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PubMed2002

Do poor nutrition and display screens affect visual acuity in children?

Two studies conducted in Scotland have shown an increase in visual acuity (VA) screening failure among primary school-aged children in recent years. Two other trends were observed during the same period - an increase in children bringing packed lunches to school, and increased access to display screen equipment (DSE) including television, computers and hand-held computer games. This study set out to assess if either DSE use of poor diet could be linked with visual acuity screening failure in Scottish primary school children. Information was collected on diet and DSE use from 1384 children who had received VA screening in eight primary schools in Glasgow. After controlling for deprivation, DSE use other than watching television was associated with an increased risk of VA screening failure, as was a 'poor' diet. If these findings are confirmed by other studies and a causal link can be made, then health education at school could be designed to prevent VA screening failure.

Child↗
PubMed1997

Projected color slides as a method for mass screening of red-green color deficient individuals.

University students (111, both male and female) were screened for red-green color deficiency using projected 35 mm slides reproduced from Ishihara and H-R-R color plates. Ishihara and H-R-R color plates were tested in the same individuals at a second setting and the responses compared: 6.3% of the students were identified as color deficient by the Ishihara and 80.2% by the H-R-R projected slides while 5.4% were designated color blind by the Ishihara plates and 4.5% by the H-R-R plates. The sensitivity of both screening systems was 100%; the specificity of the Ishihara slides was 98.1% compared to only 20.8% for the H-R-R. The 9.8% prevalence of red-green deficiency detected by the Ishihara plates and 8.2% by the H-R-R plates for males is similar to the 6 to 9% frequency found for Caucasian males in other population studies. Within rigid guidelines, projected color slides have potential usefulness as a screening method for detecting individuals with red-green color deficiencies.

Adult↗
PubMed1993

Correlates of cognitive function scores in elderly outpatients.

OBJECTIVE: To determine medical, ophthalmologic, and demographic predictors of cognitive function scores as measured by the Telephone Interview for Cognitive Status (TICS), an adaptation of the Folstein Mini-Mental Status Exam. A secondary objective was to perform an item-by-item analysis of the TICS scores to determine which items correlated most highly with the overall scores. DESIGN: Cross-sectional cohort study. SETTING: The Glaucoma Consultation Service of the Massachusetts Eye and Ear Infirmary. SUBJECTS: 472 of 565 consecutive patients age 65 and older who were seen at the Glaucoma Consultation Service between November 1, 1987 and October 31, 1988. MEASUREMENTS: Each subject had a standard visual examination and review of medical history at entry, followed by a telephone interview that collected information on demographic characteristics, cognitive status, health status, accidents, falls, symptoms of depression, and alcohol intake. RESULTS: A multivariate linear regression model of correlates of TICS score found the strongest correlates to be education, age, occupation, and the presence of depressive symptoms. The only significant ocular condition that correlated with lower TICS score was the presence of surgical aphakia (model R2 = .46). Forty-six percent (216/472) of patients fell below the established definition of normal on the mental status scale. In a logistic regression analysis, the strongest correlates of an abnormal cognitive function score were age, diabetes, educational status, and occupational status. An item analysis using step-wise linear regression showed that 85 percent of the variance in the TICS score was explained by the ability to perform serial sevens and to repeat 10 items immediately after hearing them. Educational status correlated most highly with both of these items (Kendall Tau R = .43 and Kendall Tau R = .30, respectively). CONCLUSION: Education, occupation, depression, and age were the strongest correlates of the score on this new screening test for assessing cognitive status. These factors were stronger correlates of the TICS score than chronic medical conditions, visual loss, or medications. The Telephone Interview for Cognitive Status is a useful instrument, but it may overestimate the prevalence of dementia in studies with a high prevalence of persons with less than a high school education.

Accidental Falls↗
PubMed2002

Incidence of retinopathy of prematurity in very-low-birth-weight infants born at Kalafong Hospital, Pretoria.

