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Catch up on the top stories in optometry during the week of July 14-July 18.

Takeaways from this week in optometry: July 14 - July 18

Articles

Nicox’s nitric oxide (NO)-donating bimatoprost eye drop works to lower intraocular pressure (IOP) in patients with glaucoma or ocular hypertension.

New agreement to authorize Kowa Company to develop, manufacture Nicox's NCX 470 in US

Study authors Preeya K. Gupta, MD; and Paul Karpecki, OD, formulated a case in their literature review for the routine evaluation of the upper eyelid during meibomian gland imaging.

Study underscores importance of upper eyelid meibography in early detection of OSD, among other conditions

Dr. Chang is a subinvestigator in numerous clinical trials. He is immediate past president of New Jersey Academy of Optometry, and an advisory board member for International Keratoconus Academy for Eye Care Professionals (IKA), Gas Permeable Lens Institut

Videos

ODs reflect on their time in Minneapolis, Minnesota, citing continuing education, tech updates, and networking opportunities as valued takeaways from the meeting.

AOA 2025: Innovation and education take forefront at Optometry's Meeting

Optometry Times delivers clinical news, practice insights, and research updates by optometrists for optometrists to advance care and patient outcomes.

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Authors

Lori Wright, JD, sat down to talk about a presentation at Collaborative Care Symposium about the risk under federal statutes and how to minimize that risk as an optometrist or an ophthalmic practice.

CCS 2025: Minimizing risk in comanagement as an eye care provider

Cothran, OD, FAAO, discussed the importance of optometrists addressing mental health with patients in their chair.

AOA 2025: A mental health primer for the optometric physician with Dr Nora Lee Cothran

During the American Optometric Association's Optometry's Meeting 2025 in Minneapolis, Minnesota, Nora Lee Cothran, OD, FAAO, delivered a presentation titled "Hello Darkness, My Old Friend: A Mental Health Primer for the Optometric Physician." Her primary objective was to educate optometrists about mental health, focusing on depression, anxiety, suicide, and intervention strategies. 

The lecture emphasized the importance of recognizing mental health changes in patients, staff, family members, and health care professionals. Cothran highlighted that mental health disorders can be triggered by significant life events like losing a loved one, experiencing divorce, or job loss, but can also emerge unexpectedly. She stressed the significance of observing behavioral changes, such as deteriorating personal hygiene or missed appointments, which could indicate underlying mental health issues. Cothran encouraged health care professionals to ask open-ended questions like "Are you okay?" and demonstrate genuine care, as sometimes simply showing someone they are valued can be life-changing. The presentation covered various mental health conditions, including major depressive disorder, seasonal affective disorder, and peripartum depression. She shared alarming statistics, such as 1 in 7 women experiencing peripartum depression, which is the leading cause of maternal mortality in the US. 

A critical aspect of her talk was destigmatizing suicide discussions. Cothran emphasized that talking about suicide does not drive individuals toward it but can actually prevent it by making people feel supported and understood. She noted that during psychological distress, individuals might not think rationally, and compassionate intervention could be life-saving. Cothran also discussed how chronic or sight-threatening conditions impact mental health. For instance, 60% of stroke patients experience poststroke depression, which increases the risk of subsequent strokes and mortality. 

Cothran's core message was for health care professionals to adopt a holistic approach to patient care. By looking beyond medical symptoms and considering patients' entire well-being, doctors can provide more comprehensive and compassionate care. She urged her colleagues to be observant, supportive, and proactive in addressing mental health concerns. The lecture concluded with a powerful call to action: Health care professionals should look out for their patients, family members, and themselves, recognizing that mental health is an integral part of overall health.

Nora Lee Cothran, OD, FAAO, discussed the importance of optometrists addressing mental health with patients in their chair.

Conference

Karen R. Hoffman, OD, shares how customizable scleral lenses can transform vision for patients with complex corneas, achieving 20/20 outcomes and enhanced comfort.

