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PubMed1994

Epidemiology and screening of open-angle glaucoma.

Two major prevalence surveys for chronic open-angle glaucoma have been published in the last year. These are discussed in relation to the comprehensive Baltimore Eye Survey of 2 years ago, which also studied the blindness arising from the disease and comparative figures for white and black individuals. The newer tests for identification of loss of visual function prior to visual field loss as demonstrated by conventional automated perimetry are considered. The three main screening tests for chronic open-angle glaucoma--ophthalmoscopy, tonometry, and perimetry--are evaluated in the light of case finding experience in the United Kingdom. The maximum detection of asymptomatic early chronic open-angle glaucoma in the community is likely to be best achieved by a combination of public awareness of glaucoma aided by patient-based associations and the promotion of improved glaucoma testing and case finding by the army of professionals who are already in place in most developed countries and who carry out primary eye examinations.

Electroretinography↗
PubMed1994

Visual impairment among people with developmental delay.

The prevalence of visual impairment (V.I.) has been described in people living in large institutions, but there is no information about the prevalence among all adult people with developmental delay (D.D.). The present study shows that the prevalence is 10-fold that of adults without D.D. Caregivers have difficulties in assessing V.I., hence professional examinations for all are necessary. Many V.I. people with D.D. simply need corrective spectacles. V.I. people with D.D. often have additional disabilities, thus 50% of patients with optic nerve atrophy or with cortical V.I. have epilepsy, cerebral palsy or both. Half the individuals with D.D. and V.I. were unable to speak, walk alone or feed themselves.

Adolescent↗
PubMed1996

Ocular defects in children and adolescents with severe mental deficiency.

To assess the need for eye care in children and adolescents with severe mental deficiency, a cross-sectional study of the prevalence and causes of ocular defects amongst these individuals was conducted. Two hundred and sixty residents in a mental handicap unit were examined from January 1992 to June 1993. It was found that there was an unusually high prevalence of severe visual impairment (25%), refractive errors (24%), squint (8%) and a number of organic ocular diseases (8%). All the patients studied were non-verbal and 18% of them were deaf. Only 23 patients could walk. The results emphasize the need for establishing an efficient system to provide regular ophthalmic care for children with severe mental deficiency.

Adolescent↗
PubMed1995

Retinopathy of prematurity in infants weighing 1000-1499 g at birth.

OBJECTIVE: To review the incidence and severity of retinopathy of prematurity (ROP) in infants with birthweights 1000-1249 g and 1250-1499 g, to establish whether the upper weight limit for routine ophthalmological examination might safely be lowered. METHODOLOGY: Prospective cohort study of infants born between 1 January 1977 and 31 December 1992 cared for in the neonatal nurseries at the Royal Women's Hospital, Melbourne. Data were retrieved on 1373 infants who survived their initial hospitalization. They comprised 657 with birthweights 1000-1249 g (group 1) and 716 with birthweights 1250-1499 g (group 2). There were 76 outborn infants in group 1 and 97 in group 2; the remaining infants were all born at the Royal Women's Hospital. Ocular examinations commenced at 2 weeks of age, when possible, and at 2-weekly intervals after that. RESULTS: In group 1, ROP was detected in 14.6% (96/657) and severe ROP (bilateral stage 3-5) in 5.0% (33/657). Five (0.8%) children required surgical intervention (reaching threshold disease); following surgery, one was legally blind, one had severely impaired vision, and the other three had near-normal vision. Another child was blind; he was born at 28 weeks gestational age with a birthweight of 1170 g, and was transferred to a Level II hospital at 9 weeks chronological age with no detectable retinopathy. He returned 1 year later totally blind with detached retinae (grade 5 ROP). The prevalence of bilateral blindness in this group was 0.3% (2/657). In group 2, ROP was detected in 6.4% (46/716) and severe ROP in 0.8% (6/716). No children required surgery; three were found to be myopic at follow-up but the corrected visual acuity was normal. No children in group 2 were blind. No significant difference was found between the rates of ROP in inborn and outborn infants. CONCLUSION: In neonatal units with similar rates of ROP and visual outcome, routine ophthalmological examination in the neonatal nursery of infants weighing more than 1249 g at birth is probably unnecessary.

Birth Weight↗
PubMed1990

The Wisconsin epidemiologic study of diabetic retinopathy: an update.

Population-based epidemiologic data on the incidence and progression of diabetic retinopathy are important in developing approaches to preventing diabetic retinopathy, in medical counselling and rehabilitative services. The objectives of the Wisconsin Epidemiological Study of Diabetic Retinopathy were as follows: (1) to describe the prevalence, incidence, and progression of diabetic retinopathy and its component lesions, and to determine the incidence of visual impairment in a large population-based cohort; and (2) to determine the relationships between incidence and progression of diabetic retinopathy and risk factors in this cohort. Grading of stereoscopic fundus photographs was performed at the University of Wisconsin Fundus Photograph Reading Centre for photographs from both the baseline examination in 1980-1982 and follow-up examination four years later. Insulin-taking persons diagnosed to have diabetes before 30 years of age had the highest prevalence (71%), four-year incidence (59%) and progression to proliferative diabetic retinopathy (11%) while older-onset persons diagnosed to have diabetes at or after 30 years of age and not using insulin had the lowest prevalence (39%), incidence (34%) and progression to proliferative diabetic retinopathy (3%). These incidence data indicate that a substantial proportion of older onset diabetic people, a group previously thought to be protected from retinopathy, developed it during the four-year interval and underscores the need for careful ophthalmologic examination.

