axial length, and corneal curvature. Results One-way ANOVA showed a significant difference in both BCDVA (P = 0.039) and macular RT (P = 0.028) among the three groups. Bonferroni's post hoc test revealed statistically significant between-group differences in BCDVA (WTR vs. controls, P = 0.041), as well as in RT at inner-nasal (WTR vs. ATR, P = 0.034) and outer-temporal subfields (WTR vs. controls, P = 0.042). BCDVA was positively associated with macular RT (r = 0.206, P = 0.041) after adjusting for age, gender, and axial length. Conclusions Greater RT and poorer BCDVA were found in eyes with WTR astigmatism. Our findings suggest that the effect of astigmatism on retinal thickness and BCDVA may vary depending on not only magnitude, but also axis of astigmatism.
Collapse
Affiliation(s)
- Dong Liang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Tsz-Wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong,Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Chea-Su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong,Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| |
Collapse
|
17
|
Asif MI, Raj N, Kalra N, Yadav MA, Bafna RK, Sinha R. Premium intraocular lenses in children. Eur J Ophthalmol 2022:11206721221126301. [PMID: 36124376 DOI: 10.1177/11206721221126301] [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: 11/15/2022]
Abstract
Multifocal and toric intraocular lenses (IOLs) or the so-called premium IOLs are currently widely used in adult patients as a one-step refractive solution following cataract surgery. However, the decision to implant a premium IOL in a pediatric patient involves multiple factors affecting the child's visual development and is associated with several dilemmas and surgical challenges. The purpose of this review is to summarize these factors and analyse the influence of each of them on the visual outcomes following premium IOL implantation. A review of literature was conducted using the relevant keywords from various databases until 31st January 2022. All pertinent studies with multifocal or toric IOL implantation in children were reviewed, and relevant articles were studied in detail for age, IOL power calculation, visual outcomes (refractive outcomes, contrast sensitivity and stereopsis) and complications such as dysphotic phenomena and others. A total of 17 relevant studies (10 case series/interventional studies and 7 case reports) on the subject were included. All studies showed a favourable refractive outcome; however, the data available was significantly less. Studies with earlier models of multifocal IOLs showed a higher incidence of IOL decentration and posterior capsule opacification; however, more recent studies with newer IOL models showed much better safety profiles. Toric IOLs showed promising results in all the studies evaluated. Premium IOLs have shown promising results in the pediatric age group. However, their long-term outcomes specifically concerning refractive shift, capsular contraction and role in the management of amblyopia needs to be explored further.
Collapse
Affiliation(s)
- Mohamed Ibrahime Asif
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Nimmy Raj
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Nidhi Kalra
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Mrinalini Anand Yadav
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Kumar Bafna
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sinha
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
18
|
Armarnik S, Kozlov Y, Yahalomi T, Ekshtein A, Levian L, Gurfinkel Y, Tehori O, Ben-Ari O, Kinori M. The influence of refractive state and heterophorias on visual acuity and stereoacuity in healthy young adults. J AAPOS 2022; 26:181.e1-181.e6. [PMID: 35863607 DOI: 10.1016/j.jaapos.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate associations of refractive error and heterophoria with best-corrected visual acuity and stereoacuity in a population of healthy young adults. METHODS Data extracted from the Israeli Defense Forces Air Force candidates database was analyzed retrospectively. Myopia and hyperopia were defined as spherical equivalent of ≤ -0.50 D and ≥ +0.50 D. Cylinder of ≥0.75 D was considered astigmatism. Oblique astigmatism was defined as axis between 30°-60° and 120°-150°. Heterophoria of ≥8Δ for near was considered exo- or esophoria. RESULTS The study population included 5,491 subjects (75.8% male), with a mean age of 17.6 ± 0.9 years: 2,355 (42.9%) had myopia, 640 (11.6%) had hyperopia, and the rest were emmetropic. Astigmatism was present in 2,006 participants (36.5%), and of those, 619 (30.9%) had oblique astigmatism. Emmetropia was correlated with better best-corrected visual acuity; astigmatism and high hyperopia, with poorer best-corrected visual acuity. A total of 331 subjects (6%) had heterophoria of ≥8Δ; of those, 300 (90.6%) had exophoria and 31 (9.4%) had esophoria. The prevalence of exophoria was higher in the myopic group, and exophoria was not associated with stereoacuity. Esophoria and anisometropia were associated with worse stereoacuity. The best stereopsis was achieved by emmetropic subjects with no astigmatism. CONCLUSIONS Emmetropia is associated with better best-corrected visual acuity and stereoacuity. Astigmatism and high hyperopia are correlated with poorer best-corrected visual acuity. Exophoria does not interfere with stereopsis, but both esophoria and anisometropia do.
Collapse
Affiliation(s)
- Sharon Armarnik
- Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Yuval Kozlov
- Israeli Air Force Aeromedical Center, Tel Hashomer, Ramat Gan, Israel; Israeli Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel; Department of Military Medicine and "Tzameret," Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tal Yahalomi
- Department of ophthalmology, Assuta Medical Center Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aya Ekshtein
- Israeli Air Force Aeromedical Center, Tel Hashomer, Ramat Gan, Israel
| | - Leora Levian
- Israeli Air Force Aeromedical Center, Tel Hashomer, Ramat Gan, Israel
| | - Yoav Gurfinkel
- Israeli Air Force Aeromedical Center, Tel Hashomer, Ramat Gan, Israel
| | - Omer Tehori
- Israeli Air Force Aeromedical Center, Tel Hashomer, Ramat Gan, Israel; Israeli Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel; Department of Military Medicine and "Tzameret," Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Oded Ben-Ari
- Israeli Air Force Aeromedical Center, Tel Hashomer, Ramat Gan, Israel; Israeli Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel; Department of Military Medicine and "Tzameret," Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Adelson School of Medicine, Ariel University, Ariel, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Kinori
- Department of ophthalmology, Assuta Medical Center Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| |
Collapse
|
19
|
Krishnamurthy S, Rangavittal S, Chandrasekar A, Narayanan A. Distribution of Astigmatism among School Children Who Fail Vision Screening in South India. Ophthalmic Epidemiol 2022; 30:276-285. [PMID: 35723007 DOI: 10.1080/09286586.2022.2088804] [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: 10/18/2022]
Abstract
PURPOSE The purpose of this study is to report the distribution of astigmatism among school children in South India. METHODS The study was conducted as part of a national school eye screening project named 'Refractive Error Among Children' (REACH) between 6 and 17 years of age. Children underwent presenting visual acuity screening, external eye examination, screening for color vision deficiency, and non-strabismic binocular vision anomalies. Those who failed screening underwent, objective and subjective refraction, and identification of other ocular conditions. Astigmatism was defined as cylindrical power greater than 0.50D. Refractive errors were classified into myopia (≤0.50D), hyperopia (≥0.75D), and other refractive errors (between -0.50D and +0.75D). The data on astigmatism were analyzed and were deduced into its vector components (M, J0 and J45). Descriptive statistics and regression analysis were performed. RESULTS Data of 245,565 children from 1047 schools were taken for analysis. The average age was 11.63 ± 3.32 (range:6-17) years. After screening, refractive errors and astigmatism was found to be 6.57% (n = 16157) and 3.69% (n = 9064), respectively. Astigmatism among children aged 6 to 10 years was 1.37%. The mean cylindrical power, J0, and J45 was found to be 1.93 ± 1.06D, 0.06 ± 0.59D, and 0.43 ± 0.81D, respectively. Linear regression showed a decreasing trend in the cylindrical component (p < .001) and shift towards less positive J0 values (p < .001). Higher proportions of astigmatism more than 1.50 D (1.83%,n = 4578) and unilateral astigmatism (1.20%,n = 2952) are evident among refractive errors. CONCLUSION More than 50% of children who failed vision screening with refractive errors presented with astigmatism. Prevalence was higher among primary school children. Presence of higher magnitude and unilateral astigmatism is amblyogenic and needs early intervention.
