Optometry Commons^™

A Comparison Of Dietary Intake Of Children/Adolescents With And Without Myopia, Niamh Burke, John Butler, Daniel Ian Flitcroft, James Loughman

Conference Papers

Myopia is caused by an eye which has grown too long. The prevalence of myopia has increased drastically in recent years and half of the world’s population is expected to be myopic by 2050.(1) Consequently, a significant increase in sight threatening diseases will follow.(1) Myopia most commonly develops in youth, and we now know that environmental factors affect its development. Nutritional status strongly influences growth and development, including that of the eye. It has been hypothesised, therefore, that nutrition may play a role in this excessive eye growth. Current findings are conflicted, with a clear gap in the evidence.(2,3) Therefore, …

Investigation And Management Of Demodex Folliculorum Blepharitis In Clinical Practice, Orla Murphy

Doctoral

Introduction: Blepharitis is a chronic inflammatory disorder of the eyelid margin. Blepharitis patients routinely present to and are managed by optometrists and ophthalmologists in practice. Demodex folliculorum is associated with anterior blepharitis. Presently, treatment with 50% tea tree oil is recommended by the American Academy of Ophthalmology for Demodex blepharitis. However, over-the-counter products have been developed and marketed at being effective for treating Demodex blepharitis. Purpose: To examine the efficacy of over-the-counter lid hygiene products and warm compress therapy for the treatment of Demodex blepharitis. Methods: Two hundred and forty-six participants were examined at multiple visits over four studies, for …

Optimising Subjective Anterior Eye Grading Precision, Marta Vianya-Estopa, Manbir Nagra, Arnold Cochrane Arnold Cochrane, Neil Retallic Neil Retallic, Dean Dunning, Louise Terry Louise Terry, Aoife Lloyd, James Wolffsohn

Articles

To establish the optimum grading increment which ensured parity between practitioners while maximising clinical precision.

The Spatial Frequency Content Of Urban And Indoor Environments As A Potential Risk Factor For Myopia Development, Daniel Ian Flitcroft, Elise Harb, Christine F Wildsoet

Articles

To examine the hypothesis that the spatial frequency spectra of urban and indoor environments differ from the natural environment in ways that may promote the development of myopia. Methods: A total of 814 images were analyzed from three datasets; University of California Berkeley (UCB), University of Texas (UT), and Botswana (UPenn). Images were processed in Matlab (Mathworks Inc) to map the camera color characteristics to human cone sensitivities. From the photopic luminance images generated, two-dimensional spatial frequency (SF) spectra were calculated and converted to one-dimensional spectra by rotational averaging. The spatial filtering profile of a 0.4 Bangerter foil, which has …

Macular Pigment Optical Density Fluctuation As A Function Of Pupillary Mydriasis: Methodological Considerations For Dual-Wavelength Autofluorescence, Ekaterina Loskutova, John Butler, Gabriela Hernandez-Martinez, Daniel Ian Flitcroft, James Loughman

Articles

Macular pigment (MP), comprising the dietary carotenoids lutein, zeaxanthin and meso-zeaxanthin, is believed to benefit eye health and vision. Numerous clinical and research devices and techniques are currently available to facilitate MP optical density (MPOD) measurement. One of those techniques, dual-wavelength fundus autofluorescence (AF) is being increasingly used for measurement of MP in the eye. There is substantial methodological variation across the published studies that have employed this technique, including in relation to the use of mydriasis, the possible influence of which does not appear to have been addressed in the literature. This prospective cross-sectional study was designed to investigate …

Willingness To Pay For Improved Vision In Mozambique, Stephen Thompson, Kovin Naidoo, Carmen Gonzalez-Alvarez, Geoff Harris, James Loughman

Articles

The burden of vision impairment due to uncorrected refractive error (needing spectacles) in Mozambique is known to be significant. To improve the planning and provision of eye health services, a better understanding of how vision is valued by patients is needed. The willingness to pay (WTP) for improved vision through correcting refractive error was investigated in Nampula, Mozambique, using stated choice and bidding game methodologies. The mean WTP values were found to be 388.92 Meticals (US$13) for stated choice and 469.89 Meticals (US$16) for the bidding game. The mean WTP values for rural dwellers were found to be lower than …

The Efficacy Of Warm Compresses In The Treatment Of Meibomian Gland Dysfunction And Demodex Folliculorum Blepharitis, Orla Murphy, Veronica O'Dwyer, Aoife Lloyd-Mckernan

Articles

Purpose: To investigate and compare the effect of warm compresses on meibomian gland dysfunction and Demodex folliculorum blepharitis.

