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This study aimed to determine the influence of physical fitness level and sex on intraocular pressure (IOP) during the low-intensity aerobic exercise. Forty-four participants (twenty-two men) cycled 30 minutes at low intensity (10% of the maximal power). Maximal power was determined by asking participants to perform maximal sprints of 6 seconds against 3-4 different resistances separated by 3 minutes of rest. The IOP was measured on 9 occasions (1) prior to the warm-up, (2) after the warm-up, (3-7) every 6 minutes during the low-intensity cycling task, and (8-9) 5 and 10 minutes after the cycling task. Low-intensity aerobic exercise had a lowering effect on IOP, being the beneficial effect more accentuated and prolonged in the High-fit group (IOP reduction compared to baseline lasted 30 minutes) than in the Low-fit group (IOP was only reduced at 6 minutes of exercise compared to baseline). Participants´ sex had no effect on the IOP behaviour at any time point (p = 0.453). These findings indicate that individuals who need to reduce IOP levels (i.e., glaucoma patients or those at risk) should increase or maintain a high fitness level to benefit more from the IOP lowering effect during low-intensity aerobic exercises.

Purpose: The ±2.00 D accommodative facility test presents several limitations, in- cluding the lack of objective information and inherent characteristics such as ver- gence/accommodative conflict, change in apparent size of the image, subjective criteria for judging blur and motor reaction time. By using free-space viewing con- ditions and an open-field autorefractor to monitor the refractive state, we exam- ined the impact of manipulating these factors on the qualitative and quantitative assessment of accommodative facility. Methods: Twenty-five healthy young adults (24.5 ± 4.5 years) took part in this study. Participants performed three accommodative facility tests (adapted flipper, 4D free-space viewing and 2.5D free-space viewing) under both monocular and binocular conditions in random order. A binocular open-field autorefractor was used to assess the accommodative response continuously, and these data were used to characterise accommodative facility quantitatively and qualitatively. Results: There were statistically significant differences between the three testing methods both quantitatively (p < 0.001) and qualitatively (p = 0.02). For the same accommodative demand, a lower number of cycles was obtained for the adapted flipper condition in comparison with the 4D free-space viewing test (corrected p-value < 0.001, Cohen's d = 0.78). However, this comparison did not reach statisti- cal significance for qualitative measures of accommodative facility (corrected p- value = 0.82, Cohen's d 0.05). Conclusions: These data provide evidence that the qualitative assessment of ac- commodative facility is not influenced by the inherent limitations of the ±2.00 D flipper test. The use of qualitative outcomes by incorporating an open-field au- torefractor allows examiners to increase the validity of the accommodative facility test in both clinical and research settings.

Objectives A variety of factors are known to mediate on the intraocular pressure (IOP) response to resistance training. However, the influence of the body position adopted during resistance training on IOP remain unknown. The objective of this study was to determine the IOP response to the bench press exercise at three levels of intensity when performed in supine and seated positions. Methods Twenty-three physically active healthy young adults (10 men and 13 women) performed 6 sets of 10 repetitions against the 10-RM (repetition maximum) load during the bench press exercise against three levels of intensity (high intensity: 10-RM load; medium intensity: 50% of the 10-RM load; and control: no external load) and while adopting two different body positions (supine and seated). A rebound tonometer was employed to measure IOP in baseline conditions (after 60 s in the corresponding body position), after each of the 10 repetitions, and after 10 s of recovery. Results The body position adopted during the execution of the bench press exercise significantly affected the changes in IOP (p < 0.001, ηp 2 = 0.83), with the seated position providing lower increases in IOP levels compared to the supine position. There was an association between IOP and exercise intensity, with greater IOP values in the more physically demanding conditions (p < 0.001, ηp 2 = 0.80). Conclusions The use of seated positions, instead of supine positions, for the execution of resistance training should be prioritized for maintaining more stable IOP levels. This set of findings incorporates novel insights into the mediating factors on the IOP response to resistance training. In future studies, the inclusion of glaucoma patients would allow to assess the generalizability of these findings., Universidad de Granada/CBUA, Ministry of Science and Innovation, Spain (MICINN) Spanish Government PID2021-127505NA-I00

Purpose: The use of swimming goggles (SG) has demonstrated to alter different ocular parameters, however, the impact of wearing SG on the tear film stability remains unknown. The main objective of this study was to determine the short-term effects of wearing SG on tear film surface quality break-up time (TFSQ-BUT). Methods: Twenty-eight young healthy adults (14 men and 14 women) wore a drilled SG, and TFSQ-BUT was measured before, during and after SG use. Dynamic-area high-speed videokeratoscopy was used for the non-invasive assessment of TFSQ-BUT. Results: TFSQ-BUT was significantly reduced while SG wear in comparison to the baseline measurement (4.8 ± 4.5 s vs. 8.8 ± 6.9 s; corrected p-value = 0.017, d = 0.57, mean difference = 4.0 [0.6, 7.3]; 45% reduction). Immediately after SG removal, TFSQ-BUT rapidly recovered baseline levels (8.2 ± 5.9 s vs. 8.8 ± 6.9 s; corrected p-value = 0.744). The impact of wearing SG on TFSQ-BUT were independent of the gender of the participants (p = 0.934). Conclusion: The use of SG induces a TFSQ-BUT reduction, with these changes returning to baseline levels immediately after SG removal. These data may be of relevance for the management of dry eye patients, who need to avoid circumstances that exacerbate tear film instability. Nevertheless, these results must be interpreted with caution since the experiment did not entirely mimic real-life conditions (e.g., eye cup piece drilled, time of exposure, environmental conditions). Future studies should consider the inclusion of dry eye patients and older individual in order to explore the generalizability of these findings.

