Non-dominant Eye Research Articles

Comparing accommodative function between dominant and non-dominant eye

This study aims to compare accommodative functions between the dominant and non dominant eyes.A comparative study done in 50 healthy subjects include both males and females with age group ranging between (18 -25 years). It was a hospital-based study conducted in the outpatient department of Ophthalmology. The comparison of accommodative function between dominant and non-dominant eyes is measured to determine which eye shows a higher level of accommodative function. This study has been approved by IRB committee, before beginning this study informed consent has been given and the procedure has been explained clearly, 50 Young emmetropic adults were included. All participants were subjected to comprehensive ophthalmic examination including vision, refraction, Intraocular pressure measurements, slit-lamp examination, the dominance of eye is determined using the hole in the card method and Accommodative functions like the Monocular estimated method (MEM), Near the point of accommodation (NPA) and Accommodative facility (AF) done to find out the ocular dominance.This study shows a higher level of accommodative function in all aspects of accommodative factor such as Monocular estimated method (MEM), near the point of accommodation (NPA) and accommodative facility in the dominant eye. The Mean and Standard deviation value shows a significant difference in all parameters in the dominant eye with a t-value of 7.055(p=.000) when comparing with the Non dominant eye.Comparing the accommodative function between the Dominant and Non dominant eye we concluded that the Near Point of accommodation and accommodation facility were observed more in the dominant eye as compared with the non dominant eyes. The mean accommodative lead was found to be greater than the normal individual (dominant eye). Hence, it is concluded that the dominant eye has a better accommodative function than the non dominant eye.

Objective excyclotorsion increases with aging in adults

ABSTRACT Introduction It has been reported that the disc-fovea angle (DFA), a measure of objective cyclotorsion, increases with age. DFA was measured in three age groups of adults and the effects of age, sex, and laterality on DFA is reported. Methods and Subjects A retrospective study was performed on patients who had a glaucoma checkup or who visited for suspected cataract, who underwent fundus photography between 2013 and 2021. Patients with visual acuity <0.7, axial length >27 mm, strabismus or ocular diseases affecting fusion were excluded. DFA was measured from digital fundus photographs obtained from 249 participants comprising three age groups (group I, 44.4 ± 0.5 years, n = 58; group II, 63.7 ± 3.6 years, n = 129; group III, 81.0 ± 3.8 years, n = 62). The sum of right- and left-eye DFAs is named as total DFA. Results Dunnett’s post-hoc test after ANOVA showed that the left-eye DFA and total DFA of group III were significantly larger than those of group I (p = .01 and p < .01, respectively). Total DFA of female participant (15.6 ± 4.7°, n = 168) was significantly larger than that of male participant (13.9 ± 4.3°, n = 81) (p < .01). The DFA of the left eye (8.2 ± 3.5°, n = 249) was significantly larger than that of the right eye (6.8 ± 3.3°, n = 249) (p < .001). Group III was subdivided based on eye dominance (right eye dominance, n = 36; left eye dominance, n = 13; NA, n = 13). The DFA in the nondominant eye (9.7 ± 4.6°) was significantly larger than that in the dominant eye (7.4 ± 3.7°) (p < .01). Discussion This study found a slight increase of DFA with age. Furthermore, DFA in female or DFA in the left-eye was larger than DFA in male or in the right-eye.

Issues Revisited: Shifts in Binocular Balance Depend on the Deprivation Duration in Normal and Amblyopic Adults.

Recent studies indicate that short-term monocular deprivation increases the deprived eye's contribution to binocular fusion in both adults with normal vision and amblyopia. In this study, we investigated whether the changes in visual plasticity depended on the duration of deprivation in normal and amblyopic adults. Twelve anisometropia amblyopic observers (aged 24.8 ± 2.3years) and 12 age-matched normal observers (aged 23.9 ± 1.2years) participated in the study. The non-dominant eye of normal observers or amblyopic eye of amblyopic observers was deprived for 30, 120, and 300min in a randomized order. Their eye balance was measured with a phase combination task, which is a psychophysical test, before and after the deprivation. This design enabled us to measure changes induced in binocular balance as an index visual plasticity due to monocular deprivations. By comparingthe ocular dominance changes as a result of monocular deprivation with different deprivation durations, we found evidence that the ocular dominance changes are slightly larger after longer deprivations in both normal and amblyopic observers, albeit with a statistical significance. The changesfrom 120-min were significantly greaterthan thosefrom 30-min deprivation in both groups. The magnitude of changes in sensory eye balance was significantly larger in normal observers than that in the amblyopic observers; however, the longevity of changes in visual plasticity was found to be more long-lasting in amblyopic observers than the normal counterparts. The duration of deprivation matters in both normal and amblyopic observers. Ocular dominance imbalance that is typically observed in amblyopia canbe more ameliorated with alonger duration of deprivation.

