Vision

15 pages, 897 KB

Open AccessArticle

Comparative Assessment of Large Language Models in Optics and Refractive Surgery: Performance on Multiple-Choice Questions

by Leah Attal, Elad Shvartz, Alon Gorenshtein, Shirley Pincovich and Daniel Bahir

Vision 2025, 9(4), 85; https://doi.org/10.3390/vision9040085 - 9 Oct 2025

Abstract

This study aimed to evaluate the performance of seven advanced AI Large Language Models (LLMs)—ChatGPT 4o, ChatGPT O3 Mini, ChatGPT O1, DeepSeek V3, DeepSeek R1, Gemini 2.0 Flash, and Grok-3—in answering multiple-choice questions (MCQs) in optics and refractive surgery, to assess their role [...] Read more.

This study aimed to evaluate the performance of seven advanced AI Large Language Models (LLMs)—ChatGPT 4o, ChatGPT O3 Mini, ChatGPT O1, DeepSeek V3, DeepSeek R1, Gemini 2.0 Flash, and Grok-3—in answering multiple-choice questions (MCQs) in optics and refractive surgery, to assess their role in medical education for residents. The AI models were tested using 134 publicly available MCQs from national ophthalmology certification exams, categorized by the need to perform calculations, the relevant subspecialty, and the use of images. Accuracy was analyzed and compared statistically. ChatGPT O1 achieved the highest overall accuracy (83.5%), excelling in complex optical calculations (84.1%) and optics questions (82.4%). DeepSeek V3 displayed superior accuracy in refractive surgery-related questions (89.7%), followed by ChatGPT O3 Mini (88.4%). ChatGPT O3 Mini significantly outperformed others in image analysis, with 88.2% accuracy. Moreover, ChatGPT O1 demonstrated comparable accuracy rates for both calculated and non-calculated questions (84.1% vs. 83.3%). This is in stark contrast to other models, which exhibited significant discrepancies in accuracy for calculated and non-calculated questions. The findings highlight the ability of LLMs to achieve high accuracy in ophthalmology MCQs, particularly in complex optical calculations and visual items. These results suggest potential applications in exam preparation and medical training contexts, while underscoring the need for future studies designed to directly evaluate their role and impact in medical education. The findings highlight the significant potential of AI models in ophthalmology education, particularly in performing complex optical calculations and visual stem questions. Future studies should utilize larger, multilingual datasets to confirm and extend these preliminary findings. Full article

► Show Figures

Figure 1

14 pages, 1203 KB

Open AccessArticle

Myopia Prediction Using Machine Learning: An External Validation Study

by Rajat S. Chandra, Bole Ying, Jianyong Wang, Hongguang Cui, Guishuang Ying and Julius T. Oatts

Vision 2025, 9(4), 84; https://doi.org/10.3390/vision9040084 - 9 Oct 2025

Abstract

We previously developed machine learning (ML) models for predicting cycloplegic spherical equivalent refraction (SER) and myopia using non-cycloplegic data and following a standardized protocol (cycloplegia with 0.5% tropicamide and biometry using NIDEK A-scan), but the models’ performance may not be generalizable to other [...] Read more.

We previously developed machine learning (ML) models for predicting cycloplegic spherical equivalent refraction (SER) and myopia using non-cycloplegic data and following a standardized protocol (cycloplegia with 0.5% tropicamide and biometry using NIDEK A-scan), but the models’ performance may not be generalizable to other settings. This study evaluated the performance of ML models in an independent cohort using a different cycloplegic agent and biometer. Chinese students (N = 614) aged 8–13 years underwent autorefraction before and after cycloplegia with 0.5% tropicamide (n = 505) or 1% cyclopentolate (n = 109). Biometric measures were obtained using an IOLMaster 700 (n = 207) or Optical Biometer SW-9000 (n = 407). ML models were evaluated using R², mean absolute error (MAE), sensitivity, specificity, and area under the ROC curve (AUC). The XGBoost model predicted cycloplegic SER very well (R² = 0.95, MAE (SD) = 0.32 (0.30) D). Both ML models predicted myopia well (random forest: AUC 0.99, sensitivity 93.7%, specificity 96.4%; XGBoost: sensitivity 90.1%, specificity 96.8%) and accurately predicted the myopia rate (observed 62.9%; random forest: 60.6%; XGBoost: 58.8%) despite heterogeneous cycloplegia and biometry factors. In this independent cohort of students, XGBoost and random forest performed very well for predicting cycloplegic SER and myopia status using non-cycloplegic data. This external validation study demonstrated that ML may provide a useful tool for estimating cycloplegic SER and myopia prevalence with heterogeneous clinical parameters, and study in additional populations is warranted. Full article

► Show Figures

Figure 1

17 pages, 1050 KB

Open AccessArticle

Oculomotor Training Improves Reading and Associated Cognitive Functions in Children with Learning Difficulties: A Pilot Study

by Alessio Facchin, Silvio Maffioletti, Marta Maffioletti, Gabriele Esposito, Marta Bonetti, Luisa Girelli and Roberta Daini

Vision 2025, 9(4), 83; https://doi.org/10.3390/vision9040083 - 7 Oct 2025

Abstract

In the first years of schooling, inefficient eye movements can impair the development of reading skills. Nonetheless, the improvement of these abilities has been little investigated in children. This pilot study aimed to verify the effectiveness of Office Based Oculomotor Training (OBOT) in [...] Read more.

