Optometry Commons^™

Accuracy And Repeatability Of Autorefraction In Young Adults: A Comparison Of Cycloplegic And Non-Cycloplegic Methods, Megan Doyle, Veronica O'Dwyer O'Dwyer, Michael Moore, Síofra Harrington

Articles

Clinical Relevance: Cycloplegic refraction remains crucial in young adults, where accommodative activity can obscure accurate refractive status. Autorefractor repeatabil­ity is essential for precise optical correction and refractive error categorisation in clinical and research settings.

Background: Cycloplegic autorefraction is recommended for individuals up to 20 years to prevent hyperopia underestimation and myopia overestimation. This study evaluated differences between non-cycloplegic and cycloplegic spherical equivalent refraction following cyclopentolate hydrochloride (cycloplegic agent) administration in young adults. This study also explored whether this difference varied by refractive status (hyperopia (≥1.00D), emmetropia ( >−0.50, < 1.00D), myopia (≤-0.50D)) or pre- instillation of proxymetacaine hydrochloride and whether cycloplegia improved autorefractor repeatability.

Methods: Participants were 182 young adults (17–30 years) (mean (standard deviation): 21.66 …

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 …

Visual Acuity, Full-Field Stimulus Thresholds, And Electroretinography For 4 Years In The Rate Of Progression Of Ush2a-Related Retinal Degeneration (Rush2a) Study, David G Birch, Peiyao Cheng, Maureen G Maguire, Jacque L Duncan, Allison R Ayala, Janet K Cheetham, Nicole R Doucet, Todd A Durham, Abigail T Fahim, Frederick L Ferris, Rachel M Huckfeldt, Michele Melia, Michel Michaelides, Mark E Pennesi, José-Alain Sahel, Katarina Stingl, Ajoy Vincent, Christina Y Weng

Faculty, Staff and Students Publications

PURPOSE: To describe progression of best-corrected visual acuity (BCVA), full-field stimulus thresholds (FST), and electroretinography (ERG) over 4 years in the

DESIGN: Prospective natural history study.

PARTICIPANTS: Participants (n = 105) with biallelic disease-causing sequence variants in USH2A and BCVA letter scores of ≥54 were included.

METHODS: BCVA, FST, fundus-guided microperimetry, static perimetry, and spectral domain OCT were performed annually and ERG at baseline and 4 years only. Mixed effects models were used to estimate annual rates of change with 95% confidence intervals. Associations of change from baseline to 4 years between BCVA, FST, ERG, and other metrics were assessed …

Dlk-Dependent Axonal Mitochondrial Fission Drives Degeneration After Axotomy, Jorge Gómez-Deza, Matthew Nebiyou, Mor R Alkaslasi, Francisco M Nadal-Nicolás, Preethi Somasundaram, Anastasia L Slavutsky, Wei Li, Michael E Ward, Trent A Watkins, Claire E Le Pichon

Faculty, Staff and Students Publications

Currently there are no effective treatments for an array of neurodegenerative disorders to a large part because cell-based models fail to recapitulate disease. Here we develop a reproducible human iPSC-based model where laser axotomy causes retrograde axon degeneration leading to neuronal cell death. Time-lapse confocal imaging revealed that damage triggers an apoptotic wave of mitochondrial fission proceeding from the site of injury to the soma. We demonstrate that this apoptotic wave is locally initiated in the axon by dual leucine zipper kinase (DLK). We find that mitochondrial fission and resultant cell death are entirely dependent on phosphorylation of dynamin related …

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. …

Clinical Applications Of Phenomenology: Analysis Of Lived Experience Of Eye Disease, Kimberly Tucker

Graduate Student Research Symposium

This paper presents a phenomenological study that explores the embodied experience of vision loss within the context of eye disease, while also providing a detailed discussion of the methodological approaches utilized in the research. Phenomenology is integrated to address clinical epistemic concerns, particularly the limitations of conventional vision tests in fully capturing perception and the lived experiences of vision loss. This interdisciplinary approach builds on the clinical understanding of eye disease by incorporating the broader dimensions of the lifeworld that intersect with visual impairment in degenerative eye diseases. While standard clinical approaches focus primarily on measurable aspects of visual function, …

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 …

Impact Of Proxymetacaine On The Dynamics Of Cyclopentolate In White 6- To 7-Year-Olds, Megan Doyle, Veronica O'Dwyer, Siofra Harrington

Articles

Purpose

This study compared the efficacy of cyclopentolate hydrochloride at 10-, 20- and 30-min post-instillation in White 6- to 7-year-olds, with and without prior instillation of proxymetacaine hydrochloride. The primary aim was to determine if accurate autorefraction values can be obtained sooner than the current standard of 30-min post-cycloplegia. The secondary aim was to investigate whether proxymetacaine hydrochloride enhances the efficiency of cyclopentolate.

