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At least 631 records · Page 35Linked to original sources
PubMed1997

Functional vision is improved in the majority of patients treated with external-beam radiotherapy for choroid metastases: a multivariate analysis of 188 patients.

PURPOSE: Metastatic deposits are the most common intraocular malignancies. We evaluated the efficacy of external-beam radiotherapy (EBRT) in the palliation of posterior uveal metastases in terms of clinically relevant outcomes: functional vision, tumor control, and globe preservation. PATIENTS AND METHODS: Four hundred eighty-three consecutive patients (578 eyes) were diagnosed with intraocular metastatic disease from solid tumors between 1972 and 1995. Of these, 233 eyes (188 patients) had lesions of the posterior uveal tract and received EBRT. Best-corrected visual acuity (VA) was documented pre- and post-EBRT. Visual function was considered excellent if VA < or = 20/50, navigational if 20/60 to 20/200, and legally blind if > or = 20/400. Most patients received 30 to 40 Gy in 2- to 3-Gy fractions to the posterior or entire globe. RESULTS: Fifty-seven percent of all assessable eyes had improved visual function or maintained at least navigational vision following EBRT. Thirty-six percent of legally blind eyes regained useful vision. Ninety-three percent experienced no clinical evidence of tumor progression and the globe preservation rate was 98%. The following characteristics independently predicted improvement to or maintenance of excellent vision on multivariate analysis: excellent vision pre-EBRT (P = .001), age less than 55 years (P = .004), white race (v black/Hispanic) (P = .003), and tumor base diameter less than 15 mm (P < .001). CONCLUSION: EBRT effectively restores and maintains useful vision in patients with choroid metastases, with a globe preservation rate of 98%. Patients less than 55 years with pretreatment VA better than 20/60 and tumor diameter less than 15 mm are most likely to benefit from this therapeutic intervention.

Adult↗
PubMed2002

The practice of your future: creating a vision.

BACKGROUND: In the realm of practice planning, a practice strategy is a combination of two things: a vision of a desired future and an action plan to make that vision a reality. This article presents a process called "Appreciative Inquiry," which dentists can use to create a vision of their future practices. TECHNIQUES: In creating a vision of his or her future practice through Appreciative Inquiry, the dentist builds on the best of what currently is (in other words, the strengths of the practice), visualizes the various possibilities of what the practice could become and, finally, designs the specific elements of what the practice actually will be at its ideal in the future. CONCLUSIONS: Appreciative Inquiry offers a dynamic perspective in helping dental teams create a vibrant new vision for their ideal practices of the future--the first step in building an effective strategy. PRACTICE IMPLICATIONS: A clear vision helps a practice set its desired course for the future, helps the practice to change in ways the dental team desires and provides a framework for responding to changes in the world in which the practice exists.

Adult↗
PubMed2004

Vision rehabilitation in the case of blindness.

This article examines the various vision rehabilitation procedures that are available for early and late blindness. Depending on the pathology involved, several vision rehabilitation procedures exist, or are in development. Visual aids are available for low vision individuals, as are sensory aids for blind persons. Most noninvasive sensory substitution prostheses as well as implanted visual prostheses in development are reviewed. Issues dealing with vision rehabilitation are also discussed, such as problems of biocompatibility, electrical safety, psychosocial aspects, and ethics. Basic studies devoted to vision rehabilitation such as simulation in mathematical models and simulation of artificial vision are also presented. Finally, the importance of accurate rehabilitation assessment is addressed, and tentative market figures are given.

Blindness↗
PubMed1992

Correlations of memory and learning with vision in aged patients before and after a cataract operation.

The connection between memory and learning with vision was investigated by studying 100 cataract operation patients, aged 71 to 76 years, 25 of them being men and 75 women. The cataract operation restored sufficient acuity of vision for reading (minimum E-test value 0.40) to 79% of the subjects. Short-term memory was studied with series of numbers, homogenic and heterogenic inhibition, and long sentences. Learning was tested with paired-associate learning and word learning. Psychological symptoms were measured on the Brief Psychiatric Rating Scale and personality on the Mini-Mult MMPI. Memory and learning improved significantly when vision was normalized after the cataract operation. Poor memory and learning scores correlated with monocular vision before the operation and with defects in the field of vision, due to glaucoma and exceeding 20%, postsurgery. Monocular vision and defects in the visual field caused a continuous sense of abnormalness, which impaired old people's ability to concentrate on tasks of memory and learning. Cerebrovascular disturbances, beginning dementia, and moderate psychological symptoms obstructed memory and learning on both test rounds. Depression was the most important psychological symptom contributing to poor memory and learning scores after the cataract operation. The memory and learning defects mainly reflected disturbances in memorizing.

