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A decrease of the Tear Meniscus Height (TMH) has been proposed as a useful indicator for Aqueous Deficient Dry Eye (ADDE) categorization. The present study aimed to calculate a TMH cut-off criterion for the categorization or severity assessment of ADDE with the Tearscope. 200 participants with a previous Dry Eye Disease (DED) diagnosis according to TFOS DEWS-II criteria were recruited. TMH by slit-lamp illumination and Lipid Layer Pattern (LLP) with Tearscope were assessed to categorise the participants into the ADDE or the Evaporative Dry Eye (EDE) group. The ADDE group was also subdivided into Mild-moderate ADDE and Moderate-severe ADDE based on TMH with slit-lamp. Additionally, the TMH was measured by Tearscope (TMH-Tc). Receiver Operating Characteristics showed that the TMH-Tc have a diagnostic capability to differentiate between ADDE and EDE participants, and between Mild-moderate or Moderate-severe ADDE, with a cut-off value of 0.159 mm (AUC = 0.843 ± 0.035, p < 0.001; sensitivity: 86.4%; specificity: 75.4%) and 0.105 mm (AUC = 0.953 ± 0.025, p < 0.001; sensitivity: 98.1%; specificity: 80.0%), respectively. The present study proposed a cut-off criterion to differentiate between ADDE and EDE participants, or between ADDE severities through TMH assessed by Tearscope.

Background: Dry eye disease (DED) is characterized by the loss of ocular surface homeostasis with specific signs and symptoms. Studying the progression of a multifactorial disease is exceedingly challenging for researchers because several factors can influence it. The present study aims to study changes in tear meniscus height (TMH), lipid layer pattern (LLP), and bulbar hyperemia over time in untreated DED participants. Methods: This retrospective longitudinal study included 73 participants (146 eyes) diagnosed with DED since at least 2013. Participants underwent new examinations between 2021 and 2023, grouped by 8-, 6-, or 4-year follow-up periods. TMH, LLP, and bulbar hyperemia were assessed in both examinations. No participant received pharmacological treatment for DED. Results: Differences in TMH, bulbar hyperemia, and LLP between sessions were obtained in the 8-year group (p ≤ 0.027). Differences in bulbar hyperemia and LLP between sessions were obtained in the 6-year group (p ≤ 0.022). The only differences in LLP between sessions were obtained in the 4-year group (p < 0.005). Conclusion: Changes in TMH were obtained after periods of eight years from the first eye examination. Also, changes in bulbar hyperemia were obtained at periods of 8 and 6 years; however, changes in LLP could be found from 4-year follow-ups.

Purpose: To evaluate how Video Display Terminal (VDT) use, Contact Lens (CL) wear, and eyedrop use affect ocular surface parameters in participants with ocular discomfort and how these factors may vary across different age groups. Methods: The current cross-sectional study initially involved a total of 252 participants who completed a self-administered survey to collect information about ocular discomfort and lifestyle factors. This online survey was composed of an Ocular Surface Disease Index (OSDI) questionnaire and three extra questions regarding lifestyle factors (VDT use, CL wear, and eyedrop use). Only 185 symptomatic participants, those with OSDI values > 12, were scheduled to undergo a comprehensive ocular examination that included tear film osmolarity, Fluorescein Break-Up Time (FBUT), Maximum Blink Interval (MBI), and corneal staining. Results: Differences in ocular parameters and lifestyle factors across age groups (<40 years, 40–60 years, >60 years) were analyzed, along with their correlations and regression. Significant age group differences were found in OSDI, osmolarity, FBUT, and MBI (One-way ANOVA, all p ≤ 0.029). Correlations were observed between CL wear and osmolarity and MBI (Pearson’s correlation, both p ≤ 0.049). Multiple regression confirmed age associations with OSDI, osmolarity, FBUT, and MBI (Multiple linear regression, all p ≤ 0.040) and found links between VDT use and osmolarity and MBI (Multiple linear regression, both p ≤ 0.038) and between eyedrop use and OSDI (Multiple linear regression, p = 0.040). Conclusion: Aging is a primary factor affecting ocular homeostasis, with older adults showing lower FBUT and MBI values and higher osmolarity. Prolonged use of VDTs exacerbates this effect, further contributing to ocular discomfort and destabilized tear film. No associations between CL wear and any of the ocular parameters were found. Eyedrop use shows varied effects on ocular comfort across age groups, emphasizing the need for age-specific ocular care. Overall, these findings confirm that aging and extended VDT use play a significant role in ocular surface discomfort.

