Distance Vision Research Articles

Managing High Anisometropia with Blended Refractive Surgery: A Comparative Study on Patient Outcomes

Purpose: To compare patient-reported outcomes (PROs) and satisfaction results after blended refractive surgery with one eye Lasik laser/ PRK and another eye ICL. Patients and Methods: A Quality of life and Patient reported spectacle independence (PRISQ) questionnaire was administered to patients who had undergone blended Refractive surgery at 2 months of follow-up. Results: Overall PROs and satisfaction was similar among all the groups. Refractive outcome and accuracy were similar among the groups, Refractive outcome differences were not meaningful among the groups and were not a differentiating factor in PROs. Substantially fewer patients in the third group noticed glare and halo compared with the 3.0/3.0 group (P<0.0001. chi-square test). No new safety concerns were reported. Conclusion: The choice of blended refractive surgery resulted in a higher percentage of patients who were deemed unfit for LVC being satisfied with Near, intermediate, and distance vision, overall the fewer PRO differences were not statistically significant.

Avatar-based versus conventional patient monitoring with distant vision: a computer-based simulation study.

Patient monitoring in the perioperative setting can be challenging, especially when monitoring multiple patients simultaneously or managing dynamic situations that require movement around the operating room. We aimed to evaluate whether avatar-based patient monitoring, which presents vital signs in the form of changing colors, shapes and motion, improves remote vital sign recognition compared to conventional monitoring. We conducted a prospective, single-center, computer-based simulation study to evaluate how anesthesia providers recognize vital signs when using the Philips Visual Patient Avatar at different viewing distances (8 and 16m) compared to conventional monitoring. The primary outcome was the total number of correctly identified vital signs which were compared for the two distances and the two devices using mixed Poisson regression. We analyzed data from 28 anesthesia providers who participated in 112 simulations. The correct recognition rate using the Visual Patient Avatar compared to conventional monitoring at 8m was increased by 74% (rate ratio 1.74, 95% CI, 1.42 to 2.14, p < 0.001) and by 51% at 16-meter viewing distance (rate ratio 1.51, 95% CI, 1.23 to 1.87, p < 0.001). We observed scenario-specific superior performance for six vital signs at 8m. The results provide empirical evidence that avatar-based monitoring can significantly improve the perception of vital signs when using distant vision.

Comparison of 3-month clinical outcomes between two enhanced monofocal intraocular lenses: A single-center prospective study.

This study aims to compare the 3-month clinical outcomes between two enhanced monofocal intraocular lenses (IOLs) following cataract surgery.Setting: Eye Clinic of Careggi University Hospital, Florence, Italy. Single-center prospective study. We included patients with cataract and corneal astigmatism less than 0.75 D, with no ocular comorbidities, who underwent unilateral cataract surgery with implantation of either the Tecnis Eyhance ICB00 (N = 25) or Evolux (N = 25) IOLs. Standard cataract procedures were performed without complications. The main outcome measures included uncorrected and corrected visual acuity at distance (4 m), intermediate (60 cm) and near (40 cm) at 3-month follow-up. Additionally, monocular defocus curves, aberrometric profiles, and perceptions of halo and glare were evaluated. The study involved 50 patients (26 male, 24 female) with a mean age of 68 ± 8 years. Preoperative characteristics were similar between the groups, and no intraoperative or postoperative complications were reported. Statistically significant differences were observed between the groups, with the Evolux IOL showing superior results (p < 0.05) in terms of uncorrected and corrected visual acuity at near, intermediate, and distance, as well as in aberrometric profiles (lower-order aberration root-mean-square [RMS], higher-order aberration RMS, spherical equivalent RMS, and point spread function) and defocus curves. Based on our experience, while both IOLs offer substantial visual performance for intermediate and distance vision, the Evolux IOL demonstrated superior mean visual outcomes and objective parameters at the 3-month follow-up compared to the Tecnis Eyhance IOL. This indicates a potential advantage of the Evolux IOL in providing better visual performance.

