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The DOT lens has now been launched across Asia-Pacific, Europe, and North America, with an estimated 500,000 fitted with DOT lenses in 2025 alone.

DOT lenses for slowing myopia progression worn by a total of 1 million children

The acquisition focuses on LayerBio's OcuRing-K technology, with plans to initiate the next clinical trial.

PainReform acquires majority equity interest in LayerBio

Researchers found that patients with primary open-angle glaucoma have less agmatine and thiamine in the aqueous humor than patients without glaucoma.

Molecules in aqueous humor may lead to biomarker discovery for glaucoma, according to study

Researchers used adaptive optics scanning light ophthalmoscopy (AOSLO) to study retinas in mice with photoreceptor damage, specifically photoreceptor laser injury.

Researchers examine brain immune cell impact on the eye

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

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Dr. Rothschild is the Director of Practice Management at Revolution EHR.

Running an eyecare practice can be complicated.

How to simplify in the optometry practice

“How do you give raises to your staff?” This is a common question among ODs. I have learned after several years of working with eyecare practices that we are all over the place in how we compensate our staffs.

4 steps to adjust staff salaries

ABB Optical Lab Services and ABB Contact Lens Specialty Vision Products are now part of an expansion of Professional Eye Care Associates of America (PECAA) and ABB Optical Group’s strategic vendor partnership.

 Now, PECAA Max members will have access to ABB’s independent lab network and comprehensive portfolio of premium and proprietary lenses, according to a news release.

“ABB is uniquely positioned to serve private practices with the independence that ensures solutions are aligned with the best interests of eye care professionals," said President of ABB Optical Group James Gilchrist. "We are excited to deepen our relationship with PECAA, and we look forward to delivering greater value to PECAA Max members through a comprehensive suite of services that provide enhanced efficiency, expanded choices, and increased value from one trusted source."

The expansion of ABB’s existing soft contact lens and business solution offerings that are available to PECAA Max members supports both companies’ commitment to supporting the success of independent eye care providers, the release stated. These members now have access to lenses including Unity and ABB Ascend, among other brands. Additionally, ABB provides a complete specialty vision product portfolio and an expert consultant team for specialty contact lens fitters, including access to ABB’s DELTA Scleral lens.

"ABB Optical Group aligns with PECAA's dedication to empowering private practices with the tools they need to thrive. ABB's exclusive Unity Rewards Program enables PECAA Max members to offset their monthly membership costs and drive profitability. This expanded partnership will give members a competitive edge and is just one of the ways in which PECAA is doubling down and delivering high-value programs to our member doctors."

ABB Labs was also recently recognized as the highest-rated lab, with more customers planning to stay with ABB Labs than any other lab network, according to the release. An independent survey reported a 92% overall customer satisfaction rating and over 98% of lab orders meeting quality expectations.

 Additionally, 9 out of 10 customers who use ABB for eyeglass lenses reported that they would stay with the lab through the following 12 months.

PECAA offers several different member options, including PECAA Max, PECAA Launch, and PECAA Propel. PECAA Max provides vendor savings and rebates (including over 200 vendor partners and IncentiveEYES and VSP Vision Exam rebates) expert business advisers, CE courses, staff training, and peer-to-peer networking, among other benefits. The membership has a monthly fee of $279 and no contract.

“PECAA has been a tremendous help for me growing my practice from day 1,” said Kennard Herring, OD, of Nostalgic Eye Care in Philadelphia, Pennsylvania, and PECAA member.

My most valued PECAA Max membership benefit is the business advisory team, which has been very impactful in building my patient base.”

PECAA Launch is a membership that supports doctors opening new practices, providing guidance from concept to grand opening. Business advisers in finance and strategy, operations, optical management, marketing, and billing and coding are available through the membership. For the first 12 months, membership is free, with reduced fees kicking in for the second year and a standard fee after 2 years.

“I gained a lot of value from PECAA’s cold start program because they meet doctors where they are,” said Chun AuYeung, OD, of Eyes on Norbeck, in Rockville, Maryland, and a PECAA member. “PECAA’s business advisors helped me maximize insurance reimbursements and so much more. Now that my practice is established, PECAA Max membership continues to support my growth through the IncentivEYES member rebate program, human resources support, and other valuable benefits, allowing me to best support my patients.”

Finally, PECAA Propel is designed for optometry students and first-year graduates and provides free membership and comprehensive business training.