In the first years of schooling, inefficient eye movements can impair the development of reading skills. Nonetheless, the improvement of these abilities has been little investigated in children. This pilot study aimed to verify the effectiveness of Office Based Oculomotor Training (OBOT) in enhancing reading skills in ‘poor’ readers. Twenty-one children (aged 7–12 years) underwent an assessment of reading, visual, and perceptual abilities before and after a training of oculomotor skills (i.e., execution of saccadic movements with symbol charts in various modes and types; 14 participants) or a simple reading exercise (7 participants). The overall duration of the training was six weeks. The results showed a specific improvement, in the group subjected to oculomotor training only, not only in oculomotor abilities but also in reading, visuo-perceptual skills, and the ability to resolve crowding. These primary results suggest that the improvement of oculomotor abilities can lead to an indirect increase in reading in developmental age. Full article

► Show Figures

Figure 1

9 pages, 201 KB

Open AccessArticle

Ocular Manifestations in Pediatric Traumatic Brain Injury Admitted to the ICU: A Prospective Analysis

by Amer Jaradat, Rami Al-Dwairi, Adam Abdallah, Atef F. Hulliel, Rawhi Alshaykh, Mahmood Al Nuaimi, Ala’ Al Barbarawi, Seren Al Beiruti and Abdelwahab Aleshawi

Vision 2025, 9(4), 82; https://doi.org/10.3390/vision9040082 - 4 Oct 2025

Abstract

Background: Traumatic Brain Injury (TBI) in children is a major cause of morbidity and mortality worldwide. Ocular manifestations are common but often overlooked, despite their potential to cause long-term visual impairment. This study aimed to evaluate the prevalence and characteristics of ocular findings [...] Read more.

Background: Traumatic Brain Injury (TBI) in children is a major cause of morbidity and mortality worldwide. Ocular manifestations are common but often overlooked, despite their potential to cause long-term visual impairment. This study aimed to evaluate the prevalence and characteristics of ocular findings in pediatric TBI patients admitted to the intensive care unit (ICU). Method: We prospectively reviewed records of pediatric patients (≤16 years) with TBI admitted to the Neurosurgery ICU at King Abdullah University Hospital (January 2022–December 2024). TBI was defined using U.S. CDC criteria and confirmed by clinical and radiological findings. Ocular manifestations were identified from ophthalmology consultations, neurosurgical notes, and bedside examinations. Demographics, injury details, and clinical outcomes were recorded. Statistical analyses included Chi-square, Fisher’s exact, and Mann–Whitney U tests, with significance set at p ≤ 0.05. Results: Thirty-eight patients (median age: 8 years; 55.3% male) were included. Ocular findings were present in 20 patients (52.6%). These patients were significantly older (median age 10 vs. 6 years, p = 0.007) and had lower admission GCS scores (11 vs. 14, p = 0.016). Male predominance was higher in the ocular group (75.0% vs. 33.3%, p = 0.030). Ocular findings were significantly associated with surgical intervention (60.0% vs. 22.2%, p = 0.025), orbital fractures (40.0% vs. 5.6%, p = 0.021), basal skull fracture signs (p = 0.036), and extraocular muscle limitation (p = 0.048). On multivariable analysis, orbital fracture remained the only independent predictor of ocular findings (aOR 2.22, 95% CI 1.17–3.57, p = 0.02). Conclusion: Over half of pediatric ICU TBI patients demonstrated ocular manifestations, closely linked to greater injury severity and craniofacial trauma. Routine, comprehensive ophthalmological evaluation should be integrated into the multidisciplinary management of severe pediatric TBI to optimize visual and functional outcomes. Full article

17 pages, 1767 KB

Open AccessArticle

Too Bright to Focus? Influence of Brightness Illusions and Ambient Light Levels on the Dynamics of Ocular Accommodation

by Antonio Rodán, Angélica Fernández-López, Jesús Vera, Pedro R. Montoro, Beatriz Redondo and Antonio Prieto

Vision 2025, 9(4), 81; https://doi.org/10.3390/vision9040081 - 30 Sep 2025

Abstract

Can brightness illusions modulate ocular accommodation? Previous studies have shown that brightness illusions can influence pupil size as if caused by actual luminance increases. However, their effects on other ocular responses—such as accommodative or focusing dynamics—remain largely unexplored. This study investigates the influence [...] Read more.