Adult↗
PubMed1990

Photoscreening to detect potential amblyopia.

Photoscreening to detect amblyopiogenic conditions is particularly applicable for the child under three years of age because conventional testing is difficult. We have designed an eccentric photoscreener that is inexpensive, easily used and requires only one diagnostic photograph. Some 231 infants and children were refracted and photoscreened and results compared in a blind study. Compliance was good and all cases of strabismus, amblyopia, and amblyopiogenic conditions were diagnosed.

Adolescent↗
PubMed2003

A survey of pediatric visual assessment by optometrists in New South Wales.

BACKGROUND: The importance of early vision care in the prevention and treatment of amblyopia is clear from an abundance of literature on visual development. Optometrists possess the necessary skills to detect and manage amblyogenic factors and thus have an important role to play in paediatric visual assessment and management. The present study investigates the role that optometrists in New South Wales are taking in paediatric vision care and the methods and strategies used in this role. METHODS: Questionnaires were sent to 400 optometrists practising in New South Wales; 179 completed questionnaires were returned. RESULTS AND DISCUSSION: Our findings reveal a number of associations between practice characteristics (such as location) and the management of paediatric patients. In general, practitioners in rural locations, in full-time practice or self-employed were more likely to treat patients and less likely to refer them elsewhere than those in city locations, in part-time practice or employed by others. In addition, our findings suggest the possibility of a changing pattern of collaboration between optometrists and ophthalmologists in the management of paediatric patients.

Anisometropia↗
PubMed2003

Vision and work.

Explore the source record for details and available documents.

Humans↗
PubMed2002

Predictors of falls in the Melbourne visual impairment project.

OBJECTIVE: To assess factors associated with falls in the past month, including visual acuity and other vision-related variables. METHODS: A household census was used to recruit permanent residents aged 40 years and older for baseline examinations of the Melbourne Visual Impairment Project conducted from 1992-94. At the five-year follow-up examinations, returning participants were asked to recall all falls that they had ever experienced and also how many falls they had experienced in the past month. Falls history was divided into those that occurred at home and away from home. Standardised examination of visual acuity was performed. RESULTS: Of the original cohort of 3,271, 231 (7.1%) were reported to have died, leaving 3,040 eligible. Of these, 2,594 (85%) were examined, 51 (2%) had moved interstate or overseas, 83 (3%) could not be traced, and 312 (10%) refused to participate. A history of having ever fallen at home was reported by 466 (20%) participants, and 406 (17.3%) reported having fallen away from home at least once. Five per cent of the cohort (129/2,343) had fallen in the previous month. Factors significantly related to falls at home in the past month in a multivariate logistic regression model included age (OR=1.56 for 10-year age groups) and nuclear cataract (OR=2.87). CONCLUSIONS: Irrespective of visual acuity, cataract is major risk factor for falls at home. IMPLICATIONS: Interventions aimed at decreasing the incidence of falls in the community should include assessment of both visual acuity and cataract status and referral for treatment if functional impairment is evident.

Accidental Falls↗
PubMed1994

Evaluation of the Sonksen picture test for detection of minor visual problems in the surveillance of preschool children.

The Sonksen Picture Test (SPT) for surveillance of vision in preschool children was evaluated in 842 children, aged 21 to 60 months, from nine health districts in England, Wales and Scotland. The failures and controls were refracted and examined for squint; the Sheridan-Gardiner seven-letter chart (SGLC) was also used with children of > or = 42 months. The SPT was quicker to administer than the SGLC, with median times of one and five minutes, respectively. 98 per cent of children of all ages completed the SPT, whereas 10 per cent of those over 42 months were unable to complete the SGLC. The test method that has been established is developmentally appropriate for this age-group, more so than optotype tests. It is a binocular test that is quick, cheap and simple to administer, and is available to children under five years.

Child, Preschool↗
PubMed2005

Retinal electrophysiological results in patients receiving lamotrigine monotherapy.