Methods: Forty-two subjects (13 males, 29 females; mean age of 56.45 years) enrolled and completed the two-month warm compress treatment study. Three warm compress therapies were compared: Warm face cloth, MGDRx EyeBag® and OPTASETM Moist Heat Mask. Subjects attended for four visits: baseline, two weeks, four weeks, and eight weeks. Subjective symptoms, osmolarity, non-invasive tear break-up time, ocular surface staining, Schirmer I test, meibum expressibility and clarity, and eyelash manipulation and epilation to assess for the presence of Demodex folliculorum, …

Prevalence Of Colour Vision Deficiency In The Republic Of Ireland Schoolchildren And Associated Socio-Demographic Factors, Síofra Harrington, Peter Davison, Veronica O'Dwyer

Articles

Clinical relevance: Early screening is essential to counsel schoolchildren with congenital colour vision deficiency (CVD) in determining their future career path and to advise teachers of the impact of CVD on classroom difficulties.

Background: Congenital CVD is an X-linked genetic abnormality relatively commonplace in humans. This study aimed to determine the prevalence of congenital CVD in the Republic of Ireland schoolchildren and associated socio-demographic factors.

Methods: A total of 1,626 schoolchildren (882 boys and 744 girls), in two age groups (728 aged 6–7 years and 898 aged 12–13 years) were examined from randomly selected schools. Colour vision …

Flash Vep In Clinically Stable Pre-Term And Full-Term Infants, Anish Kharal, Safal Khanal, Jyoti Baba Shrestha, Gauri Shankar Shrestha, Nabin Paudel

Articles

Purpose

Pre-term infants are at risk of abnormal visual development that can range from subtle to severe. The aim of this study was to compare flash VEPs in clinically stable pre-term and full-term infants at 6 months of age.

Methods

Twenty-five pre-term and 25 full-term infants underwent flash VEP testing at the age of 6 months. Monocular VEPs were recorded using flash goggles on a RETIscan system under normal sleeping conditions. Amplitude and peak time responses of the P2 component in the two eyes were averaged and compared between the two groups. Multiple regression analyses were performed to assess the …

Can Protanopia Be Correctly Diagnosed In Clinical Practice? An Evaluation Of Diagnosis By Four Screening Tests, Peter Davison, Grainne Scanlon

Articles

SIGNIFICANCE

Protanopia is a color vision deficiency (CVD) that is unacceptable for certain occupations. This study compares simultaneously for the first time the ability of three recently revised or developed clinical tests of color vision with the Ishihara test to diagnose protanopia from other color vision deficiencies.

PURPOSE

The objectives were to examine the ability of four clinical tests to differentiate (1) between protan and deutan CVDs in patients with protanopia and deuteranopia, and (2) protanopes and deuteranopes as “strong” deficiencies.

METHODS

The Hardy-Rand-Rittler (4th ed.), City University (3rd ed.), Ishihara, and Mollon-Reffin tests were evaluated against the Oculus Heidelberg …

Herpes Simplex Virus 1 Targets Irf7 Via Icp0 To Limit Type I Ifn Induction, David Shahnazaryan, Rana Khalil, Claire Wynne, Caroline A Jefferies, Joan Ní Gabhann-Dromgoole, Conor C Murphy

Articles

Herpes simplex keratitis (HSK), caused by herpes simplex virus type 1 (HSV‑1) infection, is the commonest cause of infectious blindness in the developed world. Following infection the virus is initially suspended in the tear film, where it encounters a multi‑pronged immune response comprising enzymes, complement, immunoglobulins and crucially, a range of anti‑viral and pro‑inflammatory cytokines. However, given that HSV‑1 can overcome innate immune responses to establish lifelong latency throughout a susceptible individual’s lifetime, there is significant interest in understanding the mechanisms employed by HSV‑1 to downregulate the anti‑viral type I interferon (IFN) mediated immune responses. This study aimed to investigate …

Raman Spectroscopy For The Discrimination Of Autoimmune Disorders, Neha Chaudhary

