Subjective Visual Function Research Articles

Neuroendoscopic surgery for acute presentation of cystic craniopharyngiomas.

Acute presentation of cystic craniopharyngioma is a potentially life-threatening condition, characterized by disability and increased mortality risk, often caused by large cysts with or without hydrocephalus. This study evaluated the applicability of minimally invasive neuroendoscopic surgery (NES) for rapid intracranial pressure relief and tumor control as an alternative to emergent microsurgical resection. A retrospective review of the electronic medical record database of patients with craniopharyngiomas treated at our institution between June 2007 and October 2024 identified 13 non-consecutive cases of acute presentation of cystic craniopharyngioma managed with NES. Interventions included pellucid septostomy (n = 2), ventriculoperitoneal shunt surgery (n = 2), and Ommaya reservoir placement (n = 6). Clinical and radiological data were analyzed to assess treatment outcomes. The most common acute symptoms were severe headache (69.2%), frequent vomiting (53.8%), sudden onset of consciousness disturbance (38.5%), visual impairment (46.2%), gait instability (23.1%), and cognitive dysfunction (15.4%). Ten patients had hydrocephalus at admission. All patients experienced symptom relief following NES, with no procedure-related mortality or complications. Hydrocephalus resolved in all cases, and subjective visual function improved in 83.3% of patients postoperatively. Endocrine function remained stable. At a median follow-up of 62 months (range, 38-130), local tumor control was achieved in 8 patients (61.5%) without requiring adjuvant therapy. NES is a safe, effective approach for managing acute presentation of cystic craniopharyngioma, particularly in patients with hydrocephalus. It offers rapid symptom relief and tumor control and is a potential staging treatment in selected cases.

Atypical presentation and treatment of congenital cataract and temporal iridolenticular coloboma in a 43-year-old male

Ocular coloboma occurs due to incomplete closure of the embryonic fissure in the 5th or 6th week of intrauterine life. Iris coloboma is characterised by a keyhole-shaped defect in the iris, typically located in the inferonasal quadrant. Temporal iris coloboma is a rare occurrence. Temporal iridolenticular coloboma is an uncommon structural anomaly within the iris that is sometimes linked to other ocular disorders, such as congenital cataracts. We describe a case study of a 43-year-old male patient who had a congenital cataract with temporal iridolenticular coloboma, which is not a common presentation. The aim is to report favourable outcomes of cataract surgery in patients with congenital cataracts associated with temporal iris coloboma with temporal lens coloboma. Phacoemulsification with intraocular lens implantation was done without any complications. Significant improvements in subjective visual function and visual acuity were seen in the post-operative follow-up.

Comparison of visual outcomes in patients with cataracts and high myopia after implantation of a zonal refractive multifocal or diffractive bifocal intraocular lens

This study compares the optical quality of zonal refractive multifocal and diffractive bifocal intraocular lenses (IOLs) and visual outcomes after implantation in 93 patients(93 eyes) with cataracts and high myopia. A retrospective analysis was conducted to measure visual acuity at far, intermediate, and near distances, defocus curves, wavefront aberrations, modulation transfer function (MTF), a Quality of Vision questionnaire (QoV) and visual quality self-evaluation were examined at 3 months. The results demonstrated the ZMB group showed better uncorrected near visual acuity (P < 0.01), and the MF15 group showed better uncorrected intermediate visual acuity (P < 0.001). The ZMB group provided better MTF than the MF15 group (P < 0.01) but demonstrated a worse QoV score, especially for the severity of glare, halo, and starburst (P < 0.05). The satisfaction score and spectacle independence rate in the ZMB group were higher than in the MF15 group (P < 0.01). LS-313MF15 and TecnisZMB00 offered excellent visual restoration, stable distance visual acuity, and good subjective visual function.

Successful Adjunctive Treatment of Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP) with High-Dose Intravenous Immunoglobulin Therapy (IVIG).