Can brightness illusions modulate ocular accommodation? Previous studies have shown that brightness illusions can influence pupil size as if caused by actual luminance increases. However, their effects on other ocular responses—such as accommodative or focusing dynamics—remain largely unexplored. This study investigates the influence of brightness illusions, under two ambient lighting conditions, on accommodative and pupillary dynamics (physiological responses), and on perceived brightness and visual comfort (subjective responses). Thirty-two young adults with healthy vision viewed four stimulus types (blue bright and non-bright, yellow bright and non-bright) under low- and high-contrast ambient lighting while ocular responses were recorded using a WAM-5500 open-field autorefractor. Brightness and comfort were rated after each session. The results showed that high ambient contrast (mesopic) and brightness illusions increased accommodative variability, while yellow stimuli elicited a greater lag under photopic condition. Pupil size decreased only under mesopic lighting. Perceived brightness was enhanced by brightness illusions and blue color, whereas visual comfort decreased for bright illusions, especially under low light. These findings suggest that ambient lighting and visual stimulus properties modulate both physiological and subjective responses, highlighting the need for dynamic accommodative assessment and visually ergonomic display design to reduce visual fatigue during digital device use. Full article

(This article belongs to the Special Issue Effects of Optical and Behavioral Factors on the Ocular Accommodation Response)

► Show Figures

Figure 1

14 pages, 428 KB

Open AccessSystematic Review

Evaluating the Clinical Validity of Commercially Available Virtual Reality Headsets for Visual Field Testing: A Systematic Review

by Jesús Vera, Alan N. Glazier, Mark T. Dunbar, Douglas Ripkin and Masoud Nafey

Vision 2025, 9(4), 80; https://doi.org/10.3390/vision9040080 - 24 Sep 2025

Abstract

Virtual reality (VR) technology has emerged as a promising alternative to conventional perimetry for assessing visual fields. However, the clinical validity of commercially available VR-based perimetry devices remains uncertain due to variability in hardware, software, and testing protocols. A systematic review was conducted [...] Read more.

Virtual reality (VR) technology has emerged as a promising alternative to conventional perimetry for assessing visual fields. However, the clinical validity of commercially available VR-based perimetry devices remains uncertain due to variability in hardware, software, and testing protocols. A systematic review was conducted following PRISMA guidelines to evaluate the validity of VR-based perimetry compared to the Humphrey Field Analyzer (HFA). Literature searches were performed across MEDLINE, Embase, Scopus, and Web of Science. Studies were included if they assessed commercially available VR-based visual field devices in comparison to HFA and reported visual field outcomes. Devices were categorized by regulatory status (FDA, CE, or uncertified), and results were synthesized narratively. Nineteen studies were included. Devices such as Heru, Olleyes VisuALL, and the Advanced Vision Analyzer showed promising agreement with HFA metrics, especially in moderate to advanced glaucoma. However, variability in performance was observed depending on disease severity, population type, and device specifications. Limited dynamic range and lack of eye tracking were common limitations in lower-complexity devices. Pediatric validation and performance in early-stage disease were often suboptimal. Several VR-based perimetry systems demonstrate clinically acceptable validity compared to HFA, particularly in certain patient subgroups. However, broader validation, protocol standardization, and regulatory approval are essential for widespread clinical adoption. These devices may support more accessible visual field testing through telemedicine and decentralized care. Full article

► Show Figures

Figure 1

19 pages, 2784 KB

Open AccessArticle

A Simulated Visual Field Defect Impairs Temporal Processing: An Effect Not Modulated by Emotional Faces

by Mohammad Ahsan Khodami and Luca Battaglini

Vision 2025, 9(3), 79; https://doi.org/10.3390/vision9030079 - 16 Sep 2025

Abstract

Temporal processing is fundamental to visual perception, yet little is known about how it functions under compromised visual field conditions or whether emotional stimuli, as reported in the literature, can modulate it. This study investigated temporal resolution using a two-flash fusion paradigm with [...] Read more.

Temporal processing is fundamental to visual perception, yet little is known about how it functions under compromised visual field conditions or whether emotional stimuli, as reported in the literature, can modulate it. This study investigated temporal resolution using a two-flash fusion paradigm with a static, semi-transparent overlay that degraded the right visual hemifield of opacity 0.60 and examined the potential modulatory effects of emotional faces. In Experiment 1, participants were asked to report if they perceived one or two flashes presented at either −6° (normal vision) or +6° (beneath a scotoma) across eight interstimulus intervals, ranging from 10 to 80 ms with a step size of 10 ms. Results showed significantly impaired temporal discrimination in the degraded vision condition, with elevated thresholds 52.29 ms vs. 34.78 ms and reduced accuracy, particularly at intermediate ISIs 30–60 ms. In Experiment 2, we introduced emotional faces before flash presentation to determine whether emotional content would differentially affect temporal processing. Our findings indicate that neither normal nor scotoma-impaired temporal processing was modulated by the specific emotional content (angry, happy, or neutral) of the facial primes. Full article

