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PubMedDate not supplied

Small-target random dot stereogram and binocular suppression testing for preschool vision screening.

BACKGROUND: New, small-target (< 1 degree) random dot stereogram (STRDS) and binocular suppression (STBS) tests appropriate for preschool vision screening were developed to correct the shortcomings of previous such tests, particularly missed cases of anisometropic amblyopia such as found with some RDS-based testing. METHODS: In Experiment 1, the tests were administered to 14 patients with current or a recent history of moderate (< or = 20/60) anisometropic amblyopia, or with accommodative esotropia or monofixation syndrome. All subjects had good binocularity (< or = 100" contour stereoacuity). In Experiment 2, the new tests were administered in a screening setting to a group of 112 three- to five-year-olds to determine testability. Visual acuity, cover testing, and photoscreening were administered as control measures. RESULTS: In Experiment 1, eleven of the 14 patients failed both tests. Two anisometropic amblyopes passing one or both tests had an acuity < or = 20/30 in the worse eye and < or = 25" stereoacuity. Three anisometropic amblyopia patients failing the STRDS passed another RDS test with similar disparity but a larger target size, confirming a report34 that anisometropic amblyopes may pass RDS testing with parafoveal stereopsis despite the presence of central suppression. The STRDS and STBS tests indicated 80% and 96% specificity, respectively, with the original methodologies; STRDS specificity increased to 95% with retesting with a different methodology. Administration time was 30 sec to 60 sec per test. CONCLUSION: Small-target RDS or suppression testing may be more effective for strabismus and amblyopia screening of preschoolers than previous RDS test formats.

Adolescent↗
PubMed2005

Numerical confusion errors in ishihara testing: findings from a population-based study.

PURPOSE: To describe the prevalence of numerical confusion errors in Ishihara testing in a representative sample of Australian children. DESIGN: Cross-sectional, population-based study. METHODS: The Sydney Myopia Study examined a representative stratified random cluster sample of 1,741 children (aged 6 years) attending 34 schools in Sydney, Australia (response rate, 78.9%), including color vision tests in 1,735 children. Those with any color vision defects (n = 33; 1.9%; 97% boys) were excluded. Responses for each Ishihara plate were recorded. RESULTS: Numerical confusion errors were made by 75.8% of children with normal color vision; there was no gender difference. Plates 3 and 7 were particularly prone to numerical confusion errors; 48.4% and 40.8%, respectively, of children misread these plates. CONCLUSION: Numerical confusion errors in the Ishihara test were relatively common in children with normal color vision. The frequency of such errors could indicate an inherent deficiency in this commonly used test.

Child↗
PubMed1978

Congenital achromatopsia in a Finnish family.

A family with two achromatic members, a sister and brother, is described. Their parents were first cousins. Eye examination of the 34 relatives examined revealed no abnormalities in 32. The son of their youngest brother was deuteranomalous. However, since this recessive trait is X chromosome linked, this failure was not related to the achromatopsia gene. The granddaughter of their eldest brother had difficulties in colour vision tests and was interpreted as an anomalous trichromat of unclassified nature. This might be a slight intermediate heterozygotic manifestation of the gene. The information of those relatives not examined revealed only a deceased paternal aunt who had had poor vision of an unknown cause. Congenital achromatopsia is rare but nevertheless should be kept in mind in cases of unexplained amblyopia. The nature of this disorder justifies the opthalamologist to inform these patients of the hereditary character of this disease and to give advice on educational guidance to them.

Adult↗
PubMed2000

Short-term pre-surgical treatment with somatostatin analogues, octreotide and lanreotide, in acromegaly.

