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PubMed2006

Vision rehabilitation for Canadians with less than 20/40 acuity: the SmartSight model.

Traditionally, vision rehabilitation was directed towards patients who were blind or had very low vision. There is increasing evidence that less severe vision loss is associated with increased risk of falls, hip fractures, medication errors, poor nutrition, reduced physical activity, social isolation, clinical depression, longer hospitalizations, and mortality. The American Academy of Ophthalmology (AAO) 2003 SmartSight initiative in low vision rehabilitation outlined a model of graduated low vision interventions. This paper is a review of the AAO SmartSight model and how it can apply in the Canadian setting. All patients with visual acuity less than 20/40, a scotoma, field loss, or loss of contrast sensitivity would be offered information about available low vision rehabilitation. Eye physicians would be encouraged to communicate with other health care providers to coordinate existing services and integrate graduated services. Enhanced communication among caregivers about the consequences of vision loss, such as depression, falls, and visual hallucinations, could help ensure that all patients who would benefit receive appropriate vision rehabilitation.

Canada↗

PubMed2000

Prevalence of amblyopia among defaulters of preschool vision screening.

The prevalence of amblyopia among screening defaulters is an important determinant of the efficacy of amblyopia detection by preschool vision screening. A retrospective cohort study was therefore performed to assess an orthoptist-based preschool vision screening programme. The preschool vision screening status of children in the cohort was determined by reviewing their Community Child Health records. The prevalence of amblyopia among screening defaulters was determined by reviewing each child's school entry vision test (performed at 5.5 years of age), with retesting if a Snellen line acuity of 6/6 in each eye had not been documented. For comparison, the prevalence of amblyopia among screening attenders was also determined. The preschool vision screening status was known for 86.0% (772/898) of the cohort. The attendance rate at preschool vision screening was 79.2%. The prevalence of amblyopia among screening defaulters was 1.3% (95% CI 0.2% to 4.5%). The prevalence of amblyopia among screening attenders was 2.5% (95% CI 1.4% to 4.1%). There was no significant difference in the prevalence of amblyopia between screening defaulters and screening attenders (P=0.53). The efficacy of amblyopia detection by preschool vision screening is therefore highly dependent on its attendance rate. Preschool vision screening programmes with a low attendance rate will fail to detect a significant proportion of children with amblyopia.

Amblyopia↗

PubMed2000

Evolution of color vision loss induced by occupational exposure to chemicals.

The evolution of occupationally induced color vision loss was studied in workers exposed to various chemicals. Exposure was evaluated by biological monitoring or personal air samplers, and color vision using the Lanthony D-15 desaturated panel (D-15 d). The effect of short-term interruption of exposure was studied in 39 Styrene (St) exposed workers: at a first examination a dose-related color vision loss was disclosed; a re-test performed after one month's interruption of exposure did not show any improvement of the effect. The evolution during longer periods was studied in another group of 30 St workers. Exposure and color vision were evaluated, then a follow-up was done 12 months later: the exposure was unmodified or slightly decreased in 20 subjects, and D-15 d outcomes remained unchanged, while St levels had increased and color vision loss progressed in the other 10. Similar results were obtained in 33 PCE exposed dry-cleaners: no change in color perception was observed in 14 workers whose exposure decreased, while in the other 19 a rise in PCE levels was followed by a significant color vision worsening. In 21 Hg exposed workers whose mean urinary excretion of Hg was threefold the BEI proposed by ACGIH, a dose-related impairment in color perception was observed. 12 months after a marked reduction of exposure, an almost complete recovery of the impairment was observed. Our data show that an increase in exposure can induce a worsening in color vision loss. A short interruption in exposure did not reduce the effect. A more prolonged reduction of dose reversed color vision loss in Hg exposed workers, while in solvent-exposed individuals the progression deserves further evaluation. D-15 d proved a useful test for studies on the evolution of color perception in workers exposed to eye-toxic chemicals.

Color Perception↗

PubMed2002

Modeling a parallel L4 neuron array of the fly (Musca domestica) vision system with a sequential processor.

