Binocular Function Research Articles

Effect of sutureless scleral fixed intraocular lens implantation on aphakic eyes: a system review and meta-analysis

BackgroundSutureless scleral fixed intraocular lens implantation (SF-IOL) has become one of the mainstream schemes in clinical treatment of aphakic eyes because of its advantages, such as avoiding dislocation of intraocular lens or subluxation caused by suture degradation or fracture and significant improvement of postoperative visual acuity. However, a consensus on the relative effectiveness and safety of this operation and other methods is still lacking. This study aimed to compare the efficacy and safety of sutureless SF-IOL with other methods. Aphakia means that the lens leaves the normal position and loses its original function, including absence or complete dislocation and subluxation of the lens which could cause anisometropic amblyopia, strabismus, and loss of binocular function in children and adolescents. For adults, the loss of the lens could lead to high hyperopia and affect vision. Above all this disease can seriously affect the quality of life of patients.MethodsLiterature about sutureless SF-IOL in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, China Technical Journal VIP database, and Wanfang database published from 2000 to 2022 was reviewed. The weighted average difference was calculated by RevMan5.3 software for analysis. Two researchers independently selected the study and used the Cochrane collaboration tool to assess the risk of errors. Cochrane bias risk tool was used to evaluate the quality of evidence. This study is registered on PROSPERO (CRD42022363282).ResultsThe postoperative IOL-related astigmatism of sutureless SF-IOL was lower than that of suture SF-IOL, and there was statistical difference when we compared the absolute postoperative spherical equivalent after sutureless SF-IOL and suture SF-IOL. Indicating that the degree of refractive error after sutureless SF-IOL was lower. Meanwhile, the operation time of sutureless SF-IOL was shorter than that of suture SF-IOL. The subgroup analysis showed that the absolute postoperative spherical equivalent and astigmatism values in Yamane technique were lower than those in suture SF-IOL.ConclusionSutureless SF-IOL has the advantages of stable refraction, short operation time, and less postoperative complications. However, high-quality literature to compare these technologies is lacking. Some long-term follow-up longitudinal prospective studies are needed to confirm the findings.

Latent Convergent Strabismus Clinical Features and Management in Sudanese Patients

Purpose: To describe the clinical features and management of latent convergent strabismus among Sudanese patients. Study Design: Descriptive observational study. Place and Duration of Study: Makkah Eye Complex, Khartoum, Sudan, from December 2018 to August 2020. Methods: The study included 137 patients, diagnosed with latent convergent strabismus (esophoria). Demographic data and ocular examination findings including visual acuity, refractive error, and degree of esophoria was collected. Esophoria was assessed by prism cover test (PCT) at near and distance. Results: Esophoria was more common among females (n = 107, 78.1%) and in age group 15 to 25 years. Headache was the most common complaint (n = 64, 46.7%). Most of the patients (n = 114, 83.2%) had 1 to 5 ∆ of esophoria with a mean of 4.17 ± 2.99∆. Majority of the patients (n = 132, 96.3%) had normal near point of convergence (NPC) 6.98 ± 3.10 cm. Positive fusional vergence (PFV) was high at 24.06 ± 9.01∆, whereas negative fusional vergence (NFV) was low at 5.0 ± 0.21∆D, P = 0.001. Majority of the patients (76.6%) responded well to the refractive correction, 11.7% patients to vision therapy and remaining 11.7% to both refractive correction and vision therapy. Correlation coefficients revealed that there was a positive correlation between, refraction, NPC, and PFV (P ˃ 0.05). Conclusion: Sophoria was more common among females and young adults. Most of the esophoric patients had uncorrected hyperopia, good PFV and relatively poor NFV amplitude. Early detection and management of young esophoric patients is essential to improve vision and binocular functions.

COMPARATIVE ANALYSIS OF VISUAL ACUITY AND BINOCULAR VISION BEFORE AND AFTER STRABISMUS SURGERY.

