Introduction: Vision impairment is common after stroke and whilst orthoptists are well placed to assess and manage post-stroke visual deficits, their role within Australian stroke care pathways is poorly understood. This study examined orthoptic practice patterns and perceived barriers to post-stroke vision care in Australia. Methods: A cross-sectional online survey of practising Australian orthoptists working in stroke care was conducted, collecting data on demographics, practice settings, referral pathways, assessment and management practices, and perceived barriers. Quantitative data were analysed descriptively, and open-ended responses thematically. Results: Twenty-nine orthoptists completed the survey, representing an estimated 22% of the orthoptic workforce engaged in stroke care. Respondents were mainly experienced clinicians working in private ophthalmology or hospital outpatient eye clinics, with limited involvement in stroke units or rehabilitation settings. Orthoptists reported managing a broad range of post-stroke visual deficits, reflected in comprehensive visual assessments and rehabilitation strategies. Orthoptic involvement most often commenced months post-stroke and key barriers to orthoptic services included limited awareness of orthoptic roles, exclusion from multidisciplinary stroke teams, funding and lack of guideline inclusion. Conclusion: Post-stroke vision care in Australia broadly aligns with international practice, but survey findings suggest that the timing and context of orthoptic involvement may be influenced by structural and organisational factors.
Background:The rise of digital technologies has enabled vision testing via applications on phones, tablets, and computers, allowing assessments beyond clinical settings. While these tools empower parents to test their children's vision at home, little is known about the attitudes of parents in the United Kingdom (UK) toward this approach. This study examines parents perceived benefits and challenges of conducting vision tests for young children at home, either independently or with the help of a qualified clinician. Research aim:This qualitative study explores parents' perspectives on at-home remote vision testing in a paediatric population. Methodology:Data was collected via two online focus groups with parents of children aged 4-8 years old. Sessions were recorded, transcribed, and thematically coded to identify key patterns and themes. Results:Five key themes emerged: navigating trust in remote vision testing, impact of child demographics, desire for professional support, digital enablers and barriers, and appointment frequency influences desire for remote testing. Parents emphasised the need for training in remote vision testing to build confidence and skill. Potential benefits included reduced travel, time off work/school, and greater flexibility. Concerns around test accuracy, occlusion, and application use highlight the need for clear guidance and virtual supervision by professionals. Conclusion:Remote vision testing could be a reliable alternative to clinic visits, provided parents receive adequate training and support. Participants expressed concerns about the reliability of remote vision testing, particularly for younger or less cooperative children, but acknowledged benefits such as reduced travel, lower costs, and greater flexibility. While app-based testing was appealing, most preferred professional involvement, either in person or virtually, to ensure accuracy, reassurance, and follow-up support.
Background:Convergence insufficiency (CI) is a binocular vision disorder that has been linked to increasing visual demands of near tasks. As young adults routinely perform many near-work tasks, often with digital devices, this study evaluated the frequency of CI among young adults in a university population. Method:In this cross-sectional study, young adults aged 18-25 years were recruited using convenience sampling. Participants were excluded if they had any ocular pathology, clinically significant anisometropia, strabismus, accommodation insufficiency, reduced visual acuity and history of ocular conditions and vision therapy. Cover test, positive fusional vergence (PFV) and near point of convergence (NPC) were performed. The clinical diagnosis of CI was based on the CI and Reading Study group criteria. Data were analysed using descriptive and inferential statistics. Results:The mean age of the sample (n = 192) was 21.1 ± 2.0 and consisted of more females (n = 106, 55%). Overall, 151 (79%) participants did not have CI while 41 (21%) had CI. In participants with CI, low suspect CI was most common (n = 26, 63%) followed by high suspect CI (n = 10, 24%) and definite CI (n = 5, 12%). Participants with CI had significantly higher NPC break and recovery values, larger exophoria measurements at distance and near and lower PFV break and recovery values (p < 0.001). Conclusion:The findings show that CI was present in 21% of young adults in this university population. The test results, for NPC, prism cover test and PFV, in individuals with CI were significantly different from the test results in individuals without CI.
Aim:To assess the change in accommodative response between electronic devices and hardcopy text after prolonged reading. Method:There were 30 participants (N = 30), with a mean age of 24.29 ± 5.21 years. The accommodative response (lag or lead of accommodation, amplitude of accommodation, and accommodative facility) was measured before and after reading for 60 minutes from a printed book, a smartphone, and a laptop, with a 24-hour break between tasks. Secondary outcomes included comparisons of accommodative responses between hardcopy text and smartphone, smartphone and laptop, and laptop and hardcopy text. Results:Accommodative lag was initially 0.50 ± 0.00 D, with significant increases observed after 60 minutes of reading from a smartphone (1.25 ± 0.50 D), a laptop (1.75 ± 0.50 D), and a hardcopy text (1.50 ± 0.25 D). A greater lag was noted with laptop use compared to smartphone reading (P < 0.01). Accommodative facility was significantly reduced when reading from a laptop compared to both a smartphone (P < 0.01) and a hardcopy (P < 0.01). The binocular mean amplitude of accommodation was -7.50 ± 1.25 D with the laptop and -8.00 ± 1.00 D with the hardcopy, with a P-value of 0.085, indicating no statistically significant difference. Conclusion:Prolonged near work significantly affects accommodative function, with laptops inducing the greatest accommodative lag and reduction in facility. Hardcopy reading preserved accommodative facility better than digital devices, while amplitude of accommodation showed minimal change. These results suggest that sustained laptop use may lead to greater visual strain compared to smartphones or printed text.
Purpose: Association of asthenopia with multiple professions involving prolonged near work is well-established but asthenopia is under-reported in postgraduate surgical trainees. The purpose of this study was to determine the prevalence of asthenopia in surgical trainees and determine the associated risk factors. Methods: This study was an institute-based observational study, conducted between July 2024 and September 2024. Out of 107 surgical trainees, 102 responded to a structured asthenopia questionnaire. Detailed ophthalmic evaluation was performed in 43 trainees who consented and presented voluntarily. Visual acuity (Snellen), cover test (near and distance), positive (PFV) and negative fusional vergence (using a prism bar at near and distance), stereoacuity (Randot), near point of convergence, near point of accommodation and accommodative amplitude (using the Royal Air Force rule) were measured. Statistical analysis was performed using SPSS 22. Results: The prevalence of asthenopia was found to be 67.6%. The highest prevalence was found in Ophthalmology trainees. Out of 43 who presented for orthoptic assessment, 11 were advised to pursue refractive correction. PFV near was significantly lower in trainees with asthenopia (mean = 10.1 PD) compared to those without asthenopia (mean = 15.1), p = 0.03. Conclusion: Asthenopia among surgical trainees was high. The visual precision needed for surgical procedures, lack of sleep and the extensive academic curriculum may contribute to asthenopia in surgical trainees. Routine ophthalmic and orthoptic testing may help alleviate symptoms.