Collapse
Affiliation(s)
- Saara Krishnamurthy
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | | | - Ambika Chandrasekar
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Anuradha Narayanan
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| |
Collapse
|
20
|
Fixation instability, astigmatism, and lack of stereopsis as factors impeding recovery of binocular balance in amblyopia following binocular therapy. Sci Rep 2022; 12:10311. [PMID: 35725590 PMCID: PMC9209502 DOI: 10.1038/s41598-022-13947-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/31/2022] [Indexed: 11/22/2022] Open
Abstract
Dichoptic therapy is a promising method for improving vision in pediatric and adult patients with amblyopia. However, a systematic understanding about changes in specific visual functions and substantial variation of effect among patients is lacking. Utilizing a novel stereoscopic augmented-reality based training program, 24 pediatric and 18 adult patients were trained for 20 h along a three-month time course with a one-month post-training follow-up for pediatric patients. Changes in stereopsis, distance and near visual acuity, and contrast sensitivity for amblyopic and fellow eyes were measured, and interocular differences were analyzed. To reveal what contributes to successful dichoptic therapy, ANCOVA models were used to analyze progress, considering clinical baseline parameters as covariates that are potential requirements for amblyopic recovery. Significant and lasting improvements have been achieved in stereoacuity, interocular near visual acuity, and interocular contrast sensitivity. Importantly, astigmatism, fixation instability, and lack of stereopsis were major limiting factors for visual acuity, stereoacuity, and contrast sensitivity recovery, respectively. The results demonstrate the feasibility of treatment-efficacy prediction in certain aspects of dichoptic amblyopia therapy. Furthermore, our findings may aid in developing personalized therapeutic protocols, capable of considering individual clinical status, to help clinicians in tailoring therapy to patient profiles for better outcome.
Collapse
|
21
|
Beesley J, Davey CJ, Elliott DB. What are the causes of non‐tolerance to new spectacles and how can they be avoided? Ophthalmic Physiol Opt 2022; 42:619-632. [PMID: 35156719 PMCID: PMC9303957 DOI: 10.1111/opo.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 11/26/2022]
Abstract
Purpose To investigate non‐tolerance cases from several UK practices to determine their likely causes and how they might have been avoided. Methods Patient complaint and refraction data were collected from non‐tolerance recheck examinations. For one practice, clinical data were also collected retrospectively to investigate the quality of the eye examinations. Results Data for 279 rechecks were gathered from 10 practices and a recheck frequency of 2.3% was found. The mean patient age was 60 (SD 16) years, with cylinder changes responsible for 38% of prescription‐related causes of rechecks, overplusing or underminusing 26%, and underplusing or overminusing just 11%. An assessment of 242 recheck corrections found that 40% were unsatisfactory (e.g., failed to address initial or recheck symptoms, N = 45) and retrospective analysis of 217 case records showed many limitations (e.g., 61% or 28% recorded no uncorrected or habitual visual acuity (VA) at either initial examination or recheck). Conclusions Given that overplus‐underminus was a much bigger proportion of prescription‐related cases than overminus‐underplus (26% vs. 11%), the refraction mantra of “maximum plus for maximum VA” should be balanced by increased teaching of the problems of overplusing and underminusing, and the use of prescribing guidelines. In addition, continuing professional development regarding the basics of the recheck examination, refraction, visual acuity and prism determination is needed. Changes of oblique cylinders should be carefully considered in older patients as this is a common cause of non‐tolerance. In addition, if the “if it ain't broke, don't fix it” and related maxims had been applied to all patients who were asymptomatic at the original examination, one third of all non‐tolerance cases could have been avoided. Finally, it would seem appropriate for practices to develop a system to deal better with non‐tolerance cases. Perhaps an experienced clinician should examine all patients with non‐tolerance and provide feedback to the original clinician.
Collapse
Affiliation(s)
- Jeremy Beesley
- Bradford School of Optometry and Vision Science University of Bradford Bradford UK
| | - Christopher J Davey
- Bradford School of Optometry and Vision Science University of Bradford Bradford UK
| | - David B Elliott
- Bradford School of Optometry and Vision Science University of Bradford Bradford UK
| |
Collapse
|
22
|
Comparison of astigmatic correction with and without limbal marking during small incision lenticule extraction. J Cataract Refract Surg 2022; 48:924-928. [DOI: 10.1097/j.jcrs.0000000000000889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 01/10/2022] [Indexed: 11/26/2022]
|
23
|
Zhang Y, Su M, Liu H, Song Y, Liu J, Sun H, Wu X, Yang X, Qi L, Du F, Liu L, Chen L, Huang J, Guo X, Yang Z, Yang X. Development of Refractive Parameters in 3- to 6-Year-Old Children and Its Application in Myopia Prediction and Intervention Guidance. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:3656831. [PMID: 34956396 PMCID: PMC8702317 DOI: 10.1155/2021/3656831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate refractive development and prevalence of myopia in children aged 3-6 years in Hebei Province, China, and to explore the developmental law of refraction, so as to clinically guide the prediction and intervention of myopia. METHODS In May 2019, a total of 6120 people were inspected in 68 kindergartens in 11 cities in Hebei Province. Child refractive refraction was checked under noncycloplegia using a handheld binocular vision screener (SW-800, SUOER, Tianjin, China). Axial length (AL) and corneal radius of curvature (CR) were measured using an ocular biometry (IOLMaster 500, Carl Zeiss, Germany). Myopia was defined as spherical equivalent (SE) ≤ -0.75 D. RESULTS A total of 5506 children aged 3-6 years met the criteria and were included in the statistical analysis. The prevalence of myopia was 3.49% (1.93% at age 3, 2.90% at age 4, 3.78% at age 5, and 3.88% at age 6). Overall, the mean SE was +0.67 ± 1.05 D (+0.81 ± 1.00 D at age 3, +0.79 ± 1.05 D at age 4, +0.67 ± 1.08 D at age 5, and +0.13 ± 1.01 D at age 6); the mean CR was 7.76 ± 0.26 mm (7.78 ± 0.26 mm at age3, 7.75 ± 0.25 mm at age 4, 7.77 ± 0.26 mm at age 5, and 7.76 ± 0.25 mm at age 6); the mean AL was 22.31 ± 0.73 mm (21.98 ± 0.63 mm at age 3, 22.12 ± 0.69 mm at age 4, 22.34 ± 0.73 mm at age 5, and 22.49 ± 0.73 mm at age 6). CONCLUSIONS Prevalence of myopia increases with age in children aged 3-6 years in Hebei, China. With the increase of age, CR is basically stable, and AL increases gradually. AL/CR, which is closely related to SE, can be used as an indicator to predict myopia and guide clinical work.
Collapse
Affiliation(s)
- Ya Zhang
- The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
| | - Ming Su
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Hua Liu
- Jinan University, Guangzhou 510632, China
- The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
| | - Yanxia Song
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Jing Liu
- Hebei Women and Children Health Care Center, 050000, China
| | - Huihui Sun
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Xueya Wu
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
| | - Xiaoge Yang
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Liqin Qi
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
| | - Feifan Du
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Lili Liu
- Baoding Aier Eye Hospital, 071000, China
| | - Lu Chen
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Jing Huang
- Cangzhou Aier Eye Hospital, 061000, China
| | - Xiting Guo
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Zhongnan Yang
- Qinhuangdao Aier Eye Hospital, Qinhuangdao 066000, China
| | - Xueping Yang
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
| |
Collapse
|
24
|
Tamura M, Moriguchi Y, Yeh SY, Matsumoto A, Shibutani M, Asao T, Mino T, Nakanishi M, Kubota A, Akiba M. Sensorless astigmatism correction using a variable cross-cylinder for high lateral resolution optical coherence tomography in a human retina. APPLIED OPTICS 2021; 60:9553-9559. [PMID: 34807099 DOI: 10.1364/ao.441646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/30/2021] [Indexed: 06/13/2023]
Abstract
High lateral resolution (∼5µm) optical coherence tomography (OCT) that employs a variable cross-cylinder (VCC) to compensate for astigmatism is presented for visualizing minute structures of the human retina. The VCC and its sensorless optimization process enable ocular astigmatism correction of up to -5.0 diopter within a few seconds. VCC correction has been proven to increase the signal-to-noise ratio and lateral resolution using a model eye. This process is also validated using the human eye by visualizing the capillary network and human cone mosaic. The proposed method is applicable to existing OCT, making high lateral resolution OCT practical in clinical settings.