At RMBS 2001 Olson presented a novel approach to image edge detection based on the vision system of the common house fly, Musca domestica [1]. Biologically based vision systems are inherently parallel and the vision related cells form a self-contained cartridge, ommatidium, which is duplicated across the surface of the fly's eye. Histological evidence provides the interconnection both within the vision cartridge and the connections to adjacent cartridges. Due to the parallel nature of biologically inspired vision systems, they outperform computer based digital vision systems in speed performance and memory requirements. Olson provided a model of the cartridge with its intra- and inter-connections. This model, rendered in MATLAB and Excel, demonstrated the feasibility of edge detection in the first several synaptic cellular connections within the cartridge. His results demonstrated how edge detection and object movements are easily obtained using a biologically based vision model. He demonstrated the model using simple rectangular and circular objects. We term this work Olson's Algorithm. We have extended Olson's Algorithm into a high-resolution model using a standard off-the-shelf frame grabber. Although, the frame grabber is a digitally based instrument, its image planes are used to model the photoreceptor layer (R1-R6), the L1, L2 monopolar cell layer, and also the monopolar L4 cell layer. The connections between these cells are programmed in "C". The high-resolution model demonstrates the feasibility of using a biologically based vision system in a real world application. Furthermore, it allows object segmentation, movement, and tracking to be modeled prior to implementation in parallel analog hardware.

Algorithms↗

PubMed2003

[Status of low-vision rehabilitation for age-related macular degeneration by orthoptists in the North of France].

AIM OF THE STUDY: To evaluate the status of low-vision rehabilitation carried out by the orthoptists in the North of France. This study was a preliminary step in setting up a network between different vision professionals for the management of age-related macular degeneration (AMD) the North of France. METHODS: The ASO (Association Septentrionale d'Ophtalmologie) conducted a survey funded by the URCAM (Union Régionale des Caisses d'Assurance Maladie) with the FAQSV (fond d'aide à la qualité des soins de ville). The survey was based on the analysis of two forms sent to orthoptists of the North region of France. RESULTS: The survey analyzed 46 responses (a representative sample with 69% responses) providing a description of the orthoptists of the North of France: 19% males, 81% females whose mean professional experience was 13.3 years. Thirty-four percent of the orthoptists have had training in low-vision rehabilitation. This training was given during the university courses for 21% of responders and during a postgraduate course for 79%. Of the orthoptists surveyed, 64% worked in a private context, 9% in a public context, and 27% in both public and private contexts. Their main activity was in their own private practice for 60%, in an ophthalmologist's office for 20%, in a public institution for 16%, and a private institution for 4%. The mean number of patients treated was 70 per week per orthoptist, with 21% working mostly with children, 36% working mainly with adults between 16 and 60 years of age, and 7% with the elderly, whereas 36% reported no specificity related to patient age. The mean number of patients dealt with for low vision related to AMD was 4.1 per month per orthoptist. The average number of patients dealt with for low vision with no relation to AMD was 1.5 per month. The prescriber of low-vision rehabilitation was an ophthalmologist for 88.9% of the orthoptists and a general practitioner for 11.1%. Questions addressed to AMD patients: at the beginning of the survey, 83.8% of the patients did not have sufficient visual acuity to be able to read a text of current size (Parinaud 4); 40.4% of the patients required help for everyday life, and 59.6% were autonomous. For 7.1% of the patients, low-vision rehabilitation was carried out less than 1 month after the stabilization of retinal lesions, but in 35.3%, rehabilitation was carried out more than 2 years after lesions were stabilized. The main request of the patients involved improvement of near vision (89.9%). CONCLUSION: This survey will be a preliminary step in setting up a regional health network coordinating the ophthalmological and orthoptic management of AMD.

Aged↗

PubMed2003

A survey of blindness and poor vision in leprosy patients.

OBJECTIVE: To determine the prevalence, cause and distributions of blindness and poor vision in patients with leprosy. METHODS: An epidemiological survey of blindness and poor vision among 1045 cases of leprosy was carried out in Taixing City of Jiangsu Province, China. RESULTS: The prevalence of bilateral blindness was 7.67%, unilateral blindness 4.4%, bilateral poor vision of various degrees 9.28% and unilateral poor vision 5.84%. The prevalence of eye complications varied significantly among different groups of patients; females had a higher prevalence than males, multibacillary patients higher than paucibacillary patients, and in-patients higher than out-patients. Corneal disease was the most common cause of blindness in study groups, followed by iritic disease and cataract; while the main cause of poor vision was cataract, then corneal and iritic diseases. Treatable blindness accounted for 62.7% of the cases and treatable poor vision for 88.6% of the patients studied. 56.62% of cases with eye complications expressed their willingness to be treated. CONCLUSIONS: Although prevention and treatment of low vision and blindness in leprosy patients is very hard, it is necessary for doctors and medical workers to make clear of the factors to cause low vision and blindness, especially those in leprosy patients so that some measures for prevention and treatment of the disease could be taken accordingly.

