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Abstract Interdisciplinary scholarship and education remains elusive at modern universities, despite efforts at both the individual and institutional levels. The objective of this paper is to identify the main motivations that bring different disciplines together in joint research and identify some of the obstacles to that coming together. Here we propose that shared purpose (why do I participate?), practice (how do we interact?), and place (where do we interact?) are, in descending order, the most important drivers for what we call “undisciplinary” research in an interaction of different disciplines. Through unstructured workshops we found the choice of participants (who participates?), aspects of time (when do we interact?), and especially the research topics and focus (what are we working on?), to be less important for individual faculty engagement. Metaphor analysis obtained during a charrette-style workshop with 13 faculty from multiple disciplines suggested “inter-epistemological ways of knowing” rather than fields of study to move us from disciplinary to interdisciplinary to undisciplinary scholarship and education. Specifically, the broad intent (why do we participate?) was found to increase the impact of undisciplinary approaches that served as drivers for engagement. These lessons learned from a series of workshops were put to the test at an experimental center that clarified the importance of both synchronous and asynchronous interactions in a common space large enough to allow these and located outside the university. Despite the valuable insights gained in what undisciplinary interaction may look like in a center, it remained clear that space design must start by mapping out why and how individuals in different disciplines may want to interact at a given institution to generate buy-in and build the foundation for continuous refinement of an institutional strategy.

OBJECTIVE:: Unnecessary dietary restraint (ie in the absence of a need to lose weight) and chronic overeating are both very unhealthy activities. As a precursor to a more involved longitudinal study, we sought to identify potential early-life predictors that merit scrutiny in this context. DESIGN:: Four retrospective questionnaire studies were conducted (Study 1, N=242; Study 2, N=297; Study 3, N=175; Study 4, N=261). Female participants (18-30?y) completed measures of current dietary restraint and overeating. They also recalled experiences between 5 and 10 years of age. All were staff or students at Loughborough University (UK). RESULTS:: After considering obvious sources of systematic bias, we report evidence that (i) dietary restraint is related to memories of maternal weight and dietary behaviour, and (ii) overeating and meal-size selection are both associated with memories of receiving a high-energy diet. CONCLUSION:: The role of maternal factors in dietary restraint is consistent with previous research exploring the early onset of this behaviour. However, the relationship between childhood diet and overeating has not been suggested elsewhere. This is particularly important because it suggests a previously unreported correspondence between childhood experience and behaviours associated with obesity in adulthood.International Journal of Obesity (2005) 29, 463-474. doi:10.1038/sj.ijo.0802890 Published online 1 February 2005 [ABSTRACT FROM AUTHOR]

Objectives Problem-solving skills training is adaptable, inexpensive and simple to deliver. However, its application with prisoners who self-harm is unknown. The study assessed the feasibility and acceptability of a problem-solving training (PST) intervention for prison staff and prisoners who self-harm, to inform the design of a large-scale study.Design and setting A mixed-methods design used routinely collected data, individual outcome measures, an economic protocol and qualitative interviews at four prisons in Yorkshire and Humber, UK.Participants (i) Front-line prison staff, (ii) male and female prisoners with an episode of self-harm in the previous 2 weeks.Intervention The intervention comprised a 1 hour staff training session and a 30 min prisoner session using adapted workbooks and case studies.Outcomes We assessed the study processes—coverage of training; recruitment and retention rates and adequacy of intervention delivery—and available data (completeness of outcome data, integrity of routinely collected data and access to the National Health Service (NHS) resource information). Prisoner outcomes assessed incidence of self-harm, quality of life and depression at baseline and at follow-up. Qualitative findings are presented elsewhere.Results Recruitment was higher than anticipated for staff n=280, but lower for prisoners, n=48. Retention was good with 43/48 (89%) prisoners completing the intervention, at follow-up we collected individual outcome data for 34/48 (71%) of prisoners. Access to routinely collected data was inconsistent. Prisoners were frequent users of NHS healthcare. The additional cost of training and intervention delivery was deemed minimal in comparison to ‘treatment as usual’. Outcome measures of self-harm, quality of life and depression were found to be acceptable.Conclusions The intervention proved feasible to adapt. Staff training was delivered but on the whole it was not deemed feasible for staff to deliver the intervention. A large-scale study is warranted, but modifications to the implementation of the intervention are required.

