Purpose:To determine the agreement of an all-in-one portable vision screener (VS) with a standard battery of optometrist-administered tests. The purpose is to understand the feasibility of rapid screening for visual functions before providing occupational visual fitness. Patients and Methods:A Prospective cross-sectional study was performed among licensed public transport drivers at community eye camps in Mumbai. Distance and near vision, contrast sensitivity (CS), stereopsis, colour vision (CV), and peripheral visual field were assessed using standard tests, including the LogMAR, Titmus Fly, Ishihara, and confrontation test, respectively. The same assessments were repeated using an all-in-one portable screener (VS). The total testing time was recorded for each test. Receiver Operating Characteristic (ROC) curves and Bland-Altman plots were used for statistical analyses. Results:A total of 384 drivers participated, with a mean age of 47.1 ± 9.14 years. The mean presenting distance visual acuity was 0.22 ± 0.16 and 0.20 ± 0.18 LogMAR (p>0.05), the mean values for CS were 2.98 ± 2% and 5.7 ± 10.17% (p<0.05), the values for stereopsis were 863.08 ± 1402.92 and 656.54 ± 933.29 sec of arc (p<0.05) with standard charts and VS, respectively. The integrated colour vision test demonstrated low sensitivity (22.2%) but high specificity (89.2%) for detecting colour vision deficiency. Screening time decreased from 20 ± 5 minutes to 7 ± 3 minutes. ROC analysis showed excellent diagnostic accuracy for distance visual acuity (AUC = 0.861) and modest discriminative ability for stereopsis (AUC = 0.653). Bland-Altman analysis indicated good agreement between the standard test and screener for vision, CS, and stereopsis, with no significant systematic bias. Conclusion:The portable vision screener demonstrated high accuracy and strong agreement with standard clinical tests for visual functional tests. It enables rapid, comprehensive assessment of visual functions, making it a practical tool for large-scale vision screening in OHCs or mobile eye screening camps.
Pheagane Motsime William Nkoana, Neo Makgatho, Rethabile Ramatsobane Lekgau, Mufhatutshedzwa M Randima, Munei Masiagwala, Moloantoa Morena, Lebogang Shaun Ntsobe, Phuti Germina MatlhadishaDepartment of Optometry, University of Limpopo, Polokwane, South AfricaCorrespondence: Pheagane Motsime William Nkoana, Department of Optometry, University of Limpopo, Polokwane, South Africa, Tel +27724296181, Email Pheagane.nkoana@ul.ac.zaBackground: Keratoconus (KC) is a progressive corneal ectatic disorder characterised by thinning and irregular steepening, which may lead to visual impairment if not detected early. Most diagnostic thresholds are derived from non-African populations, limiting their relevance in local settings.Aim: To profile corneal thickness, curvature, eccentricity and topographic indices, and assess their implications for keratoconus screening in a South African university clinic population.Methods: A quantitative cross-sectional study was conducted using clinical data from patients attending a university optometry clinic. Mean central corneal thickness (CCT), radius of curvature (r), eccentricity (e) and KC related indices of 300 clinic patients were measured using Oculus Pentacam. Descriptive and inferential statistics were used to analyse the data.Results: Corneal parameters were generally within normal ranges. The mean CCT was 504.79 ± 33.12 μm. The mean r was 7.83 ± 0.28 mm, indicating relatively flatter corneas compared to some international populations. Mean e-value was 0.47 ± 0.13, suggesting prolate corneal profiles. Keratoconus related indices were largely within normal limits, although they appeared more conservative than corneal thickness in identifying suspected ectasia. Weak to moderate correlations were observed between variables.Conclusion: Corneal characteristics were within normal limits but showed subtle population specific variation. A multi-parameter approach integrating thickness, curvature and indices is recommended to improve KC screening and to strengthen region-specific diagnostic thresholds.Keywords: keratoconus, corneal thickness, corneal curvature, eccentricity, ectasia screening, topographic indices, South Africa