INTRODUCTION: Retinopathy of prematurity (ROP) is a complication of prematurity, is diagnosed by ophthalmological screening of infants at risk (birth weight < or = 1,500 g), and may lead to blindness. The incidence of ROP is under-reported in developing countries, including South Africa. Published data from the USA (CRYO-ROP) show that black infants have a lower incidence of threshold ROP than their white counterparts (3.2% v. 7.4%). Preliminary results of a screening programme initiated at Kalafong Hospital in 1999 are reported. AIM: To determine the incidence of ROP in infants with a birth weight of < or = 1,500 g born at Kalafong Hospital. PATIENTS AND METHODS: Consecutive infants were enrolled at birth and screened for ROP 4-6 weeks later by indirect ophthalmoscopy. Repeat examinations were performed until vascularisation was complete or until the infant reached a postconceptional age of 40 weeks. Infants with stage 3 ROP who developed threshold disease were treated with cryotherapy or laser therapy. RESULTS: One hundred and forty-five infants were enrolled over 10 months (15 February 1999-25 December 1999); of these 94 were screened. Of the remaining 51 infants, 24 died before screening and 27 were discharged before screening and were lost to follow-up. ROP was diagnosed in 23 of the 94 infants screened (24.5%). Stage 1 and 2 ROP occurred in 17 of the infants screened (18.1%) and stage 3 ROP in 6 (6.4%), of whom 4 (median birth weight 995 g, range 900-1,450 g) developed threshold ROP and were treated. CONCLUSIONS: The incidence of ROP in black very-low-birth-weight infants born at Kalafong Hospital is 24.5%. The incidence of threshold ROP is 4.3% (3.2% in infants < or = 1,250 g) and correlates with published data from the USA. Infants with a birth weight < or = 1,500 g should receive ophthalmological screening to diagnose stage 3 ROP timeously.

Black or African American↗
PubMed1995

An optical practice based diabetic eye screening programme.

In many cases, blindness due to diabetic retinopathy can be prevented provided treatment with laser photocoagulation is used at the correct time. A screening programme is required to identify cases of sight threatening retinopathy. An optical practice based diabetic eye screening programme has been established in Dorset. The optometrist undertaking the examination is paid a fee. The findings are recorded on a coded form and sent to the hospital diabetologist who recalls positive cases. Seventy-six optical practices have joined the scheme and 3224 patients have been screened in the first 6 months (Dorset population 655,000). In the Poole area (population 230,000), 1922 patients were screened and 129 (6.7%) were recalled in 6 months. Outcome of 3 months screening, identified 59 recalls. Referral to the opthalmologist was made in 15 cases for potentially sight threatening retinopathy, 14 cases were followed in the diabetic clinic for significant background retinopathy, and 24 cases were returned to the annual screening in the optical practices. Six cases where the patients either failed or were unable to attend were reviewed by the GP. An optical practice based diabetic eye screening programme has been successful in screening a large number of patients.

Diabetic Retinopathy↗
PubMed1993

Videographic Hirschberg measurement of simulated strabismic deviations.

PURPOSE: To demonstrate the potential use of subpixel image processing methods to perform automated Hirschberg measurements of strabismic deviations using relatively inexpensive personal computer hardware; to determine if the method might allow screening for strabismus using full-face video images obtained from a distance of 1 meter. METHODS: Strabismic deviations (< 25 prism diopters) were simulated by means of induced asymmetric fixation. A ring of coaxial infrared light-emitting diodes (LED) were used to generate first Purkinje reflexes. Computerized image analysis with subpixel processing was used to measure the locations of the first Purkinje reflexes and pupil centers of video images of 10 normal subjects, following the technique of the clinical Hirschberg test. The apparent strabismic deviation was calculated from the relative asymmetry of the center of the corneal reflex ring to the pupil center in each eye. RESULTS: In 10 normal subjects, there was a statistically significant linear correlation of Hirschberg horizontal reflex deviation with asymmetric fixation pseudo-esotropia (0.85 > or = r2 > or = 0.99, P < 0.05). CONCLUSIONS: The Hirschberg test is used manually to detect strabismus in infants and children but requires a highly skilled examiner. The image processing method described here requires no operator interpretation and may make the test more applicable. The results suggest that this technology may be appropriate for a screening instrument.

Adult↗
PubMed1990

Blindness and visual impairment in an American urban population. The Baltimore Eye Survey.

Data on the prevalence of blindness and visual impairment in multiracial urban populations of the United States are not readily available. The Baltimore Eye Survey was designed to address this lack of information and provide estimates of prevalence in age-race subgroups that had not been well studied in the past. A population-based sample of 5300 blacks and whites from east Baltimore, Md, received an ophthalmologic screening examination that included detailed visual acuity measurements. Blacks had, on average, a twofold excess prevalence of blindness and visual impairment than whites, irrespective of definition. Rates rose dramatically with age for all definitions of vision loss, but there was no difference in prevalence by sex. More than 50% of subjects improved their presenting vision after refractive correction, with 7.5% improving three or more lines. Rates in Baltimore are as high or higher than those reported from previous studies. National projections indicate that greater than 3 million persons are visually impaired, 890,000 of whom are bilaterally blind by US definitions.

