Optometric Physician



Vol. 25, #22 •   Monday, June 24, 2024


Off the Cuff: AOA Nashville 2024

This week I've been attending the American Optometric Association's meeting in Nashville, Tennessee. This has been a pretty impressive venue even with the humidity level being an entirely different experience for this desert dweller. Especially impressive was this year’s exhibit hall with the array of vendors, size and layout. As I've mentioned before, one of my favorite things about attending our big optometry meetings are the launches of new products, new technologies, and seeing newer instrumentation in person. I thought I'd share two things that particularly caught my eye this year


First thing is the BOSA or Bruder Ocular Surface Analyzer. For our specialty dry eye practice, this was an instrument I was particularly looking forward to evaluating in person. It essentially does in one instrument what we currently have multiple different instruments doing in our practice. This will free up some footprint real estate in our dry eye testing room. It performs non-invasive tear breakup times without sodium fluorescein, blink analysis, redness analysis, tear miniscus height, and lipid layer interferometry as well as many more tests all in one. Additionally, it has a fast dry eye screener mode as well as a slower more in-depth testing mode. Per my editorial last week, the only downside I see with this instrument is it has the same one-year manufacturer warranty (industry standard) but its extended warranty after that is currently sitting at 25% of the instrument price. They’ve recently lowered the price of the instrument so they're likely looking at adjusting the extended warranty fee or at least really need to. Fingers crossed because I'd really like to have this one.

Second is the virtual reality visual field analyzer by Virtual Vision. This headset-type visual field analyzer was developed at Bascom Palmer. What I really like about this one is that it follows the typical Humphrey testing strategies, and the reports mimic the Humphrey reports. No reinventing the wheel. It has the same test patterns as a Humphrey as well as the ability to do ptosis fields and can run these in different thresholds and stimulus sizes. My hesitancy with these types of visual field analyzers has always been in their defendability in a malpractice scenario. Because the testing strategies and reporting parallel the Humphrey visual fields, which have been well-established as the standard of care, I have a lot less concern in that regard for this particular instrument.

I'm sure you're thinking it, but I'm not getting any kind of discount or kickback from either of these companies. Next time you're at an in-person meeting, check these out. I hope you like them as much as I do and also think these have the potential to make the care we provide just that much better for us and our patients.

Shannon L. Steinhäuser, OD, MS, FAAO
Chief Medical Editor


Want to share your perspective?
Write to Dr. Shannon L. Steinhäuser, OD, MS, FAAO at ssteinhauser@gmail.com. The views expressed in this editorial are solely those of the author and do not necessarily represent the opinions of Jobson Medical Information LLC (JMI), or any other entities or individuals.



The Impact of Donor History of Sleep Apnea on Corneal Tissue Evaluation Parameters

The goal of this study was to explore whether the donor history of sleep apnea affects corneal tissue evaluation parameters. This was a retrospective study assessing the impact of donor history of sleep apnea in a dataset obtained from the Eversight Eye Bank. Comparative analysis and multivariate regression were used to assess differences in key parameters including endothelial cell density (ECD) and central corneal thickness.

Data analyzed consisted of 50,170 tissues from 25,399 donors with no history of sleep apnea and 5,473 tissues from 2,774 donors with a history of sleep apnea. Tissue from donors with a history of sleep apnea showed lower ECD than those from donors with no history of sleep apnea (-51 cells/mm2, p<0.001). Multivariate linear regression demonstrated that history of sleep apnea was a predictor of lower ECD by 13.72 cells/mm2. Secondary analysis demonstrated that underweight and obese body mass indexes were significant predictors of increased ECD in donors with no history of sleep apnea. Body mass index category was not a significant predictor of ECD in donors with a history of sleep apnea. In a smaller subset of 10,756 tissues, sleep apnea was not a significant predictor of central corneal thickness.

Researchers wrote that the study is the first to demonstrate that a donor's history of sleep apnea is associated with a lower ECD in a large eye bank dataset. They noted that future studies would be needed to investigate whether history of sleep apnea affects post-transplantation outcomes.

SOURCE: Abhishek Ramini, Nancy Zhang, Megan Lee, et al. The Impact of Donor History of Sleep Apnea on Corneal Tissue Evaluation Parameters. Cornea. 2024 Jun 18. Online ahead of print.




Quality of Life and Mental Health Status of Glaucoma Patients

Glaucoma, a leading cause of irreversible blindness worldwide, poses significant challenges to patients' quality of life (QOL) and mental well-being. This study aimed to investigate the complex interplay between clinical, demographic, and psychological factors and their impact on QOL among patients diagnosed with glaucoma. A cohort of 201 glaucoma patients, with a mean age of 70 years, participated in the study.

