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PubMed2026

Near and distance vergence facility provides complementary clinical information in concussion-related convergence insufficiency.

PURPOSE: To compare near and distance vergence facility testing in adolescents and young adults with concussion-related convergence insufficiency and evaluate changes following office-based vergence/accommodative therapy (OBVAM). METHODS: This secondary analysis of the CONCUSS randomized clinical trial evaluated vergence facility at near (40&#xa0;cm) and distance (4&#xa0;m) using a 12&#x394; base out/3&#x394; base in prism flipper. Participants aged 11-25&#xa0;years with concussion-related convergence insufficiency were randomized to immediate or 6&#xa0;weeks delayed OBVAM. Vergence facility was assessed at baseline, outcome time 1 assessment (after 12 therapy sessions for the immediate group and 6&#xa0;weeks of watchful waiting for the delayed group), and outcome time 2 assessment (after both groups completed 16 therapy sessions). Agreement between near and distance vergence facility classifications was evaluated, and treatment-related changes were compared between groups. RESULTS: Of the 106 enrolled participants, 102 completed all study visits. At baseline, the near and distance vergence facility classifications demonstrated substantial discordance. Among 101 participants with both measures available, 49 demonstrated reduced distance vergence facility despite normal near vergence facility, whereas only two showed the opposite pattern (Cohen's &#x3ba;&#xa0;=&#xa0;0.12; p&#xa0;<&#xa0;0.0001). Vergence facility improved following therapy in both treatment groups, with larger early improvements in the immediate-treatment group. CONCLUSIONS: Near and distance vergence facility testing provided complementary rather than interchangeable clinical information in adolescents and young adults with concussion-related convergence insufficiency. Both measures improved following vergence/accommodative therapy, supporting consideration of both testing distances in clinical assessment.

Humans↗
PubMed1983

Practical management of amblyopia.

Our knowledge on the mechanism of amblyopia has gained in recent years from concerted research efforts in basic science and clinical laboratories. Different clinical forms of amblyopia are reviewed and their diagnostic and therapeutic significance discussed. In spite of etiologic differences there are pathophysiological similarities. The value of the time proven constant occlusion treatment of the sound eye remains unchallenged even though minor modifications have become necessary to prevent occlusion amblyopia in infants and young children. Part-time occlusion and penalization are of ancillary value but cannot be considered equal in effectiveness to constant occlusion. Due to increasing public awareness there is a trend toward earlier diagnosis and thus successful treatment of amblyopia. However, more efforts must be directed toward including newborns in visual screening examinations.

Amblyopia↗
PubMed1983

Penalization in strabismus.

Penalization includes all those methods apart from total occlusion which disturb the central vision of one eye by favouring the other eye. Penalization has a sensory action on functional amblyopia; moreover it also has a motor action, influencing the non-accommodative element of spasm in esotropia. Optical penalization is the most classical method. However, one should also be aware of penalization with partial occlusion or fogging, penalization with mydriatics, and penalization with sectors, which are very often used in association with the classical technique.

Amblyopia↗
PubMed1983

Monocular visual form deprivation in human infants.

A preferential looking technique was used to measure visual acuity in human infants under one year of age who experienced monocular visual form deprivation. Of the 14 cases reviewed, 9 infants had monocular occlusion as therapy for esotropia; 3 infants had unilateral opacities of the ocular media; and 2 infants had unilateral eyelid closure from infection or burns. Despite differences in exact mode of deprivation, the effects on visual acuity were similar. There was a reduction in visual acuity in the deprived eye and a simultaneous increase in acuity of the non-deprived eye. These effects of monocular deprivation were not permanent. Recovery occurred with reverse deprivation or by simple cessation of the deprivation.

Cataract↗
PubMed1979

The superior oblique: a challenging extraocular muscle.

Isolated paralysis of one or both superior oblique muscles in a consecutive series of 43 patients was found to occur most often by indirect injury to the skull. The etiology in the group of spontaneous cases was mostly vascular. With rare exceptions the latter recovered spontaneously. Those with traumatic palsy may be due to "contrecoup" trauma at the decussation of the nerves or by decompensation of the cerebral fusional mechanism, with dissociation of the images of the two eyes and subsequent vertical deviation. The traumatic cases never recover spontaneously and recession or myectomy of the ipsilateral inferior oblique with or without recession of the contralateral inferior rectus is recommended but only in cases of more than 8 diopters squint, and in cases which do not adapt themselves by minor head-tilting.

Adult↗
PubMed1992

The Visual Advice Centre, Eindhoven, The Netherlands. An intervenient evaluation.

On referral by ophthalmologists, the Visual Advice Centre provides the partially sighted with advice and prescriptions for illumination and visual aids. In this paper the multidisciplinary structure of the centre is presented and the results obtained in the first 18 months of its existence are discussed. Two hundred and ninety-eight patients were referred to the centre in this period. The majority of these patients (79.2%) were older than 60 years. The main cause of visual impairment was macular disease (45.3% of the patients). An interesting finding is that, although reading is an important need, reading problems only constituted 35.9% of the total number of demands for help. From an inquiry into the situation of 125 patients 6 months after prescription, it appears that more than 90% of the aids prescribed are used regularly. The conclusion is drawn that patients referred to the Visual Advice Centre benefit from the multi-disciplinary approach to their problems.

Adolescent↗
PubMed1986

Evaluation of colour vision, mesopic vision, visual evoked potentials and lightness discrimination in adult amblyopes.

This is a study conducted on thirty adult strabismic and anisometropic amblyopes using colour vision tests, the lightness discrimination test, mesopic vision and visual evoked responses, in order to determine the probable site of the amblyopic defect. The results showed that, in its progressed stages, amblyopia is associated with eccentric fixation, abnormal hue discrimination, disturbed lightness discrimination and mesopic vision, and attenuation of the amplitude of the pattern visual evoked response. It is suggested that these abnormalities result from a defect involving the extrastriate higher visual association areas 18 & 19 of Brodmann.

Adult↗