Adult↗
PubMed1994

[Video refraction measurement in the first year of life].

BACKGROUND: 426 children were examined, using the isotropic photorefraction method (Atkinson et al. 1981). The aim of this study was to analyze whether the frequency of convergent strabismus and/or amblyopia would increase, particularly in cases of high ametropia, and whether the early prescription of spectacles would be beneficial. The preliminary results of this study are presented here. MATERIALS AND METHODS: 426 children aged between 5 and 12 months were examined. Family history, particularly involving strabismus, ametropia and amblyopia, was ascertained and taken into consideration. RESULTS: Spherical refraction: 92% of the children were emmetropic or slightly hyperopic (< or = +2.5 D). 3.4% were hyperopic (> +2.5 D spherical equivalent) and 4.6% were myopic (0.9 > or = -2.0 D). Astigmatism: 85% had no or mild (< or = 1.5 D) astigmatism. Values greater than 3.5 D were rarely seen. Anisometropia: 67% of the children had no side-difference and only 2.4% had anisometropia with values greater than 1.5 D. Family history/orthoptic findings: 2.6% of the examined population had strabismus. In 12.2% of all the cases one or more first degree relatives had strabismus. Hyperopia and strabismus were found more frequently in this latter group, namely hyperopia (> +2.5 D spherical equivalent) in 13.6% and strabismus in 11.5%. CONCLUSIONS: Refractive errors greater than 2.5 D were seldom seen in this study, and yet were more frequently detected in families with a history of strabismus. In our opinion, isotropic photorefraction is a method most suitable to screening these especially high-risk groups.

Amblyopia↗
PubMedDate not supplied

Mobile retinal screening--a Waikato Area Health Board initiative.

In conclusion the Waikato Area Health Board has shown that regular eye review can be offered to all patients with diabetes by means of a register of people with diabetes, and the provision of a mobile retinal screening service. The use of a mydriatic camera is a practical and cost-effective way of providing this service, and with suitably designed carrying systems it can be provided at almost any venue, ensuring access even for people in remote rural areas. Demands for our service have meant that we are now offering retinal screening to other Waikato communities which do not have access to a visiting ophthalmologist.

Diabetic Retinopathy↗
PubMedDate not supplied

Visual status of industrial workers.

Two hundred and eighty four industrial workers were screened to determine their visual acuity. Significant visual impairment was observed in 21.8% individuals and moderate impairment in 34.5% of cases. Convergence insufficiency was a problem in 9.86% of the workers. Since uncorrected refractive errors are a prelude to disastrous workplace related eye injuries, it is recommended that prior to job placement all workers undergo visual acuity screening and get their refractive errors rectified.

Adult↗
PubMed2006

Screening for retinopathy of prematurity in developing countries.

Improved survival of low birth weight, premature babies in India has increased the incidence of retinopathy of prematurity. Western reports describe screening criteria to pick up babies most at risk. However, our population of at-risk neonates is likely to be different, as most nurseries in India are not very well equipped. Our aim was to develop a screening strategy appropriate for our conditions. Ophthalmic records of 60 neonates with gestational age < or =35 weeks and/or birth weight < or =1500 g, born over a 1-year period, were retrospectively reviewed. Laterality, location and stage of retinopathy of prematurity were recorded. Age at detection, at threshold disease and at maximum stage was recorded, and progression or regression of retinopathy noted. The incidence of retinopathy was 13/60 (21.7%) and of threshold disease was 3/60 (5.0%). Threshold disease was never seen before 5.5 weeks PNA. Zone I disease invariably, zone II disease in 12.5% cases and zone III disease never progressed to threshold stage. Most (10/13; 76.9%) cases regressed without treatment. Screening for retinopathy should commence at 4 weeks PNA (post-neonatal age). Screening time, discomfort to the baby and complications can be reduced by examining temporal retina first. If normal, the nasal retina need not be examined. Also, babies with zone III disease need not be followed up to complete visualization. Retinal vascular dilatation, resistance to pupillary dilation and persistence of tunica vasculosa lentis can be indicators of intensive screening.

Age Factors↗