AOA 2025: Highlighting microvaults in customizable scleral lenses for patients with complex corneas

At the 2025 AOA Optometry’s Meeting, Karen R. Hoffman, OD, presented 3 cases in which patients with complex corneas were fitted with customized scleral lenses (Zenlens; Bausch + Lomb); in the end, each patient achieved 20/20 vision and were happy with their vision and were able to wear the lenses comfortably for extended periods.

Hoffman's poster, which is entitled, "Utilization of customizable toric peripheral curves to optimize scleral lens fit and vision outcomes in patients with irregular astigmatism and corneal complexities," showcased the clinical work of herself, Cian Gildea, BscOptom, and Boris Severinsky, OD, FAAO, FBCLA, FSLS.

Hoffman spoke on the clinical utility and customization potential of microvaults in scleral lens design. Her work highlights an underutilized yet powerful approach to managing complex corneal irregularities and improving outcomes for both patients and practitioners.

According to Hoffman, microvaults can be placed anywhere on a scleral lens, including the vaulting chamber or at the lens edge. With dimensions up to 900 microns in depth and 9 millimeters in diameter, these design modifications allow for precise vaulting over corneal abnormalities such as scars or elevated tissue.

In one standout case, Hoffman describes a patient with a peripheral corneal scar. By placing a microvault inside the vaulting chamber, the lens achieved complete clearance, avoiding any contact with the sensitive area. "We don’t want the lens touching the eye anywhere except at the landing zone," she emphasized.

Clinical outcomes: Better vision with fewer revisions

One of the most surprising and encouraging aspects of her findings was that in all three presented cases, patients achieved 20/20 vision with only 2 to 3 lens revisions. "It is possible in our practices to fit these lenses successfully—even in challenging cases," she said.

Patients reported high comfort and long wear time, while eye care professionals (ECPs) also expressed high satisfaction with the fitting process and outcomes. These findings speak not only to the viability of advanced scleral lens designs but also to the importance of broader adoption.

Hoffman sees a significant gap in access to specialty lens fittings, noting the demand far exceeds the number of providers currently offering these services. “This is a big underserved area in our field,” she stated. “My hope is that my presentation inspires even one optometrist to take that next step and begin fitting scleral lenses.”

Hoffman’s work at the 2025 AOA Optometry’s Meeting reinforces the transformative potential of modern scleral lens technologies, especially for patients with challenging ocular conditions. With tools like microvaults, today's optometrists are equipped to provide life-changing vision correction—one custom lens at a time.

In its debut year, the AOA Innovation Hub encouraged conversation between clinicians, tech titans, startups, and industry reps about the road ahead for technology and artificial intelligence (AI) in eye care. Moderated by Scot Morris, OD, the Innovation Hub was split into 3 panel discussions on assessing future health through AI-enabled tools, addressing patient workflow challenges through AI, and enhancing treatment through new technologies.

"This isn't just another summit—it's a call to action to challenge your perspectives, engage with these industry titans and be at the forefront of the evolution of eye care," said Scot Morris, OD, session moderator.

Assessing future health through AI-enabled tools

Panelists Laure Pichereau, CEO of SiView; Patrick Sauvageau, OD, MSc, CEO of Zilia; and Catherine Bornbaum, PhD, MBA, president of RetiSpec, joined moderator Scot Morris in discussing the broad challenges of integrating AI into practice. One of the biggest challenges cited was overcoming resistance to change, but panelists agreed that AI could be a powerful tool to delegate and streamline routine tasks, which would give practitioners more time to dedicate to complex patient needs and enhanced care quality.

In addition to streamlining routine tasks, the experts discussed the eye’s position as the “window to health,” which creates an opportunity to leverage quantifiable ocular biomarkers to discover problems elsewhere in the body. AI has the potential to make this particularly powerful. However, the panelists agreed that seamless integration into existing workflows was the key to adoption to minimize disruption to the staff and the patient. Other factors in successful adoption were discussed, with the panelists especially interested in models that leverage established reimbursement pathways, such as CPT codes, and a tangible return on investment. Collaboration between eye care providers and technology developers would be key in creating a model that meets the needs of most optometric practices.