PURPOSE: To evaluate the effects on vision in patients receiving lamotrigine (LTG) monotherapy. METHODS: Twenty-four consecutive patients taking LTG for partial seizures were referred for a routine ophthalmologic examination including visual acuity testing, tonometry, slit lamp, and fundus examination. Automated kinetic perimetry, electrooculogram (EOG), and electroretinogram were performed after informed consent was obtained. RESULTS: In 18 patients finally included, the clinical ophthalmologic examination showed no abnormality. Four patients complained of blurring; among them, one patient had a visual field constriction in both eyes, which, however, was of unclear clinical significance (poor compliance) and a reduced light/dark ratio of the electrooculogram. One other patient with blurred vision had a reduced EOG, but the visual field was normal. Two patients had a reduced EOG but no visual symptoms. Considering the whole group of patients receiving LTG therapy, the light/dark ratio of the EOG was reduced in a dose-dependent fashion (p < 0.0001). The electroretinogram was normal in all patients. CONCLUSIONS: No irreversible visual field impairment in patients treated with LTG was encountered, although a dose-dependent retinal toxicity may have been present. The exact cellular mechanism of the electrophysiologic changes in patients taking LTG remain to be explained.

Adolescent↗
PubMed1992

The relationship between low vision and performance of activities of daily living in nursing home residents.

OBJECTIVE: To explore the link between low vision and Activities of Daily Living (ADL) performance in cognitively intact nursing home residents. DESIGN: Survey. SETTING: A non-profit geriatric long-term care facility. SUBJECTS: 21 males, 82 females, aged 66-98. MEASURES: Survey of 103 nursing home residents. ADL functioning assessed via Maryland Appraisal of Patient Progress (MAPP); medical data collected through chart review; ophthalmological data obtained through dilated eye examination by an ophthalmologist. RESULTS: In comparison with residents having good vision (n = 52), a significantly greater proportion of residents with low vision (n = 51) were dependent on caregivers for performing ADLs (eg, toileting, transferring, washing). Residents with low vision had significantly more eye pathology (eg, cataracts, age-related macular degeneration) than did residents with good vision. There were no significant differences between groups with regard to presence of musculoskeletal problems (eg, arthritis) or number of medical conditions (eg, cardiovascular disorder, cerebrovascular accident). CONCLUSIONS: There is a strong link between low vision and ADL disability in nursing home residents. Moreover, ADL dependency is significantly related to the presence of eye disorders.

Activities of Daily Living↗
PubMed1990

People's Republic of China: perspectives in school health.

As the population growth rate of the People's Republic of China slows, the health of its schoolchildren is improving. A three-tiered health system incorporating traditional and modern medicine is reflected in an educational curriculum that is based on community involvement and, more recently, on prevention. The Chinese Ministry of Public Health focuses on three main issues affecting the health of schoolchildren: poor vision (myopia), dental care, and nutrition. Vision problems are predominant among Chinese students and are addressed through treatment, improved architectural design of school buildings, and lessening of homework assignments. Dental care is addressed through treatment and education. Nutrition, a problem primarily among rural schoolchildren, is addressed through vitamin and mineral supplements and community involvement.

China↗
PubMed1990

A longitudinal study of a population based sample of astigmatic children. I. Refraction and amblyopia.

The refraction changes in 310 children with astigmatism greater than or equal to 1.0 D in at least one eye at one year of age were followed during a period of 3 years. At the age 4 years amblyopia was found in 23 children (7%). The refraction data of these children were compared to the rest of the sample. We found that an increasing astigmatism during the test period was associated with an increased risk to develop amblyopia. The majority of children (n = 280) showed a decrease of their astigmatism, whereas all cases with a marked amblyopia (V.A. less than 0.5) or binocular amblyopia, except one, had an increasing or unchanged astigmatism during the age period 1 to 4 years. Strabismus and oblique astigmatism at any time during the test period was also strongly related to amblyopia. The incidence of strabismus (1%) was unexpectedly low. The study also showed that independent of age there was no simple relationship between amblyopia and refraction errors measured at a single test session. The main conclusion of this study is that failure of emmetropization may play an important role in visual development.

Amblyopia↗
PubMed1990

Airpuff tonometry versus applanation tonometry.

In order to study the reliability of airpuff tonometry, 230 eyes of 115 patients had their IOP measured with 2 airpuff tonometers, NCT and Pulsair, and one applanation tonometer, Perkins handheld Goldmann Type, between Dec 87 and March 89. Each patient had three readings per eye with each airpuff instrument and two readings per eye with the Perkins instrument. Mean age for the group was 68 +/- 11 (SD), range 36-87 years. The mean values were for Perkins: 21.21 +/- 6.27 R.E., 21.28 +/- 5.67 L.E.; for NCT: 21.11 +/- 6.95 R.E., 21.27 +/- 5.41 L.E.; for Pulsair: 23.05 +/- 6.00 R.E., 23.76 +/- 5.39 L.E. The ranges were for Perkins: 9-45 R.E., 9-38 L.E.; for NCT: 8-59 R.E., 11-38 L.E.; for Pulsair: 9-52 R.E., 11-38 L.E. For the Pulsair a value of 18 was found to be a cut-off point below which there were no false negatives, and for the NCT this value was found to be 17. A linear relation between airpuff and applanation tonometry was found, but also a large spread, both for false positives and false negatives.

Adult↗