Mumtaz Qazi, Prema K Chande, Neha Dattatray Jadhav, Nuzhat KhanLotus College of Optometry, Lotus Eye Hospital, Mumbai, Maharashtra, IndiaCorrespondence: Prema K Chande, Lotus College of Optometry, Lotus Eye Hospital, Mumbai, Maharashtra, India, Tel +91 9820164222, Email prema@lcoo.edu.inPurpose: To determine the agreement of an all-in-one portable vision screener (VS) with a standard battery of optometrist-administered tests. The purpose is to understand the feasibility of rapid screening for visual functions before providing occupational visual fitness.Patients and Methods: A Prospective cross-sectional study was performed among licensed public transport drivers at community eye camps in Mumbai. Distance and near vision, contrast sensitivity (CS), stereopsis, colour vision (CV), and peripheral visual field were assessed using standard tests, including the LogMAR, Titmus Fly, Ishihara, and confrontation test, respectively. The same assessments were repeated using an all-in-one portable screener (VS). The total testing time was recorded for each test. Receiver Operating Characteristic (ROC) curves and Bland-Altman plots were used for statistical analyses.Results: A total of 384 drivers participated, with a mean age of 47.1 ± 9.14 years. The mean presenting distance visual acuity was 0.22 ± 0.16 and 0.20 ± 0.18 LogMAR (p> 0.05), the mean values for CS were 2.98 ± 2% and 5.7 ± 10.17% (p< 0.05), the values for stereopsis were 863.08 ± 1402.92 and 656.54 ± 933.29 sec of arc (p< 0.05) with standard charts and VS, respectively. The integrated colour vision test demonstrated low sensitivity (22.2%) but high specificity (89.2%) for detecting colour vision deficiency. Screening time decreased from 20 ± 5 minutes to 7 ± 3 minutes. ROC analysis showed excellent diagnostic accuracy for distance visual acuity (AUC = 0.861) and modest discriminative ability for stereopsis (AUC = 0.653). Bland–Altman analysis indicated good agreement between the standard test and screener for vision, CS, and stereopsis, with no significant systematic bias.Conclusion: The portable vision screener demonstrated high accuracy and strong agreement with standard clinical tests for visual functional tests. It enables rapid, comprehensive assessment of visual functions, making it a practical tool for large-scale vision screening in OHCs or mobile eye screening camps.Keywords: vision screening, occupational health, visiolite vision screener, visual functions
Background:Traditional eye medicine (TEM) is widely used in low- to middle-income countries as an accessible, affordable, and culturally accepted approach to eye care. Despite its prevalence, persons using TEM commonly present for formal late for eye care after the onset of significant ocular complications. Purpose:To synthesize evidence on global TEM utilization, perceptions, determinants, types, administration methods, and associated ocular complications. Methods:Google Scholar, ScienceDirect, Scopus, PubMed and grey literature up to September 2025 were used to conduct a comprehensive literature search. Studies reporting on TEM use, perceptions, determinants, remedies, administration, and ocular outcomes were included. Fifty-seven studies met inclusion criteria following systematic screening. Results:TEM prevalence varied widely, from 4.3% in Nigeria to 80% in Ethiopia, with other regions reporting rates of 36-65.7%. TEM was used to manage redness, itching, tearing, pain, poor vision, cataracts, and glaucoma. Remedies included plant extracts, honey, rosewater, milk, salts, animal products, and ritualistic substances, administered topically, orally, dermally, nasally, auricularly, or in combination. Determinants of use include accessibility, affordability, cultural beliefs, family influence, rural residence, and dissatisfaction with modern medicine. Perceptions were generally positive, particularly among older adults and communities with active traditional healers (THs). TEM use was frequently linked to ocular complications such as conjunctivitis, corneal ulcers, microbial keratitis, uveitis, staphyloma, panophthalmitis, and blindness. TEM users often presented later to eye care facilities, resulting in poorer visual outcomes compared to non-users. Conclusion:TEM remains a culturally entrenched and widely used form of eye care but carries substantial risks of ocular morbidity and vision loss. Reducing harmful outcomes requires strengthening access to formal eye care, educating communities, and engaging THs to promote safe practices.
