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At least 649 records · Page 36Linked to original sources
PubMed1995

Prognostic factors of vision in patients with Behçet disease.

BACKGROUND: Behçet disease is a chronic, recurrent, inflammatory disorder characterized by the triad of oral and genital ulcers and ocular lesions. The etiology is unknown. Although many of these patients become blind, some have good vision all their life. METHODS: To attain more accurate data on the prognosis of these patients, the authors studied 52 Japanese patients (101 eyes) seen at Kyushu University Hospital between 1980 and 1990. At the first visit, patients ranged in age from 21 to 61 years; at onset, they ranged in age from 17 to 55 years; and the disease duration at first visit was from 0 to 22 years. Thirty-five of the 101 eyes had a visual loss of more than five lines or the patients became blind. The authors divided the subjects into two groups--favorable group and unfavorable group. If an eye had more than five lines of visual loss or the patient became blind 3 years after the first visit, it was placed in the unfavorable group, and if not, it was classed in the favorable group. Thirty-two factors determined from clinical records were used to select statistically significant risk factors for visual loss, using univariate analysis and multivariate logistic regression analysis. RESULTS: Univariate analysis showed the following four factors that were significantly different between favorable and unfavorable groups: sex, disease interval, other complications, and skin lesions (first year). Multivariate analysis showed that the following seven factors had mutually independent contributions to visual loss: skin lesions; arthritis; posterior attacks; other complications (experienced), including gastrointestinal, vascular, and central nervous system lesions; female sex; disease interval; and anterior attacks. The first four factors have effects of losing vision, whereas the others are related to vision retention. CONCLUSION: The authors find that skin lesions, arthritis, posterior attacks, and other complications are linked to loss of vision, whereas female sex, disease interval, and anterior attacks are related to retention of vision.

Adult↗
PubMed1999

[Disturbances of binocular vision in macular heterotopia].

BACKGROUND: Tractive translocation of the macula (secondary macular heterotopia) may result in disturbance of binocular vision. The report of a case shall discuss the sensorial problems of these patients. HISTORY AND SIGNS: We report of a 40-years old male who had decreased visual acuity and loss of binocular vision for several years due to episodes of uveitis with intravitreous hemorrhage and cataract formation. After bilateral vitrectomy and cataract extraction a good visual acuity was restored in both eyes. Postoperatively, the patient monocularly complained about disturbed egocentric localization (tilting of the visual environment, "past-pointing") and metamorphopsia. Binocularly he was confused by doubled vision with tilted images. Both maculae showed a tractive translocation of 15 degrees downward. Measurements of binocular alignment with the tangent screen showed an excyclotropia of 8 degrees and an exotropia of 7 degrees in all directions of gaze. Haploscopic examination with fusion images demonstrated that sensorial fusion was not possible even with perfect ocular alignment due to disturbed relative retinal localization (obligate fixation disparity). THERAPY AND OUTCOME: Initially, full time occlusion of the left eye was required. After improvement of symptoms occlusion therapy was slowly tapered. Within one year the patient had learned to suppress the image of his left eye and reported only minor residual visual disturbances even without occlusion of his left eye. CONCLUSIONS: Secondary translocation of the macula monocularly results in a disturbance of egocentric localization and in metamorphopsia. Binocularly doubled vision with tilted images and a loss of sensorial fusion are seen. With monocular vision, perceptual adapting to the aberration in egocentric localisation is possible within weeks by reallocation of the retinal meridians in the central nervous system. Binocular improvement of symptoms is limited to the learning of suppression. Improvement of binocular symptoms by adaptation of retinal correspondence does not occur.

Adult↗
PubMedDate not supplied

Dose-related color vision impairment in toluene-exposed workers.

Occupational exposure to various neurotoxic chemicals can impair color vision. We evaluated this possibility in toluene-exposed workers. Thirty-three rubber workers and 16 referents were studied. We estimated toluene exposure by measuring urinary excretion of the unmodified form of the solvent (i.e., TolU). Color vision was tested with the Lanthony D-15 desaturated panel, and the outcomes were expressed quantitatively with the Color Confusion Index and the Total Confusion Index. Toluene-exposed workers had a subclinical reduction in color vision, compared with referents. We related this effect to solvent cumulative exposure--estimated as the product of urinary excretion of unmodified toluene by previous toluene exposure duration. This approach supports the hypothesis that impairment progresses as exposure continues. In the examined group of workers, toluene exposure was within the occupational limit proposed by the American Conference of Governmental Industrial Hygienists. The observed loss in color vision raises doubts on the real protection afforded by this limit--at least for effects of the solvent on the eyes. Finally, the Total Confusion Index was a more sensitive index than the Color Confusion Index in the evaluation of toluene-related color-vision impairment, suggesting that this index should be adopted in future studies of the effects of chemicals on color perception.

