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PubMed1982

The Medical University of Southern Africa after 5 years.

The Medical University of Southern Africa (MEDUNSA), created by an Act of Parliament on 1 August 1976, comprises Faculties of Medicine, Dentistry and Veterinary Science. Optimal co-operation between these faculties in teaching, research and even patient care is basic to the education philosophy of MEDUNSA. The first students enrolled 5 years ago, in February 1978, and will graduate on 26 November 1982. Students were admitted to degree courses in veterinary science and dentistry at the beginning of 1982. The training of nurses and supplementary health-professionals (encompassing the fields of physiotherapy, occupational therapy, radiography and dietetics) take place within the Faculty of Medicine. Schools of pharmacy and optometry will open in 1984. Although the university is empowered to admit students to all racial groups it sees its primary task as being the training of Black health professionals. Students of other races are at present admitted only when suitable Black candidates are not available. Academic standards are monitored by respective statutory councils, and are on a par with other, comparable South African health science faculties. MEDUNSA is enthusiastic to co-operate with neighbouring states in the field of health education, and students from as far afield as Malawi and Zaire number among our graduates.

Faculty↗
PubMed1983

Optical prophylaxis for environmental myopia: an epidemiological assessment of short-term effects.

The biologically plausible concept that relief of accommodation may reduce myopic progression, although not confirmed and not universally accepted, has nevertheless strongly influenced the practice of preventive optometry. Yet, no quantitative estimates of the strength of this postulated effect were found in the literature. From a cohort study of 120 young (18 to 20 years of age) male military students with low initial refractive error (less than or equal to +/- 1D, spherical equivalent), estimates were made of the short-term (5 months) effect of two forms of optical treatment to prevent school-related myopia. The cumulative incidence of clinically significant (greater than 0.25 D, spherical equivalent) myopic progression was less [standardized morbidity ratio (SMR) = 0.45] among those prescribed monofocal convex lenses (+1.25 D over far Rx) and prisms (2 delta base-in OU) and even more reduced (SMR = 0.32) among those prescribed bifocals (+1.5 D near adds) compared with those receiving sham treatment (no. 1 pink tint). Placebo-treated patients were more than twice [rate ratio (RR) = 2.2, 1.5] as likely as the monofocal group, and more than three times (RR = 3.2, 1.7) as likely as the bifocal patients, to suffer myopic progression during the period of follow-up. Etiologic fractions (EF, increase in myopic progression if treatment were eliminated) of 37 and 47% and preventive fractions (PF, decrease in myopic progression attributable to the treatment) of 27 and 32% were estimated for the monofocal and bifocal treatments, respectively. These findings suggest that while both modes of therapy are efficacious, the bifocal form is 20% (32/27 = 1.2) more preventive.

Adolescent↗
PubMed1978

Easier and more productive study and desk work.

This article is a uniquely optometric public service. Working from an optometric model of vision, the authors collected and condensed extensive information from many professions and scientific fields, developed additional material, field-tested the information, and created an original, easy-to-apply handbook to help the very large segment of the population that does near tasks. Only an optometric model of vision can tell us how near tasks produce a general tightening of the musculature and undesirable changes in visual status, which in turn lower efficiency at near tasks; and that the way to counteract this process is to have minimal obstructions to movement at such tasks (thus, the information on chair and table design, shoes, etc.). Only an optometric model of vision makes us aware of the value of breaks to offset tightening, and tells us when to take breaks, what to do during breaks, and specific exercises to reduce near task stress. Only an optometric model tells us that the lighting which others consider adequate is often excessive and leads to fatigue, and allows us to determine the proper amount of lighting in general and for the individual. And only an optometric model of vision tells us of the value of adjustable arm typing stands. Because of its approach, "Easier and More Productive Study and Desk Work" reinforces the view of optometry as a broad-based discipline which relates vision to all areas of human performance.

Efficiency↗
PubMed1982

Vascular anastomoses in ocular toxoplasmosis.

Toxoplasmosis is a frequent cause of uveitis seen in clinical practice and fundus scars typical of ocular toxoplasmosis are common. It has been reported that vascular anastomoses between the retinal and choroidal circulation can occur through the damaged Bruch's membrane in fundus scars resulting from ocular toxoplasmosis. Although it has been stated that these vascular anastomoses are a rare occurrence, it has also been suggested that they are relatively common. In order to determine the prevalence rate of patients with vascular anastomoses in toxoplasmic fundus scars, 3,850 consecutive optometry patient files were studied retrospectively. Seventy-four patients (1.92%) had a clinical diagnosis of ocular toxoplasmosis with typical fundus scars, and two of these patients (2.70%) had documented vascular anastomoses.

