Optometry Commons^™

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 …

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 …

Thank You To Our 2024/2025 Reviewers, Paul B. Freeman Od, Brian K. Foutch Od, Phd

Optometric Clinical Practice

Reviewers

Branch Retinal Artery Occlusion After Covid-19, Danielle Kalberer Od, Mba, Grace Tan Od

Optometric Clinical Practice

Background: A healthy, 39-year-old male patient presented with sudden onset, painless vision loss of the right eye’s superior visual field two months after a mild case of COVID-19.

Case Report: The patient was diagnosed with an acute branch retinal artery occlusion and referred to the emergency department for prompt evaluation. When the emergency workup was unremarkable the patient was referred to cardiology and hematology and follow up with a retinal specialist. The exhaustive systemic work-up was unremarkable other than recent COVID-19. Retinal perfusion to the affected area resumed in the weeks after the incident but irreversible vision loss occurred.

Conclusion: …

Ocular Myasthenia Gravis: A Case Report, Erica Vanderpool Od, Carla Gilbertson Kuiken Od

Optometric Clinical Practice

Background: Myasthenia gravis (MG) is an autoimmune disease caused by faulty transmission at the neuromuscular junction leading to fatigable muscular weakness. Ocular MG is distressing in that it can cause visual difficulties, but generalized MG can be life-threatening. MG is an acquired disorder that can easily be overlooked in clinic and is commonly misdiagnosed. Providers should be aware of the clinical features of this condition, as well as the critical testing needed to confirm the diagnosis so the appropriate management course can be implemented.

Case Report: This case features a 67-year-old Caucasian male diagnosed with ocular myasthenia gravis …

Treatment Considerations For Early Primary Open Angle Glaucoma In Active-Duty Military, Ridwan Carim-Sanni Od, Danielle Kalberer Od, Mba

Optometric Clinical Practice

Background: Glaucoma is one of the leading causes of blindness in the United States. The tools available to treat glaucoma via intraocular pressure (IOP) reduction include pharmacological therapy or surgical intervention.

Case Report: This case study explores these tools in the context of glaucoma in active-duty military personnel. It involves an active-duty army patient diagnosed with early Primary Open Angle Glaucoma (POAG) who was initially prescribed IOP-lowering medication. Barriers in treatment compliance occurred while the patient was deployed that led to significant glaucomatous changes detected when the patient returned stateside.

Conclusion: This report suggests a shift from the traditional pharmacological …

Cryopreserved Amniotic Membrane For Corneal Epithelial Abrasions: Case Series, Laura Goldberg Od

Optometric Clinical Practice

Background: Corneal abrasions are one of the most frequent ocular conditions encountered in the emergency department and can lead to significant morbidity and visual impairment. Amniotic membrane has inherent anti-inflammatory and anti-scarring properties that help accelerate epithelialization and help prevent the complications known to be associated with corneal injuries. Herein we assessed the time till complete epithelialization after in-office application of cryopreserved amniotic membrane in cases of traumatic corneal abrasions in the acute setting.

Case Reports: A total of ten eyes (5 right eye; 5 left eye) of ten consecutive patients (8 Male; 2 Female; average age 40.9 ± 17.8 …

The Art Of Prescribing Low Amounts Of Prism: Optimizing Outcomes, Leonard J. Press Od

Optometric Clinical Practice

Expanding the Box

Learning From Our Future Colleagues, One Case At A Time, Paul B. Freeman Od

Optometric Clinical Practice

Editorial

Biallelic Loss-Of-Function Variants In C19orf44 Lead To Retinal Degeneration, Hafiz Muhammad Jafar Hussain, Wang Meng, Yumei Li, Sabika Firasat, Mark E Pennesi, Michael B Gorin, Bin Guan, Rebecca Lynn Clark, Emma Fale-Olsen, Ranya Al Rawi, Aime Agather, Laryssa A Huryn, Paul Yang, Anna Matynia, Rui Chen

Faculty, Staff and Students Publications

Background: Inherited retinal diseases (IRDs) are a group of disorders often resulting in progressive vision loss, ultimately leading to blindness. A significant portion of their genetic causes remain unresolved, partly due to undiscovered disease-associated genes or variants. This study aimed to identify novel genetic links to IRDs.

