Corrective Eyewear Research Articles

Refractive Errors of School Children from Economically Disadvantaged Areas in Northwest México.

Background: Refractive errors, including myopia, hyperopia, and astigmatism, are the leading causes of visual impairment in school-aged children and can significantly impact their academic performance and quality of life. This study aimed to assess the prevalence of refractive errors among school children from economically disadvantaged areas in Northwest México, using a consistent methodology to facilitate comparison with global data. Methods: We adopted the Refractive Error Study in Children (RESC) protocol by the World Health Organization to examine the prevalence of myopia, hyperopia, and astigmatism. The study comprised a systematic sampling of children aged 6 to 18 years from diverse schools in Northwest México. Trained optometrists conducted visual acuity testing and autorefraction, while ophthalmologists performed cycloplegic refraction to ensure accuracy. Results: The study found a myopia (SE ≤-1.50 D at least one eye) prevalence of 14.55% (95% CI: 13.27-15.91), with a higher incidence in females (6.92%) compared to males (6.00%) in at least one eye. Hyperopia (SE ≥ +1.00 D at least one eye) was less common, at 3.23% (95% CI: 2.61-3.95), with a slightly higher occurrence in males in at least one eye. Astigmatism (Cylinder ≥ 0.75 D at least one eye) was present in 18.63% (95% CI: 17.21-20.12) of the students in at least one eye, with no significant difference between genders. These findings are consistent with other studies in regions such as Puerto Rico and Iran, indicating widespread refractive error issues among schoolchildren. Conclusions: The high prevalence of refractive errors, particularly myopia and astigmatism, highlights the critical need for regular vision screenings in schools and the implementation of public health interventions to provide corrective eyewear. Our study confirms the importance of utilizing standardized methodologies like the RESC protocol to compare refractive error prevalence across different geographical and socio-economic contexts, thereby informing global public health strategies.

Myopia Control Effect of Repeated Low-Level Red-Light Therapy Combined with Orthokeratology: A Multicenter Randomized Controlled Trial

To investigate the efficacy and safety of repeated low-level red-light(RLRL) therapy combined with orthokeratology(Ortho-k) among the children who, despite undergoing Ortho-k treatment, exhibited an axial elongation of at least 0.50mm over 1 year. Multicenter, randomized, parallel-group, single-blind clinical trial (ClinicaTrials.gov,NCT04722874). Eligible children were aged 8-13 years with a cycloplegic spherical equivalent refraction of -1.00 to -5.00 diopters in the initial Ortho-k fitting examination and had annual axial length (AL) elongation ≥ 0.50 mm despite undergoing Ortho-k for 1 year. A total of 48 children were enrolled from March 2021 to January 2022, and the final follow-up was completed in March 2023. Children were randomly assigned to the RLRL combined with Ortho-k(RCO) or the Ortho-k group in a 2:1 ratio. The Ortho-k group wore Ortho-k at least 8 hours per night, while the RCO group received daily RLRL therapy twice a day for 3 minutes in addition to Ortho-k wearing. The primary outcome was AL change measured at 12 months relative to baseline. The primary analysis was conducted in children who received the assigned intervention and completed at least 1 post-randomization follow-up using the modified intention-to-treat principle. A total of 47(97.9%) children were included in the analysis (30 in the RCO group and 17 in the Ortho-k group). The mean axial elongation rate before the trial was 0.60mm/year in the RCO group and 0.61mm/year in the Ortho-k group. After 12 months following the intended intervention, the adjusted mean AL changes were -0.02mm(95% CI, -0.08 to +0.03 mm) in the RCO group and 0.27mm(0.19-0.34 mm) in the Ortho-k group. The adjusted mean difference in AL change was -0.29mm(-0.44 to -0.14mm) between the RCO and Ortho-k groups. The percentage of children achieving an uncorrected visual acuity greater than 20/25 was similar in the RCO (64.3%) and Ortho-k (65.5%) groups (Chi2 test, P=0.937). Combining RLRL therapy with Ortho-k may offer a promising approach to optimize axial elongation control among myopic children. This approach also potentially allows children to achieve satisfactory visual acuity, reducing the daytime dependence on corrective eyewear.

