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PubMed1985

[The preferential looking technic: material and procedure for testing baby vision].

The preferential looking technique, together with a cover test, retinoscopy and a fundus examination is done in a hospital setting for screening and follow-up of visual deficiencies in infants between 3 and 12 months of age. A series of granting from .375 to 18 cycles per degree are generated by slides, paired with a matched mean luminance uniform area. The child's preferred gaze orientation is determined by an orthoptist unaware of the randomized side of the granting, from a picture of the infant displayed on a closed-circuit television. The baby is gratified after each positive trial. The finest grating toward which the baby systematically orients its gaze is a behavioral estimate of its spatial resolution ability. Binocular and monocular testing are performed in at least 15 minutes. Details of equipment and procedure are described.

Differential Threshold↗
PubMed2006

Quantitative analysis of OCT characteristics in patients with achromatopsia and blue-cone monochromatism.

PURPOSE: To quantify optical coherence tomography (OCT) images of the central retina in patients with blue-cone monochromatism (BCM) and achromatopsia (ACH) compared with healthy control individuals. METHODS: The study included 15 patients with ACH, 6 with BCM, and 20 control subjects. Diagnosis of BCM and ACH was established by visual acuity testing, morphologic examination, color vision testing, and Ganzfeld ERG recording. OCT images were acquired with the Stratus OCT 3 (Carl Zeiss Meditec AG, Oberkochen, Germany). Foveal OCT images were analyzed by calculating longitudinal reflectivity profiles (LRPs) from scan lines. Profiles were analyzed quantitatively to determine foveal thickness and distances between reflectivity layers. RESULTS: Patients with ACH and BCM had a mean visual acuity of 20/200 and 20/60, respectively. Color vision testing results were characteristic of the diseases. The LRPs of control subjects yielded four peaks (P1-P4), presumably representing the RPE (P1), the ovoid region of the photoreceptors (P2), the external limiting membrane (ELM) (P3), and the internal limiting membrane (P4). In patients with ACH, P2 was absent, but foveal thickness (P1-P4) did not differ significantly from that in the control subjects (187 +/- 20 vs. 192 +/- 14 microm, respectively). The distance from P1 to P3 did not differ significantly (78 +/- 10 vs. 82 +/- 5 microm) between ACH and controls subjects. In patients with BCM, P3 was lacking, and P2 advanced toward P1 compared with the control subjects (32 +/- 6 vs. 48 +/- 4 microm). Foveal thickness (153 +/- 16 microm) was significantly reduced compared with that in control subjects and patients with ACH. CONCLUSIONS: Quantitative OCT image analysis reveals distinct patterns for controls subjects and patients with ACH and BCM, respectively. Quantitative analysis of OCT imaging can be useful in differentiating retinal diseases affecting photoreceptors. Foveal thickness is similar in both normal subjects and patients with ACH but is decreased in patients with BCM.

Adult↗
PubMed2005

Factors related to vision care in an older adult cohort.

PURPOSE: This study provides cross-sectional data on eye care utilization in a community-based adult population. METHODS: Data are from a questionnaire administered during the 7-year follow-up of the Epidemiology of Hearing Loss Study in 2000 to 2002. Participants in the population-based Beaver Dam Eye Study were eligible for the Epidemiology of Hearing Loss Study, which began in 1997. The primary outcome was self-reported vision testing within the past year. RESULTS: Subject ages ranged from 55 to 99 years (n = 2433), and 60.4% were female. Fifty-three percent of subjects reported they had their vision tested in the past year. Diabetes was self-reported by 11.5% of subjects, and 70.9% of diabetic participants had their vision tested in the past year. A current hospitalization or health insurance plan was reported by 98.6% of subjects. In multivariate analyses, self-reported factors significantly associated with having a vision test in the past year were female gender (odds ratio [OR] = 1.27; 95% confidence interval [CI] 1.06-1.52), current use of refractive correction for distance (OR = 1.98; 95% CI 1.56-2.52), glaucoma (OR = 3.52; 95% CI 2.37-5.24), cataract surgery (OR = 1.57; 95% CI 1.21-2.03), age-related macular degeneration (ARMD) (OR = 1.74; 95% CI 1.22-2.47), diabetes (OR = 2.46; 95% CI 1.83-3.31), visiting a primary care practitioner for any reason in the past year (OR = 1.72; 95% CI 1.32-2.25), having a hearing test in the past year (OR = 1.79; 95% CI 1.40-2.28), and the cessation of driving because of poor vision (OR = 1.64; 95% CI 1.16-2.52). In participants 65 years of age or older, having private insurance was associated with increased odds (OR = 3.39, 95% CI 1.82-6.31) of vision testing in the past year. CONCLUSION: This study suggests that chronic ocular conditions, diabetes, health insurance beyond government entitlements, and the use of other healthcare services are associated with increased eye care utilization.