Eighteen patients with symptoms of active acromegaly were treated with somatostatin analogues for 4 weeks before surgery. Both before and after the treatment, levels of growth hormone (GH), prolactin (PRL), insulin growth factor -I (IGF-I), luteotropin (LH), folliculostimulin (FSH) and subunit alpha of glycoprotein hormones were estimated. Glucose tolerance test, magnetic resonance imaging (MRI) examination, sight acuity and field of vision tests were also performed. The same tests were performed on ten control patients with clinically and biochemically active acromegaly, subjected to surgery but not treated with somatostatin analogues. In six patients treated with somatostatin analogues GH levels decreased significantly to less than 5 ng/ml and in two patients remained elevated while in 10 patients GH level decreased and ranged from 6.1 to 42.9 ng/ml. In 13 patients we observed a decrease in IGF-I to normal levels (<400 ng/dl) and in 3 patients we noted a decrease to levels slightly higher than normal. There was also a slight decrease in alpha subunit concentration. In the glucose inhibition test 4 patients demonstrated normalized GH levels. In patients with elevated PRL and TSH levels, treatment with somatostatin analogues induced their decrease. No changes were observed in levels of LH and FSH. After therapy MRI examination disclosed a decrease in tumor volume in two patients (by 20 and 25%, respectively) and no changes in tumor size in 16 patients. The two patients with a decreased tumor volume also showed normalized glucose tolerance tests. All patients manifested an improved clinical condition. Neurosurgeons disclosed a decreased tumor consistency which greatly facilitated surgical procedure. Our studies documented favourable effects of somatostatin analogues on the assayed hormone levels, and on the general condition of the patients as well as on the course of the surgical procedure itself.

Acromegaly↗
PubMed2000

Hydroxychloroquine retinopathy despite regular ophthalmologic evaluation: a consecutive series.

We describe a consecutive series of patients with hydroxychloroquine (HCQ) retinopathy. Their clinical features illustrate that with normal renal function there is no threshold for total dosage for HCQ toxicity; that color vision testing is important; that almost all patients complain of altered central vision as their first symptom; and that a normal optic fundus does not exclude the diagnosis. Finally, HCQ retinopathy may progress even when the agent is stopped.

Aged↗
PubMed1984

Correlation of color vision deficits and observable changes in the optic disc in a population of ocular hypertensives.

Both glaucomatous cupping and the presence of acquired color vision deficits have been reported to be precursors to the onset of visual field defects in patients with suspected glaucoma. To examine the relationship between early glaucomatous cupping and acquired color vision anomalies, we performed anomaloscope (Pickford-Nicholson) and Farnsworth-Munsell 100-Hue color vision tests in 48 ocular hypertensive eyes with either clinical evidence of early glaucomatous cupping (group 1) or no evidence of glaucomatous cupping (group 2). All patients had normal visual fields, as determined by extensive static perimetry of the central visual field and kinetic perimetry of the peripheral visual field. Although the overall incidence of blue and blue-green color vision anomalies in the ocular hypertensives was comparable with that reported in previous studies, we found no clear association between early glaucomatous cupping and color vision anomalies. The relationship between these two precursors to visual field loss remains unclear.

Adult↗
PubMed2000

Quantitative anomaloscopy and optical coherence tomography scanning in central serous chorioretinopathy.

BACKGROUND: Dyschromatopsia is a prominent sign in a variety of central retinal diseases, such as central serous chorioretinopathy (CSC). The changes in colour vision may be due to either optical or neuronal factors in the diseased retina. The relative contribution from the two causes is unknown, but may be elucidated by obtaining knowledge of the anatomical derangement in the diseased retina in CSC. METHODS: Twenty-six normal persons had their colour vision tested using the Tomey anomaloscope. The calculation of setting range (SR) and central mean point (CMP) for Rayleigh match and Moreland match was optimized, and normal ranges for these values were defined. Subsequently 24 patients with CSC were examined by anomaloscopy and optical coherence tomography scanning, and the measures of colour vision were related to the anatomical changes observed on the scans. RESULTS: The algorithm for calculating SR and CMP which is integrated into the Tomey anomaloscope could be considerably improved to increase sensitivity and reproducibility of these measures. Fifteen patients had abnormal colour vision. Nine patients had pseudo-protanomaly, seven patients had pseudo-tritanomaly, and three patients had abnormalities in both matches. There was no relation between these colour vision abnormalities and the anatomical derangement as seen by OCT in the diseased central retina. CONCLUSION: The findings argue against the notion that the density of retinal cell nuclei, the orientation of photoreceptors, or the size of the central serous detachment are related to the colour vision abnormalities in CSC. The question of whether these abnormalities are due to optical or neuronal factors remains open.

