Relationship between dynamic visual acuity and static visual acuity, refractive error, and binocular vision in elite soccer players.

CLINICAL RELEVANCE: In many sports, dynamic visual acuity is used. In order to improve dynamic visual acuity, it is important to understand the aspects of the visual system that can cause compromise. BACKGROUND: To investigate the parameters of the visual system that may influence dynamic visual acuity in professional soccer players. METHODS: In 2022, 40 professional players were analysed. Screening consisted of a survey, the measurement refractive error, and static and dynamic visual acuity and the binocular vision parameters. All athletes were men with a mean age of 24.9 ± 4.8 years. RESULTS: The mean refractive error was -0.29 ± 0.61D, and 22.5% of athletes are myopic only and 7.5% hyperopic. Static visual acuity was R: -0.037 ± 0.094 LogMAR , L: -0.036 ± 0.098 LogMAR. Dynamic visual acuity was 0.154 ± 0.118 LogMAR . There is a positive and moderate correlation between monocular static visual acuity and dynamic visual acuity, with r = 0.524 (r2 = 0.275 , p < 0.001) for the right eye and r = 0.553 (r2 = 0.306, p < 0.001) for the left eye. For the component of astigmatism (J = 0) and for stereopsis in distance vision, the correlation was, r = -0.472 (r2 = 0.223, p = 0.002) and r = -0.467 (r2 = 0.218, p = 0.002), respectively. CONCLUSION: Athletes with lower static visual acuity in distance vision, or with worse stereopsis in distance vision or more myopic astigmatism, have lower dynamic visual acuity than other athletes.

Self-reported visual symptoms and high visual demand activities in professional football players: a cross-sectional survey.

Background: Vision is crucial for football players, impacting decision-making and athletic performance. Despite its global popularity, football lacks comprehensive evaluations of the impact of digital device use on ocular symptoms during high-demand activities. Purpose: To gain knowledge about the time spent by football players in high visual demand activities, the symptoms associated with binocular vision dysfunction, and their relationship with sports performance. Methods: A cross-sectional observational study was conducted in 2020 using an online survey targeting football players from Portugal, England, Spain, and Saudi Arabia. The survey, distributed over 5 weeks, aimed to collect data from approximately 5,000 football players. Information on player profiles, competitive levels, vision habits, and symptoms related to binocular vision dysfunctions was collected. The Convergence Insufficiency Symptom Survey (CISS) employed a 5-point Likert scale to indicate the average frequency of each symptom. Due to non-normality, non-parametric tests were used (p < 0.05). Specifically, Mann-Whitney U, Kruskal-Wallis, Chi-square, and Spearman's rank correlation tests were used as appropriate. Results: Analyzing male professional football players (mean age: 27.4 ± 5.0 years, 95% CI, 26.7-28.1), it was found that 38.1% of the players had been called up to the national team and 6.9% had played over 50 games. Self-rated last season's performance had a mean score of 6.5 ± 2.1 (95% CI, 6.2-6.8)(on a scale of 1 to 10). Smartphone use exceeded 1 h daily for all players, with 36.0% surpassing 4 h. Visual symptoms, notably associated with smartphone use (35.5%), were observed. Regarding the CISS score, the mean was 7.1 ± 7.7 (IC95%: 6.6 to 8.8). A weak negative correlation (rho = -0.215, p = 0.003) emerged between CISS scores and self-perceived sports performance. Football players using prescription lenses had significantly higher CISS scores (11.9 ± 10.4, 95% CI, 12.3-7.7) compared to non-users (6.2 ± 6.8, 95% CI, 7.8-5.7) (p < 0.001). Conclusion: This study reveals that professional football players engage in high visual demand tasks, notably on smartphones. One-third of the players link smartphone use to ocular symptoms. The Convergence Insufficiency Symptoms Survey indicates that 6.3% exhibit binocular vision dysfunction symptoms. Those with fewer ocular symptoms perceive that they have better sports performance than their counterparts.

Binocular Function Parameters in Elite Football Players.

