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Purpose: To assess the possible benefits of the use of perceptual learning and dichoptic therapy combined with patching in children with amblyopia over the use of only patching., Methods: Quasi-experimental multicentric study including 52 amblyopic children. Patients who improved their visual acuity (VA) by combining spectacles and patching were included in patching group (PG: 20 subjects), whereas those that did not improved with patching performed visual training (perceptual learning + dichoptic therapy) combined with patching, being assigned to the visual treatment group (VT: 32 subjects). Changes in VA, contrast sensitivity (CS), and stereopsis were monitored during a 6-month follow-up in each group., Results: Significant improvements in VA were found in both groups at 1 month (p < 0.01). The total improvement of VA was 0.18 ± 0.16 and 0.31 ± 0.35 logMAR in PG and VT groups, respectively (p = 0.317). The Wilcoxon effect size was slightly higher in VT (0.48 vs. 0.54) at 6 months. An enhancement in CS was observed in the amblyopic eye of the VT group for all spatial frequencies at 1 month (p < 0.001). Likewise, the binocular function score also increased significantly in VT group (p = 0.002). A prediction equation of VA improvement at 1 month in VT group was obtained by multiple linear regression analysis (p < 0.001, R 2  = 0.747)., Conclusions: A combined treatment of visual training and patching is effective for obtaining a predictable improvement of VA, CS, and binocularity in patching-resistant amblyopic children., (© 2024. The Author(s).)

Biological visual systems rely on pose estimation of 3D objects to navigate and interact with their environment, but the neural mechanisms and computations for inferring 3D poses from 2D retinal images are only partially understood, especially where stereo information is missing. We previously presented evidence that humans infer the poses of 3D objects lying centered on the ground by using the geometrical back-transform from retinal images to viewer-centered world coordinates. This model explained the almost veridical estimation of poses in real scenes and the illusory rotation of poses in obliquely viewed pictures, which includes the "pointing out of the picture" phenomenon. Here we test this model for more varied configurations and find that it needs to be augmented. Five observers estimated poses of sloped, elevated, or off-center 3D sticks in each of 16 different poses displayed on a monitor in frontal and oblique views. Pose estimates in scenes and pictures showed remarkable accuracy and agreement between observers, but with a systematic fronto-parallel bias for oblique poses similar to the ground condition. The retinal projection of the pose of an object sloped wrt the ground depends on the slope. We show that observers' estimates can be explained by the back-transform derived for close to the correct slope. The back-transform explanation also applies to obliquely viewed pictures and to off-center objects and elevated objects, making it more likely that observers use internalized perspective geometry to make 3D pose inferences while actively incorporating inferences about other aspects of object placement., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Accurate visual information is needed to guide and perform efficient movements in daily life., Aims: To investigate the relation between visual functions, functional vision, and bimanual function in children with unilateral cerebral palsy (uCP)., Methods and Procedures: In 49 children with uCP (7-15 y), we investigated the relation between stereoacuity (Titmus Stereo Fly test), visual perception (Test of Visual Perceptual Skills), visuomotor integration (Beery Buktenica Test of Visual-Motor Integration) and functional vision (Flemish cerebral visual impairment questionnaire) with bimanual dexterity (Tyneside Pegboard Test), bimanual coordination (Kinarm exoskeleton robot, Box opening task), and functional hand use (Children's Hand-use Experience Questionnaire; Assisting Hand Assessment) using correlations (r s ) and elastic-net regularized regressions (d)., Outcomes and Results: Visual perception correlated with bimanual coordination (r s =0.407-0.436) and functional hand use (r s =0.380-0.533). Stereoacuity (r s =-0.404), visual perception (r s =-0.391 to -0.620), and visuomotor integration (r s =-0.377) correlated with bimanual dexterity. Functional vision correlated with functional hand use (r s =-0.441 to -0.458). Visual perception predicted bimanual dexterity (d=0.001-0.315), bimanual coordination (d=0.004-0.176), and functional hand use (d=0.001-0.345), whereas functional vision mainly predicted functional hand use (d=0.001-0.201)., Conclusions and Implications: Visual functions and functional vision are related to bimanual function in children with uCP highlighting the importance of performing extensive visual assessment to better understand children's difficulties in performing bimanual tasks., What This Paper Adds: Previous findings showed that up to 62 % of children with unilateral cerebral palsy (uCP) present with visual impairment, which can further compromise their motor performance. However, the relation between visual and motor function has hardly been investigated in this population. This study makes a significant contribution to the literature by comprehensively investigating the multi-level relation between the heterogenous spectrum of visual abilities and bimanual function in children with uCP. We found that mainly decreased visual perception was related to decreased bimanual dexterity, bimanual coordination, and functional hand use while impairments in functional vision were only related to decreased functional hand use. Additionally, elastic-net regression models showed that visual assessments can predict bimanual function in children with uCP, however, effect sizes were only tiny to small. With our study, we demonstrated a relation between visual functions and bimanual function in children with uCP. These findings suggest the relevance of thoroughly examining visual functions in children with uCP to identify the presence of visual impairments that may further compromise their bimanual function., Competing Interests: Declaration of Competing Interest We have no Conflict of Interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Recently, immersive media devices have seen a boost in popularity. However, many problems still remain. Depth perception is a crucial part of how humans behave and interact with their environment. Convergence and accommodation are two physiological mechanisms that provide important depth cues. However, when humans are immersed in virtual environments, they experience a mismatch between these cues. This mismatch causes users to feel discomfort while also hindering their ability to fully perceive object distances. To address the conflict, we have developed a technique that encompasses inverse blurring into immersive media devices. For the inverse blurring, we utilize the classical Wiener deconvolution approach by proposing a novel technique that is applied without the need for an eye-tracker and implemented in a commercial immersive media device. The technique's ability to compensate for the vergence-accommodation conflict was verified through two user studies aimed at reaching and spatial awareness, respectively. The two studies yielded a statistically significant 36% and 48% error reduction in user performance to estimate distances, respectively. Overall, the work done demonstrates how visual stimuli can be modified to allow users to achieve a more natural perception and interaction with the virtual environment.

Purpose: This study is to evaluate the optical characteristics of a non-diffractive wavefront-shaping intraocular lens which incorporates surface refractive modifications for shaping the wavefront in order to achieve extended depth of focus (EDoF) and to assess whether the nominal power of this IOL influences the attainable add power., Methods: A commercially available optical bench NIMO TR1504 device (LAMBDA-X, Nivelles, Belgium) was employed to obtain full optical characterization of three non-diffractive EDoF intraocular lenses with + 10 D, + 20 D, and + 30 D powers. After NIMO measurements, data were computed using a custom-made MATLAB program (Mathworks, Inc., Natick, MA, USA) to evaluate the optical quality functions, such as the point spread function (PSF), wavefront profiles, and modulation transfer function (MTF) for two pupil sizes: 3 mm and 4.0 mm., Results: The non-diffractive EDoF intraocular lens showed a central serrated power profile behavior with additions of + 2.00 to + 2.50 D over the nominal power. Higher order aberrations were found to be driven mainly by the spherical aberration, with almost null comatic influence. Optical quality metrics showed good values, better for a 3 mm pupil compared to a 4.5 mm one, as expected. The three IOL powers tested showed a very similar behavior in terms of power and aberrometric profiles, with minimal to null differences related to the nominal power., Conclusion: The non-diffractive wavefront-shaping EDoF intraocular lens achieves a near addition up to + 2.50 D aiming for an extended range of vision, almost independently of the base power., (© 2024. The Author(s).)

