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PubMedDate not supplied

Accommodation deficiency in healthy young individuals.

Ten patients, ages 10 to 19, with accommodation insufficiency are reported. All patients were in good health and asymptomatic, except for asthenopia during near visual activities. Each patient's amplitude of accommodation was measured and found to be considerably below the minimal normal for their respective ages (an average of 6 diopters). Only three patients had associated convergence insufficiency. No etiology for the diminished accommodation was suggested by history or could be identified by careful examination. All patients were successfully managed optically with bifocals or reading glasses, although three required the addition of base-in prisms for the near exodeviation. Near vision testing and determination of the near point of accommodation should be part of the pediatric ophthalmologic examination in all patients with complaints referable to their reading and visual performance at near.

Accommodation, Ocular↗
PubMed2002

Presence of visual head tracking differentiates normal sighted from retinal degenerate mice.

We have generated a large number of potential eye and vision mutants by a mouse mutagenesis programme and sought to develop a rapid method for testing vision. This experiment assesses whether the visual tracking drum can differentiate between mice with and without retinal degeneration. The population of mice tested had a proportion with retinal degeneration, the remainder having normal retinas. Mice were observed in the visual tracking drum for a head tracking response to a visual stimulus. They were then examined for retinal degeneration. Of 204 animals tested, 138 had retinal degeneration. None of these showed any head tracking response. Of the remaining 66 with normal retinas, 45 showed a normal response, and 19 of the 21 mice which did not respond on a first test showed a normal response when the test was repeated. The visual tracking drum differentiates reliably between mice with normal vision and mice with severely decreased vision. There was a relatively high rate of non-responders among the normal sighted mice on a first test, but the test is rapid enough to be repeated easily.

Animals↗
PubMed1988

Clinical psychophysics.

New developments in clinical psychophysics allow a non-invasive assessment of visual function which may otherwise not be possible. Measurements of spatial and temporal contrast sensitivity functions, perimetric rod and cone sensitivity, colour vision testing, and newer tests such as hyperacuity thresholds may provide information about the mechanism of an abnormality, allow earlier detection of damage, determination of retinal function in the presence of ocular media disturbances, and allow more sensitive detection of the effects of treatment on visual function. Some methods are more effective in screening or monitoring patients over time while others can be used as research tools to investigate the underlying causes of visual dysfunction. Emerging technologies such as those based on video displays and computer generated graphics and advances in methodology provide potential for new applications. The selection of which aspect of visual function to test depends on the condition (e.g., retinal degeneration or glaucoma), the goals of the investigation, and the facilities available. These non-invasive methods can provide accurate information about retinal function and further improve our ability to quantify and document this most important aspect of the eye--its role in visual function.

Humans↗
PubMed1997

Analysis of visual dysfunctions in HIV-positive patients without retinitis.

PURPOSE: To investigate visual dysfunctions in ophthalmoscopically normal human immunodeficiency virus (HIV)-positive patients and to correlate the results to the stage of HIV disease and neuropsychological status. METHODS: Fifty-one randomly selected eyes (26 right, 25 left) of 51 HIV-positive patients with visual acuity measurements of 20/20 or better and no ophthalmoscopically detectable disorders were prospectively examined using achromatic and short-wavelength automated perimetry, color vision testing, and contrast sensitivity testing. CD4+ T-lymphocyte count, presence of systemic infection, hemoglobin, hematocrit, serum beta 2-microglobulin levels, and results of neuropsychological testing were also analyzed. RESULTS: On achromatic automated perimetry, 21.6% (11/51) of patients performed abnormally according to the mean defect and 27.5% (14/51) according to the Glaucoma Hemifield Test; 29.4% (15/51) performed abnormally on short-wave-length automated perimetry according to the mean defect and 23.5% (12/51) according to the Glaucoma Hemifield Test. On contrast sensitivity, 5.9% (3/51) of patients performed abnormally in the 1.5-cycles per degree (cpd) line, 2.0% (2/51) in the 3-cpd line, 23.5% (12/51) in the 6-cpd line, 25.5% (13/51) in the 12-cpd line, and 33.3% (17/51) in the 18-cpd line. On the Farnsworth-Munsell 100-hue test, 29.4% (15/51) of patients performed abnormally. After correction for multiple correlations, two statistically significant correlations were found: sum of log contrast sensitivity with achromatic automated perimetry and sum of log contrast sensitivity with the Farnsworth-Munsell 100-hue test. CONCLUSIONS: A significant percentage of HIV-positive patients with visual acuity of 20/20 or better and no ophthalmologic evidence of retinitis performed abnormally on visual psychophysical tests. The severity of visual dysfunction was not correlated with the stage of HIV infection or the degree of neuropsychological dysfunction.