BACKGROUND: To investigate the binocular function in elite football players, and to analyze the differences (i) between athletes who play in different positions and (ii) between players of different ethnicities. METHODS: We screened 102 professional football players from four teams. The screening consisted of the measurement of refractive error. The binocular function parameters evaluated were: horizontal and vertical ocular alignment for distance (DF) and near fixation (NF), the values of break and recovery for negative and positive fusional vergences at DF and NF, vergence facility at NF, monocular accommodative facility at NF, near point of convergence (NPC) (break and recovery points), and NF stereopsis. All the athletes were men with a mean age of 24.6 ± 4.1 years. RESULTS: No statistically significant differences were found based on the athletes' ethnicity, except for ametropia prevalence, negative fusional vergences at DF, and NPC. We verified a statistically significant difference for the value of the break of negative fusional vergence at DF. The values found for Arab athletes are higher by more than 2 prism diopters than athletes of other ethnicities (p = .021). Arab athletes also show NPC values more distant than other athletes (p = .019, and p = .002 for break and recovery, respectively). CONCLUSION: Arab athletes have some binocular function parameters better than the remaining athletes, in particular when compared to Caucasian athletes. When compared to reference studies, athletes' binocular function seems to be better than those of the general population.

Prevalence of binocular vision dysfunctions in professional football players.

CLINICAL RELEVANCE: The extent of binocular vision dysfunction in elite soccer players needs to be determined as it may impact performance. BACKGROUND: The purpose of the study was to investigate the prevalence of binocular vision dysfunctions in elite soccer players. METHODS: One hundred and seven professional soccer players were evaluated. Refractive error was measured and the following binocular vision parameters were assessed: horizontal and vertical phoria for distance and near vision, the values of break and recovery for negative and positive fusional vergences at distance and near vision, vergence facility at distance and near vision, monocular accommodative facility at near vision, and near point of convergence (break and recovery points). All the athletes were men with a mean age of 24.4 ± 4.8 years. RESULTS: No athlete was diagnosed with divergence excess, divergence insufficiency, or basic exophoria. About 13.0% of the athletes have binocular vision dysfunctions related to esophoria (0.9% with esophoria at near vision and 12.1% with esophoria at distance and near vision). About 10.3% have convergence insufficiency and 2.8% were diagnosed with fusional vergence dysfunction. The only accommodation-related parameter analysed was accommodative infacility, and 6.5% of the athletes had this dysfunction. Vertical phoria was present in 3.7% of the athletes. No statistically significant differences were found based on in athletes with respect to ethnicity, position occupied on the field, age, ametropia or laterality. CONCLUSION: The overall prevalence of binocular vision dysfunction in elite soccer players was 36.4%. The most prevalent dysfunctions are related to the presence of esophoria (13.0%). The values found point out the need to include binocular vision assessment protocols in the visual assessment routine for athletes.

Competencies and training needs of the Portuguese optometrists - a national inquiry / Competencias y necesidades de formación de los Optometristas portugueses: encuesta a nivel nacional

PURPOSE: The World Health Organization places the Optometrist as the primary eye care provider, clearly defining its competencies and scope of practice. In Portugal, there are no studies about Optometrists professional competencies and the profession remains unregulated. The aim of this study was to describe the Portuguese optometrists' professional competencies model and to identify possible training needs felt. METHODS: A questionnaire survey was carried out, with the Portuguese optometric population as target group, ascertaining the level of academic qualifications, the clinical procedures most frequently performed, the training needs felt and the confidence levels in the performance of certain procedures. RESULTS: The 444 validated surveys represent 28.41% of the study population, making it a representative sample. The validated sample had 78.8% of Graduates, 20.5% of Masters and 0.7% of PhDs in Optometry. CONCLUSIONS: The results of this study allowed us to conclude that the competences most frequently performed by Portuguese optometrists are a very reductive view of the internationally stipulated, based on Refraction, Basic Ocular Health Assessment, Contactology and Paediatric Optometry in School Age (>6 years old). The most important training needs occur at the level of Applied Ocular Pharmacology, Prismatic Prescription, Optometry in Special Needs Populations, Contactology in Special Cases, Low Vision and Clinical/Hospital Internship. Professional experience of 10 years or more and Master's/PhD qualifications give rise to more skills, higher levels of confidence and lower training needs. Higher frequency of execution of certain procedures translates into high levels of confidence and less training needs in the área