(This article belongs to the Section Visual Neuroscience)

► Show Figures

Figure 1

20 pages, 986 KB

Open AccessSystematic Review

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review of Ophthalmic Management and Treatment

by Korolos Sawires, Brendan K. Tao, Harrish Nithianandan, Larena Menant-Tay, Michael O’Connor, Peng Yan and Parnian Arjmand

Vision 2025, 9(3), 78; https://doi.org/10.3390/vision9030078 - 11 Sep 2025

Abstract

Background: Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare, life-threatening mucocutaneous disorders often associated with severe ophthalmic complications. Ocular involvement occurs in 50–68% of cases and can result in permanent vision loss. Despite this, optimal management strategies remain unclear, and treatment [...] Read more.

Background: Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare, life-threatening mucocutaneous disorders often associated with severe ophthalmic complications. Ocular involvement occurs in 50–68% of cases and can result in permanent vision loss. Despite this, optimal management strategies remain unclear, and treatment practices vary widely. Methods: A systematic review was conducted in accordance with PRISMA guidelines and prospectively registered on PROSPERO (CRD420251022655). Medline, Embase, and CENTRAL were searched from 1998 to 2024 for English-language studies reporting treatment outcomes for ocular SJS/TEN. Results: A total of 194 studies encompassing 6698 treated eyes were included. Best-corrected visual acuity (BCVA) improved in 52.2% of eyes, epithelial regeneration occurred in 16.8%, and symptom relief was reported in 26.3%. Common treatments included topical therapy (n = 1424), mucosal grafts (n = 1220), contact lenses (n = 1134), amniotic membrane transplantation (AMT) (n = 889), systemic medical therapy (n = 524), and punctal occlusion (n = 456). Emerging therapies included TNF-alpha inhibitors, anti-VEGF agents, photodynamic therapy, and 5-fluorouracil. Conclusions: Disease-stage-specific therapy is crucial in ocular SJS/TEN. Acute interventions such as AMT may prevent long-term complications, while chronic care targets structural and tear-film abnormalities. Further prospective studies are needed to standardize care and optimize visual outcomes. Full article

► Show Figures

Figure 1

13 pages, 1000 KB

Open AccessArticle

Predicting Pattern Standard Deviation in Glaucoma: A Machine Learning Approach Leveraging Clinical Data

by Raheem Remtulla, Patrik Abdelnour, Daniel R. Chow, Andres C. Ramos, Guillermo Rocha and Paul Harasymowycz

Vision 2025, 9(3), 77; https://doi.org/10.3390/vision9030077 - 1 Sep 2025

Abstract

Visual field (VF) testing is crucial for the management of glaucoma. However, the process is often hindered by technician shortages and reliability issues. In this study, we leveraged machine learning to predict pattern standard deviation (PSD) using clinical inputs. This machine learning retrospective [...] Read more.

Visual field (VF) testing is crucial for the management of glaucoma. However, the process is often hindered by technician shortages and reliability issues. In this study, we leveraged machine learning to predict pattern standard deviation (PSD) using clinical inputs. This machine learning retrospective study used publicly accessible data from 743 eyes (541 glaucoma and 202 non-glaucoma controls). An automated neural network (ANN) model was trained using seven clinical input features: mean retinal nerve fiber layer (RNFL), IOP, patient age, CCT, glaucoma diagnosis, study protocol, and laterality. The ANN demonstrated efficient training across 1000 epochs, with consistent error reduction in training and test sets. Mean RMSEs were 1.67 ± 0.05 for training, and 2.27 ± 0.27 for testing. The r was 0.89 ± 0.01 for training, and 0.81 ± 0.04 for testing, indicating strong predictive accuracy with minimal overfitting. The LOFO analysis revealed that the primary contributors to PSD prediction were RNFL, CCT, IOP, glaucoma status, study protocol, and age, listed in order of significance. Our neural network successfully predicted PSD from RNFL and clinical data with strong performance metrics, in addition to demonstrating construct validity. This work demonstrates that neural networks hold the potential to predict or even generate VF estimations based solely on RNFL and clinical inputs. Full article

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

► Show Figures

Figure 1

10 pages, 505 KB

Open AccessArticle

Gaze Dispersion During a Sustained-Fixation Task as a Proxy of Visual Attention in Children with ADHD

by Lionel Moiroud, Ana Moscoso, Eric Acquaviva, Alexandre Michel, Richard Delorme and Maria Pia Bucci

Vision 2025, 9(3), 76; https://doi.org/10.3390/vision9030076 - 1 Sep 2025

Abstract

Aim: The aim of this preliminary study was to explore the visual attention in children with ADHD using eye-tracking, and to identify a relevant quantitative proxy of their attentional control. Methods: Twenty-two children diagnosed with ADHD (aged 7 to 12 years) and their [...] Read more.

