Optometry Commons^™

Thank You To Our 2025-26 Reviewers, Paul B. Freeman Od, Raelyn Ottenbreit Od

Optometric Clinical Practice

Reviewers

There's No Vision Like Low Vision: Living With And Serving Those With Macular Degeneration And Stargardt Macular Dystrophy, Paul B. Freeman Od

Optometric Clinical Practice

Book Review: Perski T, There's No Vision Like Low Vision: Living with and Serving Those with Macular Degeneration and Stargardt Macular Dystrophy, Inicio Press, 2025. 306 pages, Paperback, $14.99, ISBN 978-1-998315-48-2, Kindle $9.99 ISBN 978–1– 998315– 49–9

But Mommy, I Can See!, Paul B. Freeman Od

Optometric Clinical Practice

Book Review: Slotnick S, But MOMMY, I can SEE! Illustrations Daniel W. Miller, Newman Springs; 2024. 76 pages, Paperback, $20.95, ISBN: 979-8-88763-556-9, Hardcover, $32.95, ISBN: 979-8-89617-040-2, eBook, $9.99, ISBN: 979-8-88763-557-6

Giant Cell Arteritis: A Case Study And Review Of Treatment, Andrew Di Mattina Od, Jeffrey Sterling Od, Heather Whyte Od

Optometric Clinical Practice

Background: Giant cell arteritis (GCA) is the most common vasculitis affecting individuals over 50, and frequently leads to severe ischemic complications, most notably irreversible vision loss. Early diagnosis and prompt, aggressive treatment with corticosteroids is paramount to protect the fellow eye. The multifaceted clinical presentation of GCA, sometimes with atypical or sequential ocular involvement, can pose significant diagnostic challenges. This paper reviews current understanding of GCA pathophysiology, diagnosis, and current management strategies.

Case Report: A 70‑year‑old man presented with “cracked glass” vision in his right eye and was diagnosed with a branch retinal artery occlusion (BRAO). Two weeks later he …

Pentosan Polysulfate Sodium (Pps, Elmiron) Maculopathy Demonstrates The Importance Of Coordinated Care From A Low Vision Perspective, Charlotte I. Spada Od, Stephanie Schmiedecke Barbieri Od, Patricia Sanchez Diaz Dvm, Phd, Jeffrey Rabin Od, Phd

Optometric Clinical Practice

Background: Pentosan polysulfate sodium (PPS, Elmiron®) is a widely used medication to reduce pain caused by interstitial cystitis, a bladder disorder most often affecting females. PPS maculopathy is a novel form of toxic retinal disease often not recognized or mistaken for other retinal conditions such as macular degeneration due to the initial similarities on fundus exam. However, when visualized using fundus autofluorescence, affected eyes show characteristic hyper/hypo-autofluorescent patterns.

Case report: A patient taking PPS for 10 years presented with macular changes and complaints of blurry vision and nyctalopia. Clinical, electrodiagnostic, and genetic testing were performed including fundus autofluorescence and …

Outer Macular Holes: A Case Series, Kaitlyn J. Moore Od, Katherine Dunatov Od, Wendy Mcgonigal Od, Karen Reeves Od

Optometric Clinical Practice

Background: Outer foveal microdefects (OFMDs) are small focal photoreceptor interruptions that often present with minimal symptoms and are best identified using optical coherence tomography (OCT).

Case Series: This report describes three cases of outer foveal microdefects discovered incidentally during routine eye examinations.

Conclusion: These cases highlight the importance of OCT in detecting subtle macular abnormalities that may be missed on clinical examination.

Outcomes Of A Vision Care Program That Provides Comprehensive Eye Exams To Children Who Have Failed School Screenings In The San Antonio Northside Independent School District, Raelyn Ottenbreit Od, Timothy Wingert Od, Chantelle Ribisi Od, Elizabeth Marunde Od

Optometric Clinical Practice

Purpose: To determine the impact of a program that provides a comprehensive eye exam to children who failed a vision screening.

