Optometric disorders are likely to increase the difficulties experienced by an individual who is struggling to read. There are some reports of a higher incidence of visual abnormalities in children with dyslexia, but there has been little investigation into adults. We therefore investigated the optometric status of a population comprising children and adults with dyslexia. Fifty-four patients (27 with dyslexia, 27 controls) underwent extensive optometric testing. Measurements included visual acuity, cycloplegic refraction, accommodation and binocular vision testing. There was a higher proportion of individuals with dyslexia presenting with optometric problems compared to controls. For children with dyslexia, the most common diagnosis were hypermetropia [far-sightedness] (forty-one percent compared to eighteen percent of the control group) and accommodation insufficiency (thirty-five percent compared to no controls). Untreated optometric disorders were present in both children and adults with dyslexia. The results strongly suggest that an optometric examination should be included in the management of this condition.

Background Lifestyle behaviour in children and adolescents has become increasingly sedentary and occupied with digital work. Concurrently, there has been an increase in the prevalence of headache, neck- and low back pain, which are leading causes of disability globally. Extensive near work and use of digital devices are demanding for both the visual system and the upper body head-stabilizing musculature. Uncorrected vision problems are present in up to 40% of Nordic school children, and a lack of corrective eye wear may cause eyestrain, musculoskeletal pain and headache. The aim of this study was to investigate associations between laboured reading, musculoskeletal pain, uncorrected vision, and lifestyle behaviours in children and adolescents. Methods This was a cross-sectional study with a total of 192 Norwegian school children aged 10–11 and 15–16 years. As a part of a school vision testing program, the children completed an online questionnaire about general and ocular health, socioeconomic status, academic ambition, near work and related symptoms, upper body musculoskeletal pain, and physical and outdoor activities. Results The 15–16-year-olds had a more indoor, sedentary, digital-based lifestyle with higher academic demands, compared with the 10–11-year-olds. Concurrently, reading became more laboured and upper body musculoskeletal pain increased with age. Girls reported more symptoms, higher academic ambitions, and more time spent on schoolwork and reading, compared with boys. Non-compliance in wearing prescribed eye wear (glasses or contact lenses), increased use of near digital devices, and experiencing visual stress (glare) were positively associated with laboured reading and upper body musculoskeletal pain. Conclusions A screen-based lifestyle with high academic demands challenges the ability to sustain long hours of static, intensive near work. Extensive near work tires the visual system and upper body musculature and provokes laboured reading and musculoskeletal pain symptoms. This study emphasizes the importance of regular eye examinations in school children, and the need to raise awareness among children, parents, and school- and health personnel about the importance of optimal vision and visual environment for academic performance and health.

An increasing number of people undergo refractive surgery, and even if the refractive result after surgery is perfect, the outcome is not always successful. Decompensation of binocular vision anomalies is rarely mentioned in reports considering the outcome of refractive surgery. This report presents 4 cases with binocular vision problems after refractive laser surgery. The patients were referred to the eye department of a Norwegian hospital after having received refractive laser surgery. All patients were male adults. For all patients the reason for referral was intermittent or constant binocular diplopia. Examinations were performed according to standard procedures of the hospital eye department. Two patients were diagnosed with decompensated esodeviations; they both had a history of treatment for accommodative esotropia. One patient had unstable binocular vision of unknown cause, and one had a decompensated congenital trochlear nerve paresis. Some binocular vision problems can be foreseen with proper evaluation before surgery. A thorough history and binocular evaluation are recommended before initiating refractive laser surgery.

The purpose of this study was to investigate the effect of optically induced refractive errors on saccade latency and fixation stability.Sixteen healthy, young adults (two males), with normal visual acuity and normal accommodation, performed a saccade task and a fixation task wearing a range of contact lenses (from +3.00 to -5.00 diopters) which induced visual blur and accommodation. The results showed that mean (± standard error) saccade latency was 207 (± 5) milliseconds (ms) and remained stable with both visual blur and accommodation, whereas mean (± standard error) fixation stability was logBCEA 2.48 (± 0.03) (arcmin²) and declined by about 0.09 logBCEA with both visual blur and accommodation.  In healthy adults with normal vision, results indicate that recording of saccade latency can be completed accurately regardless of the moderate refractive errors induced in this study. Fixation stability, on the other hand, degrades slightly with blur and with accommodation.

The purpose was to assess the differences in spherical equivalent refractive error (SER) between cycloplegic autorefraction (1% cyclopentolate), non-cycloplegic autorefraction, and non-cycloplegic retinoscopy measured by experienced optometrists in a population with a high prevalence of hyperopia. Refractive error was measured with the three methods in 111 children aged 7–8 and 10–11 years. Bland-Altman analysis was used to assess the mean of the differences (MD) and the 95% limits of agreement (LoA) between cycloplegic autorefraction and the two non-cycloplegic methods. A mixed effects model was used to investigate the differences between methods by refractive group. Cycloplegic autorefraction gave a significantly more positive SER than both non-cycloplegic retinoscopy (MD = 0.47 D, LoA = -0.59–1.53 D) and non-cycloplegic autorefraction (MD = 0.92 D, LoA of -1.12 to 2.95 D). The mean differences in SER increased with increasing degree of hyperopia [F(4, 215) = 12.6, p < .001], both when comparing cycloplegic refraction with non-cycloplegic retinoscopy and non-cycloplegic autorefraction. Non-cycloplegic retinoscopy and autorefraction result in significantly less positive SER than cycloplegic autorefraction. The wide confidence intervals for the mean difference and limits of agreement are clinically unacceptable and the methods cannot be used interchangeably. Consequently, refraction without cycloplegia would cause misdiagnosis in some children. Even if non-cycloplegic retinoscopy results in narrower limits of agreement, the risk of misdiagnosis is not eliminated by being experienced in carrying out retinoscopy. We show that it is essential to use cycloplegia when refracting children, and in particular to ensure that no hyperope goes undetected.