Purpose: The purpose of this study was to determine if control observers can be used as surrogates to predict visual acuity (VA) of patients with Down syndrome (DS)., Methods: Thirty adults with DS were enrolled in a clinical trial testing three refraction types: clinical refraction and two using wavefront aberration measures to optimize the metrics pupil fraction tessellated (PFSt) and visual Strehl ratio (VSX). Monocular VA was obtained through habitual refractions and each experimental refraction type. Five controls without DS viewed acuity charts simulating the retinal image produced when the corrections for each DS eye are worn, performing VA and scoring image quality of each chart. Group median VA (DS versus controls) were compared for each refraction type, and control image quality scores were compared to corresponding VA across refraction types., Results: Median VA for participants with DS ranged from 0.46 logMAR (interquartile range [IQR] = 0.32 to 0.54) with habitual correction to 0.36 logMAR (IQR = 0.28 to 0.54) with VSX, whereas controls ranged from 0.37 logMAR (IQR = 0.29 to 0.42) with habitual correction to 0.01 logMAR (IQR = -0.02 to 0.05) with VSX. Overall image quality scores were best for PFSt and VSX and showed a strong linear relationship with control VA (r = -0.91, P < 0.001), and a lesser correlation with DS VA (r = -0.33, P < 0.001)., Conclusions: Using surrogate observers to judge image quality simulations of eyes with DS did not predict actual VA, suggesting additional, non-optical factors may be limiting VA in individuals with DS., Translational Relevance: Findings may guide clinical refraction practices for patients with DS.

The prevalence of myopia is growing at an alarming rate and is associated with axial elongation of the eye. The cause of this undesirable physiological change involves multiple factors. When the magnitude of myopia approaches high levels, this accompanying mechanical effect increases the risk of developing other clinical conditions associated with permanent vision loss. Prior work has investigated how we may halt or reverse this process of axial elongation associated with myopic progression when we expose the eye to a peripheral myopic defocus stimulus. Specifically, the known, short-term response to myopic defocus stimulation is promising and demonstrates the possibility of establishing more permanent effects by regulating the axial length of the eye with specific defocus stimulation. However, how to directly convert these known, short-term effects into more long-term, permanent changes to effectively prevent these unfavourable physiological and refractive changes over time is yet to be understood. Here, we show for the first time that we can produce sustained, long-term reductions in axial length and refractive endpoints with cumulative short-term exposure to specific myopic defocus stimuli using a novel optical design that incorporates an augmented reality optical system. We believe that this technology will have the potential to improve the quality of vision in mankind., (© 2022. The Author(s).)

Purpose: To investigate the ratio of accommodative convergence per diopter of accommodative response (AC/A ratio) before, during, and after myopia onset., Methods: Subjects were 698 children aged 6 to 14 years who became myopic and 430 emmetropic children participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error. Refractive error was measured using cycloplegic autorefraction, near work by parent survey, and the AC/A ratio by simultaneously monitoring convergence and accommodative response. The response AC/A ratios of children who became myopic were compared with age-, sex-, and ethnicity-matched model estimates for emmetropic children from 5 years before through 5 years after the onset of myopia., Results: The response AC/A ratio was not significantly different between the two groups 5 years before onset, then increased monotonically in children who became myopic until reaching a plateau at myopia onset of about 7 Δ/D compared to about 4 Δ/D for children who remained emmetropic (differences between groups significant at P < 0.01 from 4 years before onset through 5 years after onset). A higher AC/A ratio was associated with greater accommodative lag but not with the rate of myopia progression regardless of the level of near work., Conclusions: An increasing AC/A ratio is an early sign of becoming myopic, is related to greater accommodative lag, but does not affect the rate of myopia progression. The association with accommodative lag suggests that the AC/A ratio increase is from greater neural effort needed per diopter of accommodation rather than change in the accommodative convergence crosslink gain relationship.

Purpose: The purpose of this study was to assess risk factors associated with soft contact lens (SCL)-related corneal infiltrative events (CIEs)., Methods: This was a single-visit, case-control study conducted at five academic centers in North America. Cases were defined as current SCL wearers with a symptomatic CIE. For each case, three age- and sex-matched controls were enrolled. Subjects completed the Contact Lens Risk Survey (CLRS), a standardized scripted medical interview, supplied a recent health history, and underwent an ocular examination. Microbial culturing of the ocular surface, SCL, and lens storage case was conducted for all cases and one of the three matched controls. Univariate and multivariate logistic regression modeling were used to assess the risk of developing a CIE., Results: Thirty cases and 90 controls 13 to 31 years of age completed the study. Corneal infiltrative event diagnosis included contact lens-associated red eye, infiltrative keratitis, and contact lens peripheral ulcer. Subjects with symptomatic CIEs were more likely to harbor substantial levels of gram-negative bioburden on the ocular surface and contact lens. Significant risk factors for developing a CIE were overnight wear of SCLs, use of multipurpose solution, rinsing SCLs with water, lens storage case older than 6 months, previous "red eye" event, use of ocular drops in the past week, and illness during the past week., Conclusions: This pilot study demonstrated feasibility of enrolling a representative pool of SCL wearers with an untreated, symptomatic CIE and assessing CIE risk factors by using standardized methods. A larger sample size is needed to determine relationships between patient-reported behaviors and exposures, microbial bioburden, and CIE development.

