Subjective Visual Acuity Research Articles

Optical coherence tomography of outer retinal holes in senile retinoschisis and schisis-detachment

PurposeOn clinical examination, it can be challenging to differentiate retinoschisis with outer retinal hole from schisis-detachment. This study examined the role of outer retinal hole spectral domain optical coherence tomography...

Unmet eye care needs among a homeless youth population

ObjectiveTo assess the rate of visual impairment and quantify the unmet eye care needs within Toronto’s homeless youth community. DesignProspective and cross sectional. ParticipantsNinety randomly selected homeless youth aged 16–24 years. MethodsFrom each of 9 participating homeless youth shelters and drop-in centres in Toronto, 10 English-speaking youths between ages 16 and 24 were randomly recruited. Information regarding sociodemographics, medical history, subjective visual acuity, and access to eye care was collected. Comprehensive visual screening and undilated direct fundoscopy were also performed. ResultsThe median age of participants was 21 years (interquartile range = 19–23 years), and 62.2% were male. Most participants were homeless for less than 5 years (90%) and earning less than $500 monthly (57.8%). Despite 51.1% of participants having previously owned corrective lenses, only 20% of participants currently owned them when assessed/at study time. When analyzing the better-seeing eye, presenting visual acuity was 20/50 or worse in 18.9% (95% CI 10.8%–27.0%) of participants. Pinhole occlusion decreased the number to 2.2% (95% CI 0%–5.3%). The most common cause of visual impairment was uncorrected refractive error. Ocular pathology was observed in 8 participants. Compared to adults, youth have similar functional visual impairment (adults 24.0%, youth 18.9%) but less impairment uncorrectable by pinhole occlusion (adults 11.0%, youth 2.2%) and are less dissatisfied with their vision (adults 70.0%, youths 36.7%). Although a higher proportion of homeless youths have visited an eye specialist in the past year (adults 14.0%; youths 17.8%), neither group is visiting as frequently as the Canadian average (41%) (p < 0.01). ConclusionsHomeless youth have a high prevalence of visual impairment, even when living within a system of universal health insurance. Ongoing vision-screening programs, readily accessible free eye clinics, and particularly low-cost glasses may help address this need.

Telephone follow-up for cataract surgery: feasibility and patient satisfaction study.

Purpose - The purpose of this paper is to investigate the feasibility of telephone follow-up (TFU) after uncomplicated cataract surgery in low-risk patients and patient satisfaction with this alternative clinical pathway. Design/methodology/approach - Prospective, non-randomised cohort study. A ten-point subjective ophthalmic assessment questionnaire and a six-point patient satisfaction questionnaire were administered to patients following routine cataract surgery at two to three weeks post-procedure. All patients were offered a further clinic review if required. Exclusion criteria comprised ophthalmic co-morbidities, hearing/language impairment and high risk of post-operative complications. Patient notes were retrospectively reviewed over the study period to ensure no additional emergency attendances took place. Findings - Over three months, 50 eyes of 50 patients (mean age: 80; age range 60-91; 66 per cent second eye surgery) underwent uncomplicated phacoemulsification surgery received a TFU at 12-24 days (mean: 16 days) post-operatively. Subjective visual acuity was graded as good by 92 per cent of patients; 72 per cent patients reported no pain and 20 per cent reported mild occasional grittiness. Patient satisfaction was graded 8.9 out of 10; 81.6 per cent defined TFU as convenient and 75.5 per cent of patients preferred TFU to routine outpatient review. No additional visits were required. Research limitations/implications - Non-randomised with no control group; small sample size. One patient was unable to be contacted. Practical implications - Post-operative TFU can be suitably targeted to low-risk patients following uncomplicated cataract surgery. This study demonstrated a high patient satisfaction. A larger, randomised study is in progress to assess this further. Originality/value - This is the first study reporting TFU results and patient satisfaction to the usual alternative two-week outpatient review.

