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ENVIRONMENTAL ASPECTS OF FATIGUE.
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[EYE DISORDERS CAUSING HEADACHE].
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[Experience with the use of ultraviolet rays absorbable glasses in controlling of asthenopic disorders from fluorencent lamps].
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The big brown eyes of Samuel Pepys.
Samuel Pepys (1633-1703) is known for writing the finest diary in the English language. He was a man of remarkable accomplishments who transformed the English Navy, was president of the Royal Society, and was a member of the British Parliament. He survived the Great Plague and imprisonment in the Tower of London. During the years when he was writing the diary, Pepys began to experience great pain in his eyes when reading and writing and from photophobia, which caused him to give up writing the diary. Pepys also had an ultimately unjustifiable fear of blindness.
Blepharoplasty. Indications and preoperative assessment.
Before performing a blepharoplasty, the surgeon must completely evaluate the patient to ascertain the proper diagnosis and indication for surgery and to identify any potentially complicating factors. The anatomy and physiology of the eyelids and lacrimal system must be understood in detail. A complete ophthalmologic examination should be performed to document preoperative decreased visual acuity or limited visual fields. The prevention of complications and the satisfaction of the patient are the goals of the blepharoplasty procedure. These require accurate assessment, proper preoperative diagnosis, and meticulous surgical technique.
Blink yes; crane no: more on video display terminals.
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Association between duration of daily VDT use and subjective symptoms.
BACKGROUND: Although visual display terminal (VDT) work has become a common task among office workers, surveys which would help to determine the allowable duration of daily VDT use are limited. METHODS: We investigated more than 25,000 workers three times over a 3-year period using a self-administered questionnaire. Three factors, namely mental, physical and sleep-related symptoms, were extracted by factor analysis. Adjusted means of each factor score were compared with the duration of daily VDT use by general linear model. RESULTS: Physical symptoms score became higher with increasing duration of daily VDT use without a threshold effect. Mental and sleep-related symptom scores of the workers using VDT for more 5 hr/day were significantly higher than that of the groups using VDT for >1, 1-3, and 3-5 hr/day. CONCLUSIONS: Duration of daily VDT use was linearly related to the physical symptom score, and was non-linearly related to mental and sleep-related symptom score with a threshold effect of 5 hr/day.
Human lateral geniculate nucleus and visual cortex respond to screen flicker.
The first electrophysiological study of the human lateral geniculate nucleus (LGN), optic radiation, striate, and extrastriate visual areas is presented in the context of presurgical evaluation of three epileptic patients (Patients 1, 2, and 3). Visual-evoked potentials to pattern reversal and face presentation were recorded with depth intracranial electrodes implanted stereotactically. For Patient 1, electrode anatomical registration, structural magnetic resonance imaging, and electrophysiological responses confirmed the location of two contacts in the geniculate body and one in the optic radiation. The first responses peaked approximately 40 milliseconds in the LGN in Patient 1 and 60 milliseconds in the V1/V2 complex in Patients 2 and 3. Moreover, steady state visual-evoked potentials evoked by the unperceived but commonly experienced video-screen flicker were recorded in the LGN, optic radiation, and V1/V2 visual areas. This study provides topographic and temporal propagation characteristics of steady state visual-evoked potentials along human visual pathways. We discuss the possible relationship between the oscillating signal recorded in subcortical and cortical areas and the electroencephalogram abnormalities observed in patients suffering from photosensitive epilepsy, particularly video-game epilepsy. The consequences of high temporal frequency visual stimuli delivered by ubiquitous video screens on epilepsy, headaches, and eyestrain must be considered.
Video display terminals: a potential occupational health hazard?
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Binocularity after retinal detachment surgery.
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Associated convergence and accommodative insufficiency.
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Does work with visual display units impair visual activities after work?
It is well established that visual display unit (VDU) operators complain of visual fatigue and visual stress during after-work hours. The present study was divided into two parts. In the first part, standard eye examinations were performed on a group of VDU workers (n = 32) and a control group (n = 15); those subjects who were found to have correct vision (n = 16 and 13, respectively) participated in the second part. The eye examinations revealed that on the average, the VDU workers suffered more than twice as many visual impairments as the controls. In those with correct vision, the near point of accommodation was measured at the beginning of the workday at the start of the week, and at the end of the workday, four days later. In the VDU group, the decrease in accommodation was uniformally distributed between zero and 1.0 diopter, whereas among the non-VDU workers, 77% of the decrease was between zero and 0.25 diopter. The dynamic range of accommodation in the VDU workers on the second examination was smaller than on the first. We conclude that some of the visual stress and visual fatigue that developed at work hindered visual activities after work.
Central nervous system effects and visual fatigue in VDT workers.
