Binocular Visual Function Research Articles

A preliminary exploration of quantitative models for evaluating binocular visual perception impairments among patients diagnosed with stroke.

The objective of this study is to formulate and implement graded biological models pertaining to binocular visual perception function with the use of computer algorithms. We aim to quantitatively assess the location, severity, and degree of impairment in binocular visual perception among patients who have suffered stroke, thereby providing valuable insights into the repercussions of cerebral tissue damage on the visual system. To overcome the shortcomings of previous instruments used to assess binocular function in terms of stereoscopic effects and the challenges posed by physiological and psychological interference during examinations, this study optimized its approach by integrating polarized stereovision technology with computer graphic modeling techniques. This study employed computer models to assess binocular visual perception function in stroke patients. Computer models refer to psychophysical testing methods used to measure binocular visual perception function, including various assessment tasks such as recognizing inverted letters and assessing stereopsis during high-speed movements. The cross-into-circle test was used as a means to quantify perceptual eye position. Subsequently, the collected data was analyzed to assess the magnitude of impairment in binocular visual perception. The results of the study revealed a spectrum of binocular visual perception impairment among patients diagnosed with stroke, demonstrating discernible variations in the recognition of inverted letters and stereopsis across different movement speeds. Importantly, perceptual eye position measurements offered valuable insights into ocular misalignment. The computational models effectively quantified both the spatial distribution and severity of these identified impairments. Damage to brain tissue resulting from a stroke can give rise to notable impairments in binocular visual perception function. Graded biological models, formulated through computer algorithms, provide a systematic framework for the comprehensive evaluation and quantification of these impairments. The comprehension of the nature and extent of visual impairments observed in patients with stroke establishes a basis for the development of personalized visual perception learning methodologies. Based on such tailored approaches, we aim to facilitate the recovery of impaired visual function, thereby contributing to the broader objective of neural system rehabilitation.

Comparison of Three Clinical Stereoscopic Methods for Measuring Binocular Visual Function During Amblyopic Treatment in Unilateral Amblyopia.

This study aimed to compare the measuring stereopsis results of unilateral amblyopia during amblyopic treatment by employing some of the most widely used clinical tests. Thirty-four individuals with previously untreated unilateral amblyopia, aged 8.4 ± 2.7 years, were included in the study. Monocular (best corrected visual acuity [BCVA] at distance) and binocular (including Titmus, Random-dot, and Frisby stereopsis) visual functions were measured at baseline and 2-month and 6-month visits after synthetical treatment. We found that Titmus stereopsis was always significantly better than Random-dot stereopsis (p < 0.001). Frisby stereopsis was also always significantly better than Random-dot stereopsis (p < 0.001). However, there was no significant difference between Titmus stereopsis and Frisby stereopsis (p = 0.562). However, interestingly, there was no significant difference in the mean improvement of the three stereopsis methods from baseline to the 2-month visit, F = 1.158, p = 0.318. Similarly, a significant difference was also lacking in the mean improvement of the three stereopsis methods from baseline to the 6-month visit, F = 0.302, p = 0.740. We conclude that there will be different results obtained from different stereopsis measuring methods used to measure amblyopia in patients. We recommend performing at least two types of stereoscopic measurements to evaluate each case of amblyopia. However, for observing therapeutic effects, each measurement method has the same performance for clinical results during amblyopic treatment.

Changes to Binocular Vision Function in Exophoric Patients After Experiencing Virtual Reality

Changes to Binocular Vision Function in Exophoric Patients After Experiencing Virtual Reality

Prevalence and associated factors of myopia among adolescents aged 12–15 in Shandong Province, China: a cross-sectional study

