UNASSIGNED: Crowding is exaggerated in central vision of strabismic amblyopia, impacting on reading ability. Crowding magnitude and interocular differences (IODs) in acuity are indicators for detection, assessment, and monitoring of treatment. Lateral masking (including contour interaction) also affects acuity and can mimic or ameliorate crowding. We investigated lateral masking/contour interaction and crowding impact on crowding magnitude and IOD measures in healthy and amblyopic pediatric and juvenile/adult groups using two Landolt C-tests with \"fixed\" arcmin separations.
UNASSIGNED: Acuity (logMAR) was measured with Landolt C-tests with specified 2.6\' (\"crowded\") and 35\' (\"uncrowded\") separations. Crowding magnitudes (crowded - uncrowded acuities) and IODs were calculated. Participants were 69 subjects with strabismic amblyopia (n = 39 pediatric, i.e. children ≤8 years of age), 31 subjects with anisometropic amblyopia (n = 14 pediatric), and 76 healthy controls (n = 36 pediatric). Subjects with amblyopia were subgrouped by acuity as low severity (<0.4 logMAR) or high severity (≥0.4 logMAR) using the 35\' separation C-test.
UNASSIGNED: Crowding magnitudes were greater in strabismic than in anisometropic amblyopia and control/fellow eyes. They were higher in pediatric control/fellow eyes than in juvenile/adult eyes. In high severity strabismic amblyopia, crowding magnitudes progressively and significantly reduced (slope = -0.17 ± 0.07, P < 0.05) with worsening acuity. IODs for this group were higher on the 2.6\' C-test, but lower than expected. In high severity pediatric subjects with anisometropic amblyopia, seven of eight had lower IODs measured with the \"crowded\" than the \"uncrowded\" C-tests.
UNASSIGNED: These C-tests detect amblyopia but underestimate crowding in children and adults with high severity strabismic amblyopia. Separate isolated optotype acuity and crowding distance tests may better target specific functions, while minimizing the impact of masking.

BACKGROUND: This study aimed to investigate the difference between cycloplegic and noncycloplegic refraction and evaluate the pseudomyopia prevalence in Chinese preschool children during the outbreak of COVID-19.
METHODS: A cross-sectional study was conducted in the Tongzhou District of Beijing, China. Refractive error was measured under both noncycloplegic and cycloplegic conditions with autorefraction. The difference between noncycloplegic and cycloplegic spherical equivalent refraction (SER) and pseudomyopia prevalence were analyzed. Pseudomyopia was defined as SER ≤-0.50D in precycloplegic assessments and >-0.50D in post-cycloplegic assessments.
RESULTS: Out of the 1487 participants who were enrolled in the study, 1471 individuals (98.92%) between the ages of 3-6 years completed all required procedures. A statistically significant difference in refraction was observed between noncycloplegic and cycloplegic measurements, the median of difference in spherical equivalent refraction (SER) of 0.88D (dioptre)(0.50,1.38). There was a high intraclass correlation (ICC) between these two methods for cylinders (ICC = 0.864; 95% CI, 0.850-0.877). The median DSE for myopia, emmetropia and hyperopia were 0.25D (0.00, 0.38),0.25D (0.06, 0.50) and 1.00D (0.62, 1.38), an hypermetropes showed considerably greater differences than myopes and emmetropes (Kruskal-Wallis test, H = 231.023, P = 0.000). Additionally, girls displayed a greater DSE than boys. Furthermore, when comparing against-the-rule (ATR) and oblique astigmatism, it was found that with-the-rule (WTR) astigmatism had the largest DSE. The study found varying prevalence rates of myopia, emmetropia, and hyperopia with and without cycloplegia, which were 1.90% vs. 10.06%, 11.49% vs. 50.31%, and 86.61% vs. 39.63%, respectively. Additionally, the overall prevalence of pseudomyopia was determined to be 8.29%. Participants with pseudomyopia had a significantly higher mean difference in SER (DSE) compared to non-pseudomyopic participants.
CONCLUSIONS: Cycloplegic refraction is more sensitive than a noncycloplegic one for measuring refractive error in preschool children. Pseudomyopia is prevalent in preschool children during the COVID-19 outbreak period. Our study indicates the possibility that cycloplegic refraction should be performed in preschool children routinely.