Binocular vision is the ability to focus on an object with both eyes simultaneously in order to create a single visual image. Although lack of binocular function is normal in infants, it is not the case in children and adults as it is necessary to have a good depth perception. Aim of this paper was to showcase postoperative binocular vision results after strabismus surgery. For that purpose, we utilized medical records of 72 patients who had their first strabismus surgery done at the Clinic for Eye Diseases in Tuzla between February 2017 and February 2023. Pre-operative deviation, diagnosis, binocular function, visual acuity and age were analyzed as factors that influence the success of the surgery. In order to assess set goals of the research, Chi square test, Wilcoxon matched-pairs signed-rank test and logistic regression analysis with forced entry were used. Patients were divided into two groups, first with esotropy and the second with exotropy, both groups were under the age of 7. Surgery success rate for respondents under the age of 7 was 67.1% and for the respondents over the age of 7 was 81.1% and no statistically significant improvement in visual acuity was observed. Success rate of achiving binocular vision, after strabismus surgery, was 49.3 for esotropy and 97.3 fir exotropy. Factors that influenced success rate were pre-operative deviation and age group.

Clinical outcomes in eyes with diffractive continuous depth-of-focus intraocular lenses enhanced for near vision: comparison with trifocal intraocular lenses

BackgroundTo prospectively evaluate visual functions and patient satisfaction after bilateral implantation of diffractive continuous depth-of-focus intraocular lens (CDF IOL) compared with trifocal IOLs.MethodsThis investigator-initiated study was approved by a certified local review board (registered: jRCTs032210305). CDF IOL (Synergy, J&J, group S) and trifocal IOL (AcrySof PanOptix, Alcon, group P) were implanted bilaterally in 30 patients each. Three months postoperatively, binocular outcomes of uncorrected (BUCVA) and distance-corrected (BDCVA) visual acuities at distances of 0.3, 0.4, 0.5, 0.7, and 5 m were measured. Contrast sensitivities were binocularly measured using CSV-1000 (2.5 m) and Pelli-Robson charts at distances of 0.4 and 1 m. Symptoms of glare, halo, starburst, and waxy vision, and satisfaction for near, intermediate, and far visions were assessed with questionnaires. Differences between the two groups were examined.ResultsTwenty-seven patients each completed the follow-up. The mean age of the group S was lower than that of the group P (P < 0.001). The BUCVA at 0.4 m was better in the S group, while the mean manifest refraction of the P group showed a significant hyperopic shift (P < 0.001). BDCVA was significantly better in the S group. The contrast sensitivity results at three distances showed no discernible differences. Although more patients in the S group reported significant glare and halo, their satisfaction with near vision was higher.ConclusionsThe binocular visual function of patients with CDF IOLs was comparable to or better than that of patients with trifocal IOLs. The patients were satisfied with near vision, despite the enhanced glare and halo. Understanding the differences between the two types of presbyopia-correcting IOLs is important to ensure patient satisfaction.Trial registrationThis clinical trial was registered in the Japan Registry for Clinical Research (identifier: jRCTs032210305) on September 13, 2021.

Binocular Function in Adults Before and after Strabismus Surgery

Purpose: To evaluate the state of binocular vision, the amount and direction of the ocular deviation before and after strabismus surgery in adult patients and to monitor the occurrence of postoperative complications. Methods: The retrospective study of 58 adult patients with selected types of strabismus who were surgically treated in the Eye Department of the Tomas Bata Regional Hospital in Zlín. We evaluated the amount and the degree of the primary ocular deviation and the binocular alignment before and after surgery, as well as the state of binocular vision after surgery and the occurrence of postoperative complications. Results: The average deviation in convergent strabismus before surgery was +23.46 degrees, after surgery +6.6 degrees, in divergent strabismus it was -21.5 degrees, after surgery -1.48 degrees, for vertical strabismus before surgery +12.5 degrees and +3.75 degrees after surgery and in paralytic strabismus +20 degrees before surgery and +3 degrees postoperatively. Preoperatively there was effectively no binocular vision in up to 63.9% of patients, superposition occurred in 31%, fusion in 5.1%. No patient had stereopsis before surgery. After surgery, superposition was present in 39.7%, fusion in 31% and stereopsis in 6.9% of patients. Only 22.4% of patients experienced no binocular vision after surgery. Of the selected 21 patients out of 58 with an observation period of at least 3 years, we observed an improvement or development of binocular vision functions after surgery in 12 patients and no improvement of binocular vision functions in 9 patients. In the first group, 58.3% had a stable deviation throughout the follow-up period. While in the second group the deviation was stable in only 33.3%. We can assume that the improvement in binocular vision function after strabismus surgery, leads to a greater longer-term stability of postoperative deviations. Conclusion: Strabismus surgery in adult patients is an effective and safe method, which is not only a cosmetic procedure used to adjust the position of the eyes, but also enables us to induce or improve the state of binocular vision functions.