Background and Aim:Ametropia is a leading cause of preventable visual impairment in children and adolescents, yet region-specific data from Al-Baha, Saudi Arabia remain limited. This study aims to characterise the patterns of refractive error and quantify the impact of cycloplegic refraction in a pediatric ametropic population in Al-Baha City. Methods:This hospital-based, prospective, cross-sectional study enrolled 654 ametropic children and adolescents (1,308 eyes), aged 3-18 years, at King Fahad Hospital between November 2022 and November 2023. Participants underwent visual acuity testing, keratometry, and pre- and post-cycloplegic refraction. Data were analysed using SPSS v24 and Microsoft Excel with paired and independent-samples t-tests and Pearson correlations (p < 0.05). Results:The cohort was 51.7% female and 48.3% male (mean age 9.17 ± 3.89 years). Post-cycloplegia, hyperopic astigmatism predominated (62.8%; 822/1,308 eyes), followed by myopic astigmatism (36.1%; 472/1,308). Cycloplegia produced a significant hyperopic shift in mean spherical equivalent, from -0.33 D dry to +0.54 D cycloplegic (paired mean difference +0.87 D, p < 0.001; r = 0.89), with 26.0% of pre-cycloplegic myopic eyes reclassified as hyperopic. Males were more hyperopic than females (+1.04 vs +0.07 D, p < 0.001), and females had steeper keratometry (43.63 vs 42.86 D, p < 0.001). Mean cycloplegic spherical equivalent (SPE) declined with age from +2.18 D at 3-5 years to -0.55 D at 15-18 years, while the proportion with myopia rose from 14.8% to 55.6%. Conclusion:Hyperopic astigmatism dominated the ametropic spectrum in this hospital-based sample of ametropic children and adolescents in Al-Baha, and cycloplegic refraction was essential to avoid misclassification. The observed age-related shift in refractive status supports standardised cycloplegic protocols and region-specific vision screening, although the clinic-based design limits generalisation to the wider paediatric population.
Objective:Previous studies have suggested that presbyopia may progress faster in patients with glaucoma. This study aimed to compare glaucoma patients and controls to assess the severity of presbyopia in terms of the preference for contact lens (CL) correction. Methods:We compared 457 glaucoma patients and 500 controls aged 40-69 years, assessing near add power, CL-corrected visual acuity, under-correction with CL (CL power- full correction power), and glaucoma and dry eye-related parameters. Regression analyses were used to evaluate the relationship between the near-add power and ocular parameters. Kaplan-Meier survival analysis estimated the age at which the near add power reached +3.00 D. Results:The mean near add power was 2.27 ± 0.84 D in the control group and 2.47 ± 0.71 D in the glaucoma group (p < 0.01). The CL-corrected visual acuity (LogMAR) was 0.02 ± 0.10 and 0.04 ± 0.11 (p < 0.01), and the under-correction was 0.28 ± 0.69 D and 0.43 ± 0.94 D (p < 0.01), respectively. The glaucoma group showed poorer dry eye-related parameters, and under-correction was associated with myopia, anisometropia, near-add power, lower Schirmer test values, and superficial punctate keratopathy. Kaplan-Meier analysis revealed that glaucoma patients reached +3.00 D near add power significantly earlier than the controls (P<0.01). Conclusion:Patients with glaucoma preferred more under-corrected CLs than controls. Our results further confirmed the presence of severe presbyopia in individuals with glaucoma.
Background:Globally, diabetic retinopathy (DR) has been identified as the cause of blindness among adults with both Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM). Purpose:The study aimed to investigate the efficacy of Avastin in improving visual acuity (VA) and reducing central foveal (CFT) and parafoveal thicknesses (PFT) in participants with DR. Patients and Methods:A cross-sectional observational study was conducted at a tertiary hospital in the Gauteng Province (South Africa). A total of 55 participants were included in the study, with VA's that were less than 0.5 LogMAR units and CFT's greater than 300 microns (µm). Measurements of VA's, CFT (µm), and PFT (µm) were conducted at baseline, after three and six months of receiving Avastin treatment. Numerical data were collected and analysed using IBM SPSS Version 28, and non-parametric tests were used to compare the means of the variables. Results:The mean VA improved from 1.00±0.71 LogMAR at baseline to 0.66±0.51 and 0.57±0.48 LogMAR at 3 and 6 months, respectively (p <0.001). The mean CFT improved from 441.22±142.35 µm at baseline to 355.58±129.38 µm and 308.40±137.60 µm at 3 and 6 months, respectively (p <0.001). The superior parafoveal thickness (SPFT) showed the highest decrease from a mean baseline of 379.04 µm to a mean baseline of 317.36 µm at 3 months. At 6 months, the decrease in the NPFT was statistically significant (p <0.025) in improving VA. Conclusion:Early administration of Avastin treatment in diabetic patients is effective in reducing the mean CFT, NPFT, and improving the mean VA.