Aged↗
PubMed1970

Testing the vision of cataract patients by means of laser-generated interference fringes.

In a new technique for measuring the visual acuity of cataract patients the light from a laser is used to form interference patterns of variable fineness on the patient's retina. The fineness of the interference pattern that the patient can detect gives an indication of the potential for improved vision. Comparison of this estimate of the potential with the patient's vision after cataract extraction shows that this test can indicate the condition of the fovea behind a cataract.

Cataract↗
PubMed2001

[Diagnosis and surgical treatment of idiopathic macular holes].

AIM: Evaluation of diagnostical methods and pars plana vitrectomy (ppv) in surgical treatment of idiopathic macular holes. MATERIAL AND METHODS: Group of 16 patients, 15 women and 1 man, aged between 48 and 78 years, mean age 63 years. The surgical treatment--ppv were performed in all patients with macular holes stage II-IV. In all patients the following examinations were performed: distant and near visual acuity, ophthalmoscopy in Volk 60 lens, Amsler test, colour vision test with anomaloscope IF2, ultrasonic evaluation of vitreous chamber and particularly of premacular region, and electrophysiological tests-visual evoked potentials (VEP) and electroretinography (ERG). 12 patients were treated by ppv with exchange fluid-gas SF6, and in 4 patients extra adjuvant--own patient's serum was injected after earlier exchange fluid-air-gas SF6. RESULTS: In 80% of cases there was an improvement of vision observed by patients, improvement of near visual acuity and reduction of metamorphopsia in Amsler test. In USG examination the reduction of macular thickening, lack of operculum and presence of complete posterior vitreous detachment in the region of macula were observed after surgery. In electrophysiological investigations there was the improvement of VEP parameters using 1/4 visual field as a stimulus. In 1 case treated with adjuvants, there was endophtalmitis with secondary retinal detachment after ppv. CONCLUSIONS: Ppv in nearly all cases gave good results for patients--improvement of visual comfort and reduction of central defect of vision. It also gave good surgical--anatomical results. Using of adjuvant--own patient's serum, did not improve in particular way the functional and anatomical results of surgery.

Aged↗
PubMed1990

Loss of P retinal ganglion cell function in resolved optic neuritis.

To determine the relative loss of P and M (X and Y) ganglion cell function in unilateral resolved optic neuritis, 10 patients with 20/20 or better Snellen acuity in both eyes had contrast sensitivity testing, color vision testing, and automated perimetry. We used contrast sensitivity gratings of 0.5 cycles per degree (cpd) with a rate of counterphase temporal modulation of 30 Hz and gratings of 11.4 cpd at 1 Hz. On 1 trial, patients responded when they detected the pattern of the grating and on the next trial when they 1st perceived movement. There was a significant difference in the 1 Hz high spatial frequency pattern and movement results suggesting loss of P cell function. Two patients were unable to perceive any movement with their involved eye with this target, but could detect the pattern. There was no significant difference between the involved and uninvolved eyes in the low spatial frequency pattern detection values. This is a function ascribed to the M cell. There was also loss of low spatial frequency movement detection. Although there was significant depression of the entire visual field in the involved eye, the probability plots showed the most significant loss in the cecocentral area. Farnsworth-Munsell 100 Hue color testing was also abnormal. Greater involvement of P than M ganglion cell axons may explain these contrast sensitivity abnormalities, central scotomata, and color vision loss.