Single Center to Evaluate and Compare Anisometropic Amblyopia in Adults Using Blood Oxygenation Level-Dependent Functional Magnetic Resonance Imaging and Diffusion Kurtosis Imaging.

BackgroundAnisometropic amblyopia results from the unequal ability to focus between the right and left eyes. Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) measures the proportion of oxygenated hemoglobin in specific areas. Diffusion kurtosis imaging (DKI) is a method of diffusion tensor imaging that estimates the skewed distribution of water diffusion probability. We aimed to evaluate and compare 11 adult patients with anisometropic amblyopia (AA) with 13 normally sighted healthy controls (HC) using BOLD-fMRI and DKI.Material/MethodsEleven adults with AA (age range 20–49; mean age 29.18±8.089) and 13 HC adults (age range 22–50; mean age 28.00±5.79) were recruited. DKI scanning used a single excitation echo-planar imaging sequence and a region of interest to obtain DKI parameters for optic radiation; the corpus callosum was manually placed, including mean kurtosis (MK), fractional anisotropic (FA), and mean diffusivity (MD) values; and BOLD data used a gradient-echo echo-planar imaging sequence.ResultsThe AA group had lower MK and FA of bilateral optic radiation than the HC group (P=0.008 and P=0.006, respectively) and higher MD than the HC group (P=0.005). The MK of the corpus callosum in the AA group was lower than that of HC group (P=0.012).Compared with the non-dominant eyes of the HC group, the amblyopic eyes in the AA group had less activation range and intensity in Brodmann areas 17, 18, and 19.ConclusionsThe combined use of DKI and BOLD-fMRI detected microstructural changes associated with local visual pathways and identified damage to the visual cortex in patients with amblyopia.

Measuring the impact of suppression on visual acuity in children with amblyopia using a dichoptic visual acuity chart.

PurposeTo develop a novel dichoptic visual acuity chart that measures the impact of interocular suppression on the visual acuity of each eye when two eyes are open.MethodsFifty-four subjects (19 anisometropic amblyopia, 20 treated amblyopia, and 15 normal children) participated in this study. The visual acuity that was tested under dichoptic-optotypes condition (i.e., presented optotypes to the untested eye) was compared with that under monocular condition (i.e., cover the untested eye with opaque patch). Visual acuity differences between these two conditions were compared among the three groups. The correlations between visual acuity differences and the depth of interocular suppression were then computed. Some participants performed the visual acuity test under dichoptic-luminance condition (i.e., presented mean luminance to the untested eye), and the test-retest reliability was established.ResultsA reduced visual acuity of the non-dominant eye was found in the dichoptic-optotypes condition for the amblyopia group (P < 0.001) and the treated group (P = 0.001); the difference in the treated group was less than that in the amblyopia group (P < 0.001) but more than that in the normal group (P = 0.026). A significant correlation was found between the visual acuity differences and the depth of suppression, which was tested with a binocular phase combination task (P = 0.005). No change was found in the dichoptic-luminance condition.ConclusionThe amblyopic eye and the previous amblyopic eye seem to suffer from a reduced visual acuity when two eyes are open due to suppression. This was successfully captured by our novel and reliable dichoptic-optotypes visual acuity chart.

Long-Term Efficacy of the Combination of Active Vision Therapy and Occlusion in Children with Strabismic and Anisometropic Amblyopia.