Adult↗

PubMed1992

Different patterns of X inactivation in MZ twins discordant for red-green color-vision deficiency.

Two female identical twins who were clinically normal were obligatory heterozygotes for X-linked deuteranomaly associated with a green-red fusion gene derived from their deuteranomalous father. On anomaloscopy, one of the twins was phenotypically deuteranomalous while the other had normal color vision. The color vision-defective twin had two sons with normal color vision and one deuteranomalous son. X-inactivation analysis was done with the highly informative probe M27 beta. This probe detects a locus (DXS255) which contains a VNTR and which is somewhat differentially methylated on the active and inactive X chromosomes. In skin cells of the color vision-defective twin, almost all paternal X chromosomes with the abnormal color-vision genes were active, thereby explaining her color-vision defect. In contrast, a different pattern was observed in skin cells from the woman with normal color vision; her maternal X chromosome was mostly active. However, in blood lymphocytes, both twins showed identical patterns with mixtures of inactivated maternal and paternal X chromosomes. Deuteranomaly in one of the twins is explained by extremely skewed X inactivation, as shown in skin cells. Failure to find this skewed pattern in blood cells is explained by the sharing of fetal circulation and exchange of hematopoietic precursor cells between twins. These data give evidence for X inactivation of the color-vision locus and add another MZ twin pair with markedly different X-inactivation patterns for X-linked traits.

Chromosome Mapping↗

PubMed1995

Low vision aids training in the home.

BACKGROUND: In a continuing effort to better serve the low vision community, The Center for the Partially Sighted has developed an in-home low vision aids training (LVAT) program. Of interest to anyone working in the field of low vision is a description of our training materials and methodology, and a discussion of the efficacy of this program. METHODS: The previous literature on low vision was evaluated and organized into an orderly program geared toward the visual rehabilitation of low vision patients. RESULTS: Implementation of LVAT in the home began as a pilot project directed toward patients with macular degeneration who have begun reading as a primary goal of rehabilitation. CONCLUSIONS: Successful vision rehabilitation with low vision devices can be accomplished with proper training. Typically the exam does not allow ample opportunity to ensure that a patient is proficient in the use of a device. Follow-up training in the home environment may provide the necessary intervention to maximize patients' comfort and efficiency with low vision devices and their ability to accomplish near point tasks.

Home Care Services↗

PubMed1997

Evaluating the value of low-vision services.

BACKGROUND: Low-vision care is a widely accepted and valued service provided by many optometrists. As in other areas of health care, evaluation of the outcome of low-vision care is increasingly necessary so it can be properly positioned in the health care delivery system. METHODS: This article reviews the literature relating to the prevalence of low vision, its impact on affected individuals, and how low-vision intervention affects those with visual impairments. This review considers the ways in which the impact of low-vision care has been evaluated. RESULTS: The existing literature demonstrates that low-vision intervention can be highly valued by low-vision patients and can have a significant impact on an individual's daily life and activities. Evaluating this impact is a significant challenge-particularly if the goal is to gauge the outcome of low vision care as broadly as possible. CONCLUSIONS: Evaluation of health-related quality of life is a desirable option for evaluation of outcomes, and the application of quality of life instruments to the visually impaired population is necessary. There remain unresolved issues of optometric research that need to be addressed.

Delivery of Health Care↗

PubMed1997

Demographic characteristics of the vision-disabled elderly.

PURPOSE: To profile certain demographic features of the low-vision population in Ontario, Canada. METHODS: Sixty-six optometrists or optometry centers, 8 ophthalmologists, and 23 Canadian National Institute for the Blind rehabilitation worker teams were recruited to the study. They were required to report on their low-vision examinations during a 3-year period. RESULTS: Reports from 4744 low-vision examinations were received. Of the patients examined, 71% were over age 65 (subsequently called seniors or elderly), and 55% were over age 75. Ninety percent of all the patients lived in households and 10% lived in institutions. Seniors made up 71% of the patients living in households and 88% of the patients living in institutions. Most of the seniors were women (65%), and 57% had functional limitations in addition to low vision, most commonly limitations in mobility, hearing, or agility. Age-related maculopathy was the primary diagnosis in 75% of seniors, and the most common secondary diagnosis was cataract (46%). The main objective for most elderly low-vision patients was to gain improvement in personal reading (75%). CONCLUSIONS: The vast majority of low-vision patients were elderly, the largest number being 75 to 84 years old. When older senior low-vision patients (> or = 85 years) were compared with younger seniors (65 to 74 years), the older seniors were more likely to be women, more likely to have additional functional limitations, more likely to live in an institution, and more likely to have age-related maculopathy and cataract. Whether some elderly low-vision patients may be helped by cataract surgery needs to be determined.