Purpose: To assess the visual and clinical outcomes after bilateral implantation of the novel extended depth of focus (EDOF) (AcrySof IQ Vivity) intraocular lens (IOL) using a micromonovision strategy., Methods: This was a prospective interventional study at a tertiary care center. Twenty patients (40 eyes) underwent bilateral implantation of AcrySof IQ Vivity IOL. Twelve weeks postoperatively, both uncorrected vision and corrected vision were assessed. Uniocular and binocular defocus curves with and without correction were noted subjectively as well as objectively on I-trace. Contrast sensitivity was assessed with a FACT (Functional Acuity Contrast Testing) machine, and objective parameters like modulation transfer function and Strehl ratio were also measured on I-Trace. Subjective quality of vision using a subjective questionnaire was also evaluated., Results: The mean binocular postoperative uncorrected distance visual acuity in LogMAR was -0.03 ± 0.09, the uncorrected intermediate visual acuity was 0.03 ± 0.09, and the uncorrected near visual acuity was 0.28 ± 0.18. All defocus curves were smooth and broad with the uncorrected defocus curve (with the micromonovision strategy) better than the corrected defocus curve. The subjective depth of focus (DOF = 3.73) was more than objective DOF (1.93) (P < 0.05). Photopic contrast was better than mesopic at all frequencies. All aberrations increased at 5 mm pupil size compared to 3 mm pupil size and were statistically significant, except for the total eye spherical aberration, which shows no significant difference at 3 mm and 5 mm pupil size (P = 0.27). Spectacle independence for distance, intermediate, and near was achieved in 100%, 94.7%, and 94.7% cases in this study, respectively., Conclusions: Using the micromonovision strategy, the visual performance of this novel EDOF IOL was outstanding both subjectively and objectively., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Purpose: To compare the quality of images of gratings placed in a model eye viewed through an extended depth of focus (EDoF) intraocular lens (IOL) to that of diffractive bifocal IOL or monofocal IOL., Design: Experimental laboratory investigation., Methods: Nondiffractive wavefront shaping EDoF (CNAET0, Alcon Laboratories), echelette-designed EDoF (ZXR00V, Johnson & Johnson Vision), diffractive bifocal IOL with low power addition (SV25T, Alcon Laboratories), or monofocal IOL (CNA0T0, Alcon Laboratories) was placed in a fluid-filled model eye. A United States Air Force Resolution Grating Target was glued to the posterior surface of the model eye and viewed through a flat or a wide-angle contact lens. The contrast of the gratings viewed through the EDoF or multifocal IOLs was compared to that through the monofocal IOL. A wavefront analyzer was used to measure the spherical power of the central 4.5 mm optics of the EDoF, multifocal, and monofocal IOLs. The distribution of the dioptric power and the dioptric power map were compared., Results: The gratings observed through the flat contact lens with CNAET0, ZXR00V, or SV25T were slightly blurred when viewed through the multifocal optics. The blurred area was in the circumferential area of CNAET0, the central area of SV25T, and the peripheral area of ZXR00V. The mean contrast was 0.258 ± 0.020 for CNAET0, 0.227 ± 0.025 for ZXR00V, and 0.221 ± 0.020 for SV25T for the 16.0 cyc/mm grating. The contrast was significantly lower for ZXR00V (P = .004) and SV25T (P = .004) than 0.303 ± 0.015 for CNA0T0 but the differences were not significant for CNAET0. For the wide-angle contact lens, the contrast for CNAET0 was 0.182 ± 0.009, for ZXR00V was 0.162 ± 0.011, and for SV25T was 0.163 ± 0.007 for the 16.0 cyc/mm grating, and none was significantly different from 0.188 ± 0.012 for CNA0T0. The dioptric variations of CNAET0 indicated a ring-shaped area of higher power corresponding to the circumferential blurred zone observed through the flat contact lens., Conclusions: The wavefront shaping and echelette-designed EDoF-IOLs reduce the contrast of the grating more than the monofocal IOL when viewed through the flat contact lens. The degree of reduction depended on the design of the extended-focus optics. The difference was less through the wide-angle contact lens., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: To investigate whether individuals with long-term reduced stereopsis were able to obtain the same level of surgical skills in simulated vitreoretinal surgery on the Eyesi Surgical Simulator as individuals with normal stereopsis., Methods: Twenty-four medical students were recruited and divided into two groups according to their degree of stereopsis: Group 1 (n = 12) included subjects with normal stereopsis (60 arcsec or lower) and Group 2 (n = 12) included subjects with reduced stereopsis (120 arcsec or higher). Stereopsis was tested using the TNO test (Lameris Ootech BV, Nieuwegein, the Netherlands). The participants were trained in virtual reality-simulated vitreoretinal surgery and continuously measured using a test with solid validity evidence and a pre-defined pass-fail score. All data were analysed using the Wilcoxon rank sum test., Results: We observed no differences in overall performance scores for any of the four modules. The participants with reduced stereopsis used 5.8 more attempts in bimanual training (p = 0.04), 8.8 more attempts in removal of posterior hyaloid (p = 0.04), 9.1 more attempts in navigation training (p = 0.20) and 0.3 fewer attempts in removal of internal limiting membrane (p = 0.69)., Conclusion: The final performance scores on the Eyesi Surgical Simulator were independent of the degree of stereopsis. However, the number of attempts to achieve the pre-defined pass-fail score increased significantly with reduced stereopsis in two of four modules. These results indicate that a high degree of stereopsis is not necessary to become proficient in microsurgery but may prolong the learning curve., (© 2024 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

Clinical Relevance: New digital systems are being developed for evaluating different aspects of the visual function, such as binocularity, and it is important to know their real performance in clinical practice in order to use them appropriately., Background: The aim was to compare binocular vision measures obtained with an online digital platform with conventional measures using prisms and printed tests., Methods: Prospective study enrolling 49 healthy patients (mean age: 35.5 ± 13.6 years). A complete visual examination was performed including measurement of near phoria (cover test), negative fusional vergence (NFV) and positive fusional vergence (PFV) ranges (prism bar), and stereopsis (24 patients Randot Stereo Test and 25 patients TNO Random Dot Test 19th edition). These same parameters were also measured with the Bynocs system (Kanohi Eye Pvt Ltd). Bland - Altman plots were used to analyse the agreement between methods., Results: Digital measurement of near phoria was significantly lower than that obtained with the cover test, with a median difference (MD) of 4.71 (-0.07-20.07) prism dioptres (pd) ( p  < 0.001). No significant differences were found between Bynocs and prism bar methods in NFV break (MD 2.00, range -21-26 pd, p  = 0.584) and recovery points (MD 0.00, range -16-24 pd, p  = .571). Near PFV were significantly lower with Bynocs (break: MD -9.00, range -38-12 pd; recovery: MD -14.00, range -43-20 pd; p  < 0.001). Bynocs stereoacuity threshold was significantly lower than that obtained with TNO ( p  = 0.004), but significantly higher compared to Randot ( p  < 0.001). Large and clinically relevant confidence intervals for the comparison between digital and conventional measures were detected in Passing-Bablok analysis., Conclusions: Digital measures of near phoria, NFV, PFV, and stereopsis with the Bynocs platform cannot be used interchangeably with conventional measures. The normal ranges of normality for this new tool are defined.