Yu Chen Low,1 Bariah Mohd-Ali,1 Mizhanim Mohamad Shahimin,1 Norhani Mohidin,1 Wan Haslina Wan Abdul Halim,2 Siti Salasiah Mokri,3 Hamzaini Abdul-Hamid41Department of Optometry and Vision Science & Research Centre for Community Health (REACH), Faculty of Health Sciences, UKM, Kuala Lumpur, Malaysia; 2Department of Ophthalmology, Faculty of Medicine, UKM, Kuala Lumpur, Malaysia; 3Department of Electrical, Electronics and System, Faculty of Engineering, UKM, Bangi Selangor, Malaysia; 4Department of Radiology, Faculty of Medicine, UKM, Kuala Lumpur, MalaysiaCorrespondence: Bariah Mohd-Ali, Optometry and Vision Science Program, Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia, Tel +603 89213032, Email bariah@ukm.edu.myPurpose: This study investigated the 12-month impact of orthokeratology (Ortho-K) treatment on eyeball dimensions using magnetic resonance imaging (MRI). Results were compared with single-vision spectacle wearers (SVS).Patients and Methods: A total of 70 Chinese schoolchildren (mean age: 8.31 ± 0.47 years) with myopia were assigned to Ortho-K (n = 45) and SVS (n = 25). Baseline spherical equivalent (SE), visual acuity (VA), and flat keratometry (FK) were measured. MRI was performed at baseline and at 12 months to measure three-dimensional ocular dimensions, including longitudinal axial length (LAL), horizontal width (HW), and vertical sagittal height (VSH). Standard slit-lamp examinations ensured ocular health at all follow-up visits.Results: At 12 months, the Ortho-K group showed significant reductions in SE and FK (p < 0.001), whereas the SVS group exhibited a significant increase (p < 0.05). LAL was significantly shorter in the Ortho-K group compared to SVS (p < 0.05). Although individual HW and VSH did not reach independent significance, repeated measures analysis of variance confirmed significant between-group differences in global eyeball shape over 12 months (p < 0.05). Correlation analysis revealed a significant association between SE and LAL in the SVS group (p < 0.05). In the Ortho-K group, SE showed no significant correlation with ocular dimensional changes (p > 0.05). In contrast, FK in the Ortho-K group demonstrated significant correlations with all dimensional parameters (p < 0.05), a pattern not observed in the SVS group.Conclusion: Findings indicate that myopic progression in the SVS group is primarily driven by axial elongation, whereas refractive changes in the Ortho-K group arise from corneal reshaping. Over 12 months, Ortho-K wear modifies ocular dimensions and inhibits AL elongation more significantly than SVS, providing a structural basis for controlling myopic progression.Keywords: orthokeratology, myopia control, MRI, axial length, ocular dimension, myopia
Background:Contact lenses are a cornerstone of vision correction for ametropia and can be of particular value for management of irregular astigmatism and corneal ectasia. Beyond objective measures of visual acuity and corneal health, patient-reported outcomes and vision-related quality of life (VR-QoL) have emerged as critical endpoints. This review aimed to synthesize evidence on VR-QoL outcomes with contact lenses. Methods:We conducted a narrative review of studies published between 2000 and 2025 on the influence of various contact lens modalities including soft conventional lenses, rigid gas-permeable (RGP) lenses, scleral and mini-scleral lenses, orthokeratology, and specialty designs on VR-QoL across myopia, keratoconus, dry-eye disease, and other conditions. Descriptive tables were developed for all identified studies, and a synthesis of the impact of contact lenses on VR-QoL findings is presented. Evidence for VR-QoL measurement and instrumentation, special considerations for pediatric/adolescent populations, and barriers/limitations to sustained contact lens wear were also appraised. Results:VR-QoL evaluations using validated instruments demonstrate favorable findings with contact lenses. VR-QoL gains with contact lenses are more favorable compared with spectacle correction, particularly in appearance, activities, peer perception, and psychological domains. In keratoconus, RGP and scleral lenses dramatically improve NEI-VFQ-25 composite scores, even in cases of advanced disease. Barriers to sustained wear of contact lenses mostly relate to lens discomfort and dry eye due to ocular surface complications, although studies in patients with ocular surface disease/dry eye still derive VR-QoL benefits with contact lenses. There is a lack of head-to-head trials for certain modalities (eg, an absence of studies directly comparing multifocal contact lenses to spectacles for fall rates). Conclusion:Contact lenses provide significant and clinically meaningful gains in VR-QoL among adult and pediatric patients with refractive error, keratoconus, ocular surface disease or dry eye, and other indications. The VR-QoL benefits of contact lenses may exceed those achieved with spectacles.