Aged↗
PubMed2006

Building a vision of dietitian services in primary health care.

PURPOSE: Primary health care (PHC) reform, especially efforts to implement interdisciplinary teams, has implications for dietetic practice. A consistent, clear vision of the registered dietitian's (RD's) role in PHC is needed to develop a successful advocacy agenda. METHODS: The Dietitians of Canada (DC) Central and Southern Ontario Primary Health Care Action Group organized a four-step process to engage dietitians in developing an advocacy agenda for RD PHC services in Ontario. Two facilitated workshops brought together dietitian opinion leaders to enhance the understanding of current roles, find common ground, and develop a shared vision. All DC members were invited to review the draft vision, and feedback was integrated into a revised vision. RESULTS: Registered dietitians saw PHC reform through many lenses, and were uncertain about how reforms would affect their practices. In a national review, the majority of reviewers (approximately 85% of 270) supported the draft vision; additional clarity was needed on resources and the breadth of services that RDs would provide. CONCLUSION: Development of a PHC vision for RDs should be helpful in advocating for dietitian services in PHC.

Dietetics↗
PubMed1995

Collaborative focus. A system and its affiliates create their vision for healthy communities.

To help the system respond to changes in healthcare, managers of Hobart, IN-based Ancilla Systems, sponsored by the Poor Handmaids of Jesus Christ, formed the System Integration Team in 1993. Using the seven steps of the Quality Improvement Story, the team agreed on the reason for improvement: "Ancilla Systems is currently not positioned to provide the healthier communities that we envision in the twenty-first century." The team also noted, "Roles, responsibilities, and authority levels are not being effected in a coordinated manner." In August 1993, the team asked that each of its six affiliates develop its own vision statement by year's end. In a September meeting the System Integration Team defined the impediments to achieving a shared vision. The team designed countermeasures to address these impediments: (1) Communicate throughout all levels of the system to clarify roles, responsibilities, and authority levels; (2) Continue educating trustees and managers on healthcare trends, costs, and quality and on Ancilla's response to the changing environment; (3) Refrain from reviewing any governance structural changes until a system vision is finalized. In February 1994 the System Integration Team recommended a vision statement to the Ancilla Systems board of directors. The system vision, as well as affiliate visions, will serve as a basis for structure and role changes that are-and continue to be-necessary.

Catholicism↗
PubMed1999

Efficacy of vision therapy for convergence insufficiency in an adult male population.

BACKGROUND: Although vision therapy has reportedly been very successful in elimination of asthenopic symptoms in adults with convergence insufficiency, controlled studies have not been performed, and a clinical bias exists against prescribing vision therapy for adults with convergence insufficiency. METHODS: Sixty adult males over the age of 40 years (median age, 65 years) with convergence insufficiency were divided into three treatment groups: office-based vision therapy with supplementary home therapy, home therapy only, and a control group. RESULTS: Vision therapy was successful in 61.9% of patients who received in-office plus home therapy, in 30% of patients who received home therapy only, and in 10.5% of the control group. The success rate for patients who received active in-office vision therapy supplemented with home procedures was significantly greater than that for controls. Home therapy alone was less successful than in-office therapy. The success rate obtained with home therapy alone was not significantly greater than that demonstrated by controls. CONCLUSIONS: Vision therapy is effective in eliminating asthenopia and improving convergence function in adult patients. In-office therapy combined with home therapy tends to produce better results than does home therapy alone.

Adult↗
PubMed2001

[Measurement of apparent accommodation with a 20/20 near vision optotype].

