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At least 505 records · Page 28Linked to original sources
PubMed1992

The relationship between low vision and performance of activities of daily living in nursing home residents.

OBJECTIVE: To explore the link between low vision and Activities of Daily Living (ADL) performance in cognitively intact nursing home residents. DESIGN: Survey. SETTING: A non-profit geriatric long-term care facility. SUBJECTS: 21 males, 82 females, aged 66-98. MEASURES: Survey of 103 nursing home residents. ADL functioning assessed via Maryland Appraisal of Patient Progress (MAPP); medical data collected through chart review; ophthalmological data obtained through dilated eye examination by an ophthalmologist. RESULTS: In comparison with residents having good vision (n = 52), a significantly greater proportion of residents with low vision (n = 51) were dependent on caregivers for performing ADLs (eg, toileting, transferring, washing). Residents with low vision had significantly more eye pathology (eg, cataracts, age-related macular degeneration) than did residents with good vision. There were no significant differences between groups with regard to presence of musculoskeletal problems (eg, arthritis) or number of medical conditions (eg, cardiovascular disorder, cerebrovascular accident). CONCLUSIONS: There is a strong link between low vision and ADL disability in nursing home residents. Moreover, ADL dependency is significantly related to the presence of eye disorders.

Activities of Daily Living↗
PubMed2005

Impact of congenital colour vision defects on occupation.

AIMS: To investigate whether there is an association between congenital colour vision defects (CVD) and occupational choice and employment history, in order to inform the debate about the value of universal childhood screening for these disorders. METHODS: Participants were 6422 males and 6112 females from the 1958 British birth cohort, followed from birth to 33 years, whose colour vision was assessed (Ishihara test) at 11 years. RESULTS: A total of 431 males (6.7%) had CVD. Men with CVD had pursued some careers for which normal colour vision is currently regarded as essential; for example, eight men (3.1%) with CVD were in the police, armed forces, or fire-fighting service at 33 years compared to 141 men (3.8%) with normal colour vision. They were, however, under-represented compared to those with normal colour vision, in other occupations; for example, no men with CVD were employed in electrical and electronic engineering at 33 years compared to 15 men (0.4%) with normal colour vision. CONCLUSIONS: The findings of this study suggest there is little to be gained by continuing with existing school screening programmes for CVD, whose primary purpose is to advise affected children against certain careers. Other ways of informing young people about potential occupational difficulties and pathways for referral for specialist assessment are likely to be more useful.

Career Choice↗
PubMed1994

The effectiveness of vision screening by school nurses in secondary school.

Vision screening of 13 and 15 year old children by school nurses in Oxfordshire has declined in recent years due to the pressure of other commitments. A study was carried out to evaluate the likely consequences of failing to provide vision screening for secondary schoolchildren, in order to make a decision about the future of the service. Parents were also asked to complete a questionnaire about their children's past eye histories. Eight schools that had had no vision screening for at least three years participated in the study. Overall, 3.8% of children between 13 and 15 years old had a visual acuity of worse than 6/12 in one or both eyes, that is they failed vision screening; there was no evidence that this percentage increased significantly across this age range. Less than 1% of children were prescribed and wore spectacles as a consequence of failing vision screening and no new cases of eye pathology were detected. Questionnaire responses suggested that about 50% of children who did not wear spectacles had had an eye examination in the previous two years. The results indicate that vision screening is not the best way to meet the eye/vision needs of secondary schoolchildren. Strategies for targeting the school nursing resource more appropriately are being considered.

Adolescent↗
PubMed1989

Vision screening at 8 and 18 months. Steering Committee of Oxford Region Child Development Project.

OBJECTIVE: To determine the effectiveness of an existing screening programme based in the community for ocular and vision defects in infants considered at increased risk of such defects. DESIGN: Children with ocular or vision defect by the age of 2 were ascertained by searching records. Those from populations at high risk were matched with their results from screening tests. The characteristics of the cases among this population were compared with those of the cases in the remainder of the population. Patterns of referral and age at referral were studied in both groups. SETTING: The study was conducted within Oxfordshire Health District. SUBJECTS: 433 Children at high risk born in 1984 to mothers living in the health district at delivery and who either weighed less than 2000 g or weighed 2000 g and over and required admission to a special care nursery for longer than 24 hours. The low risk population (6254) were infants without these characteristics who were resident in the health district at the time of referral. INTERVENTIONS: Screening tests for vision or ocular defects already routinely used were applied by health visitors at 8 and 18 months to the children at high risk. MAIN OUTCOME MEASURE: Comparison of results of screening tests with vision and ocular defects detected by the age of 2. RESULTS: Screening tests in current use for vision loss and squint in this age group were insensitive and had a low positive predictive value when applied to a high risk population. Defects that were not apparent on direct inspection were unlikely to be detected by these tests. In the high risk group the relative risk of having a defect was 2.8 (95% confidence interval 1.8 to 4.5) but 85% of all cases detected by the age of 2 were in children at low risk. Referral patterns and age of referral differed in the two groups. CONCLUSIONS: Screening by health visitors of high risk populations contributes little to the detection of vision and ocular defects. This type of evaluation needs to be applied also to low risk populations, who have different referral patterns and contribute most of the cases.