Purpose: The management of bilateral diffuse uveal melanocytic proliferation is controversial, with most earlier reports advocating for plasmapheresis. Here, we report a case of bilateral diffuse uveal melanocytic proliferation secondary to gastric adenocarcinoma that was successfully treated with adjunctive intravenous immunoglobulin, using a loading dose followed by a treat-and-extend strategy. Methods: Clinical case report with 3 years of follow-up including serial ophthalmologic examinations. Functional assessments included visual acuity and subjective visual complaints. Periodic anatomic assessments were performed including serial optical coherence tomography, ultra-widefield fundus imaging, multimodal angiography, and ophthalmic ultrasound. Results: A 75-year-old man presented with a 6-month history of blurry vision and difficulty with dark and light adaptation in both eyes. A diagnosis of bilateral diffuse uveal melanocytic proliferation was established based on clinical findings and subsequent discovery of an underlying gastric malignancy; the diagnosis of a paraneoplastic syndrome was further substantiated by documentation of cancer-associated antiretinal antibodies and serum reactivity against human retina by immunohistochemistry. Treatment with high-dose (2 g/kg) intravenous immunoglobulin was initiated with biweekly, followed by monthly, then q2-3 monthly dosing intervals. Meanwhile, the patient received surgical resection and systemic chemotherapy resulting in complete radiographic remission of the primary cancer. Over the course of 3 years, the patient has demonstrated clinically significant improvements in visual acuity and subjective visual function. Rapid and sustained anatomic improvements were observed in serous retinopathy and choroidal thickness. Conclusion: Intravenous immunoglobulin may be a viable adjunctive treatment option for some patients with bilateral diffuse uveal melanocytic proliferation.

Subclinical variability in visual function modulates visual dependence - independent of age

Paradoxically visual dependence is reported to increase with age, contributing to falls risk, whereas visual function typically declines. This study assesses the relationship between age, objective and subjective measures of visual function and visual dependence, in healthy young and older adults. Forty-four healthy Young (YA; n = 32; 18 males, aged 26.2 ± 5.3 yrs.) and Older (OA; n = 12; 3 males, aged 62.4 ± 6.7 yrs.) adults were assessed for objective (visual acuity, contrast sensitivity, depth perception, and lower peripheral vision), and subjective visual function (VFQ-25) along with motion sickness susceptibility. Subjective Visual Vertical (SVV) and induced nausea and vection were assessed using the Rod and Disc Test (RDT). Groups were compared using Mann-Whitney U, whilst determinants of SVV variability were evaluated using Multiple regression modelling. Visual acuity (p < 0.01) and contrast sensitivity (p = 0.04) were lower in OA. Visual dependence (SVV tilt errors) was not associated with ageing (p = 0.46). YA experienced greater RDT-induced vection (p = 0.03). Visual acuity and contrast sensitivity accounted for modest proportions of variance in SVV tilt errors (VA; R2 = 0.14, F(1,42) = 8.00, p < 0.01; β = 6.37) and (CS; R2 = 0.06, F(1,42) = 3.93, p = 0.05; β = −4.97), respectively. Our findings suggest that subclinical differences in visual acuity and contrast sensitivity contribute to SVV tilt error variability, among both healthy young and older adults. Further studies are needed to define the inter-relationship between age-related visual function, non-visual factors (including vestibular and somatosensory fidelity, activity levels, fear of falling and cognitive function) and visual dependence.

Vision-related quality of life in patients with glaucoma before and after trabeculectomy.