Windows provide access to daylight and outdoor views, influencing building design. Various glazing and window shade materials are used to mitigate glare, overheating and privacy issues, and they affect view clarity. Among them, we evaluated the effect of window films, electrochromic (EC) glass, and fabric shades on view clarity. We conducted an experiment with 50 participants using visual tests adapted from clinical vision tests (visual acuity, contrast sensitivity, color sensitivity) and images displayed on a computer monitor in a controlled laboratory. Window films and EC glass tints outperformed fabric shades in visual acuity, contrast sensitivity and view satisfaction with the exception of the darkest EC tint state and dark grey VLT 3% shade for color sensitivity and view satisfaction. The EC tints pose internal reflection issues and fabric shades are preferred for visual privacy. Window films and EC glass hinder participants\' blue-green color discrimination while fabric shades also decrease red-yellow color discrimination. Visual acuity predicts view satisfaction and contrast sensitivity is the strongest predictor for visual privacy. Generally, higher visible light transmittance and lower solar reflectance (darker color) enhance human visual performance. The proposed workflow provides an experimental procedure, identifies the primary variables and establishes a predictive framework for assessing view clarity of fenestration.

CONCLUSIONS: Angular Indication Measurement (AIM) is an adaptive, self-administered, and generalizable orientation-judgment method designed to interrogate visual functions. We introduce AIM Visual Acuity (VA) and show its features and outcome measures. Angular Indication Measurement VA\'s ability to detect defocus was comparable with that of an Early Treatment of Diabetic Retinopathy Study (ETDRS) letter chart and showed greater sensitivity to astigmatic blur.
OBJECTIVE: This proof-of-concept study introduces Angular Indication Measurement and applies it to VA.
METHODS: First, we compared the ability of AIM-VA and ETDRS to detect defocus and astigmatic blur in 22 normally sighted adults. Spherical and cylindrical lenses in the dominant eye induced blur. Second, we compared repeatability over two tests of AIM-VA and ETDRS.
RESULTS: A repeated-measure analysis of variance showed a main effect for defocus blur and test. For the astigmatism experiment, an interaction between blur and orientation was found. Pairwise comparisons showed that AIM was more sensitive to astigmatic-induced VA loss than ETDRS. Bland-Altman plots showed small bias and no systematic learning effect for either test type and improved repeatability with more than two adaptive steps for AIM-VA.
CONCLUSIONS: Angular Indication Measurement VA\'s ability to detect defocus was comparable with that of an ETDRS letter chart and showed greater sensitivity to induced astigmatic blur, and AIM-VA\'s repeatability is comparable with ETDRS when using two or more adaptive steps. Angular Indication Measurement\'s self-administered orientation judgment approach is generalizable to interrogate other visual functions, e.g., contrast, color, motion, and stereovision.

To evaluate the usefulness of the Tokyo Metropolitan Government\'s Eye Health Screening Program for 3-year-old children, which combines the Single-Picture Optotype Visual Acuity Chart (SPVAC) and Spot™ Vision Screener (SVS) tests. This was a retrospective, observational, matched study. Patients who underwent the eye health screening program and had abnormalities were classified into 3 groups according to the outcomes of the SPVAC (SPVAC-passed, SPVAC-P; SPVAC-failed, SPVAC-F) and SVS (SVS-passed, SVS-P; SVS-failed, SVS-F) tests as follows: SPVAC-P/SVS-F, SPVAC-F/SVS-P, and SPVAC-F/SVS-F. We evaluated the age at examination, SPVAC and SVS test success rates, and SVS refractive power. Additionally, the rates of refractive error, amblyopia, and strabismus were compared among the 3 groups. The SPVAC-P/SVS-F, SPVAC-F/SVS-P, and SPVAC-F/SVS-F groups comprised 158, 28, and 74 eyes, respectively. The mean age was 37.4 months. The success rates of the SPVAC and SVS tests were 69.8% and 96.2%, respectively. The mean SVS hyperopia value in the SPVAC-F/SVS-F group (2.71 ± 1.50 D) was significantly higher than that of the SPVAC-P/SVS-F group. The mean SVS astigmatism and myopia values were -2.21 diopter (D) ± 1.09 D and -3.40 ± 1.82 D, respectively; they did not differ significantly from that of the SPVAC-P/SVS-F group. Significant differences were observed in the refractive error, amblyopia, and strabismus rates among the 3 groups. Regarding disease determination, no significant difference was observed among participants who passed and failed the SPVAC test, regardless of the outcome of the other test. However, a significant difference was observed between those passing and failing the SVS tests. The SPVAC method used to screen 3-year-old children should be modified to commence at 42 months of age or be replaced with a single Landolt C test. The SVS test is useful for screening younger patients. Furthermore, the SVS test showed that the degree of hyperopia was higher in patients who did not pass the SPVAC test.