Aim: The aim of this preliminary study was to explore the visual attention in children with ADHD using eye-tracking, and to identify a relevant quantitative proxy of their attentional control. Methods: Twenty-two children diagnosed with ADHD (aged 7 to 12 years) and their 24 sex-, age-matched control participants with typical development performed a visual sustained-fixation task using an eye-tracker. Fixation stability was estimated by calculating the bivariate contour ellipse area (BCEA) as a continuous index of gaze dispersion during the task. Results: Children with ADHD showed a significantly higher BCEA than control participants (p < 0.001), reflecting their increased gaze instability. The impairment in gaze fixation persisted even in the absence of visual distractors, suggesting intrinsic attentional dysregulation in ADHD. Conclusions: Our results provide preliminary evidence that eye-tracking coupled with BCEA analysis, provides a sensitive and non-invasive tool for quantifying visual attentional resources of children with ADHD. If replicated and extended, the increased use of gaze instability as an indicator of visual attention in children could have a major impact in clinical settings to assist clinicians. This analysis focuses on overall gaze dispersion rather than fine eye micro-movements such as microsaccades. Full article

► Show Figures

Figure 1

12 pages, 1154 KB

Open AccessArticle

A Comparative Study Between Clinical Optical Coherence Tomography (OCT) Analysis and Artificial Intelligence-Based Quantitative Evaluation in the Diagnosis of Diabetic Macular Edema

by Camila Brandão Fantozzi, Letícia Margaria Peres, Jogi Suda Neto, Cinara Cássia Brandão, Rodrigo Capobianco Guido and Rubens Camargo Siqueira

Vision 2025, 9(3), 75; https://doi.org/10.3390/vision9030075 - 1 Sep 2025

Abstract

Recent advances in artificial intelligence (AI) have transformed ophthalmic diagnostics, particularly for retinal diseases. In this prospective, non-randomized study, we evaluated the performance of an AI-based software system against conventional clinical assessment—both quantitative and qualitative—of optical coherence tomography (OCT) images for diagnosing diabetic [...] Read more.

Recent advances in artificial intelligence (AI) have transformed ophthalmic diagnostics, particularly for retinal diseases. In this prospective, non-randomized study, we evaluated the performance of an AI-based software system against conventional clinical assessment—both quantitative and qualitative—of optical coherence tomography (OCT) images for diagnosing diabetic macular edema (DME). A total of 700 OCT exams were analyzed across 26 features, including demographic data (age, sex), eye laterality, visual acuity, and 21 quantitative OCT parameters (Macula Map A X-Y). We tested two classification scenarios: binary (DME presence vs. absence) and multiclass (six distinct DME phenotypes). To streamline feature selection, we applied paraconsistent feature engineering (PFE), isolating the most diagnostically relevant variables. We then compared the diagnostic accuracies of logistic regression, support vector machines (SVM), K-nearest neighbors (KNN), and decision tree models. In the binary classification using all features, SVM and KNN achieved 92% accuracy, while logistic regression reached 91%. When restricted to the four PFE-selected features, accuracy modestly declined to 84% for both logistic regression and SVM. These findings underscore the potential of AI—and particularly PFE—as an efficient, accurate aid for DME screening and diagnosis. Full article

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

► Show Figures

Figure 1

19 pages, 2318 KB

Open AccessArticle

Modulating Multisensory Processing: Interactions Between Semantic Congruence and Temporal Synchrony

by Susan Geffen, Taylor Beck and Christopher W. Robinson

Vision 2025, 9(3), 74; https://doi.org/10.3390/vision9030074 - 1 Sep 2025

Abstract

Presenting information to multiple sensory modalities often facilitates or interferes with processing, yet the mechanisms remain unclear. Using a Stroop-like task, the two reported experiments examined how semantic congruency and incongruency in one sensory modality affect processing and responding in a different modality. [...] Read more.

Presenting information to multiple sensory modalities often facilitates or interferes with processing, yet the mechanisms remain unclear. Using a Stroop-like task, the two reported experiments examined how semantic congruency and incongruency in one sensory modality affect processing and responding in a different modality. Participants were presented with pictures and sounds simultaneously (Experiment 1) or asynchronously (Experiment 2) and had to respond whether the visual or auditory stimulus was an animal or vehicle, while ignoring the other modality. Semantic congruency and incongruency in the unattended modality both affected responses in the attended modality, with visual stimuli having larger effects on auditory processing than the reverse (Experiment 1). Effects of visual input on auditory processing decreased under longer SOAs, while effects of auditory input on visual processing increased over SOAs and were correlated with relative processing speed (Experiment 2). These results suggest that congruence and modality both impact multisensory processing. Full article