Background and Objectives: To clinically validate a semi-automatic measurement of Tear Meniscus Central Area (TMCA) to differentiate between Non-Aqueous Deficient Dry Eye (Non-ADDE) and Aqueous Deficient Dry Eye (ADDE) patients. Materials and Methods: 120 volunteer participants were included in the study. Following TFOS DEWS II diagnostic criteria, a battery of tests was conducted for dry eye diagnosis: Ocular Surface Disease Index questionnaire, tear film osmolarity, tear film break-up time, and corneal staining. Additionally, lower tear meniscus videos were captured with Tearscope illumination and, separately, with fluorescein using slit-lamp blue light and a yellow filter. Tear meniscus height was measured from Tearscope videos to differentiate Non-ADDE from ADDE participants, while TMCA was obtained from fluorescein videos. Both parameters were analyzed using the open-source software NIH ImageJ. Results: Receiver Operating Characteristics analysis showed that semi-automatic TMCA evaluation had significant diagnostic capability to differentiate between Non-ADDE and ADDE participants, with an optimal cut-off value to differentiate between the two groups of 54.62 mm2 (Area Under the Curve = 0.714 ± 0.051, p < 0.001; specificity: 71.7%; sensitivity: 68.9%). Conclusions: The semi-automatic TMCA evaluation showed preliminary valuable results as a diagnostic tool for distinguishing between ADDE and Non-ADDE individuals.

The present study aimed to assess the symptomatic status of Convergence Insufficiency (CI) in university students from 2018 to 2023 considering the educational environment pre- and post-COVID-19 pandemic confinements. A Convergence Insufficiency Symptom Survey (CISS) was conducted annually from 2018 to 2023, excluding 2020, in an initial group of 217 third-year Optics and Optometry degree university student participants. In the final group (178 participants), the statistical differences in CISS scores between years were analysed, both overall and by questionnaire subgroup, along with associations between CISS diagnostic categories before and after 2020. Significant differences were found between years in the subscale and total score analyses (Kruskal–Wallis, both p ≤ 0.049). Pairwise comparisons showed significant differences for the performance subgroup in 2021 vs. 2019 and 2018 (Mann–Whitney, both p ≤ 0.004), while in terms of the total score, there was a statistical difference in 2021 vs. 2018 (Mann–Whitney, p < 0.001). The distribution analysis indicated a significant difference between groups (Chi, p = 0.004), with participants from 2021 or later more likely to exhibit higher CISS scores (OR = 3.47, 95%CI 1.04–8.58). The present study shows significant temporal increments in symptomatic status related to CI among university students from 2018 to 2023, indicating a potential impact of the COVID-19 pandemic educational landscape on these outcomes.

Background: The purpose of this study was to assess differences in clinical symptoms and signs of DED in non-adherent to treatment patients to describe long-term disease progression. Methods: 120 patients previously diagnosed with Dry Eye Disease (DED) were contacted to undergo a second eye examination. The final included participants were classified into three groups based on when the second examination was scheduled: 4 years (Group 1; n = 33), 6 years (Group 2; n = 18) or 8 years (Group 3; n = 37) since the diagnostic visit. All included participants were classified as ‘non-adherent to DED treatment’, defined as patients who reported not following their prescribed DED therapy. In both examinations, Ocular Surface Disease Index (OSDI) questionnaire, tear film osmolarity, inter-eye osmolarity (osmolarity |OD-OS|), Fluorescein Break-Up Time (FBUT), Maximum Blink Interval (MBI) and corneal staining were evaluated. Results: OSDI score improved after 4 years of DED diagnosis (Group 1, mean difference close to 12 points, p < 0.001) and after 8 years (Group 3, mean difference of 9 points, p < 0.001), but remained stable after 6 years (Group 2, p = 0.328). Osmolarity worsened only after 6 years of DED diagnosis (Group 2, mean difference of 13.2 mOsm/L, p = 0.011), while osmolarity |OD–OS| showed no change (all p ≥ 0.231). FBUT values were stable across all groups (all p ≥ 0.265). MBI increased after 4 and 8 years of DED diagnosis (Groups 1 and 3, p ≤ 0.003), but not after 6 years (Group 2, p = 0.391). Corneal staining worsened after 8 years of DED diagnosis (Group 3, 0.55 points, p = 0.011), with no changes at 4 or 6 years (Groups 1 and 2, both p ≥ 0.318). Conclusions: In non-adherent DED patients, osmolarity |OD-OS| and tear film stability remain stable during the natural course of the disease, while ocular surface damage increases. However, the subjective symptomatology and the nociceptive blink reflex due to ocular discomfort decreased since the diagnostic visit.

