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Results for “Vision Screening”

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At least 1,189 records · Page 66Linked to original sources
PubMed2003

Ophthalmic assessment of children before renal transplantation.

OBJECTIVE: To evaluate the usefulness of routine ophthalmic examination before renal transplantation in children. METHODS: We reviewed the records of ophthalmic assessments of renal transplant recipients at The Hospital for Sick Children, Toronto, Ont., from January 1989 to June 1996. If abnormalities had been found, we determined whether they had previously been documented, were related to the renal disease or other systemic disease, had required intervention or had affected visual function. We calculated the maximum statistical chance of detecting a meaningful eye problem at the pretransplantation assessment. We also estimated the direct cost of the ophthalmic assessment and the effect, if any, of the findings on the patient's medical management. RESULTS: We included 107 charts. Before the ophthalmic assessment, 32 patients (30%) had known eye problems. The ocular examination detected abnormalities in 46 patients (43%); the abnormalities had not been detected previously in 14 (13%). New, potentially vision-threatening eye disorders were found in 6 (6%) of the patients. No finding affected the short- or long-term management of any patient. CONCLUSION: Children with chronic renal failure had a high prevalence of ocular abnormalities, but most of the abnormalities did not affect visual function. Although ophthalmic assessment before transplantation did not alter the medical management of the renal transplant patients, consultation may be helpful in selected patients, particularly those who are not already under the care of an optometrist or ophthalmologist and those who have a visual complaint.

Adolescent↗
PubMed2003

Amblyopia.

Amblyopia is a serious medical condition affecting tens of millions of individuals around the world. For the most part it is correctable, assuming that it is promptly recognized and vigorously treated. Amblyopia may result from form deprivation, anisometropia, or strabismus in infants and young children. Basic research in animal models has shown that the major pathologic changes in amblyopia occur in the visual cortex of the brain. The mainstay of treatment remains patching, although penalization has a role to play in the management of moderate degrees of amblyopia. Better methods for early identification of patients with amblyopia are being developed, along with newer novel methods of treatment.

Amblyopia↗
PubMed2003

Guidelines for pediatrician referrals to the ophthalmologist.

It is common in pediatric ophthalmology to see children with eye disorders that have gone undetected for years. Many conditions can progress slowly, are not painful, or are unilateral so as not to be bothersome to the child or noticeable to the parent or physician. Pediatricians often ask what they could have done to confirm the presence of the condition and whether the child should have been referred for specialty examination. The guidelines set forth in this article should clarify for the pediatrician which children warrant referral to the ophthalmologist.

Blinking↗
PubMed2000

Photoscreening.

Explore the source record for details and available documents.

Amblyopia↗
PubMed2001

The feasibility of short automated static perimetry in children.

OBJECTIVE: To evaluate the feasibility of short automated static perimetry using tendency-oriented perimetry in the pediatric population. DESIGN: Prospective observational case series. PARTICIPANTS: Fifty normal children age 6 through 12 years. TESTING: Subjects underwent testing with the Octopus TOP-32 program on the Octopus 1-2-3 automated perimeter. Testing was performed in a typical clinical setting without adaptations to the perimeter, prolonged training, or the use of custom seating. Each eye was tested twice. MAIN OUTCOME MEASURES: Ability to complete automated static perimetry tests with both eyes. Mean sensitivity, mean defect, and loss of variance; gray scale and numeric representations of the field; duration of each test and of the entire session; subjective assessment of each test as normal or abnormal; calculation of test specificity. Comparisons by age and test number were performed. RESULTS: All subjects successfully completed all four tests. The mean duration for each test was 2:30+/- 0.23 minutes. The average time for the whole session, including training, testing both eyes twice, and rest periods, was 25.8+/-4.87 minutes. Improvement in the specificity of the test (fewer abnormal tests in normal children) occurred in direct relation to subject age (R = 0.5). CONCLUSIONS: Automated static perimetry using short, tendency-oriented programs can be successfully performed in normal children age 6 through 12 years in a typical clinical setting. Age was the best predictor of the mean sensitivity, reproducibility, and accuracy of the test, with the most reliable results obtained after 7 years of age. In children 6 to 7 years old, significant interindividual variability was present, and testing success was more dependent on the child's maturity and ability to concentrate. Short automated perimetry seems to be a promising tool for the evaluation of peripheral vision in pediatric patients.