Objective and subjective visual quality after implantation of all optic zone diffractive multifocal intraocular lenses: a prospective, case-control observational study

Background and aimsTo evaluate the objective and subjective optical quality of all optic zone diffractive multifocal intraocular lens (IOL).MethodsFifty patients (50 eyes) having phacoemulsification and IOL implantation surgery were enrolled....

The impact of cataract surgery on subjective visual functions and quality of life in patients with cataract in Northwestern Nigeria

Purpose: To determine the impact of cataract surgery on visual functions (VFs) and quality of life (QoL) in patients with cataract at the National Eye Center, Kaduna. Methods: VFs and QoL questionnaires were administered to the patients preoperatively and 6 weeks postoperatively. Correlation was assessed among subjective VF, QoL, and visual acuity (VA). The preoperative and sixth-week postoperative VA, VF scores, and QoL scores were compared. A paired t-test was used for comparison between before and after surgery. Results: Two hundred and seventy-one patients were studied. The age range of the patients was 45 to 85 years with a mean age of 64.2 years (SD ± 6.51). There was significant improvement in overall VF and QoL following cataract surgery (P < 0.0001). Mean VF scores preoperatively and at 6 weeks postoperatively were 28.6 (SD ± 7.9) and 15.1 (SD ± 3.5), respectively. The overall mean QoL scores were 23.7 (SD ± 9.0.) preoperatively and 13.5 (SD ± 1.1) postoperatively. This difference was statistically significant P < 0.0001. Bilateral cataract surgery patients had greater gain in VF and QoL than those that had uniocular surgery. Conclusion: This study demonstrated that cataract surgery is effective in improving overall VF and vision-related QoL, which resulted in functional independence. The second eye surgery confers additional gains in terms of VF and QoL in patients with bilateral cataract.

전남지역 초등학생의 굴절이상 유병률에 관한 연구

목적: 본 연구는 전남지역 초등학생들의 성별과 연령, 나안시력에 따른 굴절이상 유병률에 관하여 알아보고자 한다. 방법: 전남지역 소재 8~13세, 735명의 초등학생을 대상으로 시력검사, 자각적 및 타각적 굴절검사를 실시하였다. 나안시력검사는 한천석식 시시력표를 이용하였으며, 타각적 굴절검사는 자동굴절계를 이용하였다. 결과: 전남지역 초등학생들 중 0.1이하의 나안시력을 보인 학생은 54명(7.3%)으로 나타났으며, 이중 49명(90.7%)이 안경을 착용하였다. 0.125~0.25의 나안시력을 보인 학생들의 안경착용률은 79.3%, 0.3~0.5의 나안시력을 보인 학생들은 64.2%, 0.6~0.8의 나안시력을 보인 학생들의 안경착용률은 61.6%를 보였다. 또한 정시 269명(36.6%), 근시 321명(43.7%), 원시 56명(7.6%), 난시 89명(12.1%)으로 굴절이상 유병률 중 근시 유병률이 가장 높게 나타났으며, 난시 유병률이 다음으로 높게 나타났다. 근시 중 약도근시의 유병률이 가장 높게 나타났으며, 약도 및 중도근시의 유병률은 연령이 증가할수록 증가하는 것으로 나타났다. 원시 유병률은 연령이 증가할수록 감소하는 것으로 나타났다. 난시 유병률에서 50.6%(45명)가 직난시, 48.3%(43명)가 도난시, 1%(1명)가 사난시를 보였다. 결론: 전남지역 초등학생들의 굴절이상 현황을 조사한 결과 466명(63.4%)의 학생들이 굴절이상을 가지고 있는 것으로 나타났고, 이중 안경교정 인원은 313명(42.6%)으로 나타났다. 또한 연령이 증가할수록 근시 유병률이 증가하는 것으로 나타나 정확한 시력검사와 굴절검사 후 적절한 교정을 통해 학생들의 지속적인 시력관리가 필요할 것으로 판단된다. Purpose: This study was designed to investigate the prevalence rate of refractive error with gender and age presenting visual acuity of primary student in Jeonnam. Methods: Subjective refraction, objective refraction and visual acuity test were examined on 735 primary school children who ages of 8~13 years lived in Jenman. Presenting visual acuity test was using Han's visual acuity chart and objective refraction was carried out using auto-refractometer. Results: The presenting visual acuity was 0.1 worse in the eye of 54(7.3%) students and 49(7.3%) of them wearing the glasses. The rate of the wearing glasses were 79.3% in 0.125~0.25 visual acuity, 64.2% in 0.3~0.5 visual acuity and 61.6% in 0.6~0.8 visual acuity. It was appeared that 269(36.6%) of them were emmetropia, 321(43.7%) of them were myopia and 56(7.6%) of them were hyperopia, and 89(12.1%) of them were astigmatism. The prevalence rate of myopia was the highest and followed by the prevalence rate of astigmatism. The low degree of myopia occupied the most and the medium degree of myopia showed the tendency of increase as the students get olds. The prevalence rate of the hyperopia showed the tendency of decrease as the students get olds. The prevalence rate of with the rule astigmatism were 50.6% students and against the rule astigmatism were 48.3% of students. Conclusions: The present study reveals the considerable prevalence rates, 466(63.4%) of included subjects, of refractive errors among primary students in Jeonnam province. The rate of the wearing glasses were 313(42.6%). The prevalence of myopia increases as the students get older. Therefore students of visual management is considered necessary through the visual acuity test and refractive examination.