In terms of future outlook, Morris made the key point of how difficult it is to secure substantial funding for research and development of AI models, particularly if they require clinical studies to validate. Interestingly, the panelists discussed how AI should be included in academic curricula to prepare the next generation of optometrists appropriately; they agreed that education on AI would help the industry move forward and march toward becoming the primary “gatekeepers of health.” They did not discuss the need to continuing education in AI.

Addressing patient workflow challenges through AI

The next panel, also moderated by Morris, analyzed the impact of natural language processing (NLP) and AI on eye care workflows. Panelists Grant Shmid, VP of business development at Altris AI; Colton Calandrella, cofounder and CEO of Barti; and Easy Anyama, OD, an AOA volunteer, chatted about their experience with AI scribes and electronic health records (EHR).

The discussion underscored the value of AI in these cases; at one point, it was stated that using an AI scribe was “10 times better” than using a traditional EHR due to time savings. Together, the panelists envisioned a future in which AI would become so engrained in workflows that it is functionally invisible, which would ultimately make doctors irreplaceable because they are now free to provide high-value patient interactions. As stated before, optometry and eye care in general have the power to detect pathology early using biomarkers in the eye, making the industry well-positioned to lead the charge in AI adoption in practice.

Enhancing treatment through new technologies

The final session pivoted away from AI a bit but honed in on new and exciting technology. This session, moderated by Nora Lee Cothran, OD, featured panelists Mile Brujic, OD, for MediPrint Ophthalmics; Ben Bergo, president chief business officer of Tenpoint Therapeutics; and Elan Weiner, founder and CEO of ECI Therapeutics.

Each panelist discussed the technology under investigation by the company they were representing. Brujic spoke about the bimataprost-eluting contact lens for the treatment of glaucoma from Mediprint; Bergo described Tenpoint’s proprietary brimochol, a combination of brimodine and carbachol for presbyopia; and Weiner discussed ECI’s platelet-rich, plasma-derived growth factor eye drops. Underscoring each of these participants was a desire to improve patient outcomes through innovative means—which is hopefully always the goal as optometrists invite technology and AI into their workflows.

The Innovation Hub was split into 3 panel discussions on assessing future health through AI-enabled tools, addressing patient workflow challenges through AI, and enhancing treatment through new technologies.

AOA 2025: Innovation Hub sparks thoughtful conversations about AI, technology in eye care

Understanding the ocular implications of sleep hygiene can make a difference for many patients, particularly those with traumatic brain injuries (TBIs), according to Jacqueline Theis, OD, FAAO, FNAP; and Joseph Allen, OD, FAAO, Dipl ABO. In their American Optometric Association’s Optometry’s Meeting 2025 presentation “Enhancing Vision and Brain Health: Understanding the Importance of Sleep” given in Minneapolis, Minnesota, the pair outlined how sleep habits can be influenced by brain and ocular health, and vice versa.

In terms of the eyes playing a role in sleep quality, Allen stated that although the rapid eye movement (REM) stage of sleep is an important stage in the sleep cycle, it largely remains a scientific mystery. “I can’t say it’s proven, but actually an eye care provider came up with this theory, because the eyes with aqueous humor need to bathe the backside of the endothelium of the cornea, and if the eyes aren’t moving, they all become stagnant,” Allen said. “Then there are concerns about hypoxia in some of those tissues. So it might have been an evolutionary benefit for our eyes to shake at night, because it’s like shaking up a snow globe and it gets the aqueous humor to start flowing and bathe those internal structures.”

According to the CDC, the recommended hours of sleep per day are 16 to 18 hours for babies and infants, 9 to 12 hours for those aged 6 to 12 years, 8 to 10 hours for those aged 13 to 18 years, and 7 to 9 hours for those 18 years and older. However, Theis said that studies have shown that patients with brain injuries or neuroinflammation need 8 to 10 hours of sleep a night.

