Background: Visio-spatial skills (VSS) are fundamental perceptual–cognitive capacities that enable athletes to process dynamic visual information, interpret spatial relationships, and execute precise motor responses under competitive conditions. In taekwondo, where scoring actions are executed within milliseconds and success depends on the rapid detection and anticipation of an opponent’s movements, well-developed VSS are considered a functional prerequisite for performance. Method: This cross-sectional observational study examined differences in VSS between amateur taekwondo athletes (n = 50) and non-athletes (n = 50) recruited from the King Cetshwayo Municipality District, KwaZulu-Natal, South Africa. Six VSS were assessed using standardized, validated instruments: accommodation facility (AF), saccadic eye movement (SEM), speed of recognition (SR), hand–eye coordination (HEC), peripheral awareness (PA), and visual memory (VM). Between-group comparisons were performed using the Mann–Whitney U test, with effect sizes reported as rank-biserial correlations (r). Results: Taekwondo athletes demonstrated significantly superior performance across all VSS domains (all p ≤ 0.05), with a large effect observed for SR (r = 0.91), HEC (r = 0,87), SEM (r = 0.78), and AF (r = 0.74), and moderate effect for VM (r = 0.58) and PA (r = 031). The largest between-group percentage differences were observed for SR (79.43%), HEC (48.13%), and SEM (33.33%), with smaller but significant differences in AF (31.05%), VM (14.92%), and PA (4.23%). Pearson correlation analysis revealed a dense, globally integrated VSS network in non-athletes anchored by AF, contrasting with a sparse pattern in taekwondo athletes, in which SEM showed the greatest number of moderate or stronger associations with other variables. These within-group correlation structures are presented as preliminary and descriptive observations only. Intraclass correlation coefficients were excellent for five of the six VSS (ICC ≥ 0.963), with PA yielding a point estimate of ICC = 0.853, characterized by a wide confidence interval. Conclusions: These findings indicate that amateur taekwondo athletes show superior perceptual, oculomotor, and visuo-motor performance compared to non-athletes. Within-group VSS correlation pattern differs descriptively between the groups. The cross-sectional design cannot determine whether these differences reflect training-associated perceptual adaptation, pre-existing trait-based self-selection into taekwondo, or a combination of both mechanisms. Both interpretations carry applied implications for talent identification and vision training program design. A longitudinal investigation is required to establish causal directionality. SEM and AF are proposed as the most diagnostically informative VSS markers for taekwondo screening, under either interpretation.
This study aims to address whether a new visual-motor-based learning paradigm with music can potentially promote neuroplasticity and create new interventional tools, building upon prior research that shows behavioral and putative neural changes following dance-based neurorehabilitation in people with Parkinson's disease (PD). Eye movements of 10 healthy adult participants, aged 20-25, were tracked using the Eyelink 1000 Plus system during a 68 s eye dance sequence. The experiment consisted of a learning phase, where participants observed the sequence five times with 30 s breaks, and a performance phase, where they performed the sequence five times from memory on a gray screen without visual cues. Results showed a significant improvement in percentage of total movements performed correctly between the first session (g1; M = 40%, SD = 7.2%) and the last session (g5; M = 69.7%, SD = 22.8%). Similarly, there was significant improvement in the average time on beat from the intended choreography timing, between the first session (g1; M = 0.29, SD = 0.06) and the fifth session (g5; M = 0.46, SD = 0.12). These findings suggest that eye movement choreography has the potential to be learned within healthy adults.
Physical activity levels, hallucination experiences, sleep quality, and perceived stress were assessed using a survey administered to 57 adults with a confirmed diagnosis of Charles Bonnet Syndrome (CBS). Physical activity demonstrated a significant negative correlation with hallucination severity (r = -0.335, p = 0.011, two-tailed). A significant negative correlation was also observed between physical activity and perceived stress (r = -0.497, p < 0.001, two-tailed). In contrast, no significant association was identified between hallucination frequency and sleep disruption or insomnia. These findings suggest that engaging in appropriate levels of physical activity may help reduce the severity of hallucinations and mitigate stress among individuals with CBS. The observation that higher levels of physical activity are associated with reduced hallucination burden may help the development of evidence-based management strategies for CBS. Additionally, the finding that physical activity was significantly related to hallucination severity, whereas sleep disruption was not, merits deeper exploration in future research.