The automatic processing of visual information at different visual acuity levels: An ERP study

This study investigated the subjective visual acuity by recording ERPs elicited by task-irrelevant visual changes. Optotypes stimuli were presented in the center of the visual field at three threshold levels (supra-threshold, threshold and sub-threshold) while participants were listening to stories. The results showed that neither vMMN nor P3a component was elicited by optotypes stimuli on the sub-threshold condition, whereas, vMMN was elicited under supra-threshold and threshold conditions, with no significant differences between those vMMN amplitudes of two conditions. The P3a amplitude was larger for supra-threshold condition than that for threshold condition. These data demonstrated that the emergence of vMMN could only reflect the automatic detection of orientation-changes in the supra-threshold and threshold conditions compared to the sub-threshold condition, whereas the P3a amplitude could reflect the difference in processing of supra-threshold and threshold stimuli.

Effect of Upper Eyelid Blepharoplasty on Vision and Corneal Tomographic Changes Measured By Pentacam

Purpose: The aim of this study is to determine whether any change occurs in corneal astigmatic values measured by a pentacam and any subjective visual acuity changes occurs following the upper eyelid blepharoplasty.Methods: This is a prospective study; 43 eyes of 23 patients with dermatochalasis underwent pentacam and surveyed for blurred vision before, 1 and 3 months after blepharoplasty surgery. In the course of those 3 measurements, both refractive and keratometric data were recorded and analyzed. The changes in refractive sphere, cylinder and cylindrical axis from both preoperative and postoperative readings were compared statistically.Results: Compared to preoperative measurements, 26 eyes (60%) had a measurable increase in corneal astigmatism after the surgery. Increased astigmatism observed by pentacam in the first and the third month after surgery, showed statistically significant results according to Wilcoxon test with (p = 0.028 < 0.05) and (p = 0.048 < 0.05) values, respectively. The mean change in astigmatism was reported as 0.15D. Regarding the astigmatism axis, no significant change was detected; in the 1 month (p = 0.435 > 0.05) and 3 months (p = 0.560 > 0.05) postoperative measurements compared to preoperative values. Two patients (4.34%) reported visual acuity change 3 months after the surgery.Conclusıon: We discovered statistically significant astigmatic changes; however, these were clinically insignificant visual acuity changes in compatibility with prior studies. Patients undergoing blepharoplasty surgery should be advised that this procedure may potentially alter vision. It is also very important to advise the patients to undergo cataract and/or refractive surgery after having upper eyelid surgery that this procedure may induce vision changes.