Adult↗
PubMed1989

What do color vision defectives say about everyday tasks?

A lengthy questionnaire was administered to 102 people with defective color vision and to an equal number of people with normal color vision. The questionnaire asked about the subjects' awareness of their defect and their knowledge of defective color vision as well as exploring the difficulties they experience with color at work and in pursuing leisure activities. The questionnaire was administered in the consulting room under conditions that might be expected to elicit frank replies. Nearly 90% of dichromats and up to two-thirds of anomalous trichomats reported difficulties with everyday tasks that involve color, nearly one-half of the dichromats and one in five anomalous trichromats reported difficulty with traffic lights, and similar proportions reported color difficulties in their present jobs. Substantial numbers reported that their color vision defect had affected their choice of career and many had been excluded from a chosen occupation. The screening of color vision in schools and provision of appropriate career counselling is urged.

Activities of Daily Living↗
PubMed1993

Redefining the optometric examination: addressing the vision needs of older adults.

The aging of America's population will result in an increased number of older adult patients in optometric practices. Although older patients frequently report declines in their vision, the results of high contrast testing procedures often do not correlate with the symptoms. Age-related functional vision decrements can impact upon an individual's ability to perform the activities of daily living. I explored the relation between reported visual complaints and the results of objective tests for older adults (N = 50) as compared with middle-aged adults (N = 20). Decrements in visual acuity, contrast sensitivity, glare sensitivity, color vision, and stereopsis were apparent in the older group and all were significant at alpha = 0.05. Open-ended questions elicited more visual complaints from older adults than from middle-aged adults. However, only the reported complaint of decreased vision was related to visual decrements as determined by clinical testing (chi 2; p = 0.0596). These results indicate that task-specific case history questions may provide greater insight into older adults' visual performance in their normal environment. Additional testing in the areas of contrast sensitivity, glare sensitivity, stereopsis, and color vision should also be included in the optometric examination when warranted.

Adult↗
PubMed1994

Enhanced vision screening of highway patrol applicants.

BACKGROUND: The Missouri State Highway Patrol (MSHP) required that its vision standards be updated in order to comply with the Americans with Disabilities Act (ADA). This act prohibits employers from using qualification standards to screen out people with disabilities, including vision, unless they are job-related and necessary. METHODS: Since 1992 the author and a team of optometry students have screened all MSHP applicants using the American Optometric Association (AOA)'s Vision Standards for Police Officers with the addition of grating contrast sensitivity. RESULTS: The mean age of this group was 24.8 years and most (87%) were male. Thirty percent wore spectacles, contact lenses, or had refractive modification. Ninety-seven percent of the applicants were able to pass all aspects of the enhanced vision screening. CONCLUSION: The initiation of optometric screening to ensure that all future troopers meet the recommended vision standards for police officers should ensure uniformity of these standards for the MSHP.

Adult↗
PubMed2005

Disruption and reacquisition of binocular vision in childhood and in adulthood.

PURPOSE OF REVIEW: This article reviews the most recent studies that address the loss of and restoration of binocular vision in childhood and adulthood and summarizes recent changes in treatment approaches. RECENT FINDINGS: Studies during the last two years support the idea of continued plasticity of the binocular visual system throughout life. Children and adults with strabismus onset following binocular vision maturation are susceptibility to a permanent disruption of stereopsis and sensory fusion. Plasticity of the binocular visual system, however, also means continued restorability of function. Despite a rather short critical time interval for restoration of normal function (three months in children and 12 months in adults), peripheral or extramacular binocular visual function can be restored in most patients whose onset of disruption follows binocular maturation. SUMMARY: Stereoacuity loss can occur in the visually mature patient who develops strabismus later in life and delay of treatment can be deleterious to the restoration of normal macular binocular vision. However, despite any delay of treatment, most patients with strabismus acquired following binocular vision maturation will manifest some stereoacuity or sensory fusion following eye realignment. These findings suggest all patients with strabismus need to have their eyes aligned, either surgically or optically, to maximize their binocular vision outcome.