Contact lenses provide safe and effective vision correction for many Americans. However, contact lens wearers risk infection if they fail to wear, clean, disinfect, and store their contact lenses as directed. Over the past decade, CDC has investigated several multistate outbreaks of serious eye infections among contact lens wearers, including Acanthamoeba keratitis. Each investigation identified frequent contact lens hygiene-related risk behaviors among patients. To guide prevention efforts, a population-based survey was used to estimate the number of contact lens wearers aged ≥18 years in the United States. A separate online survey of contact lens wearers assessed the prevalence of contact lens hygiene-related risk behaviors. Approximately 99% of wearers reported at least one contact lens hygiene risk behavior. Nearly one third of contact lens wearers reported having experienced a previous contact lens-related red or painful eye requiring a doctor's visit. An estimated 40.9 million U.S. adults wear contact lenses, and many could be at risk for serious eye infections because of poor contact lens wear and care behaviors. These findings have informed the creation of targeted prevention messages aimed at contact lens wearers such as keeping all water away from contact lenses, discarding used disinfecting solution from the case and cleaning with fresh solution each day, and replacing their contact lens case every 3 months.

Purpose: To describe age and other risk factors for corneal infiltrative and inflammatory events (CIEs) in young, soft contact lens (SCL) wearers and to model the age-related risk., Methods: A multicenter, retrospective chart review of 3549 SCL wearers (8-33 years at first observed visit, +8.00 to -12.00D, oversampling <18 years) captured CIEs from January 2006 to September 2009. The review noted age, sex, SCL worn, use of lens care products, and SCL wearing history. Event diagnoses were adjudicated to consensus by reviewers masked to wearer identity, age, and SCL parameters. Significant univariate risk factors for CIEs were subsequently tested in multivariate generalized estimating equations., Results: Charts from 14,305 visits observing 4,663 SCL years yielded 187 CIEs in 168 wearers. Age was a significant nonlinear risk factor, peaking between 15 and 25 years (P < 0.008). Less than 1 year of SCL use was protective versus longer years of wear (P < 0.0003). Use of multipurpose care products (2.86×), silicone hydrogels (1.85×), and extended wear (2.37×) were significantly associated with CIEs in the multivariate model (P < 0.0001 each)., Conclusions: Patient age, years of lens wear, use of multipurpose care products, silicone hydrogels, and extended wear were all significantly associated with CIEs with SCL wear. Use of SCLs in young patients aged 8 to 15 years was associated with a lower risk of infiltrative events compared with teens and young adults. In terms of safety outcomes, SCLs appear to be an acceptable method of delivering optics designed to manage myopia progression in children and young teens in the future.

Purpose: To investigate visual activities before and after the onset of juvenile myopia., Methods: The subjects were 731 incident myopes (-0.75 D or more myopia on cycloplegic autorefraction in both meridians) and 587 emmetropes (between -0.25 and +1.00 D) in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. Parents supplied visual activity data annually. Data from myopic children 5 years before through 5 years after myopia onset were compared to data from age-, sex-, and ethnicity-matched models of children who remained emmetropic., Results: Hours per week spent reading or using a computer/playing video games did not differ between the groups before myopia onset; however, hours per week for both activities were significantly greater in myopes than in emmetropes at onset and in 4 of the 5 years after onset by 0.7 to 1.6 hours per week. Hours per week spent in outdoor/sports activities were significantly fewer for children who became myopic 3 years before onset through 4 years after onset by 1.1 to 1.8 hours per week. Studying and TV watching were not significantly different before myopia onset., Conclusions: Before myopia onset, near work activities of future myopic children did not differ from those of emmetropes. Those who became myopic had fewer outdoor/sports activity hours than the emmetropes before, at, and after myopia onset. Myopia onset may influence children's near work behavior, but the lack of difference before onset argues against a major causative role for near work. Less outdoor/sports activity before myopia onset may exert a stronger influence on development than near work.

Purpose: To investigate whether relative peripheral hyperopia is a risk factor for either the onset of myopia in children or the rate of myopic progression., Methods: The risk of myopia onset was assessed in 2043 nonmyopic third-grade children (mean age ± SD = 8.8 ± 0.52 years) participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study between 1995 and 2007, 324 of whom became myopic by the eighth grade. Progression analyses used data from 774 myopic children in grades 1 to 8. Foveal and relative peripheral refractive error 30° in the nasal visual field was measured annually by using cycloplegic autorefraction. Axial length was measured by A-scan ultrasonography., Results: The association between more hyperopic relative peripheral refractive error in the third grade and the risk of the onset of myopia by the eighth grade varied by ethnic group (Asian children odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.06-2.30; African-American children OR = 0.75, 95% CI = 0.58-0.96; Hispanics, Native Americans, and whites showed no significant association). Myopia progression was greater per diopter of more hyperopic relative peripheral refractive error, but only by a small amount (-0.024 D per year; P = 0.02). Axial elongation was unrelated to the average relative peripheral refractive error (P = 0.77), regardless of ethnicity., Conclusions: Relative peripheral hyperopia appears to exert little consistent influence on the risk of the onset of myopic refractive error, on the rate of myopia progression, or on axial elongation.