Music with Repeated Sprint Training Impacts on Respiratory Rate and Speed Performance of Students with Visual Impairment

Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as corrective eyewear, assistive devices, and medical treatment– visual impairment may cause the individual difficulties with normal daily tasks including reading and walking. Visual or vision impairment (VI or VIP) is the partial or total inability of visual perception. To achieve these study fifteen male students with visual impairment (b2)were selected from the, Star Special School in Coimbatore, Tamil Nadu. Their age ranged between 15 to 20 years. These subjects were gone for repeated sprint training on daily 60 minutes morning 6 to 7 am up to eight weeks. The selected respiratory rate assessed with manual method and speed performance assessed with 50 m dash. Pre and post-test data were collected and analyzed using the dependent ‘t’ test, with a confidence level set at 0.05. The findings of the study revealed significant changes in respiratory rate and improvements in speed performance intervention of repeated sprint training.

To Approach the Factors of Influencing Consumer Preferences for Corrective Eyewear Design

Correctional eyeglasses used for myopia, hyperopia, astigmatism, and presbyopia require adaptation and prolonged wearing, similar to assistive devices. Unlike decorative glasses, which can be freely changed or not worn as desired and coordinated with overall attire, wearing eyeglasses alters facial appearance. The aesthetics, comfort, and functional quality of eyeglasses directly affect the wearer's willingness, thus impacting visual health and quality of life. Therefore, corrective eyeglass frames need to balance between aesthetic appearance and visual health. This study employs methods such as the Kano Model, Important Performance Analysis (IPA), and Choquet integral to explore the key preference factors for the design of corrective eyeglass frames. Differing from traditional 5-point equidistant semantic questionnaires, this study employs a non-equal interval semantic questionnaire with a golden ratio scale to differentiate adjacent semantic importance ratios, highlighting weighted emphasis on aesthetics. The results provide reference for eyeglass designers and related industries. It is expected to design eyewear that better meets the needs of the Taiwanese population, encouraging people to wear corrective eyewear willingly, thereby further maintaining visual health, improving quality of life, enhancing visual health, and quality of life.

Effects of Miosis on the Visual Acuity Space under Varying Conditions of Contrast and Ambient Luminance in Presbyopia.

Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye's ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal or lens based), and, more recently, the FDA-approved topical administration of 1.25% pilocarpine. While prior research has demonstrated the efficacy of daily pilocarpine eye drop application in enhancing near visual acuity by increasing the depth of focus leveraging the pinhole effect, limited knowledge exists regarding its influence on visual acuity under varying conditions of contrast and ambient luminance. Methods: This study aims to investigate the impact of these variables on visual acuity, employing the VA-CAL test, among 11 emmetropic and 11 presbyopic volunteers who reported subjective difficulties with near vision. This study includes evaluations under natural conditions with a pinhole occluder (diameter of 2 mm), and subsequent administration of 1% pilocarpine (Pilomann, Bausch + Lomb, Laval, Canada). Results: The VA-CAL results demonstrate the expected, statistically significant effects of contrast and ambient luminance on visual acuity in both emmetropic and presbyopic volunteers. Furthermore, in emmetropic individuals, the application of pilocarpine resulted in a statistically significant reduction in visual acuity. In contrast, presbyopes did not exhibit statistically significant differences in the visual acuity space under either the pinhole or pilocarpine conditions when compared to natural conditions. Conclusions: The pharmacological treatment of presbyopia with pilocarpine eye drops, intended to enhance near vision, does not adversely affect visual acuity in presbyopes. This suggests that pilocarpine may offer a viable alternative for individuals averse to wearing corrective eyewear.

Eyes on road safety

How eye conditions can impact road safety and the importance of wearing corrective eyewear when driving were among the issues highlighted this Road Safety Week. Emma White reports

Inequity In Corrective Eyewear Insurance In Ontario: A Repeated Cross-Sectional Study