Collapse
|
25
|
Luensmann D, Schaeffer JL, Rumney NJ, Stanberry A, Fonn D. Magnitude of astigmatism - A comparison between eyes. Cont Lens Anterior Eye 2021; 45:101510. [PMID: 34507898 DOI: 10.1016/j.clae.2021.101510] [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: 04/22/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Astigmatism is a highly prevalent refractive error and while studies typically focus to describe the axis symmetry between eyes, little is known about the refractive symmetry. Therefore, this study determined the astigmatic power symmetry between eyes in a large clinic population. METHODS A clinical chart review was conducted at three optometric practices in the United States, the United Kingdom and Canada and subjective refraction data from 88,891 patients 14-70 years of age who presented with at least -0.25DC refractive astigmatism in at least one eye were included in the analysis. Data were obtained at these practices between January 2014 and March 2017. The overall distribution (%) and magnitude (DC) of astigmatism was determined and refractive differences between eyes were identified. RESULTS The mean age of the patients was 42.1 ± 15.9 years and included 51,685 (58%) female and 37,206 (42%) male patients. In this data pool of 177,782 eyes, 10.9% required zero astigmatic correction, while 56.2% had astigmatism of -0.25 to -0.75DC. In total 23.9% of patients presented with astigmatism of at least -0.75DC in only one eye, while the other eye had 0 to -0.50DC. Overall, the difference in astigmatism between eyes was less than -0.75DC for 82.1% of astigmatic patients. For patients who presented with astigmatism of -1.00DC in the right eye, 80.8% of them had an astigmatic prescription of -1.00 ± 0.50DC in the left eye. For an astigmatic prescription of -4.00DC in the right eye, only 40.6% of patients exhibited astigmatism of -4.00DC ± 0.50DC in the left eye. CONCLUSIONS The majority of patients exhibited a difference in astigmatism between eyes of less than -0.75DC, however the refractive cylinder power symmetry was significantly lower in patients with higher refractive astigmatism.
Collapse
Affiliation(s)
- Doerte Luensmann
- Centre for Ocular Research & Education, Waterloo, Canada; School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada.
| | | | | | - Andre Stanberry
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Desmond Fonn
- Centre for Ocular Research & Education, Waterloo, Canada; School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| |
Collapse
|
26
|
Opportunities and threats to contact lens practice: A global survey perspective. Cont Lens Anterior Eye 2021; 44:101496. [PMID: 34426063 DOI: 10.1016/j.clae.2021.101496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 06/11/2021] [Accepted: 07/26/2021] [Indexed: 12/14/2022]
Abstract
AIM To understand the views of contact lens (CL) practitioners across the globe regarding what they perceive as opportunities and threats in CL practice. METHODS A self-administered anonymised questionnaire, constructed in English and translated in six more languages, was distributed through reputed international professional bodies and academic institutions worldwide. The questionnaire included items on demographic characteristics, type of practice, and questions designed to explore practitioners' perspective on the future of their CL practice over the next five years. RESULTS A total of 2408 valid responses were analysed. Multifocal CLs for presbyopia, CLs for myopia control, use of daily disposable (DD) CLs for occasional wear, and biocompatible materials to improve comfort were identified as promising areas of opportunities by practitioners (all 8/10). Respondents from North America, and Europe valued DDCLs for occasional wear moderately more favourable (Median: 9/10 for all) as compared to colleagues in Asia (Median: 8/10, p < 0.001), South America (Median: 8/10, p < 0.01), and Africa (Median: 8/10p < 0.01). Multifocal CLs for presbyopia was perceived as a better opportunity by practitioners in North America and Europe (Median: 9/10 for both), as well as in Australasia (Median: 8/10), in comparison to Asia, Africa, and Middle East (for all Median: 6/10, p < 0.001). Practitioners expressed concerns about the availability of CLs and CL prescriptions online without direct professional involvement (both 9/10). CONCLUSIONS Overall, the most appealing opportunities for CL practice growth were identified in occasional use of DD CLs, biocompatible materials to reduce CL discomfort, multifocal CLs for presbyopia correction and management of myopia control with CLs. Lack of regulation in CL sales, especially online, seemed to be a constant threat. The insights from this study can be used to design targeted strategies to enhance CL practice across the globe and in specific geographical areas.
Collapse
|
27
|
Characterizing Astigmatism in the United States. J Cataract Refract Surg 2021; 48:519-527. [PMID: 34417780 DOI: 10.1097/j.jcrs.0000000000000786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To study astigmatism and astigmatism rule by 1) determining changes in prevalence in the United States between 1971-1975 and 1999-2008 and 2) identifying associations with demographic factors. SETTING National survey. DESIGN Retrospective cross-sectional study. METHODS Participants of the 1971-1975 and 1999-2008 National Health and Nutrition Examination Survey (NHANES) aged 20-74 years representing the United States population. The 1971-1975 NHANES measured astigmatism in individuals using an algorithm based on presenting visual acuity, lensometry and objective refraction. We implemented similar methods using 1999-2008 NHANES data for comparison. We identified prevalence of clinically significant astigmatism (≥1.0 D) and used logistic regression models to assess demographic associations with rule of astigmatism. RESULTS Main outcomes were prevalence estimates of astigmatism and odds ratios estimating associations with demographic characteristics. There was an increase in astigmatism from the 1970's to 2000's [14% (95% CI: 13.2-14.5) vs. 24% (22.8-24.6)], which was more pronounced in men [12% (10.8-12.7) vs. 23% (21.9-24.2)] than women [16% (14.9-16.8) vs. 24% (23.0-25.7)]. In adjusted analysis of the 2000's cohort, myopes had 8.34 (CI: 7.30-9.54) times greater odds of astigmatism than non-myopes. In the 2000's, there was increased odds of ATR astigmatism in males (OR, 1.4; 95% CI: 1.1-1.8) compared to females, non-myopes (OR, 2.3; 95% CI: 1.7-3.1) compared to myopes, and 60-74 year olds (OR, 3.7; 95% CI: 2.7-5.1) compared to 20-39 year olds. CONCLUSIONS There is greater prevalence of astigmatism and against-the-rule astigmatism in 1999-2008 compared to 30 years prior. Factors associated with against-the-rule astigmatism were being male, white, and nonmyopic.
Collapse
|
28
|
Hopkins S, Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Do reduced visual acuity and refractive error affect classroom performance? Clin Exp Optom 2021; 103:278-289. [DOI: 10.1111/cxo.12953] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Shelley Hopkins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| | - Sumithira Narayanasamy
- Programme of Optometry & Vision Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Stephen J Vincent
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| | - Geoff P Sampson
- School of Medicine (Optometry), Faculty of Health, Deakin University, Geelong, Australia,
| | - Joanne M Wood
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| |
Collapse
|
29
|
Cycloplegic Effects on the Cylindrical Components of the Refraction. J Ophthalmol 2021; 2021:8810782. [PMID: 33884203 PMCID: PMC8041553 DOI: 10.1155/2021/8810782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/11/2021] [Accepted: 03/25/2021] [Indexed: 11/17/2022] Open
Abstract
It is important to predict which astigmatic patients require separate refraction for near vision. This study compared cylindrical components changes by cyclopentolate 1% for the low and high amount of astigmatism. The right eyes of 1014 healthy individuals (307 males and 707 females) with cylindrical refractive power more than -0.5 diopter on autorefractometer were selected. Both male and female patients in the age range of 17-45 years were refracted before and after cycloplegia, using 1% cyclopentolate. All volunteers were classified into 2 subgroups including the lower astigmatism group (-2.25 to -0.50) and the higher astigmatic group (-2.50 to over). Alpines' method was used to compare the effect of cycloplegic drop on cylindrical power. The mean age in the lower astigmatism group (29.58; 95% CI: 29.18 to 29.99 years) was not significantly different from the higher astigmatic group (29.85; 95% CI: 29.07 to 30.62) and there were no significant differences in gender between these two groups (P=0.54). Differences between wet and dry refraction in J0 (-0.03; 95% CI:-0.06 to -0.008) and J45 (-0.03; 95% CI:-0.06 to -0.01) were significant only in the higher astigmatic group. Axis changes by the cycloplegic drop in the lower astigmatism group were 3.51 (CI: 3.22 to 3.81) and axis changes by the cycloplegic drop in the higher astigmatism group were 2.21 (CI: 1.73 to 2.49). In patients with a lower amount of astigmatism (-2.25 to -0.50), additional near subjective refraction could be done for precise determination of axis and in patients with a higher amount of astigmatism (-2.50 to over), near subjective refraction might be done for precise determination of power.