Combined intrastromal corneal ring segment implantation with corneal collagen cross-linking (CXL) aims to improve optical regularity and reduce the risk of ectatic progression in selected eyes with keratoconus. In this retrospective, single-center, complete-case longitudinal series, 58 eyes from 40 patients treated at OCULENS Ophthalmology Clinic between 2019 and 2022 were analyzed after same-session KeraRing implantation and conventional epithelium-off CXL, with baseline and 6-, 12-, 24-, and 36-month follow-up data. Outcomes included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), thinnest pachymetry, maximum keratometry (Kmax), the Belin/Ambrosio enhanced ectasia total deviation index (BAD-D), the C and D components of the ABCD classification, and Corvis ST-derived dynamic deformation parameters. Longitudinal continuous outcomes were analyzed as eye-level repeated-measures estimates with Holm-adjusted paired comparisons, and stage distributions were analyzed with the Friedman test. At 36 months, UDVA improved from 0.560 ± 0.151 to 0.469 ± 0.136 logMAR and CDVA from 0.350 ± 0.109 to 0.287 ± 0.092 logMAR (both p < 0.001). Kmax decreased from 56.11 ± 3.17 D to 54.87 ± 2.86 D, BAD-D improved from 5.62 ± 1.89 to 4.70 ± 1.75, and thinnest pachymetry measured 440.7 ± 21.9 µm at 36 months, corresponding to 97.0% of baseline thickness. Corvis ST-derived deformation behavior shifted toward lower deformation amplitude and higher stiffness parameter at first applanation (SP-A1), but these device-derived parameters should be interpreted as indirect deformation response metrics rather than as direct tissue stiffness measurements. Two clinically significant complications were recorded (2/58 eyes, 3.4%): one sterile corneal infiltrate requiring ring explantation and one case of corneal melting requiring ring explantation and referral for keratoplasty. The findings support sustained 36-month visual, tomographic, and Corvis ST-derived changes after combined treatment, while interpretation remains limited by the retrospective complete-case design, unavailable denominator for cases excluded because of incomplete follow-up, eye-level analysis with bilateral cases, lack of a control group, and indirect nature of Corvis ST-derived biomechanical assessment.
Myopia is an increasingly common refractive disorder in children, with growing concern regarding the potential role of screen time and digital device use in its development and progression. This systematic review assessed the association between screen-related behaviours and myopia in European children and adolescents. A systematic search of Ovid Embase, Ovid MEDLINE, Scopus, Web of Science and Cochrane/CENTRAL was conducted in accordance with PRISMA guidance. Original English-language studies published within the last 10 years were included if they involved participants aged <18 years, were conducted in Europe, and investigated screen time, digital device use, near-work behaviour or related lifestyle exposures in relation to myopia-related outcomes. A total of 1196 records were identified across the databases. After duplicate removal, title and abstract screening, and full-text assessment, 14 studies were included. Overall, the evidence suggested an association between screen-related behaviours, prolonged near work, reduced outdoor exposure and myopia-related outcomes in European children. However, findings were heterogeneous, and screen exposure was often measured using broad or proxy variables, including total screen time, smartphone use, internet data consumption, computer use, handheld near-screen use and COVID-19-related lifestyle change. Outdoor activity appeared to be a protective factor, while parental myopia was an important risk factor and confounder. Most included studies were observational, many were cross-sectional, and several relied on self- or parent-reported exposure measures, limiting causal inference and introducing potential recall bias. Overall, the certainty of evidence was low to very low. Practical advice should therefore be framed around balanced digital device use, regular breaks from prolonged near work, appropriate viewing distances and increased outdoor activity, while further longitudinal studies using objective screen-use measures, cycloplegic refraction and axial length outcomes are needed to clarify causality.