Methods: All patients underwent comprehensive ophthalmological evaluation, including retinal imaging (fundus autofluorescence and macular optical coherence tomography) and electroretinogram testing. Whole exome sequencing and whole genome sequencing were performed on patients with clinically unsolved IRD, and data were analysed using an in-house pipeline to identify causal variants. Subsequently, Sanger sequencing was performed to …

Eye On The Prize: Expanding Student Awareness Of Optometry As A Profession, Lorena Flores-Hernandez

MedEd Teaching Certificate Program

The proposed Doctor of Optometry program at UTRGV has the potential to positively enhance the ocular health of our communities. Implementing an outreach program highlighting a career path in optometry will be essential for the future of eyecare in the Rio Grande Valley.

According to data from the US Bureau of Labor Statistics, the optometric workforce is projected to grow over the next decade. The increased demand for optometrists is related to multiple factors including an aging population with chronic diseases and a nationwide shortage of ophthalmology practitioners.

Nationally, the Optometry Gives Me Life campaign, launched by the Association of …

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 …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

Analyzing The Role Of Ai In Resident Education: An Evaluation Of Chatgpt On Ophthalmology Trainee Examination Questions By Subtopic, Kimberly Cartagena, Simran Ohri, Carolina Ramos, Yaxel Levin-Carrion, Alexandra Sanchez, Marko Oydanich, Albert S. Khouri

Journal of Academic Ophthalmology

Background: ChatGPT is a large-scale language model trained on various datasets to learn, analyze, and generate human-like answers to user’s questions. To assess its applicability to medical education, more information is required to understand whether its analyses can provide accurate and coherent responses to questions. The aim of this study was to characterize ChatGPT responses to ophthalmology questions according to subtopic to determine where the system might be used reliably in resident education and where its performance remains weak.

Methods: Ophthalmology questions were obtained from a widely utilized study resource, OphthoQuestions. Thirteen sections, each with a differing ophthalmic …

Non-Isolated Tetralogy Of Fallot (Tof+): Exome Sequencing Efficacy And Phenotypic Expansions, Julia Volpi, Xiaonan Zhao, Nichole Owen, Tia Evans, Muriel Holder-Espinasse, Nayana Lahiri, Eleanor Sherlock, Gemma Poke, Jeroen Breckpot, Koen Devriendt, Bjorn Cools, Alfredo Brusco, Giovanni Battista Ferrero, Enrico Grosso, Pradeep Vasudevan, Sara Loddo, Antonio Novelli, Maria Cristina Digilio, Aafke Engwerda, Marrit Hitzert, Alison Male, Lucy Bownass, Ruth Newbury-Ecob, Zosia Miedzybrodzka, Ruth Armstrong, Sally Ann Lynch, Gunnar Houge, Shiyi Xiong, Seema R Lalani, Jill A Rosenfeld, Pamela N Luna, Chad A Shaw, Daryl A Scott

Faculty, Staff and Students Publications

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect (CHD). TOF may present in isolation or in conjunction with one or more non-cardiac congenital anomalies or neurodevelopmental disorders (TOF+). Uncertainty regarding the efficacy of various genetic testing strategies, and an incomplete understanding of the genetic causes of TOF+, may lead to hesitancy in recommending genetic testing, particularly, clinical exome sequencing (cES). Here, we analyzed cES data from 131 individuals with TOF+. A definitive or probable diagnosis was made for 31 individuals, yielding a diagnostic rate of 23.6% (31/131). One individual received three diagnoses. Commercially available CHD panels …

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 …

Comparative Efficacy Of Current Topical Treatments For Dry Eye Disease: A Review Of Pivotal Clinical Trials Evaluating Corneal Staining Outcomes, Ahmad Fahmy, Masih Ahmed, Stephen Pflugfelder, Anara Serikbaeva, Fang-Wei Tsao

