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PurposeTo analyze the objective and subjective visual performances of a new hybrid refractive/aspheric extended depth of focus (EDOF) intraocular lens (IOL).MethodsIn this monocentric prospective study patients with bilateral cataracts underwent cataract surgery and were implanted with a Lucidis IOL (SAV-IOL SA, Neuchâtel, Switzerland) in both eyes, 1 week apart from each other. At 3 months from implantation postoperative evaluations included monocular and binocular uncorrected and distance-corrected distant (4 m), intermediate (80 cm, 67 cm) and near (40 cm) visual acuities (UDVA/DCVA, UI80-67VA/DCI80-67VA, UNVA/DCNVA), binocular defocus curves, halometry, contrast sensitivity and objective quality-of-vision measurements. Also, patients were also asked to complete the national eye institute refractive error quality of life (NEI-RQL-42) questionnaire.ResultsTwenty-five patients (50 eyes) were included. The mean postoperative binocular UDVA, UI80VA, UI67VA and UNVA were-0.02 ± 0.13, 0.05 ± 0.09, 0.05 ± 0.08 and 0.03 ± 0.1 LogMar, and did not significantly differ from their corrected counterparts. On binocular defocus curves a VA ≥0.05LogMar was found between +0.50 and − 2.50 D of vergence, whereas the mean distance from the central stimulus on halometry was 1.23 ± 0.01. Mean ocular and corneal radical mean square at 4 mm were 0.31 ± 0.28 and 0.19 ± 0.07, respectively; whereas the mean Strehl ratio was 0.2 ± 0.09.ConclusionLucidis IOLs demonstrated excellent visual performances, especially at close distances while maintain good quality of vision, contrast sensitivity, and overall patient-satisfaction.

PURPOSE: To compare the effectiveness and safety of the TECNIS Symfony® intraocular lens (IOL; ZXR00) with the TECNIS® 1-piece monofocal IOL (ZCB00). SETTING: Fifteen sites in the United States. DESIGN: Prospective, randomized, subject/evaluator-masked clinical trial. METHODS: Randomized participants received either the ZXR00 or ZCB00 IOL bilaterally. Six-month postoperative outcomes included monocular and binocular distance, intermediate, and near visual acuity (VA), spherical equivalent refraction and refractive cylinder, spectacle wear, and visual symptoms. RESULTS: Overall, 299 patients were implanted with a study lens (ZXR00, n = 148; ZCB00 control, n = 151). At 6-month follow-up, mean binocular uncorrected distance VA was comparable between ZXR00 and ZCB00 recipients (P = .1011). The ZXR00 group had significantly better mean binocular uncorrected intermediate VA and uncorrected near VA (both P < .0001) than the ZCB00 group. Mean binocular distance-corrected intermediate VA and distance-corrected near VA were also better in the ZXR00 group (both P < .0001). More ZXR00 recipients reported wearing spectacles "none of the time" or "a little of the time" for overall vision at 6 months compared with the ZCB00 group (85.0% vs 59.9%, P < .0001). In ZXR00-implanted patients, low incidence rates of night glare (mild to moderate, 2.7%), halo (mild to moderate, 13.6%; severe, 2.7%), and starbursts (mild to moderate, 7.5%; severe, 1.4%) were reported. CONCLUSIONS: The TECNIS Symfony® IOL provided comparable distance vision and improved uncorrected and distance-corrected intermediate and near vision, along with decreased spectacle wear and low incidence rates of dysphotopsias, compared with the TECNIS® 1-piece monofocal IOL.

Purpose: To evaluate the visual acuity, defocus curve and visual quality of life following bilateral implantation of a new hybrid extended depth of focus (EDOF)-multifocal diffractive intraocular lens (IOL). Methods: Patients who underwent cataract surgery with bilateral implantation of Tecnis Synergy IOL were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. Results: The mean ± SD values for binocular UDVA, UIVA and UNVA were −0.01 ± 0.04, 0.05 ± 0.03 and 0.03 ± 0.05 logMAR, respectively. Defocus curve showed a continuous vision above 0.16 logMAR between +0.50 D and −2.50 D. Patients had good visual performance with mean VF-14 scores above 3 points. Driving at night (3.47 ± 0.64) was found to be the most difficult task to perform. Spectacle independence was 100% for both distant and near vision. Conclusion: Bilateral implantation of Tecnis Synergy IOL in cataract patients shows good visual acuity and performance, covering a good visual range without any need of spectacles.

PURPOSE: To investigate the factors affecting near vision spectacle dependence after mix-and-match implantation of the trifocal extended depth of focus (EDOF) and trifocal intraocular lens (IOL). METHODS: A total of 204 eyes of 102 patients who underwent mix-and-match implantation of one trifocal EDOF and one trifocal IOL were enrolled in this study. Patients were divided into two groups according to spectacle dependence for near vision: reading glasses and no glasses. Clinical characteristics were compared between the two groups and multivariate binary logistic regression analysis was performed to determine the odds ratio of factors potentially associated with the need for reading glasses. RESULTS: Eighty-one patients (79.4%) did not need reading glasses and 21 (20.6%) did. The mean age of the no glasses group (55.6 ± 5.6 years) was significantly higher than that of the reading glasses group (52.7 ± 4.1 years). Preoperative refractions were more myopic in the reading glasses group than in the no glasses group. The postoperative uncorrected near visual acuities were better and the satisfaction scores were higher in the no glasses group compared to the reading glasses group. Multivariate binary regression analysis revealed that only pre-operative spherical equivalent (odds ratio: 1.397; P = .025) was related to the spectacle independence for near vision. CONCLUSIONS: Patients who had preoperative myopia and underwent mix-and-match implantation of trifocal EDOF and tri-focal IOLs tended to need spectacles for near vision. Surgeons should be aware of patients with myopia when considering mix-and-match implantation of trifocal EDOF and trifocal IOLs. [ J Refract Surg . 2021;37(11):746–753.]