Adult↗
PubMed2003

Peripheral retinal dysfunction in patients taking vigabatrin.

OBJECTIVE: To assess the wide-field multifocal electroretinogram (WF-mfERG) for assessment of retinal function in vigabatrin-treated patients. METHODS: Thirty-two adults who had taken vigabatrin for at least 3 years for localization-related epilepsy underwent WF-mfERG, ERG, logMar visual acuity and color vision evaluation, Humphrey visual field analysis (static perimetry), and funduscopy. The group was matched with a cohort of patients who had never received vigabatrin. Results were compared with a normative data set (120 drug-free controls) with respect to potential bilateral abnormalities in response timing. RESULTS: There were no significant differences between groups in visual acuity or color vision testing. Of the vigabatrin patients, 19 (59%) had bilateral visual field defects compared to none of the controls. Using WF-mfERG, all patients on vigabatrin with visual field defects showed abnormalities (100% sensitivity) and only 2 of the 13 patients without a field defect showed retinal abnormalities (86% specificity). CONCLUSIONS: WF-mfERG may be useful for detecting retinal pathology in patients taking vigabatrin. The majority of previous reports based on subjective testing may have underestimated the prevalence of peripheral retinal toxicity related to the drug.

Adult↗
PubMedDate not supplied

A primer of ophthalmic computer graphics.

Computer graphics offers an unprecedented opportunity to probe new and old ideas in vision testing, without going to the expense of building dedicated equipment. However, the large variety of computer hardware is bewildering and only occasionally can commercial software tools be used. This mini review of the basic principles of computer graphics on personal computers is intended to help the newcomer to the field.

Computer Graphics↗
PubMed1992

Photographic cockpit model for prescribing multifocals.

Recent interest in the relevancy of near vision tests for presbyopic aircrew members has led to the development of a photographic cockpit model. This model is used to prescribe more accurately for flying personnel. Prescriptions can be evaluated by use of trial lenses. This allows the aircrew members to experience the effect of viewing instruments in the cockpit of a C-130 aircraft.

Aircraft↗
PubMed2003

Simple device for quantifying the influence of halos after lasik surgery.

We present a simple device (called a halometer) to detect and quantify the phenomenon of halos after certain surgical procedures, such as refractive surgery. The task of the subject consists basically of discriminating, after dark adaptation, a small light source around a central high-luminance stimulus. The device, which is connected to a computer, provides a disturbance index to measure the effect of halos on the observer's vision. Tested with normal subjects and patients after LASIK (laser in situ keratomileusis) surgery, this apparatus proved sufficiently sensitive to quantify the halos in subjects who had undergone surgery.

Dark Adaptation↗
PubMed1992

Juvenile atrophy of pigment epithelium and choriocapillaris.

Two brothers, 20 and 21 years of age, are reported who had a circumscribed area of atrophy of the pigment epithelium, choriocapillaris and part of the choroidal vessels in the posterior pole; they were otherwise in good health. In addition, the optic discs, particularly in the older brother had hypoplastic characteristics. Both patients were known to have had low visual acuity and nystagmus since early childhood. Electro-oculography was normal. Electroretinography and color vision tests were subnormal in both patients. Although the morphological picture showed features similar to central areolar choroidal dystrophy, familial bilateral macular colobomata, serpiginous choroiditis and some cases of cone dystrophy, there are clinical and electrophysiological reasons for differentiating the cases presented here from these other diseases.

Adult↗
PubMed2004

Visual function more than 10 years after optic neuritis: experience of the optic neuritis treatment trial.

PURPOSE: To assess visual function more than 10 years after an episode of optic neuritis in patients enrolled in the Optic Neuritis Treatment Trial. DESIGN: Longitudinal follow-up of a randomized clinical trial. METHODS: Vision testing included measures of visual acuity, contrast sensitivity, and visual field. Quality of life was assessed with the National Eye Institute Visual Function Questionnaire. RESULTS: Examinations were completed on 319 patients. In most patients, visual function test results in the eyes that experienced optic neuritis at study entry ("affected eyes") were normal or only slightly abnormal after 9.9 to 13.7 years. Visual acuity in the affected eyes was >or=20/20 in 74%, 20/25 to 20/40 in 18%, <20/40 to 20/200 in 5%, and <20/200 in 3%. On average, visual function was worse in patients with multiple sclerosis (MS) than in those without MS. Recurrent optic neuritis in either eye occurred in 35% of patients. Such attacks were more frequent in patients with MS (P <.001). The National Eye Institute Visual Function Questionnaire scores were lower when visual acuity was abnormal and when MS was present. CONCLUSIONS: Most patients retained good to excellent vision more than 10 years after an attack of optic neuritis. Recurrences were more frequent in patients with MS.

