Optimizing the methodology for the assessment of bulbar conjunctival lissamine green staining.

Significance: When using lissamine green for bulbar conjunctival evaluation, the most staining was observed with two applications of the same strip in the same eye, wetted with a drop of saline. The first application was 5 seconds after wetting the strip, and the second was 1 minute later, followed by immediate viewing. This suggests that bulbar staining should be viewed before the lid wiper region.

Light exposure profiles differ between myopes and non-myopes outside school hours.

Purpose: Considering the putative role of light in myopia, and variations in socioeconomic, lifestyle, educational and environmental factors across ethnicities, we objectively investigated light exposure patterns in Indian school children.

Methods: The light exposure profile of 143 school children (9-15 years, 50 myopes) recorded using a validated wearable light tracker for six continuous days was analysed. Additional data for non-school days were available for 87 children (26 myopes).

Current approaches to soft contact lens handling training - Global perspectives.

Purpose: All neophyte contact lens wearers require training on how to handle contact lenses. Currently, almost no published information exists describing the most common approaches used by those involved in such training in soft contact lens wearers. This study aimed to gather information on the approaches taken by those conducting this training worldwide.

TFOS Lifestyle: Impact of the digital environment on the ocular surface.

Eye strain when performing tasks reliant on a digital environment can cause discomfort, affecting productivity and quality of life. Digital eye strain (the preferred terminology) was defined as "the development or exacerbation of recurrent ocular symptoms and/or signs related specifically to digital device screen viewing". Digital eye strain prevalence of up to 97% has been reported, due to no previously agreed definition/diagnostic criteria and limitations of current questionnaires which fail to differentiate such symptoms from those arising from non-digital tasks.

Interventions for myopia control in children: a living systematic review and network meta-analysis.

Background: Myopia is a common refractive error, where elongation of the eyeball causes distant objects to appear blurred. The increasing prevalence of myopia is a growing global public health problem, in terms of rates of uncorrected refractive error and significantly, an increased risk of visual impairment due to myopia-related ocular morbidity. Since myopia is usually detected in children before 10 years of age and can progress rapidly, interventions to slow its progression need to be delivered in childhood.

Influence of location, season and time of day on the spectral composition of ambient light: Investigation for application in myopia.

Purpose: Given the possible role of spectral composition of light and myopia, this study aimed at investigating the variation in the spectral composition of ambient light in different (a) outdoor/indoor locations, (b) time of a day and (c) seasons.

Methods: The spectral power distribution (SPD), categorised into short (380-500 nm), middle (505-565 nm) and long wavelengths (625-780 nm), was recorded using a handheld spectrometer at three outdoor locations ('open playground', 'under shade of tree' and 'canopy') and three indoor locations ('room with multiple windows', 'closed room' and 'closed corridor'). Readings were taken at five different time points (3-h intervals between 6:30 and 18:00 hours) on two days, each during the summer and monsoon seasons.

Development and validation of a 'MyLyt' wearable light tracking device.

Purpose: We developed a clip-on light tracker (MyLyt) for estimating light exposure in real time. This study aimed at validating and investigating the feasibility of using MyLyt in children and adults.

Method: The study was conducted in two phases.

Time spent outdoors as an intervention for myopia prevention and control in children: an overview of systematic reviews.

Purpose: Outdoor light exposure is considered a safe and effective strategy to reduce myopia development and aligns with existing public health initiatives to promote healthier lifestyles in children. However, it is unclear whether this strategy reduces myopia progression in eyes that are already myopic. This study aims to conduct an overview of systematic reviews (SRs) reporting time spent outdoors as a strategy to prevent myopia or slow its progression in children.

Fast versus gradual adaptation of soft monthly contact lenses in neophyte wearers.

Aim: To determine if a gradual adaptation period is necessary for neophytes when fitted with modern hydrogel or silicone hydrogel reusable disposable contact lenses.

