Vision

15 pages, 600 KiB

Open AccessArticle

A Comparison of All-Cause Mortality in Patients Who Required Glaucoma Surgery for Neovascular Glaucoma or Primary Open-Angle Glaucoma: A Retrospective Cohort Study

by Laura D. Palmer, Levi D. Kauffman, Gregory B. Russell, Atalie C. Thompson and Gillian G. Treadwell

Vision 2025, 9(2), 49; https://doi.org/10.3390/vision9020049 - 13 Jun 2025

Viewed by 338

Abstract

This retrospective review examines whether there is a difference in all-cause mortality in patients who required surgical intervention for neovascular glaucoma (NVG, N = 186) versus primary open-angle glaucoma (POAG, N = 190). Cox proportional hazard models compared mortality across three models: unadjusted, [...] Read more.

This retrospective review examines whether there is a difference in all-cause mortality in patients who required surgical intervention for neovascular glaucoma (NVG, N = 186) versus primary open-angle glaucoma (POAG, N = 190). Cox proportional hazard models compared mortality across three models: unadjusted, age-adjusted (Model 1), and age-, hypertension-, and diabetes-adjusted (Model 2). In all models, NVG patients who required glaucoma surgery had a higher all-cause mortality rate compared to those with POAG who underwent similar procedures: unadjusted (HR 2.22, (1.59, 3.10), p < 0.0001), Model 1 (HR 2.99, 95% CI (2.12, 4.22), p < 0.0001), and Model 2 (HR 1.88, 95% CI (1.27, 2.80), p < 0.0018). In Model 1, those with NVG due to PDR had a higher all-cause mortality rate after glaucoma surgery than those with NVG secondary to CRVO (HR 2.00, 95% CI (1.19, 3.45), p < 0.0095). Patients treated with CPC had higher all-cause mortality rates than those treated with tube shunt in all models: unadjusted (HR 1.82, 95% CI (1.33, 2.47), p < 0.0001), Model 1 (HR 1.91, 95% CI (1.40, 2.61), p < 0.0001), and Model 2 (HR 1.50, 95% CI (1.04, 2.16), p < 0.03). We observed a higher all-cause mortality rate among patients with NVG requiring glaucoma surgery compared to those with POAG requiring similar surgeries, which could suggest that NVG patients requiring glaucoma surgery had more compromised systemic health. Full article

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19 pages, 1648 KiB

Open AccessArticle

by Avi Portnoy and Sharon Gilaie-Dotan

Vision 2025, 9(2), 48; https://doi.org/10.3390/vision9020048 - 4 Jun 2025

Viewed by 1096

Abstract

Some estimates suggest that one in seven good readers and the majority of children with reading difficulties suffer from oculomotor dysfunction (OMD), an umbrella term for abnormalities in comfortable and accurate fixations, pursuits, and saccades. However, national vision evaluation programs worldwide are often [...] Read more.

Some estimates suggest that one in seven good readers and the majority of children with reading difficulties suffer from oculomotor dysfunction (OMD), an umbrella term for abnormalities in comfortable and accurate fixations, pursuits, and saccades. However, national vision evaluation programs worldwide are often limited to distance visual acuity (dVA), not testing for OMD despite its high prevalence and the ease of detecting it in brief optometric evaluations. We hypothesized that reading acquisition is dependent on good oculomotor functions, and therefore inadequate oculomotor control will be associated with reading difficulties. We retrospectively examined and compared oculomotor evaluations (using DEM and NSUCO) and reading assessments (using standardized national reading norms) of a normative class (28 first graders (6–7 yr. olds)) that were independently obtained while blind to the other assessment. Better oculomotor performance as estimated by DEM was associated with better reading performance, and almost a third (29.6%) of the children were categorized by DEM as having OMD-related difficulties. Control analysis revealed dVA was not positively associated with reading performance. Linear regression analyses further corroborated these findings. Since this study is based on a small cohort and since there are studies suggesting that DEM may actually reflect visual processing speed or cognitive factors rather than oculomotor function, replications are needed to substantiate the direct contribution of oculomotor functions to reading acquisition. Young children struggling with reading may benefit from a comprehensive visual evaluation, including oculomotor testing, to provide a more thorough assessment of their learning-related difficulties. Full article

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25 pages, 14027 KiB

Open AccessReview

Revealing the Concealed in Monocular and Binocular Vision

by Nicholas J. Wade

Vision 2025, 9(2), 47; https://doi.org/10.3390/vision9020047 - 3 Jun 2025

Viewed by 1147

Abstract

Concealing images has been a concern of artists and scientists, as have the conditions that can reveal them. It is relatively easy to hide images in pictures, but this is of little value if they remain hidden. The skill is in revealing previously [...] Read more.

Concealing images has been a concern of artists and scientists, as have the conditions that can reveal them. It is relatively easy to hide images in pictures, but this is of little value if they remain hidden. The skill is in revealing previously concealed images. Three aspects of hiding images are examined, two of which are monocular and the third is binocular. Firstly, high-contrast patterns, like Street figures and Mooney faces, have been used in psychological tests of pattern recognition, and Gestalt grouping principles can result in concealing images. Second, it is possible to hide low spatial frequency content carried by high-spatial-frequency patterns. A wider range of carriers than gratings can be used, like graphics, photographs, and combinations of them (photo-graphics). Pictorial images can be concealed in terms of detection or recognition. In both cases, there is interplay between the global features of the concealed image and the local elements that carry it. Third, randomly textured stereograms reveal to two eyes what is concealed from each one alone—stereoscopic depth. The dimension of stereoscopic depth can be manipulated, as can that of binocular rivalry, to conceal images. Full article

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10 pages, 3422 KiB

Open AccessArticle

Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients

by Roberta M. van den Berg, Sarah DeVaro, Karolinne Maia Rocha, Marcela Fetrin de Barros and Stephen D. Klyce

Vision 2025, 9(2), 46; https://doi.org/10.3390/vision9020046 - 29 May 2025

Viewed by 560

Abstract

The purpose of this study is to evaluate the potential impact of small aperture optics on corneal aberrations in post-RK patients. Preoperative data was evaluated from 32 eyes of 23 post-RK patients. Scheimpflug tomography was used to obtain measurements of corneal HOAs at [...] Read more.