Adolescent↗

PubMed1998

Threshold perimetry of each eye with both eyes open in patients with monocular functional (nonorganic) and organic vision loss.

PURPOSE: To report a novel binocular perimetry test to identify monocular functional vision loss. METHODS: In a prospective study, 10 patients with monocular functional vision loss, 10 patients with monocular organic vision loss, and 10 normal subjects were tested using a Humphrey automated perimeter attachment that performs central threshold perimetry of both eyes in a single test. First, patients were tested after being told their "good" (unaffected) eye was being tested; this was followed by a second identical test said to be on the "bad" (affected) eye. Two measurements were calculated for each subject: the functional component (deltaF), defined as the difference (in dB) between the mean threshold of the first and second tests, and the organic component (deltaO), the difference (in dB) between the mean threshold of the unaffected and affected eyes. RESULTS: Patients with monocular functional vision loss produced lower thresholds when they thought their affected eye alone was being tested but little intereye difference (mean deltaF +/- SD = 17.35 +/- 7.50 dB; mean deltaO = 0.01 +/- 1.40 dB). Patients with monocular organic vision loss had little difference between tests and lower thresholds in their affected eye (mean deltaF = 0.84 +/- 1.15 dB; mean deltaO = 9.01 +/- 4.71 dB). Normal subjects demonstrated little intertest or intereye differences (mean deltaF = -0.15 +/- 0.78 dB; mean deltaO = -0.05 +/- 0.51 dB). CONCLUSION: This perimetry method effectively distinguished between normal subjects, patients with monocular functional vision loss, and patients with monocular organic vision loss.

Adolescent↗

PubMed1994

Preteaching developmentally delayed preschoolers to aid vision screening.

Early identification and treatment of vision problems is a key element in learning. For preschool children already identified with developmental delay, vision screening and visual correction are particularly essential. Participants drawn from a public Special School District were 105 preschoolers ages 3 to 5 years identified as having developmental delay. Examples included autism, Down syndrome, physical handicap, or cognitive impairment. A partnership was created between the public preschool and the University Schools of Nursing and Optometry to implement vision screening. Teachers/teacher assistants were asked to characterize the children before and after preteaching and after vision screening. Using a semantic differential scale of bipolar descriptors, planned comparisons within a repeated measures MANOVA were statistically significant for all pairs before teaching vs. the mean of after teaching/after screening (p = 0.027) but not statistically significant for after teaching vs. after vision screening (p = 1.000). Results of this preliminary study suggest preteaching could be an important part of a successful vision screening partnership in that 102 (97%) of developmentally delayed children successfully completed screening for vision problems.

Child, Preschool↗

PubMed2004

Vision screening in schoolchildren: two years results.

OBJECTIVE: To assess the prevalence of visual impairment and ocular abnormalities among schoolchildren in Chiang Mai. DESIGN: A community-based survey. SUBJECTS AND METHOD: The vision screening project was conducted from June 2000 to March 2002. Students in grade I in the Chiang Mai municipal area were examined for visual acuity (VA), color vision, ocular alignment, anterior segment and fundus. Subjective refraction was done in students with subnormal vision (VA 20/30 or less). Referral to the hospital for further evaluation and treatment was made for students with strabismus, amblyopia and other ocular abnormalities. RESULTS: A total of 3,431 and 3,467 students were enrolled in 2000 and 2001, respectively. The prevalence of normal vision (VA 20/20), VA 20/30 or better in at least one eye and 20/40 or less in at least one eye were similar in both years (87%, 5.7%, 7.3% and 85%, 6.4%, 8.7%, respectively). There was no statistically significant difference in visual acuity among boys and girls in either year (p = 0.6 and p = 0.2). Prevalence of abnormal color vision was 4.2%. Other causes of visual impairment in both years included strabismus (1.5% and 6.2%), amblyopia (1.1% and 1.4%) and some congenital abnormalities. Most cases of amblyopia were due to uncorrected refractive errors. CONCLUSION: The authors found that over 10% of school-aged children had subnormal vision. The important causes of visual deterioration came from refractive errors, strabismus and amblyopia. The authors concluded that vision screening is a cost-effective way of reducing visual morbidity from preventable visual impairment, which is a tragedy that cannot be ignored.