Purpose: To evaluate the effectiveness of the Convergence Insufficiency Treatment Trial (CITT) placebo therapy program in maintaining masking of patients randomized to the office-based treatment arms, determine whether demographic variables affect masking, and determine whether perception of assigned treatment group was associated with treatment outcome or adherence to treatment., Methods: Patients (n = 221, ages, 9-17 years) were randomized to one of four treatment groups, two of which were office-based and masked to treatment (n = 114). The placebo therapy program was designed to appear to be real vergence/accommodative therapy, without stimulating vergence, accommodation, or fine saccades (beyond levels of daily visual activities). After treatment, patients in the office-based groups were asked whether they thought they had received real or placebo therapy and how confident they were in their answers., Results: Ninety-three percent of patients assigned to real therapy and 85% assigned to placebo therapy thought they were in the real therapy group (P = 0.17). No significant differences were found between the two groups in adherence to the therapy (P >or= 0.22 for all comparisons). The percentage of patients who thought they were assigned to real therapy did not differ by age, sex, race, or ethnicity (P > 0.30 for all comparisons). No association was found between patients' perception of group assignment and symptoms or signs at outcome (P >or= 0.38 for all comparisons)., Conclusions: The CITT placebo therapy program was effective in maintaining patient masking in this study and therefore may have potential for use in future clinical trials using vergence/accommodative therapy. Masking was not affected by demographic variables. Perception of group assignment was not related to symptoms or signs at outcome (ClinicalTrials.gov number, NCT00338611).

Purpose: To identify whether parental history of myopia and/or parent-reported children's visual activity levels can predict juvenile-onset myopia., Methods: Survey-based data from Orinda Longitudinal Study of Myopia subjects from 1989 to 2001 were used to predict future myopia. Univariate and multiple logistic regression analyses were performed, and receiver operator characteristic (ROC) curves were generated. Differences among the areas under the ROC curves were compared using the method of multiple comparison with the best., Results: Of the 514 children eligible for this analysis, 111 (21.6%) became myopic. Differences in the third grade between eventual myopes and nonmyopes were seen for the number of myopic parents (P < 0.001) and for the number of sports and outdoor activity hours per week (11.65 +/- 6.97 hours for nonmyopes vs. 7.98 +/- 6.54 hours for future myopes, P < 0.001). Analysis of the areas under the ROC curves showed three variables with a predictive value better than chance: the number of myopic parents, the number of sports and outdoor activity hours per week, and the number of reading hours per week. After controlling for sports and outdoor hours per week and parental myopia history, reading hours per week was no longer a statistically significant factor. The area under the curve for the parental myopia history and sports and outdoor activities model was 0.73. A significant interaction in the logistic model showed a differential effect of sport and outdoor activity hours per week based on a child's number of myopic parents., Conclusions: Parental history of myopia was an important predictor in univariate and multivariate models, with a differential effect of sports and outdoor activity hours per week based on the number of myopic parents. Lower amounts of sports and outdoor activity increased the odds of becoming myopic in those children with two myopic parents more than in those children with either zero or one myopic parent. The chance of becoming myopic for children with no myopic parents appears lowest in the children with the highest amount of sports and outdoor activity, compared with those with two myopic parents.

Purpose: To evaluate refractive error, axial length, and relative peripheral refractive error before, during the year of, and after the onset of myopia in children who became myopic compared with emmetropes., Methods: Subjects were 605 children 6 to 14 years of age who became myopic (at least -0.75 D in each meridian) and 374 emmetropic (between -0.25 D and +1.00 D in each meridian at all visits) children participating between 1995 and 2003 in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. Axial length was measured annually by A-scan ultrasonography. Relative peripheral refractive error (the difference between the spherical equivalent cycloplegic autorefraction 30 degrees in the nasal visual field and in primary gaze) was measured using either of two autorefractors (R-1; Canon, Lake Success, NY [no longer manufactured] or WR 5100-K; Grand Seiko, Hiroshima, Japan). Refractive error was measured with the same autorefractor with the subjects under cycloplegia. Each variable in children who became myopic was compared to age-, gender-, and ethnicity-matched model estimates of emmetrope values for each annual visit from 5 years before through 5 years after the onset of myopia., Results: In the sample as a whole, children who became myopic had less hyperopia and longer axial lengths than did emmetropes before and after the onset of myopia (4 years before through 5 years after for refractive error and 3 years before through 5 years after for axial length; P < 0.0001 for each year). Children who became myopic had more hyperopic relative peripheral refractive errors than did emmetropes from 2 years before onset through 5 years after onset of myopia (P < 0.002 for each year). The fastest rate of change in refractive error, axial length, and relative peripheral refractive error occurred during the year before onset rather than in any year after onset. Relative peripheral refractive error remained at a consistent level of hyperopia each year after onset, whereas axial length and myopic refractive error continued to elongate and to progress, respectively, although at slower rates compared with the rate at onset., Conclusions: A more negative refractive error, longer axial length, and more hyperopic relative peripheral refractive error in addition to faster rates of change in these variables may be useful for predicting the onset of myopia, but only within a span of 2 to 4 years before onset. Becoming myopic does not appear to be characterized by a consistent rate of increase in refractive error and expansion of the globe. Acceleration in myopia progression, axial elongation, and peripheral hyperopia in the year prior to onset followed by relatively slower, more stable rates of change after onset suggests that more than one factor may influence ocular expansion during myopia onset and progression.

