Gender distribution in publishing in five leading optometry journals.

PURPOSE: To explore gender distribution in authorship and citation parameters of articles published in five optometry journals included in the Ophthalmology category of Journal Citation Reports. METHODS: The Scopus database was used to retrieve all citable articles published in 2011 and 2021 in Optometry and Vision Science, Ophthalmic and Physiological Optics, Clinical Experimental Optometry, Contact Lens and Anterior Eye, and Eye and Contact Lens. Gender of the first, last and single authors of all articles, and citation parameters of articles published in 2011 up to May 2023 were determined. Gender of the editor-in-chief and members of the editorial board of these journals was investigated (May 2023). RESULTS: Only one journal had a female editor-in-chief and three journals had more males than females in their editorial board. In 2011 and 2021, respectively, 40.1% and 48.0% of articles had female as the first authors ( χ 1 , 948 2 = 5.77; p = 0.02), and 32.7% and 39.6% had female as the last authors ( χ 1 , 948 2 = 4.61; p = 0.03). Gender parity was observed in one journal for the first author and none for the last author in 2011, and in three journals for the first author and one for the last author in 2021. Regarding combinations of male (M) and female (F) first and last authorship positions, the authors of articles in 2011 were MM (44.5%), FM (22.8%), FF (17.3%) and MF (15.4%), and MM (34.6%), FM (25.8%), FF (22.1%) and MF (17.5%) in 2021. Differences between 2011 and 2021 were statistically significant ( χ 3 , 948 2 = 9.80; p = 0.02). The proportion of authorship combinations did not show statistically significant differences among journals in 2011 or in 2021. Neither citation nor self-citation were influenced by gender. CONCLUSIONS: Gender disparities persist in optometry journals, with females being under-represented in senior and leadership positions. Increasing the awareness of gender disparity in authorship is a necessary step towards ensuring fairness in science in general, and optometry in particular.

Are Patients Sufficiently Informed about Contact Lens Wear and Care?

SIGNIFICANCE: Frequent and effective patient-practitioner communication is essential to ensure that instructions regarding contact lens use, care, and maintenance are understood and followed. Given the relevance of good patient compliance, the responsibility of practitioners to provide adequate information may not be neglected. PURPOSE: This study aimed to determine the content and type of information licensed optometrists in Spain provide their patients during the first contact lens fitting and at follow-up visits. METHODS: A self-reported ad hoc survey was distributed to licensed optometrists in Spain to investigate, among other factors, whether practitioners provided information on several aspects of contact lens use and maintenance, how was this information provided, and whether in-office practical demonstrations were conducted at all contact lens appointments. RESULTS: Respondents of 321 surveys had a median of 20 years of contact lens fitting experience and worked on independent practices (67.6%), and national (29.0%) and regional chains (3.4%). Type of practice influenced continuous education habits ( P = .03). Overall, 28.0% of participants did not always instruct patients on the need to rub contact lenses, 34.3% did not always address contact lens replacement, and 6.8% did not always explain storage case hygiene and replacement. At the follow-up visit, only 8.4% of respondents asked their patients to demonstrate their care routines. Information was mostly oral (48.6%) or oral and written (43.0%). Contact lens-related complications were reported more frequently by participants with less continuous education training ( P = .01), by those not always recommending rubbing ( P = .002), and by those not providing written information about storage case hygiene and replacement ( P = .002). CONCLUSIONS: Patient-practitioner communication was good, albeit several areas were identified where information was insufficient or not provided in a correct and timely format. Precise, written information on rubbing and storage case hygiene and replacement may improve compliance and assist in avoiding complications and dropout.

Compliance versus Risk Awareness with Contact Lens Storage Case Hygiene and Replacement.