PurposeTo investigate the burden of near vision loss (NVL) in China by year, age and gender from 1990 to 2019.MethodsWe used estimates from the Global Burden of Disease (GBD) 2019 study to report the prevalence and disability-adjusted life-years (DALYs) due to NVL in China. Estimates of crude counts and age-standardised rates per 100 000 population are accompanied by 95% uncertainty intervals (UIs). We summarised the age-specific and sex-specific patterns and trends regarding the burden of NVL in China, compared with seven neighbouring countries.ResultsFrom 1990 to 2019, the all-age number and rate for NVL prevalence and DALYs increased significantly in China (all pConclusionsDespite a small decrease in age-standardised prevalence and DALYs due to NVL in China in the past two decades, the existing burden is still considerable and significantly higher compared with neighbouring developed countries. An approach that includes all stakeholders is needed to further reduce this burden.

This study aimed to develop a valid and reliable instrument that measures the functional vision of students with low vision. Thus, an assessment tool and performance activities were developed for three vision skill groups (near vision skills, distance vision skills, and visual field) that include functional vision skills. The universe was 1485 students studying in various primary and middle schools (from 2nd to 7th grades) affiliated to the Ministry of National Education, and simple random sampling was used to select 310 students. The data were collected using the Gazi Functional Vision Assessment Instrument developed by the researchers. Many-facet Rasch model and generalizability theory were used for the rater reliability of the measurements obtained from the instrument, while discriminant analysis was used for the validity of the measurements. The analysis showed that the measurements were reliable, and the inferences based on these measurements were valid. Thus, this instrument can be used to identify and assess the functional vision status of students with low vision.

The authors would like to thank Luneau Technology Portugal for lending the Visionix VX120., Purpose: To study the effect of near-vision reading task on optical quality of the eye when performed on a computer monitor and on printed paper, and to identify which of the two results in greater changes. Methods: Two groups of subjects performed a 30-min reading task in two different conditions: on a computer monitor and on printed paper. Ocular, corneal, and internal wavefront aberrations (Zernike coefficients up to 6th order), root-mean-square of low- and high-order aberrations, spherical equivalent, vectoral components of ocular astigmatism ( J45 and J0), and the compensation factor between internal and corneal aberrations were measured before and after the tasks. Their changes were analyzed in each group and between groups. Results: Statistically significant changes in wavefront aberrations and in root mean square of low- and high-order aberrations were observed in both groups which was significantly greater when the task was performed on printed paper. Partial loss of compensation mechanism and variation in spherical equivalent in a negative direction occurred after both reading tasks; however, it was statistically significant only with printed paper reading task. The vectoral components of ocular astigmatism did not show statistically significant changes in either groups. Conclusion: Near-vision reading tasks can change the optical quality of the eye, especially when the task is performed on printed paper., This work was supported by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UID/FIS/04650/2019 and by the project PTDC/FIS-OTI/ 31486/2017.

Matthew Ison,1,2 Jane Scott,3 John Apel,3 Andrew Apel1,3 1Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia; 2University of Queensland, St Lucia, QLD, 4072, Australia; 3The Eye Health Centre, Brisbane, QLD, 4000, AustraliaCorrespondence: Matthew IsonPrincess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, AustraliaTel +61 434 946 264Email Matthew.Ison2@health.qld.gov.auPurpose: To report patient expectations, visual performance and satisfaction with AcrySof IQ PanOptix multifocal intraocular lens in a heterogeneous patient group. Additionally, determine if identifiable pre-operative characteristics can predict post-operative satisfaction.Methods: Data were prospectively collected for 67 consecutive patients (134 eyes) who underwent bilateral Panoptix implantation in a private ophthalmology clinic. A pre-operative questionnaire was completed regarding vision satisfaction, visual phenomena and expectations. Routine clinical parameters were collected 1 month and follow-up questionnaire administered 3 months post-operatively.Results: Post-operative unaided distance vision was 20/20 (0.01 ± 0.10) and binocular near vision 20/25-2 (N5; 0.14 ± 0.06). Patients satisfied with vision increased from 6% (n=4) unaided and 48% (n=32) aided pre-operatively to 94% (n=63) unaided post-operatively (p< 0.001). There was marked increase in frequency of halo from 14% (n=9) to 69% (n=46; p< 0.001) but no corresponding increase in how bothersome this symptom was (p=0.193) nor the frequency of other visual phenomena. Worse post-operative vision and fluctuating vision were associated with lower post-operative satisfaction. There was no difference in satisfaction or residual astigmatism in those implanted with toric lenses. A total of 96% (n=64) of patients were spectacle-free at 3-months and would recommend this procedure to others.Conclusion: This study supports the trend towards increased patient expectations of multifocal intraocular lenses, matched by excellent visual outcomes and satisfaction. Visual phenomena may be less troubling with new multifocal lenses than previously reported. A pre-operative questionnaire may be a useful education tool but could not isolate pre-operative characteristics that predict post-operative satisfaction.Keywords: multifocal, intraocular lens, cataract, refractive lens exchange, satisfaction

Purpose: This study compared the extended depth of focus (EDOF) intraocular lens (IOL) (ZXR00; Tecnis Symfony, Johnson & Johnson Vision, Santa Ana, CA, US) to a novel, higher-order aspheric monofocal IOL (ICB00; Tecnis Eyhance, Johnson & Johnson Vision, Santa Ana, CA, US) which uses the same platform and material. Methods: Medical records of patients undergoing cataract surgery with ZXR00 or ICB00 implantation between March 2020 and January 2021 and with the data available for the 3-month visit were reviewed. The uncorrected near, intermediate, and distance visual acuity (VA); corrected distance VA; and optical quality parameters were the main outcome measures. Results: Among the 174 enrolled patients, 72 and 102 received the ZXR00 and ICB00, respectively. The average patient ages were 59.6 ± 10.6 (range: 49 to 70) and 65.2 ± 8.2 (range: 45 to 82) years in the ZXR00 and ICB00 groups, respectively, with significantly older patients in the ICB00 group. The other baseline parameters were not different for the 2 groups. Compared to the ICB00 group, the ZXR00 group showed markedly superior near VA (P

