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Background and Aim: Optometrists play a critical role in delivering primary eye care worldwide. This study evaluates the availability, utilization, and impact of optometry services within primary healthcare centers (PHCs) in Saudi Arabia, focusing on their contributions to patient care and the healthcare system.Methodology: A multicenter cross-sectional study was conducted across 10 PHCs in four regions of Saudi Arabia. Data on workforce distribution, the number of cases managed, referral rates, and available equipment were collected via surveys and analyzed.Results: Among the 2,120 PHCs in Saudi Arabia, only 10 centers (0.47%) provided optometry services, staffed by a total of 11 optometrists and 3 opticians. These centers managed 36,849 eye care cases in 2022, with 10,526 (28.57%) referred to secondary care for further management. The referral rates varied significantly across the PHCs, ranging from 0% at Al-Fayhaa PHC in Riyadh, which handled all cases in-house, to 46.35% at Al-Safra PHC in Al-Qassim, which relied heavily on secondary care. Regional disparities in service utilization were also evident, with the Eastern Province managing the highest number of treated cases (13,078), while Al-Qassim recorded the lowest (1,754). The analysis revealed that refractive errors (36%), cataracts (29.1%), and diabetic retinopathy (20.9%) were the most common conditions managed by optometrists.Conclusion: Optometrists significantly contribute to primary eye care in Saudi Arabia, reducing the burden on secondary care and enhancing access to eye services. However, the limited availability of optometry services necessitates targeted interventions, including increasing workforce capacity, expanding service coverage, and raising public awareness about the importance of routine eye care.

Background At our institution, we hold OSCEs for Internationally Educated Optometrists, for which Standardised Patients are used. The stations involve invasive optometric procedures; as such, the SPs' safety is paramount. We have developed a process to ensure SP safety and comfort throughout the training and examination process. While standardisation is at the forefront of any assessment, SP safety is of greatest importance during Optometry OSCEs. In this session, we will present the methods that have been developed for ensuring SP safety during the assessments. Outcomes The methods we have developed over the last 3 years of conducting the optometry assessment have ensured that the SPs are safe during interactions with candidates. While the SPs are screened before recruitment, they may still have different reactions to the methods used by the candidates during the assessment. Our exam day processes are as such that these reactions are limited or non-existent. As of May 2017, we have had no major incidents or injuries to the SPs. Conclusion Over the last two years of this assessment, we have found that different procedures require different safeguards for the SPs. What we have developed has been instrumental in protecting the SPs as well as providing a valid and reliable assessment for the candidates.

Animals that explore the world need to reliably move in a preplanned direction. With the optomotor response, flies stabilize a straight path during flight by visual feedback. Unintended deviations from a straight path are perceived as rotation of the scenery around the fly, and smooth syndirectional flight turns minimize the asymmetric optic flow. At the same time, voluntary turns cause optic flow that is indistinguishable from visual input due to involuntary, external causes. Therefore, a motor-command efference copy has been postulated to counteract reafferent sensory perceptions that arise from volitional actions, and to provide context to resolve the ambiguity in perception. In flies, HS (horizontal system) cells are thought to mediate optomotor responses to horizontal motion. During spontaneous flight saccades, HS cells have been shown to receive input that could function as an efference copy to mitigate stabilization reflexes.Here, I investigated how this putative efference copy suppresses the processing of visual motion in HS cells by recording intracellularly during tethered flight. First, it is shown that looming-elicited avoidance saccades exhibit similar effects as spontaneous saccades. Additionally, the visual experience of the looming stimulus influences the subsequent responses of HS cells. Importantly, an inhibitory efference copy suppresses the processing of excitatory optic flow during both left- and rightward saccadic turns. We found that this effect is limited to a subset of HS cells and does not markedly reduce responses to inhibitory optic flow.To refine our understanding of this efference copy mechanism and resolve the counter-intuitive findings, I reconstructed the reafferent visual input to each HS subtype during escape saccades. The reafference is biphasic and largely symmetric for left- and rightward saccades, and thus supports a functional role for reduced excitatory responses in both directions. In contrast, the reafference is not evidently different for HSS, which suggests a functional subdivision between subtypes.To improve our understanding of the efference copy function and flight control, I investigated the impact of DNp15, a descending neuron postsynaptic to HSN and HSE. Intracellular recordings show that DNp15 prefers rotational to translational optic flow by integrating binocular information and relays graded potentials. The connectome suggests that DNp15 controls head and flight turns during panoramic visual stimuli. Through silencing and activation experiments, it is found that this neuron is essential for slow optomotor turns of both the head and wings, but acts in conjunction with other descending neurons.This work contributes to our understanding of a feedforward pathway from vision to behavior and how visual processing is internally fine-tuned for behavioral context.