► Show Figures

Figure 1

10 pages, 348 KB

Open AccessArticle

Effect of Acetazolamide on Intraocular Pressure After Uneventful Phacoemulsification Using an Anterior Chamber Maintainer

by Assaf Kratz, Tom Kornhauser, Eyal Walter, Ran Abuhasira, Ivan Goldberg and Aviel Hadad

Vision 2025, 9(3), 73; https://doi.org/10.3390/vision9030073 - 28 Aug 2025

Abstract

Background: Transient intraocular pressure (IOP) elevations frequently occur after cataract surgery and may raise concerns, especially in patients susceptible to glaucomatous damage or pressure-related complications. These IOP spikes have also been linked to postoperative discomfort and headache. Oral acetazolamide is often used prophylactically, [...] Read more.

Background: Transient intraocular pressure (IOP) elevations frequently occur after cataract surgery and may raise concerns, especially in patients susceptible to glaucomatous damage or pressure-related complications. These IOP spikes have also been linked to postoperative discomfort and headache. Oral acetazolamide is often used prophylactically, despite its known systemic side effects. Objectives: To evaluate the clinical benefit of routine prophylactic oral acetazolamide in reducing IOP after uncomplicated phacoemulsification performed with an anterior chamber maintainer (ACM). Methods: In this retrospective case–control study, 196 eyes from 196 patients were included. All underwent standard phacoemulsification with an ACM. Patients either received oral acetazolamide postoperatively (n = 98) or no IOP-lowering medication (n = 98). IOP was measured preoperatively, and on postoperative days one and seven. Results: On day one, mean IOP was 14.0 ± 3.8 mmHg in the acetazolamide group versus 15.4 ± 3.8 mmHg in controls (p < 0.005). By day seven, IOP was identical in both groups (13.5 mmHg), with no statistically significant difference (p = 0.95). No participant in either group reported headache or serious adverse effects, though 10% in the acetazolamide group experienced mild, transient systemic symptoms. Conclusions: In low-risk patients undergoing uneventful cataract surgery with ACM, routine use of oral acetazolamide yields only a modest, short-lived IOP reduction without evident clinical benefit. Its use may be unnecessary in this setting, though targeted prophylaxis could be considered for high-risk individuals. Full article

► Show Figures

Figure 1

17 pages, 1059 KB

Open AccessArticle

Three-View Relative Pose Estimation Under Planar Motion Constraints

by Ziqin Dai, Weimin Lv and Liang Liu

Vision 2025, 9(3), 72; https://doi.org/10.3390/vision9030072 - 25 Aug 2025

Abstract

Vision-based relative pose estimation serves as a core technology for high-precision localization in autonomous vehicles and mobile platforms. To overcome the limitations of conventional three-view pose estimation methods that rely heavily on dense feature matching and incur high computational costs, this paper proposes [...] Read more.

Vision-based relative pose estimation serves as a core technology for high-precision localization in autonomous vehicles and mobile platforms. To overcome the limitations of conventional three-view pose estimation methods that rely heavily on dense feature matching and incur high computational costs, this paper proposes an efficient three-point correspondence algorithm based on planar motion constraints. The method constructs trifocal tensor constraint equations and develops a linearized three-point solution framework, enabling rapid relative pose estimation using merely three corresponding points in three views. In simulation experiments, we systematically analyzed the robustness of the algorithm under complex conditions that included image noise, angular deviation, and vibration. The method was further validated in real-world scenarios using the KITTI public dataset. Experimental results demonstrate that under the condition of satisfying the planar motion assumption, the proposed method achieves significantly improved computational efficiency compared with traditional methods (including general three-view methods, two-view planar motion estimation methods, and classical two-view methods), with the single-solution time reduced by more than 80% compared to general three-view methods. In the public dataset, our algorithm achieves a median rotation estimation error of less than 0.0545 degrees and maintains a translation estimation error of less than 2.1319 degrees. The proposed method exhibits higher computational efficiency and better numerical stability compared to conventional algorithms. This research provides an effective pose estimation solution with real-time performance and high accuracy for planar motion platforms such as autonomous vehicles and indoor mobile robots, demonstrating substantial engineering application value. Full article

► Show Figures

Figure 1

37 pages, 525 KB

Open AccessReview

Clinical Applications of Artificial Intelligence in Corneal Diseases

by Omar Nusair, Hassan Asadigandomani, Hossein Farrokhpour, Fatemeh Moosaie, Zahra Bibak-Bejandi, Alireza Razavi, Kimia Daneshvar and Mohammad Soleimani

Vision 2025, 9(3), 71; https://doi.org/10.3390/vision9030071 - 18 Aug 2025

Abstract

We evaluated the clinical applications of artificial intelligence models in diagnosing corneal diseases, highlighting their performance metrics and clinical potential. A systematic search was conducted for several disease categories: keratoconus (KC), Fuch’s endothelial corneal dystrophy (FECD), infectious keratitis (IK), corneal neuropathy, dry eye [...] Read more.