SIGNIFICANCE: Compliance with hygiene and replacement of contact lens (CL) storage cases is key to avoid CL contamination and anterior ocular surface complications. However, compliance levels with these accessories remain low, even in patients with awareness of the risk associated with noncompliance. PURPOSE: This study aimed to determine level of compliance with common practices regarding CL storage case hygiene and replacement, type of information provided by practitioners, and risk perception. METHODS: An ad hoc self-reported survey was used to collect demographic and CL wear details, compliance with storage case care, type of received information, and risk perception (in a 1-to-5 scale). Inferential statistics explored the relationship of demographic details and type of received information with compliance and risk perception. RESULTS: Nondaily disposable wearing participants returned 299 completed surveys, with a median age of 24 years (76.9% females). Monthly replacement silicone hydrogel CLs and multipurpose solutions were predominant. Self-reported compliance with storage case care was poor, with 19.1% of respondents never cleaning their cases, 68.6% exposing them to tap water, and 26.4% failing to replace them within 6 months of acquisition. Two-thirds of respondents received specific information on case maintenance, mainly in oral form. Perceived risk associated with poor-compliance practices was high (median values of 4 and 5), and increased with educational level (P = .02, regarding handwashing; P = .03, regarding case hygiene), with years of CL wear experience (P < .001, regarding handwashing), in those patients provided with specific information on CL case care (P = .01, regarding case replacement). CONCLUSIONS: Compliance with CL storage case hygiene and replacement was generally poor, although awareness of risk associated with noncompliance was high and influenced by factors related to demographic details, CL experience, and patient-practitioner communication. Strategies must be explored to increase risk awareness through education because this may lead to better compliance practices.

Should Overnight Orthokeratology Patients Wear Their Lenses During Their Afternoon Nap?

PURPOSE: The purpose of this study was to evaluate changes in visual acuity, corneal curvature, elevation, pachymetry, and objective quality of vision of experienced orthokeratology patients using their contact lenses during a simulated 30-min afternoon nap. METHOD: Twelve patients aged 30.8±8.3 years were recruited for the study, with a history of overnight orthokeratology of 27.4±23.0 months. Patients were instructed to close their eyes for 30 min while wearing their contact lenses or without lenses. Anterior corneal curvature, elevation, and corneal pachymetry were assessed with the Pentacam Scheimpflug System at 17 predefined corneal locations, and the HD Analyzer (Terrassa, Spain) was used to measure objective quality of vision. Measurements were conducted before eye closure (baseline), immediately after eye opening/lens removal (M1), and 30 min later (M2). RESULTS: No statistically significant differences were found in anterior corneal curvature and elevation between baseline values and M1 or M2, with and without contact lenses. Corneal swelling at M1 was greater without contact lenses (change in central corneal thickness of 2.3%±3.1%, P=0.001) than with contact lenses (1.7%±1.3%, P<0.001). Recovery at M2 was slower when lenses were worn. A statistically significant improvement in objective quality of vision and visual acuity was found only when patients napped with their lenses. CONCLUSIONS: Even if no significant changes were found in corneal curvature and elevation, patients of overnight orthokeratology may benefit from using their contact lenses during their afternoon nap in terms of objective quality of vision and visual acuity.

Visual acuity and defocus curves with six multifocal intraocular lenses.

PURPOSE: The purpose of this prospective, randomized, double-masked, study was to compare the visual performance of patients after bilateral implantation of six different IOLs. METHODS: The following IOLs were used in the study: SV25T0 (n = 19), ATLISA 809M (n = 18), ATLISA Tri 839MP (n = 19), ZKB00 (n = 20), ZLB00 (n = 20) and Symfony ZXR00 (n = 20). Visual performance was assessed by the monocular distance-corrected visual acuity at 4 m (CDVA), distance-corrected intermediate visual acuity (DCIVA) at 60 cm and distance-corrected near visual acuity (DCNVA) at 40 cm. Binocular defocus curves were obtained for a range of defocus from + 1.50 D to - 4.50 D, in 0.50 D steps. Quality of life was assessed with the VF-14 questionnaire. RESULTS: CDVA was better with the Symfony ZXR00 than with the SV25T0 (p = 0.032), ATLISA Tri 839MP (p = 0.032) and ATLISA 809M (p = 0.018). The Symfony ZXR00 offered the best DCIVA, followed by the ZKB00. The best and worst DCNVA results corresponded to the ZLB00, and the SV25T0 and Symfony ZXR00, respectively. Defocus curves at distance were good in all groups, although the Symfony had a wider range of clear vision (- 1.50 D to + 0.50 D), with no decay. For intermediate vision, only the Symfony obtained sharp visual acuity. The ATLISA 809M, ATLISA Tri 839MP and ZLB00 were superior at near distance. CONCLUSIONS: The extended depth of focus of the Symfony ZXR00 offers a superior range of clear vision at far and intermediate distances than other multifocal designs, with worse results at near distance. Visual outcomes reflect the particular optical, geometrical and power distribution characteristics of each IOL.

