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Biomedical subjects

R A Weale

Publications and source records attributed to R A Weale.

At least 37 records · Page 2Linked to original sources

Contact lenses and the cornea: age and length of wear.

During a monitoring study related to photorefractive keratectomy, objective tests with the Oqual (a device that can be attached to the slit-lamp) were made of the image forming quality of treated, central, and untreated peripheral regions of the cornea. In a significant number of cases the untreated part was optically inferior to the treated part. Observations on 183 patients implicated prior contact lens wear: patients who had worn hard or gas permeable lenses scored less well than those wearing soft ones or none at all. The effects of age and length of wear were analysed. With one exception, corneal quality did not correlate with age or with length of contact lens wear either for the total sample (A) or for those aged 40 years and less (B). In A, all contact lens wearers scored less well than those who had never worn any. In B, whose eye lenses were most probably more transparent than those of the older group (A-B), those who had worn hard or gas permeable lenses scored significantly less than soft contact lens wearers or those who had never worn any. Although visual acuity is unimpaired, the optical capacity of the affected peripheral corneal regions appears to be permanently degraded, and the observation may have a potential bearing--for example, on the choice of contact lens types selected for cosmetic reasons.

Adult↗

Inter-ethnic risk ratios for different types of cataract.

Patients at Moorfields Eye Hospital were divided according to five broad geographical areas of origin in four continents, and classified according as they had cortical, nuclear, posterior subcapsular cataract or any of their combinations. Relative risk ratios and their tolerances were calculated. Risk ratios for some types of cataract were inter-related. Ethnic traits appear to be more important than climatic conditions.

Africa↗

Decreasing stromal iris pigmentation as a risk factor for age-related macular degeneration.

To evaluate iris color, change of iris color, and iris pigment epithelial defects as risk factors in age-related macular degeneration, we compared 101 patients with age-related macular changes with 102 control subjects in a case-control study. Three of 101 patients (3%) and four of 102 control subjects (4%) had epithelial iris defects. Light iris color during youth was reported by 51 of 101 patients (50.5%) and 42 of 102 control subjects (41.2%) (odds ratio, 1.46; P = .184). Of the 101 patients, 26 (25.7%) noticed their iris color to have become lighter during life compared with six of 102 control subjects (5.9%) (odds ratio, 5.5; P = .0001). At present examination, 63 of 101 patients (62.4%) had light irides compared with 43 of 102 control subjects (42.2%) (odds ratio, 2.27; P = .004). These results suggest that initial light iris color and iris pigment epithelial defects are not associated with an increased risk of age-related macular degeneration, whereas decreased stromal iris pigmentation may indicate a higher risk.

Aged↗

Self-administered automatic sight-testing. A feasibility study.

A feasibility study to estimate the extent to which self-administered computerized sight-testing instruments would be acceptable to patients and staff in a hospital outpatient eye department has been carried out. Visual acuity was measured in two ways for each of 86 patients in the age range 20-79 years; Snellen acuity was compared with the screen-based Landolt C test. The patient was seated in front of the computer controlled display, supplied with tape-recorded instructions: his/her progress was monitored without intervention unless there were obvious difficulties. The mean acuities as measured by the two methods did not differ significantly from each other, with similar variances. More than 70% of patients managed the self-administered test without any help at all, only 4-5% failing completely. The computerized test was favoured by most except the oldest patients. It forms therefore a sound basis for further development on a large scale.

Adult↗

The objective clinical assessment of the quality of the anterior segment by means of the Oqual.

The Oqual is a simple new device attachable to the (Haag-Streit or Topcon) slit-lamp. It provides objective numerical assessments of the optical quality of the anterior segment. In the present study, patients attending Outpatients Clinics at Moorfields Eye Hospital were divided into those who suffered from lenticular symptoms and those who did not. Their monocular visual acuity was measured routinely by means of a Snellen chart, and thereafter their eyes were examined with the Oqual. Results are given for the correlation between the two measures overall (R2 = 47.35%), and for inter-observer performance (r = 0.8878). Earlier conclusions on the effects of smoking habits are supported.

Adult↗

Have human biological functions evolved in support of a life-span?

Published data on age-related human biological functions are surveyed. For the many showing a linear decrease, regressions were calculated, or existing functions extrapolated, to yield an intercept on the abscissa. The values of chi(0), the age at which a function ceases, provide a tentative common means of comparison. The distribution of chi(0) is skewed because of the apparent longevity of nervous and cerebral functions. The database is sufficiently large to enable one to distinguish those biological functions which appear to have immediate survival value from those which do not. Such an approach may link biomarkers to estimates of the life-span of species.