Adult↗
PubMed2005

Vision requirements for driver's license examiners.

PURPOSE: The purpose of this study was to determine the vision requirements for licensing and registration examiners (LREs) of motor vehicle drivers in the state of California. METHODS: A comprehensive investigation was conducted that included a literature review, consideration of the Americans with Disabilities Act, analysis of materials with a subject matter expert panel, an overview of visual function tests, a formal job analysis, job audits and site visits to licensing offices, analysis of accidents and critical incidents, performance of simulation studies, and a review and evaluation of all materials collected during the study. RESULTS: Based on this analysis, three visual functions (best-corrected visual acuity, peripheral visual field extent, and color vision) were determined to be important for performing the essential job functions of an LRE. It was recommended that LREs demonstrate a best-corrected visual acuity of at least 20/20 in each eye, a peripheral visual field of at least 100 degrees diameter of horizontal and vertical extent in each eye (with no evidence of scotomas or pathologic areas of nonseeing within the visual field), and color vision capabilities that permit a passing score on the Farnsworth Panel D-15 color vision test. DISCUSSION: The findings of this investigation provide a strong basis for specifying and justifying vision requirements for performing essential job functions for an LRE in the state of California.

Adult↗
PubMed1992

Vision and visual disability in the daily life of a representative population sample aged 82 years.

A representative population sample (n = 203) aged 82 years was studied to determine the prevalence of impaired vision and visual disability in a cohort previously investigated at the age of 70 years. Visual impairments and disabilities were generally most marked among the non-ambulatory subjects. In the ambulatory group (n = 160) 54% had VA greater than 0.8 and 8% VA less than 0.3. Near vision was also markedly better in this group. About 90% of the ambulatory cases could read J2 or better, read books and watch TV. Statistical analysis showed no sex difference with respect to visual ability for ambulatory subjects. Subjects with a wide range of distance VA were able to read J1 and J2, whereas only one ambulatory patient with J4 or worse had a distance VA above 0.3. To watch TV and manage most of the everyday activities a distance VA of 0.4-0.5 was required. To read newspapers and books a near vision of J2 was needed and for the telephone book J1 was needed. Improvements of near vision obtained by a change of own glasses were small. Hobby and household work proved less dependent on vision. The subjects showed a fairly realistic view of their visual capability, and distance VA was a valuable predictor of visual ability and disability.

Aged↗
PubMed2004

The Seoul Metropolitan Preschool Vision Screening Programme: results from South Korea.

AIM: To report on a new model of preschool vision screening that was performed in metropolitan Seoul and to investigate the distribution of various ocular disorders in this metropolitan preschool population. METHODS: Vision screening was conducted on 36 973 kindergarten children aged 3-5 years in a stepwise manner. The first step was home screening using a set of five picture cards and a questionnaire. The children who did not pass the first step (VA <0.5 in at least one eye or any abnormal responses on the questionnaire) were retested with regular vision charts at the regional public healthcare centres. After this retest, some children were referred to ophthalmologists. The referral criteria for visual acuity were <0.5 at 3 years and <0.63 at 4 or 5 years in at least one eye. RESULTS: Of those screened, 7116 (19.2%) children did not pass the home screening tests and 2058 (28.9%) out of the 7116 were referred. The results of the ophthalmological examination in eye clinics were only available for 894 children (43.4%) of those who were referred. The rest of the children did not visit ophthalmologists because they had been checked at an eye clinic, were currently under treatment, or for personal reasons. Refractive errors were found in 608 (1.6%) children. Astigmatism was associated in 78.2% of ametropes. Amblyopia was discovered in 149 (0.4%) children and refractive error was the major aetiology with a predominant rate (82.5%). Manifest strabismus was detected in 52 children. The positive predictive value of vision screening for any ophthalmological disorder was 0.77, and 0.49 for significant disorders requiring treatment. CONCLUSIONS: This preschool vision screening model was highly accessible to the children and their parents, easy to administer, and effective to detect a variety of ocular disorders. However, the participation rate of the referred children in the examinations by ophthalmologists was quite low. The performance and efficiency of this screening programme need to be optimised with further revision.

Amblyopia↗
PubMed1999

Creation and testing of a practical visual function assessment for use in Africa: correlation with visual acuity, contrast sensitivity, and near vision in Malawian adults.

