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At least 235 records · Page 13Linked to original sources
PubMed2003

The symptomatic patient with normal phorias at distance and near: what tests detect a binocular vision problem?

PURPOSE: Patients often manifest symptoms that appear to be related to binocular distress. Many of these patients have normal heterophoria at distance and near, making the etiology of such symptoms perplexing. We performed a visual examination of patients having normal heterophoria at distance and near in order to investigate which visual analysis tests differentiate symptomatic from asymptomatic patients. METHODS: Eighty subjects (30 symptomatic, 50 asymptomatic) with ages between 18 to 35 years of either sex and any race were pooled based on vision-symptom level determined by a 9-question standardized visual-symptoms questionnaire scored using a 100-point scale (asymptomatic: score > or = 85; symptomatic: score < or = 75). Inclusion/exclusion criteria included vision correctable to 6/6 (20/20) Snellen acuity or better in each eye, normal phorias, no latent cyclovertical heterophoria, and normal ocular health. RESULTS: Of the 30 symptomatic patients, 18 had reduced vergence facility response using 3 pd base-in/12 pd base-out loose prism at distance (n = 10; t-score = 2.41, p < 0.02, d = 76) and near (n = 15; t-score = 3.32, p < 0.01, df = 78) with a significant difference beyond the 0.02 level. No other test including measurement of accommodation, showed a significant between-group difference. However, three patients with normal vergence facility (distance and near) showed a reduced binocular accommodative facility response (+/-2.00 D at 40 cm). CONCLUSION: Given a patent with asthenopia, normal phorias, and visual acuity, a differential diagnosis may be made based primarily on using vergence facility and accommodative facility testing. From a clinical standpoint, the results expedite diagnosis of binocular vision abnormalities and direct treatment.

Accommodation, Ocular↗
PubMed2005

[Application of lacrimal plug for dry eye patients].

OBJECTIVE: To observe the availability and efficacy of Smart PLUG in lacrimal plug in the treatment of serious dry eye. METHODS: Lacrimal plug was applied in 43 patients (72 eyes) in our clinic from July to October in 2004. Questionnaire was used in these patients before the surgery 3 days and repeated after surgery 1 week and 3 months. Slit lamp microscope examination, fluorescent staining for tear break-up time (BUT), Schirmer test I (STI), impression cytology (IC) were carried out at the same time. RESULTS: Questionnaire indicated most patients complained about dry eye, foreinbody sensation, asthenopia and red eye. These symptoms were relieved obviously after the application of lacrimal plug. Compared with pre-operation, tear production was increased significantly on the surface of eyes and the defect of corneal epithelium was healed in 37 patients (62 eyes). Compared with pre-operation, BUT and STI were increased and elongated on these patients, IC suggests squamous metaplasia of epithelial layer of conjunctiva in these patients was improved. CONCLUSIONS: Symptoms of patients suffered from dry eye were relieved obviously by using Smart PLUG. Therefore lacrimal plug can be used for patients with serious dry eye by improving tear volume and tear film stability.

Adult↗
PubMed1991

[The late whiplash syndrome; reality or fiction?].

To answer the question whether there are clinical arguments for organic lesions in patients with persistent complaints after whiplash-injuries, 200 patients referred for assessment by insurance companies and legal institutions, were investigated 2 years or more after the injury. There were 89 males and 111 females. Pain in neck, head and arms persisted in 195 patients. Dizziness persisted in 60 patients. Vestibular investigation revealed abnormalities in 48 of them and in 9 patients without dizziness. As these vestibular findings can not be understood from a neurological point of view, further research as to their significance is needed. Asthenopia was present in 3 cases and psychic disturbances in 27. Of 100 patients 87 regarded themselves as more or less severely invalidated. It is concluded that this investigation shows no evidence for organic lesions in these patients. This does not mean however that the complaints should be considered unjustified.

Adolescent↗
PubMedDate not supplied

[Drug therapy of progressive myopia].

To stabilize weak and medium-severity progressive myopia, instillations of cycloplegics (homatropin or tropicamid) and of hypotensive agents (clofelin or thymolol) were administered into the conjunctival cavity once a day (at bedtime). The course of treatment lasted 30 days and was repeated every 2-3 months. Complete stabilization of myopia was achieved in 65-58% of cases, as evidenced by a follow-up of 3 years, on an average. Incomplete stabilization of the condition was observed in 35-42% of patients, the annual progress gradient being above 0.15 diopters. Simultaneously an accumulation of the relative accommodation reserves was observed, by 38.3% on an average, and a resolution of asthenopia. In a reference group of 50 subjects (100 eyes) spontaneous stabilization took place in 27% of cases, the relative accommodation reserve being unchanged.

