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Fulltext UK Optometrists' Professional Learning Needs Toward Engaging with Myopia Control Interventions

Wan Omar WE, Cruickshank F, Radhakrishnan H

Br Ir Orthopt J, 2024;20(1):69-84.
PMID: 38344428 DOI: 10.22599/bioj.341

PURPOSE: This study aimed to explore the support that UK optometrists feel they require to facilitate their engagement with myopia control intervention.
METHODS: A self-administered online survey was distributed via QualtricsXM to practising optometrists in the UK via email lists and newsletters of local optical committees, social media, and optometric networks. Questions focussed on learning styles, training needs and barriers to learning.
RESULTS: Fifty-five respondents completed the survey. Forty-eight respondents answered the question on where they get information about myopia control and learning style, 79.2% indicated that conferences offering Continuing Professional Development (CPD) material were their main source, and 20.8% preferred online learning as the preferred format of delivery. Optometrists would like to receive training in clinical assessments (78.9%), evaluating suitable interventions (76.3%), developing and implementing specific patient intervention plans (76.3%), carrying out chosen myopia control interventions (fitting/prescribing) (73.7%), and the use of pharmacological interventions (94.4%). Of the 40 respondents who answered professional development questions, 97 5% were most interested in finding, identifying and applying evidencebased practice (EBP), followed by clinical decision-making in myopia control (95.0%). When asked about barriers to learning in this field, 29.7% reported limited time to attend training as the greatest barrier.
CONCLUSION: Optometrists felt they need training in various aspects of myopia management, from practical skills to assessing and fitting/prescribing appropriate myopia control interventions. They were also interested in learning more on EBP and clinical decision-making related to myopia control. To improve the uptake of myopia control among optometrists, various learning methods, especially online learning, and providing sufficient time for training are crucial.
Fulltext Accommodation response to Chinese and Latin characters in Chinese-illiterate young adults

Radhakrishnan H, Hartwig A, Charman WN, Llorente L

Clin Exp Optom, 2015 Nov;98(6):527-34.
PMID: 26450168 DOI: 10.1111/cxo.12296

BACKGROUND: Differences in accommodation when reading Chinese, as compared to Latin, characters have been suggested to have a role in the higher prevalence of myopia in some Asian countries. Yeo and colleagues (Optom Vis Sci 2013; 90: 156-163) found that, in Chinese-literate children, accommodation was marginally more accurate (by less than 0.05 D), when reading Chinese text. This was attributed to the additional cognitive demand associated with interpreting the more complex Chinese symbols. The present study compared responses to single Chinese and Latin characters, while controlling for cognitive demand.
METHODS: The monocular accommodative response was measured in Chinese-illiterate adults (10 emmetropes, mean spherical equivalent: -0.07 ± 0.42 D, age: 29.9 ± 4.2 years; 11 myopes, mean spherical equivalent: -4.28 ± 2.84 D, age: 31.7 ± 4.6 years) with an open-field autorefractor. Four Chinese and three Latin characters (approximately 1.15 degrees subtense) were individually presented on a display screen one metre away from the subject, while their vergence was varied over the range zero to 5.00 D using spectacle trial lenses. The slope and the accommodative error index (AEI) were calculated from the accommodative stimulus/response curves (ASRC).
RESULTS: No statistically significant differences were found between refractive groups or among characters within the same refractive group in ARSC slopes (Latin: 0.87 ± 0.14 for myopes versus 0.81 ± 0.12 for emmetropes; Chinese: 0.84 ± 0.12 for myopes versus 0.85 ± 0.12 for emmetropes). No significant differences were found between characters in accommodative error index either (Latin, 0.78 ± 0.42 D for myopes versus 1.15 ± 0.72 D for emmetropes; Chinese, 0.74 ± 0.37 D for myopes versus 1.17 ± 0.83 D for emmetropes). However, accommodative error indices and accommodative errors were significantly higher for emmetropes.
CONCLUSION: Under controlled cognitive demand, Chinese and Latin characters elicited similar responses in both individual refractive groups. This study fails to support the hypothesis that development of myopia in some Asian populations is associated with larger lags of accommodation when reading or viewing Chinese characters.
Study site: Manchester, United Kingdom
The Cambridge Anti-myopia Study: variables associated with myopia progression

Price H, Allen PM, Radhakrishnan H, Calver R, Rae S, Theagarayan B, et al.

Optom Vis Sci, 2013 Nov;90(11):1274-83.
PMID: 24100478 DOI: 10.1097/OPX.0000000000000067

To identify variables associated with myopia progression and to identify any interaction between accommodative function, myopia progression, age, and treatment effect in the Cambridge Anti-Myopia Study.
Gut Microbiota Profiles in Myopes and Nonmyopes

Omar WEW, Singh G, McBain AJ, Cruickshank F, Radhakrishnan H

Invest Ophthalmol Vis Sci, 2024 May 01;65(5):2.
PMID: 38691091 DOI: 10.1167/iovs.65.5.2

PURPOSE: To identify compositional differences in the gut microbiome of nonmyopes (NM) and myopes using 16S ribosomal RNA sequencing and to investigate whether the microbiome may contribute to the onset or progression of the condition.
METHODS: Faecal samples were collected from 52 adult participants, of whom 23 were NM, 8 were progressive myopes (PM), and 21 were stable myopes (SM). The composition of the gut microbiota in each group was analysed using 16S ribosomal RNA gene sequencing.
RESULTS: There were no significant differences in alpha and beta diversity between the three groups (NM, PM, and SM). However, the distributions of Bifidobacterium, Bacteroides, Megamonas, Faecalibacterium, Coprococcus, Dorea, Roseburia, and Blautia were significantly higher in the myopes (SM and PM combined) when compared with emmetropes. The myopes exhibited significantly greater abundance of bacteria that are linked to the regulation of dopaminergic signalling, such as Clostridium, Ruminococcus, Bifidobacterium, and Bacteroides. Individuals with stable myopia were found to have a significantly higher proportion of Prevotella copri than those with progressive myopia. Bifidobacterium adolescentis, a gamma-aminobutyric acid (GABA)-producing bacterium, was significantly higher in all myopes than in NM and, in the comparison between SM and PM, it is significantly higher in SM. B. uniformis and B. fragilis, both GABA-producing Bacteroides, were present in relatively high abundance in all myopes and in SM compared with PM, respectively.
CONCLUSIONS: The presence of bacteria related to dopamine effect and GABA-producing bacteria in the gut microbiome of myopes may suggest a role of these microorganisms in the onset and progression of myopia.