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Purpose:\ud \ud Vision impairment (VI) may impact a person’s functional ability resulting in a loss of independence, anxiety, depression, social isolation and reduced quality of life. Caregivers also experience similar problems due to the increased burden placed on them. Support to address these difficulties encountered by those with VI and their caregivers may not always be accessible. An internet-based intervention may provide more accessible support. The aim of this study was to obtain consensus regarding the content and accessibility features required to design an internet-based intervention to promote wellbeing for people with VI and their caregivers.\ud \ud Method:\ud \ud A three-round Delphi review was conducted with a panel of 30 stakeholders. Three stakeholder groups were included, namely individuals with vision loss, experts in the field of vision loss and mental health and carers of individuals with vision loss. Conceptual wellbeing ideas were examined in round 1, the intervention modules and module content were proposed in round 2 and refined in round 3.\ud \ud Results:\ud \ud Consensus of 75% or more was reached to include 18 modules into the intervention. These were divided into seven sections: understanding vision loss, emotional wellbeing, functional wellbeing, social wellbeing, physical wellbeing, wellbeing for carers and maintaining wellbeing. The accessibility features deemed most important were font size, colour and contrast options, compatibility with low vision aids and layout of the intervention.\ud \ud Conclusions:\ud \ud The Delphi process positively informed the design of an internet-based intervention for individuals with acquired VI and their caregivers. Suggestions provided by stakeholders should now be incorporated into the intervention. Future evaluation of efficacy and cost-effectiveness of such an intervention are necessary.

Purpose:\ud \ud The aim of this study is to relate areas of the visual field to functional difficulties to inform the development of a binocular visual field assessment that can reflect the functional consequences of visual field loss.\ud \ud \ud Methods:\ud \ud Fifty-two participants with peripheral visual field loss undertook binocular assessment of visual fields using the 30-2 and 60-4 SITA Fast programs on the Humphrey Field Analyser, and mean thresholds were derived. Binocular visual acuity, contrast sensitivity and near reading performance were also determined. Self-reported overall and mobility function were assessed using the Dutch ICF Activity Inventory.\ud \ud \ud Results:\ud \ud Greater visual field loss (0–60°) was associated with worse self-reported function both overall (R2 = 0.50; p < 0.0001), and for mobility (R2 = 0.64; p < 0.0001). Central (0–30°) and peripheral (30–60°) visual field areas were similarly related to mobility function (R2 = 0.61, p < 0.0001 and R2 = 0.63, p < 0.0001 respectively), although the peripheral (30–60°) visual field was the best predictor of mobility self-reported function in multiple regression analyses. Superior and inferior visual field areas related similarly to mobility function (R2 = 0.56, p < 0.0001 and R2 = 0.67, p < 0.0001 respectively). The inferior field was found to be the best predictor of mobility function in multiple regression analysis.\ud \ud \ud Conclusion:\ud \ud Mean threshold of the binocular visual field to 60° eccentricity is a good predictor of self-reported function overall, and particularly of mobility function. Both the central (0–30°) and peripheral (30–60°) mean threshold are good predictors of self-reported function, but the peripheral (30–0°) field is a slightly better predictor of mobility function, and should not be ignored when considering functional consequences of field loss. The inferior visual field is a slightly stronger predictor of perceived overall and mobility function than the superior field.

The measurement of distance visual acuity is the most familiar and most widely used test of visual function. However, this is only one in a battery of tests used in the assessment of patients with visual impairment. A full and comprehensive assessment helps to build a picture of the need and urgency for further treatment, including the provision of rehabilitative interventions and to predict the performance of low-vision devices. This review outlines some of the principal tests and strategies available for the clinical assessment of visually impaired patients that are readily available to practising optometrists. The generic principles of the key visual functions assessed in the low-vision assessment are outlined, together with a critical review of those instruments still currently used within optometric practice which may not yield the most reliable results. Improving the accuracy of visual assessment will improve referral refinement, support decision making and assist in prescribing the most appropriate solutions for visually impaired patients.

Background: To assess the cross-sectional association between self-rated eyesight and physical activity behaviour in a large general population sample of older English adults.\ud \ud Methods: Analyses of data from the English Longitudinal Study of Ageing. Participants provided information on self-rated eyesight (categorised as: excellent/ very good/ good/ fair-poor) and their own physical activity levels (categorised as: inactive/ moderate only at least 1/ week/ vigorous at least 1/ week). Associations between self-rated eyesight and physical activity levels were examined using logistic regression. \ud \ud Results: A total of 6,634 participants (mean age 65.0±9.2years) were included in the analyses. In adjusted logistic regression models those with fair-poor and good eyesight were significantly more likely to be inactive than those who reported excellent eyesight (OR 2.07, 95% CI 1.58, 2.72; OR 1.59, 1.27, 1.99, respectively).\ud \ud Conclusion: In this sample of older English adults, those with self-rated fair-poor vision were over twice as likely to be physically inactive than those who reported having excellent vision. When consistent data has emerged, interventions to increase physical activity in those who have poor eyesight are needed.

Purpose: To evaluate the effect of a dual treatment modality for myopia, by improving accommodative functions, on myopia progression.\ud Methods: A double blind randomised control trial was conducted on 96 subjects. The treatment modality for the trial employed custom designed contact lenses which control spherical aberration in an attempt to optimise static accommodation responses during near-work, and a vision-training programme to improve accommodation dynamics. Myopia progression was assessed over a 2 year period using cycloplegic autorefraction and biometry.\ud Results: The mean progression was found to be -0.33D over the 2 years of the study. There was no interaction between contact lens treatment and vision training treatment at 24 months (p=0.72). There was no significant treatment effect of either Vision Training or Contact Lens Spherical Aberration control on myopia progression.\ud Conclusions: This study is unable to demonstrate that the progression of myopia can be reduced over a 2 year period by either of the 2 treatments aimed at improving accommodative function. Neither treatment group (contact lens or vision training) progressed at a slower rate over the 2 years of the study than did the appropriate control group.

Purpose: Clinical tests of contrast sensitivity are performed at near with letters large enough to be above the acuity threshold of presbyopes with normal vision. Is a reading addition necessary to obtain accurate thresholds? Method: Contrast sensitivity was assessed using Pelli-Robson and Mars charts. Participants were presbyopes with normal or corrected-to-normal distance and near acuity. Contrast sensitivity was assessed with participants wearing distance refractive correction, and also wearing an appropriate addition for the working distance (+0.75DS for the Pelli-Robson at 1m; +2.00DS for the Mars at 50cm). Results: The difference between contrast sensitivity measurements made with and without the reading addition was not signifi cant for either chart (repeated measures t-test, p>0.05 for Pelli-Robson and Mars). Conclusion: Contrast sensitivity can be assessed in presbyopic visual normals with patients wearing either distance or near correction without affecting thresholds.