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PURPOSE: To determine the association of gut microbiome diversity and sight-threatening diabetic retinopathy (STDR) amongst patients with pre-existing diabetes. METHODS: A cross-sectional study was performed, wherein 54 participants selected in total were placed into cases cohort if diagnosed with STDR and those without STDR but had a diagnosis of diabetes mellitus of at least 10-year duration were taken as controls. Statistical analysis comparing the gut microbial alpha diversity between cases and control groups as well as patients differentiated based on previously hypothesized Bacteroidetes/Firmicutes(B/F) ratio with an optimal cut-off 1.05 to identify patients with STDR were performed. RESULTS: Comparing gut microbial alpha diversity did not show any difference between cases and control groups. However, statistically significant difference was noted amongst patients with B/F ratio ≥1.05 when compared to B/F ratio < 1.05; ACE index [Cut-off < 1.05:773.83 ± 362.73; Cut-off > 1.05:728.03 ± 227.37; p-0.016]; Chao1index [Cut-off < 1.05:773.63 ± 361.88; Cut-off > 1.05:728.13 ± 227.58; p-0.016]; Simpson index [Cut-off < 1.05:0.998 ± 0.001; Cut-off > 1.05:0.997 ± 0.001; p-0.006]; Shannon index [Cut-off < 1.05:6.37 ± 0.49; Cut-off > 1.05:6.10 ± 0.43; p-0.003]. Sub-group analysis showed that cases with B/F ratio ≥ 1.05, divided into proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME), showed decreased diversity compared to controls (B/F ratio < 1.05). For PDR, all four diversity indices significantly decreased (p < 0.05). However, for CSME, only Shannon and Simpson indices showed significant decrease in diversity (p < 0.05). CONCLUSIONS: Based on clinical diagnosis, decreasing gut microbial diversity was observed among patients with STDR, although not statistically significant. When utilizing B/F ratio, the decreasing gut microbial diversity in STDR patients seems to be associated due to species richness and evenness in PDR when compared to decreasing species richness in CSME.

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Background: Well-being has become a key outcome of health and support services for adults with visual impairment (V.I.). However, there is a lack of consensus on how well-being is conceptualized and assessed in V.I. research, if it is defined at all. A shared understanding of what well-being means in the context of adult V.I. is essential to enable comparison of findings across studies and collaboration between support organizations. Methods: This article reports findings from a series of four online focus groups with adults with V.I. and one with practitioners working in the field of adult V.I. The focus groups explored what participants meant by well-being and which factors impacted their well-being. A total of 17 adults with V.I. and five practitioners took part. A list of all components of well-being, factors that impact well-being, and items in the protective buffer that may mitigate the impact of factors on well-being were extracted from the data. Results: Despite the noted difficulty in defining well-being and disagreement around the extent to which well-being was universal or individual, a preliminary model of well-being emerged from the focus group discussions. The core of well-being reflects an overall feeling of contentment arising from a positive evaluation of how one is feeling, how one is feeling within oneself, and how one is feeling about one's life. Factors relating to balance/equilibrium, health, mood, other people, the self, and a sense of security and purpose can positively or negatively impact well-being. This impact may be mitigated by a protective buffer consisting of one's mood, mindset, ability to cope, resilience, and acceptance. Many items were discussed in multiple roles, e.g., as a component of well-being or factor. Conclusion: This research took a bottom-up approach to explore what well-being means in the context of adult V.I. The role of certain items and the structure of the proposed model of well-being will need to be confirmed in future research with stakeholders across the V.I. sector.

