Anup Subedi,1,* Bidhan Lamsal,1,* Samriddhi Lamsal,1 Sushma Giri,1 Roshni Malla,1 Mario Cantó-Cerdán,2 Santosh Chhetri,3 Ravin Kumar Mishra,1 Umesh Belbase41Department of Optometry, Himalaya Eye Hospital, Pokhara University, Pokhara, Nepal; 2Department of Optometry, Vissum Grupo Miranza, Alicante, Spain; 3Department of Optometry, Lumbini Eye Institute and Research Center, Bhairahawa, Nepal; 4Department of Physiological Optics, University of Houston, College of Optometry, Houston, TX, USA*These authors contributed equally to this workCorrespondence: Anup Subedi, Department of Optometry, Himalaya Eye Hospital, Pokhara University, Pokhara, Nepal, Email anup.subedi10@gmail.com Umesh Belbase, Department of Physiological Optics, University of Houston, College of Optometry, Houston, TX, USA, Email ubelbase@uh.eduPurpose: To compare subjective binocular amplitude of accommodation (AA) between myopic and hyperopic individuals and examine its association with age, sex, and refractive error in a Nepalese clinical population.Methods: This cross-sectional study included 160 participants aged 11– 35 years, comprising 113 with myopia and 47 with hyperopia. Binocular AA was measured using the push-up technique with a Royal Air Force rule. Group differences were assessed using t-tests and analysis of variance, while associations with age, sex, and spherical equivalent refractive error were examined using multiple linear regression. Repeatability and agreement between push-up and pull-away measurements were also evaluated.Results: Mean age was 21.49 ± 7.29 years, and 55.6% of participants were female. AA was greater in myopic than hyperopic participants (13.34 ± 2.80 vs 10.76 ± 3.15 D; mean difference 2.59 D, 95% CI 1.53– 3.64; P < 0.001). After adjustment for age and sex, the difference remained significant (adjusted mean difference 1.94 D, 95% CI 1.28– 2.60; P < 0.001). AA declined with age (r = − 0.746, P < 0.001). In multivariable analysis, both age (B = − 0.310 D/year) and spherical equivalent refractive error (B = − 0.433 D/D) were independently associated with AA (both P < 0.001), whereas sex was not. Push-up measurements showed excellent repeatability (ICC = 0.997), while agreement with pull-away measurements showed a mean bias of 0.53 D and limits of agreement from − 1.80 to 2.87 D.Conclusion: Subjective AA was greater in myopic than hyperopic individuals and decreased with age. Age and refractive error were independently associated with AA, whereas sex was not. Although push-up measurements were highly repeatable, the limits of agreement with pull-away measurements suggest that the two techniques should not be used interchangeably for individual assessment.Keywords: amplitude of accommodation, accommodative function, refractive error, myopia, hyperopia, spherical equivalent, royal air force rule
Amir Reza Farsiani,1 Mehran Zarei-Ghanavati,2 Golshan Latifi,2 Marzieh Pirzadeh,2 Saeed Rezaei,2 Fatemeh Ameli,3 Hamed Ghassemi21Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; 2Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; 3School of Medicine, Qazvin University of Medical Sciences, Qazvin, IranCorrespondence: Hamed Ghassemi, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran, Tel +989376256210, Email hamedghasemi@yahoo.comBackground: To evaluate the photorefractive keratectomy (PRK) results in patients with moderate to high astigmatism.Research Design and Methods: One hundred twelve eyes of 71 patients with a cylindrical component of greater than 3 diopters (D) (moderate: 3.00 to 3.99 D; high: ≥ 4.00 D) undergone PRK were reviewed. UDVA, CDVA, and subjective refraction before and after surgery (1, 3, 6, 12 months) were extracted.Results: The preoperative mean spherical equivalent (SE) was − 3.39 ± 1.82 D (range − 9.00 to 2.50 D), and the mean cylinder was − 3.76 ± 0.78 D (range − 3.00 to − 6.00 D). The mean postoperative cylinder values were − 0.73 ± 0.49 D, − 0.72 ± 0.46 D, − 0.58 ± 0.48 D, and − 0.4 ± 0.63 D at 1- month, 3-month, 6-month, and 12-month visits, respectively. The final follow-up efficacy and safety indices were 0.92 ± 0.14 and 0.99 ± 0.10, respectively. The postoperative