Optometry Commons^™

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 …

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 …

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 …

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 …

Translational Research On Color Vision: From Mechanisms To Performance Enhancement In Diverse Settings, Jewearly Lundby

Theses & Dissertations

This dissertation investigated the mechanisms and applications for optimizing color vision performance across diverse contexts. In a world where color cues augment critical decisions to optimize performance and safety in transportation (e.g., aviation, railway), military, law enforcement, medical diagnostics, and myriad occupational tasks, deficiencies in color perception pose significant challenges. By uniting four interrelated studies, this work explored intrinsic retinal processes, assistive technologies for deficiencies, and novel pathways that challenge conventional understandings of vision. The research bridged fundamental vision science with applications in occupational settings, low vision rehabilitation, and clinical diagnostics, ultimately aiming to optimize color performance.

The first study …

Attitudes Of Optometrists Towards Referring Patients For Nutrition And Lifestyle Changes To Treat Diabetic Retinopathy And Age-Related Macular Degeneration, Samantha Chapman

All ETDs from UAB

Some ocular diseases, including diabetic retinopathy and age-related macular degeneration, have direct links to systemic diseases or the condition of the body as a whole. Specific diet and lifestyle changes have been studied in relation to these two diseases and, while it is not within the scope of optometry to prescribe these changes for patients, an optometrist may refer to a variety of specialists so that patients can receive the most holistic care available. The primary goal of this study is to assess the attitudes of currently practicing United States optometrists towards referring to nutrition and lifestyle professionals and their …

Advanced Interactions Of Directed Energy With Retinal Pigment Epithelial Cells And Their Photochemical And Photothermal Responses, Jin B. Ha

Theses & Dissertations

Excess optical radiation can injure the retina through either rapid heat deposition (photothermal damage) or cumulative photo‑oxidative stress (photochemical damage), yet current laser‑safety limits treat these mechanisms as independent. To test that assumption, this dissertation integrated systematic wavelength, duration and temperature‑controlled laser exposures with live/dead fluorescence imaging in a melanin‑loaded hTERT‑RPE1 monolayer model. First, concurrent 447 nm (blue) and 2 µm (infra‑red) beams delivered for 200 s demonstrated a strong thermal–photochemical synergy: each beam alone was sub‑threshold (≤25 % lethality) but together produced 100 % RPE death without exceeding 50 °C, proving that modest heating markedly lowers the photon dose …

The Interplay Of Accommodation And Oculomotor Vergence Within Young Adults With Binocularly Normal Vision And Typically-Occurring Convergence Insufficiency, Sebastian Fine

Dissertations

Concerted binocular coordination evoking oculomotor and refractive responses to visual stimuli are essential to daily function. Oculomotor dysfunctions can inhibit binocular responses to visually-near stimuli and have high comorbidities to accommodative dysfunctions. Three visual cues for inward (convergent) and outward (divergent) oculomotor movements, when presented concertedly create natural-viewing conditions: disparity- the binocular difference in light cast onto the fovea due to differing ocular perspectives, blur- the acuity of a visual target which stimulates accommodation, and proximal- the perceived distance of a visual stimuli based on size.

This study aims to quantitatively investigate oculomotor vergence and accommodation performances between individuals with …

Guidelines For The Creation And Implementation Of A School-Based Vision Program For The Greater Seattle Area, Suzanna P. Gill

Honors Projects

Proper vision care contributes to a child’s ability to perform academically as well as their overall health and wellbeing. Pediatric vision care begins with vision screening, which occurs in public schools in Washington state. These vision screenings allow for possible vision issues to be identified in children. They are not, however, a replacement for eye examinations that help determine what is causing the problem and provide treatment. A substantial proportion of children that are recommended to receive the exams will not, partially because Washington does not require parents to take their children to eye care professionals. These children are more …

Molecular Mechanism Of Congenital Cataract Caused By G91 Deletion In Cryβa1, Akosua Konadu Boateng

All ETDs from UAB

The Deletion of Glycine 91 is a mutational hotspot in the CRYβA1 gene (mutant named βA3ΔG91), which causes autosomal dominant congenital nuclear cataracts in several ethnically diverse populations worldwide. Previous in-vitro studies of recombinant βA3ΔG91 protein revealed that this mutation results in defective protein folding, reduced solubility, and oligomerization with other crystallins. While βA3/A1-crystallin is primarily known as a structural protein in the lens, it also plays a role in autophagy regulation in the retinal pigment epithelium (RPE) by controlling endolysosomal acidification through the V-ATPase proton pump. This study employs a novel βA3ΔG91 knock-in mouse model to investigate the pathogenic …

Prevalence Of Meibomian Gland Dysfunction In A Young Adult Population, Tyler Thomas

All ETDs from UAB

Background Meibomian gland dysfunction (MGD) varies in prevalence depending on the demographic and can significantly impact quality of life. There is a lack of research on MGD in young adult, professional student populations. Professional students often experience high levels of stress, reduced sleep, and increased electronic device use, which may elevate their risk for developing MGD. Specific Aims This cross-sectional clinical analysis has two specific aims: (1) to determine the prevalence of MGD in a young adult, professional student population, and (2) to identify potential risk factors and clinical assessments correlated with MGD. Methods A total of 147 professional students …