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In his 1872 monograph, Charles Darwin posited that "… the habit of expressing our feelings by certain movements, though now rendered innate, had been in some manner gradually acquired."1 Nearly 150 years later, researchers are still teasing apart innate versus experience-dependent contributions to expression recognition. Indeed, studies have shown that face detection is surprisingly resilient to early visual deprivation,2,3,4,5 pointing to plasticity that extends beyond dogmatic critical periods.6,7,8 However, it remains unclear whether such resilience extends to downstream processing, such as the ability to recognize facial expressions. The extent to which innate versus experience-dependent mechanisms contribute to this ability has yet to be fully explored.9,10,11,12,13 To investigate the impact of early visual experience on facial-expression recognition, we studied children with congenital cataracts who have undergone sight-correcting treatment14,15 and tracked their longitudinal skill acquisition as they gain sight late in life. We introduce and explore two potential facilitators of late-life plasticity: the availability of newborn-like coarse visual acuity prior to treatment16 and the privileged role of motion following treatment.4,17,18 We find that early visual deprivation does not preclude partial acquisition of facial-expression recognition. While rudimentary pretreatment vision is sufficient to allow a low level of expression recognition, it does not facilitate post-treatment improvements. Additionally, only children commencing vision with high visual acuity privilege the use of dynamic cues. We conclude that skipping typical visual experience early in development and introducing high-resolution imagery late in development restricts, but does not preclude, facial-expression skill acquisition and that the representational mechanisms driving this learning differ from those that emerge during typical visual development.

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BACKGROUND CONTEXT: During the radiographic examination, the cranium orientation varies not only individually but also within the same subject, in different imaging sessions. Knowing how changes in the orientation of the cranium influences cervical sagittal alignment during the radiographic examination of the cervical spine can aid clinicians in the accurate evaluation for cervical sagittal alignment in clinical practice. PURPOSE: To radiographically examine the influence of cranium orientation on cervical sagittal alignment during radiographic examination in an asymptomatic cohort. STUDY DESIGN: A prospective radiographic study. PATIENT SAMPLE: Eighty asymptomatic volunteers (mean age, 40.4 years; 50.0% male) were enrolled. OUTCOME MEASURES: Cervical sagittal parameters including the regional slope (C1 slope, C2 slope, C5 slope, C7 slope, and T1 slope), Cobb angle (O-C1 angle, C1-C2 angle, C2-C5 angle, C5-C7 angle, and C7-T1 angle), and cranial/cervical offset (sella turcica tilt [ST tilt] and C2 tilt). METHODS: In all participants, standing lateral radiographs of the cervical spine were taken in 3 forward-gazing positions: anteverted-cranium (AC) position; neutral-cranium (NC) position; and retroverted-cranium (RC) position. Cervical sagittal parameters, including the regional slope, Cobb angle, and cranial/cervical offset, in these 3 positions were statistically compared. RESULTS: The C1 and C2 slopes were anteverted and retroverted in the AC and RC positions, respectively, compared to those in the NC position. The C5 slope, C7 slope, and T1 slope were constant among the 3 positions. In O-C2 and C2-C5, statistically significant differences in the regional Cobb angles were identified among the 3 positions; however, there were no significant differences in the C5-C7 or C7-T1 segments. Cranial and cervical offsets of ST tilt and C2 tilt increased and decreased when the cranium was anteverted and retroverted, respectively. CONCLUSIONS: The current study suggests that the adjustment of the cranium orientation when taking cervical spine radiographs is mainly controlled at the upper cervical spine of the O-C2 segment in an asymptomatic cohort. On radiograph, alignment in the upper cervical segment of O-C2 changes; accordingly, the middle cervical segment of C2-C5 can change during the adjustment of cranium orientation. However, alignment in the lower cervical segment of C5-C7 and the cervicothoracic junction of C7-T1 remains constant. Further, cranial/cervical offset increases and decreases when the cranium is anteverted and retroverted, respectively. Our results can help the accurate evaluation of cervical sagittal alignment on plain radiographs in clinical practice.

