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PubMed1987

Two-flash photorefraction in screening of amblyogenic refractive errors.

A selection of amblyopic (n = 14) and nonamblyopic (n = 18) children with different ametropias, anisometropias, and astigmatisms was photorefracted without cycloplegia by two-flash photorefraction (T-FP) in which refractions in both horizontal and vertical meridians of both eyes are measured simultaneously. The results were compared to conventional cycloplegic retinoscopy in a blind study. Significant amblyogenic conditions, such as hyperopic anisometropias of more than 1.0 diopter (D), high ametropias, or astigmatism and strabismus cases of 2 degrees to 3 degrees or more are detectable. The technique provides a simple and useful tool for mass screening of infants. The sensitivity of the method for detecting amblyopia seems to be at least as high as in visual checking. Media opacities are recordable, and a permanent document is obtained.

Amblyopia↗
PubMed1989

The influence of refractive error and lattice degeneration on the incidence of retinal detachment.

This study indicates the feasibility of stratifying the general population into various risk pools for retinal detachment depending on a person's age, refractive status, and the presence of lattice degeneration. At first impression the risks seem at variance with the fine clinical studies of Byer, who has shown a very low detachment rate in the population with lattice degeneration. In all likelihood the vast majority of his patients were emmetropic or mildly myopic, so that very few would be expected to develop detachments during their entire lifetimes, let along during intervals of only 10 to 20 years. This study shows the futility of following, or treating prophylactically, young emmetropic individuals with lattice degeneration. Assuming that prophylaxis is actually effective, one would have to treat 1000 emmetropic lattice patients in the 30 to 39 year age group to prevent a single detachment over a 10-year period. Lattice patients with low to moderate degrees of myopia tend to develop detachments between 40 and 60 years of age caused by premature posterior vitreous separation and tractional tears. Clearly prophylaxis for this group is not warranted, since only 5% to 10% of these individuals will experience detachments in their lifetimes. On the other hand this study has verified the previous suspicions that persons with myopia exceeding -5.0 D accompanied by lattice degeneration have an extraordinarily high risk of detachment during their lifetimes. Detachments in this group tend to cluster in the second, third, and fourth decades, are typically caused by atrophic holes, are slowly progressive, and are often simultaneously bilateral. Enhanced vigilance is certainly appropriate during this time and perhaps consideration should be given to prophylactically treating this group. This would be no small task, since within a population of 1 million persons there would be about 1150 aged 10 to 39 years with myopia exceeding -5.0 D and lattice degeneration. Only 4 detachments annually and 40 detachments in 10 years would be expected in this highest risk group.

Adolescent↗
PubMed1987

Tonic accommodation, accommodative hysteresis, and refractive error.

Accommodative hysteresis was compared in high myopes, low myopes, emmetropes, and hyperopes. Subjects consisted of 48 visually normal young adults who were fully corrected for their ametropia and equally distributed among the four refractive categories. Baseline measures of tonic accommodation, nearpoint, and farpoint were followed by a 10 min period of monocular fixation on a target which provided a stimulus equal to the subject's accommodative amplitude. The tonic measures were repeated immediately after fixation and were followed by either reassessment of the nearpoint and farpoint, or a 20 min period in darkness with reassessment of the tonic level at 5-min intervals. The period of sustained maximal focus produced significant increases in both tonic accommodation and the accommodative nearpoint in each refractive group. Although the magnitude of change was statistically equivalent across groups, a tendency to greater increases in tonic accommodation was noted for the high myopes. Although the farpoint remained relatively stable in the individual refractive groups, a slight inward shift was found in the combined sample. The tonic change diminished primarily during the first 5 min in darkness, with no significant difference in either the rate or degree of decay in the various refractive groups. The results indicate no clear association between susceptibility to accommodative hysteresis and refractive category.

Accommodation, Ocular↗
PubMed1988

The relationship between refractive errors and retinal detachment--analysis of 1,166 retinal detachment cases.

We compared 1,166 eyes with retinal detachment to 11,671 eyes of patients without retinal detachment in order to clarify the distribution of refraction ranges and the relative frequency in incidence of retinal detachment for each range. In the retinal detachment group, hyperopia was detected in 8.58%, emmetropia in 9.26% and myopia in 82.16%, and the corresponding ratios in the control group were 24.29%, 41.30% and 34.41%, respectively. The retinal detachment group thus exhibited a high frequency of myopia, as has been known. The relative frequency of retinal detachment for each range of refraction was 0.35 for hyperopia, 0.22 for emmetropia and 0.83 for myopia in the range -0.75 to -2.75 D. The relative frequency increased with an increase of severity in myopia up to the range of higher than -15.0 D, where the frequency was 68.6 times higher than for the hyperopic range.

Adolescent↗
PubMed1962

Refractive error and vision in fishes.

The eyes of living immersed herring and silversides are farsighted and require greater hypermetropic correction for lateral vision than for anterior vision. Comparisons of lens-to-retina distances in frozen material with focal lengths of lenses are consistent with the degree of hypermetropy found by retinoscopy.

Eye↗