Visual field asymmetries in visual word form identification.

Visual performance across the visual fields interacts with visual tasks and visual stimuli, and visual resolution decreases as a function of eccentricity, varying at isoeccentric locations. In this study, we investigated the extent of asymmetry and the rate of change in visual acuity threshold for visual word form (VWF) identification at horizontal and vertical azimuths across the fovea, and at eccentricities of 1°, 2°, 4°, 6° and 8° for 10%, 20%, 40%, and 80% contrast levels, to determine whether and how the eccentricities, meridians, and contrasts modulated the VWF identification acuity threshold. The stimuli were 16 traditional Chinese characters of similar legibility. Participants pressed a key to indicate the character presented, either monocularly or binocularly, at one of 21 randomly selected locations. A staircase procedure was used to determine the threshold, and a multiple linear regression model was used to fit the linear cortical magnification factor (CMF). We found that (1) the asymmetry was most pronounced on the vertical and superior azimuths, (2) the asymmetry between the right and left azimuths was not significant, (3) the CMF was significantly smaller on the vertical azimuth than on the horizontal azimuth, (4) the CMF was smaller on the superior vertical azimuth than on the inferior azimuth, and (5) monocular viewing and low contrast enhanced the CMF difference between azimuths. In conclusion, vertical and horizontal azimuths, location of eccentricity, contrast levels of word symbols, and monocular/binocular viewing have different effects on visual field asymmetry and cortical magnification factors.

Long-Term Effect of Systemic Comorbidity on Glaucoma Medication Adherence.

PURPOSE: To determine whether systemic comorbidity is associated with reduced adherence to glaucoma medication and whether this decrease varies according to the number of comorbidity and the time after glaucoma onset. DESIGN: Cohort study. METHODS: Setting: Population-based. STUDY POPULATION: All patients with confirmed newly diagnosed glaucoma in one or both eyes were identified using National Health Insurance (NHI) claims data from Taiwan. OBSERVATION PROCEDURE: Individuals with newly diagnosed glaucoma were followed up for 5 years from onset. The study period was from January 1, 2011, to December, 31, 2020. Patient comorbidities were identified using the Deyo-Charlson Comorbidity Index. Adherence was measured using the medication possession ratio (MPR). The MPR was calculated by dividing the total number of days a patient had a supply of glaucoma medication by 365. Data for the MPR were extracted from NHI outpatient and drug records. RESULTS: This study included a total of 50 408 patients. Compared with patients without comorbidity, patients with at least 1 comorbidity exhibited higher MPR in the first 2 years following glaucoma onset. However, their MPR decreased in the long term, specifically in the fourth and fifth years after onset. Additionally, the degree of nonadherence increased with the number of comorbidities. Patients with ≥4 comorbidities had significantly lower glaucoma medication adherence, with reductions of 6.4% (P = .033) and 11.8% (P < .001) in the fourth and fifth years after glaucoma onset, respectively. CONCLUSION: The presence of comorbidity can reduce glaucoma medication adherence by up to 12% in the long term. More comorbidities may increase the burden of managing chronic diseases; as a result, treatment for glaucoma may not receive priority due to the absence of clear symptoms of the condition.

Ophthalmic health care needs of children with disabilities.

BACKGROUNDS: Although vision care is crucial for pediatric eye health, research on vision care utilization by children with disabilities remains limited. Furthermore, no study has investigated the variations among various disability types and the interaction between disability status and age. METHODS: All children with disabilities listed in the Taiwan National Disability Registry during the study period (2015-2019) were matched by age and sex at a 1:4 ratio with children without disabilities. Vision care needs were measured on the basis of (1) the number of outpatient ophthalmology visits, (2) total medical costs associated with outpatient ophthalmology visits, and (3) whether ophthalmic care was provided. Generalized estimating equation models were estimated to determine the relationships between utilization, disability status, and age. RESULTS: Significant differences in needs between various disability types were identified. Other than children with visual disability, children with facial disability and balance abnormalities also had considerable needs. Children with intellectual disabilities, which constituted the most common disability type (29.4% in 2019), had fewer visits (mean = 1.38, SD = 2.12) and lower medical costs, compared with the averages for all children with disabilities. Care utilization shared an inverted U-shaped relationship with age. CONCLUSIONS: Children with disabilities have higher vision care needs, which vary by disability type and age. Such needs are greater at younger ages and decreases after the ages of 9-10 years. Policies should be specific to disability type and age to ensure vision care needs are met.