Amblyopia↗

PubMed1993

Does the production of letter strokes in handwriting benefit from vision?

In earlier studies the involvement of vision in handwriting was suggested by the finding that the production of a letter sequence in a condition without vision took more time and resulted in larger letter trajectories. The present study raises the question whether vision has an impact on the production of the individual up- and downstrokes constituting the letters. More specifically, the aim is to examine whether vision is employed either during the completion of a movement, or concurrent with the entire course of a stroke movement. Adult writers produced the letter sequence lelele under a no-vision and a vision condition, the latter serving as a base-line condition. It was found that movement time and trajectory size of acceleration and deceleration phases of a stroke movement increased under no vision, the magnitude of which depended on letter type. Letter e, with a smaller size and more frequently used in Dutch writing than letter l, was less affected by the no-vision condition. Although, close examination of downstrokes produced in later letter positions of the sequence revealed that the acceleration as compared to the deceleration phase took proportionally less time, the general finding was that increments in time and size proved to be equally distributed across entire stroke movements.

Adult↗

PubMed2006

"Instant vision" compared with postoperative patching: clinical evaluation and patient satisfaction after bilateral cataract surgery.

PURPOSE: To compare two methods of postoperative dressing regimen: patching vs "instant vision" without patch. DESIGN: Prospective randomized clinical trial. METHODS: Sixty consecutive hospitalized, nonambulatory patients with cataract surgery under topical anesthesia on both eyes at different days were enrolled prospectively. In randomized order, one eye was patched for the first 24 hours postoperatively; the other eye was left open without patch to obtain "instant vision." Both eyes received the same anti-inflammatory and antibiotic drop therapy. RESULTS: Twenty-four hours postoperatively, no significant differences between patching and "instant vision" could be found for corrected and uncorrected visual acuity, corneal epithelial defects, conjunctival inflammation, anterior chamber flare, and intraocular pressure (P > .05). During the first 24 hours postoperatively, all tear film parameters were significantly worse in the "instant vision" eyes (P < .001), indicating a transient tear film instability. During the first four hours after cataract surgery, pain scores in the "instant vision" eyes were significantly higher than in the patched eyes (P < .001). Eight hours postoperatively and later, there were no significant differences in any pain scores (P > .05). After experiencing both methods, 27% of the patients subjectively rated the two methods as equivalent; 8% of the patients preferred "instant vision." Despite of the benefits of immediately improved orientation, 65% of the tested patients preferred patching to "instant vision" because of lower pain and foreign body sensations and psychologic arguments. CONCLUSIONS: The clinical examinations showed that both methods were equally safe for postoperative therapy. However, further efforts have to be made to increase the patients' comfort with "instant vision" in the first hours after cataract surgery.

Aged↗

PubMed2005

Pharmacological management of night vision disturbances after refractive surgery Results of a randomized clinical trial.

PURPOSE: To evaluate the efficacy and safety of diluted aceclidine eyedrops in reducing night vision disturbances after refractive surgery. SETTING: Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano-Milano, Italy. METHODS: This double-masked randomized clinical trial included 30 patients (60 eyes) with chronic night vision disturbance after refractive surgery. Patients were randomly allocated to receive (1) placebo, (2) aceclidine 0.016%, or (3) aceclidine 0.032%. Drugs were administered once or twice daily. Anterior segment, haze, uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal maps, and scotopic pupil size were determined at baseline and at follow-up examinations (15 and 30 days after inclusion). Halos and double vision 4-step scales were built to determine subjective grading of night vision disturbance, and the root mean square (RMS) was calculated to determine objective changes in night vision disturbance. RESULTS: The effect of diluted aceclidine started about 15 minutes after instillation and lasted for about 5 hours. No difference between the 2 dilutions could be found. Thirty-nine of 40 treated eyes showed a reduction in night vision disturbance. The mean reduction in halos and double vision grading was 1.42 +/- 0.5 (SD) and 1.14 +/- 0.4, respectively. A mean decrease in pupil size of 2.5 mm was measured. Thirty minutes after the instillation of diluted aceclidine, the topography-derived wavefront error showed a statistically significant reduction in RMS values (total, spherical, astigmatic, coma, and higher order), which was maintained for 5 hours. A transitory conjunctival hyperemia was the only side effect reported. CONCLUSION: Diluted aceclidine seemed to be an effective and safe treatment for night vision disturbance following refractive surgery.