Doctoral

The bidirectional cooperativity between the innate and adaptive arm of the immune network in response to foreign invaders has long been accepted. Under normal circumstances this response is very effective at eliminating infection, however, inappropriate activation triggered by self components is observed in autoimmune conditions such as Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). Due to the overlapping nature of the symptoms of each of the syndromes, in terms of clinical and laboratory manifestations, and the lack of a single marker predictive methodology, the differential diagnosis and treatment of these patients still proves challenging. With the advent of targeted …

Holographic Sensors For The Detection Of Liquid Phase Analytes, Sabad-E Gul

Doctoral

The aim of this project is to design, fabricate and study experimentally photonic structures created by holographic lithography for application in sensing. The aim is to modify the photonic structures with analyte sensitive materials and view of their application in environmental and biomedical sensing. Two types of photonic structures were investigated in these studies: modified surface relief holographic gratings and volume holographic gratings.

Low-Dose (0.01%) Atropine Eye Drops To Reduce Progression Of Myopia In Children: A Multi-Centre Placebo- Controlled Randomised Trial In The United Kingdom (Champ- Uk) – Study Protocol., Augusto Azuara-Blanco, Nicola Logan, Niall Strang, Peter Allen, Ruth Hogg, Ruth Weir, Paul Doherty, Catherine Adams, Margaret Mcfarland, Evie Gardner, Rejina Verghis, Jennifer Preston, James Loughman, Daniel I. Flintcroft, David Mackey, Samantha Lee, Christopher Hammond, Nathan Congdon, Mike Clarke

Articles

Background/aims To report the protocol of a trial designed to evaluate the efficacy, safety and mechanism of action of low-dose atropine (0.01%) eye-drops for reducing progression of myopia in UK children. Methods Multicentre, double-masked, superiority, placebo-controlled, randomised trial. We will enrol children aged 6–12 years with myopia of −0.50 dioptres or worse in both eyes. We will recruit 289 participants with an allocation ratio of 2:1 (193 atropine; 96 placebo) from five centres. Participants will instil one drop in each eye every day for 2 years and attend a research centre every 6 months. The vehicle and preservative will be …

Association Of Total Zinc Intake With Myopia In U.S. Children And Adolescents, Niamh Burke, John Butler, Daniel Ian Flitcroft, Daniel Mccartney, James Loughman

Articles

Significance: This present study advances our knowledge on the role of lifestyle factors in myopia (short-sightedness), specifically dietary factors. It has been suggested in previous studies that lower zinc status is associated with myopia; however, this article shows no relationship between dietary zinc intake and myopia in U.S. adolescents. Purpose: It has been suggested that low zinc levels may contribute to the development of myopia. The aim of the present study is to examine, for the first time in a Western population, the association of total dietary and supplement zinc intake with myopia. Methods: A total of 1095 children/adolescents aged …

Clinical Accuracy Of The Nidek Ark-1 Autorefractor, Nabin Paudel, Sameep Adhikari, Ajit Thakur, Bhairaja Shrestha, James Loughman

Articles

Autorefractors are commonly used by eye care practitioners worldwide as a starting point for clinical prescribing and by researchers as an instrument to study development of refractive errors and accommodation. This study demonstrates that the Nidek ARK-1 provides a reasonable and repeatable estimate of refractive error.

Prevalence Of Ametropia, Amblyopia And Visual Impairment In Schoolchildren In Ireland, Siofra Harrington

Doctoral

Background: Uncorrected refractive error is an avoidable cause of visual impairment (Naidoo et al., 2016). Currently, there is a lack of adequate data on eye and vision disorders in schoolchildren in Ireland. Accurate prevalence estimates of refractive error and vision disorders are necessary to determine their impact on public health and to assess the need for interventions (McCarty and Taylor, 2000). Purpose: This study reports the prevalence of ametropia, presenting visual impairment, amblyopia and provides population norms for ocular biometric measures in schoolchildren in Ireland. Links between refractive error and demographic and lifestyle factors were investigated. The impact of poor …

Consort Checklist, Myopia Outcome Study Of Atropine In Children (Mosaic): Design And Methodology, Saoirse Mccrann, Daniel Ian Flitcroft, John Butler, James Loughman

Articles

Purpose

The Myopia Outcome Study of Atropine in Children (MOSAIC) aims to explore the efficacy, safety, acceptability and mechanisms of action of 0.01% atropine for myopia control in a European population.

