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PubMed1997

The SKILL Card. An acuity test of reduced luminance and contrast. Smith-Kettlewell Institute Low Luminance.

PURPOSE: To design and evaluate a new vision test that combines low contrast and reduced illumination to stress the visual system and be sensitive to subtle alterations in function. METHODS: A simple new clinical test, the Smith-Kettlewell Institute Low Luminance (SKILL) Card, is designed to measure spatial vision under conditions of reduced contrast and luminance using normal office lighting. The SKILL Card consists of two near acuity charts mounted back to back. One side has a chart with black letters on a dark gray background designed to simulate reduced contrast and luminance conditions. The other side has a high-contrast, black-on-white letter chart. The SKILL score is the acuity loss (number of letters) between the light and dark sides. RESULTS: Age norms for a large normal population have been established and show that test scores increase with age, particularly after age 50. Repeatability is as good as that of standard Snellen acuity. The SKILL score is affected minimally by blur, but it is affected by large variations in light level. SKILL scores are sensitive to the presence of visual disease such as "recovered" optic neuritis. CONCLUSIONS: The SKILL card allows quick, reliable measurement of the effect of reduced luminance and contrast on acuity SKILL scores are not correlated with other vision measures in patients with optic neuritis, which shows that the SKILL card measures a different dimension of vision function than existing clinical tests.

Adult↗
PubMed1997

Effects of changes in lighting level on performance with the AcuVision 1000.

BACKGROUND: The AcuVision 1000 Trainer is an instrument designed to assess and train eye-hand coordination in athletes. Variable environmental conditions are encountered when sports-vision screenings are performed. The effect of these factors on scores attained on sports-vision testing equipment is an important consideration when results for different populations are compared. METHODS: This study investigated the effect of different lighting levels on subject performance. Twenty-five subjects performed three trials at each of three lighting levels (day-light, dim room, and dark. The presentation order of lighting level was counterbalanced and subjects were randomly assigned to the various presentation orders. RESULTS: The results indicate a statistically significant difference in performance at the various levels. High lighting levels decreased scores significantly, whereas there was no significant difference between the two lower levels. CONCLUSIONS: This study emphasizes the effect lighting can have on performance, and illustrates the need to properly control environmental factors through well-defined testing protocols for the use of the AcuVision 1000.

Adult↗
PubMed1977

The early phase in Leber hereditary optic atrophy.

Clinical, ophthalmoscopic, perimetric, and color vision tests and visual evoked responses were recorded in symptomatic and asymptomatic eyes in five members of a family with Leber hereditary optic atrophy. The presymptomatic eyes showed abnormalities in the retinal nerve fiber layer. Optic nerve dysfunction was found before central vision failed. The appearance of degenerating retinal nerve fibers, particularly in the papillomacular bundle, was documented photographically in the weeks after the onset of visual symptoms. Treatment with prednisone and hydroxocobalamin did not reverse or halt serious impairment of vision.

Adolescent↗
PubMed1981

Visual acuity of school entrants.

A study of 4239 school entrants showed that 3.4% had less than normal or near normal distant vision and 0.8% had near vision impairment. The group requiring specialist advice and care, that is, those with 6/12 or worse vision in either eye were further investigated. The effectiveness of pre-school examinations in the early detection of vision defects could thus be assessed. The results indicated that two-thirds had not been detected during the pre-school period. Where diagnosed, the great majority were between 3 and 5 years of age. In general, attendance at child health clinics for developmental surveillance was not a significant factor. Given that maturation has an effect, the difficulty seems to be the lack of suitable techniques rather than expertise. This suggests that the whole area of vision testing during the pre-school periods needs to be reviewed.

Child, Preschool↗
PubMed2003

Autologous retinal pigment epithelium and choroid translocation in patients with exudative age-related macular degeneration: short-term follow-up.

