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Optometry & Vision Science:
doi: 10.1097/OPX.0000000000000194
OVS Announces

OVS ANNOUNCES

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IN THIS ISSUE:

Age and Associated Risk Factors for Soft Contact Lens Infection and Inflammation?
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While the risk of corneal infectious and inflammatory events (CIEs) is highest in late adolescence and early adulthood, the age relationship and the potential associated risk factors are less clear. In a non-clinical survey of almost 550 young (12 to 33 years) soft contact lens (SCL) wearers (34% males) across five US cities, our authors looked at the effect of age and the associations within each age group Wearers aged 18 to 21 years reported more recent nights with less than 6 hours of sleep, more colds and flu, and higher stress levels. Younger wearers were also more likely to wear SCLs when showering and reported more frequent naps with SCLs, sleeping in SCLs after alcohol use, and less regular hand washing before lens application. (p. 252)

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Non-Compliance again “Raises Its Ugly Head” for Contact Lens Wearers
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For most contact lens wearers, compliance with an effective case-cleaning regime is an important part of lens wear. In this study, case-cleaning compliance was improved when written instructions were used. Tap water rinsing of cases was also associated with increased gram-negative bacterial case contamination, irrespective of lens care regime or lens care solution efficacy. (p. 262)

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Multipurpose Solutions against Acinetobacter Carrying Antiseptic Resistance Genes
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Acinetobacter is a fairly uncommon cause of ocular infections, but these infections are difficult to treat because the organism is usually highly antibiotic resistant. Its ubiquity in the environment and its presence in human skin flora allow the organism to frequently contaminate contact lenses and accessories. It is important that multipurpose solutions (MPS) effectively destroy it. Recent emerging antiseptic resistance increases concerns about disinfection. This study shows biguanide-based MPS can successfully reduce numbers of Acinetobacter containing antiseptic resistance (QAC) genes, but monitoring should be continued given the potential for diluted or expired solutions. (p. 272)

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Vision-Related Quality of Life with Infectious Keratitis
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Our authors determined the vision-related quality of life (VR-QOL) in patients with infectious keratitis using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25). They found unilateral infectious keratitis has extensive impact on patients’ VR-QOL. Unlike many binocular diseases, the best-corrected visual acuity of the worse-seeing eye, rather than better-seeing eye, correlated significantly to VR-QOL. Early treatment should be encouraged to obtain an improved vision prognosis and VR-QOL for patients. (p. 278)

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Color Vision Worsens with Age
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Using two tests of color vision, our authors demonstrated that color vision perception deteriorates in a large population (almost 900) of older people (ages 58–102). Forty percent of the study population failed at least one of the color discrimination tests and almost 20% failed both tests. Most (75%) of the color discrimination errors involve confusion of pastel blue-purples and yellow-greens (known as “blue-yellow errors“), and these differ from the red-green errors that 8% of males and 0.5% of females inherit with so-called color blindness. The errors increase with age, such that about 45% of those in the mid-70s, and 65% in the mid-90s, make some noticeable color discrimination errors, particularly confusions of pastel colors of light green and light purple. The authors attribute this to a combination of the aging changes of smaller pupils, increased yellowing of the lens inside the eye, more eye disease, and changes in the sensitivity of the receptors and the vision pathways. (p. 284)

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A New iPad Contrast Sensitivity Test Validated
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The validity and repeatability of an iPad-based letter contrast sensitivity test was assessed in 20 normally sighted and 20 low-vision subjects. The iPad test showed excellent agreement with the Freiburg test, but the Pelli-Robson test gave significantly lower values. The iPad test showed good and similar repeatability to the other tests and may be a rapid and convenient alternative for evaluating contrast sensitivity in patients. (p. 291)

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Do You Really Blink More at the Computer?
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While several studies have reported this, our authors tried to compare print reading with comparably demanding tasks. They compared blink patterns when reading either from a computer monitor or printed text under equivalent viewing conditions. They found no significant difference in mean blink rates, although a significantly higher percentage of incomplete blinks were found for the computer condition. They conclude previously reported differences in blink rate were probably produced by changes in cognitive demand, rather than computer use, while the higher percentage of incomplete blinks may have been related to visual fatigue. (p. 297)

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Sensory Condition and Pedestrian Crossing Safety
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Crossing the street is a dangerous activity of everyday life. To improve pedestrian safety, the authors measured how well pedestrians could make time-to-arrival (TTA) judgments about approaching vehicles when using both their vision and hearing or when using just their hearing. Perhaps surprisingly, they found that females tended to be accurate under either condition when making TTA judgments, but males initially tended to be more accurate when using their hearing only. The overall accuracy of subjects’ performance suggests that the TTA component of street crossing decision-making is not a contributing factor to pedestrians making incorrect (unsafe) crossing decisions. (p. 303)