Two experiments explored the hypothesis that distraction causes a reduced sensitivity to the physiological and sensory cues that signal when to terminate a meal. In Experiment 1, eighty-eight females ate five 'Jaffa Cakes' either while distracted by a computer game or while sitting in silence. Analysis of the difference in rated hunger, fullness and desire to eat (pre- to post-intake) revealed that distracted participants experienced smaller changes in their desire to eat and fullness than did non-distracted participants. Experiment 2 assessed whether changes in ratings are attenuated because sensory-specific satiety (or a related process) fails to develop. Using a similar procedure, eighty-four females provided desire to eat, pleasantness and intensity ratings for Jaffa Cakes and for two 'uneaten' foods, both before and at three time-points after consuming five Jaffa Cakes. Non-distracted participants reported a reduction in their desire to eat the eaten food relative to the uneaten food (food-specific satiety), whereas distracted participants maintained a desire to eat all foods. Moreover, this difference between distracted and non-distracted participants was evident 5 and 10 min after the eating episode had terminated. The present findings invite speculation that distraction attenuates the development of sensory-specific satiety, and that this effect persists (at least for a brief period) after the distractor has terminated. More generally, this kind of phenomenon warrants further scrutiny because it holds the potential to contribute towards overeating, either by prolonging an eating episode or by reducing the interval between meals.

Purpose: To evaluate accommodative lag before, during the year of, and after the onset of myopia in children who became myopic, compared with emmetropes., Methods: The subjects were 568 children who became myopic (at least -0.75 D in each meridian) and 539 children who were emmetropic (between -0.25 D and +1.00 D in each meridian at all visits) participating between 1995 and 2003 in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. Accommodative lag was measured annually with either a Canon R-1 (Canon USA., Lake Success, NY; no longer manufactured) or a Grand Seiko WR 5100-K (Grand Seiko Co., Hiroshima, Japan) autorefractor. Subjects wore their habitual refractive corrections while viewing a letter target accommodative stimulus of 4 D (either in a Badal system or at 25 cm from the subject, designated Badal and near, respectively) or of 2 D (Badal only). Refractive error was measured with the same autorefractor in subjects under cycloplegia. Accommodative lag in children who became myopic was compared to age-, gender-, and ethnicity-matched model estimates of emmetropic values for each annual visit from 5 years before, through 5 years after, the onset of myopia., Results: In the sample as a whole, accommodative lag was not significantly different in children who became myopic compared with model estimates in emmetropes in any year before onset of myopia for either the 4-D or 2-D Badal stimulus. For the 4-D near target, there was only a greater amount of accommodative lag in children who became myopic compared with emmetropes 4 years before onset (difference, 0.22 D; P = 0.0002). Accommodative lag was not significantly elevated during the year of onset of myopia in any of the three measurement conditions (P < 0.82 for all three). A consistently higher lag was seen in children after the onset of their myopia (range, 0.13-0.56 D; P < 0.004 for all comparisons). These patterns were generally followed by each ethnic group, with Asian children typically showing the most, African-American and white children showing the least, and Hispanic children having intermediate accommodative lag., Conclusions: Substantive and consistent elevations in accommodative lag relative to model estimates of lag in emmetropes did not occur in children who became myopic before the onset of myopia or during the year of onset. Increased accommodative lag occurred in children after the onset of myopia. Elevated accommodative lag is unlikely to be a useful predictive factor for the onset of myopia. Increased hyperopic defocus from accommodative lag may be a consequence rather than a cause of myopia.

Purpose: To compare base-in prism reading glasses with placebo reading glasses for the treatment of symptomatic convergence insufficiency (CI) in children aged 9 to <18 years., Methods: In a randomised clinical trial, 72 children aged 9 to <18 years with symptomatic CI were assigned to either base-in prism glasses or placebo reading glasses. Symptom level, measured with a quantitative symptom questionnaire (CI Symptom Survey-V15), was the primary outcome measure. Near point of convergence and positive fusional vergence at near were secondary outcomes., Results: The mean (SD) CI Symptom Survey score decreased (that is, less symptomatic) in both groups (base-in prism glasses from 31.6 (10.4) to 16.5 (9.2); placebo glasses from 28.4 (8.8) to 17.5 (12.3)). The change in the CI Symptom Survey scores (p = 0.33), near point of convergence (p = 0.91), and positive fusional vergence (p = 0.59) were not significantly different between the two groups after 6 weeks of wearing glasses., Conclusions: Base-in prism reading glasses were found to be no more effective in alleviating symptoms, improving the near point of convergence, or improving positive fusional vergence at near than placebo reading glasses for the treatment of children aged 9 to <18 years with symptomatic CI.