Purpose: We aimed to evaluate distance stereoacuity (DS) in patients with successfully treated accommodative esotropia (AET) and its association with other clinical factors., Methods: The medical records of 176 children with refractive AET with a follow-up period ≥ 1 year were reviewed to identify a cohort of patients who achieved a stable alignment within 4 prism diopters (PD) of orthotropia at both distance and near fixation. Age of onset, duration of misalignment, uncorrected near and distance deviation, accommodative convergence/accommodation ratio, refractive error, presence of anisometropia and amblyopia, near stereopsis were evaluated as predictors of outcome. DS was measured using the Distance Randot Stereo test and near stereoacuity by Randot Stereotest. The patient group was compared with 50 age-matched normal controls for DS., Results: Fifty-six patients were included, and 38 patients had DS at the final visit. All patients with DS attained uncontoured near stereopsis (UCNS). UCNS was present only in 11 patients without DS (p = 0.001). Anisometropia (p = 0.997), uncorrected near deviation (p = 0.224), distance deviation with correction (p = 0.255), and high hypermetropia (p = 0.998) were not associated with DS. The multivariable regression model showed a significant positive correlation between UCNS and DS (OR = 31.14 (95% CI 2.25-430.48); p = 0.01). Contoured near stereopsis outcome was significantly different between the patients with and without DS (p = 0.001 for animals and p = 0.003 for circles). Compared with the control group, the patient group yielded lower DS scores (p = 0.001)., Conclusion: Distance Randot Stereotest can be useful in measuring binocular vision recovery after successful realignment in refractive AET patients. Patients attaining normal scores for near stereopsis tests after optical correction revealed subnormal thresholds for DS., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: To determine the efficacy of extended depth of focus (EDOF) contact lenses for controlling myopia progression in children through a 1-year randomised clinical trial., Methods: A total of 104 children aged 7-15 years, with spherical equivalent refraction ≤-0.50 D, were randomly assigned to wear SEED 1 dayPure EDOF Mid contact lenses (n=48) or single vision spectacle lenses (n=56). Cycloplegic refraction with Shin-Nippon open field autorefractor and axial length with Lenstar LS 900 was determined at the baseline and 12-month visits. The compliance, visual discomfort and dryness questionnaires were administered during the final visit., Results: Sixty-nine children (control: n=38; treatment: 31) completed the 12-month follow-up visit, with no difference in baseline characteristics between the groups. Mean (SEM) myopia progression in the 12th month was -0.48±0.07D in the control group and -0.20±0.08D in the treatment group. Mean axial elongation was 0.22±0.03 mm and 0.11±0.03 mm in the control and treatment groups, respectively. SEED 1 dayPure EDOF Mid contact lenses slowed myopia progression by 59% (-0.28D; p=0.01) based on spherical equivalent refraction and controlled axial length by 49% (0.11 mm; p=0.007) in comparison to single vision spectacle lenses. None of the participants reported any adverse effects. While most of the participants (82%) were comfortable with the contact lenses, 11% reported occasional dryness and 14% experienced mild fluctuations in visual acuity after immediate lens wear., Conclusion: Daily wear of SEED 1 dayPure EDOF Mid contact lenses in Indian children showed a significant effect in controlling myopia progression and axial elongation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Utilizing the high temporal resolution of event-related potentials (ERPs), we compared the time course of processing incongruent color versus 3D-depth information. Participants were asked to judge whether the food color (color condition) or 3D structure (3D-depth condition) was congruent or incongruent with their previous knowledge and experience. The behavioral results showed that the reaction times in the congruent 3D-depth condition were slower than those in the congruent color condition. The reaction times in the incongruent 3D-depth condition were slower than those in the incongruent color condition. The ERP results showed that incongruent color stimuli induced a larger N270, larger P300, and smaller N400 components in the fronto-central region than the congruent color stimuli. Incongruent 3D-depth stimuli induced a smaller N1 in the occipital region, larger P300 and smaller N400 in the parietal-occipital region than congruent 3D-depth stimuli. The time-frequency analysis found that incongruent color stimuli induced a larger theta band (360-580 ms) activation in the fronto-central region than congruent color stimuli. Incongruent 3D-depth stimuli induced larger alpha and beta bands (240-350 ms) activation in the parietal region than congruent 3D-depth stimuli. Our results suggest that the human brain deals with violating general color or depth knowledge in different time courses. We speculate that the depth perception conflict was dominated by solving the problem with visual processing, whereas the color perception conflict was dominated by solving the problem with semantic violation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Modern intraocular lens (IOL) designs for cataract treatment can be broadly classified into three focal range categories; monofocal, extended depth-of-focus (EDOF) and multifocal IOLs.Monofocal IOLs allow spectacle independence for one focus, typically distance. In contrast, EDOF IOLs provide a greater range of vision, extending spectacle independence to intermediate distance, while multifocal IOLs enable spectacle independence at all distances with the drawback of positive dysphotopsias and reduced contrast perception.EDOF lenses are an attractive compromise with fewer dysphotopic side effects than multifocals. The purpose of this study is to assess whether implanting an EDOF IOL in the second eye of a patient who received a monofocal IOL in the first eye can improve spectacle independence while maintaining the same optical quality as bilateral monofocal IOL implantation., Methods and Analysis: This study compares combined monofocal and EDOF IOL implantation versus bilateral monofocal IOL implantation in terms of clinical and patient-reported outcomes in a monocentric, randomised, patient-masked and assessor-masked, parallel group trial in 88 bilateral cataract patients. The primary outcome measure is binocular photopic distance corrected intermediate visual acuity. The secondary outcome measures include (un)corrected distance and near visual acuity, reading speed at intermediate distance, quality of visual function assessments, patient-reported spectacle independence, contrast sensitivity, aberrometry, stereopsis and straylight measurement at the 3-month follow-up., Ethics and Dissemination: The protocol was approved by the ethical committee of the University Hospital of Brussels (BUN 23219&#95;EDOF)., Trial Registration Number: NCT06002399., Competing Interests: Competing interests: The authors have no financial interest in any of the interventions or products associated with this trial., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The visual performance and the optical quality of a segmental refractive extended depth-of-focus (EDoF) intraocular lens (IOL) were evaluated in a prospective, single-arm, single-center study., Methods: A total of 20 patients (40 eyes) after bilateral implantation of the refractive segmental EDoF Acunex Vario AN6V were included. Assessment procedure: refraction outcome, monocular and binocular uncorrected (UCVA) and distance-corrected visual acuity (DCVA), defocus curve, contrast sensitivity (CS), higher-order aberrations (HOAs) and patient satisfaction were evaluated 1 and 3 months after surgery., Results: At 3-month follow-up, mean spherical equivalent was - 0.23 ± 0.32 D. Binocular uncorrected distance visual acuity (VA) at distance, intermediate and near was - 0.08 ± 0.06 logMAR at 4 m, -0.03 ± 0.06 logMAR at 66 cm and 0.16 ± 0.06 logMAR at 40 cm, respectively. The binocular defocus curve showed a VA better than 0.20 logMAR over a range from + 1.50 to - 2.45 D. Contrast sensitivity aligned with monofocal lenses, highlighting the lens's clinical value. Aberrometry showed minimal changes in corneal aberrations. NEI-RQL-42-Questionnaire showed a high patient satisfaction for daily activities and revealed reduced dependence on glasses, particularly for near and intermediate vision. The Acunex Vario AN6V demonstrated minimal dysphotopsias, making it a promising option for those seeking spectacle independence., Conclusion: This segmental refractive EDoF IOL provides a high degree of spectacle independence for far and intermediate distances with functional near VA. Although inducing residual coma aberrations, it showed subjectively good results with little dysphotopsias., Trial Registration: This study protocol was reviewed and approved by ethics committee of Charité University, Berlin, Germany, with approval number EA4/126/20., (© 2024. The Author(s).)

Rectangularity and perpendicularity of contours are important properties of 3D shape for the visual system and the visual system can use them asa prioriconstraints for perceivingshape veridically. The presentarticle provides a comprehensive review ofpriorstudiesofthe perception of rectangularity and perpendicularity anditdiscussestheir effects on3D shape perception from both theoretical and empiricalapproaches. It has been shown that the visual system is biased to perceive a rectangular 3D shape from a 2D image. We thought that this bias might be attributable to the likelihood of a rectangular interpretation but this hypothesis is not supported by the results of our psychophysical experiment. Note that the perception ofa rectangular shape cannot be explained solely on the basis of geometry. A rectangular shape is perceived from an image that is inconsistent with a rectangular interpretation. To address thisissue, we developed a computational model that can recover a rectangular shape from an image of a parallelopiped. The model allows the recovered shape to be slightly inconsistent so that the recovered shape satisfies the a priori constraints of maximum compactness and minimal surface area. This model captures someof thephenomenaassociated withthe perception of the rectangular shape that were reported inpriorstudies. This finding suggests that rectangularity works for shape perception by incorporatingitwith someadditionalconstraints., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: To evaluate stereopsis in term-born, preterm, and preterm children with and without retinopathy of prematurity (ROP) and its treatment., Methods: The cross-sectional study included 322 children between 3 and 11 years of age born term or preterm, with or without ROP, and with or without treatment for ROP. The ROP treatments were laser therapy, intravitreal injection (IVI) of anti-vascular endothelial growth factor, or their combination. Stereoacuity was measured using the Titmus Stereo Test, and the results among various age groups were analyzed., Results: Stereopsis was found to improve with increasing age at testing (P < 0.001) across the entire study population. The term group exhibited significantly better stereoacuity than the preterm group (P < 0.001). At 3-5 years and 6-8 years, the preterm children without ROP exhibited significantly better stereoacuity than did those with ROP (P < 0.001 and P = 0.02, respectively); however, at 9-11 years, both groups exhibited similar stereoacuity (P = 0.34). The stereoacuity in the children with untreated ROP was similar to that of the children with treated ROP in all age groups (P > 0.05). No significant differences in stereopsis were identified between children with ROP treated with laser versus with IVI (P > 0.05). From multivariate analysis, younger age at testing (P = 0.001) and younger gestational age (P < 0.001) were associated with poorer stereopsis., Conclusions: Stereopsis development gradually improved with age in all groups. The children born preterm exhibited poorer stereoacuity than those born term. Children with ROP treated with laser photocoagulation versus IVI may exhibit similar levels of stereoacuity. Younger age at testing and gestational age were independent risk factors for poorer stereoacuity., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: This study aims to compare the effectiveness of pencil push-up training and binocular vision training in treating post-operative mild under-correction in patients with intermittent exotropia., Methods: A prospective cohort study was conducted, including patients who underwent surgery for intermittent exotropia at Children's Hospital of Nanjing Medical University between June 2022 and January 2023 and experienced post-operative mild under-correction (-8∆ to -15∆). Patients were divided into two groups: pencil push-up training group and binocular vision training group. All patients underwent measurements of exodeviation and stereoacuity at distance and near, sensory fusion, and fusion convergence amplitude. The data were analyzed using independent sample t-tests, repeated measures analysis of variance, and Chi-square tests., Results: There were no statistically significant differences in exodeviation at distance and near between the two training groups before the training. After 6 months of training, the exodeviation at distance and near achieved a significant decrease in both groups (P < 0.05), and the pencil push-up training group showed a similar distance and near exodeviation compared to the binocular vision training group (t = 1.58, P ＞ 0.05; t = 0.43, P ＞ 0.05). After 6 months of training, the binocular vision training group exhibited significantly superior stereoacuity and fusion convergence amplitude compared to the pencil push-up training group (P < 0.001)., Conclusion: Both pencil push-up training and binocular vision training are effective in reducing exodeviation in patients with post-operative mild under-correction of intermittent exotropia. However, binocular vision training demonstrates superior efficacy in restoring stereopsis and fusion convergence amplitude compared to pencil push-up training., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

