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PubMed1994

Sensitivity of random dot stereoacuity and Snellen acuity to optical blur.

The purpose of this study is to investigate the usefulness of a random dot stereogram for the detection of refractive blur by determining the relative sensitivity of random dot stereoacuity (RDS) and Snellen visual acuity to the effects of optically induced blur. Measurements of Snellen and stereoacuity were compLeted on four young adult subjects under cycloplegia and through artificial pupils. Optical blur was varied binocularly and monocularly in 0.50 D steps up to +/- 6.00 D while the subjects viewed targets composed of stimuli arranged in 0.1 log unit size increments. The results show the relation between RDS and Snellen acuity to be SA = 1.341 (VA) + 0.281 for equal amounts of binocularly induced optical blur. Moreover, the RDS appeared more highly sensitive when the blur in the 2 eyes was unequal [SA = 3.774 (VA) - 1.180], a condition approximating refractive anisometropic amblyopia. These results provide a rationale for the use of random element stereograms for the detection of refractive amblyopia and ametropia in the vision screening of children.

Adult↗
PubMed1999

Progression of myopia in Hong Kong Chinese schoolchildren is slowed by wearing progressive lenses.

PURPOSE: In Chinese societies, primary and secondary schoolchildren perform large amounts of reading and homework and thus spend long periods performing near work during their growth years. Progressive lenses, which can permit a focused retinal image at distance, intermediate, and near, without accommodation, may slow the development of myopia. This paper reports results of a 2-year longitudinal study to examine the effects of progressive lenses on myopia progression in myopic Chinese children; these children were aged between 9 and 12 years at the beginning of the study. METHODS: Prestudy vision screening tests and five examinations, which included noncycloplegic refraction, were conducted at half-yearly intervals. Of those who completed the study, 32 children wore single vision (SV) lenses (the SV group) and 36 wore progressive lenses; of the latter, 22 wore a +1.50 D addition (the P1 group) and 14 wore a +2.00 D addition (the P2 group). Refractive error, corneal curvature, axial length, vitreous depth, and intraocular pressure were measured at every examination. Height was measured as an index of general growth. RESULTS: Progressive lenses significantly retarded the progression of the myopia in these children. Initially, the mean refractive error of the SV group was -3.67 D, of the P1 group was -3.73 D, and of the P2 group was -3.67 D. The mean myopic progressions over the 2 years of the study were -1.23, -0.76, and -0.66 D for the SV, P1, and P2 groups, respectively. CONCLUSION: Progressive lenses reduce the progression of myopia. It may be that the interaction of the progressive lenses with the accommodation system is the cause of this reduction in myopia progression because the +2.00 D addition appeared more effective than the +1.50 D addition in slowing the progression.

Child↗
PubMed1993

[A critical analysis of school screenings. The performance of each type of examination].

The results of a student screening program performed by the Primary Care Team of Gandía on 359 children (180 males and 179 females) that attended 1. EGB are presented. We reviewed the following: vision, hearing, dentition, somatometry, immunization, and urological and traumatological problems. Children with pathologies were referred to specialists to confirm the diagnosis. Of these children, 78% had some form of pathology. The most frequent system involved was hearing, followed by dentition and vision. The correlation of these results with those of the specialists was good (> 50%). The best results were obtained on vision screening results (100% correlation and 2/3 of the problems formerly detected). Twenty-four percent of the children had caries and this was not of major concern to the families. The worst results were obtained in auditive screening. Because the primary care examination model is not generalized, school screening is still a good method to detect previously undiagnosed pathologies in children.

Child↗
PubMed1986

Visual acuity screening of infants and young children with the acuity card procedure.

A new acuity test for infants and young children between 1 and 36 months of age is described. The test was used to evaluate the acuities of 66 infants and young children during a one-day vision screening. At least one estimate of visual acuity was obtained from 63 of the 66 children. Fifty-two of the children completed two monocular acuity tests (or two monocular tests plus a binocular test). The average total test time for these 52 children was less than 15 minutes. Results indicate that the acuity card procedure can be used as a complement to standard optometric tests for large-scale screening of infants and young children.

Child, Preschool↗
PubMed2002

Effect of depression on vision function in age-related macular degeneration.