To determine vision-related quality of life (VR-QoL) and functional and structural parameters associated with VR-QoL in patients with glaucoma before and 12 months after trabeculectomy. Fifty-eight patients undergoing trabeculectomy were included. Participants completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) prior to and 12 months after trabeculectomy. Functional (visual acuity and visual fields) and structural (ganglion cell layer volume) parameters were evaluated for their association with VR-QoL using multiple linear regression of VFQ-25 subscale scores. Intraocular pressure and the number of glaucoma medications were also included in the analyses. The VFQ-25 composite score did not change after trabeculectomy (before: 74.9; 12 months: 74.0; p = 0.512). The subscale mental health had a significantly higher score 12 months after trabeculectomy (before: 65.6; 12 months: 71.4; p = 0.017). The VFQ-25 scores for general health (before: 68.5; 12 months: 62.5; p = 0.009) and role difficulties (before: 78.9; 12 months: 53.7; p < 0.001) were significantly lower 12 months after trabeculectomy. No functional or structural parameters were associated with VFQ-25 composite score. Overall, VR-QoL in glaucoma patients was similar before and after trabeculectomy, reflecting the procedure's stabilizing effect on both objective and subjective visual function. The absence of correlations between VR-QoL and clinical parameters emphasizes the multifaceted nature of VR-QoL and highlights the limitations of depending solely on objective clinical metrics to evaluate patients' subjective experiences. Using both objective measures and VR-QoL, clinicians can better understand the challenges patients face due to glaucoma and trabeculectomy, potentially leading to better solutions.

Ray-Tracing Customization in Myopic and Myopic Astigmatism LASIK Treatments for Low and High Order Aberrations Treatment: 2-Year Visual Function and Psychometric Value Outcomes of a Consecutive Case Series.

The safety and long-term efficacy of automated ray-tracing customized myopic and myopic astigmatic femtosecond laser-assisted LASIK. This consecutive case series retrospective analysis, of 20 subjects (40 eyes) treated with automated raytracing named Wavelight Plus, to include low and high order aberrations based on a three-dimensional custom virtual eye for each case-calculated from interferometry data-obtained from a single diagnostic device that also provides Hartman-Shack Wavefront and Scheimpflug tomography data. We evaluated before and after the customized LASIK procedure: visual acuity, refractive error, high order aberrations, contrast sensitivity, and psychometric post-operative visual function data. At 24 months, the comparison of the pre-operative to the post-operative refractive and visual function value changes in average were: subjective manifest refraction from -4.38 ± 2.54 diopters (D) (range -9.75 to -1.25 D) to +0.11 ± 0.19 D; subjective manifest refractive astigmatism from -0.76 ± 0.91 D (range -2.75 to 0 D) to -0.13 ± 0.16 D, corneal astigmatism from -1.16 ± 0.64 D (range -0.2 to -2.8) to -0.47 ± 0.11 D. 65% of the eyes studied demonstrated an increase of at least one line of vision, while from the same group 38% demonstrated 2 lines of increase. High order aberrations, contrast sensitivity as well as the subjective psychometric input based on the VFQ-25 questionnaire demonstrated actual improvement. This longer-term follow-up, single-arm retrospective consecutive case series documents LASIK treatment customization that appears to be safe and effective in the correction of myopia and myopic astigmatism. Markedly improved objective and subjective visual function post-operatively, underlying the potential importance of simultaneously attempting to correct high order aberrations and improving the spatial alignment of total, measured human eye optics.

The bidirectional relationship between subjective visual function and domain-specific cognition in cognitively unimpaired older adults and adults with mild cognitive impairment.

Subjective visual impairment (VI) is related to cognition in cognitively unimpaired (CU) older adults, mild cognitive impairment (MCI) patients, and Alzheimer's disease (AD) patients. The utility of subjective VI as an indicator for domain-specific cognitive impairment is unknown. We used the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25 item) and a neuropsychological battery to assess the relationship between subjective VI and domain-specific cognitive performance in CU older adults (N = 58) and MCI patients (N = 16). The CU group showed a positive relationship between subjective VI and visuospatial performance. CU older adults at high risk for AD demonstrated a unique relationship between subjective VI and attention, processing speed, and executive function. Peripheral vision was related to domain-specific performance in the patient group. Subjective VI complaints may indicate potential for domain-specific cognitive decline in visuospatial performance, executive function, processing speed, and attention in older adults.