INTEROCULAR ASYMMETRY IN CHOROIDAL THICKNESS AND RETINAL SENSITIVITY IN HIGH MYOPIA.

PURPOSE: To investigate the normal range of interocular asymmetry in choroidal thickness and retinal sensitivity in high myopia without ocular fundus manifestations and to determine the relationship between interocular asymmetry and refractive error. METHODS: Forty-three patients (35.07 ± 13.31 years) with high myopia and 45 healthy participants (39.9 ± 14.1 years) were administered an ocular coherence tomography and a microperimetry examination to determine choroidal thickness and retinal sensitivity at the foveal region and at 1, 2, and 3 mm, nasally, temporally, superiorly, and inferiorly. Absolute interocular differences were calculated to determine the normal range of asymmetry, in 95% confidence intervals. RESULTS: The choroid was thinner in the myopic group at all explored locations (all P < 0.05), with larger absolute interocular differences in most of the choroidal locations under evaluation (all P < 0.05). Similarly, retinal sensitivity was reduced in the myopic group, although statistically significant differences were only encountered at the subfoveal location (P = 0.001). Retinal sensitivity asymmetry was found to increase with refractive error. CONCLUSION: The expanded range of choroidal thickness and retinal sensitivity asymmetry found in high myopia in the absence of disease is of relevance when exploring these patients for early signs of ocular pathology.

Comparative Analysis of Peripheral Corneal Geometry in Health and Keratoconus.

OBJECTIVES: To describe and compare corneal peripheral angles in normal and keratoconic eyes, to gain a better understanding of the topography of the periphery of the cornea in keratoconus and assist practitioners in the selection and fitting of large diameter contact lenses. METHODS: Eighty-eight eyes were included in the study, divided into three groups: healthy (A0, 28 eyes), keratoconus at stage I according to the Amsler-Krumeich classification (AI, 33 eyes) and keratoconus at stages II to IV (AII, 27 eyes). The Pentacam Scheimpflug system was used to manually measure the corneal peripheral angles corresponding to a chord length range between 8.6 and 12.6 mm at 8 different peripheral locations. RESULTS: The peripheral angle was influenced by ocular condition and by the peripheral location, with no interaction effect between both factors. Statistically significant differences were found in mean corneal peripheral angles between groups A0 (30.84°±2.33°) and AI (31.63°±2.02°) (P=0.001) and between A0 and AII (31.37°±2.11°) (P=0.030). The differences between AI and AII were not significant. In all eyes, the largest and smallest peripheral angles were found at the temporal inferior and temporal superior locations, respectively, with a mean difference between largest and smallest of 3.37°±1.42° in healthy eyes and 2.96°±1.54° in keratoconus (AI+AII). CONCLUSION: Clinically insignificant differences were found in peripheral angles between keratoconus and healthy eyes, giving support to the use of large diameter, intralimbal contact lenses with peripheral designs, and resting on the same corneal region, as those fitted on normal corneas.

Real-Time Non-Intrusive Assessment of Viewing Distance during Computer Use.

PURPOSE: To develop and test the sensitivity of an ultrasound-based sensor to assess the viewing distance of visual display terminals operators in real-time conditions. METHODS: A modified ultrasound sensor was attached to a computer display to assess viewing distance in real time. Sensor functionality was tested on a sample of 20 healthy participants while they conducted four 10-minute randomly presented typical computer tasks (a match-three puzzle game, a video documentary, a task requiring participants to complete a series of sentences, and a predefined internet search). RESULTS: The ultrasound sensor offered good measurement repeatability. Game, text completion, and web search tasks were conducted at shorter viewing distances (54.4 cm [95% CI 51.3-57.5 cm], 54.5 cm [95% CI 51.1-58.0 cm], and 54.5 cm [95% CI 51.4-57.7 cm], respectively) than the video task (62.3 cm [95% CI 58.9-65.7 cm]). Statistically significant differences were found between the video task and the other three tasks (all p < 0.05). Range of viewing distances (from 22 to 27 cm) was similar for all tasks (F = 0.996; p = 0.413). CONCLUSIONS: Real-time assessment of the viewing distance of computer users with a non-intrusive ultrasonic device disclosed a task-dependent pattern.