OBJECTIVES: To report the prevalence rate of depression in older patients with recent vision loss due to age-related macular degeneration (AMD) and to describe the effect of depression on self-reported vision function during 6 months. METHODS: Prospective cohort study of 51 older patients with recent-onset bilateral AMD attending the Retina Clinic of Wills Eye Hospital, Philadelphia, Pa. Main outcome measures included the Center for Epidemiological Studies Depression Scale, visual acuity, Functional Vision Screening Questionnaire, Chronic Disease Score, and Community Disability Scale. RESULTS: Seventeen patients (33%) were depressed at baseline and had worse visual acuity (P =.04) and greater levels of vision-specific (P =.03) and general (P =.002) physical disability than nondepressed patients. The correlations of Center for Epidemiological Studies Depression Scale score with visual acuity and visual-specific disability, however, were not significant after controlling for general physical disability. An increase in depressive symptoms over time predicted decline in self-reported vision function independent of changes in visual acuity or medical status (P<.05). CONCLUSIONS: The prevalence and disabling effects of depression in older patients with AMD are substantial. Recognizing that depression is a treatable disorder that exacerbates the effects of AMD will lead to improved outcomes. Innovative interventions to prevent or treat depression in specialty eye clinics are possible.

Aged↗
PubMed1986

Visual acuity of the preschool child: a review.

The need for visual acuity assessment in preschool children has long been recognized, yet there are no standardized visual acuity norms or screening criteria. This report reviews the literature on distance visual acuity in the preschool child. The areas of review include: methods of assessment of visual acuity; visual acuity norms obtained with these tests; reasons for the variations in reported visual acuity norms; variations in referral criteria for vision screenings; testability reported for various visual acuity tests; and important design principles and recommendations for preschool visual acuity tests. It is concluded that a well designed preschool visual acuity test should consist of high contrast Snellen optotypes without directional components that progress in 0.1 log steps down to a level of 6/3. To improve testability, a matching or forced choice response should be used. Of the tests that have been standardized, STY-CAR (Sheridan-Gardiner) comes closest to meeting these criteria.

Child↗
PubMed2002

Clinical testing of accommodative facility: part III. Masked assessment of the relation between visual symptoms and binocular test results in school children and adults.

BACKGROUND: Accommodative facility is commonly assessed using +/- 2.00 lenses at 40 cm. Significant differences have been demonstrated on binocular facility testing between symptomatic and asymptomatic children; studies on adults have not replicated these results. We evaluate the relation between symptoms and binocular amplitude-scaled facility (equivalent stimulus for each subject based on individual amplitude). METHODS: Optometry students (N = 98) and school children IN= 152) participated in a vision screening. A 9-question standardized questionnaire quantified symptoms. Binocular accommodative facility was assessed using random presentation of standard and amplitude-scaled facility, without knowledge of symptom level. Subjects with abnormal binocular vision were excluded from data analysis. RESULTS: For children, both amplitude-scaled (p = 0.0004). and standard accommodative facility (p = 0.0055) significantly differentiated symptomatic from asymptomatic responses. For adults, amplitude-scaled responses were significantly different (p= 0.0228) between symptomatic and asymptomatic subjects; standard testing results were not (p = 0.2013). CONCLUSION: Binocular amplitude-scaled facility testing (test distance 45%, lens power range 30% of push-up amplitude) identifies symptomatic adults at high significance level. And both children and adults perform similarly on amplitude-scaled testing. These results suggest that amplitude-scaled binocular accommodative facility should be the test of choice for evaluation of patients between the age of 8 years and the onset of presbyopia. Patients who perform less than 10 cycles per minute are likely to be symptomatic.

Accommodation, Ocular↗
PubMed2001

Eye conditions among 5- to 7-year-old Asian-Pacific Islander schoolchildren in Southern California.

BACKGROUND: The prevalence rates and specific risk factors for development of eye conditions among Asian-Pacific Islander schoolchildren are unknown. This information is necessary to understand their eye care needs and to improve access to eye care for this rapidly growing population. METHODS: Data obtained from a computer database of vision screening examinations conducted by the UCLA Mobile Eye Clinic from October 1987 through December 1996 were analyzed for 2,687 Asian-Pacific Islander schoolchildren between 5 and 7 years of age. RESULTS: Myopia (8.9%) and astigmatism (15.8%) represented the majority of visual disorders. Mean myopic refractive error was -1.21 +/- 0.83 D among bilateral myopes. Color-vision deficiency was prevalent among 2.8% of male children, extraocular muscle imbalance among 3.0% of children, and amblyopia among 1.0% of children. All other conditions were present in less than 4% of children screened. CONCLUSIONS: Asian-Pacific Islander schoolchildren may be at higher risk for development of juvenile myopia than white, Hispanic, and African-American children. Prevalence rates of other disorders are comparable to those obtained for other ethnic groups. This information can be used in planning to meet the eye care needs of Asian-Pacific Islander schoolchildren.

Asia↗
PubMed1998

Common ophthalmologic concerns in infants and children.

Pediatric ophthalmology differs from adult eye care in many aspects. Some disorders are seen only in children although others may be found in adults as well. A major difference between pediatric and adult ophthalmology is the impact that almost any disorder may have on the developing visual system. This article addresses common pediatric eye disorders and their potential effects on the visually impaired immature child. Referral guidelines and vision screening are also discussed.