PURPOSE: The value of apparent accommodation varies with methods of measurement. To discuss the details of apparent accommodation, it is appropriate to measure it with the smallest possible near vision optotype. In the present study, we used a 20/20 near vision optotype for the measurement of apparent accommodation. SUBJECTS AND METHODS: Forty-six eyes of thirty-eight patients (45-84 years old) who had undergone cataract surgery and intraocular lens implantation, and had at least 20/20 best corrected visual acuity at near and far distances, were used in this study. After the eyes were corrected by glasses to gain the best corrected long distance visual acuity, they were forced to watch a 20/20 near vision optotype. Then we gradually added plus lenses until they could recognize the optotype. The value of apparent accommodation was recorded by subtracting the value of plus lens by which the eye could first recognize the 20/20 near vision optotype from three diopters. RESULTS: The value of apparent accommodation was 0.00-3.00 D (medium 0.50 D). Two eyes had three diopters of apparent accommodation. CONCLUSION: In the present study with correction of astigmatism and small near vision optotype, most eyes showed smaller apparent accommodation than those in previous studies. Despite that, patients with three diopters of apparent accommodation do exist. To analyze high quality visual functions, we should use the smallest possible near vision optotype for the measurement of apparent accommodation.

Accommodation, Ocular↗
PubMedDate not supplied

[Acute loss of vision in children].

The differential diagnosis of acute loss of vision in children includes acute loss of vision due to retinal or optic nerve disease, and cortical blindness. The retinal disorders which may be mis diagnosed as optic neuritis include Leber neuroretinitis, Leber hereditary optic neuropathy, and Stargardt macular dystrophy. Retinal changes which evolve in neuroretinitis, and the pseudopapilledema in Leber heredity optic neuropathy are helpful in differentiating these disorders from optic neuritis. Stargardt macular dystrophy, a disorder associated with a variety of mutations, may be mis diagnosed as psychogenic visual loss due to the early normal appearance of the retina, and the loss of vision over a period of weeks. The differentiation of optic neuritis from anterior ischemic optic neuropathy (AION), depends upon the initial appearance of the optic disc (in AION either hyperemia due to reperfusion, or swelling and pallor if total infarction has occurred). The authors have described children with abrupt loss of vision during renal dialysis, whose risk factors for AION included systemic hypotension and intra ocular hypertension. Children with vigorous treatment of accelerated hypertension, and children with migraine and pro thrombotic disorders have also incurred AION. Thus, AION should be suspected when acute loss of vision occurs in association with certain ocular and systemic risk factors. In children capable of cooperating for visual field examination, the typical change in AION is an altitudinal defect, while optic neuritis it is a central scotoma. The association of optic neuritis with multiple sclerosis, DeVic disease, and with acute demyelinating1 encephalomyelitis require special consideration in regard to treatment and prognosis. Acute loss of vision due to cerebral cortical insults involves a large differential diagnosis which includes vascular, metabolic and infective disease; as well as disorders causing transitory blindness such as seizures and migraine

Blindness, Cortical↗
PubMed1984

Individual variations in color vision among squirrel monkeys (Saimiri sciureus) of different geographical origins.

A forced-choice discrimination procedure was used to test color vision and visual sensitivity in 10 squirrel monkeys (Saimiri sciureus) originating from three geographical locations (Bolivia, Colombia, Guyana). In agreement with results from an earlier study of vision in squirrel monkeys of Peruvian origin, striking individual variations in color vision were found among these squirrel monkeys. Some of these animals had trichromatic color vision, while others were dichromats. Within these two categories, a total of five color vision phenotypes could be discerned. Most of these types are qualitatively similar to common forms of human color-defective vision.

Animals↗
PubMed1981

Aniseikonia for near vision with unilateral aphakia corrected by intraocular lenses.

1. Our methods for calculation of aniseikonia for near vision allow one to determine it in every patient with an intraocular lens. 2. With an eye with an artificial lens there is a correlation between the amount of accommodation used by the phakic eye and aniseikonia changes subject to the distance from the object. Calculations for aniseikonia for near vision in 43 patients showed that with accommodation used by the normal eye aniseikonia was increased by 3.0% to 7.8% as compared with aniseikonia for distance. With accommodation of the phakic eye lacking, aniseikonia for near vision did not differ much from its value for distance. 3. Calculations for aniseikonia for near vision showed the advantage of intraocular lens implantation for obtaining iso-iconia for distance or tolerable aniseikonia not more than 2.5% to 3.0%. 4. For obtaining iso-iconia for near vision it is necessary to correct the phakic eye to switch off its accommodation partially or completely (with emmetropia, correction +2.0D for near vision).