Effects of optical blur reduction on equivalent intrinsic blur.

To determine the effect of optical blur reduction on equivalent intrinsic blur, an estimate of the blur within the visual system, by comparing optical and equivalent intrinsic blur before and after adaptive optics (AO) correction of wavefront error. Twelve visually normal subjects (mean [±SD] age, 31 [±12] years) participated in this study. Equivalent intrinsic blur (σint) was derived using a previously described model. Optical blur (σopt) caused by high-order aberrations was quantified by Shack-Hartmann aberrometry and minimized using AO correction of wavefront error. σopt and σint were significantly reduced and visual acuity was significantly improved after AO correction (p ≤ 0.004). Reductions in σopt and σint were linearly dependent on the values before AO correction (r ≥ 0.94, p ≤ 0.002). The reduction in σint was greater than the reduction in σopt, although it was marginally significant (p = 0.05). σint after AO correlated significantly with σint before AO (r = 0.92, p < 0.001), and the two parameters were related linearly with a slope of 0.46. Reduction in equivalent intrinsic blur was greater than the reduction in optical blur after AO correction of wavefront error. This finding implies that visual acuity in subjects with high equivalent intrinsic blur can be improved beyond that expected from the reduction in optical blur alone.

Visual impairment and unmet eye care needs among homeless adults in a Canadian city.

The ocular status of homeless populations remains largely unknown. Given that visual acuity has been shown to be heavily correlated with reduced well-being and decreased earning potential, findings of poor vision could have important health implications for people experiencing homelessness. To assess the prevalence of visual impairment and to identify unmet eye care needs in an adult homeless population. For this cross-sectional study, we recruited 100 homeless persons using a stratified random sampling technique from January to March 2014. Recruitment took place at 10 randomly selected adult shelters in Toronto, Ontario, Canada. All English-speaking persons older than 18 years of age were eligible to participate. Information was obtained on sociodemographic characteristics, ocular history, and subjective visual acuity. A comprehensive vision screening and an undilated retinal examination were performed for each participant. Rates of functional visual impairment and prevalence of nonrefractive eye pathology. The median age of participants was 48 years (interquartile range, 36-56 years), and 62% were men. The median lifetime duration of homelessness was 12 months (interquartile range, 5-36 months). Based on the participants' presenting visual acuity, the age-standardized rate of visual impairment was 25.2% (95% CI, 16.7%-33.7%). After pinhole occlusion, this number decreased to 15.2% (95% CI, 7.7%-22.7%). In total, 13.0% (95% CI, 7.8%-20.0%) of participants experienced visual impairment secondary to a correctable refractive error. Although the major problem for this demographic was limited access to refractive correction, a large degree of nonrefractive pathology was also observed. Of all the participants, 34.0% (95% CI, 24.7%-43.3%) had 1 or more abnormal findings during the vision screening, and 8% (95% CI, 2.7%-13.3%) required urgent referral to an ophthalmologist. A large majority of participants (89.0%) indicated interest in accessing free eye examinations. These data suggest that homeless adults have a high prevalence of visual impairment, even when living within a system of universal health insurance. Given the high level of interest in eye care among homeless persons, ongoing vision-screening programs and readily accessible free eye clinics may help address this need.

Initial clinical results of a new telescopic IOL implanted in patients with dry age-related macular degeneration.