Background 
 Although the lack of vision insurance coverage has been linked to adverse vision outcomes, Canada still has a patchwork system that provides poor or no coverage to many of its residents. 
 Data and methods 
 We used data from the Canadian Community Health Survey (2005, 2008, 2013-2014) and logistic regressions to describe the extent to which Ontario residents reported insurance coverage for corrective eyewear after the delisting of routine eye examinations for healthy adults in 2004; and, to examine associations between socioeconomic and demographic characteristics, self-reported health and insurance coverage for corrective eyewear. 
 Results 
 We found important socioeconomic differences in the reporting of corrective eyewear insurance. Lower-SES adults were more likely to have reported public corrective eyewear coverage, whereas higher-SES adults and older adults were more likely to have reported private coverage. Overall, lower-SES adults and older adults were substantially less likely to have reported any corrective eyewear coverage. Adults and older adults in poorer health had lower odds of having reported private coverage for corrective eyewear. Relative to 2005, adults had higher odds of having reported public coverage, while older adults had lower odds of having reported public coverage for corrective eyewear in 2013 and 2014. 
 Interpretation
 Our findings reinforce the limits of the current patchwork insurance system for eye care and eyewear in Ontario. The substantial socioeconomic differences in the reporting of corrective eyewear insurance, as well as the low coverage in older adults, particularly among the poor and unhealthy, are of concern.

Laboured reading and musculoskeletal pain in school children - the role of lifestyle behaviour and eye wear: a cross-sectional study

BackgroundLifestyle behaviour in children and adolescents has become increasingly sedentary and occupied with digital work. Concurrently, there has been an increase in the prevalence of headache, neck- and low back pain, which are leading causes of disability globally. Extensive near work and use of digital devices are demanding for both the visual system and the upper body head-stabilizing musculature. Uncorrected vision problems are present in up to 40% of Nordic school children, and a lack of corrective eye wear may cause eyestrain, musculoskeletal pain and headache. The aim of this study was to investigate associations between laboured reading, musculoskeletal pain, uncorrected vision, and lifestyle behaviours in children and adolescents.MethodsThis was a cross-sectional study with a total of 192 Norwegian school children aged 10–11 and 15–16 years. As a part of a school vision testing program, the children completed an online questionnaire about general and ocular health, socioeconomic status, academic ambition, near work and related symptoms, upper body musculoskeletal pain, and physical and outdoor activities.ResultsThe 15–16-year-olds had a more indoor, sedentary, digital-based lifestyle with higher academic demands, compared with the 10–11-year-olds. Concurrently, reading became more laboured and upper body musculoskeletal pain increased with age. Girls reported more symptoms, higher academic ambitions, and more time spent on schoolwork and reading, compared with boys. Non-compliance in wearing prescribed eye wear (glasses or contact lenses), increased use of near digital devices, and experiencing visual stress (glare) were positively associated with laboured reading and upper body musculoskeletal pain.ConclusionsA screen-based lifestyle with high academic demands challenges the ability to sustain long hours of static, intensive near work. Extensive near work tires the visual system and upper body musculature and provokes laboured reading and musculoskeletal pain symptoms. This study emphasizes the importance of regular eye examinations in school children, and the need to raise awareness among children, parents, and school- and health personnel about the importance of optimal vision and visual environment for academic performance and health.

Under the Microscope: The Evolution of Surgical Loupes.

Fine motor movements of the surgeon's hands are limited by the resolution of the eye. Surgical loupes have allowed the profession of surgery to surpass this threshold. This is a review of the historical milestones that lead up to the development of the modern-day loupes. We explore the Greco-Roman history of the magnifying lens, its subsequent application to corrective eyewear centuries later, and the multiple ground-breaking advancements of the compound lens microscope. Moreover, we review the development of pre-modern loupes as each iteration improved through time. The aim of this historical review is to kindle an appreciation for the millennia of development that led to such instrumental modern-day technology.

Outcomes and Revenue Generation of a Community-based Screening at a Center in the United States: The SToP Glaucoma Program.

