Search Results (72)

Background and Objectives: Children with autism spectrum disorder (ASD) often experience visual problems, yet their ophthalmic health remains underexplored due to testability challenges and limited-service access. This study evaluated ophthalmic screening outcomes in children with ASD and examined whether autism severity influenced ocular findings or cooperation during examinations. Materials and Methods: This cross-sectional study included 210 children with ASD (mean age 8.18 ± 4.99 years; 83.3% male). Examinations were conducted in an autism education center using non-contact methods: stereopsis (LANG I stereotest; LANG-STEREOTEST AG, Küsnacht, Switzerland), cover–uncover, and Hirschberg tests for strabismus, Spot Vision Screener (Welch Allyn Inc., Skaneateles Falls, NY, USA) for refractive errors, and Brückner test for red reflex. Autism severity was assessed with the Turkish version of the Adapted Autism Behavior Checklist (AABC). Results: Refractive errors were identified in 22.3% of participants: astigmatism in 15.2%, myopia in 5.2% (including 3 high myopia), and hyperopia in 1.9%. Strabismus was present in 11.9%, most commonly intermittent exotropia. Nearly half (49.5%) could not complete stereopsis testing, and a weak positive correlation was observed between AABC scores and the higher absolute spherical equivalent (SE) value between the two eyes (r = 0.173, p = 0.044). Children unable to complete stereopsis testing had significantly higher AABC scores (22.66 ± 9.69 vs. 13.39 ± 9.41, p < 0.001). Notably, 50 children (23.8%) had never undergone an eye examination prior to this study. Conclusions: Ophthalmic findings, particularly astigmatism and strabismus, are common in children with ASD. Greater autism severity was associated with reduced testability and modestly worse refractive error status. These findings suggest that tailored, accessible eye-care approaches and systematic vision screening may help to reduce overlooked visual problems and support more equitable care for children with ASD. Full article

Background: The goal of the study was to describe the visual function characteristics of children with developmental epileptic encephalopathy resulting from mutations in the STXBP1 gene. Methods: The study included 26 consecutive patients from the Polish STXBP1 population (11 male and 16 female; mean age: 7 years and 4 months; SD 4.03; range: 2–16 years) evaluated at a single center for strabismus and binocular vision. Data were obtained from medical records, including ophthalmological, neurological, and genetic information, as well as orthoptic and ophthalmological examinations performed in the clinic. Results: No major eye disorders were identified during the ophthalmological evaluation. The average prevalence of hyperopia was 76.9% (mean for OD, OS), with hyperopia above 4.25 D occurring in 17.3% (n = 4) of participants. Astigmatism was present in 96.2% of patients, with values ≥ 2.75 D in 27% (n = 7) of the group. The mean disc–foveal angle across all subjects was 7.23° ± 6.85° (range: −10.34° to 19.77°). Convergence was absent in 53.8% (n = 14) of patients. Mean accommodation responses equal to or higher than +1.0 D in any eye were noted in 90.5% of subjects. The mean accommodative/convergence (AC/A) ratio was 1.16 (SD 1.05; range: 0–3.3). Fusion was diagnosed using the 20 base-out prism test in 77% (n = 20) of patients, of which 85% (n = 17) had a positive response. Conclusions: This is the first study to comprehensively assess visual function in children with STXBP1 synaptopathy. Binocular vision development in individuals with STXBP1 differs from that of the general population. Considering the high prevalence of refractive errors, deficits in accommodation, and a low AC/A ratio, early visual diagnostics and the use of corrective eyewear are recommended in these patients. Full article

We developed an innovative method using the focal length change in the zoom lens to enable subjects with refractive errors to see the E chart image. For myopes, the distant E chart image is in front of the retina. By using the focal length change in the zoom lens, the E chart is located inside the first focal point of the zoom, diverging light. The E chart image is formed on the retina, and the myopes can clearly see the E chart. For hyperopia, the distant E chart image is behind the retina. Similarly, by using the focal length change in the zoom lens, the E chart is located outside the first focal point of the zoom lens and converges light, and the E chart image is formed on the retina. Hyperopia patients can clearly see the converged E chart. The test for myopia was repeated 30 times. The average of the two test values was −0.7, and the rest were −0.8. The error in the two test datasets can be minimized by optimizing the zoom lens, reducing the optical image value, and expanding the field of view (FOV). Full article

