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Open research questions in Ophthalmology and Visual Impairment Studies

47 unresolved questions extracted from the limitations and future-work sections of 1,015 Ophthalmology and Visual Impairment Studies papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Future research should prioritize multicenter, long-term RCTs comparing spectacle lenses with atropine, orthokeratology, and multifocal contact lenses. Mechanistic studies should clarify the action of novel designs such as CARE and DOT.

    Types of Spectacle Lenses for Myopia Control in Children: A Narrative Review with Quantitative Synthesis · 2026 · DOI

  • The literature cited in the discussion section of this paper does not derive entirely from the results of this bibliometric search. On the one hand, the initial key- words may have led to certain omissions during the screening process; on the other hand, these discus- sions were written by our team based on the results of this bibliometric search, combined with our assess- ment of future professional trends. Furthermore, our assessment and judgment of future trends in MMFL may be influenced by the cognitive limitations of our team.

    Myopia management functional lenses (MMFL): a bibliometric analysis of multidisciplinary perspective and trend insights in the context of vision health · 2026 · DOI

  • To the best of our knowledge, adherence to the AREDS2 recommendations and lifestyle modifications in AMD has not yet been studied in the Turkish population.

    Assessment of Dietary Nutritional Profile in Turkish Patients with Age-Related Macular Degeneration · 2026 · DOI

  • 1. Further studies comparing VA assessed at home with apps to that of Snellen chart at clinic setting can be done. 2. A study involving eyes with various ocular pathologies is suggested. 3. Validation among elderly and VI impaired population is suggested 4. To study cost- effectiveness of WHOeyes as against Routine Camp screening.

    Comparative assessment of visual acuity: ‘WHOeyes’ Versus Snellen chart in a rural setting · 2026 · DOI

  • This study did not include eyes with gross ocular pathologies, may result in underestimation of VI. Possible Measurement Bias due to varying lighting conditions in the field settings. The convenience sampling technique would have likely introduced inherent selection bias. No test- retest assessment was done. Only unaided VA screening was assessed; no clinical refraction confirmation was performed. The study was restricted to single-rural filed practice area which limits generalizability.

    Comparative assessment of visual acuity: ‘WHOeyes’ Versus Snellen chart in a rural setting · 2026 · DOI

  • Advances in high-resolution imaging, electrophysiology, and functional neuroimaging have reported structural and functional differences in the retina and central visual pathways that may be detectable early during myopia development; however, evidence that such alterations consistently precede refractive error remains limited, and causal direction is not fully established.

    Neuro-ophthalmic review on pediatric myopia: Advancing from refraction to a brain-centric model of axial growth · 2026 · DOI

  • The aim of this study was to explore outcomes of telehealth; therefore, patient and clinician perspectives were not explored. A limitation of retrospective analysis is that coding was subject to uncertainty in some cases. To avoid potential misrepresentation of results, uncertain cases were identified in the results section and excluded from analysis rather than making assumptions. Another limitation is that the longstanding nature of the service (since 2011) means that prospective pre- and post-implementation comparison within the same setting was not possible. Therefore, variations in demographics and service delivery models were described within the case study to provide context. Patients were triaged to telehealth or face‑to‑face care based on clinical details provided in the referral. This potential selection bias may have contributed to the observed differences in attendance rates and wait times. Collaborative telehealth would be valuable for underserved communities or any system where the current needs are unable to keep up with demand. However, the findings in the current study may not be generalisable to less resourced or urban settings. Therefore, implementation in different settings would require careful consideration of contextual factors.

    Improving Access and Reducing the Burden on Public Ophthalmology: Collaborative Telehealth Models Between Ophthalmology and Optometry in Australia · 2026 · DOI

  • International Journal of Current Pharmaceutical Review and Research 160 International Journal of Current Pharmaceutical Review and Research e-ISSN: 0976-822X, p-ISSN: 2961-6042 One of the limitations of the present study was, it did not comprehensively account for other variables that could influence ACA and AL, such as lens thickness, corneal curvature, systemic diseases, or medication use.

    Normative Distribution of Axial Length and Anterior Chamber Angle Parameters in an Adult Healthy Population · 2026 · DOI