Adolescent↗
PubMed1990

[The measurement theory and the example of the number zero].

For basic research, measurement used in our medical routine doesn't seem to be self-evident. Classical physics claim and demand that everything should be measured with a maximum of exactness in order to avoid errors principly. Results of measurement and diagnosis are often regarded as on and the same thing. For quantum physics, measuring means rather description, approximation, and even perturbation due to manipulation. In strabismology, zero is the starting point of measurement and defines normality. The examination of 70 patients with asthenopia has reveiled that zero-localisation at the Maddox Wing doesn't imply parallelism of the eyes but an esophoria combined with an ocular-cervical syndrome.

Adolescent↗
PubMed1990

[Changes in color perception during the use of the Vacumcolor 50% tinted glasses in normal trichromatic individuals].

The authors assessed the spectral absorption of coloured glasses Vacumcolor 50% and found differences between different pairs of glasses which attained in the red areas as much as 17%. They also examined changes of the colour sense in a group of normal trichromats when using these coloured glasses. They found that these glasses alter the colour sense in the direction of deuteranomaly and cause deterioration of colour asthenopia.

Adult↗
PubMed1989

Analysis of a community vision screening program.

For 3 consecutive years a community vision screening program has been conducted on-site at the Walker Eye Clinic of the Indiana University (IU) School of Optometry. A group of 490 screened patients, including 86 who returned for comprehensive evaluation, was retrospectively studied for a variety of characteristics. It was determined that the typical participant was likely to be an adult female who learned of the screening program through the written media. She was likely to have had a previous vision examination but it probably took place 3 or more years earlier. She usually failed the vision screening for reasons of reduced visual acuity, a problem with binocularity or asthenopia. If she returned to the Walker Eye Clinic for a comprehensive examination, she was likely to do so within 5 months and would be found to have been accurately identified as being in need of vision care. The organization and implementation of this vision screening program are described, and its value as an educational tool for students of optometry and its technician program is discussed.

Adolescent↗
PubMed1987

[Akinetic mutism from recurrent hydrocephalus: successful treatment with levodopa, bromocriptine and trihexyphenidyl].

A case of akinetic mutism was reported with reference to a marked improvement by levodopa, bromocriptine and trihexyphenidyl. A 39-year-old male, first seen on February 2, 1981, had an occipitalgia, accompanied by nausea and vomiting. For several months before this consultation, the patient had suffered from asthenopia. Brain CT scan and cerebral angiogram demonstrated internal hydrocephalus due to aqueduct stenosis of unknown etiology. After a ventriculoperitoneal shunt operation on February 20, 1981, he completely recovered. Two years and a half after the shunt insertion he had no difficulty in his daily life. He reentered the hospital on December 21, 1983, because of personality change, mental deterioration and bradykinesia. Brain CT scan showed recurrent hydrocephalus resulting from shunt blockage. Following the shunt revision, hydrocephalus was resolved. Nevertheless, the patient did not return to his previous state. And he became bed-ridden, incontinent of urine, and unable to take fluids or foods, following which he went into a state of akinetic mutism. Other neurological findings were as follows: upward gaze palsy, impaired convergence, convergence nystagmus, plastic rigidity of neck and all four limbs, and diffuse hyperreflexia with right Babinski's sign. Abnormal involuntary movement was not seen. On March 27, 1984, levodopa therapy was instituted and on April 2, trihexyphenidyl was combined with levodopa. Shortly after administration of levodopa and trihexyphenidyl, akinetic mutism began to improve, but upward gaze palsy was not affected. He began to speak and could walk unassisted by the end of July.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Objective and subjective measurement of tonic accommodation.

Measurements of tonic accommodation (TA) were made on 25 subjects using He-Ne laser optometry (HNL), infra-red optometry (IR) and near retinoscopy (NR) under darkroom conditions. All three techniques were shown to produce comparable mean estimates of TA (HNL: 1.10 D; IR: 1.15 D; NR: 1.07 D). Significant correlations were found between HNL and IR (r = 0.88, p less than 0.001) and between HNL and NR (r = 0.81. p less than 0.001). Control studies under cycloplegia indicate that the estimates are not seriously affected by fluctuations in accommodative state. These findings indicate that ophthalmic practitioners can gain access to refractive data that aids the clinical management of the "anomalous myopias" and asthenopia associated with VDU work.