Purpose: To evaluate the contribution made by the ocular components to the emmetropization of spherical equivalent refractive error in human infants between 3 and 9 months of age., Methods: Keratophakometry in two meridians was performed on 222 normal-birthweight infant subjects at 3 and 9 months of age. The spherical equivalent refractive error was measured by cycloplegic retinoscopy (cyclopentolate 1%). Anterior chamber depth, lens thickness, and vitreous chamber depth were measured by A-scan ultrasonography over the closed eyelid., Results: Both the mean and SD for spherical equivalent refractive error decreased between 3 and 9 months of age (+2.16 +/- 1.30 D at 3 months; +1.36 +/- 1.06 D at 9 months; P < 0.0001, for the change in both mean and SD). Average ocular component change was characterized by increases in axial length, thinning, and flattening of the crystalline lens, increases in lens equivalent refractive index, and decreases in lens and corneal power. Initial refractive error was associated in a nonlinear manner with the change in refractive error (R(2) = 0.41; P < 0.0001) and with axial growth (R(2) = 0.082; P = 0.0005). Reduction in hyperopia correlated significantly with increases in axial length (R(2) = 0.16; P < 0.0001), but not with changes in corneal and lenticular power. Decreases in lenticular and corneal power were associated with axial elongation (R(2) = 0.40, R(2) = 0.12, respectively; both P < 0.0001)., Conclusions: Modulation in the amount of axial growth in relation to initial refractive error appeared to be the most influential factor in emmetropization of spherical equivalent refractive error. The associations between initial refractive error, subsequent axial growth, and change in refractive error were consistent with a visual basis for emmetropization. The cornea and crystalline lens lost substantial amounts of dioptric power in this phase of growth, but neither appeared to play a significant role in emmetropization.

Purpose: To apply interferometry as an in vivo measure of tear film thinning between blinks., Methods: Wavelength-dependent interference was used to measure the tear film thinning rates in 20 normal contact lens wearers, and spectra were captured at a rate of 4.5 per second for 20 seconds. Four recordings of precorneal tear film (PCTF) thinning were made, followed by 1 hour of hydrogel lens wear and then four recordings of prelens tear film (PLTF) thinning. Subjects were asked to blink 1 second after the beginning of the recording and then hold their eyes open for an additional 19 seconds, followed by 2 minutes of rest between recordings., Results: The average thinning rate of the PLTF was greater than that of the PCTF and average initial tear film thickness of the PLTF was less than that of the PCTF. For both these reasons, the "tear thinning time" (time to reach 0 thickness) was typically shorter for the PLTF than for the PCTF. Histograms of PCTF and PLTF thinning rates showed a narrow peak corresponding to slow thinning of approximately 1 microm/min, but also many examples of rapid thinning of approximately 10 microm/min, with greater variability. Both the initial thickness and thinning rate of the PLTF correlated with corresponding values for the PCTF, although many more rapidly changing values were associated with the PLTF. Plots of rapid thinning of PCTF and PLTF were both linear and were not accompanied by any significant increase in thickness of corneal epithelium or contact lens, respectively., Conclusions: Tear film thinning can be analyzed in terms of flow in three spatial directions: (1) outward (evaporation), (2) inward (into the epithelium or contact lens), and (3) parallel to the tear film surface. The results indicate that the second mechanism may be unimportant. Studies have shown a range of tear film evaporation rates from 0.24 to 1.45 microm/min, whereas, when the lipid layer is washed away from the tear film, the thinning rate, due to evaporation, would be approximately 7 microm/min. Thus, slow thinning rates may be due to tear film evaporation, whereas rapid rates (which are often greater than 7 microm/min) presumably include other mechanisms such as dewetting, Marangoni flow (i.e., surface tension gradients), and pressure-gradient flow.

Purpose: To compare ocular component growth curves among four refractive error groups in children. methods Cycloplegic refractive error was categorized into four groups: persistent emmetropia between -0.25 and +1.00 D (exclusive) in both the vertical and horizontal meridians on all study visits (n = 194); myopia of at least -0.75 D in both meridians on at least one visit (n = 247); persistent hyperopia of at least +1.00 D in both meridians on all visits (n = 43); and emmetropizing hyperopia of at least +1.00 D in both meridians on at least the first but not at all visits (n = 253). Subjects were seen for three visits or more between the ages of 6 and 14 years. Growth curves were modeled for the persistent emmetropes to describe the relation between age and the ocular components and were applied to the other three refractive error groups to determine significant differences. results At baseline, eyes of myopes and persistent emmetropes differed in vitreous chamber depth, anterior chamber depth, axial length, and corneal power and produced growth curves that showed differences in the same ocular components. Persistent hyperopes were significantly different from persistent emmetropes in most components at baseline, whereas growth curve shapes were not significantly different, with the exception of anterior chamber depth (slower growth in persistent hyperopes compared with emmetropes) and axial length (lesser annual growth per year in persistent hyperopes compared with emmetropes). The growth curve shape for corneal power was different between the emmetropizing hyperopes and persistent emmetropes (increasing corneal power compared with decreasing power in emmetropes). conclusions Comparisons of growth curves between persistent emmetropes and three other refractive error groups showed that there are many similarities in the growth patterns for both the emmetropizing and persistent hyperopes, whereas the differences in growth lie mainly between the emmetropes and myopes.