Faculty, Staff and Students Publications

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Childhood Myopia Part I: Contemporary Treatment Options., Safal Khanal Dr, Erin S. Tomiyama Dr, Síofra Harrington Dr

Articles

Abstract

Childhood myopia is a growing global public health concern. Treatments to control myopia are a priority because myopia, particularly high myopia, poses significant lifelong risks of vision loss from myopia-associated ocular pathologies. Intensive research efforts over the past two decades have led to the development of several effective strategies for controlling myopia in children: increased time outdoors, atropine eye drops, dual-focus and multifocal contact lenses, orthokeratology lenses, and specialized spectacle lenses. While the efficacy of these strategies is variable, evidence is growing regarding the potential benefits of applying these interventions in children with myopia, although none completely halt myopia …

Childhood Myopia Part Ii: Treatment Mechanisms, Emerging Options, And Considerations, Safal Khanal Dr, Erin S. Tomiyama Dr, Síofra Harrington Dr

Articles

Abstract

The rapidly increasing prevalence of myopia and its association with vision-threatening complications in later life has intensified efforts to identify treatments that can prevent the onset and slow the progression of myopia in children. These efforts have led to the development of several optical, environmental, and pharmacological myopia control treatments. Investigations of additional treatment options are ongoing and have shown great promise for clinical translation. Although significant progress has been made in identifying potential pathways and modes of action of these treatments, a complete mechanistic understanding is still lacking. This critical review article explores the potential mechanisms underlying the …

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 …

Optimising Non-Cycloplegic Screening Strategies For Early Detection Of Pre-Myopia And Myopia In Young Children, Síofra Harrington, Michael Moore, James Loughman, Ian Flitcroft, Veronica O'Dwyer

Articles

Purpose: Early detection of myopia is essential to delay its onset and progression. Pre-myopia, defined by an inadequate hyperopic reserve, increases myopia risk in childhood. However, effective screening methods remain limited. This study aimed to develop practical non-cycloplegic screening methods for pre-myopia and myopia in 6- to 7-year-olds to support earlier interventions.

Methods: This cross-sectional study of 621 Irish schoolchildren (mean age: 7.12 ± 0.45 years; 51.8% boys) assessed uncorrected distance visual acuity (UDVA). Cycloplegic spherical equivalent refraction (SER) classified refractive status (myopia: SER ≤ −0.50D; pre-myopia: SER > −0.50 ≤ 0.75D). Pre- and post-cycloplegic SER were measured using the Welch …

Oculomics: Current Concepts And Evidence, Zhuoting Zhu, Yueye Wang, Ziyi Qi, Wenyi Hu, Xiayin Zhang, Siegfried K Wagner, Yujie Wang, An Ran Ran, Joshua Ong, Ethan Waisberg, Mouayad Masalkhi, Alex Suh, Yih Chung Tham, Carol Y Cheung, Xiaohong Yang, Honghua Yu, Zongyuan Ge, Wei Wang, Bin Sheng, Yun Liu, Andrew G Lee, Alastair K Denniston, Peter Van Wijngaarden, Pearse A Keane, Ching-Yu Cheng, Mingguang He, Tien Yin Wong

Faculty, Staff and Student Publications

The eye provides novel insights into general health, as well as pathogenesis and development of systemic diseases. In the past decade, growing evidence has demonstrated that the eye's structure and function mirror multiple systemic health conditions, especially in cardiovascular diseases, neurodegenerative disorders, and kidney impairments. This has given rise to the field of oculomics-the application of ophthalmic biomarkers to understand mechanisms, detect and predict disease. The development of this field has been accelerated by three major advances: 1) the availability and widespread clinical adoption of high-resolution and non-invasive ophthalmic imaging ("hardware"); 2) the availability of large studies to interrogate associations …

The Digital Glow: Effects Of Blue Light On Children And The Development Of A Children's Book To Raise Awareness On Eye Health, Mallory Easland

Honors Program: Senior Projects (Public)

As digital screen use continues to rise among children, concerns about the effects of blue light on eye health, sleep patterns, and overall well-being have grown. Research suggests that prolonged exposure to blue light can contribute to digital eye strain, disrupt circadian rhythms, and impact cognitive development. This thesis explores scientific literature on the biological effects of blue light, specifically on children, examining both the risks associated with excessive exposure and strategies for mitigating its impact.

