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Blurred vision during sexual arousal associated with narrow-angle glaucoma.

PURPOSE: To describe three women with narrow-angle glaucoma who had transient blurred vision during sexual arousal. METHOD: Case reports. RESULTS: Three women, aged 37, 45, and 55 years, were seen with bilateral narrow-angle glaucoma and were treated with bilateral laser iridotomy. In each patient, additional surgery was required to control the glaucoma. After establishing a rapport with her physician, each patient described transient blurred vision, from a few minutes to several hours in duration, which began during sexual arousal. This symptom resolved after peripheral iridotomy and, in one patient, after laser iridoplasty. CONCLUSION: The association of transient blurred vision with sexual activity may delay presentation of patients with symptomatic narrow-angle glaucoma.

Adult↗

The role of vision in spatial representation.

A complex link exists between vision and unilateral spatial neglect (USN). Firstly, USN is not a perceptual deficit, secondly, USN is not necessarily accompanied by a visual deficit and finally, USN can be observed in non-visual modalities as well as in mental spatial imagery. This apparent supramodality of USN stands in sharp contrast to the fact that neglect signs are often more severe and more durable in the visual than in other sensory modalities (Chokron et al., 2002). The influence of vision on spatial representation has rarely been studied. In the present study we assessed six right brain-damaged patients suffering from left USN on two tasks involving spatial representations: a clock-drawing task and a drawing from memory task in two experimental conditions, with and without visual control. We confirm that even in mental imagery, the absence of visual feedback may decrease and even suppress left neglect signs (Bartolomeo and Chokron, 2001b; 2002). Since vision is largely involved in the orientation of attention in space, suppressing visual control could reduce the magnetic attraction towards the right ipsilesional hemispace and in this way could allow a re-orientation of attention towards the left neglected hemispace. We discuss the theoretical and therapeutic implications of these findings.

Adult↗

Evaluation of the NEI visual functioning questionnaire as an interval measure of visual ability in low vision.

The National Eye Institute developed a visual functioning questionnaire (NEI-VFQ) designed to assess health-related quality of life of patients with visual impairments. The developers of the NEI-VFQ distributed the original 52 items into 13 different domains. The recommended method for scoring the NEI-VFQ is to linearly transform the sum of the ordinal ratings to each item within each domain to produce 13 scores. The major shortcoming of this scoring method is that sums of ordinal numbers do not necessarily generate valid measurement scales. However, Rasch models can be used to estimate interval measurement scales from ordinal responses to items. We administered 27 items from the 52-item NEI-VFQ to 341 patients with low vision. Rasch analysis was used to estimate the 'visual ability' required by each item for a particular response (item measures) and to estimate the 'visual ability' of each patient (person measures). The validity of the model was evaluated by examining the distributions of residuals for item and person measures. We observed that the 17 items we tested from the NEI-VFQ that require difficulty ratings produce a valid interval scale for low-vision patients. The estimated person measures of visual ability are linear with log MAR acuity. The ten items that require frequency or level of agreement ratings do not work together to produce a valid interval scale. Rather, these items appear to be confounded by other variables distributed in the patient sample (e.g. psychological state). The visual ability scale estimated from the 17 NEI-VFQ items is proportional to the visual ability scales estimated from two earlier studies that also elicited difficulty ratings from low-vision patients.

Adolescent↗

The cyclopean eye in vision: the new and old data continue to hit you right between the eyes.

We argue against recent claims by Erkelens and van Ee (Vision Res., in press) and by Erkelens (Vision Res. 40 (2000) 2411) that "the concept of the cyclopean eye is em leader always irrelevant as far as vision is concerned" (p. 1157) [corrected] and that "perceived direction during monocular viewing is based on the signals of the viewing eye only" (p. 2411), respectively. In Experiment 1, we presented a pair of small lights on a visual axis and measured the absolute visual direction of the near light with reference to different parts of the face. The near light appeared in front of the bridge of the nose or very near it, contrary to what was expected from Erkelens and van Ee's claim that monocular stimuli are seen in their correct locations. In Experiment 2, we replicated Erkelens' experiments with measurements of phoria and analyses of eye movements. The results confirmed his finding that the cyclopean illusion occurred rarely in the monocular condition, but our phoria and eye movement data provided the basis for a very different interpretation. Our data show that the oculomotor signal in his particular monocular condition was considerably weaker than in his binocular condition; therefore, the rarity of the monocular cyclopean illusion is not surprising. Moreover, since both claims above are based on an over-generalization of the results of Erkelens' study, neither claim is persuasive.

