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Turkish Journal of Ophthalmology Jun 2022To compare reading parameters measured with the Turkish version of the Minnesota Low Vision Reading Test (MNREAD-TR) printed acuity chart and the tablet application...
OBJECTIVES
To compare reading parameters measured with the Turkish version of the Minnesota Low Vision Reading Test (MNREAD-TR) printed acuity chart and the tablet application version of the same test for both normally sighted and low-vision individuals.
MATERIALS AND METHODS
A total of 116 individuals (92 normally sighted and 24 low-vision) were included in the study. All participants were tested with both the print version of the MNREAD-TR chart (method 1) and the tablet application version (method 2). Reading acuity (RA), critical print size (CPS), maximum reading speed (MRS), and reading accessibility index (ACC) were compared statistically.
RESULTS
No statistically significant difference was found in RA and CPS between the two methods for the normally sighted individuals (p=0.083 and p=0.075, respectively). There was no statistically significant difference in RA and ACC between the two methods for the patients with low vision (p=0.159 and p=0.103, respectively). The mean MRS was 233.1±34.7 words per minute (wpm) with method 1 and 169.3±23.4 wpm with method 2 in the normally sighted group (p<0.001) and 93.2±50.2 wpm with method 1 and 68.2±34.7 wpm with method 2 in the low-vision group (p<0.001).
CONCLUSION
In our study, it was found that the parameters RA and CPS in the normally sighted individuals and RA and ACC in the low vision individuals provided similar results in both forms of the MNREAD. The tablet application method can be preferred to eliminate evaluators' bias of scoring the printed chart. In addition, applications have other advantages such as being faster and more practical and providing automatic analysis of parameters, especially in low-vision rehabilitation.
Topics: Humans; Minnesota; Reading; Vision Tests; Vision, Low; Visual Acuity
PubMed: 35770299
DOI: 10.4274/tjo.galenos.2021.33581 -
Indian Journal of Ophthalmology Feb 2021The objective of this study was to identify and validate smartphone-based visual acuity (VA) apps that can be used in a teleophthalmology portal.
PURPOSE
The objective of this study was to identify and validate smartphone-based visual acuity (VA) apps that can be used in a teleophthalmology portal.
METHODS
The study was conducted in three phases: A survey to investigate if the SmartOptometry App was easy to download, understand and test (phase I), an in-clinic comparison of VA measured in a random testing order with four tools namely COMPlog, Reduced Snellen near vision, Peek Acuity (Distance VA) and SmartOptometry (Near VA) (phase II) and a repeatability study on these 4 tools by measuring VA again (phase III). The study recruited the employees of our institute and adhered to the strict COVID-19 protocols of testing.
RESULTS
Phase I Survey (n = 40) showed 90% of participants used android phones, 60% reported that instructions were clear, and all users were able to self-assess their near VA with SmartOptometry App. Phase II (n = 68) revealed that Peek Acuity was comparable to COMPlog VA (P = 0.31), however SmartOptometry was statistically significantly different (within 2 log MAR lines) from Reduced Snellen near vision test, particularly for young (n = 44, P = 0.004) and emmetropic (n = 16, P = 0.04) participants. All the 4 tests were found to be repeatable in phase III (n = 10) with a coefficient of repeatability ≤0.14.
CONCLUSION
Smartphone-based apps were easy to download and can be used for checking patient's distance and near visual acuity. An effect of age and refractive error should be considered when interpreting the results. Further studies with real-time patients are required to identify potential benefits and challenges to solve.
Topics: Adult; Aged; COVID-19; Comorbidity; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mobile Applications; Ophthalmology; Pandemics; Prospective Studies; Refractive Errors; Reproducibility of Results; SARS-CoV-2; Smartphone; Telemedicine; Vision Tests; Visual Acuity; Young Adult
PubMed: 33380619
DOI: 10.4103/ijo.IJO_2333_20 -
Ophthalmic & Physiological Optics : the... May 2021Preschool children in New Zealand undergo vision screening to detect amblyopia at 4-5 years of age. The current test, the Parr vision test, does not meet international...
