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PubMedDate not supplied

Optic nerve sheath decompression in the treatment of progressive nonarteritic ischemic optic neuropathy.

1. Visual loss improves when optic nerve sheath decompression is used in treating progressive nonarteritic ischemic optic neuropathy. 2. Repeated neuro-ophthalmic examinations, including visual acuity, visual field testing, and color vision testing, should be done weekly to detect progression of nonarteritic ischemic optic neuropathy. 3. Postoperatively, the neuro-ophthalmologist monitors for visual acuity, proptosis, evidence of retro-orbital hemorrhage, loss of normal motility, evidence of pupil malfunction, and disc hemorrhages.

Humans↗
PubMed2001

Disc excavation in dominant optic atrophy: differentiation from normal tension glaucoma.

OBJECTIVE: In patients with dominant optic atrophy (DOA, Kjer type), excavation of the optic nerve develops, and these patients may be misdiagnosed as having normal tension glaucoma (NTG). This study examined disc morphologic features in patients with DOA and explored features that help distinguish this condition from NTG. DESIGN: Noncomparative, observational case series. PARTICIPANTS: Patients with DOA who were seen at the Duke University Eye Center between 1987 and 1996 and who had bilateral optic nerve photographs. METHODS: Retrospective chart review of the results of visual acuity testing, visual field testing by Goldmann perimetry, color vision testing, intraocular pressure measurement, and observation of bilateral optic nerve photographs. MAIN OUTCOME MEASURES: Appearance of the optic disc and peripapillary zone in patients with DOA. RESULTS: Nine patients were identified. The mean age at the time of evaluation was 28 years (range, 11-62 years). Most patients had a mild to moderate reduction in visual acuity. Color vision as tested with Hardy-Rand-Rittler plates was reduced (4.0/10 +/- 4.2/10). A cup-to-disc ratio of more than 0.5 was observed in at least one eye of eight patients. A temporal wedge-shaped area of excavation was observed in 14 of the 18 eyes studied. Moderate to severe temporal pallor was observed in all of the eyes. Pallor of the remaining (noncupped) neuroretinal rim was also observed consistently, ranging from mild to moderate. A gray crescent and some degree of peripapillary atrophy were noted in all eyes. CONCLUSIONS: Several clinical features, including early age of onset, preferential loss of central vision, sparing of the peripheral fields, pallor of the remaining neuroretinal rim, and a family history of unexplained visual loss or optic atrophy, help to distinguish patients with DOA from those with NTG.

Adolescent↗
PubMed1996

Vision screening in junior schools.

A prospective study of routine school vision tests in 1809 children aged 8 and 10 y was undertaken in schools in the Cambridge Health District over two years (1988-1990) to establish whether a significant number of defects of vision were detected. Although the visual acuity of 31% of children who had an abnormal test was recorded as abnormal, most abnormalities were minimal. Only 15 (0.83%) had newly diagnosed problems requiring treatment. Almost all children with marked visual abnormalities had already been detected before school entry, at the 5 y school vision test or on another occasion. Near vision testing did not identify any previously undiagnosed child with significant defects who did not also have distant vision abnormalities. Satisfactory colour vision test results had been recorded for most children at the 5 y school entry vision test. These data do not justify the continued use of routine screening in junior schools.

Child↗
PubMed2000

Visual outcome and complications of bilateral intraocular lens implantation in children.

PURPOSE: To determine the safety and efficacy of bilateral intraocular lens (IOL) implantation in children. SETTING: Tertiary referral pediatric ophthalmology department. METHODS: This retrospective study comprised 13 children (26 eyes) who had bilateral cataract surgery with IOL implantation. Patients were divided into 2 groups: congenital cases, diagnosed during the first year of life, and developmental cases, diagnosed after 1 year of age. All patients had small incision phacoemulsification with primary implantation of a poly(methyl methacrylate) or a foldable acrylic IOL. Primary posterior capsulotomy was performed in 16 eyes (61.5%). RESULTS: Age at surgery ranged from 1 week to just under 8 years. Seven patients (53.8%) had a systemic diagnosis: Down's syndrome (n = 4); developmental delay or cerebral atrophy (n = 3). Five children with systemic problems could not cooperate with formal vision testing; 2 could fix and follow bilaterally, and 3 had central, steady, and maintained vision bilaterally. In the congenital group, 37.5% of eyes attained a visual acuity of 20/20 and 87.5%, 20/120 or better. In the developmental group, formal vision testing was possible in 4 children. Five eyes (83.3%) attained a visual acuity of 20/40 or better. Thirteen eyes (50.0%) required posterior capsulotomy. Primary posterior capsulotomy reduced the incidence of posterior capsule opacification (PCO), but there was no correlation between PCO and IOL material. One patient developed glaucoma bilaterally. CONCLUSION: Bilateral IOL implantation was safe and produced good visual results in children of all ages with bilateral cataract.

