Search Results (10)

Dry eye disease (DED) is a multifactorial, chronic, and often relapsing condition with a significant impact on patient quality of life (QoL). Symptoms such as ocular discomfort and visual disturbances are diverse and frequently misaligned with objective clinical signs, complicating diagnosis and management. DED not only interferes with daily activities like reading, driving, and computer use but also imposes a substantial economic burden due to direct healthcare costs and reduced work productivity. Beyond its ocular manifestations, DED has been associated with higher prevalence rates of depression and anxiety, with a complex bidirectional relationship. Patients with DED may experience psychological distress that exacerbates symptoms, leading to a vicious cycle that further impairs QoL. This underscores the importance of integrating mental health screening into the management of DED, particularly for high-risk populations. Optimizing the care of DED patients requires empathy, effective communication, and the establishment of a therapeutic alliance that acknowledges patient experiences and involves them in personalized treatment plans. Such an approach can improve patient satisfaction, enhance treatment adherence, and address both ocular and psychological dimensions of the disease. This paper highlights current evidence on the impact of DED symptoms and its association with mental health and recommends strategies to improve clinical management through a patient-centered approach. Full article

Background/Objectives: Ocular proprioception is implicated in balance control and heterophoria is associated with abnormal posture, though previous research focused mainly on the role of vertical phoria and the use of vertical prisms. This study aims to evaluate whether ocular misalignment and prismatic correction of horizontal phoria affect posture. Methods: Sixty-nine (N = 69) young healthy subjects were included and equally divided by horizontal distance phoria: orthophoria (n = 23), esophoria (n = 23) and exophoria (n = 23). A prism of low power (two-diopter) was placed base out on the non-dominant eye, reducing misalignment in esophorics and increasing it in exophorics more than in orthophorics. Dynamic computerized posturography was performed with the sensory organization test protocol (SOT) of the EquiTest^® NeuroCom^® version 8 platform both without and with prism, always maintaining subjects unaware of prism use. A mixed model for repeated measures analysis of variance was run to evaluate the main effect of prism and the interaction effect of prism with baseline phoria. Results: Composite movement strategy score without prism was 88.1 ± 2.8% (ankle-dominant strategy) and slightly increased to 89.0 ± 3.1% with prism insertion (p = 0.004), further shifting toward ankle strategy. Composite equilibrium score without prism was 80.3 ± 6.5% and remained stable with prism insertion (81.3 ± 8.2%, p = 0.117), medio-lateral and antero-posterior projection of center of gravity did not displace significantly under prism insertion (p = 0.652 and p = 0.270, respectively). At baseline, posturographic parameters were statistically independent of individual phoria, and no significant interaction between prism insertion and individual phoria was documented for any parameters (p > 0.05 for all). Secondary analysis and pairwise comparisons confirmed that the effect of prism was strongly selective on condition SOT 5 (eyes-closed, platform sway-referenced) with improvement of equilibrium (70.4 ± 9.7% with prism vs. 65.7 ± 11.6% without) and more use of ankle strategy (81.6 ± 5.3% with prism vs. 78.2 ± 6.0% without), without any interaction of phoria and ocular dominance, while the other conditions were comparable with and without prism. Conclusions: A two-diopter prism base out on the non-dominant eye induces the body to use the ankle joint more independently of individual phoria, suggesting a small improvement in postural control, while maintaining oscillations of the center of gravity unaltered. Prism seems to enhance the function of vestibular system selectively. Phoria adjustments with prismatic correction enable intervention in postural behavior. Extraocular muscles could act as proprioceptors influencing postural stability. Full article

This study presents a novel method for the early detection of strabismus, a common eye misalignment disorder, with an emphasis on its application in telemedicine. The technique leverages synchronized eye movements to estimate the pupil location of one eye based on the other, achieving close alignment in non-strabismic cases. Regression models for each eye are developed using advanced machine learning algorithms, and significant discrepancies between estimated and actual pupil positions indicate the presence of strabismus. This approach provides a non-invasive, efficient solution for early detection and bridges the gap between basic research and clinical care by offering an accessible, machine learning-based tool that facilitates timely intervention and improved outcomes in diverse healthcare settings. The potential for pediatric screening is discussed as a possible direction for future research. Full article

