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At least 667 records · Page 37Linked to original sources
PubMed2003

Do video display units cause visual problems? - a bedside story about the processes of public health decision-making.

PURPOSE: Since the 1980s, it has been common for employers to provide eyesight testing for operators of screen-based equipment (SBE). This practice arose because many SBE operators reported symptoms of visual discomfort at work and there was apprehension that radiation emitted by SBE might be harmful to vision. Visual screening of SBE operators has been encouraged by government guidelines and in some countries, is required by legislation. This paper questions whether this practice should continue. METHOD AND RESULTS: A review of the literature shows: 1. SBE does not emit radiation in sufficient quantity to be harmful and there is no credible epidemiological evidence that work with SBE will damage the eyes; 2. SBE operators often report symptoms of visual discomfort but office workers who do not use SBE also report visual symptoms with the same or slightly lower frequency; 3. about 20 per cent of office workers have some uncorrected defect of vision that can contribute to the occurrence of visual discomfort at work and optometric intervention to correct these defects does reduce the occurrence of visual symptoms. However, defects of vision are not the only cause of visual symptoms at work. Other contributing factors are poor workplace ergonomics and psychosocial stress arising from poor work systems or poor inter-personal relationships at work. CONCLUSIONS: There is no compelling public health justification for requiring vision screening of SBE operators but it could be introduced as one element of a more comprehensive strategy to enhance visual comfort at work. If it is introduced, it should be for all employees engaged in visually demanding tasks, not just SBE users. An alternative to eyesight testing of employees is to encourage but not require employees to obtain eye care privately on their own initiative. This option has the advantage of restoring autonomy to employees to arrange their own eye care. Eyesight testing of employees in vision-critical occupations should be undertaken to ensure safety. In occupations in which there is a risk of eye injury, vision screening should be undertaken to provide a pre-injury record of vision.

Australia↗
PubMed2003

Screening older people for impaired vision in primary care: cluster randomised trial.

OBJECTIVE: To determine the effectiveness of screening for visual impairment in people aged 75 or over as part of a multidimensional screening programme. DESIGN: Cluster randomised trial. SETTING: General practices in the United Kingdom participating in the MRC trial of assessment and management of older people in the community. PARTICIPANTS: 4340 people aged 75 years or over randomly sampled from 20 general practices, excluding people resident in hospitals or nursing homes. INTERVENTION: Visual acuity testing and referral to eye services for people with visual impairment. Universal screening (assessment and visual acuity testing) was compared with targeted screening, in which only participants with a range of health related problems were offered an assessment that included acuity screening. MAIN OUTCOME MEASURES: Proportion of people with visual acuity less than 6/18 in either eye; mean composite score of 25 item version of the National Eye Institute visual function questionnaire. RESULTS: Three to five years after screening, the relative risk of having visual acuity < 6/18 in either eye, comparing universal with targeted screening, was 1.07 (95% confidence interval 0.84 to 1.36; P = 0.58). The mean composite score of the visual function questionnaire was 85.6 in the targeted screening group and 86.0 in the universal group (difference 0.4, 95% confidence interval -1.7 to 2.5, P = 0.69). CONCLUSIONS: Including a vision screening component by a practice nurse in a pragmatic trial of multidimensional screening for older people did not lead to improved visual outcomes.

Aged↗
PubMed1991

Velhagen Pfügertrident pseudoisochromatic plates in screening congenital red-green vision defects.

Red-green colour vision defects were screened in a group of 425 trade school students using Velhagen Pflügertrident pseudoisochromatic plates. Thereafter, the students were examined with the Nagel anomaloscope. Of the 425 students, 31 (7.3%) were found to be colour defectives. Deuteranomalous defects were found in 4.9% of cases; deuteranopic defects, in 0.2%; and protanomalous defects, in 2.1%. There were no protanopic students in the study group. The Velhagen plates found 19 of the 31 defectives (sensitivity, 61.3%); none of the students with normal colour vision were suspected of being colour defectives (specificity, 100%). The sensitivity of the Velhagen plates is not as high as that of other pseudoisochromatic tests. However, the Velhagen Pflügertrident test is easy to use when screening of pre-school-aged children is needed.