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BACKGROUND: This research aimed to identify the clinical profile and risk factors of retinopathy of prematurity (ROP) among "at-risk" newborns treated at a sick newborn care unit (SNCU) located at high altitude in North India, with the intention of contributing to formulate regional and national ROP screening guidelines. MATERIALS AND METHODS: In a prospective observational study from 2021 to 2022, outborn and inborn babies eligible for ROP screening were screened. RESULTS: Total 39/122 screened neonates had laser for Type 1 ROP, and 22/39 (56.4%) had aggressive ROP (AROP). The average birth weight (BW) was 1803.87 g, and the average gestational age was 34 weeks. Respiratory distress, bronchopulmonary dysplasia, sepsis, and apnea were present in 57.3%, 13%, 52.5%, and 25.4%, respectively. Sight-threatening ROP was present in 50% below 28+6 weeks, 27% between 29 and 30+6 weeks, 52% between 31 and 33+6 weeks, and 15% with gestation >34 weeks. Two babies with Type 1 ROP weighed >2 kg and one had AROP. Upon regression analysis, BW <1500 g, gestation <32 weeks, oxygen >48 h, clinical sepsis, total SNCU stay >14 days, continuous positive airway pressure support with oxygen >50%, and >10 days to achieve full feeds were associated with severe ROP. Caffeine to treat apnea and kangaroo mother care reduced ROP. None had short-term unfavorable outcome. CONCLUSION: With similar infrastructure and work force shortage in most SNCUs, these findings can be generalized. The burden of Type 1 and AROP is increasing, as seen in higher gestation and BWs. This needs revision of ROP screening criteria at local and national level. It is crucial to emphasize on the importance of pediatrician and ophthalmologist collaboration, early ROP screening, diagnosis, and treatment to stop disease progression to severe ROP.

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Cannabidiol (CBD) is a non-psychoactive component of cannabis with potential applications in biomedicine, food, and cosmetics due to its analgesic, anti-inflammatory, and anticonvulsant properties. However, increasing reports of adverse CBD exposure events underscore the necessity of evaluating its toxicity. In this study, we investigated the developmental toxicity of CBD in zebrafish during the embryonic (0-4 dpf, days post fertilization) and early larval stages (5-7 dpf). The median lethal concentration of CBD in embryos/larvae is 793.28 µg/L. CBD exhibited concentration-dependent manner (ranging from 250 to 1500 µg/L) in inducing serious malformed somatotypes, like shorter body length, pericardial cysts, vitelline cysts, spinal curvature, and smaller eyes. However, no singular deformity predominates. The 5-month-old zebrafish treated with 100 and 200 µg/L of CBD during the embryonic and early larval stages produced fewer offspring with higher natural mortality and malformation rate. Gonadal growth and gamete development were inhibited. Transcriptomic and metabolomic analyses conducted with 400 µg/L CBD on embryos/larvae from 0 to 5 dpf suggested that CBD promoted the formation and transportation of extracellular matrix components on 1 dpf, promoting abnormal cell division and migration, probably resulting in random malformed somatotypes. It inhibited optical vesicle development and photoreceptors formation on 2 and 3 dpf, resulting in damaged sight and smaller eye size. CBD also induced an integrated stress response on 4 and 5 dpf, disrupting redox, protein, and cholesterol homeostasis, contributing to cellular damage, physiological dysfunction, embryonic death, and inhibited reproductive system and ability in adult zebrafish. At the tested concentrations, CBD exhibited developmental toxicity, lethal toxicity, and reproductive inhibition in zebrafish. These findings demonstrate that CBD threatens the model aquatic animal, highlighting the need for additional toxicological evaluations of CBD before its inclusion in dietary supplements, edible food, and other products.

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The field of cortical sight restoration prostheses is making rapid progress with three clinical trials of visual cortical prostheses underway. However, as yet, we have only limited insight into the perceptual experiences produced by these implants. Here we describe a computational model or 'virtual patient', based on the neurophysiological architecture of V1, which successfully predicts the perceptual experience of participants across a wide range of previously published human cortical stimulation studies describing the location, size, brightness and spatiotemporal shape of electrically induced percepts in humans. Our simulations suggest that, in the foreseeable future the perceptual quality of cortical prosthetic devices is likely to be limited by the neurophysiological organization of visual cortex, rather than engineering constraints.