Glaucoma is the most severe eye disease that leads to irreversible blindness, and is a widespread pathology among the population of different countries and especially in the elderly. The urgency of the problem increases in connection with the demographic processes occurring in industrial countries, characterized by aging of the population. The development of glaucoma in the elderly exacerbates the image and quality of life of these patients, which must be taken into account in the implementation of medical and social and specialized ophthalmological care. However, the study of the quality of life in elderly glaucoma patients by a specific questionnaire was not carried out.The purpose: to analyze the quality of life of elderly patients suffering from glaucoma for a long time.Material and methods. The study of quality of life was carried out in the Tambov branch of the S. Fyodorov Eye Microsurgery Federal State Institution. In clinical conditions, a survey of 228 patients with glaucoma aged 60–75 years, who made up the main group. The survey was conducted on a special questionnaire-National Eye Institute Visual Functioning Questionnaire among patients of the above group by direct interviewing. The results were integrated into 122 scales for processing and analysis in accordance with the requirements of this questionnaire. Similarly, for comparison, the quality of life was studied in 178 patients of the same age with no history of glaucoma and at the present time. In assessing the quality of life, arithmetic averages and their errors were calculated, and the nonparametric t-white criterion was used to determine the reliability of the differences.Results. It was found that the development of glaucoma in the elderly causes a significant decrease in the quality of life on all scales of the questionnaire, reflecting the specific manifestations due to visual impairment. At the same time, the most pronounced effect of glaucoma has on the reduction of distant vision — 19.5 ± 1.3 points against 69.5 ± 1.8 points (p < 0.001) in the control group. The defeat of glaucoma leads to a significant decrease in the quality of life of elderly patients and other indicators. In the main group, the overall score of vision (23.5 ± 1.5 points vs. 75.2 ± 1.9 points in the control), near vision (26.8 ± 1.6 points vs. 73.5 ± 2.0 points in the control), high dependence on outsiders in solving everyday problems (30.5 ± 1.6 points vs. 79.3 ± 1.8 points in the control) were significantly lower. To a lesser extent, with the development of glaucoma, color perception suffers.Conclusion. The analysis of the quality of life in elderly patients with glaucoma is of practical importance for the organization of an individual treatment and prevention plan, since it takes into account the opinion of each patient about the perception of the disease.

Purpose: Unaddressed near vision impairment (NVI) affects more than 500 million people. Testing near vision is necessary to identify those in need of services. To make such testing readily accessible, we have developed and validated a new smartphone-based near visual acuity (NVA) test: Peek Near Vision (PeekNV). Methods: Two forms of the PeekNV test were developed: (1) quantitative measurement of NVA, and (2) binary screening test for presence or absence of NVI. The valid-ity study was carried out with 483 participants in Sagarmatha Choudhary Eye Hospital, Lahan, Nepal, using a conventional Tumbling “E” Near Point Vision Chart as the reference standard. Bland–Altman limits of agreement (LoA) were used to evaluate test agreement and test–retest repeatability. NVI screening was assessed using Cohen’s kappa coeffi-cient, sensitivity, and specificity. Results: The mean difference between PeekNV and chart NVA results was 0.008 logMAR units (95% confidence interval [CI], −0.005 to 0.021) in right eye data, and the 95% LoA between PeekNV and chart testing were within 0.235 and −0.218 logMAR. As a NVI screening tool, the overall agreement between tests was 92.9% (κ = 0.85). The positive predictive value of PeekNV was 93.2% (95% CI, 89.6% to 96.9%), and the negative predictive value 92.7% (95% CI, 88.9% to 96.4%). PeekNV had a faster NVI screening time (11.6 seconds; 95% CI, 10.5 to 12.6) than the chart (14.9 seconds; 95% CI, 13.5 to 16.2; P < 0.001). Conclusions: The PeekNV smartphone-based test produces rapid NVA test results, comparable to those of an accepted NV test. Translational Relevance: PeekNV is a validated, reliable option for NV testing for use with smartphones or digital devices.

Purpose. To determine the effects of cataract surgery and preoperative factors on the vision-related quality of life (QOL) in patients with retinitis pigmentosa (RP). Materials and Methods. This was a prospective, interventional study of 54 patients diagnosed with RP. The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was used to determine the QOL before and after the cataract surgery. The correlations between the scores of the questionnaire and the best-corrected visual acuity (BCVA), macular structure, and degree of improvement of the NEI VFQ-25 scores were also determined. Results. Statistically significant improvements were observed in the BCVA and all of the NEI VFQ-25 subscale scores except for color vision. The improvement of general vision was the largest. The postoperative BCVA of the better-seeing eye was more strongly and significantly correlated with the postoperative NEI VFQ-25 scores than that of the worse-seeing eye. All of the postoperative NEI VFQ-25 scores were significantly correlated with the length of the ellipsoid zone (EZ) of the photoreceptors. No significant correlation was found between the preoperative general vision, near vision, mental health scores, and EZ length. All of the preoperative NEI VFQ-25 scores except the social function and mental health scores were negatively and significantly correlated with the degree of improvement of the NEI VFQ-25 score. The EZ length was significantly correlated with the degree of improvement of the NEI VFQ-25 scores of the general vision, distance vision, mental health, dependency, and composite 9 scores. Conclusions. Cataract surgery can significantly improve the NEI VFQ-25 scores in RP patients. The EZ length can be used to predict the postoperative VFQ scores. We conclude that the NEI VFQ-25 is a useful method to evaluate the impact of cataract surgery on the BCVA in patients with RP.