residual astigmatism was 0.5 D or less in 50% of the eyes, and 75.9% of eyes were within ± 0.50 D of the target spherical equivalent. In multivariable GEE analysis, higher preoperative cylinder (P = 0.005) and poorer preoperative CDVA (P = 0.002) were significant independent predictors of higher residual astigmatism. Longer Mitomycin C (MMC) application time was also associated with higher residual astigmatism (β = 0.006 D/s, P = 0.033), which likely reflects confounding by indication. The target induced astigmatism vector (TIA), surgically induced astigmatism vector (SIA), and difference vector (DV) were significantly higher in the high astigmatism group at final follow-up (p < 0.001). The angle of error was ± 5 degrees in 71% and ± 15 degrees in 100% of the eyes.Conclusion: PRK is an effective and predictable method for the correction of moderate to high astigmatism.Keywords: PRK, high astigmatism, moderate astigmatism, vector analysis
Nonkazimulo Shabalala,1,2 Velibanti Sukati,2 Nishanee Rampersad11Department of Optometry, University of KwaZulu-Natal, Durban, South Africa; 2Department of Optometry, University of Limpopo, Polokwane, South AfricaCorrespondence: Nonkazimulo Shabalala, University of Limpopo, C/O R71 Tzaneen Road and University Street, Mankweng township, Polokwane, Limpopo, 0727, South Africa, Tel +27641302922, Email Nonkazimulo.shabalala@ul.ac.zaBackground: Corneal variables such as thickness, curvature and diameter are important for ocular assessments in children. Despite this, there is limited normative data relevant to children for these corneal variables. Developmental changes, together with potential demographic differences, complicate the direct extrapolation of adult reference values to paediatric populations.Purpose: To map literature related to corneal thickness, curvature, and diameter in healthy children.Methods: A comprehensive literature search was conducted across different electronic databases to identify articles published from January 2000 to December 2024 reporting on these corneal variables in healthy children aged less than 18 years.Results: Twenty-eight articles with data from more than 46,000 healthy children were included. The majority of articles originated from Asia. Central corneal thickness was the most commonly reported corneal variable compared with corneal curvature and diameter. Overall, the articles showed that the corneal variables showed lesser variation in early childhood and highlighted age, gender, ethnicity, and geographical variations.Conclusion: Currently available literature on corneal variables shows a predominant focus on central corneal thickness measurements, with limited research on corneal curvature and diameter. The currently available literature was predominantly from studies conducted on Asian populations, with an underrepresentation of African and other geographical regions. As corneal variables differ by geographical location, this skewed distribution limits the applicability of current normative values to diverse paediatric populations. Additionally, the differences in study methodologies and reporting limit the integration of the normative data available in current literature, thus limiting their clinical applicability when diagnosing and managing paediatric ocular conditions. Future research would benefit from a more standardised approach and a comprehensive assessment of corneal variables in diverse paediatric populations.Keywords: corneal parameters, corneal thickness, corneal curvature, corneal diameter, paediatric cornea