Diagnostic accuracy of the Parr vision test, single crowded Lea symbols and Spot vision screener for vision screening of preschool children aged 4-5 years in Aotearoa/New Zealand.
PURPOSE
Preschool children in New Zealand undergo vision screening to detect amblyopia at 4-5 years of age. The current test, the Parr vision test, does not meet international visual acuity chart guidelines and has not been validated against other commonly used paediatric vision tests. New Zealand vision screening protocols are also not targeted for detecting other eye conditions such as uncorrected refractive error, which may affect school performance. We compared the Parr vision test with the single crowded Lea symbols and the Spot vision screener for detecting ocular pathology, refractive error and amblyopic risk factors in preschool children.
METHODS
A cross-sectional diagnostic accuracy study recruited children aged 4-5 years via convenience sampling from the University of Auckland Optometry Clinic and through primary schools in Auckland, New Zealand. Participants received vision screening with the three different instruments administered by a lay screener. Comprehensive eye examinations were completed by a paediatric optometrist to determine the presence of vision disorders.
RESULTS
Of 197 children who received a comprehensive eye examination, 14 (7.1%) had amblyopic risk factors and 43 (21.8%) had significant refractive error (15.7% with astigmatism, 9.1% with hyperopia). The sensitivity for detecting any ocular condition did not differ significantly between the tests (50.0% for Parr, 43.5% for Lea, 42.5% for Spot). Specificity was significantly lower for the Parr vision test (80.8%) than for the Lea symbols (93.4%) and Spot vision screener (98.0%). Adding the Spot vision screener to measurements of visual acuity significantly improved sensitivity in detecting any ocular condition with the Parr vision test (67.5% for Parr/Spot vs 50% for Parr alone), but not with the Lea symbols (52.5% for Lea/Spot vs 43.5% for Lea alone).
CONCLUSION
The sensitivity of the Parr vision test for detecting ocular conditions in preschool children does not vary significantly from that achieved by the Lea symbols or the Spot vision screener. However, current New Zealand vision screening protocols could be improved by expanding the target conditions to include significant refractive error and incorporating the use of the Spot vision screener to increase the accuracy with which children with refractive error are identified. Future research should include longitudinal studies to determine the effect of preschool vision screening on later ocular and academic outcomes.
Topics: Child, Preschool; Cross-Sectional Studies; Humans; Incidence; New Zealand; Refraction, Ocular; Refractive Errors; Reproducibility of Results; Schools; Vision Screening; Visual Acuity
PubMed: 33813777
DOI: 10.1111/opo.12816 -
Journal of Cataract and Refractive... Jul 2023To validate the Democritus Digital Acuity and Reading Test (DDART) as a distance VA (dVA) test against a series of prevalent conventional distance vision charts.
PURPOSE
To validate the Democritus Digital Acuity and Reading Test (DDART) as a distance VA (dVA) test against a series of prevalent conventional distance vision charts.
SETTING
Ophthalmology Department, University Hospital of Alexandroupolis, Alexandroupolis, Greece; Ophthalmology Department, AHEPA University Hospital, Thessaloniki, Greece; and Ophthalmica Institute of Ophthalmology & Microsurgery, Thessaloniki, Greece.
DESIGN
Prospective multicenter validation study.
METHODS
The distance best spectacle-corrected visual acuity (dBSCVA) was compared in normal (NVG) and low (LVG) vision participants against 4 prevalent conventional distance vision charts (ETDRS, Snellen, Landolt C, and Tumbling E) by a predefined 2.5-symbol noninferiority margin and intraclass correlation coefficients (ICCs). DDART's test-retest (TRT) reliability was assessed with ICCs.