Method: Across four sites, 74 neophytes (18-28 years) were randomly assigned to a reusable lens cleaned nightly with Opti-Free® Puremoist® multi-purpose contact lens solution: Proclear® (hydrogel) or Biofinity® (silicone hydrogel) and an adaptation schedule: fast (10 h wear from the first day) or gradual (4 h on the first day, increasing their wear time by 2 h on each subsequent day until they had reached 10 h). Masked investigators graded ocular surface physiology and non-invasive tear breakup time (NIBUT) and a range of comfort, vision and lens handling subjective ratings (0-100 visual analogue scales) were recorded at the baseline visit and after 10 h of lens wear, 4-6 days and 12-14 days after lens fitting.

CLEAR - Evidence-based contact lens practice.

Evidence-based contact lens -->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patient. This reports reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as -->minimising risks of lens wear through encouraging compliance) and an aftercare routine.

Intra- and Inter-Model Variability of Light Detection Using a Commercially Available Light Sensor.

The veracity of claims made by researchers and clinicians when reporting the impact of lighting on vision and other biological mechanisms is, in part, reliant on accurate and valid measurement devices. We aim to quantify the intra- and inter-watch variability of a commercially available light sensor device which has been widely used in vision and other photobiological research. Intra- and inter-watch differences were investigated between four Actiwatch Spectrum Pro devices.

Foveal macular pigment dip in offspring of age-related macular degeneration patients is inversely associated with omega-3 index.

Background: Offspring of parent(s) with age-related macular degeneration (AMD) have a 45% lifetime risk of developing the disease. High foveal macular pigment optical density (MPOD) is protective, whereas individuals with a "foveal macular pigment dip" (FMPD) are at increased risk. Shortage of the dietary carotenoids lutein, zeaxanthin as well as fish consumption are reported AMD risk factors.

Open versus closed view autorefraction in young adults.

Purpose: While there are numerous studies comparing open-view autorefractors to subjective refraction or other open-view autorefractors, most studies between closed and open-view autorefraction tend to focus on children rather than young adults. The aim of this study was to determine the concordance in non-cycloplegic refractive error between two modern objective autorefractors: the closed-view monocular Topcon TRK-2P and the binocular open-view Grand Seiko WR-5500.

Methods: Fifty young adults aged 20-29 years (mean age 22 ± 1.

Patients' attitudes and beliefs to presbyopia and its correction.

Objective: Presbyopia is the gradual inability to focus near objects with age. This study explores patients' attitudes and beliefs towards presbyopia including preferred modes of near refractive correction.

Methods: In the United Kingdom, twenty-four volunteers completed an online questionnaire and attended a structured, recorded focus group.

The effect of sodium fluorescein on anterior eye surface measurements.

Purpose: During image acquisition, certain topographers require the addition of sodium fluorescein (NaFl) dye to the tear film. This study investigates the effect of NaFl dye on corneal topography and tear surface quality.

Method: The E300 corneal topographer (Medmont International Pty Ltd.

Smartphone ophthalmoscopy: patient and student practitioner perceptions.

It can take several years to become proficient at direct ophthalmoscopy; the instrument's single eyepiece allows only one individual to view the image at a time, which is considered disadvantageous during teaching. The introduction of smartphone ophthalmoscopes enables groups of teachers and students to view images together which could encourage peer-to-peer learning. In addition, the technology is significantly cheaper than the direct ophthalmoscope.

Evaluating a new objective grading software for conjunctival hyperaemia.

Background/ Aims: Standardised numeric grading scales are used in ophthalmic practice to improve consistency between clinicians in recording the severity of ocular conditions and to facilitate the monitoring of such changes. We investigated the intra- and inter-observer grading reliability and the agreement between subjective Cornea and Contact Lens Research Unit (CCLRU) and Efron grading scales as well as a new Advanced Ophthalmic Systems (AOS) software which uses an objective approach to grading conjunctival hyperaemia.