The purpose of this study is to evaluate the potential impact of small aperture optics on corneal aberrations in post-RK patients. Preoperative data was evaluated from 32 eyes of 23 post-RK patients. Scheimpflug tomography was used to obtain measurements of corneal HOAs at 6-mm, 4-mm, and 2-mm corneal plane aperture diameters. The data was extrapolated using a non-linear fit to estimate HOAs that would be obtained with the 1.6 mm effective pinhole IOL aperture at the corneal plane for individual patients. The average RMS HOAs estimated for the 1.6 mm aperture was 0.063 ± 0.015 μm compared to 0.185 ± 0.029 μm for the natural pupil size. A postoperative RK case with an IC-8^® Apthera™ unilateral implantation demonstrated a 70% reduction in HOAs by objective measurement and prediction, plus a 2-line improvement in CDVA. Prediction modeling revealed that HOAs may be reduced in post-RK patients following pinhole IOL implantation, compared to the natural photopic pupil size. Furthermore, the approach can be used to guide which post-RK patients would benefit from a small aperture IOL during cataract surgery. Full article

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8 pages, 821 KiB

Open AccessArticle

Anatomical and Functional Outcomes of Human-Amniotic Membrane Graft in Refractory Macular Hole Cases

by Soefiandi Soedarman, Sandi Muslim, Waldensius Girsang, Elvioza, Referano Agustiawan, Alberthus Donni Budi Prasetya and Ichsan Fauzi Triyoga

Vision 2025, 9(2), 45; https://doi.org/10.3390/vision9020045 - 22 May 2025

Viewed by 587

Abstract

Macular hole (MH) surgery generally has a high success rate, but finding anatomical plug for refractory cases remains challenging. The human amniotic membrane (hAM), with its anti-inflammatory and regenerative properties, has emerged as a potential option. This study aims to report the anatomical [...] Read more.

Macular hole (MH) surgery generally has a high success rate, but finding anatomical plug for refractory cases remains challenging. The human amniotic membrane (hAM), with its anti-inflammatory and regenerative properties, has emerged as a potential option. This study aims to report the anatomical and functional outcomes of human amniotic membrane (hAM) graft as an intervention to repair refractory macular hole cases where wide internal limiting membrane (ILM) peeling was unsuccessful. A retrospective chart review was conducted at a single center, with the main outcomes being closure rate and postoperative BCVA at 6 months. Eleven eyes of 11 patients with refractory macular holes were identified and included in the study. Participants were predominantly males (72.73%) with a mean age of 49.27 years. Nine eyes achieved successful MH closure with a single intervention and showed no recurrence during the 6-month follow-up. Mean BCVA at 3 and 6 months improved significantly (p = 0.0207) from 1.747 ± 0.74 logMAR to 1.210 ± 0.51 logMAR and 0.939 ± 0.47 logMAR (range 2.079–0.301 logMAR). The use of human amniotic membrane (hAM) graft seems to be a viable and effective alternative for the treatment of refractory macular holes. However, further larger prospective controlled studies are necessary to confirm our results. Full article

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23 pages, 4658 KiB

Open AccessReview

Ocular and General Proprioception in Dyslexic Children: A Review of Their Diurnal and Nocturnal Dysfunctions and Their Repercussions

by Patrick Quercia, Kalvin Chavet and Jérémie Gaveau

Vision 2025, 9(2), 44; https://doi.org/10.3390/vision9020044 - 20 May 2025

Viewed by 2568

Abstract

We provide a summary of the research conducted in our laboratory on the relationship between ocular proprioception, general proprioception, and dyslexia. Dyslexic children show a marked proprioceptive deficit which affects motor control, attention and spatial perception. The spatial disturbances are expressed by the [...] Read more.

We provide a summary of the research conducted in our laboratory on the relationship between ocular proprioception, general proprioception, and dyslexia. Dyslexic children show a marked proprioceptive deficit which affects motor control, attention and spatial perception. The spatial disturbances are expressed by the presence of a vertical microheterophoria which has very specific characteristics. It is associated with abnormal tone of the oblique muscles and can be modified by means of very low powered prisms and/or remote sensory stimulation. When ocular proprioception is modified, sounds cause stochastic visual losses. This may interfere with the association between phonemes and graphemes, which is necessary for learning to read. The effects of a generalized nocturnal proprioceptive disorder may play a role in the abnormal brain development that has been observed in dyslexic children. Full article

(This article belongs to the Section Visual Neuroscience)

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17 pages, 2749 KiB

Open AccessArticle

Perception and Decision-Making in Virtual Telepsychology Spaces and Professionals

by Luis-Lucio Lobato Rincón, Maria Ángeles Medina Sánchez and Rubén Tovar Bordón

Vision 2025, 9(2), 43; https://doi.org/10.3390/vision9020043 - 6 May 2025

Viewed by 1016

Abstract

Humans interact with virtual environments for a variety of purposes, and the use of telemedicine services and e-health platforms has become increasingly significant in recent years. Telepsychology is an emerging service and is understood as the provision of psychological aid and counseling through [...] Read more.