RESULTS
534 participants (471 and 63 with normal and low vision, respectively) were included in the study. The mean difference between dBSCVA measured with DDART and conventional charts ranged between -0.84 and +0.85 symbols, without exceeding the 2.5-symbol noninferiority margin. ICCs indicated an excellent level of agreement for all patient groups (from 0.848 to 0.985). TRT reliability indicated differences below 1 symbol both for the NVG and LVG, with ICCs ranging between 0.912 and 0.964 for the 4 DDARTs.
CONCLUSIONS
DDART was a valid web-based dVA test that provided reliable measurements in clinical and telemedical settings, both for normal and low vision patients.
Topics: Humans; Vision Tests; Vision, Low; Prospective Studies; Reproducibility of Results; Visual Acuity; Internet
PubMed: 36853857
DOI: 10.1097/j.jcrs.0000000000001176 -
Optometry and Vision Science : Official... Aug 2015H.J. Haase developed a set of tests for measuring associated phoria and stereopsis using a variety of different targets for each. This testing method is known as the...
PURPOSE
H.J. Haase developed a set of tests for measuring associated phoria and stereopsis using a variety of different targets for each. This testing method is known as the MKH-Haase method and it is used commonly in Germany. The aim of this study was to investigate the test-retest repeatability of the distance and near associated phoria tests for the MKH-Haase charts and other clinical tests.
METHODS
Horizontal and vertical associated phorias were measured at distance and near for 34 symptomatic and 40 asymptomatic participants with different tests. The tests are Cross, Pointer, Double Pointer, and Rectangle tests of MKH-Haase charts at distance and near. The other common tests include the Mallett Test and the American Optical (AO) Slide at distance. At near, there are the Mallett Test, the AO Card, the Saladin Card, the Wesson Card, and the Sheedy Disparometer.
RESULTS
The 95% limits of agreement for all of the distance horizontal values for the symptomatic group were within ±1.25, except for the AO Slide limits, which were larger by 0.43. The limits of agreement for the asymptomatic group were within ±0.875. At near, the 95% limits of agreement for most of the horizontal associated phoria tests were ±2.00. The exception was the symptomatic group's Sheedy Disparometer limits, which were -4.25 to 5.75. Except for the Disparometer values for the asymptomatic group, the mean between-session differences were not statistically significant different from zero based on the 95% confidence interval. The asymptomatic group's mean Disparometer value was less eso at the second session. The 95% limits of agreement for all of the vertical values at distance and near for both groups were very narrow (i.e., within ±0.375).
CONCLUSIONS
Most of the tests showed good repeatability for both subject groups at distance and near, except for the Sheedy Disparometer. The reason for the lower repeatability could be the design of the Disparometer.
Topics: Adolescent; Adult; Depth Perception; Ethnicity; Female; Fixation, Ocular; Germany; Humans; Male; Oculomotor Muscles; Reproducibility of Results; Strabismus; Vision Tests; Vision, Binocular
PubMed: 26099058
DOI: 10.1097/OPX.0000000000000638 -
Eye (London, England) Jan 2024After going into the etymology of the word "optotype", this article covers some tasks in ancient times that required good visual acuity (VA). Around 300 BCE, Euclid... (Review)
Review
After going into the etymology of the word "optotype", this article covers some tasks in ancient times that required good visual acuity (VA). Around 300 BCE, Euclid formulated the existence of a visual cone with a minimal visual angle at its tip. Trials to test VA appeared AD 1754. Around that time, texts were introduced by opticians in order to be able to prescribe more reliably. In the early nineteenth century, the need for VA tests in ophthalmology resulted in German and English test charts. Numerous variants emerged after the first edition of Snellen's optotypes in 1862 in The Netherlands. However, 100 years later there was still no standard optotype to reliably test VA. Multidisciplinary approaches between ophthalmology, linguistics, psychology and psychophysics improved optotypes and VA testing, which led to the more reliable LogMAR charts. Recent advances in aids and therapies for the blind and severely visually handicapped, necessitate further development of new and standardized VA tests.
