Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Summary
The present research demonstrates a method to accurately examine dynamic visual acuity (DVA) in myopic subjects with eyeglass correction. Further analysis indicated that the closer the refraction state to emmetropia, the better the eyeglass-corrected binocular DVA is at both 40 and 80 degrees per second.
Abstract
Current clinical visual assessment mainly focuses on static vision. However, static vision may not sufficiently reflect real-life visual function as moving optotypes are frequently observed daily. Dynamic visual acuity (DVA) might reflect real-life situations better, especially when objects are moving at high speeds. Myopia impacts static uncorrected distance visual acuity, conveniently corrected with eyeglasses. However, due to peripheral defocus and prism effects, eyeglass correction might affect DVA. The present research demonstrates a standard method to examine eyeglass-corrected DVA in myopia patients, and aimed to explore the influence of eyeglass correction on DVA.
Initially, standard subjective refraction was performed to provide the eyeglass prescription to correct the refractive error. Then, binocular distance vision-corrected DVA was examined using the object-moving DVA protocol. Software was designed to display the moving optotypes according to the preset velocity and size on a screen. The optotype was the standard logarithmic visual chart letter E and moves from the middle of the left to the right side horizontally during the test. Moving optotypes with randomized opening direction for each size are displayed. The subjects were required to identify the opening direction of the optotype, and the DVA is defined as the minimum optotype that subjects could recognize, calculated according to the algorithm of logarithmic visual acuity.
Then, the method was applied in 181 young myopic subjects with eyeglass-corrected-to-normal static visual acuity. Dominant eye, cycloplegic subjective refraction (sphere and cylinder), accommodation function (negative and positive relative accommodation, binocular cross-cylinder), and binocular DVA at 40 and 80 degrees per second (dps) were examined. The results showed that with increasing age, DVA first increased and then decreased. When myopia was fully corrected with eyeglasses, a worse binocular DVA was associated with more significant myopic refractive error. There was no correlation between the dominant eye, accommodation function, and binocular DVA.
Introduction
Current visual assessment mainly focuses on static vision, including static visual acuity (SVA), visual field, and contrast sensitivity. In daily life, either the object or the observer is often in motion rather than being stationary. Therefore, SVA may not sufficiently reflect visual function in daily lives, especially when objects are moving at high speeds, such as during sports and driving1. DVA defines the ability to identify the details of moving optotypes1,2, which might reflect real-life situations better and be more sensitive to visual disturbance and improvement3,4. Moreover, as magnocellular (M) ganglion cells located mainly in the peripheral retina primarily transmit high temporal frequency signals, DVA might reflect visual signal transmission differently from SVA5,6. The DVA test (DVAT) can be mainly divided into two types: static- and moving-object DVATs. While the static-object DVAT demonstrates the vestibule-ocular reflex7,8,9,10, the moving-object DVAT is commonly applied in clinical ophthalmology to detect visual acuity in the identification of moving targets3,4.
The prevalence of myopia has rapidly increased in recent decades, especially in Asian countries11. Myopia has an essential impact on static uncorrected distance visual acuity, which could be corrected with various lenses. Eyeglasses are mostly used among myopia patients due to accessibility and convenience. However, eyeglasses, especially high myopia lenses, have obvious peripheral defocus and prism effects that cause unclear and skewed images to be observed through the peripheral region12,13,14,15. For a static optotype, the subject commonly uses the central area of eyeglasses that could obtain a clear vision. However, the moving target could easily move out of the eyeglasses' clearest point. Thus, with eyeglass correction, myopic subjects might have normal SVA and affected DVA. However, no research has been performed to investigate the impact of myopia diopter on DVA in populations with eyeglasses.
This study demonstrates a method to examine DVA in eyeglass-corrected myopia patients and aimed to explore the impact of myopia diopter on moving-object binocular DVA in eyeglass-corrected patients. The research provides a basis for accurately interpreting DVAT in clinical ophthalmology considering the impact of eyeglasses and evidence on the influence of corrected myopia on motion-related activities.
Protocol
Representative Results
Discussion
DVA is a promising indicator to assess visual function, which might better reflect actual vision in daily life. Myopic patients could have corrected, normal SVA, but their DVA might be affected. This study demonstrates a method to examine the DVA in myopic subjects with eyeglass correction accurately and analyzes its correlation with optometric parameters, including refraction, accommodation, and the dominant eye. The results indicated that DVA at 40 dps was superior to that at 80 dps. The closer the refraction state is …
Disclosures
The authors have nothing to disclose.
Acknowledgements
This work was supported by Natural Science Foundation of Beijing Municipality (7202229).
Materials
| Automatic computer optometry | TOPCON | KR8100 | |
| Corneal topography | OCULUS | Pentacam | |
| Dynamic visual acuity test design software | Mathworks | matlab 2017b | |
| Fundus photography | Optos | Daytona | |
| Matlab | Mathworks | 2017b | |
| Noncontact tonometry | CANON | TX-20 | |
| Phoropter | NIDEK | RT-5100 | |
| scientific statistical software | IBM | SPSS 26.0 | |
| Slit lamp | Koniz | IM 900 |
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