Peter M. Allen

Background: Day–night test cricket uses a pink ball that players have reported as less visible than the traditional red ball, particularly at dusk. Around 9% of male cricketers have a colour vision deficiency (CVD), yet how CVD interacts with ball colour and match conditions is unknown. Objective: To investigate the degree to which protanomaly (‘red’ deficiency) and deuteranomaly (‘green’ deficiency) affect the visibility of different coloured balls in professional cricket. Design: Mathematical modelling. Methods: Spectral reflectance of new and old red and pink balls was measured in the laboratory. Spectral measurements of backgrounds and illuminance were gathered during a day–night match at Lord’s Cricket Ground (London, England) at day, dusk and night. Luminance contrast of the ball relative to the background was calculated for each combination of ball, time of day and background surface for a typical observer and for observers with CVD. Results: Across all backgrounds and lighting conditions, ball visibility varied by colour, ball age and observer type, with the old pink ball being the most problematic, particularly for observers with deuteranomaly and typical observers at dusk, and for observers with protanomaly against the crowd and grass. Notably, observers with protanomaly sometimes experienced enhanced contrast, especially against the pitch and dusk sky, where more severe CVD paradoxically improved visibility of the old pink ball. Conclusions: The pink ball may disproportionately affect cricket players with CVD. On balance, the red ball affords the most consistent and equitable visibility across match contexts.

Physical activity levels, hallucination experiences, sleep quality, and perceived stress were assessed using a survey administered to 57 adults with a confirmed diagnosis of Charles Bonnet Syndrome (CBS). Physical activity demonstrated a significant negative correlation with hallucination severity (r = –0.335, p = 0.011, two-tailed). A significant negative correlation was also observed between physical activity and perceived stress (r = –0.497, p < 0.001, two-tailed). In contrast, no significant association was identified between hallucination frequency and sleep disruption or insomnia. These findings suggest that engaging in appropriate levels of physical activity may help reduce the severity of hallucinations and mitigate stress among individuals with CBS. The observation that higher levels of physical activity are associated with reduced hallucination burden may help the development of evidence-based management strategies for CBS. Additionally, the finding that physical activity was significantly related to hallucination severity, whereas sleep disruption was not, merits deeper exploration in future research.

Objectives: To evaluate the efficacy and safety of low concentration atropine eye drops for reducing progression of myopia in children in the UK. Design: Multicentre, double masked, superiority, placebo controlled, randomised trial. Setting: National Health Service hospital eye services and academic institutions at five UK centres. Participants: 289 children aged 6-12 years with myopia between −0.50 and −10.0 dioptres (D). Participants were allocated in ratio of 2:1 to atropine or placebo. Interventions: One eye drop of preserved atropine 0.01% or placebo daily for two years. Main outcome measures: The primary outcome was spherical equivalent refractive error of both eyes measured by autorefractor under cycloplegia after two years. Secondary outcomes included change in axial length, best corrected distance and near visual acuity, reading speed, pupil diameter, spectacle correction, adverse event rates, quality of life, and tolerability. Outcomes were collected every six months. An electronic monitoring system was used to assess adherence. Results: 192 participants were included in the atropine group and 97 in the placebo group, with an average age of 9.3 years (standard deviation (SD) 1.7 years). 207 (72%) reported white ethnicity, 161 (56%) were girls, and the mean level of myopia was −2.87 D (SD 1.71 D). A total of 235 (81%) participants completed the study, with primary outcome data available for 230 (80%) participants: 151 (79%) in the atropine group and 79 (81%) in the placebo group. Atropine eye drops were more effective than placebo in reducing myopia progression (mean difference 0.33 D, 95% confidence interval (CI) 0.17 to 0.49 D, P<0.001). Prespecified subgroup analyses did not show differences according to age, ethnicity, sex, or severity of myopia. Changes in central axial length were significantly less in the atropine group versus placebo group: mean difference 0.14 mm (95% CI 0.07 to 0.21, P<0.001). There were no differences in other secondary outcomes, except pupil diameter, which was greater in the atropine group (0.36 mm, 95% CI 0.17, 0.55, P<0.001), and no differences in frequency of adverse events or in tolerability measures. No serious adverse events were related to the trial drugs. Conclusions: Low concentration atropine (0.01%) eye drops significantly reduced progression of myopia and were well tolerated compared with placebo in children in the UK. Trial registration: ISRCTN registry ISRCTN99883695 , ClinicalTrials.gov NCT03690089 .

Visual discomfort or visual stress is an uncomfortable subjective experience that occurs in response to specific visual stimuli. It affects a large proportion of the population to various degrees, disproportionately impacting those with heightened sensory sensitivities, particularly neurodivergent individuals. We argue that this might stem from a mismatch between the statistical properties of visual stimuli in human-made environments and those in natural environments that the visual system can process efficiently. We discuss the inefficiency with which images with certain spatial, chromatic and temporal characteristics are processed by the visual system and propose a cerebral mechanism to account for the discomfort they induce. The mechanism offers a potential explanation for the large individual differences in susceptibility to discomfort. We highlight two avenues for intervention: (1) environmental modifications aimed at reducing the prevalence of visually stressing stimuli in urban settings, and (2) individual-level strategies, such as personalised optical treatments. Addressing these challenges requires an interdisciplinary effort bridging neuroscience, vision science, interior and urban design and typography to create visually accessible and inclusive environments.

