Optometry & Vision Science

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Optometry & Vision Science:
doi: 10.1097/OPX.0b013e31826d29b8
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Validation of a Questionnaire Tool to Reflect Opinion of Soft Contact Lenses

Our authors report on the development and validation of a short form of the Contact Lens Dry Eye Questionnaire (the CLDEQ-8) to enable it to reflect status of, and change in, overall opinion of soft contact lenses. They found that the CLDEQ-8 score significantly reflected baseline status and change in overall opinion after refitting with two types of silicone hydrogels. They conclude the CLDEQ-8 is a valid outcome measure in clinical trials to reflect opinion of soft contact lenses. (p. 1435)

Closing the Lid on Dry Eye

There is renewed interest in the role of the eyelid in dry eye and meibomian gland dysfunction. The authors used the traditional Cochet-Bonnet esthesiometer to show that lower lid sensitivity correlated with tear osmolarity and inversely correlated with meibomian gland dysfunction. This suggests a promising new tool for evaluating ocular health and effectiveness of treatment in dry eye disease and meibomian gland dysfunction. (p. 1443)

Contact Lens Comfort Related to Both Protein Activity and Quantity

The authors demonstrate that even during a short period of contact lens wear, a significant correlation exists between subjective symptoms of comfort and dryness, and the activity of lysozyme recovered from etafilcon contact lenses. They suggest that it is important to investigate the activity of the deposited protein, in addition to determining quantity of the protein deposited on contact lenses. (p. 1450)

In Vitro Human Epithelial Cells Die and Release Cytokines with CL Multipurpose Disinfecting Solutions

In this study, human corneal limbal epithelial cells were found to differ in their physiological response and production of inflammatory mediators during exposure to two multipurpose disinfecting solutions that differ in only four excipients. They appear to be the first to describe the pattern of cytokine production produced in corneal epithelial cells in response to contact lens solutions. They found the solutions stimulated different types of cell death (necrosis vs. apoptosis) and stimulated the corneal epithelial cells to release cytokines. Importantly, differences in these events could not explain differences in corneal infiltrative events between the two solutions. (p. 1460)

Tracking CL Mechanical Properties with a Novel Protocol

A novel tensile testing protocol, with point tracking, was developed to measure the mechanical properties at any point on the lens. They found five commercial brands of hydrogel lens differed in their modulus properties by up to 6× from one material to another. They also differed with temperature and water content variation. Surprisingly, within a given lens, material modulus did not vary with lens power, thickness, or surface treatment. (p. 1468)

How Reliable is Peripheral Retinal Refraction in Myopia Treated with Orthokeratology?

There is increasing interest in peripheral retina refractive error because of the potential role of peripheral refraction on myopic development and progression. Consequently, both the validity and repeatability of such measures in eyes treated for myopia by orthokeratology is of interest. Our authors found repeatability of these measures in treated and untreated eyes (COR = ±0.71 D and ±1.25 D, respectively) was not greatly different in the two groups. Variability did increase with field angle and orthokeratology treatment. (p. 1477)

Prevalence of Myopia in Parents Doesn't Dictate Prevalence of Myopic Children

Although this population-based study of 4364 Chinese children (aged 5 to 15 years) found that the prevalence of myopia in children (78%) was significantly higher than in their parents (20%), there was certainly an additional risk of myopia in children if they had myopic parents. This observed additional risk among those with more myopic parents could not be attributed to reported near-work activities in the children. (p. 1487)

Looking at Ease and Comfort While Reading

Our authors looked at both a composite method for determining near point adds and participant-preferred prescriptions for reading additions at 40 cm for 80 young (18–30 years) study participants. As a result, using participant's preferred lenses for ease and comfort reading, they suggest guidelines for prescribing plus adds for improved near point function in non-presbyopes based on dynamic retinoscopy and dissociated heterophorias. (p. 1497)

Phenylephrine Does Not Alter Ciliary Muscle Dimensions or Contractility

Topical phenylephrine is often used to dilate the pupil and allow monitoring of accommodation or imaging of structures behind the iris. Many studies have explored the drug's effect on accommodation, but none have explained how this vasoconstrictor affects the ciliary muscle. The authors' research demonstrates that 2.5% phenylephrine does not significantly change the dimensions of the ciliary muscle nor the way in which it changes with accommodation. (p. 1507)

What Kind of Symptoms Do Children with CI Report?