Acrylic Resins↗
PubMed1988

Cyclopean visual evoked potentials: a new test of binocular vision.

A new objective method is described to test binocular vision. Identical gratings are presented to each eye, but they are drifted in opposite directions. Uniocular stimulation does not produce a response, but binocular combination of the gratings results in robust visual evoked potentials. Data from cats are presented to illustrate the use of this technique.

Animals↗
PubMed1983

Validation of the Holmes - Wright lanterns for testing colour vision.

The recently introduced Holmes - Wright Type A and Type B lanterns and the Farnsworth lantern were administered to 100 observers with normal colour vision and 100 observers with defective colour vision. With the fail criteria adopted, all normals passed the Holmes - Wright Type A lantern and with one exception all normals passed the Farnsworth lantern. However, 8% of normals failed the more difficult Holmes - Wright Type B lantern. It is noted that the normals who fail this lantern test appear to do so not because of poor colour discrimination but because the coloured stimuli presented by the lantern have a point brilliance close to the average chromatic threshold. About one-third of the colour vision defective group passed the Farnsworth lantern and between 14 and 17% passed the Holmes - Wright Type A lantern depending on the test procedure used. Only two mild deuteranomals in the sample of 100 colour abnormal observers succeeded in passing the Holmes - Wright Type B lantern. Dichromats and severe anomalous trichromats fail all three lanterns so that those who pass are all mild anomalous trichromats. A significant proportion of protanomals pass the Farnsworth lantern and some protanomals pass the Holmes - Wright Type A lantern despite their reduced sensitivity to red light and correspondingly reduced signal range for red signals.

Color Perception Tests↗
PubMed2003

Vision and driving self-restriction in older adults.

OBJECTIVES: To assess driving self-restriction (vision related and nonvision related) in relation to vision test performance of older adults. DESIGN: Cross-sectional study. SETTING: Population-based cohort of community-dwelling older adults. PARTICIPANTS: Six hundred twenty-nine current drivers aged 55 and older had driving behavior, health, and physical function assessed and vision function tested in 1993-95. MEASUREMENTS: Self-report of driving restriction as vision or non-vision related and performance on a comprehensive battery of vision tests (visual acuity; contrast sensitivity; effects of illumination level, contrast, and glare on acuity; visual fields with and without attentional load; color vision; temporal sensitivity; and the effect of dim light on walking ability). RESULTS: Demographic, health, and functional characteristics differed significantly between restrictors and nonrestrictors but not between vision- and nonvision-related restrictors. Controlling for potential confounding, only vision-related driving self-restriction was significantly associated with reduced performance on nonstandard measures of acuity. Poor depth perception was significantly associated with restriction for both vision- and nonvision-related reasons. Poor performance on attentional visual field tests, analyzed individually and in combination with standard field tests, was not associated with driving self-restriction. CONCLUSION: Older adults with early changes in spatial vision function and depth perception appear to recognize their limitations and restrict their driving even if they do not acknowledge the visual impairment as the cause for restriction. Poor visual attention, a risk factor for crashes, may not be recognized. Additional studies of driving self-restriction in relation to risk factors for crashes in older adults may help refine this strategy of reducing driving-related injury and death.

Aged↗
PubMed2000

Aircrew visors and color vision performance: a comparative and preliminary pilot study analysis.