Clinical Outcomes and Nutritional Status of Children with Intermittent Exotropia Treated with Surgery During the Preschool and Post-School Age

In this study, we compared the clinical outcomes and differences in nutritional status between preschool and post-surgical treatment of intermittent exotropia. We selected 100 children with intermittent exotropia between August 2019 and August 2022 for the study. Among them, 42 children received surgical treatment before school age (4–6 years) and were considered to be in group A, whereas 58 children received surgical treatment after school age (7–12 years) and were considered to be in group B. We found no difference in orthokeratology, overcorrection, or undercorrection rates between the two groups of children before and after surgery (P &gt; 0.05), and the strabismus was lower at 6 and 12 months after surgery than before surgery and lowest at 12 months after surgery (P &lt; 0.05). In addition, the normal rates of visual function, fusion function, and binocular stereopsis were higher in group A than in the control group at 6 and 12 months postoperatively (P &lt; 0.05). The Child Intermittent Exotropia Questionnaire scores were higher in both groups at 12 months postoperatively than at 6 months and were higher in group A than in group B (P &lt; 0.05). Family members of children in group A were more satisfied with the treatment than in group B (P &lt; 0.05), but the difference in albumin, transferrin, and proalbumin before and after surgery was lower in group B than in group A (P &lt; 0.05). It follows that performing intermittent exotropia surgery before school age can more effectively improve the prognosis of children’s binocular visual function, whereas performing intermittent exotropia after school age has less impact on nutritional status.

Digital Therapy for Visual Acuity and Binocular Function in Children with Anisometropic Amblyopia.

Amblyopia affects development of children's monocular vision and binocular function and becomes a largely intractable problem with increasing aging. This study is to investigate the binocular function and evaluate efficacy of digital therapy in children 8-13 years of age with anisometropic amblyopia. The patients in the digital therapy group performed the training with the digital amblyopia therapeutic software. The visual acuity and binocular function (perceptual eye position [PEP], suppression, and stereopsis) were examined at the first visit and 3-month post-treatment. Twenty-three cases in the control group and 25 cases in the digital therapy group were enrolled. The results revealed that 3-month digital therapy can effectively improve corrected distance visual acuity (CDVA) and improve the binocular function, including PEP, suppression, and second-order stereopsis in children with anisometropic amblyopia, 8-13 years of age. Digital therapy for amblyopia can effectively improve monocular CDVA of amblyopic eyes and binocular function in older children with anisometropic amblyopia.

Effect of visual perception training on binocular visual function reconstruction in patients after strabismus surgery.

To explore the effect of visual perception learning software training (VPT) on binocular visual function reconstruction in children with intermittent exotropia after strabismus surgery. Ninety children with intermittent exotropia admitted to our hospital from June 2018 to December 2018 were included, and randomly divided into VPT and control groups. Children in the control group received basic binocular vision training, while those in the VPT group received VPT after strabismus surgery. Tertiary visual function, visual perception function, Newcastle Control Score (NCS), and ocular position retraction rate were compared at 3 and 12mo after the surgery. At 3 and 12mo after the surgery, the proportion of simultaneous perception, binocular fusion version and binocular stereo vision in the VPT group was conspicuously higher than that in the control group (P<0.05). After the vision training, the binocular visual perception functions of children in both groups were significantly improved compared with that before training (P<0.05). Interestingly, the grating sharpness, texture perception and texture motion perception in the VPT group were dramatically better than control group (P<0.01). The NCS in the VPT group was significantly lower than that in the control group (P<0.05). The ocular position retraction rate in the VPT group was significantly lower than that in the control group at 12mo (8.89% vs 26.67%, P=0.03). VPT effectively promotes binocular visual function reconstruction in intermittent exotropia children after strabismus surgery and reduces the strabismus severity and ocular position retraction rate.