Methods

MOSAIC is an investigator-led, double-masked, placebo-controlled, randomised clinical trial (RCT) investigating the efficacy, safety and mechanisms of action of 0.01% atropine in myopia progression management. During Phase 1 of the trial, 250 children aged 6-16 years with progressive myopia apply eye drops once nightly in both eyes from randomisation to month 24. No treatment is given during Phase 2 from month 24 to 36 (washout period) for those …

Spirit Checklist, Myopia Outcome Study Of Atropine In Children (Mosaic): Design And Methodology, Saoirse Mccrann, Daniel Ian Flitcroft, John S. Butler, James Loughman

Articles

Purpose

The Myopia Outcome Study of Atropine in Children (MOSAIC) aims to explore the efficacy, safety, acceptability and mechanisms of action of 0.01% atropine for myopia control in a European population.

Methods

MOSAIC is an investigator-led, double-masked, placebo-controlled, randomised clinical trial (RCT) investigating the efficacy, safety and mechanisms of action of 0.01% atropine in myopia progression management. During Phase 1 of the trial, 250 children aged 6-16 years with progressive myopia apply eye drops once nightly in both eyes from randomisation to month 24. No treatment is given during Phase 2 from month 24 to 36 (washout period) for those …

Is Optometry Ready For Myopia Control? Education And Other Barriers To The Treatment Of Myopia, Saoirse Mccrann, Daniel Ian Flitcroft, James Loughman

Other Resources

Background

With the increasing prevalence of myopia there is growing interest in active myopia control. However, the majority of progressive myopes are still prescribed single vision spectacles. This prospective study aims to elucidate the knowledge and attitudes of optometrists toward myopia control, and thereby identify perceived barriers to the implementation of a risk focussed model of myopia management.

Methods

A series of four focus group discussions were conducted involving optometrists in different settings and career stages.

Results

The key finding to emerge is a clear disconnect between academic optometrists, optometry students and clinicians in practice. Academic faculty considered themselves competent …

Myopia Outcome Study Of Atropine In Children (Mosaic): Design And Methodology, Saoirse Mccrann, Daniel Ian Flitcroft, John Butler, James Loughman

Articles

Purpose

The Myopia Outcome Study of Atropine in Children (MOSAIC) aims to explore the efficacy, safety, acceptability and mechanisms of action of 0.01% atropine for myopia control in a European population.

Methods

MOSAIC is an investigator-led, double-masked, placebo-controlled, randomised clinical trial investigating the efficacy, safety and mechanisms of action of 0.01% atropine eyedrops in myopic progression management. During phase 1 of the trial, 250 children aged 6-16 years with progressive myopia apply eye drops once nightly in both eyes from randomisation to month 24. No treatment is given during phase 2 from month 24 to 36 (washout period) for those …

Multivariate Statistical Methodologies Used In In-Vitro Raman Spectroscopy: Simulations And Applications For Drug And Nanoparticle Interactions, Mark Edward Keating

Doctoral

Raman spectroscopy is a growing technology in the fields of in-vitro drug and nanoparticle screening. The label free capability provided by vibrational spectroscopy, as well as the ability of the technique to probe the chemical nature of samples, makes it a good candidate for use in these fields. Crucial to the progress of these methods is the development and validation of robust and accurate multivariate statistical analysis protocols. In this thesis, both established and novel methods are examined using both real and simulated datasets. In particular, simulated datasets are used to validate and assess the accuracy of these methods in …

Mutation Status In Myeloid Malignancies Informs Clinical Insight, Karl Haslam

Doctoral

The last decade has seen significant development in understanding the genetic basis of myeloproliferative neoplasms (MPN), with the underlying somatic mutational landscape revealed by genome and targeted exome sequencing. The aim of this research was to conduct a series of original investigations to develop insight into the utility and clinical application of these disease markers. Initially, three recently identified disease-specific molecular markers (mutations in JAK2, CALR and CSF3R) were utilised to measure the burden of disease post allogeneic transplantation using methods based on quantitative PCR, capillary electrophoresis and Sanger sequencing. The measured variant allelic frequency of the disease was compared …

Is Optometry Ready For Myopia Control? Education And Other Barriers To The Treatment Of Myopia, Saoirse Mccrann, Daniel Ian Flitcroft, James Loughman

Articles

Background: With the increasing prevalence of myopia there is growing interest in active myopia control. However, the majority of progressive myopes are still prescribed single vision spectacles. This prospective study aims to elucidate the knowledge and attitudes of optometrists toward myopia control, and thereby identify perceived barriers to the implementation of a risk focussed model of myopia management.