Chorioretinitis↗
PubMed1982

A mammoth vision screening--public relations and public service.

This paper describes the methods employed and the results of a very large vision screening program co-sponsored by the State College of Optometry SUNY and WABC-TV. The paper is designed so that other groups might organize a similar public service program.

Adult↗
PubMed1982

The role of selected health problems in the causation of juvenile delinquency.

This paper examines the role of selected health problems in the causation of delinquency. These problems are considered in the framework of sociological theories of delinquency causation in order to attempt to integrate research from the fields of optometry, audiology, neurology, and pediatric medicine into the mainstream of sociological theories of delinquency causation. A review of the research indicates strong and consistent relationships between the presence of these health problems and delinquency, especially more serious delinquency. While the research indicates a direct and consistent relationship, it suggests but does not establish a causal one. Nevertheless, the findings are provocative in indicating future research directions and in suggesting policy initiatives for those concerned with the prevention of some portion of delinquency.

Adolescent↗
PubMed1980

Incidence of vision difficulties in children with learning disabilities.

The article discusses the incidence of three categories of visual difficulties found in a learning disabled population seen at the Southern California College of Optometry. Four of the areas showing the largest incidence were also examined in a nonlearning disabled clinic population. The relationship between the two populations shows a much larger incidence of these problems in the learning disabled group, although the problems were noted in both groups.

Accommodation, Ocular↗
PubMed1978

The AO SR IIItm Subjective Refraction System: comparison with Phoropter measures.

Subjective measures of refractive error were obtained on 530 eyes using the AO SR III Subjective refraction System (operated by a trained secretary) and using a phoropter (operated by optometrists and optometry students) in a clinical setting. Comparison of these measures from the present study and from a previous study by Bannon leads us to conclude that the SR III instrument is capable of estimating refractive error with good agreement with conventional refractive methods. Comparison with the Acuity Systems 6600 Auto-RefractorTM was also made.

Adolescent↗
PubMed1995

Sarcoid optic neuropathy: a case report.

BACKGROUND: Sarcoidosis is frequently overlooked as a cause of optic neuropathy. A cascade of immune interactions has been cited in the pathogenesis. Optic nerve involvement can be the initial manifestation of systemic disease, making the diagnosis even more elusive. Compatible clinicoradiographic and abnormal laboratory findings along with histologic evidence of noncaseating granuloma are necessary to secure the diagnosis of sarcoidosis. METHODS: A case report is presented of a 41-year-old patient with severe papillitis and a junctional scotoma as the first declaration heralding neurosarcoidosis (NS). Co-management with a neuroophthalmologist at an academic teaching hospital prompted the necessary diagnostic studies to preserve vision. RESULTS: Sarcoidosis was diagnosed on the basis of the patient's clinical presentation of rapid vision loss, enlarging mass in the anterior visual pathway revealed by CT and MRI, as well as increased uptake of gallium in the lungs and lacrimal glands. Also considered in the differential diagnosis were glioblastoma, lymphoma, and demyelinating disease. CONCLUSIONS: This case represents an example of triage referral involving optometry and academic ophthalmology. Rapid intervention with intravenous corticosteroids should be considered in the face of atypical optic neuritis with a suspected inflammatory etiology.

Adult↗
PubMed1995

The fragile X female: a case report of the visual, visual perceptual, and ocular health findings.

BACKGROUND: Fragile X syndrome is one of the most frequently encountered etiologies of X-linked mental retardation. Even though it is second only to Down syndrome in prevalence among children with chromosomal abnormalities, few studies have investigated the visual, visual perceptual and ocular health anomalies associated with this syndrome. No studies have been published that report on these areas for females with fragile X. This case report describes a 10-year-old white female with fragile X syndrome who exhibited numerous oculo-visual and perceptual abnormalities. METHODS: A 10-year, 7-month-old white female diagnosed as having fragile X syndrome was examined in the Illinois Eye Institute/Illinois College of Optometry Department of Pediatrics and Binocular Vision using diagnostic techniques appropriate for special populations. These techniques included a battery of tests that determine binocular vision function, ocular health status and visual perceptual abilities. RESULTS: Oculo-visual abnormalities noted include a non-active chorioretinal lesion, refractive amblyopia, anisometropia, accommodative insufficiency, and convergence excess, as well as mild to severe dysfunctions in visual motor integration, ocular motilities, laterality/directionality, visual figure ground, visual closure, visual form constancy, visual memory and visual sequential memory. CONCLUSION: Although thousands of articles, monographs, and textbooks have been written describing the numerous anomalies associated with the fragile X syndrome, little has been published in the area of oculo-visual and visual perceptual dysfunctions associated with this frequently encountered genetic abnormality. This paper is the first to demonstrate the presence of ocular health anomalies and learning-related vision problems that could adversely affect the individual's academic performance and rehabilitative program. Additional research is needed to ascertain the prevalence of these disorders within the fragile X community.