Age Factors↗
PubMed1998

Effectiveness of screening older people for impaired vision in community setting: systematic review of evidence from randomised controlled trials.

OBJECTIVE: To assess whether population screening for impaired vision among older people in the community leads to improvements in vision. DESIGN: Systematic review of randomised controlled trials of population screening in the community that included any assessment of vision or visual function with at least 6 months' follow up. SUBJECTS: Adults aged 65 or over. MAIN OUTCOME MEASURE: Proportions with visual impairment in intervention and control groups with any method of assessing visual impairment. RESULTS: There were no trials that primarily assessed visual screening. Outcome data on vision were available for 3494 people in five trials of multiphasic assessment. All the trials used self reported measures for vision impairment, both as screening tools and as outcome measures. The inclusion of a visual screening component in the assessment did not result in improvements in self reported visual problems (pooled odds ratio 1.04:95% confidence interval 0.89 to 1.22). A small reduction (11%) in the number of older people with self reported visual problems cannot be excluded. CONCLUSIONS: Screening of asymptomatic older people in the community is not justified on present evidence. Visual impairment in this age group can usually be reduced with treatment. It is unclear why no benefit was seen. Further work is needed to clarify what interventions are appropriate for older people with unreported impairment of vision.

Aged↗
PubMed1999

Testability of a color vision screening test in a population with mental retardation.

PURPOSE: The purpose of this study was to determine the testability of the "Co or Vision Testing Made Easy" color vision test, marketed as a screening test for young children, in a population of individuals with mental retardation. The test uses simple geometric figures that are easily identified. Previously, the test has demonstrated validity as a measure of color deficiency. METHODS: The test was presented to Special Olympic athletes, who are individuals with mental retardation or significant developmental delay, at four sites: the 1997 World Winter Games in Toronto, Canada; the Texas Summer Games in Houston, Texas; the Massachusetts Summer Games in Boston, Massachusetts; and Regional European Swim Competition in Seville, Spain. The criteria for passing was 8 correct responses on the first trial or 9 of 9 on the second attempt. RESULTS: Testability in Toronto, Canada; Houston, Texas; and Seville, Spain was high--95.5%, 98.7%, and 95.7%, respectively. Testability, however, dropped to 78.8% during the Boston, Massachusetts screening. There was no apparent difference in the testing environment that would account for the difference. The overall rate of testability was 93.2% for the 1078 athletes screened. The frequency of males identified as color deficient was similar to that expected in the general population; only two females (in Spain) failed the color vision screening. CONCLUSIONS: The "Color Vision Testing Made Easy" color vision test was successfully completed by a very high percentage of Special Olympics athletes. These results suggest that this test is useful in screening this population for color deficiencies, and that the prevalence of color vision deficiencies is approximately the same in individuals with mental retardation as in the general population.

Adolescent↗
PubMed2000

Vision screening survey of all children starting primary school in 1998 in the Federal State of Saarland, Germany.