The inhibition of return (IOR) is a phenomenon where response times (RTs) to a target appearing at a previously cued location are slower than those for an uncued location. IOR can improve visual search efficiency. This study aimed to investigate IOR in badminton athletes at different cue depths using a cue-target paradigm in three-dimensional (3-D) static and dynamic scenarios. The study involved 28 badminton athletes (M age = 21.29, SD = 2.39, 14 males) and 25 non-athletes (M age = 21.56, SD = 2.38, 11 males). In the static scenario (Experiment 1), no significant difference between IOR in cueing near and far conditions. IOR was showed both in cueing the near and far condition. Badminton athletes had a speed advantage than non-athletes. In the dynamic scenario (Experiment 2), only badminton athletes showed IOR in cueing the far-to-near condition, but not for the near-to-far. The present study showed that depth information influenced the IOR only in far-to-near condition. Badminton athletes showed more sensitivity to depth information than non-athletes. Additionally, the study expands the object-based IOR in 3-D dynamic scenario., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: To evaluate the differences between two extended depth-of-focus intraocular lenses, the Alcon IQ Vivity and the Bausch & Lomb LuxSmart and to compare them with a simple monofocal lens, the Alcon IQ, using a simulation-based approach., Methods: A mathematical lens model was created for each lens type based on a measured surface geometry. The lens model was then used in a raytracer to calculate a refractive power map of the lens and a ray propagation image for the focal zone., Results: The simulations confirm the enhanced depth of focus of these two lenses. There are apparent differences between the models. For the Vivity, more light is directed into the far focus in low light conditions, whereas the LuxSmart behaves more pupil independent and prioritizes intermediate vision., Conclusions: The simulation-based approach was effective in evaluating and comparing the design aspects of these lenses. It can be positioned as a valuable third tool for lens characterization, complementing in vivo studies and in vitro measurements., Translational Relevance: With this approach not only focusing on the resulting optical performance, but the underlying functional mechanisms, it paves the way forward for a better adaptation to the individual needs and preferences of patients.

Purpose: This study aimed to investigate the in vitro tolerance to decentration of biaspheric intraocular lens (IOLs) with refractive phase-ring extended depth-of-focus (EDOF) and diffractive trifocal designs., Methods: This experimental study was carried out at the Department of Optics and Optometry and Vision Science, University of Valencia, Spain. The modulation transfer function (MTF) of the ETLIO130C EDOF and the TFLIO130C trifocal IOLs (AST Products Inc., Billerica, MA, USA) were determined at different levels of decentration for a given wavelength and pupil diameter using the PMTF optical bench (Lambda-X Ophthalmics, Nivelles, Belgium). The modulation transfer function (MTF) curves, the through-focus MTF curves, and the Strehl ratios were measured at 3-mm pupil aperture for 0.25-, 0.50- and 0.75-mm decentration., Results: The optical design of the trifocal TFLIO130C IOL is robust to small decentrations, with virtually no change in MTF response for 0.25 mm decentration. For greater decentration levels, the MTF response is slightly reduced with increasing decentration. The ETLIO130C EDOF design is robust to decentration, as the MTF response is only minimally affected when increasing the decentration up to 0.75 mm., Conclusions: MTF responses are slightly reduced with greater levels of decentration, but the range of focus provided by both trifocal and EDOF designs are preserved. The effects for average levels of decentration reported in the literature are minimum for both IOL designs., (© 2024. The Author(s).)

The optimal choice of the level of realism in instructional visualizations is a difficult task. Previous studies suggest that realism can overwhelm learners, but a growing body of research demonstrates that realistic details can enhance learning. In the first experiment (n = 107), it was assessed whether learning using realistic visualizations can be distracting and therefore particularly benefits from pre-training. Participants learned the anatomy of the parotid gland using labeled visualizations. While pre-training did not have an effect, a more realistic visualization enhanced learning compared to a schematic visualization. In the second experiment (n = 132), a schematic diagram was compared to a more realistic style featuring basic depth cues, and a highly realistic visualization containing a detailed surface. Regarding retention performance, no significant differences were found. However, an interesting pattern regarding subjective cognitive load ratings emerged: the schematic version received the highest cognitive load ratings, while the version featuring simplified shading was rated as least demanding. The version containing simplified depth cues also elicited lower cognitive load ratings than the detailed visualization. The two experiments demonstrate that fears concerning a detrimental effect of realistic details should not be over-generalized. While schematic visualizations may be easier to visually process in some cases, extracting depth information from contour drawings adds cognitive demands to a learning task. Thus, it is advisable that computer-generated visualizations contain at least simplified forms of shading, while the addition of details does not appear to have a strong positive effect., (© 2024. The Author(s).)

Purpose: To evaluate the clinical outcomes following bilateral implantation of the AcrySof™ IQ Vivity™ toric extended depth of focus (EDOF) intraocular lens (IOL)., Design: Prospective interventional case series., Methods: Patients with bilateral significant cataracts and pre-existing corneal astigmatism underwent cataract surgery and implantation with the AcrySof™ IQ Vivity™ toric IOL. Dominant eyes were targeted at emmetropia and non-dominant eyes at -0.50D. Primary endpoints were binocular uncorrected distance (UDVA), intermediate (UIVA at 66 cm) and near (UNVA at 40 cm) acuities at 3 months. Secondary outcomes were corrected distance (CDVA), distance corrected intermediate (DCIVA) and distance corrected near (DCNVA), refractive predictability, rotational stability, binocular defocus curve, contrast sensitivity, Questionnaire for Visual Disturbances (QUVID) and Visual Function Index (VF-14) questionnaire scores. All visual acuities were converted to logarithm of minimum angle of resolution (logMAR) for analysis., Results: 30 patients underwent uneventful phacoemulsification. The mean binocular UDVA, UIVA and UNVA were 0.06 ± 0.12, 0.11 ± 0.10 and 0.26 ± 0.10 respectively. The mean refractive spherical equivalent (MRSE) for dominant and non-dominant eyes were - 0.07D ± 0.27 and - 0.12D ± 0.54 respectively. 92.4% of dominant eyes and 84.6% of non-dominant eyes within 0.50D of target. The mean IOL rotation was 3.85° ± 5.09 with 86.7% of eyes with less than 5° of rotation. 26.7%, 20% and 36.7% of patients reported starbursts, haloes and glare respectively. The mean VF-14 score was 91.77., Conclusion: Bilateral implantation of the AcrySof™ IQ Vivity™ Toric IOL resulted in very good unaided visual acuities for far and intermediate distance with functional near vision. Dysphotopsias were reported but despite this, a high level of visual function was achieved., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Perceiving verticality is crucial for accurate spatial orientation. Previous research has revealed that tilted scenes can bias verticality perception. Verticality perception bias can be represented as the sum of multiple periodic functions that play a role in the perception of visual orientation, where the specific factors affecting each periodicity remain uncertain. This study investigated the influence of the width and depth of an indoor scene on each periodic component of the bias. The participants were presented with an indoor scene showing a rectangular checkerboard room (Experiment 1), a rectangular aperture on the wall (Experiment 2), or a rectangular dotted room (Experiment 3), with various aspect ratios. The stimuli were presented with roll orientations ranging from 90° clockwise to 90° counterclockwise. The participants were asked to report their subjective visual vertical (SVV) perceptions. The contributions of 45°, 90°, and 180° periodicities to the SVV error were assessed by the weighted vector sum model. In Experiment 1, the periodic components of the SVV error increased with the aspect ratio. In Experiments 2 and 3, only the 90° component increased with the aspect ratio. These findings suggest that extended transverse surfaces may modulate the periodic components of verticality perception.