Purpose: To compare self-reported dry eye disease across contact lens wearers, spectacles wearers, and clinical emmetropes (i.e., those not requiring refractive correction)., Methods: The survey included two symptom questions (dryness and light sensitivity) that inquired about frequency and intensity at three times of day (morning, afternoon, and evening) and a self-perception question (i.e., Do you think you have dry eyes?). Dryness and light sensitivity scales were then calculated, summed, and scored, providing a dry eye classification. Logistic regression (binary and multinomial) and analysis of covariance were used to examine the relation between mode of refractive correction and dry eye status, frequency of symptoms, and diurnal change in symptom intensity., Results: Overall, 893 surveys were completed, and the age-adjusted frequency of dry eye in the sample was 28.7%, with 3.5% of the sample reporting severe symptoms (at least grade 4 of a possible 5 for both symptoms). Contact lens wearers were most likely to report dry eye disease (52.3%), followed by spectacle wearers (23.9%) and clinical emmetropes (7.1%). Adjustment for age and gender showed that contact lens (adjusted odds ratio = 12.37, 95% confidence interval = 7.55-20.26) and spectacle wearers (adjusted odds ratio = 2.06, 95% confidence interval = 1.12-3.80) were more likely than emmetropes to report dry eye problems. After adjustment for age and gender, contact lens wearers were shown to be more likely to experience frequent symptoms and an increase in symptoms throughout the day (F = 51.4, P < 0.0001)., Conclusions: The frequency of self-reported dry eye is high, especially in contact lens wearers.

Purpose: The contour of the human cornea is closely modeled by a conic section, which is fully described by asphericity (Q) and apical radius of curvature (r(o)). The relationship between corneal shape and other ocular dimensions in children, including anterior and vitreous chamber depths, axial length, and spherical equivalent refractive error, was investigated., Methods: Corneal asphericity and r(o) were calculated by using corneal topography data on 643 children (72 myopes, 370 emmetropes, and 201 hyperopes), ages 6 to 15 years, who participated in the Orinda Longitudinal Study of Myopia (OLSM) during 1991. Measurements from a younger subset of these children, including 8 myopes, 92 emmetropes, and 75 hyperopes, ages 6 to 9 years in 1991, were compared to 1996 data for longitudinal analysis., Results: Mean +/- SD Q of the 1991 study sample was -0.346 +/- 0.101, representing a prolate corneal shape. Almost all (99.7%) of the corneas examined were prolate. Corneal asphericity was less prolate among myopes than in emmetropes and hyperopes (P = 0.010). Less prolate corneas were related to deeper anterior chamber depths among emmetropes (r = 0.324, P < 0.0001) and hyperopes (r = 0.275, P < 0.0001), but not among myopes (r = 0.230, P = 0.0515). Flatter values of r(o) were related to longer vitreous chamber depth (r = 0.607, P < 0.0001) and axial length (r = 0.606, P < 0.0001) in all refractive error groups. Initial corneal shape was unrelated to change in refractive error over a 5-year period., Conclusions: Most corneas examined in this study were prolate in contour. Deeper anterior chamber depths were related to less prolate corneas among emmetropes and hyperopes, which is probably the result of mechanical influences on the peripheral cornea as the anterior chamber elongates during ocular growth. Longitudinal results suggest initial corneal shape is of little or no value in predicting refractive error progression.

Purpose: To evaluate the reliability of self-reported dry eye disease status and patient-related predictors of misclassification in contact lens wearers., Methods: Patients completed the Contact Lens Dry Eye Questionnaire (CLDEQ) short form on two occasions. Test-retest reliability of the CLDEQ composite score was determined using the 95% limits of agreement (LoA) and an intraclass correlation coefficient (ICC). The kappa statistic was used to determine reliability of disease-classification-based CLDEQ composite score cutoff points. Predictors of misclassification were determined by multivariate logistic regression., Results: The sample included 274 patients. The range of CLDEQ composite scores from both visits was -1.83 to 4.50 and the mean difference between administrations was -0.05 +/- 0.75 (P = 0.30). The 95% LoA of the CLDEQ composite score were -1.51 to 1.42 and the ICC was 0.61 (95% confidence interval [CI]: 0.53-0.68). Calculations using the lower limit of the 95% CI showed that three administrations of the survey would be required to obtain a more desirable ICC (0.70). The kappa statistic for reliability of dry eye disease classification was 0.58 (95% CI: 0.48-0.67). Logistic regression showed a significant interaction between gender (females) and younger age (P = 0.02) in relation to misclassification of self-reported dry eye disease status., Conclusions: The reliability of self-reported dry eye disease classification in contact lens wearers is moderate. In epidemiologic studies of factors associated with self-reported disease status, investigators may be well advised to consider using multiple administers of such outcome instruments and controlling for sociodemographic characteristics to maintain internal validity.