Kjell G Gundersen,1 Richard Potvin2 1IFocus Øyeklinikk AS, Haugesund, Norway; 2Science in Vision, Bend, OR, USACorrespondence: Kjell G Gundersen Email kg@ifocus.noPurpose: To quantify the changes in the binocular defocus curve associated with the Vivity™ non-diffractive extended vision intraocular lens when the dominant eye was targeted for emmetropia and the non-dominant eye was artificially targeted for slight myopia using spectacles.Patients and Methods: This was a non-interventional research study of the corrected binocular defocus curve associated with binocular emmetropia (Setting A) and with emmetropia in the dominant eye and two different levels of myopia simulated in the non-dominant eye (− 0.50 D, Setting B and − 1.00 D, Setting C). Subjects were patients implanted with the AcrySof® IQ Vivity® intraocular lens in both eyes 3 to 12 months previously. Using the defocus data, the percentage of subjects with a continuous 2.5 D range of vision (distance to 40 cm) was calculated for various levels of minimum visual acuity (VA).Results: Forty subjects were enrolled. The mean spherical equivalent refraction was − 0.06 D ± 0.36 D, with 0.37 D ± 0.29 D of refractive cylinder. There was no statistically significant difference in the mean VA at − 0.25 D or at − 0.50 D vergences between the test Settings, but there was a statistically significant difference at all other vergences. Differences were particularly noticeable at − 2.00 D, − 2.50 D and − 3.00 D, where higher myopia in the non-dominant eye yielded better binocular VA. A 2.5 D range of functional vision (20/25) was achieved by 38% of subjects at Setting A, 68% of subjects at Setting B and 85% of subjects at Setting C. At setting C, all but one subject (39/40, 97.5%) had a 2.5 D range of vision with a VA of 20/32 or better.Conclusion: Significant gains in binocular near vision, with only a nominal effect on distance vision, can be achieved with the Vivity IOL by leaving the non-dominant eye of patients with 0.50 D or 1.00 D of myopia.Keywords: non-diffractive, extended vision, extended depth of focus, presbyopia, cataract

Clayton Blehm,1 Richard Potvin2 1Gainesville Eye Associates, Gainesville, GA, USA; 2Science in Vision, Bend, OR, USACorrespondence: Richard PotvinScience in Vision, 127 NW Revere Ave, Bend, OR, 97703, USATel +1 407-697-6008Email rick@scienceinvision.comPurpose: To assess the spectacle independence and satisfaction of subjects after bilateral implantation of the PanOptix® trifocal intraocular lens (IOL) at the time of cataract surgery.Design: Single site, prospective, single-arm study.Methods: Eligible subjects interested in a trifocal IOL to potentially reduce dependence on spectacles for near, intermediate and distance vision were enrolled and followed for 3 months after the second eye surgery. Visual acuity and refractive data were collected 1 month and 3 months postoperative, including the uncorrected and best distance-corrected binocular visual acuities at distance (4m), intermediate (60 cm) and near (40cm). A patient satisfaction and spectacle independence questionnaire were administered at the 3-month visit.Results: A total of 30 subjects successfully completed the study. Eighty-five percent of eyes (51/60) had a refraction within 0.50 D of plano with ≤ 0.50 D of refractive cylinder. One subject (3%) reported needing glasses for distance work, 3 (10%) for intermediate work and 4 (13%) for near work. Ninety percent or more of all subjects reported never wearing glasses or wearing them only a little at all working distances. Ninety percent or more were able to function without glasses at all 3 working distances all or most of the time. More than ninety percent of subjects reported being “com.pletely” or “mostly” satisfied with their vision without glasses or contact lenses at all three distances and overall.Conclusion: A high percentage of patients are likely to achieve spectacle independence for distance, intermediate and near vision with this trifocal IOL.Keywords: cataract surgery, spectacle independence, presbyopia correction, trifocal IOL, toric trifocal IOL

To compare the visual and refractive outcomes of a new intraocular lens (IOL) with extended depth of focus (Tecnis Eyhance IOL) and Tecnis Monofocal IOL, retrospectively. Eighty-five eyes of 85 patients with cataract who had undergone standard phacoemulsification and Tecnis Eyhance (ICB00) intraocular lens (IOL) implantation operation (group 1), and 83 eyes of 83 patients with cataract who had undergone standard phacoemulsification and Tecnis Monofocal (ZCB00) IOL implantation (group 2) between April 2019 and May 2019 were compared in terms of visual outcomes. There were no significant differences between the two groups with respect to preoperative and postoperative spherical, astigmatic, and spherical equivalent (SE) values (p > 0.05). The mean postoperative spherical, astigmatic, and SE values were significantly lower than those of preoperative values in both groups (p 0.05). The mean postoperative UCDVA, BCDVA, and CNVA of the first group were not different statistically from those of the second group (p > 0.05). However, the mean postoperative 6th month UCIVA, DCIVA, UNVA, and DCNVA of the first group were significantly better than those of the second group (p < 0.05). Also, additional degrees needed for near vision correction was significantly lower in the first group when compared to the second group (p < 0.05). There were no halo and/or glare complaints of patients in either group. Tecnis Eyhance IOL provides good distance and intermediate vision and improves near vision partially, and it does not cause photic phenomenon like halo and glare.

Objectives: Sensory loss may be a barrier to accessing healthcare services, and this study seeks to examine the association of sensory loss with whether older adults report having a usual source of health care. Methods: Our study included 7548 older adults who participated in the National Health and Aging Trends Study in 2015. Having a self-reported usual source of health care was our outcome, and hearing and vision loss were our primary independent variables. Results: In multivariate analysis accounting for demographics, socioeconomic, health status, and environmental covariates, near vision loss but not distance vision or hearing loss was associated with decreased odds of having a usual source of health care. Discussion: That older adults with near vision loss were less likely to report having a usual source of health care is concerning. Examining barriers to care is needed to identify sensory loss-relevant processes to optimize and intervene upon.

