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Results for “Vision Screening”

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At least 1,243 records · Page 69Linked to original sources
PubMed2001

Detection of improper fixation in MTI photoscreening images.

PURPOSE: To determine the effect of fixation shift on photoscreening crescents, the ability of human interpreters to detect fixation shift, and the potential improvement by image processing. METHODS: MTI photoscreening (Medical Technologies & Innovations, Inc, Lancaster, PA) images, measured at 11 positions of gaze, were obtained from 10 subjects (9 with refractive error warranting spectacle correction). Photographs were taken with subjects fixating at 20, 15, 10, and 5 cm to the left and the right of the camera fixation target (1 m distant); 5 cm above and below the camera fixation target; and on-axis. Photographs were inspected by 11 experienced raters, who indicated if the subject appeared to be looking directly at the camera. The photographs were digitized, enlarged, contrast enhanced, and measured by 3 raters. For each photograph, distance from the corneal light reflex to the nasal limbus was measured and a measure of asymmetry computed. RESULTS: Raters could reliably detect off-axis fixation greater than 10 cm away from the intended fixation target. Raters correctly identified on-axis subject viewing 73% of the time. Crescents became larger when the fixation shifted off-axis for both the myopic and hyperopic subjects. Image analysis correctly classified 10 of 10 on-axis measurements and 34 of 39 off-axis measurements. CONCLUSION: Direct inspection of photoscreening images by trained raters can result in the failure to detect small but relevant errors of fixation. These fixation shifts can cause crescents to become larger than expected, resulting in false-positive classification. Image analysis offers a potential improvement in the detection of off-axis fixation in MTI photoscreening images.

Adult↗
PubMed1998

Methods for the Hong Kong Vision Study: a pilot assessment of visual impairment in adults.

INTRODUCTION: The Hong Kong Vision Study (HKVS) was a pilot study to collect data on the prevalence of eye diseases and risk factors in Hong Kong using methodology comparable to that developed in America and Australia. AIM: The main goal was: to evaluate the application of the methodology in a different culture and language; and to determine the prevalence and risk factors of eye diseases in order to design a larger study of an ethnic Chinese population. METHOD: This study was patterned after the Melbourne Visual Impairment Project using the Chinese language in data collection and examinations. CONCLUSION: Well-designed methodology is transferable to different cultures, languages and continents. Use of similar methodology will enable better comparisons and analyses to be made from population-based data.

Adult↗
PubMed1998

Development of a questionnaire for measurement of vision-related quality of life.

PURPOSE: To define vision-related quality of life, to outline the development of a vision-specific quality of life instrument and to present the characteristics of a 10-item 'core' questionnaire. METHOD: A standard method included: 1. Generation of relevant issues by individual interviews with 38 visually impaired adults, consultation with 37 professionals and support workers and literature review. 2. Operationalisation, involving 58 ophthalmic patients. 3. Pre-testing, to maximise face validity and content validity, involving 184 individuals with a variety of different visual problems and social backgrounds. 4. Adoption of a modular approach to item selection. 5. Formal piloting in 92 individuals to establish reliability and construct validity. RESULTS: More than 232 items were tested of which 139 were considered suitable for a final question pool or 'parent' questionnaire (the VQOL). From this parent questionnaire individual items or groups of items can be selected. Ten broadly applicable items referring to physical, social and psychological issues were selected for the core questionnaire (the VCM1). The VCM1 has high reliability (alpha = 0.93) and validity. CONCLUSIONS: Any self-reported problem relating to vision may constitute a quality of life issue. A modular approach to item selection may provide the flexibility to investigate vision-related quality of life in a wide range of clinical settings, allowing detailed assessment of specific problems and also cross-study comparisons where appropriate.

Adult↗
PubMed2003

Mutational analysis of the OA1 gene in ocular albinism.

Ocular albinism type 1 (OA1) is an X-linked disorder, mainly characterized by a severe reduction in visual acuity, foveal hypoplasia, nystagmus, hypopigmentation of the retina, the presence of macromelanosomes in the skin and eyes, and the misrouting of optic pathways, resulting in the loss of stereoscopic vision. We screened the OA1 gene for mutations in three unrelated Canadian and French families and in two isolated patients with OA1. We found three different missense mutations and two different nonsense mutations, three of which were novel. To date, 41 mutations (including missense mutations, insertions, and deletions) have been reported in the OA1 gene. Mutation and polymorphism data for this gene are available from the international albinism center albinism database website: http://www.cbc.umn.edu/tad/oa1map.htm.