Topics: Humans; Ophthalmology; Vision Tests; Visual Acuity
PubMed: 35922542
DOI: 10.1038/s41433-022-02180-6 -
Ophthalmology Dec 2017To assess the validity of a novel, simplified, noninvasive test for strabismus using video goggles. (Comparative Study)
Comparative Study
PURPOSE
To assess the validity of a novel, simplified, noninvasive test for strabismus using video goggles.
DESIGN
Cross-sectional method comparison study in which the new test, the strabismus video goggles, is compared with the existing reference standard, the Hess screen test.
PARTICIPANTS
We studied 41 adult and child patients aged ≥6 years with ocular misalignment owing to congenital or acquired paralytic or comitant strabismus and 17 healthy volunteers.
METHODS
All participants were tested with binocular infrared video goggles with built-in laser target projection and liquid crystal display shutters for alternate occlusion of the eyes and the conventional Hess screen test. In both tests, ocular deviations were measured on a 9-point target grid located at 0±15° horizontal and vertical eccentricity.
MAIN OUTCOME MEASURES
Horizontal and vertical ocular deviations at 9 different gaze positions of each eye were measured by the strabismus video goggles and the Hess screen test. Agreement was quantified as the intraclass correlation coefficient. Secondary outcomes were the utility of the goggles in patients with visual suppression and in children.
RESULTS
There was good agreement between the strabismus video goggles and the Hess screen test in the measurements of horizontal and vertical deviation (intraclass correlation coefficient horizontal 0.83, 95% confidence interval [0.77, 0.88], vertical 0.76, 95% confidence interval [0.68, 0.82]). Both methods reproduced the characteristic strabismus patterns in the 9-point grid. In contrast to Hess screen testing, strabismus video goggle measurements were even possible in patients with comitant strabismus and visual suppression.
CONCLUSIONS
The new device is simple and is fast and accurate in measuring ocular deviations, and the results are closely correlated with those obtained using the conventional Hess screen test. It can even be used in patients with visual suppression who are not suitable for the Hess screen test. The device can be applied in children as young as 6 years of age.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Cross-Sectional Studies; Female; Healthy Volunteers; Humans; Male; Middle Aged; Oculomotor Muscles; Signal Processing, Computer-Assisted; Strabismus; Vision Tests; Visual Field Tests
PubMed: 28728924
DOI: 10.1016/j.ophtha.2017.06.020 -
Restorative Neurology and Neuroscience 2019Color vision has been consistently shown to be unaffected in animals that are raised in dark or in color-deprived environments. However, there are only a few studies...
BACKGROUND
Color vision has been consistently shown to be unaffected in animals that are raised in dark or in color-deprived environments. However, there are only a few studies that directly addressed the effect of congenital visual deprivation in color perception in humans.
OBJECTIVE
The goal of the current study was to assess the effect of congenital visual deprivation on color vision using a panel based color arrangement test.
METHODS
We investigated the recovery of color vision using the Farnsworth D15 test in a group of individuals who had experienced visual deprivation since birth due to bilateral dense congenital cataracts before undergoing cataract-reversal surgery (Congenital cataract, CC, n = 12). In addition, we tested two groups of control participants: (1) individuals who had had non-dense congenital cataract or developed cataract later in their childhood (Developmental cataract, DC, n = 10), and (2) sighted controls with normal or corrected to normal vision (n = 14). Based on the methods proposed by Vingrys and King-Smith (1988), we derived the following metrics of color vision performance: (1) total error score, (2) confusion index, (3) confusion angle, and (4) selectivity index.
RESULTS
All of the measured indices of color vision performance were unaltered by a period of congenital visual deprivation.
CONCLUSIONS
Our results support the view that, development of visual functions such as color discrimination and color arrangement does not depend on typical visual experience during a sensitive phase in early childhood.