Adult↗
PubMedDate not supplied

Quality of vision: A consensus building initiative for a new ophthalmologic concept.

PURPOSE: Many studies have addressed the quantification of visual acuity, and the conventional method of measuring it has so far demonstrated serious limitations. Vision testing requires new methods that can more precisely express the quality of vision as perceived by the patient. METHODS: This study employed the Delphi method of consensus building. Concepts associated with quality of vision (QoV) were identified by a board of experts and proposed to participating specialists in two subsequent questionnaires. Upon receipt of the completed questionnaires, the replies were classified to determine the building blocks of a consensus. RESULTS: By analyzing the replies to the two questionnaires, the authors determined the key elements of QoV on which a consensus was found among the respondents. CONCLUSIONS: A consensus was reached on the opinion that the quantification of visual acuity by traditional means is inadequate for investigating QoV. Although visual acuity is still a basic element for testing, the experts believe that contrast sensitivity, reading speed, and microperimetry are additional parameters necessary for quantifying QoV. The use of a psychometric questionnaire on visual function could allow a better interpretation of visual impairment.

Consensus↗
PubMed1992

Color vision in dominant optic atrophy.

The color vision of seven patients with dominant optic atrophy in four different families was studied with the following color vision tests: the Standard Pseudoisochromatic Plates part 2, the Lanthony Tritan Album, the Velhagen Pflügertrident plates, and Farnsworth Panel D 15, the Farnsworth-Munsell 100 hue test, the Nagel anomaloscope, and the Besancon anomalometer. In the first family, the mother, one of the sons, and one of the grandsons were affected. The mother had a deutantritan defect; the son and the grandson both had an undefined red-green and a tritan defect. In the third family, the mother and the son were affected. Only the color vision of the son could be examined. He had a tritan defect. In the fourth family, the mother and the daughter were affected. Both had a deutan defect. In the diagnosis of dominant optic atrophy, it must be remembered that not only blue color vision defects occur, but that other kinds of defects are also possible.

Adult↗
PubMed1999

Medical students and congenital colour vision deficiency: unnoticed problems and the case for screening.

The results are given of a questionnaire study to determine the range of difficulties that doctors notice in their work due to congenital colour vision deficiency (CCVD). The study is primarily qualitative. A questionnaire was sent to 40 self-selected doctors, 35 of whom were general practitioners (GPs). All were administered a number of colour vision tests to assess the type and severity of their deficiency. Many difficulties and some ways of overcoming them were reported. Those with a mild deficiency reported fewer difficulties and this relationship was significant. Twenty-three of the doctors also reported difficulties as medical students and their answers are given verbatim. The results are discussed in relation to other studies and data on colour vision. The reasons for and against screening medical students for this deficiency are considered and it is concluded that there is a strong case for screening.

Color Perception Tests↗
PubMed1979

Screening of red-green defects of colour vision with pseudoisochromatic tests.