Supine Positioning for Graft Attachment After Descemet Membrane Endothelial Keratoplasty: A Randomized Controlled Trial

The Supine Positioning for Descemet Membrane Endothelial Keratoplasty Attachment (SUPER-DMEK) trial assessed the efficacy of prolonged supine head positioning on graft attachment. Randomized controlled trial. Participants with Fuchs' dystrophy were randomized to 5 days of supine head positioning (intervention) or to 1 day (control). Participants, surgeons, and investigators were masked until the day after surgery. Adherence to the allocated intervention was monitored using a head sensor. Main outcome measures were area and volume of graft detachment (coprimary end points) 2 weeks after surgery quantified using a validated neural network for image segmentation on anterior segment optical coherence tomography images, and repeat air injection (rebubbling), subjective visual function, and adverse events (secondary end points). A total of 86 participants received the allocated intervention (35 eyes intervention and 51 eyes control). In the intention-to-treat analysis, the mean area of graft detachment was 28.6% in the intervention arm and 27.5% in the control arm (adjusted between-arm difference, 1.3; 95% CI, -8.7 to 11.4; P = .80). Results for volume of detachment and as-treated analyses based on head position sensor data indicated no potentially clinically relevant effect of prolonged supine positioning on graft attachment. Results were not compatible with a relevant treatment effect on rebubbling or subjective visual function. Adverse events, most commonly back pain, were more common and more severe with the intervention. In this randomized controlled trial, graft attachment was not improved with prolonged supine head positioning. Prolonged supine positioning frequently caused back pain. Prolonged supine positioning after Descemet membrane endothelial keratoplasty for Fuchs' dystrophy may not be needed in routine practice.

Twenty-Year Follow-Up of Cataract Surgery in Car-Drivers: Associations Between Subjective Visual Difficulties and Objective Visual Function.

Driving especially at night is a visually demanding task. Long-time outcome of cataract surgery in drivers is important to study, as many patients live for decades after surgery. The purpose of this study is to longitudinally investigate visual function in active car drivers, 20 years after cataract surgery. From a population-based, prospective, cohort of cataract surgery patients, initiated in 1997-98, 114 of the 133 surviving patients were included. Preoperatively, postoperatively 5, 10, 15 and 20 years after surgery, the patients answered a visual function questionnaire including driving status and difficulty. Habitual visual acuity, best corrected visual acuity (BCVA), and low contrast acuity (LCVA) 10% and 2.5% were measured. The driving difficulties in daylight were almost absent after surgery and did not change over 20 years. Nighttime driving was more difficult and declined longitudinally after surgery, p=0.013, but were at 20 years still less than before cataract surgery. Patients with better BCVA experienced less difficulties driving in darkness, p=0.005. Self-reported problems with glare were significantly associated with BCVA of the better-seeing eye, LCVA 10% and LCVA 2.5% (p=0.046, p=0.033, and 0.024 respectively). Self-reported difficulties with seeing in low-contrast conditions were also significantly associated with BCVA, p=0.004. Twenty years after cataract surgery, most active drivers have no or minor visual functional problems during driving in daytime. Difficulties in nighttime driving are more common and increase significantly over time. Twenty years after surgery, all current drivers had still better subjective ability to drive, compared with before surgery.

Visual function assessment of Chinese cataract patients after individual aspheric intraocular lens implantation according to preoperative cornea spherical aberration.

Aspheric intraocular lens (IOLs) implantation has been widely applied in cataract surgery. However, there is no consensus on the optimal guidance for the operations in IOLs implantation. This study evaluated the visual function of Chinese cataract patients six months after cataract surgery with two different guiding ideologies. We evaluated 50 patients (61 eyes) with implantation of different aspheric IOLs (SN60WF IOLs, ZCB00 IOLs, PY-60AD IOLs, AO IOLs) 6 months after cataract surgery. Twenty-four patients (30 eyes) under individual implantation were ascribed to group 1 and 26 patients (31 eyes) with randomized implantation were ascribed to the control group (group 2). Postoperatively parameters included monocular best-corrected visual acuity (BCVA), contrast sensitivity (CS), total spherical aberration Z (4, 0) at 5 mm pupil size, and patient satisfaction. The quality of life after operation was assessed through the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Six months after cataract operation, the contrast sensitivity with glare of group 1 at 2.5∘ was 0.697 ± 0.027, and 0.532 ± 0.049 in group 2. Besides, there was no significant difference at any other special frequency. The mean spherical aberration Z (4, 0) at 5 mm pupil size in group 1 was 0.015 ± 0.028 um, and in group 2 was 0.043 ± 0.109 um, with a significant difference (p< 0.01). The mean scores obtained from NEI VFQ-25 were not significantly different. It is effective to implant aspheric IOLs individually according to preoperative corneal spherical aberration. Patients obtained better contrast sensitivity with glare at 2.5∘, but there was no significant difference in BCVA, contrast sensitivity at other special frequency, and subjective visual function.