Patient-Reported Outcomes in RLBP1 Retinal Dystrophy: Longitudinal Assessment in a Prospective Natural History Study.

To evaluate the performance of two non-disease-specific patient-reported outcome (PRO) instruments, the National Eye Institute Visual Function Questionnaire-25 (VFQ-25) and the Low Luminance Questionnaire (LLQ), in patients with retinaldehyde-binding protein 1 retinal dystrophy (RLBP1 RD). PROs were assessed using the VFQ-25 and LLQ. Rasch analysis was conducted to estimate person and item measures of the VFQ-25 and LLQ questionnaires to determine the association between the two PROs. In addition, the association between these two instruments and their correlations to weighted measures of visual function and disease progression were analyzed in this three-year PRO-focused sub-study of a five-year prospective natural history study. Forty-two patients participated, with most of them having completed at least two PRO follow-up visits at least one year apart. The mean VFQ-25 scores were lowest for distance activities (39.2-49.0) and peripheral vision (37.5-52.4), with mean LLQ subscale scores generally low (<41), except for the emotional distress subscale. Using Rasch analysis, calibrated item and person measures along with their standard errors were estimated for both ePROs. This indicated that the distribution of the VFQ-25 and LLQ item measures well covered the distribution of person function in this group. This suggests that the item difficulties well cover the person-level performance in this population. As well, the two PROs showed a strong and significant correlation at all assessed time points as assessed with Pearson correlation coefficient (0.81, 0.91, 0.81 and 0.87 at baseline, 1/1.5, 2/2.5 (P < 0.001) and 3/3.5 years (P = 0.002)). The composite scores of both PRO questionnaires strongly correlated with clinical measures of visual function. At 2 to 2.5 years of follow-up, meaningful statistically significant declines in peripheral vision (both VFQ-25 and LLQ), distance vision (VFQ-25), and extreme lighting in dark and bright light (LLQ) subscales were noted. This study demonstrated a strong association between VFQ-25 and LLQ scores and their association with clinical measures of visual function. PRO instruments can provide insights into the specific disabilities of this unique patient population and help to guide appropriate outcome measures for future clinical trials.

NEIVATECH pilot study: immersive virtual reality training in older amblyopic children with non-compliance or non-response to patching.

Immersive virtual reality (VR) is recently being explored as a therapeutic alternative for the treatment of amblyopia. This pilot study aimed to evaluate the preliminary efficacy, safety, usability and satisfaction obtained with the use of a novel VR system (NEIVATECH) to provide binocular vision training in previously treated older amblyopic children with non-compliance or non-response to patching. A prospective, multicentre, open-label, single-arm, pilot study was conducted in which the intervention under study was 9h of therapy with the NEIVATECH system, distributed in 18 half-hour sessions spread over 1 month. A comprehensive visual assessment was conducted before and after the intervention, and at the end of the intervention the safety and usability of the system and patient satisfaction were evaluated. After therapy, statistically significant differences were observed in the near best-corrected visual acuity (BCVA) of the dominant (p = 0.022) and non-dominant (p = 0.022) eye, in stereopsis based on the Binocular Function Score (p = 0.045) and in the break (p = 0.012) and recovery (p = 0.009) points of negative fusional vergence for distance vision. The safety and usability of the system and patient satisfaction with the therapy were adequate. These findings support further investigation of this treatment option in future studies incorporating a control group with which to compare the results obtained. Trial registration: NCT04819386.

Interventions to prevent visual fatigue during robotic surgery.