Child↗
PubMed1995

The photic sneeze response: a descriptive report of a clinic population.

BACKGROUND: The prevalence of the photic sneeze response (PSR) as well as other characteristics have been studied in selected populations. However, the PSR has not been investigated in a general eye care patient population. This study was performed in an attempt to characterize the epidemiologic, descriptive, and demographic aspects of the photic sneeze response among patients attending for primary eye care. METHODS: A questionnaire on demographics, risk factors, and triggering stimuli was distributed to 500 consecutive patients presenting for a general eye examination at an academic health center optometry clinic. RESULTS: Three hundred and sixty-seven of 500 questionnaires were returned (73.4%). Among this sample 33% were self-recognized photic sneezers with the majority being females (67%) and Caucasian (94.3%). Statistically significant correlations were found between the presence of photic sneezing and the presence of a deviated nasal septum and a non-significant association was found with tobacco use. Uniform frequency of sneezing does not occur in response to light stimulus; only 12.3% of sneezers responded consistently to sunlight exposure. The majority of sneezers (90.7%) responded with three or fewer sneezes. The interval between successive sneezes was fewer than 19 seconds in 85% of respondents. Fewer than 27% of respondents were able to recall a parent who exhibited a sneeze response. CONCLUSIONS: The PSR is not an uncommon phenomenon. Systemic associations with the PSR are as diverse as deviated nasal septum and tobacco use. Results suggest that there may be a threshold level of light or frequency of light exposure which produces the response and that more patients may acquire the response than inherit it.

Adolescent↗
PubMed1995

Periodic health examination, 1995 update: 3. Screening for visual problems among elderly patients. Canadian Task Force on the Periodic Health Examination.

OBJECTIVE: To provide recommendations to family physicians for screening elderly patients (over 65 years of age) for visual impairment and its common clinical causes. OPTIONS: Visual acuity screening with Snellen sight chart, funduscopy, retinal photography, tonometry and perimetry. OUTCOMES: Delay or prevention of visual deterioration or blindness. EVIDENCE: A MEDLINE search for relevant articles published between January 1986 and December 1993 was undertaken, the bibliographies of the articles were scrutinized for additional articles, and experts were consulted. The highest available level of evidence was used in making recommendations. VALUES: The evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination were used. Preservation of vision was given the highest value in accordance with other guidelines regarding eyesight. BENEFITS, HARMS AND COSTS: Potential benefits are to maintain or improve visual acuity. Potential for harm to patients is minimal. Limited data are available on costs. RECOMMENDATIONS: There is fair evidence to include in the periodic health examination visual acuity testing with a Snellen sight chart and funduscopy or retinal photography in elderly patients with diabetes of at least 5 years' duration (grade B recommendation). The place of funduscopy in the detection of age-related macular degeneration and glaucomatous changes is controversial. For patients at high risk for glaucoma (positive family history, black race, severe myopia or diabetes) it would be prudent to have a periodic assessment by an ophthalmologist. VALIDATION: Recommendations differ from those of the American Academy of Ophthalmology and the American Optometric Association. Recommendations for glaucoma screening are similar to those of the US Preventive Services Task Force. Present recommendations have been reviewed by experts in ophthalmology and optometry. SPONSOR: These guidelines were developed and endorsed by the task force, which is funded by Health Canada and the National Health Research and Development Program. The principal author (C.P.) was supported in part by the Educational Centre for Aging and Health, McMaster University, Hamilton, Ont.

Aged↗
PubMed1994

Adverse reactions during retinal fluorescein angiography.

BACKGROUND: Fast sequence retinal fluorescein angiography is a commonly employed diagnostic procedure within the optometric practice with relatively few serious adverse reactions. A retrospective study was conducted to document the incidence of adverse reactions with this procedure. METHODS: A total of 1,173 patient charts who had undergone intravenous injection for retinal fluorescein angiography at a specility referral clinic or a referral clinic at a school of optometry. All patients had been intra-venously injected with 500 mg of sodium fluorescein in 25% or 10% solution. Adverse reactions were noted within the charts. RESULTS: The most common adverse reaction were nausea (.8% of patients) and urticaria (.6% of patients), with other reactions including emesis and hypoglycemia. Extravasation of dye was noted in .2% of patients. No acute anaphylaxis was noted. CONCLUSIONS: Fast sequence retinal fluorescein angiography is a relatively safe diagnostic test. However, one should be prepared to handle acute anaphylaxis within the office before administering the test because of previously published cases of life-threatening reactions.