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Vision plays a major role in perceiving external stimuli and information in our daily lives. The neural mechanism of color vision is complicated, involving the co-ordinated functions of a variety of cells, such as retinal cells and lateral geniculate nucleus cells, as well as multiple levels of the visual cortex. In this work, we reviewed the history of experimental and theoretical studies on this issue, from the fundamental functions of the individual cells of the visual system to the coding in the transmission of neural signals and sophisticated brain processes at different levels. We discuss various hypotheses, models, and theories related to the color vision mechanism and present some suggestions for developing novel implanted devices that may help restore color vision in visually impaired people or introduce artificial color vision to those who need it.

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Background: The current study sought to examine whether psycholinguistic assessments could discriminate children and adolescents with developmental language disorder (DLD) from those with attention-deficit/hyperactivity disorder (ADHD; combined or inattentive subtype) and comorbid DLD + ADHD. Methods: The Clinical Evaluation of Language Fundamentals-Screening Test (CELFST; Wiig et al., 2013), the Comprehensive Test of Phonological Processing (nonword repetition subtest; Wagner et al., 2013), and the Test of Word Reading Efficiency (sight word and phonemic decoding subtests; Torgesen et al., 2012) were examined in 441 children and adolescents between 6 and 16 years of age. Results: The presence of a language disorder (with or without ADHD) predicted poor performance across tasks. Children and adolescents with ADHD (combined vs. inattentive) only significantly differed in sight word reading, in favor of those with combined type. Measures of reading efficiency could distinguish between the two types of ADHD, but not between other groups. Interestingly, scores on the standard language screener were no worse for children with ADHD + DLD than children with DLD only. Conclusions: The combination of comorbid ADHD + DLD did not appear to be associated with lower language abilities, sight word reading, or phonemic decoding relative to DLD alone. Reading efficiency was effective in discriminating between ADHD subtypes. These findings offer valuable insights into differential diagnosis and the identification of comorbidity.

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This paper studies the maximum reliability of multi-hop relay UAVs, in which UAVs provide wireless services for remote users as a coded cooperative relay without an end-to-end direct communication link. In this paper, the analytical expressions of the total power loss and total bit error rate are derived as reliability measures. First, based on the environmental statistical parameters, a LOS probability model is proposed. Then, the problem of minimizing the bit error rate of static and mobile UAVs is studied. The goal is to minimize the total bit error rate by jointly optimizing the height, elevation, power and path loss and introducing the maximum allowable path loss constraints, transmission power allocation constraints, and UAV height and elevation constraints. At the same time, the total path loss is minimized to achieve maximum ground communication coverage. However, the formulated joint optimization problem is nonconvex and generally difficult to solve. Therefore, we decomposed the problem into two subproblems and proposed an effective joint optimization iteration algorithm. Finally, the simulation results are given, and the analysis shows that the optimal height of different reliability measures is slightly different; thus, using the mobility of UAVs can improve the reliability of communication performance.

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Aiming at the problem that ultra-wide band (UWB) cannot be accurately localized in environments with large noise variations and unknown statistical properties, a combinatorial localization method based on improved cubature (CKF) is proposed. First, in order to overcome the problem of inaccurate local approximation or even the inability to converge due to the initial value not being set near the optimal solution in the process of solving the UWB position by the least-squares method, the Levenberg-Marquardt algorithm (L-M) is adopted to optimally solve the UWB position. Secondly, because UWB and IMU information are centrally fused, an adaptive factor is introduced to update the measurement noise covariance matrix in real time to update the observation noise, and the fading factor is added to suppress the filtering divergence to achieve an improvement for the traditional CKF algorithm. Finally, the performance of the proposed combined localization method is verified by field experiments in line-of-sight (LOS) and non-line-of-sight (NLOS) scenarios, respectively. The results show that the proposed method can maintain high localization accuracy in both LOS and NLOS scenarios. Compared with the Extended Kalman filter (EKF), unbiased Kalman filter (UKF), and CKF algorithms, the localization accuracies of the proposed method in NLOS scenarios are improved by 25.2%, 18.3%, and 11.3%, respectively.

