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PubMed2005

Hypnosis-associated blue-tinted vision: a case report.

BACKGROUND: Self-hypnosis has been taught routinely at the SUNY Upstate Medical University for treatment of pulmonary symptoms thought to be amenable to psychological therapy. While using hypnosis for relaxation, four individuals, including a patient with cystic fibrosis, reported development of blue-tinted vision. Based on a search of the literature, we believe this is the first published report of hypnosis-associated blue-tinted vision. CASE PRESENTATION: The patient reported blue-tinted vision when he used hypnosis on an almost daily basis for seven years. The visual change typically occurred when he was relaxed. Moreover, a concurrent erection in the absence of sexual thoughts usually was present. The other three individuals reported blue-tinted vision after learning how to use hypnosis for relaxation as part of a group hypnosis instruction. CONCLUSION: The blue-tinted vision experienced by the individuals in this report may be the result of an hypnosis-induced primary change in cognitive processing. Additionally, as the relaxing effect of hypnosis can be associated with a reduction in blood pressure and increased blood flow, hypnosis-associated blue-tinted vision also may be related to retinal vasodilation.

Adolescent↗
PubMed2005

Visual difficulties reported by low-vision and nonimpaired older adult drivers.

Nonimpaired and low-vision older adults responded to a questionnaire regarding the types of visual difficulties experienced while performing daily tasks and while driving. Using the factors produced from a factor analysis as predictors, a discriminant analysis was performed to determine whether significant differences in visual problems existed between the groups. The majority of participants reported that they currently required more time than in the past to perform tasks that depended on their vision, regardless of their visual status. All participants reported experiencing significant difficulties with static and dynamic acuity, peripheral vision, illumination problems, and contrast sensitivity. Both nonimpaired and low-vision older adult drivers reported experiencing difficulty with glare, peripheral vision, and night driving. Low-vision drivers reported experiencing unique difficulties with near acuity, distant acuity, and physical obstructions. Potential applications of this research include suggestions for redesigning automobiles and highway signs for safer use and viewing.

Aged↗
PubMed2003

Preschool vision screening frequency after an office-based training session for primary care staff.

OBJECTIVE: Although vision screening for preschool children is recommended for detecting amblyopia, many pediatric and family medicine practices do not screen preschool-aged children. The aim of this study was to determine the effect of a training program for primary care clinical staff on vision screening behavior and attitudes. METHODS: All local pediatric and family medicine practices were mailed invitations for free training sessions in preliterate eye chart vision screening. The clinical support staff at each participating practice location received a single training session. The lead ancillary medical employee of each practice location was surveyed immediately before and after training, and again 4 to 6 months later, to determine the effect of a single training session on screening behavior and attitudes. RESULTS: Twenty-nine (26%) of 110 practice locations received training in vision screening. Four to 6 months after training, reported screening frequency of 3-year-olds increased, but not of other ages. The reported comfort level with screening 3-year-olds and 4-year-olds was improved 4 to 6 months after training. Most practices responded that the training was beneficial and worthwhile, but lasting impact on practice behavior for the cohort was modest. CONCLUSIONS: Direct, practical training in preliterate eye chart vision screening may increase the number of 3-year-old children screened and improve clinical support staff comfort with screening preschool children. A single training session is not sufficient in itself, however, to achieve the goal of universal preschool vision screening in the primary care setting.

Adult↗
PubMed2004

Causes of low vision and use of optical aids in the elderly.

PURPOSE: To determine the causes of low vision in an elderly population attended by a university visual rehabilitation service and to check for the use of prescribed optical aids. METHOD: A cross-sectional study was carried out on patients aged 60 years or over attending for the first time a university low vision service in 2001. Ophthalmic reevaluation and interview were performed by means of a structured questionnaire in 2002. RESULTS: The sample comprised 50 subjects aged between 60 and 90 years. Severe low vision (< or =20/200) was present in 68.0% of patients. The main cause of low vision was age-related macular degeneration (44.0%). Regarding literacy, 16.0% were illiterate and 72.0% had completed fundamental schooling. Thirty-one patients (62.0%) had been prescribed optical aids; 54.8% of these patients stated that they use them. A majority (70.6%) held a favorable opinion of these aids. CONCLUSIONS: The main cause of low vision was age-related macular degeneration. Approximately half of those receiving prescriptions reported actually using the aids in their daily activities. Making best use of residual vision in the elderly population with visual impairment is a priority, given the social context, if the independence necessary for enhanced quality of life is to be achieved.