Effects of alcohol consumption on driving performance in the presence of interocular differences simulated by filters

The role of interocular differences simulated by filters (fog filter and Bangerter foil) on visual and driving performance in alcohol users was assessed. We found that the binocular visual function deteriorates significantly in terms of contrast sensitivity (from 6 to 18 cpd). Additionally, driving performance is significantly impaired under these conditions as evidenced by increased mean speed, standard deviation of the lateral position, distance traveled outside the lane, reaction time and number of collisions. Furthermore, we found that interocular differences due to intraocular scattering and straylight are directly related to an overall reduction in visual and driving performance. This provided a comprehensive perspective from which to understand the relationship between binocular visual function, interocular differences, and driving performance. In practice, our findings contribute to the understanding of the importance of limiting interocular differences, which can be common among presbyopes corrected using the monovision technique, as well as in cases of cataract or other ocular pathology affecting only one eye, or even in cases of cataract surgery of the first eye. These interocular differences can have an adverse impact on road safety, especially when combined with moderate alcohol consumption.

Characteristics of childhood intermittent exotropia with and without DVD

ABSTRACT Purpose: Although dissociated vertical deviation (DVD) is reported to occur rarely in children with intermittent exotropia (IXT), little is known regarding the clinical features of these children. The purpose of this study was to compare the demographic and clinical characteristics of children with intermittent exotropia and DVD to those without DVD. Methods: The medical records of all children diagnosed with intermittent exotropia at our institution from 1 January 2002, through 31 December 2018, who had 2 or more exams with 3 or more assessments of control, were retrospectively reviewed. Exotropic children with DVD were compared to those without DVD. Results: During the 17-year study period, 115 children met the inclusion criteria, of which 25 (21.7%) had DVD. Compared to the 90 exotropic children without DVD, children with IXT and DVD were more likely to have a motility disorder (p = .021), a worse mean distance control score (2.8 vs 2.4; p = .09), a larger mean angle of deviation (27.8 prism diopters [PD] vs 25.1 PD; p = .04), and a lower median stereopsis (200 secs vs 100 secs; p = .08). The children with DVD were more likely to have undergone surgery (p = .17) although there was no difference in the mean age at initial surgery between the two groups. Conclusions: The presence of dissociated vertical deviation in children with intermittent exotropia is associated with more motility disorders and worse binocular function compared to those without DVD. These children will likely require closer observation and earlier intervention.

Measurements of Binocular Visual Function and Reading Ability in Induced Aniseikonia

Measurements of Binocular Visual Function and Reading Ability in Induced Aniseikonia

Changes in saccadic eye movement and smooth pursuit gain in patients with acquired comitant esotropia after strabismus surgery.

This study investigates the change in horizontal saccadic eye movement and smooth pursuit in patients with acquired comitant esotropia (ACE), before and after strabismus surgery. The horizontal saccades and pursuit in 11 patients with ACE were recorded using a video eye-tracker under binocular viewing before and after strabismus surgery. Participants were instructed to fixate on the new target as rapidly as possible when it randomly appeared at either 18.3° rightward or 18.3° leftward. For smooth pursuit, participants were asked to track, as accurately as possible, a step-ramp target moving at ±6.1°/s. The asymmetry of adduction-abduction and the binocular coordination in gains of saccade and pursuit were compared between the pre- and post-surgical data. The asymmetry of adduction-abduction saccade gain in each eye after surgery tended to be smaller than that before surgery. The binocular coordination of saccade showed significant improvement after surgery in only the non-dominant eye direction. Adduction-abduction asymmetry in the smooth pursuit gain in each eye after surgery tended to be smaller than before surgery. After surgery, the binocular coordination of pursuit was improved significantly in both directions. In patients with ACE, binocular coordination of saccade and smooth pursuit was poor. Binocular coordination of saccade and pursuit seems to be improved due to the improvement in ocular deviation angle and binocular visual function after surgery.