BACKGROUND: The excellent co-operation with the pediatric public health service of the local health authorities enables us to present the collected results of a vision screening survey of all children starting primary school in 1998 in the Federal State of Saarland. The aim is to analyze the prevalence of amblyopia, strabismus, reduced visual acuity, refractive errors and severe visual impairment in one complete grade of pre-schoolers. METHODS: The examination parameters had been determined in co-operation with the Department of Pediatric Ophthalmology at the University of Saarland and had been fitted to the needs and abilities of lay persons (health workers) doing a vision screening as part of a general health check-up. Parameters were: visual acuity (Rodenstock R21), color vision (Ishihara), stereopsis (Lang), and test for latent hyperopia. Referral to an ophthalmologist if: visual acuity < 0.7; difference in visual acuity in both eyes of more than one line, or any other pathological test result. A total of 12,192 children were screened. RESULTS: The preventive pediatric examinations were complete in 5756 children (56.4%), incomplete in 4449 children (43. 6%) and in 1987 children (16.3%) the degree of completion could not be determined. Eyes: pathological findings in 41.7%. Reduced visual acuity in 30.8%, color vision defects in 1.3%, severe visual impairment in 0.3%. Pathological findings in other organ systems: skeleton 33.5%, teeth 32.6%. For the urban confederacy of Saarbrücken: referrals to ophthalmologists: n=1108. No feedback information: 380; refractive correction: 226; recommendation for regular checks: 346; no pathological findings: 156. CONCLUSION. The high percentage of pathological findings in the vision screening of 12,192 pre-schoolers is an important confirmation that there is a need for a preventive ophthalmologic examination before the age of six. Only an area-wide ophthalmologic vision screening around the second or third year of life can effectively reduce the high prevalence of pathological findings at the time of starting primary school. To improve the present screening situation, networks between ophthalmologists and pediatricians would be beneficial.

Child↗
PubMed2001

Development of a quantitative method to measure vision in children with chronic cortical visual impairment.

PURPOSE: Cortical visual impairment (CVI) is the most common cause of bilateral vision impairment in children in Western countries. Better quantitative tools for measuring vision are needed to assess these children, to allow measurement of their visual deficit, and to monitor their response to treatment and rehabilitation. The author performed a series of experiments to assess the use of the sweep visual evoked potential (VEP) as a quantitative tool for measuring vision in CVI. METHODS: The first experiment was a reliability measure (test/retest) of VEP grating acuity thresholds of 23 children with CVI. To validate the VEP procedure, VEP grating acuity was compared to a clinical measure of vision, the Huo scale, and to a psychophysical measure of vision, the Teller Acuity Card procedure. Finally, the sweep VEP was tested as a tool for defining optimal luminance conditions for grating acuity in 13 children with CVI, by measuring grating thresholds under 2 different luminance conditions: 50 and 100 candela per square meter (cd/m2). RESULTS: Retest thresholds were similar to original thresholds (r2 = 0.662; P = .003, 1-tailed t test). Grating VEP measures correlate significantly with the clinical index (r2 = 0.63; P = .00004). Teller acuity measurements are also similar to VEP measures in children (r2 = 0.64; P = .0005) but show lower acuities compared to the VEP for children with particularly low vision. Finally, 3 of 13 children tested under 2 background luminance conditions showed paradoxical improvement in grating threshold with dimmer luminance. CONCLUSIONS: The sweep VEP tool is a reliable and valid means for measuring grating acuity in children with CVI. The tool also shows promise as a means of determining the optimal visual environment for children with CVI.

Blindness, Cortical↗
PubMed1992

The True Daylight Illuminator (TDI): a less expensive source of illumination for color vision screening.

This experiment was designed to examine the feasibility of using the True Daylight Illuminator (TDI) as an illumination option for conducting color vision screening with the Ishihara Test(s). The MacBeth Easel Lamp was designed to provide proper illumination for performing color vision screening with a variety of pseudoisochromatic (PIC) plate tests including the Ishihara. However, over the years, the MacBeth Lamp has become so expensive that many smaller programs cannot afford to purchase one. This problem has promoted the use of alternate light sources that have had a deleterious effect on test results and in some instances contributed to job discrimination. Recently the MacBeth Division of the Kollmorgan Corporation discontinued the manufacture of the MacBeth Lamp due to lack of demand. Thus, it is important to find an inexpensive illumination option for conducting color vision screening. Two groups of subjects were used to compare test results for the 24-plate edition of the Ishihara Test using both the MacBeth Lamp and the True Daylight Illuminator. The first group contained 45 subjects with inherited color defective vision. The second group was made up of 30 color normals. The Nagel anomaloscope was used to confirm the color vision status of the subjects in both groups. Statistics to test the significance of differences between group means clearly demonstrated that there were no significant differences between the mean error scores of the two groups for these two pieces of equipment. Thus, it was concluded that the TDI can be used in lieu of the MacBeth Easel Lamp for screening color vision with the Ishihara test.

Adolescent↗
PubMed1986

Acquired color vision defects and self monitoring of blood sugar in diabetics.

Color vision defects are common in diabetic patients and may precede visible retinal changes. More severe retinopathy is generally associated with more severe color vision defects. Many diabetics err when making color comparisons using self monitoring techniques. Optometrists can play an important role in diabetes patient management by monitoring color vision defects and making patients aware of problems or potential problems in self monitoring. Care must be taken in color vision evaluation as the most frequent acquired color vision defect in diabetics is a blue-yellow axis defect. Most commonly employed color vision tests are not sensitive in detecting this defect.