Topics: Adolescent; Adult; Cataract; Cataract Extraction; Child; Color Vision; Female; Humans; Infant; Male; Recovery of Function; Vision Tests; Young Adult
PubMed: 31839614
DOI: 10.3233/RNN-190928 -
International Ophthalmology Feb 2021Traditional color vision tests depend on subjective judgments and are not suitable for infant children and subjects with cognitive dysfunction. We aimed to explore an...
PURPOSE
Traditional color vision tests depend on subjective judgments and are not suitable for infant children and subjects with cognitive dysfunction. We aimed to explore an objective and quantitative color vision testing method based on sweep steady-state visual evoked potentials (sweep SSVEPs) and compare the results with subjective Farnsworth-Munsell (FM) 100-hue test results.
METHODS
A red-green SSVEP pattern reversal checkboard paradigm at different luminance ratios was used to induce visual evoked potentials (VEPs) from 15 color vision deficiencies (CVDs) and 11 normal color vision subjects. After electroencephalography signals were processed by canonical correlation analysis, an equiluminance turning curve corresponding to the activation of the L-cones and M-cones at different levels of color vision was established. Then, we obtained different equiluminance T and proposed the SSVEP color vision severity index (I) to quantify color vision function and the severity of CVDs. In addition, the FM 100-hue test was used to obtain subjective data for the diagnosis of color vision.
RESULTS
The value of I can be an indicator of the level of color vision. Both the total error scores (TES) and confusion index (C-index) of the FM 100-hue test were significantly correlated with I values (P < 0.001, respectively). I also had a good classification effect in detecting normals, anomalous trichromats and dichromats. Moreover, equiluminance T had a good effect on classifying protans and deutans in subjects with CVDs.
CONCLUSION
Color vision evaluation with sweep SSVEPs showed a good correlation with subjective psychophysical methods. SSVEPs can be an objective and quantitative method to test color vision and diagnose CVDs.
Topics: Child; Color Perception; Color Perception Tests; Color Vision; Color Vision Defects; Evoked Potentials, Visual; Humans; Vision Tests
PubMed: 33044670
DOI: 10.1007/s10792-020-01613-z -
Der Ophthalmologe : Zeitschrift Der... Dec 2016To analyze currently available reading charts regarding print size, logarithmic print size progression, and the background of test-item standardization. (Comparative Study)
Comparative Study Review
PURPOSE
To analyze currently available reading charts regarding print size, logarithmic print size progression, and the background of test-item standardization.
METHODS
For the present study, the following logarithmically scaled reading charts were investigated using a measuring microscope (iNexis VMA 2520; Nikon, Tokyo): Eschenbach, Zeiss, OCULUS, MNREAD (Minnesota Near Reading Test), Colenbrander, and RADNER. Calculations were made according to EN-ISO 8596 and the International Research Council recommendations.
RESULTS
Modern reading charts and cards exhibit a logarithmic progression of print sizes. The RADNER reading charts comprise four different cards with standardized test items (sentence optotypes), a well-defined stop criterion, accurate letter sizes, and a high print quality. Numbers and Landolt rings are also given in the booklet. The OCULUS cards have currently been reissued according to recent standards and also exhibit a high print quality. In addition to letters, numbers, Landolt rings, and examples taken from a timetable and the telephone book, sheet music is also offered. The Colenbrander cards use short sentences of 44 characters, including spaces, and exhibit inaccuracy at smaller letter sizes, as do the MNREAD cards. The MNREAD cards use sentences of 60 characters, including spaces, and have a high print quality.
CONCLUSION
Modern reading charts show that international standards can be achieved with test items similar to optotypes, by using recent technology and developing new concepts of test-item standardization. Accurate print sizes, high print quality, and a logarithmic progression should become the minimum requirements for reading charts and reading cards in ophthalmology.
Topics: Humans; Practice Guidelines as Topic; Printing; Reading; Reproducibility of Results; Sensitivity and Specificity; Vision Screening; Visual Acuity
PubMed: 26586550
DOI: 10.1007/s00347-015-0175-7