AIM: To develop and test a practical visual function assessment for use in developing countries. METHODS: Using focus group discussions and interviews with eyecare workers and low vision specialists in Malawi, 13 questions related to visual characteristics of activities of daily living were designed. Patients presenting to an eye clinic were recruited and interviewed. Visual acuity, near vision, and contrast sensitivity were measured. Analysis sought to determine the degree of correlation between the vision indices and visual function. RESULTS: The visual function questionnaire was easy to administer. Visual function correlated with visual acuity, contrast sensitivity, near vision, and patient reported visual problem. People with a higher frequency of "not applicable" responses had lower visual function scores. Multivariate modelling revealed that visual acuity and number of questions felt to be applicable were independently associated with visual function. Reducing the questionnaire to nine questions did not affect the degree of correlation with any of the visual indices. CONCLUSION: The authors' visual function assessment correlates well with different measures of visual acuity. People with reduced vision for a prolonged period may no longer consider doing certain tasks and the number of questions considered appropriate by an individual may be an additional measure of visual function. Assessment of visual function by health workers may be a valuable tool in improving surgical uptake by encouraging both health personnel and patients to recognise that they have difficulties undertaking activities of daily living as well as a measure of monitoring and evaluating cataract outcomes.

Contrast Sensitivity↗
PubMed1978

Vision screening in children tested at 7, 11, and 16 years.

Distant vision screenings of a national sample of children were performed at the ages of 7, 11, and 16. Many children with normal vision at one screening showed defects at later screenings, and altogether 18% of children with normal vision at the age of 7 had defects by the time they were 16. Twelve per cent of those with normal vision at 7 and 11 had developed a visual defect by the age of 16. Apparent improvements between screenings probably resulted largely from technical difficulties inherent in testing young children. The results clearly indicate the importance of regular vision screening during the school years and the need for comprehensive but flexible back-up services.

Adolescent↗
PubMed2006

Surgical decompression and coil removal for the recovery of vision after coiling and proximal occlusion of a clinoidal segment aneurysm: technical case report.

OBJECTIVE: We present the case of a patient with continued deterioration of vision after endovascular treatment of an unruptured clinoidal segment aneurysm. In conjunction with a review of the literature, the findings in this case highlight the need for further refinements in our understanding of pathophysiological changes induced by coiling of cerebral aneurysms, especially those in aneurysms producing signs and symptoms relating to mass effect. CLINICAL PRESENTATION: The patient is a 45-year-old man who presented with progressive vision loss. Imaging studies revealed a large, clinoidal segment aneurysm. The patient continued to experience progressive vision loss despite treatment with endovascular coiling, proximal occlusion, and high-dose steroid medication. INTERVENTION: The patient underwent a craniotomy for decompression of the optic nerve and for salvage of vision. Clipping of the distal vessel was performed, and the coil mass was removed. The patient experienced marked improvement of central vision after the surgical procedure. CONCLUSION: Although endovascular treatment of aneurysms protects most patients from aneurysm rupture, this case illustrates the fact that coiling, followed by proximal occlusion, might fail to alleviate symptoms related to mass effect. Our experience in this case suggests that early surgical decompression may be indicated for patients presenting with progressive visual deterioration.

Carotid Artery Diseases↗
PubMedDate not supplied

Compliance with vision-screening guidelines among a national sample of pediatricians.

OBJECTIVE: The American Academy of Pediatrics (AAP) recommends vision screening from birth through adolescence, with visual acuity testing and binocular screening to begin at age 3 years. The 1996 AAP guidelines advised referral for visual acuity worse than 20/40 for children aged 3 to 5 years and worse than 20/30 for children aged 6 years and older. Our objective was to describe vision-screening and referral practices in a national sample of primary care pediatricians. METHODS: We mailed a survey to a random sample of US pediatricians. Initial nonresponders were mailed up to 3 additional surveys. All mailings occurred between May and October 1998. Analyses focused on primary care pediatricians and consisted of descriptive statistics and regression analyses. The main outcome measure was compliance with 1996 AAP recommendations for vision screening. RESULTS: Of the 1491 surveys mailed, 888 (60%) were returned, including 576 (65%) from primary care pediatricians. Vision-screening methods included visual acuity testing (92%), cover test (64%), red reflex test (95%), fundoscopic examinations (65%), and stereopsis testing (32%). Respondents routinely performed visual acuity testing at 3 years (37%), 4 years (79%), 5 years (91%), 6 years (80%), 7-12 years (82%), and 13-18 years (80%). Visual acuity thresholds for referring 3- and 4-year-olds were 20/40 (47%, 51%), 20/50 (36%, 32%), or worse than 20/50 (14%, 12%). The majority of pediatricians referred children aged 5 years and older at 20/40, although thresholds worse than 20/40 were reported commonly (18%-33%). Logistic regressions were done to identify factors associated with higher likelihood of performing specific screening tests. Although no factor was consistently associated with use of all screening tests, size of the practice was significant in several regression models. CONCLUSIONS: Many pediatricians do not follow AAP guidelines for vision screening and referral, especially in younger children. Two thirds of pediatricians do not begin visual acuity testing at age 3 years as recommended, and about one fifth do not test until age 5 years. In addition, one fourth do not perform cover tests or stereopsis testing at any age.