Introduction The measures of ophthalmic anthropometric parameters may vary among races and ethnic groups but are of immense importance in clinical diagnosis and management of oculo-visual defects. There is paucity of data on these measures among the Zimbabwean population. Purpose The aim was to determine ophthalmic anthropometric parameters among rural dwellers in Zimbabwe. Methods Six ophthalmic anthropometric parameters including interpupillary distance (IPD), head width (HW), temple width (TW), length to bend (LTB), and apical radius were measured using a pupillometer, PD rule, Head width calipers, Fairbank facial gauge, and ABDO frame rule. Results A total of 471 participants aged 18 to 100 years (mean age = 55.13; SD± 17.33 years). Of the 471 participants, 206 (43.7%) were males and 265 (56.3%) were females. A mean interpupillary distance at far was 65.57 ± 4.80 mm, mean temple width of 12.49 ± 1.53 cm, mean head width of 13.61 ± 1.39 cm and a side length to bend of 10.24 ± 1.20 cm and the apical radius was 9.94 ± 1.37. There was a significant (P < 0.05) difference between the ophthalmic anthropometric parameters of males and females except for temple width and apical radius. Conclusion A narrower interpupillary distance but a wider temple width was observed among adult Zimbabweans. A significant difference in ophthalmic anthropometric parameters between males and females were observed except for temple width and apical radius. This should inform eyewear manufacturers and importers of frames on the facial and ocular parameters of Zimbabweans to improve the aesthetics and ensure a comfortable vision for wearers of already-made near vision spectacles for presbyopes. Rwanda J Med Health Sci 2021;4(1):99-111

It is important to predict which astigmatic patients require separate refraction for near vision. This study compared cylindrical components changes by cyclopentolate 1% for the low and high amount of astigmatism. The right eyes of 1014 healthy individuals (307 males and 707 females) with cylindrical refractive power more than −0.5 diopter on autorefractometer were selected. Both male and female patients in the age range of 17–45 years were refracted before and after cycloplegia, using 1% cyclopentolate. All volunteers were classified into 2 subgroups including the lower astigmatism group (−2.25 to −0.50) and the higher astigmatic group (−2.50 to over). Alpines’ method was used to compare the effect of cycloplegic drop on cylindrical power. The mean age in the lower astigmatism group (29.58; 95% CI: 29.18 to 29.99 years) was not significantly different from the higher astigmatic group (29.85; 95% CI: 29.07 to 30.62) and there were no significant differences in gender between these two groups (P=0.54). Differences between wet and dry refraction in J0 (−0.03; 95% CI:−0.06 to −0.008) and J45 (−0.03; 95% CI:−0.06 to −0.01) were significant only in the higher astigmatic group. Axis changes by the cycloplegic drop in the lower astigmatism group were 3.51 (CI: 3.22 to 3.81) and axis changes by the cycloplegic drop in the higher astigmatism group were 2.21 (CI: 1.73 to 2.49). In patients with a lower amount of astigmatism (−2.25 to −0.50), additional near subjective refraction could be done for precise determination of axis and in patients with a higher amount of astigmatism (−2.50 to over), near subjective refraction might be done for precise determination of power.

Purpose: This study aimed to translate the Convergence Insufficiency Symptom Survey (CISS) into the Italian language and assess psychometric properties of the translated questionnaire (CISS_I). Methods: The CISS_I was arranged according to guidelines for a comprehensive multistep methodologic process for translating, adapting, and validating psychometric instruments in health care research. The CISS_I questionnaire was administered to 103 volunteers (21.8 ± 2.2 years), students in higher education, at two different times. A complete optometric evaluation was performed including subjective refraction, best corrected visual acuity, near point of convergence, prism fusional ranges to blur, diplopia and recovery, TNO stereo test and prism cover test for measurement of heterophoria. Results: The performance of the CISS_I in terms of validity showed some points of weakness. Sensitivity was 42%, specificity was 74%, positive predictive value was 27% and negative predictive value was 85%. The area under the ROC curve was 0.672. On the contrary, the results showed good internal consistency of the CISS_I (Cronbach's alpha - α=0.89) and good test-retest reliability (ICC = 0.92). Rasch analysis showed good model fit (all items, except one, with infit and outfit mean square between 0.7 and 1.3), good measurement precision (person separation = 2.66) and good targeting –0,81 logits but also some evidence of multidimensionality. Conclusions: The CISS_I showed some point of weakness in terms of validity but also good psychometric properties and has been shown to be applicable to an Italian speaking population to quantify the visual discomfort associated with near vision in higher education students. The results show that high CISS_I score is not necessarily linked to convergence insufficiency, while low scores can exclude the presence of this anomaly. The CISS_I can help in interpreting and monitoring convergence insufficiency symptoms in already identified subjects, but it is not suitable for screening a general population of young adults.

Purpose : In this study, in order to find out the necessity of using reading glasses according to the correct prescription, the variables of the users of the ready-made reading glasses were measured and analyzed for those who are using the ready-made reading glasses. Methods : A total of 50 subjects over 45 years of age were selected, and refraction tests, maximal accommodation, near addition, and near PD were measured. In addition, the distance between center points of the ready-made reading glasses frames and the distance between the optical center points of the glasses were measured. Results : As a result of checking the clearest distance according to the purchase period of the ready-made reading glasses, the clearest distance became longer as the period of purchase increased. As a result of comparing the distance between the reference points of the glasses frames and the distance between the optical center points of the ready-made reading glasses, the larger the distance between the reference points of the frames, the larger the distance between the optical center points. It was found that 71.00% had a difference of 2 mm or more. In addition, as a result of confirming the inducing prism affecting binocular vision, BO △ was induced in 80.00%, BI △ was induced in 16.00%. Conclusion : This study was able to confirm the eye strain caused by the different refractive power and PD between the ready-made reading glasses and the actual prescription glasses for near vision use. Therefore, standards for selling ready-made reading glasses, including online and it is necessary to improve the quality of national security services by strengthening the expertise of optometrist to prevent the use of ready-made reading glasses which may adversely affect eye health.