Herein, we report a USB-powered VR-HMD prototype integrated with our 33 mm aperture varifocal liquid lenses and electronic drive components, all assembled in a conventional VR-HMD form-factor. In this volumetric-display-based VR system, a sequence of virtual images are rapidly flash-projected at different plane depths in front of the observer and are synchronized with the correct accommodations provided by the varifocal lenses for depth-matched focusing at chosen sweep frequency. This projection mechanism aids in resolving the VAC that is present in conventional fixed-depth VR. Additionally, this system can address refractive error corrections like myopia and hyperopia for prescription users and do not require any eye-tracking systems. We experimentally demonstrate these lenses can vibrate up to frequencies approaching 100 Hz and report the frequency response of the varifocal lenses and their focal characteristics in real time as a function of the drive frequency. When integrated with the prototype’s 120 fps VR display system, these lenses produce a net diopter change of 2.3 D at a sweep frequency of 45 Hz while operating at ~70% of its maximum actuation voltage. The components add a total weight of around 50 g to the off-the-shelf VR set, making it a cost-effective but lightweight minimal solution. Full article

Background: Visual impairment (VI) continues to be a significant global public health concern, especially in underserved rural communities. Objectives: This study aims to assess the prevalence of VI and refractive errors, as well as to identify the causes and risk factors associated with VI in Duhknah, a rural area in Qassim Province, Saudi Arabia. Methods: This cross-sectional study, conducted in May 2024, included 929 participants aged 6–90 years from Duhknah, a rural area in Qassim Province, Saudi Arabia. Refractive errors (REs) were measured using a non-cycloplegic autorefractometer. Anterior and posterior eye examinations were performed using slit lamp biomicroscopy, direct ophthalmoscopy, and 90 D fundus biomicroscopy. VI was classified based on the International Classification of Diseases 11th revision (ICD-11), 2018. Results: The findings revealed that 671 (72.2%) participants had never undergone an eye examination. The overall prevalence of presenting VI was 370 (39.8%), comprising 21.6% with mild VI, 11.0% moderate, 4.1% severe, and 3.1% classified as blind. The prevalence of hyperopia, myopia, and astigmatism was 20.6%, 36.9%, and 13.2%, respectively. Uncorrected REs were the most common cause of VI (81.4%), followed by amblyopia (13.5%) and cataracts (3.2%). Regression analysis showed that women had 1.58 times higher odds of VI (p = 0.001). Participants with eye examinations for one year or more had 3.64 times higher odds (p < 0.001). Additionally, the risk of VI was significantly lower among older participants (ages 18–90) compared to younger ones (ages 6–17), (p < 0.001). Conclusions: This study found most participants had never had an eye exam, and VI was highly prevalent in the rural community. These findings underscore the need to strengthen primary eye care in rural Saudi Arabia. Regular vision screening, particularly for children, and better access to refractive services could significantly reduce VI and support the goals of Saudi Vision 2030. Full article

Background/Objectives: Although both the MEL90 (Carl Zeiss Meditec AG, Jena, Germany) and WaveLight EX500 (Alcon Laboratories, Inc., Fort Worth, TX, USA) are two widely used excimer lasers, comparisons between the two remain limited. This study evaluates visual and refractive outcomes from the U.S. Food and Drug Administration (FDA) premarket approval trials of these platforms in the treatment of myopia with and without astigmatism, hyperopia with and without astigmatism, and mixed astigmatism. Methods: Clinical outcomes from FDA premarket approval trials were compared between the recently approved MEL90 and the WaveLight (now termed EX500) excimer lasers. Results: A total of 714 eyes (358 patients) from MEL90 and 1353 eyes (706 patients) from EX500 were analyzed up to 6 months postoperatively. In the hyperopia/hyperopic astigmatism cohort, the EX500 demonstrated greater efficacy relative to MEL90, with more eyes achieving a postoperative uncorrected distance visual acuity (UDVA) of 20/20 or better (48.6% vs. 68.7%, respectively; p < 0.001). In both the MEL90 and EX500, at least 85% of eyes with myopia/myopic astigmatism and 68% with mixed astigmatism achieved a postoperative UDVA of 20/20 or better. For all refractive cohorts, more than 95% of eyes achieved a UDVA of 20/40 or better at 6 months (all p > 0.05). The EX500 was more likely to demonstrate an improvement of more than two lines of UDVA compared to baseline CDVA (all p < 0.05). In contrast, the MEL90 showed greater predictability of spherical equivalent within ±0.50 D and ±1.00 D for the hyperopia/hyperopic astigmatism cohort (both p = 0.007), as well as within ±0.50 D for the myopia/myopic astigmatism cohort (p < 0.001). Postoperatively, both platforms were associated with decreased glare and halos, although findings were variable in the EX500 mixed astigmatism cohort. Conclusions: Both excimer lasers demonstrated safe and effective outcomes that exceed the threshold set by the FDA. Full article

