Background/Objectives: The prevalence of myopia is increasing globally, including in Spain. The early detection of ocular biometric parameters associated with myopia development is crucial for implementing control strategies. This study aims to describe the normative biometric values in a Spanish school-aged population and compare them with previously established reference data. Methods: A cross-sectional, observational, and analytical study was conducted on 558 students aged 6 to 12 years from the Educare Valdefuentes School in Madrid. Ocular biometric parameters, including axial length (AL), corneal curvature (CR), anterior chamber depth (ACD), crystalline lens thickness (LT), corneal thickness (CCT), and posterior vitreous depth (PVD), were measured using IOLMaster 700. The axial length/corneal radius (AL/CR) ratio was calculated. Percentile growth curves were generated, and the results were statistically analyzed using IBM SPSS 29. Results: AL significantly increased with age (p < 0.001), and boys had longer AL than girls. The AL/CR ratio showed a moderate correlation with myopia risk (ρ = 0.647, p < 0.001). Compared to previous European studies, no significant differences were found, except for minor variations in AL and CR. Conclusions: These percentile-based biometric values provide a useful reference for monitoring ocular growth and assessing myopia risk in Spanish children. The AL/CR ratio remains a strong predictor of myopia development, supporting its role in early detection strategies.

Background: Eye-tracking technology enables the objective quantification of oculomotor behavior, providing key insights into visuocognitive performance. This study presents a comparative analysis of visual attention patterns between rhythmic gymnasts and school-aged students using an optical eye-tracking system combined with machine learning algorithms. Methods: Eye movement data were recorded during controlled visual tasks using the DIVE system (sampling rate: 120 Hz). Spatiotemporal metrics—including fixation duration, saccadic amplitude, and gaze entropy—were extracted and used as input features for supervised models: Support Vector Machine (SVM), k-Nearest Neighbors (k-NN), Decision Tree (CART), Random Forest, XGBoost, and a one-dimensional Convolutional Neural Network (1D-CNN). Data were divided according to a hold-out scheme (70/30) and evaluated using accuracy, F1-macro score, and Receiver Operating Characteristic (ROC) curves. Results: XGBoost achieved the best performance (accuracy = 94.6%; F1-macro = 0.945), followed by Random Forest (accuracy = 94.0%; F1-macro = 0.937). The neural network showed intermediate performance (accuracy = 89.3%; F1-macro = 0.888), whereas SVM and k-NN exhibited lower values. Gymnasts demonstrated more stable and goal-directed gaze patterns than students, reflecting greater efficiency in visuomotor control. Conclusions: Integrating eye-tracking with artificial intelligence provides a robust framework for the quantitative assessment of visuocognitive performance. Ensemble algorithms demonstrated high discriminative power, while neural networks require further optimization. This approach shows promising applications in sports science, cognitive diagnostics, and the development of adaptive human–machine interfaces.

Background: Acquired brain injury (ABI) often disrupts binocular vision, causing deviations on the cover test and reduced stereopsis that impair functional visual performance. This study investigated the effects of a dichoptic vision therapy protocol—based on an immersive virtual reality (VR) system—on visual field parameters, oculomotor reaction times, and self-reported visual symptoms in adults with ABI. Methods: In a controlled parallel-group design, adult ABI patients (median age 51 years) were assigned to an experimental group (dichoptic VR therapy) or a control group. Six sessions of visual therapy were performed. Primary outcomes included perimetric visual field indices and oculomotor reaction times; the secondary outcome was the Brain Injury Vision Symptom Survey (BIVSS) score. Etiology (stroke vs. traumatic brain injury) was recorded. Results: No statistically significant improvements were found in perimetric visual field indices (p > 0.05), except for a slight gain in the top-right quadrant in the experimental group. Reaction times did not differ significantly between groups. However, the experimental group reported a greater reduction in visual symptoms as measured by the BIVSS. Patients with traumatic brain injury exhibited better functional improvement, particularly in the top-left quadrant (p = 0.04). Conclusions: Dichoptic VR-based therapy did not restore perimetric field losses in ABI patients but reduced visual symptoms and may enhance functional adaptation of residual vision rather than structural recovery. The therapeutic response varied by etiology, favoring traumatic brain injury. Larger, longer trials integrating objective and subjective measures, including neuroimaging, are warranted.