Albinism, Ocular↗
PubMed2005

Defining amblyopia: the need for a joint classification.

Recent years have shown an impressive rise in high quality research on amblyopia. Unfortunately, the condition is not sufficiently defined, and consequently different studies have been used different definitions of amblyopia. Aspects in need of consideration include the degree of visual acuity reduction, magnitude of interocular difference in acuity, method of visual acuity testing used, the effect of refractive adaption, the presence of amblyogenic factors, the absence of organic cause and the treat ability of the deficit. Vision scientists worldwide are encouraged to jointly decide on what is, and what is not, amblyopia.

Amblyopia↗
PubMed2005

Evaluation of the traveling vision examiner program in the submacular surgery trials pilot study.

PURPOSE: To describe methods and results and to assess the value of a Traveling Vision Examiner (TVE) Program designed to provide masked vision measurements by expert vision examiners who were independent of, and traveled to, local clinical centers. METHODS: The Submacular Surgery Trials (SST) Pilot Study was conducted to refine the design and methods for a set of multicenter, randomized clinical trials to evaluate submacular surgery in patients with subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) or ocular histoplasmosis (OHS), or idiopathic CNV in which the primary study outcome would be change in 2-year best-corrected vision from baseline. As part of the SST Pilot Study, the feasibility and value of a TVE Program was assessed. The goal of the program was to obtain unbiased vision measurements, according to a standard protocol, of best-corrected visual acuity, reading speed, and contrast threshold, of each patient at 2 and 4 years after enrollment. RESULTS: Eighty-three visits by TVEs were made to 16 centers participating in the SST Pilot Study; 239 patients had at least one masked vision examination. Comparison of pairs of vision measurements of the traveling vision examiners and local vision examiners for 71 patients made on the same day showed good agreement overall (intraclass correlation coefficient > or = 0.81). CONCLUSIONS: The proposed TVE Program was judged to be a feasible and useful method of providing standardized, unbiased, masked vision measurements. This approach was incorporated into the larger clinical trials conducted by the SST Research Group.

Choroidal Neovascularization↗
PubMed2006

Patterns of eyecare utilization by young Australian children: findings from a population-based study.

OBJECTIVES: To report factors associated with childhood eyecare utilization in a random sample of 1740 Sydney schoolchildren aged 6, examined during 2003-4. METHODS: Information on use of eyecare services, defined as any previous consultation with an ophthalmologist or optometrist, was sought from parents. Children had comprehensive eye examinations, including visual acuity (VA), cover testing, cycloplegic refraction and dilated fundus examination. RESULTS: Prior ophthalmic or optometric assessment was reported by 465 children (29.2%), and was not associated with gender (p = 0.9), parental employment (p = 0.4) or home ownership (p = 0.9). Children of East Asian (odds ratio, OR, 0.7, 95% confidence interval, CI, 0.5-0.9) or other ethnicities (OR 0.7, CI 0.6-1.0) were less likely than European Caucasian children to have been examined. Parent-expressed concern about their child's vision was associated with a 10-fold increased likelihood of previous eye examination (OR 10.2, CI 7.3-14.5). Complaints of eyestrain were associated with a 4-fold increase (OR 4.4, CI 3.2-5.9). Most children with VA < 20/40 in at least one eye (63.1%), amblyopia (80.0%) or strabismus (86.4%) had been assessed. CONCLUSIONS: One third of this childhood sample reported prior examination by an eyecare professional. Given that most children needing vision assessment had been examined and likely effects of parental motivation, this rate seems reasonable and appropriate.

Australia↗
PubMed2001

Reliability and reproducibility of a Chinese-language visual function assessment.

OBJECTIVE: The purpose of the study was to validate a Chinese-language visual function assessment within the context of a routine cataract surgery practice and to assess the contribution of the method of questionnaire administration. DESIGN: The visual function assessment (VFA) was translated into Chinese. Two groups of study subjects were recruited: Chinese who did not speak English and Chinese conversant in English. Consecutive preoperative cataract patients of Chinese ancestry presenting to an urban ophthalmology practice were recruited. The questionnaire was administered in person or by telephone interview. Pre-operative visual acuity was recorded. Visual function scores were analyzed to assess reliability and correlation with visual acuity. RESULTS: Among the 186 potential study subjects, 155 patients completed the study The Chinese-language visual function assessment had good internal consistency (Cronbach alpha = 0.97, inter-item correlations = 0.43 to 0.96) . Reliability (with regard to the English version) and test-retest reproducibility of the Chinese questionnaire were strong with intraclass correlation coefficients greater than 0.60. The method of administration contributed to the measures of reliability and reproducibility. CONCLUSION: These results show that a Chinese-language version of the VFA questionnaire is reliable and valid. In industrialized countries with large Chinese-speaking populations and newly developed countries of East and Southeast Asia, the visual function assessment may be helpful in assisting routine clinical patient evaluation and cross-cultural outcome assessment programmes. Our findings also suggest that self-administered visual function assessments may be more reliable and valid than interview-generated assessments.