Adult↗

PubMed2000

First operation anatomic success and other predictors of postoperative vision after complex retinal detachment repair with vitrectomy and silicone oil tamponade.

PURPOSE: To evaluate the role of first operation anatomic success compared with success after reoperation and preoperative characteristics in achieving ambulatory vision (>/=4/200) and good vision (>/=20/100) after repair of complex retinal detachment with vitrectomy and silicone oil tamponade. METHODS: A prospective, observational, multicenter study of patients who underwent vitrectomy with silicone oil for retinal detachments associated with cytomegalovirus necrotizing retinitis or a non-cytomegalovirus necrotizing retinitis etiology, including proliferative diabetic retinopathy, giant retinal tear, proliferative vitreoretinopathy, and ocular trauma. RESULTS: A higher rate of ambulatory vision was achieved in the first operation anatomic success cases, compared with the reoperation cases, for eyes with cytomegalovirus necrotizing retinitis (72% vs 50%, P < 0.01) and eyes without cytomegalovirus necrotizing retinitis (51% vs 38%, P = 0.04). For eyes with cytomegalovirus necrotizing retinitis, preoperative ambulatory vision (RR = 2.3, P < 0.0001) and reoperation (RR = 0.4, P = 0.05) were independent predictors of postoperative ambulatory vision. For eyes without cytomegalovirus necrotizing retinitis, preoperative ambulatory vision (RR = 4.0, p < 0.0001) and retinal detachment etiology (P = 0.02) were prognostic factors. Compared to eyes with trauma, eyes with giant retinal tear, proliferative vitreoretinopathy and proliferative diabetic retinopathy were 2.8 (P < 0.003), 2.2 (P = 0.01) and 1.6 (P = 0.17) times as likely to achieve postoperative ambulatory vision, respectively. Within the giant retinal tear group, a higher rate of ambulatory vision was achieved in the first operation anatomic success cases compared with the reoperation cases (66% vs 31%, P = 0.03). Although not statistically significant, similar outcomes occurred in the proliferative diabetic retinopathy (48% vs 25%) and proliferative vitreoretinopathy groups (54% vs 45%). Similar prognostic relationships were found for good visual acuity outcomes. CONCLUSIONS: First operation anatomic success, preoperative visual acuity, and giant retinal tear or proliferative vitreoretinopathy as the retinal detachment etiology are important factors that predict visual outcome.

Adult↗

PubMed2004

[Lasik, PRK and quality of vision: a study of prognostic factors and a satisfaction survey].

PURPOSE: To confirm the clinical interest of pupillary diameter measurement for selecting indications and determining surgical protocols, to look for clinical factors predisposing to night vision symptoms, and to the assess patient satisfaction level for photoablation techniques not based on aberrometry. METHODS: This retrospective study was conducted on 111 consecutive myopic patients (219 eyes, with a mean spherical equivalent of -4.25+/-1.84 D); they underwent Lasik (91.3% of cases) or photorefractive keratectomy, after having their pupillary diameter measured by the Colvard pupillometer. Clinical data were collected from medical files, and an anonymous questionnaire was sent in order to assess quality of vision and postoperative satisfaction. RESULTS: Preoperative aims were reached (r=0.41, p<0.0001). The response rate for the questionnaire was 81.1%. Daytime vision was the same or better for 91.1% of the patients, but 25.6% had worse night vision than before. Night vision symptoms were mentioned by 46.7% of the patients, and the most frequent complaint was halos. However, 97.8% of the patients declared themselves as satisfied and would recommend such surgery to their family and friends. A preoperative myopia greater than 4.50D (RR=1.52, p<0.05) and a postoperative keratometry greater than 8.44 mm (RR=1.62, p<0.05) were risk factors for having night vision symptoms, but pupillary diameter was not a risk factor. CONCLUSION: This survey gives an indirect confirmation of the interest of scotopic pupillary diameter measurement and taking it into account in photoablation protocols. However, night vision symptoms remain frequent but do not influence patient satisfaction. Knowledge of risk factors and technical progress should provide a better quality of vision after Lasik.

Adult↗