Humans interact with virtual environments for a variety of purposes, and the use of telemedicine services and e-health platforms has become increasingly significant in recent years. Telepsychology is an emerging service and is understood as the provision of psychological aid and counseling through the use of telecommunication technologies. This study investigates the impact of visual backgrounds in a mental health simulation app and explores the decision-making of potential patients for telepsychology. In this experimental study, we developed an instrument to assess the preferences for manipulated features of photomontages and portraits. A total of 310 participants from diverse backgrounds were surveyed about their preferences regarding visual backgrounds and silhouettes for this hypothetical service, with key independent variables such as complexity, naturalness, and color hues being manipulated. Our findings represent the first example of data collected on background preferences in telepsychology. The results suggest a preference for backgrounds with medium complexity and naturalness for clinical settings. Additionally, we observed variations in preferences based on gender and age. These findings highlight the importance of customizing visual elements to enhance patient engagement in telepsychology. Full article

(This article belongs to the Section Visual Neuroscience)

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13 pages, 3709 KiB

Open AccessSystematic Review

Latin American Prevalence of Glaucoma: A Systematic Review and Meta-Analysis

by Denisse J. Mora-Paez, Jaime Guedes, Dillan Cunha Amaral, Marcelo Alves Ferreira, Bruno F. Fernandes, Sacha F. Pereira, Bruno Botton, Alisha Desai, Helena Messinger Pakter, Fabio Lavinsky and Adroaldo Alencar Costa Filho

Vision 2025, 9(2), 42; https://doi.org/10.3390/vision9020042 - 5 May 2025

Viewed by 1071

Abstract

We conducted a systematic review and meta-analysis to estimate the prevalence of all types of glaucoma in Latin America (LATAM) and evaluate potential demographic associations. This study followed PRISMA guidelines and was registered in PROSPERO (CRD42024506330). A comprehensive search of PubMed, SciELO, and [...] Read more.

We conducted a systematic review and meta-analysis to estimate the prevalence of all types of glaucoma in Latin America (LATAM) and evaluate potential demographic associations. This study followed PRISMA guidelines and was registered in PROSPERO (CRD42024506330). A comprehensive search of PubMed, SciELO, and Web of Science was conducted to identify population-based or cross-sectional studies reporting glaucoma prevalence in LATAM. Studies were categorized into two groups: Group 1 included general population studies without selection based on visual acuity (VA), and Group 2 included studies limited to individuals with VA < 20/60. Data from five studies in Group 1 (25,288 individuals) and eight studies in Group 2 (29,882 individuals) were analyzed using R software. The pooled prevalence of glaucoma was 4% (95% CI: 1–3%) in Group 1 and 1% (95% CI: 0–1%) in Group 2. No statistically significant associations were found between glaucoma prevalence and sex (p = 0.08) or age (p = 0.5669). Although our findings highlight the relevance of glaucoma as a public health concern in LATAM, the limited number of available studies and methodological variability reduce the certainty of the estimates. Full article

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14 pages, 534 KiB

Open AccessArticle

The Influence of the Level of Monovision upon Early Outcomes Following the Bilateral Implantation of an Enhanced Monovision Intraocular Lens

by Richard N. McNeely, Stephen Stewart, Niraj Mandal, Salissou Moutari, Allon Barsam and Jonathan E. Moore

Vision 2025, 9(2), 41; https://doi.org/10.3390/vision9020041 - 3 May 2025

Viewed by 992

Abstract

This article provides an assessment of the impact of different levels of monovision upon early visual outcomes and quality of vision (QoV) following the bilateral implantation of enhanced monovision intraocular lenses (IOLs). Consecutive patients implanted bilaterally with the Rayone EMV (Rayner) were recruited. [...] Read more.

This article provides an assessment of the impact of different levels of monovision upon early visual outcomes and quality of vision (QoV) following the bilateral implantation of enhanced monovision intraocular lenses (IOLs). Consecutive patients implanted bilaterally with the Rayone EMV (Rayner) were recruited. The dominant eye was targeted for emmetropia, and myopia was targeted in the nondominant eye. Patients were categorized based upon the postoperative refractive outcome in the nondominant eye as follows: Group A: −0.50 to −1.0 D (n = 40), Group B: <−1.00 = D (n = 46). Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity, and QoV were compared 3 months postoperatively. Binocular UIVA was 0.05 ± 0.10 and −0.01 ± 0.11logMAR (p = 0.03) in the two respective groups, and binocular UNVA was 0.23 ± 0.09 and 0.14 ± 0.09logMAR (p < 0.001). Day QoV was 8.77 ± 1.33 and 8.13 ± 1.34 for night QoV in group A, and 8.85 ± 0.99 and 7.85 ± 1.35, respectively, in group B. Group A had a lower spectacle independence rate of 55% compared to 89.1%. This IOL provides a satisfactory range of vision with high QoV satisfaction. A postoperative refractive error of −1.0 D or more in the nondominant eye significantly improves binocular UIVA, UNVA, and spectacle independence, without negatively impacting QoV. Full article

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8 pages, 180 KiB

Open AccessArticle

The Association Between Sensory Impairment and Adherence to COVID-19 Prevention Measures in the Adult California Health Interview Survey Population

by Catherine T. Cascavita, Ahmad Santina, Ken Kitayama, Fei Yu, Victoria L. Tseng and Anne L. Coleman

Vision 2025, 9(2), 40; https://doi.org/10.3390/vision9020040 - 2 May 2025

Viewed by 580

Abstract

This study explores the association between vision/hearing impairment and COVID-19 prevention strategies in the 2020 and 2021 California Health Interview Survey (CHIS). This cross-sectional study used data from the 2020 and 2021 CHIS. The exposure of interest was self-reported history of sensory impairment. [...] Read more.