Descriptive analyses revealed that participants reported living with a glaucoma diagnosis for an average of 13.38 years, highlighting the chronic nature of the disease in the cohort. Comorbidity was shown to be in close relationship with QOL, where with additional health problems have lower QOL scores (M=34.86, SD=18.25), as well as higher levels of anxiety (M=10.64, SD=5.38) and depression (M=13.42, SD=7.37). Correlation analyses further unveiled robust associations between clinical characteristics and psychological outcomes, with lower visual acuity strongly correlated with reduced QOL (rR=-0.74, pR<0.001; rL=-0.78, pL<0.001) and higher levels of anxiety and depression. Additionally, longer duration of glaucoma diagnosis was moderately associated with poorer QOL (r=0.56, p<0.001) and increased psychological distress, highlighting the cumulative burden of living with the disease over time. Mediation analyses indicated that duration of diagnosis partially mediated the relationship between depression and QOL, as well as anxiety and QOL, suggesting that the prolonged experience of living with glaucoma may exacerbate the impact of psychological distress on QOL.

These findings underscore the importance of holistic patient care approaches that address both the physical and psychological aspects of glaucoma to improve patient outcomes and enhance overall well-being.

SOURCE: Vanja Kopilaš, Mirko Kopilaš. Quality of life and mental health status of glaucoma patients. Front Med (Lausanne). 2024 Jun 3:11:1402604.

Analysis of Treatment Discontinuation in Orthokeratology: Studying Efficacy, Safety, and Patient Adherence Over Six Months

This study aimed to evaluate the efficacy, safety, and participant compliance of orthokeratology treatment for the correction of myopic refractive errors over a six-month prospective study and to define the potential reasons for early treatment discontinuation. A total of 32 participants with low-to-moderate myopia were fitted with the spherical model of corneal refractive therapy (CRT) orthokeratology lenses (Paragon Vision Sciences) and followed over six months, with specific attention to alterations in refractive error, corneal topography, and epithelial thickness. Concurrently, participant feedback and reasons for any treatment discontinuation were documented.

Significant changes in refractive error and in corneal topography were observed, with approximately 50% of the refractive error being corrected on the first night of use and 100% by the first two weeks. Central epithelial thickness experienced substantial thinning, reducing to 15.65±4.49 μm (67.38%) after 6 months of lens use. Six participants withdrew from this study for varied reasons, including unmet visual expectations and difficulty adhering to the lens-wearing regimen. Notably, the dropout group exhibited higher baseline low-order aberrations and less prolate corneas than those who persisted with the treatment.

Orthokeratology with CRT is efficacious and safe for the correction of low-to-moderate myopia in adults, but a portion of patients discontinue the treatment in the first 6 months of contact lens wear. Special care should be taken when recommending orthokeratology in patients with higher levels of myopia and corneas with less prolate shape, providing more realistic expectations and even changing to dual axis or more sophisticated designs.

SOURCE: Alicia Sánchez-García, Ainhoa Molina-Martin, Miguel Ángel Ariza-Gracia, David P Piñero. Analysis of Treatment Discontinuation in Orthokeratology: Studying Efficacy, Safety, and Patient Adherence Over Six Months. Eye Contact Lens. 2024 Jun 18. Online ahead of print.




Industry News

AOA Optometry’s Meeting Announcements

• Johnson & Johnson Vision showcased its Vision Made Possible initiative, with a variety of educational events and series dedicated to discussing access and diversity in patient care and the importance of sight throughout all stages of life, from infants to the aging eye. Highlights include a dedicated Juneteenth collaboration with the AOA and the Black Eye Care Perspective on the importance of diversity in eyecare and connection to allyship in leadership. Additionally, the company participated in podium and peer-to-peer education supporting patient care access, interactive pop-up experiences, and discuss contact lens technologies, with emphasis on Blink Stabilized® Design, ACUVUE® for Astigmatism, Myopia Management awareness, practice opportunities for Presbyopia patients and Pupil Optimized Design. Read more about the Vision Made Possible Initiative

• Virtual Vision Health offered product demonstrations of new features integrated into their VR visual field devices. Learn more about the company.


• Aurion Biotech announced CEO Greg Kunst was named winner of the Ernst & Young 2024 Entrepreneur of the Year award for the Mountain West Region. Read more.








Journal Reviews Editor:
Shannon L. Steinhäuser, OD, MS, FAAO

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