Funding Open Access funding provided thanks to the CRUECSIC agreement with Springer Nature. Funding for open access charge: Universidad de Granada / CBUA., Background Acute caffeine ingestion has been associated with improvements in cognitive performance and visual functioning. The main objective of this study was to determine the effects of caffeine intake on dynamic visual acuity (DVA). Methods Twenty-one low caffeine consumers (22.5 +/- 1.6 years) took part in this placebo-controlled, double-blind, and balanced crossover study. In two different days and following a random order, participants ingested either caffeine (4 mg/kg) or placebo, and DVA was measured after 60 min of ingesting the corresponding capsule. A recently developed and validated software (moV& test, V&mp Vision Suite, Waterloo, Canada) was used to assess DVA. Results We found a greater accuracy for both the horizontal and random motion paths of DVA after caffeine ingestion (p < 0.001 and p = 0.002, respectively). In regard to the speed of the response, our data revealed that caffeine intake was associated with a faster reaction time for horizontally (p = 0.012) but not for randomly (p = 0.846) moving targets. Also, participants reported higher levels of perceived activation after consuming caffeine in comparison to placebo (p < 0.001). Conclusions Our data suggest that caffeine intake (i.e., a capsule containing 4 mg/kg) has an ergogenic effect on DVA, which may be of special relevance in real-word contexts that require to accurately and rapidly detect moving targets (e.g., sports, driving, or piloting)., CRUE-CSIC agreement, Springer Nature, Universidad de Granada / CBUA

Several questionable research practices have been detected by the scientific community, with some of them being associated with the actual format of scientific publication. The field of ophthalmology, optometry and vision sciences is not exempt of this problematic. This article has been written to describe the Registered Reports format of scientific publication, which in our opinion, could help to minimize questionable research practices in our field of knowledge. Complementarily, we have collected the opinion of some editors in-chief from journals in the JCR category of Ophthalmology about the presence of questionable research practices and the potential benefits of implementing the Registered Reports format. Overall, most responders (87.5%) agreed that publication bias, cherry picking, p-hacking and HARKing are a considerable problem in the field of ophthalmology, optometry and vision sciences, and it could be (partially) solved by the adoption of the Registered Reports format. Nevertheless, most journals did not have plans to include this publication format in the near future. In our opinion, and as demonstrated in other fields, the adoption of the Registered Reports format may be an effective alternative to minimize questionable research practices and enhance the quality and rigor of the scientific work in the field of ophthalmology, optometry and vision sciences.

Clinical relevance: Caffeine intake has been demonstrated to influence several physiological measures, including some related to eye physiology. The ability to focus at different distances is of paramount importance in real-world situations, and thus, the possible impact of caffeine intake on accommodative facility may have important clinical implications. Background: This placebo-controlled, double-blind, balanced crossover study aimed to assess the acute effects of caffeine ingestion on the frequency and precision of the binocular accommodative facility. Methods: Twenty university students (21.9 ± 3.4 years) ingested a capsule of caffeine (4 mg/kg) or placebo (300 mg of corn-starch) on two different days and counterbalanced order. The binocular accommodative facility was objectively assessed, using the WAM-5500 binocular open-field autorefractometer, after 60 min of capsule ingestion (caffeine/placebo). Perceived levels of activation was also assessed in each experimental condition. Results: The ingestion of a single administration of caffeine (~ 4 mg/kg) causes an increase in the number of cycles performed per minute (p = 0.023, Cohen’s d = 0.55), whereas no effects were observed for the mean magnitude of accommodative change between the far and near targets (p = 0.794), and the percentage of incorrect cycles of accommodation and dis-accommodation (p = 0.271 and 0.396, respectively). Participants reported a perceived level of activation of 6.8 ± 1.5 and 7.6 ± 1.8 in the placebo and caffeine conditions, respectively (p = 0.059). Conclusion: Caffeine intake improves quantitative, but not qualitative, measures of accommodative facility. These results corroborate the impact of caffeine on visual function and suggest that this ergogenic effect of caffeine may be used to enhance visual performance in applied situations.

There is scientific evidence that an individual's beliefs and/or expectations play a role in the behavioural and physiological response to a given treatment. This study aimed to assess whether the dynamics of the accommodative response and stereoacuity are sensitive to experimentally induced placebo and nocebo effects.Nineteen healthy university students performed three experimental sessions (placebo, nocebo and control) in randomised order, with the dynamics of the accommodative response (magnitude and variability), stereoacuity and subjective measures being assessed in all sessions. For the experimental manipulation, participants ingested an inert capsule that was alleged to have positive (white capsule, placebo condition) or negative (yellow capsule, nocebo conditions) effects on the human physiology. In the control condition, participants did not ingest a capsule.The data revealed that the variability of accommodation was sensitive to experimentally induced placebo and nocebo effects, showing a more stable accommodative response for the placebo compared with the nocebo condition (corrected p-value = 0.04, Cohen's d = 0.60). In addition, better stereoacuity was found with the placebo, compared with the nocebo (corrected p-value = 0.01, Cohen's d = 0.69) and control (corrected p-value = 0.03, Cohen's d = 0.59) conditions. Successful experimental manipulation was confirmed by the analysis of subjective perceptions.These findings provide evidence that manipulating expectations about the efficacy of an inert treatment affect the dynamics of the accommodative response (variability of accommodation) and stereoacuity. The results have important applications in both clinical and research outcomes, where individuals´ beliefs/expectations could modulate the visual function.

Low-intensity aerobic exercise is recommended to reduce intraocular pressure (IOP) levels. However, this effect depends on several factors. We found that using an elevation training mask (ETM) during low-intensity aerobic exercise causes an IOP rise.The aim was to assess the influence of wearing an ETM on IOP during low-intensity endurance training.Sixteen physically active young adults (age=23.9±2.9 y) cycled during 30 minutes at 10% of maximal power production with and without an ETM in 2 different days and randomized order. A rebound tonometer was used to measure IOP at baseline, after a warm-up of 5 minutes, during cycling (6, 12, 18, 24, and 30 min), and recovery (5 and 10 min) by rebound tonometry.The use of an ETM significantly affects the IOP behaviour during exercise (P0.001, ηp²=0.66). In the ETM condition, there was an IOP increment during exercise (P0.001, ηp²=0.28) whereas an IOP-lowering effect was observed in the control condition (P0.001, ηp²=0.41). Post hoc comparisons showed that there were greater IOP values during exercise in the ETM condition in comparison to the control condition (average IOP difference=3.7±2.2 mm Hg; corrected P0.01, and the Cohen d's1.10, in all cases).Low-intensity endurance exercise causes an increment in IOP when it is performed wearing an ETM and a decrease in IOP when the air flow is not restricted (control condition). Therefore, the ETM should be discouraged during low-intensity endurance exercise for individuals who need to reduce IOP levels (eg, glaucoma patients or those at risk). However, the external validity of these results needs to be addressed in future studies with the inclusion of glaucoma patients.