Methods: One experienced observer graded n = 30 bulbar and n = 26 palpebral conjunctival hyperaemia images to 0.

Repeatability of the macular pigment spatial profile: A comparison of objective versus subjective classification.

Purpose: Classification of macular pigment (MP) spatial profile phenotypes varies and is often based on subjective visualisation. We investigated repeatability of MP optical density (MPOD) comparing an objective versus subjective profiling system.

Methods: The coefficient of repeatability (CoR) was calculated for point MPOD values (0-3.

Effect of varying skin surface electrode position on electroretinogram responses recorded using a handheld stimulating and recording system.

Purpose: A handheld device (the RETeval system, LKC Technologies) aims to increase the ease of electroretinogram (ERG) recording by using specially designed skin electrodes, rather than corneal electrodes. We explored effects of electrode position on response parameters recorded using this device.

Methods: Healthy adult twins were recruited from the TwinsUK cohort and underwent recording of light-adapted flicker ERGs (corresponding to international standard stimuli).

Nutritional and smoking advice recalled by patients attending a UK age-related macular degeneration clinic.

Background: Age-related macular degeneration (AMD) is responsible for half of registered visual impairment in the UK. The Royal College of Ophthalmologists recommends providing guidance to people with AMD regarding smoking, diet, and nutritional supplements. The aim of this study was to investigate lifestyle advice recalled by patients with neovascular AMD (nAMD).

The Association between Foveal Morphology and Macular Pigment Spatial Distribution: An Ethnicity Study.

Purpose: Macular pigment (MP) spatial distribution varies considerably among individuals. We investigated ethnic variations in MP spatial distribution in relation to foveal architecture.

Methods: We measured MP optical density (MPOD) using heterochromatic flicker photometry (MAP test, City, University of London) in 76 white, 80 South Asian and 70 black volunteers (18 to 39 years).

Repeatability of Foveal Measurements Using Spectralis Optical Coherence Tomography Segmentation Software.

Purpose: To investigate repeatability and reproducibility of thickness of eight individual retinal layers at axial and lateral foveal locations, as well as foveal width, measured from Spectralis spectral domain optical coherence tomography (SD-OCT) scans using newly available retinal layer segmentation software.

Methods: High-resolution SD-OCT scans were acquired for 40 eyes of 40 young healthy volunteers. Two scans were obtained in a single visit for each participant.

The effects of ocular magnification on Spectralis spectral domain optical coherence tomography scan length.

Purpose: The purpose of this study was to assess the effects of incorporating individual ocular biometry measures of corneal curvature, refractive error, and axial length on scan length obtained using Spectralis spectral domain optical coherence tomography (SD-OCT).

Methods: Two SD-OCT scans were acquired for 50 eyes of 50 healthy participants, first using the Spectralis default keratometry (K) setting followed by incorporating individual mean-K values. Resulting scan lengths were compared to predicted scan lengths produced by image simulation software, based on individual ocular biometry measures including axial length.

Macular pigment spatial profiles in South Asian and white subjects.

Purpose: Variability in central macular pigment optical density (MPOD) has been reported among healthy individuals. These variations seem to be related to risk factors of AMD, such as female sex, smoking, and ethnicity. This study investigates variations in the spatial profiles of MPOD among ethnicities.

Short-term stability in refractive status despite large fluctuations in glucose levels in diabetes mellitus type 1 and 2.

Purpose: This work investigates how short-term changes in blood glucose concentration affect the refractive components of the diabetic eye in patients with long-term Type 1 and Type 2 diabetes.

Methods: Blood glucose concentration, refractive error components (mean spherical equivalent MSE, J0, J45), central corneal thickness (CCT), anterior chamber depth (ACD), crystalline lens thickness (LT), axial length (AL) and ocular aberrations were monitored at two-hourly intervals over a 12-hour period in: 20 T1DM patients (mean age ± SD) 38±14 years, baseline HbA1c 8.6±1.