Tatsuya Mimura,1– 3 Ryota Nakagomi,4 Hidetaka Noma51Department of Ophthalmology, Tsurumi University School of Dental Medicine, Yokohama, Kanagawa, Japan; 2Department of Ophthalmology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan; 3Nerima Station West Eye Clinic, Nerima, Tokyo, Japan; 4Department of Orthoptics, Faculty of Medical Technology, Teikyo University, Itabashi, Tokyo, Japan; 5Department of Ophthalmology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, JapanCorrespondence: Tatsuya Mimura, Department of Ophthalmology, Tsurumi University School of Dental Medicine, 2-1-3, Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, 230-0063, Japan, Tel +81 4 5580 8500, Email mimurat-tky@umin.ac.jpPurpose: Contact lens (CL) wear can exacerbate allergic conjunctivitis. This study compared the effects of narafilcon A and verofilcon A on clinical signs of allergic conjunctivitis in CL wearers. Our previous studies using the same crossover cohort examined subjective CL comfort and related symptoms and tear-film stability and surface wettability. In contrast, the present study specifically evaluated objective clinical signs of allergic conjunctivitis, which were not the primary outcomes of those previous studies.Methods: The study included 62 CL wearers, comprising 124 eyes, who experienced CL discomfort. Participants were randomized to a cross-over design, wearing narafilcon A and verofilcon A each for 2 weeks. Ten clinical signs associated with allergic conjunctivitis related to the palpebral conjunctiva, bulbar conjunctiva, corneal limbus, and cornea were scored on a 4-point scale (0– 3) according to the Japanese guidelines for allergic conjunctival diseases (3rd edition). The total score was calculated by summing the scores of the 10 items (0– 30, with lower scores indicating better outcomes).Results: No participants discontinued narafilcon A or verofilcon A due to intolerance during the study period. Compared to baseline, there was no significant worsening of the mean total allergic conjunctivitis score for either narafilcon A or verofilcon A. Furthermore, the mean total score was significantly lower for verofilcon A (1.8 ± 1.4) compared to narafilcon A (4.1 ± 3.0, p < 0.01).Conclusion: These findings suggest that verofilcon A may be associated with more favorable clinical signs of allergic conjunctivitis than narafilcon A in CL wearers with CL discomfort.Keywords: allergic conjunctivitis, daily disposable soft contact lens, narafilcon A, Silicone hydrogel, verofilcon A
Genis Cardona, Pengbo Xia, Silvia Alonso-MatarínOptics and Optometry Department, Universitat Politècnica de Catalunya (UPC), Terrassa, SpainCorrespondence: Genis Cardona, Optics and Optometry Department, Universitat Politècnica de Catalunya (UPC), Terrassa, Spain, Email genis.cardona@upc.eduPurpose: This study aimed to assess the design, scientific accuracy and clinical usefulness of freely available online infographics as educational tools addressed to contact lens wearers.Methods: A Google search was conducted to collect static non-interactive infographics related to contact lens wear and maintenance. A 25-item ad hoc non-validated rubric was employed by two assessors to evaluate eligible Google Images results, selected using a convenience-based stopping rule, in terms of overall description (5 items), scientific and clinical content (9 items) and design (11 items).Results: A sample of 200 infographics was included in the study. The main sources of the infographics were commercial (30.5%), unknown (26.0%) and healthcare center (22.5%). Most infographics lacked credibility indicators such as authorship, publication date or references. Median scientific accuracy and expert-rated clinical usefulness were 9.5 and 9 (on a 0– 10 scale), with differences in both items depending on the source (p< 0.001). Search engine order of appearance was weakly correlated with scientific accuracy (rho=− 0.273, p< 0.001) and clinical usefulness (rho=− 0.369, p< 0.001). Overall, graphic design choices such as use of color, typography and layout were adequate. Information saturation was not correlated with scientific accuracy (rho=0.157, p=0.026).Conclusion: This study evaluated existing online infographics. Overall, graphic design choices, scientific accuracy and clinical usefulness were adequate, although areas for improvement were detected in the availability of credibility indicators, such as the lack of authorship and publication details, insufficient supporting references, and use of technical jargon. Further research should explore the actual effectiveness of infographics among contact lens wearers.Keywords: contact lens, graphic design, health education, infographic, online health information, scientific accuracy
