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PubMed1982

STYCAR ball acuity in relation to contrast and blur.

The graded balls test of Sheridan is used to screen for vision problems in infants and poorly communicative patients. To simulate what the infant with a refractive error may see, we photographed black and white spheres of identical size through various plus lenses. The results show that the white ball becomes progressively easier to identify with increasing blur. The size of the blur circle is shown to be directly related to background contrast. Because the white balls are viewed against a black cloth at 10 ft to enhance contrast, this may significantly bias the test results. Consequently, a neutral background may be a more appropriate surface upon which to assess the visual acuity by this technique.

Age Factors↗
PubMed1989

Optometric services in the prison system.

Traditionally, optometric services have been limited to practitioners' offices or clinical settings. Recently more optometric practitioners have ventured out of the office to provide eye care to those who otherwise would not receive such care. This report discusses the need to provide eye care to prison inmates. It also addresses the nature of vision and eye problems more common among the prison population and the need for mandated eye care for the inmates.

Delivery of Health Care↗
PubMed1989

Optometric care for the handicapped.

The need for optometric vision care for handicapped people is discussed. The high incidence of functional vision problems among the disabled population is presented. A vision clinic operated jointly by the New England College of Optometry and the Cotting School, a school for physically disabled children, is described. Suggestions for achieving successful involvement with the vision care of disabled people are presented.

Adolescent↗
PubMed1989

Team approach to home health care delivery: optometry as the primary vision care provider.

The purpose of this report is to describe a vision care program, utilizing optometry as the primary vision care provider, for patients unable to obtain care in traditional ways. The impact of this program upon the community, its impact upon an educational curriculum, and the program itself are discussed. The program provides a model for delivery of health care to patients who would otherwise go without care.

Age Factors↗
PubMed1989

Effects of viewing conditions on standard measures of acquired and congenital color defects.

We examined the effect of variations in viewing distance and viewing duration on the performance of color-normal observers with four standard tests of color vision. Significant effects of the experimental manipulations were obtained: both increasing viewing distance and decreasing viewing duration significantly increased the number of errors made by observers. Moreover, the four tests differed widely in their sensitivity to the variations in viewing conditions. Practical implications of the findings for the administration and selection of plate tests are discussed, and possible mechanisms underlying the results are suggested.

Color Perception↗
PubMed1991

Validity of the dyslexia screener.

Optometrists see many patients who complain of reading difficulty. The Dyslexia Screener (TDS) is an instrument which has been developed to determine, within 5 min, whether or not a patient shows evidence of having one of the three basic types of dyslexia (a coding problem in reading and spelling). Results using TDS were compared with the Dyslexia Determination Test (DDT). TDS rating scores were shown to contain much of the same clinical information as the DDT rating scores.

Adolescent↗
PubMed2000

Inter-rater and intra-rater reliability in the interpretation of MTI Photoscreener photographs of Native American preschool children.

PURPOSE: To evaluate inter- and intra-rater reliability for the interpretation of MTI Photoscreener photographs taken in a population of Native American preschool children with a high prevalence of astigmatism. METHODS: Photographs of 369 children were rated by 11 nonexpert and 3 expert raters. Photographs for each child were scored as pass, refer, or retake. Nonexpert raters scored photos on two separate occasions, permitting analysis of intra-rater reliability. RESULTS: Analyses of pass/refer responses only: inter-rater reliability was moderate to substantial among nonexpert raters and substantial among expert raters. Intra-rater reliability among nonexperts was substantial. Analyses of all responses (pass, refer, and retake): inter-rater reliability for pass and refer scores was moderate among nonexperts and substantial among experts; for retake scores inter-rater reliability was slight for nonexperts and moderate for experts. Intra-rater reliability among nonexperts was substantial for pass and refer scores and moderate for retake scores. CONCLUSIONS: In this population with a high prevalence of astigmatism, whether MTI photoscreening results are interpretable is much more variable among and within raters than whether an interpretable photograph should be scored as pass or refer. The level of agreement among raters in the current study was influenced by the experience of the raters. In addition, nonexpert raters were more likely to deem a photograph uninterpretable than expert raters.

Arizona↗
PubMed2003

Ocular component data in schoolchildren as a function of age and gender.

