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User involvement in the design and evaluation of a smart mobility aid.

This paper describes the design and evaluation of an innovative smart mobility aid for the frail visually impaired. The Personal Adaptive Mobility AID (PAM-AID) was developed to address the difficulties in personal mobility of the frail and elderly visually impaired. The paper provides an overview of the PAM-AID research at Trinity College and describes the evolutionary nature of the design process. Because there were no existing systems to guide its development, a series of prototypes was constructed and they were regularly evaluated in the field. This approach views potential users as vital contributing members of the design team and led to rapid and hopefully useful improvements in the design.

Aged↗

A curriculum for training patients with peripheral visual field loss to use bioptic amorphic lenses.

This article describes the experimental protocol used to instruct fifteen patients with peripheral visual field loss due to retinitis pigmentosa, choroideremia, or Usher's syndrome Type II how to effectively use bioptic amorphic lenses. The factors that contributed to the successful use of these lenses, as well as difficulties the patients encountered, are discussed. The results of the study (published in detail in Szlyk et al. Use of bioptic amorphic lenses to expand the visual field in patients with peripheral loss. Optom Vis Sci 1998;75:518-24) indicate that bioptic amorphic lenses, when combined with a comprehensive training program, can expand visual function in the areas of peripheral detection, recognition, scanning, tracking, visual memory, and mobility.

Adult↗

Assessment of adult stereopsis using the Lang 1 Stereotest: a pilot study.

BACKGROUND AND PURPOSE: To assess the use of the Lang 1 Stereotest as a vision-screening test for adults, for which little is known or reported. METHOD: The Lang 1 Stereotest was administered to 292 consecutive participants of the Visual Impairment Project (VIP) five year followup study, which is a population based study of eye disease in Melbourne, Australia. 56.9% were female. The mean age was 59.4 years, range 44-90 years. A "positive" stereoscopic response was recorded where the stereoscopic target image was correctly named; a "partial positive" response where depth was appreciated but the shape could not be named; and a "negative" response where there was no appreciation of a stereo effect. The responses were further categorized so that the test was either "passed" or "failed". A "pass" score was 3/3 positive responses; 3/3 partial positive responses or 2/3 positive and/or partial positive responses where the negative response was at the 550" of arc stereoacuity level. "Failure" was 3/3 negative responses and 2/3 negative responses where the positive or partial positive response as at the 1200" level. RESULTS: Of the 292 participants tested, 19 (6.5%) participants "failed" the test. In addition to strabismus and anisometropia, failure was associated significantly (p<0.001) with reduced distance visual acuity (<6/12) irrespective of the ocular morbidity. CONCLUSION: The Lang 1 Stereotest correctly identified people with vision defects associated with reduced stereopsis. This suggests the Lang 1 Stereotest is an appropriate for the vision screening of adults as it is for children.

Adult↗

The virtual retinal display as a low-vision computer interface: a pilot study.

This pilot study examined the performance of an alternative computer visual interface, the Virtual Retinal Display (VRD), for low-vision use. The VRD scans laser light directly onto the retina, creating a virtual image. Since visually impaired individuals can have difficulty using computer displays, a matched comparison study was done between the VRD and the standard cathode ray tube (CRT) monitor. Reading speed and acuity tests were collected from 13 low-vision volunteers selected to represent the broad range of partially sighted individuals actively involved in the work force. Forty-six percent of subjects had highest visual acuity while viewing the VRD; 30% of subjects had highest acuity viewing the CRT; and 24% of subjects had equal acuity across the two displays. Although mean reading speed across all 13 subjects indicated no significant difference between displays, individual subjects with predominantly optical causes of low vision exhibited clinically important increases in reading speed versus the CRT. However, most subjects with predominantly retinal damage showed a slight disadvantage using the VRD. We give theoretical explanation to the bifurcated results and conclude that for a subset of low-vision users, the VRD technology is very promising as a basis for future low-vision aids.

Adult↗

[Knowledge about sexuality and sex behavior in university students with visual impairment: need of educational materials].

The objective of this study was to identify the knowledge about sexuality (including STD/HIV/AIDS), the sexual practices more frequents and sexuality education sources in a group of students with visual impairments. A self administered questionnaire was utilized in 50 students with visual impairment. Descriptive statistics were utilized. Seventy six percent (76.0%) of the participants presented a high knowledge about sexuality and 22.0% presented moderated knowledge. The no penetrative sexual practice more frequent was corporal caress (82.0%) and the penetrative was penis-vagina (74.0%). The source of sexuality education most common was the conferences (83.9%). Although, in general, the knowledge about sexuality was high, there are "gaps" in them. There is the need to develop educational materials adapted to the needs of the studied population.

Adult↗

Grating visual acuity using the preferential-looking method in elderly nursing home residents.

