Select articles from the OVP14-1 Journal

The latest editorial in Optometry & Visual Performance tackles a unique clinical challenge: the intersection of severe dry eye and assistive communication in patients with ALS. For these individuals, eye-controlled speech devices are often their only remaining link to the outside world. However, when ocular surface issues inevitably arise—whether from the neurodegenerative process itself, reduced blink rates during intense screen time, or drying side effects from medications like baclofen—these essential tracking devices fail. The authors share some fantastic clinical insights, specifically detailing how fitting advanced-stage ALS patients with scleral contact lenses stabilized their ocular surface enough to allow 4 to 18 hours of comfortable device use per day. It is a highly worthwhile read that reinforces exactly why optometric care is such a vital component of interdisciplinary neuro-rehabilitation.

The latest work from Kenneth Ciuffreda and his team in Optometry & Visual Performance provides a deep dive into the objective quantification of oculomotor function, specifically focusing on the nuances of fixational stability and saccadic dynamics. Rather than relying solely on traditional clinical observations, the authors emphasize the role of advanced eye-tracking technology to bridge the gap between subjective symptoms and measurable neuro-optometric data. The article is particularly valuable for those of us integrated into neuro-rehabilitation, as it details how subtle dysfunctions in micro-saccades and pursuit movements—often missed in a standard exam—can serve as critical biomarkers for mild traumatic brain injury (mTBI) and other neurological conditions.

This review by DeStefano et al. delineates the diagnostic criteria and suspected pathophysiology of Visual Snow Syndrome (VSS), a condition characterized by a continuous, pan-field “static” or “snow” appearance. The authors differentiate VSS from typical entoptic phenomena and migraine auras, noting that while comorbid with migraine in many cases, VSS represents a distinct neurological profile. Current research suggests a core mechanism of cortical hyperexcitability, particularly within the lingual gyrus and the larger visual associative cortex. The article details the clinical presentation of secondary symptoms, such as palinopsia, nyctalopia, and enhanced entoptic phenomena, while examining the current lack of a standard pharmacological “cure.” Instead, the focus is placed on the potential for neuro-optometric rehabilitation and filter-based interventions to modulate the sensory processing of these patients.

This article by Squier et al. evaluates the outcomes of a one-year pilot program designed to integrate social work services within an established low vision clinic. Recognizing that visual impairment frequently coincides with significant psychosocial challenges—including depression, loss of independence, and navigation of complex social benefits—the study examines how a multidisciplinary approach addresses the “non-visual” barriers to successful rehabilitation. The authors detail the logistical framework of the pilot, the types of interventions provided (such as counseling and resource coordination), and the qualitative feedback from both patients and clinical staff. The findings suggest that on-site social work support not only improves patient follow-through with low vision device training but also mitigates the emotional distress that often hinders a patient’s transition to using compensatory visual strategies.