Incidence and prevalence of keratoconus in Taiwan during 2000-2018 and their association with the use of corneal topography and tomography.

PURPOSE: The aim of this study was to determine the age- and sex-specific incidence and prevalence of keratoconus (KC) in Taiwan and explore their association with the use of computerized corneal topography and tomography (TG). DESIGN: This nationwide retrospective study included the Taiwanese population (N = 27,540,859) from the National Health Insurance Research Database (NHIRD) between 2000 and 2018. METHOD: We estimated the incidence of KC by identifying patients with newly diagnosed KC and estimated its prevalence by identifying patients who had the ICD9-CM code 371.6 or ICD-10-CM code H18.609 twice or more in NHIRD during 2000-2018. RESULTS: The incidence of KC in Taiwan during 2000-2018 was 7075, with the incidence rate being 1.56 (95% confidence interval [CI]: 1.53-1.60) per 100,000 person-years. The prevalence of KC was 4.29 (95% CI: 4.23-4.35) per 100,000 person-years. The KC incidence rate peaked in patients aged 21-25 (6.40 in males and 3.19 in females). The overall incidence rates in males and females were 2.01 and 1.35, respectively (incidence rate ratio: 1.46), indicating that KC had a significant male predisposition. Moreover, we noted a linear correlation (R2 = 0.7488) between the proportion of the use of TG and the incidence of KC. CONCLUSION: Estimates of nationwide population-based incidence and prevalence can contribute to a better understanding of the risk of ethnic groups and geographic locations in KC, and the trend can help physicians improve the general vision health of the population.

Decomposition of socioeconomic inequalities in glaucoma knowledge in Taiwan.

OBJECTIVES: Glaucoma knowledge is strongly associated with medication adherence and preventive behavior. Studies have frequently reported socioeconomic inequalities in glaucoma knowledge. This study aimed to decompose such inequalities. Decomposition analysis enables the design of policies directly targeting the underlying causes of inequality. METHODS: We performed a cross-sectional survey from January 1, 2019 to June 30, 2019, at the departments of ophthalmology of 2 medical centers belonging to a hospital chain in northern Taiwan. Socioeconomic inequalities in glaucoma knowledge were ranked based on 3 aspects of socioeconomic status (SES): (1) education, (2) income, and (3) self-perceived financial status. The concentration index was calculated and decomposed using decomposition analysis. Elasticity and marginal effects were estimated for each decomposed factor. RESULTS: In total, 1,203 patients completed the survey. Both measures of glaucoma knowledge and overall glaucoma knowledge score significantly contributed to the progressivity of knowledge inequalities (pro-high-SES inequalities). The concentration index for overall knowledge score with respect to education was 0.166 (p<0.001). Both objective and subjective measures of SES were associated with pro-high-SES inequalities. Our decomposition analysis revealed that demographic factors and attitudinal factors such as the level of concern regarding developing glaucoma contributed significantly to SES-based inequalities in glaucoma knowledge. CONCLUSIONS: Our decomposition analysis provided empirical evidence regarding the underlying causes of SES-based inequalities in glaucoma knowledge. Efforts to improve glaucoma knowledge should consider specific factors that drive SES-based inequalities, such as age, sex, and concern about vision health, to ultimately achieve low SES-based inequalities.

Efficacy of Multifocal Soft Contact Lenses in Reducing Myopia Progression Among Taiwanese Schoolchildren: A Randomized Paired-Eye Clinical Trial.