Purpose: to evaluate dynamics of subjective and objective accommodation in children wearing bifocal soft contact lenses (BSCLs) for myopia control with +4.00 D addition power. M e t h o d s: the study involved 22 patients (44 eyes).Mean age amounted to 10.1 ± 1.46 years and mean myopic refraction amounted to –3.21 ± 1.23 D. Patients were fitted Prima BIO Bi-focal BSCLs (OKVision Retail, Russia). All patients underwent cycloplegic refraction assessed with Auto Ref/Keratometer ARK 530A (Nidek, Japan), had axial length measured with IOL Master 500 optical biometry device (Carl Zeiss, Germany), had positive relative accommodation (PRA) assessed with and without lenses and had binocular (BAR) and monocular (MAR) accommodative response assessed at a distance of 33 cm with WAM-5500 Binocular Accommodation Auto Ref/Keratometer (Grand Seiko, Japan) prior to wearing BSCLs as well as 3, 6 and 12 months after wearing BSCLs.Results: neither MAR nor BAR measured without lenses changed after 3, 6 and 12 months of wearing BSCLs (p >0,05). A change in PRA evaluated without lenses was noted after 12 months (p < 0,05). PRA evaluated with lenses after 3, 6 and 12 months differed from baseline significantly (p < 0,001). Over 12 months of wearing BSCLs, changes in AL (0.09 ± 0.17 mm) and cycloplegic refraction (0.3 ±0.43 D) correlated with baseline BAR and MAR loosely. C o n c l u s i o n: objective accommodation (MAR and BAR) did not change in the course of wearing BSCLs with +4.00 D addition power. Increase in PRA evaluated without BSCLs may be associated with improvement of accommodation due to a full correction in the optic zone. The gradual increase in PRA evaluated with BSCLs probably indicates an adaptation of patients to addition zone in near vision conditions.

We report a case of a 19-year-old Indian male with stage 2 Coats’ disease who was managed with monthly intravitreal biosimilar ranibizumab injections (n=3) along with laser photocoagulation in the right eye. Post-treatment, significant reductions were seen in the exudation, angioma-like lesions, central macular thickness and edema in the retina. At the last follow-up at 9 months after intravitreal biosimilar ranibizumab initiation, distant vision improved from best corrected visual acuity (BCVA) of 5/60 at baseline to 6/18, and near vision from ‘not able to read’ to N/12 in the right eye. Keywords: Biosimilar, Coats’ disease, Laser photocoagulation, Ranibizumab.

Purpose There is a need for a simple and accurate way to assess visual acuity in telemedicine consultations in ophthalmology and other related specialties. Design We surveyed visual acuity testing apps available that allow patients to measure their own acuity, focusing on freely accessible resources suitable for all resource settings. Methods A systematic search was performed for visual acuity testing apps on 2 major platforms: Google Play Store (Google, CA, USA) and Apple App Store (Apple, CA, USA). Results Sixteen apps (67%) tested near vision, 5 apps (21%) tested distance vision, and 3 apps (13%) offered options for both near and distance vision testing. Of the 24 apps, 5 (21%) offered a method of calibration of optotype size. Three apps (13%) demonstrated evidence of clinical validation. Only 3 apps fulfilled our criteria for suitability for clinical practice. Conclusions We have recommended 3 apps that may be quickly integrated into clinical practice in both ophthalmic and non-ophthalmic all resource settings.

PURPOSE To compare the visual outcomes and patient satisfaction after bilateral implantation of an extended range-of-vision intraocular lens (ERoV IOL) (Tecnis Symfony) vs 2 different mix-and-match approaches combining the ERoV IOL with bifocal IOLs. SETTING Glory Seoul Eye Clinic, Seoul, South Korea. DESIGN Prospective observational nonrandomized comparative study. METHODS Patients undergoing cataract surgery were distributed into 3 groups based on their lifestyle and near visual demands: bilateral Symfony IOL, mix-and-match Symfony IOL with bifocal +3.25 diopters (D) IOL, and Symfony IOL with bifocal +4.0 D IOL. Binocular uncorrected visual acuity for distance, intermediate, and near, manifest refraction, defocus curve, contrast sensitivity, and subjective visual perception and satisfaction (photic phenomena, spectacle independence, and patient satisfaction) were evaluated at 1 week, 1 month, and 3 months postoperatively. RESULTS The study comprised 103 people (206 eyes). There were no significant differences for uncorrected visual acuity between groups for distance, intermediate, and near vision (P > .05). Contrast sensitivity under low and high luminance conditions was not different between groups (P > .05). Influence of glare on image perception was found to reduce contrast sensitivity more in the bilateral group for smaller target sizes (P < .05). Patients implanted bilaterally with Symfony IOLs reported photic phenomena more frequently than those implanted with the mix-and-match combinations. CONCLUSIONS All combinations evaluated provided good visual outcomes for distance, intermediate, and near. The lower incidence of photic phenomena reported by patients, and the lower reduction on contrast sensitivity for low illumination levels with the presence of glare, suggest that mix-and-match approaches might be a better option compared with bilateral implantation of ERoV IOLs.