To assess central nervous system effects and visual fatigue induced by work with visual display terminals (VDT), symptom frequency was assessed and visual evoked potential (VEP), critical flicker fusion (CFF) and near-point distance were measured in 24 female keypunchers before and after 2.5 h of VDT work and in 6 non-VDT-exposed subjects at the same intervals. Each keypuncher had been engaged in data entry for 1-7 (mean, 4) years. After VDT work, the number of complaints of subjective fatigue as well as an objective measure of near-point distance were significantly increased as compared with those before work; also, the N75, P100 and N145 latencies of VEP were significantly prolonged. The change of P100 latency during VDT work was inversely correlated with the number of years worked in data entry. No significant change was seen in any of these tests in the non-VDT-exposed subjects. The changes in N75 latency and subjective fatigue related to drowsiness and dullness in the keypunchers were significantly larger than those in the non-VDT-exposed subjects. The CFF was significantly lower in keypunchers than in non-VDT-exposed subjects in both the first and the second tests. These data suggest that VDT work is associated with impairment of the visual nervous system function, that VEP latencies appear to be a sensitive indicator of visual fatigue, at least transiently, and that CFF appears to be a good parameter for estimations of chronic visual fatigue.
Identification of the preferential gaze position through elevation of visual fatigue in a selected group of VDU operators. A preliminary study.
A selected group of VDU workers were tested in an attempt to achieve objective evidence of visual fatigue and to identify a preferential monitor/gaze position during a particular work setting. Each subject was scored in a two-phase test. The highest mean scores were achieved when the monitor was lowered with respect to the primary/gaze position; the scores obtained with the monitor in primary or upward gaze position were significantly lower (p < 0.001). The downward gaze position should be considered more comfortable for both innervational and anatomical factors, as stated in previous studies of ocular mobility. A reduction of vertical saccades could also play a role in lessening visual fatigue in this gaze position.
[Prism correction in heterophoria].
Unlike heterotropia (= manifest strabismus), heterophoria (= latent strabismus) is not a primarily existing condition but is a reaction to an interruption of the sensory-motor feedback control system. The reaction consists of a deviation from the orthovergence position. Binocular vision causes a continuous calibration of the vergence position. This "orthophorisation" explains that in most persons, heterophoria differs only slightly from zero. Nevertheless, a small heterophoria is common (70-80% of the population). The need to compensate for heterophoria by sensory-motor fusion can cause asthenopic complaints, such as headaches with prolonged reading. Since a variety of other defects can lead to similar symptoms, a causal relationship with heterophoria can be assumed only after a thorough differential diagnosis. Prism spectacles or eye muscle surgery for heterophoria should be recommended only after prism trials in free space, which include yoked prisms as a placebo control. Heterophoria should be distinguished from "Winkelfehlsichtigkeit", which is a deviation from orthoposition that results from the "measuring and correcting methodology after H.-J. Haase" (MKH) and is based on the idea that fixation disparity, a minute deviation from orthovergence position, indicates an inability to overcome a larger "vergence angle at rest". Objective recordings have, however, revealed that the subjective tests with stereo cues applied in the MKH can mislead to the assumption of a fixation disparity although both eyes are aligned exactly to the fixation point. A trial conducted in the Netherlands concerning the therapy of asthenopic complaints showed no statistically significant advantage of prism spectacles determined with the MKH over conventional spectacles.
The antisaccade task in a sample of 2,006 young males. II. Effects of task parameters.
Antisaccade performance was investigated in a sample of 2,006 young males as part of a large epidemiological study investigating psychosis proneness. This report summarizes the effects of task parameters on performance using a sample of 55,678 antisaccade trials collected from a subpopulation of 947 individuals. Neither the amplitude nor the latency of an error prosaccade in the antisaccade task was correlated with the latency of the ensuing corrective antisaccade that almost always followed an error. However, the latency of the corrective antisaccade decreased with increasing stimulus distance. Concerning the effects of specific task parameters, trials with stimuli closer to the central fixation point and trials preceded by shorter fixation intervals resulted in more errors and longer latencies for the antisaccades. Finally, there were learning and fatigue effects reflected mainly in the error rate, which was greater at the beginning and at the end of the 5-min task. We used a model to predict whether an error or a correct antisaccade would follow a particular trial. All task parameters were significant predictors of the trial outcome but their power was negligible. However, when modeled alone, response latency of the first movement predicted 40% of errors. In particular, the smaller this latency was, the higher the probability of an error. These findings are discussed in light of current hypotheses on antisaccade production mechanisms involving mainly the superior colliculus.
Influence of two-dimensional and three-dimensional imaging on endoscopic bowel suturing.
Several three-dimensional (3-D) video-endoscopic systems have been introduced in surgical practice to enhance depth perception during minimal access surgery (MAS), but the facilitation of endoscopic manipulations by the current 3-D systems remains unproved. The aim of the study was to investigate the influence of 2-D and 3-D imaging modalities on intracorporeal suturing. The standard task consisted of suture closure of 60 mm enterotomies made in porcine small bowel with continuous seromuscular 3/0 Polysorb. Ten experienced surgeons participated in the study. The imaging systems were Storz (2-D), Welch Allyn (3-D), and Zeiss (as both 2-D and 3-D). Each surgeon performed two tasks with each modality in a random sequence. The outcome measures were execution time, suture line leakage pressure, and suture placement score. In addition, the participating surgeons assigned subjective scores on the image quality and the adverse effects of the imaging systems. There was no significant difference in the execution time, leakage pressure, and suture placement score among the various imaging modalities. Depth perception was rated as similar with 2-D and 3-D imaging. Surgeons experienced visual strain with the three systems, but it was rated higher with 3-D imaging. With the current technology, we have not documented any significant difference in task efficiency and quality of endoscopic bowel suturing by trained surgeons between 2-D and 3-D imaging systems.