Mei Ying Boon

Purpose: Previous research has reported a significant effect of refractive defocus on the correct identification of red signals. The purpose of this study is to investigate the effects of both refractive defocus and non-refractive defocus (using Bangerter filters) on the perception of rail signals using the Railway LED Lantern Test (RLLT). The RLLT is the simulated practical test nominated in the Australian National Standard for Health Assessment of Railway Safety Workers. Method: Participants were 19–59 years old, and the best corrected visual acuity (BVCA) was required to be no worse than 6/9 binocularly. Subjects with current or active ocular conditions were excluded, and sufficiency in English was required. Best corrected refraction, visual acuity and colour vision were assessed. Participants carried out the RLLT binocularly under five conditions: best corrected, +0.50 DS, +0.75 DS and Bangerter filters 1.0 and 0.8. Results: Ten male and 10 female subjects completed the study; age range 20–25 and mean age 22.4 ± 1.1 years. BVCA was 6/6 (logMAR 0.0 or better). Errors occurred far more often with red than with yellow or green ( p < 0.0001) and with Bangerter filter blur more than refractive blur ( p < 0.0001). Failing to see a red signal, rather than misnaming the red as yellow or green, was the predominant error ( p < 0.0001) and was induced far more frequently by Bangerter filters than refractive blur ( p < 0.0001). This error was far more common than miscalling red as yellow ( p < 0.0001) (paired t -tests). Conclusion: These findings suggest that a large proportion of errors are due to not seeing the red signal rather than miscalling the red as yellow or green. Non-refractive blur was found to cause a greater increase in colour errors.

To investigate how refractive imbalance affects binocular vision parameters, reading performance, and vision-related reading difficulty symptomatology after short periods of reading with different simulated ophthalmic lens power conditions in expert adult readers. Eighteen adult participants (18-35 years of age) were recruited. They were expert readers, defined as currently studying, or previously studied to, at least a bachelor's degree tertiary education level. Refractive imbalance conditions were simulated by placing -2.00, -1.00, 0.00, +1.00, and +2.00 diopters (D) ophthalmic lenses in front of the dominant eye over their full refractive error correction. For each condition, participants were required to read sets of three paragraphs from the background section of an academic journal paper, after which reading comprehension, reading speed, symptomatology, visual acuity, and binocular vision status were assessed for each set through refractive imbalance conditions. A significant reduction of binocular visual acuity was observed for distance (+2.00 D condition) and near (±2.00 D conditions) viewing distances. The greater the refractive imbalance stimulus provided to the dominant eye monocularly, the more underfocused the binocular accommodative response. Simulated refractive imbalance did not affect reading speed and comprehension. Stereoacuity and subjective vision-related reading difficulty symptoms worsened with increased absolute refractive imbalance. Simulated refractive imbalance did not affect reading performance for the short reading task but resulted in statistically significant reductions in clarity, increased binocular difficulties, and visual discomfort. During reading, full correction of refractive imbalance is beneficial and recommended.

The possibility that changes in blue-yellow visual thresholds and some retinal thickness measures in children with diabetes mellitus may be observed before any visible fundus changes points to the possibility of these measures being a useful predictor that the risks of diabetic retinopathy are higher in some children than in others. Previous studies showed mixed results on chromatic and achromatic contrast sensitivity early in the course of diabetes mellitus, and the findings of these studies may have been influenced by a lack of experimental sensitivity to visual deficits, a bias towards tritan-like errors or the cognitive demands of the tests and variations in sample composition. The purpose of this study was to evaluate colour and contrast thresholds and retinal thickness in children with type 1 diabetes mellitus compared with age-matched controls. A prospective case-control study was carried out on 9-14-year-old children with type 1 diabetes mellitus (49 cases) and age matched controls (49) in which isoluminant red-green and blue-yellow and achromatic luminance contrast thresholds were measured. Fundus photography was used to grade diabetic retinopathy. Retinal thickness parameters were measured using optical coherence tomography. Data on the duration of diabetes mellitus, glycaemic control (HbA_1c), blood glucose level, body mass index, blood pressure and blood oxygenation at the time of testing were obtained. The cases mostly had poorly controlled diabetes, HbA_1c 8.6% (6.4-12.8%), for an average (range) duration of 5 (0.4-12) years. The cases had significantly higher blue-yellow thresholds (p = 0.02) and greater total retinal and inner retinal thickness (p < 0.05) than controls. No cases had diabetic retinopathy. Within the cases, poorer visual function and systemic health measures were associated with thinner retinal structures and greater global loss volume percentage in the ganglion cell complex. Blue-yellow thresholds of cases were raised compared to normal. Within the cases, higher luminance contrast thresholds were also associated with, mostly, ganglion cell complex reductions.