Aged↗
PubMed1996

A simplified screening test for identifying people with low vision in developing countries.

Simple but effective tests have been produced for screening subjects with low vision in developing countries. These tests of distance and near vision, based on the E test, were evaluated and validated in trials with people aged 4-90 years, and have been field tested in the health, education and rehabilitation services in 32 developing countries. Their sensitivity and specificity as screening tools for low vision have been calculated; sensitivity of 85% and specificity of 96% for the distance vision test, and sensitivity of 100% and specificity of 84% for the near vision test. The content and format of the tests have been demonstrated to be appropriate for developing countries, and their effectiveness for screening for low vision has been confirmed.

Adolescent↗
PubMed1996

Performance of color-dependent air traffic control tasks as a function of color vision deficiency.

BACKGROUND: This experiment was conducted to validate the requirement for normal color vision in Air Traffic Control Specialist (ATCS) personnel who work at en route center, terminal, and Flight Service Station (FSS) facilities. METHODS: A data base was developed involving 121 individuals with normal color vision, 31 simple and 44 extreme anomalous trichromats, and 48 dichromats; both protans and deutans were included. The performance of subjects with normal color vision was compared with the performance of individuals with various classifications of color vision deficiencies on a battery of color-dependent ATCS tasks. Simulations of the ATC color tasks concerned color coding in flight progress strips (at en route centers), aircraft lights and Aviation Signal Light indicator (in tower operations), and color weather radar (at FSS's). RESULTS: Errors were rare among normal trichromats. Mean errors were significantly higher at every level (degree) of color vision deficiency. Approximately 6% of color deficient subjects were able to perform ATC color tasks without error. The 6% were all from the simple anomalous trichromat category; all extreme anomalous trichromats and dichromats were prone to error on ATC tasks. CONCLUSIONS: We conclude that these findings provide support for the requirement of normal color vision in the initial medical screening of ATCS personnel.

Accidents, Aviation↗
PubMed1997

Stereopsis and disparity vergence in monkeys with subnormal binocular vision.

The surgical treatment for strabismus in infants generally results in microtropia or subnormal binocular vision. Although the clinical characteristics of these conditions are well established, there are important questions about the mechanisms of binocular vision in these patients that can best be investigated in an appropriate animal model. In the present psychophysical investigations, spatial frequency response functions for disparity-induced fusional vergence and for local stereopsis were studied in macaque monkeys, who demonstrated many of the major visual characteristics of patients whose eyes were surgically aligned during infancy. In six rhesus monkeys, unilateral esotropia was surgically induced at various ages (30-184 days of age). However, over the next 12 months, all of the monkeys recovered normal eye alignment. Behavioral measurements at 4-6 years of age showed that the monkeys' prism-induced fusional vergence responses were indistinguishable from those of control monkeys or humans with normal binocular vision. Investigations of stereo-depth discrimination demonstrated that each of the experimental monkeys also had stereoscopic vision, but their stereoacuities varied from being essentially normal to severely stereo-deficient. The degree of stereo-deficiency was not related to the age at which surgical esotropia was induced, or to the presence or absence of amblyopia, and was not dependent on the spatial frequency of the test stimulus. Altogether, these experiments demonstrate that a temporary, early esotropia can affect the binocular disparity responses of motor and sensory components of binocular vision differently, probably because of different sensitive periods of development for the two components.

Amblyopia↗
PubMed1989

Analysis of a community vision screening program.

For 3 consecutive years a community vision screening program has been conducted on-site at the Walker Eye Clinic of the Indiana University (IU) School of Optometry. A group of 490 screened patients, including 86 who returned for comprehensive evaluation, was retrospectively studied for a variety of characteristics. It was determined that the typical participant was likely to be an adult female who learned of the screening program through the written media. She was likely to have had a previous vision examination but it probably took place 3 or more years earlier. She usually failed the vision screening for reasons of reduced visual acuity, a problem with binocularity or asthenopia. If she returned to the Walker Eye Clinic for a comprehensive examination, she was likely to do so within 5 months and would be found to have been accurately identified as being in need of vision care. The organization and implementation of this vision screening program are described, and its value as an educational tool for students of optometry and its technician program is discussed.

Adolescent↗
PubMed2006

Racial and ethnic differences in unmet need for vision care among children with special health care needs.