In addition to conducting a comprehensive literature review, this project applies research findings to the creation of an educational children’s book aimed at promoting …

Refractive Error And Axial Length (Real) Study: Feasibility Of A Population Study In The United States, Sarah E. Singh Dr, Lisa A. Ostrin, Kristen Kerber Dr, Concepcion Cayle, Celia Gong Dr, Lal Barsha Dr, Ian Flitcroft, Síofra Harrington, James Loughman, Kathryn Saunders Prof, Fuensanta Vera-Diaz Dr

Articles

Myopia is the most common eye disease and a leading cause of blindness. A contemporary, large, and ethnically and geographically diverse study of ocular biometry and refractive error in children in the United States is needed to help better describe differences between myopic and nonmyopic eyes.

This is an initial cross-sectional report from the Refractive Error and Axial Length Growth Curve Study that includes ocular component data as a function of age, gender, and geographic location. This feasibility report will inform a planned larger longitudinal ocular growth study in children in the United States.

Cross-sectional data on children, ages 3 …

Book Review: Neuro-Visual Processing Rehabilitation: An Interdisciplinary Approach, Paul B. Freeman Od

Optometric Clinical Practice

Book review

Disc Edema Secondary To Sleep Apnea: A Case Report, Jeannette A. Wong-Powell Od

Optometric Clinical Practice

Background: Bilateral optic disc edema is associated with multiple systemic conditions of potentially dire consequences. Idiopathic intracranial hypertension (IIH) is a common culprit and diagnosis of exclusion, which has been observed in multiple patients with obstructive sleep apnea (OSA) and raised questions of a pathophysiological link between the two.

Case Report: A 28-year-old Caucasian male with history of transient ischemic attack-like symptoms presented with bilateral disc edema prompting a multi-disciplinary work up that included imaging, lumbar puncture, laboratory analysis, neuroophthalmological, cardiological, and pulmonary evaluations that ultimately led to a diagnosis of OSA. The case is unique in that it followed …

An Uncharacteristic Case Presentation Of Functional Vision Disorder, Ramandeep Kaur Od, Theresa Zerilli-Zavgorodni Od, Nancy Shenouda-Awad Od

Optometric Clinical Practice

Background: Functional Vision Disorder (FVD), also commonly referred to as functional vision loss (FVL) or non-organic vision loss (NOVL), is defined as a visual acuity (VA) loss and/or visual field (VF) loss, without any identifiable ocular or cortical pathology. Many clinicians look at FVD as a diagnosis of exclusion and while it is imperative to rule out organic pathology, FVD diagnosis must be supported by clinical findings that prove normal visual function. Incorporating supplementary tests specific for demonstrating the integrity of the visual system and the non-organic nature of the symptoms will allow clinicians to be more confident when diagnosing …

A Case Report Of Vitreopapillary Traction Mistaken For Optic Disc Edema, Breyne Middleton Od, Drew Anderson Od

Optometric Clinical Practice

Background: Traction of the optic disc occurs during incomplete detachment of the posterior vitreous from the peripapillary glial tissue. It can sometimes cause the appearance of disc edema and bilateral cases can be confused with papilledema or cause patients to be worked up for pseudotumor cerebri.

Case Report: A patient presented with an outside diagnosis of unilateral optic disc edema and was found in fact to have vitreopapillary traction.

Conclusion: Costly, ultimately unnecessary testing such as magnetic resonance imaging can be sometimes avoided if vitreopapillary traction is considered as a differential for disc edema. It can be easily identified with …