We evaluated the clinical applications of artificial intelligence models in diagnosing corneal diseases, highlighting their performance metrics and clinical potential. A systematic search was conducted for several disease categories: keratoconus (KC), Fuch’s endothelial corneal dystrophy (FECD), infectious keratitis (IK), corneal neuropathy, dry eye disease (DED), and conjunctival diseases. Metrics such as sensitivity, specificity, accuracy, and area under the curve (AUC) were extracted. Across the diseases, convolutional neural networks and other deep learning models frequently achieved or exceeded established diagnostic benchmarks (AUC > 0.90; sensitivity/specificity > 0.85–0.90), with a particularly strong performance for KC and FECD when trained on consistent imaging modalities such as anterior segment optical coherence tomography (AS-OCT). Models for IK and conjunctival diseases showed promise but faced challenges in heterogeneous image quality and limited objective training criteria. DED and tear film models benefited from multimodal data yet lacked direct comparisons with expert clinicians. Despite high diagnostic precision, challenges from heterogeneous data, a lack of standardization in disease definitions, imaging acquisition, and model training remain. The broad implementation of artificial intelligence must address these limitations to improve eye care equity. Full article

10 pages, 434 KB

Open AccessArticle

Color Vision in Schoolchildren with Low Birth Weight and Those Born Full-Term with Appropriate Weight for Gestational Age

by Paula Yuri Sacai, Maria Cecília Saccomani Lapa, Rosana Fiorini Puccini and Nívea Nunes Ferraz

Vision 2025, 9(3), 70; https://doi.org/10.3390/vision9030070 - 12 Aug 2025

Abstract

Purpose: To evaluate color discrimination in schoolchildren with low birth weight (LBW) and those born full-term and at a weight appropriate for gestational age (AGA). Methods: LBW children aged 5–11 years and school-, grade-, sex-, and age-matched full-term (birth weight ≥ 2500 g) [...] Read more.

Purpose: To evaluate color discrimination in schoolchildren with low birth weight (LBW) and those born full-term and at a weight appropriate for gestational age (AGA). Methods: LBW children aged 5–11 years and school-, grade-, sex-, and age-matched full-term (birth weight ≥ 2500 g) AGA controls from 14 randomly selected schools from a low-income region were tested. Examinations included visual acuity, ocular motility, and color vision testing using the Farnsworth D-15 test. Color score and interocular color score difference (ICD) were compared between the groups. Multiple logistic regression was used to analyze associations between color vision deficit and group, adjusting for age, sex, visual acuity, strabismus, and amblyopia. Results: A total of 291 LBW children (age = 8.5 ± 1.3 yrs; 55.7% females) and 265 AGA children (age = 8.5 ± 1.4 yrs; 56.2% females) were examined. Dyschromatopsia was detected in 10.3% of LBW and 7.9% of AGA children, primarily involving tritan and non-specific defects. Color scores were comparable between the groups, and color deficit was significantly associated with younger age and worse visual acuity. The ICD was statistically larger (p = 0.004) in the LBW group, in which the frequencies of strabismus and amblyopia were also higher. Conclusions: Most LBW children demonstrated normal color discrimination, but their interocular color score difference was larger than that of AGA children. Full article

► Show Figures

Figure 1

14 pages, 895 KB

Open AccessArticle

Form and Temporal Integration in the Perception of Simple Glass Patterns

by Rita Donato, Michele Vicovaro, Massimo Nucci, Marco Roccato, Gianluca Campana and Andrea Pavan

Vision 2025, 9(3), 69; https://doi.org/10.3390/vision9030069 - 4 Aug 2025

Abstract

This study presents a reanalysis of existing data to clarify how the visual system processes simple dynamic Glass patterns (GPs), with a particular focus on translational configurations. By combining datasets from previous studies, we apply a mixed-effects modeling approach—which offers advantages over the [...] Read more.

This study presents a reanalysis of existing data to clarify how the visual system processes simple dynamic Glass patterns (GPs), with a particular focus on translational configurations. By combining datasets from previous studies, we apply a mixed-effects modeling approach—which offers advantages over the statistical methods used in previous studies—to investigate the contributions of pattern update rate and number of unique frames to perceptual sensitivity. Our findings indicate that the number of unique frames is the most robust predictor of discrimination thresholds, supporting the idea that the visual system integrates global form information across multiple frames—a process consistent with spatiotemporal summation. In contrast, the pattern update rate showed a weaker, though statistically significant, effect. This suggests that faster updates help preserve temporal consistency between frames, facilitating global form extraction. These results align with previous observations on complex dynamic GPs, where discrimination thresholds decrease with more unique frames, suggesting that the summation of form signals across time plays a key role in form–motion perception. By adopting a mixed-effects modeling approach, our reanalysis provides new insights into the mechanisms underlying global form perception in dynamic GPs. Full article