Adolescent↗
PubMedDate not supplied

Lanthony 15-Hue Desaturated Test for screening of early color vision defects in uncomplicated juvenile diabetes.

PURPOSE: To identify the most appropriate test for screening of early color vision abnormalities in uncomplicated juvenile diabetes. METHODS: Enrolled in this study were 39 diabetic adolescents, characterized by optimal Early Treatment Diabetic Retinopathy Study criteria for visual acuity, transparent dioptric means and angiographically normal retinas. Color vision was examined with Standard Pseudoisochromatic Plates (Part 2, SPP2), Roth 28-Hue Test (R28), Farnsworth-Munsell 100-Hue Tests (FM100), and Lanthony 15-Hue Desaturated Test (L15). Color confusion score (CCS) and desaturation angle (DSAT) were measured on L15 only. Thirty-nine normal subjects served as a control group. Poor metabolic control was an exclusion criteria. RESULTS: CCS was significantly higher in the patients than in the controls (37.8 +/- 11.1 vs 0 +/- P < .001) and normal scores were found in only 4 diabetic patients. DSAT values were spread, not showing a well-defined axis of the defect. The results of FM100 were clinically reliable but affected by a longer execution time. R28 and SPP2 demonstrated a low sensitivity, as all patients scored normally with both tests. CONCLUSIONS: Impaired color vision is a common observation even in patients with uncomplicated juvenile diabetes. Our results indicate that L15 is the most suitable test for screening of early color vision abnormalities in these subjects.

Adolescent↗
PubMed1986

Comparison of six colour vision tests for occupational screening.

Screening of red-green colour vision defects was done for 52 school children (22 boys and 30 girls) and 231 trade school students (226 boys and 5 girls) with three different kinds of pseudo-isochromatic plates: Ishihara (1983), Boström-Kugelberg (1972), and Standard Pseudoisochromatic Plates part 1 (SPP 1) 1978, and with three different kinds of vision screeners: Keystone View Model DVS 2, Bausch and Lomb Vision Tester, and Rodenstock Farbentestscheibe 3040.173. After these tests, each subject was examined with the Nagel Anomaloscope; this revealed 26 red-green defectives in the study group. Ishihara found 20/26 (76.9%), Boström-Kugelberg 24/26 (92.3%), and SPP 1 17/26 (65.4%) of the defectives. None of the normals were diagnosed as defectives with Ishihara or SPP 1. With Boström-Kugelberg four normals were diagnosed as defectives. Keystone found 24/26 (92.3%), Bausch and Lomb 26/26 (100%), and Rodenstock 25/26 (96.2%) of the defectives. But 9, 21, and 112 normals, respectively, were diagnosed as defective. In the present study, the Boström-Kugelberg and Ishihara plates as well as Keystone Vision Screener and Bausch and Lomb Vision tester came close to an effective screening test and could be recommended for screening red-green colour vision defects in occupational health care.

Adolescent↗
PubMed2002

Adaptation of dementia screening for vision-impaired older persons: administration of the Mini-Mental State Examination (MMSE).

In epidemiologic field studies on the prevalence and incidence of dementia the problems associated with the cognitive testing of visually impaired individuals are rarely discussed. In the Leipzig Longitudinal Study of the Aged (LEILA 75+) a version of the Mini-Mental State Examination for the visually impaired (MMSE-blind) was employed from which all items requiring image processing had been omitted. To be able to interpret the test results and include vision-impaired individuals in the field study, the scores for the full MMSE were estimated by conducting linear transformation of the scores obtained on the MMSE-blind. The method of linear transformation is based on certain theoretical assumptions that are examined in this article. Linear transformation of scores has proved to be a valid procedure only for individuals with very high or very low cognitive performance. Thus, evaluation of the estimated full MMSE scores based on the norms for the original MMSE is not recommended. A blind version of the MMSE with age- and education-specific norms that has been validated as a screening tool for dementia is therefore presented.