Accommodation, Ocular↗
PubMed1985

Orthoptic effects on accommodation and related visual functions in an adult alternating esotrope.

Orthoptic therapy was instituted in an adult, alternating esotrope with asthenopia who exhibited inaccurate static accommodative responses with adequate, clinically determined, accommodative facility. During and following therapy the patient showed considerable improvement in accommodative accuracy and related visual functions, such as contrast sensitivity, in the absence of any change in strabismic deviation. This case provides the first laboratory documentation of orthoptic effects on accommodation in an adult strabismic.

Accommodation, Ocular↗
PubMed1983

A review of ocular malingering and hysteria for the flight surgeon.

Malingering is the conscious creation of a functional defect or denial of a true defect. Positive malingering is the former, and negative malingering is the latter. Hysteria is similar to malingering except that it is unconscious. Ocular malingering is common among draft evaders. The flight surgeon or military ophthalmologist will more commonly see the negative malingerer in peacetime because of the high physical standards for flying. Wartime creates a sudden shift towards positive malingering, however, for obvious reasons. This paper carefully defines the distinctions between malingering, hysteria, and true disease consistent with the defect claimed. It also provides a systematic approach to history, examination, and special testing of a possible ocular malingerer/hysteric. A number of common ocular complaints are considered separately, including decreased visual acuity, visual field defects, night vision defects, color vision defects, ocular muscle defects, automutilatory defects, opacification of transparent media, blepharospasm, intraocular disease, and asthenopia.

Aerospace Medicine↗
PubMed1982

[Psychosomatic diseases of the eye--a review].

After remarks on the uncritical use of the term "hysteria" in some investigations on psychosomatic phenomena in ophthalmology some recent reviews are presented, followed by the results of psychosomatic research on specific ophthalmological diseases. Dealing with glaucoma controlled studies are emphasized which attempt to determine the structure of neuroses and the importance of environmental situations. Using the MMPI high values on the scales 'depression', 'hypochondria' and 'hysteria' were observed. In previous attempts to influence glaucoma psychotherapeutically mainly autosuggestive and hypnotizing methods have been applied. The number of reported cases of psychogenic blindness has decreased considerably. We discuss, that it may not only be caused by the mechanism of hysterical conversion but also by a tendency to regression in schizoid neurotic structure. Concerning asthenopia and amblyopia the dependence of vision and visual acuity of the level of vegetative innervation is being accentuated; there appear to be correlations between certain errors of refraction and certain personality patterns. Psychiatric diseases may also influence vision: observations in paranoid and affective psychoses of later life and in schizophrenic children confirm it. This leads to the question, if schizoid neurotic structure can also be characterized by a specific disturbance in affective relations to sensations. Examples are given for investigations on other diseases (ablantio retinae, retinopathia centrales serosa), on the problem of self mutilation (auto-enuclation) and on neurophysiological question (psychogenic influences on pupil size).

Amblyopia↗
PubMed1994

[Changes in visual function caused by work at a data display terminal].

Working at video display terminals (VDTs) is particularly demanding in terms of orthopaedic and visual functions. This study was initiated to examine whether, and if so how, VDT work can influence the visual system. It was designed as a 5-year-prospective study based on the matched-pairs technique. The subjects were examined at the beginning and after 5 years of VDT work. The study group consisted of 102 people working at VDTs, and these were paired with 102 other office workers who did not use VDTs. The legally prescribed screening examinations of visual acuity (distance and near vision, phorias, stereopsis, and colour vision) were carried out. We also checked the anterior segments by examination with the slit-lamp and the fundus by ophthalmoscopy. Break-up time, Schirmer-I test, perimetry and tonometry were included in our range of examinations. We found a significant difference in asthenopia and daily hours of VDT work between VDT workers working less than 6 h daily and those working more than 6 h daily. In the study group pre-existing exophoria seemed to increase, but no statistical significance was found on testing. Nor was there any significant difference between the study group and the control group in the parameters examined in the course of the screening examination. In our investigation of monocular VDT workers (n = 3) we could not find any visual problems.

