[The rod vision or cone vision in fluoroscopy; test chart for fluoroscopic vision].
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Fluoroscopy↗
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Spatial localization in visual impairment.
PURPOSE: To investigate self-reported difficulties experienced by visually impaired subjects in real-world tasks requiring judgment of space and distance and to determine whether laboratory measures of spatial localization predict self-reported difficulty with spatial tasks better than traditional measures of visual function, such as visual acuity and contrast sensitivity. METHODS: Forty-two subjects with visual impairment participated. The Spatial Localization Questionnaire (SLQ) was developed to investigate self-reported spatial localization difficulties, and subjects answered the questionnaire as part of the study. Subjects also completed a variety of clinical vision tests (visual acuity, contrast sensitivity, stereo acuity, and reading speed) and laboratory vision tests (vernier acuity, bisection acuity, and visual direction). RESULTS: The SLQ was found to have good validity. Several significant correlations were found between the Rasch analysis ability scores for the questionnaire and the clinical and laboratory vision tests. Using stepwise regression analysis, we found that vernier acuity and contrast sensitivity accounted for 42% of the variance in the Rasch scores (P < 0.001). CONCLUSIONS: The findings indicate that certain subjects with visual impairment have difficulty with real-world spatial tasks, as indicated by the SLQ. Of note, these difficulties were better predicted by vernier acuity (a resolution test) and contrast sensitivity, rather than vernier or bisection bias, which measure localization.
Adult↗
Visual function tests on the Internet--sense or nonsense?
BACKGROUND: The quantitative capability of the visual system can be tested using graphic presentations with defined size, form and color. For presentations, a chart projector or monitor can be used. Today, the number of visual function tests on the Internet is increasing constantly. Options and limitations of visual function tests using the METHODS: Internet and the authors' own test results are described. RESULTS: Several visual function tests, such as visual acuity tests, the Amsler-Grid, stereo and color vision tests, can already be given via Internet. The variability of the tests ranges from the simple presentation of graphic elements to the laboriously programmed interactive input by the user to specify the test result. Under standardized examination conditions, there was a very high correspondence between the results of the authors' own web-based color vision test and those of luminescence color test plates and conventional pigment color plates. CONCLUSIONS: However, the interpretation of the test results is difficult due to the absence of controls during the test as well as the heterogeneity of the hardware. In order to obtain comparable test results, differences in size and resolution as well as in brightness, contrast and color of computer monitors must be taken into consideration. Due to the deficits described in the tests, the value of visual function tests on the Internet is rather limited. Currently, the data of test distributers with respect to the test conditions are all still insufficient. Standards need to be defined for Internet-based visual function tests. However, visual function tests on the Internet can achieve test results comparable to those of conventional visual function tests under standardized examination conditions in clinical practice. Further studies are needed to check the accuracy of web-based screening examinations in ophthalmology.
Color Perception Tests↗
Vision screening in a primary care setting. A missed opportunity?
To determine the effectiveness of vision screening in a primary care setting, we administered a questionnaire and a vision test to 458 patients from a general medical clinic. Subjects were referred for complete ophthalmologic evaluation if they failed the vision test or met other "high-risk" criteria based on information contained in the questionnaire. Patient-initiated requests for eye examinations were also honored. A total of 169 patients were scheduled for eye examinations, and 148 actually underwent ophthalmologic evaluation. One hundred one of those examined were referred on the basis of the study criteria. "Serious eye disease" (cataract, glaucoma, diabetic retinopathy, or age-related macular degeneration) was diagnosed in 96 (95%) of these patients. Prompt surgical intervention was recommended in 27 (27%), and medical treatment was begun in 21 (21%). Of those with serious eye disease, 59% met the criteria by failing the vision test, while 69% met the high-risk criteria determined by the questionnaire. Of the 148 subjects who received ophthalmologic evaluations, 47 requested them. Serious eye disease was diagnosed in 23 (50%) of the 47 patients. None of these individuals required immediate surgery, and medical treatment for glaucoma was begun in eight (17%). These data suggest that screening for serious eye disease in a primary care setting is an efficient mechanism to use for the identification of patients with undetected ocular disorders that require follow-up or treatment.
Aged↗
The Davidson and Hemmendinger color rule as a color vision screening test.