This study explores the association between vision/hearing impairment and COVID-19 prevention strategies in the 2020 and 2021 California Health Interview Survey (CHIS). This cross-sectional study used data from the 2020 and 2021 CHIS. The exposure of interest was self-reported history of sensory impairment. The outcome of interest was adherence to COVID-19 mitigation strategies defined as obtaining a COVID-19 vaccine, face mask adherence, hand washing, social distancing, and not gathering with non-household members. Logistic regression models examined the association between sensory impairment and adherence to COVID-19 mitigation strategies, controlling for age, sex, race and ethnicity, general health status, and household income. All analyses were weighted according to the CHIS sampling design. With 24,453 California adults representing 29,649,837 people, the weighted prevalence of sensory impairment was 6.1% (1,808,640/29,649,837). The regression revealed that adults with sensory impairment were 80% more likely not to maintain social distancing (odds ratio: 1.80, 95%CI: 1.03–3.13, p = 0.04) compared to those without impairment. No significant differences were found for adherence to other COVID-19 strategies. Individuals with sensory impairment may have increased difficulty with physical distancing due to their underlying impairment. Further studies are needed to explore risk reduction strategies for COVID-19 and the transmission of other infections for those with sensory impairment. Full article

19 pages, 3446 KiB

Open AccessArticle

Training Improves Avoidance of Natural Sick Faces: Changes in Visual Attention and Approach Decisions

by Tiffany S. Leung, Krisztina V. Jakobsen, Sarah E. Maylott, Arushi Malik, Shuo Zhang and Elizabeth A. Simpson

Vision 2025, 9(2), 39; https://doi.org/10.3390/vision9020039 - 2 May 2025

Cited by 1 | Viewed by 873

Abstract

Humans evolved a behavioral immune system to avoid infectious disease, including the ability to detect sickness in faces. However, it is unclear whether the ability to recognize and avoid facial cues of disease is malleable, flexibly calibrated by experience. Thus, we experimentally tested [...] Read more.

Humans evolved a behavioral immune system to avoid infectious disease, including the ability to detect sickness in faces. However, it is unclear whether the ability to recognize and avoid facial cues of disease is malleable, flexibly calibrated by experience. Thus, we experimentally tested whether we can improve adults’ (N = 133) lassitude (sick) face perception, measuring their recognition, avoidance, and visual attention to naturally sick and healthy faces. Participants randomly assigned to a training about disease, but not a control group, were better at avoiding sick people. The disease-trained group also looked more equally between sick and healthy faces when identifying who was sick compared to the control group who looked longer at the sick faces than the healthy faces. Though we detected no group differences in time looking at the eyes and at the mouths, the disease-trained group used these features more to decide who was sick, reflecting key features of the lassitude expression. Our findings suggest that facial sickness perception may be flexible, influenced by experience, and underscore the need for future studies to test how to further strengthen this skill. Ultimately, developing interventions that use this sick face plasticity may reduce disease transmission. Full article

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10 pages, 2293 KiB

Open AccessArticle

Short-Wavelength and Infrared Autofluorescence Imaging in Pachychoroid Neovasculopathy

by Norihiko Nakagawa, Takuya Shunto, Issei Nishiyama, Kohei Maruyama and Miki Sawa

Vision 2025, 9(2), 38; https://doi.org/10.3390/vision9020038 - 21 Apr 2025

Viewed by 509

Abstract

Purpose: The purpose of this paper is to investigate the relationship between short-wavelength autofluorescence (SWAF) and infrared autofluorescence (IRAF) patterns in pachychoroid neovasculopathy (PNV) with serous retinal detachment (SRD). Methods: This study used an observational case series of 62 eyes of 58 consecutive [...] Read more.

Purpose: The purpose of this paper is to investigate the relationship between short-wavelength autofluorescence (SWAF) and infrared autofluorescence (IRAF) patterns in pachychoroid neovasculopathy (PNV) with serous retinal detachment (SRD). Methods: This study used an observational case series of 62 eyes of 58 consecutive patients diagnosed with symptomatic PNV from January 2019 and October 2021 at a single institution. SWAF and IRAF patterns were analyzed with disease chronicity, and autofluorescence changes in macular neovascularization (MNV) were assessed in two images. Results: SWAF patterns and the mean duration of symptoms were as follows: blocked (15 eyes, 24%), 1.0 months; mottled (8 eyes, 13%), 2.8 months; hyper (24 eyes, 39%), 5.0 months; hyper/hypo (10 eyes, 16%), 7.0 months; descending tract (5 eyes, 8%), 12.0 months (p < 0.01). IRAF patterns and the mean duration of symptoms were as follows: blocked (17 eyes, 27%), 1.0 months; hyper (22 eyes, 35%), 4.0 months; mixed/hyper dominant (9 eyes, 15%), 5.0 months; mixed/hypo dominant (9 eyes, 15%), 6.8 months; descending tract (5 eyes, 8%), 12.0 months (p < 0.01). Abnormal autofluorescence corresponding to MNV lesion was seen in 34 eyes (55%) with SWAF and 59 eyes (95%) with IRAF (p < 0.01). Conclusions: SWAF and IRAF show multiple patterns and are related to disease chronicity in symptomatic PNV. IRAF could be helpful in detecting the lesion of MNV. Full article

(This article belongs to the Section Retinal Function and Disease)

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17 pages, 2799 KiB

Open AccessArticle

The Phenomenology of Offline Perception: Multisensory Profiles of Voluntary Mental Imagery and Dream Imagery

by Maren Bilzer and Merlin Monzel

Vision 2025, 9(2), 37; https://doi.org/10.3390/vision9020037 - 21 Apr 2025

Cited by 1 | Viewed by 1239

Abstract

Both voluntary mental imagery and dream imagery involve multisensory representations without externally present stimuli that can be categorized as offline perceptions. Due to common mechanisms, correlations between multisensory dream imagery profiles and multisensory voluntary mental imagery profiles were hypothesized. In a sample of [...] Read more.