Methods

Participants were 112 White 6- to 7-year-olds from the Child Eye Health Study. The right eye received 0.5% proxymetacaine hydrochloride and 1.0% cyclopentolate hydrochloride, and the left eye received only 1.0% cyclopentolate hydrochloride. Non-cycloplegic and cycloplegic …

Total Retinal Thickness Is An Important Factor In Evaluating Diabetic Retinal Neurodegeneration, Noor-Us-Sabah Ahmad, Kristen Staggers, Kyungmoo Lee, Nitish Mehta, Amitha Domalpally, Benjamin J Frankfort, Yao Liu, Roomasa Channa

Faculty, Staff and Students Publications

OBJECTIVE: Macular retinal nerve fibre layer (mRNFL) and ganglion cell-inner plexiform layer thickness (GC-IPL) measurements are important markers of diabetic retinal neurodegeneration (DRN). In this cross-sectional study, we aimed to quantify the contribution of total retinal thickness (TRT) and other factors in the variation of mRNFL and GC-IPL thickness among participants with diabetes.

METHODS AND ANALYSIS: We used macular-centred spectral domain-optical coherence tomography scans from participants with diabetes in the UK Biobank. Two multiple linear regression models (prior to and after adjusting for TRT) were used to determine factors associated with mRNFL and GC-IPL thicknesses. A p value of less …

Transport Of Β-Amyloid From Brain To Eye Causes Retinal Degeneration In Alzheimer’S Disease, Qiuchen Cao, Shige Yang, Xiaowei Wang, Huaiqing Sun, Weijie Chen, Yuliang Wang, Junying Gao, Yanchi Wu, Qiuhua Yang, Xue Chen, Songtao Yuan, Ming Xiao, Maiken Nedergaard, Yuqing Huo, Qinghuai Liu

Faculty, Staff and Students Publications

The eye is closely connected to the brain, providing a unique window to detect pathological changes in the brain. In this study, we discovered β-amyloid (Aβ) deposits along the ocular glymphatic system in patients with Alzheimer's disease (AD) and 5×FAD transgenic mouse model. Interestingly, Aβ from the brain can flow into the eyes along the optic nerve through cerebrospinal fluid (CSF), causing retinal degeneration. Aβ is mainly observed in the optic nerve sheath, the neural axon, and the perivascular space, which might represent the critical steps of the Aβ transportation from the brain to the eyes. Aquaporin-4 facilitates the influx …

Thank You To Our 2023/2024 Reviewers, Paul Freeman, William Miller

Optometric Clinical Practice

Reviewers

Applying Multimodal Imaging In The Evaluation Of A Rare Complication Of Retinal Cavernous Hemangioma, Mariana Ferraz Od, Julie Rodman Od, Msc, Jose Diaz Md

Optometric Clinical Practice

Abstract

Background: Retinal cavernous hemangiomas are rare, benign vascular tumors usually encountered incidentally on routine examination. Although usually asymptomatic, complications have been reported and can result in vision loss. Ancillary imaging modalities such as fundus photography, fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography provide valuable information about the lesion and possible associated findings. Case Report: A 66-year-old Caucasian female presented to the clinic for a comprehensive exam with mild blurry vision in both eyes with current spectacles. Her ocular history was remarkable for a retinal cavernous hemangioma along the superior-temporal arcade of the left eye. Dilated fundus …

Herpes Zoster Ophthalmicus Associated With Ipsilateral Bell's Palsy, Patricia Salazar Od

Optometric Clinical Practice

Abstract

Background: Herpes zoster is caused by reactivation of the varicella zoster virus with spread along the dorsal root ganglion and sensory nerve to a dermatome. In herpes zoster ophthalmicus (HZO), involvement of the ophthalmic (V₁) branch of the trigeminal nerve results in ocular sequelae and often presents with a characteristic pseudodendrite. Reactivation within cranial nerve VII can lead to the neurologic complication of facial nerve palsy on the affected side. Case Report: This case report describes a patient diagnosed with HZO and subsequent same-sided facial nerve palsy (Bell’s palsy) and discusses the potential link between the two …