Purpose: To analyze the motor and sensory outcomes of strabismus surgery in children born preterm (premature group) and full-term (control group)., Methods: The study was performed at a tertiary university hospital. Children who underwent strabismus surgery between 2012 and 2019 were retrospectively reviewed. The success of surgery, postoperative over-correction and undercorrection rates, and stereopsis and fusion test results were compared between the premature and control groups., Results: There were 70 patients in the premature group (mean gestational age: 31.25 weeks; range: 24 to 35 weeks) and 242 patients in the control group. The amounts of preoperative and postoperative deviations and overcorrection, undercorrection, and success rates were similar between the premature and control groups ( P > .05). Stereopsis improved from 560 to 300 arc/sec postoperatively in the premature group ( P = .066) and from 1,156 to 685 arc/sec in the control group ( P < .001). The rate of fusion increased from 12.5% to 25% in the premature group ( P = .50) and from 17% to 47% in the control group ( P < .001). The analysis of strabismus subgroups revealed significant improvement of fusion in full-term patients ( P < .001) and not in preterm patients ( P = .50) with esotropia. Preoperative amount of deviation was the only risk factor for surgical success ( P < .001). Age, sex, history of prematurity, and spherical equivalent refraction were not correlated with undercorrection ( P > .05)., Conclusions: Regardless of the type of strabismus, although the functional results after strabismus surgery were similar in preterm and full-term patients, the gain of stereopsis and central fusion was significantly higher in full-term patients compared to preterm patients. [ J Pediatr Ophthalmol Strabismus . 2024;61(4):267-272.] .

Perceiving motion in depth is important in everyday life, especially motion in relation to the body. Visual and auditory cues inform us about motion in space when presented in isolation from each other, but the most comprehensive information is obtained through the combination of both of these cues. We traced the development of infants' ability to discriminate between visual motion trajectories across peripersonal space and to match these with auditory cues specifying the same peripersonal motion. We measured 5-month-old (n = 20) and 9-month-old (n = 20) infants' visual preferences for visual motion toward or away from their body (presented simultaneously and side by side) across three conditions: (a) visual displays presented alone, (b) paired with a sound increasing in intensity, and (c) paired with a sound decreasing in intensity. Both groups preferred approaching motion in the visual-only condition. When the visual displays were paired with a sound increasing in intensity, neither group showed a visual preference. When a sound decreasing in intensity was played instead, the 5-month-olds preferred the receding (spatiotemporally congruent) visual stimulus, whereas the 9-month-olds preferred the approaching (spatiotemporally incongruent) visual stimulus. We speculate that in the approaching sound condition, the behavioral salience of the sound could have led infants to focus on the auditory information alone, in order to prepare a motor response, and to neglect the visual stimuli. In the receding sound condition, instead, the difference in response patterns in the two groups may have been driven by infants' emerging motor abilities and their developing predictive processing mechanisms supporting and influencing each other., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: To develop an indigenous "Do it yourself" (DIY) three-dimensional (3D) ophthalmic surgery recording system and validate the perception of stereopsis using it., Methods: A cross-sectional survey of practicing ophthalmologists with post-postgraduation experience of at least 5 years for perception of stereopsis for three different surgeries was performed; cataract, retinal detachment, and intravitreal drug injection were recorded on DIY assembly, viewed on VRBOX and using laptop videos and pseudo 3 d videos as control., Results: The laptop videos and 3D VR Box videos received higher ratings for stereopsis than the pseudo 3D videos. The parameters that received significantly higher ratings on the 3D VR Box viewing were instrument's position relative to the ocular surface in cataract surgery, anterior chamber depth during capsular staining, ophthalmic visco-surgical device injection, capsulorhexis, phaco tunnel depth, movement of nuclear fragments in the anterior chamber, and intra-ocular lens tilt in the capsular bag during cataract surgery ( P < 0.05). In scleral buckling surgery, the parameters that were significantly rated higher on VR Box were globe contour, separation of the scleral plane from muscle, and explant plane ( P < 0.05). Furthermore, the depth of the needle in the vitreous cavity while administering intravitreal drug injection was also rated significantly higher on VR Box ( P < 0.05). However, the ratings for the depth of corneal incision, depth of scleral incision, overall color, and overall quality were not different statistically when compared between laptop and VR Box viewing., Conclusion: DIY 3D recording assembly offers a superior means of appreciating depth at various stages of cataract surgery, scleral buckling, and intravitreal drug injection when compared to laptop viewing and can serve as an effective tool for skill transfer., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Purpose: To investigate the effect of epiblepharon surgery on motor and sensory function in children with epiblepharon and concomitant strabismus., Methods: Among 564 patients who underwent epiblepharon correction surgery from May 2016 to April 2023, 45 children who were examined for strabismus were included in the study. Preoperative and postoperative visual acuity, refraction, and angle of deviation were analyzed. For those with significant angle of deviation, additional stereopsis, sensory fusion, and returning time were retrospectively investigated. The angle of deviation was examined by one examiner at distance and near., Results: The mean age of 45 children (18 boys and 27 girls) was 6.8 ± 2.9 years. Fifteen had significant strabismus at the time of epiblepharon surgery. Visual acuity improved in both the total and strabismus groups. Improvement in stereopsis and fusion was also observed in the strabismus group. The angle of deviation showed no difference in both groups., Conclusions: Epiblepharon could affect ocular manifestations of strabismus as shown in this study. The authors suggest strabismus treatment be continued after epiblepharon surgery, with improved sensory function. Further evaluation with larger groups is needed in the future. [ J Pediatr Ophthalmol Strabismus . 2024;61(4):257-261.] .

Background and Objectives: The invention described herein is a prototype based on computer vision technology that measures depth perception and is intended for the early examination of stereopsis., Materials and Methods: The prototype (software and hardware) is a depth perception measurement system that consists on: (a) a screen showing stereoscopic models with a guide point that the subject must point to; (b) a camera capturing the distance between the screen and the subject's finger; and (c) a unit for recording, processing and storing the captured measurements. For test validation, the reproducibility and reliability of the platform were calculated by comparing results with standard stereoscopic tests. A demographic study of depth perception by subgroup analysis is shown. Subjective comparison of the different tests was carried out by means of a satisfaction survey., Results: We included 94 subjects, 25 children and 69 adults, with a mean age of 34.2 ± 18.9 years; 36.2 % were men and 63.8 % were women. The DALE3D platform obtained good repeatability with an interclass correlation coefficient (ICC) between 0.94 and 0.87, and coefficient of variation (CV) between 0.1 and 0.26. Threshold determining optimal and suboptimal results was calculated for Randot and DALE3D test. Spearman's correlation coefficient, between thresholds was not statistically significant (p value > 0.05). The test was considered more visually appealing and easier to use by the participants (90 % maximum score)., Conclusions: The DALE3D platform is a potentially useful tool for measuring depth perception with optimal reproducibility rates. Its innovative design makes it a more intuitive tool for children than current stereoscopic tests. Nevertheless, further studies will be needed to assess whether the depth perception measured by the DALE3D platform is a sufficiently reliable parameter to assess stereopsis., Competing Interests: Conflict of interest The authors have no conflict of interests to declare., (Copyright © 2023. Published by Elsevier España, S.L.U.)

Purpose: To assess the feasibility of the clinical use of a novel Virtual Reality (VR) training software designed to be used for active vision therapy in amblyopic patients by determining its preliminary safety and acceptance on the visual function of healthy adults., Methods: Pilot study enrolling 10 individuals (3 men, 7 women, mean age: 31.8 ± 6.5 years) with a best-corrected visual acuity (BCVA) of ≥ .90 (decimal) in both eyes were evaluated before and after 20 minutes of exposure to the NEIVATECH VR system using the HTC Vive Pro Eye head mounted display. Visual function assessment included near (40 cm) and distance (6 m) cover test (CT), stereopsis, binocular accommodative facility (BAF), near point of convergence (NPC), near point of accommodation (NPA), accommodative-convergence over accommodation (AC/A) ratio and positive and negative fusional vergences. Safety was assessed using the VR Sickness Questionnaire (VRSQ) and acceptance using the Technology Acceptance Model ;(TAM). Changes in all these variables after VR exposure were analyzed., Results: Short-term exposure to the NEIVATECH VR system only induced statistically significant changes in distance phoria ( p  = .016), but these changes were not clinically relevant. No significant changes were observed in VRSQ oculo-motricity and disorientation scores after exposure ( p  = .197 and .317, respectively). TAM scores showed a good acceptance of the system in terms of perceived enjoyment and perceived ease of use, although some concerns were raised in relation to the intention-to-use domain., Conclusion: Exposure to the NEIVATECH VR system does not seem to adversely affect the visual function in healthy adults and its safety and acceptance profile seems to be adequate for supporting its potential use in other populations, such as amblyopic patients.