OBJECTIVE: To examine racial and ethnic differences in unmet need for vision care among children with special health care needs. METHODS: Cross-sectional data from the National Survey of Children with Special Health Care Needs were analyzed. The analytic sample was 14,070 children with special health care needs who needed eyeglasses or vision care in the previous year. Children who did not receive all the eyeglasses or vision care they needed were considered to have unmet need for vision care. RESULTS: Of the sample, 5.8%, representing approximately 198,600 children with special health care needs in the United States, had unmet need for vision care. Rates of unmet need ranged from 2.5% to 14.3% across the 7 racial and ethnic groups studied. Relative to whites, children of African American, Latino, and multiracial backgrounds had approximately twice the adjusted risk of unmet need, whereas American Indian or Alaskan Native children had a lower adjusted risk. Health care providers, school personnel, insurance coverage, and other factors also contributed to differences in the risk of unmet need, independently of child race/ethnicity. CONCLUSION: Further research is needed to explain and address the causes of racial and ethnic differences in unmet need for vision care among children with special health care needs.

Adolescent↗
PubMed2006

Orientation and mobility training for adults with low vision.

BACKGROUND: Orientation and mobility (O&M) training is provided to people who are visually impaired to help them maintain travel independence. It teaches them new orientation and mobility skills to compensate for reduced visual information. OBJECTIVES: The objective of this review was to assess the effects of (O&M) training, with or without associated devices, for adults with low vision. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) in The Cochrane Library, MEDLINE, SIGLE, EMBASE, National Research Register, Zetoc, LILACS, and the reference lists of articles. Updated searches were in 2006. SELECTION CRITERIA: We planned to include randomised or quasi-randomised trials comparing (O&M) training with no training in adults with low vision. DATA COLLECTION AND ANALYSIS: Two authors independently assessed the search results for eligibility, evaluated study quality and extracted the data. MAIN RESULTS: Two small studies satisfied the inclusion criteria. They were consecutive phases of development of the same training curriculum and assessment tool. The intervention was administered by a volunteer on the basis of written and oral instruction. In both studies the randomisation technique was inadequate, being based on alternation, and masking was not achieved. Training had no effect in the first study while it was found to be beneficial in the second. Reasons for this may have been: the high scores obtained in the first study, suggestive of little need for training and small room for further improvement (a ceiling effect), and the refinement of the curriculum allowing better tailoring to patients' specific needs and characteristics, in the second study. AUTHORS' CONCLUSIONS: The review found two small trials with similar methods, comparing (O&M) training to physical exercise, which were unable to demonstrate a difference. Therefore, there is little evidence on which type of orientation and mobility training is better for people with low vision who have specific characteristics and needs. Orientation and mobility instructors and scientists should plan randomised controlled studies to compare the effectiveness of different types of (O&M) training. A consensus is needed on the adoption of standard measurement instruments of mobility performance which are proved to be reliable and sensitive to the diverse mobility needs of people with low vision. For this purpose, questionnaires and performance-based tests may represent different tools that explore people with low vision's subjective experience or their objective functioning, respectively.

Adult↗
PubMed1995

Long-term results of low vision rehabilitation in age-related macular degeneration.

One to five years after successful low vision rehabilitation, 199 patients with age-related macular degeneration were asked by means of a questionnaire whether they still used their low vision aids and whether they were satisfied with the low vision counseling. We received feedback from 66% of the patients. 20 patients had already passed away. 74% of the 112 answering patients still use a low vision aid today. Three-quarters of them still use the originally prescribed low vision aid. Interestingly enough, the daily reading time was rather short, only 16% of the patients read more than 1 hour per day, 42% read somewhat more and 13% somewhat less than 10 minutes per day. Retrospectively, 81% of all responding patients found their low vision counseling at least a little, more of them quite or very helpful. These numbers suggest, that the initial labor of patiently examining and training older, visually handicapped patients is worthwhile.

Aged↗
PubMedDate not supplied

Low vision correction for high myopia.

High myopia is favorable for low vision corrections because the vision has usually been poor since childhood and the person has been able to read at close range, producing magnification. For near vision, in addition to bringing objects close, magnification is produced by high-add bifocals, trifocals, strong near vision spectacles and nonspectacle magnifiers. Hand magnifiers held at a distance from the eye are used with the spectacle correction. This paper describes the Visolett, used without correction or near vision correction, as the preferred non-spectacle magnifier because the reading area is self-illuminated, it doubles the approach magnification, rests on the paper, is simple to use, produces binocular vision, and attracts the least attention. Combination method of magnification consists in the use of the Visolett in addition to a spectacle magnifier, which doubles the magnification.

Contact Lenses↗