Aging↗

Problems related to diffuse versus localized loss in the perimetry of glaucomatous visual fields.

The separation of diffuse loss from more localized loss in the glaucomatous visual field is desirable for a number of reasons. In previous papers, the characteristics of several methods and algorithms for distinguishing among normal visual fields and those exhibiting diffuse and localized loss have been described and compared. In particular, a new diffuse loss index has been introduced that serves to decide whether or not a diffuse loss component is present and, if so, helps to estimate the amount. Here the approaches utilized for calculating empiric probability maps (Heijl) and the pattern deviation plots (STATPAC) are compared with results obtained with the diffuse loss index algorithm. Based on 197 Octopus G1 examinations of glaucomatous visual fields, it is shown that both methods produce large differences when compared with the diffuse loss index. For this and other reasons, it is argued that both empiric probability maps and pattern deviation plots may lead the inexperienced clinician to ignore valuable information concerning actual pathology.

Algorithms↗

The lenticular nucleus, light, and the retina.

Lenticular absorbance and retinal illumination are reviewed in the light of earlier observations showing that the nucleus rather than the lens as a whole is the main absorber of radiation. Corneal refraction is taken into account. Consideration is given to the Stiles-Crawford effect, and to the accumulation of lipofuscin in the retinal pigment epithelium which may be caused by illumination of the retina.

Adolescent↗

A new analysis of United Nations mortality statistics.

Demographic data published by the United Nations in 1987 are analysed in terms of the Gompertz function. Projections for maximum life spans are obtained, with the data broadly divisible into three clusters. These are attributable not only to the influence of high infant mortality, but suggest also constitutional and/or environmental variations among members of the clusters. The difference between life span and life expectancy is estimated analytically. A comparison with an earlier analysis supports the view that there are important differences between the life expectancies of the sexes.

Adult↗

Evolution, age and ocular focus.

A number of hypotheses has been advanced during the last 130 years to explain the progressive loss of accommodation of the human crystalline lens. None has dealt with the high initial value of accommodation which enables infants to form sharp retinal images of objects as close as 6 or 7 cm. This paper attempts to relate the initial value to the overall loss in terms of evolution and biological cost.

Accommodation, Ocular↗

Retinal illumination using a wide-angle model of the eye: comment.

When the human eye is modeled, consideration must be given to three anatomical factors that are sometimes overlooked. First, the apparent pupillary area is likely to exceed the real one, particularly at large paraxial displacements. Second, the earlier assumption [J. Opt. Soc. Am. A 5, 146 (1988)] that lenticular pigment is distributed uniformly throughout the lens is no longer valid except along the visual axis. Third, as measurable reflection occurs within the eye, the polar retinal illumination is likely to receive a significant indirect quantity of light in addition to the direct light.

Eye↗

Do years or quanta age the retina?

The progressive loss of visual faculties with advancing age is attributed, sometimes, mainly to allegedly inevitable optical deterioration, such as clouding of the media, or again to neurosenescence, as typified by cell-death. The relevant factors are assessed, and it is not thought likely that changes in normal ocular optics account for changes in contrast sensitivity and visual acuity with age. The role of senescent changes in the retina is analyzed. The progressive temporal and spatial patterns of the accumulation of lipofuscin in the retinal pigment epithelium (RPE) and the putative control of its concentration by the crystalline lens are examined following an earlier suggestion that lenticular UVA transmissivity may control the rate of UVA entry into the eye and so perhaps the amount of lipofuscin formed in the RPE. It is suggested that morphological changes attributed to senescence may partly be due to cumyulative effects of irradiation.

Aging↗

A further note on the photography of cataracts.

Polarized light used in conjunction with a quarter-wave plate, as previously described, was further modified with colour filters in order to test whether blue-free light increased contrast by reducing fogging due to lenticular fluorescence. The reproducibility of photographic records over a period of at least six months was also tested with satisfactory results in both of these objectives.

Cataract↗

Age and the transmittance of the human crystalline lens.

1. Conflicting data both on the transmission of the human crystalline lens in the ultra-violet part of the spectrum and on its variation with age necessitate a re-examination of the subject. 2. Twenty-four excised lenses in the age range of 0-85 years were studied with a Perkin-Elmer spectrophotometer between 327 and 700 nm. 3. Some lenses were homogenized and the homogenates were similarly examined. 4. A systematic increase in absorbance with age was observed both in the visible and the ultra-violet parts of the spectrum. 5. An exponential function describes the data, facilitating comparison with, and prediction of, other values. 6. The absorbance of homogenized material was found to be predictable from that of intact lenses, and does not support the notion that mechanical trauma may account for high values in earlier studies.

Adolescent↗