Evoked Potentials, Visual↗
PubMed1996

Deletion in the peripherin/RDS gene in two unrelated Sardinian families with autosomal dominant butterfly-shaped macular dystrophy.

BACKGROUND: Autosomal dominant butterfly-shaped macular dystrophy is associated with different mutations of the peripherin/RDS gene. We studied the phenotype of two families with a novel large deletion in the peripherin/RDS gene. METHODS: Clinical study, fluorescein angiography, color vision testing, automatic perimetry, electrophysiologic studies, and DNA analysis were performed on all the members of the two families. RESULTS: Fundus examination in patients aged 30 to 60 years showed yellow deposits in the macula with a butterfly-shaped pattern. Central choroidal atrophy was present in the older patients only. Macular visual function tests (color vision and central visual field) were abnormal, and electro-oculograms were slightly subnormal in five individuals tested. Electroretinograms and results of dark adaptometry were normal. Linkage analysis with intragenic polymorphic markers and quantitative polymerase chain reaction showed heterozygosity for a large deletion that removed exons 2 and 3 of the peripherin/RDS gene in all affected members of two families. CONCLUSIONS: This deletion escaped detection by direct analysis of amplified exons and was identified by intragenic polymorphic markers analysis, resulting in loss of heterozygosity from affected parents to affected children, and by quantitative polymerase chain reaction. The delineation of the molecular defect associated with the disease in these two families allows us to verify the presence or absence of the disease in clinically unaffected members.

Adolescent↗
PubMed2001

Poor correlation between "fix-follow-maintain" monocular/binocular fixation pattern evaluation and presence of functional amblyopia.

PURPOSE: To assess the reliability of visual screening with fix- follow-maintain (FFM) method in early detection of amblyopia in children who are not able to cooperate in testing with Allen Figures or Snellen E-chart. METHODS: Followup records of 89 patients that were examined in our pediatric ophthalmology department between May 1996 and May 1999 were evaluated retrospectively. The visual acuities that were measured with FFM method at the first visit were compared with the visual acuity levels that were measured with the Snellen E-chart at later followup visits. Functional amblyopia was defined as a difference of 2 or more Snellen lines between the two eyes. RESULTS: Amblyopia was later definitively diagnosed on the E-chart in only 17 (32.6%) of the 52 eyes that were estimated to have a significantly lower visual acuity than the fellow eye with the FFM method. Sensitivity of the FFM method in diagnosing amblyopia was found to be 53.1% and the specificity was 38.5%. CONCLUSIONS: The use of the FFM monocular/binocular fixation pattern to determine visual acuity and the possible presence of amblyopia is so insensitive, and so unspecific, that its reliability is very low and the results of such testing are therefore virtually useless, if not medically hazardous. There is, therefore, a need to make more universally available more sophisticated tests of vision (preferential looking, VEP); where they are not available, further emphasis should be placed on Snellen equivalent vision testing as with Allen Cards, Tumbling E, HOTV Test, Lea Figures etc. so as to obtain an accurate direct visual acuity at as young an age as possible. Amblyopia treatment should not be initiated solely on the basis of FFM testing.

Amblyopia↗
PubMed2004

Contrast and glare testing in keratoconus and after penetrating keratoplasty.

