UNASSIGNED: To explore a potential functional classification of intraocular lenses (IOLs) based on monocular visual acuity defocus curves (VADCs) as a primary end-point.
UNASSIGNED: A systematic literature search was conducted using PubMed. Two independent reviewers screened the literature for inclusion and data extraction. Inclusion criteria were full-text primary clinical studies of IOLs, published in English from 2010 onward, involving patients undergoing cataract or refractive lens exchange. A cluster analysis was conducted to explore similarities in the range of field (RoF) and increase of visual acuity from intermediate to near (ΔVA).
UNASSIGNED: A total of 107 studies were ultimately included from the 436 identified in the systematic search, with an additional 5 studies added through the snowballing technique search. The cluster analysis was conducted using 69 reports that included monocular VADCs. Two main categories were identified based on the achieved RoF for 0.2 and 0.3 logMAR: full (FRoF) and partial (PRoF) RoF IOLs. Three subcategories were identified for FRoF depending on ΔVA: continuous (FRoF-C), smooth (FRoF-Sm), and steep (FRoF-St). On the other hand, PRoF IOLs shared the characteristic of monotonous decrease in visual acuity and were subclassified into two subcategories depending on the achieved RoF: narrowed (PRoF-N) and extended (PRoF-Ex). An additional subcategory was added to PRoF, enhanced (PRoF-En), for 7 reports alternating between PRoF-N and PRoF-Ex depending on the use of 0.2 or 0.3 logMAR as a cut-off for calculating the RoF.
UNASSIGNED: IOLs can be functionally classified into six types depending on the RoF and shape of the monocular VADC. [J Refract Surg. 2024;40(2):e108-e116.].

In the field of pediatric ophthalmology, assessment of visual acuity is important and necessary in determining treatment plans for children with both functional as well as organic amblyopia, and also to monitor the effect and success of treatment.We shall review the qualitative/subjective tests, as well as the objective/quantitative tests described in the literature for assessing visual acuity, and we shall outline the complexity of vision and its impact on the objective tests.The main purpose of our paper is to present our own scheme of determining visual acuities in infants and pre-literate children, a scheme we believe is simple, effective, implies no extra costs, applicable to infants and young children, and almost infallible in detecting severe amblyopia.

Mucoceles are chronic non-neoplastic cystic lesions lined by mucus-secreting respiratory epithelium in the paranasal sinuses. Mucocele of the anterior clinoid process is a particularly rare entity most often presenting with rapidly progressive monocular blindness. The authors describe the case of a 32 year-old man who presented with acute painless visual loss in the left eye. Workup revealed an expansile lesion of the left anterior clinoid process with associated optic nerve compression. The patient underwent emergent endoscopic-assisted transnasal decompression of the optic nerve with full recovery of visual function. Early diagnosis and prompt surgical intervention optimizes the chances of functional regain of visual acuity.

What happens to vision in the remaining eye following the loss of vision in the fellow eye? Does the one-eyed individual have supernormal visual ability with the remaining eye in order to adapt and compensate for the loss of binocularity and the binocular depth cue, stereopsis? There are subtle changes in visual function following the complete loss of one eye from unilateral enucleation. Losing binocularity early in life results in a dissociation in form perception and motion processing: some aspects of visual spatial ability are enhanced, whereas motion processing and oculomotor behaviour appear to be adversely affected suggesting they are intrinsically linked to the presence of binocularity in early life. These differential effects may be due to a number of factors, including plasticity through recruitment of resources to the remaining eye; the absence of binocular inhibitory interactions; and/or years of monocular practice after enucleation. Finally, despite this dissociation of spatial vision and motion processing, research that has examined visual direction and performance on monocular tasks shows adaptive effects as a result of the loss of one eye. Practically speaking, one-eyed individuals maintain perfectly normal lives and are not limited by their lack of binocularity.