To evaluate the safety and efficacy of the iol-AMD technology (London Eye Hospital Pharma, London, UK), which includes two injectable, hydrophobic acrylic intraocular lenses (IOLs) in a pilot study of patients diagnosed as having cataract and dry age-related macular degeneration. The cataract surgery and IOL implantation were performed after a preoperative evaluation using the iolAMD simulator in eyes with bilateral intermediate dry age-related macular degeneration. Outcomes were intraoperative and postoperative complications, subjective and objective visual acuity improvement, visual field changes, and postoperative diplopia. Three eyes of 2 patients were evaluated. The surgeries were uneventful. All eyes gained monocular reading vision at the 1-week postoperative visit. One patient with monocular implantation recognized diplopia for distance vision. Preoperative corrected distance visual acuity ranged from 20/800 to 20/125 and corrected near visual acuity was 20/800 or less. Two months after surgery, corrected distance and near visual acuities increased to levels between 20/40 and 20/25 (uncorrected distance visual acuity was 20/60 to 20/32; uncorrected near visual acuity was 20/200 to 20/25). These early results showed that the iolAMD simulator is a promising technology improving near and distance visual acuity in eyes with intermediate dry macular degeneration. The prismatic IOL effect did not lead to diplopia when implanted bilaterally. The surgery was safely performed.

A Case of Bilateral Diabetic Papillopathy Related to Rapid Hemoglobin A1c Decrease in Type I Diabetes Mellitus

Purpose: To report a case of bilateral diabetic papillopathy related to rapid hemoglobin A1c (HbA1c) decrease in a type I diabetic patient. Case summary: A 39-year-old female who was diagnosed with type I diabetes mellitus for the first time at this hospital was presented to our clinic for evaluation of diabetic retinopathy. There were no subjective symptoms, including blurred vision or visual defect. Her best corrected visual acuity in both eyes was 1.0, but her fundus resembled mild nonproliferative diabetic retinopathy. When diagnosed with type I diabetes mellitus, her HbA1c was 15.3%. She used insulin to control her blood glucose and her HbA1c reached 7.3% two months after controlling the blood glucose. Three months after her diabetic diagnosis, there were no differences in subjective symptoms and best corrected visual acuity. Fundus examination showed optic disc swelling in both eyes. To evaluate for the etiology of optic disc swelling, we did the examinations of the optic disc, fundus, and brain magnetic resonance imaging. No specific signs were observed. We diagnosed diabetic papillopathy and observed the patient without any treatments. Her optic disc swelling showed gradual improvement. Conclusions: This case shows that the rapid HbA1c decrease in type I diabetes mellitus is related to the occurrence of bilateral diabetic papillopathy. This supports previous studies that estimated that the rapid HbA1c decrease in type I diabetes mellitus in response to insulin treatment is one of the risk factors for bilateral diabetic papillopathy. J Korean Ophthalmol Soc 2015;56(12):1985-1990

Abstract 15681: Endothelial Dysfunction, Arterial Stiffness and Inflammation Are Associated With Visual Impairment in Diabetic Patients

Introduction: Diabetic Retinopathy (DR) is a complication of diabetes mellitus (DM) leading to deterioration of vision. Hypothesis: We investigated the possible association of vascular function and inflammation with visual acuity in subjects with DM. Methods: We enrolled 100 consecutive subjects with DM. Patients were divided in those with DR (53 subjects, mean age 68±9) and those with no evidence of DR (NDR) (mean age 66±6). The diagnosis of DR was made by ophthalmoscopy and best-corrected visual acuity (BCVA) was measured in both eyes. A BCVA less than 0.8 was considered as severely impaired. Endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery and arterial stiffness was evaluated by carotid femoral pulse wave velocity (PWV). C reactive protein (CRP) and interleukin 6 (IL6) levels were measured. Results: Patients with DR compared to NDR patients had impaired FMD (3.42±1.08% vs. 5.39±1.47%, p&lt;0.001), impaired PWV (11.10±3.11m/sec vs. 9.02±2.13m/sec, p=0.001) and worse BCVA (p&lt;0.001). Moreover in DM subjects, BCVA was positively correlated with FMD, creatinine clearance, and inversely correlated with PWV, glycosylated hemoglobin levels, C- reactive protein levels, IL6 levels, age and with duration of diabetes mellitus (p&lt;0.01 for all). Interestingly, after adjustment for age, smoking habits and the aforementioned confounders, FMD, IL6 levels, DM duration and male gender were independently associated with BCVA (p&lt;0.05 for all). Moreover, ROC curve analysis revealed that both impaired FMD (AUC=0.79, p&lt;0.001) and PWV (AUC=0.8, p&lt;0.001) have a significant diagnostic ability in detecting diabetic subjects with severely impaired BCVA. More precisely, FMD less than 4.5% has a sensitivity of 90% and a specificity of 60%, while PWV over 10.0 m/sec has a sensitivity of 83% and a specificity of 68%, for the diagnosis of severely impaired BCVA. Conclusion: Patients with DR have significantly impaired visual acuity witch is associated with impaired vascular function and inflammation. Moreover, both endothelial function and arterial stiffness were high sensitivity predictors of visual impairment highlighting their potential role on the prevention and management of the complications in diabetes mellitus.