Long-term results of cataract surgery in type 2 diabetics, a 20-year prospective longitudinal study.

To investigate the 20-year outcome, in best-corrected visual acuity (BCVA), and subjective visual function (VF-questionnaire, VF-14) after cataract surgery in type 2 diabetics, compared with non-diabetics. 109 type 2 diabetics and 698 non-diabetics, who had cataract surgery during 1 year at one institution, were included in this prospective, longitudinal, population-based cohort study. BCVA and VF-14 responses were recorded pre- and postoperatively, and every 5 years up to 20 years after surgery. Retinopathy was graded before surgery. There was no significant difference between diabetics and non-diabetics, in change in BCVA from 10 years or more after surgery, p = 0.45, p = 0.44 and p = 0.83, at 10, 15 and 20 years, respectively, as well as in self-perceived visual function (VF-14) at any time after surgery, p = 0.72, p = 0.20 and p = 0.78, 10-20 years, respectively. At any follow-up, there was no significant difference in BCVA in relation to retinopathy level before surgery, p = 0.1 at 20 years. There was a trend from 10 years after surgery and onward that patients with no retinopathy at baseline lost fewer letters during the 20 years than diabetics with retinopathy. Patients with known type 2 diabetes at surgery had a significantly lower survival compared with the non-diabetics at each follow-up, p = 0.003. In surviving diabetics, BCVA and subjective visual function were retained in most cases up to 20 years after cataract surgery. Cataract extraction is effective in causing a sustainable improvement in visual function also in type 2 diabetics. Knowledge of these long-term outcomes is essential when counselling diabetics for cataract surgery.

Catquest-9SF questionnaire: validation of the Portuguese version using the Rasch analysis.

The aim of this study was to validate the Portuguese version of Catquest-9SF through its application in a native Brazilian population with cataracts and to determine the correlation of the questionnaire scores with preoperative visual acuity. A prospective study was conducted to validate the Catquest-9SF questionnaire, which was translated and back-translated, generating a final version in Portuguese. A total of 120 Brazilian patients awaiting cataract surgery were recruited to answer the questionnaire and to document their preoperative data and visual acuity. The Rasch analysis was used to assess the instrument's psychometric properties. The Portuguese version of Catquest-9SF demonstrated an acceptable adjustment of the items (item fit statistics ranging from 0.7 to 1.3), unidimensionality (principal component analysis), and good organization in the item response categories (thresholds of the categories: -2.79, 0.57, and 2.22, respectively). The questionnaire contains items with stable relationships if considered at the same level of visual impairment in the comparison between the two groups (absence of differential item functioning). The separation of people (person separation index, 3.07) was adequate. The visual acuity in the logarithm of the minimum angle of resolution (logMAR) in the best eye with the best optical correction showed a statistically significant correlation with the Catquest-9SF logit score (r=0.282 and p=0.004). The Portuguese version of Catquest-9SF presents evidence of validity and reliability, in addition to being linguistically and culturally understandable for Portuguese-speaking patients born in Brazil. The questionnaire is easy to understand and quick to apply, as it could adequately estimate the subjective visual functioning in patients with cataracts. We found a significant correlation between visual acuity and the questionnaire score.

Evaluation value of subjective visual quality examination on surgical indications of the early cataracts based on objective scatter index values.

