Vision

8 pages, 1471 KiB

Open AccessArticle

Individual Variations in Vergence and Accommodation Responses Following Virtual Reality Gameplay

by Alona Sumarokova, Reinis Alksnis, Dagni Rappo, Karola Panke, Gunta Krumina and Tatjana Pladere

Vision 2024, 8(4), 69; https://doi.org/10.3390/vision8040069 - 20 Dec 2024

Viewed by 765

Abstract

Virtual reality (VR) can challenge the visual system, leading to temporary oculomotor changes, though the degree of change varies among individuals. While the vergence and accommodation system plays a crucial role in VR perception, it remains unclear whether individuals whose visual functions fall [...] Read more.

Virtual reality (VR) can challenge the visual system, leading to temporary oculomotor changes, though the degree of change varies among individuals. While the vergence and accommodation system plays a crucial role in VR perception, it remains unclear whether individuals whose visual functions fall outside clinical norms experience larger changes. Thus, our study aimed to investigate whether changes in vergence and accommodation responses following VR gameplay differ between individuals with and without non-strabismic binocular and accommodative disorders. To assess this, both subjective and objective measurements were conducted before and after 20 min of playing Beat Saber. Results revealed significant alterations across both subjective measurements—near point of convergence and near point of accommodation—and objective measurements, including eye refraction, accommodation lag, and accommodative microfluctuations at far. Moreover, individuals with non-strabismic binocular and accommodative disorders exhibited larger accommodative microfluctuations at far compared to the control group. Overall, these findings indicate that considering individual differences in vergence and accommodation responses is important when evaluating the impact of VR on the visual system and can be helpful in the design and use of VR systems, particularly for individuals with binocular and accommodative disorders. Full article

(This article belongs to the Special Issue Selected Papers from the 4th International Symposium on Visual Physiology, Environment, and Perception (VisPEP 2024))

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4 pages, 458 KiB

Open AccessEditorial

New Horizons in Myopia Management: Bridging Epidemiology and Clinical Innovation

by Nir Erdinest and Yair Morad

Vision 2024, 8(4), 68; https://doi.org/10.3390/vision8040068 - 1 Dec 2024

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Abstract

In 1975, Brit J [...] Full article

(This article belongs to the Special Issue New Horizons in Myopia Management: Bridging Epidemiology and Clinical Innovation)

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12 pages, 243 KiB

Open AccessReview

Digital Applications for Videoterminal-Associated Dry Eye Disease

by Maria Angela Romeo, Giulia Coco, Andrea Taloni, Giovanna Carnovale-Scalzo, Vincenzo Scorcia and Giuseppe Giannaccare

Vision 2024, 8(4), 67; https://doi.org/10.3390/vision8040067 - 28 Nov 2024

Viewed by 846

Abstract

Dry eye disease (DED) has become increasingly prevalent in the digital era, largely due to prolonged screen exposure. The excessive use of digital devices contributes to inappropriate blink frequency and dynamics, leading to ocular surface dryness and discomfort. Additionally, digital screen use has [...] Read more.

Dry eye disease (DED) has become increasingly prevalent in the digital era, largely due to prolonged screen exposure. The excessive use of digital devices contributes to inappropriate blink frequency and dynamics, leading to ocular surface dryness and discomfort. Additionally, digital screen use has broader implications for systemic health, including visual strain, headaches, and disrupted circadian rhythms caused by blue light exposure. Previous studies have shown that prolonged screen time correlates with altered blink frequency and increased symptom severity in DED patients, exacerbating the imbalance in tear film production and evaporation. Blinking dynamics, particularly blink rate and completeness, are crucial in maintaining ocular surface moisture. Incomplete blinking impairs meibomian gland function, reducing lipid secretion, which is essential for preventing tear evaporation. Raising patient awareness through educational material, ergonomic adjustments, and blinking exercises has been shown to mitigate these effects. Digital tools that provide targeted educational interventions can be particularly effective in improving blink dynamics and overall ocular comfort. This study evaluates the efficacy of digital applications in optimizing blinking dynamics and enhancing tear film stability. The findings suggest that these innovations improve patient outcomes by encouraging healthier eye care practices. However, further research is needed to assess their long-term impact across diverse populations. Full article