OBJETIVO: La Organización Mundial de la Salud considera al Optometrista como el profesional primario de la salud ocular, definiendo con claridad sus competencias y ámbito de práctica. En Portugal, no existen estudios sobre las competencias profesionales de los Optometristas, por lo que la profesión no está regulada. El objetivo de este estudio fue describir el modelo de competencias profesionales de los optometristas portugueses, y identificar las posibles necesidades de formación constatadas. MÉTODOS: Se llevó a cabo una encuesta mediante empleo de cuestionario, cuyo objetivo fue la población optométrica portuguesa, verificando el nivel de titulaciones académicas, los procedimientos clínicos más frecuentemente utilizados, las necesidades de formación constatadas, y los niveles de confianza en la realización de ciertos procedimientos. RESULTADOS: Las 444 encuestas validadas representan el 28,41% de la población de estudio, lo cual supone una muestra representativa. La muestra validada incluyó un 78.8% de Graduados, un 20.5% de Titulados de Máster y un 0.7% de Doctores en Optometría. CONCLUSIONES: Los resultados de este estudio nos permitieron concluir que las competencias más frecuentemente realizadas por los optometristas portugueses constituyen una visión muy reductiva de las internacionalmente estipuladas, basándose en refracción, valoración básica de la salud ocular, contactología y optometría pediátrica en la edad escolar (> 6 años). Las necesidades más importantes en cuanto a formación se producen a nivel de Farmacología Ocular Aplicada, Prescripción Prismática, Optometría en poblaciones con necesidades especiales, Contactología en casos especiales, baja visión y Prácticas Clínicas/Hospitalarias. La experiencia profesional superior a 10 años, y la titulación de doctorado, redundan en una mayor competencia, niveles superiores de confianza, y menores necesidades de formación. Cuanto más elevada es la ejecución de ciertos procedimientos, mayores son los niveles de confianza, y menores las necesidades de formación en este área

Competencies and training needs of the Portuguese optometrists - a national inquiry.

PURPOSE: The World Health Organization places the Optometrist as the primary eye care provider, clearly defining its competencies and scope of practice. In Portugal, there are no studies about Optometrists professional competencies and the profession remains unregulated. The aim of this study was to describe the Portuguese optometrists' professional competencies model and to identify possible training needs felt. METHODS: A questionnaire survey was carried out, with the Portuguese optometric population as target group, ascertaining the level of academic qualifications, the clinical procedures most frequently performed, the training needs felt and the confidence levels in the performance of certain procedures. RESULTS: The 444 validated surveys represent 28.41% of the study population, making it a representative sample. The validated sample had 78.8% of Graduates, 20.5% of Masters and 0.7% of PhDs in Optometry. CONCLUSIONS: The results of this study allowed us to conclude that the competences most frequently performed by Portuguese optometrists are a very reductive view of the internationally stipulated, based on Refraction, Basic Ocular Health Assessment, Contactology and Paediatric Optometry in School Age (>6 years old). The most important training needs occur at the level of Applied Ocular Pharmacology, Prismatic Prescription, Optometry in Special Needs Populations, Contactology in Special Cases, Low Vision and Clinical/Hospital Internship. Professional experience of 10 years or more and Master's/PhD qualifications give rise to more skills, higher levels of confidence and lower training needs. Higher frequency of execution of certain procedures translates into high levels of confidence and less training needs in the area.

Impact of contact lens materials on the mfERG response of the human retina.

PURPOSE: To investigate the effect of different hydrophilic and rigid gas-permeable contact lens (CL) materials on multifocal electroretinography (mfERG). METHODS: The mfERG was recorded in 18 healthy subjects with RETI-port/scan21™: 11 subjects underwent mfERG recording wearing two different hydrophilic CLs with different water contents in a randomized order (1 silicone hydrogel-Comfilcon A, 48%EWC, and 1 hydrogel-Omafilcon A, 62% EWC) and 7 other subjects wore a hydrophobic rigid gas-permeable scleral lens (SL)-Hexafocon A. Control measures were recorded without CL in both groups. mfERG recordings were performed with a stimulus array pattern of 103-scaled hexagons displayed on a 19-inch RGB monitor at 28 cm distance at a frame rate of 60 Hz. The amplitude (nV), implicit time and response density (nV/deg2) of the first-order kernel components N1, P1 and N2 were evaluated for the total mfERG response and for the response averages of 4 quadrants and of 6 successive concentric rings. Subjects were optically corrected for the working distance of ERG display. RESULTS: Hydrophobic material significantly decreased the P1 amplitude of the total mfERG response, at Rings 3, 4 and 6 and Quadrant 4 (> 53.77 ± 43.2 nV; P ≤ 0.050), as well as the total (- 71.59 ± 50.68 nV) and Ring 6 (- 104.76 ± 79.88 nV) N2 amplitude (P ≤ 0.043). N1, P1 and N2 peak times suffered significant changes with both hydrophilic CL (P ≤ 0.050). Omafilcon A significantly increased P1 amplitude of Ring 5 and N2 amplitude of Ring 4, when compared to baseline (52.40 ± 71.87 nV; P = 0.036) and to Comfilcon A (39.51 ± 48.63 nV; P = 0.023), respectively. CONCLUSIONS: Hydrophobic CL slightly attenuated the strength of the mfERG signal, especially at the middle to peripheral retinal areas, while hydrophilic CL slightly changed the implicit time of the response. Different hydrophilic CL materials might affect the mfERG response differently. When considering the measurement of mfERG obtained with a CL in place, researchers should bear in mind that some changes can be related to CL material.