PURPOSE: To describe the refractive error and ocular components of a large group of school-aged children as a function of age and gender. METHODS: In this report, we describe the refractive error and ocular components of 2583 school-aged children (49.3% girls, overall mean [+/-SD] age 10.0 +/- 2.3). Measurement methods included cycloplegic autorefraction, autokeratometry, videophakometry, and A-scan ultrasonography. For statistical comparisons across gender and age, a critical point of alpha = 0.005 was used to assess significance because of the large sample size and the large number of comparisons made. RESULTS: Of these 2583 children, 10.1% were myopic (-0.75 D or more myopia in both meridians), and 8.6% were hyperopic (+1.25 D or more hyperopia in both meridians). As would be expected, there was a significant effect of age on refractive error (spherical equivalent, p < 0.0001), toward less hyperopia/more myopia. There was no significant difference in the average refractive error between girls and boys (p = 0.0192). Girls had steeper corneas than boys (0.74 D steeper in the vertical meridian and 0.63 D steeper in the horizontal meridian, p < 0.0001). There were no significant differences in corneal power with age (p = 0.16). Both older age and male gender were significantly associated with deeper anterior chambers (p < 0.0001 for both). The crystalline lens showed significant thinning with age (p < 0.0001), however, there was no significant difference in the lens thickness between girls and boys (p = 0.66). Both Gullstrand lens power and calculated lens power showed significant effects of age and gender (p < 0.0001 for both). Girls, on average, had Gullstrand lens powers that were 0.28 D steeper and calculated lens powers that were 0.80 D more powerful than boys. Axial length also showed significant effects of age and gender (p < 0.0001 for both). Girls' eyes were, on average, 0.32 mm shorter than those of boys. CONCLUSIONS: These cross-sectional data show a general pattern of ocular growth, no change in corneal power, and crystalline lens thinning and flattening between the ages of 6 and 14 years. Girls tended to have steeper corneas, stronger crystalline lenses, and shorter eyes compared with boys.

Adolescent↗
PubMed2003

Clinical evaluation of the Shin-Nippon NVision-K 5001/Grand Seiko WR-5100K autorefractor.

PURPOSE: A clinical evaluation of the Shin-Nippon NVision-K 5001 (also branded as the Grand Seiko WR-5100K) autorefractor (Japan) was performed to examine validity and repeatability compared with subjective refraction and Javal-Schiotz keratometry. METHODS: Measurements of refractive error were performed on 198 eyes of 99 subjects (aged 23.2 +/- 7.4 years) subjectively (noncycloplegic) by one masked optometrist and objectively with the NVision-K autorefractor by a second optometrist. Keratometry measurements using the NVision-K were compared with the Javal-Schiotz keratometer. Intrasession repeatability of the NVision-K was also assessed on all 99 subjects together with intersession repeatability on a separate occasion separated by 7 to 14 days. RESULTS: Refractive error as measured by the NVision-K was found to be similar (p = 0.67) to subjective refraction (difference, 0.14 +/- 0.35 D). It was both accurate and repeatable over a wide prescription range (-8.25 to +7.25 D). Keratometry as measured by the NVision-K was found to be similar (p > 0.50) to the Javal-Schiotz technique in both the horizontal and vertical meridians (horizontal: difference, 0.02 +/- 0.09 mm; vertical: difference, 0.01 +/- 0.14 mm). There was minimal bias, and the results were repeatable (horizontal: intersession difference, 0.00 +/- 0.09 mm; vertical: intersession difference, -0.01 +/- 0.12 mm). CONCLUSION: The open-view arrangement of the Shin-Nippon NVision-K 5001 facilitates the measurement of static refractive error and the accommodative response to real-world stimuli. Coupled with its accuracy, repeatability, and capability to measure corneal curvature, it is a valuable addition to objective instrumentation currently available to the optometrist and researcher.

Adolescent↗
PubMed2003

Validation of a clinical Shack-Hartmann aberrometer.

PURPOSE: To validate the accuracy, tolerance, and repeatability of the complete ophthalmic analysis system aberrometer (COAS, Wavefront Sciences Inc.) with model eyes and normal human eyes. METHOD: Model eyes were constructed from six polymethyl methacrylate, single-surface lenses with known characteristics. Accuracy of second-order aberrations was verified by measuring defocus and astigmatism induced by series of spherical and cylindrical trial lenses. Accuracy of higher-order aberrations was evaluated by comparing ray-tracing predictions with measured spherical aberration and coma of the aspheric model eyes. Tolerance to axial and lateral misalignment was measured by controlled displacements of the model eye relative to the aberrometer. Repeatability was tested on the same model eyes with repeated measurements taken within 1 s or within half an hour with realignment between each trial. Analyses were based on a 5-mm pupil diameter. RESULTS: Defocus and astigmatism were accurately measured within the working range of the instrument automatic focus adjustment (e.g., measured defocus was within +/-0.25 diopters over a -6.50 to +3.00 D range of refractive error). Accuracy of spherical aberration and coma agreed closely with theoretical predictions (e.g., for all six aspheric models, the mean absolute difference between predicted and measured Z(4)0 was 0.007 microm). Axial displacements over the range +/-2.5 mm had little effect on measurements for myopic and emmetropic model eyes. Also, lateral displacements over the range +/-1.5 mm did not produce significant coma. The standard deviations of repeated measurements of higher-order root mean square on model eyes were <1% of the mean with repeated measures within 1 s and 10% of the mean for five individual measurements with realignment in between each. Tolerance to small lateral displacements was also observed for human eyes. CONCLUSION: The complete ophthalmic analysis system aberrometer can measure second-, third-, and fourth-order aberrations accurately and repeatedly on model eyes.