Visual impairment and multimorbidity in a representative sample of the Spanish population.

BackgroundIn the context of population aging, visual impairment has emerged as a growing concern in public health. However, there is a need for further research into the relationship between visual impairment and chronic medical conditions in the elderly. The aim of our study was to examine the relationship between visual impairment and three main types of co-morbidity: chronic physical conditions (both at an independent and additive level), mental health and cognitive functioning.MethodsData were collected from the COURAGE in Europe project, a cross-sectional study. A total of 4,583 participants from Spain were included. Diagnosis of chronic medical conditions included self-reported medical diagnosis and symptomatic algorithms. Depression and anxiety were assessed using CIDI algorithms. Visual assessment included objective distance/near visual acuity and subjective visual performance. Descriptive analyses included the whole sample (n = 4,583). Statistical analyses included participants aged over 50 years (n = 3,625; mean age = 66.45 years) since they have a significant prevalence of chronic conditions and visual impairment. Crude and adjusted binary logistic regressions were performed to identify independent associations between visual impairment and chronic medical conditions, physical multimorbidity and mental conditions. Covariates included age, gender, marital status, education level, employment status and urbanicity.ResultsThe number of chronic physical conditions was found to be associated with poorer results in both distance and near visual acuity [OR 1.75 (CI 1.38-2.23); OR 1.69 (CI 1.27-2.24)]. At an independent level, arthritis, stroke and diabetes were associated with poorer distance visual acuity results after adjusting for covariates [OR 1.79 (CI 1.46-2.21); OR 1.59 (CI 1.05-2.42); OR 1.27 (1.01-1.60)]. Only stroke was associated with near visual impairment [OR 3.01 (CI 1.86-4.87)]. With regard to mental health, poor subjective visual acuity was associated with depression [OR 1.61 (CI 1.14-2.27); OR 1.48 (CI 1.03-2.13)]. Both objective and subjective poor distance and near visual acuity were associated with worse cognitive functioning.ConclusionsArthritis, stroke and the co-occurrence of various chronic physical diseases are associated with higher prevalence of visual impairment. Visual impairment is associated with higher prevalence of depression and poorer cognitive function results. There is a need to implement patient-centered care involving special visual assessment in these cases.

Original article. Repeatability assessment of the New Numbers Contrast Sensitivity Chart