“The problem is that when you had a brain injury, you injured your brain, which regulates when you fall asleep,” Theis said. “One of the most common things that people have when they had a brain injury is sleep dysfunction in our clinic.”

Otherwise, a patient who is getting an excessive amount of sleep (more than 10 hours) may have other underlying health conditions, such as cardiovascular disease.

Light also plays a large role in sleep quality, with sleep being highly affected by the intrinsically photosensitive retinal ganglion cells’ (ipRGCs) role in the light-dark cycle, which aids in circadian synchronization. Because ipRGCs contain melanopsin, which is directly excited by blue light and rod/cone inputs, a lack of or decrease in blue light causes the cells to signal to the brain to secrete melatonin, thus preparing the body for sleep. Theis said that in the case of blue blockers, preventing the eyes from too much light exposure has the potential to affect sleep hygiene.

“Blue light suppresses melatonin secretion so that you’re awake, so putting someone in a blue blocker all day long can actually cause chronic fatigue if you put them in too intense of a blue blocker because blue light keeps us awake, it gives us cognitive function,” Theis said.

However, Theis and Allen said that there remain significant discrepancies regarding whether blue blockers are effective at blocking blue light. Allen said the transmittance percent of a given blocker can be indicative of how effective said blocker may be.

 “FL 41 is a top-notch filter. Not every FL 41 is the same,” Allen said. I have bought every FL 41 on the market. I have every single one in my practice, and I’ve done spectrophotometry through all of them, and they all have different profiles. When I had my migraine patients come into my office and they try on different lenses, they’re like, ‘I like this one, but not that one,’ and every single one of them is different. So just because they’ve tried one and they say it doesn’t work for them, try another.”

Theis also noted that the amount of blue light that is processed by the eye depends on how close or far away a device is held to the face. She noted that prominent blue light researcher Phillip Yuhas, PhD, often compares a blue blocker as having the same effect as holding a device an additional foot or so away from your eyes.

 One study also found that switching devices into night-mode functions reduced melatonin suppression value by up to 93%, whereas blue light-reducing spectacles reduced suppression by 33%, with coated lenses more efficient than tinted lenses.

 Theis recommends to her patients to turn all televisions, smartphones, and laptops to blue mode or night mode 3 hours before bedtime to help aid in sleep hygiene.

Theis and Allen also discussed that insufficient/short sleep duration is associated with an increased risk of early age-related macular degeneration, associations between sleep apnea and glaucoma, CPAP machines causing dry eye, and when to refer patients to have sleep studies performed (often when presenting symptoms of floppy lid syndrome).

“Our big thing is to have a conversation with the patient,” Theis said. “I can’t get your dry eye better if you’re not sleeping."

Allen J, Theis J. Enhancing Vision and Brain Health: Understanding the Importance of Sleep. Presented at: Optometry’s Meeting 2025; June 25-28; Minneapolis, MN.

Teran E, Yee-Rendon CM, Ortega-Salazard J, De Gracia P, Garcia-Romo E, Woods RD. Evaluation of 2 strategies for alleviating the impact on the circadian cycle of smartphone screens. 

Optom and Vis Sci: Official pub of the Am Academy of Optom. 

2020;97(3):207-217. https://doi.org/10.1097/OPX0000000000001485

From blue light blockers to sleep apnea, Jacqueline Theis, OD, FAAO, FNAP; and Joseph Allen, OD, FAAO, Dipl ABO, outlined how sleep can influence brain and ocular health, and vice versa.

AOA 2025: Improving sleep hygiene for the sake of brain and ocular health

Artificial intelligence (AI)-powered retinal diagnostics AEYE Health and health care distributor Ford Medical have announced a partnership to bring AEYE’s autonomous diabetic eye examination screening solutions to pharmacies and nonacute centers around the nation.

 These screening solutions will work to make early detection of diabetic retinopathy (DR) easier with on-the-spot screening that is more widely accessible for patients, according to a news release.