To evaluate the subjective visual functions of early cataracts patients and assess their surgical indications. Eyes were separated into a control group (Group A without cataract) and two early cataracts groups (Group B with 2.0 ≤ OSI < 3.0 and Group C with 3.0 ≤ OSI < 4.0). The objective scatter index (OSI), modulation transfer function cut-off frequency (MTF cut-off), and Strehl ratio (SR) values were applied to measure objective visual functions. The contrast sensitivity (CS) and scores of the questionnaires (QOL and VF-14) characterized subjective visual functions. Above visual functions were compared among three groups. Postoperative visual functions in Group B and C were analyzed to assess the outcome of surgery. Ninety two subjects (126 eyes) were included in the study. All objective visual function in Group B were significantly better than Group C (all P < 0.01), but worse than Group A (all P < 0.01). Except for 1.5 c/d CS, subjective visual function in Group A were significantly better than Group B and C (all P < 0.05), but there was no significant differences between Group B and C. As for eyes that underwent surgery in Group B and C, all visual functions significantly improved after surgery (P < 0.05), except for 1.5 c/d CS in Group C. There were no significant differences among the three groups after surgery. The subjective visual function can be impaired in early cataracts patients with OSI < 3.0, whose objective visual functions were statistically better than patients with OSI ≥ 3.0. These patients can benefit equally from surgery as patients with OSI ≥ 3.0. Subjective visual functions can be used as surgical indications for these patients.

Pseudophakia and Lens Opacities in 70-Year-Olds in Gothenburg, Sweden; Gender Differences, Impact on Self-Reported Visual Function and Validation of Self-Reported Cataract and Pseudophakia.

PurposeThe study aimed at determining the prevalence and sex differences in cataract, pseudophakia, lens opacities and self-reported cataract in 70-year-old people in Gothenburg, Sweden. The purpose was also to identify correlations between lens opacities, visual acuity and subjective visual function, and to validate self-reported cataract and cataract surgery.Patients and MethodsPopulation-based cross-sectional study where participants (n=1182) answered questions about self-reported diagnosis of cataract and cataract surgery. A total of 1139 subjects completed the National Eye Institute Visual Functioning Questionnaire‐25 (NEI VFQ‐25), 560 subjects underwent ophthalmic examination including visual acuity and lens photography. t-test, Pearson chi-square and Mann–Whitney U-test were used for obtaining p-values. ANOVA (analysis of variances, Kruskal–Wallis, one-way) was used to compare VFQ-25 between 3 groups; no cataract, cataract and pseudophakia. To clarify the differences between specific pairs of groups post-hoc test (Bonferroni) was used after ANOVA.ResultsSelf-reported cataract was more common in women than in men (27.2% vs 19.1%, p=0.001, chi-square). Cataract surgery was reported by 16.3% of women and 12.6% of men (p=0.072). Upon eye examination, the prevalence of pseudophakia was 16.9% in women compared to 10.2% in men (p=0.020). The prevalence of cataract, including pseudophakia, was 31.9% in women versus 23.8% in men (p=0.033). Significant correlations (Spearman’s rho) were found between lens opacities and visual acuity. Self-reported cataract surgery showed a very high specificity and high sensitivity. The composite score from NEI VFQ‐25 was lower in people with pseudophakia than in people with/without cataract (p=0.012, Kruskal–Wallis).ConclusionThe prevalence of cataract including pseudophakia in 70-year-olds in Gothenburg is higher compared to previous studies in similar geographical areas. Also, it is more common in women than in men. The lack of significant sex differences in lens opacities may be due to cataract surgery at an earlier stage. Validation showed very good agreement between pseudophakia and self-reported cataract surgery.