Background: Sensor-based systems and virtual reality (VR) technologies provide new opportunities for the objective, technology-driven assessment and training of visuomotor performance in applied contexts such as sport. Methods: This study examined the effects of an integrated visual training program combining stroboscopic stimulation, VR-based vergence exercises, and instrumented reaction-light tasks in adolescent handball players. Twenty-eight adolescent handball players (under-18 competitive level) completed two baseline assessments separated by six weeks, followed by a six-session training program (approximately 15 min per session) integrated into regular team practice. The intervention targeted visuomotor reaction speed, accommodative dynamics, and peripheral visual responsiveness using sensor-based and virtual reality–assisted stimuli. Results: Compared with both baseline measurements, the intervention produced selective improvements in accommodative facility (cycles per minute, cpm)—particularly near–far focusing speed—and in multiple reaction-time conditions (milliseconds, ms) involving manual and decision-based responses. Specific peripheral-field locations showed increased response scores, whereas binocular alignment, AC/A ratio, near phoria, and stereoscopic acuity remained unchanged. Conclusions: These findings indicate that technology-supported visual training protocols incorporating sensor-based reaction systems and VR stimuli were associated with measurable adaptations in dynamic visuomotor processing while preserving fundamental binocular vision parameters.

Background: Table tennis is a fast interceptive sport that requires continuous visual information processing and precise visuomotor control. Wearable eye tracking may provide objective information about ocular behaviour during sport-specific performance, although evidence on blink behaviour and pupil diameter in elite players remains limited. Methods: This observational cross-sectional study analysed blink-related and pupil-related variables during a standardised table tennis stroke-performance test in 17 elite male players. Participants completed a 56-ball robot-based protocol, consisting of six familiarisation trials followed by 50 analysed forehand topspin strokes. Ocular variables included total blink count, blink frequency, mean blink duration, mean pupil diameter, maximum pupil diameter, and minimum pupil diameter. Technical performance outcomes were stroke accuracy and ball velocity. Results: Blink frequency showed the strongest positive association with stroke accuracy score (Spearman’s ρ = 0.613, 95% CI [0.060, 0.881], p = 0.012), although this association did not remain statistically significant after false discovery rate correction (FDR-adjusted p = 0.115). Total blink count showed a similar association that did not reach statistical significance (ρ = 0.496, p = 0.051). No significant associations were observed between blink-related variables and ball velocity. Pupil-diameter variables were not significantly associated with either stroke accuracy or ball velocity. Conclusions: Blink-related measures showed the clearest relationship with stroke accuracy, whereas global pupil-diameter measures did not show comparable associations with technical performance. These findings should be interpreted as exploratory and hypothesis-generating and require confirmation in larger samples using time-resolved analyses of ocular behaviour.

Background/Objectives: Efficient visual processing is relevant for reading, writing, and sustained attention in schoolchildren. However, the relative discriminative value of different visual domains for identifying teacher-reported academic difficulties remains unclear. This study evaluated five visual system alteration domains for identifying teacher-reported academic difficulties using machine learning models. Methods: An observational analytical study was conducted in 581 primary schoolchildren. After complete-case analysis, 506 participants were included in the machine-learning analyses. Academic functioning was rated by teachers using a 1–5 ordinal scale and dichotomized as a pragmatic school-based indicator of teacher-reported academic difficulties. Five predictor groups were analyzed: DIVE-based oculomotor function, clinical oculomotor assessment, accommodative system, vergence system, and axial length. Five classifiers were evaluated using stratified 5-fold cross-validation combined with model-complexity penalization through hyperparameter optimization. Results: The accommodative system showed the highest cross-validated performance (XGBoost: accuracy 0.952 ± 0.021; macro-F1 0.919 ± 0.028), followed by clinically assessed and instrumentally assessed oculomotor predictors. Oculomotor alterations also showed strong performance, whereas vergence alterations showed high specificity but very low sensitivity, and abnormal axial length showed limited discriminative performance. Conclusions: Functional visual domains, particularly accommodation and oculomotor control, showed stronger cross-validated classification performance than vergence or axial-length variables. These findings are exploratory and require external validation cohorts, standardized academic outcomes, and future combined-domain modeling before clinical or educational implementation.