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Letter Targets Best for Fixation Training in Bilateral Central Scotomas
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It is difficult to train patients with central scotomas to eccentrically view without a fundus-imaging device for the examiner, to assure a level of fixation ability by the patient. Why? Because without an imaging device the examiner is left to estimate the magnitude of the patient’s eye movements, and thus the retinal locus used, by gross observation. So how should training be approached? The retinal location and stability of fixation were measured using the Nidek MP-1 microperimeter in 12 patients with bilateral central scotomas for six types of fixation target—three expected to fill in and three that included letters. It appears that the fill-in targets did not provide the fixation stability needed for training, and instead our authors suggest that letter targets generate more consistent fixation than large “fill-in” targets and should be used for eccentric viewing training and perimetry. (p. 312)

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The Biomechanics of Eyes Looking Down: Myopia Implications
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Myopia (shortsightedness) is becoming more prevalent in developed countries, particularly in Southeast Asia, and an association with intense near work during childhood is well established. This study identified a number of important changes in the biomechanical characteristics of the eye during near focusing of the eyes, when looking down, which may contribute to the development of myopia. This was achieved by developing a new technique for measuring the anterior biometrics, axial length and choroidal thickness of the eye, in downward gaze. A better understanding of these issues may lead to improvements in the clinical management of childhood myopia. (p. 322)

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Light Exposure or Outdoor Activity Influencing Myopia?
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Previous research, primarily using questionnaires, suggests that more time outdoors is associated with lower myopia in childhood. In this study, objective measures of both light exposure and physical activity (sampled every 30 seconds over a 2-week period) were collected in myopic and emmetropic children. The authors found a significantly higher average daily light exposure in the emmetropic children compared to the myopes, but no significant differences in physical activity associated with refractive error. These findings support a potential role for bright-light exposure in the apparent protective effects of outdoor activities in childhood myopia. (p. 330)

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Atropine Slows Myopia Progression in Children
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Four randomized clinical trials and seven cohort studies with 1815 children aged 5 to 15 years old were included in our authors’ meta-analysis on the effects of atropine in slowing myopia progression. The analysis of changes over approximately 2 years confirms that atropine can significantly slow myopia progression in children, with greater effects in Asian than in Caucasian children. Compared with placebo, the risk of myopia progression over 1D was significantly reduced. The randomized clinical trials and cohort studies suggested comparable effects. (p. 342)

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Stereo Acuity is a Marker for Preschool Vision Disorders
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The association between stereo acuity presence, and the type and severity of vision disorders was evaluated in almost 3000 preschool Head Start children participating in the Vision in Preschoolers (VIP) study. The presence, type, and increasing severity of any VIP study–targeted vision disorder were all highly associated with worse stereo acuity in preschool children and a remarkable 99% could be tested. Most preschool children without vision disorders are able to obtain 120 sec arc of stereo acuity or better. (p. 351)

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An Optometric Challenge for a Billion People in Africa
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Africa has a population of over one billion people, and the prevalence of visual impairment and blindness is high, mostly a result of refractive errors. Unfortunately, there are few optometrists and few optometry training institutions. Our authors trace the history, current optometric education programs, and their challenges in a call for an expansion of both training institutions and optometrists in the African continent. (p. 359)

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A Call for Improved Donor Cornea Screening
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While the inadvertent use of donor corneal tissue for a deep anterior lamella keratoplasty from a patient who had previously undergone LASIK had a satisfactory outcome, the authors urge greater attention and procedures for screening with donor corneas. With refractive surgery being performed commonly, they propose a careful and specific history from the relatives of the deceased. They also call for the incorporation of standard imaging protocols in eye banks for detection of previous refractive surgery in donor corneas. (p. e59)

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Novel Approach to Classification and Treatment of Granular Corneal Dystrophy
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Our author presents a case report of granular corneal dystrophy and examines a new paradigm in its classification and treatment. The classification takes advantage of the advances in histochemical and immunohistochemical analysis, genetic testing, diagnostic instruments, and medical and surgical treatments. (p. e63)

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Don’t Miss that Sebaceous Carcinoma of the Lacrimal Caruncle
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Though the occurrence of a sebaceous cell carcinoma in the caruncle is rare, it can be histopathologically misdiagnosed as another benign condition. As the authors highlight, this results in both a delay in correct diagnosis as well as increased morbidity and mortality. The condition should not be neglected in the differential diagnosis of caruncular lesions. The authors detail a case of sebaceous carcinoma of the caruncle and review the relevant literature to raise awareness about this rare disease. (p. e72)

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Intracranial Chordoma, with Ocular Symptoms, May Have Delayed Recurrence
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The authors present a case of chordoma, a rare bone tumor of the basal skull and spine. By patient history, it was considered in remission for nearly a decade. How does this case relate to the primary care optometrist? First, as the authors saw in this case, chordoma often presents with ocular symptoms and signs. Second, and more importantly, this case serves as an example of how easy it is to presume that patients with cancer in remission are “cured”. The presumption can be wrong. (p. e76)

Copyright © 2014 American Academy of Optometry

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