Funding for open access charge: Universidad de Granada/CBUA. The authors have no financial or proprietary interest in a product, method or material described herein. The article has not been presented in a meeting., Purpose This study aimed to assess the impact of wearing swimming goggles (SG) on corneal biomechanics. Methods Corneal deformation response, central corneal thickness (CCT), intraocular pressure (IOP) and biomechanically corrected intraocular pressure (bIOP) were measured with the Corvis system (Oculus Optikgeräte GmbH, Wetzlar, Germany) in thirtyone healthy young adults while wearing a drilled SG. All measurements were obtained before, at 30 s, 2 min, 3.5 min and 5 min of wearing SG, just after SG removal and after 2 min of SG removal. Results The corneal biomechanics is sensitive to SG wear, observing lower corneal deformability during SG use. Specifically, wearing SG caused an increase in the time and length of the first applanation and radius curvature at the highest concavity, as well as a decrease and in the velocity of the first applanation and time and deformation amplitude of the second applanation (p < 0.001 in all cases). After SG removal, corneal biomechanical parameters showed a rebound-effect, obtaining a higher corneal deformability in comparison with baseline reading (p-corrected < 0.05 in all cases). Additionally, IOP and bIOP significantly increased while wearing SG (p < 0.001 in both cases), whereas CCT remained stable (p = 0.850). Conclusions Wearing SG modifies the biomechanical properties of the cornea, with reduced corneal deformability during SG wear. The outcomes of this study should be taken into consideration when making clinical decisions in subjects at high risk of developing corneal ectasias or glaucoma, as well as in the post-surgical management of these ocular conditions., Universidad de Granada/CBUA

A military-specific reaction time (RT) test was developed to explore its reliability and sensitivity to discriminate between military personnel and sport science students. Fifteen male professional Spanish soldiers and 16 male sport science students completed two RT test modalities: military-specific and nonspecific RT tests. For each RT test modality, both the Simple (i.e., one stimulus, one response) and the Go, No-Go RT (i.e., true, and false stimuli, one response) were tested. The military-specific RT test consisted of a video presented through virtual reality glasses of a forest environment in which soldiers would appear from behind different bushes (stimuli) and the response consisted of pressing the button of a gun-shaped mouse (when they saw a soldier pointing a rifle at them). Both Simple and Go, No-Go RT reached acceptable reliability in both populations (coefficient of variation ≤ 9.64%). Military personnel presented a lower RT than sport science students during the military-specific RT test (p ≤ .001), while no differences were obtained during the nonspecific RT test. RT values were not significantly correlated between the military-specific and nonspecific RT tests (r ≤ .02). These findings collectively suggest that the novel military-specific RT test is an ecologically valid alternative to evaluate the information processing abilities of military personnel.

Appropriate visual function is paramount to ensuring adequate driving performance and road safety. Here, we examined the influence of sudden artificially-impaired binocular vision on driving performance using a car simulator. Twenty-four young drivers (mean age 22.42

SIGNIFICANCE: The performance of resistance exercise has evidenced to induce abrupt intraocular pressure (IOP) changes, which has been linked to the onset and progression of glaucoma. We found that four different isometric resistance exercises lead to an instantaneous and progressive IOP elevation, with these changes being independent of the type of exercise. PURPOSE: The impact of physical exercise on IOP has demonstrated to be dependent on exercise type and intesity, as well as individuals' characteristics. In this study, we aimed to explore the influence of the load, exercise type, and participant's sex on the IOP behavior during a 2-minute isometric effort. METHODS: Twenty-eight physically active collegiate students performed 2 minutes of isometric exercise in the military press, biceps curl, leg extension, and calf raise exercises against two different loads (high load and low load). Intraocular pressure was measured by rebound tonometry before, during (semicontinuos assessment [24 measurements]), and after 10 seconds of recovery in each of the eight (four exercises × two loads) conditions. RESULTS: We found a statistically significant effect of load (P < .001, np2 = 0.906), with greater IOP values when performing the isometric exercises against heavier loads. There was a positive IOP rise during the execution of isometric exercise in the high-load condition, returning to baseline levels after 10 seconds of passive recovery. The exercise type and participant's sex did not reveal statistically significant differences (P = .33 and P = .56, respectively). CONCLUSIONS: Our data evidenced an instanteneous and progressive IOP rise during the execution of isometric exercise leading to muscular failure, regardless of the exercise type and participant's sex. After exercise, IOP rapidly retuned to baseline levels (within 10 seconds). The inclusion of glaucoma patients in future studies is guarranteed.

PReCIS:: Greater intraocular pressure (IOP) values are observed when reading in the supine position in comparison with the sitting position, and thus, it should be considered by eye care specialists for the management of glaucoma patients or those at risk. PURPOSE IOP is sensitive to near work and body position, however, the influence of the body position adopted while performing near tasks remains unknown. This study aimed to assess the IOP changes induced by reading on a smartphone in sitting and supine position, and to explore whether these IOP changes differ between men and women. METHODS Twenty-four healthy young adults (12 men and 12 women) read a text on a smartphone placed at 30 cm for 25 minutes while lying down and sitting in 2 different days. A rebound tonometer, which allows assessing IOP in the supine position, was used to measure IOP before reading, during reading (5, 15, and 25 min), and after 5 minutes of recovery. Complementarily, the authors checked the level of sleepiness/alertness before reading, and the perceived levels of fatigue and discomfort after reading. RESULTS The data showed that reading induces an IOP rise [P

To evaluate the acute effect of caffeine consumption on the accuracy and variability of accommodation, as well as its impact on pupil size and perceived levels of activation.22 university students (21.68 ± 3.67 years old) ingested a capsule of caffeine (4 mg/kg) or placebo (300 mg of corn-starch) in two different days and counterbalanced order. After 30 min of capsule ingestion, we objectively measured the accuracy and variability of accommodation, and pupil size using the WAM-5500 binocular open-field autorefractometer for 2 min at each of the six viewing distances (5 m, 50 cm, 40 cm, 33 cm, 25 cm, and 20 cm). Subjective levels of activation to check the effectiveness of caffeine/placebo manipulation were also reported.We found that after 30 min of caffeine/placebo ingestion, participant perceived higher levels of activation in the caffeine condition (Our data suggest that caffeine consumption reduced the variability of accommodative response and induced pupil dilation. Nevertheless, the accuracy of accommodation was insensitive to caffeine intake. These findings may be explained by the bidirectional relationship between ocular functioning and the nervous system´s state of activation.

The purpose of the present study was to assess the accommodative response and pupillary dynamics while reading passages with different text-background color combinations on an LCD screen. Twenty healthy young adults read fourteen 2-min passages designed with fourteen different color combinations between text and background, while the accommodative and pupil responses were continuously measured with a binocular open-field autorefractometer. Our results revealed that the text-background color combination modulates the accommodative and pupillary dynamics during a 2-minutes reading task. The blue-red combination induced a heightened accommodative response, whereas positive polarities were associated with more variability of the accommodative response and smaller pupil sizes. Participants reported lower perceived ratings of legibility for text-background color combination with lower luminance contrast (white-yellow). The manipulation of text-background color did not have a significant effect on reading speed. These results may have important applications in the design of digital visual interfaces.