Nanida Tiraset,1 Anuchit Poonyathalang,1 Tanyatuth Padungkiatsagul,1 Montakarn Deeyai,1 Polathep Vichitkunakorn,2 Kavin Vanikieti1 1Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandCorrespondence: Kavin Vanikieti Email Vanikieti.kavin@gmail.comPurpose: To validate the Rosenbaum near vision card (Near Chart) and a smartphone-based visual acuity (VA) test (Eye Chart) against a standard retro-illuminated Early Treatment Diabetic Retinopathy Study (ETDRS) chart within participants.Materials and Methods: A cross-sectional study of participants aged ≥ 18 years was conducted. VA was measured in all participants using the ETDRS chart, Near Chart and smartphone-based Eye Chart application, respectively. VA was converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Eyes with ETDRS VA worse than 1.0 logMAR (20/200) were excluded. The main outcome measures were levels of agreement between VA measured using the Near Chart or Eye Chart application vs the ETDRS chart.Results: A total of 295 eyes of 151 participants were included. One hundred participants (66.2%) were female and the mean age was 64.3 ± 12.5 years. Educational level was high school or below for 49% of participants and at Bachelor’s degree or above for 51%. The median logMAR VAs of all eyes tested using the ETDRS chart, Near Chart and Eye Chart application were 0.1, 0.0 and 0.1, respectively. The median VA difference between the Near Chart vs ETDRS chart and Eye Chart application vs ETDRS chart was 0.0 logMAR in both cases for both the right eye (OD) and left eye (OS). Intraclass correlation coefficient (ICC) demonstrated a strong positive correlation between VA tested with the Near Chart vs ETDRS chart (OD: ICC=0.85; p< 0.001, OS: ICC=0.77; p< 0.001) and Eye Chart application vs ETDRS chart (OD: ICC=0.88; p< 0.001, OS: ICC=0.74; p< 0.001).Conclusion: VA measurements with the Near Chart and smartphone-based Eye Chart application corresponded well to the standard ETDRS chart, suggesting potential utility of alternative portable VA tests for in-office or remote vision monitoring, particularly during periods of physical distancing such as the Coronavirus disease 2019 (COVID-19) era.Keywords: visual acuity, ETDRS chart, Rosenbaum near vision card, smartphone-based Eye Chart application, COVID-19

The aim of this study was to quantify vibrations and their influence on visual acuity. The study consisted of two parts, laboratory and clinical. Time-averaged holographic interferometry (TAHI) method was used in laboratory for measuring the amplitude of tooth vibrations induced by dental handpiece. The amplitudes of tooth vibrations were measured for the three diameters and three speeds. The larger diameter coupled with increasing speed resulted in greater vibration amplitudes, whereby a maximum amplitude of less than one micrometer was detected. For quantifying the natural visual acuity for the corresponding tooth vibrations, we have used the clinical condition approach with miniaturized Snellen optotype as an assessing tool. Central visual acuity did not display variance in visual acuity at rest or under load. Results indicate that the vibrations induced during cavity preparation are not sufficient to negatively affect visual acuity of dentists.

Significance Image simulation is a useful and efficient tool to explore the impact of defocus and astigmatism combinations on visual acuity and image quality score when accommodation is taken into account. Purpose The goal of this experiment was to determine if a simulation is able to predict visual acuity and image quality score (IQS) with defocus and astigmatism combinations in presbyopes. Methods We measured visual acuity and IQS in five defocus and astigmatism combinations in either real or simulated conditions. In real conditions, the subjects viewed a stimulus through an ophthalmic lens or a deformable mirror. In simulated conditions, subjects viewed images of the same stimulus with simulated blur. The amounts of defocus and astigmatism combinations of a progressive addition lens in near vision were generated through a static correction of the subject's aberrations. We simulated three levels of accommodation: subject could not accommodate (FOC0), subject could accommodate to the less hyperopic focal point (FOC1), or subject could accommodate to the circle of least confusion (FOC2). Results Visual acuity or IQS did not differ between mirror and progressive addition lens conditions. Visual acuity measured in real blur conditions differed significantly from that in FOC0 simulated blur condition but were similar to that in FOC1 and FOC2 simulated blur conditions. Image quality score obtained in real conditions were between scores measured with the FOC0 and FOC1 simulated conditions, suggesting that the subjects were able to produce a low level of accommodation. Conclusions Accommodation may play a role when comparing optical and simulated defocus and astigmatism combinations. Presbyopic subjects are able to produce a low level of accommodation that may counterbalance a part of the deleterious effect of the astigmatism on image quality. Simulation remains a useful tool if the correct accommodation state is taken into account.

Purpose: To compare the visual outcome in terms of multifocality in Manual Small Incision Cataract Surgery (MSICS) with and without intraoperative manipulation of corneal curvature. Methods: This was a prospective study on 80 subjects (80 eyes) who underwent MSICS with monofocal posterior chamber intraocular lens (PCIOL) implantation between January 2018 and October 2019. Intraoperative manipulation of corneal curvature using viscoelastics was performed during MSICS in 40 subjects (cases) while this intraoperative manipulation was not performed in the remaining 40 subjects (controls). Uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) were compared at day 1, 7, 30 and 180postoperatively. Results: At 1 month and 6 months of follow up, UDVA was comparable in the 2 groups. UNVA was better in cases than controls at 1 month and6 months (P < 0.001). At 6 months of follow up,76% of cases with UDVA of 6/9 or better had UNVA of N8 while only 15% of controls with UDVA of 6/9 or better had UNVA of N8 (P

The eye should have a particular focal length in order to see an object. As there are many things to see, the focal length of the eye must vary because these things are not all at the same distance from the eye. We explore the eye accommodation from a geometrical optics point of view and present our results in this paper; the study includes a description of the accommodation mechanism and a scientific definition of near vision and far vision.

Introduction: The literature supports the importance of adequate lighting for people with visual impairments, but little is known regarding ambient color temperature at home, and the evaluation process is not standardized. Thus, this study aimed to test a method for evaluating the preferred ambient color temperature, established with a near-vision assessment in clinic, and by using standardized tools to evaluate the effects at home for people with central visual field loss. Methods: An exploratory quasi-experimental study was conducted with three interventions and six observation times. A convenience sample of eight women and two men with central visual field loss, aged 64–91 years with visual acuity between 6/21 (20/69) and 6/48 (20/158), was recruited. Two certified low vision therapists realized evaluations with Minnesota Low-Vision Reading Test, International Reading Speed Texts, a Visual Comfort Scale, a Digital Light Meter LX1330B, and Home Environment Lighting Assessment. The LuxIQ and various illuminated magnifiers were used for clinical interventions. Home lighting interventions were individualized and aimed to apply participants’ preferred color temperature in a selected room. Results: The use of the LuxIQ and illuminated magnifiers showed positive effects in near-vision for all participants by increasing reading speed and visual comfort. Home lighting interventions in participants’ kitchen ( n = 4), living room ( n = 4), or office ( n = 2) also had beneficial effects on their visual comfort and ability to perform activities of daily living. The choice of preferred color temperature was transferable from near-vision to ambient lighting for all participants but one and varied widely. Discussion: Innovative preliminary data support the importance of ambient color temperature for people with visual impairments and suggest an efficient standardized evaluation method. Further research is needed to obtain statistically significant empirical evidence in this field. Implications for practitioners: It could be beneficial for low vision therapists to evaluate the individual ambient color temperature preferences of people with visual impairments by using standardized tools.