The study aimed to assess the agreement between OptoTab SERIES, alternating Cover Test, Modified Thorington test, and Von Graefe method in measuring heterophoria and accommodative convergence over accommodation (AC/A) ratio. In an initial step, heterophoria was assessed at both distance and near in a cohort of 76 healthy young volunteers using the previously described tests. Subsequently, to determine the AC/A ratio, near-vision measurements were repeated with +1.00 D and −1.00 D lenses. All tests were performed in a randomized order across participants under consistent conditions. Significant differences were found between the Modified Thorington test and all other tests at distance (Wilcoxon test, all p ≤ 0.001) and between Von Graefe and all other tests at near (Wilcoxon test, all p ≤ 0.005). Regarding the AC/A ratio, significant differences were observed between all methods in +1.00 D AC/A ratio, except for the Modified Thorington test vs. the alternating Cover Test (Wilcoxon test, p = 0.024). In the −1.00 D AC/A ratio, differences were observed between OptoTab POCKET and all the other tests (Wilcoxon test, all p ≤ 0.001). The results indicate that all methods are interchangeable except the Modified Thorington test at distance and Von Graefe at near. For the AC/A ratio, only the Modified Thorington test is interchangeable with the alternating Cover Test using +1.00 D lenses and all are interchangeable using −1.00 D lenses except OptoTab POCKET.

Determining the axial length (AL) of the eye is of significant interest in the management of myopia. However, the devices that allow this value to be obtained are either expensive, for example, optical biometers, or inconvenient for use in pediatric population, such is the case with ultrasound biometers. Therefore, this study aimed to develop a mathematical model for estimating the AL value based on easily obtainable variables, with the novel addition of body height to the analysis. A total of 170 eyes of 85 myopic volunteers (mean age of 10.8 ± 1.45 years, ranging from 7 to 14 years) were included in the analysis. Participants underwent anamnesis, keratometry by NVISION-K 5001, subjective refraction by an optometrist, AL measurement by the Topcon MYAH biometer, and body height measurement. Spearman’s correlation test was employed to analyze the relationships between AL and keratometry, spherical equivalent, body height (Sperman’s correlation, all r ≥ 0.267, all p < 0.001), and age (Spearman’s correlation, p = 0.081). Subsequently, multiple regression analysis was conducted on the variables that demonstrated a previous correlation. The mathematical model obtained permits the estimation of AL based on average keratometry, spherical equivalent, and body height. This model is significant (p < 0.001) and explains 82.4% of AL variability.

Myopia is a refractive error widely spread throughout the world, usually related to excessive axial length (AL) of the eye. This elongation could have severe consequences, even leading to blindness. However, AL varies among subjects, and it may be correlated with other anthropometric parameters. The aim of this study was to evaluate the relationships between AL, body height, refractive error, and sex. A total of 72 eyes of 36 myopic participants with a mean age of 11.1 ± 1.42 years (ranging from 8 to 14 years) were included in the study. Participants underwent objective refraction by NVision-K5001, AL measurement by Topcon MYAH biometer, and body height measurement. Significant correlations were observed between AL, body height, and spherical equivalent (SE) (Spearman’s correlation, all p ≤ 0.016). When participants were grouped by AL, significant differences were observed for body height and SE, and when grouped by height percentile, significant differences were observed for AL and SE (Kruskal–Wallis test, all p ≤ 0.006). There was a significant difference in SE, AL, and body height between genders (Mann–Whitney U test, all p ≤ 0.038). AL relates to the refractive state of the eye and is also influenced by individual anatomical characteristics.

The present study aimed to assess the agreement of three commercially available devices on the measurement of anterior chamber depth (ACD) with and without compensation by central corneal thickness measurement (CCT). Fifty eyes were included in an observational cross-sectional study. Participants underwent a single visit during which devices were used to obtain the inclusion/exclusion (ARK510A, Canon TX-10) and studied (VX-120, Lenstar LS900 and EchoScan US-800) parameters. Based on invasiveness, tests were always performed in the same order by one researcher (to avoid inter-observer variability) and only in the right eye (to avoid overstating the precision of estimates) in each participant. The keratometry, autorefraction, intraocular pressure and anterior chamber angle values were used as inclusion criteria, while the CCT and ACD values were used in the agreement analysis between devices. There was a general and a paired difference in ACD measurements between devices (Greenhouse–Geisser: p ≤ 0.001; Sidak: all p ≤ 0.001). No significant difference was found in ACD measurements compensated by CCT values between the devices (Greenhouse–Geisser: p = 0.200). Pairwise analysis showed a significant difference in VX-120 vs. Lenstar (Sidak: p = 0.021). The differences in ACD measurements compensated by CCT values between the devices were clinically acceptable. Consequently, using these instruments interchangeably in daily routines based on this correction is justified.