Elizabeth L. Irving

Refractive plasticity of the developing chick eye.

We have developed a lightweight plastic goggle with rigid contact lens inserts that can be applied to the eyes of newly hatched chicks to explore the range and accuracy of the developmental mechanism that responds to retinal defocus. Convex and concave lenses of 5, 10, 15, 20 and +30D were applied to one eye on the day of hatching. The chick eye responds accurately to defocus between ‐10 and + 15D. although hyperopia develops more rapidly than myopia. Beyond this range there is first a levelling off of the response and then a decrease. The resulting refractive errors are caused mainly by increases and decreases in axial length, although high levels of hyperopia are associated with corneal flattening. If ±10 D defocusing lenses are applied nine days after hatching the resulting myopia and hyperopia are equal to about 80% of the inducing power. After one week of inducing myopia and hyperopia with ±10 D lenses, the inducing lenses were reversed. In this case, the refractive error did not reach the power of the second lens after another week of wear. Instead, astigmatism in varying amounts (0–12 D) was produced, being greater when reversal was from plus to minus. Finally, astigmatism can also be produced by applying 9 D toric inducing lenses on the day of hatching. The astigmatism produced varies from 2 to 6 D. and the most myopic meridian coincides with the power meridian of the inducing lens. This astigmatism appears to be primarily due to corneal toricity. Furthermore, the greatest magnitude of astigmatism was produced when the piano meridian of the inducing lens was placed 45° from the line of the palpebral fissure.

Inducing myopia, hyperopia, and astigmatism in chicks

Myopia and hyperopia have been produced in chicks by applying specially designed convex and concave soft contact lenses to the eyes of newly hatched birds. After 2 weeks of wear, the eyes develop refractive states equivalent in sign and amount (+8 and -10 D) to the lens used. However, the lenses produce an artificial hyperopic shift during the first week of wear due to corneal flattening. We have developed a new approach involving the use of goggles with hard convex and concave contact lens inserts placed between the frontal and lateral visual fields. Myopia and hyperopia (+10 and -10 D) can be produced within days (4 days for hyperopia and 7 days for myopia) if the defocus is applied from the day of hatching. We can also produce significant amounts of astigmatism (1 to 5 D) axis at 90° and 180° by using cylindrical contact lens inserts. Although these last results are preliminary, they suggest that accommodation is not likely involved at this stage of refractive development because we do not believe that the accommodative mechanism can cope with cylindrical defocus. All spherical refractive errors produced using the goggle system appear to result from alterations in vitreous chamber depth.

Inducing ametropias in hatchling chicks by defocus-aperture effects and cylindrical lenses

Light-weight translucent plastic goggles with convex or concave rigid contact lens inserts were applied unilaterally to the eyes of young chicks. Convex and concave cylindrical lenses produced astigmatic refractive errors. The magnitude of the induced astigmatism was less than that of the inducing lens and varied with axis orientation. Decreased aperture size or interruption of the defocus resulted in a decreased response to refractive defocus. Slit apertures and spherical defocus produced variable amounts of myopia, hyperopia and astigmatism. Choroidal changes (increased thickness) were observed only in birds developing hyperopia or recovering from myopia.