PECAA and ABB Optical Group announce expansion of strategic vendor partnership to include lab services and specialty vision products. News release. August 18, 2025. Accessed August 19, 2025. 

https://abboptical.com/about-us/pressroom/8_18_2025

Looking for a lab? ABB Optical Group. Accessed August 19, 2025. 

https://info.abboptical.com/abb-labs-lab-awareness

Membership options. Professional Eye Care Associates of America. Accessed August 19, 2025. 

Now, PECAA Max members will have access to ABB’s independent lab network and comprehensive portfolio of premium and proprietary lenses.

PECAA, ABB Optical Group partnership expands to optical lab services, specialty vision products

A recent study assessed the association between exposure to green space and dry eye. According to first coauthors Weijing Cheng, MD, and Hanyou Wu, MD, greater 10-year green space exposure was associated significantly with lower odds of development of dry eye.

Cheng and Wu are from the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University; and Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.

"Dry eye is closely associated with environmental exposure and presents a significant risk to human visual health and quality of life,"

Previous results have supported that environmental exposure is a culprit, with studies indicating the impact of air pollution and climatic factors. The air pollutants associated with dry eye primarily include particulate matter, nitrogen dioxide, ozone, sulfur dioxide, and carbon monoxide.

 Climatic culprits include temperature, humidity, and sunlight exposure.

They cited a large study that found that the prevalence of dry eye disease is higher among urban residents than those in rural areas.

"Urbanization has resulted in a decrease in green space despite its known positive impact on public health. Studies have demonstrated that green space exposure can mitigate the prevalence of mental health disorders, including anxiety, depression, and sleep disturbances, all of which are recognized risk factors for the onset of dry eye.

 Furthermore, studies have also reported that exposure to green spaces has positive effects on eye health, such as reducing the prevalence of myopia and the incidence of allergic conjunctivitis,"

In light of all the previous research, they wanted to determine if there was a relationship between green space and dry eye.

The study under discussion included 2 parts: a case-control study and a cross-sectional study.

Part 1 included 450 patients with dry eye and 900 controls recruited from electronic health records database. The data were used to investigate the relationship between green space exposure and the occurrence of dry eye.

The cross-sectional segment included 140 patients with diabetes recruited from the community registry in Guangzhou. The data were analyzed to identify an association between green space exposure and quantitative measures of the tear meniscus.

Part 1 included a total of 1350 patients and controls, of whom 59.33% were female. The participants were an average age of 31.07 ± 4.58 years.

The investigators reported that “higher 10-year green space exposure was significantly associated with lower odds of dry eye (OR, 0.96; 95% CI, 0.94-0.97; 

 < .001) after adjusting for age, sex, rainfall, temperature, particulate matter, and other factors.

Part 2 comprised 140 patients with diabetes, of whom 53.57% were women. The average patient age was 64.48 ± 8.19 years. In this group, the investigators found that “greater 10-year green space exposure was associated with a higher tear meniscus area (β = 0.07; 95 % CI, 0.02-0.11; 

 = .007) after adjusting for the same factors as in Part 1.

In commenting on their findings, the authors explained the significant public health implications of their results, specifically that “the potential protective effect of green space exposure on dry eye warrants consideration. Disparities in access to green space between urban residents in developed and developing countries are stark, with the latter having access to only one-third of the green space available to the former.

 This research underscores the need to enhance urban planning and management, improve urban spatial organization, and promote the equitable distribution of green space. Furthermore, future research on conditions such as dry eye should account for the potential influence of green space exposure.”

They continued, “Our research identified a negative relationship between green space exposure and dry eye. Urban planning decisions should thoroughly incorporate the design and functionality of green space to offer effective measures for preventing dry eye.”

Cheng W, Wu H, Wang Z, Liang L. Association between long-term green space exposure and dry eye in China. 

https://doi.org/10.1016/j.apjo.2025.100165

Moss SE, Klein R, Klein B. Prevalence of and risk factors for dry eye syndrome. 

 Economic and humanistic burden of dry eye disease in Europe, North America, and Asia: a systematic literature review. 

Lu C-W, Fu J, Liu X, et al. Impacts of air pollution and meteorological conditions on dry eye disease among residents in a northeastern Chinese metropolis: a six-year crossover study in a cold region. 

Yu D, Deng Q, Wang J, et al. Air pollutants are associated with dry eye disease in urban ophthalmic outpatients: a prevalence study in China. 

Um SB, Kim NH, Lee HK, et al. Spatial epidemiology of dry eye disease: findings from South Korea. 

Mo Z, Fu Q, Lyu D, et al. Impacts of air pollution on dry eye disease among residents in Hangzhou, China: a case-crossover study. 