This retrospective study was conducted to evaluate the efficacy of the combined treatment of occlusion and active vision therapy in a total of 27 amblyopic children, including 14 strabismic and 13 anisometropic cases. For such purpose, changes in distance and near visual acuity as well as in the binocular function was evaluated during a two-year follow-up. In both amblyopia groups, significant improvements were found in distance and near visual acuity in the non-dominant eye (p < 0.001). In the strabismic amblyopia group, the percentage of patients with binocular function score (BF) > 3.3 decreased significantly from a baseline value of 64.3% to a two-year follow-up value of 7.1% (p < 0.001). In the anisometropic amblyopia group, this percentage also decreased significantly from a baseline value of 15.4% to a two-year follow-up value of 0.0% (p < 0.001). No recurrences were observed in the anisometropic amblyopia group, whereas recurrence occurred in two cases of the strabismic amblyopia group after finishing the vision rehabilitation process. In conclusion, the combined approach of the treatment evaluated is efficacious for providing an improvement in visual acuity and binocular function in both anisometropic and strabismic amblyopia, which was maintained over time.

Correlation of saccade amplitude during refusion with the fusional convergence amplitude in patients with intermittent exotropia

ABSTRACT In patients with intermittent exotropia (IXT), to investigate the correlation between fusional convergence amplitude and saccade during refusion, as well as the differences in saccade caused by suppression. We measured the fusional convergence amplitude using a synoptophore. Suppression was assessed in 15 patients with IXT (mean age 18.1 ± 11.0 yrs, range 8–54 yrs) having diplopia during exotropia. We performed the cover-uncover test and recorded the saccade during the shift from exotropia to binocular fixation using an eye-tracking system. We analyzed the correlation between the fusional convergence amplitude on the one hand and the saccade peak velocity (PV), the saccade amplitude, and the saccade amplitude of the fusion on the other. We also investigated the difference of those saccade variables between patients with and without suppression. In 15 patients with IXT, the median fusional convergence amplitude was 14 (range 0–60) °, and suppression was confirmed in 11 patients. When the cover was removed from the dominant eye, the fusional convergence amplitude showed a positive correlation with the saccade PV and the amplitude in non-dominant eye (r = 0.570, p = 0.042 and r = 0.669, p = 0.012, respectively). The mean saccade PV, the mean saccade amplitude and the mean saccade amplitude of the fusion were not significantly different with the presence or the absence of the suppression. The fusional convergence amplitude was correlated with saccade in patients with IXT. The saccade during refusion can thus be used to quantitatively evaluate sensory and/or motor fusion.

Evaluation of the Efficacy of a New Dichoptic Digital Platform to Treat the Anisometropic and Isometropic Amblyopia.

The aim of the current study was to evaluate the results of a novel dichoptic training program using an online platform in a group of subjects with refractive amblyopia, performing a comparative analysis of unilateral and bilateral amblyopic cases. For this purpose, a retrospective study analysis of data of 161 children (4–13 years) who underwent dichoptic treatment with the Bynocs® platform (Kanohi Eye Pvt. Ltd., Mumbai, India) was performed. In all cases, the therapy protocol consisted of sessions of training of 30 min daily 5 times a week for 6 weeks. Best corrected visual acuity (BCVA) in the non-dominant eye improved significantly with the treatment, with a mean change of 0.39 logMAR in the whole sample (p < 0.001). Regarding binocularity, the binocular function (BF) score also experienced a significant improvement (p < 0.001), with a mean change of 1.55 with therapy in the whole sample. The BCVA of the dominant eye only improved significantly (p < 0.001) in the isometropic amblyopic subgroup. In conclusion, the use of the dichoptic therapy with the digital platform evaluated allows an effective restoration of visual acuity and binocular function in children with anisometropic and isometropic amblyopia.