Fifty red-green defectives and 100 normal subjects were examined with the second edition of the Boström-Kugelberg (BK II, 1972) series and the Ishihara complete edition (1976) of pseudoisochromatic plates. The results are related to those obtained with the first edition of the Boström-Kugelberg test (BK I, 1944) and the Boström test (II B, 1950) and to the classification of defects obtained with the Nagel anomaloscope. The 50 red-green defectives were originally selected by using a combination of the BK I and II B tests. The normal subjects also, passed this preliminary test, as well as an examination with the Nagel anomaloscope. In the final examinations performed under standardized conditions, three red-green defectives passed both the BK II and the BK I test, while eight defectives passed the Ishihara test. Combination of BK II or BK I test with the Ishihara test does not improve the result. Only one defective (a borderline case of protanomaly) passed the separate II B test. Normal subjects were not classified as colour defectives with any of the four pseudoisochromatic tests used. All normal subjects passed both the BK II and the Ishihara test. Classified as suspected red-green defectives (one misreading made in standardized conditions) were five normal subjects with the II B test and one normal subject with the BK I test. In the second edition of Boström-Kugelberg series, the plates numbered 3, 5, 11, 16 and 18 are clearly less effective than respective plates of the first edition. Only the plates numbered 1 and 10 have markedly improved in the second edition. Red-green defectives made on average 0.54 misreadings per plate in the BK II test as compared with respective 0.62 in BK I, 0.69 in the Ishihara and 0.56 in the II B test.

Color Perception Tests↗
PubMed1992

Study of the performance of four prelinguistically or perilinguistically deaf patients with a multi-electrode, intracochlear implant.

Individuals who are born deaf or become deaf in early childhood and are implanted as adults (or in late adolescence) with a multi-electrode, intracochlear implant often cannot understand speech by audition alone. Test results of four implanted patients were analyzed to determine 1. if there was a difference in performance between patients; 2. if there was a relation between performance and history of auditory stimulation; and 3. which tests revealed performance differences. On audition-only and audition-plus-vision tests, overall performance was rank-ordered from lowest to highest for patients 1, 2, 3, and 4, respectively. Patient 4 recognized a few words audition-only. Patients 1 and 2 had long periods of no auditory stimulation; patients 3 and 4 had long periods of auditory stimulation with hearing aids prior to implantation. Tests not revealing differences in performance were identified.

Adolescent↗
PubMed1992

New method based on random luminance masking for measuring isochromatic zones using high resolution colour displays.

A new method of measuring normal hue discrimination ellipses and dichromatic zones using a high resolution colour monitor is described. The test involves the detection of chromatic bars on a grey background (x = 0.305, y = 0.323) having a luminance of 34 cd m-2. Elements of the background matrix of square checks are varied randomly in luminance in space and time to provide random luminance masking (RLM) which compensates for differences in the relative luminous efficiency of different observers. The measurement technique provides a rapid and comprehensive colour vision test. Typical results are presented for normal trichromats, protanopes and deuteranopes without RLM and with the RLM set of 25%. The size of the discrimination ellipse in normal observers is the same in both viewing conditions, but the use of the RLM technique reveals the extent of the isochromatic zones in colour deficient observers.

Color Perception Tests↗
PubMed1989

[The ocular fundus findings in dengue fever].

From September to December of 1988, 24 cases of clinical diagnosed dengue fever accompanied by visual disturbances were studied. A detailed history and a detailed ocular examination including visual acuity, slit lamp examination, fundus examination through dilated pupil and fluorescein angiography were conducted. In some cases, Amsler grid, visual field, visual evoked potential and color vision test were also evaluated. The chief complaints of these 24 patients were blurred vision, central scotoma, floaters, photophobia and halo vision. The intervals between onset of fever and awareness of blurred vision were 2 to 15 days with an average of 7.26 days. The ocular fundus changes included macular hemorrhage, retinal hemorrhage, maculopathy, Roth's spot, diffuse retinal edema, peripapillary hemorrhage vitreous cells and blurring optic disc. The fluorescein angiographic findings included poor choroidal flushing, delayed disc filling, disc extravasation, block fluorescence, capillary obliteration, non filling of macular network, capillary leakage and window defect. Seventeen cases (30 eyes) were followed-up for 2 weeks to 3 months. Visual recovery was good in most of the cases. However, 2 cases (4 eyes) showed poor visual outcome. In this series studied, the principle ocular fundus change caused by dengue fever was macular hemorrhage. This may be due to the capillary changes near the macular area. But in some of the cases, the direct viral invasion and/or indirect changes of the optic nerve, the retinal pigment epithelium or photoreceptors should be considered.