Access to culturally safe health services is a basic human right, however through the lasting effects of colonisation, oppression, and systemic racism, the individual and community health of Indigenous peoples in Australia and Aotearoa New Zealand have been severely impacted. The Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy of the Australian Health Practitioners Regulation Agency, and the Standards of Cultural Competence and Cultural Safety of the Optometrists and Dispensing Opticians Board of New Zealand, recognise the importance of access to safe health care for Aboriginal, Torres Strait Islander and Māori patients, which encompasses both clinical competency and cultural safety. Universities have an ongoing responsibility to ensure their learning and teaching activities result in graduates being able to provide culturally safe practice. This article highlights the emergence of culturally safe practices in the Australian and Aotearoa New Zealand optometry curricula over the last five years incorporating Indigenous ways of knowing, being and doing into the curricula, understanding the local Indigenous histories and contexts, the adoption of online cultural education modules, and clinical placement partnerships with local Indigenous communities. Whilst there is still much work to do to achieve the goal of graduating culturally safe optometrists, this paper focuses on features that enable or impede progress in the development of culturally safe practices within the optometry programmes to improve eye health equity for Indigenous recognise the diversity of Indigenous cultures across Australia and NZ.

Patients should be able to rely on optometrists and optical dispensers to provide evidence-based answers to their questions on eye protection, including against ultraviolet radiation. Surveys indicate that there is public concern about the need for protection against ultraviolet radiation, particularly in sunlight. This investigation aimed to evaluate the quality of information provided by practitioners in response to typical questions to which they might reasonably be expected to have ready answers. A cross-sectional study was conducted of on-site responses from attendees of a 3 day optical fair, in Sydney, Australia, in 2017. Subjects were not forewarned about the study. The portion of the questionnaire reported here comprised open answers to four questions intended to represent typical enquiries of patients. The questions were about recommendations for ultraviolet protection in the context of 1) computer use, 2) outdoor use, 3) driving and 4) under office lighting. Eighty-three participants returned completed questionnaires out of 140 issued (61% response). The open-answer question responses were grouped into appropriate, borderline (mostly appropriate but mixed with non-UVR related recommendations) and others (mostly non-UVR related recommendations) and by job title. The proportion of appropriate answers to the four questions were 20%, 30%, 12% and 15%, respectively, which did not differ by job title. A significantly higher proportion of optical dispensers than optometrists selected ‘Don’t know/no answer’ for all questions except office use. Eyecare professionals need to be educated on eye protection against UV radiation to improve the quality of information to be given to the public.

Appropriately skilled staff are required to meet the health and care needs of aging populations yet, shared competencies for the workforce are lacking. This study aimed to develop multidisciplinary core competencies for health and aged care workers in Australia through a scoping review and Delphi survey. The scoping review identified 28 records which were synthesized through thematic analysis into draft domains and measurable competencies. Consensus was sought from experts over two Delphi rounds (n = 111 invited; n = 59 round one; n = 42 round two). Ten domains with 66 core competencies, to be interpreted and applied according to the worker’s scope of practice were finalized. Consensus on multidisciplinary core competencies which are inclusive of a broad range of registered health professionals and unregistered aged care workers was achieved. Shared knowledge, attitudes, and skills across the workforce may improve the standard and coordination of person-centered, integrated care for older Australians from diverse backgrounds.

Clinical relevance Tinted lenses may adversely affect colour discrimination. Before recommending tinted lenses to patients, practitioners should bear in mind any effects on colour discrimination. The effects of ‘blue‐blocking’ spectacle lenses with high luminous transmittance on colour vision is not a concern. Background Blue‐blocking lenses have been widely promoted by manufacturers and practitioners. The more blue‐blocking lenses are known to affect colour vision significantly but there has been no study of the effects of ‘blue‐blocking’ spectacle lenses. Methods The transmittances of commercially available lenses were measured and the three lenses with the lowest blue light transmittance were selected. Subjects undertook the following computer‐based colour vision tests: Colour Assessment and Diagnosis; the Cambridge Colour Test; and the Farnsworth‐Munsell 100 Hue Test. Results Blue and luminous transmittances of lenses were documented. The reduction in blue transmittance varied from 12 to 40 per cent (two to 30 per cent compared with an untinted lens). The lenses were found to have no significant, statistical or possibly practical, effect on the results of the three colour vision tests (t‐test, analysis of variance, Mann–Whitney, Kruskal‐Wallis). Conclusion The modest blue light transmittance reduction of the ‘blue‐blocking’ spectacle lenses examined was not sufficient to have a statistically significant effect on colour vision.