Abstract Background: The validity and agreement of the New Numbers Contrast Sensitivity Chart with the original Mars chart have been found to be good. The two charts can be used interchangeably; however, evidence of the repeatability of the new chart remains to be sought. This study was to assess the repeatability of the New Numbers Contrast Sensitivity Chart. Objectives: We assessed the repeatability of the Numbers Contrast Sensitivity Chart. Methods: Two hundred subjects from the ophthalmic clinic of the King Chulalongkorn Memorial Hospital, who were able to communicate and read Arabic numerals were recruited. The contrast sensitivity (CS) scores were collected by reading the same Numbers Contrast Sensitivity Chart in the same environment with each eye and both eyes ten minutes apart. The repeatability of the CS score was assessed by Bland-Altman plot analysis. Results: The visual acuity of subjects with variety in diagnoses ranged from 20/480 to 20/20. The mean differences were -0.006, -0.008, -0.002 log CS and the coefficients of repeatability were 0.155, 0.141, and 0.093 for the right eye, left eye, and both eyes, respectively. The plots showed a narrow range of 95% limit of agreement, which were (+0.146, -0.159) in the right eye, (+0.130, -0.147) in the left eye, and (+0.089, -0.093) in both eyes. Conclusions: The New Numbers Contrast Sensitivity Chart has good repeatability. With proven good validity and repeatability, this easy and convenient numbers chart is beneficial for practical use in a clinical setting where English is not used as the primary language.

Does levodopa improve vision in albinism? Results of a randomized, controlled clinical trial

Dopamine is an intermediate product in the biosynthesis of melanin pigment, which is absent or reduced in albinism. Animal research has shown that supplying a precursor to dopamine, levodopa, may improve visual acuity in albinism by enhancing neural networks. This study examines the safety and effectiveness of levodopa on best-corrected visual acuity in human subjects with albinism. Prospective, randomized, placebo-controlled, double-masked clinical trial conducted at the University of Minnesota. Forty-five subjects with albinism. Subjects with albinism were randomly assigned to one of three treatment arms: levodopa 0.76 mg/kg with 25% carbidopa, levodopa 0.51 mg/kg with 25% carbidopa, or placebo and followed for 20 weeks, with best-corrected visual acuity measured at enrollment, and at weeks 5, 10, 15, and 20 after enrollment. Side-effects were recorded with a symptom survey. Blood was drawn for genotyping. Side-effects and best-corrected visual acuity 20 weeks after enrolment. All subjects had at least one mutation found in a gene known to cause albinism. Mean age was 14.5 years (range: 3.5 to 57.8 years). Follow up was 100% and compliance was good. Minor side-effects were reported; there were no serious adverse events. There was no statistically significant improvement in best-corrected visual acuity after 20 weeks with either dose of levodopa. Levodopa, in the doses used in this trial and for the time course of administration, did not improve visual acuity in subjects with albinism.

Double-Pass System Assessing the Optical Quality of Pseudophakic Eyes

To compare the optical quality measurements obtained from the double-pass system and ocular aberrations, subjective visual acuity, and contrast sensitivity score in pseudophakic eyes. Three months after cataract surgery, modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scatter index, and objective pseudoaccommodation obtained from the double-pass system were compared with total aberration, higher-order aberration, and spherical aberration obtained from ray-tracing aberrometer. In addition, parameters of the double-pass system were compared with subjective visual acuity and the contrast sensitivity score. Forty eyes of 40 patients were included. The MTF cutoff frequency and Strehl ratio were negatively correlated with total aberration (r = -0.503, p = 0.003; r = -0.509, p = 0.003, respectively) and subjective visual acuity (r = -0.453, p = 0.007; r = -0.354, p = 0.040, respectively). The objective scatter index was positively correlated with total aberration (r = 0.451, p = 0.024) and subjective visual acuity (r = 0.516, p = 0.008). The MTF cutoff frequency showed a correlation with contrast sensitivity score under photopic and mesopic conditions. Optical quality parameters obtained from the double-pass system were correlated with ocular aberrations, subjective visual acuity, and contrast sensitivity score in pseudophakic eyes.