Automation↗
PubMed2001

Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program.

OBJECTIVES: (1) To describe baseline patterns of adherence to American Diabetes Association and American Academy of Ophthalmology vision care guidelines for diabetes in the Diabetic Retinopathy Awareness Program, and (2) to evaluate factors associated with nonadherence. This paper describes the baseline characteristics of a population enrolled in a prospective, randomized clinical trial. DESIGN: Cross-sectional study. PARTICIPANTS: Between October 1993 and May 1994, the study identified 2308 persons with diabetes, 18 years of age or older, who were residents of Suffolk County, New York, via a multimedia community-wide recruitment campaign. INTERVENTION AND METHODS: Eligibility for the trial was determined during a 20-minute phone interview, which included questions about vision care practices; diabetes management; and knowledge, attitudes, and beliefs about diabetes, vision, and diabetic retinopathy. This paper describes these patient characteristics at baseline. Eligible patients would be randomized subsequently to a 2-year diabetes educational intervention arm, which included mailed packets and newsletters focused on vision care, or to a control nonintervention arm. MAIN OUTCOME MEASURE: Nonadherence to guidelines at baseline was defined as the absence of a dilated eye examination during the year before recruitment into the study. RESULTS: Of the 2308 persons interviewed, 813 (35%) did not follow the vision care guidelines; two thirds of this group reported no eye examination in the year before the interview, and one third had an undilated examination. Ophthalmologists performed 49% of the examinations in the nonadherent group, versus 86% in the adherent group. In logistic regression analyses, factors related to nonadherence were: younger age (odds ratio [OR] = 0.97), type 2 diabetes with or without insulin use (OR = 1.62 and 1.99, respectively), shorter diabetes duration (OR = 0.97), last eye examination performed by an optometrist (OR = 5.32) or other nonophthalmologist (OR = 4.29), less practical knowledge about diabetes (OR = 1.57), and no prior formal diabetes education (OR = 1.30). CONCLUSIONS: Within this population, more than one third of participants had not been following vision care guidelines. Nonadherence was linked to several potentially modifiable factors; changes in these factors could enhance the early detection of diabetic retinopathy.

Adolescent↗
PubMed1992

Prevalence of age-related lens opacities in a population. The Beaver Dam Eye Study.

Age-related lens opacities are common and are a frequent cause of loss of vision. The Beaver Dam Eye Study was designed to estimate the prevalence and severity of lens opacities in a rural community in the United States. Adults between the ages of 43 and 84 years, identified by private census, were examined and participated in the study (n = 4926). Photographs were taken of the lenses and were graded in masked fashion according to a standardized protocol. For nuclear sclerosis, more severe levels occurred more commonly in older age groups and in women. Overall, 17.3% had nuclear sclerosis more severe than level 3 in a 5-step scale of severity. Cortical opacities increased with increasing age and were more common in women. They were found in 16.3% of the population. Posterior subcapsular opacities occur in 6.0% of the population. There was a significant trend of greater prevalence at older ages, but no sex effect. The frequency of early cataract increased in both sexes through the age group 65 to 74 years, but declined in those 75 years of age and older. The frequency of late cataract increased consistently with age. Women were more severely affected than men. This study confirms that lens opacities are common in adults in the United States. These data are important for providing for social and health care needs. It is important to determine causes of cataracts in order to develop preventive programs.

Adult↗
PubMed1999

Pediatric photoscreening for strabismus and refractive errors in a high-risk population.

