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Purpose: Traditional normative values of binocular vision, known as Morgan’s & Scheiman’s and Optometry Extension Program(OEP) expected findings, have been used since long in clinical optometry. However, with technological advances, visual habits and visual demands have changed. Therefore, clinical assessment could examine the applicability of the established criteria in Taiwan. Methods: Participants aged 15–24 years were recruited from three universities and colleges. After completing the Visual Behavioral Performance questionnaire with four components: near work, visual perception, visual comfort and balance of body, participants were separated into symptomatic or asymptomatic groups based on the results of the questionnaire survey. A 24-step binocular visual examination was undertaken. Data were analyzed with the one-sample t-test and an ROC curve to compare and establish normative values for Taiwanese young adults.Results: Among the 308 healthy Taiwanese young adults, the prevalence of accommodation or vergence anomalies was 15% (46 participants). The commonest dysfunctions in this study were accommodative excess and convergence excess. Most of the binocular visual functions in this study showed significant difference from the traditional normative values: amplitude of accommodation, base-in prism to break and recovery points at distance were better than the traditional normative values, whereas others were worse. In addition, different visual tasks require different binocular visual functions, and the ROC curve was used to analyze the normative values of binocular visual functions required for near work, visual perception, visual comfort, and body balance.Conclusion and Discussion: The mean values of binocular visual function in Taiwanese young adults were worse than that in the traditional normative values. With changing times, racial differences, and more tasks for visual needs, it is essential to establish binocular visual normative values for Taiwanese young adults.

Purpose: The transition of Taiwan from an aging to a super-aging society has come with a cost as more elderly now suffer from cognitive impairment. The main purpose of our study was to investigate if early detection can be developed so that timely intervention can be instituted. We analyzed the correlation of cognitive function with ocular physiology and visual functions between senior citizens aged 60 years or older in Taiwan. Methods: Thirty-six healthy subjects were recruited for the study. Addenbrooke’s cognitive examination III (ACE-III), binocular functions (including objective and subjective refraction, distance and near dissociated phoria, stereopsis, contrast sensitivity, adult developmental eye movement (ADEM), and ocular physiology (by using optical coherence tomography, OCT, and macular pigment measurement, MPS) were performed, and the data were analyzed via independent t-test, chi-square test, Pearson correlation, linear regression, and ROC (receiver operating characteristic) curve. Results: Data analysis showed that (1) patients with poor eye movement had a strong correlation with the total score and all dimensions of cognitive functions, (2) the thickness of the macula had a strong correlation with attention and memory, and (3) patients with poor eye movement and poor stereopsis in combination with thinner inferior macula appeared to have lower cognitive abilities. Discussion and Conclusions: Cognitive dysfunction is not readily identified during the early stage of cognitive decline. The use of simple and inexpensive ADEM or stereopsis test and comparing the OCT results that are popular in optometry clinics for reference can be diagnostic in identifying patients with mild cognitive impairments. With the combined use of macular pigment density or retinal thickness measurements, it was possible to effectively predict the early degradation of cognition.

Purpose: With the benefits of advanced medical technology, Taiwan has gradually changed from an aged society to a super-aged society. According to previous studies, the prevalence rate of mild cognitive impairment (MCI) over the age of 60 is 15% to 20%. Therefore, the main purpose of our study was to analyze the correlation of cognitive function with visual function (specifically, binocular vision and visual perception) in Taiwanese volunteers aged 60 years or older. Methods: Thirty-six healthy participants who were not taking psychiatric medications and who had not been diagnosed with any retinal or optic nerve diseases were enrolled. Addenbrooke’s cognitive examination III (ACE-III), binocular visual function, and visual perception evaluation were performed, and the data analyzed statistically by t-test, χ2, linear regression, and MANOVA. Results: Cognitive function was closely correlated with visual function and visual perception; the horizontal adjustment time of binocular eye movement, stereopsis, the motor-free visual perception test-4 (MVPT-4), and peripheral awareness actually displayed higher explanatory power in predicting cognitive function. In addition, various interactive parameters between visual function and visual perception were found to affect specific aspects of ACE-III. Discussion: Our study revealed that there was a close correlation of cognitive function with visual function; as such, it may be possible to predict visual function deficits in patients with mild cognitive impairment.

Purpose To investigate factors that may contribute to the myopization of urban elementary school students in Taiwan. Methods Grades 1 to 6 students of the same racial background (n = 1894; mean age, 6.3-11.3 years) in three schools, located in Tamsui, Taichung, and Tainan, were refracted to obtain the best corrected visual acuity. The refractive power needed for best corrected visual acuity was used for subsequent statistical analysis. On behalf of their children, parents also completed a questionnaire on six categories of potential myopization variables. Correlation between these variables and the increase or decrease in the refractive error was assessed. The predictive value of each variable was also calculated based on linear regression analysis. Results The overall mean refractive error in grades 1 to 6 was -0.37, -0.68, -1.33, -1.60, -1.90, and -2.51 D, respectively. The prevalence of myopia (-1.00 D or more minus) showed a significant difference between grades 2 and 3 and, again, between grades 5 and 6. In addition, 20 potential modulating factors were evaluated; 65.9% of the change in the refractive error could be explained by four: (1) lag in optimal correction, defined as a -1.00-D deficit between new refractive error and current optical correction; (2) outdoor spectacle wear; (3) spectacles for different working distances; and (4) hours spent on reading and writing on weekdays. In contrast, outdoor time and the intake frequency of 36 food items both held very low predictive values of 0.2% and 2.5%, respectively. Conclusions Each variable associated with the refractive error has a different predictive value, either positive or negative. Ultimately, the interplay of these variables decides the outcome of the pattern and the degree of school myopia.