Purpose: To assess the possible impact of minor changes in fixation on wavefront measurements as a potential constraint in detecting subtle temporal variations in ocular wavefront error. Methods: Twelve healthy subjects with an average age of 36.3 ± 8.8 were instructed to put their heads in the aberrometer’s chin-rest and look at a fixation target that was embedded in the device. The fixation targets were readily observable to the participants without accommodation, thanks to the aberrometer’s Badal system. When each eye was staring at the target, its wavefront aberration was recorded three times and then averaged for further analysis. The averaged Zernike coefficients were rescaled to the smallest value of the maximum round pupil found among all eyes (4.41 mm), and this procedure was repeated for each target. Results: Alteration of the fixation targets caused changes to the Zernike coefficients of defocus (C(2,0)), vertical trefoil (C(3,–3)), vertical coma (C(3,–1)), horizontal coma (C(3,1)), oblique trefoil (C(3,3)), primary spherical aberration (C(4,0)), and secondary spherical aberration (C(6,0)), but the changes were not statistically significant. Nevertheless, an alteration in the target’s size and shape exhibited a significant correlation across all of the aforementioned coefficients in both eyes (p < 0.05). The total RMS of aberrations and the RMS of the spherical-like aberrations were both lowest while choosing the larger Maltese cross, and the bigger E-letter minimized the RMS of HOA and comatic aberrations. Conclusion: The aberrometric changes occur as a consequence of altering the fixational gaze and are within the range of the changes found after performing a near-vision task, so they might potentially act as a confounding factor when attempting to identify such small variations in the ocular wavefront. Using a smaller E-letter (5 arcmin) as an internal fixation target resulted in the least standard deviation of measurements, fixational stability, and higher accuracy in ocular wavefront measurements. Full article

The objective of this study was to assess the effect of sustained reading on the temporal changes in the wavefront error in the presbyopic eye. The wavefront aberration of the eyes was measured using an IRX3 Shack–Hartmann aberrometer before and after (immediately, 5 min, and 10 min after) a reading task. Temporal changes in ${\mathrm{C}}_2^0$, ${\mathrm{C}}_4^0$, and ${\mathrm{C}}_3^{-1}$ coefficient values of the eyes were plotted, showing a predominant number of V-shaped patterns (for ${\mathrm{C}}_4^0$ and ${\mathrm{C}}_3^{-1}$) and inverse V-shaped patterns (for ${\mathrm{C}}_2^0$) among the study group, and the percentages (between 27 and 73%) were reported. The median of the total RMS of aberrations and the RMS of HOA (higher-order aberrations), which included comatic (3rd order) and spherical-like aberrations (4th and 6th order), increased immediately after finishing the near-vision reading task and then decreased. The median of RMS of comatic aberrations had a similar pattern of variations, while the median of RMS of spherical-like aberrations displayed an opposite pattern. Simulating the aberration changes due to lens decentration caused by relaxed zonules during 4 D accommodation in an eye model demonstrated that the expected range of changes for the vertical coma and spherical aberrations are in the order of 0.001 and 0.01 μm, respectively, which could justify why the observed changes were not statistically significant. The observed dynamic changes in HOA might be linked to the biomechanical characteristics and alterations in the displacement of the crystalline lens following prolonged near-vision tasks in presbyopic people. Although some predominant patterns under some conditions were shown, they exhibit considerable inter-subject and inter-ocular variability. This might be due to slight misalignments while fixating on the internal extended object in the aberrometer. Full article