Hwang SH, Choi Y, Paik HJ, et al. Potential importance of ozone in the association between outdoor air pollution and dry eye disease in South Korea. 

Tandon R, Vashist, Gupta N, et al. Association of dry eye disease and sun exposure in geographically diverse adult (≥40 years) populations of India: The SEED (sun exposure, environment and dry eye disease) study - Second report of the ICMR-EYE SEE study group. 

Chen B, Wu S, Song Y, et al. Contrasting inequality in human exposure to greenspace between cities of global north and global south. 

Peng BA, Naduvilath TJ, Flitcroft DI, et al. Is myopia prevalence related to outdoor green space? 

Yang Y, Chen W, Xu A, et al. Spatial technology assessment of green space exposure and myopia. 

Lin L, Chen Y, Wei J, et al. The associations between residential greenness and allergic diseases in Chinese toddlers: A birth cohort study. 

Klohe K, Koudou BG, Fenwick A, et al.A systematic literature review of schistosomiasis in urban and peri-urban settings. 

Research reveals that increased exposure to green spaces significantly reduces the risk of developing dry eye disease, highlighting urban planning's vital role in public health.

Exposure to green space linked to lower odds of dry eye disease development

Nutritional influences on ocular tissue integrity

The retina, particularly the macula, is one of the most metabolically active tissues in the body. Its constant exposure to light and oxygen makes it uniquely susceptible to oxidative damage. Nutrients such as lutein, zeaxanthin, and meso-zeaxanthin are selectively concentrated in the macula, where they filter harmful blue light and neutralize reactive oxygen species. Lutein and zeaxanthin are not synthesized by the human body and must be obtained from dietary sources. Meso-zeaxanthin, while less common in foods, can be synthesized in the retina from lutein.¹ Clinical trials, most notably the Age-Related Eye Disease Studies (AREDS and AREDS2), have demonstrated that appropriate levels of these antioxidants can slow the progression of intermediate to advanced age-related macular degeneration (AMD).²

Antioxidants also play a broader role across ocular structures. Vitamin C contributes to collagen synthesis in the cornea and supports the integrity of the sclera and conjunctiva. Vitamin E, a lipid-soluble antioxidant, protects photoreceptor cell membranes from peroxidative damage. These nutrients, along with zinc—a trace element essential for enzymatic antioxidant activity in the retinal pigment epithelium—comprise the foundational elements of many evidence-based ocular supplements. Together, they help maintain tissue resilience in the face of oxidative and inflammatory insults.²

Diet, inflammation, and disease progression

Chronic low-grade inflammation is a shared feature of many ocular diseases, including AMD, glaucoma, diabetic retinopathy, and dry eye. Diets rich in refined carbohydrates, saturated fats, and ultraprocessed foods contribute to systemic inflammation and glycemic volatility, which exacerbate endothelial dysfunction and neurovascular compromise in the eye. Conversely, diets high in fiber, phytonutrients, and healthy fats support anti-inflammatory pathways and improve metabolic control.

In the context of diabetic eye disease, for example, the role of nutrition extends beyond glucose management. Nutritional strategies that emphasize low glycemic index foods, w-3 fatty acids, and polyphenol-rich fruits and vegetables can reduce vascular permeability and oxidative stress in the retina. This adjunctive approach is particularly valuable in the early stages of diabetic retinopathy, when retinal changes may precede systemic symptoms and present an opportunity for lifestyle-based intervention.

Glaucoma, though classically associated with intraocular pressure, also involves mitochondrial dysfunction and impaired optic nerve perfusion. Nutritional compounds, including coenzyme Q10, magnesium, and B vitamins, have demonstrated neuroprotective potential in both experimental and early clinical models of glaucoma.³ Nitrate-rich vegetables such as spinach and beetroot may influence intraocular pressure through nitric oxide pathways, and epidemiological data suggest that patients adhering to plant-rich, Mediterranean-style diets experience a reduced risk of glaucoma progression.⁴

The role of w-3 fatty acids in ocular surface and retinal health

Essential fatty acids, particularly w-3s such as eicosapentaenoic acid and docosahexaenoic acid (DHA), play a critical role in modulating inflammation, maintaining neural membranes, and supporting meibomian gland function. Clinical studies have demonstrated that w-3 fatty acids can improve tear breakup time, reduce ocular surface inflammation, and enhance patient-reported comfort in those with dry eye disease.⁵ DHA also plays a vital structural role in photoreceptor membranes and may offer retinal neuroprotection.

