A rapid fire look at research presented at AAOpt26

AAOpt26’s research symposium brought hundreds of presenters to the exhibit hall to discuss their latest projects. Optometry Times spoke to a few of this year’s presenters, who shared their findings on pediatric dry eye, chromatic aberration-reducing lenses, scleral lens fitting-induced edema, and vision therapy for intermittent exotropia treatment.

Pediatric meibomian gland dropout

Elaine Chen, OD, FAAO, FSLS, DipAAO, and Rima Khankan, MS, PhD, presented 3 posters detailing their findings from a cross-sectional study on pediatric dry eye. Using the JENVIS grading scale, the group found that a large portion of the cohort had meibomian gland dropout, particularly in the lower lid. Chen describes pediatric dry eye as a challenging, new field as children can’t put their symptoms into words the way adults can. “There is definitely changes in morphology in meibomian glands that we’re seeing in kids and, for me, I was very surprised at how much potential gland loss there is … and I think the takeaway for optometrists is to look for dryness in young kids,” Chen stated.

Khankan gave a lecture at AAOpt26 on the distribution and severity of meibomian gland dropout in children. The team is working on validating a scale to allow pediatric patients to report their dry eye symptoms, called the PED-DEQ. The group also hopes to conduct a longitudinal follow-up with their pediatric cohort to assess the cause of meibomian gland dropout. “We don’t have a baseline, so we don’t know if this dropout of the gland is actually due to normal developmental variations, … physiological, behavioral, or if it’s … part of the pathology [of] MGD or dry eye,” Khankan noted. The group is also looking to develop a normative data set for pediatric patients.

Reducing chromatic aberration in progressive lenses

Marcos García Ortega, MSc, presented the findings from IOT Lenses’ recent study “Polychromatic optimization of ophthalmic lenses for chromatic aberration reduction.” The study examined progressive lenses with and without IOT Lenses’ chromatic aberration reduction (CAR) technology, compared across materials typically used in optics. The study also examined CAR’s effectiveness across a range of prescriptions. “What we could find is that in longitudinal chromatic aberration, we could see a significant reduction of chromatic aberration towards the sides of the lenses,” Ortega stated. In a small feasibility study, Ortega reported that wearers rated the lenses with comparable scores to premium progressive lenses on the market.

Scleral lens wear and edema formation

Obinwanne Chukwuemeka Jr, OD, MOptom, DipAAO, FAAO, FLVPEI, FSLS, presented his poster titled “Impact of short-term non-fenestrated scleral lens wear on the mean limbal cornea epithelial thickness.” This study examined a cohort of 10 participants and found that scleral lens wear caused mild epithelial swelling, or edema, at the inferior limbus.

Chukwuemeka recommends that optometrists examine the limbus, in addition to the central cornea, when fitting scleral lenses. He also suggests performing imaging with anterior segment OCT in addition to staining with fluorescein. “Don’t just look at the central cornea when you fit scleral lenses. You also need to look at the limbus and find out what’s going on there,” Chukwuemeka noted.

He also discussed his future plans for research in scleral lenses, including scaling up his study to examine a larger cohort. In broader eye care research, he hoped to see more developments in accessibility. “I [would] like to see more of the gadgets and devices that we have nowadays translate to the people who actually need them in low-income countries, making a change and impacting quality of life [for] those people … from research to bedside,” Chukwuemeka stated.

Vision therapy for intermittent exotropia

Angela Chen, OD, MS, FAAO, and Erin Jenewein, OD, FAAO, DipAAO, represented the pediatric intermittent exotropia study group, where they presented 2 posters. Their posters shared the results of a randomized 20-week clinical trial examining office-based vergence, accommodative, and antisuppression therapy. According to Chen, the researchers wanted to see if vision therapy led to increases in patient’s ability to control their exodeviation. Their study found significant improvement in the distance IXT control score in the vision therapy group, compared to the control. “There's actually no randomized clinical trial done in the United States to look at the effectiveness of this treatment, so we're happy that we're able to show that there is actually evidence to support what we do in clinic,” Chen said.

Their study also looked at secondary outcomes, including vergence function, positive/negative fusional vergence at distance and near, vergence facility, near point of convergence, and suppression. They found that all domains improved in the vision therapy group. Jenewein highlighted that their data provides evidence that vision therapy is an effective treatment for intermittent exotropia.