Comparison of binocular visual quality in six treatment protocols for bilateral cataract surgery with presbyopia correction: a prospective two-center single-blinded cohort study

Objective To compare the postoperative binocular visual quality in six treatment protocols for bilateral age-related cataract surgery with presbyopia correction for clinical decisions. Materials and methods In this prospective two-center single-blinded cohort study, participants from North or South China who underwent bilateral phacoemulsification and intraocular lens implantation were divided into six protocols: monovision, diffractive bifocal, mixed, refractive bifocal, trifocal, and micro-monovision extended range of vision (EROV). Binocular visual quality was evaluated at 3 months postoperatively, including binocular uncorrected full-range visual acuity, binocular defocus curves (depth of focus [DoF] and area under the curve [AUC]), binocular visual function (fusion function and stereopsis), binocular subjective spectacle independence rates, visual analog scale (VAS) of overall satisfaction, 25-item visual function questionnaire (VFQ-25), and binocular dysphotopsia symptoms. Results Of the 300 enrolled patients, 272 (90.7%; 544 eyes) were analyzed. The trifocal protocol showed excellent binocular full-range visual acuity and the best performance for most DoFs and AUCs. The monovision protocol presented the worst binocular visual quality in most perspectives, especially in convergence, distance, and near stereopsis (p < 0.001). The full-range subjective spectacle independence rates were sorted from highest to lowest as follows: trifocal (84.8%), refractive bifocal (80.9%), EROV (80.0%), mixed (73.3%), diffractive bifocal (65.2%), and monovision (32.6%) protocols, with no statistically significant differences between the former five protocols (p > 0.05). The EROV protocol achieved the highest VAS and VFQ-25 scores. The incidence of postoperative binocular dysphotopsia symptoms was comparable in all protocols. Conclusions The trifocal protocol showed the best performance, and the monovision protocol presented the worst performance in most perspectives of binocular visual quality for presbyopia correction. The refractive bifocal, mixed, or EROV protocols can provide an approximate performance as a trifocal protocol. Ophthalmologists can customize therapies using different protocols.

TOF-assisted binocular vision accuracy improvement method for underwater fish size inspection.

To address problems such as the lack of accuracy in acquiring depth maps for dynamic fish 3D measurements by usual binocular vision or a time-of-flight (TOF) depth camera, a TOF-assisted binocular vision depth acquisition algorithm is used to obtain high-quality depth maps. The TOF depth energy function is designed to guide the binocular stereo matching process, which improves the correct matching rate of binocular matching in low-texture regions; the TOF and binocular stereo matching confidence weighting functions are designed to achieve the fusion of the two at pixel level to improve the matching quality of fish in the occluded overlapping regions. The experimental results show that the TOF-assisted binocular vision system improves the accuracy of fish size measurement compared to single binocular vision while reducing the measurement error when the fish body has a significant inclination along the depth axis.

Gaze behaviour during multiple object tracking is dependent on binocular vision integrity.

Despite the critical importance of binocular vision integrity in daily activities, there exists limited understanding of how alterations in binocular vision integrity impact gaze behaviour during dynamic, complex psychomotor skills. This study aimed to measure how alterations in binocular vision integrity, created by Bangerter filters (BF), affect gaze behaviour during multiple object tracking (MOT). During the experiment, 22 volunteers completed the MOT task under three different visual conditions. The first condition involved natural binocular viewing, while the second and third conditions used 0.4 and 0.2 neutral density BF, respectively, resulting in monocular blur in the sensorially dominant eye. During the MOT task, participants were instructed to track three of eight balls for 10 s, and the speed was adjusted using a staircase procedure. Throughout the task, the following gaze parameters were recorded: fixation duration, saccade duration, amplitude and frequency as well as blink rate. During MOT execution, participants employed three gaze strategies regardless of viewing conditions: saccadic movements were predominant, followed by maintaining fixation on a central location throughout the trial and to a lesser extent, smooth pursuit eye movements. There was a significant effect of manipulating viewing conditions on the MOT scores (p = 0.046, η2 = 0.09). As the viewing conditions became more difficult, we observed a decrease in fixation duration (p = 0.004, η2 = 0.16) and blink rate (p < 0.001, η2 = 0.20) and an increase in saccadic amplitude (p < 0.001, η2 = 0.29). The results support the notion that perceptual-cognitive skills depend on the integrity of binocular vision, underscoring the sensitivity of gaze behaviours to any impairment of binocular function.