Adult↗

Shift of equiluminance in congenital color vision deficiencies: pattern-ERG, VEP and psychophysical findings.

We compared electrophysiological responses [pattern-ERG (PERG) and VEP] and psychophysical measures to color stimuli to separate different forms of anomalous color vision. PERG and VEP were recorded from seven normals and 14 subjects with congenital color vision deficiencies. Stimuli were color checkerboards with 0.5 deg check size, phase reversing at 34 rev/sec. The luminances of the red and green parts were varied in opposite direction from 0 to 30 cd/m2, while the hue of individual squares and space-averaged luminance were held constant. This allowed for one equiluminance condition where flicker appeared fused. In the seven normals, the subjective equiluminance was reached at a luminance ratio red/(red + green) = 0.50-0.53. At that point, the PERG amplitude was moderately, and the VEP amplitude sharply reduced. In 14 color anomalous subjects both the PERG and VEP were sharply reduced at equiluminance. These dips were shifted compared to normals and the dip position corresponded to the predicted luminance ratios obtained by calculations from L- and M-cone activation using the Smith-Pokorny transformation. As we found a close correlation of the VEP-dip position and the anomalous quotient, these electrophysiological measures may allow objective assessment of color vision deficiencies.

Adult↗

Psychophysics of reading--XVI. The visual span in normal and low vision.

The visual span in reading is the number of characters that can be recognized at a glance. The shrinking visual span hypothesis attributes reading deficits in low vision, and slow reading in normal vision at low contrast, to a reduction in the visual span. This hypothesis predicts that reading time (msec/word) becomes increasingly dependent on word length as text contrast decreases. We tested and confirmed this prediction using the rapid serial visual presentation (RSVP) method. Estimates of the visual span ranged from about 10 characters for high-contrast text to less than two characters for low-contrast text. Eye-movement recordings showed that longer reading times at low contrast are partitioned about equally between prolonged fixation times and an increased number of saccades (presumably related to a reduced visual span). RSVP measurements for six out of seven low-vision subjects revealed a strong dependence of reading time on word length, as expected from reduced visual spans.

Adolescent↗

A perspective on color vision in platyrrhine monkeys.

Studies carried out over the past two decades show that many platyrrhine (New World) monkeys have polymorphic color vision. This condition results from the sorting of allelic versions of X-chromosome cone opsin genes at a single gene site, yielding a mixture of dichromatic and trichromatic phenotypes in the population. Two genera of platyrrhine monkey are known to deviate significantly from this pattern. Examination of color vision, photopigments, and photopigment genes of all of these monkeys have stimulated a renewed interest in understanding the evolution of primate color vision.

Animals↗

Can clinical colour vision tests be used to predict the results of the Farnsworth lantern test?

Clinicians usually do not have access to a lantern test when making an occupational assessment of the ability of a person with defective colour vision to recognise signal light colours: they must rely on the results of ordinary clinical tests. While all colour vision defectives fail the Holmes Wright Type B lantern test and most fail the Holmes Wright Type A lantern, 35% of colour vision defectives pass the Farnsworth lantern. Can clinical tests predict who will pass and fail the Farnsworth lantern? We find that a pass (less than two or more diametrical crossings) at the Farnsworth Panel D 15 Dichotomous test has a sensitivity of 0.67 and specificity of 0.94 in predicting a pass or fail at the Farnsworth lantern test: a Nagel range of > 10 has a sensitivity of 0.87 and a specificity of 0.57. We conclude that neither the D 15 nor the Nagel Anomaloscope matching range are satisfactory predictors of performance on the Farnsworth Lantern.