Purpose: To assess the effects of intraocular lens (IOL) decentration and tilt, as well as age, on postoperative visual function (corrected distance visual acuity [CDVA] and contrast sensitivity) by comparing an extended depth-of-focus IOL using higher order aspheric optics against a monofocal IOL from the same platform., Methods: This retrospective observational study targeted patients without other eye diseases who underwent surgery to implant the Tecnis Eyhance OptiBlue or the monofocal IOL Tecnis OptiBlue 1-Piece (J&J Vision) during cataract surgery from November 2021 to December 2022. The effects of age, axial length, IOL decentration, tilt, and corneal higher order aberrations (HOAs) on the postoperative 5 m CDVA and area under log contrast sensitivity function (AULCSF) under photopic and scotopic conditions were evaluated within 3 months of surgery., Results: No significant difference was found in postoperative CDVA between the Tecnis Eyhance OptiBlue group (n = 61 eyes) and the Tecnis OptiBlue 1-Piece group (n = 35 eyes), but AULCSF was significantly better in the Tecnis Eyhance OptiBlue group for photopic (1.58 ± 0.13 vs 1.46 ± 0.18; P = .002) and scotopic (1.71 ± 0.11 vs 1.59 ± 0.19; P = .002) eyes. Multivariate analysis showed a negative correlation between AULCSF and IOL decentration and age in the Tecnis Eyhance OptiBlue group ( P < .01), with no significant correlation with tilt, axial length, and corneal HOAs., Conclusions: The Tecnis Eyhance OptiBlue yielded significantly better contrast sensitivity under photopic and scotopic conditions than the Tecnis OptiBlue 1-Piece. However, it is important to consider the effects of IOL decentration and age when evaluating the contrast sensitivity of the Tecnis Eyhance OptiBlue. [ J Refract Surg . 2024;40(7):e499-e505.] .

Purpose: Do one-eyed (uniocular) humans use monocular depth cues differently from those with intact binocularity to perform depth-related visuomotor tasks that emulate complex activities of daily living? If so, does performance depend on the participant's age, duration of uniocularity and head movements?, Methods: Forty-five uniocular cases (age range 6-37 years; 2.4 months-31.0 years of uniocularity) and 46 age-similar binocular controls performed a task that required them to pass a hoop around an electrified wire convoluted in depth multiple times, while avoiding contact as indicated by auditory feedback. The task was performed with and without head restraint, in random order. The error rate and speed were calculated from the frequency of contact between the hoop and wire and the total task duration (adjusting for error time), respectively, all determined from video recordings of the task. Head movements were analyzed from the videos using face-tracking software., Results: Error rate decreased with age (P < 0.001) until the late teen years while speed revealed no such trend. Across all ages, the error rate increased and speed decreased in the absence of binocularity (P < 0.001). There was no additional error reduction with duration of uniocularity (P = 0.16). Head movements provided no advantage to task performance, despite generating parallax disparities comparable to binocular viewing., Conclusions: Performance in a dynamic, depth-related visuomotor task is reduced in the absence of binocular viewing, independent of age-related performance level. This study finds no evidence for a prolonged experience with monocular depth cues being advantageous for such tasks over transient loss of binocularity.

Purpose: No method to quantitatively evaluate stereopsis within the 15º visual field has been clinically established. We developed a program to measure paracentral stereopsis and evaluated its feasibility in visually normal participants., Study Design: Experimental investigation METHODS: Ten visually normal volunteers with stereopsis of 60 arcseconds or better were included. The Stereo Eccentricity Analysis (SEA) program for stereopsis measurement across the visual field was integrated into the binocular visual field analyzer imovifa ® . Subjects with established binocular stereopsis detected a stereoscopic circular target presented with crossed disparity on random dots at the fovea, 3°, 5°, 10°, and 15° on the 45°, 135°, 225°, and 315° meridians. The subjects performed two tasks for measurement in the periphery: a detection task by pressing the response button when the circular target was perceived and a localization task by tilting a joystick to indicate in which quadrant the circular target was perceived. The duration of the target presentation was 500 ms., Results: The stereo thresholds at 0º and 3° did not significantly differ. The thresholds at 10º and 15º were significantly higher than at 0° (P < 0.01). While no inter-individual threshold difference was observed at the fovea, the difference was large at 15°. The stereo thresholds for the detection and localization tasks also did not differ significantly., Conclusion: With the SEA program, paracentral stereopsis can be measured and the stereo threshold increases with eccentricity. The SEA program appears to be a feasible clinical method to evaluate paracentral stereopsis., (© 2024. Japanese Ophthalmological Society.)

Studies have explored how human spatial attention appears allocated in three-dimensional (3D) space. It has been demonstrated that target distance from the viewer can modulate performance in target detection and localization tasks: reaction times are shorter when targets appear nearer to the observer compared to farther distances (i.e., near advantage). Times have reached to quantitatively analyze this literature. In the current meta-analysis, 29 studies (n = 1260 participants) examined target detection and localization across 3-D space. Moderator analyses included: detection vs localization tasks, spatial cueing vs uncued tasks, control of retinal size across depth, central vs peripheral targets, real-space vs stereoscopic vs monocular depth environments, and inclusion of in-trial motion. The analyses revealed a near advantage for spatial attention that was affected by the moderating variables of controlling for retinal size across depth, the use of spatial cueing tasks, and the inclusion of in-trial motion. Overall, these results provide an up-to-date quantification of the effect of depth and provide insight into methodological differences in evaluating spatial attention., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

When observers perceive 3D relations, they represent depth and spatial locations with the ground as a reference. This frame of reference could be egocentric, that is, moving with the observer, or allocentric, that is, remaining stationary and independent of the moving observer. We tested whether the representation of relative depth and of spatial location took an egocentric or allocentric frame of reference in three experiments, using a blind walking task. In Experiments 1 and 2, participants either observed a target in depth, and then straightaway blind walked for the previously seen distance between the target and the self; or walked to the side or along an oblique path for 3 m and then started blind walking for the previously seen distance. The difference between the conditions was whether blind walking started from the observation point. Results showed that blind walking distance varied with the starting locations. Thus, the represented distance did not seem to go through spatial updating with the moving observer and the frame of reference was likely allocentric. In Experiment 3, participants observed a target in space, then immediately blind walked to the target, or blind walked to another starting point and then blind walked to the target. Results showed that the end location of blind walking was different for different starting points, which suggested the representation of spatial location is likely to take an allocentric frame of reference. Taken together, these experiments convergingly suggested that observers used an allocentric frame of reference to construct their mental space representation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