Background/Objectives: High astigmatism remains challenging in keratorefractive lenticule extraction because small errors in centration or cyclotorsion may affect astigmatic correction. This study evaluated early refractive and astigmatic vector outcomes after small-incision lenticule extraction (SMILE) Pro using the VISUMAX 800 in eyes with high astigmatism. Methods: This prospective interventional cohort study was conducted at Cung Hong Son International Eye Hospital, Hanoi, Vietnam. Refractive outcomes, including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, astigmatic vector analysis, and intraoperative and postoperative complications, were evaluated up to 3 months postoperatively. Results: A total of 160 eyes from 102 patients were included in the final analysis. The mean age was 23.7 ± 4.7 years, and 63.7% of participants were female. The mean preoperative spherical equivalent (SEQ) was -7.21 ± 2.03 D, and the mean preoperative refractive cylinder was -2.51 ± 0.56 D. Mean postoperative SEQ was -0.10 ± 0.38 D at 1 month and 0.02 ± 0.31 D at 3 months. At 3 months, 99% and 84% of eyes achieved UDVA of 0.8 decimal or better and 0.9 decimal or better, respectively. The mean residual refractive cylinder was -0.52 ± 0.28 D, with 69% and 98% of eyes achieving a residual cylinder ≤0.50 D and ≤1.00 D, respectively. All eyes had an angle of error within ±15°. The safety index was 1.01, and no eyes lost two or more lines of CDVA. Conclusions: SMILE Pro performed with the VISUMAX 800 provided favorable early 3-month refractive and astigmatic vector outcomes with a satisfactory safety profile in eyes with high astigmatism.
Spatial working memory (SWM) has been characterised as a flexible resource that determines the precision with which memoranda are stored. The 'cortical map' proposal predicts that resource allocation, and therefore mnemonic precision, is limited by the availability of cortical space to represent memoranda. This hypothesis was tested using a continuous spatial localisation task in which memory items were presented at three eccentricities and set sizes of 1-8. Localisation error increased systematically with eccentricity, as predicted by the cortical maps hypothesis. Mixture-modelling analyses indicated that the eccentricity effect was primarily driven by increases in imprecision at small set sizes (set sizes 1-5). In contrast, when set size exceeded five items, guessing made an increasingly important contribution to localisation error, suggesting that representations of peripheral locations become more vulnerable to memory failure under high memory loads. Misbinding errors were most prominent for locations nearest fixation, likely reflecting reduced inter-item spacing at small eccentricities. Stimuli were not scaled to compensate for cortical magnification, but the observed increase in imprecision closely matched predictions derived from a cortical magnification function. Together, these findings support the cortical maps hypothesis and indicate that spatial working memory representations compete for limited representational resources within the spatial maps that guide action.
Keratoconus is a progressive corneal ectasia that results in substantial visual impairment and imposes a significant functional and psychosocial burden on affected individuals. Despite evidence suggesting earlier onset and a potentially more aggressive disease course of keratoconus in Saudi populations, there is a significant lack of region-specific data evaluating vision-related quality of life (VRQoL) in Riyadh. This cross-sectional study conducted in Riyadh, Saudi Arabia, evaluated VRQoL in individuals with keratoconus using the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Data were obtained from January to March 2025 through an online, structured, self-administered questionnaire. A total of 1007 participants were included, of whom 299 (29.7%) reported a diagnosis of keratoconus. The mean composite NEI-VFQ-25 score among participants with keratoconus was 61.0 ± 15.8, reflecting moderate impairment in VRQoL. Reduced VRQoL was significantly associated with eye-rubbing behavior, including both frequency (p = 0.027) and method (p = 0.026). The results highlight the importance of early detection and the relevance of eye-rubbing behavior in relation to reduced VRQoL, while supporting the need for longitudinal research to further clarify these associations.