Objectives: To compare the objective refraction of young hyperopes obtained by two wavefront autorefractors with identical measurement principles but different optical designs: a monocular closed-field (VX 120) and a binocular open-field (Eye Refract), both developed by the same manufacturer (Visionix; Pont-de-l’Arche, France). Methods: A randomized, cross-sectional study was carried out with 37 hyperopic participants (18.2 ± 7.8 years; range 8 to 31 years). Each participant underwent two measurement sessions (one with and one without cycloplegia), during which three measurements were taken per autorefractor (monocular and binocular). Refractive variables (M, J0, and J45) were analyzed in one randomly selected eye. Results: The spherical equivalent (M) showed significant differences between autorefractors under noncycloplegic and cycloplegic conditions (p < 0.001). Without cycloplegia, the binocular autorefractor measured +0.45 (+1.49, −0.58) D more hyperopia than the monocular device. Under cycloplegia, this difference decreased to +0.26 D (+0.99, −0.48) D. Both autorefractors provided higher hyperopia with cycloplegia, with differences inversely correlated with age (r = −0.4; p < 0.05). Conclusions: Whenever possible, refraction in young hyperopes should be measured under cycloplegic conditions using a binocular open-field autorefractor to promote greater accommodative relaxation and ensure more reliable hyperopia measurements in both clinical practice and research. Full article

This study analyzed the impact of corneal epithelial refraction on the correction of hyperopic and mixed astigmatism eyes treated with transepithelial photorefractive keratectomy. From the epithelial refraction provided by the diagnostic device, OCT correlations were evaluated with respect to manifest refraction. The postoperative outcomes showed a mean sphere of −0.03 D and a mean cylinder of −0.33 D, with 93% and 98% having 0.5 D, 1 D, or less spherical equivalent refractive error. The epithelium showed preoperative toricity: at 6 mm, the epithelium showed a compensational effect of ~15% for the refractive astigmatism, whereas at 3 mm, the compensation accounted for ~25% of the refractive astigmatism. No correlation was found between preoperative epithelial refraction and refractive deviation after hyperopic or mixed astigmatic transepithelial photorefractive treatment. This work provides insight into the refractive compensatory impact of the epithelium, suggests how one can benefit from that in transepithelial corrections, and sets a framework for the potential induction of errors in non-transepithelial corrections. Full article

Sensenbrenner syndrome, or cranioectodermal dysplasia (CED), is a rare autosomal recessive ciliopathy characterized by craniofacial, skeletal, ectodermal, and renal abnormalities. Ocular involvement, though infrequent, can include retinal dystrophy with early-onset visual impairment. We report a case of a 2-year-old boy with classic clinical features of CED and significant ocular findings. Genetic testing revealed two novel compound heterozygous variants in the WDR19 gene—c.1778G>T and c.3536T>G—expanding the known mutational spectrum associated with this condition. Ophthalmologic evaluation demonstrated bilateral optic nerve hypoplasia, high hyperopia, and severely reduced ERG responses, consistent with global retinal dysfunction. Fundoscopy revealed optic disk pallor, vessel attenuation, and peripheral pigment changes. Multisystem findings included postaxial polydactyly, brachydactyly, short stature, hypotonia, and stage 2 chronic kidney disease. This case highlights the importance of early ophthalmologic screening in suspected CED and underscores the utility of ERG in detecting early retinal involvement. The identification of two previously undescribed WDR19 variants contributes to genotype–phenotype correlation in CED and emphasizes the need for ongoing documentation to guide diagnosis, management, and genetic counseling. Full article