UNASSIGNED: To establish the reliability and validity of five performance-based activities of daily living task tests (ADLTT), to correlate structure to function, to evaluate the impact of visual impairment (VI) on age-related macular degeneration (AMD), and to develop new outcome measures.
UNASSIGNED: A multidisciplinary team developed five ADLTTs: (1) reading test (RT); (2) facial expression (FE) recognition; (3) item search (IS) task; (4) money counting (MC) task; and (5) making a drink (MD), tested with binocular and monocular vision. ADLTTs were tested for known-group (i.e., difference between AMD group and controls) and convergent (i.e., correlation to other measures of visual function), validity metrics, and test-retest reliability in 36 patients with VI (visual acuity (logMAR VA > 0.4) in at least one eye caused by AMD versus 36 healthy controls without VI.
UNASSIGNED: Compared to controls, AMD patients had a slower reading speed (-77.41 words/min; P < 0.001); took longer to complete MC using monocular worse eye and binocular vision (15.13 seconds and 4.06 seconds longer compared to controls, respectively; P < 0.001); and MD using monocular worse eye vision (9.37 sec; P = 0.033), demonstrating known-group validity. Only RT and MC demonstrated convergent validity, showing correlations with VA, contrast sensitivity, and microperimetry testing. Moderate to good test-retest reliability was observed for MC and MD (interclass correlation coefficient = 0.55 and 0.77; P < 0.001) using monocular worse eye vision.
UNASSIGNED: Real-world ADL functioning associated with VI-related AMD can be assessed with our validated ADLTTs, particularly MC and MD.
UNASSIGNED: This study validates visual function outcome measures that are developed for use in future clinical practice and clinical trials.

OBJECTIVE: Stereopsis is a critical visual function, however clinical stereotests are time-consuming, coarse in resolution, suffer memorization artifacts, poor repeatability, and low agreement with other tests. Foraging Interactive D-prime (FInD) Stereo and Angular Indication Measurement (AIM) Stereo were designed to address these problems. Here, their performance was compared with 2-Alternative-Forced-Choice (2-AFC) paradigms (FInD Stereo only) and clinical tests (Titmus and Randot) in 40 normally-sighted and 5 binocularly impaired participants (FInD Stereo only).
METHODS: During FInD tasks, participants indicated which cells in three 4*4 charts of bandpass-filtered targets (1,2,4,8c/° conditions) contained depth, compared with 2-AFC and clinical tests. During the AIM task, participants reported the orientation of depth-defined bars in three 4*4 charts. Stereoscopic disparity was adaptively changed after each chart. Inter-test agreement, repeatability and duration were compared.
RESULTS: Test duration was significantly longer for 2-AFC (mean = 317s;79s per condition) than FInD (216s,18s per chart), AIM (179s, 60s per chart), Titmus (66s) or RanDot (97s). Estimates of stereoacuity differed across tests and were higher by a factor of 1.1 for AIM and 1.3 for FInD. No effect of stimulus spatial frequency was found. Agreement among tests was generally low (R2 = 0.001 to 0.24) and was highest between FInD and 2-AFC (R2 = 0.24;p<0.01). Stereoacuity deficits were detected by all tests in binocularly impaired participants.
CONCLUSIONS: Agreement among all tests was low. FInD and AIM inter-test agreement was comparable with other methods. FInD Stereo detected stereo deficits and may only require one condition to identify these deficits. AIM and FInD are response-adaptive, self-administrable methods that can estimate stereoacuity reliably within one minute.

OBJECTIVE: To determine the impact of optotype choice on the determination of defocus curve in patients with cataract implanted with presbyopia-correcting intraocular lens (IOL).
METHODS: Oftalvist Alicante, Alicante, Spain.
METHODS: Observational case-control study.
METHODS: Patients implanted with Asqelio Trifocal IOL participated in this study. Uncorrected and corrected distance visual acuity (VA) and subjective refraction were determined. Monocular defocus curves were obtained 6 months postoperatively with the Clinical Trial Suite system using either Early Treatment Diabetic Retinopathy Study (ETDRS) or Landolt C charts under photopic conditions (85 cd/m 2 ), and range of vergence from +2.00 to -5.00 diopters (D) in 0.50 D steps.
RESULTS: A total of 49 patients were enrolled in the study, 24 in the ETDRS group (7 male, 17 female) and 25 in the Landolt C group (5 male, 20 female). Nonsignificant differences were found between patients conforming both groups, except for preoperative intraocular pressure and white-to-white distance. All patients were within ±1.00 D from intended refraction after surgery. 75% of patients in the ETDRS group and 84% in the Landolt C group were within ±0.50 D. Average difference between the groups across vergences provided by the defocus curve was 0.12 ± 0.05 logMAR units, significant for all vergences ( P < .05). Differences in VA were significant for distance, intermediate, and near between both groups, except for uncorrected distance VA.
CONCLUSIONS: Defocus curves created using Landolt C charts yield significantly lower through-focus outcomes than those created with standard ETDRS charts. This should be taken into account when comparing the performance of presbyopia-correcting systems across studies where recognition charts might have been used because of patient characteristics.