Activities of Daily Living↗
PubMed1995

Providing low vision rehabilitation services with occupational therapy and ophthalmology: a program description.

This article describes a low vision rehabilitation program operating within a hospital-based outpatient rehabilitation clinic. The program uses a team approach combining ophthalmology and occupational therapy services. Patients are referred to the program by their primary care physician for a low vision evaluation completed jointly by the ophthalmologist and occupational therapist. The ophthalmology portion of the evaluation includes assessment of visual acuity, contrast sensitivity function, and macular perimetry with a scanning laser ophthalmoscope. The occupational therapy evaluation focuses on assessing the functional limitations experienced by the patient due to the vision loss and determining how the patient is best able to use remaining vision to complete daily activities. Occupational therapy treatment emphasizes training the patient to use remaining vision as efficiently and effectively as possible to complete daily activities and includes training in use of optical devices. Because of the specialized nature of the service provided, additional postgraduate preparation is needed to enable occupational therapists to provide effective low vision rehabilitation.

Activities of Daily Living↗
PubMed1999

Common causes of vision loss in elderly patients.

Vision loss among the elderly is a major health care problem. Approximately one person in three has some form of vision-reducing eye disease by the age of 65. The most common causes of vision loss among the elderly are age-related macular degeneration, glaucoma, cataract and diabetic retinopathy. Age-related macular degeneration is characterized by the loss of central vision. Primary open-angle glaucoma results in optic nerve damage and visual field loss. Because this condition may initially be asymptomatic, regular screening examinations are recommended for elderly patients. Cataract is a common cause of vision impairment among the elderly, but surgery is often effective in restoring vision. Diabetic retinopathy may be observed in the elderly at the time of diagnosis or during the first few years of diabetes. Patients should undergo eye examinations with dilation when diabetes is diagnosed and annually thereafter.

Age Factors↗
PubMed1997

[An approach to the binocular vision of traumatic cataract after intraocular lens implantation].

OBJECTIVE: To explore the recovery of binocular vision and stereoacuity of monocular cataract extraction after posterior chamber intraocular lens (IOL) implantation. METHODS: After extraction of traumatic cataract, primary or secondary posterior chamber IOL implantation was performed on 36 cases. The naked vision, corrected vision and binocular dioptric state were observed pre- and post-operatively. Synoptophore, Bogolini striated glasses, barred reading and Tiemus stereoscopic vision picture were applied. RESULTS: The visual acuities of 36 cases were significantly improved postoperatively, the corrected visual acuities of 24 cases (66.7%) were over 4.95 and 30 cases were over 4.8 after three months. The binocular and stereoscopic vision of 21 cases was recovered well. CONCLUSION: IOL implantation should be performed early after extraction of monocular cataract in order to improve the recovery and development of binocular vision and stereoacuity, particularly in children.

Adolescent↗
PubMed2002

[Effect of early surgery in essential infantile esotropia on the quality of binocular vision].

In a retrospective study of 397 children operated in the course of 10 years (1985-1995) on account of essential infantile esotropia the authors evaluate the effect of early surgery implemented before the age of two years on the quality of binocular vision as compared with a later operation. The group of children was divided into three sub-groups. Group A comprised 75 children with the operation during the first six months of life (mean 3.8 months), sub-group B 194 children with the operation at the age of 6-24 months and in group C 128 children operated at the age of 2-6 years (mean 3.56 years). In group A binocular vision was recorded in 80% children (15% superposition, 60% fusion, 5% stereopsy). In groups B binocular vision was recorded in 76% children (18% superposition, 50% fusion, 8% stereopsy). In group C simple binocular vision in the form of superposition was present in 24% and fusion only in 21% children. The results of binocular vision after surgery of essential infantile esotropia are in favour of early surgery, preferably by the age of 6 months, not later than at the age of 2 years. An essential part of comprehensive treatment is active and positive pleoptic and orthoptic care incl. supplementary surgical correction of residual horizontal or vertical deviations. Early surgery of an adequate extent with a safeguarded parallel position of the eyes implies in the long run more frequent achievement of a higher quality of binocular vision incl. stereopsy.