More Than Meets The Eye: A Phenomenological Study Of Self-Concept, Identity, And Meaning-Making In Adults With Acquired Vision Loss, Melinda M. Szilva

Theses and Dissertations (Comprehensive)

The qualitative research project examines the lived experience of acquired vision loss in adulthood and its impact on the way participants see themselves and the world around them, both sensorially and metaphorically. The research question, “What are the lived experiences of adults with acquired vision loss as they relate to identity and conceptions of self?” is informed by the researcher’s clinical practice as a psychotherapist in a low vision clinic. The dissertation includes a literature review focussed on the psychosocial aspects of vision loss to provide insight into the intended population and context for the study. Data for the phenomenological …

How Scientists Can Investigate Perception: Phenomenological Foundations For Qualitative Research, Kimberly Tucker

Electronic Theses and Dissertations

While medicine makes visible symptoms of disease, phenomenology provides a different tool for making illness experience visible. Phenomenology offers a tool for a new kind of description and a different kind of knowledge of disease. It holds a unique epistemic power through the descriptions it generates through the application of the transcendental phenomenological method. Husserl’s method, outlined in Ideas I, provides the steps for its implementation in clinical research. This dissertation explores the application of the transcendental phenomenological method as a foundation for research on perception, with the goal of characterizing phenomenological validity as a proper goal of medical epistemology. …

Corneal Transplants And Their Impact, Bianca Estrada

Honors Capstones

A corneal transplant, also called keratoplasty or corneal grafting, is a type of surgery where damaged or diseased corneal tissue is replaced by a healthy donor cornea. The first successful corneal transplant was performed in 1905 by Dr. Eduard Zirm, but since then, surgical advancements have developed greatly, leading to more beneficial outcomes. Corneal blindness is a major form of reversible blindness that is manageable with healthy donor cornea transplantation. Other recipients or possible candidates for corneal transplantation include those with keratoconus, Fuchs’ dystrophy, eye infections, or eye injuries. This remarkable surgery is now one of the most common transplant …

Role Of Customized Visual And Multifactorial Interventions In Preventing Falls Among Individuals With Visual Impairment In South India, Ramya S

Theses and Dissertations

Falls are the second leading cause of unintentional injuries and extensively studied among the elderly. Hence, intervention studies for falls prevention are restricted to the elderly with or without visual impairment (VI). Even among studies with VI, strategies for treatable VI are widely explored. Hence this study aimed to understand falls and interventions that may reduce falls in all the age groups especially among those with untreatable VI.

This mixed methods study included identification of subjects aged ≥ 18 years with VI from clinical records of Medical Research Foundation, Chennai and details of previous history of falls were enquired over …

Oral Administration Of Alpha-Cyclodextrin Corrects Diabetes Induced Retinopathy And Bone Marrow Pathology By Modulation Of The Gut-Retina Axis., Yvonne Adu-Agyeiwaah

All ETDs from UAB

Diabetic retinopathy represents a common complication of diabetes, exerting a significant financial burden globally across nations, particularly impacting the working-age population and thereby affecting productivity. Extensive investigations have unveiled its multifaceted etiology, implicating a convergence of diverse causative factors. Notably, seminal studies such as the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study have underscored the pivotal role of cholesterol dysregulation and dyslipidemia in the pathogenesis of diabetic retinopathy. This dysregulation stems from an imbalance characterized by heightened cholesterol production coupled with deficient cholesterol efflux or removal mechanisms. Liver X receptors (LXRs), ligand-activated nuclear receptors function in transcriptional …

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …

Aligning Eye Care Provider Beliefs With Behaviors: Exploring And Improving Ocular Surface Disease Decision-Making In A Cataract Surgery Clinic, Amy Hellem

Communication (PhD) Dissertations

Millions of cataract surgeries are performed every year in the United States, yet both surgeon reports and patient reports indicate that practices are not utilizing the diagnostic tests and treatments that are advocated in the medical literature to identify and manage ocular surface disease prior to surgery. As a result, patients risk suffering several significant consequences with regard to their vision, comfort and safety. Personal observations from my 25 years of experience working with ophthalmologists and optometrists led to curiosity regarding the root cause of undertreatment of ocular surface disease. Specifically, I had the impression that eye care providers held …

Exploring The Impact Of Caffeine, Alcohol, And Opioids On Intraocular Pressure: A Comprehensive Analysis Of Short-Term And Long-Term Effects On Vision, Jake Prieto

CMC Senior Theses

Coffee, alcohol, and opioids are addictive drugs commonly used in modern society, yet their impact on ocular health remains ambiguous. This systematic review aims to elucidate this ambiguity by examining their effects on intraocular pressure (IOP). Utilizing IOP as a metric, both short-term and long-term effects are evaluated across individuals with irregular IOP levels and healthy subjects. Furthermore, the study analyzes choroidal thickness as an additional measure to reinforce or challenge the findings regarding IOP, leveraging the inverse relationship between the two metrics concerning elevated IOP-related illnesses, such as open-angle glaucoma (OAG).

