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PubMed1997

Evaluation of Kojima-Matsubara color vision test plates: validity in young children.

PURPOSE: We examined a pseudoisochromatic color plate test by Kojima and Matsubara for young children which uses drawings of familiar objects rather than letters or numbers. First, we evaluated the test's efficacy as a color deficiency screener and its validity in classifying the types of color deficiencies by comparing its results with those from the Moreland anomaloscope. Second, we eliminated the chromatic factor and evaluated the functional ability of young children to perform the task by determining how many correct responses were obtained using modified black/white replicas of the test plates. METHODS: Part 1: Twenty color-normal and 13 color-deficient adults were diagnosed and classified with the Ishihara test, Panel D-15 test, and anomaloscope. Subjects were then tested with the Kojima-Matsubara test and result were compared with those from the anomaloscope. Part 2: Fifty children aged 3 to 7 years were tested with modified black/white test plate replicas. The number of correct responses for each plate was determined for five different age groups. RESULTS: Part 1: Among the 20 color-normal subjects, 18 read all 10 plates correctly and 2 subjects missed 1 of the 10. Only 1 of the 13 color-deficient subjects exhibited the expected responses for plates 2 to 6 (used for color deficiency screening). The color-deficient subjects' responses for plates 7 to 10, which are used to classify red-green defects, were varied and only the protanomalous subjects (n = 2) followed the expected response pattern. Part 2: Of the 10 black/white modified plates, only 2 were correctly identified by all 50 children. The other plates had a recognition rate that ranged from 32 to 98%. CONCLUSIONS: Because the response patterns given by most of the color-deficient adult subjects were different from those in the test manual, ambiguous results would occur if the Kojima-Matsubara test were used for color vision screening or the diagnosis of color deficiency. In addition, the difficulty that many of the young children exhibited in identifying the objects in the black/white replica plates suggests that there would be a large number of false positive errors (classifying a color normal as color deficient) when using this test in young children.

Adult↗
PubMed2005

The prevalence of strabismus and amblyopia in Japanese elementary school children.

BACKGROUND: The purpose of this study is to elucidate the prevalence of strabismus and amblyopia in a large population of Japanese elementary school children, from Grade 1 to Grade 6, ages ranging from 6 to 12 years. The School Health Law requires that all pupils in Grade 1 to Grade 6 be examined for vision and eye problems. Visual acuity testing is done by school teachers and eye disease screening by school ophthalmologists. Pupils with suspected ocular diseases are further examined by extramural ophthalmologists and the results reported back to the schools. The schools then summarize and send uncorrected visual acuity and ocular disease incidence, together with other health statistics, to the municipal education committees. The data are forwarded to the Prefecture Governments and finally submitted to the Education Ministry of the Central Government. Both the Prefecture Governments and the Education Ministry publicize the school health statistics on their websites. The prevalence of strabismus and amblyopia remains unknown from these data because both diagnoses are included under the heading, eye diseases. METHODS: Questionnaires asking about the numbers of children with different types of strabismus and amblyopia were sent to all elementary schools in Okayama Prefecture and the results were summarized. RESULTS: The number of children covered by the return of questionnaires was 86,531 (76.4%) of 113,254 total pupils in Grade 1 to Grade 6 in Okayama Prefecture in the year 2003. The total numbers of children with strabismus and amblyopia were 1,112 (1.28%) and 125 (0.14%), respectively. The numbers of children with any type of exotropia and any type of esotropia were 602 (0.69%) and 245 (0.28%), respectively. The major types of strabismus and amblyopia were intermittent exotropia in 109 children (0.12%), accommodative esotropia in 19 children (0.02%), anisometropic amblyopia in 23 children (0.03%), and ametropic amblyopia in 12 children (0.01%). The number of children with strabismus of unknown type was 245 (0.28%) while the number of children with amblyopia of unknown type was 81 (0.09%). CONCLUSIONS: The prevalence rates of strabismus and amblyopia in this population of Japanese elementary school children were lower than those reported in Western countries. The exotropia/esotropia ratio were increased in comparison with past studies in Japan. The school eye doctors need to be more diligent in identifying and diagnosing various types of strabismus and amblyopia in order to contribute to the school vision screening program already in place in Japan

Amblyopia↗
PubMed2001

Sensitivity and specificity of tests to detect eye disease in an older population.