Astigmatism↗
PubMedDate not supplied

Treating myopia with acoustic biofeedback: a prospective study on the evolution of visual acuity and psychological distress.

OBJECTIVE: The effects of a visual training technique on changes in myopia, visual acuity, and psychological distress were studied in a controlled prospective study. METHOD: A group of 33 female students with myopia < or = 3.50 diopters (D) underwent visual training using an acoustic biofeedback technique. A group of 22 female students with myopia and a group of 27 students with emmetropia formed the two control groups, matched for school, age, sex, and refractive error. Manifest and cycloplegic refraction, visual acuity, personality profile (CPI), and psychological distress (SCL-90) were measured at the baseline (T0), at 10 weeks (T1), and after 12 months (T2). RESULTS: At T2, myopia significantly progressed both in the treated and in the untreated students with myopia. Visual acuity improved only in the treated myopia group (despite refraction objectively being worse). No differences were found among the personality profiles in the three groups. All items indicative of psychological suffering improved in the group treated for myopia whose visual acuity was ameliorated. CONCLUSIONS: The visual training technique led to no improvement in objective measures of visual acuity, but did lead to an improvement in one relatively subjective measure of visual acuity and a parallel improvement in psychological conditions. The students with myopia who were treated consequently had a greater sense of general well-being.

Accommodation, Ocular↗
PubMed1998

A comparison of self-reported utilization of ophthalmic care for diabetes in managed care versus fee-for-service.

PURPOSE: To assess the association between structural factors in the health care delivery system and self-reported utilization of ophthalmic services by patients with diabetes in the Medical Outcomes Study (MOS). METHODS: Self-reported utilization of ophthalmic services within the 6 months preceding enrollment into the MOS among 522 of 567 individuals with diabetes in the MOS longitudinal panel was measured. Use of eye care services was regressed (logistic model) on patient demographics, geographic location, physician specialty, type of practice, and finance plan (prepaid or fee-for-service). RESULTS: None of the variables was significantly associated with a higher or lower likelihood of having used ophthalmic services in the preceding 6 months. Thus, no difference between prepaid or fee-for-service plans or among solo practice, large multispecialty groups, or HMOs were identified. Having seen an internist, family practitioner, or diabetes specialist for diabetes care was not related to use of ophthalmic services. CONCLUSIONS: Despite a presumed greater interest in preventive health, prepaid health plans were no more or less likely than the fee-for-service sector to have patients with diabetes reporting an eye examination within the prior 6 months. Thus, steps to improve the rate of eye examinations of diabetics may need to focus beyond the structural elements of the health care delivery system.

Diabetes Mellitus↗
PubMed2003

Chorioretinal lesions in patients with chronic granulomatous disease.

PURPOSE: To describe the frequency and clinical characteristics of chorioretinal lesions as a complication of chronic granulomatous disease (CGD). METHODS: Seventeen patients with CGD examined at Seoul National University Children's Hospital between 1996 and 1999 were recruited for this study. A review of their historical, clinical, and fluorescein angiographic features was performed, and the prevalence and demographic and clinical features of the chorioretinal lesions were summarized. RESULTS: Chorioretinal lesions were identified in 11 eyes of six patients with CGD, an overall prevalence of 35.3%. Patients' ages ranged from 6 months to 10 years, with a median of 47.0 months. Three of the six patients were boys. The lesions included RPE atrophy or pigment clumping, chorioretinal atrophy. Among the six patients, two had vision loss because of ischemia in the peripheral retina, neovascular membrane, and macular edema, which had not been previously reported. CONCLUSIONS: Chorioretinal lesions are not uncommon in patients with CGD and they may affect vision. Regular screening of patients with CGD and long-term follow-up of CGD chorioretinopathy patients should be performed to define the lesion, natural history, and pathogenesis.

Adolescent↗