Of 611 individuals seen at referral clinic visits following community screenings, 76% were diagnosed with ≤1 eye condition needing treatment, generating a total of $213,110 in collections for the institution over 2.5 years. The purpose of this study was to examine the outcomes and revenue generation of community-based eye screenings. Individuals aged 50 years and above screened at community sites in Baltimore, MD, with abnormal ophthalmic findings were referred for one free-of-charge definitive eye examination at the Wilmer Eye Institute. Diagnoses, treatment, and billing information were abstracted from electronic medical records of patients subsequently seen at Wilmer from January 1, 2016, to July 31, 2018. A total of 611 individuals attended 3696 encounters at Wilmer during this time period. Most patients were female (60.3%) and African American (83.7%). At the screening event, 82.9% reported difficulty seeing when not wearing corrective eyewear, although only 49.8% reported having visited an eye doctor within the last 2 years. The majority (60.2%) reported having Medicare/Medicaid coverage, and 8.1% reported being uninsured. At the definitive eye examination after the screening, 75.5% of patients were diagnosed with ≥1 eye condition, most commonly cataract (30.3%), suspicion of glaucoma (24.9%), manifest glaucoma (11.9%), diabetic retinopathy (5.4%), and ocular hypertension (2.6%). Overall, 430 (70.4%) individuals required treatment including surgery (n=106), intravitreal injections (n=14), laser procedures (n=9), and medications (n=48). A total of $213,110 was collected for visits and procedures after the initial referral visit during the study period. A large community-based vision screening program in Baltimore was able to identify ocular conditions requiring treatment in underserved older adults and connect them to eyecare. Our findings also highlight that this model simultaneously generates new revenue streams for the institution organizing the community screenings.

Age-related laryngoscopic visual acuity.

BackgroundEndotracheal intubation by direct laryngoscopy is a mainstay of advanced airway management performed both in the prehospital environment and in the Emergency Department. Many factors may affect the quality of view during direct laryngoscopy, one of them being the visual acuity (VA) of the intubator under these demanding conditions. While some individual variation in VA is to be expected in younger populations, VA naturally deteriorates in older populations particularly beyond the age of 40 years. This study aimed to describe VA in a younger (n=19) and an older (≥40 years of age, n=20) cohort of intubators at baseline and during simulated adult laryngoscopy, and to compare VA between these two age cohorts.MethodsA baseline near VA test was done using a Sloan Early Treatment Diabetic Retinopathy Study (EDTRS) near vision chart at 40 cm under ambient indoor light. Participants in both age cohorts were then requested to perform laryngoscopy using an airway simulator at 40 cm viewing distance and again at a viewing distance of their choice. Both binocular and monocular VA were tested using a near VA chart placed anterior to the vocal cords of the airway trainer. VA was quantified using the logarithm of the minimum angle of resolution (logMAR). Differences in VA between age cohorts were assessed using independent samples t-tests and differences within age cohorts were assessed using paired samples t-tests.ResultsBinocular and monocular near VA was significantly reduced in the older cohort compared to the younger cohort at baseline (both eyes −0.129 logMAR; p = 0.04, right eye −0.147 logMAR; p = 0.005, left eye −0.197 logMAR; p = 0.002). Within each age cohort VA was significantly reduced during laryngoscopy at a fixed viewing distance (younger; both eyes −0.111 logMAR; p < 0.001, right eye −0.095 logMAR; p < 0.001, left eye −0.105 logMAR; p < 0.001; older; both eyes −0,08 logMAR; p < 0.001, right eye −0.110 logMAR; p < 0.001, left eye −0.065 logMAR; p = 0.01) but this was improved by reducing viewing distance.ConclusionIncreased age was associated with a significant reduction in VA at baseline and during laryngoscopy, which can be partially compensated for by adjusting viewing distance. Although it is currently unknown to what extent this age-related reduction of VA might negatively affect time to place an endotracheal tube or success of placement under direct vision, older intubators should be aware of this effect and consider specialized corrective eyewear in order to maintain an adequate level of VA.