In presbyopia, patients can no longer obtain clear vision at distance and near. Monovision is a method of correcting presbyopia where one eye is focussed for distance vision and the other for near. Monovision is a fairly common method of correcting presbyopia with contact lenses and has received renewed interest with the increase in refractive surgery. The present paper is a review of the literature on monovision. The success rate of monovision in adapted contact lens wearers is 59-67%. The main limitations are problems with suppressing the blurred image when driving at night and the need for a third focal length, for example with computer screens at intermediate distances. Stereopsis is impaired in monovision, but most patients do not seem to notice this. These limitations highlight the need to take account of occupational factors. Monovision could cause a binocular vision anomaly to decompensate, so the pre-fitting screening should include an assessment of orthoptic function. Various methods have been used to determine which eye should be given the distance vision contact lens and the literature on tests of ocular dominance is reviewed. It is concluded that tests of blur suppression are most likely to be relevant, but that ocular dominance is not fixed but is rather a fluid, adaptive, phenomenon in most patients. Suitable patients can often be given trial lenses that allow them to experiment with monovision in real world situations and this can be a useful way of revealing the preferred eye for each distance. Of course, no patient should drive or operate machinery until successfully adapted to monovision. Surgically induced monovision is less easily reversed than contact lens-induced monovision, and is only appropriate after a successful trial of monovision with contact lenses.

Scedosporium species (sp) can cause disseminated disease in lung transplant recipients with almost universal mortality. We present 2 cases of disseminated disease, which responded to voriconazole therapy. In the first case, polymerase chain reaction was used to make a rapid diagnosis and allow differentiation from Aspergillus sp. In this patient, Scedosporium sp could be isolated in the urine despite therapy, and direct irrigation of the renal tract with voriconazole was used with apparent efficacy. In the other case, withdrawal of therapy resulted in clinical relapse, suggesting that lifelong therapy is probably required.

The temporal crescent syndrome or half-moon syndrome is a rare mono ocular retrochiasmatic visual field defect that can be correlated to a lesion along the contralateral parieto-occipital sulcus. This field defect may be missed in automated perimetry. We report a 45 year old man, consulting for sudden loss of the peripheral temporal field in his right eye. The magnetic resonance imaging and the spectroscopy studies confirmed an ischemic lesion on the left anterior occipital cortex. Control imaging studies six months later did not show changes in the lesion.

We reviewed the scientific literature on monovision to compare the visual performance of monovision patients with that of others wearing more traditional prescriptions. We found that visual performance of monovision patients was comparable to that of control patients wearing a balanced binocular correction, provided that reading adds were not greater than about +2.5 D, that illumination was photopic, and that stimuli were presented at supra-threshold levels. Under these conditions, monovision patients were satisfied with their perceptual experience and performed within 2 to 6% of balanced binocular control patients on a range of occupational tasks. It is noteworthy that monovision patients had relatively more difficulty with acuity-based tasks than with tasks demanding good depth perception. With reading adds over +2.5 D, at low levels of illumination, or with near-threshold level stimuli, visual performance of monovision patients was reduced compared with controls. Subjectively, under low levels of illumination, monovision patients experienced problems with glare and halos around point sources of light.

The monovision concept of correcting one eye for distance and the other for near may be utilized in presbyopes undergoing refractive surgery. We have performed a systematic review of published literature to evaluate the factors influencing monovision success, and to determine the visual outcome in patients with monovision. Articles in MEDLINE and published bibliographies reporting monovision prescription for correction of presbyopia were systematically identified and reviewed. Pertinent data were abstracted and, when feasible, statistically analyzed. The mean success rate was 73%. The success in monovision correlated with distance correction on dominant eye, alternating dominance, less than 50 seconds of are stereoacuity reduction, and less than 0.6 prism diopter of distance esophoric shifts. Monovision resulted in significant reduction of binocular contrast sensitivity function at spatial frequencies higher than 4 cycles per degree, and 2-6% reduction in task performance, but resulted in minimal reduction of binocular visual acuity, peripheral vision, visual field width and binocular depth of focus. The published literature indicates that monovision is an effective and reasonable therapeutic modality for correcting presbyopia. Proper patient selection and clinical screening are essential for monovision success.