Purpose: To quantify the degree of association between juvenile myopia and parental myopia, near work, and school achievement., Methods: Refractive error, parental refractive status, current level of near activities (assumed working distance-weighted hours per week spent studying, reading for pleasure, watching television, playing video games or working on the computer), hours per week spent playing sports, and level of school achievement (scores on the Iowa Tests of Basic Skills [ITBS]) were assessed in 366 eighth grade children who participated in the Orinda Longitudinal Study of Myopia in 1991 to 1996., Results: Children with myopia were more likely to have parents with myopia; to spend significantly more time studying, more time reading, and less time playing sports; and to score higher on the ITBS Reading and Total Language subtests than emmetropic children (chi(2) and Wilcoxon rank-sum tests; P < 0.024). Multivariate logistic regression models showed no substantial confounding effects between parental myopia, near work, sports activity, and school achievement, suggesting that each factor has an independent association with myopia. The multivariate odds ratio (95% confidence interval) for two compared with no parents with myopia was 6.40 (2.17-18.87) and was 1.020 (1.008-1.032) for each diopter-hour per week of near work. Interactions between parental myopia and near work were not significant (P = 0.67), indicating no increase in the risk associated with near work with an increasing number of parents with myopia., Conclusions: Heredity was the most important factor associated with juvenile myopia, with smaller independent contributions from more near work, higher school achievement, and less time in sports activity. There was no evidence that children inherit a myopigenic environment or a susceptibility to the effects of near work from their parents.

Low molecular weight phosphotyrosyl protein phosphatases of human placenta and human red cell were purified and sequenced by a combination of Edman degradation and tandem mass spectrometry. Screening of a human placental lambda gt11 cDNA library yielded overlapping cDNA clones coding for two distinct human cytoplasmic low molecular weight phosphotyrosyl protein phosphatases (HCPTPs). The two longest clones, designated HCPTP1-1 and HCPTP2-1, were found to have identical nucleotide sequences, with the exception of a 108-base pair segment in the middle of the open reading frame. Polymerase chain reaction studies with human genomic DNA suggest that the difference between HCPTP1-1 and HCPTP2-1 does not result from alternative RNA splicing. Studies with a human chromosome 2-specific library confirmed that these sequences are located on chromosome 2, which is known to be the location of red cell acid phosphatase locus ACP1. The coding sequences of HCPTP1-1 and HCPTP2-1 were placed downstream from a bacteriophage T7 promoter and the proteins were expressed in Escherichia coli. The resulting recombinant enzymes (designated HCPTP-A and HCPTP-B, respectively) showed molecular weights of 18,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and both of them exhibited immunoreactivity with antisera raised against authentic human placental and bovine heart enzymes. The expressed proteins were highly active towards the phosphatase substrates p-nitrophenyl phosphate, beta-naphthyl phosphate, and O-phospho-L-tyrosine, but not alpha-naphthyl phosphate, threonine phosphate, or O-phospho-L-serine. HCPTP-A and -B possessed effectively identical amino acid compositions, immunoreactivities, inhibition by formaldehyde, and kinetic properties when compared with two human red cell acid phosphatase isoenzymes. It is concluded that HCPTP-A and -B are the fast and slow forms of red cell acid phosphatase, respectively, and that this enzyme is not unique to the red cell but is instead expressed in all human tissues.

A new fiber-optic oxygen sensor has been developed for use in medical applications. The sensor's viologen indicator becomes strongly absorbent after brief UV stimulation, and then returns to the transparent state. The rate of indicator return to transparency is proportional to the local oxygen concentration. Indicator absorbance is monitored with a red LED and receiving photodiode, and absorbance data are processed by a dedicated cpu. The solid-state sensor system has performance comparable to existing oxygen measurement techniques, and may be applicable for both in vitro and in vivo oxygen measurements.

Fiber optic Fabry-Perot sensors have been developed whose optical reflectance varies with optical cavity depth (pressure) or with change in a material's refractive index (temperature). These sensors employ a unique combination of features: they are interrogated by an LED; they are designed to operate within a single reflectance cycle; and their returned light is analyzed by a dichroic ratio technique. The sensors use a step index glass fiber and are relatively insensitive to absolute light levels and fiber bending. They have an expanded linear operating range and can be built for low cost disposable applications. Sensor performance meets or exceeds established medical requirements.