PURPOSE: To evaluate the feasibilty of translocating autologous retinal pigment epithelium cells and choroid after the removal of a subfoveal choroidal neovascular membrane in patients with exudative age-related macular degeneration. DESIGN: Interventional case series. METHODS: This was a prospective evaluation of six patients with a follow-up of 7 to 13 months. All patients had large (> 1 disk diameter) subfoveal choroidal membranes, five with subretinal hemorrhage. Preoperative visual acuity ranged from 20/400 to 20/200. After the extraction of the neovascular complex, an autologous peripheral full-thickness patch of retinal pigment epithelium, Bruch membrane, choriocapillary, and choroid was cut out from the midperiphery and repositioned under the macula. Functional tests included Early Treatment Diabetic Retinopathy Study vision testing, fixation testing on a optical coherence tomography monitor, fluorescein and indocyanine green angiography, and scanning laser ophthalmoscopy autofluorescence. RESULTS: The retinal pigment epithelium patch appeared flat and had a brown furry aspect in four patients. Fixation was on the patch in these four patients. Postoperative vision ranged from 20/200 to 20/64, with a 2-line increase in three patients. Revascularization was visible on fluorescein and indocyanide angiography in three patients examined in this manner. Normal retinal pigment epithelium autofluorescence was present over the patch in four patients. CONCLUSIONS: The translocation of a full-thickness patch with autologous peripheral retinal pigment epithelium to the macula after choroidal neovascular membrane extraction was feasible and may result in a surviving and functioning graft for more than 1 year. Longer follow-up to evaluate its long-term benefit is necessary, as well as refinement of the surgery.

Aged↗
PubMed2005

A detailed study of the phenotype of an autosomal dominant cone-rod dystrophy (CORD7) associated with mutation in the gene for RIM1.

AIM: To characterise the phenotype of an autosomal dominant cone-rod dystrophy (CORD7) associated with the Arg844His mutation in RIM1. METHODS: Eight members of a four generation, non-consanguineous British family were examined clinically and underwent electrophysiological testing, automated dark adapted perimetry, dark adaptometry, colour vision assessment, colour fundus photography, fundus fluorescein angiography (FFA), and fundus autofluorescence (AF) imaging. RESULTS: The majority of affected individuals described a progressive deterioration of central vision, night vision, and peripheral visual field usually between the third and fourth decades. The visual acuity ranged from 6/6 to 3/60. Colour vision testing showed mild to moderate dyschromatopsia in the majority of individuals. Fundus changes comprised a range of macular appearances varying from mild retinal pigment epithelial (RPE) disturbance to extensive atrophy and pigmentation. In some individuals retinal vessels were attenuated and in two subjects peripheral areas of retinal atrophy were present. An absent or severely reduced PERG was detected in all subjects, indicative of marked macular dysfunction. Full field ERG showed abnormal rod and cone responses. AF imaging revealed decreased macular AF centrally surrounded by a ring of increased AF in the majority of individuals. "Bull's eye" lesions were present in two individuals, comprising of a ring of decreased perifoveal AF bordered peripherally and centrally by increased AF. Photopic sensitivity testing demonstrated elevated central visual field thresholds with additional superior greater than inferior peripheral field loss. There were rod and cone sensitivity reductions in the central and peripheral visual fields, with the inferior retina being more affected than the superior. CONCLUSIONS: The detailed phenotype is described of the autosomal dominant cone-rod dystrophy, CORD7, which is associated with a point mutation in RIM1, a gene encoding a photoreceptor synaptic protein. The pattern of disease progression and long term visual outcome facilitates improved genetic counselling and advice on prognosis. Such phenotypic data will be invaluable in the event of future therapy.

Adolescent↗
PubMed1991

Visual requirements for safety and mobility of older drivers.

Efforts to assess visual deterioration with increasing age, coupled with new mechanisms proposed to limit the exposure of visually impaired drivers to driving risks, have emerged in response to the increase in older drivers. Visual functions discussed in this context include static acuity (photopic, mesopic, and in the presence of glare), dynamic visual acuity, visual field, contrast sensitivity, and motion perception. Exposure control mechanisms discussed include alternative periodic vision testing strategies, visual training, and environmental and vehicular modifications to accommodate the older driver. Finally, relevant research needs are addressed.

Aging↗
PubMed2001

Leber hereditary optic neuropathy associated with antiretroviral therapy for human immunodeficiency virus infection.

PURPOSE: Antiretroviral therapy has reduced the morbidity and mortality associated with human immunodeficiency virus (HIV) infection. However, side effects are increasingly recognized, including a commonly reported toxic mitochondrial myopathy. We report such a case of Leber hereditary optic neuropathy in a patient with antiretroviral therapy for HIV infection and speculate on a possible toxic etiologic role in the development of Leber hereditary optic neuropathy by a shared mitochondrial mechanism. METHODS: Case Report. Bilateral optic disk abnormalities observed in a 38-year-old HIV positive man with a family history of Leber hereditary optic neuropathy were documented with fundus photography, color vision testing, and visual field testing. Mitochondrial DNA testing was used to confirm the genetic predisposition to Leber hereditary optic neuropathy. RESULTS: Progressive bilateral optic nerve pallor temporally associated with the administration of antiretroviral medication was observed. Diagnostic testing revealed progressive visual field and color vision loss as well as a mitochondrial DNA mutation consistent with Leber hereditary optic neuropathy. CONCLUSION: Antiretroviral therapy may be associated with the onset of Leber hereditary optic neuropathy in genetically predisposed patients.

