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Medical students and congenital colour vision deficiency: unnoticed problems and the case for screening.

The results are given of a questionnaire study to determine the range of difficulties that doctors notice in their work due to congenital colour vision deficiency (CCVD). The study is primarily qualitative. A questionnaire was sent to 40 self-selected doctors, 35 of whom were general practitioners (GPs). All were administered a number of colour vision tests to assess the type and severity of their deficiency. Many difficulties and some ways of overcoming them were reported. Those with a mild deficiency reported fewer difficulties and this relationship was significant. Twenty-three of the doctors also reported difficulties as medical students and their answers are given verbatim. The results are discussed in relation to other studies and data on colour vision. The reasons for and against screening medical students for this deficiency are considered and it is concluded that there is a strong case for screening.

Color Perception Tests↗

Serious ophthalmic pathology compromising vision in HCV/HIV co-infected patients treated with peginterferon alpha-2b and ribavirin.

OBJECTIVE: To characterize the ocular changes associated with peginterferon alpha 2b (peg-IFN alpha-2b) and ribavirin therapy for chronic hepatitis C infection in HIV co-infected individuals. METHODS: A prospective, open-label trial treating HIV/hepatitis C (HCV) co-infected individuals with peg-IFN alpha-2b and ribavirin at the Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA. Twenty-three patients with a high mean CD4+ T-cell count were treated with peg-IFN alpha-2b and ribavirin and followed for 40 to 88 weeks. Ophthalmologic evaluations including visual acuity, visual field testing, color vision examination and indirect ophthalmoscopy were performed at baseline and every 3 months. RESULTS: Eight of the 23 patients (35%) developed ophthalmologic pathology, including cotton wool spots, cataracts, and two patients developed decreased color vision. These two patients regained their color vision, one after cessation of anti-HCV therapy. CONCLUSIONS: Although retinal pathologies have been reported in patients treated with interferon-alpha, they have not been reported during peg-IFN alpha-2b therapy nor in HIV/HCV co-infected patients. The incidence of serious ocular pathology associated with anti-HCV therapy may be very high and is probably associated with peg-IFN alpha-2b. Increased monitoring of patients treated with peg-IFN alpha-2b for retinal and visual changes is warranted.

Adult↗

Alzheimer-like visual deficits in Down syndrome.

Patients with Alzheimer disease (AD) show visual impairments in color discrimination (blue hues), stereoacuity, and contrast sensitivity. We asked whether the AD-type visual profile occurs in Down syndrome (DS) in light of the fact that AD neuropathology is present in DS by age 40. We tested 22 adults with DS and 18 adults with mental retardation of non-DS etiology (MR). DS subjects made more tritanomalous errors on the test of color vision than predicated by chance (p < 0.05), indicating a deficiency in the discrimination of short wavelengths (blue hues) but not more of other types of hue discrimination errors. DS subjects had higher stereoacuity thresholds than MR subjects (p < 0.01) and reduced contrast sensitivity across the frequency range (p < 0.01). Taken together, the results point to AD-like visual deficits in DS. Like classic AD, DS may be associated with pathological changes in the parastriate and peristriate visual cortex. DS performance was not correlated with age, suggesting that in individual subjects, the AD-like visual deficits may present prior to and independent of age-associated dementia.

Alzheimer Disease↗

Orbital decompression for Grave's disease leaving the periosteum intact.

A prospective trial was carried out to determine whether or not transorbital floor and medial wall decompression without opening the orbital periosteum would relieve compressive optic neuropathy in patients with Grave's disease. In four orbits (three patients), the procedure was performed, and in all cases, the vision returned to 20/30 or better. All other parameters of optic nerve function improved as well. No patient had worsening of ocular motility that was attributable to the surgery. The amount of retroplacement of the globe may be less than with standard orbital decompression.

Adult↗

Color vision testing in young children: a review.

It is often recommended that children be screened for possible color vision deficiencies as early as possible. This paper examines the validity of commercially-available color vision tests when used with young children (age three to seven years). It is concluded that with the possible exception of the anomaloscope, no test is entirely suited for children, in most cases because the test makes cognitive demands beyond the capability of the young child.

Adult↗