A comprehensive literature search was performed through Google …

The Importance Of Contrast Sensitivity, Color Vision, And Electrophysiological Testing In Clinical And Occupational Settings, Frances Silva

Theses & Dissertations

Visual acuity (VA) is universally accepted as the gold standard metric for ocular vision and function. Contrast sensitivity (CS), color vision, and electrophysiological testing for clinical and occupational settings are warranted despite being deemed ancillary and minimally utilized by clinicians. These assessments provide essential information to subjectively and objectively quantify and obtain optimal functional vision. They are useful for baseline data and monitoring hereditary and progressive ocular conditions and cognitive function. The studies in this dissertation highlight the value of contrast sensitivity, color vision, and cone specific electrophysiological testing, as well as the novel metrics obtained with potential practical clinical …

Acquired Brain Injury: A Vision Screening Protocol For Occupational Therapists, Sebastian Cheung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists have a unique set of skills that allow them to assess individuals with an acquired brain injury who have visual impairments. However, it is frequently neglected in practice owing to a lack of confidence, knowledge, or training. There is a need for a vision screening protocol that will help occupational therapists learn more about visual impairments in adults with an acquired brain injury (ABI) and feel more confident in their ability to identify them. This quality improvement capstone project was a feasibility study and consisted of a sample size of N = 6, utilizing a one group pretest-posttest …

Importance Of Eye Exams As A Secondary Preventative Measure For Diabetic Retinopathy: Winning The War On Blindness, Alondra S. Arredondo, Olivia Demeyer, Rachel Louise Pfenning-Wendt, Samuel Wolfe

All Electronic Theses and Dissertations

Despite current efforts by medical professionals to reduce the prevalence of diabetic retinopathy (DR), a microvascular complication of uncontrolled diabetes, this noncommunicable disease remains the leading cause of preventable vision loss worldwide (Cheloni et al., 2019). Research estimates 90% of DR cases could be prevented if detected early through routine eye exams, yet certain social determinants of health still remain a significant barrier for many individuals to receive this care. According to Wong & Sabanayagam (2020), only 25% of DM patients in developing countries receive routine care with adequate eye screenings. The goal of this community service project was to …

Differential Mechanisms Of Intestinal Inflammation Drive Pathogenesis Of Diabetic Retinopathy In Type 1 And Type 2 Diabetes, Jason Levi Floyd

All ETDs from UAB

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and, along with diabetic macular edema (DME), accounts for the greatest source of vision-threatening eye disease in the working-age community. DR is caused by weakening of the retinal vasculature, the blood-retinal barrier (BRB), by high levels of blood glucose (hyperglycemia), exacerbations of oxidative stress, and systemic inflammatory factors. Many of these inflammatory factors are metabolic by-products and cell membrane constituents of the gut microbiota, the resident community of microbial species which inhabit the lumen of the gastrointestinal tract. These factors are collectively termed gut microbial antigens (GMAs). In diabetes, …

Examining The Effects Of Hyperglycemia On Retinal Regeneration, Emmanuella Ec Kyllians

Theses and Dissertations--Biology

Diabetes is a disease that affects how the body processes glucose, leading to a cascade of other complications, one of which is diabetic retinopathy (DR). DR is a neurovascular disease that affects the retina and research has revealed the role of retinal neurodegeneration in its development. Animal models like zebrafish have emerged as important tools for studying the molecular and cellular mechanisms underlying DR. On the other hand, retinitis pigmentosa (RP) is a degenerative disease that involves the progressive degeneration of rods and cones, and hyperglycemia has been found to impair regeneration. Therefore, this study aims to examine the effects …

Differential Recruitment Of Bone Marrow-Derived Cells Into The Injured Retina, Bright Asare-Bediako

All ETDs from UAB

The hematopoietic system, which resides in the bone marrow in adults, maintains the constant turnover of blood cells in the circulatory system and supplies inflammatory/vascular reparative cells to the retina. Chronic metabolic diseases disrupt hematopoietic homeostasis, suppressing the generation of bone marrow-derived reparative cells in favor of pro-inflammatory cells. While much research has been done on development and disease-associated changes in hematopoiesis in the long bones and how mobilization to the retina is affected, the calvarium's hematopoiesis is underexplored. This dissertation investigated hematopoiesis in postnatal development and in disease, comparing calvarium hematopoiesis to that of long bones. The findings showed …

Perceptions Of Comfort And Vison In Center Distance Multifocal Contact Lenses In Non-Presbyopic Adults, D'Ajanee Smallwood

All ETDs from UAB

Purpose: The aim of this study was to assess the subjective performance of four different multifocal contact lenses (MFCLs) amongst a population of adults excluding presbyopes. Methods: Forty-three subjects were fit with up to four different lenses (Biofinity “D” MFCL, NaturalVue MFCL, MiSight 1 Day contact lens, & Intelliwave MFCL). Information about vision and comfort were gathered using subjective assessments. Pupil size data were gathered as secondary outcome measurements. Results: There were no significant differences in ghosting, haloes, and visual clarity between larger and smaller pupils. All MFCLs had reduced overall visual clarity compared to habitual correction except for Biofinity. …