The Davidson and Hemmendinger (DH) color rule was evaluated for color vision screening of normal and congenital color-defective subjects. Ninety-eight normal and 14 color-defective subjects were tested on the color rule under Macbeth illumination of 5,400 K. The color-defective subjects were also tested on the Nagel anomaloscope, the Farnsworth D-15, and the H-R-R pseudoisochromatic plates. The DH color rule performed as accurately as the anomaloscope and was superior to the other two tests in detecting anomalous trichromats and in discriminating protanomalous subjects. The color rule also discriminated dichromats from anomalous trichromats. For severe color-defective subjects (dichromats, achromats), the color rule was more time-consuming than the other tests and discrimination was less certain. Response patterns on the DH color rule and response variability of the different classifications are reported.
Adolescent↗
Incorporating vision and hearing tests into aged care assessment: methods and the pilot study.
PURPOSE: Vision and hearing impairments are frequent in older people and may contribute to their reliance on aged care services. This study aims to assess whether incorporating vision and hearing screening into routine aged care assessments and provision of appropriate health care services will influence health outcomes of older individuals. METHODS: The proposed project is a 2 x 2 factorial design randomized controlled trial. The pilot study recruited 208 participants aged 65+ years attending an aged care assessment center at Westmead Hospital, Sydney, who were randomly allocated to one of four groups: vision and hearing tests, vision tests only, hearing tests only, or neither. Face-to-face interviews with all participants were conducted. Questionnaires included Activity of Daily Living (ADL), 36-item Short-Form health survey (SF-36), Mini-Mental State Exam (MMSE) and questions about use of health care and community support services. Participants will be re-examined after 12 months to assess changes over time in quality-of-life, physical and cognitive function, incident falls and use of health and community aged care services.
Aged↗
Elderly licensure laws and motor vehicle fatalities.
CONTEXT: Little is known about how state-level driver licensure laws, such as in-person renewal, vision tests, road tests, and the frequency of license renewal relate to the older driver traffic fatality rate. OBJECTIVE: To determine whether state driver's license renewal policies are associated with the fatality rate among elderly drivers. DESIGN, SETTING, AND POPULATION: Retrospective, longitudinal study conducted January 1990 through December 2000 of all fatal crashes in the contiguous United States identified in the Fatality Analysis Reporting System, which involved either an older (ages 65-74 years, 75-84 years, and > or =85 years) or middle-aged (ages 25-64 years) driver. Two regression approaches were used to study the effect of state laws mandating in-person renewal, vision tests, road tests, and frequency of license renewal on driver fatalities, controlling for state-level factors including the number of licensed elderly drivers, primary and secondary seatbelt laws, maximum speed limit laws, blood alcohol level of 0.08, and administrative license revocation drinking and driving laws, per capita income, and unemployment rate. The first regression approach examined only elderly driver fatalities and the second approach examined daytime elderly driver fatalities and used daytime fatalities among middle-aged drivers as a general control for unobserved variation across states and over time. MAIN OUTCOME MEASURES: Older driver fatalities and older and middle-aged daytime driver fatalities. RESULTS: Among individuals aged 85 years or older, there were a total of 4605 driver fatalities and 4179 daytime driver fatalities during the study period. For this age cohort, after controlling for middle-aged daytime driver deaths, states with in-person license renewal were associated with a lower driver fatality rate (incident rate ratio [RR], 0.83; 95% confidence interval [CI], 0.72-0.96). This was the only policy related to older drivers that was significantly associated with a lower fatality risk across both regression models. Thus, state-mandated vision tests, road tests, more frequent license renewal, and in-person renewal (for individuals aged 65-74 years and 75-84 years) were not found to be independently associated with the fatality rate among older drivers in the 2 models. CONCLUSIONS: In-person license renewal was related to a significantly lower fatality rate among the oldest old drivers. More stringent state licensure policies such as vision tests, road tests, and more frequent license renewal cycles were not independently associated with additional benefits.
Accidents, Traffic↗
Binocular Polaroid Test for vision screening of pre-school age children.