Systane® Ultra Lubricant Eye Drops for Treatment of Contact Lens–Related Dryness

To assess the clinical performance of Systane Ultra lubricant eye drops in daily disposable soft contact lens wearers who experience contact lens-related dryness. In this randomized, investigator-masked study, daily disposable lens wearers with symptoms of dryness were randomized to use Systane Ultra lubricant eye drops or to no treatment. The lubricant regimen was applied twice a day, 10 minutes before lens insertion and after lens removal, for the 2-week study period. Subjective comfort, wear time, and visual acuity were assessed at baseline and after 2 weeks. A total of 89 daily disposable lens wearers were randomly assigned to the Systane Ultra group (n=44) or the control group (n=45). Two weeks of Systane Ultra lubricant eye drop use resulted in a significant increase in comfortable lens wear time when compared with baseline assessment (P=0.001) and a trend toward significant improvement compared with the control group (P=0.078). End-of-the-day comfort was significantly improved in the Systane Ultra group compared with the control group (P=0.007). A significant reduction in the overall dryness (P<0.001) and end-of-day dryness (P=0.047) was observed in subjects using the Systane Ultra lubricant eye drops compared with the control group. The study demonstrates that Systane Ultra lubricant eye drops applied before and after contact lens wear is an effective artificial tear for alleviating symptoms of contact lens-related dry eye.

Evaluation of optical quality parameters and ocular aberrations in multifocal intraocular lens implanted eyes.

PurposeWe investigated the correlations between optical quality parameters obtained from the double-pass system and ocular aberrations obtained from the ray-tracing aberrometer in multifocal intraocular lens (IOL) implanted eyes.Materials and MethodsTwenty eyes from 20 patients were enrolled in this study. Modulation transfer function cutoff frequency, The Strehl ratio, objective scatter index, and objective pseudo-accommodation obtained from the double-pass system were compared with root mean square (RMS) total aberration, RMS higher-order aberration, and spherical aberration obtained from the ray-tracing aberrometer. Additionally, parameters of the double-pass system and ray-tracing aberrometer were compared with manifested refraction values and subjective visual acuity, respectively.ResultsThere was no statistically significant correlation between optical quality parameters obtained from the double-pass system and ocular aberrations, except between the Strehl ratio and RMS total aberration (r=-0.566, p=0.018). No significant correlations were found between the parameters of both devices, and manifested refraction values or subjective visual acuity.ConclusionOptical quality parameters, especially the Strehl ratio, in multifocal IOL implanted eyes were affected by RMS total aberration. Further studies based on accurate measurements of ocular aberrations and additional optical quality parameters are needed to delineate relationships between optical quality parameters and ocular aberrations in multifocal IOL implanted eyes.

A Prospective Study of Pterygium Excision and Conjunctival Autograft With Human Fibrin Tissue Adhesive: Effects on Vision, Refraction, and Corneal Topography.

This study aimed to investigate changes in visual acuity, corneal parameters, and topographic parameters after pterygium surgery. A prospective observational study was conducted. Twenty eyes of 20 participants undergoing pterygium excision with conjunctival autograft secured using human fibrin tissue adhesive were included in the study. All the participants were assessed preoperatively and 1 and 3 months postoperatively. The parameters included subjective refraction, visual acuity, and pterygium size (pterygium horizontal corneal length [PHCL]) and corneal tomography by Pentacam rotating Scheimpflug tomographer (OCULUS Optikgeräte GmbH, Wetzlar, Germany). The astigmatic changes were calculated using vector analysis. The mean age of participants was 49.3 ± 12.1 years. Mean PHCL was 2.68 ± 0.30 mm. The mean best corrected visual acuity preoperatively was 6/7.5, improving significantly to 6/6 at 1 month (P = 0.001) with this improvement remaining stable at 3 months postoperatively (P = 0.34). There was no significant change in subjective astigmatism, however, mean topographic astigmatism decreased significantly at 1 month (4.36 diopter, P < 0.01) and remained unchanged at 3 months (P < 0.01). Greater PHCL was associated with greater changes in corneal astigmatism. Significant improvements and early stabilization of visual acuity and topographic astigmatism confirm the optical benefits of pterygium excision. These data also suggest a significant advantage of performing pterygium before rather than simultaneously with or after cataract surgery by enabling the most accurate biometry.