► Show Figures

Figure 1

9 pages, 557 KB

Open AccessArticle

Is Combined PhacoAhmed Less Effective than Ahmed Surgery Alone? A 5-Year Retrospective Study of Long-Term Effects

by Maria Vivas, José Charréu, Bruno Pombo, Tomás Costa, Ana Sofia Lopes, Fernando Trancoso Vaz, Maria João Santos and Isabel Prieto

Vision 2025, 9(3), 68; https://doi.org/10.3390/vision9030068 - 4 Aug 2025

Abstract

Combined trabeculectomy–phacoemulsification is known to provoke more inflammation and yield a poorer long-term efficacy than trabeculectomy alone. This study evaluates whether a similar trend exists for Ahmed glaucoma valve implantation when performed with or without concurrent phacoemulsification. We retrospectively analyzed 51 eyes from [...] Read more.

Combined trabeculectomy–phacoemulsification is known to provoke more inflammation and yield a poorer long-term efficacy than trabeculectomy alone. This study evaluates whether a similar trend exists for Ahmed glaucoma valve implantation when performed with or without concurrent phacoemulsification. We retrospectively analyzed 51 eyes from patients who underwent either Ahmed-Alone (n = 25) or PhacoAhmed (n = 26) surgery over a 5-year period. The primary outcomes included intraocular pressure (IOP), the use of IOP-lowering medications, and the need for further surgical intervention. Absolute success was defined as IOP reduction > 20% and IOP < 21 mmHg without medication; relative success allowed for continued pharmacologic therapy. Both groups showed a significant IOP reduction, with similar final mean IOP values (Ahmed-Alone: 14.02 ± 4.76 mmHg; PhacoAhmed: 13.89 ± 4.17 mmHg; p = 0.99) and comparable reductions in medication use (p = 0.52). Reinterventions occurred less frequently and later in the PhacoAhmed group (12% vs. 27.3%; median time: 27.1 vs. 12 months). Absolute success was not achieved in any PhacoAhmed case but occurred in 9.3% of Ahmed-Alone cases; relative success rates were similar (83.3% vs. 81.4%; p = 0.291). These findings suggest that combining phacoemulsification with Ahmed valve implantation does not significantly alter efficacy or safety profiles. Additional prospective studies are warranted to assess long-term outcomes. Full article

► Show Figures

Figure 1

13 pages, 692 KB

Open AccessArticle

Contrast Sensitivity Comparison of Daily Simultaneous-Vision Center-Near Multifocal Contact Lenses: A Pilot Study

by David P. Piñero, Ainhoa Molina-Martín, Elena Martínez-Plaza, Kevin J. Mena-Guevara, Violeta Gómez-Vicente and Dolores de Fez

Vision 2025, 9(3), 67; https://doi.org/10.3390/vision9030067 - 1 Aug 2025

Abstract

Our purpose is to evaluate the binocular contrast sensitivity function (CSF) in a presbyopic population and compare the results obtained with four different simultaneous-vision center-near multifocal contact lens (MCL) designs for distance vision under two illumination conditions. Additionally, chromatic CSF (red-green and blue-yellow) [...] Read more.

Our purpose is to evaluate the binocular contrast sensitivity function (CSF) in a presbyopic population and compare the results obtained with four different simultaneous-vision center-near multifocal contact lens (MCL) designs for distance vision under two illumination conditions. Additionally, chromatic CSF (red-green and blue-yellow) was evaluated. A randomized crossover pilot study was conducted. Four daily disposable lens designs, based on simultaneous-vision and center-near correction, were compared. The achromatic contrast sensitivity function (CSF) was measured binocularly using the CSV1000e test under two lighting conditions: room light on and off. Chromatic CSF was measured using the OptoPad-CSF test. Comparison of achromatic results with room lighting showed a statistically significant difference only for 3 cpd (p = 0.03) between the baseline visit (with spectacles) and all MCLs. Comparison of achromatic results without room lighting showed no statistically significant differences between the baseline and all MCLs for any spatial frequency (p > 0.05 in all cases). Comparison of CSF-T results showed a statistically significant difference only for 4 cpd (p = 0.002). Comparison of CSF-D results showed no statistically significant difference for all frequencies (p > 0.05 in all cases). The MCL designs analyzed provided satisfactory achromatic contrast sensitivity results for distance vision, similar to those obtained with spectacles, with no remarkable differences between designs. Chromatic contrast sensitivity for the red-green and blue-yellow mechanisms revealed some differences from the baseline that should be further investigated in future studies. Full article

► Show Figures

Figure 1

Journal Description

Vision

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Further Information

Guidelines

MDPI Initiatives

Follow MDPI