Collapse
|
30
|
Wolffsohn JS, Dumbleton K, Huntjens B, Kandel H, Koh S, Kunnen CME, Nagra M, Pult H, Sulley AL, Vianya-Estopa M, Walsh K, Wong S, Stapleton F. CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye 2021; 44:368-397. [PMID: 33775383 DOI: 10.1016/j.clae.2021.02.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022]
Abstract
Evidence-based contact lens -->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patient. This reports reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as -->minimising risks of lens wear through encouraging compliance) and an aftercare routine.
Collapse
Affiliation(s)
| | - Kathy Dumbleton
- School of Optometry, University of California, Berkeley, CA, USA
| | - Byki Huntjens
- Division of Optometry and Visual Sciences at City, University of London, London, UK
| | - Himal Kandel
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Shizuka Koh
- Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Japan
| | | | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Cambridge, UK
| | - Heiko Pult
- Optometry and Vision Research, Weinheim, Germany
| | | | - Marta Vianya-Estopa
- Department of Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Karen Walsh
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Stephanie Wong
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
| |
Collapse
|
31
|
Gu L, Wang Y, Feng L, Li S, Zhang M, Ye Q, Zhuang Y, Lu ZL, Li J, Yuan J. Meridian-Specific and Post-Optical Deficits of Spatial Vision in Human Astigmatism: Evidences From Psycho-Physical and EEG Scalings. Front Psychol 2021; 12:595536. [PMID: 33815196 PMCID: PMC8010696 DOI: 10.3389/fpsyg.2021.595536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies have demonstrated that orientation-specific deprivation in early life can lead to neural deficits of spatial vision in certain space, and can even result in meridional amblyopia (MA). Individuals with astigmatism are the optimal and natural models for exploring this asymmetric development of spatial vision in the human visual system. This study aims to assess the contrast sensitivity function (CSF) and EEG signals along two principal meridians in participants with regular astigmatism when being optimal optical corrected. Twelve participants with astigmatism (AST group, 20 eyes) and thirteen participants with (MA group, 19 eyes) were recruited in the current study. CSFs and spatial sweep visual evoked potentials (sVEP) were measured with vertical and horizontal sinewave gratings along two principal meridians monocularly. Area under log CSF (AULCSF), spatial frequency threshold corresponding to 80% contrast gratings (SF threshold at 80% ctr), and CSF acuity were calculated from CSF test. In addition, sVEP amplitudes and thresholds were calculated with the recursive least square method. Participants with astigmatism exhibited marked vertical-horizontal resolution disparities even after they were corrected with optimal optical corrections. CSF tests showed that AULCSF along weak meridian (measured with horizontal gratings) was lower than that along strong meridian (measured with vertical gratings) in both groups. Significant meridional disparity of CSF acuity was also found in both groups. In addition, the MA group showed larger meridional disparity compared to the AST group. Spatial sVEP thresholds also supported the existence of marked meridional disparity. Our results suggest that meridian-specific partial deprivation in early life might lead to monocularly asymmetric development of spatial vision in the human visual system. In terms of application, we tested the feasibility and reliability of adopting psychophysical and EEG scalings to investigate the asymmetric development of spatial vision related to astigmatism. These paradigms are potentially applicable to reduce and even eliminate the meridional disparity in the primary visual cortex by adopting perceptual learning or other vision-related interventions.
Collapse
Affiliation(s)
- Li Gu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yiyao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lei Feng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Saiqun Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mengwei Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Qingqing Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yijing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhong-Lin Lu
- Division of Arts and Sciences, NYU Shanghai, Shanghai, China.,Center for Neural Science, Department of Psychology, New York University, New York, NY, United States.,NYU-ECNU Institute of Cognitive Neuroscience, NYU Shanghai, Shanghai, China
| | - Jinrong Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jin Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
32
|
Tong H, Hao Q, Wang Z, Wang Y, Li R, Zhao X, Sun Q, Zhang X, Chen X, Zhu H, Huang D, Liu H. The biometric parameters of aniso-astigmatism and its risk factor in Chinese preschool children: the Nanjing eye study. BMC Ophthalmol 2021; 21:67. [PMID: 33535994 PMCID: PMC7860027 DOI: 10.1186/s12886-021-01808-7] [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: 06/01/2020] [Accepted: 01/07/2021] [Indexed: 11/15/2022] Open
Abstract
Backgrounds Aniso-astigmatism may hinder normal visual development in preschool children. Knowing its prevalence, biometric parameters and risk factors is fundamental to children eye care. The purpose of this study was to determine the biometric components of aniso-astigmatism and associated maternal risk factors in Chinese preschool children. Methods In the population-based, prospective cohort Nanjing Eye Study, children were measured for noncycloplegic refractive error using an autorefractor and for biometric parameters using an optical low-coherent reflectometry. The difference of total astigmatism (TA) between both eyes was calculated using cylinder power (non-vectorial aniso-TA was defined as ≥1.00 Dioptre Cylinder [DC] between both eyes) and by vector analysis (vectorial aniso-TA was defined as a difference of ≥0.5 in J0 or J45 between both eyes which is equivalent to 1.00 DC). The prevalence of aniso-TA was presented. Interocular biometric parameters were compared between with vs. without aniso-astigmatism group. In addition, risk factors were determined using multivariate logistic regression model. Results Of 1131 children (66.90 ± 3.38 months, 53.31% male), the prevalence of non-vectorial aniso-TA was 1.95% (95% Confidence Interval (CI) = 1.14–2.75%), while the prevalence of vectorial aniso-TA was twice as common as non-vectorial aniso-TA, neither varying with sex or age. With aniso-TA eyes were more asymmetric in axial length and corneal curvature radius than without aniso-TA eyes. In multivariate logistic regression model, 5-min Apgar score less than 7 was significantly associated with higher risk of aniso-TA (vectorial aniso-TA: Odds Ratio (OR) = 6.42, 95%CI = 2.63–15.69, P < 0.001; non-vectorial aniso-TA: OR = 4.99, 95%CI = 1.41–17.68, P = 0.01). Being twin or triple was significantly associated with higher risk of vectorial aniso-CA (OR = 2.43, 95%CI = 1.05–5.60, P = 0.04). Pre-term delivery (OR = 2.60, 95%CI = 1.09–6.15, P = 0.03) and post-term delivery (OR = 3.61, 95%CI = 1.31–9.96, P = 0.01) were significantly associated with higher risk of vectorial aniso-CA. Conclusions Both corneal curvature radius and axial length asymmetry were correlated with aniso-TA. Children with 5-min Apgar score < 7 were more likely to have aniso-TA, while twin or triple, pre-term or post-term delivery were more likely to have vectorial aniso-CA. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01808-7.