Aged↗
PubMed2001

Visual risk factors for falls in older people.

OBJECTIVES: To determine the tests most predictive of falls in community-dwelling older people from a range of visual screening tests (high and low contrast visual acuity, edge contrast sensitivity, depth perception, and visual field size). To determine whether one or more of these visual measures, in association with measures of sensation, strength, reaction time, and balance, can accurately predict falls in this group. DESIGN: Prospective cohort study of 12 months duration. SETTING: Falls and Balance Laboratory, Prince of Wales Medical Research Institute. PARTICIPANTS: 156 community-dwelling men and women age 63 to 90 (mean age 76.5, standard deviation = 5.1). MEASUREMENTS: Screening tests of vision, sensation, strength, reaction time and balance, falls. RESULTS: Of the 148 subjects available at follow-up, 64 (43.2%) reported falling, with 32 (21.7%) reporting multiple falls. Multiple fallers had decreased vision, as indicated by all visual tests, with impaired depth perception, contrast sensitivity, and low-contrast visual acuity being the strongest risk factors. Subjects with good vision in both eyes had the lowest rate of falls, whereas those with good vision in one eye and only moderate or poor vision in the other eye had elevated falling rates-equivalent to those with moderate or poor vision in both eyes. Discriminant analysis revealed that impaired depth perception, slow reaction time, and increased body sway on a compliant surface were significantly and independently associated with falls. These variables correctly classified 76% of the cases, with similar sensitivity and specificity. CONCLUSION: The study findings indicate that impaired vision is an important and independent risk factor for falls. Adequate depth perception and distant-edge-contrast sensitivity, in particular, appear to be important for maintaining balance and detecting and avoiding hazards in the environment.

Accidental Falls↗
PubMed2003

Screening at school entry: vision, hearing and growth.

Tam Fry of the Child Growth Foundation criticises the new recommendations for screening at school entry in the 2003 edition of Health for all Children. He argues that proposals to reduce preschool surveillance make the school entry screening even more important for detecting deviations from the normal, especially in vision, hearing and growth. This surveillance needs to be rigorously performed, yet a shortage of school nurses and optometrists makes this less likely to happen. The author argues that even though there may be insufficient evidence for retaining current preschool screening programmes, there is also insufficient evidence to show that severely curtailing them will not cause harm.

Child↗
PubMed2000

[Cost effectiveness of mass orthoptic screening in kindergarten for early detection of developmental vision disorders].

PURPOSE: Orthoptic screening in the kindergarten is one option to improve early detection of amblyopia in children aged 3 years. The purpose of this study was to analyse the cost-effectiveness of such a screening programme in Germany. METHODS: Based on data from the literature and own experience gained from orthoptic screening in kindergarten a decision-analytic model was developed. According to the model, all children in kindergarten, aged 3 years, who had not been treated for amblyopia before, were subjected to an orthoptic examination. Non-cooperative children were reexamined in kindergarten after one year. Children with positive test results were examined by an ophthalmologist for diagnosis. Effects were measured by the number of newly diagnosed cases of amblyopia, non-obvious strabismus and amblyogenic refractive errors. Direct costs were estimated from a third-party payer perspective. The influence of uncertain model parameters was tested by sensitivity analysis. RESULTS: In the base analysis the cost per orthoptic screening test was DM 15.39. Examination by an ophthalmologist cost DM 71.20. The total cost of the screening programme in all German kindergartens was DM 6.1 million. With a 1.5% age-specific prevalence of undiagnosed cases, a sensitivity of 95% and a specificity of 98%, a total of 4,261 new cases would be detected. The cost-effectiveness ratio was DM 1,421 per case detected. Sensitivity analysis showed considerable influence of prevalence and specificity on the cost-effectiveness ratio. It was more cost-effective to re-screen non-cooperative children in kindergarten than to have them examined by an ophthalmologist straight-away. CONCLUSIONS: The decision-analytic model showed stable results which may serve as a basis for discussion on the implementation of orthoptic screening and for planning a field study.