Static and dynamic visual acuity and refractive errors in elite football players.

BACKGROUND: The aim of this study was to investigate static and dynamic visual acuity, refractive error, and the use of visual compensation of elite football players. METHODS: From 2015 to 2017, 147 professional players from five teams were analysed. Screening consisted of a survey about the use of visual correction, and measurement refractive error, static visual acuity and dynamic visual acuity. Refractive error was assessed using an autorefractor. Distance static visual acuity was evaluated using a Snellen chart. Dynamic visual acuity was measured at five metres using the software COI-SV. All athletes were male with a mean age of 24.6 ± 4.1 years. RESULTS: The mean refractive error of the athletes was -0.04 ± 0.83 D, and 16.4 per cent were myopic. Statistically significant differences were found for dynamic visual acuity (p = 0.033), based on the position occupied. Goalkeepers displayed the best dynamic visual acuity and forwards had the lowest values (0.82 ± 0.14 and 0.62 ± 0.17, respectively). The forwards presented with the highest prevalence of myopia and goalkeepers the lowest, at 22.5 per cent and 12.5 per cent, respectively. All goalkeepers who needed to use a correction for play used it, whereas only 16 per cent of the forwards who needed a correction used it. CONCLUSION: Dynamic visual acuity of forwards is lower than that of other players. Twenty-five per cent of players who need to use visual correction to practice sports actually use it.

IVTH BRAZILIAN CONSENSUS CONFERENCE ON HELICOBACTER PYLORI INFECTION.

Significant progress has been obtained since the III Brazilian Consensus Conference on H. pylori infection held in 2012, in Bento Gonçalves, Brazil, and justify a fourth meeting to establish updated guidelines on the current management of H. pylori infection. Therefore, the Núcleo Brasileiro para Estudo do Helicobacter pylori e Microbiota (NBEHPM), association linked to Brazilian Federation of Gastroenterology (FBG) held its fourth meeting again in Bento Gonçalves, RS, Brazil, on August 25-27, 2017. Twenty-six delegates, including gastroenterologists, endoscopists, and pathologists from the five regions of Brazil as well as one international guest from the United States, participated in the meeting. The participants were invited based on their knowledge and contribution to the study of H. pylori infection. The meeting sought to review different aspects of treatment for infection; establish a correlation between infection, dyspepsia, intestinal microbiota changes, and other disorders with a special emphasis on gastric cancer; and reassess the epidemiological and diagnostic aspects of H. pylori infection. Participants were allocated into four groups as follows: 1) Epidemiology and Diagnosis, 2) Dyspepsia, intestinal microbiota and other afections, 3) Gastric Cancer, and, 4) Treatment. Before the consensus meeting, participants received a topic to be discussed and prepared a document containing a recent literature review and statements that should be discussed and eventually modified during the face-to-face meeting. All statements were evaluated in two rounds of voting. Initially, each participant discussed the document and statements with his group for possible modifications and voting. Subsequently, during a second voting in a plenary session in the presence of all participants, the statements were voted upon and eventually modified. The participants could vote using five alternatives: 1) strongly agree; 2) partially agree; 3) undecided; 4) disagree; and 5) strongly disagree. The adopted consensus index was that 80% of the participants responded that they strongly or partially agreed with each statement. The recommendations reported are intended to provide the most current and relevant evidences to management of H. pylori infection in adult population in Brazil.

Changes in Myopia Prevalence among First-Year University Students in 12 Years.

PURPOSE: The aim of this study is to compare the changes in myopia prevalence among Portuguese first-year university students in 2002 and 2014 at the University of Minho. METHODS: The refractive status and axial length of first-year students at the School of Sciences, University of Minho, were measured in 2014. Refractive error was measured with subjective refraction under cycloplegia and axial length was measured by optical biometry. The data were compared with those obtained from a similar cohort of 111 students in 2002. Myopia was defined as a mean spherical equivalent of ≤-0.50D. A survey was conducted to know the routine of the participants. They were asked how many hours per week (hrs/wk) they had spent, on average in the previous year, watching TV, using the computer, studying, participating in manual hobbies, and participating in outdoor activities. RESULTS: In 2014, 75 students were assessed (15 male and 60 female) with a mean age (mean ± SD) of 19.8 ± 1.6 years (ranging from 18 to 24 years). The mean refractive error M (spherical equivalent) was -0.77 ± 1.79D and the axial length was 23.74 ± 1.19 mm. The prevalence of myopia was 41.3% (31 of 75). In 2002, the mean refractive error M was 0.01 ± 1.53D, the axial length was 23.40 ± 0.93 mm, and the myopia prevalence was 23.4% (26 of 111). The differences between myopia prevalence and mean refractive error are statistically significant (p < 0.05). A statistically significant increase in the number of hrs/wk spent on near activities (p < 0.05) was found. CONCLUSIONS: In 12 years, the prevalence of myopia among first-year university students at the School of Sciences of the University of Minho rose from 23.4 to 41.3%. This increase in myopia prevalence could be related to the lifestyle changes of the studied population.