Fixation Pattern Analysis With Microperimetry In Strabismic Subjects: A Pilot Study

ABSTRACTObjectiveStrabismic amblyopia is a motor and sensory deficit produced by unilateral constant strabismus and binocular imbalance. The aim of this study was to analyse the retinal fixation pattern using microperimetry in subjects with strabismus with and without amblyopia associated, and to compare the results with those obtained in normal subjects.MethodsProspective comparative study conducted at the Optometric Clinic of the University of Valencia and Oftalvist Alicante (Spain) including 46 eyes with ages from 3 to 16 years. Three groups were differentiated: patients with persistent strabismic amblyopia after occlusion and active therapy (group 1, 7 patients, 30.4%), strabismic patients without amblyopia (group 2, 8 patients, 34.8%) and a control group (8 patients, 34.8%). Microperimetric analysis was performed with the Macular Integrity Assessment (MAIA) system (Centervue, Padova, Italy) and using the following parameters: P1% and P2% fixation indexes, and the ellipse areas (BCEA) for 95% and 63% of points for the first 10 seconds, 30 seconds, 60 seconds, and the total examination time.ResultsSignificant differences were found between groups for dominant eyes in P2 calculated at 30 (p = .04) and 60 seconds (p = .03). However, these differences between groups in non-dominant eyes were close to statistical significance (p = .07 and p = .08). Specifically, P2 was significantly lower in group 1 compared to control group (p = .01). Best corrected visual acuity was found to be significantly correlated (p ≤ .04) with total P1 (dominant eye, r = −0.51; non-dominant eye, r = −0.50), total P2 (dominant eye, r = −0.50; non-dominant eye, r = −0.50), and BCEA63 (dominant eye, r = 0.50; non-dominant eye, r = 0.40) and BCEA95 (dominant eye, r = 0.50; non-dominant eye, r = 0.40) measured at 10 seconds.ConclusionsThe preliminary results of this study seem to indicate that subjects with strabismus have fixation instability regardless of the presence or absence of amblyopia.

Correlation between retinal oxygen saturation and the haemodynamic parameters of the ophthalmic artery in healthy subjects.

The aim of the study was to obtain the values of oxygen saturation in retinal vessels and ophthalmic blood flow parameters in a healthy Caucasian population and assess whether the oximetry parameters are affected by the flow rate or the vascular resistance. The spectrophotometric retinal oximetry and colour Doppler imaging (CDI) of retinal vessels were successfully performed with 52 healthy subjects (average age 29.7 ± 5.6 years). The retinal oximeter simultaneously measures the wavelength difference of haemoglobin oxygen saturation in retinal arterioles and venules. The arteriolar and venular saturation in both eyes was measured. The peak systolic (PSV) end diastolic (EDV) velocities, resistive (RI) and pulsatility (PI) indices were obtained for both eyes using CDI in the ophthalmic artery. A paired t-test and two sample t-tests were used for statistical analyses. The correlation was assessed using the Pearson coefficient correlation. The mean oxygen saturation level was 96.9 ± 3.0% for the retinal arterioles and 65.0 ± 5.1% for the retinal venules. The A-V difference was 31.8 ± 4.6%. The mean of the measured haemodynamic parameters was PSV 46.6 ± 9.4 cm/s, EDV 12.0 ± 3.5 cm/s, PI 1.68 ± 0.38 and RI 0.74 ± 0.05. No significant difference in oxygen saturation and haemodynamic parameters was found between the left and the right eyes or the dominant and non-dominant eye. The oximetry and ultrasound values were sex independent. The Pearson correlation coefficient demonstrated a significant yet weak negative correlation between A-V difference and RI (r = -0.321, p = 0.020). A negative correlation between A-V difference and resistance index was observed, suggesting that reduced oxygen consumption may reflect the increased vascular tone of the ophthalmic vessels, which is likely determined by autoregulatory mechanisms.

Interocular differences in subfoveal choroidal thickness in monocular intermittent exotropia

To determine whether subfoveal choroidal thickness and central foveal thickness differ according to the presence of fixation preference in patients with intermittent exotropia without anisometropia or amblyopia. Children ≥4 years of age with either monocular (fixation preference) or alternating intermittent exotropia on three consecutive visits who had no anisometropia, no amblyopia, and spherical equivalent of ± 1.25 D or less in both eyes were recruited for this study. Subfoveal choroidal thickness and central foveal thickness, measured using spectral domain optical coherence tomography, in the monocular group and the alternating group were compared. A total of 81 patients were enrolled: 46 in the monocular exotropia group and 35 in the alternating exotropia group. The interocular difference in subfoveal choroidal thickness was -11.0 ± 18.0 μm in the monocular group (dominant eye - nondominant eye) and 1.9 ± 22.2 μm in the alternating group (right eye - left eye). The difference between groups was statistically significant (P = 0.005). The interocular difference in central foveal thickness was 1.1 ± 5.7 μm in the monocular group (dominant eye - nondominant eye) and 0.9 ± 5.0 μm in the alternating group (right eye - left eye). The difference between groups was not significant. In patients with intermittent exotropia without amblyopia, the difference in subfoveal choroidal thickness between the eyes in the monocular group was significantly greater than that between eyes in the alternating group. These findings suggest the presence or absence of fixation preference may affect subfoveal choroidal thickness.