The robotic surgeon is at risk of visual fatigue from prolonged viewing of the video display resulting in digital eye strain and use of the three-dimensional binoculars resulting in accommodative stress. Symptoms of digital eye strain include blurred vision, dry eyes, eyestrain, neck and back ache, diplopia, light sensitivity, and headaches. Vergence or accommodation-related symptoms include blurred near or distance vision, difficulty refocusing, and diplopia. Beneficial ergonomic interventions to manage digital eye strain during robotic surgery include appropriate lighting, improved neck positioning, optimal screen positioning, improved image parameters, screen breaks, optimising environmental factors, and eye exercises. Correction of refractive error, use of lubricating eye drops, and blink efficiency training to induce motor memory have been shown to be effective in reducing visual fatigue. Vergence-accommodation mismatch can be reduced with slower movement of the camera, screen breaks, and correction of refractive error. Robotic surgeons should adopt these simple and non-invasive interventions to minimise visual fatigue.

Randomised controlled trial of HOYA One-day Multifocal Contact Lenses: – the HOMCL trial

Trial designDouble-masked crossover RCT (Research Registry: #8136) comparison of a new HOYA one-day disposable multifocal contact lens (HOMCL) with Alcon DAILIES TOTAL1® Multifocal (ADT1). MethodsSixty presbyopic participants from three countries attended for baseline measurements and fitting of both lens types and then for a fortnight completed daily diaries of symptoms with habitual optical correction, and VF-14 questionnaire. Participants collected either HOMCL or ADT1, when the vision was measured again, and they wore this product for a fortnight, completing daily diaries and VF-14. Participants then collected the other type and had vision and symptoms recorded in the same way. ResultsThere were no serious adverse events. Primary outcomes were no significant differences between the lens types in willingness to purchase nor stated preference; no significant differences in the daily symptom ratings of comfort; statistically significant findings with the daily symptom ratings and VF-14 of better near vision with HOMCL and better distance vision with ADT1. Secondary outcomes were better high contrast distance visual acuity with ADT1 (<1 line), better low contrast distance visual acuity with ADT1; faster Wilkins rate of reading test with HOMCL; no significant differences in near visual acuity, wearing time, or number of lenses during fitting process. Exploratory analyses were better handling scores with ADT1; and some, but not all of the dry eye data indicating better acceptance of HOMCL by patients with relatively dry eyes. For all measures, there were some participants who preferred/performed better with each lens type. ConclusionsThe differences between the performance of the two products were small. There was a trend in some clinical measurements and the daily diary data and VF-14 questionnaire, for HOMCL to outperform ADT1 for near vision and vice versa for distance vision.

Visual quality following FS-LASIK with Q-value-guided optimized monovision in patients with myopia and presbyopia: Custom-Q in treating myopia and presbyopia

PurposeTo evaluate the objective and subjective visual quality 3 months after femtosecond laser‐assisted laser in situ keratomileusis (FS-LASIK) performed with Q-value–guided optimized monovision scheme (Custom-Q) for correction of myopia with or without astigmatism and compensate for age-related accommodation deficiency. DesignProspective before-and-after study. MethodsPatients who had Custom-Q FS-LASIK for myopia with age-related accommodation deficiency were included in this prospective study. Distance, intermediate, and near visual acuities; refraction; Q value; corneal higher-order aberrations (HOAs); accommodative and binocular function measurements; defocus curve; contrast sensitivity and a subjective questionnaire assessing near visual ability and visual discomforts were evaluated before and after surgery. ResultsClinical data of 48 cases were analyzed. The mean age was 42.73 ± 2.67 years (40 to 50 years). At the 3-month follow-up, there were 100% (48/48), 92% (44/48), and 56% (27/48) patients who achieved a binocular uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA) not less than 20/20 separately. Defocus curves revealed better results postoperatively at – 1.00 D and – 1.50 D. The Q value in the dominant eyes was more positive postoperatively (P<0.001), and in the non-dominant eyes, the Q value and corneal spherical aberration (SA) became more negative (P<0.05). The accommodative amplitude (AA) and relative accommodation improved binocularly (P<0.001). The questionnaire demonstrated high patient satisfaction with near vision, and patients’ perceptions of visual discomforts had no significantly difference compare with preoperative. ConclusionFor myopic patients with age-related accommodation deficiency, the Custom-Q ablation could improve near vision without compromising distance vision. It also led to minimal changes in objective optical quality, coordination of accommodative and binocular functions, contrast sensitivity, and subjective visual discomforts perceptions.