For convenience and experimental control, cognitive science has relied largely on images as stimuli rather than the real, tangible objects encountered in the real world. Recent evidence suggests that the cognitive processing of images may differ from real objects, especially in the processing of spatial locations and actions, thought to be mediated by the dorsal visual stream. Perceptual and semantic processing in the ventral visual stream, however, has been assumed to be largely unaffected by the realism of objects. Several studies have found that one key difference accounting for differences between real objects and images is actability; however, less research has investigated another potential difference - the three-dimensional nature of real objects as conveyed by cues like binocular disparity. To investigate the extent to which perception is affected by the realism of a stimulus, we compared viewpoint adaptation when stimuli (a face or a kettle) were 2D (flat images without binocular disparity) vs. 3D (i.e., real, tangible objects or stereoscopic images with binocular disparity). For both faces and kettles, adaptation to 3D stimuli induced stronger viewpoint aftereffects than adaptation to 2D images when the adapting orientation was rightward. A computational model suggested that the difference in aftereffects could be explained by broader viewpoint tuning for 3D compared to 2D stimuli. Overall, our finding narrowed the gap between understanding the neural processing of visual images and real-world objects by suggesting that compared to 2D images, real and simulated 3D objects evoke more broadly tuned neural representations, which may result in stronger viewpoint invariance., Competing Interests: Declaration of competing interest The authors declare no competing financial interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: The aim of this pilot study was to determine whether viewing an immersive 3D movie with large disparities in a cinema resulted in improved visual acuity (VA), stereoscopic depth perception (ST), and improved eye alignment in residual amblyopic children and children without amblyopia., Methods: A total of 24 children aged between 5 and 12 years with a history of anisometropic and/or strabismic amblyopia, that had been previously treated and who currently have residual amblyopia (N = 14), and in children with typical development without amblyopia (N = 10) viewed the movie in 3D Sing 2 in a cinema for 110 minutes. Visual acuity, stereoacuity and ocular deviation were assessed before viewing the movie, and three months later. Stereoacuity and ocular deviation were also measured immediately after viewing the movie., Results: We observed an improvement in visual acuity in the non-dominant (amblyopic) eye 3 months after viewing the movie in the amblyopic group (P<0.001). Stereopsis improved immediately after viewing the movie (P = 0.02), and after 3 months by ≈ 40% (P = 0.01). Moreover, improvements in stereopsis were also observed in children without amblyopia (P = 0.04). No significant changes in ocular deviation were observed in either group., Conclusions: These pilot results suggest that brief exposure to large disparities by viewing a 3D movie in a cinema can help to improve stereopsis and visual acuity in children aged 5‒12 years with previously treated amblyopia, and provide a rationale for a randomized clinical trial., Competing Interests: The authors have declared that there are no competing interests., (Copyright: © 2024 Asensio-Jurado et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: Stereopsis is a critical visual function, however clinical stereotests are time-consuming, coarse in resolution, suffer memorization artifacts, poor repeatability, and low agreement with other tests. Foraging Interactive D-prime (FInD) Stereo and Angular Indication Measurement (AIM) Stereo were designed to address these problems. Here, their performance was compared with 2-Alternative-Forced-Choice (2-AFC) paradigms (FInD Stereo only) and clinical tests (Titmus and Randot) in 40 normally-sighted and 5 binocularly impaired participants (FInD Stereo only)., Methods: During FInD tasks, participants indicated which cells in three 4*4 charts of bandpass-filtered targets (1,2,4,8c/° conditions) contained depth, compared with 2-AFC and clinical tests. During the AIM task, participants reported the orientation of depth-defined bars in three 4*4 charts. Stereoscopic disparity was adaptively changed after each chart. Inter-test agreement, repeatability and duration were compared., Results: Test duration was significantly longer for 2-AFC (mean = 317s;79s per condition) than FInD (216s,18s per chart), AIM (179s, 60s per chart), Titmus (66s) or RanDot (97s). Estimates of stereoacuity differed across tests and were higher by a factor of 1.1 for AIM and 1.3 for FInD. No effect of stimulus spatial frequency was found. Agreement among tests was generally low (R2 = 0.001 to 0.24) and was highest between FInD and 2-AFC (R2 = 0.24;p<0.01). Stereoacuity deficits were detected by all tests in binocularly impaired participants., Conclusions: Agreement among all tests was low. FInD and AIM inter-test agreement was comparable with other methods. FInD Stereo detected stereo deficits and may only require one condition to identify these deficits. AIM and FInD are response-adaptive, self-administrable methods that can estimate stereoacuity reliably within one minute., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: FInD and AIM technologies are disclosed as provisional patented (AIM) and pending patent (FInD) and held by Northeastern University, Boston, USA. FInD title: Method for visual function assessment; Application PCT/US2021/049250 AIM title: Self-administered adaptive vision screening test using angular indication; Application PCT/US2023/012959 JS and PJB are founders and shareholders of PerZeption Inc, which has an exclusive license agreement for FInD and AIM with Northeastern University. SN declares that she has no conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Neupane et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Playing two-dimensional video games has been shown to result in improvements in a range of visual and cognitive tasks, and these improvements appear to generalize widely 1 , 2 , 3 , 4 , 5 , 6 . Here we report that young adults with healthy vision, surprisingly, showed a dramatic improvement in stereo vision after playing three-dimensional, but not two-dimensional, video games for a relatively short period of time. Intriguingly, neither group showed any significant improvement in binocular contrast sensitivity. This dissociation suggests that the visual enhancement was specific to genuine stereoscopic processing, not indirectly resulting from enhanced contrast processing, and required engaging in a disparity cue-rich three-dimensional environment., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Individuals with acquired brain injury have reported subjective complaints of depth perception deficits, but few have undergone objective assessments to confirm these deficits. As a result, the literature currently lacks reports detailing the correlation between subjective depth perception deficits and objective stereoscopic vision deficits in individuals with acquired brain injury, particularly those cases that are characterized by a clearly defined lesion. To investigate this relationship, we recruited three individuals with acquired brain injury who experienced depth perception deficits and related difficulties in their daily lives. We had them take neurologic, ophthalmological, and neuropsychological examinations. We also had them take two types of stereoscopic vision tests: a Howard-Dolman-type stereoscopic vision test and the Topcon New Objective Stereo Test. Then, we compared the results with those of two control groups: a group with damage to the right hemisphere of the brain and a group of healthy controls. Performance on the two stereoscopic vision tests was severely impaired in the three patients. One of the patients also presented with cerebral diplopia. We identified the potential neural basis of these deficits in the cuneus and the posterior section of the superior parietal lobule, which play a role in vergence fusion and are located in the caudal region of the dorso-dorsal visual pathway, which is known to be crucial not only for visual spatial perception, but also for reaching, grasping, and making hand postures in the further course of that pathway., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To evaluate subjective and objective outcomes after combined implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) and a combined technology multifocal lens (CT-IOL)., Setting: 2 clinical practices (Carolina Eyecare Physicians, Center For Sight) in the United States., Design: Prospective, unmasked, multicenter, nonrandomized bilateral eye study., Methods: Patients interested in reducing their dependence on spectacles were implanted with an EDOF IOL in the dominant eye and a CT-IOL in the nondominant eye. Refractive and visual acuity (VA) data at various distances (4 m, 66 cm, 40 cm, and 33 cm) were collected 3 months postsurgery, along with the distance-corrected binocular defocus curve and responses to questionnaires related to spectacle independence, visual disturbances, and overall visual function., Results: Data from 37 participants were analyzed. The distance-corrected binocular defocus curve showed a mean VA better than 0.1 logMAR (20/25) at all vergences from +1.00 to -2.50 diopters (D). 36 participants (97%) had an uncorrected binocular VA of 0.3 logMAR or better, at all test distances. 70% of participants (26/37) reported never wearing spectacles at any distance, and 84% (31/37) were "completely" or "mostly" satisfied with their overall vision after surgery. Halos were the disturbance reported most frequently and reported as most bothersome, with difficulty driving at night the most common visual function issue. Difficulty reading was the next most reported issue. Overall eyesight was rated as "excellent" or "good" by 92% (34/37) of participants., Conclusions: This combined EDOF/CT-IOL approach was well-tolerated by participants and provided some potential benefits relative to bilateral implantation of either lens., (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Masking experiments, using vertical and horizontal sinusoidal depth corrugations, have suggested the existence of more than two spatial-frequency disparity mechanisms. This result was confirmed through an individual differences approach. Here, using factor analytic techniques, we want to investigate the existence of independent temporal mechanisms in frontoparallel stereoscopic (cyclopean) motion. To construct stereomotion, we used sinusoidal depth corrugations obtained with dynamic random-dot stereograms. Thus, no luminance motion was present monocularly. We measured disparity thresholds for drifting vertical (up-down) and horizontal (left-right) sinusoidal corrugations of 0.4 cyc/deg at 0.25, 0.5, 1, 2, 4, 6, and 8 Hz. In total, we tested 34 participants. Results showed a small orientation anisotropy with lower thresholds for horizontal corrugations. Disparity thresholds as a function of temporal frequency were almost constant from 0.25 up to 1 Hz, and then they increased monotonically. Principal component analysis uncovered two significant factors for vertical and two for horizontal corrugations. Varimax rotation showed that one factor loaded from 0.25 to 1-2 Hz and a second factor from 2 to 4 to 8 Hz. Direct Oblimin rotation indicated a moderate intercorrelation of both factors. Our results suggest the possible existence of two somewhat interdependent temporal mechanisms involved in frontoparallel stereomotion., (© 2024 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Purpose: Depth estimation in robotic surgery is vital in 3D reconstruction, surgical navigation and augmented reality visualization. Although the foundation model exhibits outstanding performance in many vision tasks, including depth estimation (e.g., DINOv2), recent works observed its limitations in medical and surgical domain-specific applications. This work presents a low-ranked adaptation (LoRA) of the foundation model for surgical depth estimation., Methods: We design a foundation model-based depth estimation method, referred to as Surgical-DINO, a low-rank adaptation of the DINOv2 for depth estimation in endoscopic surgery. We build LoRA layers and integrate them into DINO to adapt with surgery-specific domain knowledge instead of conventional fine-tuning. During training, we freeze the DINO image encoder, which shows excellent visual representation capacity, and only optimize the LoRA layers and depth decoder to integrate features from the surgical scene., Results: Our model is extensively validated on a MICCAI challenge dataset of SCARED, which is collected from da Vinci Xi endoscope surgery. We empirically show that Surgical-DINO significantly outperforms all the state-of-the-art models in endoscopic depth estimation tasks. The analysis with ablation studies has shown evidence of the remarkable effect of our LoRA layers and adaptation., Conclusion: Surgical-DINO shed some light on the successful adaptation of the foundation models into the surgical domain for depth estimation. There is clear evidence in the results that zero-shot prediction on pre-trained weights in computer vision datasets or naive fine-tuning is not sufficient to use the foundation model in the surgical domain directly., (© 2024. The Author(s).)