Acute Syphilitic Posterior Placoid Chorioretinopathy: A Case Report, Kendra R. Null Od, Danielle E. Toms Od, Elizabeth M. Phillips Od, Candice A. Law Od, Ms

Optometric Clinical Practice

Abstract

Background: Acute syphilitic posterior placoid chorioretinopathy is a rare manifestation of ocular syphilis that can significantly impact the patient’s vision. However, it has been shown to have a good prognosis with the appropriate diagnosis and treatment of the underlying systemic syphilis infection. In addition to discussing the details of the case, this report also highlights the systemic staging, diagnosis, and treatment of syphilis. Case Report: This case features a 60-year-old Caucasian male diagnosed and treated for acute syphilitic posterior placoid chorioretinopathy after a recent diagnosis of syphilis. Conclusion: With the incidence rates of syphilis infections increasing, it is imperative …

Ocular Myasthenia Gravis; A Case Report, Amy Garbo Maxey Od, Kristin Wilson Od

Optometric Clinical Practice

Abstract

Background: Myasthenia gravis (MG) is an autoimmune disease disorder that affects the skeletal muscles causing increased fatigability and weakness. When it affects the ocular muscles only, it is known as ocular myasthenia gravis (OMG). Patients with OMG will often have symptoms of diplopia and ptosis, which will be worse towards the end of the day. This case report will discuss the common symptoms of OMG as well as the appropriate treatment and management. It will also review the diagnostic tests used to aid in the diagnosis of OMG and discuss the prognosis of OMG. Case Report: A 67-year-old male …

A Most Difficult Conversation, Paul Freeman Od

Optometric Clinical Practice

Editorial

Mouse Corneal Immune Cell Heterogeneity Revealed By Single-Cell Rna Sequencing, Ebru Yaman, Nicole Heyer, Cintia S De Paiva, Mary Ann Stepp, Stephen C Pflugfelder, Jehan Alam

Faculty, Staff and Students Publications

PURPOSE: This study aimed to define the heterogeneity, spatial localization, and functional roles of immune cells in the mouse cornea using single-cell RNA sequencing (scRNA-seq) and immunofluorescent staining.

METHODS: Enriched mouse corneal immune cells (C57BL/6 strain, age 16-20 weeks) underwent single-cell RNA sequencing library preparation, sequencing, and analysis with Seurat, Monocle 3, and CellChat packages in R. Pathway analysis used Qiagen Ingenuity Pathway Analysis software. Immunostaining confirmed cell distribution.

RESULTS: We identified 14 distinct immune cell clusters (56% myeloid and 44% lymphoid). Myeloid populations included resident macrophages, conventional dendritic cells (cDC2s), Langerhans cells, neutrophils, monocytes, and mast cells. Additionally, lymphocyte …

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 …

Machine Learning To Enhance Electronic Detection Of Diagnostic Errors, Andrew J Zimolzak, Li Wei, Usman Mir, Ashish Gupta, Viralkumar Vaghani, Devika Subramanian, Hardeep Singh

Faculty, Staff and Students Publications

This cohort study examines whether machine learning (ML) can enhance the ability of electronic triggers to identify possible missed opportunities in diagnosis.

Optimal Humanized Scg3-Neutralizing Antibodies For Anti-Angiogenic Therapy Of Diabetic Retinopathy, Chengchi Huang, Prabuddha Waduge, Avinash Kaur, Hong Tian, Christina Y Weng, John Timothy Stout, Iok-Hou Pang, Keith A Webster, Wei Li

Faculty, Staff and Students Publications

Secretogranin III (Scg3) is a diabetic retinopathy (DR)-restricted angiogenic factor identified in preclinical studies as a target for DR therapy. Previously, our group generated and characterized ML49.3, an anti-Scg3 monoclonal antibody (mAb) which we then converted into an EBP2 humanized antibody Fab fragment (hFab) with potential for clinical application. We also generated anti-Scg3 mT4 mAb and related EBP3 hFab. In this study, to identify the preferred hFab for DR therapy, we compared all four antibodies for binding, neutralizing and therapeutic activities in vitro and in vivo. Octet binding kinetics analyses revealed that ML49.3 mAb, EBP2 hFab, mT4 mAb and EBP3 …