Purpose:Contact lens (CL) wear may induce changes to the tear film, leading to sensations of ocular dryness and CL discomfort, key reasons for CL discontinuation. CL care solutions can help address underlying mechanisms of CL discomfort, improving wear experience. We report outcomes of an in-home use test of Biotrue® Hydration Plus Multi-Purpose Solution (BHP MPS; Bausch + Lomb, Rochester, NY, USA), which is formulated to maintain ocular surface homeostasis and improve CL comfort. Patients and Methods:In this IRB-approved, real-world survey study, adult soft CL users used BHP MPS for 7 days before completing a survey rating their experience (agreement/disagreement for attributes including CL cleanliness, comfort [including during extended screen use], prevention of CL dryness, perception of CL hydration, gentleness on eyes, and likelihood to recommend to others). A power analysis estimated sample size for 80% statistical power. Responses were analyzed with 2-sided exact binomial tests for agreement in >50% of responses (significance level α=0.05). Results:Participants (N=435) were demographically balanced (mean age 42.5 years; 52.9% female). Over 60% of participants reported baseline CL dryness and tired eyes; 8.0% were likely to discontinue CL wear. At the end of the trial period, 98.9% were satisfied with how their CLs felt. Individual responses were significantly >50% for all attributes (p<0.05), including 91.7% agreeing that BHP MPS positively impacted CL comfort (and helped to keep CLs feeling clean [96.8%], keep CLs comfortable so that eyes do not feel tired [93.1%], maintain CL comfort [94.7%], prevent CL dryness [93.6%], maintain comfort with extended screen use [92.0%], and maintain hydration [94.7%] while being gentle on eyes [96.6%]); 94.0% would recommend BHP MPS to other CL wearers. No adverse events were reported. Conclusion:BHP MPS demonstrated strong performance across all key criteria evaluated in this real-world cohort of soft CL wearers for improved CL wear experience.
Introduction:Demodex blepharitis (DB) is a chronic ocular inflammation caused by Demodex mite infestation of the eyelid. DB is often misdiagnosed, as some of its clinical findings and patient-reported outcomes overlap with those of other ocular surface diseases. The Demodex Expert Panel on Treatment and Eyelid Health (DEPTH) has reached consensus on the symptomatology, diagnosis, and treatment of DB. Consensus findings from the DEPTH group include that collarettes are pathognomonic for DB and that lotilaner ophthalmic solution, 0.25%, the first and only FDA-approved treatment for DB, should be the first-line treatment for the disease. This case series highlights two instances of misdiagnosis that were subsequently re-evaluated using consensus findings from the DEPTH group, leading to a correct diagnosis and effective treatment with XDEMVY® (lotilaner ophthalmic solution) 0.25%. Case Reports:Two cases of patients with DB are presented. In the first case, a 75-year-old female presented with collarettes, reduced meibomian gland secretions, and lid margin erythema. After an unsuccessful initial treatment for bacterial infection, the patient was diagnosed with DB and prescribed lotilaner ophthalmic solution, 0.25% twice daily for 6 weeks, which improved all clinical findings and patient-reported outcomes. In the second case, a 62-year-old male presented with ocular discomfort, dry eye, and burning and itching sensations. After an unsuccessful initial treatment for dry eye disease, collarettes were detected, and the patient was diagnosed with DB. Subsequent treatment with lotilaner ophthalmic solution, 0.25% reduced collarettes and resolved patient-reported symptoms. Conclusion:These cases highlight patients with DB who were initially misdiagnosed and eventually treated with lotilaner ophthalmic solution, 0.25%. Each case exemplifies the utility of the DEPTH consensus findings in improving the diagnostic path for patients and eye care providers. Future case series from other groups will continue to shed light on the best practices for diagnosing and treating patients with DB.