There is some controversy about the utility of prescribing blue-blocking filters to mitigate digital eye strain. We found that using commercially available blue-blocking filters was ineffective in reducing orbicularis oculi muscle activity and visual symptomatology during a 30-min reading task from a computer screen.There are some claims that blue-blocking (B-B) filters may be effective in reducing symptoms and signs of digital eye strain. However, recent studies have suggested that there is no sufficient evidence to support their use. This study assessed the short-term effects of a commercially available, B-B filter on orbicularis oculi (OO) muscle activity and symptoms of digital eye strain during the execution of a 30-min reading tas.Twenty-three healthy young adults (22.9 ± 3.2 years of age) performed two reading tasks from a computer screen with or without a B-B filter on two different days. OO muscle activity was recorded by surface electromyography 4-5, 9-10, 14-15, 19-20, 24-25 and 29-30 min into the trial. Participants reported their perceived levels of visual discomfort and activation before and after completing the reading task.A Bayesian analysis favoured the null hypothesis that there was no change in OO muscle activity with or without using the B-B filter (Bayes Factor01 [BF01] = 7.08). Regarding symptomatology, the analysis favoured the time model that reading increased visual fatigue and discomfort but reduced activation levels (BF01 0.33 in all cases). However, our data did not support the alternative model that using B-B filter affected these visual symptoms.The B-B filter did not alter OO muscle activity or visual symptomatology significantly during the execution of a 30-min reading task in asymptomatic subjects. These findings support the idea that B-B filters do not attenuate signs and symptoms of digital eye strain.

Introduction: Dual-focus soft contact lenses for myopia management have demonstrated to be an effective strategy to reduce myopia progression. However, this optical design has been shown to alter visual quality and accommodative function. The aim of this study was to examine the accommodative and behavioural performance during the execution of a psychomotor vigilance task (PVT) while wearing dual-focus and single-vision soft contact lenses. Methods: The steady-state accommodative response was recorded with the WAM-5500 binocular open-field autorefractor during the execution of a 10-min PVT at 50 cm either with the dual-focus (MiSight 1-day) or single-vision (Proclear 1-day) soft contact lenses, using a sample of 23 healthy young adults. Each experimental session was performed on two different days in a counterbalanced order. Results: A greater lag of accommodation, variability of accommodation and reaction time was found while wearing dual-focus in comparison with single-vision soft contact lenses (mean differences during the 10-min PVT were 0.58 ± 0.81 D, p < 0.001; 0.31 ± 0.17 D, p < 0.001 and 15.22 ± 20.93 ms, p = 0.002, respectively). Also, a time-on- task effect was found for the variability of accommodation and reaction time (p = 0.001 and p < 0.001, respectively), observing higher values over time. However, the lag of accommodation did not change significantly as a function of time-on- task (p = 0.33). Conclusion: Dual-focus soft contact lens wear influences the steady-state accommodative response and behavioural performance during the execution of a visual vigilance task in the short-term. Eye care practitioners should be aware of these effects when prescribing these lenses for myopia management, and provide specific recommendations according to the individual visual needs.

Clinical relevance: The use of face masks has demonstrated to be an effective strategy to prevent transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Wearing face masks, mainly Filtering Face Piece 2 (FFP2) masks, during exercise practice has demonstrated to affect several physiological measures. Background: This study was aimed at assessing the intraocular pressure (IOP) behaviour during the execution of the dynamic and isometric biceps-curl exercise with a surgical and FFP2 face mask. Methods: Twenty two physically active young adults performed sets of 10 repetitions against the 10-RM (repetition maximum) load and 1-minute isometric effort against a load 15% lower than the 10-RM load with the FFP2 and surgical mask and without any mask. A total of six exercise sets (3 experimental conditions [FFP2, surgical and control] × 2 exercise modalities) were performed. A rebound tonometer was used to measure IOP before, during (10 measurements), and after (30-seconds of passive recovery) each training set. Results: At rest, there were not statistically significant IOP differences (p = 0.222). During dynamic exercise, there was a progressive IOP rise (p < 0.001), and a higher IOP response with the FFP2 than without the mask (corrected p-value = 0.003). For the isometric exercise, there was a greater IOP response as a function of accumulated effort (p < 0.001), which was dependent of the face mask used (FFP2> surgical>control; corrected p-values< 0.01). Conclusions: The FFP2 masks cause a heightened IOP response during the execution of dynamic and isometric biceps-curl exercise, suggesting that, when possible, glaucoma patients should limit the use of FFP2 masks during resistance training.

Purpose: Recent technological advances have permitted to objectively record the accommodative response while shifting between two different levels of accommodation. This study is aimed at examining the concurrent validity of a new objective method for the qualitative and quantitative assessment of binocular accommodative facility, which is named 2Q-AF test, in comparison to the ±2.00 DS lens flippers. Methods: Fifty-six individuals took part in this study (36 healthy young adults [24.4 ± 3.2 years] and 20 children [12.2 ± 0.4 years]). Participants randomly performed the 2Q-AF and the ±2.00 DS lens flipper tests. For the 2Q-AF test, a binocular open-field autorefractor was used to record the magnitude of accommodative response during a 60-sec period, while participants repeatedly changed fixation from a 5 m to a 40 cm chart when clarity of vision was achieved at each level. Due to the advantages of the proposed method, we have determined the number of cycles and the 2Q-AF score, with the latter also considering the accuracy of changes in accommodation. A standard procedure was followed for the ±2.00 DS flipper test. Results: Our data exhibited a moderate association between the number of cycles with the ±2.00 DS lens flippers and the number of cycles in the 2Q-AF test in the group of young adults (p = .005, r = 0.46 [0.15–0.68]) and children (p = .007, r = 0.58 [0.19–0.81]), whereas a stronger relationship was observed when considering the number of cycles with the ±2.00 DS lens flippers and the 2Q-AF score (young adults: p < .001, r = 0.83 [0.69–0.91]; and children: p < .001, r = 0.78 [0.52–0.91]). Conclusions: The current findings show that the 2Q-AF test is a valid method for accommodative facility assessment, as suggested by its good levels of reliability and validity. This method allows to examine the accommodative facility in qualitative terms and solve most of the limitations associated with the ±2.00 DS lens flipper test.