Accommodative responses under various viewing conditions in surgical patients with intermittent exotropia: an institutional, retrospective study

PurposeTo investigate the difference of spherical equivalent (SE) and pupil diameter in adult patients with intermittent exotropia (IXT) under various viewing conditions before and after surgery.MethodsWe retrospectively analyzed the medical records of 23 adult patients who underwent a surgery for IXT. The angle of deviation was measured by the prism and alternative cover test. Refractive error and pupil diameter were measured using the Grand Seiko WAM-5500 open-field autorefractor under binocular and monocular viewing conditions when patients stared at distance (6 m) and near (33 cm). Regression analyses were performed between accommodative load and the angle of deviation.ResultsTwenty-three patients (10 males, 13 females) with a mean age of 31.17±8.95 years, of whom 13 (56.5%) had the right eye as the dominant eye. The mean angle of deviation at near and at distance was 69.57±26.37 and 65.43±28.92 prism diopters respectively. There were no significant differences in accommodative response and pupil diameter between the dominant and non-dominant eyes. SE decreased when patients changed from monocular to binocular viewing, and from distant to near viewing (all P< 0.05), so as the pupil diameter (all P< 0.001). During binocular, not monocular viewing, SE was significantly greater after operation than it was before operation (P< 0.001). Accommodative load and pupillary constriction narrowed (p< 0.001) after the operation. Linear regression analysis showed a correlation between the angle of deviation at distance and accommodative load at distance (r2=0.278, p=0.010) and at near (r2=0.332, p=0.005).ConclusionIn order to maintain ocular alignment, patients with IXT suffer a large accommodative load, which is related to the angle of deviation. Surgery helps eliminating extra accommodation.

Psychophysical Reverse Correlation Revealed Broader Orientation Tuning and Prolonged Reaction Time in Amblyopia.

PurposeNeural selectivity of orientation is a fundamental property of visual system. We aim to investigate whether and how the orientation selectivity changes in amblyopia.MethodsSeventeen patients with amblyopia (27.1 ± 7.1 years) and 18 healthy participants (25.1 ± 2.7 years) took part in this study. They were asked to continuously detect vertical gratings embedded in a stream of randomly oriented gratings. Using a technique of subspace reverse correlation, the orientation-time perceptive field (PF) for the atypical grating detection task was derived for each participant. Detailed comparisons were made between the PFs measured with the amblyopic and healthy eyes.ResultsThe PF of the amblyopic eyes showed significant differences in orientation and time domain compared with that of the normal eyes (cluster-based permutation test, ps < 0.05), with broader bandwidth of orientation tuning (31.41 ± 10.59 degrees [mean ± SD] vs. 24.76 ± 6.85 degrees, P = 0.039) and delayed temporal dynamics (483 ± 68 ms vs. 425 ± 58 ms, P = 0.015). None of the altered PF properties correlated with the contrast sensitivity at 1 cycle per degree (c/deg) in amblyopia. No difference in PFs between the dominant and non-dominant eyes in the healthy group was found.ConclusionsThe altered orientation-time PF to the low spatial frequency and high contrast stimuli suggests amblyopes had coarser orientation selectivity and prolonged reaction time. The broader orientation tuning probably reflects the abnormal lateral interaction in the primary visual cortex, whereas the temporal delay might indicate a high level deficit.

Theta burst stimulation in adults with symmetric and asymmetric visual acuity.