Adult↗
PubMed1998

The effect of nimodipine, a centrally active calcium antagonist, on visual function and mascular blood flow in patients with normal-tension glaucoma and control subjects.

PURPOSE: This study was performed to evaluate the effect of nimodipine, a centrally active calcium channel antagonist on automated Humphrey visual fields, Farnsworth-Munsell 100 (FM-100) hue color vision testing, and macular blood flow (blue field entoptic simulation technique) in patients with normal-tension glaucoma (NTG) and control subjects. METHODS: Thirteen patients with NTG and thirteen age- and sex-matched control subjects were studied in a prospective, placebo-controlled, double-masked, crossover protocol. On each of the two study dates, testing was performed at baseline and 90 minutes after administration of either two 30-mg nimodipine capsules or two identical appearing placebo capsules. Blood pressure and pulse were monitored throughout the study. RESULTS: Nimodipine administration resulted in a performance corrected improvement in Humphrey visual field mean deviation (patients with NTG and control subjects), corrected pattern standard deviation (patients with NTG), and macular sensitivity (the average of the foveal threshold and the four most central points of the visual field; patients with NTG). The FM-100 hue error scores significantly decreased after administration of nimodipine in patients with NTG and control subjects compared with baseline. There were no significant differences in baseline leukocyte velocity or density between patients with NTG and control subjects; no significant changes in leukocyte velocity or density were noted after administration of nimodipine in either group. CONCLUSION: Nimodipine caused a significant performance corrected improvement in visual field testing and a significant improvement in color vision. Nimodipine did not alter macular hemodynamics as measured using the blue field entoptic simulation technique, although results were hampered by high variability, particularly in the leukocyte density measurements.

Aged↗
PubMed1986

City tests and information theory.

The responses of 455 male subjects on both editions of the City University Colour Vision Tests (City 1 and City 2) were recorded after the establishment of each subject's criterial status using the Nagel anomaloscope. Based on the Information Theory, each plate was assigned a contributory weighted score to the total test score. Using informational analysis, a cut-off point in test score separating normals and defectives was also determined for each test. This scoring system is an improvement on the existing (or manufacturer's) system. The analysis has also shown that the second edition (City 2) is a considerable improvement on the first (City 1). Despite this, even the improved City 2, like its origin, the D-15, is shown to be poorer than most of the commonly used PIC tests.

Adolescent↗
PubMed1981

Reversible colour vision defects in obstructive jaundice.

The ocular function of 14 non-alcoholic, high icteric patients with recent occlusion of the common bile duct and 3 patients with viral hepatitis with a cholestatic pattern was studied. By means of a colour vision test panel including the Farnsworth-Munsell 100-hue test, 12 patients were initially classified as colour defective with a pattern of acquired colour vision deficiency (ACVD), predominantly of a tritan type. Visual acuity, visual field, slit lamp microscopy, intraocular pressure, ophthalmoscopy and tear secretion tests were normal, and all patients had normal levels of serum vitamin A. Retesting of 4 initially colour defective patients after disappearance of the obstructive jaundice showed a complete normalisation of the ACVD's. It is concluded, that the colour perception in patients with obstructive jaundice is related to the serum bilirubin level, and not to a deficiency of vitamin A.

Adult↗
PubMed2006

Efficacy of measuring visual performance of LASIK patients under photopic and mesopic conditions.

INTRODUCTION: The aim of the study was to compare the visual performance of LASIK eyes measured using high-contrast logMAR letter charts under bright (photopic) and dim (mesopic) conditions. MATERIALS AND METHODS: A total of 46 subjects (35 +/- 8 years of age) undergoing LASIK procedures were recruited for the study. The best spectacle-corrected visual acuity (BSCVA) of each subject was measured using the high-contrast ETDRS logMAR chart under photopic and mesopic conditions at 3 visits: preoperative (Pre), 1 month postoperative (Post1) and 3 months postoperative (Post3). The differences in logMAR scores for the right eyes only were analysed for the Pre-Post1 (n = 46), Pre-Post3 (n = 18) and Post1-Post3 (n = 16) comparisons. RESULTS: The logMAR scores of subjects were worse at the 1-month postoperative visit than preoperatively, and improvement in visual performance was seen at the 3-month postoperative visit. These changes in visual performance became more evident under mesopic conditions. The means and standard errors of the differences in logMAR scores for the Pre-Post3 (0.097 +/- 0.020) were slightly larger than those of the Pre-Post1 (-0.067 +/- 0.019) and Post1-Post3 (0.031 +/- 0.012) comparisons. Under mesopic conditions, the visual performance of the subjects was statistically significant for the 3 comparisons, but not under photopic conditions. CONCLUSION: High-contrast logMAR chart performed under mesopic conditions has the potential to replace visual acuity measured under photopic conditions in providing more reliable representation of postoperative visual outcomes of LASIK eyes. Eye doctors should consider performing this vision test routinely to gauge the success of LASIK surgery.