  • their function and https://doi.org/10.1016/j.jcjo.2025.12.018 ISSN 0008-4182 © 2026 The Authors. Published by Elsevier Inc. on behalf of Canadian Ophthalmological Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) 613 Downloaded for Anonymous User (n/a) at Kirikkale University from ClinicalKey.com by Elsevier on June 04, 2026. For personal use only. No other uses without permission. Copyright ©2026. Elsevier Inc. All rights reserved. D 1 X 2 X X D 3 X 4 X X D 5 X 6 X X D 7 X 8 X X Can J Ophthalmol Volume 61, Number 3, June 2026 necessitating a holistic approach to identifying barriers and solutions in accessible design.4 the relevant Despite the responsibility of eye care clinics to design spaces that are accessible for patients with visual impairment, there remains a notable gap in the literature, as few studies have explored accessibility through the lens of lived patient experien- ces. Of studies, most occurred in hospital settings.5(cid:1)8 Dr. Lisa Iezzoni and Dr. Bonnie O’Day conducted a study in 2004 that assembled focus groups with patients who have low vision and blindness. This study identified key barriers to high-quality care: respect, communication, physical access, and information.9 More recently, Dr. Iezzoni’s team surveyed 75 ophthalmologists in the United States on their use of 2 accessi- bility features: verbally describing the examination room to patients and providing large-font printed materials.10 They dis- covered that while 24% of ophthalmologists provided both of these measures, 47% only offered one, and 29% provided nei- ther, revealing a deficiency in accessible designs for visually impaired patients when accessing vision care. In this study, we follow in the footsteps of their work completed over 2 decades ago to again bring accessibility into the spotlight, integrating new themes and current technologies. We interviewed patients with severe visual impairment to elicit their experiences of obtaining eye care services with the aim toward identifying challenges and opportunities for improved design.

    Patient perspectives on clinical environment accessibility: a qualitative study in severe vision loss · 2026 · DOI

  • This study has several limitations. Both NHANES and KNHANES used noncycloplegic refraction. Although the lack of cycloplegia may introduce some misclassification of refractive error in younger participants, this is unlikely to materially affect the main findings. In the Beaver Dam Offspring Study, the mean difference between cycloplegic and noncycloplegic refraction in 40 to 49 year-old myopes was 0.3 D and >60 years of age was just 0.03 D. 42 Recent work in various populations has also demonstrated that the difference between noncycloplegic and cycloplegic refraction is lowest among myopes, and particularly older myopes, with those aged ≥60 years having a difference of 0.07 D. 43,44 The cross-sectional design precludes direct causal inference and limits assessment of longitudinal changes in visual impairment risk. As with the Kaplan—Meier curves presented in Tideman et al, 16 the Kaplan—Meier curves in Figure 2 should be interpreted as estimates of the cumulative probability of visual impairment at a given age, that is prevalence, rather than incidence because the underlying data are cross-sectional. In addition, the direct cause of visual impairment was not assessed; hence, the results represent the associations be- tween myopia, sex, age, and visual impairment of all causes. Axial length was not measured for either the NHANES or KNHANES and as such the relationship between axial length and vision impairment could not be determined. It has, however, been shown that most myopia is axial in na- ture and in this case, SER is likely a reasonable surrogate for axial length. 16 Other unmeasured environmental, genetic, or phenotypic factors that may modify susceptibility to visual impairment in the presence of myopia may have contributed to the observed regional differences. Choroidal thickness, which was not measured in the NHANES and KNHANES surveys, has been identified as an independent risk factor for myopia-related pathology, 45 but little data exists regarding regional differences in this parameter. considerations may Alternatively, methodological contribute, including differences in the distribution of high myopia between surveys. The greater representation of individuals with very high myopia in KNHANES may accentuate effects at the upper end of the refractive error spectrum. Despite this variation, the existence of a consistent, dose—response relationship between myopia and visual impairment in both surveys supports the conclu- sion that myopia-related risk of visual impairment is a robust and generalizable concept across populations. Differences in survey methodology, examination protocols, and population characteristics between the 2 countries may have influenced comparisons. Visual acuity assessment differed between NHANES and KNHANES, which may in- fluence absolute estimates of visual impairment and should be considered when interpreting intercountry comparisons. The NHANES used a letter-based chart integrated into an autor- efractor, whereas KNHANES employed a logMAR chart with numeric optotypes. Differences in optotype design, chart characteristics, and testing conditions are known to produce systematic variation in measured acuity. Such methodological differences could contribute to observed intercountry Moore et al • Myopia and Vision Loss by Age and Sex differences in vision impairment, particularly at higher levels of myopia. Accordingly, intercountry comparisons should be interpreted cautiously. However, these differences are unlikely to explain the consistent within-country patterns observed across refractive error severity, age, or sex. Finally, unmea- sured confounding factors such as socioeconomic status, ac- cess to eye care, or comorbid health conditions may also have contributed to observed differences.

    Global Patterns of Myopia, Age, Sex, and Vision Loss: A Comparative Analysis of US and South Korean National Surveys · 2026 · DOI

  • 20 mm/year for good response) does not account for age-dependent physiological eye growth and may therefore misclassify response in younger versus older children, although this bias is likely to be non-differential across groups. (5) The analyses did not account for heterogeneity in treatment response between rapid and slow progressors, as they represent average effects that may mask important sub- group differences.

    Comparison of effectiveness of four myopia control interventions in Chinese children: a real-world retrospective study · 2026 · DOI

  • Although the precise etiological mechanisms remain to be fully elucidated, this phenomenon may result from a confluence of factors, including earlier biological maturation in females (26– 28) and potential sex-related behavioral differences (29–31).

