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PubMed1978

Incomplete achromatopsia in Bishnupur.

Nine males and 2 females from the Shankhabanik Community in Bishnupur, provisionally diagnosed as incomplete rod achromats by Bose, Joardar and Sukul in 1968, with 2 new similar males, were tested more fully with six colour vision tests. All had photophobia, nystagmus of fixation, extremely low visual acuity and extreme loss of colour sense with shortened red spectrum. 40 other males and 24 females, relatives of the defectives, were also tested for comparison. The provisional diagnosis was confirmed, and the hypothesis of autosomal inheritance seemed most probably true. Various details about the relatives emerged.

Color Vision Defects↗

PubMed1989

[Examination strategies in the diagnosis of drug-induced retinal damage].

The large number of potentially retinotoxic drugs and their effects at multiple structural sites, from pigment epithelium to retina and optic nerve, imply complex diagnostic procedures rather than a single test. Early diagnosis of retinotoxicity, however, can be established by through history, ophthalmoscopy and routine (simple) functional tests carried out by the responsible ophthalmologist. In case of suspected damage of the retina or of the optic nerve electrophysiology, angiography, selective perimetry and color vision tests are recommended. In this outline chloroquine retinopathy is discussed in detail.

Chloroquine↗

PubMed1994

Does color vision deficiency in the endoscopist influence the accuracy of endoscopic diagnosis? An anonymous study with Dutch gastrointestinal endoscopists.

Colors play a major role in the endoscopic diagnosis of many gastrointestinal conditions. Gastrointestinal endoscopists in the Netherlands are predominantly male (> 90%), and from population data it is to be expected that approximately 8% will have a color vision deficiency. The present study was designed to assess the prevalence of color vision deficiencies amongst Dutch gastrointestinal endoscopists and to determine whether color vision deficiency affects an endoscopist's diagnostic skill. One hundred and thirty-nine gastroenterologists and physicians of internal medicine took an F2 color vision test and assessed nine videofragments of endoscopies. Color vision deficiencies were detected in 8% of Dutch gastrointestinal endoscopists. In one out of the nine video excerpts of endoscopies, a statistically significant difference was detected between test subjects with and without a color vision deficiency. However, this video excerpt showed a green pea, which could not be mistaken for a polyp at polypectomy. The study therefore does not show any effect of color vision deficiencies on endoscopic skills, nor does it show any deviant prevalence of color vision deficiencies amongst Dutch gastrointestinal endoscopists.

Adult↗

PubMed1997

Visual performance and patient preference: a comparison of anti-reflection coated and uncoated spectacle lenses.

BACKGROUND: Anti-reflection (AR) coatings of spectacle lenses are designed to reduce the reflected images often found in uncoated lenses. This study examined the visual impact of a specific AR coating. METHODS: First, using a survey, it was determined if patients were aware of the AR coating and, if given an identical pair of lenses without the AR coating, which lenses were preferred and why. Second, in the laboratory, changes in visual performance were evaluated when an anti-reflection coating was applied to a lens. RESULTS: Verbal reports were obtained from 18 patients on both types of lenses. All patients were aware the AR coating reduced unwanted reflections, and many reported reductions in visual problems associated with glare. Within the laboratory, 28 patients were tested on a battery of clinical vision tests. Under normal room illumination, visual acuity, grating-contrast sensitivity, and letter-contrast sensitivity were identical for both coated or uncoated lenses. In a second experiment, the effects of AR coating on contrast sensitivity were examined when subjects viewed a dimly illuminated target while their eye and face were brightly illuminated. Under these conditions, significantly better (a factor of two) contrast sensitivity was observed with AR-coated lenses. CONCLUSIONS: On the basis of these findings, it is proposed that drivers should wear AR-coated spectacle lenses at night.

Adult↗

PubMed1982

Recent findings from the 1970 child health and education study: preliminary communication.