Method: Seven hundred seventeen students from the San Antonio Northside Independent School District (NISD) received a comprehensive eye examination. The records of these students were retrospectively analyzed to determine the impact of the exam on this population.

Results: The mean improvement in visual acuity after receiving a comprehensive eye exam at the Rosenberg School of Optometry was approximately five- and one-half lines of acuity. In addition to refractive error, other conditions related to eye coordination and ocular …

The Other Visual Acuity, Paul B. Freeman Od

Optometric Clinical Practice

Editorial

The Effects Of Age Related Ocular Diseases On Nighttime Driving Within Geriatric Populations, Donovan J. O'Keefe

Undergraduate Research Symposium

Driving at night is a task that places large demands onto the sensory system as a whole, and in particular, the visual system. As a task that already comes with an increased risk when compared to daytime driving, various factors can contribute to how safely one can drive on a roadway. As individuals progress in age, age-related ocular diseases can develop. These ocular diseases further impair vision, which can lead to an overall decrease in road safety. Three of the most common of these diseases include Open-Angle Glaucoma, Dry Age-Related Macular Degeneration, and Cataracts. Understanding how each of these diseases …

Artificial Intelligence-Assisted Retinal Imaging For Chronic Disease Detection, Prediction, And Screening, Shivani Gandhi

Master's Projects and Capstones

A retinal image may reveal more than eye disease; it may also show early signs of chronic illness elsewhere in the body. Diabetes, hypertension, cardiovascular disease, and chronic kidney disease can develop before symptoms become noticeable, making earlier detection an important public health goal. Advances in artificial intelligence have created new possibilities for using retinal images to identify patterns linked to these conditions. This scoping review examined how Artificial Intelligence -assisted retinal imaging has been used for chronic disease detection, prediction, and screening, along with the practical and health-equity factors that may influence its use.

To map the current evidence, …

Improving Diabetic Retinopathy Screening Among Adults With Diabetes In Boston, Massachusetts: A Policy Brief For Primary Care Implementation, Amber L. Auger

Capstones

No abstract provided.

Electrophysiological Retinal Changes In Aging And Its Implication In Alzheimer’S Disease, Samuel Jacob Haskins

ETDs from 2020-2029

Alzheimer’s disease remains one of the most expensive and fatal diseases facing medical practitioners to this day. According to the CDC, statistics show that it is the seventh leading cause of death worldwide. In addition to fatalities, there is a tremendous financial and emotional cost of dementia to the patient and surrounding caregivers. Improved screening techniques and new treatments for this disease are a priority of several institutes within the NIH. Early detection and early intervention are critical to improve the outcomes of patients worldwide. Amyloid beta plaques and neurofibrillary tangles (NFT) are two of the most important protein aggregates …

Floaters, Kyle Gyumin Dong

Masters Theses

The eye is often regarded as the primary sensory organ of the human body, and the ocular system as our most reliable means of perceiving the world.

With vision, we travel across vast distances through telescopes to expand our knowledge of the observable universe and peer into the hidden world of atoms through microscopes. At the same time, we seek divinity from apparitions in the clouds, broaden the range of colors visible under closed eyelids, and catch a brief glimpse of the future in clairvoyant dreams.

My photographic practice oscillates across this spectrum. Between reason and intuition, between the measurable …

Convergence And Divergence Of Opinion About Treatment Of Binocular Vision Disorders Among Vision Care Professionals, Sonia Young

Dissertations

There are three distinct professions prominent in the field of pediatric vision care. They are ophthalmology, optometry and orthoptics. All professions are integral to the detection and treatment of pediatric binocular vision disorders. However, distinct schools of thought exist to describe the best approach to pediatric binocular vision disorders and their treatments. Literature often highlights two opposing schools of thought represented by the “medical” and “behavioral” approaches. While there is academic debate about the merits and pitfalls of either approach, there is a paucity of nuanced perspectives which more closely resemble the ways in which pediatric ocular clinicians approach diagnosis …