“We're excited to collaborate with Ford Medical to bring AEYE-DS into pharmacies and nonacute centers - a strategic step toward making diabetic eye exams more accessible than ever," said Zack Dvey-Aharon, PhD, CEO and cofounder of AEYE Health, in the release. "By integrating fully autonomous AI into everyday care settings, we're making it much easier to detect disease early and prevent blindness for millions at risk."

AEYE-DS, AEYE Health’s AI-driven technology, is the first and only FDA-cleared AI solution compatible with a portable camera. The technology allows for point-of-care screening for patients who may not regularly see an eye care provider or specialist, which enhances care outreach, expands pharmacy services, and creates new revenue opportunities, according to the company.

 In 5 seconds, the technology analyses the examinations, with 93% sensitivity and 91.4% specificity for diagnosing more-than-mild retinopathy on desktop and between 92% and 93% sensitivity and between 89% and 94% specificity in handheld devices.

"This partnership with AEYE Health represents a major step forward in making AI-driven diagnostics more accessible," said Scott Greenberg, vice president of sales at Ford Medical, in the release. "We're giving nonacute providers the ability to deliver real clinical value through early detection - keeping patients healthier and helping providers grow their impact and their business."

Specifically, the partnership will allow Ford Medical to distribute AEYE Health’s screening solutions, which will allow pharmacies and acute centers to offer in-house, noninvasive eye examinations that deliver immediate diagnostic results with no specialist needed. The solution is also fully reimbursable under an existing CPT code.

AEYE is also developing an AEYE-CS comprehensive screening technology, which is used to diagnose or predict the development of numerous diseases from retinal images, including DR, glaucoma, age-related macular degeneration, diabetes, cataract, diabetic macular edema, cardiovascular disease, occlusion, and hypertension. The device is currently being utilized in investigational use only in the US.

AEYE-DS can also be utilized in primary care, home care, and teleretinal screening services, in addition to enhancing fundus cameras for camera manufacturers.

AEYE Health and Ford Medical partner to bring fully autonomous, reimbursable AI diabetic eye exam screening solutions to pharmacies. News release. PR Newswire. July 15, 2025. Accessed July 16, 2025. 

https://www.prnewswire.com/news-releases/aeye-health-and-ford-medical-partner-to-bring-fully-autonomous-reimbursable-ai-diabetic-eye-exam-screening-solutions-to-pharmacies-302505909.html

1-minutes AI diabetic eye exam at any point of care. AEYE Health. Accessed July 16, 2025. 

AEYE Comprehensive Screening (AEYE-CS). AEYE Health. Accessed July 16, 2025. 

https://www.aeyehealth.com/aeye-comprehensive-screening

These screening solutions will work to make early detection of diabetic retinopathy easier with on-the-spot screening.

AEYE Health, Ford Medical partner to expand diabetic eye exam screening solutions to pharmacies

A new Chinese investigation found that attention-deficit hyperactivity disorder (ADHD) is associated with reduced myopia prevalence, more hyperopic spherical equivalent refraction (SER), and shorter axial length (AL) in schoolchildren, according to Xiu Nian Chen, PhD, from the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.

Chen and colleagues explained that increased risks of astigmatism, strabismus, reduced near point of convergence, color discrimination, and contrast sensitivity have been reported in patients with ADHD.

 This is noteworthy considering that myopia is the most common ocular disease worldwide with a heavy public health burden in many parts of the world.

Although a few studies have found no difference in the prevalence of myopia between patients with ADHD and healthy controls,

 Chen and colleagues noted that the methodologies of those studies may not have been able to detect a difference.

Another consideration is that the first-line treatment for ADHD, oral methylphenidate, inhibits the reuptake of dopamine and norepinephrine, thereby enhancing catecholaminergic activity in the brain regions involved in ADHD pathogenesis, which leads to symptom improvement.

 “Concurrently,” they stated, “the dopamine system plays a significant role in mediating myopic eye growth and is broadly associated with other myopic mechanisms.