Age Factors↗
PubMed2001

[An epidemiological survey of blindness and low vision in Meixian County].

OBJECTIVE: To study the status of blindness and low vision in Meixian County. METHODS: The stratified random sampling rule and the standard grading system of blindness set by WHO were adopted in the study, and 11 327 subjects were enrolled (a sampling fraction of 2.01%) in the whole county. RESULTS: The prevalence of bilateral blindness and low vision was found to be 0.47% and 0.89%; that of monocular blindness and low vision was 0.72% and 0.59%, respectively. Subjects over 50 years old had a significantly higher prevalence of blindness and low vision. The causes leading to blindness and low vision were, in falling order, cataract, glaucoma, ametropia/amblyopia and pterygium. CONCLUSION: The treatment of cataract is the main measure to decrease the prevalence of blindness and low vision.

Adolescent↗
PubMed2001

[Value of the Bébé-Vision test in the screening of strabismus and anisometropic amblyopia in infants].

PURPOSE: To evaluate the accuracy of the Bébé-Vision test for detecting strabismic, ametropic and anisometropic amblyopia in childhood. METHODS: We screened 199 infants under 20 months of age. The screening consisted of a full orthoptic examination by a trained orthopist (cover test, fixation test), a forced choice preferential looking technique (Bébé-Vision test) prior to cycloplegia to test visual acuity, cycloplegic refraction by retinoscopy, and examination of the fundi. RESULTS: Fifteen infants were abnormal on orthoptic examination (clinical evidence of esotropia and/or limitation of abduction and/or amblyopia). The Bébé-Vision test demonstrated a significant interocular difference on the same side of the suspected amblyopic eye in 3 cases and on the opposite side in 3 cases, and no difference in 9 cases. The monocular Bébé-Vision test was abnormal in 51 cases and there was an abnormal cycloplegic refraction in 33 cases. Statistical analysis of these tests demonstrated a very low sensitivity (42%) and a good specificity (90%) for the Bébé-Vision test in detecting amblyopia related to refractive error. CONCLUSION: The Bébé-Vision test does not reliably reveal strabismic or anisometropic amblyopia and is not recommended as a screening test. Diagnosis should continue to be based mainly on the classical clinical methods.

Amblyopia↗
PubMed2002

Measuring low-vision rehabilitation outcomes with the NEI VFQ-25.

PURPOSE: To evaluate the sensitivity of the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) to change in visual abilities after low-vision rehabilitation in two different Veterans Administration (VA) low-vision programs METHODS: Seventy-seven legally blind veterans from the Blind Rehabilitation Center (BRC) at Hines VA Hospital and 51 partially sighted veterans from the Visual Impairment Center to Optimize Remaining Sight (VICTORS) program at the Chicago Health Care Network, West Side Division, were administered the NEI VFQ-25 plus supplement in interview format at admission and discharge. Instructions for administration were modified to have study participants answer all the questions as if they were wearing glasses or contact lenses or were using low-vision devices. Interval measures of person ability and item difficulty were estimated from the patients' responses to 34 of the 39 items on the VFQ-25 plus supplement before and after rehabilitation, by the polytomous rating scale measurement model of Wright and Masters. RESULTS: In VICTORS patients, item order by difficulty before rehabilitation agreed with item order for BRC patients. Visual ability scales are used similarly by different patients with different degrees of low vision. Based on prerehabilitation person measure distributions, VICTORS patients were less disabled, as would be predicted by visual acuity, than were BRC patients. After rehabilitation, estimated item difficulty for 4 of the 34 items decreased significantly in both BRC and VICTORS patients. CONCLUSIONS: The present study demonstrates that the NEI VFQ-25 plus supplement can be used to measure the effects of low-vision rehabilitation; however, only 7 of the 34 items tested are sensitive to change after rehabilitation. Targeted activities, such as reading ordinary print, small print, and street signs are easier to perform for graduates of both programs after rehabilitation. The patients' visual ability also shows improvement in both BRC and VICTORS. Improvement in visual ability is independent of change in difficulty of targeted items. Although this was not a controlled clinical trial, the decrease in difficulty of targeted items may reflect the use of low-vision aids and training to make tasks easier. The change in visual ability may reflect positive outcomes of rehabilitation or may be the consequence of patients' overestimates of their functional ability at the time of discharge.

