Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach.

In chicks, visual deprivation leads to myopia and enlargement of the vitreous chamber of the eye. When chicks were raised with white translucent occluders over their eyes so that either the nasal half, the temporal half, or all of the retina was visually deprived, the resulting myopia (median = -15 diopters) was limited to the deprived part of the retina, regardless of which half of the retina was visually deprived; the nondeprived part remained nearly emmetropic. Correspondingly, the vitreous chamber was elongated only in the region of the visual deprivation, resulting in eyes with different asymmetric shapes depending on which retinal region was deprived. These results argue for a local regulation of ocular growth that is dependent on vision and suggest a hypothesis to explain the epidemiological association of myopia in humans with large amounts of reading. Because most nonfoveal retinal neurons have large receptive fields, they cannot resolve the individual letters on the printed page; this may lead to their activity being less during reading than during most other forms of visual stimulation. Thus, the impoverished stimulus situation of reading may lead to myopia, as do other types of visual form deprivation.

https://science.sciencemag.org/content/sci/237/4810/73.full.pdf

Local Retinal Regions Control Local Eye Growth and Myopia

Developmental aspects of experimental myopia in chicks: susceptibility, recovery and relation to emmetropization.

Myopia develops in macaque monkeys when their lids are surgically fused at birth and kept closed for one year. This experimental refractive error has many features in common with human myo...

An Animal Model of Myopia

PURPOSE—To characterize the in vivo epithelial thickness profile in a population of normal eyes. METHODS—An epithelial thickness profile was measured by Artemis 1 (Ultralink LLC) very highfrequency (VHF) digital ultrasound scanning across the central 10-mm diameter of the cornea of 110 eyes of 56 patients who presented for refractive surgery assessment. The average, standard deviation, minimum, maximum, and range of epithelial thickness were calculated for each point in the 10×10mm Cartesian matrix and plotted. Differences between the epithelial thickness at the corneal vertex and peripheral locations at the 3-mm radius were calculated. The location of the thinnest epithelium was found for each eye and averaged. Correlations of corneal vertex epithelial thickness with age, spherical equivalent refraction, and average keratometry were calculated. RESULTS—The mean epithelial thickness at the corneal vertex was 53.4±4.6 μm, with no statistically significant difference between right and left eyes, and no significant differences in age, spherical equivalent refraction, or keratometry. The average epithelial thickness map showed that the corneal epithelium was thicker inferiorly than superiorly (5.9 μm at the 3-mm radius, P<.001) and thicker nasally than temporally (1.3 μm at the 3-mm radius, P< 001). The location of the thinnest epithelium was displaced on average 0.33 mm temporally and 0.90 mm superiorly with reference to the corneal vertex. CONCLUSIONS—Three-dimensional thickness mapping of the corneal epithelium demonstrated that the epithelial thickness is not evenly distributed across the cornea; the epithelium was significantly thicker inferiorly than superiorly and significantly thicker nasally than temporally with a larger inferosuperior difference than nasotemporal difference. The human corneal epithelium has five to seven cell layers and an accepted central thickness of approximately 50 to 52 μm. 1 Bowman’s layer, a dense collagenous layer approximately 8 to 10 μm thickness lies between the epithelium and stroma. The anterior margin of Bowman’s

/pdf/epithelial-thickness-in-the-normal-cornea-three-dimensional-3xevpkyj1t.pdf

Epithelial Thickness in the Normal Cornea: Three-dimensional Display With Very High Frequency Ultrasound

Previous theoretical attempts to predict the refractive effects of intraocular lens (IOL) misalignment have resulted in conflicting information. Discrepancies in both the potential magnitude and direction of the refractive changes exist in the literature. This paper provides a detailed description of the mathematical framework required to achieve a valid predictive model and a quantitative analysis of the effects of IOL positional errors. The effects of misalignment are shown to influence the spherical refractive component primarily. Astigmatism related to oblique incidence is generally small. Movement of the IOL away from the retina produces myopia, while movement toward the retina produces hyperopia. It is likely that longitudinal IOL positional errors are a principal component of postoperative refractive errors. Alignment errors, on the other hand, must have generally minor effects on refraction.

Effects of intraocular lens position errors on postoperative refractive error

Purpose
To systematically analyse the differences between cycloplegic and noncycloplegic refractive errors (RE) in children and to determine if the predictive value of noncycloplegic RE in categorizing RE can be improved.

Methods
Random cluster sampling was used to select 6825 children aged 4–15 years. Autorefraction was performed under both noncycloplegic and cycloplegic (induced with 1% cyclopentolate drops) conditions. Paired differences between noncycloplegic and cycloplegic spherical equivalent (SE) RE were determined. A general linear model was developed to determine whether cycloplegic SE can be predicted using noncycloplegic SE, age and uncorrected visual acuity (UCVA).

Results
Compared to cycloplegia, noncycloplegia resulted in a more myopic SE (paired difference: −0.63 ± 0.65D, 95% CI: −0.612 to −0.65D, 6017 eligible right eyes) with greater differences observed in younger participants and in eyes with more hyperopic RE and smaller AL. Using raw noncycloplegic data resulted in only 61% of the eyes being correctly classified as myopic, emmetropic or hyperopic. Using age and uncorrected VA in the model, the association improved and 77% of the eyes were classified correctly. However, predicted cycloplegic SE continued to show large residual errors for low myopic to hyperopic RE. Applying the model to only those eyes with uncorrected VA <6/6 resulted in an improvement (R2 = 0. 93), with 80% of the eyes correctly classified. A higher VA cut-off (i.e., ≤6/18) resulted in 97.5% of eyes classified correctly.

Conclusion
Noncycloplegic assessment of RE in children overestimates myopia and results in a high error rate for emmetropic and hyperopic RE. Adjusting for age and applying uncorrected VA cut-offs to noncycloplegic assessments improves detection of myopic RE and may help in identifying myopic RE in situations where cycloplegia is not available but does not help in identifying the magnitude of refractive error and therefore is of limited value.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/aos.13569

Comparison of noncycloplegic and cycloplegic autorefraction in categorizing refractive error data in children.

Monovision (MV) contact lens correction of presbyopia induces substantial reductions in stereoacuity and small reductions in binocular visual acuity (VA). This study examined those effects in a group of successful and a group of unsuccessful MV patients. Compared to performance with a full binocular correction, the unsuccessful group demonstrated significant losses in both functions. These reductions were smaller in the successful group and of marginal statistical significance only for stereoacuity. Laterality of sighting dominance and laterality of distance/near correction had minimal effect on the results.

Role of visual acuity, stereoacuity, and ocular dominance in monovision patient success.

A method of cast molding toric contact lenses having a toric posterior surface permits aligning the mold sections at multiple rotational positions.

Method of cast molding toric contact lenses

All forms of ophthalmic correction for presbyopia require compromises in viewing flexibility and visual function. The unique effects on vision of contact lenses used in managing presbyopia are especially intriguing and potentially problematic. Bifocal contact lenses produce unique changes in the nature and quality of the retinal image. In monovision (MV) correction, anisometropia is intentionally created by fitting one eye to see clearly at optical infinity and the other eye to see clearly at the near working distance. Our review of the literature indicates that most visual functions are affected by these departures from the conventional optical correction strategies used on nonpresbyopes. Sensory functions such as contrast sensitivity and stereoacuity are affected most, whereas motor functions such as convergence and accommodation are not noticeably impaired. MV appears to produce a more widely acceptable visual compromise than currently available bifocal contact lenses for most patients.

Visual function with presbyopic contact lens correction.

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