12 pages, 1913 KiB

Open AccessArticle

Optical Bench Evaluation of a Novel, Hydrophobic, Acrylic, One-Piece, Polyfocal Intraocular Lens with a “Zig-Zag” L-Loop Haptic Design

by Andreas F. Borkenstein, Eva-Maria Borkenstein, Pooria Omidi and Achim Langenbucher

Vision 2024, 8(4), 66; https://doi.org/10.3390/vision8040066 - 14 Nov 2024

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Abstract

Purpose: The number of presbyopia-correcting (premium) intraocular lenses (IOLs) is growing steadily as the desire for spectacle independence after cataract surgery increases. The aim of this laboratory study was to evaluate a newly launched hydrophobic, acrylic, polyfocal, refractive intraocular lens with a new [...] Read more.

Purpose: The number of presbyopia-correcting (premium) intraocular lenses (IOLs) is growing steadily as the desire for spectacle independence after cataract surgery increases. The aim of this laboratory study was to evaluate a newly launched hydrophobic, acrylic, polyfocal, refractive intraocular lens with a new optical design and geometry. This polyfocal IOL has three different zones (within the optic) with radially asymmetric design. Methods: We performed optical bench tests to calculate the optical characteristics of the sample. The optical performance and quality of IOLs based on ISO 11979-2 and 11979-9 requirements were analyzed with the NIMO TR0815 (Lambda-X). In addition, optical quality metrics were evaluated with the IOLA MFD device (Rotlex). Sphere, Add, modulation transfer function (MTF), the energy distribution between the modes and the MTF along the whole range from far to near were analyzed. Results: The power histogram showed that the tested IOL has the characteristics of a polyfocal IOL with a wide range of optical power between 20.5 and 24.5 diopters. Two distinct peaks were observed, indicating bifocal functionality. In the radial and axial power surface map, all three zones, stated by the company, could be detected. Larger apertures lead to a significant increase in MTF at the far peak, indicating better visual acuity for distant objects under low-light conditions. It was observed that in small aperture sizes, intermediate vision seems to be dominant. The energy distribution remained almost constant with increasing aperture size. Conclusions: This laboratory study was able to confirm the properties of the polyfocal lens stated by the company. Three optical zones could be identified. However, further optical bench tests should be performed to evaluate the new lens under tilted and decentered conditions. Clinical studies have to confirm that the presbyopia-correcting, polyfocal lens can achieve good clinical results with high patient satisfaction without disturbing side effects. Full article

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40 pages, 5307 KiB

Open AccessSystematic Review

Optimal Timing for Intraocular Pressure Measurement Following Phacoemulsification Cataract Surgery: A Systematic Review and a Meta-Analysis

by William J. Herspiegel, Brian E. Yu, Hamzah S. Algodi, Monali S. Malvankar-Mehta and Cindy M. L. Hutnik

Vision 2024, 8(4), 65; https://doi.org/10.3390/vision8040065 - 8 Nov 2024

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Abstract

Post-operative increases in intraocular pressure (IOP) are a frequent complication following phacoemulsification cataract surgery. Assessment of IOP is an essential element in post-operative checks. Despite this, guidance regarding the optimal timing remains vague. The purpose of this meta-analysis was to determine the current [...] Read more.

Post-operative increases in intraocular pressure (IOP) are a frequent complication following phacoemulsification cataract surgery. Assessment of IOP is an essential element in post-operative checks. Despite this, guidance regarding the optimal timing remains vague. The purpose of this meta-analysis was to determine the current status of evidence that may help guide best practice regarding the optimal time following phacoemulsification cataract surgery to measure IOP. A comprehensive literature search was performed on MEDLINE and EMBASE. In two stages, independent reviewers screened articles that reported IOP measurements following uncomplicated cataract surgery. Risk of Bias Assessment was conducted following data extraction. The meta-analysis incorporated 57 randomized clinical studies involving a total of 6318 participants and 7089 eyes. Post-operative hour one had a significant decrease in IOP from baseline, while hour two had a non-significant increase. Post-operative hours four, six, and eight were the only timepoints to have a significant increase in IOP. Finally, post-operative day one had no significant change in IOP, while day two had a non-significant decrease. These results suggest that the optimal time to measure IOP is within the first 4–8 h following phacoemulsification cataract extraction. Taking measurements too soon or too late could result in missed IOP spikes. Full article