Accommodation, Ocular↗
PubMed1994

[A 64-year-old man with recurrent blurred vision and an abdominal mass].

We report a 64-year-old man with recurrent bouts of blurred vision who died after developing an abdominal mass. He was well until June of 1985 when he was 59-years-old when he had an acute onset of loss of vision in his right eye. He was treated by prednisolone with a complete remission. In August of 1986, he had another bout of blurring of vision in his left eye. Once he lost his left vision completely, from which he showed slow recovery. In January of 1987, he developed blurring of his right eye and loss of pain and touch sensation in his right leg. Since then he repeated loss of vision in his right or left eye five times, and he was admitted to our hospital in May of 1990. On admission, he was alert and oriented. General physical examination was unremarkable. Neurologic examination revealed bilateral optic nerve atrophy. He could not discriminate light or dark by either eye. Other cranial nerves were unremarkable. He could walk in a wide-base only with support; spasticity was noted in his left leg. Muscle strength was preserved. Deep reflexes were exaggerated in both legs with extensor plantar reflex bilaterally. Pain and touch sensation was decreased in the left leg by 30%, and vibration was diminished in both feet. Position sense was preserved. Routine blood counts and chemistries were unremarkable. Cranial MRI scans revealed multiple high-signal intensity lesions in both pontine bases, basal ganglia, thalami, and in the deep cerebral white matters. He was treated with oral prednisolone, plasmapheresis, lymphocytapheresis, and then immuran. His vision showed only slight recovery to discriminate light and dark. In October of 1990, slight weakness appeared in his both legs. In December of that year, he developed nausea, and a fiber colonoscopic study revealed a stenosis in the transverse colon. In March of 1991, he developed anemia and liver dysfunction. In July of that year, jaundice appeared, and his serum bilirubin was increased. In October, his leg weakness became more prominent, and his cranial CT scans at that time revealed a low density change in the right cerebellum in the right superior cerebellar artery territory; in addition, multiple low density spots were scattered to be seen in both cerebral hemispheres including the basal ganglia and thalamic areas with ventricular dilatation and cortical atrophy.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma, Mucinous↗
PubMed1996

Determination and application of vision standards in industry.

Job-related vision standards benefit both employee and employer. By comparing employees' vision to specific job requirements, workers can be better placed into positions commensurate with their visual abilities. For a company without a vision care program, a project was undertaken to determine visual standards, and the need for vision care services for employees to better meet these standards. The critical factors for performing specific visual tasks for 40 job classifications were identified through direct observation and measurement, and through worker interviews. Additionally, a sample of employees was screened to determine plant population characteristics, and to determine what percentage of employees met the newly formed standards. This study can serve as a model for the application of visual standards to the workplace and is pertinent, as "reduced vision" is increasingly defined by government as a disability.

Adult↗
PubMed1998

[Low Vision Enhancement System (LVES). Initial clinical experiences with a new kind of optoelectronic rehabilitation system].

BACKGROUND: The Low-Vision-Enhancement-System (LVES) is the first binocular optoelectronic rehabilitation device with variable focus distance. METHOD: LVES was attempted on 25 patients who were not adequately treatable with classic rehabilitation devices. Using the new device, short-distance vision as well as the ability to read and write were tested. RESULTS: In six patients, a significant improvement was achieved using LVES. In these patients, short-distance vision as measured by LVES varied from 0.63 to 1.0. All succeeded in reading fluently, and five patients, in writing. Of these patients, five suffered from large central scotomas due to macular disease, and one female patient, from post-traumatic optic nerve atrophy. In 10 patients, near-sighted vision could be improved although the ability to read and write could not be restored, while nine patients did not show any benefit. In the latter group, were four patients with retinopathia pigmentosa, who complained of the further reduction in visual field due to the system. CONCLUSION: LVES is an additional device for the rehabilitation of low-vision patients which is especially useful in cases of macular diseases.

Adult↗
PubMed1988

Visual results with low-vision aids in age-related macular degeneration.

