Optometry Commons^™

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 …

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 …

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.

Lutein And Zeaxanthin: The Possible Contribution, Mechanisms Of Action And Implications Of Modern Dietary Intake For Cognitive Development In Children. [Version 1; Peer Review: 2 Approved], Ekaterina Loskutova, Kajal Shah, Daniel Ian Flitcroft, Annalisa Setti, John Butler, Yvonne Nolan, Nabin Paudel, James Loughman

Articles

No abstract provided.

We Can’T Afford To Turn A Blind Eye To Myopia, Christine Marie Bourke, James Loughman, Daniel Ian Flitcroft, Ekaterina Loskutova, Colm O’Brien

Articles

Background

Myopia is becoming increasingly prevalent throughout the world. It is an overlooked but leading cause of blindness, particularly among the working aged population. Myopia is often considered benign because it is easily corrected with glasses, contact lenses, or refractive surgery. Traditionally myopia has been classified into physiological and pathological subtypes based on the degree of myopia present. Higher levels of myopia are associated with increased risk of pathological complications but it is important to note that there is no safe level of myopia. Even low levels of myopia increase the risk of retinal detachment and other ocular comorbidities which …

Refractive Error And Visual Impairment In Ireland Schoolchildren, Síofra Harrington, Jim Stack, Kathryn Saunders, Veronica O'Dwyer

Articles

Aim To report refractive error prevalence and visual impairment in Republic of Ireland (henceforth 'Ireland') schoolchildren.

Methods The Ireland Eye Study examined 1626 participants (881 boys, 745 girls) in two age groups, 6–7 years (728) and 12–13 years (898), in Ireland between June 2016 and January 2018. Participating schools were selected by stratified random sampling, representing a mix of school type (primary/postprimary), location (urban/rural) and socioeconomic status (disadvantaged/advantaged). Examination included monocular logarithm of the minimum angle of resolution (logMAR) presenting visual acuity (with spectacles if worn) and cycloplegic autorefraction (1% Cyclopentolate Hydrochloride). Parents completed a questionnaire to ascertain participants’ lifestyle. …

Comparison Of Amblyopia In Schoolchildren In Ireland And Northern Ireland: A Population-Based Observational Cross-Sectional Analysis Of A Treatable Childhood Visual Deficit, Síofra Harrington, Karen Breslin, Veronica O'Dwyer, Kathryn Saunders

Articles

Objectives This study reports the prevalence of persistent amblyopia (post-traditional treatment age) in schoolchildren in the Republic of Ireland (henceforth Ireland) and Northern Ireland (NI), UK; populations with broadly similar refractive and genetic profiles but different eye-care systems. Design This is a population-based observational study of amblyopia and refractive error. Setting Recruitment and testing in primary and postprimary schools in Ireland and NI. Participants Two groups identified through random cluster sampling to represent the underlying population; Ireland 898 participants (12–13 years old) and NI 723 participants (295 aged 9–10 years old, 428 aged 15– 16 years old). Main outcome measures …

Risk Factors Associated With Myopia In Schoolchildren In Ireland, Síofra Harrington, Jim Stack, Veronica O'Dwyer

Articles

Aim To examine the demographic and social factors associated with myopia in schoolchildren in Ireland.

Methods Thirty-seven schools participated, representing a mix of urban and rural schools and schools in socioeconomically disadvantaged and non-disadvantaged areas in Ireland. Examination included cyclopleged autorefraction (1% cyclopentolate hydrochloride). Height and weight of participants were measured. Parents filled in a participant’s lifestyle questionnaire, including questions on daily screen time use and daylight exposure. Myopia was defined as spherical equivalent ≤−0.50 D.

Results Data from 1626 participants (881 boys, 745 girls) in two age groups, 6–7 years (728) and 12–13 years (898), were examined. Myopia prevalence …

Comparison Of Amblyopia In Schoolchildren In Ireland And Northern Ireland: A Population-Based Observational Cross-Sectional Analysis Of A Treatable Childhood Visual Deficit, Síofra Harrington, Karen Breslin, Veronica O'Dwyer, Kathryn Saunders

Articles

Objectives This study reports the prevalence of persistent amblyopia (post-traditional treatment age) in schoolchildren in the Republic of Ireland (henceforth Ireland) and Northern Ireland (NI), UK; populations with broadly similar refractive and genetic profiles but different eye-care systems.

Design This is a population-based observational study of amblyopia and refractive error.

Setting Recruitment and testing in primary and post-primary schools in Ireland and NI.

Participants Two groups identified through random cluster sampling to represent the underlying population; Ireland 898 participants (12–13 years old) and NI 723 participants (295 aged 9–10 years old, 428 aged 15–16 years old).