Purpose: Optical coherence tomography (OCT) is a widely utilized ophthalmic imaging technique commonly used in clinical practice. The axial resolution of modern commercial OCT devices is at the micron level, facilitating the detection of retinal problems that may be unable to be detected in conventional dilated fundus examination (DFE). We evaluated the efficacy of integrating OCT as a routine ophthalmic procedure for identifying occult retinal abnormalities using a university clinical dataset. Methods: The University Optometry Clinic initiated routine OCT screening as part of comprehensive eye examinations at no additional cost in summer 2025. An ophthalmic assistant captured OCT images of patients aged 40 years or older under natural pupils before the optometrist consultation. A retrospective analysis was conducted based on these OCT images acquired with a concurrent review of electronic medical records. Results: Overall, 1398 patients underwent routine OCT examinations in two months. Thirty-two patients were excluded because of bilateral suboptimal image quality attributed to undilated pupils. The three most common occult retinal abnormalities not identified by conventional DFE but revealed by OCT were partial posterior vitreous detachment (81 patients, 5.9%), epiretinal membrane, ERM (46 patients, 3.4%), and peripapillary intrachoroidal cavitation (43 patients, 3.1%). Other abnormalities identified by OCT included pigment epithelial detachment, thin retinal nerve fiber layer, focal choroidal excavation (FCE), and idiopathic central serous chorioretinopathy (ICSC). A more serious abnormality included lamellar holes. Patients with ERM (p < 0.001) and lamellar hole (p < 0.001) were older than those without. FCE (p = 0.003) and ICSC (p = 0.009) were more commonly occurred in male. Conclusion: Some occult retinal abnormalities were identified using OCT alone, but not discernible by conventional DFE. These mild abnormalities were unlikely to have serious consequence which may not affect clinical management. OCT examination might not be regarded as a necessary routine procedure.
Background:Dry Eye Disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability, ocular discomfort, and visual disturbance. Traditional diagnostic methods often show poor correlation with symptoms and lack reproducibility. The JENVIS Pro Dry Eye Report, integrated with the OCULUS Keratograph 5M, provides a structured, non-invasive, and multimodal approach to DED diagnosis in line with TFOS DEWS II recommendations. Aim:To review Dry Eye Disease and evaluate the diagnostic role of the JENVIS Pro Dry Eye Report, with particular emphasis on its application and limited utilization in African populations. Methods:A literature review was conducted using Google Scholar, PubMed, and ScienceDirect, focusing on studies published between 2017 and 2025. Search terms included Dry Eye Disease, JENVIS Pro Dry Eye Report, OCULUS Keratograph 5M, non-invasive diagnostics, and tear film instability. Studies addressing DED epidemiology, risk factors, diagnostic methods, and JENVIS-related parameters such as non-invasive tear break-up time, tear meniscus height, and meibography were included. Results:Seventy sources were reviewed, including peer-reviewed articles and relevant grey literature. The evidence supports the JENVIS Pro Dry Eye Report as a reliable and reproducible diagnostic system that integrates objective clinical signs with subjective symptom assessment. While the tool is widely recognised internationally, its clinical use in African populations remains limited, with most regional studies relying on traditional diagnostic techniques such as Schirmer's test and fluorescein tear break-up time. Conclusion:The JENVIS Pro Dry Eye Report offers a comprehensive and objective approach to DED diagnosis compared with conventional methods. Expanding its application in African clinical settings may improve diagnostic consistency, patient education, and evidence-based management of Dry Eye Disease. Contribution:The study provides background and benefits of the use of JENVIS Dry Eye report in diagnosing DED and advocates for its use due to its benefits.