The progress is described of the longtudinal cohort study based on all children born in England, Scotland and Wales in one week of April 1970. The children and their mothers have been surveyed at birth, at five, and recently, at ten. Analyses of the data presented include the finding of improved intellectual outcome in children who had been immunized against pertussis, compared with poor intellectual outcome in children who had had hospital admissions for the disease itself. Preliminary data collected at 10 show that routine hearing and vision testing during the child's school life fell short of recommended standards. The major aim of the 10-year-old contact, however, is to establish details of the national prevalence and pathogenesis of disability. The identification of disability uses a life skills questionnaire, medical history and examination.

Child↗

PubMed1980

Behavioral tests of visual acuity in infants.

Two behavioral techniques--OKN and PL--have been used to test visual acuity in young infants in both laboratory and clinical settings. Clinically, OKN is used widely by ophthalmologists as an informal, subjective estimate of an infant's visual status. However, the difficulty of the judgments required and the problem of obtaining good OKN gratings that can be used at a near enough distance to maintain an infant's attention make the procedcure less than ideal. The PL procedure has been used much more widely in laboratory testing than has the OKN procedure, probably because the grating stimuli used are smaller and easier to obtain than OKN stimuli and because the judgments required of the observer necessitate only comparison of the infant's looking behavior in the presence of two stimuli, rather than judgments concerning the presence or absence of a behavior. However, it is only recently that PL procedures, in the form of the diagnostic stripes procedure, have been introduced into clinical settings for measurement of acuity. To date, the diagnostic stripes procedure has proved to be a rapid and practical test to carry out in the clinic, and it appears to be effective in diagnosing infants with ophthalmic problems that would be expected to interfere with vision tested binocularly. However, whether the procedure will be more useful than a standard pediatric or ophthalmic examination for screening infants for visual problems has yet to be determined. In addition, the treatment implications of early detection of poor visual acuity cannot yet be known. To be a truly useful test, a procedure that assesses visual acuity in infants should have prognostic or treatment value--neither of which has been clearly established for the OKN or the PL procedure. The problem is a circular one. We do not know the value of developing tests of visual acuity in infants because the treatment implications and prognostic value of early detection have not yet been established. However, knowledge of the value of early treatment is useless unless early detection is possible. Now that the cycle is beginning to be broken through development of techniques for early detection of poor acuity, research into the prognostic and treatment value of early diagnosis becomes possible for the first time. In conclusion, a number of researchers are working on the development of behavioral techniques for measurement of visual acuity in infants. Whether or not these procedures can be helpful clinically depends on what visual problems can be identified with each technique in the clinic, and whether or not it will turn out to be useful to identify these visual problems at such an early age, a question that can only be answered by further clinical and laboratory observations.

Age Factors↗

PubMed1987

Test charts for distance preferred for low-vision.

Two wall test charts with Snellen letters on both sides have been designed for the purpose of testing vision accurately, especially for the patient with low vision. Visual designations of 20/160 (6/48) and 20/125 (6/37.5) are included on the chart. This makes each line 26% larger. Sloan letters are used and arranged so that each line is of equal difficulty.

Humans↗

PubMed1988

Sahlgren's Saturation Test for acquired dyschromatopsia: increased lightness enhances sensitivity.

Sahlgren's Saturation Test (SST) is a simple sorting test designed for the detection and grading of acquired color vision defects. Like other pigment-based color vision tests, the SST color samples have medium lightness, i.e., they belong to the intermediate part of the gray scale. We tested normal controls and subjects with congenital or acquired dyschromatopsia with five SST versions that differed only in the amount of lightness. The sensitivity of the test increased considerably with increasing lightness. Therefore, the lightness level of SST has now been changed from 30 to 10 Natural Color System units.

Color↗

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

Measuring resolution in the contrast domain: the small letter contrast test.