Chatgpt And Google Assistant As A Source Of Patient Education For Patients With Amblyopia: Content Analysis, Gloria Wu, David A Lee, Weichen Zhao, Adrial Wong, Rohan Jhangiani, Sri Kurniawan

Faculty, Staff and Student Publications

Background: We queried ChatGPT (OpenAI) and Google Assistant about amblyopia and compared their answers with the keywords found on the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) website, specifically the section on amblyopia. Out of the 26 keywords chosen from the website, ChatGPT included 11 (42%) in its responses, while Google included 8 (31%).

Objective: Our study investigated the adherence of ChatGPT-3.5 and Google Assistant to the guidelines of the AAPOS for patient education on amblyopia.

Methods: ChatGPT-3.5 was used. The four questions taken from the AAPOS website, specifically its glossary section for amblyopia, are as follows: (1) What …

Inhibition Of Cathepsin S In Autoimmune Cd25ko Mouse Improves Sjögren Disease-Like Lacrimal Gland Pathology, Kaitlin K Scholand, Jeremias Galletti, Wolfgang Haap, Tiago Santos-Ferreira, Christoph Ullmer, Cintia S De Paiva

Faculty, Staff and Students Publications

PURPOSE: CD25KO mice are a model of Sjögren disease (SjD) driven by autoreactive T cells. Cathepsin S (CTSS) is a protease crucial for major histocompatibility complex class II presentation that primes T cells. We investigated if a diet containing CTSS inhibitor would improve autoimmune signs in CD25KO mice.

METHODS: Four-week female CD25KO mice were randomly chosen to receive chow containing a CTSS inhibitor (R05461111, 262.5 mg/kg chow) or standard chow for 4 weeks. Cornea sensitivity was measured. Inflammatory score was assessed in lacrimal gland (LG) histologic sections. Flow cytometry of LG and ocular draining lymph nodes (dLNs) investigated expression of …

Ectoine Enhances Mucin Production Via Restoring Il-13/Ifn-Γ Balance In A Murine Dry Eye Model, Na Lin, Xin Chen, Haixia Liu, Ning Gao, Zhao Liu, Jin Li, Stephen C Pflugfelder, De-Quan Li

Faculty, Staff and Students Publications

PURPOSE: This study aimed to explore protective effects and potential mechanism of ectoine, a natural osmoprotectant, on ocular surface mucin production in dry eye disease.

METHODS: A dry eye model was established in C57BL/6 mice exposed to desiccating stress (DS) with untreated (UT) mice as controls. DS mice were topically treated with 2.0% ectoine or PBS vehicle. Corneal epithelial defects were assessed by Oregon Green Dextran (OGD) fluorescent staining. Conjunctival goblet cells, ocular mucins, and T help (Th) cytokines were evaluated by immunofluorescent staining or ELISA, and RT-qPCR.

RESULTS: Compared with UT mice, corneal epithelial defects were detected as strong …

Self-Reported Functional Vision In Ush2a-Associated Retinal Degeneration As Measured By The Michigan Retinal Degeneration Questionnaire, Bela Parekh, Jacque L Duncan, Lassana Samarakoon, Michele Melia, Maria Fernanda Abalem, Chris A Andrews, Isabelle Audo, Allison R Ayala, Chris Bradley, Janet K Cheetham, Gislin Dagnelie, Todd A Durham, Rachel M Huckfeldt, Gabrielle D Lacy, Brett Malbin, Michel Michaelides, David C Musch, Nicholas Peck-Dimit, Katarina Stingl, Christina Y Weng, Alex Z Zmejkoski, K Thiran Jayasundera

Faculty, Staff and Students Publications

PURPOSE: The purpose of this study was to evaluate self-reported functional vision (FV) and the impact of vision loss in patients with USH2A-associated retinal degeneration using a patient-reported outcome (PRO) measure, the Michigan Retinal Degeneration Questionnaire (MRDQ), to correlate MRDQ scores with well-established visual function measurements.

DESIGN: An observational cross-sectional study (n = 93) of participants who had Usher Syndrome Type 2 (USH2, n = 55) or autosomal recessive non-syndromic retinitis pigmentosa (ARRP; n = 38) associated with biallelic variants in the USH2A gene.