Purpose: This study was conducted to assess retinal responses in myopic and non-myopic participants after exposure to repeated low-level red-light therapy (RLRT) of 3 min and 1 min duration to see if response differs with exposure time and refractive status using global flash multifocal electroretinogram (gf-mfERG). Methods: This was a prospective exploratory pilot study with a convenient sample of 20 participants of mean age of 25.5 years (18 to 39 years) who underwent 3 min therapy, followed by, 1 week after, 1 min therapy in each participant between February to May 2025. However, four participants who did not appear in 1 min therapy for measurements were excluded from the between-group comparison analysis. We measured retinal responses using gf-mfERG ring-wise implicit time (DCT, ICT) and amplitude (DCA, ICA), baseline, post-first and post-second RLRT. Data analysis included descriptives, repeated measures ANOVA, post hoc test, Bonferroni adjusted correction, and correlation with axial length (AL) and choroidal thickness (CT) in each group. The study was conducted at CEORLab, University of Minho, Portugal, and adhered to Ethical Committee approval and the tenets of the Declaration of Helsinki. Results: In 3 min RLRT exposure, no significant within-subject changes were observed across direct (DC) and induced (IC) gf-mfERG components across all rings (p > 0.05). Statistically significant between-group differences in DC implicit time were noted in Ring 2 (p = 0.029) and Ring 3 (p = 0.012). IC amplitude showed significant within-subject changes in myopes (Ring 1: p = 0.030; Ring 4: p = 0.035) and non-myopes (Ring 1: p = 0.042; Ring 3: p = 0.001; Ring 4: p < 0.001; Ring 5: p = 0.034), with no significant between-group differences (p > 0.05). In contrast, 1 min RLRT showed no significant changes in DC, IC time or amplitudes ICA, DCA (all p > 0.05). Correlation analysis after 3 min RLRT showed that in myopes, DCT positively correlated with AL in Ring 3 (r = 0.591, p = 0.006) and Ring 4 (r = 0.615, p = 0.004), ICT positively correlated with CT in Ring 2 (r = 0.601, p = 0.005) and Ring 3 (r = 0.573, p = 0.008), and ICA negatively correlated with AL in Rings 3–5 (all p < 0.01). Non-myopes demonstrated limited correlations, including a negative association between ICT and axial length in Ring 4 (r = −0.619, p = 0.004). Similar but weaker patterns were observed following 1 min RLRT. Conclusions: 3-min RLRT induces localized inner retinal functional changes without significantly altering outer retinal responses, while 1-min exposure shows no measurable effect. Retinal ERG responses are primarily influenced by axial length, particularly in myopic eyes, highlighting a structure–function relationship rather than a robust short-term therapeutic effect of RLRT.
(1) Background: Ultra-early optical coherence tomography (OCT) changes following intravitreal injection may reflect transient mechanical compression rather than pharmacologic effects; however, this temporal profile has not been rigorously characterised with appropriate statistical methodology. (2) Methods: In this prospective observational study, 40 eyes of 40 consecutive patients (one per patient) with macular edema secondary to neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or chronic central serous retinopathy (CSR) underwent intravitreal bevacizumab (n = 35) or triamcinolone acetonide (n = 5). Goldmann applanation tonometry and spectral-domain OCT were performed at baseline, 2–5 min, 15 ± 5 min, 24 h, and 48 h post-injection. Repeated-measures ANOVA with Greenhouse–Geisser correction, linear regression, and Spearman rank correlation were applied. (3) Results: Central subfield thickness (CST) decreased markedly at 15 ± 5 min (mean −24.8 ± 11.5%; 95% CI: −28.5% to −21.1%; p < 0.001; partial η2 = 0.70), with near-complete rebound by 48 h (−1.0%; p = 0.400). Peak intraocular pressure (IOP) elevation correlated with CST reduction (Spearman rs = 0.61; 95% CI: 0.39–0.77; p < 0.001), and baseline CST predicted thinning magnitude (R2 = 0.52; p < 0.001). (4) Conclusions: Ultra-early OCT thinning after intravitreal injection is consistent with transient mechanical compression. Retinal thickness measurements within 48 h post-injection should be interpreted with caution when assessing treatment response, as early anatomic reduction may not reflect pharmacologic efficacy.
Visual discomfort or visual stress is an uncomfortable subjective experience that occurs in response to specific visual stimuli. It affects a large proportion of the population to various degrees, disproportionately impacting those with heightened sensory sensitivities, particularly neurodivergent individuals. We argue that this might stem from a mismatch between the statistical properties of visual stimuli in human-made environments and those in natural environments that the visual system can process efficiently. We discuss the inefficiency with which images with certain spatial, chromatic and temporal characteristics are processed by the visual system and propose a cerebral mechanism to account for the discomfort they induce. The mechanism offers a potential explanation for the large individual differences in susceptibility to discomfort. We highlight two avenues for intervention: (1) environmental modifications aimed at reducing the prevalence of visually stressing stimuli in urban settings, and (2) individual-level strategies, such as personalised optical treatments. Addressing these challenges requires an interdisciplinary effort bridging neuroscience, vision science, interior and urban design and typography to create visually accessible and inclusive environments.