Main outcome measures Monocular …

Ocular Biometry, Refraction And Time Spent Outdoors During Daylight In Irish Schoolchildren, Síofra Harrington, Veronica O'Dwyer

Articles

Background: Previous studies have investigated the relationship between ocular biometry and spherical equivalent refraction in children. This is the first such study in Ireland. The effect of time spent outdoors was also investigated.

Methods: Examination included cycloplegic autorefraction and non-contact ocular biometric measures of axial length, corneal radius and anterior chamber depth from 1,626 children in two age groups: six to seven years and 12 to 13 years, from 37 schools. Parents/guardians completed a participant questionnaire detailing time spent outdoors during daylight in summer and winter.

Results: Ocular biometric data were correlated with spherical equivalent refraction (axial …

Ocular Demodex Folliculorum: Prevalence And Associated Symptoms In An Irish Population, Orla Murphy, Veronica O'Dwyer, Aoife Lloyd-Mckernan

Articles

Purpose To investigate the prevalence of ocular Demodex folliculorum (DF) in an Irish population. To validate a modified Ocular Surface Disease Index questionnaire and employ it to evaluate the relationship between dry eye symptoms and the presence of DF. Methods One hundred and fifty-six subjects were enrolled in an epidemiological cross-sectional prevalence study. Each subject completed a novel questionnaire on ocular symptoms and was assessed for the presence of DF. Data was analysed to assess prevalence and to search for significant links between each symptom and DF. Results An overall prevalence of 68% was found. Total mean number of DF …

Parental Attitudes To Myopia: A Key Agent Of Change For Myopia Control?, Saoirse Mccrann, Daniel Ian Flitcroft, Kevin Lalor, John Butler, Aaron Bush, James Loughman

Articles

Purpose

With the increasing prevalence in myopia there is growing interest in active myopia prevention. This study aims to increase our understanding of parental attitudes to myopia development and control, as a means to inform future health planning and policy. It evaluates, for the first time, the attitude of parents to myopia and its associated risks, as well as assessing the exposure of Irish children to environmental factors that may influence their risk profile for myopia development.

Methods

Parents of 8–13 year old children in eight participating schools completed a questionnaire designed to assess their knowledge of and attitudes towards …

Highly Sensitive Strain Sensor Based On Composite Interference Established Within S-Tapered Multimode Fiber Structure, Ke Tian, Ment Zhang, Gerald Farrell, Ruoning Wang, Elfed Lewis, Pengfei Wang

Articles

In this paper, a novel strain sensor based on composite interference established within an S-tapered multimode (STM) fiber structure is proposed and experimentally demonstrated. The STM fibre structure is simply realized by non-axially tapering a traditional single-mode-multimode-single-mode (SMS) fiber into S-shape using a fusion splicer. This fabricated S-tapered structure provides an extra Mach-Zehnder interferometer (MZI) that is introduced within the multimode fibre (MMF) section; therefore, composite interference based on the inherent multimode interference (MMI) of an SMS and the introduced MZI is successfully established. This resultant composite interference greatly enhances the performance of traditional SMS fibre structures for strain sensing, …

Expanding The Traditional Role Of Optometry: Current Practice Patterns And Attitudes To Enhanced Glaucoma Services In Ireland, Catriona Barrett, James Loughman

Articles

Purpose: To investigate current diagnostic equipment availability and usage for glaucoma casefinding within community optometric practice, and to explore optometrists’ attitudes towards an enhanced scope of clinical practice. Methods: An anonymous survey was developed, validated, and distributed to all optometrists in Ireland. Results: 199 optometrists (27% of registrants) responded to the survey. 87% had access to the traditional triad of tests necessary to conduct adequate glaucoma case finding. Standard automated perimetry was the most commonly absent (13%) of the three essential screening tests. 64% of respondents indicated that monocular direct ophthalmoscopy was their first choice technique for fundus examination. 47% …

Nutritional Supplementation In The Treatment Of Glaucoma: A Systematic Review, Ekaterina Loskutova, Colm O’Brien, Igor Loskutov, James Loughman

Articles

Current treatment strategies for glaucoma are limited to halting disease progression and do not restore lost visual function. Intraocular pressure is the main risk factor for glaucoma, and intraocular pressure–lowering treatment remains the mainstay of glaucoma treatment, but even successful intraocular pressure reduction does not stop the progression of glaucoma in all patients. We review the literature to determine whether nutritional interventions intended to prevent or delay the progression of glaucoma could prove to be a valuable addition to the mainstay of glaucoma therapy. A total of 33 intervention trials were included in this review, including 21 randomized controlled …

Glaucoma Referral Refinement In Ireland: Managing The Sensitivity-Specificity Paradox In Optometric Practice, Catriona Barrett, O'Brien Colm, James Loughman

Articles

Purpose: Glaucoma referral refinement (GRR) has pr ven a successful demand management strategy for glaucoma suspect cases in the United Kingdom (UK). A GRR clinic was established in Dublin, Ireland to investigate the clinical viability of this pathway outside the UK's National Health Service (NHS) structures, and away from the influence of National Institute for Clinical Excellence (NICE) guidance.