Adolescent↗
PubMed1985

Comparison of refractive findings obtained by the Bausch and Lomb IVEX and by conventional clinical refraction.

The Bausch and Lomb IVEX (Integrated Vision Examination System) is a computerized refractor, designed for both subjective and objective refraction and binocular vision testing. Using a double-masked protocol, subjective refraction findings were obtained on 40 subjects by means of both IVEX and conventional clinical refraction. Although for most subjects IVEX spherical equivalent findings varied by no more than 0.25 or 0.50 D from conventional refractive findings, for some subjects IVEX findings yielded more minus or less plus than conventional refractive findings by as much as 1.00 or 1.25 D.

Adult↗
PubMed1992

The Tokyo Metropolitan Home Vision Screening Program for amblyopia in 3-year-old children.

In August 1989, the Tokyo Metropolitan Government officially began a vision screening program for children aged 3 years 1 month. A 1988 pilot study of 1,303 children this age disclosed five cases (0.38%) of amblyopia. The home vision test, which uses picture cards of familiar figures, proved to be an efficient and inexpensive method of screening when incorporated into the existing health-check program for 3-year-old children. In the initial eight months of the program, 21,906 children were screened. Of these, 419 children (1.9%) were referred to an ophthalmologist for follow-up, and amblyopia was detected in 41 children (0.19%).

Amblyopia↗
PubMed1998

Assessment of stereopsis in college baseball pitchers and batters.

BACKGROUND/PURPOSE: In baseball pitching is a much less visually demanding task than hitting is. We sought to find a stronger relationship between visual function (as measured by stereopsis) and hitting a baseball than between stereopsis and pitching skill. METHODS: Multiple parameters including near and distance stereopsis (as a measure of visual function) were measured in 23 returning college baseball players (with a prior year's record). Their level of stereopsis (measured at distance with use of the B-VAT II BVS Binocular Vision Testing System) was compared with their batting statistics (in the case of the 14 position players) or their pitching statistics (for the 9 pitchers). Batting average and slugging percentage were used as measures of hitting skill, and earned run average, "out percentage" (1.000--Opposing players' batting average) and "strike-out percentage" (frequency of batters struck out) were used as pitching parameters. RESULTS: As a group, visual parameters were excellent in these college athletes. Although the newer test of distance stereopsis correlated with the standard near stereo test (Spearman coefficients), there was no correlation between distance stereopsis and any of the pitching or hitting performance parameters. CONCLUSIONS: The nature of the visual demands required of successful baseball hitters may have yet to be determined or are difficult to identify among a population homogeneous for excellent visual function, true for most groups of competitive athletes. In addition, simpler parameters such as plain visual acuity may be the most important factor(s).

Baseball↗
PubMed2005

[Toxic optic neuropathy due to cisplatin therapy: a case report].

BACKGROUND: Optic neuropathies presenting as bilateral disc oedema lead to a vast field of differential diagnosis; a toxic aetiology should be taken into consideration. HISTORY AND SIGNS: A 55-year-old patient with a non-metastatic pleuramesothelioma received cisplatin as palliative chemotherapy. Due to a unilateral high myopia on the left eye the patient has a severe anisometropic amblyopia. The patient complained about visual loss and changed colour vision. Visual acuity was 0.1 on the right eye and counting fingers on the left eye. The anterior parts of the eyes were unremarkable, the optic nerve head showed bilateral disc oedema. The MRI was free of tumour or signs of elevated intracranial pressure. Colour vision test Panel D-15 revealed a pathologic colour perception affecting the tetartan-axis. Perimetry showed a cecocentral and superior bundle scotoma. THERAPY AND OUTCOME: The patient has been treated with methylprednisolone (Solu-Medrol) 500 mg i. v. 1 gr daily for three days, continued by 100 mg oral steroids successively reduced over a period of three weeks. After three weeks visual acuity increased to 0.3. CONCLUSIONS: Toxic neuropathies including disc oedema, retinal oedema and optic neuritis are rare, but have been described as occasional side effects of treatment with cisplatin.

Antineoplastic Agents↗
PubMed1984

Assessment of acuity in human infants using face and grating stimuli.

In a variety of ocular disorders, square-wave gratings yield more optimistic estimates of visual acuity than more complex stimuli such as letters. However, for clinical vision testing of preverbal patients, square-wave gratings are usually employed in conjunction with preferential looking procedures. We developed a complex stimulus--a schematic face--for use in preferential looking procedures. Using the method of constant stimuli, the acuities of 1-, 3-, and 5-month-old infants with normal eyes were estimated using schematic faces and square-wave gratings. Within each age group, thresholds for face and grating stimuli were not significantly different, but psychometric functions obtained with faces were significantly steeper than those obtained with square-wave gratings. This suggests that complex stimuli such as the schematic face could yield more precise acuity estimates than gratings in some pediatric eye patients.