PURPOSE:Recent studies have shown that subjects with congenital colour vision deficiency (CVD) can pass the saturated Farnsworth D15 (FD15) through practice. The Lanthony D15 (LD15) uses desaturated colours and is a difficult test even for patients with mild CVD. This study investigated if subjects could improve their performance on the LD15 with intentional practice. METHODS:Twenty-one male subjects (mean/SD age = 30.2/8.9 years) with congenital CVD were enrolled in the two-visit study. Their CVD status was evaluated with colour vision book screening, anomaloscope, and FD15 tests. The recruited subjects completed four trials of the LD15 at the baseline visit. Once all data collection was completed at the first visit, it was revealed to the subjects that the correct cap order could be determined by viewing the undersides of the caps. The subjects were given an LD15 test kit to practice at home to improve their performance before returning for a second visit. At the second visit, subjects performed another four trials of the LD15. The colour confusion indices for each trial were recorded for both visits, and the average values were used in paired t-tests to determine if significant improvement occurred. RESULTS:A significant decrease in colour confusion index (CCI) of 0.51 (visit 1 mean/SE = 3.75/0.20; visit 2 mean/SE = 3.23/0.24) between the two visits was observed (p = 0.01). Further, subjects with deutan deficiency showed a significant (p = 0.003) decrease, whereas subjects with protan deficiency did not (p = 0.88). CONCLUSION:Despite an already challenging test, this study showed that subjects with congenital red-green CVD can improve their performance on the Lanthony D15 test. However, this is unlikely to change pass-fail rates when the baseline CCI is high, and further study on this issue is warranted.
In the current study, the impact of an unexpected color swap (from target to distractor color and vice versa) on reaction times (RTs) and eye fixations was investigated. Within a visual search task, participants reported the location of a shape-defined target letter above or below a distractor letter. Across time, participants learned the consistent relationships between the visual target features (shape and color), establishing an according expectancy. To that end, fixed colors were first assigned to both a fixed-shape target (e.g., red) and a fixed-shape distractor (e.g., green). Next, this expectancy was violated by an unannounced swapping of target- and distractor-associated colors in the critical trial. In addition, subsequent color swaps estimated the costs of better anticipated color swaps. Eye movements showed longer fixation times on the distractor letter during and immediately after the critical trial compared to trials before the color swap (precritical trials), and, in line with prior research, we also found longer RTs in critical trials compared to consecutive (postcritical) trials without color swaps (Experiment 1). Finally, varying the number of distractors per trial indicated no set-size effect (Experiment 2), but again costs for all expectancy violations were found. In sum, our results indicate that humans tend to fall for expectancy violations more than once, and costs associated with color swaps cannot be avoided entirely.
Subtitles often attract visual attention even when they are not necessary for comprehension. In the present eye-tracking experiment, we examined whether attention to subtitles in instructional videos varies as a function of audio-subtitle language-script pairing in Hindi-English bilinguals with an English-medium instruction (EMI) background. Native Hindi participants viewed videos in three conditions: English audio with English subtitles (L2-L2), Hindi audio with Hindi subtitles (L1-L1), and English audio with Hindi subtitles (L2-L1). In the L2-L2 condition, gaze was distributed similarly across speakers' faces and subtitles. In contrast, in both Hindi-subtitle formats, viewers allocated more dwell time to the speakers' faces than to the subtitles. Comprehension scores did not differ significantly across conditions. These findings suggest that subtitle engagement among EMI bilinguals is not solely determined by the presence of subtitles but is also modulated by the properties and perceived utility of the written channel. More generally, our results caution against the view that subtitle engagement is uniformly automatic across multilingual instructional settings.