Collapse
Affiliation(s)
- Haohai Tong
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qingfeng Hao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Zijin Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yue Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Rui Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qigang Sun
- Department of Ophthalmology, Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China
| | - Xiaohan Zhang
- Department of Ophthalmology, Wuxi Children's Hospital, Wuxi, China
| | - Xuejuan Chen
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Dan Huang
- Department of Child Healthcare, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| |
Collapse
|
33
|
Padhy D, Bharadwaj SR, Nayak S, Rath S, Das T. Does the Accuracy and Repeatability of Refractive Error Estimates Depend on the Measurement Principle of Autorefractors? Transl Vis Sci Technol 2021; 10:2. [PMID: 33505769 PMCID: PMC7794271 DOI: 10.1167/tvst.10.1.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose The purpose of this study was to determine the accuracy and repeatability of refractive errors obtained using three autorefractors based on different measurement principles, vis-à-vis, gold-standard retinoscopy. Methodology Accuracy of noncycloplegic, sphero-cylindrical refractive error of 234 eyes was obtained using the rotary prism-based RM-8900 closed-field autorefractor, photorefraction based Spot vision screener, wavefront aberrometry based E-see, and streak retinoscopy by four different examiners, masked to the results of each other. Intersession repeatability of autorefractors was determined by repeat measurements in a subset of 40 subjects. Results Retinoscopy values of M, J0, and J45 power vectors for the cohort ranged from -10.2 to 8 D, -1.4 to 1.8 D, and -0.9 to 1.2 D, respectively. Across autorefractors, the interequipment bias of M and J0 power vectors were statistically insignificant (< ±0.5 D; P > 0.05) but the corresponding limits of agreement were ±2.5 and ±1 D, respectively, without any trend across instruments or the patient's age (P > 0.5). Repeatability of M and J0 power vectors were ±0.75 D and ±0.40 D, respectively, across autorefractors. The range of J45 power vector was too narrow for any meaningful analysis. Conclusions Refractive errors measured using autorefractors operating on different principles show minimal bias and good short-term repeatability but relatively large agreement limits, vis-à-vis, retinoscopy. Among them, the wavefront aberrometry based E-see autorefractor performs relatively better in all measurement parameters evaluated here. Translational Relevance Although autorefractor estimates of noncycloplegic refractive error appears independent of their measurement principle, their relatively poor agreement with gold-standard retinoscopy warrants caution while used for screening and quantification of refractive errors.
Collapse
Affiliation(s)
- Debananda Padhy
- Mithu Tulsi Chanrai campus, L V Prasad Eye Institute, Bhubaneswar, Odisha, India.,Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Shrikant R Bharadwaj
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Suryasmita Nayak
- Mithu Tulsi Chanrai campus, L V Prasad Eye Institute, Bhubaneswar, Odisha, India.,Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Suryasnata Rath
- Ophthalmic Plastics, Orbit and Ocular Oncology Services, Mithu Tulsi Chanrai campus, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Taraprasad Das
- Srimati Kanuri Santhamma Centre for Vitreoretinal Disease, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| |
Collapse
|
34
|
Hoseini-Yazdi H, Vincent SJ, Read SA, Collins MJ. Astigmatic Defocus Leads to Short-Term Changes in Human Choroidal Thickness. Invest Ophthalmol Vis Sci 2021; 61:48. [PMID: 32729913 PMCID: PMC7425733 DOI: 10.1167/iovs.61.8.48] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine the choroidal thickness (ChT) response to short-term with-the-rule (WTR) and against-the-rule (ATR) simple myopic astigmatic defocus, with the response to spherical myopic defocus and clear vision used as control conditions. Methods The left eye of 18 healthy adults aged 28 ± 6 years was exposed to clear vision, +3 D spherical myopic defocus, +3 D × 180 WTR, or +3 D × 90 ATR astigmatic defocus for 60 minutes, over four randomly ordered visits, while their right eye was optimally corrected. The macular ChT was measured with optical coherence tomography along the vertical and horizontal meridians before and after 20, 40, and 60 minutes of defocus. Results After 60 minutes of defocus, ChT increased by +8 ± 5 µm (P < 0.001) with spherical myopic defocus, but varied with simple myopic astigmatic defocus, depending on the axis of astigmatism (P < 0.001), increasing by +5 ± 6 µm (P = 0.037) with WTR and decreasing by −4 ± 5 µm (P = 0.011) with ATR astigmatic defocus. These changes were similar across the vertical and horizontal meridians (P = 0.22). The ChT changes were greater than the change during the clear vision control condition (−1 ± 4 µm) for WTR (+5 ± 5 µm, P = 0.002) but not ATR (−4 ± 6 µm, P = 0.09) astigmatic defocus. Conclusions These results provide insights into the human ChT response to short-term astigmatic defocus and highlight a potential difference in the myopiagenic signal associated with the orientation of astigmatic blur.
Collapse
|
35
|
Wu PL, Lee CY, Cheng HC, Lin HY, Lai LJ, Wu WC, Chen HC. Correction of Myopic Astigmatism with Topography-Guided Laser In Situ Keratomileusis (TOPOLINK). Healthcare (Basel) 2020; 8:healthcare8040477. [PMID: 33187386 PMCID: PMC7712020 DOI: 10.3390/healthcare8040477] [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: 10/06/2020] [Revised: 10/31/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022] Open
Abstract
We aim to assess the feasibility of topography-guided laser in situ keratomileusis (TOPOLINK) for correcting pre-existing and surgical-induced astigmatism. A retrospective, single center cohort study was conducted. Patients with pre-existing irregular myopic astigmatism were recruited into the primary group and those with irregular myopic astigmatism following laser in situ keratomileusis (LASIK) were recruited into the enhancement group. The changes in uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), maximum astigmatism, spherical equivalent (SE) and patient satisfaction were recorded. The Chi-square test, Mann-Whitney U test and Generalized Linear Mixed Model were utilized for the analysis in the current study. A total of 18 eyes were studied in the primary group and 14 eyes were examined in the enhancement group. One year postoperatively, the UCVA, BCVA, maximum astigmatism and SE improved significantly in both the primary and the enhancement groups (all p < 0.05). The UCVA (p = 0.046) and SE (p = 0.003) were worse in the primary group preoperatively but became similar in both groups postoperatively, while the BCVA and maximum astigmatism remained identical between groups throughout the study period (all p < 0.05). In addition, the rate of high and moderate satisfaction reached 90.0% in the primary and the enhancement groups, without significant differences (p = 0.871). In conclusion, the TOPOLINK showed high predictability and will contribute to similar outcomes between primary and postoperative irregular myopic astigmatism concerning visual acuity, refractive status and subject satisfaction.
Collapse
Affiliation(s)
- Pei-Lun Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi 61301, Taiwan; (P.-L.W.); (L.-J.L.)
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan;
| | - Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 50093, Taiwan; (C.-Y.L.); (H.-Y.L.)
| | - Han-Chih Cheng
- Department of Ophthalmology, Buddhist Tzu Chi Hospital, Taipei 23142, Taiwan;
| | - Hung-Yu Lin
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 50093, Taiwan; (C.-Y.L.); (H.-Y.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Optometry, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Li-Ju Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi 61301, Taiwan; (P.-L.W.); (L.-J.L.)
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan;
| | - Wei-Chi Wu
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan;
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
| | - Hung-Chi Chen
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan;
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 8674)
| |
Collapse
|
36
|
Junghans BM, Azizoglu S, Crewther SG. Unexpectedly high prevalence of asthenopia in Australian school children identified by the CISS survey tool. BMC Ophthalmol 2020; 20:408. [PMID: 33046042 PMCID: PMC7549207 DOI: 10.1186/s12886-020-01642-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/10/2020] [Indexed: 12/03/2022] Open
Abstract
Background To date there have been few systematic attempts to establish the general prevalence of asthenopia in unselected populations of school-aged children. Thus, the aim of this study was to determine whether the incorporation of Borsting et al’s 2003 Revised Convergence-Insufficiency Symptom Survey (CISS) into a general school vision screening could aid in the identification of children with visual discomfort and indicate the need for further investigation. Methods Vision screening of an unselected middle school population investigated and analysed the incidence of self-reported nearwork-related visual discomfort via the CISS along with distance and near visual acuities plus non-cycloplegic autorefraction using a Shin-Nippon NVision-K 5001. Results Of the 384 unselected students approached in Grades 6–9, 353 participated (92.2%, mean 13.2 ± 1.4 years). The mean CISS score for the population without amblyopia and/or strabismus (96.0% of all students) was 16.8 ± 0.6, i.e., 45% of students in this cohort had CISS scores greater than one standard deviation above the mean found by Borsting et al. in 2003 during their validation study of the CISS on 9 to 18 year old children without binocular anomalies. Regression analyses indicated significantly higher (p < 0.001) mean CISS scores for the 3.2% who were hyperopes ≥ + 2.00D by non-cycloplegic autorefraction (27.7 ± 14.7) and for those who were amblyopic (24.3 ± 6.6) or strabismic (34.0 ± 9.8). The mean CISS score of 31.6 ± 9.0 for non-amblyopic/strabismic students having near vision poorer than 0.1 LogMAR was significantly higher (p < 0.001) than for those with good acuity. Conclusion The most important finding of this study was the high incidence of asthenopia in an unselected population and that refractive status per se was not a major contributor to CISS scores. The results highlight the usefulness of the CISS questionnaire for assessment of visual discomfort in school vision screenings and the need for future exploration of near binocular vision status as a potential driver of asthenopia in school students, especially given current trends for frequent daily use of computers and handheld devices and necessarily prolonged accommodative-convergence effort at near, both at school and at home.