Clinical Comparison of a Small-Aperture Intraocular Lens Versus a Monofocal Control.

To evaluate range of visual acuity, visual quality, and safety of the IC-8 small-aperture (SA) intraocular lens (IOL) (Apthera; Bausch & Lomb, Inc) in patients with cataract. This was a prospective, multicenter, open-label, parallel-group, non-randomized, examiner-masked, 12-month clinical study conducted at 21 sites in the United States. Included patients (N = 453) received either the SA IOL (targeted to -0.75 diopters) in one eye and a monofocal or monofocal toric IOL (targeted to plano) in the fellow eye (SA IOL group, n = 343) or bilateral monofocal/monofocal toric IOLs (control group, n = 110). At 6 months, the SA IOL group achieved superior binocular uncorrected intermediate and near visual acuity (P < .0001) and equivalent binocular uncorrected distance visual acuity versus the control group. In SA IOL eyes, 99.1% achieved monocular corrected distance visual acuity of 0.3 logarithm of the minimum angle of resolution or better. The SA IOL and control groups had comparable binocular photopic and mesopic contrast sensitivities at 6 months both with and without glare. The SA IOL group reported few visual symptoms overall, although at higher rates than in the control group. The SA IOL group exhibited improved intermediate and near vision, comparable distance vision and binocular contrast sensitivities, and few visual symptoms or adverse events versus the bilateral monofocal/monofocal toric IOL group, suggesting that the SA IOL is an effective option for presbyopia correction at the time of cataract surgery. [J Refract Surg. 2024;40(11):e824-e835.].

Ocular manifestations in neurofibromatosis: A case series

Background: A collection of inherited diseases known as neurofibromatosis (NF) are distinguished by a broad spectrum of clinical manifestations. A genetic mutation on chromosome 17 (17q11.2) is the cause of NF type 1 (NF1), whereas a mutation on chromosome 22 (22q12.2) is the cause of NF type 2 (NF2). In NF1, ocular symptoms are more frequent. Patients with NF1 commonly appear with globe enlargement, glaucoma, and orbital facial involvement. Palpebral neurofibromas have the potential to grow extensively and, in rare instances, develop into malignant tumors. Optic nerve gliomas can result in strabismus and proptosis. Up to 80% of patients with NF2 may experience early-onset cataracts, optic nerve hamartomas, and mixed pigment retinal and epithelial hamartomas. Case presentation: We present four cases of neurofibromatosis, each displaying typical clinical features of the disorder. · Case 1: A 28-year-old male presented with headaches, reduced vision, and multiple tiny discolorations in both eyes for six months. Examination revealed multiple hyperpigmented skin lesions (2-5 mm) across his body, and ocular assessment showed normal pupillary reactions and distant vision of 6/6 in both eyes. Slit-lamp examination identified multiple dome-shaped lesions on the iris, consistent with Lisch nodules. · Case 2: A 42-year-old female experienced reduced vision for six months and skin lesions for five years. Examination revealed multiple discrete skin-colored papules and café-au-lait macules on her hands. Her vision was 6/12 in both eyes, with normal pupillary reactions. Slit-lamp findings were also consistent with Lisch nodules. o Case 3: A 48-year-old male reported vision loss in both eyes over two months, accompanied by swelling of the right upper eyelid, which was increasing in size. Lisch nodules were found on the iris of the left eye, and he was diagnosed with typical NF. o Case 4: A 38-year-old male presented with diminished vision. Slit-lamp examination revealed multiple dome-shaped lesions on the iris, suggesting Lisch nodules, along with skin lesions on the face and other body areas Conclusion: Managing neurofibromatosis requires a multidisciplinary approach, involving close collaboration between healthcare providers. Monitoring visual prognosis, enrolling patients in clinical trials, and regular disease monitoring are essential steps in managing the condition.