INTRODUCTION: To evaluate the efficacy and safety of myopia control using a multifocal soft contact lens designed with high peripheral add power in schoolchildren. METHODS: This 1-year multi-center, prospective, randomized, double-blind, controlled study enrolled myopic schoolchildren aged 6-15 years with refractive errors between - 1.0 D and - 10.0 D. Each participant was randomly allocated to wear a daily disposable multifocal soft contact lens as the treatment in one eye and a single-vision soft contact lens as the control in the other eye. The primary endpoints were changes in the cycloplegic spherical equivalent (SE) and axial length at 1 year. RESULTS: Fifty-two of the 59 participants (88.1%) completed the study protocol. The mean change in SE was - 0.73 ± 0.40 D in the treatment group. and - 0.85 ± 0.51 D in the control group (mean difference: - 0.12 ± 0.34 D, p = 0.012). The mean change in axial length was 0.25 ± 0.14 mm in the treatment group, and 0.33 ± 0.17 mm in the control group (mean difference: 0.08 ± 0.10 mm, p < 0.001). The treatment was well tolerated, and no serious adverse events were observed. CONCLUSIONS: Treatment with multifocal soft contact lenses with high peripheral add power was effective in controlling the progression of myopia and axial length elongation in myopic schoolchildren.

Trends in the prevalence of common ocular conditions and comparison of ophthalmic outpatient utilisation related to these conditions in children with and without various types of disabilities: analysis of nationwide population-based data from Taiwan, 2014-2019.

OBJECTIVE: The study objectives were to investigate trends in the prevalence of common ocular conditions among children with and without disabilities; to compare the prevalence of these conditions in children with various disabilities; and to compare ophthalmic outpatient utilisation related to these ocular conditions in children with and without disabilities. DESIGN: Repeated cross-sectional nationwide population-based study. SETTING: Nationwide analysis in Taiwan based on National Health Insurance (NHI) claims data and the National Disability Registry, from 2014 to 2019. PARTICIPANTS: All children (aged under 18 years) with a disability in any given year between 2014 and 2019 were included in our analysis. All children with a disability (experimental group) were matched 1:1 with a child of the same age without a disability (control group). Data regarding the children's disability type and status and ocular conditions were obtained from the National Disability Registry and NHI database of Taiwan. OUTCOME MEASURES: (1) The prevalence of myopia, strabismus, astigmatism, amblyopia and hyperopia over time; (2) the prevalence of myopia, strabismus, astigmatism, amblyopia and hyperopia in children with various disabilities; and (3) the association between disability and the use of outpatient vision care. All outcome measures were assessed using data from 2014 to 2019. RESULTS: Among children with disability, the prevalence of myopia increased from 15.97% in 2014 to 18.07% in 2019. The prevalence of strabismus (2.06-3.90%), astigmatism (8.25-9.24%), amblyopia (4.13-4.95%) and hyperopia (3.36-4.58%) also increased over the study period in children with disabilities. The prevalence of strabismus, astigmatism, amblyopia and hyperopia was significantly higher in children with disabilities than in those without disabilities in all years. For example, in 2019, the prevalence values for strabismus, astigmatism, amblyopia and hyperopia were 3.90%, 9.24%, 4.95% and 4.58%, respectively, among children with disabilities, and 0.67%, 5.84%, 1.33% and 1.70%, respectively, for those without disabilities. The prevalence of these conditions varied considerably across disability types. For example, in 2019, the prevalence of strabismus was highest in children with visual disabilities (10.66%; p<0.001); these children also exhibited a high prevalence of amblyopia (24.34%; p<0.001). The prevalence of myopia was high in children with autism (24.77%), but the prevalence of other ocular conditions was not elevated in this group. Regression results indicated that for myopia, children with disability had 0.48 fewer outpatient clinic visits than those without disability (p<0.001). CONCLUSIONS: The prevalence of common ocular conditions and the corresponding vision care required vary across types of disabilities among children. Healthcare policies must account for children at high risk of various ocular conditions, including those with less common disabilities.

Risk and dose-response relationship of diabetes mellitus for endophthalmitis after cataract surgery in a nationwide cohort study in Taiwan.