Age-Related Cataract Is Associated with Type 2 Diabetes and Statin Use

Purpose. Diabetes has been shown to be a risk factor for age-related (AR) cataract. As statins (HMG-CoA reductase inhibitors) are now commonly prescribed for patients with type 2 diabetes, their impact on AR cataract prevalence should be considered. This study determines associations between AR cataract, type 2 diabetes, and reported statin use in a large optometric clinic population. Methods. In all, 6397 patient files (ages <1–93 years) were reviewed. Overall prevalence of statin use was calculated for patients with type 2 diabetes (n = 452) and without diabetes (n = 5884). Multivariable logistic regression analysis for AR cataract was performed controlling for patient sex, smoking, high blood pressure, type 2 diabetes, and statin use. Results. The prevalence of statin use (in patients aged >38 years) was 56% for those with type 2 diabetes and 16% for those without diabetes. Type 2 diabetes was significantly associated with nuclear sclerosis (OR = 1.62, 1.14–2.29) and cortical cataract (OR = 1.37, 1.02–1.83). Statin use was associated with nuclear sclerosis (OR = 1.48, 1.09–2.00) and posterior subcapsular cataract (OR = 1.48, 1.07–2.04). The 50% probability of cataract in statin users occurred at age 51.7 and 54.9 years in patients with type 2 diabetes and without diabetes, respectively. In non-statin users, it was significantly later at age 55.1 and 57.3 years for patients with type 2 diabetes and without diabetes, respectively (p < 0.001). Conclusions. In this population, statin use was substantially higher in patients with type 2 diabetes and was associated with AR cataracts. Further long-term study is warranted to recommend monitoring of crystalline lenses in patients with type 2 diabetes benefiting from statins.

CHICK EYE OPTICS : ZERO TO FOURTEEN DAYS

Ocular dimensions and refractive state data for chicks 0 to 14 days of age were obtained from 234 untreated control eyes of birds treated unilaterally in previous work involving various defocussing lenses and/or translucent goggles. Refractive state and corneal curvatures were measured in vivo by retinoscopy and ophthalmometry respectively. Intraocular dimensions were measured by A-scan ultrasonography, after which the eyes were removed, weighed and measured. In some cases (n=52) intraocular dimensions and lens curvatures were obtained from frozen sections of enucleated eyes. The hyperopia of hatchling chicks (+6.5+4.0 D) initially decreases rapidly and then more gradually to + 2.0 ± 0.5 D by 16 days. The distribution of refractive errors is very broad at Day 0, but becomes leptokurtotic, with a slight myopic skew, by Day 14. Corneal radius is constant for the first four days, possible as a result of pre-hatching lid pressure, and then increases linearly, as do all lens dimensions, axial diameter and equatorial diameter. Schematic eyes were developed for Days 0, 7, and 14.

The technique, validity and clinical use of the sweep VEP

Vision scientists have concentrated on studying two visual functions when it comes to assessing the sensory visual development in human: visual acuity and contrast sensitivity. The methods used to measure these visual functions can be either behavioral or electrophysiological. A relatively new technique for measuring the visual acuity and contrast sensitivity electrophysiologically is the sweep visual evoked potential (sVEP). This paper is a review of the literature on the sVEP technique: stimulus parameters, threshold determination, validity and reliability of sVEP are discussed. Different studies using the sVEP to study the development of visual acuity, contrast sensitivity, and vernier acuity are presented. Studies have demonstrated that the sVEP is a potentially important tool for assessing visual acuity and contrast sensitivity in non‐verbal individuals with disorders affecting their visual system.

Binocular adaptation to near addition lenses in emmetropic adults

Near addition lenses are prescribed to pre-presbyopic individuals for treatment of binocular motor problems such as convergence excess and to control the progression of myopia. To date, no investigation has looked at the complete sequence of binocular motor responses during a period of near work with +2D lenses. This investigation evaluated changes to accommodation and vergence responses when young adults sustained fixation at 33 cm with +2D addition lenses. In addition, the effect of the accommodative vergence cross-link (AV/A) on the magnitude and the completeness of binocular adaptation to these lenses were evaluated. The results showed that +2D lenses initiate an increase in exophoria and convergence driven accommodation. The degree of the initial induced phoria was dependant upon the magnitude of the AV/A ratio. Vergence adaptation occurred after 3 min of near fixation and reduced the exophoria and convergence driven accommodation. The magnitude of vergence adaptation was dependant upon the size of the induced phoria and hence the AV/A ratio. The completeness of adaptation was seen to vary inversely with induced exophoria and thus the AV/A ratio.