Clinical Relevance Background: Steady-state accommodation is frequently evaluated with open-field autorefractors; however there is no consensus regarding the optimal test duration. Our results allow us to standardise the procedure followed for the assessment of the steady-state accommodative response in clinical and laboratory settings and may be of great relevance in time-constrained situations. BACKGROUND The present study aims to determine the optimal recording time to assess the magnitude and variability of the accommodative response with a binocular open-field autorefractor. METHODS The steady-state accommodative response of 84 healthy undergraduate students was dynamically measured using the Grand Seiko WAM-5500 autorefractor at 500 cm, 40 cm and 20 cm for 90 s while participants maintained focus on a stationary target. We examined the reliability and level of agreement between four time intervals (the first 10-s, 30-s, 60-s and 90-s) at three accommodative demands (0.2D, 2.5D and 5D). RESULTS The magnitude of accommodation showed an excellent level of reliability (intraclass correlation coefficient [ICC]> 0.90) for the comparisons between the 90-s, 60-s and 30-s time intervals at the three viewing distances tested. However, when including the 10-s interval, there was a moderate reduction of the reliability indices and an increase of the mean difference between two time intervals (intra-class correlation [ICC] ranging from 0.89 to 0.97; and ESs ranging from 0.16 to 0.42). For the variability of accommodation, we observed an excellent reliability for the comparisons of the 90-s and 60-s measures at the three accommodative demands (ICC: 0.95-0.96), whereas for the rest of comparisons we observed from moderate to good levels of reliability. CONCLUSION Our data indicate that of 30-s and 60-s are enough to accurately assess the magnitude and variability of the accommodative response with the WAM-5500 autorefractor, respectively.

Ocular physiology is sensitive to cognitively demanding tasks. However, it is unknown whether the intraocular pressure is also affected by the cognitive demands of military operations. The main objective was to determine the impact of a virtual reality shooting simulation with two levels of complexity on intraocular pressure levels in military personnel. Eighteen active-duty members of the Spanish Army and eighteen civilians performed two 4 min simulated shooting tasks with two levels of complexity using a virtual reality. In the “easy” task participants performed a simulated shoot when the stimulus (military with a rifle) appeared, while in the “difficult” task the stimulus randomly was a military with a rifle or with his hands on the air and participants were instructed to respond only when the military with a rifle appeared. Intraocular pressure was measured with a rebound tonometer before and immediately after each task. Complementarily, perceived levels of mental load and shooting performance (reaction time) were assessed. Intraocular pressure was greater after completing the more complex task in both military personnel (p-value < 0.01, Cohen´s d = 1.19) and civilians (p-value < 0.01, Cohen´s d = 1.16). Also, perceived levels of task load and reaction time were higher in the difficult compared to the easy shooting tasks (both p < 0.001). The rise in intraocular pressure is positively associated with the cognitive demands of simulated military operations. The potential application of this finding is the development of objective tools based on intraocular pressure for the evaluation of the mental state in real-world contexts, permitting to improve soldiers´safety and performance., CEMIX (Centro Mixto UGR-MADOC, Army of Spain) 5/4/20 TR-COMBATE

Technology is ubiquitous in the educational field nowadays. Augmented Reality is one of the emerging technologies with more potential in educational contexts in the mid-term. The purpose of this study is to evaluate if the use of Augmented Reality in early childhood education improves the learning of English as a foreign language, increases pupils’ motivation and helps children at this age to establish more positive socio-affective relationships. A quasi-experimental study with an experimental and a control group was carried out with 52 and 50 early childhood education pupils, respectively. The results show a significant improvement in motivation, learning and socio-affective relationships in the experimental group, who completed instruction where AR was employed as a teaching tool, in comparison with the control group.

This study evaluated the time-on-task effect of a sustained attention task on the accommodative response, explored the link between ocular accommodation, cardiac autonomic regulation and behavioral performance, and tested the inter-session repeatability of these results by performing the same experimental procedure on different days. The accommodative response was measured in 25 university students using a WAM-5500 autorefractor, while participants performed a 10-minute psychomotor vigilance task at 50 cm. There were no time-on-task effects for the lag of accommodation, whereas the microfluctuations of accommodation and reaction time were modulated as a function of time-on-task, observing a progressive increment of both variables over time. Multiple regression analysis revealed that the microfluctuations of accommodation were a reasonably good predictor of behavioral performance. Analysis of inter-session repeatability showed that ocular accommodation, heart rate variability and reaction time had a low to moderate level of repeatability between two measurements. The microfluctuations of accommodation were sensitive to time-on-task effects during sustained attention, with a lower stability of accommodation being linked to reduced behavioral performance. The predictive capacity of the variability of accommodation for behavioral performance might be explained by the brain mechanisms shared by the ocular dynamics and attentional state; however, future studies would be required to elucidate this association. The low to moderate inter-session repeatability indicated that results in two measurement periods cannot be considered interchangeable, and therefore, the results of this study should be interpreted cautiously in this regard.

SIGNIFICANCE The present study addresses the accommodative response and its dependence on the type of optical correction used. The results are discussed relative to their possible implications for myopia progression and visual fatigue. PURPOSE The accommodative response has been investigated owing to its possible relationship with the onset and progression of myopia and visual fatigue. This study explored the influence of wearing soft contact lenses in comparison with spectacles in terms of magnitude and variability of accommodation. In addition, we analyzed the intersession and intermethod repeatability. METHODS Dynamic accommodative response was recorded during 30-second epochs, at five different distances (50, 40, 33, 25, and 20 cm), in 21 individuals (mean refractive error ± SD, -0.79 ± 1.39 D) while wearing either soft contact lenses or spectacles on two different days. To assess repeatability, a second identical intervention was conducted. RESULTS Higher lags of accommodation were obtained with the use of soft contact lenses in comparison with the spectacle condition (P =.04, partial η 2 [η p 2] = 0.204), and similarly, a higher variability of accommodation at near distances was found during the soft contact lens measurement (P

The present study aimed (1) to examine the impact of two high-intensity interval training (HIIT) protocols differing in exercise intensity (low intensity and high intensity) on the dynamic accommodative response (AR), and (2) to elucidate whether the ocular accommodation changes are associated with the function of the autonomic nervous system during stimulus processing, as measured by the heart rate variability (HRV).Twenty physically active university students (9 women; age = 23.9 ± 3.3 years) were tested on three separate sessions. The lag of accommodation and the root mean square of successive R-R interval differences (RMSSD) parameter of HRV were obtained at the beginning and at the end of each testing session, while one of the following protocols was applied in a randomized order between the measurements, low-intensity HIIT (8 sprints with 60 s of rest), high-intensity HIIT (8 sprints with 30 s of rest), and Control (walking for 8 min).Our data demonstrated a higher lag of accommodation after the high-intensity HIIT compared to the low-intensity HIIT (p = 0.006, d = 0.798) and control (p = 0.007, d = 0.741), but no significant differences were observed between the low-intensity HIIT protocol and control condition (p = 0.598, d = 0.12). As expected, lower HRV values were observed with higher exercise intensity, but the changes of AR and HRV were not significantly correlated (p 0.05 in all cases).The present findings indicate that the acute effects of exercise on ocular accommodation depend on exercise intensity, showing that highly demanding physical effort induces a greater lag of accommodation, which may be of relevance when performing near activities after physical efforts.