UNASSIGNED: Most neovascular age-related macular degeneration (nAMD) treatments involve long-term follow-up of disease activity. Home-monitoring would reduce the burden on patients and their caregivers and release clinic capacity.
UNASSIGNED: To evaluate 3 vision home-monitoring tests for patients to use to detect active nAMD compared with diagnosing active nAMD at hospital follow-up during the after-treatment monitoring phase.
UNASSIGNED: This was a diagnostic test accuracy study wherein the reference standard was detection of active nAMD by an ophthalmologist at hospital follow-up. The 3 home-monitoring tests evaluated included the following: (1) the KeepSight Journal (KSJ [International Macular and Retinal Foundation]), which contains paper-based near-vision tests presented as word puzzles, (2) the MyVisionTrack (mVT [Genentech]) vision-monitoring mobile app, viewed on an Apple mobile operating system-based device, and (3) the MultiBit (MBT [Visumetrics]) app, viewed on an Apple mobile operating system-based device. Participants were asked to test weekly; mVT and MBT scores were transmitted automatically, and KSJ scores were returned to the research office every 6 months. Raw scores between hospital follow-ups were summarized as averages. Patients were recruited from 6 UK hospital eye clinics and were 50 years and older with at least 1 eye first treated for active nAMD for at least 6 months or longer to a maximum of 42 months before approach. Participants were stratified by time since starting treatment. Study data were analyzed from May to September 2021.
UNASSIGNED: The KSJ, mVT, and MBT were compared with the reference standard (in-hospital ophthalmologist examination).
UNASSIGNED: Estimated area under receiver operating characteristic curve (AUROC). The study had 90% power to detect a difference of 0.06, or 80% power to detect a difference of 0.05, if the AUROC for 2 tests was 0.75.
UNASSIGNED: A total of 297 patients (mean [SD] age, 74.9 [6.6] years; 174 female [58.6%]) were included in the study. At least 1 hospital follow-up was available for 312 study eyes in 259 participants (1549 complete visits). Median (IQR) home-monitoring testing frequency was 3 (1-4) times per month. Estimated AUROC was less than 0.6 for all home-monitoring tests, and only the KSJ summary score was associated with lesion activity (odds ratio, 3.48; 95% CI, 1.09-11.13; P = .04).
UNASSIGNED: Results suggest that no home-monitoring vision test evaluated provided satisfactory diagnostic accuracy to identify active nAMD diagnosed in hospital eye service follow-up clinics. Implementing any of these evaluated tests, with ophthalmologists only reviewing test positives, would mean most active lesions were missed, risking unnecessary sight loss.

OBJECTIVE: The Pelli-Robson and LEA contrast sensitivity charts are commonly used in clinical settings to measure contrast sensitivity. Although the Pelli-Robson chart is considered the gold standard, it is limited by its bulky size. The LEA chart, on the contrary, offers a more practical and portable option that is still reliable. This has led to questions about whether we can predict Pelli-Robson scores based on LEA scores. This study developed a conversion method to help transition from the LEA chart to the Pelli-Robson chart and validate the conversion score.
METHODS: In this retrospective study, we analyzed the relationship between LEA and the Pelli-Robson contrast sensitivity test. Our study examined a total of 120 eyes. We developed a conversion table through the equipercentile equating method. Subsequently, we assessed the reliability and accuracy of this algorithm for converting LEA results into Pelli-Robson contrast sensitivity scores.
RESULTS: The study used a conversion table to convert LEA scores to Pelli-Robson scores. The conversion table achieved a reliability of 0.91 based on intraclass correlation, and the algorithm had an accuracy of 81.6% within a 1-point difference from the raw score.
CONCLUSIONS: This study reported a reliable and comparable conversion algorithm for transforming LEA scores into converted estimated Pelli-Robson scores, thereby improving the usefulness of existing data in both clinical and research contexts.