PurposeTo evaluate the intention to continue wearing silicone hydrogel daily disposable contact lenses (CLs) in verofilcon A (PRECISION1®, Alcon Laboratories, USA) among neophyte wearers after a short period of use and to identify potential factors influencing this intention.MethodsA prospective, single-masked, single-arm clinical trial, was conducted at the University of Milano-Bicocca on ninety-five ametropic non-contact lens wearers (52 females and 43 males; mean age ± SD: 25.4 ± 5.3 years; range: 18–40). Participants were fitted in verofilcon A daily disposable CLs, and after receiving training on lens application and removal, were instructed to wear them for 14 days (at least 5 days a week, minimum 5 hours a day). At the follow-up visit, participants completed a series of subjective evaluations (0–100 visual analogue scales; VAS) referring to their experience over the 14-day with lens insertion and removal, comfort at insertion, end of day comfort, quality of vision, and overall satisfaction. They also rated their intention to continue CLs wear (0–100 VAS scale) and indicated their main reasons for doing so.ResultsThe mean (± SD) CL power prescribed was −1.90±1.42 D (range +2.00 to −6.00) for the right eye and −1.86±1.43 D (range +1.50 to −6.00) for the left eye. At the follow-up visit, monocular visual acuity with CLs was −0.15±0.08 logMAR in both eyes and −0.20±0.07 logMAR binocularly. Hierarchical regression analysis incorporating motivation-to-continue wear variables accounted for 57% of the variance. Three motivational factors (aesthetic, convenience, and sport) were significant predictors of the intention to continue CL wear.ConclusionProviding ametropic non-CL wearers with a structured, evidence-based CL fitting experience can be an effective strategy to promote long-term CL adoption. Behavioral intention to continue daily disposable CL wear was mainly influenced by motivational factors related to aesthetics, convenience and sport activities.

PurposeTo compare and evaluate the clinical performance and fit success of lehfilcon A and lotrafilcon B multifocal soft contact lenses (MfSCLs).Patients and MethodsThis was a prospective, randomized, double-masked, crossover, dispensing clinical study. Eligible wearers were fitted and wore study MfSCLs bilaterally (≥8 hours/day, ≥5 days/week) over 30 days. Endpoints: binocular visual acuity (VA) at distance (4 m), intermediate (80 cm), and near (40 cm) at day 30; fit rate success; eye care professional (ECP) rating, study dispensed lens power at visit 1; lens fit, and surface characteristics at dispense and day 30; safety assessments.ResultsOverall, 101 subjects were enrolled. At day 30, lehfilcon A MfSCLs were noninferior to lotrafilcon B MfSCLs for distance, intermediate, and near VA (non-inferiority margin: 0.05; 95% UCL of LSM difference 0.00, 0.02, 0.04; mean VA, lehfilcon A: −0.10 ± 0.08, −0.10 ± 0.08, and 0.01 ± 0.12; lotrafilcon B: −0.09 ± 0.07, −0.11 ± 0.08, and −0.02 ± 0.11). At visit 1, ≥99.5% of both MfSCLs achieved successful fit with 1–2 lenses/eye. Mean ECP ratings for ease of fit: lehfilcon A 9.8 ± 0.6; lotrafilcon B: 9.7 ± 0.6. About 96.0% of subjects had same sphere (D) power and 100.0% had same ADD power in both eyes for both lenses. All MfSCLs had optimal/acceptable fit. Majority of MfSCLs (>96%) had grade 0/1 front surface wettability and front/back surface deposits. No serious AEs were reported, and all biomicroscopy findings were graded 2 (mild) or lower.ConclusionLehfilcon A multifocal contact lenses combine excellent visual performance, high fit success, and a stable, comfortable wearing experience over 30 days of daily wear. With their water-gradient surface, favorable safety profile, and ease of fit, they represent a reliable and beneficial option for clinicians to consider when selecting multifocal lenses for presbyopic patients.