Myopia is a growing concern worldwide, especially among adolescents. This study aimed to investigate the prevalence and associated factors of myopia in adolescents aged 12–15 in Shandong Province, China. This cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and involved stratified random cluster sampling of 128,678 students from 186 middle schools across 17 cities in Shandong Province. Data collection was conducted from March to April 2024. We excluded students with organic eye diseases, abnormal binocular vision functions, or a history of eye injuries or surgeries. Myopia was assessed using the standard logarithmic visual acuity chart and autorefractor without inducing ciliary muscle paralysis. A comprehensive questionnaire survey was conducted to gather demographic characteristics and daily life behaviors. With the chi-squared test for univariable analysis and multivariable logistic regression for identifying significant factors. This study included 126,375 participants, with a gender distribution of 51.02% male and 48.98% female. The overall prevalence of myopia was 71.34%. Higher prevalence was observed in girls (72.26%) compared to boys (70.45%), and the prevalence increased with age, peaking at 73.12% in 15-year-olds. Urban residents had a higher prevalence (71.86%) than rural (70.39%). Factors such as increased frequency of eye usage while lying down or leaning forward, frequent use of eyes while walking or riding in a car, prolonged screen time, and extended homework duration were associated with higher odds of developing myopia. Conversely, higher frequency of outdoor exercise, maintaining proper posture during reading and writing, greater distance from eyes to screen, and longer sleep duration were associated with lower odds. Additionally, female gender, older age, urban residence, and parental history of myopia increased the risk. The high prevalence of myopia among adolescents in Shandong Province was influenced by a combination of demographic, behavioral, and environmental factors. The study highlighted the importance of lifestyle modifications, such as increasing outdoor activities and maintaining proper visual habits, limiting the duration of screen exposure and homework sessions, and extending sleep duration, to mitigate the risk of developing myopia. These findings underscored the need for targeted public health interventions and educational campaigns to address this significant public health issue.

Impact of Online Video Game-Based Dichoptic Training on Binocular Vision Rehabilitation in Post-surgical Patients with Intermittent Exotropia.

Dichoptic training has emerged as a promising rehabilitation approach for improving binocular visual function in patients with strabismus. A prospective observational study design was employed to assess the effectiveness of online video game-based dichoptic training in rehabilitating binocular visual function in patients who had undergone anoperation for intermittent exotropia. A total of 64 patients who had undergone anoperation for intermittent exotropia were recruited and divided into the training group and the control group based on whether they would receive the dichoptic training. The dichoptic training was conducted for 3 months in the training group and the control group would not accept any form of orthoptic therapy. Assessments of binocular visual functions and deviation were conducted at baseline, 3-month and 6-month follow-up. Twenty-nine participants in the training group (mean 9.69 ± 2.66years old) and 26 participants in the control group (mean 8.41 ± 2.64years old) completed follow-up. At both 3- and 6-month follow-ups, the training group showed superior distance stereopsis compared to the control group, with near stereopsis only showing significant difference at the 6-month follow-up. Additionally, the training group exhibited significantly less distance exo-deviation drift than the control group at these times, and no significant difference was observed in near exo-deviation drift between the groups. The control group had a significantly higher rate of suboptimal surgical outcomes at both the 3- and 6-month follow-up. However, no significant differences were observed in simultaneous perception and fusion functions between the two groups. Online video game-based dichoptic training has the potential to become a novel postoperative rehabilitation strategy for patients with intermittent exotropia.

High Magnesium Promotes the Recovery of Binocular Vision from Amblyopia via TRPM7.

Abnormal visual experience during the critical period can cause deficits in visual function, such as amblyopia. High magnesium (Mg2+) supplementary can restore ocular dominance (OD) plasticity, which promotes the recovery of amblyopic eye acuity in adults. However, it remains unsolved whether Mg2+ could recover binocular vision in amblyopic adults and what the molecular mechanism is for the recovery. We found that in addition to the recovery of OD plasticity, binocular integration can be restored under the treatment of high Mg2+ in amblyopic mice. Behaviorally, Mg2+-treated amblyopic mice showed better depth perception. Moreover, the effect of high Mg2+ can be suppressed with transient receptor potential melastatin-like 7 (TRPM7) knockdown. Collectively, our results demonstrate that high Mg2+ could restore binocular visual functions from amblyopia. TRPM7 is required for the restoration of plasticity in the visual cortex after high Mg2+ treatment, which can provide possible clinical applications for future research and treatment of amblyopia.

The role of lateral rectus muscle resection for severe esotropia after medial rectus muscle myectomy in Graves' ophthalmopathy.

Persistent diplopia after rectus muscle myectomy is not uncommon but challenging in patients with Graves' ophthalmopathy. We investigated the role of lateral rectus muscle resection for patients after medial rectus muscle myectomy in Graves' ophthalmopathy. We retrospectively reviewed and collected data from patients with persistent diplopia after medial rectus muscle myectomy for Graves' ophthalmopathy who underwent unilateral or bilateral lateral rectus muscle resection. The eyeball deviations in the primary and reading positions before and after the operation were measured. A successful surgical outcome was defined as having less than five prism diopters (PD) in the primary gaze and functional binocular vision in the central 30° field postoperatively. A total of fifteen patients were included (mean post-myectomy deviation: 35.9 PD, range: 14 to -75 PD). The lateral rectus muscle resection after medial rectus muscle myectomy achieved an 80.0% success rate, with one patient over-corrected and two patients under-corrected. The lateral rectus muscle resection is an effective and predictable procedure for managing residual esotropia in Graves' ophthalmopathy patients who have previously undergone medial rectus muscle myectomy.