Objective: To assess the impact of using dual-focus soft contact lenses for myopia control on the dynamics of the accommodative response and facility. Methods: 24 young adult myopes were fitted with dual-focus soft contact lenses for myopia control (MiSight®) and single-vision soft contact lenses (Proclear®). The WAM-5500 open-field autorefractor was used to measure the dynamics of the accommodative response (magnitude and variability) in binocular conditions, with accommodative data being gathered from the dominant eye, at three viewing distances (500 cm, 40 cm, and 20 cm) during 90 s. Also, the binocular accommodative facility was assessed with the WAM-5500 autorefractor. All participants performed the same experimental protocol with the dual-focus (MiSight) and single-vision (Proclear) soft contact lenses, with both experimental sessions being carried in two different days and following a counterbalanced order. Results: This study showed greater lags of accommodation with the MiSight than the Proclear lenses at near distances (40 cm: 1.27 ± 0.77 vs. 0.68 ± 0.37 D, corrected p-value = 0.002, Cohen-d = 0.90; and 20 cm: 1.47 ± 0.84 vs. 1.01 ± 0.52 D, corrected p-value = 0.007, Cohen-d = 0.75), whereas a higher variability of accommodation was observed with the dual-focus than the single-vision lenses at 500 cm (0.53 ± 0.11 vs. 0.23 ± 0.10 D), 40 cm (0.82 ± 0.31 vs. 0.68 ± 0.37 D), and 20 cm (1.50 ± 0.56 vs. 1.15 ± 0.39 D) (corrected p-value < 0.001 in all cases, and Cohen-ds = 0.67–2.33). Also, a worse quantitative (27.75 ± 8.79 vs. 34.29 ± 10.08 cycles per minute, p = 0.029, Cohen-d = 0.48) and qualitative (23.68 ± 7.12 vs. 28.43 ± 7.97 score, p = 0.039, Cohen-d = 0.45) performance was observed with the MiSight when compared to the Proclear lenses. Conclusions: The use of dual-focus soft contact lenses for myopia control alters the dynamics of accommodative response and facility in the short-term. Although this optical design has demonstrated its effectiveness for myopia control, eye care specialists should be aware of the acute effects of these lenses on accommodation performance.

The present study was aimed at assessing the impact of manipulating the attentional load using a multiple object tracking (MOT) task on the dynamics of the accommodative response in children with attention deficit hyperactivity disorder (ADHD). The pupil size was recorded to assess the effectiveness of the experimental manipulation, and the role of ADHD medication was also explored. The accommodative and pupil dynamics (magnitude and variability) were monitored with an open-field autorefractometer (WAM-5500) in 41 children with ADHD (24 non-medicated and 17 medicated) and 21 non-ADHD controls, while they performed the MOT task with four different levels of complexity (i.e., tracking zero, one, two, or three targets). We found that increasing the attentional load caused a heightened accommodative response, showing a negative association between MOT complexity and accommodative lag in children with ADHD and non-ADHD controls. Complementarily, the pupil size increased as a function of task complexity, confirming a successful experimental manipulation. The stability of accommodation was insensitive to the attentional manipulation, but it differed between groups. Specifically, non-medicated children with ADHD exhibited a greater variability of accommodation in comparison to controls. Increasing the attentional load is associated with a reduction in the accommodative lag in children with ADHD and controls. Our findings show that the allocation of attention plays an important role in the dynamics of the accommodative response, which may be of relevance in the diagnosis and treatment of accommodative deficits in children with and without ADHD.

Purpose The use of face mask is globally recommended as a preventive measure against COVID-19. However, the intraocular pressure (IOP) changes caused by face masks remain unknown. The objective of this study was to assess the impact of wearing surgical and FFP2/N95 face masks during a 400-m walking protocol on IOP in primary open-angle glaucoma (POAG) patients. Methods Thirteen subjects diagnosed of POAG (21 eyes) were enrolled in this study. IOP was measured at baseline, during the 400-m walking protocol and after 5 min of passive recovery while POAG patients wore a surgical mask, FFP2/N95 mask and no mask in randomized order. From the 21 POAG eyes, we analyzed the IOP changes caused by physical exercise with two face masks and without wearing any face mask. Results At rest (baseline and recovery measurements), the use of the different face masks did not affect IOP levels (mean differences ranging from 0.1 to 0.6 mmHg). During physical activity, wearing an FFP2/N95 mask caused a small (mean differences ranging from 1 to 2 mmHg), but statistically significant, IOP rise in comparison to both the surgical mask and control conditions (Cohen’s d = 0.63 and 0.83, respectively). Conclusion Face masks must be used to minimize the risk of SARS-CoV-2 transmission, and POAG patients can safely use FFP2/N95 and surgical masks at rest. However, due to the IOP rise observed while walking with the FFP2/N95 mask, when possible, POAG patients should prioritized the use of surgical masks during physical activity.

We assessed the mediating role of the breathing pattern adopted during isometric exercise on the intraocular pressure (IOP) response in the back squat and biceps curl exercises. Twenty physically active young adults performed sets of 1-minute isometric effort against a load corresponding to 80% of the maximum load while adopting three different breathing patterns: (i) Constant breathing: 10 cycles consisting of 3 s of inhalation and 3 s of exhalation, (ii) 10-sec Valsalva: 3 cycles consisting of 10 s holding the breath and 10 s of normal breathing, and (iii) 25-sec Valsalva: 2 cycles consisting of 25 s of the Valsalva maneuver and 5 s of normal breathing. A rebound tonometer was used to semi-continuously assesses IOP during the six sets of 1-minute isometric effort (2 exercises × 3 breathing patterns). We found a progressive IOP rise during isometric effort (P 10-sec Valsalva = constant breathing). There was a trend towards higher IOP values for the back squat in comparison to the biceps curl, although these differences did not reach statistical significance for any breathing pattern (corrected P-value ≥ 0.146, d ≤ 0.69). These findings reveal that glaucoma patients or those at risk should avoid activities in which the breath is held, especially when combined with physical exercise modalities that also promote an increment in IOP values (e.g. isometric contractions).