Visuelle Beeinträchtigung in der Kontaktlinsenpraxis

Purpose. The aim of this case report is to describe the treatment of myopic eyes with pathological reduced vision. A contact lens and a spectacle lens build a telescope and the associated magnification helps to increase vision acuity. Material and Methods. The myopic not presbyopic eyes (−3.00 D) were overcorrected by −7 D with bitoric, spherical, rigid contact lenses, base curve = 8.00/7.65 mm, back-vertex-power = −10.00/−12.00 D, over-all diameter = 10.4 mm. The refractive compensation with the spectacle lens, back-vertex-power = +6.50 D (corneal-vertex-distance 12.0 mm), front-surface-power = +7.50 D, refractive index = 1.50, over-all diameter = 65 mm, centre thickness = 7.10 mm together with contact lens build a Galilean type telescope with a maximum of magnification power. Results. The magnification power of the telescope was Vs = 1.091, the magnification power of the spectacle lens was Ve = 1.037 and the related total magnification power was Vg = 1.131. The telescope increased the binocular distance vision acuity from 0.40− to 0.63 and the binocular near vision acuity from 0.32+ to 0.40+. Conclusion. The Galilei system described is suitable for improving visual acuity in the case of special visual impairments.

Unveiling loneliness: health determinants of feeling alone in the older urban residents

Abstract In older people health condition contributes to the feeling of being alone (loneliness). We aimed to assess which chronic health conditions are the strongest determinants of loneliness in older urban residents. Participants of the Polish part of the HAPIEE Study (Health Alcohol and Psychosocial Factors in Eastern Europe) examined in 2019-20 were included to the analysis. Trained nurses interviewed respondents in their homes. Loneliness was assessed using 3-item UCLA scale (range: 3-9, cuf-off≥ 6 points). Socioeconomic data, self-rated health (SRH) and the history of 18 diseases diagnosed by the doctor was assessed using standardized questionnaire. Multivariable logistic regression was used; odds ratios and 95% confidence intervals are presented (OR (95%CI)). There were 461 participants (48% males) of mean age 72 years (SD = 6.3). In 34 participants (7%) UCLA score was 6 or more. The majority (63%) of respondents were married or cohabiting. Nearly 90% declared having children. After adjustment for marital status and having children, poor distance vision 3.84 (1.31-6.12), hearing problems 2.20 (1.07-4.53), acute back pain syndrome 2.21 (1.06-4.59) and cancer 2.36 (1.03-5.41) were determinants of loneliness. Further adjustment for age weakened the association with distance vision 2.74 (1.26-5.94) and waved the relationship with hearing problems 2.06 (0.99-4.29). The estimates for remaining health conditions remained almost unchanged. The strongest predictor of loneliness was SRH. After adjustment for age, marital status, having children and objective burden of chronic diseases, compared to good SRH, participants with moderate and poor SRH were more likely to report loneliness by over 3 and 6 times: 3.41 (1.29-9.05) and 6.60 (2.16-20.18), respectively. The perception of poor health and diagnosis of cancer strongly determined loneliness in older people, but other important predictors of loneliness were conditions that objectively hinder maintaining social contacts. Key messages • In older people health condition is related to the feeling of being alone, and the strongest objective health determinant of loneliness was diagnosis of cancer. • Independently of objective burden of chronic diseases, self-rated health was a significant predictor of loneliness in older urban residents.

