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Optometry & Vision Science:
doi: 10.1097/OPX.0000000000000143
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OVS Announces

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How Well Do Structure and Function Coincide in Glaucoma?
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Our authors look for the closest relationship between standard automated visual fields (SAP) and retinal nerve fiber layer thickness (RNFLT). Of the three RNFLT measures (spectral domain optical coherence tomography [SDOCT], scanning laser polarimetry [SLP], and confocal scanning laser tomography [CSLT]), they found that SAP is most closely related to loss of retinal ganglion cells (SDOCT) rather than a loss of axonal integrity/transport (SLP) or changes to surface topography (CSLT). (p. 1353)

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Editor’s Choice open access

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Asian and White Tear Lipids Behave Differently
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The dynamic properties of multilayered human tear lipids extracted from silicone hydrogel contact lenses differ between asymptomatic Asian and white subjects. Surface pressure was recorded during slow expansion/contraction cycles applied to extracted lipid layers to evaluate compressibility and hysteresis of lipid films. These differences in tear film properties are most apparent at higher surface pressures and may account for lower pre-lens tear film stability for Asian subjects compared with whites. (p. 1361)

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Registration Tolerances in Wavefront Corneal Correction for Visual Acuity
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The predictive potential of a model of the registration tolerance for wavefront-guided correction to maintain acuity within fixed acuity limits is demonstrated using two typical keratoconic eyes. The authors apply this for both one line and two line acuity tolerances and conclude that their predictive model can be applied to establish the unique tolerances for each wavefront error and wavefront-guided correction design. (p. 1370)

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Dry Eye Clinical Approaches of Optometrists
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The authors’ survey of more than 600 Australian optometrists demonstrate that practitioners possess a strong knowledge of tear film assessment, use both subjective and objective diagnostic tests, and adopt treatment approaches that are based on disease severity. However, there is a lack of uniformity regarding the use of diagnostic tests. Clinical care procedures and evidence-based guidelines relating to diagnosis and treatment are not consistently adopted. The authors argue that their study highlights the potential to make better use of dry eye research in clinical practice. (p. 1385)

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Repeatability of OCT Lens Thickness Measures
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The authors believe that this is the first study to illustrate repeatability of crystalline lens thickness measurements in the adult noncyclopleged eye using the Visante Anterior Segment Optical Coherence Tomographer. In their 100-patient study, the authors cover a wide age range, including presbyopes and pre-presbyopes, as well as data for the unaccommodated noncyclopleged eye and a range of accommodative demands. They are impressed with the repeatability and ability to detect small changes with the instrument. (p. 1396)

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Accommodative State and Accommodative Stimulus: New Metric for Assessment
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The authors suggest that the steady state accommodative response is altered by the method used for providing the accommodative stimulus (AS), including the sequence of AS presentation. They propose that the accommodative error area, a new parameter, be applied to either the linear or the nonlinear portion of the accommodative stimulus response curve (ASRC), and this will provide an optimal index to evaluate the accuracy of the ASRC. (p. 1406)

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Accommodating and Monofocal IOLs Compared
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The authors use a model eye simulator where the optical characteristics of an intraocular lens (IOL) or other device can be simulated and a single observer can measure his/her vision through the simulator with that correction. They compared an unaccommodated IOL Crystalens HD with a monofocal IOL and found comparable vision. Then, at near, the same simulator was used to assess vision with the accommodated Crystalens HD IOL by simulating 1.4 mm of forward movement. Based on this simulated accommodation of the Crystalens HD IOL, the authors claim that it will provide “high-quality optics” for near vision. (p. 1413)

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Presbyopia Correction Needs in Durban
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The authors interviewed and performed standard clinical eye examinations on 2000 of the almost 3000 participants older than 35 years (median, 52 years) from 18 randomly selected regional clusters of Durban suburbs (South Africa). They discovered a high prevalence of presbyopia with low spectacle coverage and concluded that uncorrected presbyopia is a significant public health concern in Durban. (p. 1424)

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Astigmatism Impact on Visual Performance
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Astigmatic subjects are adapted to their astigmatism and perceptually recalibrate on its correction. However, whether perceptual changes parallel changes in visual acuity is unknown. Visual acuity was measured during a 6-month period in nonastigmats, corrected astigmats, and uncorrected astigmats (who were given spectacles after the first session) under induction of astigmatism at different axis while controlling aberrations. Induction of astigmatism decreases visual performance and is axis dependent. It was better for astigmatism induced at 90 degrees in nonastigmats and at their natural axis in astigmats. This suggests that astigmats may store adaptation states/cues related to their natural astigmatism. (p. 1430)