The authors thank Ernesto Suarez and David Nesbitt for translating the text into English. We also acknowledge all the participants who selflessly participated in this study. The study was funded in part by a Spanish Ministry of Economy and Competitiveness grant #DEP2013-48211-R., Background Athletes tend to have better visuo-motor performance than do sedentary individuals. However, several basic visual-function and perceptual parameters remain unexplored to date. In this study, we investigated whether differences exist in visual function, performance, and processing between basketball players and individuals without a sport-involvement background. Methods A total of 33 healthy men with no visual impairment or pathology were divided into 2 groups, depending on the involvement in sport (semi-professional basketball players and sedentary individuals). We tested their baseline heart-rate variability in the resting position apart from subjective questionnaires to determine their physical fitness level, and we checked their visual function, performance, and processing through an extended battery of optometric tests. Results The 2 groups differed in resting heart-rate variability parameters (p < 0.001), confirming their dissimilarities in regular time practising sports per week. The basketball players showed a closer breakpoint and recovery nearpoint of convergence, a higher fusional-vergence rate, better discriminability halos, and better eye–hand coordination (all p values < 0.05). Conclusion These results show evidence that athletes, basketball players in this case, exhibit better performance in several visual abilities in comparison to a group of individuals without sporting backgrounds, suggesting an improvement due to the systematic involvement of those skills during basketball practice., Spanish Ministry of Economy and Competitiveness DEP2013-48211-R

To assess the mediating role of strength levels, hand dominance and participants´ sex on the intraocular pressure (IOP) behaviour during the execution of a maximal isometric handgrip test.One hundred and seventy-six sport science students (102 men and 74 women) performed a maximal isometric handgrip test with the dominant and non-dominant hands. A rebound tonometer was used to measure IOP before effort, during effort, and immediately after performing the handgrip test. Men and women were divided based on their handgrip strength in low- and high-strength groups using a median split analysis.There was an acute IOP rise during effort, returning to baseline levels immediately after exercise cessation (The IOP rise associated with a maximal isometric handgrip effort is affected by the participants´ sex (menwomen) and hand dominance (dominant handnon-dominant hand), but not on strength levels. These findings need to be corroborated in glaucoma patients.

Background and Aims Secondary Hyperparathyroidism (SHPT) is a complication of chronic kidney disease (CKD). Etelcalcetide is the first intravenous calcimimetic authorized for the treatment of SHPT in haemodialysis (HD). It has proven to be effective in lowering parathyroid hormone (PTH), with an acceptable and comparable safety profile. The aim of this descriptive study was to evaluate the results of using etelcalcetide in patients on HD with SHPT. Method Thirty patients on HD received etelcalcetide were enrolled (figure 1). The minimum observation period was 6 months. Fifteen (50%) were previously with cinacalcet (group 1) and 15 (50%) received etelcalcetide at onset (group 2). We analyzed change of serum iPTH, calcium (Ca) and phosphorus (P) in both cohorts; as well as the dosage of calcium carbonate, non-calcium (phosphate binders) and / or vitamin D analogs. The presence of adverse effects were also recorded. Results Thirty patients on HD received etelcalcetide were enrolled (figure 1). The minimum observation period was 6 months. Fifteen (50%) were previously with cinacalcet (group 1) and 15 (50%) received etelcalcetide at onset (group 2). We analyzed change of serum iPTH, calcium (Ca) and phosphorus (P) in both cohorts; as well as the dosage of calcium carbonate, non-calcium (phosphate binders) and / or vitamin D analogs. The presence of adverse effects were also recorded. In global, serum iPTH levels were significantly decreased during therapy compared to baseline levels. When comparing both groups, we found a significant decrease of Ca, P and iPTH in group 2. However, we only found significant decrease of Ca in group 1 (figure 2). When we analyzed the reducton of PTH >30% in both groups, we observed that 46.6% of patients treated with etecalcetide compared to 33.3% of patients treated with cinacalcet, achieved this reduction in PTH. The dosage of calcium binders (33.3% pretreatment vs 56.7% at the end of follow-up, p 0.054), non-calcium binders (40% pretreatment vs 63.3% at the end of follow-up, p 0.02) and vitamin D analogues (56,7% pretreatment vs 66,7% at the end of follow-up, p 0,3) were increased when etelcalcetide treatment was started. No changes were made in dialysate calcium concentration. Six patients, presented hypocalcemia (Ca < 7.5 mEq/l). Conclusion In our cohort, etelcalcetide has shown to be effective in reducing serum iPTH. In addition, etecalcetide was noninferior to cinacalcet reducing PTH>30%. An increase in the use of vitamin D analogues, calcium binders and non-calcium binders has been observed, probably due to the hypocalcemia.

Background and Aims Vascular endothelial growth factor inhibitors (anti-VEGF) have been shown to be effective in the treatment of macular degeneration and diabetic macular edema. It is known that systemic administration of these drugs can produce adverse renal effects, such as decreased glomerular filtration rate (eFGR), proteinuria, hypertension or thrombotic microangiopathy. However, there is little information about it when the administration is intravitreal. The aim of this study was analyzed the effect of anti-VEGF drugs on renal function and proteinuria. Method Observational and prospective study on diabetic patients, which were divided into two groups: non-cronic kidney disease (CKD) (group 1) and CKD (group 2). We analyzed clinical and analytical variables during follow-up. Results We included 45 diabetic patients (55.6% males) with a median age of 75 (50-91) years. Forty one patients (91.1%) were hypertensive and thirty three (73.3%) were CKD patients. Twenty six (57.8%) received bevazicumab, while the rest (42.2%) received ranibizumab, with a median dose of 6 (1-22). The median follow-up was 25 (9-94) months. The evolution of eFGR and albuminuria are described in Figure 1, where it stands out the increase in albuminuria in group 2. Regarding the drug type, there were no differences. Within the CKD group, one patient presented two episodes of decompensation of heart failure after the administration of an anti-VEGF drug, and two required the initiation of renal replacement therapy. Conclusion Based on the results of our cohort, we believe that it would be advisable to establish a closer monitoring in diabetic patients who are administered an intravitreal anti-VEGF drug, with determination of renal function as well as albuminuria to establish an early diagnosis of possible complications.