A new slit lamp-based technique for anterior chamber angle estimation.

PURPOSE: To design and test a new noninvasive method for anterior chamber angle (ACA) estimation based on the slit lamp that is accessible to all eye-care professionals. METHODS: A new technique (slit lamp anterior chamber estimation [SLACE]) that aims to overcome some of the limitations of the van Herick procedure was designed. The technique, which only requires a slit lamp, was applied to estimate the ACA of 50 participants (100 eyes) using two different slit lamp models, and results were compared with gonioscopy as the clinical standard. RESULTS: The Spearman nonparametric correlation between ACA values as determined by gonioscopy and SLACE were 0.81 (p < 0.001) and 0.79 (p < 0.001) for each slit lamp. Sensitivity values of 100 and 87.5% and specificity values of 75 and 81.2%, depending on the slit lamp used, were obtained for the SLACE technique as compared with gonioscopy (Spaeth classification). CONCLUSIONS: The SLACE technique, when compared with gonioscopy, displayed good accuracy in the detection of narrow angles, and it may be useful for eye-care clinicians without access to expensive alternative equipment or those who cannot perform gonioscopy because of legal constraints regarding the use of diagnostic drugs.

Citation parameters of contact lens-related articles published in the ophthalmic literature.

OBJECTIVE: This study aimed at exploring the citation parameters of contact lenses articles published in the Ophthalmology thematic category of the Journal Citation Reports (JCR). METHODS: The Thompson Reuters Web of Science database was accessed to record bibliometric information and citation parameters of all journals listed under the Ophthalmology area of the 2011 JCR edition, including the journals with main publication interests in the contact lens field. In addition, the same database was used to unveil all contact lens-related articles published in 2011 in the same thematic area, whereupon differences in citation parameters between those articles published in contact lens and non-contact lens-related journals were explored. RESULTS: Significant differences in some bibliometric indicators such as half-life and overall citation count were found between contact lens-related journals (shorter half-life and fewer citations) and the median values for the Ophthalmology thematic area of the JCR. Visual examination of all Ophthalmology journals uncovered a total of 156 contact lens-related articles, published in 28 different journals, with 27 articles each for Contact Lens & Anterior Eye, Eye & Contact Lens, and Optometry and Vision Science. Significant differences in citation parameters were encountered between those articles published in contact lens and non-contact lens source journals. CONCLUSIONS: These findings, which disclosed contact lenses to be a fertile area of research, may be of interest to researchers and institutions. Differences in bibliometric indicators are of relevance to avoid unwanted bias when conducting between- and within-discipline comparisons of articles, journals, and researchers.

The Interaction between Vergence and Accommodation Cues in the Assessment of Fusional Vergence Range.

Fusional vergence range tests are commonly used in optometric practice. The aim of this study was to investigate the possible contribution of CA/C, AC/A, and proximal cues (PCT) to the magnitude and presence of blur and recovery during the measurement of fusional vergence ranges and to determine whether the occurrence of blur is influenced by these vergence and accommodation cues. A total of 27 participants with normal binocular vision were included and AC/A, CA/C, and PCT ratios were evaluated. Blur, break, and recovery values in convergence and divergence were assessed with base-out and base-in prisms, respectively. No statistical correlations were found between AC/A, CA/C, and PCT ratios and the magnitude of blur, break, and recovery values in neither far, near, convergence, nor divergence testing conditions. However, better near point of convergence values were related to higher break values in convergence at far distances, but not at near distances. In addition, for convergence and far distance, a statistical difference was found between groups reporting and not reporting blur in AC/A stimulus and PCT ratios. The present results cannot confirm whether vergence and accommodation cues, such as AC/A, CA/C, and PCT ratios, may play an active role during the assessment of fusional vergence range.

New Designs of Spectacle Lenses for the Control of Myopia Progression: A Scoping Review.