Color Perception Tests↗

Pupil size and quality of vision after LASIK.

PURPOSE: To evaluate factors related to the quality of vision after LASIK. DESIGN: Survey study. PARTICIPANTS: One hundred consecutive patients. INTERVENTION: LASIK with a 6.0-mm elliptical ablation pattern without transition zone to treat mild to moderate myopia or astigmatism (preoperative manifest spherical equivalent [MSE], -4.79 +/- 1.33 diopters [D]; range, -2.88 to -9.25 D). The second eye was treated 1 month after the first. MAIN OUTCOME MEASURES: Completed questionnaires assessing night vision problems (glare, haze, and halo symptoms) before surgery and at 1, 3, and 6 months after surgery in 97, 75, 81, and 66 subjects, respectively. Mesopic pupil size and preoperative and postoperative variables were analyzed with questionnaire data using an analysis of variance (ANOVA) and multivariate regression analysis. RESULTS: Patients with large mesopic pupils had significantly more reports of glare, haze, and halo than did those with smaller pupils in the treated eye at 1 month after surgery (P=0.02, P=0.03, and P=0.02, respectively ANOVA) and of glare at 3 months (P=0.05). Significant predictors of symptoms at 6 months, identified through multivariate regression analysis, included preoperative MSE (for glare and haze), preoperative contrast acuity (glare), postoperative uncorrected visual acuity (UCVA; haze), and residual cylinder (haze). Together, these factors accounted for only 19% of the overall variability in glare and 37% of the variability in haze responses. No relationship between pupils and symptoms was noted at 6 months after surgery in either the ANOVA or regression analysis group. CONCLUSIONS: Patients with large pupils had more quality of vision symptoms in the early postoperative period, but no correlation was observed 6 months after surgery. Factors related to long-term symptoms include the level of treatment (preoperative myopia), preoperative contrast acuity, postoperative UCVA, and residual cylinder. Most of the variability in visual quality could not be explained by preoperative or clinical outcome measures, including pupil size.

Adult↗

The relation of socioeconomic factors to age-related cataract, maculopathy, and impaired vision. The Beaver Dam Eye Study.

PURPOSE: To investigate the relations between socioeconomic factors and the prevalence of age-related cataract, maculopathy, and visual impairment. METHODS: A population-based sample of 4926 people 43 to 86 years of age was examined from 1988 to 1990. Education, income, employment status, marital status, nuclear sclerosis, cortical, and posterior subcapsular cataract, age-related maculopathy, and impaired vision were all ascertained using standard protocols. RESULTS: While controlling for age, sex, diabetes status, multivitamin use, alcohol consumption, and cigarette smoking, less education was significantly associated with nuclear and cortical cataract, and lower income was significantly associated with cortical and posterior subcapsular cataract and impaired vision. There was a "U-shaped" relation between income and cataract surgery. Neither income nor education was related to age-related maculopathy. There was no relation of marital status to cataract status or age-related maculopathy. CONCLUSION: These data suggest that education and income are associated with cataract, cataract surgery, and impaired vision. These relations were not explained by other risk factors measured in the study.

Adult↗

Retinopathy and vision loss in insulin-dependent diabetes in Europe. The EURODIAB IDDM Complications Study.