We report the results obtained with the Binocular Polaroid Test in a large population screening devised to detect vision disturbances in pre-school age children. The Binocular Polaroid Test is a new test for rapid detection of small unilateral scotoma in the binocular visual field. The test was performed on 1566 children age 3 to 6 years in a field examination. The reliability of the test was controlled in a study examination. A complete study examination was performed in 60 of the 96 subjects with a positive response to the test. One hundred subjects selected at random among those with a negative response were used as controls. The study examination disclosed vision disturbances in 41 of the 60 children with a positive response to the Binocular Polaroid Test. The remaining 19 results were normal. No vision disturbances were detected in the control group. The predictive value and the "phi" coefficient were calculated. The results indicate that the Binocular Polaroid Test appears very suitable for vision screening in pre-school age children for whom an early diagnosis is of paramount importance for treatment and prognosis of a vision alteration.
Child↗
Sensitivity of screening tests for detecting vision in preschoolers-targeted vision disorders when specificity is 94%.
PURPOSE: To compare the sensitivity of 11 preschool vision screening tests administered by licensed eye care professionals for the detection of the 4 Vision in Preschoolers (VIP)-targeted vision disorders when specificity is 94%. METHODS: This study consisted of a sample (n = 2588) of 3- to 5-year-old children enrolled in Head Start programs, 57% of whom had failed an initial Head Start vision screening. Screening results from 11 tests were compared with results from a standardized comprehensive eye examination that was used to classify children with respect to the four VIP-targeted vision disorders: amblyopia, strabismus, significant refractive error, and unexplained reduced visual acuity (VA). With overall specificity set to 94%, we calculated the sensitivity for the detection of each targeted vision disorder. RESULTS: With the overall specificity set to 94%, the most accurate tests for detection of amblyopia were noncycloplegic retinoscopy (NCR) (88% sensitivity), the SureSight Vision Screener (80%), and the Retinomax Autorefractor (78%). For detection of strabismus, the most accurate tests were the MTI Photoscreener (65%), the cover-uncover test (60%), the Stereo Smile II stereoacuity test (58%), the SureSight Vision Screener (54%), and the Retinomax Autorefractor (54% in year 1, 53% in year 2). The most accurate tests for detection of significant refractive error were NCR (74%), the Retinomax Autorefractor (66%), the SureSight Vision Screener (63%), and the Lea Symbols VA test (58%). For detection of reduced VA, the most accurate tests were the Lea Symbols Distance VA test (48%), the Retinomax Autorefractor (39%), and NCR (38%). CONCLUSIONS: Similar to the previously reported results at 90% specificity, the screening tests vary widely in sensitivity with specificity set at 94%. The rankings of the sensitivities for detection of the 4 VIP-targeted vision disorders are similar to those with specificity set to 90%.
Amblyopia↗
Different uses of chromatic signals in patients with congenital and acquired colour vision deficiencies.
Chromatic signals can be used to generate perceived colour and also to detect spatially structured objects defined only by chromatic differences. These two attributes have previously been investigated in dichromats and cerebral achromatopsic patients using a new colour vision test developed at City University that makes possible the isolation of pure chromatic signals (Barbur et al. Proc. R. Soc. London B 258, 327-334, 1994). We have investigated acquired colour vision changes in a 69-year-old patient, after conventional colour vision tests gave ambiguous results. His ability to detect an object using chromatic signals was impaired more than his ability to detect a colour change, and this impairment was greater in the right eye than in the left eye. This dissociation suggests parallel pathways may be involved in the two processes of coding chromatic signals. Recent neurological testing on the same patient has indicated the onset of multiple sclerosis. Our much earlier finding based on colour vision testing may therefore have useful diagnostic implications.
Aged↗
A comprehensive assessment of visual impairment in a population of older Americans. The SEE Study. Salisbury Eye Evaluation Project.