Both voluntary mental imagery and dream imagery involve multisensory representations without externally present stimuli that can be categorized as offline perceptions. Due to common mechanisms, correlations between multisensory dream imagery profiles and multisensory voluntary mental imagery profiles were hypothesized. In a sample of 226 participants, correlations within the respective state of consciousness were significantly bigger than across, favouring two distinct networks. However, the association between the vividness of voluntary mental imagery and vividness of dream imagery was moderated by the frequency of dream recall and lucid dreaming, suggesting that both networks become increasingly similar when higher metacognition is involved. Additionally, the vividness of emotional and visual imagery was significantly higher for dream imagery than for voluntary mental imagery, reflecting the immersive nature of dreams and the continuity of visual dominance while being awake and asleep. In contrast, the vividness of auditory, olfactory, gustatory, and tactile imagery was higher for voluntary mental imagery, probably due to higher cognitive control while being awake. Most results were replicated four weeks later, weakening the notion of state influences. Overall, our results indicate similarities between dream imagery and voluntary mental imagery that justify a common classification as offline perception, but also highlight important differences. Full article

(This article belongs to the Special Issue Visual Mental Imagery System: How We Image the World)

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14 pages, 542 KiB

Open AccessArticle

The Relationship Between Anxiety Sensitivity, Emotional States, and Dry Eye Disease Symptom Severity: A Cross-Sectional Study

by Marko Toth, Nataša Jokić-Begić and Sandro Krašić

Vision 2025, 9(2), 36; https://doi.org/10.3390/vision9020036 - 18 Apr 2025

Viewed by 1902

Abstract

Dry eye disease (DED) is often comorbid with psychiatric conditions and psychological disturbances like anxiety and depression. The psychological symptoms are mostly considered to be a consequence of DED or a side-effect of medication. However, the possible psychological etiology of DED is seldom [...] Read more.

Dry eye disease (DED) is often comorbid with psychiatric conditions and psychological disturbances like anxiety and depression. The psychological symptoms are mostly considered to be a consequence of DED or a side-effect of medication. However, the possible psychological etiology of DED is seldom explored. This study explores the relationship between anxiety sensitivity (AS), unpleasant emotional states, and the severity of DED symptoms in a healthy general population sample in Croatia. A total of 766 adults (62.27% females) aged between 18 and 88 years completed an online survey consisting of the Ocular Surface Disease Index (OSDI), Anxiety Sensitivity Index (ASI), and Depression Anxiety Stress Scales (DASS21) together with socio-demographic data. The results revealed significant positive correlations between ASI, emotional states, and OSDI (r = 0.25–0.29, p < 0.01). Mediation analysis showed that DASS21 significantly mediates the relationship between ASI and OSDI (B = 0.1, CI = [0.004, 0.2]). Highly anxiety sensitive people are more sensitive to DED symptoms, which additionally increases in a state of emotional stress. Thus, DED symptoms are perceived more intensely and frequently than in less sensitive people. Understanding these associations is crucial for comprehensive DED management, indicating potential benefits from addressing psychological health in DED patients and eye health in psychiatric patients. Full article

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18 pages, 755 KiB

Open AccessReview

Novel Therapeutic Approaches for Treatment of Diabetic Retinopathy and Age-Related Macular Degeneration

by Deokho Lee, Soo Jin Kim and Junyeop Lee

Vision 2025, 9(2), 35; https://doi.org/10.3390/vision9020035 - 17 Apr 2025

Viewed by 1660

Abstract

Retina, a light-sensitive layer of tissue of the eye, requires high levels of oxygen for its physiology. Retinal ischemia occurs due to inadequate supply of blood to the retina and choroid. Retinal ischemia is implicated in the development or progression of many ocular [...] Read more.

Retina, a light-sensitive layer of tissue of the eye, requires high levels of oxygen for its physiology. Retinal ischemia occurs due to inadequate supply of blood to the retina and choroid. Retinal ischemia is implicated in the development or progression of many ocular diseases, such as diabetic retinopathy (DR) and age-related macular degeneration (AMD). To date, anti-vascular endothelial growth factor (VEGF) treatment has been widely used to manage neovascular diseases associated with retinal ischemia. Nonetheless, a substantial number of patients with DR or AMD still suffer from incomplete response and adverse effects related to its therapy with limitations. Therefore, research scientists have been developing and finding novel treatments to protect against or prevent vision loss in those diseases. In this review article, we summarize the recent novel therapeutic approaches for the treatment of ischemic retinopathy (e.g., cell therapy, advanced molecular targeting, or drug delivery). This summary enables further research to obtain more solid evidence of novel effective drug development in retinal ischemic diseases. Full article

(This article belongs to the Special Issue Retinal and Optic Nerve Diseases: New Advances and Current Challenges)

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26 pages, 3351 KiB

Open AccessArticle

Reconciling the Neurophysiological and Cognitive Theories of Stimulus–Response Spatial Compatibility Effects: A Visual–Motor Dissociation Approach

by Elton H. Matsushima and Jose Antonio Aznar-Casanova

Vision 2025, 9(2), 34; https://doi.org/10.3390/vision9020034 - 17 Apr 2025

Viewed by 938

Abstract

This study investigated the differential impact of two visual dimensions (direction and spatial location) in two spatial Stroop tasks, where the relevant dimension for the response varied. Three studies compared the interactions between spatial compatibility and congruence effects on reaction time performances to [...] Read more.