Adolescent↗
PubMed1994

[Methods for screening and surveillance of diabetic retinopathy].

PURPOSE: The aim of this study is to investigate the various tests which allow to detect and follow-up diabetic retinopathy (DR). METHODS: Sixteen patients without DR or with background retinopathy underwent, once every six months: a full ophthalmologic investigation; a fluorescein angiography; a color vision test; a central visual field investigation. RESULTS: The impairment of angiography preceeded damage of eye fundus in 27% of cases. Deficiency of color vision and visual field were found in 57% of cases and in 35% respectively. These preceeded the appearance of angiographic DR in 50% of cases and 32% of cases respectively. CONCLUSION: The importance of such tools in the evolution of DR especially in young diabetics is discussed.

Adult↗
PubMed1995

Adaptation to macular scotomas in persons with low vision.

Persons with scotomas in their central 20 degrees of vision often do not notice these blind spots within their visual field and have visual performance difficulties far exceeding what would be expected from standard vision tests. Before persons with macular scotomas can be assisted to optimally use their remaining vision for a better quality of life, more must be known about how the visual system adapts to a macular scotoma. Important issues include spatial and temporal characteristics of perceptual completion and metamorphopsia, development of preferred retinal loci for fixation and visual search, and dynamics of the preferred retinal locus development in terms of the changes in the eye movement system. With a full understanding of the visual system's adaptation to macular scotomas, new low vision devices and training techniques can be proposed to promote independence in activities of daily living for the person with low vision.

Activities of Daily Living↗
PubMed1982

A survey and evaluation of lantern tests of color vision.

This paper reports a survey of the lantern tests that have been or are used to evaluate the color vision of people who wish to enter occupations that require the ability to recognize colored signal lights reliably. The origin of each lantern is traced and the principal features of each are described. The available data concerning failure rate of normals, the failure rate of people with defective color vision, and the extent to which scores on lantern tests correlate with field trials are summarized. Despite the fact that lantern tests have been used since the turn of the century and that some lanterns have been in use for more than 30 years and some for much longer periods, the available validation data are incomplete and sometimes conflicting. However, the data do indicate that some lanterns may fail a significant proportion of normals and that there is considerable variation between lanterns in the proportion of color vision defectives that will fail. It is noted that most lanterns will pass some protanomals despite their reduced sensitivity to red light and correspondingly short visual range for red signals. The view of Cameron is supported that a more rational approach would be to made a clinical diagnosis of the type of color vision defect, to reject protanopes, deuteranopes, and protanomals and to use a lantern test only to determine which deuteranomals should be accepted.

Aerospace Medicine↗
PubMed1981

Digoxin retinal toxicity. Clinical and electrophysiological evaluation of a cone dysfunction syndrome.

A 70-year-old man was studied both during and after resolution of clinical digoxin toxicity using color vision tests, ganzfeld electroretinography and electro-oculography. Concomitant administration of quinidine sulfate probably contributed to digoxin toxicity. Abnormalities in color vision and subnormal amplitude and prolonged implicit time for cone-mediated electroretinogram (ERG) responses suggested a cone dysfunction syndrome. The electro-oculographic light-to-dark ratio during clinical toxicity was high for our laboratory, but this is probably normal. Notable improvement was seen in color vision and the ERG after cessation of digoxin therapy. Inhibition of sodium-potassium adenosine triphosphatase by digoxin probably influences normal uptake of extracellular potassium by Müller's cells and other retinal neurons. This mechanism may contribute to subnormal, prolonged cone-mediated ERG responses in retinal toxic reactions from cardiac glycosides.

Adaptation, Ocular↗