Distance stereoacuity measurement enables the evaluation and management of binocular vision disorders. Here, we compare the results obtained using standard tests for distance stereoacuity measurement with the novel STab test. We tested 87 children (4-17 years of age) using different tests for the quantification of stereopsis at distance: Distance Randot Stereotest (DRS), M&S random dots (M&S), and STab. A strong correlation was demonstrated between M&S-DRS (0.8), M&S-STab (0.81), DRS-STab (0.85) (all P < 0.0001). The limit of agreement between M&S and DRS was 0.45; between M&S and STab, 0.47; and between DRS and STab, 0.38. Our results suggest that all three methods can be used interchangeably., (Copyright © 2024 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Purpose: To report the long-term outcomes of a noninferiority randomized controlled trial (RCT) with a binocular eye-tracking-based home treatment (CureSight; NovaSight, Ltd.) in patients with amblyopia., Design: Prospective, multicenter, nonrandomized, long-term follow-up observational study of an RCT., Methods: Forty-three children 4 to <9 years of age with anisometropic, small-angle strabismic, or mixed-mechanism amblyopia were initially treated for 16 weeks (NCT05185076) with CureSight. In this planned observational follow-up study, 38 patients with no additional amblyopia treatment were evaluated at 12 weeks post-treatment, and 27 were evaluated at 1-year post-treatment. The main outcome measures were visual acuity (VA), stereoacuity, and amblyopia recurrence at 12- and 52-week post-treatment., Results: At 12-week post-treatment, improvement in amblyopic eye VA was maintained vs baseline (0.27 ± 0.14 logMAR, P< .0001), with no change vs the end-of-treatment visit (P > .05). At 1 year there was a partial reduction in the amblyopic eye VA gain of 0.085±0.1 logMAR compared to end-of-treatment (P = .001), but the residual gain of 0.20±0.14 logMAR compared to baseline was statistically significant (P < .0001). Gains in stereoacuity and binocular VA were maintained vs baseline at both 12-weeks and 1-year post-treatment (P < .0001), with no change vs end-of-treatment (P > .05). Amblyopia recurrence (a worsening of ≥2 logMAR levels compared with end-of-treatment) occurred in 2/38 patients at 12-weeks post-treatment (5.3%), and in 5/27 patients at 1-year post-treatment (20.4%)., Conclusions: VA and stereopsis gains following binocular treatment with CureSight were maintained at 1 year without additional treatment., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: To assess the utility of 3D, tablet-based, glasses-free Accurate STEReotest (ASTEROID) in children compared with the Titmus test., Methods: Children aged 5-13 years were enrolled in a single-center, nonrandomized, observational comparison study and analyzed by age (5-7 vs 8-13 years) and visual acuity (20/25 or better in both eyes vs abnormal). Each participant underwent both the ASTEROID and Titmus stereoacuity tests. Stereoacuity was defined as fine (≤60 arcsec), moderate (61-200 arcsec), coarse (201-1199 arcsec), or very coarse to nil (≥1200 arcsec). Agreement between the tests was assessed using a weighted kappa (κ) statistic based on all four categories., Results: A total of 112 children were included: 28 aged 5-7 with normal visual acuity, 30 aged 5-7 with abnormal visual acuity, 34 aged 8-13 with normal visual acuity, and 20 aged 8-13 with abnormal visual acuity. Mean ASTEROID score was 688 ± 533 arcsec (range, 13-1200 arcsec). Agreement between ASTEROID and Titmus test scores for participants overall was moderate (κ = 0.52). By subgroup, agreement was fair for children 5-7 with abnormal visual acuity (κ = 0.31), moderate for children 5-7 with normal visual acuity (κ = 0.47) and children 8-13 with normal visual acuity (κ = 0.42), and substantial for children 8-13 with abnormal visual acuity (κ = 0.76). Where ASTEROID and Titmus score group varied, ASTEROID score was poorer in 94% (47/50) of cases., Conclusions: ASTEROID is a digital, tablet-based test that evaluates global stereopsis, does not require glasses, and provides a continuum of scores. Among children, ASTEROID has good agreement with the Titmus test; however, it may be more sensitive at detecting stereovision deficits. Further study is necessary to determine which test is more accurate., (Copyright © 2024 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Arthropods' eyes are effective biological vision systems for object tracking and wide field of view because of their structural uniqueness; however, unlike mammalian eyes, they can hardly acquire the depth information of a static object because of their monocular cues. Therefore, most arthropods rely on motion parallax to track the object in three-dimensional (3D) space. Uniquely, the praying mantis (Mantodea) uses both compound structured eyes and a form of stereopsis and is capable of achieving object recognition in 3D space. Here, by mimicking the vision system of the praying mantis using stereoscopically coupled artificial compound eyes, we demonstrated spatiotemporal object sensing and tracking in 3D space with a wide field of view. Furthermore, to achieve a fast response with minimal latency, data storage/transportation, and power consumption, we processed the visual information at the edge of the system using a synaptic device and a federated split learning algorithm. The designed and fabricated stereoscopic artificial compound eye provides energy-efficient and accurate spatiotemporal object sensing and optical flow tracking. It exhibits a root mean square error of 0.3 centimeter, consuming only approximately 4 millijoules for sensing and tracking. These results are more than 400 times lower than conventional complementary metal-oxide semiconductor-based imaging systems. Our biomimetic imager shows the potential of integrating nature's unique design using hardware and software codesigned technology toward capabilities of edge computing and sensing.

Objectives: The purpose of this study is to evaluate the optical and expected clinical performance of a new refractive Extended Depth of Focus (EDF) intraocular lens (IOL) designed to maintain a monofocal-like dysphotopsia profile., Methods: Simulated visual acuity (sVA) with varying defocus was calculated using the area under the Modulation Transfer Function measured in an average eye model and from computer simulations in eye models with corneal higher-order aberrations. Tolerance to defocus was evaluated using computer simulations of the uncorrected distance sVA under defocus. To evaluate the dysphotopsia profile, halo pictures obtained using an IOL-telescope, as well as simulated images in a realistic eye model under defocus were assessed. The results of the refractive EDF were compared to those of a diffractive EDF of the same platform., Results: The refractive EDF IOL provides similar range of vision to the diffractive EDF IOL with the same distance, and similar intermediate and near sVA. The refractive EDF IOL provides the same tolerance to hyperopia as the diffractive EDF but more tolerance to myopia. Halo pictures and simulations showed that the refractive EDF provides comparable dysphotopsia profile to the monofocal IOL and better than the diffractive EDF., Conclusions: The results of this preclinical study in clinically relevant conditions show that the new refractive EDF IOL is expected to provide similar range of vision to the diffractive IOL of the same platform and higher tolerance to refractive errors. The refractive EDF provides a dysphotopsia profile that is better than the diffractive EDF and comparable to that of the monofocal IOL, also in the presence of residual refractive errors., (© 2024. The Author(s).)

Purpose: To discuss factors influencing corneal aberrations that might influence the optical quality after intraocular lens (IOL) implantation., Methods: PubMed and Scopus were the main resources used to search the medical literature. An extensive search was performed to identify relevant articles concerning factors influencing the level of corneal aberrations as of August 27, 2023. The following keywords were used in various combinations: corneal, aberrations, defocus, astigmatism, spherical aberration, coma, trefoil, quadrafoil, intraocular lens, and IOL., Results: Conclusive evidence is lacking regarding the correlation between age and changes in corneal aberrations. Patients with astigmatism have greater corneal higher-order aberrations than those with minimal astigmatism, particularly concerning trefoil and coma. Increased levels of corneal higher-order aberrations are noted following contact lens wear, in patients with dry eye disease, and with pterygium. Increased higher-order aberrations have been reported following corneal refractive surgery and for 3 months following trabeculectomy; regarding intraocular lens surgery, the results remain controversial., Conclusions: Several factors influence the level of corneal higher-order aberrations. Multifocal and extended depth-of-focus IOLs can share similarities in their optical properties, and the main difference arises in their design and performance with respect to spherical aberration. Preoperative evaluation is critical for proper IOL choice, particularly in corneas with risk of high levels of aberrations. [ J Refract Surg . 2024;40(6):e420-e434.] .