We reviewed the records of 61 patients with age-related macular degeneration who had an exudative or a dry macular scar and who had received low-vision rehabilitation. Exudative scars resulted from the natural course of sub-retinal new vessels, and dry scars from successful photocoagulation to the new vessels. Low-vision aids consisted of high-power positive lenses. Eyes were divided into three groups according to their distance visual acuity before using low-vision aids: Group 1, 20/100; Group 2, 20/200 to 20/300; and Group 3, 20/400 or poorer. The print size resolution on the Rosenbaum pocket vision screener and power of the low-vision aid in each group were compared for the eyes having exudative scars and those with dry photocoagulation scars. In Groups 2 and 3, eyes with dry macular scars reached a similar resolution of print size but with significantly (P less than .01) lower-power visual aids than eyes with exudative macular scars. In Group 1, eyes with dry macular scars achieved a better print size resolution using significantly (P less than .01) lower-power visual aids than eyes with exudative scars.

Aging↗
PubMed1995

Psychophysics of reading--XIII. Predictors of magnifier-aided reading speed in low vision.

A key clinical problem in low-vision assessment is finding simple measures that are predictive of real-world performance. Our purpose was to determine whether a set of clinical variables could predict how well low-vision subjects read with their magnifiers. The variables were Snellen acuity, presence/absence of central scotomas, clear/cloudy ocular media, age, magnifier type, and score on a standardized test of reading speed (Minnesota Low-vision Reading Test). Forty low-vision subjects identified the magnifier they most "preferred" to use, based on the frequency and length of time used, ease of use, or any other factor considered important by each subject. All subjects were highly experienced with their magnifier (3 months to 21 yr of use). We classified the magnifiers into five categories: (1) standard correction only; (2) hand-held magnifier; (3) spectacle-mounted magnifier; (4) closed-circuit TV; and (5) stand magnifier. Subjects used their preferred magnifiers to read aloud printed paragraphs of about 150 words from which their reading speeds were calculated. By far the best predictor of the magnifier-aided reading speed was the score on the standardized reading test which accounted for 79.7% of the variance. 43.7% of the variance was accounted for by age, and 42.3% by magnifier type. Snellen acuity, central visual field status, and ocular media status were not significantly correlated with magnifier-aided reading speed. We conclude that a standardized clinical reading test can give a valid prediction of the reading speed a low-vision patient is likely to achieve with a magnifier.

Adult↗
PubMed2004

Monocular versus binocular vision in postural control.

OBJECTIVE: In previous studies about the control of posture there have been controversial findings. Our aim was to examine the role of monocular and binocular vision in controlling posture in quiet stance. METHODS: Twenty-eight normal subjects were tested. We used a force platform in measuring postural stability. In main experiment, postural stability was measured in four conditions: both eyes open (BEO), dominant eye open (DEO) non-dominant eye open (NDEO), and both eyes closed (BEC). In a further experiment, 11 subjects were tested in conditions where a vertical prism was placed in front of dominant eye. Prism was strong enough to cause diplopia. Our interest was to see, if diplopia affected the balance. RESULTS: In main experiment, at level of group the body-sway in any of the three ocular (viewing) conditions did not differ from each other. At level of individuals, binocular vision was more effective on controlling posture in only half of subjects. In prism experiment, relative to normal binocular viewing the postural stability was modified in both prism conditions, but there was no difference between monocular and binocular viewing with prism. CONCLUSION: In quiet stance and in subjects with perfect binocular vision and stereopsis, the benefit out of binocular viewing in postural stability is subject-dependent. At the level of group, monocular vision provides equally good postural stability as binocular vision.

Adult↗
PubMed1982

Prismatic scanning method for improving visual acuity in patients with low vision.

Frequently, patients with macular lesions and others who are visually handicapped do not receive adequate low vision care by ophthalmologists if a routine trial of low vision aids has no gratifying results. This paper describes for the first time a technique in which functional vision was achieved with the aid of prismatic scanning in patients for whom the usual low vision aids had proved ineffectual. The procedure in which prisms are used to achieve functional vision in patients with macular lesions in uncomplicated, inexpensive, and rapid; indeed, it can be used by an ophthalmologist in routine office practice with existing equipment.

Adult↗