BACKGROUND: To investigate the risk of endophthalmitis after cataract surgery in patients with diabetes mellitus (DM) and evaluate the dose-response relationship. METHODS: This retrospective cohort study enrolled patients who underwent bilateral cataract surgeries from 2000 to 2017 in Taiwan National Health Insurance Research Database. The endophthalmitis rates within 3 months after cataract surgery were compared between DM and non-DM cohorts using a generalised estimating equation. The diabetes complications severity index (DSCI) score was adopted to assess the dose-response effect on the endophthalmitis rate. RESULTS: A total of 883 398 patients (1 766 796 eyes) were included. Patients with DM had an increased risk of endophthalmitis after cataract surgery than patients without DM (0.261% vs. 0.242%, adjusted odds ratio = 1.09, 95% confidence interval = 1.03-1.16). The higher endophthalmitis rate in the DM group than in the non-DM group remains after excluding those with prior vitrectomy or intravitreal injection (IVI), and took IVI between the cataract surgery and endophthalmitis (p = 0.0156, 0.0048, and 0.0139). There was a significant dose-response relationship on the likelihood of endophthalmitis in DM patients when DCSI score >10. The endophthalmitis rate is highest among DM complications in patients with metabolic disorders (0.342%). CONCLUSION: DM was a risk factor for endophthalmitis after cataract surgery after adjusting for age, sex, common systemic disorders, and excluding those with prior vitrectomy or IVI and having IVI between cataract surgery and endophthalmitis. A dose-response relationship was noted in DM patients with a DCSI score >10.

Changes in anisometropia by age in children with hyperopia, myopia, and antimetropia.

Anisometropia is a unique condition of both eyes and it is associated with vision problems such as amblyopia and reduced stereoacuity. Previous studies have not reported its change pattern by age and its correlation with the refractive condition of both eyes. This study aims to compare the changes in anisometropia by age in children with hyperopia, myopia, and antimetropia. In total, 156 children were included. Children aged 3-11 years with anisometropia ≥ 1.00 D were followed up for ≥ 1 year with ≥ 2 visits at two medical centers in Taiwan. Refractive errors by cycloplegic autorefractometry, best-corrected visual acuity, eye position, and atropine use were recorded. The children were divided into hyperopic, myopic, and antimetropic groups. The results showed that anisometropia decreased in children aged < 6 years (3.34-2.96 D; P = 0.038) and increased in older children (2.16-2.55 D; P = 0.005). In children aged 3, 4, 5, and 6 years, the mean anisometropia was higher in children with myopia and antimetropia than in those with hyperopia (P = 0.005, 0.002, 0.001, and 0.011, respectively). The differences were not significant in children aged > 6 years (all P > 0.05). The factors associated with changes in anisometropia were age, refractive group, amblyopia, and strabismus. Anisometropia decreased with age in children younger than 6 years, and the changes in anisometropia was found in children with myopia and antimetropia.

Achromatic and chromatic contrast discrimination in patients with type 2 diabetes.

Effects of type 2 diabetes on achromatic and chromatic contrast sensitivity (CS) are still controversial. In this study, we aimed to investigate CS in patients without diabetic retinopathy (no-DR) and in those with non-proliferative DR (NPDR) and proliferative DR (PDR) using psychophysical methods with transient and sustained achromatic stimuli and color patches. Achromatic CS was measured with the pulsed pedestal (PP) paradigm (7, 12, and 19 cd/m2) and pedestal-△-pedestal (P-△-P) paradigm (11.4, 18, and 28.5 cd/m2). A chromatic discrimination paradigm that assesses protan, deutan, and tritan color vision was adopted. Forty-two patients (no-DR n = 24, NPDR n = 12, PDR = 6; male n = 22, mean age = 58.1 y/o) and 38 controls (male n = 18, mean age = 53.4 y/o) participated. In patients, mean thresholds were higher than in controls and linear trends were significant in most conditions. For the PP paradigm, differences were significant in the PDR and NPDR groups in the 7 and 12 cd/m2 condition. For the P-△-P paradigm, differences were only significant in the PDR group in the 11 cd/m2 condition. Chromatic contrast loss was significant in the PDR group along the protan, deutan and tritan axes. The results suggest independent involvements of achromatic and chromatic CS in diabetic patients.

Adherence of those With Self-Reported Glaucoma in the United States to Eye Examination Visits.