Age Factors↗
PubMed1993

Pigment tests evaluated by a model of chromatic discrimination.

Clinical color-vision tests are evaluated within the framework of a model of chromatic discrimination in terms of cone excitation. The motivation for this study was to derive a method for evaluation of test design, test sensitivity, and observer performance. The discrimination model is based on the assumption that chromatic discrimination is mediated in two independent channels, one for short-wavelength cones and one for long- and middle-wavelength cones. Luminance-dependent templates are derived for each channel, and they describe chromatic-discrimination behavior of the young color-normal observer. The templates incorporate receptor- and opponent-level gain controls. We show how the chromaticities of clinical tests can be calculated in cone-excitation units and how discrimination behavior on the tests can be plotted on the templates. The tests include the Farnsworth-Munsell 100-hue, the Farnsworth Panel D-15, the Farnsworth Panel D-15 desaturated, the American Optical Hardy-Rand-Rittler, the Farnsworth F2 plate, the Standard Pseudoisochromatic Plates, Part II, the Ishihara, and the Minimalist tests. Clinical-test data collected on young color-normal observers at different illumination levels show the validity of the techniques.

Color Perception↗
PubMed1992

Comparative visual performance of three presbyopic contact lens corrections.

We compared the visual performance of a soft diffractive (DIFF) bifocal contact lens, a near center (CN) concentric bifocal design, and monovision (MV), using a comprehensive vision testing protocol. Fifteen presbyopic subjects who were successfully wearing DIFF bifocal contact lenses participated in the study. Of the three systems tested, MV provided best visual acuity at distance and near; less than one line of acuity was lost relative to best spectacle acuity under all lighting and contrast conditions, and there was less disturbance of a point source of light. Both bifocal corrections gave similar visual acuity performance, with more lines of acuity lost relative to spectacles at near compared to distance. However, the concentric bifocal induced more ghosting at near than the other two systems. Stereopsis was compromised at distance with MV correction, but all systems performed worse than spectacles at near. An understanding of the strengths and weaknesses of presbyopic contact lens options allows the clinician to improve management of the presbyope who wishes to wear contact lenses.

Contact Lenses, Hydrophilic↗
PubMed2003

Functional and structural recovery of the retina after gene therapy in the RPE65 null mutation dog.

PURPOSE: To assess the efficacy of AAV-mediated gene therapy to restore vision in a large number of RPE65(-/-) dogs and to determine whether systemic and local side effects are caused by the treatment. METHODS: Normal RPE65 dog cDNA was subcloned into an rAAV vector under control of a cytomegalovirus promoter, and an AAV.GFP control vector was also produced with the titers 2 x 10(12) particles/mL and 2 x 10(10) transducing U/mL, respectively. RPE65(-/-) dogs, aged 4 to 30 months were treated with subretinal injections of the AAV.RPE65 and control vectors, respectively, in each eye, and three 24- to 30-month-old normal control dogs with the latter. Baseline and postoperative systemic and ophthalmic examinations, blood screenings, vision testing, and electroretinography (ERG) were performed. Two RPE65(-/-) dogs were killed at 3 and 6 months after treatment for morphologic examination of the retinas. RESULTS: RPE65(-/-) dogs were practically blind from birth with nonrecordable or low-amplitude ERGs. Construct injections or sham surgeries were performed in 28 eyes; 11 were injected subretinally with the AAV.RPE65 construct. ERGs at 3 months after surgery showed that in the latter eyes, dark-adapted b-wave amplitudes recovered to an average of 28% of normal, and light adapted b-wave amplitudes to 32% of normal. ERG amplitudes were not reduced during a 6- to 9-month follow-up. No systemic side effects were observed, but uveitis developed in nine AAV.RPE65-treated eyes. No uveitis was observed in the eyes treated with the control vector. Immunocytochemistry showed expression of RPE65 in the retinal pigment epithelium (RPE) of AAV.RPE65-treated eyes. Fluorescence microscopy showed expression of green fluorescent protein (GFP) in the RPE and, to a lesser extent, in the neural retinas of AAV.GFP-treated eyes. Ultrastructurally, a reversal of RPE lipid droplet accumulation was observed at the AAV.RPE65 transgene injection site, but not at the site of injection of the control vector. CONCLUSIONS: In 10 of 11 treated RPE65(-/-) eyes, gene transfer resulted in development of vision, both subjectively apparent by loss of nystagmus, and objectively recorded by ERG. Structurally, there was reversal of lipid droplet accumulation in the RPE. Uveitis developed in 75% of the transgene-treated eyes, a complication possibly due to an immunopathogenic response to the RPE65 molecule.

Animals↗