Aged↗
PubMed2004

Telehealth practice recommendations for diabetic retinopathy.

Telehealth holds the promise of increased adherence to evidenced-based medicine and improved consistency of care. Goals for an ocular telehealth program include preserving vision, reducing vision loss, and providing better access to medicine. Establishing recommendations for an ocular telehealth program may improve clinical outcomes and promote informed and reasonable patient expectations. This document addresses current diabetic retinopathy telehealth clinical and administrative issues and provides recommendations for designing and implementing a diabetic retinopathy ocular telehealth care program. The recommendations also form the basis for evaluating diabetic retinopathy telehealth techniques and technologies. Recommendations in this document are based on careful reviews of current evidence, medical literature and clinical practice. They do not, however, replace sound medical judgment or traditional clinical decision-making. "Telehealth Practice Recommendations for Diabetic Retinopathy" will be annually reviewed and updated to reflect evolving technologies and clinical guidelines.

Diabetic Retinopathy↗
PubMed1995

Sensory impairments and mortality in an elderly community population: a six-year follow-up study.

Previous studies have shown that sensory impairments adversely affect the quality of life of elderly people, but have failed to demonstrate consistent results on mortality. We examined the predictive value of hearing and visual impairments on mortality in an urban population of 1140 non-institutionalized elderly subjects, aged 70-75 years. Baseline information was collected in 1986 through a door-to-door interview with a standardized questionnaire and the sensory assessment was performed using bedside tasks: the whispered voice test for hearing and the Snellen chart for vision. Overall mortality rate at 6 years was 25.5%, with a significant sex difference (males = 37.5%; females = 19.8%) and a significant interaction between sex and sensory impairment. Bivariate logistic regression showed that hearing deficit was associated with a significant increase in mortality risk only in the men. This increase remained significant even after control for the demographic variables and the global physical health status. Multivariate logistic regression showed that the effect of hearing deficit on mortality was mediated by psychosocial parameters (mood and social relationships level). Sensory assessment through simple bedside tests should become part of the routine clinical evaluation of elderly people.

Activities of Daily Living↗
PubMed1999

Determinants of attendance and patient satisfaction at eye clinics in south-western Uganda.

PURPOSE: To identify the reasons for subjects deciding to attend or not attend local and referral ophthalmology clinics in south-west Uganda, and to establish the levels of satisfaction of clinic attenders with the services they received. METHODS: A population survey identified subjects with ocular conditions who were referred to the local clinic or the district hospital. All non-attenders and a group of attenders were interviewed at home. RESULTS: 31% of those referred did not attend the local clinic. The most common reasons were 'too busy' (29%) or 'unwilling to buy spectacles' (17%). Less than half of attenders were satisfied, mainly because of no perceived clinical improvement or having to buy spectacles. Only 13% of those referred to the district hospital clinic attended. The main reasons for non-attendance were high transport cost and fear of the clinic. CONCLUSION: Attendance and satisfaction with the community ophthalmology service could be improved by more intensive motivation and explanation for patients, and assistance with spectacle and transport costs. The use of aphakic motivators should be tested in this context.

Community Health Centers↗
PubMed2001

Frequency of ophthalmic assessments among elderly whites and African Americans with eye disease and impact on visual function.

OBJECTIVES: To study the difference in patterns of utilization of eye-care services among white and African American senior citizens with eye disease and its impact on visual function. METHODS: This study involved cross-sectional assessments of visual function using the Activities of Daily Vision Scale (ADVS), as well as retrospective self-recall of history of eye disease and frequency of ophthalmic assessments. Participants included 99 consecutive elderly patients with history of eye disease who were attending the outpatient medical clinics at Nassau University Medical Center, a community teaching hospital in Long Island, New York. RESULTS: White Americans constituted 52% of the study sample and African Americans constituted the remaining 48%. African American subjects were less likely than whites to report visiting an eye specialist over the previous 5 years (69% versus 88%, P < 0.05). African American subjects who reported undergoing ophthalmic assessments over the past 5 years showed a trend of having higher ADVS scores (indicating better visual function) compared with those who did not report such history (86 +/- 12 versus 79 +/- 15, P = 0.098). On the other hand, reporting such history had no apparent relation to the ADVS scores in whites. CONCLUSIONS: African American elderly ambulatory medical patients with eye disease were less likely than their white counterparts to report use of eye-care services. The use of eye-care services in African American but not white subjects was linked to better visual function as assessed by the ADVS.