Theta Burst Stimulation can influence adult neuro-visual response in imbalanced visual pathways, possibly by influencing cortical excitability. Our objective was to compare suppressive imbalance (SI) and visual acuity (VA) after applying repetitive Transcranial Magnetic Stimulation between groups of subjects with normal binocular vision, visual asymmetry, and amblyopia. Thirty-five volunteers between 19 and 51years of age were split into three groups: 6 volunteers with asymmetric VA (group A); 19 amblyopes (group B); and 10 subjects with normal binocular vision (group C). VA and SI of all groups were evaluated before and after a single session of continuous Theta Burst Stimulation (cTBS) or placebo stimulation over the right occipital cortex. In both groups A and B, we found a significant VA improvement in the non-dominant eye after cTBS (p = 0.04 and p = 0.01, respectively). In SI evaluation, group A and group B also revealed a significant improvement after the cTBS session (p = 0.03 and p = 0.01, respectively). Finally, in the group of volunteers with normal binocular vision and for placebo groups A and B, there were no significant differences in VA and SI after cTBS. Amblyopic and visually asymmetric individuals improved VA and SI of the non-dominant eye after cTBS when compared to baseline and to placebo stimulation. These enhancements were not found in the group of volunteers with normal binocular vision. We can therefore reasonably assume that cTBS may interfere with the visual system of subjects that present some kind of asymmetry, possibly by improving neuronal imbalances.

Comparative Analysis of the Clinical Outcomes of Mix-and-Match Implantation of an Extended Depth-of-Focus and a Diffractive Bifocal Intraocular Lens.

To evaluate and compare the clinical outcomes of the extended depth-of-focus intraocular lens (EDOF-IOL) and the diffractive bifocal IOL. Fifty-six eyes of 28 patients underwent cataract surgery with implantation of an EDOF-IOL (TECNIS Symfony, ZXR00) in their dominant eye and a diffractive bifocal IOL (+3.25 D add TECNIS ZLB00) in their nondominant eye. Monocular and binocular uncorrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivity, patient satisfaction score (0-5), and spectacle dependence at near vision were evaluated at 3 months after the surgery. Postoperative binocular uncorrected distant visual acuity was 0.009±0.031 logMAR, uncorrected intermediate visual acuity was 0.090±0.158 logMAR, and uncorrected near visual acuity was 0.099±0.068 logMAR. The monocular defocus curve demonstrated better performance at intermediate distance in eyes with an EDOF-IOL and better performance at near distance in eyes with a diffractive bifocal IOL. An EDOF-IOL exhibited better outcomes in contrast sensitivity compared with a diffractive bifocal IOL. Three patients (10.7%) required glasses for near vision. Mix-and-match implantation of a diffractive bifocal IOL with an EDOF-IOL provides an excellent range of vision, and high levels of contrast sensitivity and patient satisfaction.

Premium Monovision versus Bilateral Myopic Monovision, Hybrid Monovision and Bilateral Trifocal Implantation: A Comparative Study.

PurposeContemporary monovision techniques use premium intraocular lenses (IOLs), either in both eyes or at least in the non-dominant one. Primary objective of this study was to compare the efficacy of premium monovision (implantation of the trifocal diffractive Panoptix IOL in the non-dominant eye and the bifocal hybrid refractive-diffractive Restor IOL in the dominant eye), against bilateral myopic monovision (implantation of the monofocal SN60WF IOL targeting −0.50 D in the dominant eye and −1.25 D myopia in the non-dominant one), hybrid monovision (implantation of Panoptix in the non-dominant eye and SN60WF in the dominant eye) and bilateral trifocal implantation (with bilateral Panoptix implantation).MethodsThis is a prospective, comparative, clinic-based trial. Cataract patients populated four study groups: Monovision Group (MoG), Multifocal Lens Group (MfG), Hybrid Monovision Group (HmG) and Premium Monovision Group (PmG). Binocular Uncorrected Distance Visual Acuity (UDVA), Uncorrected Reading Acuity and Critical Print Size at 60cm (UIRA, UICPS) and at 40cm (UNRA, UNCPS), contrast sensitivity, vision-related functional impairment, dysphotopsia symptoms and spectacle dependence were evaluated 6 months following the operation of the second eye. A mathematical model was constructed, which calculated the relative efficacy of each surgical intervention.ResultsA total of 120 participants were recruited and populated equally the study groups. Significant improvement of preoperative UDVA was observed in all study groups. No significant differences could be detected in postoperative UDVA and UIRA (p = 0.24) among study groups, while significant differences were noticed in UICPS (p = 0.04), UNRA (p = 0.02) and UNCPS (p = 0.01). Dysphotopic phenomena (glare and shadows) were significantly more in the MfG arm followed by the PmG group (p = 0.04 and p = 0.02, respectively), while perceived difficulty and spectacle independence rates were significantly better in PmG group. PmG presented the best overall relative efficacy.ConclusionAll surgical techniques present satisfactory outcomes. Premium monovision seems to demonstrate the best outcomes.Trial RegistrationClinicalTrials.gov, NCT04618380. Registered 05 November 2020, https://clinicaltrials.gov/ct2/show/NCT04618380.