Strategies to Regulate Myopia Progression With Contact Lenses: A Review.

PURPOSE: Higher myopic refractive errors are associated with serious ocular complications that can put visual function at risk. There is respective interest in slowing and if possible stopping myopia progression before it reaches a level associated with increased risk of secondary pathology. The purpose of this report was to review our understanding of the rationale(s) and success of contact lenses (CLs) used to reduce myopia progression. METHODS: A review commenced by searching the PubMed database. The inclusion criteria stipulated publications of clinical trials evaluating the efficacy of CLs in regulating myopia progression based on the primary endpoint of changes in axial length measurements and published in peer-reviewed journals. Other publications from conference proceedings or patents were exceptionally considered when no peer-review articles were available. RESULTS: The mechanisms that presently support myopia regulation with CLs are based on the change of relative peripheral defocus and changing the foveal image quality signal to potentially interfere with the accommodative system. Ten clinical trials addressing myopia regulation with CLs were reviewed, including corneal refractive therapy (orthokeratology), peripheral gradient lenses, and bifocal (dual-focus) and multifocal lenses. CONCLUSIONS: CLs were reported to be well accepted, consistent, and safe methods to address myopia regulation in children. Corneal refractive therapy (orthokeratology) is so far the method with the largest demonstrated efficacy in myopia regulation across different ethnic groups. However, factors such as patient convenience, the degree of initial myopia, and non-CL treatments may also be considered. The combination of different strategies (i.e., central defocus, peripheral defocus, spectral filters, pharmaceutical delivery, and active lens-borne illumination) in a single device will present further testable hypotheses exploring how different mechanisms can reinforce or compete with each other to improve or reduce myopia regulation with CLs.

Errors associated with IOLMaster biometry as a function of internal ocular dimensions.

PURPOSE: To evaluate the error in the estimation of axial length (AL) with the IOLMaster partial coherence interferometry (PCI) biometer and obtain a correction factor that varies as a function of AL and crystalline lens thickness (LT). METHODS: Optical simulations were produced for theoretical eyes using Zemax-EE software. Thirty-three combinations including eleven different AL (from 20mm to 30mm in 1mm steps) and three different LT (3.6mm, 4.2mm and 4.8mm) were used. Errors were obtained comparing the AL measured for a constant equivalent refractive index of 1.3549 and for the actual combinations of indices and intra-ocular dimensions of LT and AL in each model eye. RESULTS: In the range from 20mm to 30mm AL and 3.6-4.8mm LT, the instrument measurements yielded an error between -0.043mm and +0.089mm. Regression analyses for the three LT condition were combined in order to derive a correction factor as a function of the instrument measured AL for each combination of AL and LT in the theoretical eye. CONCLUSIONS: The assumption of a single "average" refractive index in the estimation of AL by the IOLMaster PCI biometer only induces very small errors in a wide range of combinations of ocular dimensions. Even so, the accurate estimation of those errors may help to improve accuracy of intra-ocular lens calculations through exact ray tracing, particularly in longer eyes and eyes with thicker or thinner crystalline lenses.

Computing retinal contour from optical biometry.

PURPOSE: To describe a new methodology that derives horizontal posterior retinal contours from partial coherence interferometry (PCI) and ray tracing using the corneal topography. METHODS: Corneal topography and PCI for seven horizontal visual field eccentricities correspondent to the central 60 degrees of the posterior pole were obtained in 55 myopic eyes. A semicustomized eye model based on the subject's corneal topography and the Navarro eye model was generated using Zemax-EE software. The model was used to compute the optical path length in the seven directions where PCI measurements were obtained. Vitreous chamber depth was computed using the PCI values obtained at each of those directions. Matlab software was developed to fit the best conic curve to the set of points previously obtained. We tested the limit in the accuracy of the methodology when the actual cornea of the subject is not used and for two different lens geometries. RESULTS: A standard eye model can induce an error in the retina sagitta estimation of the order of hundreds of micrometers in comparison with the semicustomized eye model. However, the use of a different lens model leads to an error of the order of tens of micrometers. The apical radius and conic constant of the average fit were -11.91 mm and -0.15, respectively. In general, a nasal-temporal asymmetry in the retina contour was found, showing mean larger values of vitreous chamber depth in the nasal side of the eye. CONCLUSIONS: The use of a semicustomized eye model, together with optical path length measured by PCI for different angles, can be used to predict the retinal contour within tenths of micrometers. This methodology can be useful in studies trying to understand the effect of peripheral retinal location on myopia progression as well as modeling the optics of the human eye for a wide field.