Adolescent↗
PubMed1983

Recent advances in clinical low-vision care.

In the past decade there has been a growth in the awareness of the impact that low vision has on the individual and on society in general. The clinical eye-care professions have become more conscious of their responsibility to assist partially sighted patients and low-vision care is becoming a specialty area within optometry and ophthalmology. This paper reviews recent advances in the optical devices and prescribing procedures that have contributed to improving the care that is available to assist low-vision patients with distance-vision tasks, near-vision tasks and visual-field problems.

Distance Perception↗
PubMedDate not supplied

Binocular Polaroid Test for vision screening of pre-school age children.

We report the results obtained with the Binocular Polaroid Test in a large population screening devised to detect vision disturbances in pre-school age children. The Binocular Polaroid Test is a new test for rapid detection of small unilateral scotoma in the binocular visual field. The test was performed on 1566 children age 3 to 6 years in a field examination. The reliability of the test was controlled in a study examination. A complete study examination was performed in 60 of the 96 subjects with a positive response to the test. One hundred subjects selected at random among those with a negative response were used as controls. The study examination disclosed vision disturbances in 41 of the 60 children with a positive response to the Binocular Polaroid Test. The remaining 19 results were normal. No vision disturbances were detected in the control group. The predictive value and the "phi" coefficient were calculated. The results indicate that the Binocular Polaroid Test appears very suitable for vision screening in pre-school age children for whom an early diagnosis is of paramount importance for treatment and prognosis of a vision alteration.

Child↗
PubMedDate not supplied

Introduction of the Low Vision Evaluator (LoVE) for children.

PURPOSE: To determine whether the Low Vision Evaluator (LoVE) can grade the visual acuity of young children with light perception and hand movement acuity into finer acuity steps and at what age reliable measurements can be obtained. METHODS: Two hundred twenty children were tested with the LoVE. Each eye was tested separately, and each stimulus magnitude (intensity x duration) was presented three times. Three catch trials per eye also were presented. RESULTS: Scores ranged from -8 to -1 on variable-duration tests and from 22.5 to 37.5 dB on fixed-duration tests for four children with hand movement vision. Scores ranged from -12 to 0 on variable-duration tests and from 12.5 to 40 dB on fixed-duration tests for five children with light perception vision. Reliable measurements were obtained at different times on different days. Mean scores for children with counting finger vision or better were significantly better than scores for eyes with light perception and hand movement (P < .001 and P < .01, respectively). Reliability was less for children younger than age 4 years. CONCLUSIONS: The LoVE is capable of grading the visual function of children with light perception and hand movement vision into finer steps. Reliable measurements can be obtained for children age 4 years and older.

Child↗
PubMed1992

Sports vision and the high school student athlete.

Thorough sports vision evaluations (SVE) utilizing a 30-test battery of established sports vision tests, variations of commonly accepted procedures, and newly designed instruments and/or methods were performed by the Wisconsin Sports Vision Project (WSVP) staff on 232 teenage male and female high school student athletes. Tests are described and results reveal that a state tournament qualifying girls volleyball team (n = 8) demonstrated significantly better visual skills and abilities than 1) the male and female general high school athlete sample (n = 224), 2) the female athlete sample (n = 78), and 3) the other female volleyball players in the sample (n = 46) in some areas of dominant eye vision contrast sensitivity, distance judgement, dynamic visual acuity, tachistoscopic skills, low light and glare-affected vision.

Adolescent↗