Engineering Silicone Magnetic Fluids For Localized Radiation Attenuation During Ocular Melanoma Brachytherapy, Zachary L. Caprow

All Dissertations

Ocular melanoma is commonly treated using plaque brachytherapy; however, radiation-induced damage to healthy ocular tissues frequently results in partial or complete vision loss. This work investigates the development of an injectable, magnetically responsive silicone magnetic fluid designed to localize adjacent to the tumor and attenuate low-energy gamma radiation during treatment.

The material system consists of iron oxide nanoparticles surface-functionalized with a siloxane polymer, in which the nanoparticles provide magnetic responsiveness and radiation attenuation, while the polymer coating ensures colloidal stability, injectability, and biocompatibility. A one-pot synthetic approach was developed wherein a functionalized siloxane polymer containing iron-affinitive groups was reacted with …

Optimisation Of Photosensitive Recording Materials For Broadband Holographic Optical Elements, Michael Murray

Doctoral

The introduction of broadband (white) LED outdoor lighting has led to significant energy savings. However, this has come at the cost of increased light pollution which has negative impacts both on ecological systems and human health. This light pollution is largely the result of the lack of control measures for the directionality of the light emitted by outdoor LED lighting. The lack of directionality also results in higher energy consumption in order to compensate for the light scattered to the atmosphere and sufficiently illuminate the target area. In this thesis holographic optical elements (HOEs) are proposed as a complementary technology …

Keratopigmentation: A Comparative Review Of Safety, Indications, And Clinical Outcomes, Emmy L. Colon Alamo

Undergraduate Scholarship and Creative Works

Throughout the years, there has been an upsurge in the quantity of cosmetic procedures aimed at changing eye color or appearance. This trend raises significant concerns about patient safety and visual health, as although many methods are promoted worldwide, their efficacy and, most importantly, safety varies greatly. This review looks at the safety of procedures that alter eye color or appearance, focusing mainly on cosmetic keratopigmentation, which is currently the only legally accepted method for changing eye color in the U.S.

A review of clinical studies was conducted to evaluate the outcomes and complications related to keratopigmentation. Then, these findings …

Effect Of Pre-Training Patients Using A Self-Directed Slideshow Presentation On Visual Field Reliability In First-Time Test Takers, Lillian M. Centlivre B.S., Derek Zahnleuter B.S., Rahul Babu B.S., Chaesik Kim, Kaitlin Ziadeh Md, Hanna Simmons Md, Vivian Rajeswaren Md, Aleskey Parker Williams Do, Jacob Im Md, Aleksey Mishulin Md, Faisal Ridha Al-Timimi Md, Hassan Tokko

Medical Student Research Symposium

Title: Effect of Pre-Training Patients Using a Self-Directed Slideshow Presentation on Visual Field Reliability in First-Time Test Takers

Authors: Lillian Centlivre BS, Derek Zahnleuter BS, Rahul Babu BS, Chaesik Kim BSEE, Kaitlin Ziadeh MD, Hanna Simmons MD, Vivian Rajeswaren MD, Aleksey Parker Williams DO, Jacob Im MD, Aleksey Mishulin MD, Faisal Ridha Al-Timimi MD, Hassan Tokko MD

Background: Visual field (VF) testing is essential for detecting glaucoma, but reliability is limited by patient inexperience and poor fixation. Prior studies report VF test reliability around 59%, primarily attributed to increased fixation loss (FL). Other studies note 75.9% reliability using training videos …

Iris Melanoma: A Case Report And Review, Emily Scully Od, Breyne Middleton Od

Optometric Clinical Practice

Background: Uveal melanoma is the most common primary cancer of the eye. It can be diagnosed with fundus exam and ancillary tests. Metastasis occurs in about half of primary uveal melanoma patients and is very often fatal. The liver is the most common site of metastasis. Iris melanomas are the least common type of uveal melanoma. Choroidal and ciliary body melanoma are the most common. Iris nevi are quite common and the rate of transformation into melanoma is low but early detection is critical given the high mortality rate associated with metastasis.