Adaptation to multifocal and monovision contact lens correction.

PURPOSE: To compare visual performance with the Biofinity multifocal (MF) contact lens with monovision (MV) with the Biofinity single-vision contact lens. METHODS: A crossover study of 20 presbyopic patients was conducted. Patients were randomized first into either an MF or an MV lens for 15 days for each modality, with a washout period between each lens type. Measurements included monocular and binocular high- and low-contrast logarithm of the minimum angle of resolution visual acuity (VA) at distance and near visions, binocular distance contrast sensitivity function, and near stereoacuity. RESULTS: At 15 days, patients lost fewer than two letters (half a line of VA) of binocular distance and near VA, with the MF and MV lens under high- and low-contrast conditions (P > 0.05 for both comparisons). No statistically significant differences were seen in binocular VA at near or distance with either lens. However, the monocular distance VA improved significantly in the nondominant eye, with the MF lens by one line over the 15-day period under high-contrast (P = 0.023) and low-contrast (P = 0.035) conditions; this effect was not seen with the MV lens. Contrast sensitivity function was within the normal limits with both lenses. The stereoacuity was significantly (P < 0.01) better with MF than with MV. CONCLUSIONS: Multifocal contact lens correction provided satisfactory levels of VA comparable with MV without compromising 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 MF lens, suggesting that patients adapted to the multifocality overtime, whereas this was not true for MV.

Clinical performance and "ex vivo" dehydration of silicone hydrogel contact lenses with two new multipurpose solutions.

PURPOSE: To compare the performance of two novel multipurpose disinfecting solutions (MPDS) in preventing silicone hydrogel contact lens dehydration, provide higher scores of subjective comfort and stable optical quality during a month of lens wear in neophyte volunteers. METHOD: This is a prospective, double-blind, contralateral and randomised study involving the contra lateral use of Complete RevitaLens and Biotrue MPDS. Twenty-five neophytes wore Air Optix Aqua for 1 month. Volunteers were evaluated on day 1 and day 30 at 2 and 10h after lens insertion. Tear film stability using Tearscope Plus (Keeler, UK), whole eye aberrations for 4.5mm pupil size (IRx3, ImaginEyes, France) and subjective comfort (0-10 score) along with the dehydration values obtained with a gravimetric method were collected at each follow-up visit. RESULTS: NIBUT values decreased significantly with both care systems from baseline to 10h visit on day 1 (p=0.032 and 0.016, mean difference=-6.7s and -7.0 s, for Complete Revitalens and Biotrue, respectively). Dehydration rates and ocular aberrations did not change significantly over the month of follow-up (p>0.05, ANOVA with Bonferroni post hoc corrections), nor between visits within the same day (p>0.05, paired sample T-test). End-of-day dryness sensation worsened similarly with both MPDS after 1 month (p=0.021 and 0.005, mean difference=-1.4 and -1.3, for Complete Revitalens and Biotrue, respectively). CONCLUSIONS: Regardless of their different chemical compositions in terms of moisture additives both MPDS solutions evaluated performed similarly regarding objective measures of dehydration, tear stability and optical quality but presented significant differences in subjective symptoms.

Peripheral refraction and retinal contour in stable and progressive myopia.

PURPOSE: To compare the patterns of relative peripheral astigmatic refraction (tangential and sagittal power errors) and eccentric eye length between progressing and stable young-adult myopes. METHODS: Sixty-two right eyes of 62 white patients participated in the study, of which 30 were nonprogressing myopes (NP group) for the last 2 years and 32 were progressing myopes (P group). Groups were matched for mean spherical refraction, axial length, and age. Peripheral refraction and eye length were measured along the horizontal meridian up to 35 and 30 degrees of eccentricity, respectively. RESULTS: There were statistically significant differences between groups (p < 0.001) in the nasal retina for the astigmatic components of peripheral refraction. The P group presented a hyperopic relative sagittal focus at 35 degrees in the nasal retina of +1.00 ± 0.83 diopters, as per comparison with a myopic relative sagittal focus of -0.10 ± 0.98 diopters observed in the NP group (p < 0.001). Retinal contour in the P group had a steeper shape in the nasal region than that in the NP group (t test, p = 0.001). An inverse correlation was found (r = -0.775; p < 0.001) between retinal contour and peripheral refraction. Thus, steeper retinas presented a more hyperopic trend in the periphery. CONCLUSIONS: Stable and progressing myopes of matched age, axial length, and central refraction showed significantly different characteristics in their peripheral retinal shape and astigmatic components of tangential and sagittal power errors. The present findings may help explain the mechanisms that regulate ocular growth in humans.