Despite their importance, w-3s are often deficient in the modern Western diet. Cold-water fish, flaxseeds, and algae-based supplements are among the few reliable sources. In optometric practice, recommending w-3 intake—whether through diet or targeted supplementation—can be a valuable, evidence-based adjunct for patients suffering from dry eye disease, macular degeneration, or even glaucoma.

Nutritional deficiencies and at-risk populations

Certain populations are at an increased risk of micronutrient deficiencies with ocular consequences. Older adults, for instance, may suffer from malabsorption, reduced dietary diversity, or medication-induced depletion of key nutrients. Vitamin A deficiency, though rare in developed countries, remains a concern in cases of malnutrition, chronic liver disease, or bariatric surgery, and can lead to xerophthalmia and night blindness.

Patients with gastrointestinal disorders, restrictive diets, or poor dietary habits may similarly lack key nutrients. For these individuals, a brief dietary assessment conducted during the case history can help identify risk and prompt referral or supplementation. While laboratory testing is not routinely performed in optometric settings, collaboration with primary care providers or integrative practitioners can support a more comprehensive management plan.

While individual nutrients have been extensively studied, dietary patterns may offer more robust protection. The Mediterranean and Mediterranean-DASH Intervention for Neurodegenerative Delay diets, both rich in plant-based foods and healthy fats, and low in processed items, have been associated with reduced risk of AMD and cognitive decline.⁶ These benefits likely stem from synergistic interactions between dietary components, rather than the isolated effects of any single vitamin or mineral.

Emerging research implicates gut dysbiosis—an imbalance in intestinal microbial communities—in the pathogenesis of several ocular conditions, including uveitis, glaucoma, and AMD.⁷ This suggests that gut health may influence immune-mediated and neurodegenerative pathways relevant to vision. Foods rich in prebiotics, probiotics, and polyphenols are being investigated for their role in reducing systemic and ocular inflammation.

Clinical integration in optometric practice

Integrating nutritional awareness into optometric practice does not require becoming a dietitian. A few simple shifts—such as asking patients about their typical diet, recommending ocular-supportive nutrients, or providing handouts on food sources of key vitamins—can add value to routine care. Educating patients about the impact of nutrition on their eye health increases adherence, improves outcomes, and fosters a more holistic patient-provider relationship.

Moreover, nutrition-focused conversations often resonate with patients who are motivated to take a proactive role in their health. As lifestyle-related diseases continue to rise, the optometrist’s role as a frontline wellness provider becomes more relevant.

Nutrition is not ancillary to eye health—it is foundational. As research continues to uncover the biochemical, vascular, and immunologic links between diet and vision, it is imperative that optometrists become conversant in nutritional strategies that support ocular wellness. From the prevention of disease to the preservation of visual function and the management of chronic ocular conditions, nutrition offers a powerful means to protect sight and improve patient quality of life. By embracing a more integrative model of care, optometrists can lead the way in promoting not only clearer vision but also healthier lives.

Meagher KA, Thurnham DI, Beatty S, et al. Serum response to supplemental macular carotenoids in subjects with and without age-related macular degeneration. 

. 2013;110(2):289-300. doi:10.1017/S0007114512004837

Age-Related Eye Disease Study 2 Research Group.Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. 

. 2013;309(19):2005-2015. doi:10.1001/jama.2013.4997

Loskutova E, Shah K, Flitcroft I, Setti A et al. Lutein and zeaxanthin: the possible contribution, mechanisms of action and implications of modern dietary intake for cognitive development in children. 

Kang JH, Willett WC, Rosner BA, Buys E, Wiggs JL, Pasquale LR. Association of dietary nitrate intake with primary open-angle glaucoma: a prospective analysis from the nurses' health study and health professionals follow-up study. 

. 2016;134(3):294-303. doi:10.1001/jamaophthalmol.2015.5601

Epitropoulos AT, Donnenfeld ED, Shah ZA, et al. Effect of oral re-esterified omega-3 nutritional supplementation on dry eyes. 

. 2016;35(9):1185-1191. doi:10.1097/ICO.0000000000000940

Meuer SM, Myers CE, Klein BEK, et al. The epidemiology of vitreoretinal interface abnormalities as detected by spectral-domain optical coherence tomography: the beaver dam eye study. 

. 2015;122(4):787–795. doi:10.1016/j.ophtha.2014.10.014

Zinkernagel MS, Zysset-Burri DC, Keller I, et al. Association of the intestinal microbiome with the development of neovascular age-related macular degeneration. 

Nutrition is not ancillary to eye health—it is foundational.

