American Optometric Association

The past articles have looked at OCT interpretation, OCT and glaucoma and OCT-A. In this article, we shall explore in more depth the role that OCT plays in the diagnosis and management of both dry and wet AMD. Jason Higginbotham investigates

This unique case report demonstrates an unusual approach to managing keratoconus: the interpalpebral fitting philosophy. This technique is rarely used in contact lens practice. In contrast, the lid-attachment fitting philosophy is more commonly utilized. The interpalpebral fitting is a challenging task concerning lens centration and stability. This report underscores the potential efficacy of the interpalpebral fitting approach in keratoconus patients with specific characteristics, such as large palpebral apertures. A 25-year-old man presented to our center for an eye examination, complaining of blurred vision. Upon examination, both eyes showed signs of keratoconus. The visual acuity without glasses was 20/400 for the right eye and 20/200 for the left eye. Visual acuity with the best correction was as follows: right eye 20/80 with -6.00/-2.50 x 45 and left eye 20/60 with -3.00/-4.00 x 145. Examinations revealed that the patient was suitable for contact lens wear, with no contraindications identified. Corneal rigid gas-permeable contact lenses with an 8.70 mm diameter were fitted according to the interpalpebral fitting strategy. The patient reported good adaptation to the lenses, with acceptable initial comfort. The fitting was excellent, resulting in a marked improvement in visual acuity, achieving 20/20 in each eye. The key takeaway from this study is that the interpalpebral fitting method is a viable option for managing keratoconus in patients with large palpebral apertures.

PurposeTo compare dry eye symptoms using the SANDE questionnaire as well as corneal and conjunctival staining with two propylene glycol lubricating eyedrops that contain very different excipients.MethodsThis was a single site, prospective, double-masked, randomized-controlled study with two arms comparing Systane Complete Multi-Dose Preservative Free (MDPF) eyedrops (Systane group) and Walgreen’s Lubricant Balance eyedrops (WLB group). Participants were 18–65 years of age, had a total score of 20–55 inclusive on the Symptom Assessment iN Dry Eye (SANDE) questionnaire at the screening visit, and were not current contact lens wearers. Subjects were randomized to either Group. Data were collected for corneal and conjunctival staining, non-invasive tear break-up time (NITBUT), and global SANDE score.ResultsA total of 70 participants completed the study (35 in each group). After 2 weeks of eyedrop use, the Systane group had a significantly greater reduction in global SANDE score (−9.9 ± 14.7) compared to the WLB group (−4.13 ± 8.6; p = 0.05). Also, the Systane group had a significantly greater reduction in total staining score (−2.8 ± 1.8) compared to the WLB group (−0.9 ± 1.5; p < 0.001). In addition, the Systane group had a greater increase in NITBUT (3.1 ± 2.9) compared to the WLB group (2.2 ± 4.5), but this was not significant (p = 0.32).ConclusionThe results of this study suggest that eyedrops with the same active ingredient, but different excipients, can have differences in performance. Participants reported less dry eye symptoms and presented with reduced clinical signs of dry eye with Systane Complete MDPF compared to those who used WLB. Systane Complete MDPF eyedrops may be a good option for practitioners to recommend for patients with mild to moderate symptoms of dry eye.

The question of when quantum mechanics becomes classical mechanics is considered from an N-slit interferometric perspective. In this regard, the design of an N-slit heavy-atom interferometer is depicted and discussed. This work includes a conceptual and experimental discussion of the Diósi-Penrose hypothesis. Such hypothesis is found to be decoupled from the interferometric foundations of quantum mechanics. For the boundary situation beyond which interference, for heavy-atom aggregates, is no longer viable, a minimalist principle is suggested: spontaneous nonsuperposition, at the probability amplitude level. This is proposed as onset for the quantum → classical transition. Further, a more pragmatic highly indeterministic mechanism is also considered.

PurposeTo construct a comprehensive reference database for a novel binocular automated perimeter. DesignA four-site prospective randomized clinical trial. Subjects and controls356 healthy subjects without ocular conditions that might affect visual function were categorized into 7 age groups. MethodsSubjects underwent comprehensive ocular examination of both eyes before enrollment. Using the TEMPO/IMOvifa automated perimeter (Topcon Healthcare/CREWT Medical Systems, Tokyo, Japan), each subject completed four binocular threshold visual field (VF) tests during a single visit: First, practice 24-2 and 10-2 tests were obtained from both eyes. Next, study 24-2 and 10-2 tests were obtained from both eyes. Test order of each sequence was randomized, and the tests were conducted under Standard Automated Perimetry testing conditions (SAP): Goldmann stimulus size III, 3183 cd/m2 maximum stimulus intensity, and background intensity of 10 cd/m2, using AIZE-Rapid test strategy. Standard VF reliability indices were assessed. For each subject, 24-2 and 10-2 test results from one randomly selected eye were analyzed. Main Outcome MeasuresPerimetric threshold sensitivity and reference limits for each test analysis parameter. ResultsThe ages of the study cohort were widely distributed, with a mean age (SD) of 52.3 (18.5) years. Sex assignment was 44.0% male and 56.0% female. The majority of subjects self-identified as White (67.4%), followed by Black or African American (13.5%) and Asian (8.7%), with 14.6% self-identified as Hispanic or Latino ethnicity. Mean sensitivity (MS) (SD) was 29.1 (1.3) decibels (dB) for the 24-2 and 32.4 (1.0) dB for the 10-2 test. For the 24-2 and 10-2, MS (SD) age-related changes averaged -0.06 (0.01) dB and -0.05 (0.01) dB per year, respectively. The normal range of pointwise threshold sensitivity increased with eccentricity and showed asymmetry around the mean, particularly notable in the 24-2 test. Mean (SD) binocular test duration was 3.18 (0.38) minutes (1 minute 35 seconds per eye) for the 24-2 test and 3.58 (0.43) minutes (1minute 47 seconds per eye) for the 10-2 test. ConclusionsA reference database for the TEMPO/IMOvifa perimeter was established, highlighting the significance of considering both age and stimulus eccentricity in interpreting threshold visual field test results.

The physics of quantum entanglement measurements and N-slit quantum interference measurements is described entirely based on quantum indeterminism without the need to invoke a ‘collapse of the wave function’ thus neutralizing concerns about ‘the measurement problem.’ It is emphasized that the physics of quantum entanglement is decoupled from Bell’s theorem. This stochastic, and pragmatic, approach also makes redundant post-Bell-superdeterminism arguments.

This fourth article by Fiona Anderson discusses the different marketing mediums, laws and regulations that apply to adverts and online behaviour

This third article by Fiona Anderson, highlights the skillset and role of the dispensing optician