Case Report: This case highlights the importance of …

Use Of Anterior Segment Optical Coherence Tomography To Manage Acute Corneal Hydrops In Keratoconus, Michelle K. Man Od

Optometric Clinical Practice

Background: Acute corneal hydrops, a rare complication of keratoconus and other corneal ectatic disorders, is characterized by a break in Descemet’s membrane (DM). The subsequent corneal edema caused by leakage of aqueous into the stroma and epithelium may result in corneal scarring that often reduces visual acuity and may mandate corneal transplantation as resolution. The initial diagnosis is sometimes challenging but can be confirmed with anterior segment optical coherence tomography (AS-OCT). AS-OCT is also useful in deciding treatment regimen.

Case Report: This case report discusses the use of AS-OCT to aid in the diagnosis of acute corneal hydrops in a …

Focal Choroidal Excavation Associated With Resolved Central Serous Chorioretinopathy, Loren W. Bennett Od, Katherine M. Mehalik Od

Optometric Clinical Practice

Background: Focal choroidal excavation is a localized concavity of the choroid within the macula defined by its appearance on optical coherence tomography. The condition is typically nonprogressive and often an incidental finding. It may not impact vision, although it can be associated with other visually significant macular pathologies.

Case Report: A 48-year-old male patient presented with a recent history of blurred vision in the left eye. A dilated fundus examination revealed a discrete area of pigment mottling in the macula; both the history and clinical appearance were consistent with resolved central serous chorioretinopathy. Optical coherence tomography did not show residual …

We Are Each One Second Away From Being Someone Else's Patient, Paul B. Freeman Od

Optometric Clinical Practice

Editorial

Birdshot Chorioretinopathy: A Review Of Diagnosis And Treatment, Jill Gottehrer Od, Steven Follansbee Od

Optometric Clinical Practice

Background: Birdshot chorioretinopathy is a rare, bilateral chronic uveitis resulting in choroidal and retinal inflammation in the form of vasculitis, papillitis, and/or macular edema. For an accurate diagnosis, a thorough patient history, fundoscopic exam, and appropriate ancillary testing are necessary.

Case Report: A 49-year-old male presented to the eye clinic due to vitreous floaters in both eyes that had worsened over the last year. The patient was new to the clinic with no prior history of eye examinations. At presentation, a mild vitritis was noted along with small, multiple white dots in the posterior pole of both eyes. Ancillary testing, …

A Case Of Adolescent Papilledema Secondary To Oral Hormonal Contraceptives, John D. Tassinari Od, Phil Kwok Od

Optometric Clinical Practice

Background: Papilledema, optic disc swelling secondary to elevated intracranial pressure (ICP), is a medical emergency given the gravity of possible disease etiologies, including but not limited to intracranial mass.

Case Report: A 12-year-old female with normal body mass index developed marked headaches and subsequently manifested bilateral swelling of the optic discs and retinal folds. Scanning laser ophthalmoscopy, particularly in the fundus autofluorescence mode, provided a striking image of the retinal folds. The posterior segment abnormalities were accompanied by reduced visual acuity and corresponding visual field defects. The edema of the optic nerve and retinal fluid were worse in her left …

Eating For Healthy Eyes: The Role Of Nutrition In Ocular Health, Brianna Stroh

Honors Program: Senior Projects (Public)