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OBJECTIVE: To identify the risk factors for the development of diabetic retinopathy (DR), diabetic macular edema (DME), and sight-threatening DR (STDR) based on a city-wide diabetes screening program. RESEARCH DESIGN AND METHODS: Diabetic patients were prospectively recruited between June 2016 and December 2022. All patients underwent dilated fundus photography centered on the disc and macula or macular spectral domain optical coherence tomography (SD-OCT) scan. Complete medical history was documented. Systematic examination, blood analysis, and urinalysis were performed. Multivariate logistic regression analysis adjusting for age and sex was conducted. RESULTS: Out of 7274 diabetic patients, 6840 had gradable images, among which 3054 (42.0%) were graded as DR, 1153 (15.9%) as DME, and 1500 (20.6%) as STDR. The factors associated with DR, DME, and STDR included younger age (odds ratio [OR]: 0.96, 0.97, and 0.96 respectively), lower BMI (OR: 0.97, 0.95, and 0.95 respectively), longer duration of diabetes (OR: 1.07, 1.03, and 1.05 respectively) and positive of urinary albumin (OR: 2.22, 2.56, and 2.88 respectively). Other associated factors included elevated blood urea nitrogen (OR: 1.22, 1.28, and 1.27 respectively), higher LDL-cholesterol, lower blood hemoglobin (OR: 0.98, 0.98, and 0.98), insulin intake, presence of diabetic foot pathologies and diabetic peripheral neuropathy. We also identified novel risk factors, including high serum potassium (OR: 1.37, 1.46, and 1.55 respectively), high-serum sodium (OR: 1.02, 1.02, and 1.04 respectively). Better family income was a protective factor for DR, DME, and STDR. Alcohol consumption once a week was also identified as a protective factor for DR. CONCLUSIONS: Similar risk factors for DR, DME, and STDR were found in this study. Our data also indicates high serum sodium, high serum potassium, low blood hemoglobin, and level of family income as novel associated factors for DR, DME, and STDR, which can help with DR monitoring and management.

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Positioning based on Global Navigation Satellite Systems (GNSSs) in urban environments always suffers from multipath and Non-Line-of-Sight (NLoS) effects. In such conditions, the GNSS pseudorange measurements can be affected by biases disrupting the GNSS-based applications. Many efforts have been devoted to detecting and mitigating the effects of multipath/NLoS, but the identification and classification of such events are still challenging. This research proposes a method for the post-processing estimation of pseudorange biases resulting from multipath/NLoS effects. Providing estimated pseudorange biases due to multipath/NLoS effects serves two main purposes. Firstly, machine learning-based techniques can leverage accurately estimated pseudorange biases as training data to detect and mitigate multipath/NLoS effects. Secondly, these accurately estimated pseudorange biases can serve as a benchmark for evaluating the effectiveness of the methods proposed to detect multipath/NLoS effects. The estimation is achieved by extracting the multipath/NLoS biases from pseudoranges using a clustering algorithm named Density-Based Spatial Clustering of Applications with Noise (DBSCAN). The performance is demonstrated using two real-world data collections in multipath/NLoS scenarios for both static and dynamic conditions. Since there is no ground truth for the pseudorange biases due to the multipath/NLoS scenarios, the proposed method is validated based on the positioning performance. Positioning solutions are computed by subtracting the estimated biases from the raw pseudoranges and comparing them to the ground truth.

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During a vertical vortex-induced vibration (VVIV), an undulating bridge deck will affect drivers' sightlines, causing the phenomenon of drifting and changes in the far blind area, thus presenting a potential threat to driving safety. Consequently, to ensure the safety of driving on a suspension bridge deck under VVIV, it is necessary to perceive the far blind spot caused by the occlusion of the driving sightlines under this condition, and to establish an online perception and evaluation mechanism for driving safety. With a long-span suspension bridge experiencing VVIV as the engineering background, this paper utilizes the acceleration integration algorithm and the sine function fitting method to achieve the online perception of real-time dynamic configurations of the main girder. Then, based on the configurations, the maximum height of the driver's far blind area and effective sight distance are calculated accordingly, and the impact of different driving conditions on them is discussed. The proposed technical framework for driving safety perception in far blind spots is feasible, as it can achieve real-time estimation of the maximum height and effective distance of the far blind area, thereby providing technical support for bridge-vehicle-human collaborative perception and traffic control during vortex-induced vibration.