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18 pages, 3425 KiB

Open AccessArticle

Corneal Endothelial Microscopy: Does a Manual Recognition of the Endothelial Cells Help the Morphometric Analysis Compared to a Fully Automatic Approach?

by Giulia Carlotta Rizzo, Rosa Di Grassi, Erika Ponzini, Silvia Tavazzi and Fabrizio Zeri

Vision 2024, 8(4), 64; https://doi.org/10.3390/vision8040064 - 30 Oct 2024

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Abstract

This study investigated whether manual integration in the recognition of the endothelial cells produces different outcomes of morphometric parameters compared to a fully automatic approach. Eight hundred and ninety endothelial images, originally acquired by the Perseus Specular Microscope (CSO, Florence, Italy), from seven [...] Read more.

This study investigated whether manual integration in the recognition of the endothelial cells produces different outcomes of morphometric parameters compared to a fully automatic approach. Eight hundred and ninety endothelial images, originally acquired by the Perseus Specular Microscope (CSO, Florence, Italy), from seven positions of right and left corneas were selected from the database of the Research Centre in Optics and Optometry at the University of Milano-Bicocca. For each image selected, two procedures of cell identification were performed by the Perseus: an automatic identification and a manual-integrated procedure to add potential additional cells with the available editing tool. At the end of both procedures, the endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX) of the mosaic were calculated. The HEX in the two procedures was significantly different for all comparisons (p < 0.001), but clinically negligible. No significant differences were found for the CV and ECD in the images of both eyes irrespective of the corneal position of acquisition (except for ECD in three corneal portions, p < 0.05). To conclude, it is possible to recognise a significantly higher number of cells using the manual-integrated procedure than it is using the fully automatic one, but this does not change the morphological parameters achieved. Full article

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6 pages, 1557 KiB

Open AccessCase Report

Combined Epiretinal Proliferation and Internal Limiting Membrane Inverted Flap for the Treatment of Large Macular Holes

by Nikolaos Dervenis, Iordanis Vagiakis, Elena P. Papadopoulou, Panagiotis Dervenis and Teresa Sandinha

Vision 2024, 8(4), 63; https://doi.org/10.3390/vision8040063 - 19 Oct 2024

Viewed by 843

Abstract

We are presenting a new method for the treatment of large macular holes (MHs) with the use of an inverted flap consisting of both internal limiting membrane (ILM) and epiretinal proliferation (EP). A prospective interventional case series was conducted from September 2021 to [...] Read more.

We are presenting a new method for the treatment of large macular holes (MHs) with the use of an inverted flap consisting of both internal limiting membrane (ILM) and epiretinal proliferation (EP). A prospective interventional case series was conducted from September 2021 to January 2023. MH patients with coexistent EP visualized preoperatively in macula optical coherence tomography and with a MHs minimum linear diameter larger than 400 microns underwent standard pars plana vitrectomy with the creation of an inverted petaloid flap (consisting of both ILM and EP) and gas tamponade. Sixteen eyes were included in our case series. MHs closure was successful in all the eyes with a single procedure. The preoperative minimum linear diameter was 707.63 (±164.02 μm), and the preoperative best corrected visual acuity was 1.11 ± 0.52. The postoperative BCVA was 0.51 ± 0.20 (p = 0.01) at 6 weeks postoperatively, and the final BCVA was 0.45 ± 0.20 (p = 0.008). EP can be safely combined with ILM for the creation of an inverted, petaloid flap to cover and facilitate the closure of large MHs. Full article

(This article belongs to the Section Retinal Function and Disease)

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12 pages, 425 KiB

Open AccessArticle

Comparison of Four Methods for Measuring Heterophoria and Accommodative Convergence over Accommodation Ratio

by Noelia Nores-Palmas, Veronica Noya-Padin, Eva Yebra-Pimentel, Maria Jesus Giraldez and Hugo Pena-Verdeal

Vision 2024, 8(4), 62; https://doi.org/10.3390/vision8040062 - 18 Oct 2024

Viewed by 1761

Abstract

The study aimed to assess the agreement between OptoTab SERIES, alternating Cover Test, Modified Thorington test, and Von Graefe method in measuring heterophoria and accommodative convergence over accommodation (AC/A) ratio. In an initial step, heterophoria was assessed at both distance and near in [...] Read more.