Myopia control with new designs of spectacle lenses is a flourishing area of research. The present work reviews the effectiveness of new designs (DIMSs, defocus-incorporated multiple segments; CARE, cylindrical annular refractive element; HALs/SALs, highly/slightly aspherical lenslets; DOT, diffusion optics technology) aiming at slowing myopia progression. A search through the PubMed database was conducted for articles published between 1 January 2003 and 28 February 2023. Publications were included if they documented baseline central refraction (SER) and/or axial length (AL) data, and the change in these parameters, in myopic children wearing new designs of spectacle lenses (treatment group) compared to myopic children using single-vision lenses, SVLs (control group). The selection process revealed nine suitable articles. Comparing the mean and standard error values of the treatment and control groups, the highest differences in the change in the SER and AL were -0.80 (1.23) D [95% CI: -1.053 to -0.547; p < 0.001] and 0.35 (0.05) mm [95% CI: 0.252 to 0.448; p < 0.001], respectively; the effect of treatment provided by a HAL design, compared to SVLs, led to a deceleration of 54.8% in the SER and 50.7% in the AL. However, the heterogeneity of the results prevents reaching strong conclusions about the effectiveness of these new designs.

Central and peripheral corneal sagittal height in keratoconus and healthy eyes.

PURPOSE: To determine central and peripheral corneal sagittal height (z) values in keratoconus and healthy eyes with the Oculus Pentacam point-by-point data extraction software. METHODS: Forty eyes from patients with central or paracentral (4 mm) keratoconus (32.0 ± 12.5 years) and 40 eyes from healthy subjects (29.1 ± 7.9 years) were included. The Oculus Pentacam software was employed to determine z values referenced to a plane tangent to the corneal apex for five circles concentric with the centre of the pupil with diameters 4, 6, 8, 9 and 10.5 mm. The variability in z values within each circle and in terms of corneal meridians and quadrants was explored in keratoconus and healthy eyes. RESULTS: Keratoconus apex was mainly located at the inferior-temporal quadrant, at a distance from 0.083 mm to 3.59 mm with reference to the centre of the pupil. Mean z was larger in keratoconus than in healthy eyes in all explored corneal diameters (all p < 0.001). Variation in z values was larger in keratoconus than healthy eyes only at the central areas of the cornea (4 mm, p = 0.02; 6 mm, p = 0.011), but not in the periphery (8, 9 and 10.5 mm). In keratoconus, the frequency of minimum z values in the IT quadrant was greater than in healthy eyes. CONCLUSION: Although peripheral z values were larger in keratoconus, rotational variations were comparable between keratoconus and healthy eyes, suggesting that large diameter spherical rigid corneal contact lenses may be an alternative to scleral lenses in central and paracentral keratoconus.

Quality of life of caregivers of children with visual impairment: A qualitative approach.

BACKGROUND: Receiving a diagnosis of a child with untreatable visual impairment (VI) may have a negative impact on parents and caregivers, and affect their quality of life (QoL). AIMS: To use a qualitative research approach to determine the impact that caregiving a child with a VI has on the QoL of caregivers in Catalonia (Spain). METHODS: An observational study was designed in which nine parents of children with VI (6 mothers) were recruited following an intentional sampling scheme. In-depth interviews were conducted, and a thematic analysis was performed to identify main themes and subthemes. The QoL domains defined in the questionnaire WHOQoL-BREF guided data interpretation. RESULTS: An overarching theme was defined (the weight on one's shoulders), as well as two main themes (obstacles race and emotional impact) and seven subthemes. QoL was negatively affected by a general lack of knowledge and understanding regarding VI in children and its implications for children and caregivers, whereas social support, gaining knowledge, or cognitive reappraisal had a positive effect. CONCLUSIONS: Caregiving for children with VI affects all QoL domains, resulting in persistent psychological distress. Both administrations and health care providers are encouraged to develop strategies to assist caregivers in their demanding roles.

Accuracy of a Large Language Model as a new tool for optometry education.