PURPOSE: To assess the frequency of retinopathy and vision loss in patients with insulin-dependent diabetes mellitus and their relations to potentially modifiable risk factors. METHODS: The authors conducted a multicenter cross-sectional study of diabetic complications and their risk factors using standardized methods of assessment. The sample was comprised of 3250 insulin-dependent diabetic patients (1668 men, 1582 women) aged 15 to 60 years with mean (standard deviation) duration of diabetes of 14.7 (9.3) years from 31 European diabetes centers; 2991 of the patients were eligible for retinal photography. Visual acuity was measured using the Snellen chart. Retinopathy was evaluated by retinal photographs (two fields per eye) graded at a central facility. Glycated hemoglobin (HbA1c), cholesterol, triglyceride, fibrinogen, von Willebrand factor, and urinary albumin excretion rate were assessed at a single location. RESULTS: Corrected visual acuity was greater than or equal to 1.0 in both eyes in 69.7% of patients and less than or equal to 0.1 in the best eye in 2.3%. Factors significantly related to vision loss were age, duration of diabetes, glycated hemoglobin (HbA1c), and level of retinopathy. Mild nonproliferative retinopathy was found in 25.8% of the patients, moderate-severe nonproliferative retinopathy in 9.8% of the patients, and proliferative retinopathy in 10.6% of the patients. After adjustment for age, duration of diabetes, HbA1c, and albumin excretion rate, significant risk factors for moderate-severe nonproliferative retinopathy were blood pressure and triglyceride, and risk factors for proliferative retinopathy were triglyceride and fibrinogen. CONCLUSION: Vision loss is a common complication of patients with insulin-dependent diabetes, with diabetic retinopathy an important cause. Apart from poor glycemic control, several other potentially modifiable risk factors for retinopathy may be important, including elevated blood pressure, plasma triglyceride, and fibrinogen. In view of the possible barriers to the full implementation of strict glycemic control in this type of diabetes, additional strategies for the prevention and slowing of progression of retinopathy should be investigated, such as blood pressure and lipid lowering therapies.

Adolescent↗

Evanescent (tunneling) photon and cellular "vision'.

The existence of a rudimentary form of cellular 'vision' was discovered experimentally by Albrecht-Buehler. He found that Swiss 3T3 cells approached distant infrared light spots and suggested that the most likely explanation for this phenomenon involves the long-range processing of electromagnetic signals by the cells. In this paper, a theoretical possibility of this phenomenon is presented within the fully quantum theoretical framework of the electromagnetic field and water. By taking into account the usually neglected interaction between the electric dipole field of water molecules and the quantized electromagnetic field, the dynamically ordered region of water surrounding the cell up to the coherence length < 50 microns is shown to play the role of a nonlinear coherent optical device through which the cells receive electromagnetic signals from distant light spots. The electromagnetic signals for the cell Albrecht-Buehler found are shown to consist of evanescent photons (i.e. soft polaritons) tunneling through the dynamically ordered region of water between the cell and the distant light spot. In contrast to the (normal) vision of animals realized by receiving (normal) photons, cellular "vision' is found to be realized by receiving evanescent photons. It is also suggested that the existence of the dynamically ordered region of water realizing a boson condensation of evanescent photons inside and outside the cell can be regarded as the definition of life.

3T3 Cells↗

Can vision compensate for a lower limbs muscular fatigue for controlling posture in humans?

The purpose of the present experiment was to investigate the effect of vision on postural control following a lower limbs muscular fatigue. Ten adult males were asked to maintain a single leg upright posture as immobile as possible in two conditions of no-fatigue and fatigue of the calf muscles. This muscles fatigue was achieved by standing on the toes until exhaustion. Within a trial, vision was suppressed or reinserted by eyes closure or opening. Center of foot pressure displacements were recorded using a force platform. Results showed that the availability of vision allowed the subjects to immediately cope with the destabilizing effect induced by muscular fatigue.

Adaptation, Physiological↗

Achromatopsia, color vision, and cortex.

Brain damage can entirely abolish color vision in cases of complete achromatopsia. Other processes that depend on wavelength differences, however, can be retained. Form and motion defined by pure color differences can be perceived readily even when the colors themselves cannot be told apart. The loss of color vision in cerebral achromatopsia has been equated with the loss of a "color center" presumed indispensable for the phenomenal experience of hue. The "color center" has been assigned a role in the cortical construction of color, specifically in implementing the computations that underlie color constancy. Many features of the condition are consistent with this account. Other neurologic patients, however, retain conscious experience of hue, yet fail to disentangle the illuminant and the reflectance properties of surfaces. For them, color experience is determined by the wavelength composition of light reflected from a surface. If their wavelength-dependent vision is mediated by activity in early visual areas, then it is difficult to understand why these areas are unable to perform a similar role when they remain intact in achromatopsic observers. The prevalence of cells in the ventral visual areas of the monkey brain that code color and the further fractionation of color-related areas in human observers revealed by functional imaging suggest multiple color areas. Their different contributions are only just beginning to become apparent.