Adult↗
PubMedDate not supplied

An adaptation of the Cambridge Colour Test for use with animals.

Recently, molecular biological techniques have presented new opportunities for addressing questions concerning the neural mechanisms involved in color coding, thereby rousing renewed interest in animal color vision testing. We have modified a computer-based assessment tool, the Cambridge Colour Test, to make it suitable for use with animals. Here, the validity and reliability of the testing method were evaluated using squirrel monkeys. Because the chromatic stimuli and the achromatic backgrounds of the test consist of dots that vary in lightness, the stimulus parameters can be adjusted so that animals are not able to use luminance differences to make correct discriminations. Thus, in contrast to methods used previously, this test does not require that time be spent equating the luminance of each chromatic stimulus examined. Furthermore, the computer video-display based design of the testing apparatus can be easily replicated and adapted for use with many species in a variety of settings. In the present experiments, the squirrel monkeys' behavioral results agreed with the predictions for their color vision based on genetic analysis and electroretinography (ERG) spectral sensitivity data. Repeated measurements were highly consistent. Thus, an adaptation of the Cambridge Colour Test provides a valid and reliable method for testing color vision in animals.

Animals↗
PubMed1982

Color vision in the spider monkey (Ateles).

Spectral sensitivity and color vision were investigated in 2 spider monkeys (Ateles) using a forced-choice discrimination paradigm. The increment-threshold spectral sensitivity functions of both animals were very similar to those of normal human trichromats; all had three regions of peak sensitivity located at 440-460, 520-540, and 670-620 nm. However, color vision tests (neutral point, anomaloscope, and wavelength discrimination) indicated that at least two qualitatively different types of color vision exist among spider monkeys. The female tested had essentially normal trichromatic color vision (although her anomaloscope match was shifted slightly in the deutan direction) with acute wavelength discrimination. The male, however, was clearly a protanomalous trichromat. He required much more red light in a red/green mixture to match a standard yellow than did normal trichromats. This variation in color vision is discussed in the context of an analogous variation known to exist among other South American monkeys.

Animals↗
PubMed1994

Visual impairment and disability in older adults.

BACKGROUND: Previous studies have reported that reduced visual acuity is associated with functional dependence in older persons. The purpose of this study was to determine whether components of vision impairment besides reduced acuity contribute to reduced functional independence. METHODS: Community dwelling adults aged 65 years and older were administered a battery of vision tests including distance acuity, letter contrast sensitivity, disability glare, and stereoacuity. A physical function questionnaire assessed self-reported difficulty with activities of daily living (ADL's), Instrumental activities of daily living (IADL's), and mobility activities. A visual function questionnaire assessed self-reported difficulty with a wide variety of everyday visual activities. RESULTS: Multiple logistic regression analysis showed that reduced acuity and reduced contrast sensitivity were independently associated with an overall vision disability score. Acuity was associated with difficulty in tasks requiring good resolution and adaption to changing light conditions, whereas contrast sensitivity was associated with difficulty in tasks requiring distance judgments, night driving, and mobility. Glare and stereoacuity were not associated with self-reported disability. CONCLUSIONS: Reduced acuity and contrast sensitivity are significant risk factors for self-reported disability.

Activities of Daily Living↗
PubMed1995

Vision screening of preschool children in Italy.

Vision screening of preschool children is designed and performed to identify those affected by amblyopia or related, predisposing visual defects. In order to determine the prevalence of preschool vision screening in Italy, a questionnaire was mailed to the 635 regional health offices in which the country's national health system was organized at the time of the study. Results of this survey demonstrated that in 61.3% of the regions which responded, some form of preschool vision screening is performed. However, individual, non-standardized methods are used by the physicians or health care professionals responsible in each regional program. It is evident from this study that standardized procedures for preschool vision testing are lacking in Italy, and that the existing European Community guidelines should be disseminated and applied on a greater scale for the development of such a program on the national and European level.

Amblyopia↗