The importance of nutrition in the preservation of visual function and the prevention and management of eye diseases

A recent longitudinal prospective study revealed that electroretinography (ERG)/pupillometry outperforms structural imaging in identifying patients at the highest risk of progressing to vision-threatening complications over 1 year. The study was published in 

and provided a post hoc analysis of 56 parameters from 4 testing modalities obtained in a multicenter US trial (NCT03197870), according to a news release.

 Eighteen of these parameters were from the RETeval device’s diabetic retinopathy (DR) Assessment protocol, graded by manufacturer LKC Technologies, which was found to be the strongest predictor of DR progression.

“The DR score, based on a combination of ERG and pupillometry, offered the best predictive capability.… These results suggest it is possible to improve the DR staging system, which in turn may enable better allocation of health care resources,” the study authors, led by C. Quentin Davis, PhD, of LKC Technologies, stated.

“This publication is a significant advancement in the quest to identify high-risk patients earlier and improve clinical outcomes,” said Dina Dubey, CEO of LKC Technologies, in the release. “The prospective study included patients with moderate to severe non-proliferative diabetic retinopathy (NPDR) and no center-involved DME at baseline and it revealed that a single number – known as the DR Score – is the most powerful predictor of progression from NPDR to vision-threatening complications, including proliferative diabetic retinopathy, diabetic macular edema, or treatment.”

The trial used in the post hoc analysis for data collection was the prospective, double-masked, randomized, placebo-controlled TIME-2b study that evaluated the safety and efficacy of 48 weeks of subcutaneous AKB-9778 (a Tie2 activator) in patients with moderate to severe NPDR. Every 12 weeks, patients underwent a comprehensive ocular assessment including a dilated slit lamp biomicroscopy, intraocular pressure, dilated indirect ophthalmoscopy, spectral-domain OCT, and 7-field FP. FA was conducted at weeks 0, 24, and 48. ERG/pupillometry, OCTA, and UWF-FA were performed using commercially available equipment at a subset of the 44 sites included in the study based on availability.

The DR Score of 26.9 demonstrated a relative risk of 5.6 for progression to vision-threatening conditions (

<.0001), surpassing other predictors including ultra-widefield fluorescein angiography (UWF-FA), optical coherence tomography angiography (OCTA), and fundus photography (FP). Comparatively, the UWF-FA total ischemia index ≥ 0.125 had a relative risk of 5.3 (

<.0001), the OCTA foveal avascular zone area ≥ 0.295 mm

<.05), and the fundus photograph-based diabetic retinopathy severity scale ≥ 27 had a relative risk of 2.1 (

<.05), each still proving statistical significance.

“There is mounting evidence that DR's effects on retinal neurons occur earlier and can progress somewhat independently of changes in retinal vasculature,” the study authors stated. “Thus, it is likely that combining measures of neuronal function with structural vascular information should enhance prediction of DR progression.

“This research suggests that the ERG provides value in defining how DR is staged and monitored, supporting mounting evidence that functional changes in the retina can precede observable vascular abnormalities,” said Mitchell Brigell, PhD, one of the study authors, in the release. “The findings clearly show the value of integrating objective functional testing into the management of diabetic retinopathy. This is also reflected in the inclusion of ERG in the American Academy of Ophthalmology’s Preferred Practice Pattern Guidelines for Diabetic Retinopathy.”

Limitations of the study include its unequal number of subjects across modalities, with fewer eyes tested with OCTA, UWF-FA, and ERG/pupillometry than FP due to equipment availability, in addition to the binary classification of high or low risk, according to study authors.

 “Thus, performance differences may reflect sampling variation, although the reported uncertainties account for differences in sample size,” the authors stated.

Study identifies RETeval DR Score as the strongest predictor of diabetic retinopathy progression. LKC Technologies. August 4, 2025. Accessed August 12, 2025.

Davis CQ, Waheed NK, Brigell M. Predicting progression to vision-threatening complications in diabetic retinopathy. 

2025;5(6). doi:10.1016/j.xops.2025.100859

Data used in the post hoc analysis were from 56 parameters from 4 testing modalities obtained in a multicenter US trial (NCT03197870).

Study finds electroretinography/pupillometry as strongest predictor of DR progression, vision-threatening complications

 published by Harvard researchers focused on enrollment by veterans who receive benefits from the Department of Veterans Affairs (VA) in Medicare Advantage insurance. While about 10% of veterans enrolled in Medicare Advantage have no Medicare services paid for annually by Medicare Advantage,

Michael Rothschild, OD

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