Adult↗
PubMed2002

[Vision deterioration after transsphenoidal surgery for removal of pituitary adenoma].

OBJECTIVE: To explore the mechanism and strategies of prevention and treatment of vision deterioration after transsphenoidal surgery for removal of pituitary adenoma. METHODS: From January 1980 to February 2001, 1 412 patients were operated on by transsphenoidal surgery to remove pituitary adenoma. Fourteen patients experienced vision deterioration after operation. Clinical data from the 14 patients with vision deterioration were analyzed retrospectively. RESULTS: In this group, the incidence of vision deterioration was 0.99%. Over packing of the adenoma bed was seen in 5 patients, apoplexy of residual tumor in 3, high intracranial pressure in 2, vascular spasm in 2, injury of the optic nerve in the cannel in 1 and unknown reason in 1. CONCLUSIONS: Vision deterioration is a severe complication after transsphenoidal surgery. Early diagnosis and treatment can greatly improve the vision.

Adenoma↗
PubMed2002

[Value and practice of in-home "low-vision" rehabilitation in Rhone-Alp region of France].

INTRODUCTION: To demonstrate the interest of patient's home orthoptist deplacement to realize an in-home low-vision rehabilitation and encourage orthoptists to integrate this task in their usual work methods. PATIENTS AND METHODS: Eighty-five consecutive patients coming from a private ophthalmic rehabilitation Center and needing low-vision rehabilitation, were studied. The exercises used at patient's home were usually the same as those used in the rehabilitation Center. The choice in the organization of rehabilitation was always function of patient general health, people vicinity, and social context. RESULTS: Among the 85 patients, 60 (70.6%) were rehabilitated only in the ophthalmic Center, 11 (12.9%) could have a low-vision rehabilitation only thanks to the organization of the home's patient rehabilitation and 14 (16.5%) were both rehabilitated at the ophthalmic Center and, in the patient's home, some training was necessary too. The reasons for in-home low-vision rehabilitation were mainly represented by isolation problems, mobilisation physical capacities, but also, home installation conditions making difficult to realize the orthoptist recommendations. DISCUSSION: Besides some disadvantages: time-consuming, badly paid, decrease of efficiency in familiar environment, advantages are easily objected: ergonomy, training on optic systems, and psychological comfort. CONCLUSION: In-home low-vision rehabilitation is represented by the necessity of correctly taking care of each patient. It is an answer to a social demand and must be an integral part of low-vision orthoptist work.

Adult↗
PubMedDate not supplied

[Present-day sports activities among the blind and persons with poor vision in different countries of the world].

The approach of a country to persons with limited physical abilities is an important component of country's social-and-cultural policy. Blindness is a most severe variety of health disorders leading to social defect and social insufficiency. The role of adaptive physical culture is important within the system of the social-and-medical rehabilitation of the blind because the sedentary life mode has a negative effect on organisms of the disabled due to vision. Sports is not only a method for correcting the general somatic condition, but it is also an important social-and-physiological factor that enables the blind to comprehend their abilities as an example for others. As for our country, the information about the modern sports activities among the disabled due to vision is absolutely insufficient for the public at large. An analysis of results of examination (conducted by using the computer data base of the International Blind Sportsmen Association--IBSA) of 2386 blind and impaired vision sportsmen is presented in the paper. Data about sport disciplines and types of ophthalmic pathologies encountered among the high-class blind and impaired vision athletes from different world countries are described. The above data can be helpful in elaborating the rehabilitation programs for persons with severe disorders of the organ of vision to be used in rehabilitation centers, sport federations and clubs of the disabled as well as in other institutions dealing with rehabilitation of the disabled due to vision in our country.

Blindness↗
PubMed2002

[Effects of head down tilt on intra-ocular pressure, near vision, and visual field and the protection effect of Chinese herbs].