Adult↗
PubMed1995

Does occupational exposure to argon laser radiation decrease colour contrast sensitivity in UK ophthalmologists?

The objects of the study were to determine: (1) whether United Kingdom ophthalmologists who used argon lasers had the elevation of colour-contrast thresholds previously discovered and (2) whether other users of argon lasers showed any unusual loss of colour vision. A total of 1072 UK ophthalmologists filled in a questionnaire about their professional use of lasers, the length of time spent operating, and their out-of-doors activities. Their colour vision was then tested by a new sensitive system, and if any abnormality was detected, a clinical eye examination was performed. The results were as follows: (1) Colour vision testing was shown to be reliable. Any self-selection bias was excluded. Test-retest variability was small. Normal results did not change during the survey. (2) A number of men with high red-green thresholds were discovered. Some were aware of their congenital insensitivity. The frequency of all such defects was less than the known incidence of congenital colour deficiency in the male population. (3) Additionally a number of high tritan (blue-yellow) thresholds were encountered, some associated with reported diabetes and hypertension. In other cases of this type, undetected or unacknowledged systemic disease may be present. (4) After making allowance for all these incidental causes of loss of colour vision, and for the effect of age on colour vision (which is very small) only four of the sample were > 2 SD above normal. (5) However, the average blue-yellow thresholds of ophthalmologists were slightly and highly significantly raised compared with normal, in the first year of the survey. During the second and third years, the mean thresholds declined to normal. Similar but less significant findings were found for protan thresholds. It is concluded that the enhanced safety precautions recently introduced are associated with a recovery of colour vision in this population, demonstrating that any changes to individuals were reversible. Colour vision screening has proved able to detect mild ocular abnormalities due to systemic and congenital disease.

Adult↗
PubMed2003

Prevalence of undetected ocular conditions in a pilot sample of school children.

Parents of 134 children (age 5-18 years; 84% participation) attending a private school gave informed consent for their child's participation in a pilot study to demonstrate the feasibility and estimate sample size for a larger study of myopia prevalence, the Sydney Myopia Study. LogMAR visual acuity and other ocular assessments, including cycloplegic autorefraction (tropicamide 1%) and examination of the media and fundus, were performed. The prevalence of significant ocular conditions was 28.2%. Eleven children (8.4%) wore glasses. Five were referred for a change in their correction. Previously undetected ocular conditions (19.8%) included one child with ocular pathology and four children with strabismus. Uncorrected refractive error (16.8%) was the most common reason for referral and was more predominant in the senior students (25%), corresponding with an age-related shift in mean spherical equivalent refraction towards myopia (less than 7 years: +0.40 +/- 0.60 D; more than 15 years: -1.15 +/- 1.18 D). Three senior students were classified as having socially significant correctable vision impairment. These findings suggest that reliance on ad hoc referrals could result in delayed referral and that vision screening in both early and later school years may be desirable.

Adolescent↗
PubMed1988

Test-retest reliability of the Arden Grating Test: inter-tester variability.

The aim of this study was to investigate the test-retest reliability of the Arden Grating Test (AGT), and to assess the extent to which any variance in AGT score on retest can be attributed to intra-subject and inter-tester differences. Twelve patients with various pathologies and whose contrast sensitivity covered a wide range were each tested twice by six testers. It was shown that variance attributable to testing by different clinicians accounted for approximately 25% of the total variance, and that the 95% confidence limits about any observed score were +/- 15 AGT units, which is about one quarter of the total dynamic range of the test. The large range of scores encompassed by the 95% confidence limits represents considerable unreliability, the consequence of which is a high misclassification rate, i.e. many false positives and false negatives, especially in the context of primary vision screening for which it was designed.

Adult↗
PubMedDate not supplied

Incidence of visual defects in Yugoslavia.

1645 children of 1-7 years of age and 103 4-year-old children of an unselected population were examined. Vision screening was performed as single E optotype. Schiascopy and fixation with visuscope were also performed. Results are presented in six tables.

Astigmatism↗
PubMed2005

Hyperopia and educational attainment in a primary school cohort.