Black or African American↗
PubMed1997

Visual acuity in extremely low birth weight infants.

The increased viability of extremely low birth weight (ELBW) infants (those weighing less than 1,000 g) and the associated increased risk of visual impairment has highlighted the need for reliable indices of visual functioning for this population. By use of the Teller Acuity Cards, we assessed grating visual acuity in 26 survivors of extreme prematurity (corrected age, 2-42 mo) and found that although most scores were within the normal range, they were significantly lower than those of full-term infants of equivalent postconceptional age, especially after 9 months of age. Moreover, the number of complications in the neonatal period (especially bronchopulmonary dysplasia) and the Neonatal Medical Index classification were associated with below-average visual acuity in infancy and early childhood.

Birth Weight↗
PubMed1992

Development of the 'Activities of Daily Vision Scale'. A measure of visual functional status.

To develop a method for the evaluation of visual function in subjects with cataracts, the authors identified 20 visual activities and categorized them into five subscales (distance vision, near vision, glare disability, night driving, and daytime driving) that comprised the Activities of Daily Vision Scale (ADVS). Each subscale in the ADVS was scored between 100 (no visual difficulty) and 0 (inability to perform the activity because of visual difficulty). In 334 subjects scheduled for cataract extraction (mean age 75 +/- 9 years, 67% women), ADVS scores (mean +/- standard deviation) for each subscale ranged from 44 +/- 31 for night driving to 72 +/- 24 for near vision activities. When administered by telephone, inter-rater reliability coefficients (r) were 0.82 to 0.97 (P < 0.001) for each of the subscales, and test-retest reliability was 0.87 for the scale overall. Cronbach's coefficient alpha was very high for both the in-person (alpha = 0.94) and telephone (alpha = 0.91) formats. Criterion validity, the correlation between visual loss and ADVS score, was -0.37 (P < 0.001) when the ADVS was administered in person and -0.39 (P < 0.001) when it was administered by telephone. Content validity as assessed with factor analysis showed that 88% of the variance of the principal components weighted on one factor. The authors conclude that substantial visual disability is not captured by routine visual testing and that the ADVS is a reliable and valid measure of patient's perception of visual functional impairment.

Activities of Daily Living↗
PubMed2000

Demographic predictors of eye care utilization among women.

BACKGROUND: Visual impairment may be preventable or treatable with timely intervention. Differences in the use of eye care services may play a role in fostering the racial and socioeconomic gap in the burden of visual impairment in the United States. OBJECTIVE: The objective of this study was to examine the frequency of eye examinations in women and how this varies with age, race, marital status, geographic region, profession, education, and income. SUBJECTS AND METHODS: We used logistic regression models to examine data obtained by mailed questionnaires from 39,876 female health professionals participating in the Women's Health Study. RESULTS: Most women (83%) had an eye examination within the past 2 years. The likelihood of having an eye examination in the past 2 years increased with age (odds ratio [OR] = 2.59 for age > or =75 years versus those <50 years; P [trend] <0.0001), higher education (OR = 1.27 for master's degree versus licensed nurse training; P [trend] = 0.0004), and higher household income (OR = 1.85 for > or =$100,000 versus <$10,000; P [trend] <0.0001). Women from the south were less likely to have had an eye examination than those from the west (OR = 0.92; P = 0.03). Compared with whites, Asian/Pacific Islanders were less likely (OR = 0.76; P = 0.02) and blacks more likely (OR = 1.27; P = 0.02) to have had an eye examination within 2 years. CONCLUSIONS: Age, education, income, race/ethnicity, and region of residence were independent predictors of having had an eye examination in the past 2 years. Known medical and ocular problems appeared to explain the association with age but not the other findings, although the clinical significance of these associations was not determined in the present study. Additional research on determinants of eye care-seeking behavior could help in devising new strategies to encourage preventive behaviors, especially among groups at higher risk of visual impairment.

Age Factors↗