AIM: To compare the performance of keratoconus, penetrating keratoplasty (PK), and control subjects on clinical tests of contrast and glare vision, to determine whether differences in vision were independent of visual acuity (VA), and thereby establish which vision tests are the most useful for outcome studies of PK for keratoconus. METHODS: All PK subjects had keratoconus before grafting and no subjects had any other eye disease. The keratoconus (n = 11, age 35.0 (SD 11.1) years), forme fruste keratoconus (n = 6, 33.0 (13.0)), PK (n = 21, 41.2 (7.9)), and control (n = 24, 33.7 (8.6)) groups were similar in age. Vision testing, conducted with optimal refractive correction in place, included low contrast visual acuity (LCVA) and Pelli-Robson contrast sensitivity (PRCS) both with and without glare, as well as VA. RESULTS: Normal subjects saw better than PK subjects who in turn saw better than keratoconus subjects on all raw measures. However, when adjusted for VA, the normal group only saw significantly better than the keratoconus group on LCVA (low contrast loss 0.05 (0.04) v 0.15 (0.12), F(2,48) = 6.16; p<0.01, post hoc Sheffé p<0.05), and the decrements to glare were no worse than for normals. The forme fruste keratoconus group were indistinguishable from normals on all measures. CONCLUSIONS: PK subjects have superior vision to keratoconus subjects, but not as good as normal subjects. Including mild keratoconus subjects within a keratoconus group could confound these differences in vision. While VA is an excellent test for comparing normal, keratoconus and PK groups, additional information can be provided by LCVA and PRCS, but not by glare testing. Outcomes research into keratoconus management should include a measure in the contrast domain.

Adult↗
PubMed1991

Comparison of the automated vision screening test to the Snellen test.

The comparison of an automatic vision screening machine using the Landolt rings and the usual Snellen Chart was carried out among 123 second grade and 149 fifth grade students in an elementary school in Jerusalem. The sensitivity of the test for a cut-off point of greater than or equal to 6/12 according to the Snellen test was 41.7% (CI = 16.5-71.4) and the specificity was 86.5% (CI 78.1-92.2) for second graders. For fifth graders the values were 50.0% (CI = 20.1-79.9) and 90.6% (CI 83.7-94.8) respectively. Diagnosis by a specialist decreased the number of 'false negatives' and confirmed the pathological cases. The automatic test was well accepted by the children. Though more time is needed for assessment using the automatic test, its advantage is that no professional staff are required.

Child↗
PubMed1999

[The diagnosis of psychogenic visual problems in children and young adults with application of visual evoked responses (VER)].

PURPOSE: To present diagnostical and therapeutical problems connected with children and adolescents suspected of aggravation or simulation of visual problems. MATERIAL: 5 patients between 10 and 13 years old with visual disturbances sent to ophthalmologist with suspicion of neuritis retrobulbaris or tumor cerebri. METHODS: Complexive diagnostical investigations (including visual field tests, color vision tests, visual evoked potentials) with complete ophthalmological examinations of visual organ and psychological evaluation of patients. RESULTS: The normal results of ophthalmological examinations and of all diagnostical investigations including visual evoked potentials. Psychological evaluation of patients showed psychological troubles of the young ones. CONCLUSIONS: The normal results of visual evoked potentials confirm the diagnosis of psychogenic visual disturbances and allow to save children before other medical invasive investigations. Such patients with psychogenic visual disturbances and their families usually need a special kind of psychogenic therapy.

Adolescent↗
PubMed1986

Retinopathy in systemic lupus erythematosus: relationship to disease activity.

Forty-three patients taking chloroquine for systemic lupus erythematosus were followed by one ophthalmologist over a 5-year period. Visual field testing, color vision testing, and fluorescein angiography were performed. Retinopathy was detected in 7 patients (16%), none of whom had hypertension or diabetes mellitus. Retinal abnormalities included cotton-wool spots in 4 patients, microaneurysms in 3, and vascular tortuosity in 4. In 4 patients, these abnormalities were associated with retinal dysfunction, measured in terms of abnormal hue discrimination. In 6 of the 7 patients, the finding of retinopathy coincided with a flare of lupus activity. In 5 patients, retinopathy improved when the disease was controlled.

Adult↗
PubMed2004

[Electroretinogram "b" wave varies with the posology of the antimalarial treatment].