Adolescent↗
PubMed1994

Questioning vision readiness in the aviation community of the United States Air Force.

A study was conducted to determine the prevalence of substandard visual acuity in a representative sample of the aviation community. In addition, mobility readiness (ocular), ocular diseases, length of time since last visual examination, and adherence to ocular requirements per AFR 160-43 were assessed. Comprehensive eye examinations were performed in the Optometry Clinic on 68 randomly chosen members scheduled by the participating squadron. Of the 68 individuals, 51 (75%) had not had a professional eye examination in the last 2 years, 17 (25%) were not mobility ready, 15 (22%) had inadequate visual acuity per AFR 160-43, and 3 (4%) had ocular disease. The study suggests that comprehensive visual examinations be performed on a regularly scheduled basis by an optometrist or ophthalmologist to ensure that members see properly to perform assigned duties, that members have required optical materials to be deployment ready, and that members who develop ocular diseases be identified in a timely manner.

Aerospace Medicine↗
PubMed1975

Behavioral effects of children's nearpoint lenses.

Procedures in clinical optometry include the therapeutic and preventive use of lenses for the express purpose of favorably modifying visual behavior in nearpoint activities, especially for children. The research bases for such procedures have been greatly elaborated in recent years. Research evidence now exists to clarify some of the actual effects of lenses upon behavior, indicating possible ways of explaining the underlying mechanisms or processes of such effects, while further suggesting clinical techniques for the appropriate diagnostic determination of nearpoint lens prescriptions.

Child↗
PubMed1994

Ocular manifestations of Sotos syndrome.

BACKGROUND: Sotos syndrome (cerebral gigantism) is a congenital syndrome characterized by large body size for patient age, advanced bone age, and unusual facial characteristics with varying levels of cognitive, developmental and perceptual deficits. While more than 150 cases have been reported, only a single case report has been published in the ophthalmic literature. This study briefly reviews the pertinent aspects of this syndrome and reports on the medical, physical, developmental and ocular manifestations of 32 subjects. METHODS: Our patient population was obtained from several schools and colleges of optometry and private offices and clinics of optometrists and ophthalmologists. The Sotos Syndrome Support Association assisted in obtaining patients for this study as well. All children had been previously diagnosed as having SS. Commonly accepted methods for evaluating young, non-verbal, and/or handicapped children were used. RESULTS: Our findings indicate that moderate to high refractive error (hyperopia), nystagmus, and strabismus (esotropia) are commonly associated conditions of this syndrome. CONCLUSIONS: Since many of our subjects exhibited these amblyogenic precursors, a routine optometric vision evaluation should be an essential part of the individual educational and habilitation plan for all children with Sotos syndrome.

Abnormalities, Multiple↗
PubMed1994

Prader-Willi syndrome.

BACKGROUND: First described in 1956, Prader-Willi syndrome is a neurogenetic condition characterized by infantile hypotonia, hypogonadism and obesity. Mental deficiency, behavioral abnormalities, and obvious dysmorphic features are frequently found as well. It is a relatively common condition, with an incidence estimated to be between 1 in 10,000 to 25,000 live births. Few studies have been published that investigated the ocular defects associated with this syndrome. METHODS: This case report discusses the systemic and oculo-visual abnormalities of a 34-year-old white male enrolled in the Easter Seal Society of Metropolitan Chicago/Illinois College of Optometry Eye Care and Treatment Program. Examination techniques commonly used for patients with cognitive/developmental dysfunctions were utilized. RESULTS: Our findings include ocular hypopigmentation with reduced visual acuity, a myopic refractive error, exotropia, corneal abnormalities, glaucoma, and other ocular and systemic health abnormalities. CONCLUSIONS: Reported ocular findings for patients with Prader-Willi syndrome include iris hypopigmentation with depressed visual acuity, moderate to high refractive error, and strabismus. Individual patients with this syndrome have also been reported with cataracts, congenital ocular fibrosis syndrome, diabetic retinopathy, and congenital ectropion uveal. The numerous ocular, systemic, and functional abnormalities of patients with Prader-Willi syndrome make it mandatory that all routinely receive primary optometric vision care.

Adult↗