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PubMed1964

PRESENT STATUS OF CORNEAL CONTACT LENSES IN MEDICAL PRACTICE.

Common indications for and contraindications to corneal contact lens wear are outlined. The processes of adaptation of the cornea to a correctly fitted contact lens are described. Biomicroscopic examination of the cornea revealed that 29 of 250 eyes in the authors' series showed small abrasions at some time during the fitting period. The dangers of infection of a simple corneal abrasion by such pathogens as Pseudomonas aeruginosa are stressed. Prophylactic treatment of abrasions with a topical antibiotic preparation containing polymyxin is recommended. Serious criticism is levelled at the practice of estimating the fit of a contact lens by the fluorescein pattern only, and repeated keratometry readings combined with biomicroscopy are considered to be essential. It is proposed that the evaluation, fitting and after-care of the contact lens patient should be the responsibility of an ophthalmologist.

Adaptation, Ocular↗
PubMed1994

Factors affecting light-adapted pupil size in normal human subjects.

PURPOSE: To investigate the effect of age, gender, refractive error, and iris color on light-adapted pupil size in humans. METHODS: Pupil diameters of 91 subjects (age range, 17 to 83 years) with normal, healthy eyes were measured using an objective infrared-based continuous recording technique. Five photopic ocular illuminance levels were used (2.15 to 1050 lumens m-2), and the accommodative status of each subject was precisely controlled at a constant level. RESULTS: Pupil size decreased linearly as a function of age at all illuminance levels. Even at the highest illuminance level, there was still a significant effect of age upon pupil size. The rate of change of pupil diameter with age decreased from 0.043 mm per year at the lowest illuminance level to 0.015 mm per year at the highest. In addition, the variability between pupil sizes of subjects of the same age decreased by a factor of approximately two as luminance was increased over the range investigated. Pupil size was found to be independent of gender, refractive error, or iris color (P > 0.1). CONCLUSIONS: Of the factors investigated, only chronologic age had a significant effect on the size of the pupil. The phenomenon of senile miosis is present over a wide range of ocular illuminance levels.

Accommodation, Ocular↗
PubMed1996

Accommodative vergence is driven by the phasic component of the accommodative controller.

Conflicting opinions exist as to whether the phasic (reflex) component alone or both the phasic and tonic (adaptive) components of the accommodation and vergence systems drive accommodative vergence and vergence accommodation crosslinks. In this study the dissociated phoria to a 2 D target was measured before and after accommodative adaptation to discriminate the two possibilities. Results showed a significant difference in the dark-focus of accommodation pre- and post-near-vision task, indicating that accommodative adaptation had occurred. No significant change occurred in dark-vergence or in the accommodative response to the 2 D target. However, a significant decrease was found in the dissociated phoria presumably because of decreased phasic accommodation and its stimulation of accommodative vergence after the adaptation. This result is consistent with a model in which the accommodative vergence crosslink is driven by phasic accommodation only.

Accommodation, Ocular↗
PubMed2006

ISCEV Standard for Clinical Electro-oculography (EOG) 2006.

The Clinical Electro-oculogram (EOG) is an electrophysiological test of function of the outer retina and retinal pigment epithelium (RPE) in which the change in the electrical potential between the cornea and the ocular fundus is recorded during successive periods of dark and light adaptation. This document sets out a Standard Method for performance of the test, and also gives detailed guidance on technical and practical issues, and on reporting test results. The main object of the Standard is to promote consistent quality of testing and reporting within and between centres. This 2006 Standard, from the International Society for Clinical Electrophysiology of Vision (ISCEV: www.iscev.org ), is a revision of the previous Standard published in 1993, and reviewed and re-issued in 1998.

Adaptation, Ocular↗
PubMed2001

Oculomotor function in the rhesus monkey after deafferentation of the extraocular muscles.