Objectives: This study aims to describe the clinical features and genetic findings of nine Vietnamese patients with autosomal recessive bestrophinopathy. Methods: This retrospective and cross-sectional study included individuals diagnosed with autosomal recessive bestrophinopathy at the Eye Clinic, Vietnam National Geriatric Hospital between May 2024 and April 2025. The patients underwent a visual acuity assessment, retinal multimodal imaging, and molecular testing through BEST1 gene sequencing. Results: Nine patients from seven unrelated families were included. The mean age was 38.6 years (range: 14.1–79.6). Visual acuity ranged from 20/20 to 20/125. All patients showed vitelliform lesions, subretinal deposits, and both intraretinal and subretinal fluid. Other main features included diffuse macular hyperfluorescence and hyperopia. Less common clinical features encompassed glaucoma, retinoschisis, outer retinal thinning, serous retinal detachment, retinal thickening, and thinning of the retinal pigment epithelium. Compound heterozygous or homozygous variants were detected in all patients. Among the five identified BEST1 variants, the most frequent were p.(A195V) and p.(R200*). One novel variant, p.(K289*), was detected. Conclusions: The main clinical retinal features of nine Vietnamese patients with autosomal recessive bestrophinopathy included vitelliform lesions, subretinal deposits, retinal fluid, and diffuse macular hyperfluorescence. The most common variants were p.(A195V) and p.(R200*). Additionally, the identification of various compound heterozygotes and a novel BEST1 variant expands the mutation spectrum of the disease. Full article

This study aimed to investigate the relationship between visual system parameters (visual acuity and refractive error) and postural balance under controlled conditions in elite football players. Visual acuity (monocular and binocular) and refractive errors were assessed in 34 male athletes using retinoscopy and subjective refraction. Postural stability was assessed with the Cyber-Sabots™ platform, recording the center of pressure (CoP) metrics, including sway amplitude, velocity, and distribution area. Visual and postural parameter correlations were assessed using Pearson’s test (p < 0.05). Athletes demonstrated good binocular visual acuity (−0.03 ± 0.09 logMAR) and were predominantly emmetropic. Visual acuity and postural parameters showed significant negative correlations, whereby visual acuity was associated with reduced CoP displacement (r = −0.352) and sway area (r = −0.367), indicating enhanced stability. Hyperopia and oblique astigmatism were moderately correlated with increased sway (r = 0.343) and antero-posterior sway amplitude in the sagittal plane (r = 0.324). Anisometropia showed moderately negative correlations with antero-posterior control (r = −0.421), suggesting a disruptive effect on postural stability. The postural analysis showed adaptations characteristic of football players, including anterior body inclination, increased forefoot loading, and medio-lateral sway. Romberg’s quotients highlighted significant visual input reliance for maintaining postural balance. Visual acuity, refractive errors, and interocular refractive asymmetries significantly influence postural stability in elite football players. These results support incorporating visual function assessment into training and injury prevention in elite sports. Full article

Small-incision lenticule extraction (SMILE) is a safe and effective procedure to correct myopia and myopic astigmatism. The corneal stromal lenticules extracted from SMILE surgery have good light transmission, mechanical properties, and biocompatibility, which are suitable for the treatment of a variety of corneal diseases and can solve the problem of donor cornea shortage. At present, no single method of preserving corneal stromal lenticules has been universally accepted as ideal, as the preservation of tissue integrity, optical transmittance, cellular viability, and the potential for long-term storage remain key challenges. Current approaches include short-term preservation methods such as the use of dehydrating agents and Optisol GS, and long-term preservation strategies such as cryopreservation, hydrogel nutrient capsules, and silicone oil. Standardized storage methods can improve the use of SMILE-derived lenticules as a substitute for donor corneal tissue in clinical settings. The reuse of corneal stromal lenticules is a highly regarded research area, especially in hyperopia, presbyopia, keratoconus, and some corneal ulcerative diseases, providing new possibilities for addressing corneal tissue shortage and improving surgical outcomes. Here, we review various preservation methods and clinical applications of SMILE-extracted lenticules, highlighting their potential in addressing corneal tissue shortages and the treatment of a variety of corneal diseases. Full article