Purpose:High-energy visible (HEV) light-filtering spectacle lenses, which selectively decrease transmission of short wavelength visible light, have been increasing in popularity in recent years despite much debate about their potential ocular benefits. This study reports on the effect of HEV light-filtering spectacle lenses on distance contrast sensitivity (CS). Patients and Methods:The study included 30 healthy young adults aged 18 to 35 years. Binocular CS was measured with the Pelli-Robson test in both photopic and mesopic illumination using three commercially available HEV light-filtering spectacle lenses and a clear uncoated control lens. Data were analyzed with descriptive and inferential statistics. Results:There was no difference in CS measurements among the four test lenses in either photopic (x2(3, n = 30) = 5.28, p = 0.153) or mesopic (x2(3, n = 30) = 0.92, p = 0.821) illumination. The CS measurements were significantly higher in photopic illumination than mesopic illumination for all four test lenses (Z ≤ -3.54, p ≤ 0.010) with mean differences ranging from 0.08 to 0.10 logCS. Conclusion:The HEV light-filtering spectacle lenses have no clinically meaningful effect on distance CS in young adults in both photopic and mesopic illumination. These results would be useful for eye care personnel when prescribing HEV light-filtering spectacle lenses.
Purpose:Efficient service delivery remains a critical benchmark of public sector performance, with lead and waiting times serving as essential indicators of responsiveness and accessibility. Long waiting times not only diminish user satisfaction but can also exacerbate inequalities in access, particularly in resource-constrained contexts. This study investigated the lead times of optometry services in selected hospitals in rural South Africa. By evaluating lead and waiting times and identifying contributing factors, the research further aimed to inform strategies for improving service delivery and reducing delays in optometry care. Methods:A cross sectional, prospective, and observational designs was adopted to record and quantitatively describe waiting and lead times in five selected hospitals in Limpopo, South Africa. Retrospective, quantitative document review was also conducted to check waiting time to receive optical devices. Descriptive and inferential statistical analysis was performed. This study used a cross-sectional, prospective, quantitative, descriptive and observational design to track consulting patients in order to record the lead times throughout the consultation, time to secure referral appointment and waiting times to receive optical devices after consultation. Secondly, a survey of available hospital staff complement, equipment and facilities was conducted. Results:The mean lead-time across all service points was 255.6 ± 124.7 minutes and 31.2 ± 35.1 minutes for optometry service. The lead times varied per hospital (p = 0.05). Overall waiting time for spectacles averaged 121.0 ± 181.5 days. All sites had basic optometry equipment, but specialised instruments (eg., fundus camera) were distributed unevenly among sites. The most frequently referred condition was cataract, and the referral time depends on the severity of the condition. Conclusion:Selected hospitals had longer waiting times that exceeded national guidelines for South Africa by an average of 2 hours. Improving capacity on staffing, equipment, patient flow management, and scheduling can reduce waiting times and guarantee more effective service delivery.
Purpose: Presbyopia is strongly dependent on age and progresses throughout life, yet the influence of lifestyle factors has not been fully determined. The aim of this study was to assess the association between presbyopia and common lifestyle factors in relation to a detailed ophthalmological evaluation. Methods: The near add power of 6258 individuals aged 40 to 79 years was measured, and its association with lifestyle factors was examined. Odds ratios for specific near add power levels were calculated, and regression analysis was conducted to evaluate the relationships between near add power, lifestyle, and ocular parameters. Results: Logistic regression analyses showed that that male sex, drinking habit, myopic spherical equivalent, astigmatic errors, and a thin ganglion cell complex were common significant risk factors associated with near add power levels of 1.50 D and 2.50 D. Smoking status, HbA1c levels, and the presence of diabetic retinopathy were not significant factors. Kaplan-Meier survival analysis indicated that men reached the end point (+1.50 D) significantly earlier than women (P < 0.01), and male drinkers reached the end point (+2.50 D) significantly earlier than male non-drinkers (P < 0.05). Conclusion: The association between lifestyle factors and near add power was analyzed, identifying drinking habit and male sex as significant contributors. These findings complement previous investigations and may be useful in healthcare education to highlight the detrimental effects of alcohol consumption on ocular health.