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PURPOSE: Although diabetes is highly prevalent in patients with MacTel, progression to severe non-proliferative (NPDR) and proliferative diabetic retinopathy (PDR) is rarely reported. We report multimodal imaging features of sight-threatening diabetic retinopathy (STDR) in eyes with macular telangiectasia type 2 (MacTel). METHODS: Retrospective case series of seven participants of the MacTel Study at the Moorfields Eye Hospital NHS Foundation Trust study site and one patient from the Institute of Retina and Vitreous of Londrina, Brazil. Sight threatening diabetic retinopathy was defined as severe NPDR, PDR or diabetic macular edema. RESULTS: We report imaging features of 16 eyes of eight patients (7/8, 87.5% female) with diagnoses of MacTel and type 2 diabetes mellitus with STDR. Mean (SD) age was 56 (8.3) years. Patients were followed-up for a mean time of 9.1 (4.7) years. A total of 10/16 (62.5%) eyes showed PDR and 2/16 (12.5%) eyes presented a macular epiretinal neovascularization. CONCLUSIONS: People with diabetes mellitus and MacTel may not be protected from STDR as previously reported. Although the two diseases rarely co-exist, regular monitoring for diabetic retinopathy progression is recommended according to baseline retinopathy severity grades in line with established international guidelines. The presence of MacTel may not modify extended screening intervals, but there is no current evidence. The limited case series in the literature support treatment for complications and should follow the standard of care for either condition. Due to dual pathology, reactivation may be difficult to diagnose on standard imaging and multimodal imaging is recommended.

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The effective identification and mitigation of non-line-of-sight (NLOS) ranging errors are essential for achieving high-precision positioning and navigation with ultra-wideband (UWB) technology in harsh indoor environments. In this paper, an efficient UWB ranging-error mitigation strategy that uses novel channel impulse response parameters based on the results of a two-step NLOS identification, composed of a decision tree and feedforward neural network, is proposed to realize indoor locations. NLOS ranging errors are classified into three types, and corresponding mitigation strategies and recall mechanisms are developed, which are also extended to partial line-of-sight (LOS) errors. Extensive experiments involving three obstacles (humans, walls, and glass) and two sites show an average NLOS identification accuracy of 95.05%, with LOS/NLOS recall rates of 95.72%/94.15%. The mitigated LOS errors are reduced by 50.4%, while the average improvement in the accuracy of the three types of NLOS ranging errors is 61.8%, reaching up to 76.84%. Overall, this method achieves a reduction in LOS and NLOS ranging errors of 25.19% and 69.85%, respectively, resulting in a 54.46% enhancement in positioning accuracy. This performance surpasses that of state-of-the-art techniques, such as the convolutional neural network (CNN), long short-term memory-extended Kalman filter (LSTM-EKF), least-squares-support vector machine (LS-SVM), and k-nearest neighbor (K-NN) algorithms.

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Despite legislation to protect people with visual impairment (V.I.) from discrimination in the United Kingdom (UK), the latter continue to experience overt and covert negative behaviours. Perceived discrimination has been associated with an adverse impact on identity, health and well-being, while negative attitudes have been identified as the biggest barrier to participation in everyday life. This article provides a narrative review of existing evidence of how the UK public treats (behaviours), thinks (perceptions) and feels (attitudes) about people with V.I. Despite limitations, the findings suggest that there is a gap between the behaviours reported by people with V.I. and the attitudes expressed by members of the UK public. Social psychological theories are used to explore possible reasons for this gap, and ways in which it may be addressed. As such, the article provides an example of how social psychological theories can be used to address problems in an applied context.