Collapse
Affiliation(s)
- Barbara M Junghans
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, 3086, Australia. .,School of Optometry and Vision Science, University of New South Wales Sydney, Sydney, NSW, 2052, Australia.
| | - Serap Azizoglu
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, 3086, Australia.,School of Medicine, Deakin University, Geelong, Victoria, 3220, Australia
| | - Sheila G Crewther
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, 3086, Australia
| |
Collapse
|
37
|
Management of Cataract in Patients with Irregular Astigmatism with Regular Central Component by Phacoemulsification Combined with Toric Intraocular Lens Implantation. J Ophthalmol 2020; 2020:3520856. [PMID: 32411427 PMCID: PMC7210554 DOI: 10.1155/2020/3520856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/23/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To evaluate visual acuity (VA) and refractive status in patients with cataract and irregular astigmatism with a regular central component after phacoemulsification with implantation of a toric intraocular lens (IOL). Methods Patients with cataract associated with irregular astigmatism with a regular central component were enrolled. All patients underwent phacoemulsification and toric IOL implantation. Postoperative visual acuity, residual astigmatism, toric IOL rotation, higher-order aberration, and objective and subjective visual quality were measured 3 months after surgery. Results Twenty-three eyes were included in the study. The logMAR corrected and uncorrected distance visual acuity values were decreased at 3 months postoperatively (p < 0.005). The preoperative average corneal astigmatism and postoperative residual astigmatism were 1.15–6.97 D (1.99 ± 1.26 D) and 0–2.75 D (0.65 ± 0.57 D), respectively. The average IOL rotation was 3.17 ± 2.01°. Some objective indicators of visual quality, including the modulation transfer function (p < 0.05), Strehl ratio (p < 0.005), 100% VA (p < 0.005), 20% VA (p < 0.005), and 9% VA (p < 0.005), were significantly higher than the corresponding preoperative values. The objective scatter index (p < 0.005) was significantly lower than that before surgery. The postoperative VF-14 scale score was 83.99 ± 14.58. Conclusion Toric IOL implantation has a good corrective effect on certain specific types of corneal irregular astigmatism with cataract. This effect can be attributed to its ability to correct the regular component of irregular astigmatism. The indications for toric IOL implantation could be expanded to some extent, thereby bringing benefit to more patients.
Collapse
|
38
|
Abstract
PURPOSE OF REVIEW Astigmatism correction in cataract surgery is a common surgical challenge. Although there are numerous approaches to its treatment during cataract surgery, there remains a lack of consensus on what level of postoperative astigmatism to target. We examine the literature to determine the effect of astigmatism on visual function and provide a recommendation on how much to treat in cataract surgery. RECENT FINDINGS Distance visual acuity decreases as myopic, hyperopic, or mixed astigmatism increases. Near visual acuity decreases with hyperopic astigmatism but improves with myopic astigmatism. The effect of astigmatism is generally independent of axis; however, against-the-rule (ATR) astigmatism with mild myopia may benefit reading. A progressive ATR shift occurs with age whether or not an individual undergoes cataract surgery. In the presence of higher order aberrations, correction of astigmatism below 0.5 D shows minimal practical benefit. Presbyopia-correcting intraocular lenses (IOLs) are sensitive to astigmatism but achieve distance visual acuities similar to monofocal IOLs and reach their full near and/or intermediate potential when residual astigmatism 0.5 D or less. SUMMARY In cataract surgery, we recommend correction to 0.5 D or less of postoperative residual astigmatism to achieve optimum visual function and patient satisfaction following cataract surgery.
Collapse
|
39
|
Xiang H, Li N, Gao J, Zheng G, Chen J, Wang C, Zhuang S. Comparison and applications of spherocylindrical, toroidal, and ellipsoidal surfaces for the correction of astigmatism in spectacle lenses. OPTICS EXPRESS 2020; 28:1745-1757. [PMID: 32121881 DOI: 10.1364/oe.380700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/03/2020] [Indexed: 06/10/2023]
Abstract
Toroidal, spherocylindrical, ellipsoidal, and combined surfaces were used to correct astigmatism in aspheric spectacle lenses, and the differences among the proposed techniques were compared. Four astigmatic spectacle lenses were designed with the same optical parameters. A freeform measuring machine was used to evaluate posterior surfaces of aspheric spectacle lenses, and spherical and cylindrical power maps were generated and compared. The measured data were analyzed via commercial software. The toroidal lens helped to extend the clear vision range around the lens, and the ellipsoidal and spherocylindrical surfaces resulted in a more accurate centering of the lens around the optical axis of the eye, avoided astigmatism, and provided better visual perception.
Collapse
|
40
|
Vincent SJ, Fadel D. Optical considerations for scleral contact lenses: A review. Cont Lens Anterior Eye 2019; 42:598-613. [DOI: 10.1016/j.clae.2019.04.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 01/07/2023]
|
41
|
Yap TP, Luu CD, Suttle CM, Chia A, Boon MY. Electrophysiological and Psychophysical Studies of Meridional Anisotropies in Children With and Without Astigmatism. Invest Ophthalmol Vis Sci 2019; 60:1906-1913. [PMID: 31042798 DOI: 10.1167/iovs.18-25924] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We investigated the pattern of meridional anisotropies, if any, for pattern onset-offset visual evoked potential (POVEPs) responses and psychophysical grating acuity (GA) in children with normal letter visual acuity (20/20 or better). Methods A total of 29 children (aged 3-9 years), nine of whom were astigmatic (AS), were recruited. Orientation-specific monocular POVEPs were recorded in response to sinewave grating stimuli oriented along the subjects' principal AS meridians. Horizontal and vertical gratings were designated Meridians 1 and 2, respectively, for nonastigmatic patients (Non-AS). Binocular POVEPs in response to the same stimuli, but oriented at 45°, 90°, 135°, and 180°, were recorded. Psychophysical GAs were assessed monocularly and binocularly along the same meridians using the same stimuli by a 2-alternative-forced-choice staircase technique. The C3 amplitudes and peak latencies of the POVEP and GAs were compared across meridians using linear mixed models (monocular) and ANOVA (binocular). Results There were significant meridional anisotropies in monocular C3 amplitudes regardless of astigmatism status (P = 0.001): Meridian 2 (mean ± SE Non-AS, 30.13 ± 2.07 μV; AS, 26.53 ± 2.98 μV) was significantly higher than Meridian 1 (Non-AS, 26.14 ± 1.87 μV; AS, 21.68 ± 2.73 μV; P = 0.019), but no meridional anisotropies were found for GA or C3 latency. Binocular C3 amplitude in response to horizontally oriented stimuli (180°, 29.71 ± 3.06 μV) was significantly lower than the oblique (45°, 36.62 ± 3 .05 μV; P = 0.03 and 135°, 35.95 ± 2.92 μV; P = 0.04) and vertical (90°, 37.82 ± 3.65 μV; P = 0.02) meridians, and binocular C3 latency was significantly shorter in response to vertical than oblique gratings (P ≤ 0.001). Conclusions Meridional anisotropy was observed in children with normal vision. The findings suggest that horizontal gratings result in a small, but significantly lower POVEP amplitude than for vertical and oblique gratings.