Thus, it is intriguing to explore whether oral methylphenidate affects myopia by influencing dopamine levels.”

Moreover, while near-work and outdoor activity affect the myopia prevalence, children with ADHD may have different patterns of near-work and outdoor activity compared to their unaffected peers, indicating that the impact of ADHD symptoms on myopia remains unclear.

The children in the study were aged 6 to 8 years and underwent a cycloplegic autorefraction and AL measurements between 2016 and 2021. The ADHD diagnoses were established according to the ICD-10 criteria, and the ADHD symptoms were assessed using the Strengths and Weaknesses of ADHD-Symptoms and Normal-Behaviors Questionnaire.

The study included 474 children with ADHD and 9950 control children.

The authors reported that the age- and sex-adjusted myopia prevalence was lower in the ADHD group (21%) compared with the controls (26%; 

= .02). Multivariable regression analysis showed that the children with ADHD had less myopia (OR, 0.75;

Specifically, the patients with ADHD who were treated with oral methylphenidate had less myopia (OR, 0.61, 

Chen and colleagues found that each additional month of treatment with oral methylphenidate was associated with a higher SER (

“For each 1-point increase in attention-deficit scores, the children were found to be less myopic (OR, 0.88, 

They also found that the prevalence of myopia among children with ADHD increased to 32% during the COVID-19 pandemic compared with 23% before the COVID-19 pandemic (

The authors concluded, “This cross-sectional study found that ADHD is associated with reduced myopia prevalence, more hyperopic SER, and shorter AL.”

However, they advised that because the effect sizes of these associations were small, the clinical relevance of the findings needs to be interpreted with caution.

Chen XN, Zhang XJ, Zhang Y, et al. Association of attention-deficit hyperactivity disorder with myopia among school children. 

Grönlund MA, Aring E, Landgren M, Hellström A. Visual function and ocular features in children and adolescents with attention deficit hyperactivity disorder, with and without treatment with stimulants. 

Ho JD, Sheu JJ, Kao YW, Shia BC, Lin HC. Associations between attention-deficit/hyperactivity disorder and ocular abnormalities in children: a population-based study. 

Reimelt C, Wolff N, Hölling H, Mogwitz S, Ehrlich S, Roessner V. The underestimated role of refractive error (hyperopia, myopia, and astigmatism) and strabismus in children with ADHD.

Bellato A, Perna J, Ganapathy PS, et al. Association between ADHD and vision problems. A systematic review and meta-analysis.

Baird PN, Saw SM, Lanca C, et al. Myopia.

Ababneh LT, Bashtawi M, Ababneh BF, Mahmoud IH, Rashdan M, Zahran M. Ocular findings in children with attention deficit hyperactivity disorder: a case-control study.

Karaca I, Demirkılınç Biler E, Palamar M, Özbaran B, Üretmen Ö. Stereoacuity, fusional vergence amplitudes, and refractive errors prior to treatment in patients with attention-deficit hyperactivity disorder.

Koda K, Ago Y, Cong Y, Kita Y, Takuma K, Matsuda T. Effects of acute and chronic administration of atomoxetine and methylphenidate on extracellular levels of noradrenaline, dopamine and serotonin in the prefrontal cortex and striatum of mice.

Quintero J, Gutiérrez-Casares JR, Álamo C. Molecular characterisation of the mechanism of action of stimulant drugs lisdexamfetamine and methylphenidate on ADHD neurobiology: a review.

Wolraich ML, Hagan JF Jr., Allan C, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents.

Huang Y, Chen X, Zhuang J, Yu K. The role of retinal dysfunction in myopia development.

Zhou X, Pardue MT, Iuvone PM, Qu J. Dopamine signaling and myopia development: what are the key challenges.

A recent study reveals that ADHD in schoolchildren correlates with lower myopia prevalence and shorter eye length, suggesting intriguing links between vision and attention disorders.

Lori Wright, JD

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