The function of extraocular muscle proprioception in the control of eye movements remains uncertain. In this study, we examined the effect of bilateral proprioceptive deafferentation of the extraocular muscles on eye movements in two rhesus monkeys. Before and after deafferentation, we analyzed baseline ocular alignment, saccades, pursuit, and vestibular eye movements. We also examined visually mediated adaptation of ocular alignment, saccades, and pursuit. Deafferentation of the eye muscles did not affect baseline ocular motor control, either acutely or over a 5-week period of study. Furthermore, visually mediated adaptation of the eye movement subtypes was also unaffected by deafferentation. These results suggest that ocular proprioception in primates is not used in the immediate, on-line control of eye movements and does not interact with visual cues in the adaptive modification of ocular motor function. We conclude that the efferent command (efference copy) provides sufficient information about eye kinematics to the brain for accurate eye movement control in normal monkeys, and that this information is modified by visual feedback independently of proprioception. We hypothesize that proprioception may be used to calibrate the efference copy during development and in response to perturbations by signaling potential mismatches between eye movement information derived from the efferent command and the actual motion of the eye transduced by the proprioceptive organs.

Adaptation, Physiological↗
PubMed1998

Expression of a protein kinase C inhibitor in Purkinje cells blocks cerebellar LTD and adaptation of the vestibulo-ocular reflex.

Cerebellar long-term depression (LTD) is a model system for neuronal information storage that has an absolute requirement for activation of protein kinase C (PKC). It has been claimed to underlie several forms of cerebellar motor learning. Previous studies using various knockout mice (mGluR1, GluRdelta2, glial fibrillary acidic protein) have supported this claim; however, this work has suffered from the limitations that the knockout technique lacks anatomical specificity and that functional compensation can occur via similar gene family members. To overcome these limitations, a transgenic mouse (called L7-PKCI) has been produced in which the pseudosubstrate PKC inhibitor, PKC[19-31], was selectively expressed in Purkinje cells under the control of the pcp-2(L7) gene promoter. Cultured Purkinje cells prepared from heterozygous or homozygous L7-PKCI embryos showed a complete blockade of LTD induction. In addition, the compensatory eye movements of L7-PKCI mice were recorded during vestibular and visual stimulation. Whereas the absolute gain, phase, and latency values of the vestibulo-ocular reflex and optokinetic reflex of the L7-PKCI mice were normal, their ability to adapt their vestibulo-ocular reflex gain during visuo-vestibular training was absent. These data strongly support the hypothesis that activation of PKC in the Purkinje cell is necessary for cerebellar LTD induction, and that cerebellar LTD is required for a particular form of motor learning, adaptation of the vestibulo-ocular reflex.

Animals↗
PubMed1989

Adaptive disorders of accommodation and vergence in binocular dysfunction.

Disturbances of binocular vision are described clinically by the Duane-White classification in terms of the magnitude of the accommodative-convergence ratio (AC/A). Convergence excess and convergence insufficiency are assumed to result from high and low AC/A ratios respectively. It is assumed that the abnormal AC/A ratio is an independent variable that underlies abnormal phorias. However, recent studies have demonstrated that the AC/A ratio is inversely related to the adaptability of tonic accommodation (lens adaptation) and directly related to adaptability of tonic vergence (prism adaptation). We have tested whether clinical categories of convergence excess and convergence insufficiency are associated with insufficient and excessive adaptation of tonic accommodation and tonic vergence. Results demonstrate greater amplitude and duration of accommodative after-effects (lens adaptation) in the convergence insufficiency than the convergence excess group. Vergence after-effects (prism adaptation) had the reverse trend for the two groups. These results indicate that adaptive disorders of accommodation and vergence may underlie binocular disorders in symptomatic patients categorized as convergence excess and convergence insufficiency.

Accommodation, Ocular↗
PubMed1988

Differences in adaptation of tonic accommodation with refractive state.

It has recently been demonstrated that intersubject variations in tonic (dark focus) levels of accommodation are related to corrected refractive state (McBrien and Millodot, 1987). The aim of the present study was to investigate the effect of sustained visual tasks on the tonic level of accommodation in different refractive groups. Eleven hyperopes, 16 emmetropes, ten early onset myopes and ten late onset myopes had their tonic accommodation measured with the objective infrared optometer Canon Autoref R-1 before and after a 15 min sustained visual counting task. The post-task tonic accommodation level was monitored for 15 min to assess the decay rate of any observed task-induced changes in tonic accommodation. Subjects repeated the experimental procedure for four task locations (6 m, pre-task tonic position, 37 cm and 20 cm). Late onset myopes showed significant positive (myopic) changes in their tonic level of accommodation at both near viewing distances, which showed no evidence of decay during the 15 min post-task monitoring period. Hyperopes, however, underwent transient "counteradaptive" decreases in their tonic level of accommodation after sustained near viewing. Emmetropes and early onset myopes showed little change in tonic levels at the two near distances. Differences between groups were also obtained at tonic and far viewing distances. Post-task changes in tonic accommodation demonstrated only a weak negative correlation with pre-task tonic accommodation levels at each task distance. It is proposed that the observed differences in adaptation of tonic accommodation among refractive groups may be related to variations in autonomic innervation of the ciliary muscle.