OBJECTIVE: To compare the ability of tests of visual function to detect the presence of eye disease. DESIGN: Cross-sectional study. PARTICIPANTS: Three thousand six hundred fifty-four of 4433 (82.4%) eligible residents of an area near Sydney aged 49 years and older had a detailed eye examination, including retinal and lens photography and subsequent grading of eye disease, tests of presenting and corrected visual acuity, contrast sensitivity, screening visual field and intraocular pressure. MAIN OUTCOME MEASURES: Receiver operator characteristic (ROC) curves were created and area under the curve compared for each vision test. Sensitivity and specificity were calculated for each test. RESULTS: No single vision test predicted the presence of eye disease with any consistency. Best-corrected visual acuity or contrast sensitivity had the highest area under the ROC curve for most eye diseases examined but had poor sensitivity and specificity. For glaucoma and diabetic retinopathy there was no difference in area under the curve for any of the tests examined, and no test had a good balance of sensitivity and specificity. Screening tests (performed with presenting correction) did not perform as well as nonscreening tests (those carried out after refraction with best correction). CONCLUSIONS: Current vision tests are not particularly good at detecting eye disease compared with the "gold standard" of a full eye examination performed by an ophthalmologist. Further work in this area should be carried out before vision screening programs can be recommended for implementation among older people.

Aged↗
PubMed1979

Screening of red-green defects of colour vision with pseudoisochromatic tests.

Fifty red-green defectives and 100 normal subjects were examined with the second edition of the Boström-Kugelberg (BK II, 1972) series and the Ishihara complete edition (1976) of pseudoisochromatic plates. The results are related to those obtained with the first edition of the Boström-Kugelberg test (BK I, 1944) and the Boström test (II B, 1950) and to the classification of defects obtained with the Nagel anomaloscope. The 50 red-green defectives were originally selected by using a combination of the BK I and II B tests. The normal subjects also, passed this preliminary test, as well as an examination with the Nagel anomaloscope. In the final examinations performed under standardized conditions, three red-green defectives passed both the BK II and the BK I test, while eight defectives passed the Ishihara test. Combination of BK II or BK I test with the Ishihara test does not improve the result. Only one defective (a borderline case of protanomaly) passed the separate II B test. Normal subjects were not classified as colour defectives with any of the four pseudoisochromatic tests used. All normal subjects passed both the BK II and the Ishihara test. Classified as suspected red-green defectives (one misreading made in standardized conditions) were five normal subjects with the II B test and one normal subject with the BK I test. In the second edition of Boström-Kugelberg series, the plates numbered 3, 5, 11, 16 and 18 are clearly less effective than respective plates of the first edition. Only the plates numbered 1 and 10 have markedly improved in the second edition. Red-green defectives made on average 0.54 misreadings per plate in the BK II test as compared with respective 0.62 in BK I, 0.69 in the Ishihara and 0.56 in the II B test.

Color Perception Tests↗
PubMed1999

The eye in childhood.

Normal visual development is rapid during the first six months of life and continues through the first decade. Young children are uniquely sensitive to conditions that interfere with vision and visual development. Amblyopia, or functionally defective development of the central visual system, may be caused by common vision problems such as strabismus, uncorrected refractive errors and deprivation secondary to occlusion. Prematurity is especially associated with eye pathology, including retinopathy of prematurity, amblyopia, strabismus and refractive errors. When detected early, amblyopia and many other childhood vision abnormalities are treatable, but the potential for correction and normal visual development is inversely related to age. Since many affected children are asymptomatic, early detection of abnormal visual function requires effective screening throughout early childhood. Special considerations apply to screening examinations of children born prematurely.

Age Factors↗
PubMed2004

Design of and normative data for a new computer based test of ocular torsion.