Dynamic accommodative response to different visual stimuli (2D vs 3D) while watching television and while playing Nintendo 3DS console.

PURPOSE: The aim of the present study was to compare the accommodative response to the same visual content presented in two dimensions (2D) and stereoscopically in three dimensions (3D) while participants were either watching a television (TV) or Nintendo 3DS console. METHODS: Twenty-two university students, with a mean age of 20.3 ± 2.0 years (mean ± S.D.), were recruited to participate in the TV experiment and fifteen, with a mean age of 20.1 ± 1.5 years took part in the Nintendo 3DS console study. The accommodative response was measured using a Grand Seiko WAM 5500 autorefractor. In the TV experiment, three conditions were used initially: the film was viewed in 2D mode (TV2D without glasses), the same sequence was watched in 2D whilst shutter-glasses were worn (TV2D with glasses) and the sequence was viewed in 3D mode (TV3D). Measurements were taken for 5 min in each condition, and these sections were sub-divided into ten 30-s segments to examine changes within the film. In addition, the accommodative response to three points of different disparity of one 3D frame was assessed for 30 s. In the Nintendo experiment, two conditions were employed - 2D viewing and stereoscopic 3D viewing. RESULTS: In the TV experiment no statistically significant differences were found between the accommodative response with TV2D without glasses (-0.38 ± 0.32D, mean ± S.D.) and TV3D (-0.37 ± 0.34D). Also, no differences were found between the various segments of the film, or between the accommodative response to different points of one frame (p > 0.05). A significant difference (p = 0.015) was found, however, between the TV2D with (-0.32 ± 0.32D) and without glasses (-0.38 ± 0.32D). In the Nintendo experiment the accommodative responses obtained in modes 2D (-2.57 ± 0.30D) and 3D (-2.49 ± 0.28D) were significantly different (paired t-test p = 0.03). CONCLUSIONS: The need to use shutter-glasses may affect the accommodative response during the viewing of displays, and the accommodative response when playing Nintendo 3DS in 3D mode is lower than when it is viewed in 2D.

Peripheral refraction in myopic eyes after LASIK surgery.

PURPOSE: To characterize the axial and off-axis refraction across the horizontal meridian of the visual field before and after myopic laser-assisted in situ keratomileusis (LASIK) surgery. This research took place at the Clinical Ophthalmologic-NovoVisión, Madrid, Spain. METHODS: Twenty-six ODs (mean age ± SD = 30.4 ± 4.8 years) of 26 patients who underwent LASIK surgery to treat myopia between -0.75/-3.88 D of spherical equivalent (M) were included in the study. Peripheral refraction was evaluated by an open field auto-refractor before and after LASIK surgery at 3 months. Along with a complete set of examination procedures to assess suitability for treatment, the central and peripheral refractions were measured along the horizontal meridian up to 35° of eccentricity in the nasal and temporal retinal areas in 5° visual field steps. RESULTS: Changes in M ranged between 1.85 ± 0.93 D at center to 0.33 ± 0.73 D at 35° in the nasal retina (p < 0.029 for all eccentricities). Treatment induced was symmetric between nasal and temporal visual fields along the horizontal meridian. The degree of myopic increase in relative peripheral refractive error as represented by the spherical equivalent for 30° (r2 = 0.462, p < 0.001) and 35° (r2 = 0.717, p < 0.001) eccentric refraction was correlated with axial spherical equivalent at baseline. CONCLUSIONS: Peripheral refraction is affected by myopic LASIK surgery. Unlike orthokeratology, which increases the peripheral myopia, LASIK reduces myopia across the horizontal visual field out to at least 35° from fixation.

