Bausch + Lomb 13th Edition 2011

NSIGHT Special Edition


One could say that optometry evolves at the speed of light but we know that, in reality, we have to be more pragmatic. Although technology expands our scope at an unprecedented rate and we live in the femtosecond domain, the reality is that, at the coalface of eye care, we still have real patients who demand real things, now. The NSIGHT study—from which this special edition has arisen—had one resounding message: Patients and consumers seek one thing as a priority—Vision.

We owe thanks to Review of Optometry for the editorial space and Bausch + Lomb, sponsors of the NSIGHT study, for the data. This provided the impetus to gather some interesting contributions from some rather interesting people.

The introductory article covers the study design, market surveyed, data analysis and results that this enlightening Needs, Symptoms, Incidence, Global Eye Health Trends (NSIGHT) Study investigated. The rest of this edition is dedicated to articles that drill down into the issues and concepts the study highlighted. The result is a blend of the esoteric and high tech with the practical, anthropological realities that face eye care providers today. The importance of communication, being a good listener, and understanding both the psychophysics of perception and psychology of patients is clear from these in depth analyses.

It's an honor to be involved in this project—all the more so considering the caliber of the people involved. They cover diverse regions and backgrounds, yet all have that critical element of passion for what they do. I am sure you will find their contributions enlightening.

Because "vision" (in the view of the consumer) was such a critical element, a number of contributions delve into the various aspects that such a broad term encompasses.

In "The Sense of Vision," Greg DeNaeyer looks into complex concepts such as visual performance testing, contrast sensitivity, higher order aberrations, neural adaptation and the role they play now and in the future.

Susan Gromacki investigates the modern approach to optimizing vision in astigmats. She looks at the numbers, challenges, limitations and solutions. Astigmatism correction was limited to spectacles until the mid 1900s. Since then, hard lenses, hydrogels and refractive procedures have also been used to correct this malady. Indeed, improvements in soft lens technology allow for great success.

Kathryn Richdale and Nidhi Satiani provide insights on how to enhance your contact lens practice through the use of aspheric designs. They summarize aberrations and the benefits of aspheric designs while providing case histories. Again, we see the scientific and technological prowess that allows high definition vision through precision design and manufacture.

Shehzad Naroo gives spherical aberration (SA) a Quixotic tilt and provides insights into the optics thereof and some clinical manifestations. He walks us through the seemingly complex realms of the various orders of aberrations, tear film and contact lens influences, practical aspects of correction and the effect of scotopic conditions. He stresses that practitioners need to embrace a more detailed visual task analysis for each of our patients.

A panel of experts—Jim Kokkinakis (Australia), Dominick Maino (USA) and James Wolffsohn (UK)— answer questions and provide their clinical and academic perspectives on many aspects of vision, including lenses, multifocals, patient dissatisfaction, kids, sport, night vision, health, comfort and much more. The panel also discusses integrating technology using the multitude of tools at our disposal.

Environment was the third most important aspect the NSIGHT study identified. Jennifer Craig and Alexis Vogt provide their analysis of this wide-ranging concept. Sick building syndrome, air quality, tear film stability, air conditioning, contact lenses, allergy and more are detailed. The effect degradation of the environment can have on quality of life, the management of various factors and resultant satisfaction, are discussed. The increasing demands that modern life places on the eye and its adnexa is an unfortunate side effect of technological advancement. Now, we seek to use technology to try and compensate and improve satisfaction and health.

Kate Johnson (Australia), Thomas Quinn (USA) and Shelly Bansal (UK) consider questions and provide their tailored answers and approach. Again we see regional variances but the essential visual and eye health needs have commonality. The individual approach of the contributors makes one consider the merits of one's own way of saying and doing things. There are many useful 'take-home' tips. Some aspects covered are personalized eye care, relationships, tools, emotions, age, electronic health records, refraction and more.

Sport and its relationship to eye care are well explored by Nick Dash. Considered the second largest industry in the world, sport certainly rates on some scales! A significant proportion of people take part in sporting activities. The effect of vision on sport is detailed, as are specifics such as swimming, contact lenses, age, region, frequency and modality. Some practitioners build very successful sports vision practices and increasingly national and international sporting groups integrate sports vision awareness and training into their structures. Performance is an important consideration. The integration of neurological, psychophysical and technological aspects is a challenging but rewarding sphere of interest.

Dominic Maino pops up again in partnership with Christopher Chase in another feature article; "Asthenopia: A Technology Induced Visual Impairment." They take us on a journey to illustrate how we have evolved as a species and have developed increasing symptoms of asthenopia. They go on to detail causes, symptoms and prevalence and consider treatment and management strategies. They also consider the influence the current swing to 3D TV will have on asthenopia and evolution.

We trust you will enjoy this special edition. It certainly provides food for thought and strategies you can implement right away.