Accommodation, Ocular↗
PubMed1990

Proximally induced accommodation and accommodative adaptation.

To determine the effect of proximally induced accommodation (PIA) on accommodative adaptation, this study has examined the posttask shift in tonic accommodation (TA) following 5-min monocular viewing of equivalent-sized targets located at distances of 0.33 and 5 m. The distal target was viewed through a negative lens to equate the dioptric stimuli (3 D). The steady-state accommodative response was measured subjectively in 10 subjects using a Hartinger coincidence optometer. A significant correlation was observed between the degree of adaptation following the two conditions, with the magnitude of adaptation for the distal target being approximately half that for the nearer target. Furthermore, adaptation magnitude was inversely correlated with pretask TA under both conditions. These results indicate that PIA can produce accommodative adaptation. The implications of this finding are discussed with regard to models of the accommodative mechanism.

Accommodation, Ocular↗
PubMed1981

Adaptability of the vestibulo-ocular reflex to vision reversal in strobe reared cats.

Optical reversal of vision brings about adaptive changes in the vestibulo-ocular reflex (VOR) tending to reduce retinal image slip during head movement. The present experiments investigated this form of adaptation in cats whose complement of direction sensitive central visual cells had been substantially reduced by rearing in 8 Hz stroboscopic light. Horizontal vision reversal was produced by dove prisms carried in a skull-mounted mask. A scleral eye coil was used to measure horizontal eye movements. VOR gain and phase were measured in the dark during sinusoidal rotation using test stimuli of 1/8 Hz and 5- or 20 degrees/sec velocity amplitude. Initially, strobe reared cats produced virtually normal VOR in the dark, except for slight but significant exaggeration of the normal phase advancement to be expected at 1/8 Hz. Addition of their familiar strobe illumination produced almost perfect oculomotor compensation. Maintained vision reversal in both strobe and normal illumination produced similar patterns of adaptive change in normal and strobe reared subjects, i.e. all animals exhibited an initial fast, and subsequent much slower, stage of gain attenuation, with similar changes in phase. Thus, strobe rearing did not prevent the development of an essentially normal VOR, nor did it interfere significantly with the ability to adapt in response to vision reversal. Since strobe rearing depletes direction selective visual movement detectors in the cortex and superior colliculi, it is inferred that signals responsible for activating the adaptive process are probably carried mainly in the accessory optic, rather than cortical and collicular, visual system.

Animals↗
PubMed1984

Preoperative prism adaptation in acquired esotropia.

41 patients with acquired esotropia who did not have preoperative prism adaptation were compared to 50 patients who were prism-adapted prior to surgery. Surgical success was evaluated at a postoperative period of 6 months. 82% of the patients who responded to prism adaptation had a successful surgical result as compared to only 51% of the patients who did not wear prisms preoperatively.

Accommodation, Ocular↗
PubMed1987

Fatigue of accommodation and vergence modifies their mutual interactions.

Aftereffects of accommodation and convergence demonstrate the adaptability of these two visual motor systems. These aftereffects were reduced after ramp tracking exercises of either accommodation or vergence, and this reduced aftereffect or fatigue was associated with an increase of accommodative vergence and vergence accommodation. When one motor system (accommodation or vergence) adapted more readily than the other, fatigue caused an increase of the cross-link interaction originating from the more adaptable motor system and a reduction of the cross-link interaction originating from the less adaptable motor system. These results suggest an inverse relationship between adaptation and the cross-link interactions between accommodation and vergence and that adaptation of tonic accommodation and tonic vergence is a process that underlies plasticity of accommodative vergence and vergence accommodation respectively.

Accommodation, Ocular↗