Background: Low-level red-light therapy (RLRT) has emerged as a potential therapy in myopia management. However, its effects on retinal structure and function following repeated exposure remain incompletely understood. Purpose: To evaluate the short-term effects of RLRT on central retinal function in myopes and non-myopes using retinal electrophysiology and structural parameters. Methods: Thirty-six subjects underwent RLRT exposures. Retinal function was assessed using pattern electroretinography (PERG) and photopic full-field electroretinography (Photopic 3.0 ERG). Structural measurements, including axial length (AL), obtained with an optical biometer and choroidal thickness (CT), were measured using MOPTIM 3000. Outcomes were compared between baseline and post-RLRT conditions (single 3 min and single 1 min exposure), across refractive groups, and correlated with AL and CT. This study was conducted at the University of Minho in accordance with the Declaration of Helsinki. Results: In myopic subjects, PERG N35–P50 amplitude significantly increased after 3 min of RLRT (baseline:0.88 ± 0.21 µV; post: 1.40 ± 0.25 µV; p = 0.013), whereas no significant changes were observed in non-myopes (baseline: 1.32 ± 0.19 µV; post: 1.39 ± 0.21 µV; p = 0.47). Latencies remained stable across all groups (p > 0.05). No significant correlations were found between PERG and AL (ρ = −0.18, p = 0.44) or CT (ρ = 0.12, p = 0.52). Photopic 3.0 ERG showed an increase in b-wave amplitude after 3 min of RLRT in myopes (Δ = +2.42 µV, p = 0.06), but not in non-myopes. In myopes, AL was negatively correlated with post-therapy latency (ρ = −0.624, p = 0.060), while CT showed strong correlations with photopic a-wave responses after 1 min RLRT (CT vs. latency: ρ = −0.873, p = 0.010; CT vs. amplitude: ρ = 0.821, p = 0.034). Conclusions: Short-term exposure to RLRT, particularly at 3 min, enhances PERG and Photopic ERG responses in myopic subjects, suggesting transient improvements in retinal function with differential effects between refractive groups.
Background/Objectives: Perceptual–cognitive abilities such as visual discrimination, reaction time, and attentional control are important for performance in dynamic sports. However, evidence remains limited regarding how simplified visual tasks capture performance variability and dynamics under repeated exposure. This study examined session-to-session performance changes and individual trajectories in a programmable visual discrimination task of increasing complexity in elite futsal players. Methods: An exploratory repeated-measures study was conducted with ten first-league futsal players. Participants completed between six and ten sessions of a color-cue visual discrimination task (“Follow the Color”) under one- and two-stimulus conditions. Outcomes included correct responses, errors, and reaction time per session. A total of 465 observations were analyzed using linear mixed-effects models to assess changes across sessions and the influence of task complexity. Individual analyses were also performed to explore player-specific trajectories. Results: Mean session accuracy was 63.8 ± 9.8 correct responses, with a mean error rate of 3.6 ± 6.1 and a mean reaction time of 0.63 ± 0.15 s. Error rates declined significantly across sessions (β = −0.008, p < 0.001), while reaction time improved modestly (β = −0.00011, p = 0.025). Correct responses showed a small negative trend over time. Increased task complexity was associated with fewer correct responses, higher error rates, and slower reaction times (all p < 0.001). Conclusions: This programmable visual discrimination task captured variability in visuomotor responses under controlled conditions and may support monitoring of performance dynamics in sports vision research.
Background: To evaluate the association between glaucomatous visual field loss and self-reported driving limitation, and to explore potential threshold ranges of visual field loss associated with an increased likelihood of driving restriction. Methods: In this cross-sectional study, 100 patients with primary open-angle glaucoma underwent standard automated perimetry. Visual function was assessed using Mean Deviation (MD) and Visual Field Index (VFI) from the better eye. Driving status, driving limitation, and self-reported driving difficulties were assessed using a structured questionnaire. Multivariable logistic regression was performed to determine independent associations between visual field parameters and driving limitation, adjusting for age, sex, cataract status, and systemic comorbidities. Because MD and VFI are closely related indices of visual field loss, separate multivariable models were constructed for each parameter. Receiver operating characteristic (ROC) analysis was used to explore threshold values associated with driving limitation. Results: Driving limitation increased progressively with worsening functional severity, affecting 17% of participants with preserved function, 48% of those with borderline impairment, and 72% of those with definite impairment (p < 0.001). Reduced VFI was independently associated with driving limitation (OR = 0.972, 95% CI: 0.948–0.996; p = 0.021). In a separate model, more negative MD was also independently associated with driving limitation (OR = 0.924, 95% CI: 0.875–0.976; p = 0.004). Male sex was associated with a lower likelihood of driving limitation. ROC analysis identified threshold values of VFI ≤ 71% (AUC = 0.663) and MD ≤ −13.36 dB (AUC = 0.650), both characterized by high specificity but limited sensitivity. Participants who had ceased driving demonstrated worse visual field indices than active drivers, whereas never-drivers showed no consistent association with visual field loss. Conclusions: Glaucomatous visual field loss was significantly associated with self-reported driving limitation and behavioural self-regulation. Objective perimetric parameters, particularly VFI and MD in the better eye, may help identify patients more likely to report driving difficulties. The reported threshold values should be interpreted as exploratory reference points rather than clinically actionable criteria and require further validation before clinical application.