OBJECTIVE: To determine the accuracy of the MTI Photoscreener in detecting strabismus and refractive errors in children. PARTICIPANTS: One hundred children underwent MTI photoscreening followed by complete ophthalmologic examination. Six observers graded the photographs for strabismus, according to the location of the corneal light reflexes, and for refractive error, according to the size and location of the light crescent. RESULTS: The sensitivity of the MTI Photoscreener in detecting any amblyogenic factor was 80% to 91%, with a specificity of 20% to 67%. The sensitivity and specificity for particular amblyogenic factors varied widely among observers. The ranges were as follows: strabismus, sensitivity = 23% to 50%, specificity = 76% to 96%; myopia, sensitivity = 89%, specificity = 48% to 76%; hyperopia, sensitivity = 20% to 80%, specificity = 88% to 96%; and astigmatism, sensitivity = 46% to 77%, specificity = 79% to 89%. CONCLUSIONS: These results suggest caution in relying on photoscreening to detect strabismus and refractive errors in children.

Child↗
PubMed2003

Color vision impairment in workers exposed to neurotoxic chemicals.

Recent research shows that occupational exposure to several solvents, metals and other industrial chemicals can impair color vision in exposed workers. Occupation-related color vision impairment usually results in blue-yellow color discrimination loss or, less frequently, a combination of blue-yellow and red-green loss. The eyes may be unequally involved, and the course is variable depending on exposure and other factors. The pathogenesis of occupational color vision loss has not been elucidated; it may be due to, e.g. a direct action of neurotoxins on receptors, possibly on the cone's membrane metabolism, and/or to an interference with neurotransmitters within the retina. Other possible pathogenetic mechanisms, such as a direct effect to the optic nerve, have also been suggested. Occupational color vision loss is usually sub-clinical, and workers are unaware of any deficit. It can be assessed using sensitive tests, such as the Farnsworth-Munsell 100 Hue (FM-100) or the Lanthony D-15 desaturated panel (D-15 d). The latter is the most widely used for studies in groups of exposed workers, and offers the possibility of a quantitative evaluation of the results by calculation of the Bowman's Color Confusion Index (CCI), or of the Vingrys' and King Smith's Confusion Index (CI). Other advantages of D-15 d are the possibility to perform the test directly at the workplace, and the reproducibility when performed in standardized conditions. In most cases, occupation-related color vision impairment is correlated to exposure levels, and has often been observed in workers exposed to environmental concentrations below the current occupational limit proposed by the ACGIH. Progression with increasing cumulative exposure has been reported, while reversibility is still discussed. Acquired color vision impairment related to occupational exposure to styrene, perchloroethylene (PCE), toluene, carbon disulfide, n-hexane, solvent mixtures, mercury and some other chemicals are discussed. Results show that color vision testing should be included in the evaluation of early neurotoxicity of chemicals in exposed workers. The D-15 d would be useful in the surveillance of workers exposed to solvents and other chemicals toxic to the visual system.

Animals↗
PubMed2002

The gatekeeper in vision care. An analysis of the co-ordination of professional services in The Netherlands.

Data from a national survey were used to explore the position of ophthalmologists, general practitioners, orthoptists, optometrists and opticians in the domain of vision care services. Options for organising the gatekeeper function were analysed. This was done on the basis of six cases that the five key occupations considered as their overlapping areas. Nearly all respondents reported to be consulted by patients with the given complaints, indicating rather unclear boundaries between the professions. Further, the opinions indicated preference for a medical gatekeeper (ophthalmologist, GP) rather than a non-medical one (optometrist). Lack of agreement on suggested gatekeeper options suggest other options to consider, like regional networks of GPs, ophthalmologists, orthoptists and optometrists who share the responsibility for a specified client population. At present, such innovative arrangements are being introduced. GPs and optometrists could share the responsibility for gate-keeping and for referring patients to more specialised services.

Attitude of Health Personnel↗
PubMed1998

Acute visual change.

Changes in vision or loss of vision are common complaints for patients presenting to the emergency department. Such complaints may represent a simple problem related to recent trauma, early evidence of a systemic disease, or may be a vision-threatening lesion. A logical and organized approach to the history and the physical examination of the patient with eye complaints is key to the diagnosis and treatment of the more significant causes of these complaints. This article reviews an organized approach to the patient with complaint of visual loss and considers the wide differential diagnosis. It focuses specifically on the evaluation of the patient complaining of visual changes resulting from central retinal artery occlusion, central retinal vein occlusion, retinal detachment, acute angle-closure glaucoma, giant cell temporal arteritis, and retrobulbar hemorrhage.

Acute Disease↗