To evaluate the association between visual symptoms and use of digital devices considering the presence of visual dysfunctions. An optometric examination was conducted in a clinical sample of 346 patients to diagnose any type of visual anomaly. Visual symptoms were collected using the validated SQVD questionnaire. A threshold of 6 hours per day was used to quantify the effects of digital device usage and patients were divided into two groups: under and above of 35 years old. A multivariate logistic regression was employed to investigate the association between digital device use and symptoms, with visual dysfunctions considered as a confounding variable. Crude and the adjusted odds ratio (OR) were calculated for each variable. 57.02 % of the subjects reported visual symptoms, and 65.02% exhibited some form of visual dysfunction. For patients under 35 years old, an association was found between having visual symptoms and digital device use (OR = 2.10, p = 0.01). However, after adjusting for visual dysfunctions, this association disappeared (OR = 1.44, p = 0.27) and the association was instead between symptoms and refractive dysfunction (OR = 6.52, p < 0.001), accommodative (OR = 10.47, p < 0.001), binocular (OR = 6.68, p < 0.001) and accommodative plus binocular dysfunctions (OR = 46.84, p < 0.001). Among patients over 35 years old, no association was found between symptoms and the use of digital devices (OR = 1.27, p = 0.49) but there was an association between symptoms and refractive dysfunction (OR = 3.54, p = 0.001). Visual symptoms are not dependent on the duration of digital device use but rather on the presence of any type of visual dysfunction: refractive, accommodative and/or binocular one, which should be diagnosed.

Purpose: The aim of the study was to compare distance vision measurements obtained with video oculography (VOG) and an alternate prism cover test (APCT). Design: Single-center, retrospective, and cross-sectional. Methods: Eighty-seven subjects with strabismus were included. All patients underwent an optometric examination. The measurement of strabismus in distance vision was performed with the best optical correction using the APCT and the VOG GazeLab. Subjects were divided according to the type of strabismus; 41 were esotropic and 46 were exotropic. Results: The general comparison of APCT and VOG showed a mean difference of 0.60±2.74 prism diopters (Δ), not observing statistical differences between both methods (P=0.059) and presenting a correlation of 0.976 (P<0.001). Using APCT, the mean amount of esotropia for the group was 18.31±11.64 Δ and that of exotropia was 19.62±8.80 Δ. Compared with the VOG, the mean value of esotropia for the group was 18.65±11.65 Δ and that of exotropia was 19.48±8.62 Δ. The means are statistically different for the esotropia group (P=0.005) but not for the exotropia group (P=0.318). There was a high direct correlation between the methods of measurement for both the esotropic (R=0.980; P<0.001) and exotropic patients (R=0.975; P<0.001). Bland-Altman analysis shows a mean difference of 1.37±2.76 Δ for the esotropia patients and 0.31±2.66 Δ for the exotropic patients, respectively. Conclusions: This study demonstrated comparable results in measuring strabismus between VOG and APTC for esotropia and exotropia, with an excellent correlation between both methods and good agreement, especially in subjects with exotropia.

Purpose: Visual skills and Oculomotor function deficits are common in children with Autism Spectrum Disorder (ASD), potentially affecting their development and quality of life. This study aimed to evaluate the effectiveness of vision therapy in visual perceptual skills and oculomotor function in children with ASD. Patients and Methods: This prospective interventional study was conducted using a convenience sampling method between February and May 2025. All children with a prior diagnosis of ASD who met the inclusion criteria were included in the study and underwent 45 sessions of vision therapy guided by the Developmental, Individual-Differences, Relationship-Based (DIR) model. Visual skills and oculomotor functions were assessed before and after vision therapy using the Wachs Analysis of Cognitive Structures (WACS) and the Northeastern State University College of Optometry (NSUCO) Oculomotor test, respectively. The paired t-test with Hedge’s g effect size was used to compare pre and post vision therapy outcomes for normally distributed data, while the Wilcoxon signed-rank test with effect size r was applied for non-normally distributed variables. Analysis of Covariance was used to examine the effect of ASD severity on post-therapy outcomes while controlling for age and gender. Results: Among the 42 children with ASD enrolled in the study, 36 completed all 45 sessions of vision therapy. Significant post-therapy improvements with large effect size were observed in visual perceptual skills (WACS) and oculomotor functions (NSUCO). Children with mild to moderate ASD showed greater improvements than those with severe ASD. Analysis of covariance revealed a significant effect of ASD severity on post-therapy outcomes: WACS (F(1,32) = 36.80, p < 0.001, R² = 0.55), saccades (F(1,32) = 36.75, p < 0.001, R² = 0.54), and pursuits (F(1,32) = 35.54, p < 0.001, R² = 0.54). Age and gender showed no statistically significant effects on the outcomes. Conclusion: This prospective study provides preliminary evidence that DIR-guided vision therapy, particularly when combined with occupational and behavioral therapy, may enhance visual perceptual and oculomotor functions in children with ASD. However, randomized controlled studies with longer follow-up are needed to confirm these results.

To evaluate the current evidence on oculomotor measurement parameters and their normative values through a systematic review. A search of primary studies was conducted using a search equation with free language. Original articles analyzing normal oculomotor function parameters in healthy populations of any age, studies that included a clearly differentiated healthy control group, and articles using any oculomotor measurement test were included. The QUADAS-2 tool was used to assess the risk of bias, applicability, and quality of the studies. The review was conducted independently by the authors and then pooled to determine the final inclusion. A total of 915 articles were identified, of which 750 were excluded after the first review of the title and In the second step, 133 out of 165 investigations were discarded. Ultimately, 32 articles from the initial search were included, along with 10 additional articles identified through a manual search. The findings revealed variations in how oculomotor skills are measured, including differences in stimuli, measurement distances, and parameters assessed. A high risk of bias was observed (≥50 % in the areas of “flow and timing”, “reference standard” and “patient selection”) along with poor applicability (≥50 % in all aspects). There is no clear evidence on normative values for oculomotor skills, nor is there a consensus on the measurement methods, stimulus used, or working distance. Furthermore, there is no agreement on which aspects of oculomotor skills should be assessed. To enhance reliability and applicability, measurement criteria should be standardized, and normative values should be established.

To identify the prevalence of non-strabismic binocular vision anomalies in a systematically randomized sample of symptomatic, non-presbyopic subjects from a tertiary hospital, using a broader range of diagnostics signs. The study was designed as hospital-based, cross-sectional, and analytical and was conducted from March 2022 to April 2023. Systematic random sampling was employed to select the subjects. Symptomatic subjects aged between 18 and 35 years with best-corrected visual acuity of 6/6 in each eye and no change in refractive error during the subjective refraction were included in the study. Out of the 231 subjects examined, 91 (39.39 %) were found to have non strabismic binocular vision anomalies. Of all the non strabismic binocular vision anomalies, 60 subjects (26 %) had binocular dysfunctions, 22 (9.5 %) had accommodative dysfunctions, and 9 (3.9 %) had both accommodative and binocular dysfunctions. The most common dysfunction was convergence insufficiency (18.2 %), followed by accommodative infacility (6.06 %) and fusional vergence dysfunction (3.9 %). The most prevalent symptom was headache (16.7 %), followed by visual fatigue (14.1 %). Two-fifths of the symptomatic subjects have non strabismic binocular vision anomalies. It is essential to assess all accommodative and binocular parameters in order to arrive at a diagnosis of non strabismic binocular vision anomalies.