Background/Objective: Poor vision can lead to low academic performance and negatively affect the quality of life. In Moldova, there are few guidelines for vision and eye care in children. Further, the prevalence of refractive errors, visual impairment, or eye disease in Moldovan children is unknown. The study aimed to explore the prevalence of refractive errors and eye disease among children examined in ophthalmological practice in Moldova. Methods: The study had a cross-sectional design, including consecutive patients, aged <18 years, examined in an ophthalmological practice in Chișinău, Moldova, during two time periods, from July to September 2018 and from May to June 2023. Results: Data of 299 children (157 female) aged 0–18 years were collected. In all, 177 (59.2%) children had cycloplegic refraction and assessment of refractive error: 47 in the age group 0–2 years, 64 in the age group 3–6 years, and 66 in the age group 7–18 years. In children under 3 years, 8 (17%) were emmetropic (−0.50 D < SER < +0.50 D), 4 (9%) were myopic (SER ≤ −0.50 D), 34 (72%) had mild hyperopia (0.5 ≤ SE < 3.0), and 1 (2%) had high hyperopia (SER > 3.0). Among children aged 3–6 years, 11 (17%) were emmetropic (−0.50 D < SER < +0.50 D), 5 (8%) were myopic (SER ≤ −0.50 D), 46 (72%) had mild hyperopia (0.5 ≤ SER < 3.0), and 2 (3%) had high hyperopia (SER > 3.0). In children over 6 years, 33 (50%) were myopic (SER ≤ −0.50 D), 2 (3%) were emmetropic (−0.50 D < SER < +0.50 D), 27 (41%) had mild hyperopia (0.5 ≤ SER < 3.0), and 4 (6%) had high hyperopia (SER > 3.0). A total of 4 children (2.3%) had amblyopia and 19 children (6.4%) had ocular pathologies. Twelve children (6.8%) were visually impaired with their habitual correction. Conclusions: Half of the school children had myopia and a little less than half had hyperopia. Among toddlers and pre-school children, one in four had myopia or were at risk of developing myopia. Full article

Investigation and evaluation of the first clinical results of the new ablative solid-state laser (AQUARIUZ) regarding clinical outcome, inclusively higher-order aberration and safety. In this case report, three hyperopic patients with six eyes were treated with the new ablative solid-state laser (AQUARIUZ). The LASIK incisions are cut with the Ziemer LDV Z8. All patients were followed for 6 months postoperatively. The treated hyperopia ranged from +0.5 D to +2.75 D. Emmetropia of 0 D was found in four eyes after 6 months. In two eyes there was a slight myopia of −0.25 D each, which is also considered emmetropia according to the definition. The aspherically optimized profile of the ablative solid-state laser did not induce a higher-order aberration or spherical aberration in any eye. No eye lost CDVA or UDVA lines after the follow-up period. The safety index was 1 in five eyes and 1.25 in one eye. The findings demonstrate a high level of precision and treatment safety with the new ablative solid-state laser. Full article

Background: Visual impairment can significantly impact an individual’s performance, productivity, and overall quality of life. Objectives: The objective of this paper is to report the prevalence, causes, and risk factors associated with visual impairment in Qbah, a rural community in the Qassim Province of Saudi Arabia. Methods: A descriptive cross-sectional study was conducted in Qbah, a rural community, with 587 subjects aged 6 to 80 years. Data were collected as part of a major campaign by Qassim University, and each participant underwent a comprehensive eye examination. Finally, the visual impairment was classified based on the International Classification of Diseases 11th revision, 2018 (ICD-11). Results: The overall prevalence of presenting visual impairment was 159 (27.1%). This included mild visual impairment 84 (14.37%), moderate visual impairment 65 (11.7%), severe visual impairment, and blindness 5 (0.90%). The main causes of visual impairment were uncorrected refractive errors (UREs), at 132 (83.0%), followed by amblyopia, at 14 (8.8%), and cataract, at 9 (5.7%). The prevalence of hyperopia, myopia, and astigmatism was 134 (22.8%), 174 (29.6%), and 13 (2.2%), respectively. Regression analysis revealed that the odds for visual impairment were 2.71 times higher in the elderly compared to the young participants. Women have 2.234 times higher odds of visual impairment compared to men, while the odds of visual impairment were 14.83 times higher in the participants with the URE compared to the emmetropic participants. Almost two-thirds of participants (65.8%) reported never having had an eye examination before. Conclusions: Visual impairment was common in the community, especially among older people and females, and URE was the main cause of visual impairment, followed by amblyopia and cataract. Considerable subjects reported never having had an eye examination before; this highlights the challenges in accessing healthcare in rural areas. These findings emphasize the importance of improving healthcare accessibility in rural regions. Full article