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Uncorrected refractive error has predominantly been delivered through commercial entrepreneurship in Kenya. However, to achieve the 2030 IN SIGHT, integration of other forms of entrepreneurship such as the social entrepreneurship is desirable to supplement the efforts of the dominant commercial entrepreneurship. Therefore, this study intended to undertake a SWOT analysis of the current models used by social enterprises in scaling effective refractive error coverage to achieve the 2030 IN SIGHT in Kenya. A review of the seven national strategic plans for eye health in Kenya was undertaken to get a glimpse on the efforts directed towards uncorrected refractive error in achieving the 2030 IN SIGHT. The review was inclined towards assessing the efforts directed by the strategic plans towards scaling human resource, spectacle provision and refraction points. A SWOT analysis was undertaken based on the financial, impact and the approach report for each model. A key informant interview was conducted with a representative and three to five members of the social enterprise about the model. Thereafter, the modified SWOT analysis based on the review and the interview was presented to the representatives of the social enterprises. Purposive sampling was used to identify seven models used by social enterprises in the delivery of refractive error services in Kenya. Finally, the recommendations were presented to key opinion leaders for an input through a Delphi technique. Out of the seven national strategic plans for eye health reviewed, only the strategic plan 2020-2025 intends to establish optical units within 15 different counties in Kenya. Of the seven models currently utilized by social enterprises, only the Kenya Society for the Blind has integrated the telemedicine concept. On application of mHealth, all of the social enterprises models tend to embrace the approach for screening activities. None of the models has a strengthened referral pathway utilizing telereferral and telemedicine. Out of all the models, only Operation Eyesight Universal, Fred Hollow Foundation and Peek Acuity do not depend on sales of subsidized spectacles for sustainability. Every model has the capacity to propel the delivery of refractive error services depending on its comprehensiveness. However, for the 2030 IN SIGHT to be achieved, models prioritizing human resource through telemedicine integration, service provision across all sectors, awareness creation and enhancing cost efficiency are desirable.

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Background: Visual impairment (V.I.) has been associated with a negative impact on social functioning, while social support can impact on well-being in those with V.I. Adults from minority ethnic communities (MEC) are projected to make up an increasing proportion of adults living with V.I. in the UK, but limited research has explored their social functioning. This article provides a preliminary insight into social functioning among MEC adults living with V.I. in the UK. Methods: The article reports findings from a secondary analysis of V.I. Lives survey data. V.I. Lives was a UK telephone survey, which explored the life experiences of people with V.I. across a wide range of topics including social functioning. This secondary analysis explored social participation, support, isolation, and relationships among a matched control sample of 77 MEC and 77 adults aged 18 and over from White communities (WC). Participants were matched on age, gender, UK region and urban/rural setting. Subgroup analyses were also conducted for the two largest subgroups within the MEC group, Asian (n = 46) and Black participants (n = 22). Results: Contact with like-minded people (U = 2174.50, p = 0.003, r = -0.24) and opportunities to take part in more social activities (U = 2253.50, p = 0.007, r = -0.22) was significantly more important to MEC than WC participants. Moreover, MEC participants were significantly less likely to feel supported by friends/family (U = 3522.50, p = 0.017, r = 0.19) and had fewer people they could ask for help (U = 3775.50, p = 0.001, r = 0.26), but there were no significant differences in the perceived impact of V.I. on their friendships/social life and marriage/relationship, their ability to take part in a range of activities, nor their marital status. Asian participants were significantly more likely than Black participants to feel cut off from the people and places around them (U = 655.50, p = 0.042, r = 0.25). Effect sizes were overall small. Although there were no further statistically significant differences between the two groups, Asian participants were also less likely to be able to take part in activities, and more likely to report a negative impact on their social life/friendships and on their marriage/relationship, as well as a smaller social network. Conclusion: The findings suggest that V.I. may have had a greater impact on social functioning among Asian participants in this sample, including on experiences of social isolation and participation in social activities. Future research will need to confirm these findings and explore the possible reasons.

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