Research on a Multi-Scale Clustering Method for Buildings Taking into Account Visual Cognition

Building clustering is a key problem that needs to be solved in the realization of the automatic synthesis of large-scale maps. The selection of different feature and spatial distance calculation methods has a great impact on the clustering results, and the need to manually select appropriate feature and distance metrics leads to the problem of not being able to fully consider the complexity and diversity of buildings. In this paper, we propose a multi-scale clustering method for buildings that takes visual perception into account using the Gestalt principle to simulate how humans classify buildings through visual perception. Moreover, by analyzing the spatial features and texture attributes of buildings, a visual distance is designed to be used as a condition for building classification to assess the similarity between buildings, solving the complexity of manually selecting feature vectors and spatial distances and realizing the adaptive selection of features. Through experimental validation at different scales (macro, meso and micro), the present method is able to achieve the accurate clustering of buildings, and a frequency threshold of 91% is found, which is able to determine the optimal clustering results. The experimental results show that the proposed method can not only fully consider the complexity and diversity of buildings but also effectively support the understanding and analysis of urban spatial structure and provide a scientific decision-making basis for urban planning and management.

Juvenile Myopia: The Silent Vision Understanding, Preventing, and Managing Childhood Myopia

Juvenile myopia, a significant visual impairment characterized by blurred distance vision, is increasingly prevalent among Indian children. This review explores the multifactorial etiology of myopia, including genetic predisposition, environmental influences, and lifestyle factors such as prolonged near work and limited outdoor activities. The pathophysiology involves abnormal eye elongation driven by genetic and environmental factors, leading to refractive errors. Clinical manifestations include blurry distance vision, squinting, eye strain, and headaches, impacting academic performance and quality of life. Emphasis on early detection, parental awareness, and adherence to treatment protocols is crucial in controlling myopia progression and preventing long-term complications such as retinal detachment, myopic maculopathy, and glaucoma. This review underscores the need for comprehensive public health strategies to address the growing burden of juvenile myopia in India. Juvenile myopia is rapidly becoming a significant public health concern in India, with increasing prevalence driven by lifestyle changes, urbanization, and academic pressures. This systematic review aims to examine the prevalence, risk factors, and interventions for childhood myopia, with a focus on understanding the silent nature of this condition, identifying early prevention strategies, and outlining management techniques to curb its progression.

Deriving disability weights for the Netherlands: findings from the Dutch disability weights measurement study

BackgroundThe aims of this study were to establish national disability weights based on the health state preferences of a Dutch general population sample, examine the relation between results and respondent’s characteristics, and compare disability weights with those estimated in the European disability weights study.MethodsIn this cross-sectional study, a web-based survey was administered to a general population 18–75 years from the Netherlands. The survey included paired comparison questions. Paired comparison data were analysed using probit regression and located results onto the 0-to-1 disability weight scale using non-parametric regression. Bootstrapping was used to estimate 95% uncertainty intervals (95%UI). Spearman’s correlation was used to investigate the relation of probit regression coefficients between respondent’s characteristics.Results3994 respondents completed the questionnaire. The disability weights ranged from 0.007 (95%UI: 0.003–0.012) for mild distance vision impairment to 0.741 (95% UI: 0.498–0.924) for intensive care unit admission. Spearman’s correlation of probit coefficients between sub-groups based on respondent’s characteristics were all above 0.95 (p < 0.001). Comparison of disability weights of 140 health states that were included in the Dutch and European disability weights study showed a high correlation (Spearman’s correlation: 0.942; p < 0.001); however, for 76 (54.3%) health states the point estimate of the Dutch disability weight fell outside of the 95%UI of the European disability weights.ConclusionsRespondent’s characteristics had no influence on health state valuations with the paired comparison. However, comparison of the Dutch disability weights to the European disability weights indicates that health state preferences of the general population of the Netherlands differ from those of other European countries.

Central tendency and serial dependence in vestibular path integration.