PRCIS: The adherence of American patients with self-reported glaucoma to the follow-up recommendations is extremely low. Estimated adherence rate is lower than that obtained by previous studies that did not use a US nationally representative sample. PURPOSE: To evaluate adherence to ophthalmic outpatient follow-up visits and vision examinations in the American population aged 40 years or above. METHODS: The percentage of American patients aged≥40 years who adhered to glaucoma treatment guidelines was estimated using 2015-2019 Medical Expenditure Panel Survey (MEPS) data. Adherence was defined according to the International Council of Ophthalmology guidelines. We also compared individuals with and without self-reported glaucoma who have made at least one ophthalmic outpatient visit and at least 1 vision examination visit within a year. Differences in means and percentages were estimated to account for the covariance due to the complex sampling design. RESULTS: Approximately 4.4 million people aged or above 40 years had self-reported glaucoma in 2019 (3.21%). The rate of prevalence significantly differed with race, with Black people having the highest prevalence in all studied years. Only 7.1% (95% CI: 0.049-0.102) and 2.67% (95% CI: 0.0137-0.0519) of this population underwent at least 1 ophthalmic outpatient examination or 1 vision examination per year. Older age, never married status, higher education, eye conditions, and diabetes were significantly associated with a higher probability of ophthalmic health care use. CONCLUSIONS: Adherence to follow-up among patients with self-reported glaucoma in this population-level study was lower than that in previously reported American, non-nationally representative studies. Barriers to adherence at the population level should be assessed to inform the design of future policy or program interventions.

Development and validation of the Visual Function Battery for Children with Special Needs.

AIM: To develop and validate the Visual Function Battery for Children with Special Needs (VFB-CSN). METHOD: This was a scale development and validation study with (1) construct and item generation and (2) evaluations of interrater reliability, acceptability, and content, ecological, and convergent validities. RESULTS: Children with special needs were recruited for the reliability (n = 32) and validity (n = 95) investigations. The construct and items were generated based on literature review and an expert panel. We constructed eight categories, namely visual reflex, ocular muscle balance, visual acuity, oculomotor, visual field, contrast sensitivity, colour/form vision, and visual attention. Both functional assessment and standardized tests were adopted. The reliabilities were high for the whole VFB-CSN (intraclass correlation coefficient [ICC] = 0.90, 95% confidence interval [CI] = 0.80-0.90) and good for the oculomotor, contrast sensitivity, and colour/form vision (ICC = 0.80-0.86, 95% CI = 0.50-0.93). Correlations between the VFB-CSN and the Functional Vision Questionnaire were strong and acceptable for the contrast sensitivity, acuity, and colour/form vision (r = 0.79, r = 0.69, r = 0.69, r = 0.70 respectively). The correlation between the VFB-CSN and standardized visual acuity test was acceptable (r = -0.72). INTERPRETATION: The VFB-CSN is a reliable and valid multifaceted battery for children with special needs. Acceptable psychometric properties were also found for the acuity and contrast sensitivity. WHAT THIS PAPER ADDS: The Visual Function Battery for Children with Special Needs (VFB-CSN) can measure several types of visual function. The VFB-CSN also measures varying degrees of visual impairment in children with special needs. The VFB-CSN provides functional assessment and quantitative measurement for children with disability and difficulty in cooperating on standardized tests.

A Comparison of Visual Quality and Contrast Sensitivity between Patients with Scleral-Fixated and In-Bag Intraocular Lenses.

PURPOSE: To analyze visual quality and contrast sensitivity in patients after intraocular lens (IOL) implantation with sutured scleral fixation. SETTING: Chang Gung Memorial Hospital, Taoyuan, Taiwan. DESIGN: Retrospective observational study. METHODS: Data on the refractive outcome, visual acuity, and subjective visual symptoms in patients with scleral-fixated or in-bag IOL implantation were collected from September 2019 to March 2020. We also investigated patients' postoperative higher-order aberrations (HOAs) and dysphotopsia using a wavefront aberrometer and glaretester, respectively. The following values were compared: corrected distance visual acuity, spherical equivalent, root mean square values for aberrations, and contrast sensitivity. RESULTS: A total of 23 eyes implanted with scleral-fixated IOL and 74 eyes with in-bag IOL were studied. The mean postoperative spherical equivalent and logarithm of the minimum angle of resolution after scleral fixation were -1.09 ± 3.32 D and 0.20 ± 0.17, respectively. The ocular HOAs were higher in the scleral-fixation group than in the in-bag group (p = 0.001). Contrast sensitivity was negatively associated with age, and it was similar between the two groups after controlling for the age effect. CONCLUSIONS: Ocular HOAs and refractive errors were higher in the scleral-fixation group than in the in-bag group. However, no significant difference was noted in contrast sensitivity between advanced scleral fixation and in-bag IOL implantation.

