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Children with visual impairments who participated in a 10-year survey were compared with peers on measures of intelligence, reading, mathematics, and sporting ability. Results are consistent with earlier findings of increased intelligence among Ss with myopia and slightly reduced intelligence among Ss with amblyopia. It was concluded that the majority of visual problems do not affect children's learning. (CL)

Reviews the research on the harmful effects of reading from a horizontal surface. Urges educators to teach children proper body-book position and, where possible, to supply book holders. (ARH)

The study assessed transfer of visual training for myopia using two different training stimuli and a single subject A-B-C-A design with a male student volunteer. A procedure including stimulus fading and reinforcement (positive verbal feedback) was used to effectively improve performance on both behavioral acuity tests during the training phases and follow-up. (Author/DB)

A discussion is presented on the safety and potential side effects of radial keratotomy, a surgical procedure that results in a flattening of the cornea and a reduction of refractive myopia (nearsightedness). (JD)

PurposeTo compare rates of retinal nerve fiber layer change over time in healthy, eyes with nonprogressing glaucoma and eyes with progressing glaucoma using single wide-field (SWF) and optic nerve head (ONH) cube scan optical coherence tomography (OCT) images.MethodsForty-five eyes of 25 healthy individuals and 263 eyes of 161 glaucoma patients from the Diagnostic Innovations in Glaucoma Study were included. All eyes underwent 24-2 visual field testing and OCT (Spectralis SD-OCT) ONH and macular imaging. SWF images (up to 43° × 28°) were created by stitching together ONH cube scans centered on the optic disc and macular cube scans centered on the fovea. Visual field progression was defined as guided progression analysis likely progression and/or a significant (P < 0.01) mean deviation slope of less than -1.0 dB/year. Mixed effects models were used to compare rates of change. Highly myopic eyes were included.ResultsThirty glaucomatous eyes were classified as progressing. In eyes with glaucoma, mean global rate of change was -1.22 µm/year (P < 0.001) using SWF images and -0.83 µm/year (P = 0.003) using ONH cube scans. Rate of change was significantly greater in eyes with progressing glaucoma compared with eyes with nonprogressing glaucoma (-1.51 µm/year vs. -1.24 µm/year; P = 0.002) using SWF images and was similar using ONH cube scans (P = 0.27).ConclusionsIn this cohort that includes eyes with and without high axial myopia, the mean rate of retinal nerve fiber layer thinning measured using SWF images was faster in eyes with progressing glaucoma than in eyes with nonprogressing glaucoma. Wide-field OCT images including the ONH and macula can be effective for monitoring glaucomatous progression in patients with and without high myopia.

PURPOSE: To assess the effect of residual sphere on vision and satisfaction in pseudophakic patients. SETTING: Private clinics, United Kingdom. DESIGN: Retrospective case series. METHODS: A multivariate model evaluated the effect of 1-month residual sphere on outcomes of pseudophakic patients. Odds ratios (ORs) were calculated to assess the relative risk of not achieving ≥20/20 monocular uncorrected distance visual acuity (UDVA), ≥20/50 uncorrected near visual acuity (UNVA), and not being satisfied with vision. ORs were assessed for residual sphere -1.00 to +1.00 diopter (D) in quarter-diopter steps, using 0.00 D as a reference. RESULTS: The analysis included 38 828 multifocal and 11 571 monofocal intraocular lenses (IOLs). The residual myopic sphere ≤-0.25 D and hyperopic sphere ≥+0.50 D had a clinically meaningful effect on UDVA. Although monofocal IOLs had an improvement in UNVA with every additional 0.25 D of myopia, the change in ORs with increasing myopia was not significant for multifocal IOLs. The mean improvement in UNVA comparing eyes with 0.00 D and -1.00 D sphere was 0.26 logMAR for monofocal and 0.03 logMAR for multifocal IOLs. Low near-addition IOLs had a slightly higher gain in UNVA with increasing myopia, but the gain was not as substantial as with monofocal IOLs. The effect of ametropia on satisfaction was more pronounced for multifocal IOLs. For every 0.25 D of residual myopia, there was >25% increase in dissatisfied patients. CONCLUSIONS: Although myopia improved UNVA in eyes with monofocal IOL, multifocal IOLs did not benefit from residual myopia. Multifocal IOL patients desiring distance vision should be targeted closest to emmetropia, even if it means targeting slight hyperopia.

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