Introduction The prescription of blue-blocking (B-B) filters for the management of visual symptoms and signs associated with the use of electronic devices is routinely performed by eye care specialists. However, the utility of B-B filters is a matter of debate and discussion by the scientific community due to the lack of evidence supporting their use. Here, we aimed to determine the effects of using B-B filters on the dynamics of the accommodative response and pupil size and perceived levels of visual discomfort, while performing a 30-min reading task at a close distance in subjects who routinely use electronic devices. Methods Nineteen healthy young adults (22.0 ± 2.7 years) read two 30-min passages on a computer screen placed at 50 cm, either while using a commercially available B-B filter or without any filter on two different days. The magnitude and variability of both the accommodative response and pupil size were dynamically measured for 60 s using the WAM-5500 open field autorefractometer at 4-5, 9-10, 14-15, 19-20, 24-25, and 29-30 min into the trial. The perceived levels of visual discomfort were also obtained. Results The lag and variability of accommodation were insensitive to the blue light level (p = 0.34 and 0.62, respectively). There was a time-on-task effect for the variability of accommodation, showing greater instability over time regardless of the blue light level. The use of the B-B filter was associated with improved reading speed (p = 0.02), with an increase of 16.5 words per minute. However, it was not associated with any significant change in pupil dynamics or the perceived levels of visual discomfort (p> 0.05 in both cases). Conclusions Our data showed that the use of a B-B filter had no effect on accommodative dynamics or visual symptomatology. Based on these findings, there is no support for the prescription of B-B filters to attenuate the visual symptoms and signs associated with the use of electronic devices in healthy young adults.

Significance Attention-deficit/hyperactivity disorder (ADHD) is characterized by oculomotor abnormalities. However, the eye movement pattern of children with ADHD during reading has yet to be fully determined. This investigation provides novel insights into the altered eye movement pattern during oral reading of nonmedicated children with pure ADHD in comparison with age-matched controls. Purpose The purpose of this study was to objectively compare the eye movement pattern during oral reading in a group of nonmedicated children with pure ADHD and an age-matched control group. Methods Forty-one children, 21 children with pure ADHD (9.3 ± 2.2 years, 15 boys) and 20 control children (9.3 ± 2.5 years, 10 boys), orally read a standardized text according to their age while the eye movement pattern was objectively recorded using the Visagraph Eye Movement recording system. Results The Bayesian statistical analyses revealed that children with ADHD exhibited a significantly higher number of fixations (Bayes factor 10 [BF10] = 3.39), regressions (BF10 = 9.97), saccades in return sweeps (BF10 = 4.63), and anomalies of fixations and regressions (BF10 = 3.66) compared with controls. In addition, children with ADHD significantly showed longer reading times (BF10 = 31.29), as well as lower reading rate (BF10 = 156.74) and grade-level equivalent (BF10 = 168.24) in comparison with controls. Conclusions Our data showed that the nonmedicated children with pure ADHD have an altered eye movement pattern during oral reading when compared with controls, which cannot be attributable to any comorbid condition. The present outcomes may help to understand the link between ADHD and reading performance and design the most pertinent strategies to enhance the reading skills of this population.

Significance The use of blood flow restriction allows obtaining beneficial physical adaptions when combined with low-intensity exercise or even when used alone. We found that using blood flow restriction may be a potential strategy to avoid IOP and ocular perfusion pressure fluctuations provoked by strength and endurance training. Purpose The purpose of this study was to assess the influence of bilateral blood flow restriction in the upper and lower body at two different intensities on IOP and ocular perfusion pressure, as well as the possible sex differences. Methods Twenty-eight physically active university students (14 men and 14 women) took part in the study, and blood flow restriction was bilaterally applied with two pressures in the legs and arms. There were five experimental conditions (control, legs-high, legs-low, arms-high, and arms-low). IOP was measured by rebound tonometry before, during (every 4 seconds), and immediately after blood flow restriction. Ocular perfusion pressure was measured before and after blood flow restriction. Results We found that only the arms-high condition promoted a statistically significant IOP rise when compared with the rest of the experimental conditions (all Bayes factors10, >100; effect sizes, 1.18, 1.06, 1.35, and 1.73 for the control, arms-low, legs-high, and legs-low conditions, respectively). For ocular perfusion pressure, there was strong evidence for the null hypothesis regarding the type of blood flow restriction (Bayes factor10, 0.012); however, men showed an ocular perfusion pressure reduction after blood flow restriction in the arms-high condition (Bayes factor10, 203.24; effect size, 1.41). Conclusions This study presents preliminary evidence regarding the safety of blood flow restriction in terms of ocular health. Blood flow restriction may be considered as an alternative training strategy to reduce abrupt fluctuations in IOP and ocular perfusion pressure because its use permits a considerable reduction of exercise intensity.

To determine the intraocular pressure (IOP) changes caused by the execution of lower body and upper body resistance training exercises leading to muscular failure depending on the exercise phase (concentric vs. eccentric). We also assessed the influence of the exercise type (back squat vs. biceps curl) and level of effort on the IOP response.Nineteen physically active young adults performed four sets (2 exercise type × 2 exercise phase) of 10 repetitions leading to muscular failure while adopting a normal breathing pattern. IOP was measured by rebound tonometry at baseline, after each of the ten repetitions, and after 1 min of recovery.There was a main effect of the exercise phase (p0.001, ηIOP fluctuates during the different phases of the repetition in dynamic resistance training exercises, being greater IOP values observed during the more physically demanding phases of the exercise (eccentric phase of the back squat and concentric phase of the biceps curl). A heightened IOP response is positively associated with muscle size (back squatbiceps curl) and with the level of effort (number of accumulated repetitions). Based on these findings, highly demanding dynamic resistance training should be avoided when maintaining stable IOP levels is desirable.

Purpose: Assessing binocular accommodative facility (BAF) enables the evaluation of the interaction between the accommodative and vergence systems, which is relevant for the diagnosis of accommodative and binocular disorders. However, the tests used to assess BAF present methodological caveats (e.g., lack of objective control, vergence demands, and image size alterations), limiting its external validity. This study aimed to (i) develop a new objective method to quantitatively and qualitatively evaluate the BAF in free-viewing conditions, and explore its validity by the comparison with the Hart Chart test, and (ii) assess the inter-session reliability of the proposed method. Methods: 33 healthy young adults took part in this study. We used a binocular open-field autorefractor to continuously assess the magnitude of accommodative response during a 60-sec period, while participants repeatedly changed fixation from a far to a near chart when clarity of vision was achieved at each level. Accommodative response data were used to characterize the BAF measurement in quantitative (number of cycles) and qualitative terms (percentage of times that correctly accommodating or dis-accommodating in each level of accommodation as well as the magnitude of the accommodative change). Results: Our data revealed that the new proposed method accurately counted the number of cycles per minute when compared with the Hart Chart test (p = .23, ES = 0.02; mean difference = 0.18 ± 0.85). The inter-session reliability of the proposed method was demonstrated to be excellent (Pearson r and intraclass correlation coefficient: 0.95 to 0.98) for the parameters obtained with the BAF test. Conclusions: The present outcomes evidence that the proposed objective method allows to accurately assess the frequency and precision of BAF by the combination of the classical Hart Chart test and a binocular open-field autorefractometer. Our findings may be of relevance for the diagnosis and treatment of accommodative and binocular disorders.