Blast injury: Impact to the cornea

Visual disorders are common even after mild traumatic brain injury (mTBI) or blast exposure. The cost of blast-induced vision loss in civilians, military personnel, and veterans is significant. The visual consequences of blasts associated with TBI are elusive. Active military personnel and veterans report various ocular pathologies including corneal disorders post-combat blasts. The wars and conflicts in Afghanistan, Iraq, Syria, and Ukraine have significantly increased the number of corneal and other ocular disorders among military personnel and veterans. Binocular vision, visual fields, and other visual functions could be impaired following blast-mediated TBI. Blast-associated injuries can cause visual disturbances, binocular system problems, and visual loss. About 25% of veterans exposed to blasts report corneal injury. Blast exposure induces corneal edema, corneal opacity, increased corneal thickness, damage of corneal epithelium, corneal abrasions, and stromal and endothelial abnormality including altered endothelial density, immune cell infiltration, corneal neovascularization, Descemet membrane rupture, and increased pain mediators in animal models and the blast-exposed military personnel including veterans. Immune response exacerbates blast-induced ocular injury. TBI is associated with dry eyes and pain in veterans. Subjects exposed to blasts that cause TBI should undergo immediate clinical visual and ocular examinations. Delayed visual care may lead to progressive vision loss, lengthening/impairing rehabilitation and ultimately may lead to permanent vision problems and blindness. Open-field blast exposure could induce corneal injuries and immune responses in the cornea. Further studies are warranted to understand corneal pathology after blast exposure. A review of current advancements in blast-induced corneal injury will help elucidate novel targets for potential therapeutic options. This review discusses the impact of blast exposure-associated corneal disorders.

Binocular Visual Function Testing in an Alzheimer’s Disease Research Center (ADRC) Cohort: Low-contrast Letter Acuity and Rapid Automatized Naming (RAN) Tasks of MULES and SUN (S40.006)

Binocular Visual Function Testing in an Alzheimer’s Disease Research Center (ADRC) Cohort: Low-contrast Letter Acuity and Rapid Automatized Naming (RAN) Tasks of MULES and SUN (S40.006)

The Relationship between Binocular Visual Function and Cybersickness by Vection in Virtual Reality

The Relationship between Binocular Visual Function and Cybersickness by Vection in Virtual Reality

Effects of Smart Glasses on the Binocular Vision and Ocular Fatigue

Purpose: The aim of this study was to investigate binocular visual function and ocular fatigue after the use of smart glasses.Methods: A total of 17 healthy volunteers (age range 13-45 years) were examined for ocular fatigue before and after watching videos for 20 minutes with a binocular smart glasses device. Subjective ocular fatigue was evaluated using a Virtual Reality Symptom Questionnaire (VRSQ). Objective fatigue was measured using the high-frequency component of accommodative microfluctuation. Accommodation amplitude was measured using the push-up method. Changes in the spherical equivalent were also measured using an autorefractometer. Strabismus angles were measured at distant (6 m) and near fixation (33 cm) in primary. Contrast sensitivity tests using the Pelli-Robson chart was performed. Accommodative convergence/accommodation (AC/A) ratio was measured by gradient methods.Results: Subjective ocular fatigue, as indicated by the VRSQ scores, significantly increased after using the smart glasses (&lt;i&gt;p&lt;/i&gt; = 0.001). The high-frequency component of accommodative microfluctuation increased in both eyes (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Accommodation amplitude was decreased, and temporary myopia was observed in both eyes (all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, there was no significant increase in general fatigue according to the VRSQ. Parameters including strabismus angle, AC/A ratio, and contrast sensitivity showed no significant differences before and after smart glasses usage (&lt;i&gt;p&lt;/i&gt; &gt; 0.05).Conclusions: The increased high-frequency component of accommodative microfluctuation, decreased accommodation amplitude, and elevated ocular fatigue scores measured by the VRSQ indicate a potential association between the use of smart glasses and ocular fatigue. Further investigations are warranted to explore methodologies for mitigating ocular fatigue and elucidating the potential risk of temporary myopic shifts arising from the utilization of smart glasses.