PURPOSE: To evaluate a new clinically practical and dynamic test for quantifying torsional binocular eye alignment changes which may occur in the change from monocular to binocular viewing conditions. METHODS: The test was developed using a computer with Lotus Freelance Software, binoculars with prisms and colored filters. The subject looks through binoculars at the computer screen two meters away. For monocular vision, six concentric blue circles, a blue horizontal line and a tilted red line were displayed on the screen. For binocular vision, white circles replaced blue circles. The subject was asked to orient the lines parallel to each other. The difference in tilt (degrees) between the subjective parallel and fixed horizontal position is the torsional alignment of the eye. The time to administer the test was approximately two minutes. RESULTS: In 70 Normal subjects, average age 16 years, the mean degree of cyclodeviation tilt in the right eye was 0.6 degrees for monocular viewing conditions and 0.7 degrees for binocular viewing conditions, with a standard deviation of approximately one degree. There was no "statistically significant" difference between monocular and binocular viewing. CONCLUSION: This computer based test is a simple, computerized, non-invasive test that has a potential for use in the diagnosis of cyclovertical strabismus. Currently, there is no commercially available test for this purpose.

Adolescent↗
PubMed2006

Frequency of colour vision deficiencies in melanoma patients: results of a prospective comparative screening study with the Farnsworth panel D 15 test including 300 melanoma patients and 100 healthy controls.

Patients with melanoma may experience a variety of different vision symptoms, in part associated with melanoma-associated retinopathy. For several melanoma patients with or without melanoma-associated retinopathy, colour vision deficiencies, especially involving the tritan system, have been reported. The frequency of colour vision deficiencies in a larger cohort of melanoma patients has not yet been investigated. The aim of this study was to investigate the frequency of colour vision deficiencies in melanoma patients subject to stage of disease, prognostic factors such as tumour thickness or Clark level, S100-beta and predisposing diseases that may have an impact on colour vision (hypertension, diabetes mellitus, glaucoma or cataract). Three hundred melanoma patients in different tumour stages and 100 healthy age-matched and sex-matched controls were examined with the saturated Farnsworth panel D 15 test. Seventy out of 300 (23.3%) melanoma patients and 12/100 (12%) controls showed pathologic results in colour testing. This discrepancy was significant (P < 0.016; odds ratio = 2.23, 95% confidence interval 1.15-4.32). Increasing age was identified as a highly significant (P = 0.0005) risk factor for blue vision deficiency. Adjusting for the age and predisposing diseases, we could show that melanoma was associated with the risk of blue vision deficiency. The frequency of blue vision deficiency in 52/260 melanoma patients without predisposing diseases (20%) compared with 4/78 controls without predisposing diseases (5.1%) differed significantly (odds ratio 4.441; confidence interval 1.54-12.62; P < 0.004). In 260 melanoma patients without predisposing diseases, blue vision deficiency, as graded on a 6-point scale, showed a weak positive correlation (Spearman) with tumour stage (r = 0.147; P < 0.01), tumour thickness (r = 0.10; P = 0.0035), Clark level (r = 0.12; P = 0.04) and a weak negative correlation with time since initial diagnosis (r = -0.11; P = 0.0455). Blue vision deficiency is associated with melanoma, but is only weakly related to stage of disease. Although we saw a positive correlation with well-known prognostic markers, such as tumour thickness and Clark level, blue vision deficiency as assessed by the Farnsworth panel D 15 test in general is inappropriate as a marker of tumour progression. For the use of blue vision deficiency in melanoma patients without predisposing diseases, a diligent test performance and interpretation is very important.

Adult↗
PubMed2005

UK population based study of severe retinopathy of prematurity: screening, treatment, and outcome.