This study investigated the differential impact of two visual dimensions (direction and spatial location) in two spatial Stroop tasks, where the relevant dimension for the response varied. Three studies compared the interactions between spatial compatibility and congruence effects on reaction time performances to infer how the dorsal pathway (DP) and ventral pathway (VP) of visual processing interfered with one another in processing relevant and irrelevant spatial information. This allowed us to bridge neurophysiological mechanisms with dual-process models of spatial compatibility. The participants responded from an avatar’s perspective, manipulated through rotations relative to the forward position, along with independent rotations of the avatar’s screen and keyboard. The results revealed two distinct response patterns: in the Direction Stroop, the performance was influenced equally by the relevant direction (VP) and the automatic processing of irrelevant location (DP); in the Location Stroop, the VP exerted minimal interference on the DP. Furthermore, the Only Keyboard rotation disrupted hand–eye coordination, modulating the DP interference on the VP in the Direction Stroop. These findings provide insights into the functional interaction of these visual pathways and their contributions to spatial compatibility effects, along with evidence for the dual-process model of spatial compatibility. Some issues about the separation of visual pathways are discussed based on our results. Full article

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11 pages, 1764 KiB

Open AccessArticle

Coherent Interpretation of Entire Visual Field Test Reports Using a Multimodal Large Language Model (ChatGPT)

by Jeremy C. K. Tan

Vision 2025, 9(2), 33; https://doi.org/10.3390/vision9020033 - 11 Apr 2025

Cited by 1 | Viewed by 1074

Abstract

This study assesses the accuracy and consistency of a commercially available large language model (LLM) in extracting and interpreting sensitivity and reliability data from entire visual field (VF) test reports for the evaluation of glaucomatous defects. Single-page anonymised VF test reports from 60 [...] Read more.

This study assesses the accuracy and consistency of a commercially available large language model (LLM) in extracting and interpreting sensitivity and reliability data from entire visual field (VF) test reports for the evaluation of glaucomatous defects. Single-page anonymised VF test reports from 60 eyes of 60 subjects were analysed by an LLM (ChatGPT 4o) across four domains—test reliability, defect type, defect severity and overall diagnosis. The main outcome measures were accuracy of data extraction, interpretation of glaucomatous field defects and diagnostic classification. The LLM displayed 100% accuracy in the extraction of global sensitivity and reliability metrics and in classifying test reliability. It also demonstrated high accuracy (96.7%) in diagnosing whether the VF defect was consistent with a healthy, suspect or glaucomatous eye. The accuracy in correctly defining the type of defect was moderate (73.3%), which only partially improved when provided with a more defined region of interest. The causes of incorrect defect type were mostly attributed to the wrong location, particularly confusing the superior and inferior hemifields. Numerical/text-based data extraction and interpretation was overall notably superior to image-based interpretation of VF defects. This study demonstrates the potential and also limitations of multimodal LLMs in processing multimodal medical investigation data such as VF reports. Full article

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15 pages, 3569 KiB

Open AccessArticle

Cup and Disc Segmentation in Smartphone Handheld Ophthalmoscope Images with a Composite Backbone and Double Decoder Architecture

by Thiago Paiva Freire, Geraldo Braz Júnior, João Dallyson Sousa de Almeida and José Ribamar Durand Rodrigues Junior

Vision 2025, 9(2), 32; https://doi.org/10.3390/vision9020032 - 11 Apr 2025

Viewed by 734

Abstract

Glaucoma is a visual disease that affects millions of people, and early diagnosis can prevent total blindness. One way to diagnose the disease is through fundus image examination, which analyzes the optic disc and cup structures. However, screening programs in primary care are [...] Read more.

Glaucoma is a visual disease that affects millions of people, and early diagnosis can prevent total blindness. One way to diagnose the disease is through fundus image examination, which analyzes the optic disc and cup structures. However, screening programs in primary care are costly and unfeasible. Neural network models have been used to segment optic nerve structures, assisting physicians in this task and reducing fatigue. This work presents a methodology to enhance morphological biomarkers of the optic disc and cup in images obtained by a smartphone coupled to an ophthalmoscope through a deep neural network, which combines two backbones and a dual decoder approach to improve the segmentation of these structures, as well as a new way to combine the loss weights in the training process. The models obtained were numerically evaluated through Dice and IoU measures. The dice values obtained in the experiments reached a Dice of 95.92% and 85.30% for the optical disc and cup and an IoU of 92.22% and 75.68% for the optical disc and cup, respectively, in the BrG dataset. These findings indicate promising architectures in the fundus image segmentation task. Full article

(This article belongs to the Section Retinal Function and Disease)

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12 pages, 3181 KiB

Open AccessArticle

Artificial Intelligence vs. Human Cognition: A Comparative Analysis of ChatGPT and Candidates Sitting the European Board of Ophthalmology Diploma Examination

by Anna P. Maino, Jakub Klikowski, Brendan Strong, Wahid Ghaffari, Michał Woźniak, Tristan Bourcier and Andrzej Grzybowski

Vision 2025, 9(2), 31; https://doi.org/10.3390/vision9020031 - 9 Apr 2025

Viewed by 1217

Abstract

Background/Objectives: This paper aims to assess ChatGPT’s performance in answering European Board of Ophthalmology Diploma (EBOD) examination papers and to compare these results to pass benchmarks and candidate results. Methods: This cross-sectional study used a sample of past exam papers from 2012, 2013, [...] Read more.