Purpose: The optometry profession has experienced massive changes amid lockdown in COVID 19 pandemic. This study gauges the impact of COVID-19 on optometry education and practices in India. Methods: The impact of COVID-19 among key stakeholders of Indian optometry that included educators, students, and practitioners was surveyed. The content validity of the survey tool was achieved through a focused group discussion with experts. Results: Of the 1408 responses, 118 were educators, 845 were students and 445 were practitioners. Post COVID-19 lock-down, a high percentage of students (96%) and educators (94%) were now using online mode of education to learn and teach. The blended learning methods were reported to be used by 81% of educators. Practical skills were the most difficult to teach by educators and to learn by students. Almost a third of the students were concerned about their internships and job opportunities amid the pandemic. Practitioners felt confident in performing routine eye examinations with personal protective equipment (PPE). Telemedicine was found to be adopted by 55% of the private practitioners and 49% of the eye hospitals. Conclusion: The COVID-19 pandemic has provided an opportunity to reform Indian optometry education through blended learning methods. Optometry practices changed and adapted instantly to the new hygiene norms that have raised the standard of care provided to patients. Telemedicine emerged as a mode of providing care by optometrists. Overall, all key stakeholders of optometry in India were found to have adapted well to the sudden changes due to COVID 19 pandemic.

Purpose: Amblyopia is the most common cause of monocular vision loss in children. Traditional amblyopia therapy has aimed to rebalance abnormalities in cortical development through monocular methods, such as patching therapy. The goal of this study is to investigate the potential for emerging binocular amblyopia therapies in terms of their ability to keep a viewer’s eyes aligned during stimulus presentation.Methods: Gaze position was recorded binocularly using an EyeLink 1000. Participants viewed a randomly ordered series of contrast-adjusted natural animal images (73 x 45 deg) presented dichoptically at a 60-70 cm viewing distance on a rear-projection screen (PROPixx, VPixx Technologies). The images were viewed at i) matched binocular RMS contrasts of 15%, 35%, 55%, 75%, 95% & full, ii) the same contrasts monocularly, iii) the same contrasts binocularly with dichoptic segmentation, iv) full contrast in one eye and the range of contrasts in the other eye with dichoptic segmentation, resulting in 30 conditions of 10 secs in a continuous trial. The median gaze position difference between the two eyes was calculated for each condition.Results: 2 adults participated in this study, both providing eye alignment measurements for each of our 30 viewing conditions. Each adult presented varying degrees of dissociation when viewing the therapeutic segmented condition.Conclusions: Measurements of eye alignment when viewing dichoptically segmented stimuli provide useful information regarding the potential efficacy of new forms of binocular amblyopia treatments (e.g. Luminopia One therapeutic) for individual patients. These data highlight the variability in alignment of typical observers and indicate the importance of ocular motor considerations for the success of these therapies.

Color vision is a complex process providing important information about objects within our environment. Color vision deficiency either congenital or acquired can impact real world performance. Current working environments either require normal color vision or utilize color as a tool to highlight critical information. The use of color in the workplace provides several advantages. Hence, color vision screening is required for entry into professions and occupational certifications. Acquired color vision deficiency may also impact job performance requiring clinical screening. The present dissertation focused on the considerations outlined by the Commission on Behavior and Social Sciences when choosing a clinical test for occupational purposes. In order to address these considerations, I conducted a series of four studies.The first study compared and contrasted three different computerized color vision tests for contrast sensitivity and analyzed how the minimum cutoff score differed between the tests. The results indicated that while log CS values were similar, there were enough differences between the values that caution should be applied when using the tests interchangeably for occupational screening. The second study assessed the Color Vision Field Test and found that it has excellent sensitivity and specificity for occupational screening when appropriate protocols are followed. The third study determined if the Cone Contrast Test could predict performance on the FM-100 Hue thereby providing a potential alternative test to the FM-100. Results indicated the CCT may be an effective substitute for the FM-100 to provide certification of jewelry appraisers, but the small sample size warrants additional comparative validation to support sole utilization of the CCT. This study also revealed exceptional hue discrimination in jewelry appraisers, a possible effect of perceptual learning. The last study expanded previous research on cell phone distraction to auditory distraction with a navigational system. Delayed response time was found which poses a threat to safety.

BackgroundA consensus on an optical coherence tomography definition of lamellar macular hole (LMH) and similar conditions is needed.MethodsThe panel reviewed relevant peer-reviewed literature to reach an accord on LMH definition and to differentiate LMH from other similar conditions.ResultsThe panel reached a consensus on the definition of three clinical entities: LMH, epiretinal membrane (ERM) foveoschisis and macular pseudohole (MPH). LMH definition is based on three mandatory criteria and three optional anatomical features. The three mandatory criteria are the presence of irregular foveal contour, the presence of a foveal cavity with undermined edges and the apparent loss of foveal tissue. Optional anatomical features include the presence of epiretinal proliferation, the presence of a central foveal bump and the disruption of the ellipsoid zone. ERM foveoschisis definition is based on two mandatory criteria: the presence of ERM and the presence of schisis at the level of Henle’s fibre layer. Three optional anatomical features can also be present: the presence of microcystoid spaces in the inner nuclear layer (INL), an increase of retinal thickness and the presence of retinal wrinkling. MPH definition is based on three mandatory criteria and two optional anatomical features. Mandatory criteria include the presence of a foveal sparing ERM, the presence of a steepened foveal profile and an increased central retinal thickness. Optional anatomical features are the presence of microcystoid spaces in the INL and a normal retinal thickness.ConclusionsThe use of the proposed definitions may provide uniform language for clinicians and future research.