Brain Diseases↗

Beam-deflection method of diagnosing impaired vision.

We describe a simple method to assign a diagnosis of cataract to patients with obscurely impaired vision as well as to those with mild lens opacities. When the narrowest slit is used in a slitlamp examination, a small beam of light appears on the macula. Routine fundoscopy with the 78.0 diopter lens or a 3-mirror glass is appropriate. If a cataract is present, the beam of light is scattered into several straight lines, distorted lines, or both. This has proved a useful diagnostic tool when the lens appears clear but the patient's vision is impaired, and extensive examinations such as computer tomography or nuclear magnetic resonance tomography for impaired vision may be avoided. The beam-deflection method uses devices that are generally available and can detect cataract in the early stages of development.

Adolescent↗

A table of color distance scores for quantitative scoring of the Lanthony Desaturate color vision test.

The Lanthony Desaturate Panel D-15 (D-15d) color vision test is used in neurotoxicological testing to assess acquired color vision deficits. The original test design included a qualitative scoring method. Quantitative scoring requires mapping the colored objects used in the test into a color space describing perceptual distances. A table of these distances has previously been published for the saturated version of this color vision test, but not the desaturate test. This communication includes a table of color distances for the calculation of Bowman's Total Color Distance Score (TCDS) for the D-15d. This table should be useful for non-computerized scoring under field test conditions or for devising one's own computerized scoring methods using the tabulated color distances for a look-up table. Data analysis programs using SAS or Matlab are available from the author.

Color↗

Vision modulates somatosensory cortical processing.

Over 150 years ago, E.H. Weber declared that experience showed that tactile acuity was not affected by viewing the stimulated body part. However, more recent investigations suggest that cross-modal links do exist between the senses. Viewing the stimulated body site improves performance on tactile discrimination and detection tasks and enhances tactile acuity. Here, we show that vision modulates somatosensory cortex activity, as measured by somatosensory event-related potentials (ERPs). This modulation is greatest when tactile stimulation is task relevant. Visual modulation is not present in the P50 component reflecting the primary afferent input to the cortex but appears in the subsequent N80 component, which has also been localized to SI, the primary somatosensory cortex. Furthermore, we replicate previous findings that noninformative vision improves spatial acuity. These results are consistent with a hypothesis that vision modulates cortical processing of tactile stimuli via back projections from multimodal cortical areas. Several neurophysiological studies suggest that primary and secondary somatosensory cortex (SI and SII, respectively) activity can be modulated by spatial and tactile attention and by visual cues. To our knowledge, this is the first demonstration of direct modulation of somatosensory cortex activity by a noninformative view of the stimulated body site with concomitant enhancement of tactile acuity in normal subjects.

Adult↗

Spatiochromatic properties of natural images and human vision.

The human visual system shows a relatively greater response to low spatial frequencies of chromatic spatial modulation than to luminance spatial modulation. However, previous work has shown that this differential sensitivity to low spatial frequencies is not reflected in any differential luminance and chromatic content of general natural scenes. This is contrary to the prevailing assumption that the spatial properties of human vision ought to reflect the structure of natural scenes. Now, colorimetric measures of scenes suggest that red-green (and perhaps blue-yellow) color discrimination in primates is particularly suited to the encoding of specific scenes: reddish or yellowish objects on a background of leaves. We therefore ask whether the spatial, as well as chromatic, properties of such scenes are matched to the different spatial-encoding properties of color and luminance modulation in human vision. We show that the spatiochromatic properties of a wide class of scenes, which contain reddish objects (e.g., fruit) on a background of leaves, correspond well to the properties of the red-green (but not blue-yellow) systems in human vision, at viewing distances commensurate with typical grasping distance. This implies that the red-green system is particularly suited to encoding both the spatial and the chromatic structure of such scenes.

Color Perception↗