Background/Objectives: This paper aims to assess ChatGPT’s performance in answering European Board of Ophthalmology Diploma (EBOD) examination papers and to compare these results to pass benchmarks and candidate results. Methods: This cross-sectional study used a sample of past exam papers from 2012, 2013, 2020–2023 EBOD examinations. This study analyzed ChatGPT’s responses to 440 multiple choice questions (MCQs), each containing five true/false statements (2200 statements in total) and 48 single best answer (SBA) questions. Results: ChatGPT, for MCQs, scored on average 64.39%. ChatGPT’s strongest metric performance for MCQs was precision (68.76%). ChatGPT performed best at answering pathology MCQs (Grubbs test p < 0.05). Optics and refraction had the lowest-scoring MCQ performance across all metrics. ChatGPT-3.5 Turbo performed worse than human candidates and ChatGPT-4o on easy questions (75% vs. 100% accuracy) but outperformed humans and ChatGPT-4o on challenging questions (50% vs. 28% accuracy). ChatGPT’s SBA performance averaged 28.43%, with the highest score and strongest performance in precision (29.36%). Pathology SBA questions were consistently the lowest-scoring topic across most metrics. ChatGPT demonstrated a nonsignificant tendency to select option 1 more frequently (p = 0.19). When answering SBAs, human candidates scored higher than ChatGPT in all metric areas measured. Conclusions: ChatGPT performed stronger for true/false questions, scoring a pass mark in most instances. Performance was poorer for SBA questions, suggesting that ChatGPT’s ability in information retrieval is better than that in knowledge integration. ChatGPT could become a valuable tool in ophthalmic education, allowing exam boards to test their exam papers to ensure they are pitched at the right level, marking open-ended questions and providing detailed feedback. Full article

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17 pages, 2231 KiB

Open AccessArticle

Brain Functional Connectivity During First- and Third-Person Visual Imagery

by Ekaterina Pechenkova, Mary Rachinskaya, Varvara Vasilenko, Olesya Blazhenkova and Elena Mershina

Vision 2025, 9(2), 30; https://doi.org/10.3390/vision9020030 - 6 Apr 2025

Viewed by 1255

Abstract

The ability to adopt different perspectives, or vantage points, is fundamental to human cognition, affecting reasoning, memory, and imagery. While the first-person perspective allows individuals to experience a scene through their own eyes, the third-person perspective involves an external viewpoint, which is thought [...] Read more.

The ability to adopt different perspectives, or vantage points, is fundamental to human cognition, affecting reasoning, memory, and imagery. While the first-person perspective allows individuals to experience a scene through their own eyes, the third-person perspective involves an external viewpoint, which is thought to demand greater cognitive effort and different neural processing. Despite the frequent use of perspective switching across various contexts, including modern media and in therapeutic settings, the neural mechanisms differentiating these two perspectives in visual imagery remain largely underexplored. In an exploratory fMRI study, we compared both activation and task-based functional connectivity underlying first-person and third-person perspective taking in the same 26 participants performing two spatial egocentric imagery tasks, namely imaginary tennis and house navigation. No significant differences in activation emerged between the first-person and third-person conditions. The network-based statistics analysis revealed a small subnetwork of the early visual and posterior temporal areas that manifested stronger functional connectivity during the first-person perspective, suggesting a closer sensory recruitment loop, or, in different terms, a loop between long-term memory and the “visual buffer” circuits. The absence of a strong neural distinction between the first-person and third-person perspectives suggests that third-person imagery may not fully decenter individuals from the scene, as is often assumed. Full article

(This article belongs to the Special Issue Visual Mental Imagery System: How We Image the World)

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15 pages, 6945 KiB

Open AccessArticle

Gaze Error Estimation and Linear Transformation to Improve Accuracy of Video-Based Eye Trackers

by Varun Padikal, Alex Plonkowski, Penelope F. Lawton, Laura K. Young and Jenny C. A. Read

Vision 2025, 9(2), 29; https://doi.org/10.3390/vision9020029 - 3 Apr 2025

Viewed by 914

Abstract

Eye tracking technology plays a crucial role in various fields such as psychology, medical training, marketing, and human–computer interaction. However, achieving high accuracy over a larger field of view in eye tracking systems remains a significant challenge, both in free viewing and in [...] Read more.

Eye tracking technology plays a crucial role in various fields such as psychology, medical training, marketing, and human–computer interaction. However, achieving high accuracy over a larger field of view in eye tracking systems remains a significant challenge, both in free viewing and in a head-stabilized condition. In this paper, we propose a simple approach to improve the accuracy of video-based eye trackers through the implementation of linear coordinate transformations. This method involves applying stretching, shearing, translation, or their combinations to correct gaze accuracy errors. Our investigation shows that re-calibrating the eye tracker via linear transformations significantly improves the accuracy of video-based tracker over a large field of view. Full article

(This article belongs to the Section Visual Neuroscience)

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15 pages, 2174 KiB

Open AccessArticle

Exploring Attention in Depth: Event-Related and Steady-State Visual Evoked Potentials During Attentional Shifts Between Depth Planes in a Novel Stimulation Setup

by Jonas Jänig, Norman Forschack, Christopher Gundlach and Matthias M. Müller

Vision 2025, 9(2), 28; https://doi.org/10.3390/vision9020028 - 3 Apr 2025

Viewed by 964

Abstract

Visuo-spatial attention acts as a filter for the flood of visual information. Until recently, experimental research in this area focused on neural dynamics of shifting attention in 2D space, leaving attentional shifts in depth less explored. In this study, twenty-three participants were cued [...] Read more.