Implantation of a Small Aperture Intraocular Lens in Eyes with Irregular Corneas and Higher Order Aberrations

PurposeCorneal irregularities can lead to high order aberrations (HOAs) and may influence the outcomes in terms of intraocular lens (IOL) selection and visual acuity assessment. The aim of this study was to evaluate the visual acuity and satisfaction after IC-8 implants in patients characterized by corneal irregularities and HOAs who could not undergo refractive surgery due to the poor residual thickness of the cornea or other conditions such as astigmatism secondary to previous radial keratotomy.MethodsThis descriptive, retrospective cohort study was conducted on nine eyes in six patients affected by corneal irregularities and HOAs who had undergone IC-8 IOL implantation. The primary endpoint was the best-corrected visual acuity (BCVA), the subjective visual function, and the visual field.ResultsNine eyes of six patients (three bilateral implantation) were enrolled. For each patient, BCVA, vision, and lifestyle quality were evaluated. In all patients, we noticed an improvement in all parameters without visual field defects.ConclusionOur work encourages the use of the IC8 lens to improve visual acuity in patients with irregular corneas and HOAs who cannot be treated with customized refractive surgery. Patients experience a subjective improvement of their quality of vision and also more self-confidence in their daily life. IC-8 lenses do not interfere with the visualization of retinal fundus and there is no impairment of the visual field detected by patients.

Visual Function of Myopic Students Wearing Contact Lens and Spectacles

Myopia people use contact lenses and spectacles as a visual aid. Measuring the suitability of the measure of visual impairment from contact lenses and spectacles is not enough to be assessed from visual acuity and visual field measurements alone, but also needed subjective patient-based visual function assessments, namely the VF-14 questionnaire. A total of 40 students were involved in this study. All of the participants were given the VF-14 questionnaire twice: for visual function using contact lenses; and visual function using spectacles. The mean VF-14 score among contact lenses and spectacles wearer were 90.63±2.96 and 93.04±2.45respectively. There were significant differences visual function between contact lens and spectacles wearer (p = 0.00) especially in reading small print activity; reading signs; watching TV; playing table games; cooking; driving during the day; and recognizing people at distance. Thus, it can be concluded that participants with low and moderate myopia, both contact lens and spectacle users, had visual function with mild and minimal disturbances. The visual function of spectacles is better for distant viewing activities and detailed work, while contact lenses are better for viewing activities at medium distances.

Chinese Version of the Vision-Related Quality of Life (NEI-VFQ-25) among Patients with Various Ocular Disorders: A Pilot Study.

Background and Objectives: Subjective visual function is currently becoming an increasing appreciation in assessing the health-related quality of life. This study aimed to assess the vision-related quality of life (VRQOL) among patients with refractive errors, keratoconus, senile cataract, and age-related macular degeneration (AMD) using the Chinese version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25). Materials and Methods: The questionnaire of NEI-VFQ-25 was filled out in a clinical setting or by telephone/mail. Univariate and multivariate analyses were used to determine which factors are associated with the NEI-VFQ-25. Results: From June 2018 to January 2019, 28 patients with refractive error, 20 patients with keratoconus, 61 with senile cataracts, and 17 with AMD completed the questionnaire NEI-VFQ-25. There were significant differences in the NEI-VFQ-25 subscale of general vision (p = 0.0017), ocular pain (p = 0.0156), near activities (p = 0.0002), vision-specific social functioning (p = 0.007), vision-specific mental health (p = 0.0083), vision-specific dependency (p = 0.0049), color vision (p < 0.0001), peripheral vision (p = 0.0065), and total score (p < 0.0001) among four disease groups, respectively. The multiple linear regression revealed that the best-corrected visual acuity (BCVA) and disease group were important factors of the total NEI-VFQ-25. After adjusting for BCVA, patients with AMD had a worse total NEI-VFQ-25 score than patients with refractive error, keratoconus, or senile cataracts. Conclusions: Among the patients with four ocular disorders and a broad vision spectrum from normal, partial sight, low vision to legal blindness, the BCVA of their better eye was the most important factor in the VRQOL.