Collapse
Affiliation(s)
- Tiong Peng Yap
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Chi D Luu
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,Department of Surgery (Ophthalmology), The University of Melbourne, Parkville, Victoria, Australia
| | - Catherine M Suttle
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.,Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, United Kingdom
| | - Audrey Chia
- Pediatric Ophthalmology and Adult Strabismus Department, Singapore National Eye Centre (SNEC), Singapore.,Pediatric Ophthalmology and Strabismus Department, KK Women's and Children's Hospital (KKH), Singapore
| | - Mei Ying Boon
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
42
|
Falkenberg HK, Langaas T, Svarverud E. Vision status of children aged 7-15 years referred from school vision screening in Norway during 2003-2013: a retrospective study. BMC Ophthalmol 2019; 19:180. [PMID: 31409305 PMCID: PMC6693216 DOI: 10.1186/s12886-019-1178-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 07/24/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Undetected vision problems is an important cause of reduced academic achievement, performance in everyday life and self-esteem. This receives little attention in national health care services in Norway even though most of these vision problems are easily correctable. There are no published data on how many Norwegian schoolchildren are affected by correctable vision problems. This study aims to determine the vision status in primary and secondary schoolchildren referred from vision screening during the 10 year period of 2003-2013. METHODS Of the 1126 children (15%) aged 7-15 years referred to the university eye clinic by the school screening program, all 782 who attended the eye clinic were included in the study. Patient records were retrospectively reviewed with regard to symptoms, refractive error, best corrected visual acuity (BCVA) of logMAR, binocular vision, ocular health and management outcomes. RESULTS Previously undetected vision problems were confirmed in 650 (83%) of the children. The most frequent outcomes were glasses (346) or follow-up (209), but types of treatment modalities varied with age. Mean refractive errors were hyperopic for all age groups but reduced with age (ANOVA, p < 0.001). Overall, 51% were hyperopic, 32% emmetropic and 17% myopic. Refractive errors did not change across the decade (linear regression, all p > 0.05). Mean logMAR BCVAs were better than 0.0 and improved with age (ANOVA, p < 0.001). The most prevalent symptoms were headaches (171), near vision problems (149) and reduced distance vision (107). CONCLUSIONS The vision screening identified children with previously undetected visual problems. This study shows that the types of visual problems varied with age and that most problems could be solved with glasses. Our results stress the importance of regular eye examinations and that vision examinations should be included in primary health care services. Furthermore, there is a need for raised awareness among parents and teaching staff regarding vision problems in children.
Collapse
Affiliation(s)
- Helle K Falkenberg
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Hasbergs vei 36, 3616, Kongsberg, Norway.
| | - Trine Langaas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Hasbergs vei 36, 3616, Kongsberg, Norway
| | - Ellen Svarverud
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Hasbergs vei 36, 3616, Kongsberg, Norway
| |
Collapse
|
43
|
Black AA, Wood JM, Colorado LH, Collins MJ. The impact of uncorrected astigmatism on night driving performance. Ophthalmic Physiol Opt 2019; 39:350-357. [DOI: 10.1111/opo.12634] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/18/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Alex A Black
- School of Optometry and Vision Science and the Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
| | - Joanne M Wood
- School of Optometry and Vision Science and the Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
| | - Luisa H Colorado
- School of Optometry and Vision Science and the Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
| | - Michael J Collins
- School of Optometry and Vision Science and the Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
| |
Collapse
|
44
|
Li C, Zhang J, Yin X, Li J, Cao Y, Lu P. Distribution and related factors of corneal regularity and posterior corneal astigmatism in cataract patients. Clin Ophthalmol 2019; 13:1341-1352. [PMID: 31440022 PMCID: PMC6664321 DOI: 10.2147/opth.s212946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 06/23/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To study the distribution of posterior corneal astigmatism (PCA) and its influencing factors in Chinese patients before cataract surgery. Patients and methods A retrospective study was conducted in the First Affiliated Hospital of Soochow University, Suzhou, China. In all, this study enrolled 121 eligible eyes of 121 cataract patients. The astigmatism, aberrations and Q value of anterior, posterior and total cornea and anterior segment parameters (ACD, CCT, WTW, ATA) were measured by the Sirius System, and AL was measured by Lenstar LS 900. Cataract was diagnosed using slit-lamp examination. Results The mean age of patients was 67.44±10.66 years old. Mean PCA was 0.31±0.17 (range 0.05–1.09) D and 85.9% eyes had PCA values <0.5 D. With-the-rule (WTR) astigmatism predominated the anterior cornea astigmatism (ACA) (48.8%) and total corneal astigmatism (TCA) (61.2%), while against-the-rule (ATR) astigmatism predominated posterior (86.0%). Significant positive correlation was found between the astigmatic power vector (APV) of ACA and PCA (Pearson correlation=0.318, P<0.001); TCA and PCA (Pearson correlation=0.204, P=0.025); keratometric astigmatism and PCA (Pearson correlation=0.356, P<0.001); this study also found a positive correlation between primary spherical aberration (Z4°) of the total cornea and PCA (Pearson correlation=0.266, P=0.003); primary spherical aberration (Z4°) of the corneal front surface and PCA (Pearson correlation=0.260, P=0.004); total corneal aberrations (Total cornea root mean square [RMS]) and PCA (Pearson correlation=0.327, P<0.001); total corneal higher-order
aberrations (Total HOA RMS) (Pearson correlation=0.232, P=0.011); total corneal lower-order aberrations (Total LOA RMS) (Pearson correlation=0.250, P=0.006). A positive linear correlation between Q value of corneal front surface and PCA, either 6 mm pupil diameter (Pearson correlation=0.264, P=0.003) or 8 mm pupil diameter (Pearson correlation=0.184, P=0.043) was found in this study. Conclusion Corneal aberration, Q value (front surface specifically) was essential that we need to take into consideration when we conduct PCA and intraocular
lens measurement in clinics.
Collapse
Affiliation(s)
- Chen Li
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Jiaju Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Xue Yin
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Jianqing Li
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Yihong Cao
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| |
Collapse
|
45
|
Atowa UC, Hansraj R, Wajuihian SO. Vision problems: A review of prevalence studies on refractive errors in school-age children. AFRICAN VISION AND EYE HEALTH 2019. [DOI: 10.4102/aveh.v78i1.461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Refractive errors are common eye disorders and are leading causes of visual impairment in the general population. Children with uncorrected refractive error may experience reduced visual acuity, transient blurring, headache and persistent ocular discomforts particularly for close work which can impair reading efficiency and school performance.Aim: This article documents the prevalence of refractive errors in school-age children of different ethnic origins. The goal is to identify possible variation in measuring techniques and diagnostic criteria, as well as limitations of studies, to provide a clear direction for future studies.Methods: The review was undertaken through a detailed evaluation of peer-reviewed publications of primary research on this topic. The keywords for the search included ‘refractive error’, ‘hyperopia’, ‘myopia’, ‘astigmatism’ and ‘school children’. Only epidemiological studies with participants between 5 and 18 years of age were included.Results: Although several population and school-based studies have been conducted in various racial groups and populations, their findings were diverse owing to inconsistencies in the methods applied in identifying children in need of refraction, measurement techniques and diagnostic criteria for refractive errors. There are also some limitations associated with the sampling design and characteristics, which may have influenced the outcome measures.Conclusion: Despite the problems inherent in the studies, the review indicates that refractive error in school-age children is a public health concern in those populations and warrants additional research that will provide reliable data for proper planning of intervention strategies.