Papéis, conflitos e gratificações de enfermeiros especialistas em enfermagem psiquiátrica e saúde mental / Roles, conflicts and fulfillment of psychiatric and mental health nurse specialists / Papeles, conflictos y gratificaciones de enfermeros especialistas en enfermería psiquiátrica y salud mental

Este estudo descritivo-exploratório de cunho qualitativo teve por objetivo verificar quais os papéis, conflitos e gratificações de enfermeiros especialistas em enfermagem psiquiátrica e saúde mental, pois com as transformações da assistência psiquiátrica nas últimas décadas tornaram-se importantes essas compreensões. Assim, quinze enfermeiros, egressos de um curso de especialização em enfermagem psiquiátrica e saúde mental, responderam a um questionário com esse objetivo, e sua análise foi realizada de forma qualitativa. Os resultados mostraram que a maioria dos entrevistados é jovem, trabalha nessa área desempenhando papéis do enfermeiro e prestando cuidado direto. Constatou-se que esses enfermeiros possuem conflitos, como falta de reconhecimento, sobrecarga e falta de recursos humanos e gratificações, como a melhora do paciente e o reconhecimento profissional. Conclui-se, portanto, que os sujeitos identificam seu papel de especialista exercendo-o com propriedade; seus conflitos se relacionam a aspectos de reconhecimento e estrutura dos serviços; e suas gratificações estão ligadas a fatores de ordem pessoal e qualificação profissional.

This descriptive-exploratory study was performed using a qualitative approach, with the objective to verify the roles, conflicts and fulfillment of psychiatric nursing and mental health nurse specialists, because these are relevant aspects considering the changes made in psychiatric care over the last decades. Therefore, fifteen nurses, graduates of a specialization course in psychiatric and mental health nursing, answered a questionnaire, which was subjected to qualitative analysis. The results showed that most subjects are young and work in the referred area, performing nursing roles and providing direct care. They reported experiencing conflicts, such as not being recognized, dealing with work overload and the lack of human resources. The aspects of fulfillment reported were the patients' improvement and professional recognition. Thus, it is concluded that the subjects identify their role as specialists and perform that role accordingly; their conflicts were related to aspects concerning recognition and the structure of the services, and their fulfillment is related to personal and professional qualification factors.

Estudio descriptivo-exploratorio de cuño cualitativo que objetivó verificar cuáles son los papeles, conflictos y gratificaciones de enfermeros especialistas en enfermería psiquiátrica y salud mental, comprensiones importantes de acuerdo a las transformaciones de la atención psiquiátrica en las últimas décadas. Quince enfermeros egresados de curso de especialización en enfermería psiquiátrica y salud mental respondieron cuestionario con tal objetivo, el análisis realizado fue de carácter cualitativo. Los resultados mostraron que la mayoría de los entrevistados es joven, trabaja en ésta área desempeñando papeles de enfermero y brindando cuidado directo. Poseen conflictos, como falta de reconocimiento, sobrecarga y falta de recursos humanos y gratificaciones, tales como la mejoría del paciente y el reconocimiento profesional. Se concluye en que los sujetos identifican su papel de especialistas ejerciéndolo adecuadamente, sus conflictos se relacionan con aspectos de reconocimiento y estructura de servicios, y sus gratificaciones están vinculadas con factores de orden personal y calificación profesional.

Quality of life of myopic subjects with different methods of visual correction using the NEI RQL-42 questionnaire.

PURPOSE: To evaluate different aspects of the visual-related quality of life using the National Eye Institute Refractive Error Quality of Life (NEI RQL)-42 questionnaire in low and moderate myopic subjects corrected with different refractive treatments including laser-assisted in situ keratomileusis (LASIK), orthokeratology (OK), soft contact lenses (SCLs), and spectacles. METHODS: The NEI RQL-42 questionnaire was administered to 217 subjects at one single clinic. All the questions consisted of 13 different subscales that were analyzed separately. The results from subjects with -1.00 to -3.00 diopter myopia corrected with LASIK (n=41), OK (n=37), SCLs (n=44), or spectacles (n=45) were compared with each other and with emmetropic subjects (n=50). RESULTS: Statistically significant differences among all groups were found in all subscales, except for satisfaction with correction (P=0.135). The average decrease in quality of life compared with emmetropes were -7.1% (P=0.021) for LASIK, -13.0% (P<0.001) for OK, -15.8% (P<0.001) for spectacles, and -17.3% (P<0.001) for SCLs. CONCLUSIONS: Although all patients in each group were considered to be successfully visually corrected, quality of life related to vision was markedly different in certain NEI RQL-42 categories. LASIK showed the lowest average decrease in quality of vision compared with emmetropes. OK was comparable with LASIK in independence of visual correction, and SCL wear was superior to LASIK and OK lens wear in glare. Except for glare and diurnal fluctuations, contact lenses (SCL and OK) were comparable with or superior to spectacle correction.