Vision status and reading test results in Norwegian adolescents

Uncorrected vision anomalies may cause headaches and may affect reading and academic performance. The purpose of this study was to quantify the frequency of vision anomalies, frequency of eye examinations, and use of corrective eye wear in adolescents in Norway, and to explore whether such vision anomalies affect reading test results or frequency of headaches. A cross-sectional study was performed in 436 adolescents (42.0% males) aged 16–19 years living in South-East Norway. Cycloplegic autorefraction, habitual stereoacuity, and habitual monocular amplitudes of accommodation were measured, and all participants reported the frequency of eye examinations, the use of spectacles and/or contact lens wear, and the frequency of headaches. Reading comprehension and decoding skills were evaluated for a subgroup of the participants (189 participants, 34.4% males) by their performance in national reading tests. Vision anomalies were defined as having refractive errors, poor habitual stereoacuity, or poor habitual amplitude of accommodation in at least one eye. Overall, 44.0% were classified as having a refractive error, and a total of 61.9% were measured to have vision anomalies. More frequent headaches were associated with poor habitual amplitude of accommodation when adjusted for sex (p = 0.04). The frequency of poor reading comprehension was higher in the group of adolescents with vision anomalies (n = 109, 31.2%) compared with those with no vision anomalies (n = 80, 18.8%; p = 0.05). Of those with vision anomalies, 33.5% had never had an eye examination, and 63.9% reported not wearing a correction. In Norway, there is no mandatory vision screening after 4 years of age. The results here show that a nation-wide programme of regular eye examinations and proper treatment of vision anomalies for all children and adolescents in Norway should be considered. Identifying and treating children with common eye problems in primary and secondary school will improve educational attainment and increase each child’s chances of succeeding in further education.

Are healthcare personnel at higher risk of seasonal influenza than other working adults?

AbstractBackground: Adults are at risk of being exposed to influenza from many sources. Healthcare personnel (HCP) have the additional risk of being exposed to ill patients.Objective:To determine whether HCP were at higher risk than adults working in nonhealthcare roles (non-HCP).Design:Prospective cohort study.Setting:Acute-care hospitals and other businesses in Toronto, Ontario, Canada.Methods:Adults aged 18–69 years were enrolled for 1 or more of the 2010/2011, 2011/2012, and 2012/2013 influenza seasons. Swabs collected during acute respiratory illnesses were tested for influenza and pre- and postseason blood samples were tested for influenza-specific immune response.Results:The adjusted odds of influenza were similar for HCP and non-HCP (odds ratio [OR], 1.29; 95% confidence interval [CI], 0.63–2.63). Older adults and those vaccinated against influenza had lower odds, and those who shared their workspace and who used corrective eyewear had higher odds of influenza.Conclusions:HCP and other working adults are at similar risk of influenza infection.

Ageing and employment: are patients ever too old to work?

In the UK more over-50s are in employment than ever before; the employment rate of older people is increasing; and over 1.2 million people are working beyond age 65.1 Several factors contribute to this. The baby boomer generation is aged 50 to 70. Falling birth rates and increased lifespans require people to work longer to meet staffing needs and provide adequate retirement income as they live longer. The default retirement age was abolished in 2011, making it unlawful to retire someone compulsorily because of age, unless justified objectively. From 2020, the state pension age will be 66, increasing to 67 between 2026 and 2028, and linked to life expectancy thereafter. Although health is a determinant of how long people continue to work, there are emotional, personal, financial, and occupational factors. Work brings benefits including self-esteem, companionship, and income. Caring responsibilities, hobbies and interests, relationships in and outside of work, a partner’s employment status, and financial security all influence decisions to retire or to continue working. Occupational factors include the availability of work that satisfies personal needs, and the fit between job demands, working environment, individual circumstances, and capability.2 A new comprehensive report considers current evidence on the impact of age on ability to work, and examines perceptions, myths, and strategies that employers, doctors, and their ageing patients might utilise to maintain meaningful employment.3 Many systems of the body demonstrate age-related changes. The special senses are affected by hearing loss (presbycusis), balance problems (presbystasis), and visual impairment (presbyopia). Presbyopia and presbycusis need not affect job performance and in most cases are overcome by hearing aids, corrective eyewear, …

Correlation of Corrective Eyewear to Acute Respiratory Infection (ARI) Among Outpatient Healthcare Personnel (HCP)

Correlation of Corrective Eyewear to Acute Respiratory Infection (ARI) Among Outpatient Healthcare Personnel (HCP)

Binocular Visual Acuity and Corrective Lens Use in the United States Army.