The influence of contact lenses with different optical designs on the binocular vision and visual behavior of young adults

Theoretically, contact lenses change the accommodation and vergence demands of the eyes and directly or indirectly influence binocular vision. The purpose of this study was to investigate the influence of different optical designs of contact lenses on binocular vision and visual behavior among young adults. In this randomized, single-blinded experimental study, visual behavioral performance (VBP) and Ocular Surface Disease Index questionnaires were used for preliminary screening. Nineteen myopic subjects aged 20–26 years (21.59 ± 1.40 years) participated in the study. Baseline values for subjective refraction and binocular visual functions were evaluated. All the subjects were randomly grouped to wear different optical designs of single-vision, progressive, and bifocal contact lenses. Eye examinations were performed on the first day (CL baseline), 2nd week, and 4th week of wearing the lenses. In addition, subjects completed the VBP and visual quality questionnaire again at the end of the examination. Single-vision contact lenses (Lens 1) increased accommodative lag, negative relative accommodation, and distant and near vergence; however, vergence facilities, accommodative facilities, heterophoria, and the comfort and posture balance dimensions in the VBP questionnaire were improved. Progressive contact lenses (Lens 2) reduced the lag of accommodation and near vergence; in addition, vergence facilities and accommodative facilities were also improved. Bifocal contact lenses (Lens 3) affected negative and positive relative accommodation, but vergence facilities and accommodative facilities also progressed. Furthermore, both progressive (Lens 2) and bifocal (Lens 3) contact lenses enhanced overall visual behavioral performance. In terms of visual quality, single-vision contact lenses (Lens 1) were the most comfortable, progressive and bifocal contact lenses reduced distant visual acuity and stability, progressive contact lenses (Lens 2) had more complaints about halos at night, and bifocal contact lens (Lens 3) users were more likely to have double vision. Compared with single-vision contact lenses, progressive and bifocal contact lenses relaxed accommodation, reduced the lag of accommodation, and improved visual behavioral performance. Although the vergence function showed a significant change, it did not show worse trends when wearing contact lenses. Contact lenses with different optical designs have a great influence on binocular vision and visual behavioral performance.

Visual Performance of a Novel Optical Design of a New Multifocal Intraocular Lens.

To evaluate the optical performance and quality of vision of a novel optical design of a new trifocal intraocular lens (IOL) using a proprietary modified algorithm. In this prospective, non-randomized, single-armed, single-center, open-label study, a total of 20 patients (40 eyes) who were candidates for multifocal lens implantation were recruited for implantation with the multifocal Intensity SL IOL (Hanita Lenses). Evaluation performed at 1 and 7 to 10 days and 1 and 3 months after implantation included corrected and uncorrected distance visual acuities at far, intermediate (80 cm), and near (40 cm). Monocular and binocular visual acuities, defocus curves, and contrast sensitivity were measured and questionnaires for grading subjective visual quality, satisfaction, and visual function were provided. Three months postoperatively, monocular uncorrected visual acuity for distance, intermediate, and near averaged 0.03 ± 0.11, 0.09 ± 0.09, and -0.22 ± 0.09 logMAR, respectively (Snellen 20/21.4, 20/24.6, and 20/12). Corrected monocular visual acuity for distance, intermediate, and near averaged -0.07 ± 0.06, 0.03 ± 0.09, and -0.25 ± 0.07 logMAR (20/17, 20/21.4, and 20/11.2), respectively. Binocular corrected visual acuity for distance, intermediate, and near was -0.1 ± 0.06, -0.02 ± 0.09, and -0.28 ± 0.04 logMAR (20/15.8, 20/19, and 20/10.5), respectively. Contrast sensitivity was similar to the normal population in photopic and mesopic conditions. Defocus curves showed that this IOL provided visual acuity of 20/28.9 or better between a defocus of +1.00 and -3.50 diopters. The Visual Function Index-14 questionnaire showed that patients reported high satisfaction. Patients specifically noted good quality of vision at near and intermediate distances. The Intensity SL IOL can provide good quality distance, intermediate, and particularly strong near vision after cataract surgery and independence from spectacles with good patient satisfaction. [J Refract Surg. 2022;38(3):150-157.].