The central research question of this thesis asks: How does nutrition influence ocular health overall and the impact of nutrition on the development or progression of common eye diseases? Building upon existing research in optometry/ophthalmology, nutrition science, and public health, this project examines the physiological mechanisms linking diet to eye health and evaluates how specific nutrients and dietary patterns contribute to disease prevention and visual function. This thesis employs a comprehensive review of peer-reviewed literature to evaluate the relationship between nutrition and ocular disease. Key areas of focus include the role of oxidative stress in eye disease development, the protective …

Novel Retinal Biomarker Development In Early Alzheimer’S Disease, Swetha Ravichandran

ETDs from 2020-2029

Alzheimer’s disease is a progressive neurodegenerative disorder that causes damage to the neurons that are present in the brain. Progress in the management and treatment of AD is limited by lack of early diagnostics, which are critical to the development of effective therapies. It is therefore critical to develop non-invasive/cost efficient biomarkers to aid in early diagnosis and interventions to prevent or delay dementia onset. While Positron Emission Tomography (PET) and cerebrospinal fluid assessment have greatest utility, they are not routinely used because they are expensive and invasive, respectively. Retinal imaging offers a promising, low-cost, and non-invasive avenue for detecting …

Relationship Between Corneal Biomechanics In Sjögren’S Disease And Risk Factors For Glaucoma Development, Isabella Grace Simmons

ETDs from 2020-2029

Both Sjögren’s disease and glaucoma are known to have abnormal corneal biomechanics that impact their disease progression. The pathophysiology of Sjögren’s disease may also increase the likelihood of developing glaucoma. However, we do not yet know whether the prevalence of risk factors associated with glaucoma in Sjögren’s patients is due to underlying weakened corneal biomechanics. Oculus Corvis ST will be used to evaluate the corneal biomechanics in Sjögren’s patients in relation to the inflammatory mediators in the tear film. These properties will then be correlated with retinal nerve fiber layer and ganglion cell layer thickness. Evaluating these findings will provide …

Holographic Sensors For The Detection Of Volatile Organic Compounds, Graceson Antony

Doctoral

Volatile organic compound (VOC) monitoring at parts-per-million (ppm) concentration levels is essential for occupational safety, indoor air quality, and regulatory compliance. Although holographic gas sensors have been widely investigated, most operate in reflection mode as qualitative visual indicators, with limited quantitative evaluation of sensing mechanisms and scarce systematic demonstrations of repeatable multi-cycle validation for VOCs at ppm concentrations. A physics-based optimisation framework for transmission-mode holographic gas sensors which can bridge this gap has remained largely undeveloped.

This thesis presents the development and optimisation of real-time transmission-mode volume phase transmission holographic grating (VPTHG) sensors for ppm-level VOC detection. A comprehensive theoretical …

Point Of Care Ultrasound For Rapid Identification Of Central Retinal Artery Occlusion And Subsequent Vision Rescue Utilizing Intravenous Alteplase, Joseph Pepe, Karl Kasischke, Calen Hart

Florida Journal of Emergency Medicine (FJEM)

Central retinal artery occlusion (CRAO) is a rare but critical diagnosis to make in patients with acute vision loss. Cases of central retinal artery occlusion historically have a poor prognosis due to delayed presentation, lack of early identification, and limited effective treatment options. Due to these challenges, patients are often left with permanent loss of vision.

We present a case of a male patient in his late 70s with sudden onset of loss of vision to the right eye. Identification of CRAO was made utilizing point of care ultrasound (POCUS). After discussion with neurology, the patient was treated with alteplase …

Through The Eyes Of Time, Shaneece Prince, Steven Indelicato

Publications and Research

Frames have been a staple throughout history, however in recent times, a trend of having multiple pairs of glasses opposed to one, life lasting pair, has emerged. As a result, frames have piled up in landfills contributing to the polluting of our environment. Through the analysis of previously recorded studies and statistics, conclusions of the eyewear industry's growing impact on society and the planet were formed.

Millions of frames are in constant circulation, studies show that up to 31% of spectacle wearers out of a group of 375, disposed of their eyewear in the trash. The lifespan of popular eyewear …