To assess uncorrected and corrected distance and near binocular visual acuity (VA) and the use of corrective lenses in U.S. Army Active Duty, Guard, and Reserve Soldiers. A descriptive statistical analysis of VA group data from the U.S. Army Vision Readiness Classification Screening system was performed. Data pulls from June 2012 to January 2015 were compared. In January 2015, 62.3% of Soldiers had an uncorrected binocular distance VA of 20/20, 21.2% of Soldiers were worse than 20/40, and 41.4% of Soldiers wore corrective eyewear for distance vision. With correction, 92.5% had a binocular distance VA of 20/20 and 1.4% were worse than 20/40. In January 2015, 32.6% of Soldiers age >45 had an uncorrected binocular near VA of 20/20, 28.4% of Soldiers age >45 were worse than 20/40, and 61.9% of Soldiers age >45 wore corrective eyewear for near vision. With correction, 74.6% had a binocular near VA of 20/20 and 3.0% were worse than 20/40. Data for both years were similar, although there were differences between individual service components. In comparison to the U.S. adult population, U.S. Army Soldiers have better uncorrected and corrected vision and are less likely to wear vision correction.

Eye Vision Testing System and Eyewear Using Micromachines

Proposed is a novel eye vision testing system based on micromachines that uses micro-optic, micromechanic, and microelectronic technologies. The micromachines include a programmable micro-optic lens and aperture control devices, pico-projectors, Radio Frequency (RF), optical wireless communication and control links, and energy harvesting and storage devices with remote wireless energy transfer capabilities. The portable lightweight system can measure eye refractive powers, optimize light conditions for the eye under testing, conduct color-blindness tests, and implement eye strain relief and eye muscle exercises via time sequenced imaging. A basic eye vision test system is built in the laboratory for near-sighted (myopic) vision spherical lens refractive error correction. Refractive error corrections from zero up to −5.0 Diopters and −2.0 Diopters are experimentally demonstrated using the Electronic-Lens (E-Lens) and aperture control methods, respectively. The proposed portable eye vision test system is suited for children’s eye tests and developing world eye centers where technical expertise may be limited. Design of a novel low-cost human vision corrective eyewear is also presented based on the proposed aperture control concept. Given its simplistic and economical design, significant impact can be created for humans with vision problems in the under-developed world.

A Total Variation Approach for Customizing Imagery to Improve Visual Acuity

We describe a technique to generate imagery with improved sharpness for individuals having refractive vision problems. Our method can reduce their dependence on corrective eyewear. It also benefits individuals with normal vision by improving visual acuity at a distance and of small details. Our approach does not require custom hardware. Instead, the calculated images can be shown on a standard computer display, on printed paper, or superimposed on a physical scene using a projector. Our technique uses a constrained total variation method to produce a deconvolution result which, upon observation, appears sharp at the edges. We introduce a novel relative total variation term that enables controlling ringing reduction, contrast gain, and sharpness. The end result is the ability to generate sharper appearing images, even for individuals with refractive vision problems including myopia, hyperopia, presbyopia, and astigmatism. Our approach has been validated in simulation, in camera-screen experiments, and in a study with human observers.

Refractive surgery in Israel Defense Forces recruits

To determine the prevalence of refractive surgery history in recruits for military service in the Israel Defense Forces (IDF) between 1998 to 2005 and to evaluate the effect of surgery on the recruits' fitness to serve in combat units. Surgeon General's HQ, Medical Corps, Israel Defense Forces. The computerized medical records of all ametropic Israeli army inductees were reviewed. They included spectacle-wearing, contact lens-wearing, and post refractive-surgery individuals who were examined in the recruitment office before their compulsory military service. The extracted data from the personal files consisted of the assignment to combat units of those who had refractive surgery and those who wore corrective eyewear and the first and last military position of all ametropic recruits who were assigned to combat units. Five hundred ninety-seven inductees (513 men, 84 women) had refractive surgery before their military service during the study period. The prevalence of recruits who had refractive surgery increased from 0.8/1000 ametropes in 1998 to 4.9/1000 ametropes in 2005. Significantly more recruits who had surgery (73.5%) than recruits who wore corrective eyewear were assigned to combat units (P<.001). The dropout rate from combat units of the former was significantly lower than that of the latter (13.1% versus 29.2%) (P<.001). More corrective eyewear users had refractive surgery before their IDF military service, and relatively more of them applied for combat duty. The high percentage of recruits who had refractive surgery who serve uninterruptedly in combat units indicates that the procedure has no deleterious effect on the recruits' fitness.

Unmet Visual Needs of Alzheimer??s Disease Patients in Long-term Care Facilities

Unmet Visual Needs of Alzheimer??s Disease Patients in Long-term Care Facilities