Strabismus, a neuro-ophthalmological condition characterized by misalignment of the eyes, is a common ophthalmic disorder affecting both children and adults. In our previous study, we identified the microsomal glutathione S-transferase 2 (MGST2) gene as one of the potential candidates for comitant strabismus susceptibility in a Japanese population. The MGST2 gene belongs to the membrane-associated protein involved in the generation of pro-inflammatory mediators, and it is also found in the protection against oxidative stress by decreasing the reactivity of oxidized lipids. To look for the roles of the MGST2 gene in the development, eye alignment, and overall morphology of the eye as the possible background of strabismus, MGST2 gene knockout (KO) mice were generated by CRISPR/Cas9-mediated gene editing with guide RNAs targeting the MGST2 exon 2. The ocular morphology of the KO mice was analyzed through high-resolution images obtained by a magnetic resonance imaging (MRI) machine for small animals. The morphometric analyses showed that the height, width, and volume of the eyeballs in MGST2 KO homozygous mice were significantly greater than those of wild-type mice, indicating that the eyes of MGST2 KO homozygous mice were significantly enlarged. There were no significant differences in the axis length and axis angle. These morphological changes may potentially contribute to the development of a subgroup of strabismus. Full article

Due to the precautions put in place during the COVID-19 pandemic, utilization of telemedicine has increased quickly for patient care and clinical trials. Unfortunately, teleconsultation is closer to a video conference than a medical consultation, with the current solutions setting the patient and doctor into an evaluation that relies entirely on a two-dimensional view of each other. We are developing a patented telehealth platform that assists with diagnostic testing of ocular manifestations of myasthenia gravis. We present a hybrid algorithm combining deep learning with computer vision to give quantitative metrics of ptosis and ocular muscle fatigue leading to eyelid droop and diplopia. The method works both on a fixed image and frame by frame of the video in real-time, allowing capture of dynamic muscular weakness during the examination. We then use signal processing and filtering to derive robust metrics of ptosis and l ocular misalignment. In our construction, we have prioritized the robustness of the method versus accuracy obtained in controlled conditions in order to provide a method that can operate in standard telehealth conditions. The approach is general and can be applied to many disorders of ocular motility and ptosis. Full article

Eye tracking techniques based on deep learning are rapidly spreading in a wide variety of application fields. With this study, we want to exploit the potentiality of eye tracking techniques in ocular proton therapy (OPT) applications. We implemented a fully automatic approach based on two-stage convolutional neural networks (CNNs): the first stage roughly identifies the eye position and the second one performs a fine iris and pupil detection. We selected 707 video frames recorded during clinical operations during OPT treatments performed at our institute. 650 frames were used for training and 57 for a blind test. The estimations of iris and pupil were evaluated against the manual labelled contours delineated by a clinical operator. For iris and pupil predictions, Dice coefficient (median = 0.94 and 0.97), Szymkiewicz–Simpson coefficient (median = 0.97 and 0.98), Intersection over Union coefficient (median = 0.88 and 0.94) and Hausdorff distance (median = 11.6 and 5.0 (pixels)) were quantified. Iris and pupil regions were found to be comparable to the manually labelled ground truths. Our proposed framework could provide an automatic approach to quantitatively evaluating pupil and iris misalignments, and it could be used as an additional support tool for clinical activity, without impacting in any way with the consolidated routine. Full article

Accurate segmentation of the iris area in input images has a significant effect on the accuracy of iris recognition and is a very important preprocessing step in the overall iris recognition process. In previous studies on iris recognition, however, the accuracy of iris segmentation was reduced when the images of captured irises were of low quality due to problems such as optical and motion blurring, thick eyelashes, and light reflected from eyeglasses. Deep learning-based iris segmentation has been proposed to improve accuracy, but its disadvantage is that it requires a long processing time. To resolve this problem, this study proposes a new method that quickly finds a rough iris box area without accurately segmenting the iris region in the input images and performs ocular recognition based on this. To address this problem of reduced accuracy, the recognition is performed using the ocular area, which is a little larger than the iris area, and a deep residual network (ResNet) is used to resolve the problem of reduced recognition rates due to misalignment between the enrolled and recognition iris images. Experiments were performed using three databases: Institute of Automation Chinese Academy of Sciences (CASIA)-Iris-Distance, CASIA-Iris-Lamp, and CASIA-Iris-Thousand. They confirmed that the method proposed in this study had a higher recognition accuracy than existing methods. Full article