A Novel Human Sex Difference: Male Sclera Are Redder and Yellower than Female Sclera

Look past the cooperative eye hypothesis: reconsidering the evolution of human eye appearance

The external appearance of the human eye has been prominently linked to the evolution of complex sociocognitive functions in our species. The cooperative eye hypothesis (CEH) proposes that human eyeballs, with their weakly expressed conjunctival and scleral pigmentation, are uniquely conspicuous and evolved under selective pressures to behave cooperatively, therefore signalling attentiveness to conspecifics. Non-human primates are instead assumed to display less-salient eye morphologies that help mask their gaze to facilitate competitive, rather than cooperative actions. Here, we argue that the CEH, although continuing to be influential, lacks robust empirical support. Over the past two decades, multidisciplinary research has undermined its original rationale and central premises: human eye pigmentation does not uniquely stand out among primates, it is not uniform at species level and the available evidence does not conclusively suggest that it facilitates gaze following to notable extents. Hence, the CEH currently provides a theoretical framework that risks confusing, rather than informing, inferences about the evolution of human external eye appearance and its selective drivers. In a call to move past it, we review alternative hypotheses with the potential to elucidate the emergence of the human ocular phenotype from the considerable spectrum of diversity found within the primate order.

Uveoscleral Outflow Routes after MicroPulse Laser Therapy for Refractory Glaucoma: An Optical Coherence Tomography Study of the Sclera

To analyze in vivo scleral changes induced by MicroPulse transscleral laser therapy (MP-TLT) in refractory glaucoma using anterior segment-optical coherence tomography (AS-OCT). Forty-two candidate patients for MP-TLT were consecutively enrolled and underwent AS-OCT at baseline and after six months. MP-TLT success was defined as an intraocular pressure (IOP) reduction by one-third. The main outcome measures were the mean superior (S-), inferior (I-), and total (T-) intra-scleral hypo-reflective space area (MISHA: mm2) and scleral reflectivity (S-SR, I-SR, T-SR; arbitrary scale) as in vivo biomarkers of uveoscleral aqueous humor (AH) outflow. The IOP was the secondary outcome. The relations between the baseline-to-six months differences (D) of DS-MISHA, DI-MISHA, and DT-MISHA and DS-SR, DI-SR, DT-SR, and DIOP, were investigated. At 6 months, the median IOP reduction was 21% in the failures and 38% in the successes. The baseline S-MISHA, I-MISHA, and T-MISHA did not differ between the groups, while S-SR and T-SR were higher in the successes (p < 0.05). At six months, successful and failed MP-TLTs showed a 50% increase in S-MISHA (p < 0.001; p = 0.037), whereas I-SR and T-SR reduced only in the successes (p = 0.002; p = 0.001). When comparing DS-MISHA, DI-MISHA, and DT-MISHA and DS-SR, DI-SR, and DT-SR, there were no significant differences between the groups. In the successful procedures, DIOP was positively correlated with DT-MISHA and DI-MISHA (ρ = 0.438 and ρ = 0.490; p < 0.05). MP-TLT produced potentially advantageous modifications of the sclera in refractory glaucoma. Given the partial correlation between these modifications and post-treatment IOP reduction, our study confirmed that the activation of the uveoscleral AH outflow route could significantly contribute to the IOP lowering after MP-TLT.

The adaptive significance of human scleral brightness: an experimental study

Homogeneously depigmented sclerae have long been proposed to be uniquely human-an adaptation to enable cooperative behaviour by facilitating interpersonal coordination through gaze following. However, recent evidence has shown that deeply pigmented sclerae also afford gaze following if surrounding a bright iris. Furthermore, while current scleral depigmentation is clearly adaptive in modern humans, it is less clear how the evolutionarily intermediate stages of scleral pigmentation may have been adaptive. In sum, it is unclear why scleral depigmentation became the norm in humans, while not so in sister species like chimpanzees, or why some extant species display intermediate degrees of pigmentation (as our ancestors presumably did at some point). We created realistic facial images of 20 individually distinct hominins with diverse facial morphologies, each face in the (i) humanlike bright sclera and (ii) generalised apelike dark sclera version. Participants in two online studies rated the bright-sclera hominins as younger, healthier, more attractive and trustworthy, but less aggressive than the dark-sclera hominins. Our results support the idea that the appearance of more depigmented sclerae promoted perceived traits that fostered trust, increasing fitness for those individuals and resulting in depigmentation as a fixed trait in extant humans.