Visuo-spatial attention acts as a filter for the flood of visual information. Until recently, experimental research in this area focused on neural dynamics of shifting attention in 2D space, leaving attentional shifts in depth less explored. In this study, twenty-three participants were cued to attend to one of two overlapping random-dot kinematograms (RDKs) in different stereoscopic depths in a novel experimental setup. These RDKs flickered at two different frequencies to evoke Steady-State Visual Evoked Potentials (SSVEPs), a neural signature of early visual stimulus processing. Subjects were instructed to detect coherent motion events in the to-be-attended-to plane/RDK. Behavioral data showed that subjects were able to perform the task and selectively respond to events at the cued depth. Event-Related Potentials (ERPs) elicited by these events—namely the Selection Negativity (SN) and the P3b—showed greater amplitudes for coherent motion events in the to-be-attended-to compared to the to-be-ignored plane/RDK, indicating that attention was shifted accordingly. Although our new experimental setting reliably evoked SSVEPs, SSVEP amplitude time courses did not differ between the to-be-attended-to and to-be-ignored stimuli. These results suggest that early visual areas may not optimally represent depth-selective attention, which might rely more on higher processing stages, as suggested by the ERP results. Full article

(This article belongs to the Section Visual Neuroscience)

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14 pages, 2108 KiB

Open AccessArticle

Tear Film Changes and Ocular Symptoms Associated with Soft Contact Lens Wear

by Eduardo Insua Pereira, Madalena Lira and Ana Paula Sampaio

Vision 2025, 9(2), 27; https://doi.org/10.3390/vision9020027 - 1 Apr 2025

Viewed by 892

Abstract

Discomfort is one of the leading causes associated with contact lens dropout. This study investigated changes in the tear film parameters induced by lens wear and their relationship with ocular symptomology. Thirty-four lens wearers (32.9 ± 9.1 years, 7 men) and thirty-three non-lens [...] Read more.

Discomfort is one of the leading causes associated with contact lens dropout. This study investigated changes in the tear film parameters induced by lens wear and their relationship with ocular symptomology. Thirty-four lens wearers (32.9 ± 9.1 years, 7 men) and thirty-three non-lens wearers (29.4 ± 6.8 years, 12 men) participated in this clinical setting. Subjects were categorised into asymptomatic (n = 11), moderate (n = 15), or severe symptomatic (n = 8). Clinical evaluations were performed in the morning, including blink frequency and completeness, pre-corneal (NIBUT) and pre-lens non-invasive break-up (PL-NIBUT), lipid interference patterns, and tear meniscus height. Contact lens wearers had a higher percentage of incomplete blinks (37% vs. 19%, p < 0.001) and reduced tear meniscus height compared to controls (0.24 ± 0.08 vs. 0.28 ± 0.10 mm, p = 0.014). PL-NIBUT was shorter than NIBUT (7.6 ± 6.2 vs. 10.7 ± 9.3 s. p = 0.002). Significant statistical differences between the groups were found in the PL-NIBUT (p = 0.01) and NIBUT (p = 0.05), with asymptomatic recording higher times than symptomatic. Long-term use of silicone–hydrogel lenses can affect tear stability, production, and adequate distribution through blinking. Ocular symptomology correlates with tear stability parameters in both lens wearers and non-wearers. Full article

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19 pages, 646 KiB

Open AccessReview

Emerging Treatments for Persistent Corneal Epithelial Defects

by Jeonghyun (Esther) Kwon, Christie Kang, Amirhossein Moghtader, Sumaiya Shahjahan, Zahra Bibak Bejandi, Ahmad Alzein and Ali R. Djalilian

Vision 2025, 9(2), 26; https://doi.org/10.3390/vision9020026 - 1 Apr 2025

Viewed by 1429

Abstract

Persistent corneal epithelial defects (PCEDs) are a challenging ocular condition characterized by the failure of complete corneal epithelial healing after an insult or injury, even after 14 days of standard care. There is a lack of therapeutics that target this condition and encourage [...] Read more.

Persistent corneal epithelial defects (PCEDs) are a challenging ocular condition characterized by the failure of complete corneal epithelial healing after an insult or injury, even after 14 days of standard care. There is a lack of therapeutics that target this condition and encourage re-epithelialization of the corneal surface in a timely and efficient manner. This review aims to provide an overview of current standards of management for PCEDs, highlighting novel, emerging treatments in this field. While many of the current non-surgical treatments aim to provide lubrication and mechanical support, novel non-surgical approaches are undergoing development to harness the proliferative and healing properties of human mesenchymal stem cells, platelets, lufepirsen, hyaluronic acid, thymosin ß4, p-derived peptide, and insulin-like growth factor for the treatment of PCEDs. Novel surgical treatments focus on corneal neurotization and limbal cell reconstruction using novel scaffold materials and cell-sources. This review provides insights into future PCED treatments that build upon current management guidelines. Full article

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29 pages, 3715 KiB

Open AccessReview

μετὰ τὰ ϕυσικά: Vision Far Beyond Physics

by Liliana Albertazzi

Vision 2025, 9(2), 25; https://doi.org/10.3390/vision9020025 - 26 Mar 2025

Viewed by 794

Abstract

Vision Science is an area of study that focuses on specific aspects of visual perception and is conducted mainly in the restricted and controlled context of laboratories. In so doing, the methodological procedures adopted necessarily reduce the variables of natural perception. For the [...] Read more.

Vision Science is an area of study that focuses on specific aspects of visual perception and is conducted mainly in the restricted and controlled context of laboratories. In so doing, the methodological procedures adopted necessarily reduce the variables of natural perception. For the time being, it is extremely difficult to perform psychophysical, neurophysiological, and phenomenological experiments in open scenery, even if that is our natural visual experience. This study discusses four points whose status in Vision Science is still controversial. Namely, the copresence of distinct visual phenomena of primary and secondary processes in natural vision; the role of visual imagination in seeing; the factors ruling the perception of global ambiguity and enigmatic and emotional atmosphere in the visual experience of a scene; and if the phenomena of subjective vision are considered, what kind of new laboratories are available for studying visual perception in open scenery. In the framework of experimental phenomenology and the use of pictorial art as a complement and test for perceptual phenomena, a case study from painting showing the copresence of perceptual and mental visual processes is also discussed and analyzed. This has involved measuring color and light in specific zones of the painting chosen for analysis, relative to visual templates, using Natural Color System notation cards. Full article

(This article belongs to the Section Visual Neuroscience)

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Vision, Volume 9, Issue 2 (June 2025) – 25 articles

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