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Optical Blur Less Devastating in Peripheral Retina for Low-Contrast Word Acuity
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The authors looked at how dioptric blur affected word acuity thresholds for targets presented at different retinal eccentricities and for different contrast levels. Although the expected increased threshold was found for increased blur levels, the effect was lower for low-contrast words or when the peripheral retina is used. Their results suggest some useful clinical guidelines. (p. 1443)

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Can Thick and Wide Eye Frame Temples Make Driving Hazardous?
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Although thick and wide spectacle temples provide better glare protection, our authors conclude that they also can dangerously limit the visual field while driving. (p. 1450)

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Prevalence of Refractive Error in Schoolchildren in Ghana
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Refractive error correction is one of the priorities of the VISION2020 global initiative. Despite the negative impact on a child’s potential for eye health planning, there is very limited information on the type and prevalence of refractive errors. The authors’ study assessed the prevalence of refractive error and visual impairment in schoolchildren in Ghana. Although the prevalence of reduced vision caused by refractive error was low, the prevalence of amblyopia, retinal disorders, and corneal opacities indicates the need for earlier interventions. (p. 1456)

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Parents’ Perception of Children’s Eye Disease Impacts Care
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The authors’ study use multiple interviews and focus group discussions to highlight how the parents’ perception and beliefs on common eye problems influence childhood eye care in India. Further education of parents was suggested. (p. 1462)

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Atropine Dosage without Unwanted Side Effects
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Because atropine is used as a therapy to slow myopia progression (particularly in China), the authors determined the dosage that did not produce unwanted side effects of poor near vision and deleterious pupil dilation. They found that 0.02% allowed 5 diopters or more of accommodation and a mean pupil diameter of 3 mm. They suggest that research studies begin with this atropine dosage to see if myopia is slowed. (p. 1467)

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Retinal Biometry for High and Low Myopic Children Younger Than 10 Years
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Our authors measured peripapillary retinal nerve fiber layer (RNFL) thickness, macular thickness, and total macular volume of high myopic eyes (6 diopters or more) and low myopic eyes (3 diopters or less) using time-domain optical coherence tomography (OCT). In their study of children younger than 10 years, they found all measures to be smaller in the high myopic eyes. Interestingly, peripapillary RNFL thinning was especially prominent in the inferior quadrant in high myopic children. (p. 1473)

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Noncycloplegic Autorefraction and Visual Acuity for Myopia Screening in China
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With a specificity of 90% (correct identification of myopes), combining uncorrected visual acuity and noncycloplegic autorefraction had a higher sensitivity (correct identification of nonmyopes) than either of the tests alone in a population of almost 1700 children aged 6 to 12 years. The authors also explored the optimal criteria of the combination test for different age groups, with the highest sensitivity in the 11- to 12-year-old age group (84%) and lowest in the 6- to 7-year-old group (64%). (p. 1479)

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Unusually Effective Atropine of the Most Myopic of Myopic Anisometropic Eyes
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Our authors report what seem to be remarkable results using 1% atropine in the most myopic eye of myopic anisometropic eyes for 7 to 16 months. Perhaps because of the unilateral nature of the atropine treatment, they report that the atropine was well tolerated. With an admittedly high dropout (9 of the 22 subjects equals 41%), those completing the study (n = 13) had reduced myopia (average 0.6 diopters [D]), whereas the untreated eye progressed an additional 0.7 D myopic. Overall, for those who remained in the study, the anisometropia decreased from an average of 1.8 to 0.5 D. (p. 1486)

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New Technology Advances Understanding of a Choroidal Vasculopathy
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The advent of OCT has allowed for optimal visualization of idiopathic polypoidal choroidal vasculopathy (IPCV) and a better understanding of the pathophysiology. As our authors’ clinical case shows, specific morphological change associated with IPCV can be visualized on OCT and is called the “double layer sign,” indicating the presence of an additional reflective layer corresponding to the anomalous choroidal vascular network of IPCV. (p. e293)

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Facilitating Appropriate and Early Diagnosis of a Corneal Dystrophy
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The author reports a rare corneal dystrophy and identifies ways to provide an appropriate and early diagnosis. Her 56-year-old male patient presented with corneal arcus, with a central haze in both eyes and crystalline deposition in the right eye. A diagnosis of Schnyder corneal dystrophy was made based on clinical presentation. Aging will change the clinical signs to decrease vision, which may necessitate referral for phototherapeutic keratectomy, penetrating keratoplasty, or deep anterior lamellar keratoplasty. The importance of appropriate management of the patient’s systemic findings, which correlate with the dystrophy, is emphasized. (p. e301)

Copyright © 2013 American Academy of Optometry

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