BACKGROUND: Retinopathy of prematurity (ROP) is one of the few causes of childhood blindness in which severe vision impairment is largely preventable. Ophthalmic screening for ROP is required to identify disease that requires treatment whereby the development of potentially blinding disease can be minimised. OBJECTIVES: To make the first UK population based estimate of the incidence of babies with severe ROP (stage 3 or more); to document their clinical characteristics and management and to evaluate the appropriateness of current ROP screening guidelines in the UK. PATIENTS: Cases were recruited through a national surveillance programme with 1 year ophthalmic follow up and data from clinician completed questionnaires. RESULTS: Between 1 December 1997 and 31 March 1999, 233 preterm babies with stage 3 ROP were identified. Severity (location, extent, and presence of plus disease) was associated with degree of prematurity, most severe in the most premature babies. Fifty nine percent were treated. The UK screening protocol was followed in two thirds of cases, but in the remainder it was begun too late or was too infrequent. Three quarters of the cases were followed up at 1 year, and 13% had a severe vision deficit as a result of ROP. CONCLUSIONS: Visual deficit as a result of ROP in premature babies continues to be a severe disability in some of the survivors of neonatal intensive care. Further efforts are needed to organise treatment regionally to improve outcome and standards of practice.

Birth Weight↗
PubMed1996

Determination and application of vision standards in industry.

Job-related vision standards benefit both employee and employer. By comparing employees' vision to specific job requirements, workers can be better placed into positions commensurate with their visual abilities. For a company without a vision care program, a project was undertaken to determine visual standards, and the need for vision care services for employees to better meet these standards. The critical factors for performing specific visual tasks for 40 job classifications were identified through direct observation and measurement, and through worker interviews. Additionally, a sample of employees was screened to determine plant population characteristics, and to determine what percentage of employees met the newly formed standards. This study can serve as a model for the application of visual standards to the workplace and is pertinent, as "reduced vision" is increasingly defined by government as a disability.

Adult↗
PubMed2000

[The development of the skin-optical perception of color and images in blind schoolchildren on an "internal visual screen"].

In profound impairement of vision the function of colour and seen objects perception is absent, with the person being unable to orient himself in space. The uncovered sensory sensations of colour allowed their use in training the blind in recognizing the colour of paper, fabric, etc. Further study in those having become blind will, we believe, help in finding eligible people and relevant approaches toward educating the blind, which will make for development of the trainee's ability to recognize images on the "inner visual screen".

Blindness↗
PubMed1996

Evaluation of a new self-screening chart for cytomegalovirus retinitis in patients with AIDS.

AIDS patients often present without visual symptoms despite severe vision-threatening cytomegalovirus (CMV) retinitis. A new self-examination chart, the Teich Target (copyright 1993, Steven A. Teich, pat. no. 370259), which tests the central 45 degrees of vision, was evaluated for its ability to screen AIDS patients for CMV retinitis. It was compared with the Amsler grid (which tests the central 20 degrees of vision) in 50 consecutive AIDS patients referred for ophthalmologic evaluation by a single practitioner. Of 19 patients found to have CMV retinitis, 12 (63%) noted scotomas with the Teich Target compared with 7 (37%) with the Amsler grid (p < 0.05). Overall, 13 of 20 (65%) infectious retinitis cases were detected by the Teich Target. and 7 of 20 (35%) with the Amsler grid (p < 0.05). All scotomas noted on the Amsler grid were detected by the Teich Target. Four visually asymptomatic patients with newly diagnosed CMV retinitis noted scotomas only with the Teich Target. Both methods detected a branch retinal artery occlusion, but only the Teich Target detected a quadrantanopsia due to cerebral toxoplasmosis. There were no false positives with either method. In this small series, the Teich Target was more effective than the Amsler grid in screening AIDS patients for CMV retinitis primarily because it detected lesions beyond the central 20 degrees of vision. Peripheral CMV retinitis beyond the central 40 degrees occurred in 37% of patients and was net detected by either method. The Teich Target therefore augments but does not replace periodic ophthalmologic evaluations. The Teich Target may have potential utility for home use as a patient self-screening test for CMV retinitis or for mass screening in an AIDS clinic.

AIDS-Related Opportunistic Infections↗
PubMed2006

The effect of colour defective vision on shade matching accuracy.