Participation in physical activity (PA) is essential for maintaining health and mobility. Although women, individuals from ethnic minority backgrounds, and people experiencing vision loss are reportedly the least active of their respective identity classifications literature is yet to acknowledge the intersectional nature of group identification, and the ways in which barriers and facilitators to PA might vary or compound in instances of multiple-minority status. Fifteen people with vision loss (six male) from different cultural backgrounds (six White: nine South Asian) were interviewed. Reflexive thematic analysis, underpinned by an interpretivist epistemology and relativist ontology, was used to analyse data. Participants identified neglect at a governmental level as the most significant barrier to PA, producing inaccessible environments that are infrastructurally inequitable. Female South Asian participants’ barriers to PA were nuanced by the intersectionality of their multiple identity positioning (gender, race, and disability). The cultural expectations placed on South Asian women, specifically those pertaining to modesty and gender, limited their capacity to engage in a physically active lifestyle. Comparisons made between the experiences of White and South Asian participants highlighted a lack of acceptance towards disabled individuals in the South Asian community. This study provided insight as to how experiences of inequality intersect and require holistic means of intervention. Governmental bodies and social innovators should strive to create spaces which are architecturally appropriate for people with vision loss, and work with sporting facilities such as gyms to centralise marginalised communities in their design to provide services which are both accessible and culturally viable.

The same dataset can be analysed in different justifiable ways to answer the same research question, potentially challenging the robustness of empirical science1–3. In this crowd initiative, we investigated the degree to which research findings in the social and behavioural sciences are contingent on analysts’ choices. We examined a stratified random sample of 100 studies published between 2009 and 2018, where for one claim per study, at least five re-analysts independently re-analysed the original data. The statistical appropriateness of the re-analyses was assessed in peer evaluations, and the robustness indicators were inspected along a range of research characteristics and study designs. We found that 34% of the independent re-analyses yielded the same result (within a tolerance region of +/- 0.05 Cohen’s d) as the original report; with a four times broader tolerance region, this indicator rose to 57%. Regarding the conclusions drawn, 74% of analyses were reported to arrive at the same conclusion as in the original investigation; 24% to no effects/inconclusive result, and 2% to the opposite effect as in the original investigation. This exploratory study suggests that the common single-path analyses in social and behavioural research should not simply be assumed to be robust to alternative analyses4. Therefore, we recommend the development and use of practices to explore and communicate this neglected source of uncertainty.

Purpose: Fania (Fanny) Kaplan (1890–1918), who was reportedly visually impaired, confessed to the attempted assassination of Soviet leader Vladimir Lenin (1870–1924) in 1918 by shooting him with a pistol. The precise nature of her visual loss is unknown and raises doubts about whether she had sufficient visual function to perform the act. Methods: Historical documents were reviewed. Results: The cause of Kaplan's visual loss is uncertain but occurred following a bomb blast in 1906. If the explosion was the cause, then she most likely had bilateral closed‐globe, blast‐related injuries, perhaps with additional functional visual loss. She reportedly received treatment at a medical centre in Kharkov (now Kharkiv), then led by the prominent ophthalmologist Leonard Girshman (1839–1921). An informal estimate of the minimum visual acuity required to shoot an adult at 10 feet (3 m) with a pistol is approximately 1.2 logMAR (Snellen equivalent 20/320 or 6/96). Conclusions: Based on available historical documents, Kaplan's visual function was most likely sufficient to carry out the assassination attempt, although her visual impairment may have contributed to the attempt being unsuccessful.

Classification in para sports aims to create equitable competition. Footballers with vision impairments are allocated to one of three classes (B1, B2, or B3). This work aimed to understand the effectiveness and inclusivity of the current classification system. Visual acuity (VA) and/or visual field of male and female international footballers was extracted anonymously via the International Blind Sports Federation classification database. The analysis included 562 individuals. Footballers were predominantly male (88.26%); 11.74% were female. Only VA was used to classify 99.11% of footballers, and only 4.50% had visual field included in their classification. VA was nonnormally distributed for all three classes. Only 2.84% of footballers had a VA between 2.10 and 2.60 logMAR, suggesting that VAs in this range and/or visual-field impairment may disproportionately impact performance compared with other footballers within their classes. The current classification system does not appear to be inclusive or create equitable competition.

Athletes with vision impairment (VI) competing in track athletics typically compete in one of three 'classes' based on the severity of their VI. The creation of these classes, however, was arbitrary and not based on evidence. The aim of this study was to investigate the relationship between monocular visual acuity (VA) and sprinting performance in athletes with a VI to establish the optimal cut-off point(s) between competition classes. Historical data including VA and sprinting performance were collected through the International Paralympic Committee's Sport Data Management System. Pearson correlations were conducted to investigate the relationship between VA and sprinting performance. VA was significantly associated with 100, 200 and 400 m race times (r = 0.26; r = 0.26; r = 0.24 [all p < 0.001], respectively). Decision tree analysis suggested splitting data into two classes with a VA cut-off at 2.1 logMAR. Stability assessment confirmed a split into two classes but showed considerable variability in the cut-off points between 2.1 and 3.2 logMAR. A two-class system would provide legitimate competition for athletes with VI in short-distance track athletics. However, other visual functions (e.g. contrast sensitivity) should be considered in future classification research.