Amblyopia↗
PubMed2001

[Value of the Bébé-Vision test in the screening of strabismus and anisometropic amblyopia in infants].

PURPOSE: To evaluate the accuracy of the Bébé-Vision test for detecting strabismic, ametropic and anisometropic amblyopia in childhood. METHODS: We screened 199 infants under 20 months of age. The screening consisted of a full orthoptic examination by a trained orthopist (cover test, fixation test), a forced choice preferential looking technique (Bébé-Vision test) prior to cycloplegia to test visual acuity, cycloplegic refraction by retinoscopy, and examination of the fundi. RESULTS: Fifteen infants were abnormal on orthoptic examination (clinical evidence of esotropia and/or limitation of abduction and/or amblyopia). The Bébé-Vision test demonstrated a significant interocular difference on the same side of the suspected amblyopic eye in 3 cases and on the opposite side in 3 cases, and no difference in 9 cases. The monocular Bébé-Vision test was abnormal in 51 cases and there was an abnormal cycloplegic refraction in 33 cases. Statistical analysis of these tests demonstrated a very low sensitivity (42%) and a good specificity (90%) for the Bébé-Vision test in detecting amblyopia related to refractive error. CONCLUSION: The Bébé-Vision test does not reliably reveal strabismic or anisometropic amblyopia and is not recommended as a screening test. Diagnosis should continue to be based mainly on the classical clinical methods.

Amblyopia↗
PubMed1995

Do we have optimal screening limits in Sweden for vision testing at the age of 4 years?

The purpose of this study was to evaluate the Swedish screening criteria for referral of children to ophthalmic care after visual acuity testing at the age of 4 years. The screening limit has generally been 0.8. To what extent do children with 0.65 in each eye (0.65/0.65) or 0.65 in one and 0.8 in the other (0.65/0.8) at the age of 4 years have visual defects needing early treatment? Sixty-three children who had failed screening underwent orthoptic and ophthalmologic evaluation. Twenty-four patients (38%) saw 0.65/0.65 or 0.65/0.8 and were studied further. None of them had manifest strabismus. Refractive errors were minor except in 2 patients who had significant hyperopia. Twenty-two of these 24 patients returned for reevaluation at the age of five years and that time 18 of them saw 0.8 or more without treatment. Our findings suggest that children with visual acuity of no less than 0.65 and no more than one line's difference between the eyes at 4 years of age seldom have visual defects needing treatment.

Child, Preschool↗
PubMed1998

Effectiveness of screening older people for impaired vision in community setting: systematic review of evidence from randomised controlled trials.

OBJECTIVE: To assess whether population screening for impaired vision among older people in the community leads to improvements in vision. DESIGN: Systematic review of randomised controlled trials of population screening in the community that included any assessment of vision or visual function with at least 6 months' follow up. SUBJECTS: Adults aged 65 or over. MAIN OUTCOME MEASURE: Proportions with visual impairment in intervention and control groups with any method of assessing visual impairment. RESULTS: There were no trials that primarily assessed visual screening. Outcome data on vision were available for 3494 people in five trials of multiphasic assessment. All the trials used self reported measures for vision impairment, both as screening tools and as outcome measures. The inclusion of a visual screening component in the assessment did not result in improvements in self reported visual problems (pooled odds ratio 1.04:95% confidence interval 0.89 to 1.22). A small reduction (11%) in the number of older people with self reported visual problems cannot be excluded. CONCLUSIONS: Screening of asymptomatic older people in the community is not justified on present evidence. Visual impairment in this age group can usually be reduced with treatment. It is unclear why no benefit was seen. Further work is needed to clarify what interventions are appropriate for older people with unreported impairment of vision.

Aged↗