Implementing A Two-Tiered Model Of Optometry Training In Mozambique As An Eye Health Development Strategy, Diane Van Staden, James Loughman, Kovin Naidoo

Articles

Background: The global burden of vision impairment has been acknowledged by the World Health Organisation as a public health challenge. In order to scale up the production of eye health personnel in developing countries, a tiered model of optometry training was explored in Mozambique.

Imi – Myopia Control Reports Overview And Introduction, James S. Wolffsohn, Daniel Ian Flitcroft, Kate L. Gifford, Monica Jong, Lyndon Jones, Caroline C. W. Klaver, Nicola S. Logan, Kovin Naidoo, Serge Resnikoff, Padmaja Sankaridurg, Earl L. Smith Iii, David Troilo, Christine F. Wildsoet

Articles

With the growing prevalence of myopia, already at epidemic levels in some countries, there is an urgent need for new management approaches. However, with the increasing number of research publications on the topic of myopia control, there is also a clear necessity for agreement and guidance on key issues, including on how myopia should be defined and how interventions, validated by well-conducted clinical trials, should be appropriately and ethically applied. The International Myopia Institute (IMI) reports the critical review and synthesis of the research evidence to date, from animal models, genetics, clinical studies, and randomized controlled trials, by more than …

Myopia Outcome Study Of Atropine In Children (Mosaic): An Investigator-Led, Double-Masked, Placebo-Controlled, Randomised Clinical Trial Protocol, Saoirse Mccrann, Daniel Ian Flitcroft, Niall C. Strang, Kathryn J. Saunders, Nicola S. Logan, Samantha Szeyee Lee, David A. Mackey, John Butler, James Loughman

Articles

Background: The Myopia Outcome Study of Atropine in Children (MOSAIC) aims to explore the efficacy, safety, acceptability and mechanisms of action of 0.01% unpreserved atropine for myopia control in a European population. Methods: MOSAIC is an

A Review Of The Putative Causal Mechanisms Associated With Lower Macular Pigment In Diabetes Mellitus, Grainne Scanlon, James Loughman, Donal Farrell, Daniel Mccartney

Articles

Macular pigment (MP) confers potent antioxidant and anti-inflammatory effects at the macula, and may therefore protect retinal tissue from the oxidative stress and inflammation associated with ocular disease and ageing. There is a body of evidence implicating oxidative damage and inflammation as underlying pathological processes in diabetic retinopathy. MP has therefore become a focus of research in diabetes, with recent evidence suggesting that individuals with diabetes, particularly type 2 diabetes, have lower MP relative to healthy controls. The present review explores the currently available evidence to illuminate the metabolic perturbations that may possibly be involved in MP’s depletion. Metabolic co-morbidities …

Addressing Vision Impairment In Mozambique And The Africa Region, Stephen Thompson, Kovin Naidoo, Joel Bambamba, Vanessa Moodley, Diane Van Staden, Amanda Forde, Kajal Shah, Luigi Bilotto, James Loughman

Articles

The Mozambique Eyecare Project was an international partnership to implement and research eye health education in Mozambique and the Africa region. An optometry degree was developed at Universidade Lúrio, Mozambique. In addition, existing eye health workers were upskilled with training. Researchers from various disciplines evaluated the project and its potential for impact on eye health in the region. The body of evidence generated from the research provides useful lessons for development programmes in general, as well as specific lessons for delivering eye health education and service delivery models for low income settings.

Identification Of Surrogate Biomarkers For The Prediction Of Patients At Risk Of Low Macular Pigment In Type 2 Diabetes, Grainne Scanlon, Daniel Mccartney, John Butler, Ekaterina Loskutova, James Loughman

Articles

Purpose: This cross-sectional study compared macular pigment (MP) levels among persons with Type 2 diabetes relative to healthy controls. Additionally, a range of behavioral, anthropometric, clinical and serum measures were explored as possible predictors of low MP optical density (MPOD) in diabetes.