PURPOSE: The Salisbury Eye Evaluation Project is a longitudinal study of risk factors for age-related eye diseases and the impact of eye disease and visual impairment on physical disability. In this article, the authors report the prevalence of visual impairment in their population and explore the relations among the various measures of visual function. METHODS: A population-based sample of 2520 residents of Salisbury, Maryland, between the ages of 65 and 84 years were enrolled in the study. Twenty-six percent of participants were black. Vision tests included best-corrected Early Treatment Diabetic Retinopathy Study acuity, Pelli-Robson contrast sensitivity with and without glare, Randot stereoacuity, and 60 degrees Humphrey visual fields. RESULTS: Visual function decreased linearly with age for the acuity, contrast sensitivity, glare, and visual field tests. Stereoacuity remained constant into the mid-70s and declined at an accelerating rate thereafter. Black participants had lower contrast sensitivity, reduced stereoacuity, and worse visual fields, at all ages compared to white participants; however, white participants were more sensitive to glare. The overall prevalence of visual acuity impairment in blacks was 5.6% versus 3.0% for whites, using the traditional United States definition (worse than 20/40 to better than 20/200) and 3.3% for blacks versus 1.6% for whites, using the World Health Organization definition (worse than 20/60 to 20/400). Acuity was correlated moderately with contrast sensitivity, stereoacuity, and visual fields (Spearman rho = 0.50, 0.35, and 0.34, respectively). The correlation between acuity and glare sensitivity was low (rho = 0.12). CONCLUSIONS: Many aspects of visual function, not just acuity, decline with age. Black participants have more visual impairement than do white participants for all tests except glare sensitivity. The prevalence of visual acuity impairement in the Salisbury Eye Evaluation population is lower than that reported by other studies using similar test procedures. Low-to-moderate correlations among vision test scores suggest that several different dimensions of visual function are being assessed.
Aged↗
Vision-perception testing and training program: clerical operations.
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Education↗
Color vision defects in retinitis pigmentosa.
Sixty-seven patients with retinitis pigmentosa underwent color vision testing with the Nagel anomaloscope and Farnsworth-Munsell (FM) 100-hue test. Results showed both similarities and differences among different genetic types. The presence of an atrophic-appearing foveal lesion found in individual cases served as a reliable indicator of performance on color vision testing as did a reduction in visual acuity to less than 20/30. When no foveal lesion was apparent in patients with visual acuity better than 20/30, patients with autosomal dominant disease showed superior performance on color vision testing when compared to autosomal recessive, X-linked recessive, and isolated cases. Regardless of genetic type, the FM 100-hue test was more sensitive in detecting poor color vision performance than the Nagel anomaloscope.
Adolescent↗
Psychophysical tests of vision and hearing in patients with multiple sclerosis.
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Auditory Pathways↗
Contrast sensitivity and visual disability in chronic simple glaucoma.
A battery of vision tests was used to quantify visual defect in a group of 50 patients with chronic simple glaucoma. The vision tests were near and distance visual acuity, visual fields, and contrast sensitivity to static and temporally modulated sinusoidal grating patterns. Of these, static contrast sensitivity function appears to be the most sensitive method of measuring visual defect in glaucoma patients. The visual disability experienced by the glaucoma patients was quantified by means of a questionnaire, and the relationship between perceived visual disability and visual defect was examined. It was found that results from a group of tests, near visual acuity, visual field, and contrast sensitivity measures, are the best predictors of the difficulty experienced by patients in performing visually dependent daily activities.
Activities of Daily Living↗
A clinical evaluation of the american optical SR III subjective refractor.
The American Optical SR III Subjective Refraction System is a recent addition to the vision care field. Subjective refractions were performed, using the SR III, on 275 eyes of 139 subjects (clinic patients, optometry students, staff members, and faculty members) and the results were compared to clinical refractive data. Although subjective refraction results were found to compare favorably to the clinical results, the instrument was found to be limited to the extent that there is no provision for binocular vision testing and no provision for near vision testing.
Humans↗
[Is it necessary to introduce an occupational color vision capacity test in current color selection?].
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Aptitude Tests↗
A study of pre-school vision screening tests' testability, validity and duration: do group differences matter?
Vision screening was performed on 268 pre-school children: 170 from a private pre-school, 33 from a Caribbean-American parochial pre-school and 65 pre-school children from a clinic serving indigent Spanish farm-workers. Using a multi-station format, a stereoacuity test and two visual acuity tests were performed during a single screening session. The time it took to complete a test was recorded. To pass the screening, children were required to pass one visual acuity test and the stereoacuity test. Children who could not complete the protocol were retested at a later date. Children who failed the screening and every fourth child who passed the screening were referred for a full eye examination. The parents and teachers were masked to the results of the screening as well as the optometrists who performed the eye examination. Sensitivity, specificity and accuracy scores were 100%, 79% and 80%, respectively. Three-year-old children completed the Lea Symbol Chart more often than the HOTV. No differences in time required to complete a visual acuity test were found. The Lea Symbol chart is more likely to be completed by young children. Testability changes significantly with age rather than with the instrument when socio-ethnic factors are held constant. Differences among groups and the sensitivity of the screening are discussed.
Child↗