Binocular function in the aging visual system: fusion, suppression, and stereoacuity.

Changes in vision that occur in normal healthy aging can be seen in fundamental measures of monocular vision. However, the nature of the changes in binocular vision with age remain unclear. A total of 28 older (53-66 years) and 28 younger adults (20-31 years) were enrolled in this study. We performed a battery of tests to assess differences in monocular contrast thresholds and various binocular visual functions including dichoptic masking weight and strength, the binocular balance point for fused stimuli, and stereoacuity in the aging and control groups. Aging significantly increased monocular contrast thresholds (p < 0.001). Although this suggests that aging reduces the effective "input gain" to vision, we also found a significantly elevated contribution of those weaker signals to interocular suppression (p < 0.001). Consequently, there was no significant net difference in the strength of interocular suppression (p = 0.065). We did not find a significant difference of absolute balance point between the two groups (p = 0.090). Lastly, the mean stereoacuity was worse in the older group compared to the younger group (p = 0.002). Our findings confirm previous results showing differences in contrast sensitivity and stereoacuity with aging. Furthermore, we find a change in interocular suppression that is a possible consequence of the change in contrast sensitivity. It is suggestive of a cortical system that maintains a homeostatic balance in interocular suppression across the lifespan.

CHANGES IN STEREOSCOPIC VISION TOWARDS STRABISMUS CORRECTION SURGERY IN DR MOHAMMAD HOESIN CENTER HOSPITAL, PALEMBANG

Abstract&#x0D; Introduction &amp; Objectives : This study aims to determine the improvement of binocular vision function after restoring the lost fusion with strabismus correction&#x0D; Methods : A before and after design clinical trial study was carried out at the Eye Polyclinic of the Moh. Hoesin Hospital in Palembang from June 2021 to February 2022 with a sample of 16 people. Stereoscopic vision examination was carried out with the TNO Stereo Test (Toegepast Natuurwetenschappeelijk Onderzoek) examination before and after strabismus correction was carried out. Analysis of research results with SPSS version 22.0.&#x0D; Results : In this study it was found that stereoscopic vision before surgery could improve significantly after strabismus correction and dichoptic training for 1 month (p&lt;0.05) as much as 68.75%. Meanwhile, confounding factors such as the type of deviation, the magnitude of the deviation, the initial onset of the deviation and the duration of the deviation did not significantly influence the incidence of increased stereoscopic vision improvement in the study subjects (p&lt;0.05).&#x0D; Conclusion : There is an increase in the value of binocular vision in strabismus patients after strabismus surgery and undergoing dichoptic vision training for 1 month. Dichoptic training can improve the function of binocular vision.

Baseline Accommodation and Binocular Vision Measures in Malay Schoolchildren Enrolled in the Myopia Control Study Using Spectacle Lenses in Kuala Lumpur.

Myopia control lenses have been shown to modify visual function; however, it is arguable if these changes are short-term or long-term. We investigated the changes in accommodative behaviour and binocular vision functions of Malay myopic children who participated in a myopia control trial utilising spectacle lenses (n = 40). This article presents baseline accommodation and binocular vision measurements. The mean (± SD) age, spherical equivalent measured by cycloplegic autorefraction, and axial length (AL) for the right eyes were 10.00 ± 1.47 years, -3.02 ± 1.20 D, and 24.42 ± 0.93 mm, respectively. All participants had good distance and near visual acuities with high-contrast charts (100%), which were significantly better than low-contrast charts (10%) (p < 0.001). The mean (± SD) accommodative lag at baseline was 1.14 ± 0.35 D, while monocular and binocular accommodative amplitudes were 15.35 ± 2.07 D and 16.82 ± 2.27 D, respectively. Malay schoolchildren in this study were more esophoric at near compared to distance, with an accommodative-convergence over accommodation (AC/A) ratio of 5.64 ± 0.66 ∆/D. A higher degree of myopia was found to be associated with a longer AL (r = -0.49, p < 0.05) and higher esophoria at near (r = -0.46, p < 0.05). These baseline measures are consistent with data from other studies showing that myopic children have a high accommodative lag, an elevated AC/A ratio, a longer AL, and are more esophoric at near. The measures reported herein will serve as a basis for examining changes that occur within 12 months of wearing myopia control spectacle lenses.