Path integration, the process of updating one's position using successive self-motion signals, has previously been studied using visual distance reproduction tasks in which optic flow patterns provide information about traveled distance. These studies have reported that reproduced distances show two types of systematic biases: central tendency and serial dependence. In the present study, we investigated whether these biases are also present in vestibular path integration. Participants were seated on a linear motion platform and performed a distance reproduction task in total darkness. The platform first passively moved the participant a pre-defined stimulus distance which they then actively reproduced by steering the platform back the same distance. Stimulus distances were sampled from short- and long-distance probability distributions and presented in either a randomized order or in separate blocks to study the effect of presentation context. Similar to the effects observed in visual path integration, we found that reproduced distances showed an overall positive central tendency effect as well as a positive, attractive serial dependence effect. Furthermore, reproduction behavior was affected by presentation context. These results were mostly consistent with predictions of a Bayesian Kalman-filter model, originally proposed for visual path integration.

Prevalence of Diabetic Macular Edema Using Optical Coherence Tomography in Type 2 Diabetics With Nephropathy in Comparison With Type 2 Diabetics Without Nephropathy.

The primary vision-threatening complication in patients with diabetic retinopathy (DR) is diabetic macular edema (DME). Diabetic nephropathy (DN) often has DR that threatens their vision and has a risk of developing DME. Hence, the presence of DN could be the only risk factor for developing DME without the presence of other factors. Hence, this study proposes to predict the prevalence of DME using optical coherence tomography (OCT) in type 2 diabetics with nephropathy in comparison with diabetics without nephropathy. This is a cross-sectional study done on patients visiting the Ophthalmology Department at Saveetha Medical College and Hospital, Chennai, for one year. A total of 120 patients were included in the study, with 60 diabetic patients without nephropathy in Group 1 and 60 diabetic patients with nephropathy in Group 2. A detailed history was recorded. Their recent blood reports of fasting blood sugar, postprandial blood sugar, hemoglobin A1c (HbA1c), renal function test, and urine protein/creatinine ratio were all noted. Chronic kidney disease (CKD) staging in nephropathy patients as done by the nephrologist was also documented. The best corrected visual acuity (BCVA) was assessed for distant and near vision. A slit lamp examination and dilated fundus examination were done. Fundus findings were independently graded according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. OCT was done in all patients to confirm DME. In our study. males and females were 60 each in number. The majority of patients(32.5%) were >70 years old. A small percentage of patients (1.7%) in Group 1 had DM of >10 years, and 41.7% of the patients in Group 2 had DM of >10 years. Meanwhile, 73.3% of the patients in Group 1 had an HbA1c level between 6% and 7.5%, and 83.3% of the patients in Group 2 had an HbA1c level >7.5%. The percentage of patients with DME in Group 1 was 1.7%, and that in Group 2 was 21.7%. The majority of patients who had BCVA of 6/6 were in Group 1. The majority of patients with DME (46.4%) had stage V nephropathy. The coexistence of nephropathy in diabetic patients increases the incidence of DME. With long-standing diabetes and uncontrolled blood sugar levels being risk factors for developing DN and subsequently DME, such patients are to be screened regularly and advised on adequate glycemic control for achieving good visual prognosis and limit retinopathy progression. Moreover, the severity of DN should be kept in mind by nephrologists, and patients are to be promptly referred to the ophthalmology department for complete evaluation.

Evaluation of Intermediate Visual Outcomes in Eyes Implanted with Bilateral Advanced Monofocal Intraocular Lens Targeting for Mini-Monovision and Its Association with Age and Corneal Asphericity.