Diplomdarbs uzrakstīts angļu valodā uz 23 lappusēm. Tajā ir 8 attēli, 4 tabulas un 17 atsauces. Īpaši ar Covid-19 tiek uzlabota elektronisko ierīču lietošana īpaši skolas vecuma bērniem, kuri ar e-mācībām daudzas stundas dienā pavadīja, izmantojot datorus, lai pētītu, palielinot jau tuvredzības laikā esošo astenopisko simptomu nopietnību. Izmantojot +0,50D atkarību skolas vecuma bērniem (8-16 g.v.) ar ezoforiju tuvredzības stāvoklī 45 dienas, mēs varam ievērojami samazināt šo simptomu skaitu, kā arī varam pamanīt foorijas samazināšanos. Izmantojot šo metodi, pacientam var būt ērta redze tuvumā un uzlabota veiktspēja datora lietošanas un studiju laikā., Thesis is written in English on 23 pages. It contains 8 figures, 4 table and 17 references. Especially with Covid-19 the use of electronically devices is improved especially for school-age children that with e-learning passed many hours a day using computers to study increasing the severity of asthenopic symptoms already present during the near vision. Using an addiction of +0.50D on school-age children (8-16 y.o.) with esophoria in near vision for 45 days, we are able to reduce considerably the amount of those symptoms and we can also notice a phoria reduction. With this method the patient could have a comfortable near vision and improved performance during computer use and study.

Purpose The aim of this cross-sectional observational study was to measure habitual viewing distance with smartphones in individuals of different ages, and to identify factors influencing viewing distance. Material Gender, reading position, forearm length, ametropia, correction modality, and near vision quality were investigated as factors affecting viewing distance. Participants were asked to read a typical text message on their own smartphone, while sitting and standing. A total of 233 subjects (129 females and 104 males), aged from 16 to 90 years old, were included and divided in two groups: 131 non-presbyopes (median 21.1, range 16 − 39), and 102 presbyopes (median 54.5, range 42 − 90). Results Mean viewing distance was 36.1 ± 7.2 cm while sitting, and 37.4 ± 6.8 cm while standing (P < 0.05), and 36.8 +/- 6.6 cm overall. The average viewing distance was 35.0 ± 6.4 cm in non-presbyopes, and 39.0 ± 6.1 cm in presbyopes (P < 0.05). The average viewing distance was 34.7 ± 6.2 cm in females, and 38.2 ± 6.3 cm in males (P < 0.001). Conclusions Significant differences between males and females were observed, due to the different average body size between the two gender groups. Average viewing distance with smartphones in presbyopes matched approximately to the typical near reading distance of 40 cm. In the non-presbyopic group, the accommodative demand when reading a smartphone was slightly higher than in the presbyopic group. High variability was observed in both age groups, without a statistically significant correlation with other assessed factors as reading position, ametropia, correction modality, and near vision quality.

BACKGROUND To evaluate the effects of the ChromaGen contact lens (CCL) on best-corrected visual acuity, contrast sensitivity and pseudoisochromatic test plate performance in patients with congenital colour vision deficiency (CVD). METHODS CCLs were inserted into 50 eyes of 25 patients with congenital red-green CVD. The patients were tested with the Ishihara and Hardy-Rand-Rittler test plates before and after the insertion of Magenta 2, Magenta 3, and Violet 3 CCLs. The patients' mean numbers of recognised symbols were calculated and the most appropriate CCL was determined for each eye. The best-corrected visual acuity for both far and near vision and contrast sensitivity were evaluated before and after the insertion of the appropriate CCLs, and the results were compared. RESULTS The mean age of the patients was 26.56 ± 10.30 years. While all CCLs increased the mean numbers of recognised symbols on the Ishihara (p

Tonic accommodation decreased with age among children. In young adults, late-onset myopia will develop due to occupational near vision demands. This study aims to investigate the accommodation response and facility between children and young adults, in emmetrope (non-myopic) and myope group. The accommodation response and facility of young adults and children were measured using monocular estimation method (MEM), monocular accommodative facility (MAF) and binocular accommodative facility (BAF) with an exposure of near task for 15 minutes. Near task has significantly increased the lag of accommodation in all groups (p0.05). Keywords: accommodation response, accommodation facility, myopes, emmetropes. eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i14.2168

Purpose : This study aimed to analyze visual functions by vision correction status, by administering questionnaires about visual functions to undergraduates. Methods : The visual functions (vision-specific quality of life) of 290 undergraduates without eye diseases were evaluated by using the Korean version of National Eye Institute's Visual Functional Questionnaire(NEI-VFQ), from March to May, 2019. This study comparatively was analyzed by the differences in visual functions by the wearing purposes of glasses or contact lens. Results : The group that did not need any correction scored 94.17 on the item of visual function, while the one that needed correction scored 85.33. The former showed the highest scores on each item but the latter showed overall lower scores at the items of the general health and general vision, ocular pain and near vision and distance vision. The group that had no need for correction scored higher at VFQ-13, while the one that needed correction scored lower at all items other than near vision and role difficulties. Conclusion : The visual functions based on the status of visual correction for undergraduates showed that the group with uncorrected vision was poorer than the other group. In particular, the scores on the items general health and general vision were significantly worse for the group with uncorrected vision. The findings suggested that uncorrected vision has negative effects on the vision-specific quality of life.