This commentary examines how misconceptions and stigma undermine adherence to spectacle wear in Somalia's outpatient eye clinics, despite clinically meaningful visual improvement during refraction. In routine practice, patients may refuse spectacles or wear them inconsistently because they believe spectacles weaken the eyes, create dependence, or lead to blindness, and because of social concerns such as being labeled as blind or disabled. These perceptions interact with service delivery constraints, including limited counselling time, variable optical quality, affordability barriers, and weak follow up, resulting in avoidable persistence of functional vision impairment and reduced educational and occupational performance. We synthesize commonly encountered themes in Somali outpatient care with relevant published evidence and propose pragmatic actions to improve acceptance and sustained wear. These include brief myth focused counselling integrated into routine workflow, clear separation of refractive error from blinding disease in patient communication, attention to comfort and dispensing quality, family engagement, early follow up for first time wearers, and low cost community normalization strategies delivered through trusted messengers.
Refractive surprises remain one of the most challenging postoperative complications in modern cataract surgery, where precision and patient expectations for plano refractive outcomes continue to rise. Despite advances in optical biometry, intraocular lens (IOL) formula optimization, and surgical technology, postoperative refractive error still occurs in a subset of patients and may significantly affect visual satisfaction and quality of life. This review synthesizes contemporary evidence on the causes, detection, and optometric management of refractive surprises, with a practical focus on the evolving role of the optometrist in co-management. Residual refractive error most commonly results from biometric inaccuracies, keratometric misalignment, incorrect estimation of effective lens position, prior corneal refractive procedures, and anatomical extremes such as axial myopia or hyperopia. Early recognition through comprehensive postoperative assessment-including manifest refraction, keratometric stability, IOL position evaluation, corneal tomography, and retinal imaging-is critical to differentiating optical errors from pathology. Management options include spectacles and contact lenses for mild errors, while significant ametropia may require corneal refractive surgery, arcuate keratotomy, piggyback IOL implantation, or IOL exchange depending on patient factors, ocular anatomy, and refractive stability. The review further discusses algorithmic approaches to decision-making, counseling strategies for dissatisfied patients, and considerations when dealing with toric and multifocal IOLs. As optometrists increasingly serve as primary comanagers of cataract surgery patients, understanding the etiology and management of refractive surprises is essential. Improved diagnostic workflows, individualized IOL planning, and collaborative postoperative care pathways can greatly enhance refractive predictability and visual outcomes.
Purpose:To assess the patterns and severity of different refractive errors in children aged 3 to 5 years presenting with established amblyopia in a tertiary care eye centre in Pakistan. Patients and Methods:A cross-sectional study was conducted at a tertiary care eye center involving 178 children (aged 3-5 years). The study specifically included only those with refractive amblyopia; children with strabismic or sensory deprivation amblyopia were excluded. From each participant, only the amblyopic eye (or the eye with the worse visual acuity in bilateral cases) was analyzed to ensure statistical independence. All participants underwent a comprehensive ophthalmic examination, including cycloplegic refraction (using 1% cyclopentolate) and dilated fundus evaluation. Refractive errors were classified according to MEPEDS criteria, and data was analyzed using SPSS version 24.0. Results:Among the 178 amblyopic eyes, astigmatism (53.4%) was common, particularly myopic astigmatism (n = 28, 15.7%) and hyperopic astigmatism (n = 27, 15.2%). Females were more likely to have myopia or astigmatism, whereas males were more likely to have hyperopia or astigmatism which may indicate some gender-specific patterns in amblyopia. Hyperopia was mostly low to moderate, while moderate astigmatism was more common than high astigmatism. These differences were also statistically significant (p < 0.001). Amblyopes with myopic astigmatism (n = 28, 15.7%) and hyperopic astigmatism (n = 27, 15.2%) exhibited the poorest visual acuity (mean LogMAR VA 1.05 ± 0.49 and 0.96 ± 0.46). Conclusion:Astigmatic refractive errors are more likely associated with greater amblyopia severity, and even lower thresholds of refractive error have the potential to cause amblyopia. By establishing these amblyogenic patterns, our study provides the surveillance data essential for early intervention. These findings advocate for preschool screening to prevent irreversible vision loss, directly advancing the WHO SPECS 2030 goal of people-centered eye care.