The status of binocular visual functions among Taiwan high-tech industry engineers and its correlation with computer vision symptom

To analyze the status of binocular visual functions, the relationship between binocular visual function and computer vision-related symptoms in the high-tech industry group. The study sample was comprised of 33 participants aged between 20 and 40 years of age. After completing basic information and the Computer Vision Symptom Scale (CVSS-17) questionnaire, the participants underwent a comprehensive examination of binocular visual function. All data were statistically analyzed with SPSS V26.0 software. The value of the binocular vision function of the Taiwan high-tech industry group was significantly different compared with the Scheiman and Morgan standard value. Study subjects were generally found to exhibit larger exophoric at distance, which in turn might lead to a lower ability to maintain binocular fusion to a single image, or recover from fusional disruption at distance. Subjects also experienced accommodation and convergence problems at near at the same time. Age, gender, and refractive errors had no significant impact on CVSS-17 scores, only the duration of computer usage showed a significant effect, particularly for internal symptom factor (ISF) dimensions. In addition, the interaction between the ISF and external symptom factor resulted in more severe visual symptoms. Long-term use of electronic devices may lead to an imbalance in binocular vision function, thereby increasing or exacerbating visual symptoms. If the use of electronic devices is an unchangeable trend, interventions in prescription, visual training or the visual design of electronic products become worthwhile topics for development.

Multifocal intraocular lens implantation in children with unilateral congenital cataracts.

To evaluate the vision recovery, reconstruction of binocular visual function, and influencing factors after multifocal intraocular lens implantation in children with unilateral congenital cataracts. University hospital. Prospective clinical study. In the prospective clinical study, 55 children aged 3 to 14 with unilateral congenital cataracts received multifocal intraocular lenses (TECNIS ZMB00) posterior optic capture from 2019 to 2022. Corrected distance visual acuity (CDVA; 5 m), distance-corrected intermediate visual acuity (DCIVA; 66 cm), distance-corrected near visual acuity (DCNVA; 33 cm), stereoscopic vision, visual quality (objective scatter index [OSI] and modulation transfer function [MTF]), axial length (AL), keratometry (K), and contrast sensitivity (CS), as well as postoperative occlusion compliance were evaluated before and after surgery. At the final follow-up, 90.91% (50/55) patients showed significant improvement in visual acuity (VA) after surgery. CDVA, DCIVA and DCNVA were 0.23 ± 0.17, 0.39 ± 0.15, and 0.44 ± 0.15 logMAR, respectively. 69.09% (38/55) patients achieved good VA (better than 0.3 logMAR).52.76% (25/48) patients had a positive Titmus test. OSI and MTF were 1.24 ± 0.91 and 42.45 ± 12.30, respectively. 73.68% (28/38) of the patients (better than 0.3 logMAR) underwent strict occlusion therapy. Postoperative VA is correlated with preoperative CDVA ( r = -0.829, P < .001), corneal astigmatism ( r = 0.384, P = .036), △AL (difference between the cataract eyes and contralateral eyes, r = -0.490, P = .006), and occlusion compliance ( r = -0.806, P < .001). Multifocal intraocular lens implantation could obtain relatively satisfactory VA (CDVA, DCIVA and DCNVA) and the binocular visual function of children with unilateral congenital cataracts. Postoperative VA is related to preoperative VA, corneal astigmatism, △AL, and occlusion compliance.

Biofeedback fixation training as an important tool to supplement strabismic amblyopia treatment in aduls—preliminary results