Objective. To observe the influences of 21 d head down tilt (HDT) bed rest on the intra-ocular pressure, visual field and near vision in human and to study the countermeasure of Chinese herb against weightlessness. Method. Ten subjects were randomly divided into control group and Chinese herb group. -6 degrees HDT was used to simulate weightlessness. Intra-ocular pressure, near vision and vision field were measured before, during and after bed rest in both groups. Result. Intra-ocular pressure and near vision showed a wave-like decrease change during bed rest, and there exists a certain coherence between them. Visual field showed no obvious changes. Taking Chinese herb was able to antagonize the decreasing of intra-ocular pressure and near vision during various phases of bed rest. Conclusion. 1) Bed rest could lead to the decreasing of intra-ocular pressure and near vision; 2) Taking Chinese herb was able to antagonize the negative influences of bed rest on visual function.

Adult↗
PubMed2003

[Prevalence of low vision and blindness in defined populations in rural and urban areas in Beijing].

OBJECTIVE: To investigate the prevalence and causes of low vision and blindness in Beijing residents aged 40 and over. METHODS: 4,451 residents aged 40 and over in 3 rural communities and 5 urban communities in Beijing underwent eye examination, including examination of distant and near visual acuity (VA), best corrected distant and near VA, pinhole VA, and visual field, slit lamp biomicroscopy, and dilated ocular examination in the form of in-home survey by defined population-based sampling. The medical history was surveyed too. The data were analyzed based on the criteria of the World Health Organization. RESULTS: The general prevalence rates of low vision and blindness were 0.99% (95% CI: 0.70-1.28) and 0.39% (95% CI: 0.21-0.57) respectively. The prevalence rate of low vision in females was 1.45%, 2.23 times that of males (0.65%) (OR: 1.97, 95% CI: 1.00-3.95). The prevalence rate of low vision of rural residents was 1.76%, 2.89 times that of urban residents (0.61%) (OR: 2.93, 95% CI: 1.43-6.11). The prevalence rate of blindness in females was 0.64% and 0.37% in males. The prevalence rate of blindness of rural residents was 1.06%, 2.04 times that of the urban residents (0.52%) (OR: 3.77, 95% CI: 1.41-10.62). The 3 major causes of blindness were cataract (37.50%), glaucoma (29.20%), and high myopic macular degeneration (8.30%). The prevalence of blindness increased with age. CONCLUSION: The prevalence rates of low vision and blindness are higher in the rural areas. Cataract, glaucoma, and high myopic macular degeneration are the major causes of blindness. The prevalence of low vision and blindness are influenced by age, sex; area, health care level, educational level, and environmental factors.

Adult↗
PubMedDate not supplied

Low vision rehabilitation: basic concepts and terms.

1. Ophthalmic professionals should avoid using the term "blindness' when referring to lesser levels of vision loss. Vision loss describes any type or degree of change in vision; blindness is total loss of sight. 2. Ophthalmologists deal with anatomy and organ function whereas rehabilitation counselors address the socioeconomic and skills aspects of vision loss. Successful visual rehabilitation must be a team effort with good communication between all professionals. 3. The replacement of the simple dichotomy between "legally sighted" and "legally blind" by normal vision, low vision, and blindness provides a more accurate and less stigmatizing classification.

Attitude of Health Personnel↗
PubMedDate not supplied

Color vision in patients with the Hermansky-Pudlak syndrome.

PURPOSE: To study color vision in patients with oculocutaneous albinism (OCA) METHODS: We evaluated color vision in 42 patients with OCA using the HRR color plates. Sixty seven percent of the patients had the Hermansky-Pudlak syndrome (HPS), diagnosed genetically or clinically. The remaining patients had unknown mutations leading to OCA. RESULTS: 47.6 % of patients of OCA of all types included had a color vision defect. Of these, 55% were female and 45% were male patients. 50% of patients with the HPS (all types) had a color vision deficit. 42.9% of patients with OCA of unknown type had color weakness. 57.1% had normal color vision. CONCLUSIONS: Results suggest that many patients with OCA and the HPS have a mild red-green color perception deficiency that is not a sex linked trait. The prevalence of color vision deficits in our study population increased with decreasing visual acuity.

Adolescent↗