BACKGROUND: Recent evidence suggests that small letter contrast sensitivity (CS) is more sensitive than visual acuity (VA) to defocus, luminance, binocular enhancement, and visual differences among pilot trainees. It would be valuable to make this test available for general use. We developed a hard copy (letter chart) version called the Small Letter Contrast Test (SLCT) and evaluated its sensitivity and reliability in comparison to standard vision tests. METHODS: The SLCT has 14 lines of letters with 10 letters per line. The letters are of constant size (20/25 or 4/5 at 4 m), but vary in contrast by line in 0.1 log steps (0.01 log units per letter). Normal room illumination is used. The SLCT was evaluated in 16 subjects under various conditions (spherical and astigmatic blur, low luminance, 2 eyes vs. 1 eye) to determine test sensitivity and reliability, and in patients with clinical conditions. Scores were compared to those obtained with standard tests of VA (Bailey-Lovie) and CS (Pelli-Robson). RESULTS: SLCT scores were similar to previous measures, and retest reliability was one line. The SLCT was more sensitive than VA to spherical and astigmatic blur, low luminance, and vision with two eyes vs. one eye. Greater sensitivity of the SLCT endured despite correction for variability. The SLCT was more sensitive than standard tests to visual loss from early cataract, keratoconus, corneal infiltrates, edema, and amblyopia. CONCLUSIONS: The SLCT is a sensitive, adjunctive test, which complements existing measures of VA. It can reveal subtle visual deficits that may be undetected by standard clinical techniques. The SLCT should prove useful for monitoring vision in refractive surgery, corneal and macular edema, optic neuritis, and for selection and evaluation of candidates for occupations requiring unique visual abilities like aviation.

Contrast Sensitivity↗

PubMed2004

Comparisons of dynamic retinoscopy measurements with a print card, a video display terminal, and a PRIO System Tester as test targets.

BACKGROUND: Dynamic retinoscopy is a common clinical test for assessment of visual function in patients with symptoms related to computer use. It has been suggested that performing dynamic retinoscopy with a fixation target resembling a computer screen may be valuable in the examination of computer users. However, such targets differ in luminance and other characteristics from the printed paper test cards typically used for dynamic retinoscopy. METHOD: To address the effect of varying test targets on dynamic retinoscopy results, this study compared lag of accommodation results from dynamic retinoscopy with three different fixation targets: (a) a printed paper target, (b) a video display terminal, and (c) the PRIO vision testing device, which is designed to simulate a computer screen. MEM (monocular estimate method) dynamic retinoscopy was performed with the print target and with the PRIO device. RESULTS: The difference between results with the different test conditions were generally small, with a statistically significant 0.32 D lower lag found on MEM retinoscopy with the PRIO target IMEM-PRIO) than on MEM retinoscopy with a print target (MEM-PRINT). Mean lag measurements on MEM with a print target and on Nott retinoscopy with the video display terminal (NOTT-VDT) were only 0.04 D different. The 95% limits of agreement for the difference between MEM-PRINT and MEM-PRIO (+/- 0.6 D) was similar to the 95% limits of agreement for the interexaminer reliability of the two procedures (+/- 0.6 D for MEM-PRINT and +/- 0.7 D for MEM-PRIO). CONCLUSION: There was a small but statistically significant difference in lag of accommodation measured with MEM dynamic retinoscopy on the PRIO testing device when compared to a print card.

Accommodation, Ocular↗

PubMed1998

Visual Ability Score -- a new method to analyze ability in visually impaired children.

PURPOSE: We analyzed the correlation between the Preferential Looking (PL) acuities and the Visual Ability Scores (VAS) of 600 patients (many with severe retinopathy of prematurity) to determine their ability to perform various activities within the daily environment. METHODS: Visual acuity was measured by PL. Sixteen visual activities within the environment were analyzed. The VAS (range, 1-16) were calculated from the results of each activity and correlated with PL acuity. RESULTS: The PL acuities of the 600 patients ranged from 20/20 (1.0) to <20/3200 (0.006) [mean, 20/337(006)]. The VAS ranged from 1 to 16 points (mean, 10.65; SD, +/-4.80) and showed a high correlation with the PL acuities (r=0.917, p=0.0001). CONCLUSIONS: In addition to PL vision testing, analyzing the environmental visual behavior of young, severely visually impaired patients is important to accurately evaluate visual abilities. We found the VAS to be an important aid for low-vision specialists, especially for those with no access to a vision evaluation system such as PL.