Application of video-based technology for the simultaneous measurement of accommodation and vergence

Accommodation and vergence are two ocular motor systems that interact during binocular vision. Independent measurement of the response dynamics of each system has been achieved by the application of optometers and eye trackers. However, relatively few devices, typically earlier model optometers, allow the simultaneous assessment of accommodation and vergence. In this study we describe the development and application of a custom designed high-speed digital photorefractor that allows for rapid measures of accommodation (up to 75Hz). In addition the photorefractor was also synchronized with a video-based stereo eye tracker to allow a simultaneous measurement of accommodation and vergence. Analysis of accommodation and vergence could then be conducted offline. The new instrumentation is suitable for investigation of young children and could be potentially used for clinical populations.

Aberrations of chick eyes during normal growth and lens induction of myopia

Understanding the control of eye growth may lead to the prevention of nearsightedness (myopia). Chicks develop refractive errors in response to defocusing lenses by changing the rate of eye elongation. Changes in optical image quality and the optical signal in lens compensation are not understood. Monochromatic ocular aberrations were measured in 16 chicks that unilaterally developed myopia in response to unilateral goggles with −15D lenses and in 6 chicks developing naturally. There is no significant difference in higher-order root mean square aberrations (RMSA) between control eyes of the goggled birds and eyes of naturally developing chicks. Higher-order RMSA for a constant pupil size exponentially decreases in the chick eye with age more slowly than defocus. In the presence of a defocusing lens, the exponential decrease begins after day 2. In goggled eyes, asymmetric aberrations initially increase significantly, followed by an exponential decrease. Higher-order RMSA is significantly higher in goggled eyes than in controls. Equivalent blur, a new measure of image quality that accounts for increasing pupil size with age, exponentially decreases with age. In goggled eyes, this decrease also occurs after day 2. The fine optical structure, reflected in higher-order aberrations, may be important in understanding normal development and the development of myopia.

Binocular Adaptation to +2 D Lenses in Myopic and Emmetropic Children:

Purpose. To compare vergence adaptation to +2 D addition lenses in myopic and emmetropic children and to evaluate the influence of the accommodative-vergence crosslink (AC/A ratio) on this adaptation. Methods. Nine myopic and 11 emmetropic children fixated a near target at a distance of 33 cm. Measures of binocular and monocular accommodation and phoria were obtained during a 20-min near task with and without +2 D lenses. Response AC/A ratios were determined from the experimental results. Vergence adaptation was quantified by the magnitude of reduction in phoria and the percentage of completeness (PC, return of adapted phoria to habitual level) after the near task. Results. Myopic children showed significantly higher AC/A ratios, which led to greater lens-induced exophoria and a greater demand for vergence adaptation. Both refractive groups showed significant vergence adaptation; however, myopes exhibited significantly reduced (p < 0.01) magnitudes compared with emmetropes (myopes = 3.95 ± 0.15 &Dgr;; emmetropes = 4.41 ± 0.08 &Dgr;). The mean PC was also significantly (p < 0.001) reduced in myopes (61.02 ± 1.57) compared with emmetropes (76.6 ± 2.10). There was a significant correlation between magnitude of adaptation and AC/A in both the refractive groups; however, myopes consistently showed reduced magnitudes compared to emmetropes. AC/A ratio influenced PC in emmetropic but not myopic children. In the accommodation system, +2 D lenses eliminated the accommodative lags observed in myopic children during natural viewing conditions. These lenses resulted in a small over-focus (−0.24 ± 0.27 D) at the onset of near work, which decreased during sustained viewing through the near add. Conclusions. Myopic children demonstrate reduced magnitude and completeness of vergence adaptation to +2 D lenses. The magnitude of vergence adaptation varied with AC/A in both refractive groups; however, the presence of myopia differentiated the amount of adaptation for all AC/A ratios. Conversely, the degree of completeness appears to be primarily associated with the type of refractive error.