A Comprehensive Experimental Study Of Whispering Gallery Modes In A Cylindrical Micro-Resonator Excited By A Tilted Fiber Taper, Vishnu Kavungal, Gerald Farrell, Qiang Wu, Arun Mallik, Yuliya Semenova

Articles

Whispering gallery modes (WGMs) excitation in a cylindrical microresonator formed by a section of silica optical fiber has been studied. Evanescent light coupling into the microresonator is realized using a tapered optical fiber, fabricated by a microheater brushing technique. Several types of silica fibers with different diameters are studied as microresonators, and the influence of the resonator's diameter on the excitation of WGMs is investigated. The excitation of WGMs in a cylindrical fiber resonator were studied with changes to the tilt angle between the microcylinder and the fiber taper in the range of angles from a perpendicular position (0 degrees) …

Addressing Avoidable Vision Impairment In Mozambique And The Africa Region, Stephen Thompson, Kovin Naidoo, Joel Bambamba, Vanessa R. 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 lowincome settings.

Refractive Error And Visual Impairment In Ireland Schoolchildren, Siofra Harrington, Kathryn J Saunders, Veronica O'Dwyer, Jim Stack

Articles

To report refractive error prevalence and visual impairment in Republic of Ireland (henceforth 'Ireland') schoolchildren.

Competency-Based Assessment Of Refractive Error Measurement In A Mozambique Optometry School, Kajal Shah, Kovin Naidoo, Luigi Bilotto, James Loughman

Articles

Background: The aims of this study were to develop a process for assessing refractive error management competence among the first two cohorts of students in a new optometry program at Unilúrio in Mozambique and to understand the effectiveness of implementing the process in the context of a low resource environment. Methods: The assessment methods were developed using information from a literature review and a focus group discussion and implemented on 15 students. Results: The exams consisted of direct observation of two patients, short-answer questions and a structured oral examination. Conclusion: The use of existing checklists and rating skills helped to …

Barriers To Glaucoma Case Finding As Perceived By Optometrists In Ireland, Catriona Barrett, Colm O'Brien, John Butler, James Loughman

Articles

Background: This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system.

Methods: A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practice in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly.

Results: One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra …

Perceived Barriers Of Optometrists To Glaucoma Case Findings In Ireland, James Loughman, Catriona Barrett, Colm O’Brien, John S. Butler

Articles

Background:

This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system.

Methods: A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practise in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly.

Results: One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra …

Time To Refocus Assessment Of Vision In Older Adults? Contrast Sensitivity But Not Visual Acuity Is Associated With Gait In Older Adults, James Loughman, Eoin Duggan, Orna Donoghue,, Rose Anne Kenny, Hilary Cronin, Ciarán Finucane

Articles

Background:

The relationship between measures of visual function and gait related risk factors for falls is unclear. In this study, we examine the relationship between visual function (visual acuity [VA] and contrast sensitivity [CS] at multiple spatial frequencies) and quantitative spatiotemporal gait, using a large, nationally representative sample of community dwelling older adults.

Methods: Participants aged 50 and over were recruited as part of The Irish Longitudinal Study on Ageing (TILDA). VA was measured with the LogMAR chart according to the Early Treatment of Diabetic Retinopathy Study protocol. CS was measured at five spatial frequencies ranging 1.5 to 18 cycles …

Novel Myopia Genes And Pathways Identified From Syndromic Forms Of Myopia, Daniel Ian Flitcroft, James Loughman, Christine F. Wildsoet, Cathy Williams, Jeremy A. Guggenheim

Articles

Clinical phenotypes and syndromes that have refractive errors as a recognized feature were identified using the Online Mendelian Inheritance in Man (OMIM) database. One hundred fifty-four unique causative genes were identified, of which 119 were specifically linked with myopia and 114 represented syndromic myopia (i.e., myopia and at least one other clinical feature). Myopia was the only refractive error listed for 98 genes and hyperopia and the only refractive error noted for 28 genes, with the remaining 28 genes linked to phenotypes with multiple forms of refractive error. Pathway analysis was carried out to find biological processes overrepresented within these …