Digital eye strain is a cross-system condition that arises from interactions between visual physiology and digital displays. As the use of screens has grown in work, education, and everyday life, researchers have sought to describe this condition through symptom questionnaires (CVS‑Q, CVSS17, DESQ), measurements of the ocular surface and blinking, tests of accommodation and vergence, and, in related visual fatigue studies, neurophysiological methods such as electromyography and electroencephalography (EEG). Nevertheless, these methods have usually examined individual mechanisms separately. Interventions-ranging from lubricating the ocular surface and filtering blue light to ergonomic changes, task‑specific refractive correction, and scheduled micro‑breaks-have seldom been guided by a unified mechanistic framework. This review compiles evidence from 128 studies to identify six mechanistic domains relevant for clinical assessment. These include ocular surface and blink dynamics, accommodation and vergence, musculoskeletal load, device-related optical stress, cognitive load, and neural markers. A systematic search of PubMed/MEDLINE, Embase, Scopus, and Web of Science was carried out through September 30th, 2025, in accordance with PRISMA guidelines. Eligible studies included randomized trials, controlled interventions, cohort studies, and laboratory experiments, with methodological quality evaluated using the Mixed Methods Appraisal Tool. Results across pediatric, adolescent, working‑age, and presbyopic groups indicate that cognitive load reduces blinking and destabilizes accommodation. Binocular incongruence links visual effort with trapezius activation, and EEG markers can precede subjective fatigue. Interventions aligned with these mechanisms-such as ocular surface care, accommodative/vergence correction, ergonomic optimization, and micro‑break scheduling-are supported across all domains. The review proposes a mechanism‑based triage model to assist clinicians in prioritizing interventions based on the patient's exposure profile, breaking neuro‑ocular feedback loops, and preserving functional performance in individuals exposed to screens. The framework provides an actionable, mechanism‑first triage checklist for optometric practice.

To evaluate the efficacy of visual training (VT) in retarding axial elongation in myopic children and to determine its additive clinical value when combined with standard myopia control modalities, including orthokeratology (OK), defocus spectacles (DS), and low-concentration atropine (LCA). This is a retrospective, multicenter, self-controlled cohort study. A total of 208 myopic children (mean age 9.73 ± 2.08 years) who underwent a structured visual training program were included. Subjects were stratified into five subgroups based on concurrent treatments: VT monotherapy, VT+DS, VT+OK, VT+DS+LCA, and VT+OK+LCA. Annualized axial elongation rates were calculated for the pre-training (baseline) and post-training intervals. The primary outcome was the reduction in axial elongation rate. The mean axial elongation rate significantly attenuated from a baseline of 0.38 ± 0.34 mm/year to 0.23 ± 0.30 mm/year following the intervention (P < 0.001), representing a mean reduction of 0.15 ± 0.31 mm/year. There were no statistically significant differences in the magnitude of rate reduction among the five subgroups (P = 0.826), indicating that VT confers a consistent additive benefit independent of concurrent optical or pharmacological therapies. Pearson correlation analysis revealed a good positive association between baseline progression rate and treatment efficacy (r = 0.57, P < 0.001), suggesting that children with faster initial progression derived the greatest therapeutic benefit. Visual training effectively slows axial elongation, shifting pathological growth trajectories toward physiological norms. It functions as a universal adjunctive therapy, providing robust and independent protective effects regardless of whether the patient is using OK lenses, defocus spectacles, or atropine. These findings support the use of visual training as a priority "rescue therapy" for rapid progressors.

To assess the patterns and severity of different refractive errors in children aged 3 to 5 years presenting with established amblyopia in a tertiary care eye centre in Pakistan. A cross-sectional study was conducted at a tertiary care eye center involving 178 children (aged 3-5 years). The study specifically included only those with refractive amblyopia; children with strabismic or sensory deprivation amblyopia were excluded. From each participant, only the amblyopic eye (or the eye with the worse visual acuity in bilateral cases) was analyzed to ensure statistical independence. All participants underwent a comprehensive ophthalmic examination, including cycloplegic refraction (using 1% cyclopentolate) and dilated fundus evaluation. Refractive errors were classified according to MEPEDS criteria, and data was analyzed using SPSS version 24.0. Among the 178 amblyopic eyes, astigmatism (53.4%) was common, particularly myopic astigmatism (n = 28, 15.7%) and hyperopic astigmatism (n = 27, 15.2%). Females were more likely to have myopia or astigmatism, whereas males were more likely to have hyperopia or astigmatism which may indicate some gender-specific patterns in amblyopia. Hyperopia was mostly low to moderate, while moderate astigmatism was more common than high astigmatism. These differences were also statistically significant (p < 0.001). Amblyopes with myopic astigmatism (n = 28, 15.7%) and hyperopic astigmatism (n = 27, 15.2%) exhibited the poorest visual acuity (mean LogMAR VA 1.05 ± 0.49 and 0.96 ± 0.46). Astigmatic refractive errors are more likely associated with greater amblyopia severity, and even lower thresholds of refractive error have the potential to cause amblyopia. By establishing these amblyogenic patterns, our study provides the surveillance data essential for early intervention. These findings advocate for preschool screening to prevent irreversible vision loss, directly advancing the WHO SPECS 2030 goal of people-centered eye care.