INTRODUCTION: The electroretinogram (ERG) is currently, together with the central visual field test, color vision test and electroculogram (EOG), an examination dedicated to prevent retinopathy due to hydroxychloroquine (HCQ) or chloroquine (CQ) intoxication. MATERIAL AND METHODS: Thirty-two patients on treatment with HCQ were studied. Each patient had underwent a complete clinical ophthalmological examination and a set of paraclinical examinations including at least an ERG. All the patients were requested to decrease or stop their HCQ treatment. Following this change, a second ERG was recorded for each patient. The ERGs before and after stopping HCQ treatment were compared. We noted a statistically significant increase in the amplitude of "b" wave of the ERG, following after decrease or discontinuation of HCQ treatment. DISCUSSION AND CONCLUSION: This study has demonstrated the ERG "b" wave sensitivity due to the variation of HCQ consumption. The amplitude and the culmination time of the ERG "b" wave are important parameters to monitor during long term treatment with HCQ. A decrease of the "b" wave amplitude, coupled with an increase of its culmination time in a patient on long term HCQ treatment showing for the same daily dose, shall be a sign of alert, imposing the performance of additional visual functional tests and leading a decrease or a discontinuation of the treatment with HCQ. The ERG is an objective examination, which needs almost no participation from the patient. Its usefulness has been demonstrated, for the prevention of retinopathy due to hydroxychloroquine or chloroquine intoxication in condition that successive ERGs of the same patient are precisely compared.

Adult↗
PubMed2003

The Tehran Eye Study: research design and eye examination protocol.

BACKGROUND: Visual impairment has a profound impact on society. The majority of visually impaired people live in developing countries, and since most disorders leading to visual impairment are preventable or curable, their control is a priority in these countries. Considering the complicated epidemiology of visual impairment and the wide variety of factors involved, region specific intervention strategies are required for every community. Therefore, providing appropriate data is one of the first steps in these communities, as it is in Iran. The objectives of this study are to describe the prevalence and causes of visual impairment in the population of Tehran city; the prevalence of refractive errors, lens opacity, ocular hypertension, and color blindness in this population, and also the familial aggregation of refractive errors, lens opacity, ocular hypertension, and color blindness within the study sample. METHODS DESIGN: Through a population-based, cross-sectional study, a total of 5300 Tehran citizens will be selected from 160 clusters using a stratified cluster random sampling strategy. The eligible people will be enumerated through a door-to-door household survey in the selected clusters and will be invited. All participants will be transferred to a clinic for measurements of uncorrected, best corrected and presenting visual acuity; manifest, subjective and cycloplegic refraction; color vision test; Goldmann applanation tonometry; examination of the external eye, anterior segment, media, and fundus; and an interview about demographic characteristics and history of eye diseases, eye trauma, diabetes mellitus, high blood pressure, and ophthalmologic cares. The study design and eye examination protocol are described. CONCLUSION: We expect that findings from the TES will show the status of visual problems and their causes in the community. This study can highlight the people who should be targeted by visual impairment prevention programs.

Blindness↗
PubMed1975

Developmental perception and cognitive styles: from young children to master artists.

The perceptual skills and cognitive styles of 30 master artists are compared to those of non-artist groups of different ages, beginning with 84 kindergarten children, and including an adult comparison group of 32. Criteria for master artists were first, handcrafted productions; second, major economic support derived from their art; third, shows in museums or good galleries; and fourth, positive peer evaluation. The test battery contained one intelligence test, two vision tests, three perceptual-discrimination measures, and five perceptual-cognitive style measures. Results show artists are significantly more flexible, accurate, variable, and field independent than all other groups. Artists, non-artist adults, and young children (60 high school sophomores, 60 children in Grade 5, 84 kindergarteners) each have differing cognitive styles. The relationship between cognitive style and artists' and non-artists' instrumental competency is discussed. Last, the extensive differences between artists' and children's performances are discussed in terms of developmental theory.

Adolescent↗
PubMed1991

Visual function after optic neuritis: a preliminary study.

We assessed visual function after recovery from optic neuritis in 15 consecutive patients using five objective tests: colour vision testing with Ishihara colour plates and with D15 colour desaturated spots, Humphrey automated perimetry, contrast acuity testing with Regan letter charts and testing of visual evoked response (VER). Recovery of visual function was not found to be dependent on presenting Snellen visual acuity or treatment with oral steroids. The most sensitive measures of residual visual deficit were mean defect on automated perimetry, low-contrast acuity and VER.

Adult↗