CLINICAL RELEVANCE: The unsupervised introduction of certain Artificial Intelligence tools in optometry education may challenge the proper acquisition of accurate clinical knowledge and skills proficiency. BACKGROUND: Large Language Models like ChatGPT (Generative Pretrained Transformer) are increasingly being used by researchers and students for work and academic assignments. The authoritative and conversationally correct language provided by these tools may mask their inherent limitations when presented with specific scientific and clinical queries. METHODS: Three sets of 10 queries related to contact lenses & anterior eye, low vision and binocular vision & vision therapy were presented to ChatGPT, with instructions to provide five relevant references to support each response. Three experts and 53 undergraduate and post-graduate students graded from 0 to 10 the accuracy of the responses, and the references were evaluated for precision and relevance. Students graded from 0 to 10 the potential usefulness of ChatGPT for their academic coursework. RESULTS: Median scores were 7, 8 and 6 (experts) and 8, 9 and 7.5 (students) for the contact lenses & anterior eye, low vision and binocular vision & vision therapy categories, respectively. Responses to more specific queries were awarded lower scores by both experts (ρ = -0.612; P < 0.001) and students (ρ = -0.578; P = 0.001). Of 150 references, 24% were accurate and 19.3% relevant. Students graded the usefulness of ChatGPT with 7.5 (2 to 9), 7 (3 to 9) and 8.5 (3 to 10) for contact lenses & anterior eye, low vision and binocular vision & vision therapy, respectively. CONCLUSION: Careful expert appraisal of the responses and, particularly, of the references provided by ChatGPT is required in research and academic settings. As the use of these tools becomes widespread, it is essential to take proactive steps to address their limitations and ensure their responsible use.

Loss of Blink Regularity and Its Impact on Ocular Surface Exposure.

(1) Background: Changes in blink parameters have been found to influence ocular surface exposure, eliciting symptoms of dry eye and ocular signs. The aim of the study was to highlight the relevance of including blink regularity as a new parameter to fully characterize blinking; (2) Methods: A novel characterization of blink parameters is described, including spontaneous eyeblink rate (SEBR), percentage of incomplete blinks, and blink regularity. A pilot study was designed in which tear film break-up time (TFBUT), blink parameters, and the time percentage of ocular surface exposure were determined in eight subjects (52.0 ± 16.6 years, 4 females) in three experimental conditions (baseline, reading a hard-copy text, and reading from an electronic display). Blink parameters were monitored through asynchronous image analysis of one minute video segments; (3) Results: All blink parameters were influenced by experimental conditions. A trend was observed in which both reading tasks resulted in an increase in ocular surface exposure, mainly related to a combination of reduced SEBR, increased percentage of incomplete blinks, and loss of blink regularity; (4) Conclusions: A complete characterization of blink parameters is relevant to better understand ocular dryness related to surface exposure and to advice patients towards a reeducation of their blinking habits.

Optometry research in Spain: Topics of interest, institutions and investigators.

PURPOSE: To determine the institutions, journals of choice and topics of investigation of the most prolific and highly cited Spanish optometrist researchers. METHODS: As a primary search strategy, the Scopus database (Elsevier) was queried with the terms (optometr* OR "contact lens*" OR refracti* OR *ocular) and the affiliation country filter "Spain". The list of authors returned by the primary search was used in a secondary manual search based on co-authors and institutions. Authors were included in the analysis if they had an h-index > 10, were of Spanish nationality, were affiliated to Spanish institutions, and possessed an optometry degree. Authors were ranked by h-index, number of publications and number of citations. Topics of research interest and target journals were determined by analyzing the 10 most highly cited papers of each author. RESULTS: A total of 32 authors with an h-index > 10 were identified, of whom 14 (43.7%) were female. Only one author had an h-index > 40, and 7 (21.9%) authors had an h-index over 20. The Journal of Cataract and Refractive Surgery was the first journal of choice (19.1% of highest cited papers), followed by Optometry and Vision Science (10.3%). The Universidad Complutense de Madrid hosted the largest percentage of authors (18.7%), followed by the Universitat de València (15.6%). Main topics of research interest were topography (6.5% of papers), cornea (6.2%) and contact lens (5.0%). CONCLUSION: Optometry in Spain is a fertile field of research, with an increasing number of highly cited authors publishing in high impact journals.

Short- and mid-term changes in CORVIS ST parameters in successful, adult orthokeratology patients.