The study aimed to assess the agreement between OptoTab SERIES, alternating Cover Test, Modified Thorington test, and Von Graefe method in measuring heterophoria and accommodative convergence over accommodation (AC/A) ratio. In an initial step, heterophoria was assessed at both distance and near in a cohort of 76 healthy young volunteers using the previously described tests. Subsequently, to determine the AC/A ratio, near-vision measurements were repeated with +1.00 D and −1.00 D lenses. All tests were performed in a randomized order across participants under consistent conditions. Significant differences were found between the Modified Thorington test and all other tests at distance (Wilcoxon test, all p ≤ 0.001) and between Von Graefe and all other tests at near (Wilcoxon test, all p ≤ 0.005). Regarding the AC/A ratio, significant differences were observed between all methods in +1.00 D AC/A ratio, except for the Modified Thorington test vs. the alternating Cover Test (Wilcoxon test, p = 0.024). In the −1.00 D AC/A ratio, differences were observed between OptoTab POCKET and all the other tests (Wilcoxon test, all p ≤ 0.001). The results indicate that all methods are interchangeable except the Modified Thorington test at distance and Von Graefe at near. For the AC/A ratio, only the Modified Thorington test is interchangeable with the alternating Cover Test using +1.00 D lenses and all are interchangeable using −1.00 D lenses except OptoTab POCKET. Full article

(This article belongs to the Special Issue Effects of Optical and Behavioral Factors on the Ocular Accommodation Response)

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4 pages, 1208 KiB

Open AccessCase Report

Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid Haemorrhage

by Olga E. Makri, Iasonas K. Tsekouras, Stylianos N. Mastronikolis, Vasileios E. Panagiotopoulos, Constantine Constantoyannis and Constantinos D. Georgakopoulos

Vision 2024, 8(4), 61; https://doi.org/10.3390/vision8040061 - 7 Oct 2024

Viewed by 1072

Abstract

We report an unusual case of pupil-involving third nerve palsy associated with Terson’s syndrome that resulted in the diagnosis of a right posterior communicating artery aneurysm. Interestingly, Terson’s syndrome presented with Roth spot-resembling features, accompanied by third nerve palsy in a patient without [...] Read more.

We report an unusual case of pupil-involving third nerve palsy associated with Terson’s syndrome that resulted in the diagnosis of a right posterior communicating artery aneurysm. Interestingly, Terson’s syndrome presented with Roth spot-resembling features, accompanied by third nerve palsy in a patient without any disturbance of consciousness. To our knowledge, the association of Terson’s syndrome with third nerve palsy has not been described before in the absence of radiologically diagnosed subarachnoid haemorrhage. We present the case of a 48-year-old woman who presented in the Department of Emergencies of the University Hospital of Patras with right-sided complete-pupil-involving third nerve palsy combined with bilateral Terson’s syndrome. More precisely, fundoscopy revealed multiple scattered intra- and pre-retinal haemorrhages in both eyes, while some retinal haemorrhages had a white-centred pattern resembling Roth spots. Neurological examination revealed no nuchal rigidity or any other neurological signs. The Glasgow coma scale score was 15/15. A cerebral computed tomography angiography revealed a 5 mm aneurysm of the right posterior communicating artery and the patient underwent a microvascular clipping operation after craniotomy. The significant contribution of the ophthalmological consultation to the appropriate and timely diagnosis and management of a life-threatening condition is highlighted. Full article

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11 pages, 622 KiB

Open AccessArticle

Measuring the Pupillary Light Reflex Using Portable Instruments in Applied Settings

by Nicola S. Gray, Menna Price, Jennifer Pink, Chris O’Connor, Ana Antunes and Robert J. Snowden

Vision 2024, 8(4), 60; https://doi.org/10.3390/vision8040060 - 1 Oct 2024

Viewed by 1653

Abstract

The early components of the pupillary light reflex (PLR) are governed by the parasympathetic nervous system. The use of cheap, portable pupillometry devices may allow for the testing of parasympathetic-system health in field settings. We examined the reliability of two portable instruments for [...] Read more.