    Combining visual acuity with refraction reduces overestimation of myopia prevalence in school screenings: an age-stratified analysis · 2026 · DOI

  • There are several limitations in this study. Firstly, this study was conducted on two-week-old guinea pigs without intervention and lon- gitudinal observation. Protein expression may change with age. Additionally, longitudinal fundus observation could provide insights into whether this form of high myopia progresses to pathological myopia. Secondly, although our Astray DIA analysis identified a panel of DEPs, these findings require independent validation using robust, targeted methods such as Western blot or parallel reaction monitoring (PRM). Subsequent studies should prioritize validating these candidate biomarkers and proceed to functionally verify their roles in spontane- ous myopia through perturbation experiments. Thirdly, the choroid and sclera are critical sites where many myopia-related biological processes occur. Since our study provided only retinal and plasma proteomic data, further research is warranted to explore the protein profiles in the cho- roid and sclera in spontaneous myopia. The datasets presented in this study can be found in online reposi- tories. The names of the repository/repositories and accession number(s) can be found in the article/Supplementary material.

    Proteomic profiling of spontaneous myopia in guinea pigs · 2026 · DOI

  • In the SITA Fast and Faster group, results were mixed: some studies suggested GT metrics could complement conventional reliability parameters, while others concluded that GT quantitative metrics did not offer clinically meaningful insights beyond existing methods.

    Quantifying Gaze Tracking for Visual Field Reliability Estimation. A Systematic Review · 2025 · DOI

  • Even designers are not immune to ignoring CVD; “Out of the many vision-based disabilities out there, it is the most common behind nearsightedness and farsightedness, it is the most under-reported, and it’s among the least likely to be corrected” (Purcell, 2020, para.

    Inclusion Over Exclusion: An Educators’ Guide to Creating Colourblind-Friendly Materials · 2024 · DOI

  • Workforce Innovation and Opportunity Act emphasizes promoting high-quality, competitive employment for people served by vocational rehabilitation (VR), but few studies have assessed VR consumers’ job quality.

    What Predicts Job Quality of Vocational Rehabilitation Consumers Who Are Blind or Have Low Vision? · 2021 · DOI

  • Despite the evidence of greater recogni- tion of the necessity to organize company- world purchasing efforts more effectively: (a) one third of questionnaire respondents indicated that no attempt had been made thus far to co-ordinate their company-world procurement; (b) a further third suggested that their co-ordination action was limited to an unstructured information exchange largely on an ad hoc basis.

    Purchasing Myopia · 1973 · DOI

  • In early childhood education, there is a growing concern with the "undifferenj], ated rejection of past theory and practice in favor of poorly defined innovation with un- realistic promise of rapid remedy [Minu- chin, Biber, Shapiro, & Zimilies, 1969, p.

    Changing Public Attitudes toward Blindness · 1972 · DOI

  • 011), whereas other correla- tions were sparse and mostly neutral to weakly positive (Fig.

    Inner retinal structure and intraocular pressure in children with obesity · 2026 · DOI

  • Background: Interocular asymmetry of axial elongation predicts accelerated myopia progression in adults, but childhood prevalence and dynamics are uncharacterised, with no standardised metric.

    Quantifying interocular asymmetry of axial elongation in childhood myopia: metric framework, prevalence, and age-related dynamics · 2026 · DOI

  • The magnitude and short-term recovery of residual objective myopic bias after a brief, clinically plausible over-minus exposure during distance refraction remain insufficiently quantified.

    Short-Term Residual Myopic Bias Measured by Open-Field Autorefraction After 10-Second Myopic Overcorrection in Young Myopic Adults · 2026 · DOI

  • In Malaysia, where refractive services are divided between the public and private sectors, limited data exist on how eye care professionals implement cycloplegic refraction in paediatric practice.

    Paediatric refraction practices: access to cyclopegia, barriers, and disparities among eye care professionals in Kuala Lumpur · 2026 · DOI

  • There is limited evidence on childhood visual impairment in Ghana; this study therefore reports the prevalence and determinants of visual impairment in a community-based sample from the Ashanti Region of Ghana.

    Prevalence of visual impairment and associated risk factors: a cross-sectional community-based study among children and adolescents in Ghana · 2026 · DOI

  • Future research should focus on validating this model in multi-ethnic longitudinal cohorts to further pave the way for precision ophthalmology.

    Unveiling the non-linear synergistic effects of smoking and aging on cataract-AMD comorbidity: an explainable artificial intelligence approach · 2026 · DOI

  • Discussion: Employers’ strong implicit bias toward sighted and competence may reflect their limited knowledge about blindness and lack of opportunities to interact with blind people.

    Professionals’ Implicit Attitudes about the Competence of People Who are Blind · 2019 · DOI

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47 open questions have been extracted from the limitations and future-work passages of 1,015 Ophthalmology and Visual Impairment Studies papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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