Chinese Version of the Vision-Related Quality of Life (NEI-VFQ-25) among Patients with Various Ocular Disorders: A Pilot Study.

Background and Objectives: Subjective visual function is currently becoming an increasing appreciation in assessing the health-related quality of life. This study aimed to assess the vision-related quality of life (VRQOL) among patients with refractive errors, keratoconus, senile cataract, and age-related macular degeneration (AMD) using the Chinese version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25). Materials and Methods: The questionnaire of NEI-VFQ-25 was filled out in a clinical setting or by telephone/mail. Univariate and multivariate analyses were used to determine which factors are associated with the NEI-VFQ-25. Results: From June 2018 to January 2019, 28 patients with refractive error, 20 patients with keratoconus, 61 with senile cataracts, and 17 with AMD completed the questionnaire NEI-VFQ-25. There were significant differences in the NEI-VFQ-25 subscale of general vision (p = 0.0017), ocular pain (p = 0.0156), near activities (p = 0.0002), vision-specific social functioning (p = 0.007), vision-specific mental health (p = 0.0083), vision-specific dependency (p = 0.0049), color vision (p < 0.0001), peripheral vision (p = 0.0065), and total score (p < 0.0001) among four disease groups, respectively. The multiple linear regression revealed that the best-corrected visual acuity (BCVA) and disease group were important factors of the total NEI-VFQ-25. After adjusting for BCVA, patients with AMD had a worse total NEI-VFQ-25 score than patients with refractive error, keratoconus, or senile cataracts. Conclusions: Among the patients with four ocular disorders and a broad vision spectrum from normal, partial sight, low vision to legal blindness, the BCVA of their better eye was the most important factor in the VRQOL.

Comparing the natural progression and clinical features of keratoconus between pediatric and adult patients.

To present the natural course of keratoconus (KC) and compare pediatric and adult patients. Design A retrospective cohort study. Setting Hospital-based. Patient Population In total, 152 patients (288 eyes) diagnosed with KC at Chang Gung Memorial Hospital, Taiwan, were included. Previously managed patients and those with missing optical data were excluded. Observation Procedures Patients were divided into pediatric (≤ 18 years) and adult (> 18 years) groups. Demographics, clinical data, and optical variables were collected, including corrected distance visual acuity (CDVA), refractive error, and keratometric readings (K). Main Outcome Measure Optical variables at the final follow-up before aggressive treatment. Results In total, 20 pediatric (37 eyes) and 132 adults (251 eyes) patients were eligible for this study. The mean follow-up time was 2.98 years. Male predominance was observed in both groups. Both groups had similar clinical characteristics and optical variables at the initial diagnosis. Pediatric patients progressed significantly more rapidly in refractive errors, including spheres and cylinders, spherical equivalence, steep K, and flat K during the follow-up. However, significant change between the two study groups was only seen in sphere refractive error spherical equivalence. Conclusion Pediatric patients had more rapidly progressive KC than adult patients, so early detection and frequent follow-up for prompt interventions are necessary for these patients.

Surgical Results of Phacoemulsification Performed by Residents: A Time-Trend Analysis in a Teaching Hospital from 2005 to 2021.