The early components of the pupillary light reflex (PLR) are governed by the parasympathetic nervous system. The use of cheap, portable pupillometry devices may allow for the testing of parasympathetic-system health in field settings. We examined the reliability of two portable instruments for measuring the PLR and their sensitivity to individual differences known to modulate the PLR. Parameters of the PLR were measured in a community sample (N = 108) in a variety of field settings. Measurements were taken using a commercial pupillometer (NeuroLight, IDMED) and an iPhone using the Reflex Pro PLR analyser (Brightlamp). The parameters of baseline pupil diameter, constriction latency, amplitude and relative amplitude of constriction, and constriction velocity were measured. Individual differences related to age, levels of anxiety, and post-traumatic stress disorder (PTSD) symptomology were assessed. Some measures could not be attained using the iPhone under these field conditions. The reliability of the measures was high, save for the measurement of contraction latency which was particularly unreliable for the iPhone system. The parameters of the PLR showed the same internal relationships as those established in laboratory-based measurements. Age was negatively correlated with all the reliable PLR parameters for both systems. Effects of anxiety and PTSD symptomology were also apparent. The study demonstrated that a hand-held portable infrared pupillometer can be used successfully to measure the PLR parameters under field settings and can be used to examine individual differences. This may allow these devices to be used in workplaces, sports fields, roadsides, etc., to examine parasympathetic activity where needed. Full article

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15 pages, 2802 KiB

Open AccessArticle

Preferred Distance in Human–Drone Interaction

by Elisabeth Maria Wögerbauer, Christoph von Castell, Robin Welsch and Heiko Hecht

Vision 2024, 8(4), 59; https://doi.org/10.3390/vision8040059 - 1 Oct 2024

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Abstract

In two augmented-reality experiments, we transferred the paradigm of interpersonal distance regulation to human–drone interaction. In the first experiment, we used a simple spherical drone model and explored how both hovering height and approach angle affect the preferred distance. Drone height above the [...] Read more.

In two augmented-reality experiments, we transferred the paradigm of interpersonal distance regulation to human–drone interaction. In the first experiment, we used a simple spherical drone model and explored how both hovering height and approach angle affect the preferred distance. Drone height above the ground had a strong effect. The preferred distance to the drone was larger than that typically found toward human actors, in particular, when the drone trajectory was very high. In the second experiment, we sought to gain a deeper understanding of the factors that may influence this effect. In addition to the simple spherical drone model used in the first experiment, we also varied its appearance and attachment to the ground. Surprisingly, anthropomorphic features increased preferred distances. We, therefore, discuss the extent to which social aspects and subjectively perceived danger influence the preferred distance for interaction with drones, which thus need to be considered in the design of human–drone interaction. Full article

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27 pages, 2184 KiB

Open AccessReview

The “What” and “How” of Pantomime Actions

by Raymond R. MacNeil and James T. Enns

Vision 2024, 8(4), 58; https://doi.org/10.3390/vision8040058 - 26 Sep 2024

Viewed by 1246

Abstract

Pantomimes are human actions that simulate ideas, objects, and events, commonly used in conversation, performance art, and gesture-based interfaces for computing and controlling robots. Yet, their underlying neurocognitive mechanisms are not well understood. In this review, we examine pantomimes through two parallel lines [...] Read more.

Pantomimes are human actions that simulate ideas, objects, and events, commonly used in conversation, performance art, and gesture-based interfaces for computing and controlling robots. Yet, their underlying neurocognitive mechanisms are not well understood. In this review, we examine pantomimes through two parallel lines of research: (1) the two visual systems (TVS) framework for visually guided action, and (2) the neuropsychological literature on limb apraxia. Historically, the TVS framework has considered pantomime actions as expressions of conscious perceptual processing in the ventral stream, but an emerging view is that they are jointly influenced by ventral and dorsal stream processing. Within the apraxia literature, pantomimes were historically viewed as learned motor schemas, but there is growing recognition that they include creative and improvised actions. Both literatures now recognize that pantomimes are often created spontaneously, sometimes drawing on memory and always requiring online cognitive control. By highlighting this convergence of ideas, we aim to encourage greater collaboration across these two research areas, in an effort to better understand these uniquely human behaviors. Full article

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Vision, Volume 8, Issue 4 (December 2024) – 12 articles

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