PurposeVisual skills and Oculomotor function deficits are common in children with Autism Spectrum Disorder (ASD), potentially affecting their development and quality of life. This study aimed to evaluate the effectiveness of vision therapy in visual perceptual skills and oculomotor function in children with ASD.Patients and MethodsThis prospective interventional study was conducted using a convenience sampling method between February and May 2025. All children with a prior diagnosis of ASD who met the inclusion criteria were included in the study and underwent 45 sessions of vision therapy guided by the Developmental, Individual-Differences, Relationship-Based (DIR) model. Visual skills and oculomotor functions were assessed before and after vision therapy using the Wachs Analysis of Cognitive Structures (WACS) and the Northeastern State University College of Optometry (NSUCO) Oculomotor test, respectively. The paired t-test with Hedge’s g effect size was used to compare pre and post vision therapy outcomes for normally distributed data, while the Wilcoxon signed-rank test with effect size r was applied for non-normally distributed variables. Analysis of Covariance was used to examine the effect of ASD severity on post-therapy outcomes while controlling for age and gender.ResultsAmong the 42 children with ASD enrolled in the study, 36 completed all 45 sessions of vision therapy. Significant post-therapy improvements with large effect size were observed in visual perceptual skills (WACS) and oculomotor functions (NSUCO). Children with mild to moderate ASD showed greater improvements than those with severe ASD. Analysis of covariance revealed a significant effect of ASD severity on post-therapy outcomes: WACS (F(1,32) = 36.80, p < 0.001, R2 = 0.55), saccades (F(1,32) = 36.75, p < 0.001, R2 = 0.54), and pursuits (F(1,32) = 35.54, p < 0.001, R2 = 0.54). Age and gender showed no statistically significant effects on the outcomes.ConclusionThis prospective study provides preliminary evidence that DIR-guided vision therapy, particularly when combined with occupational and behavioral therapy, may enhance visual perceptual and oculomotor functions in children with ASD. However, randomized controlled studies with longer follow-up are needed to confirm these results.

This narrative review explores the relationship between African facial anthropometry and spectacle frame design. Despite the global eyewear market’s growth, a significant gap exists in designs accommodating African facial features. Through a comprehensive literature analysis, this review examines key anthropometric measurements relevant to eyewear fit across diverse African populations, current challenges in spectacle frame design, and emerging solutions. Findings reveal persistent underrepresentation of African facial measurements in global design standards, leading to poor fit, discomfort, and reduced compliance. The review identifies opportunities for innovative frame designs, material selection, and manufacturing approaches that could better serve African populations. Recommendations include increased anthropometric research across different African ethnicities, integration of digital technologies, and development of region-specific design parameters. This review contributes to the growing body of knowledge advocating for more inclusive and culturally appropriate eyewear solutions.

[This corrects the article DOI: 10.2147/OPTO.S485270.].

The purpose of this work was to determine the comfort performance of a toric, monthly, silicon hydrogel CL (lehfilcon A; TOTAL30 for Astigmatism) over a long day of wear. This was a 1-month, 3-visit, prospective, single-arm study. Adult, 18- to 45-year-old CL wearers with good vision who were minimally symptomatic (CLDEQ-8 scores ≤12) were enrolled. Subjects were required to have astigmatism ranging from -0.75 D to -2.50 D in each eye and were required to wear the study CLs from about 8:00 AM until 12:00 AM each day. Comfort data with the study CL throughout the wear day were collected via text messaging. A total of 47 subjects who had a mean ± SD age of 29.5 ± 7.0 years were analyzed. Within a specified time point across the month of wear, CL comfort did not vary (all p-value ≥ 0.82), yet CL comfort did decrease across the wear day for all days evaluated (all p-value <0.001). Most subjects found their CLs to be comfortable with only 1.8% of subjects reporting an uncomfortable score at CL application and only 8.5% of subjects reporting an uncomfortable score after 16hours of CL wear. A high level of consistency and predictability in comfort was found within the first month of wearing lehfilcon A CLs. This suggests that patients with minimal CL-related discomfort at initial fitting of a lehfilcon A CL may likely tolerate longer wear time with minimal discomfort across the entire month of wear. NCT06052046.