CLINICAL RELEVANCE: The changes in various biomechanical and tomographic characteristics of the cornea associated with orthokeratology may allow us to identify potential mid- and long-term structural alterations, resulting in a better understanding of the governing mechanisms of this procedure and in its optimisation. BACKGROUND: The study aimed at describing short and mid-term changes in CORVIS ST® parameters and indices in orthokeratology (ortho-k), and their diurnal variations. METHODS: A prospective observational study was designed in which several CORVIS ST® parameters of 75 new adult participants successfully fitted with overnight ortho-k Seefree® (Conóptica - Hecht Contactlinsen) contact lenses were explored. Measurements were conducted in baseline (BL) conditions and in the morning and evening at the one-night (1 NM/1NT), one-week (1WM/1 WT) and 3-month (3 MM/3MT) follow-up visits. RESULTS: Statistically significant differences were found in DARatio_2 mm, IntRad, ARTh, CBI and TBI following overnight ortho-k, when compared with BL values, with most values reaching stability at 1WM or reverting to BL values at 3 MM. The ARTh and CBI parameters showed some of the most significant temporal variations (both p < 0.001), probably reflecting the encountered differences in central corneal thickness between BL and 1WM (p = 0.010) and between BL and 3 MM (p = 0.016). In general, corneal rigidity was higher in the morning at all follow-up visits, and decreased during the day. No statistically significant changes in adjusted intraocular pressure values were found. CONCLUSION: Ortho-k in adults may be considered a safe procedure in terms of short and mid-term changes in CORVIS ST® parameters. The observed alterations in most of the parameters provided by the Corvis ST® probably responded to the well-described changes in corneal pachymetry and tomography, rather than to actual alterations in corneal rigidity.

The Relationship between Fixation Stability and Retinal Structural Parameters in Children with Anisometropic, Strabismic and Mixed Amblyopia.

(1) Background: Amblyopia is an ocular condition leading to structural and functional changes. The relationship between these changes is complex and remains poorly understood. (2) Methods: Participants included 31 children aged 5 to 9 years with strabismic (n = 9), anisometropic (n = 16) and mixed (n = 6) unilateral amblyopia, and 14 age-matched non-amblyopic children. The 95% and 63% Bivariate Contour Ellipse Area (BCEA), axial length, Foveal Avascular Zone (FAZ) area, center macular thickness and volume were assessed. The relationship between these parameters was explored. (3) Results: Statistically significant differences were found among the four groups in best corrected distance visual acuity (BCVA) (p < 0.001), BCEA 95% (p = 0.002) and BCEA 63% (p = 0.002), but not in the FAZ area, central macular thickness, central macular volume and axial length. Eyes with amblyopia had poorer BCVA and larger fixation instability than controls. Inter-ocular differences were more significant in patients with strabismic amblyopia, particularly in BCVA (p = 0.003), central macular thickness (p < 0.001) and central macular volume (p = 0.002). In amblyopic eyes, BCEA 95% and 63% were correlated with BCVA, but not with the FAZ area. (4) Conclusion: Amblyopia is associated with a reduction in fixation stability and BCVA, although there is a general lack of correlation with structural changes, suggesting a complex interaction between anatomy and function in amblyopia.

Toric double tear reservoir contact lens in orthokeratology for astigmatism.

OBJECTIVES: This study aimed at assessing the performance of a double tear reservoir toric reverse geometry contact lens design for the correction of myopic and astigmatic refractive errors through overnight orthokeratology (Ortho-K). METHODS: Consecutive records of a total of 32 patients with refractive astigmatism greater than 1.25 D at any orientation, best corrected distance monocular visual acuity ≥ 1.00 (decimal) before Ortho-K treatment and stable ocular refraction for at least 1 month at the time of the last visit were retrospectively examined. Preorthokeratology and postorthokeratology information included noncycloplegic subjective refraction, best-corrected visual acuity, pupil diameter, corneal topography, and ocular aberrometry. The associations between the achieved myopic and cylinder reduction and the modifications in various corneal topographic parameters were investigated. Right eyes were chosen for data analysis. RESULTS: A statistically significant difference (Z=-4.805; P<0.001) was encountered between initial refractive sphere and final residual refractive sphere, with a dioptric change of -2.05 ± 1.46 D (median: -1.88; -5.25 to 0.50), accounting for a change of 106% of the initial myopia. Similarly, differences between pretreatment and posttreatment refractive cylinders were significant (Z=-4.945; P<0.001), with a dioptric change of -1.80 ± 1.06 D (median: -1.50; -5.25 to -0.50), that is, a change of 85% of the initial astigmatism. Changes in topographic Best Fit Sphere and Best Fit Toric presented a strong positive correlation with the accomplished myopic and astigmatic refractive changes, respectively. CONCLUSIONS: The results of this investigation suggest that the correction of astigmatic errors with toric orthokeratology lens designs may have a promising future.