To assess the visualoutcomes in patients bilaterally implanted with novel Clareon® intraocular lens when targeting mini monovision post-operatively. The study was conducted at Laxmi Eye Institute; itis a tertiary care eye institution in Panvel, India. This is an investigator initiated, prospective, single-centre longitudinal study of 45 patients to assess the visual outcomes in patients who were implanted with Clareon ® IOL bilaterally. Patients with corneal astigmatism of ≤0.75 D who underwent bilateral cataract surgery with pseudophakic mini-monovision and implanted with novel Clareon® intraocular lens were included. Patients having post op manifest refraction >±0.25 D in the dominant eye and <-0.5 D or >-0.75 D in the non-dominant eye were excluded. The main study outcomes were assessed at 1 and 3 months; itincluded uncorrected visual acuities assessment, defocus curve, and patient reported spectacle use. The mean (SD) binocular distance corrected intermediate visual acuity at 3 months was 0.22 (0.09) LogMAR. At 3 months, 54% of patients enjoyed 0.4 LogMAR or better BUCNVA. The defocus curve showed good distance and intermediate visual acuity with >0.2 LogMAR vision from +0.50 D to -1.50 D. We found a positive correlation between the Q value of the dominant eye and the BCIVA at 3 months postoperatively, however it was not statistically significant. The Q value was more negative when the intermediate vision was closer to 0 LogMAR. Post operatively, at3 months,95% patients did not need glasses for distance and intermediate vision and 73% of patients were comfortable for intermediate vision without glasses all the time. Mini-monovision with Clareon® monofocal IOL implantation can offer overall satisfactory vision for far and intermediate distances with minimal need for use of spectacles for near vision.

Posture and vision: How different distances of viewing target affect postural stability and plantar pressure parameters in healthy population

BackgroundPostural stability is maintained by the Postural Control System (PCS), consisting of anatomical structures of Central Nervous System and peripheral receptors, interacting with each other, in order to keep whole-body balance by modulating the myofascial chains against gravity. The vision is one of the most important peripheral receptors for postural control. Previous studies analyzed the changes of body sway during viewing nearby (VNT) and distant (VDT) targets in healthy population without considering the feet adaptations related to the body weight distribution. Aim of this study was to investigate how different distances of viewing target affect the variability of postural stability and plantar pressure parameters in healthy subjects. Methods31 stabilometric and plantar pressure parameters were acquired in 20 young healthy subjects by baropodometry performed in bipedal standing during VNT and VDT (0.70 m and 3 m from the heels, respectively). Variability and statistical differences between VDT and VNT were implemented. ResultsResults showed the highest repeatability for plantar pressure parameters, a slightly high for CP speed and a lowest for CoPsa and Length Surface Function during both VNT and VDT. Moreover, a significant increase of load percentage on left-foot and right-Forefoot, of mean and maximum pressures on left-Forefoot, of CoPsa and CPspeed and a decrease of LSF were found during VDT. DiscussionThis study revealed how a greater distance of viewing target affects body-weight distribution and increases body oscillations. These findings highlighted the importance of visual target distance for the correct interpretation of postural stability and plantar pressure parameters, and the need to standardize target distance during stabilometric exam.

Interdependence of Nutrition, Physical Activity, and Myopia.

Background: Myopia (also known as nearsightedness), a prevalent refractive error, occurs when parallel rays of light converge in front of the retina, resulting in blurry distance vision. Recently, there has been a marked rise in myopia among the global population. The absence of effective methods of controlling the progression of this visual defect prompts the search for new preventive and therapeutic options. The impact of diet and lifestyle on the progression of myopia is still not fully understood. Therefore, our aim was to examine how these factors might affect the advancement of myopia, based on the existing literature. Methods: This manuscript was prepared through an extensive literature review conducted from June 2022 to September 2024. We searched for pertinent research articles using reputable databases, including PubMed, Scopus, and Web of Science. We included all types of publications, with a special focus on the newest ones. Results: Despite far-reaching examination, the relationship between these factors and myopia control remains inconclusive with varying degrees of evidence supporting their roles. Conclusions: However, promoting a healthy lifestyle, particularly increasing physical activity and outdoor time, is essential. Additionally, emerging research suggests that maintaining a balanced diet is important due to the potential impact of certain nutrients on myopia development. Ophthalmologists should also guide parents on the alternative correction methods beyond single vision glasses, especially for rapidly progressing cases. With the rising prevalence of myopia in children, further research is necessary.