PURPOSE: To assess the performance of two approaches to visual acuity testing in a group of nursing home residents with cognitive impairment. The study was a cross-sectional comparison of the effectiveness of two tests of visual acuity. METHODS: Nursing home residents participating in a clinical trial were tested with both recognition acuity charts and grating acuity cards (Teller) by masked observers. RESULTS: Of the nursing home residents (n = 656) who participated in the study, 86% could respond to visual acuity testing in at least one eye. Eighty-four percent were testable using Teller cards versus 73% who were testable by Early-Treatment Diabetic Retinopathy Study (ETDRS) charts or Lea symbol charts. Forty-one percent of individuals with MiniMental Status Examination (MMSE) scores lower than 10 were testable by recognition acuity, whereas 61% were testable with grating acuity cards. Grating acuity correlated well with recognition acuity (R = 0.79; 95% CI, 0.75-0.98, intraclass correlation coefficient [ICC]). The correlation was slightly lower in individuals with decreased MMSE scores. Although grating acuity was one line better than recognition acuity on average and median acuities were the same, 24% of individuals had results that differed by three or more lines. CONCLUSIONS: Teller acuity cards can effectively test the vision in cognitively impaired individuals who are not testable by conventional means. Grating acuity results correlated well with those of recognition acuity, although differences of three or more lines were not uncommon. Wider use of grating acuity testing allows a more complete assessment of visual function in the cognitively impaired elderly.

Aged↗

Blurred vision.

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Employment↗

The three phases of Eve: exploring the common and unique findings in oral and systemic health of differently aging women.

Given that, collectively, women are the longer-lived of the human species, it is fitting that we examine the impact and correlations of aging on systemic and oral health with women as the paradigm. Aging, however, is not a homogeneous process. Its influences are as diverse as the subgroups of people affected. To exemplify the differing manifestations and progressiveness of aging, this article highlights the profiles of three differently aging women: an independent dweller in the community, a participant in an assisted living program, and a resident of a skilled nursing home. How aging has affected their lives commonly and uniquely is addressed, as are medical and oral health issues that transcend functional capability, and evolving research in preventive strategies focusing on successful aging.

Activities of Daily Living↗

[Adolescent psychiatric aspects of visual handicap and blindness].

The focus of the study was a questionnaire-based overview concerning psychiatric symptoms, self image, control beliefs and some aspects of family relations of severely visually impaired and blind adolescents and young adults. The high incidence of emotional and social problems seemed to be equal to that of a clinical sample, competence and control beliefs differed between impaired und unimpaired adolescents as well as between visually impaired und blind adolescents. Self-perceptions of bonding- vs. detachment behaviour from the viewpoint of the blind adolescents appeared somewhat "surer", nearer to the ratings of the unimpaired peers. The ratings of the visually impaired peers however seem to express more "uncertainties" in both main directions, bonding as well as detachment behaviour. Concerning global self image there seemed to exist no significant difference between our whole sample and unimpaired peers.

Adolescent↗

Postoperative pain relief after laparoscopic cholecystectomy: a randomised prospective double-blind clinical trial.

BACKGROUND AND AIMS: The clinical value of infiltration of wounds with local anaesthetics (LA) and their intraperitoneal application for treating pain after laparoscopic cholecystectomy (LC) still remain controversial. In this study the use of intraincisional and intraperitoneal LA was evaluated. MATERIAL AND METHODS: Eighty patients were prospectively randomised into four groups. In the control group (G1) LA was not used. In G2 all wounds were infiltrated with 80 ml of 0.125 % Bupivacaine containing 5 mg of Phenylephrine. In G3 the wounds were infiltrated with 80 ml of 0.9 % NaCl. In G4, in addition to wound infiltration with Bupivacaine/Phenylephrine, 200 ml of normal saline, containing 0.15 % of Lidocaine, was left intraperitoneally under the right diaphragm. Postoperative abdominal and shoulder pain scores were recorded on a visual analogue scale (VAS) during 24 hours after LC. Narcotic analgesic consumption was also recorded. RESULTS: The mean abdominal pain scores were significantly lower in G2, compared with G3, 3 to 24 hours after operation, compared with G4, 3 to 6 hours and compared with G1, 3 to 24 hours (except at hour 12) after surgery. The incidence of shoulder pain was 30 %. There were no significant differences in the mean shoulder pain scores between the groups. The mean dosage and the total amount of Pethidine at 24 hours were significantly lower in G2 compared with G1. CONCLUSIONS: Intraincisional infiltration with a Bupivacaine/Phenylephrine mixture reduces significantly abdominal postoperative pain (for up to 24 h) and narcotic analgesic consumption after LC. An intraperitoneal subdiaphragmatic dilute solution of Lidocaine was not effective in reducing overall pain and shoulder pain after LC.

Adult↗