One hundred and forty one male dental students and staff were screened for colour-defective vision. Ten colour-defective and 20 non colour-defective subjects then carried out a shade matching exercise using nine selected shades and another matched, shade tab (to test for consistency) from Vita shade guides. All shade matching took place under standard lighting conditions. Each subject also completed a short questionnaire relevant to shade matching. There were no significant differences found between colour-defective and non colour-defective subjects in shade matching abilities. Although both subject groups were similar in their shade matching abilities, individuals with colour defective vision perceived it to be a slightly more difficult exercise.

Case-Control Studies↗
PubMed1990

The proportion of various types of congenital color vision defects.

One hundred and three color vision defective subjects were screened from 3456 middle school students with pseudoisochromatic plate test. One hundred subjects out of them were further examined with a test battery including Panel D-15 and FM 100-hue test and Neitz anomaloscope test. It was found that there were 21 protanopes (P), 3 extremely protanomalous (EPA), 13 protanomalous (PA), 25 deutenopes (D), 5 extremely deuteranomalous (EDA), 28 deuteranomalous (DA), 6 unclassified subjects in our investigation. The proportion of various types of congenital color vision defects was P:EPA:PA:D:EDA:DA = 1.00:0.14:0.62:1.19:0.24:1.33.

Adolescent↗
PubMed1989

Contrast sensitivity norms for the Mentor B-VAT II-SG video acuity tester.

The Mentor B-VAT II-SG video acuity tester is a high-resolution video system designed to present many of the targets used in standard vision examinations (Snellen optotypes, clock charts, etc.). The SG model also presents sinusoidal gratings at various spatial frequencies and contrasts, making it possible to measure contrast sensitivity functions (CSF's). Using this system, we measured CSF's in a group of 69 young observers with well corrected vision. Contrast sensitivity scores were obtained at each of five spatial frequencies. A total of 5710 trials was presented. The mean contrast sensitivity scores of our group agree well with norms of other available CSF measurement systems, provided that the low spatial frequency truncation effects of each system are taken into account. A random subset of the group was retested 1 month later; no significant differences were found, demonstrating the reliability of the measurements. The data of this study should aid the clinician in identifying visual disorders. The data may be used to determine quantitative deviations from the norms or as a rapid screening test.

Adult↗
PubMed2000

A comparison of the diagnostic utility of two image receptors for panoramic radiography.

OBJECTIVE: To compare the diagnostic utility of two screen-film systems for panoramic radiography, one based on green and the other on ultraviolet light. MATERIALS AND METHODS: Two hundred consecutive adult patients with teeth in all four quadrants requiring panoramic radiographs were randomly allocated to one of two groups. One group was imaged with OGA L (CEA AB, Strängnäs, Sweden) film using Lanex Regular (Eastman Kodak, Rochester, NY, USA) screens (the Lanex group). The other group was imaged using Ultra-Vision (Dupont UK Limited, Hertfordshire, UK) film and screens (the Ultra-vision group). Two different panoramic machines were used, a Planmeca (Planmeca OY, Helsinki, Finland) and Cranex (Soredex Orion Corporation, Helsinki, Finland). The radiographs were evaluated by two radiographers for overall quality and any faults recorded. Two dental radiologists evaluated the crestal and apical areas of every standing tooth on a 4-point scale. The likelihood of getting a high-quality image with the different films was modelled using logistic regression, adjusting for the radiologist and the area of the tooth being examined. Inter- and intra-examiner agreement was calculated using Kappa and weighted Kappa where appropriate. RESULTS: The radiographers recorded no significant differences in positioning errors between the two groups of film. However, the films produced on the Cranex were less likely to be recorded as excellent. The radiologists' interexaminer agreement for the lower molars and upper incisors was only moderate at best (kappa = 0.56). No significant differences were found between the likelihood of the two types of film providing a high-quality image. Crestal areas were more likely to be scored well than apical areas. CONCLUSION: There were no differences in ease of discerning apical and crestal areas between the two screen-film systems. There was only poor to moderate agreement between the two radiologists. Ultra-Vision can be recommended as an alternative to existing rare earth systems for panoramic radiography.

Adult↗