Horizontal Heterophoria Modifications by Means of Thin Proprioceptive Stimulations Applied on the Foot Sole: A Randomised Study

Some authors have demonstrated that proprioceptive stimuli applied on the feet soles can interfere on the ocular muscles. However, these studies do not clarify possible functional differences between the dominant eye and the non-dominant eye. The purpose of this randomised study is to establish if the positioning of an Internal Heel Wedge (IHW) and an External Heel Wedge (EHW) can modify horizontal heterophoria, determine dissimilar behaviours between the dominant eye and the non-dominant eye. Forty-two healthy subjects, with a right dominant eye, were tested. The 1.5 mm-thick proprioceptive stimuli were shaped out of a cork half-moon. The experimental group was divided into two groups: IHW group and EHW group. Both groups performed the “Baseline” (without mechanical stimulation) and “After 15’” (following a fitting period of 15 minutes on a treadmill with mechanical stimulation) trials. The control group performed the same trials without any podalic stimulation. Meaningful changes were observed on the horizontal heterophoria of the non-dominating eye with an IHW. Non-statistically significant variations were observed with an EHW and in the Control group. A thin heel wedge applied on the foot sole was able to generate functional changes in the non-dominant eye and could help health professionals develop increasingly personalised rehabilitation programmes.

Ocular Dominance in Open-angle Glaucoma: The Shifting Trend Depending on Stage of the Disease.

PurposeTo investigate the characteristics and distribution of ocular dominance in primary open-angle glaucoma eyes. In addition, we tried to catch any trend of ocular dominance according to the stage of disease.MethodsTwo hundred participants with bilateral open-angle glaucoma underwent ocular dominant testing by “the hole-in-a-card” test. Using optical coherence tomography, macular ganglion cell-inner plexiform layer, as well as circumpapillary retinal nerve fiber layer thickness were measured and compared according to ocular dominance. Of the two eyes of one subject, the eye with less glaucomatous damage based on mean deviation was considered to be the “better eye” in our study.ResultsOcular dominance was in the right eye in 66% of the population and ocular dominance was positioned in the better eye in 70% of the population (p = 0.001 and p = 0.002, respectively). In conditional logistic regression analyses, right eye and better mean deviation were significantly associated with ocular dominance (p = 0.001 and p = 0.002, respectively). Ocular dominance tends to be present in the better eye and this trend was more apparent as the severity of glaucoma increased. Intereye comparison of visual field indices and retinal nerve fiber layer thickness between dominant versus nondominant eye become apparent in moderate and advanced glaucoma whereas it was not as apparent in early glaucoma.ConclusionsIn glaucomatous eyes, laterality and severity of glaucoma determined ocular dominance. Intereye difference between nondominant and dominant eyes increased with the severity of glaucoma. Our findings suggest the existence of potential reciprocal interactions between ocular dominance and glaucoma.

