IN THIS ISSUE:
• Overnight Orthokeratology: Is It Bending or Remodeling Anterior Cornea?
Everyone has his or her opinion, but now the authors make a clear statement here. The refractive effect in the myopic overnight orthokeratology with reverse geometry rigid gas-permeable contact lenses, over 14 nights, is achieved primarily through remodeling of the anterior corneal layers, without overall corneal bending. (p. 196)
Editor’s Choice open access
• What “Vision Loss Price“ Do Myopes Pay with a New Contact Lens Designed for Myopia Control?
Our authors conclude that there is a slight decrease in patient-perceived quality and measured vision. However, they assert that this minor decrease in vision may be more than acceptable for those aiming to control their myopia progression with a new lens designed specifically to limit progression of myopia. Vision with these lenses is similar to that obtained with a typical multifocal contact lens. (p. 205)
• Myopia-Related Peripheral Eye Lengths Compared Using Two Instruments
Two commercial partial coherence interferometry instruments demonstrated good intrasessional and intersessional repeatability for peripheral eye length measurements, with the Lenstar showing better repeatability. Such peripheral eye length measurements have become of interest in treatments for myopia progression. The Lenstar gives a slightly greater range of eye lengths than the IOLMaster across the visual field. (p. 215)
• Visual Impairment in Brazil Results Primarily from Uncorrected Myopia
This population-based refractive error survey performed in a representative Brazilian city showed that the prevalence of visual impairment among children is low, mostly related to uncorrected myopia. The authors state that this is the first population-based refractive error survey based on Refractive Error Study in Children (RESC) protocols (Am J Ophthalmol 2000;129:421–6) performed in Brazil. The chosen city of the Brazilian central region is in many ways representative of the low-middle socioeconomic profile of the country. (p. 223)
• Multifocal Versus Monovision Correction: Game on!
Multifocal contact lens correction provides satisfactory levels of visual acuity and identical comfort profiles when comparable to monovision according to our authors. The multifocal contact lens, in contrast, does not compromise stereoacuity in this crossover study. The near vision significantly improved in the dominant eye, and the distance vision improved in the nondominant eye from 1 to 15 days with the multifocal lens, suggesting that patients adapted to the multifocal modality over time, whereas this was not the case for monovision. (p. 228)
• Which Is the More Accurate Test of Visual Acuity?
Preschoolers’ monocular visual acuity was tested with both the Patti Pics and Lea Symbol optotypes, two current pediatric tests that conform best to the recommended international standard. The Lea symbols yielded estimates a little less than 0.10 logMAR better than the Patti Pics. However, the estimates of visual acuity with the Patti Pics may be more accurate based on comparisons with adult testing using the same tests; the Patti Pics were highly consistent with the “gold standard” Sloan letters. (p. 236)
• Yellow Filters Improve Vision Response Times for Younger, but Not Older, Adults in Driving Tasks
Here, our authors report research that focuses on response times to traffic hazards and simple low-contrast gratings. One group wore neutral filters and the other wore yellow filters (both groups with and without a linear polarizer). Two separate age groups (young and older) participated. Only the younger group responded faster to hazards with the yellow filter. Only the younger group also responded faster to the simple low-contrast gratings with the yellow filter but, curiously, only when combined with a polarizer. (p. 242)
• To Dilate or Not to Dilate Diabetes Patients Before Refraction
Although dilation always occurred in the examination, our authors conducted a randomized, controlled, equivalence trial. In a largely white diabetic population with limited ocular pathology they demonstrated that there was no difference in advice given to patients with dilated pupils before, versus after, refraction and visual acuity assessment. Early pupillary dilation can be considered equivalent to pupillary dilation after refraction and visual acuity assessment. The authors note that there are obvious benefits in time and patient satisfaction with dilating eyes before refraction. (p. 249)
• Cataract and Household Fuel Use by Nepalese Women
Cataract is the most prevalent cause of blindness in Nepal. Several epidemiologic studies, although not without experimental design limitations, have associated cataracts with use of biomass cookstoves. Avoiding selection bias and using lens photography and a detailed questionnaire, our authors investigated cataracts at the preclinical stage in Nepalese women aged 20 to 65 years. Compared with gas cookstoves, current use of both biomass and kerosene cookstoves showed evidence of an association with nuclear opacity and change in nuclear color. (p. 257)
• Ocular Discomfort with Pterygium
Apparently paradoxically, the authors found that the larger the lesion size, the less the ocular discomfort in 40 patients with primary pterygium. This suggests to the authors that there may be corneal hypoesthesia in patients with pterygium, and they advocate further research on this possibility. (p. 269)
• The Eye as a Model for Studying Neuroplasticity in the Central Nervous System?
The authors’ research shows that aging eyes have a reduced functional capacity to cope with repeated injury, producing permanent ERG dysfunction. More importantly, they show, for the first time, that, in response to injury, younger eyes are capable of up-regulating sensitivity to light at multiple stages of serial processing in the retina to maintain normal function of the retinal ganglion output cells. This form of functional plasticity in young eyes may be an important means by which the eye protects itself from injury. The eye may be an excellent model for studying age-related changes in neuroplasticity in the central nervous system. (p. 275)
• Performance of Customized and Classical Progressive Power Lenses
The authors show that the base curve of a progressive power lens has an important effect on performance, particularly when the lens is customized for a specific user and position of wear. The measurement method is also an important factor: effects on performance are reliably shown only when the lens is measured in a way that mimics the eye viewing through the lens. (p. 282)
• Optical Aberrations Compared Using Three Different Keratoplasty Procedures in Keratoconus
Our authors compare higher order aberrations in the anterior and posterior corneal surface after conventional penetrating keratoplasty (PK), deep-anterior-lamellar-keratoplasty (DALK), and automated-lamellar-therapeutic-keratoplasty (ALTK) in patients undergoing corneal transplantation for keratoconus. The corneal anterior surface optical quality appeared significantly better after DALK than that after ALTK and PK. (p. 293)
• Monocular Vision Rehabilitation Is Needed
Low-vision optometrists rarely receive referrals for monocular patients because of “good” vision in their remaining eye. This case report illustrates the implementation and benefits of an Acquired Monocular Vision Rehabilitation evaluation and training program. The authors argue for adding monocular rehabilitation therapy to current vision rehabilitation programs. (p. e89)
• On Again–Off Again Strabismus
Cyclic strabismus is a rare and poorly understood condition in which heterotropia and orthotropia alternate typically in 48-hour periods. The clinical case of cyclic esotropia, along with a brief literature review, provides insights in etiology and pathogenesis. The authors note that the condition can be successfully treated by correcting the deviation measured on the squinting day. (p. e95)