Adult↗
PubMedDate not supplied

[Mean-term variations of visual function of video display terminal operators: observations on 70 cases].

The aim of the study was to evaluate medium-term variations of visual functions in VDT operators and their possible relationship to VDT exposure. The clinical records of 70 VDT operators attending our outpatient service for periodical ergophthalmological evaluation were reviewed in order to evaluate the variation of some visual parameters after a two-years follow-up. These included refraction, phorias, fusional convergence and divergence, stereopsis. The group did not include subjects affected by hyperopia, large ametropias, or binocular vision disturbances and was divided into two subgroups: low exposure group (n = 20; < 4 hours/day) and high exposure group (n = 50; exposure > 4 hours/day). Asthenopia was frequent in both groups. Variation of refraction and binocular vision parameters were absent or rather limited in both exposure groups. This seems to indicate that in subjects without significant ophthalmological problems the risk of permanent functional damage is very low at medium-term.

Adult↗
PubMedDate not supplied

[Use of laser speckle in occupational eye diseases].

Forty-one diamond sorters aged 18 to 45 with occupational ophthalmopathy (asthenotopic complaints and accommodation disorders) were treated. In 35 female workers the vision acuity without correction was equal to 1.0, in 5 to 0.2-0.8 because of slight myopia. He-Ne LG-52-2 laser specle was used in the treatment. The training was carried out using modified method of accommodation "swinging" after V.V. Volkov and L.N. Kolesnikova. The course of treatment lasted for 10 days. The most appreciable shifts occurred in the nearest vision zone. The nearest point became closer to the eye by 0.55 +/- 0.02 diopters, the furthest became still further by 0.33 +/- 0.01 diopters. Relative accommodation reserve increased by 0.34 +/- 0.03 diopters. Asthenotopic complaints completely disappeared in 25 subjects and noticeably reduced in 4. Such exercises are recommended for subjects with asthenopia engaged in precision work.

Accommodation, Ocular↗
PubMed1996

A comparison of three subjective tests for astigmatism and their interexaminer reliabilities.

BACKGROUND: Astigmatism is a common cause of blurred vision and asthenopia. Several different tests for the measurement of astigmatism have been described in the literature, but there are few studies that have compared the results of various tests. METHODS: The results of three astigmatism tests performed on 40 subjects by two examiners were compared. Two of the tests, the Jackson cross cylinder (JCC) and the Humphriss immediate contrast (HIC), utilized distance targets; one test, the Pratt test, involved a near target. RESULTS: The mean differences between all tests were less than 0.25D. There was a slight tendency for higher cylinder power to be found on the Pratt test. The three tests agreed within +/- 0.25D on cylinder power 80 to 98 percent of the time and within 10 degrees of cylinder axis 85 to 98 percent of the time. Interexaminer reliability showed mean differences less than 0.12D for each of the three tests, agreement within +/- 0.25D on cylinder power 88 to 90 percent of the time and within 10 degrees on cylinder axis 85 to 93 percent of the time. CONCLUSIONS: The results suggested that any of the three techniques could be substituted for another for astigmatism testing. On theoretical grounds, a binocular refraction method for cylinder axis determination, such as the HIC, is advisable for patients with cyclophorias and significant amounts of astigmatism. The results showed good reliability for each of the three methods.

Adolescent↗
PubMed1996

[A clinical report on mixed astigmatism].

OBJECTIVE: This study was designed to analyze the common cause of asthenopia, mixed astigmatism. METHODS: The types and characters of mixed astigmatism in 356 eyes (207 patients) were analyzed and their naked and corrected visual acuities were investigated. Some problems of mixed astigmatism were discussed. RESULTS: Most of the patients had evident visual defects, the average naked visual acuity being 0.3 (20/60). However, all the patients had better corrected visual acuities with an average of 0.6 (20/30). CONCLUSIONS: Due to the presence of accommodation during the examination, an incorrect lens may be prescribed. Three mistakes might occur, (1) A mixed astigmatism is not detected, and a simple myopic lens is prescribed; (2) An eye with mixed astigmatism is diagnosed as simple or compound myopic astigmatism; (3) A hyperopic astigmatism is diagnosed as mixed astigmatism. The visual defects caused by mixed astigmatism can be satisfactorily corrected by spectacles.

Adolescent↗