METHODS: The study protocol was approved by all ethics boards and informed consent was obtained from …

The Aging Lacrimal Gland Of Female C57bl/6j Mice Exhibits Multinucleate Macrophage Infiltration Associated With Lipid Dysregulation, Minchang Choi, Cindy Toscano, Maria C Edman, Cintia S De Paiva, Sarah F Hamm-Alvarez

Faculty, Staff and Students Publications

PURPOSE: Loss of function of the lacrimal gland (LG), which produces the aqueous tear film, is implicated in age-related dry eye. To better understand this deterioration, we evaluated changes in lipid metabolism and inflammation in LGs from an aging model.

METHODS: LG sections from female C57BL/6J mice of different ages (young, 2-3 months; intermediate, 10-14 months; old, ≥24 months) were stained with Oil Red-O or Toluidine blue to detect lipids. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis and western blotting of LG lysates determined differences in the expression of genes and proteins related to lipid metabolism. A photobleaching protocol to …

Understanding The Treatment Paradigm And The Sequencing Of Antiglaucoma Fixed-Dose Combinations In A Tertiary Center In South India, Ronnie George, Praggya Mishra, Balekudaru Shantha, Lingam Vijaya, Nitin Maksane, Neha Gurha

Faculty, Staff and Student Publications

PURPOSE: To analyze the medical management of primary open-angle glaucoma (POAG) and ocular hypertension (OHT) and the placement of fixed-drug combination drugs (FDC) in the treatment paradigm at a tertiary eye care center in South India.

METHODS: Retrospective study (January 2011-December 2015) of newly diagnosed POAG and OHT patients (≥18 years) with ≥5 years follow-up. Primary outcome included percentage use of different antiglaucoma drugs (at initiation) and FDCs at the first, second, and third progression (sequencing). Secondary outcomes: Percentage discontinuation for different FDCs, efficacy parameters (decrease in intraocular pressure (IOP)/visual field), adverse events, and the median number of antiglaucoma medications …

Fetal Brain-Derived Exosomal Mirnas From Maternal Blood: Potential Diagnostic Biomarkers For Fetal Alcohol Spectrum Disorders (Fasds), Nune Darbinian, Monica Hampe, Diana Martirosyan, Ahsun Bajwa, Armine Darbinyan, Nana Merabova, Gabriel Tatevosian, Laura Goetzl, Shohreh Amini, Michael E Selzer

Faculty, Staff and Student Publications

Fetal alcohol spectrum disorders (FASDs) are leading causes of neurodevelopmental disability but cannot be diagnosed early in utero. Because several microRNAs (miRNAs) are implicated in other neurological and neurodevelopmental disorders, the effects of EtOH exposure on the expression of these miRNAs and their target genes and pathways were assessed. In women who drank alcohol (EtOH) during pregnancy and non-drinking controls, matched individually for fetal sex and gestational age, the levels of miRNAs in fetal brain-derived exosomes (FB-Es) isolated from the mothers’ serum correlated well with the contents of the corresponding fetal brain tissues obtained after voluntary pregnancy termination. In six …

Ciliary Tip Actin Dynamics Regulate Photoreceptor Outer Segment Integrity, Roly Megaw, Abigail Moye, Zhixian Zhang, Fay Newton, Fraser Mcphie, Laura C Murphy, Lisa Mckie, Feng He, Melissa K Jungnickel, Alex Von Kriegsheim, Peter A Tennant, Chloe Brotherton, Christine Gurniak, Alecia K Gross, Laura M Machesky, Theodore G Wensel, Pleasantine Mill

Faculty, Staff and Students Publications

As signalling organelles, cilia regulate their G protein-coupled receptor content by ectocytosis, a process requiring localised actin dynamics to alter membrane shape. Photoreceptor outer segments comprise an expanse of folded membranes (discs) at the tip of highly-specialised connecting cilia, into which photosensitive GPCRs are concentrated. Discs are shed and remade daily. Defects in this process, due to mutations, cause retinitis pigmentosa (RP). Whilst fundamental for vision, the mechanism of photoreceptor disc generation is poorly understood. Here, we show membrane deformation required for disc genesis is driven by dynamic actin changes in a process akin to ectocytosis. We show RPGR, a …