Partial monovision achieved by unilateral implantation of a multifocal add-on lens with bilateral pseudophakia: evaluation and results

PurposeTo assess the results of partial monovision (PMV) in comparison to a bilateral monofocal implantation (MMV).MethodsThe PMV group was treated bilaterally with a monofocal intraocular lens (IOL) implantation, followed 3 months later by the implantation of a multifocal AddOn® lens (+ 3.00 D) into the non-dominant eye. The MMV group received a bilateral monofocal IOL implantation intending to achieve a slight anisometropia (0.0 D/ − 0.50 D). The near visual acuity (UNVA), intermediate visual acuity (UIVA), distance visual acuity (UDVA), defocus curve, and Lang-Stereotest II were conducted uncorrected, binocular, and minimum 3 months after the last operation. For the contrast sensitivity test, the patients were refractively corrected. The Quality of Vision Questionnaire (QoV), Visual Function Questionnaire (VF-14), spectacle independence, and general satisfaction were also assessed.ResultsA total of 27 PMV patients and 28 MMV patients without ocular diseases relevant to visual acuity were examined. The PMV group was significantly better at UNVA (0.11 ± 0.08 logMAR vs 0.56 ± 0.16 logMAR) and between − 2.00 and − 4.00 D in the defocus curve (p < 0.001). At the UIVA, the PMV group was slightly better (0.11 ± 0.10 logMAR vs 0.20 ± 0.18 logMAR) but not significant (p = 0.054). The UDVA (− 0.13 ± 0.09 logMAR vs − 0.09 ± 0.14 logMAR) (p = 0.315) and contrast sensitivity (p = 0.667) revealed no differences between the groups. The stereo vision was in favor of PMV (p = 0.008). Spectacle independence was statistically better for PMV at distance, intermediate, and near (distance p = 0.012; intermediate p < 0.001; near p < 0.001). In the VF-14 Questionnaire, the PMV was statistically superior (p < 0.001). The QoV Questionnaire showed no differences regarding frequency and severity of visual disturbances. Both groups were highly satisfied (p = 0.509).ConclusionPatients with PMV are more independent of glasses and are able to read without disadvantages in distance vision, due to halos and glare. The concept of PMV is well suited for the desire of eyeglass independence, without optical side effects.

Long-term follow-up for monovision surgery by Implantable Collamer Lens V4c implantation for myopia correction in early presbyopia

PurposeTo investigate the long-term safety and efficacy of monovision surgery using implantable collamer lens V4c (ICL V4c) implantation in myopic patients with early presbyopia.SettingEye and ENT Hospital of Fudan University, Shanghai, China.DesignProspective case series study.MethodsThis study included 64 eyes of 32 patients with early presbyopia, who underwent bilateral ICL V4c implantation for myopia correction. Parameters, including mean spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity, intraocular pressure, endothelial cell density, presbyopic add power, visual acuity (logMAR) of dominant eyes (D-eye), nondominant (nD-eye) eyes, and both eyes (Bi) at 0.4 m, 0.8 m, and 5 m were recorded at the last follow-up.ResultsAll surgeries were uneventful. At the last follow-up, the safety indices were 1.23 ± 0.18 (D-eyes) and 1.21 ± 0.18 (nD-eyes) (p > 0.05); the efficacy indices were 0.95 ± 0.27 (D-eyes) and 0.92 ± 0.28 (nD-eyes) (p < 0.05), the SE was -0.62 ± 0.47 D (D-eyes); and − 1.21 ± 0.78D (nD-eyes) (p < 0.05), presbyopic add power was 1.31 ± 0.58 D. The visual acuity (logMAR) of D-eyes, nD-eyes, and binocular (Bi) at 5.0 m were: 0.06 ± 0.15 (D-eye), 0.21 ± 0.18 (nD-eye), (p < 0.01), and 0.04 ± 0.13 (Bi); 0.8 m: 0.03 ± 0.18 (D-eye), 0.08 ± 0.16 (nD-eye), (p > 0.05), and − 0.02 ± 0.11 (Bi); 0.4 m: 0.08 ± 0.09 (D-eye), − 0.02 ± 0.08 (nD-eye), (p < 0.001), and − 0.03 ± 0.09 (Bi). Subjects were very satisfied or felt excellent with their visual acuity at near (81.25%) and far distances (87.50%), respectively (versus preoperative, p < 0.001).ConclusionMonovision surgery using ICL V4c implantation is safe and practicable for correction of myopes with presbyopia, with long-term efficacy at near and far distances and patient satisfaction.