Aims/Purpose: Fixation stability may be a biomarker of strabismus and amblyopia recurrence after strabismus surgery and therapeutic interventions to improve visual acuity in amblyopic eyes, respectively. We have recently shown that it is possible to improve fixation stability in adult amblyopic eyes after strabismus surgery using microperimetric biofeedback fixation training (BFT). In this study we evaluated the effects of BFT on fixation stability influencing monocular and binocular visual functions in adult patients with amblyopia.Methods: Participants were 18 patients with monocular amblyopia (mean age = 35.2 ± 9.8 years; 6 females, 3 anisometropic, 5 strabismic and 10 mixed amblyopia). BFT has been applied monocularly to 13 amblyopic eyes either on the spontaneous preferential retinal locus (PRL) or to a fixation area close to the PRL. The other five subjects did not undergo BFT (control group). Best‐corrected visual acuity (BCVA near and distance), monocular (PRL) and dichoptic contrast sensitivity function (CSF) and fixation stability (BCEA 68%) were measured three times: baseline, after 10 and after 20 BFT sessions or twice within 6 months interval for the controls.Results: Baseline fixation stability correlated positively with monocular amblyopic BCVA and CSF, especially in the high frequency range, whereas it was positively associated with dichoptic amblyopic CSF only in the low frequency range, most likely reflecting binocular imbalance. Preliminary results showed that BFT applied to amblyopic eyes improved fixation stability and visual functions. However, some clinical conditions may be required to achieve significant changes.Conclusions: BFT applied to adult amblyopic eyes is a new potential approach to aid in the treatment of suppresive amblyopia in adult patients. Critical pre‐treatment fixational and/or sensorial criteria associated with satisfactory therapeutic effects of BFT on amblyopia remains to be investigated.

A study on the application of artificial intelligence in the design of intelligent medical robots

Abstract With the development of artificial intelligence and robotics technology, the combination of artificial intelligence and medical device research and development has been promoted, which is an important product of the development of artificial intelligence. In this paper, the general structure of the intelligent medical robot is designed by combining artificial intelligence technology and robotics-related technology. Then, the binocular vision function of the robot was realized by visually acquiring the image of the target object, 3D reconstruction of the target object, and combining the SIFT image recognition algorithm and target tracking algorithm. Then, a new speech recognition algorithm was constructed to realize the human-robot interaction function with the medical robot based on the deep learning Transforme network after the construction of the human acoustic model. Finally, the designed intelligent medical robot was tested, and its overall performance was evaluated. The results show that the recognition errors of the intelligent medical robot on the features of the items are all within 0.05, the recognition errors on the features of the human body are within 0.2, and the speed of the target tracking is between 6km/h and 16km/h. The average recognition accuracy of the medical robot for voice commands is about 0.9, the recognition time is about 0.7s, the normal working rate of each function is more than 0.99, and the test speed is within 2s.

Efficacy of anti-suppression therapy in improving binocular vision in children with small-angle Esotropia

PurposeTo evaluate the efficacy of anti-suppression exercises in children with small-angle esotropia in achieving binocular vision. MethodsA retrospective review of patients aged 3–8 years who underwent anti-suppression exercises for either monocular or alternate suppression between January 2016 and December 2021 was conducted. Patients with esotropia less than 15 prism diopters (PD) and visual acuity ≥ 6/12 were included. Patients with previous intra-ocular surgery or less than three-month follow-up were excluded. Success was defined as the development of binocular single vision (BSV) for distance, near, or both (measured clinically with either the 4 prism base out test or Worth four dot test) and maintained at two consecutive visits. Qualified success was defined as the presence of diplopia response for both distance and near. Additionally, improvement in near stereo acuity was measured using the Stereo Fly test. ResultsEighteen patients with a mean age of 5.4 ± 1.38 years (range 3–8 years) at the time of initiation of exercises were included in the study. The male female ratio was 10:8. The mean best corrected visual acuity was 0.18 LogMAR unit(s) and the mean spherical equivalent was +3.8 ± 0.14 diopters (D). The etiology of the esotropia was fully accommodative refractive esotropia (8), microtropia (1), post–operative infantile esotropia (4), partially accommodative esotropia (1), and post-operative partially accommodative esotropia (4). Patients received either office-based, home-based, or both modes of treatment for an average duration of 4.8 months (range 3–8). After therapy, BSV was achieved for either distance or near in 66.6 % of patients (95 % CI = 40.03–93.31 %). Binocular single vision for both distance and near was seen in 50 % of children. Qualified success was observed in 38.46% of patients. Persistence of suppression was observed in one patient (5.5 %). Near stereopsis improved to 200 s of arc or more in 60% of the patients. The mean esotropia reduced from 5.7 ± 4.0 PD for distance and 6.2 ± 4.66 PD for near to 2.7 ± 2.4 PD and 3.38 ± 4.7 PD respectively, at the last follow-up (p-value 0.004 and 0.006). Failure of therapy was noticed after six months of follow-up in the child with infantile esotropia. ConclusionAnti-suppression exercises may be beneficial to improve binocular vision functions in children with small-angle esotropias of variable etiologies. Recurrence of suppression after cessation of therapy is possible, warranting regular follow up.

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.