Monocular and Binocular Visual Function Assessments and Activities of Daily Living Performance in Age-Related Macular Degeneration

To evaluate the relationship between specific monocular and binocular visual function (VF) assessments with binocularly performed activities of daily living task tests (ADLTTs) in patients with age-related macular degeneration (AMD) and healthy controls. Prospective case-control cohort study. Thirty-six AMD patients and 36 controls. Visual field assessments included monocular and binocular best-corrected visual acuity (BCVA), contrast sensitivity (CS), and monocular microperimetry testing for mean macula sensitivity, mean retina sensitivity (MRS), fixation area, and fixation distance from fovea (FDF). Age-related macular degeneration lesion area and sensitivity were measured on OCT and microperimetry, respectively. Participants performed 4 validated ADLTTs with binocular BCVA: (1) reading; (2) item-search; (3) money-counting; and (4) multi-step drink-making tasks. Spearman correlations and multivariate regression analysis, adjusted for age, sex, and potential correlation between the 2 eyes, were used to assess the relationship between monocular and binocular VF assessments, and ADLTT performance in both groups. Age-related macular degeneration patients had poorer VF (BCVA, CS, mean macula sensitivity, and MRS) compared with healthy controls. Monocular BCVA in both better- and worse-vision eyes was moderately correlated with the binocular reading speed and money-counting tasks in participants with AMD. In AMD, monocular worse eye CS, MRS, AMD lesion area on OCT, and lesion sensitivity on microperimetry showed moderate correlations to various ADLTTs, such as reading, money-counting, and drink-making. Similar findings were found in our AMD cohort on multivariate regression analysis. Fewer significant correlations were observed for the better-vision eye, whereas no correlations were observed for healthy controls between VF parameters and ADLTTs. In contrast, significant associations were observed between binocular BCVA and CS with binocular ADLTTs (reading and item-search tasks) but not in AMD patients. Although monocular BCVA remains the most common measure of VF, CS and microperimetry testing also show significant correlations with ADLTTs performance in AMD patients, and should be considered as complimentary VF-outcome measures in both clinical and research settings. Unlike healthy subjects, AMD patients do not rely on binocular VF for ADLTT function, with the worse-vision eye impacting binocular ADLTT function more than the better-vision eye. Therefore, the worse-vision eye should not be neglected during the management of AMD. Proprietary or commercial disclosure may be found after the references.

Unilateral visual impairment: impact on binocular function of school children in rural communities of Saki-East, Southwest Nigeria

PurposeThis study was designed to determine the impact of unilateral visual impairment or blindness on binocular visual function in children. MethodsA multistage, cross-sectional study was conducted among primary and secondary school students in the Saki-East Local Government Area of Oyo State between May and July 2021. Unilateral visual impairment was defined as presenting visual acuity <+0.3 LogMAR. Stereopsis, contrast sensitivity and peripheral visual fields were assessed with the Titmus fly test chart, Mars Contrast sensitivity chart and Lister perimeter respectively. Chi-squared test and Logistic regression were performed to assess the association between the degree of unilateral visual impairment and the other independent variables. ResultsFifty-one of 3671 (1.4%) children had unilateral visual impairment or blindness. The mean age was 10.7 ± 3.6 years. Stereopsis was weak or absent in 38 (74.5%) participants, contrast sensitivity values were impaired in 50 (98%) participants, and 29 (61.7%) participants had constricted peripheral visual fields. The level of stereopsis of participants worsened with increasing severity of the unilateral visual impairment, and this was statistically significant (p < 0.001). ConclusionChildren with unilateral visual impairment had poor binocular function. This correlated with stereopsis, worse in participants with severe visual impairment.

Treatment of Anisometropic Amblyopia with a Dichoptic Digital Platform in Argentinian Children and Adults

ABSTRACT Purpose To evaluate and compare the results of dichoptic training in Argentinian children and adults with anisometropic amblyopia. Methods Prospective non-comparative study enrolling 41 subjects with anisometropic amblyopia (age, 6–60 years old). Two groups were differentiated according to age, children (6–16 years, 24 subjects) and adults (>17 years, 17 subjects). All patients were treated with the Bynocs® platform (Kanohi Eye Pvt. Ltd, India) following a protocol of 30 sessions of training of 30 min daily 5 times a week for 6 weeks. Changes in corrected distance visual acuity (CDVA) and binocular function (BF) score with treatment were analyzed. Results In the whole sample, CDVA in the amblyopic eye improved significantly, with a mean change of 0.30 logMAR (p < .001). Likewise, a significant improvement was also found in BF score (p < .001), with a mean change of 1.14 log units. The change achieved in CDVA was significantly correlated with the baseline CDVA in the amblyopic eye (r=-0.568, p < .001). Furthermore, no significant differences were found between age groups in the change achieved in CDVA (p = .431) and BF with therapy (p = .760). Conclusions Dichoptic training with the digital platform evaluated provides an effective improvement of visual acuity and binocular function in children and adults with anisometropic amblyopia.