Convergence insufficiency is a common binocular vision disorder that is often associated with symptoms that occur during reading or close work. Children in the convergence insufficiency treatment trial reported performance-related symptoms (e.g., loss of concentration, loss of place with reading, reading slowly) more frequently than eye-related symptoms (e.g., diplopia, blurred vision, headaches) before treatment. With increasing age, the frequency of eye-related symptoms increases. Both types of symptoms decrease in children after successful treatment. The authors call for more research to determine whether a decrease in performance-related symptoms after treatment affects specific measures of reading performance and attention in children with symptomatic convergence insufficiency. (p. 1512)

What Limits Preschool Vision Screening at Pediatric Primary Care Offices?

Our authors used focused groups of physicians, nurses, and certified medical assistants at 9 practices in Alabama to discuss preschool vision screening. All practices had agreed that such screening was an important part of the well child visit. Barriers involved difficulty testing young children (<5 years old) with existing methods, lack of time, and lack of reimbursement. No practice was aware of newer test formats, but all were willing to pilot single, surrounded LEA pictures, at a 5 foot distance. (p. 1521)

Progressive Addition Lens Measurement by a Simple, Novel, and Robust Instrument

The authors propose that a modified point diffraction interferometer can be used for accurate measurements of local powers of progressive addition lenses. They suggest the setup is easy to align; has a high dynamic range that allows the measurement of a wide range of PALs; is simple, compact, and robust; and could become an alternative to existing instruments in optometric and clinical centers. (p. 1532)

Seeing How Patients See in the Periphery

To appreciate how patients with eye disease see across the visual field, the authors simulate colored images for a spatiochromatic corresponding pair algorithm they previously reported (J Opt Soc Am (A) 2004;21:176–186). The weights for their algorithm came from visual field data of a patient with Leber's Hereditary Optic Neuropathy and an age-matched sample of normal subjects, using achromatic, red-green, and blue-yellow gratings of different spatial frequencies. The authors hope that this will increase understanding of patients' visual limitations. (p. 1543)

A Viable Alternative to “Classic” Cross-Linking for Keratoconus to Minimize Patient Intolerance

This is a report highlighting a collagen cross-linking option for the treatment of progressive keratoconus. In this technique, the obligatory epithelial debridement is eliminated, increasing patient tolerance and enabling treatment of thinner corneas. (p. e1)

Blood Thinners Increase the Risk of Complications in DSEK

DSEK is becoming a more common procedure for management of corneal endotheliopathy. The likelihood of co-managing DSEK will increase. In this patient, taking oral antiplatelet medication, there is the report of recurrent interface hemorrhage. This case illustrates that even with this complication, proper management can still result in reasonable outcomes. (p. e8)

Chronic Horner Syndrome May Be Associated with Neurovascular Disease

As clinicians we are at times ineffective in pupillary analysis, and this case illustrates how this inadequacy could result in a significant clinical “miss.” In this presentation, the clinician is alerted to yet another “association” with the presentation of chronic Horner's. There is “new” technology available that can help us with more effective pupillary analysis. (p. e12)

Chemotherapy Has Potential Side Effects

As practitioners in the primary care arena, we must be constantly vigilant regarding ocular side effects of systemic medications. Although we concentrate heavily on the physical diagnostic aspects of eye disease, we just have to remember that virtually every “pharmaceutical” advertised on television has a litany of side effects. An increase in the “chemotherapy” of so many conditions that affect the immunological system should keep us on the alert to investigate these ocular side effects. (p. e16)

Assessing Cognitive Impairment is Critical in Making Decisions on Medical Intervention

As our population ages, we can expect more issues that both compromise vision and are potentially amendable by intervention. It is critical that health care providers take a logical approach to the assessment of the decision-making capacity of patients regarding these interventions. This article, with accompanying videos, offers a simple in-office approach to the assessing the patient for the informed medical decision-making process. (p. e23)

A Plea for the Correct Use of VA Designation in Clinic

In a Clinical Commentary, our author provocatively argues that it is time to drop what he calls the “the erroneous use of the Snellen fraction” in designating visual acuity. He advocates the logMAR system as the optimum method of recording VA, using either the decimal equivalent or the minimum angle of resolution. He argues that both are “superior to the incorrect procedures widely used at present.” (p. e27)

© 2012 American Academy of Optometry


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