Purpose: To report a long-term trend of surgical results of phacoemulsification performed by residents in a teaching hospital. Methods: This study analyzed 1,409 consecutive cases of phacoemulsification performed by residents under a single supervisor from July 2005 to March 2021. The 15.75-year period was divided into seven equal intervals for time-trend analysis. Main Outcome Measures. Rates of completion and complications were collected to assess the surgical results. Results: The overall completion rate was 60.5% (852/1409), and the intraoperative complication rate was 14.5% (204/1409). The completion rates from the first to the seventh interval were 44.7%, 54.2%, 60.6%, 50.6%, 65.1%, 72.5%, and 81.8%, respectively. The completion rate improved significantly with time, mainly in the steps of anterior capsulorhexis and nucleus emulsification. The intraoperative complication rates from the first to the seventh interval were 27.4%, 20.4%, 14.0%, 11.8%, 8.2%, 9.6%, and 7.3%, respectively. The complication rate also decreased significantly with time, mainly in the steps of anterior capsulorhexis, nucleus emulsification, and cortex removal. The major complications included anterior capsulorhexis tear (n = 95), vitreous loss (n = 40), iris damage or prolapse (n = 36), and posterior capsule tear without vitreous loss (n = 29). There was a significant improvement of surgical results with the level of residency in the completion rate but not in the complication rate. Conclusions: With a long-term evolution in the surgical training curriculum, it is possible to reach a goal of both higher completion and lower complication rates of resident-performed phacoemulsification.

Association of sports vision with age, gender, and static visual acuity among nonathletic population.

PURPOSE: Excellent vision is essential to performing well in sports. Sports vision includes visual, perceptual, cognitive, and oculomotor tasks that enable athletes to process and respond to what is seen. We aimed to examined how sports vision parameters - dynamic visual acuity (DVA), eye movement (EM), peripheral vision (PV), and momentary vision (MV) - varied with age and sex and assessed how static visual acuity (SVA) affect sports vision performance. MATERIALS AND METHODS: Sports vision was assessed at 45 cm distance at best-corrected SVA in 310 nonathletic participants (age, 6-60 years). Among these 310 participants, 108 university students underwent their sports vision test at 45 cm and 2.5 m distance, with and without glasses. The 4 sports vision parameters were measured by Athlevision software package installed to a laptop. Two-way analysis of variance (ANOVA) was used to compare sports vision performance in relation to age group and sex. Repeated-measures ANOVA with 1 within-factor (4 conditions) were used to analyze how sports vision varied among the near/far distance with/without glasses conditions. RESULTS: DVA increased during childhood, peaked during the 20s or 30s, and gradually decreased during middle age (P < 0.0001). DVA was significantly better in males than in females (P = 0.0001). The other 3 sport vision parameters - EM, PV, and MV - exhibited similar age trends (P < 0.001) but did not differ between two sexes. The university students with mild myopia had similar DVA, EM, and PV at both near and far distances, with and without correction; but moderate or severe myopic students with uncorrected vision had worse DVA, EM, and PV at 2.5 m than at 45 cm. CONCLUSION: Low SVA in uncorrected myopia significantly interferes the performance in sport vision tests applied in this study, especially in far distance. Improve static vision, such as myopic correction, may significantly improve sports vision, which is important in athletic performance and safety.

Prediction of residual astigmatism in cataract surgery at different diameter zones using optical biometry measurement.

The studies for astigmatism prediction error at different diameters using optical biometry are scant. We investigated patients who underwent cataract surgery with monofocal, nontoric intraocular lens (IOL) from 2017 through 2019 in a medical center. Patients with prior refractive surgeries, corneal opacity, or surgical complications were excluded. Corneal astigmatism (CA) was measured using AL-Scan at 2.4- and 3.3-mm diameter zones and calculated using the Barrett toric calculator preoperatively and postoperatively. The mean absolute error and centroid prediction error for the two zones were computed using double-angle plots. In total, 101 eyes of 76 patients were analyzed. Mean patient age was 68.7 ± 9.3 years and mean preoperative CA power was 0.7 ± 0.5 D. The overall centroid prediction error a 3.3 mm (0.09 ± 0.58 D@25) was significantly lower than that at 2.4 mm (0.09 ± 0.68 D@87) on the X-axis (P = 0.003). The 3.3-mm measurement also had a lower centroid prediction error than the 2.4-mm did for eyes with against-the-rule (ATR) and oblique astigmatism (P = 0.024; 0.002 on X-axis, respectively). The 3.3-mm measurement provided a more accurate CA estimation than the 2.4-mm did, particularly for ATR astigmatism. Diameter zone and astigmatism type should be considered crucial to precise astigmatism calculation.