Collapse
|
46
|
Hashemi H, Asharlous A, Yekta A, Ostadimoghaddam H, Mohebi M, Aghamirsalim M, Khabazkhoob M. Enantiomorphism and rule similarity in the astigmatism axes of fellow eyes: A population-based study. JOURNAL OF OPTOMETRY 2019; 12:44-54. [PMID: 29625892 PMCID: PMC6318548 DOI: 10.1016/j.optom.2017.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 12/03/2017] [Accepted: 12/06/2017] [Indexed: 06/02/2023]
Abstract
PURPOSE To evaluate the relationship patterns between astigmatism axes of fellow eyes (rule similarity and symmetry) and to determine the prevalence of each pattern in the studied population. METHODS This population-based study was conducted in 2015 in Iran. All participants had tests for visual acuity, objective refraction, subjective refraction (if cooperative), and assessment of eye health at the slit-lamp. Axis symmetry was based on two different patterns: direct (equal axes) and mirror (mirror image symmetry) or enantiomorphism. Bilateral astigmatism was classified as isorule if fellow eyes had the same orientation (e.g. both eyes were with-the-rule) and as anisorule if otherwise. RESULTS Of the total cases of bilateral astigmatism, 80% were isorule, and in the studied population, the prevalence of isorule and anisorule astigmatism was 14.89% and 3.53%, respectively. The prevalence of isorule increased with age (p<0.001). The prevalence of both isorule and anisorule increased at higher degrees of spherical ametropia (p<0.001). Median inter-ocular axis difference was 10° in mirror symmetry and 20° in direct symmetry with no significant difference between two genders (p>0.288). Both symmetry patterns reduced with age (p<0.001). Among cases of bilateral astigmatism, 15.5% and 19.8% had exact direct and mirror symmetry, respectively. CONCLUSION Bilateral astigmatism is mainly isorule in the population and anisorule astigmatism is rare. The enantiomorphism is the most common pattern in the population of bilateral astigmatism.
Collapse
Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Amir Asharlous
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masumeh Mohebi
- Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
47
|
A Randomized Trial to Evaluate the Effect of Toric Versus Spherical Contact Lenses on Vision and Eyestrain. Eye Contact Lens 2018; 45:28-33. [PMID: 30562274 PMCID: PMC6319569 DOI: 10.1097/icl.0000000000000528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the effect of toric versus spherical soft contact lenses on objective measures of visual performance using visual acuity and electromyography of the orbicularis oculi muscle. METHODS Current soft contact lens wearers with -0.75 to -1.75 D astigmatism in each eye were binocularly fitted with toric (1-Day ACUVUE MOIST for astigmatism) and spherical (1-Day ACUVUE MOIST) contact lenses in random order. After each fitting and at 1-week follow-up, high- and low-contrast visual acuities were measured. Electromyography was used to objectively evaluate eyestrain. Linear mixed models were used to assess differences between toric and spherical contact lenses. RESULTS The mean age (±SD) of the 60 participants was 27.5±5.0 years, spherical refractive error was -3.68±2.01 D, and cylinder was -1.28±0.36 D. High- and low-contrast visual acuities with toric lenses were better than with spherical lenses at both fitting (toric high-contrast: -0.065±0.078 and low-contrast: 0.133±0.103 vs. spherical high-contrast: 0.001±0.104 and low-contrast: 0.224±0.107) and follow-up (toric high-contrast: -0.083±0.087 and low-contrast: 0.108±0.107 vs. spherical high-contrast: -0.015±0.095 and low-contrast: 0.211±0.104) (all P<0.0001). Electromyography-measured eyestrain was less with toric versus spherical contact lenses at fitting (least-square ratio of toric over spherical=0.72; P=0.0019) but not at follow-up (ratio=0.86; P=0.11). CONCLUSION These results suggest that toric contact lenses provided improved objective measures of vision in a low-to-moderate astigmatic population.
Collapse
|
48
|
Day AC, Dhariwal M, Keith MS, Ender F, Perez Vives C, Miglio C, Zou L, Anderson DF. Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK. Br J Ophthalmol 2018; 103:993-1000. [PMID: 30190365 PMCID: PMC6591741 DOI: 10.1136/bjophthalmol-2018-312025] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/17/2018] [Accepted: 08/07/2018] [Indexed: 11/26/2022]
Abstract
Purpose To assess the prevalence and severity of preoperative and postoperative astigmatism in patients with cataract in the UK. Setting Data from 8 UK National Health Service ophthalmology clinics using MediSoft electronic medical records (EMRs). Design Retrospective cohort study. Methods Eyes from patients aged ≥65 years undergoing cataract surgery were analysed. For all eyes, preoperative (corneal) astigmatism was evaluated using the most recent keratometry measure within 2 years prior to surgery. For eyes receiving standard monofocal intraocular lens (IOLs), postoperative refractive astigmatism was evaluated using the most recent refraction measure within 2–12 months postsurgery. A power vector analysis compared changes in the astigmatic 2-dimensional vector (J0, J45) before and after surgery, for the subgroup of eyes with both preoperative and postoperative astigmatism measurements. Visual acuity was also assessed preoperatively and postoperatively. Results Eligible eyes included in the analysis were 110 468. Of these, 78% (n=85 650) had preoperative (corneal) astigmatism ≥0.5 dioptres (D), 42% (n=46 003) ≥1.0 D, 21% (n=22 899) ≥1.5 D and 11% (n=11 651) ≥2.0 D. After surgery, the refraction cylinder was available for 39 744 (36%) eyes receiving standard monofocal IOLs, of which 90% (n=35 907) had postoperative astigmatism ≥0.5 D and 58% (n=22 886) ≥1.0 D. Visual acuity tended to worsen postoperatively with increased astigmatism (ρ=−0.44, P<0.01). Conclusions There is a significant burden of preoperative astigmatism in the UK cataract population. The available refraction data indicate that this burden is not reduced after surgery with implantation of standard monofocal IOLs. Measures should be taken to improve visual outcomes of patients with astigmatic cataract by simultaneously correcting astigmatism during cataract surgery.
Collapse
Affiliation(s)
- Alexander C Day
- The NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,Cataract Service, Moorfields Eye Hospital, London, UK
| | | | | | | | | | - Cristiana Miglio
- Centre of Excellence for Retrospective Studies, IQVIA, London, UK
| | - Lu Zou
- Centre of Excellence for Retrospective Studies, IQVIA, London, UK
| | - David F Anderson
- Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK .,Ophthalmology, University of Southampton, Southampton, UK
| |
Collapse
|
49
|
Cox SM, Berntsen DA, Bickle KM, Mathew JH, Powell DR, Little BK, Lorenz KO, Nichols JJ. Efficacy of Toric Contact Lenses in Fitting and Patient-Reported Outcomes in Contact Lens Wearers. Eye Contact Lens 2018; 44 Suppl 1:S296-S299. [DOI: 10.1097/icl.0000000000000418] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
50
|
Wang LL, Wang W, Han XT, He MG. Influence of severity and types of astigmatism on visual acuity in school-aged children in southern China. Int J Ophthalmol 2018; 11:1377-1383. [PMID: 30140644 PMCID: PMC6090130 DOI: 10.18240/ijo.2018.08.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/28/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the influence of astigmatism on visual acuity in school-aged children, and to define a cutoff for clinically significant astigmatism. METHODS This is a population-based, cross-sectional study. Among 5053 enumerated children aged 5-15y in Guangzhou, 3729 (73.8%) children aged 7-15 with successful cycloplegic auto-refraction (1% cyclopentolate) and a reliable visual acuity measurement were included. Ocular measurement included external eye, anterior segment, media and fundus and cycloplegic auto-refraction. Primary outcome measures included the relationship between severity and subtypes of astigmatism and the prevalence of visual impairment. Three criteria for visual impairment were adopted: best-corrected visual acuity (BCVA) ≤0.7, uncorrected visual acuity (UCVA) ≤0.5 or <0.7 in the right eye. RESULTS Increases of cylinder power was significantly associated with worse visual acuity (UCVA: β=0.051, P<0.01; BCVA: β=0.025, P<0.001). A substantial increase in UCVI and BCVI was seen with astigmatism of 1.00 diopter (D) or more. Astigmatism ≥1.00 D had a greater BCVI prevalence than cylinder power less than 1.00 D (OR=4.20, 95%CI: 3.08-5.74), and this was also true for hyperopic, emmetropic and myopic refraction categories. Oblique astigmatism was associated with a higher risk of BCVI relative to with the rule astigmatism in myopic refractive category (OR=12.87, 95%CI: 2.20-75.38). CONCLUSION Both magnitude and subtypes of astigmatism influence the prevalence of visual impairment in school children. Cylinder ≥1.00 D may be useful as a cutoff for clinically significant astigmatism.
Collapse
Affiliation(s)
- Li-Li Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou 510060, Guangdong Province, China
| | - Wei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Tong Han
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou 510060, Guangdong Province, China
| | - Ming-Guang He
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou 510060, Guangdong Province, China
| |
Collapse
|