Impact of Monocular and Binocular Visual Function Parameters on Vision-Related Quality of Life in Glaucoma.

This study describes the impact of monocular (M/O) and binocular (B/O) visual function decline, primarily the contrast sensitivity (CS) and visual field (VF) defect severity and its location, on the subjective perception of quality of life (QoL) among the Indian glaucoma population with spared central acuity. To investigate the influence of M/O and B/O visual function parameters on vision-related QoL (VRQoL) in glaucoma with spared central visual acuity. Glaucoma subjects underwent M/O and B/O visual acuity, CS assessment, followed by the M/O perimetry from which the integrated VF was estimated (B/O summation method). VRQoL was evaluated using the Glaucoma Quality Of Life-15 (GQL-15) and Visual Function Questionnaire-Utility Index (VFQ-UI) questionnaires. The relationship between CS and VF defect (VFD) with the composite VRQoL scores was analyzed. A total of 154 glaucoma subjects with a median age of 61 (range: 24-83) years were enrolled. Subjects with severe VFD reported poor composite scores for GQL-15 and VFQ-UI when compared with unilateral and mild groups ( P < 0.001, Dunn post hoc). Both the composite scores were negatively correlated with M/O and B/O CS and VF mean deviation ( r range: -0.3 to -0.5, P < 0.001, Spearman rank correlation). B/O VFD in the inferior central zone contributed to poor GQL-15 score [odds ratio: 1.14 (95% CI: 1.10-1.29), P = 0.04] irrespective of sex, whereas females with increasing B/O VFD reported poor QoL score in VFQ-UI [odds ratio: 4.09 (95% CI: 1.77-9.43), p=0.003]. Poor GQL-15 and VFQ-UI scores were reported with increasing disease severity. B/O VFD in the inferior central region was found to contribute predominantly to the poor GQL-15 scores while both disease severity and sex influenced VFQ-UI scores.

Korean Versions of the Reading Test and Visual Perception Test for Children Treated for Unilateral Amblyopia

Purpose: Reading speed and visual perception are used to evaluate visual function in children with amblyopia. This study used standardized tests to evaluate binocular reading performance and visual motor function in children treated for unilateral refractive amblyopia.Methods: In a prospective pilot study, reading and visual perception were evaluated in children aged 5-12 years who were diagnosed with unilateral refractive amblyopia between September 2020 and March 2021. To evaluate reading skills, the Readability Diagnostic Assessment and Korean Language-based Reading Assessment (KOLRA) were administered. The Korean version of the Developmental Test of Visual Perception-Third Edition (K-DTVP-3) test was used to evaluate visual perception function.Results: Reading ability and visual perception function were evaluated in 10 patients with unilateral refractive amblyopia. In the reading fluency test, the average reading speed of the patients was 185 ± 78.2 words per minute (WPM), and did not differ from that of the control group provided by KOLRA (p &gt; 0.05). The general visual perception score was not significantly different from that of the controls. Among subtests of the K-DTVP-3, the hand coordination and figure-background tests scored 32.3 ± 17.7% and 29.9 ± 18.7%, respectively, lower than 50% of the normal average. The scores of the eye-hand coordination (r2 = 0.585, p = 0.01) and figure-background (r2 = 0.482, p = 0.03) tests were significantly correlated with the subject’s best-corrected visual acuity.Conclusions: In this study, there was no significant difference in reading fluency between the patients and controls. Among the K-DTVP-3 subtests, the average scores of the hand coordination and figure-background tests were lower than normal. Further studies are required to determine whether the reading fluency test and K-DTVP-3 reflect visual perception deficits in amblyopic patients.