BACKGROUND: A very important aspect of visual performance to consider, for present and future recommendations regarding aircrew visors, concerns their impact on color vision. The literature has remained mostly inconclusive with respect to the human perceptual process of colors during actual mission employment. OBJECTIVE: This study uses active duty military aircrews to provide objective and valuable information on the effects of Short Wavelength Absorbing Filters (SWAFs), such as the High Contrast Visor (HCV), and some selected waveband type Laser Eye Protection (LEP) visors on color vision. It provides a direct comparison of several current and proposed aircrew eye protective visors with respect to their effects on color vision. The data analyzed in this study will also be used to support a recommendation regarding a new optimal visor for aircrew wear during air to air (and ground) engagements, for sun protection, and possible visual enhancement in order to improve user compliance. METHODS: Seven volunteers on active flying status each underwent comprehensive color vision testing with and without seven of the U. S. Air Force's (USAF's) current or proposed aircrew visors/filters. Spectral transmissions of these visors/filters were obtained to identify and determine their individual characteristics which included their ability to induce acquired color vision decrements in "color normal" individuals. RESULTS: The widely utilized USAF HCV significantly degraded color vision more than luminosity matched neutral density visors. Abrupt color vision decrements for specifically fielded LEP visors were also noted. Their objective data supported theoretical and speculated color vision effects. Even though low transmittance neutral density visors did have some effect on color vision, decrement severity was not considered significant enough to affect overall performance during color vision testing. CONCLUSIONS AND DISCUSSION: Because of their ability to significantly affect color vision, concerns regarding the use of HCV and LEP visors should entail age, baseline color vision, environmental, and mission factors. Further testing should be done to evaluate the definitive effects that these visors actually have on the recognition of color symbology of Multi Function and Electronic Flight Information Displays. Findings in this study also support theoretical opinions that encourage the fielding of a neutral density filter (mildly tinted) with an overall transmission of 25-49%. Its use by flyers during low and bright illuminant conditions may greatly enhance visual performance by encouraging wearer compliance while allowing colors to be perceived normally.

Adult↗
PubMed2002

Neodymium:YAG laser capsulotomy: a clinical morphological analysis.

BACKGROUND: There are no prospective controlled trials comparing methods of capsulotomy or patterns of capsulotomy openings in similarly graded opacified posterior capsules. This paper aims to investigate the effect of various forms of posterior capsular opacification (PCO) capsulotomy openings on visual function METHODS: Thirty-six eyes of 34 patients had vision tested and posterior capsules were digitally photographed. Each patient then underwent Nd:YAG laser capsulotomy. Patients returned 1 week later for repeat vision tests and photography. Analyses of areas of pearls and fibrosis were performed using the EPCO software system. Analyses of size and shape of capsulotomy was also done with image analysis software. The capsulotomy characteristics were analysed with respect to improvements in vision, taking into consideration the PCO scores. RESULTS: No correlation was found between capsulotomy dimensions and visual function improvement, even when PCO details were included in the analyses. Neither capsulotomy area, eccentricity, nor shape irregularity in the ranges measured was found to correlate significantly with eventual visual outcome in terms of contrast sensitivity, near and distance visual acuity, or glare readings. CONCLUSION: Performing a small capsulotomy (at least 1.5 mm in diameter), even if decentred up to 1 mm, may allow for satisfactory visual performance as long as the aperture is clear and not obscured by residual strands.

Cataract Extraction↗
PubMed1999

[Color vision in relation to age: a study of normal values].

BACKGROUND: It is difficult to quantify thresholds in most colour vision tests, and this is especially the case for tritan hues, where a strong age-related increase of threshold has been reported. With the development of computer-graphic methods it is possible to remove brightness clues caused by lens absorption. This study attempts to give normative values for colour contrast thresholds and assess the age related changes therein. PATIENTS AND METHODS: 115 patients aged between 6 & 71 years were tested for central and peripheral colour contrast sensitivity. No patient had any systemic or eye disease. As a preliminary, heterochromatic flicker balance between the luminosities of the R and G and B and G phosphors was established, so that all colours subsequently generated were isoluminant for the person tested. Then, using a modified binary search technique, colour contrast thresholds were established using both 2 degree optotypes, for central vision, and a ring, 12.5 degrees in radius for peripheral vision. In the latter case, the observer had to name the position of the missing quadrant in the ring. Stimuli were presented for 200 msec at 1 Hz. Colours were modulated on protan, deutan or tritan colour axis. RESULTS: No correlation between age and central colour vision thresholds was observed. By contrast a significant but only minor increase of peripheral colour vision threshold was observed for the peripheral protan and tritan axis. DISCUSSION: The present system removes luminance clues from colour vision tests and permits both central and peripheral retina to be tested. The results are simple in that the influence of age can be neglected. The variability of threshold results is small, and it is easy to detect the relatively large changes associated with disease. Since high-quality monitors are standardised and calibrated, providing the stimulus parameters described are adhered to, the results given here for upper limits of normal may be used for other similar systems.

Adolescent↗