BACKGROUND: Vision screening addresses the visual impairments that impact on child development. Tests of long-sightedness are not found in most school screening programmes. The evidence linking mild-moderate hyperopia and lack of progress in school is insufficient, although strengthened by recent findings of developmental problems in infants. AIMS: To report on the relation between hyperopia and education test results in a cohort of primary school children. METHODS: A total of 1298 children, aged 8 years, were screened for hyperopia on the basis of fogging test results. School test results (NFER and SATs) were compared between groups categorised by referral status and refractive error. RESULTS: A total of 166 (12.8%) fogging test failures were referred for ophthalmic assessment. Ophthalmic tests on 105 children provided an accurate diagnosis of vision defects, for reference to their education scores. Fifty per cent of the children examined by optometrists required an intervention (prescription change, glasses prescribed, or referral). Mean (95% CI) NFER scores of children with refractive errors (summed for both eyes) >+3D (98.4, 93.0-103.8, n = 32) or >+1.25D (best eye) (99.3, 93.0-105.6, n = 26) were lower than the respective scores of children with a less positive refractive state (104.8, 100.7-108.9, n = 43) (103.6, 99.7-107.4, n = 49), the non-referred group, and total sample. The SATs results followed a similar trend. A high proportion of the fogging test failures (16%) and confirmed hyperopes (29%) had been referred to an educational psychologist, and the latter group contributed substantially to the poor education scores. CONCLUSIONS: The results of this study provide further evidence for a link between hyperopia and impaired literacy standards in children.

Analysis of Variance↗
PubMed2000

Healthy People 2010--vision objectives for the nation.

BACKGROUND: In January 2000, the U.S. Department of Health and Human Services released new national health goals and objectives in a report entitled Healthy People 2010. This national report includes specific objectives for improving the vision of people in the United States during the 2000-2010 decade through prevention, early detection, treatment, and rehabilitation. The vision objectives, along with other health objectives, are designed to help the nation achieve two major outcomes: (1) increase the quality and years of healthy life and (2) eliminate health disparities among different groups. These health objectives will strongly influence many health care programs and the provision of health care through laws, regulations, reimbursements, and clinical guidelines enacted by federal and state agencies. PURPOSE: The purpose of this article is to inform optometrists about the new Healthy People 2010 vision objectives. METHODS: A summary of the Healthy People process for developing the objectives--and the specific vision objectives--is provided. These objectives address many important areas, including: regular dilated eye examinations; vision screening for preschool children; uncorrected visual impairment due to refractive errors; blindness and visual impairment in children and adolescents; visual impairment due to diabetic retinopathy, glaucoma, and cataracts; occupational eye injury; the use of personal protective eye wear in recreational activities and hazardous situations around the home; and the use of vision rehabilitation services and adaptive devices by people with visual impairments. CONCLUSION: These new national health goals and objectives will impact optometrists. Therefore, it is important that optometrists understand these objectives and actively work to help implement them at the national, state, and local levels. By doing this, they can help provide the services needed to reduce visual impairments and improve the vision of people in their communities.

Health Promotion↗
PubMed1980

Optometric and ophthalmological eye care under the Medicare program.

A questionnaire survey was administered to more than 600 elderly persons within several senior citizens centers in New York City. Data was collected on the elderly's use of eye care services, particularly the site where eye care was obtained, the type of provider chosen and the source of payment, i.e. Medicare, Medicaid or self pay. The second stage of the survey was to screen all participants for the absence or presence of visual problems. Significant differences were found when comparing the use of optometrists and ophthalmologists with the method by which the respondent paid for their last eye examination. Among those who were seen by an ophthalmologist and reported that Medicare paid for their examination half either passed or failed the vision screening test due only to poor visual acuities. Statistical evidence seems to indicate that Medicare payments to ophthalmologists may not be solely for actual or suspected disease conditions. Implications for the Medicare program seem evident.

Aged↗
PubMed1988

Prevalence of illegal motor vehicle driving among visually impaired elderly patients in Alberta.

Of 491 patients aged 65 years or older consecutively referred to a sight enhancement clinic in northern Alberta, 22 (4%) with vision below legal limits persisted in driving a motor vehicle. Significantly more men (11%) than women (1%) were driving illegally (p less than 0.00001). Among the men, a higher proportion of those aged 65 to 79 years (17%) than those aged 80 years or older (6%) were driving illegally (p less than 0.009). Many patients had several diseases, including tremor, hearing loss, heart problems and insulin-dependent diabetes mellitus. None had been reported to the Motor Vehicles Division. Both patients and physicians appear reluctant to acknowledge the consequences of visual disabilities. Drivers should have their vision screened regularly beginning at age 65 years. Physicians should notify the appropriate authorities when a patient can no longer drive legally and safely.

Aged↗
PubMed1995

[Clinical aspects of hypophyseal diseases from the viewpoint of the ophthalmologist].

The anatomy of the chiasmal region and the visual symptoms due to pituitary tumors will be presented from the viewpoint of an ophthalmologist. The importance of perimetry in every patient with otherwise unexplained loss of vision is stressed. Other tests (swinging flash light test, colour vision, screening ophthalmoscopy) are mentioned as well. An ophthalmologist should participate in the diagnosis as well as in the follow-up after treatment of any case with pituitary tumors.

Humans↗