Activities of Daily Living↗

PubMed1993

Color vision deficiencies in the course of acute alcohol withdrawal.

Thirty-six male patients with a diagnosis of chronic alcoholism were detoxified and color vision tests were performed on day 4, 11, and 32 of their abstinence on an inpatient basis (Ishihara color plates, Nagel anomaloscope, three color-matching tests according to Farnsworth). Of the 36 patients, 47.2% manifested color vision deficiencies. The frequency of congenital red/green defects (11.1%) and a ratio of 3:1 deutan/protan defects showed no significant difference from the incidence in the normal population. In 36.1%, manifest acquired color vision deficiencies were diagnosed. Within the course of withdrawal, a marked improvement of these disturbances could be proved. The degree of the disturbance seems to correlate with the severity of withdrawal symptoms, but seems to be unrelated to acute toxic effects of alcohol, nicotine, or medication.

Adult↗

PubMed1979

Advanced diagnostic procedures for evaluating the visual status of the child.

Single cell studies of cats and monkeys, recent behavioral testing methods, and improved sophisticated electrodiagnostic procedures have resulted in a new awareness of and concern for the development of the visual system. This paper will review select relevant research and highlight some of the new diagnostic vision tests presently available for the clinical assessment of infants and young children.

Amblyopia↗

PubMed1994

Proposed protocol for a multi-centre study to compare clinical and trade tests of colour vision in firefighters.

Fire-brigade recruits in the UK have their colour vision screened using the Ishihara test. This is unsatisfactory because it rejects subjects with minor deficiencies in colour vision and does not test for blue defects. The Home Office is currently reviewing its recommendations on visual standards. This paper summarizes defects in colour vision, discusses alternative clinical and trade tests for the fire-brigade, and proposes a multi-centre study to collect data on the performance of fire-brigade recruits in clinical and trade tests.

Clinical Protocols↗

PubMed1988

Ocular effects and safety of antimalarial agents.

The clinical experiences with 1,500 patients receiving chloroquine or hydroxychloroquine over a 15-year period are reviewed. Forty-six patients with confirmed irreversible, bilateral, early chloroquine retinopathy have been followed prospectively since 1980. Patients presenting with normal color vision and relative paracentral scotomas appear not to progress over short-term follow-up of five years. Retinopathy in patients presenting with less than 20/20 vision, abnormal color vision, and positive fluorescein angiography may progress even if treatment with the medication is discontinued. The Amsler grid is an effective method of screening patients taking antimalarial agents for early relative paracentral scotomas. Color vision testing and fluorescein angiography are useful in elderly patients with age-related macular disease when visual field testing is unreliable.

Antimalarials↗

PubMedDate not supplied

Acquired dyschromatopsia in glaucoma.

Recent studies have suggested that the recognition of blue-yellow color vision deficits may have some predictive value in determining which ocular hypertensives are at risk of developing glaucoma and in monitoring the progress of the disease in glaucoma patients. This article reviews current theories of normal color vision and the differences that may occur in glaucoma, outlining methods of color vision testing and interpretation, and summarizing the results of recent studies.

Adaptation, Physiological↗

PubMed2005

Silent substitution S-cone electroretinogram in subjects with diabetes mellitus.

A defect in the blue sensitive mechanism has been reported in certain ocular and systemic diseases. For example, tritanopic colour vision defects and changes to the S-cone electroretinogram (ERG) have been demonstrated in glaucoma and diabetes mellitus. Electrophysiological methods of eliciting the S-cone ERG, however, often result in considerable L- and M-cone intrusion. We report the findings of a study employing the silent substitution S-cone ERG technique, which is thought to represent an almost pure S-cone signal, and the L'Anthony desaturated D15 colour vision test in subjects with Type 1 or 2 diabetes mellitus with no or minimal background retinopathy. The results of this study show a significantly increased S-cone ERG b-wave implicit time and significantly worse colour vision in those with background retinopathy compared with those with no diabetic retinopathy. This suggests that S-cone pathway dysfunction may be responsible for the deterioration in colour vision found in diabetes mellitus.

Adolescent↗