Cataracts represent the leading cause of blindness worldwide, particularly in older adults, and constitute a significant public health challenge. Although cataract surgery is generally associated with a high safety profile, both patients and healthcare providers often face significant challenges due to age-related physiological changes and the high prevalence of comorbidities, which are directly linked to cataractogenesis and other systemic diseases that can complicate both the surgical procedure and postoperative recovery. This narrative review aimed to assess the epidemiological characteristics of age-related physiological and pathological comorbidities in older adults with cataracts, evaluating their impact on preoperative assessment, surgical outcomes, and public health planning. Articles were identified through non-systematic searches of PubMed, EMBASE, and Scopus using a combination of medical subject headings (MeSH) terms and free-text keywords. Among the multiple non-ocular comorbidities, carotid artery disease (CAD) and hypertension (HTN) are among the cardiovascular diseases (CVDs) with the highest correlations with cataract. Diabetes, dyslipidemia, and metabolic syndrome are also highly prevalent and significantly influence surgical outcomes, as poor glycemic control increases intraoperative risks and postoperative complications. Additionally, neurological conditions such as stroke, Parkinson’s disease, and epilepsy often complicate anesthesia administration, contribute to postoperative delirium, and affect adherence to treatment protocols. Given these complexities, a multidisciplinary approach and targeted preoperative screening may offer personalized care to improve safety and outcomes. Despite advances in clinical care, disparities in access to cataract surgery, especially in underserved populations, continue to exist. Thus, a coordinated public health strategy that promotes early detection, equitable access, and the integration of innovations such as teleophthalmology and artificial intelligence is essential to optimize care for older adults with cataracts worldwide.
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and newer dual-incretin therapies have become central to the treatment of diabetes mellitus and obesity, with benefits extending beyond glycemic control. Their expanding use has prompted growing interest in their potential ocular effects. Experimental data support plausible protective mechanisms, including reduction in oxidative stress and neuroprotective effects on retinal and optic nerve tissues. Clinical evidence, however, remains heterogeneous. In diabetic retinopathy, the main concern appears to be transient early worsening associated with rapid glycemic improvement rather than direct retinal toxicity. A potential semaglutide-associated signal for non-arteritic anterior ischemic optic neuropathy has raised concern, although the absolute risk appears low and causality remains unproven. Emerging studies also suggest possible beneficial associations with glaucoma, ocular surface diseases, and certain retinal vascular outcomes, whereas the evidence regarding age-related macular degeneration and cataract remains conflicting or preliminary. Overall, ocular outcomes associated with incretin-based therapies seem to reflect a complex interplay among drug-specific pharmacology, systemic metabolic changes, and individual patient susceptibility rather than a class effect. Baseline ophthalmic assessment and individualized follow-up may be advisable in selected high-risk patients. Further prospective ophthalmology-focused studies are needed to clarify long-term safety and identify the patients most likely to benefit or develop adverse events.
Age-related macular degeneration (AMD) is one of the leading causes of vision impairment worldwide, making early and accurate detection essential for effective clinical intervention. Recent advances in deep learning have demonstrated promising results in automated retinal image analysis; however, most existing approaches rely on datasets acquired under controlled conditions, limiting their generalizability to real-world clinical environments. In this paper, we propose a novel AMD dataset designed to simulate unconstrained imaging conditions, by incorporating noise, luminance variations, and device-related artifacts commonly encountered during retinal scan acquisition. Using this dataset, we conduct a comprehensive comparative evaluation of six widely adopted deep learning architectures: VGG16, VGG19, InceptionV3, MobileNetV2, ResNet50, and DenseNet. Experimental results indicate notable performance variations across models, highlighting the impact of architectural design on robustness to image degradation. Among the evaluated approaches, VGG16 achieved the best overall performance. By further optimizing this architecture through targeted training and fine-tuning strategies, the proposed system reached an accuracy of 88% in AMD detection. These findings demonstrate the effectiveness of the optimized VGG16 model and underline the importance of realistic datasets for developing reliable deep learning-based diagnostic tools for practical clinical settings.
