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Acta Clinica Croatica Apr 2023Acute optic neuritis is often associated with multiple sclerosis. It is considered to be the most common ocular symptom of multiple sclerosis. In addition to acute optic...
Acute optic neuritis is often associated with multiple sclerosis. It is considered to be the most common ocular symptom of multiple sclerosis. In addition to acute optic neuritis, in patients with multiple sclerosis, subclinical optic neuritis is also described. It is characterized by slow progression and bilateral involvement, thus being unnoticed by the patient. The purpose of the present study was to assess vision impairment in multiple sclerosis patients without a history of acute optic neuritis, using a number of functional tests including visual field testing by Octopus 101 perimetry N1 program, contrast sensitivity testing by Pelli Robson chart, and color vision by Ishihara pseudoisochromatic plates. The study included 35 multiple sclerosis patients aged 18-50 years, without subjective signs of vision impairment and visual acuity 1.0 according to Snellen. Visual field defects were found in 28 patients. The most common defects of visual fields were retinal sensitivity depression in peripheral zone and nerve fiber bundle defect. Reduced contrast sensitivity was found in 30 (86%) patients. Study results indicated multiple sclerosis patients free from signs of optic neuritis to suffer vision function impairment, as demonstrated by Octopus perimetry and contrast sensitivity testing with Pelli Robson charts.
Topics: Humans; Visual Acuity; Visual Fields; Vision Tests; Multiple Sclerosis; Optic Neuritis
PubMed: 38304362
DOI: 10.20471/acc.2023.62.01.24 -
Scientific Reports Apr 2023This study evaluated the long-term myopia control effect and safety in children wearing Defocus Incorporated Multiple Segments (DIMS) spectacle lenses. Participants who...
This study evaluated the long-term myopia control effect and safety in children wearing Defocus Incorporated Multiple Segments (DIMS) spectacle lenses. Participants who completed the 2-year RCT were followed for a total of 6 years; their cycloplegic refractions and axial length were measured. Group 1 (n = 36) wore DIMS spectacles for 6 years; Group 2 (n = 14) wore DIMS lens for the first 3.5 years and SV spectacles afterwards; Group 3 (n = 22) wore SV spectacles in the first 2 years and switched to DIMS; Group 4 (n = 18) wore SV spectacles in the first 2 years, switched to DIMS for 1.5 years and then SV spectacles again. Group 1 showed no significant differences in myopia progression (- 0.52 ± 0.66 vs. - 0.40 ± 0.72D) and axial elongation (0.32 ± 0.26 vs. 0.28 ± 0.28 mm, both p > 0.05) between the first and the later 3 years. In the last 2.5 years, DIMS lens groups (Groups 1 and 3) had less myopia progression and axial elongation than the single vision groups (Groups 2 and 4). There was no evidence of rebound after stopping the treatment. Post-wear visual functions in all groups were within norms. The results supported that DIMS lenses provided sustained myopia control without adverse effects over the 6-year study period.Trial registration: clinicaltrials.gov; NCT02206217.
Topics: Humans; Child; Eyeglasses; Refraction, Ocular; Myopia; Vision Tests
PubMed: 37015996
DOI: 10.1038/s41598-023-32700-7 -
Current Opinion in Ophthalmology Jul 2020This review outlines ophthalmic diagnostic systems, which objectively evaluates the human visual system and its potential beyond that of Snellen acuity. (Review)
Review
PURPOSE OF REVIEW
This review outlines ophthalmic diagnostic systems, which objectively evaluates the human visual system and its potential beyond that of Snellen acuity.
RECENT FINDINGS
Advances in ophthalmic diagnostic systems have allowed for a deeper understanding of the optical principles of the human eye and have created the opportunity to evolve our current standards of vision assessment beyond Snellen acuity charts. Definitive comparative and validation trials will continue to be necessary in order for these advanced diagnostics to gain more widespread acceptance in the specialty, in addition to providing the guidance on the specific indications and utilities.
SUMMARY
Advancements in wavefront analysis, light scatter measurements, and adaptive optics technologies can provide greater insight into an individual optical system's potential and irregularities. Modalities that test for anterior corneal surface and whole eye aberrations, light scatter and contrast sensitivity can be an excellent educational tool for our patients to help them better understand their visual dysfunction and can prove useful for medical or surgical decision-making.
Topics: Contrast Sensitivity; Cornea; Corneal Wavefront Aberration; Humans; Light; Refraction, Ocular; Scattering, Radiation; Vision Tests; Visual Acuity
PubMed: 32398417
DOI: 10.1097/ICU.0000000000000664 -
Acta Ophthalmologica Sep 2021
Review
A novel excel sheet conversion tool from Snellen fraction to LogMAR including 'counting fingers', 'hand movement', 'light perception' and 'no light perception' and focused review of literature of low visual acuity reference values.
Topics: Humans; Reference Values; Statistics, Nonparametric; Vision Disorders; Vision Tests; Visual Acuity
PubMed: 33326177
DOI: 10.1111/aos.14659 -
Current Opinion in Ophthalmology May 2022The evaluation of refractive error is probably the most important and common procedure in eye care. The gold standard method for evaluating refractive error is... (Review)
Review
PURPOSE OF REVIEW
The evaluation of refractive error is probably the most important and common procedure in eye care. The gold standard method for evaluating refractive error is subjective refraction, a process that has not significantly changed in 200years. This article aims to review recent technologies and novel approaches attempting to improve this traditional procedure.
RECENT FINDINGS
From laboratory prototypes to commercial instruments, the proposed methods aim to perform reliable and fast subjective refractions, following different approaches: using motorized phoropters in combination with automatic algorithms or even self-refraction, hybridizing objective and subjective measurements within the same instruments, or using new visual tasks beyond letter identification of blur estimation to obtain the refractive error subjectively.
SUMMARY
The current trend in subjective refraction is to overcome the traditional manual blur reduction method, using automatic and self-refraction instruments, which can provide faster measurements with lower variability. Many of the technologies reported here are already in the market, and some have the potential of becoming the new standard in subjective refraction.
Topics: Algorithms; Humans; Refraction, Ocular; Refractive Errors; Vision Tests
PubMed: 35102097
DOI: 10.1097/ICU.0000000000000834 -
Lancet (London, England) Oct 2021
Topics: Digital Technology; Humans; Vision Tests
PubMed: 34627485
DOI: 10.1016/S0140-6736(21)02149-8 -
Ophthalmic & Physiological Optics : the... Nov 2022To establish age-related, normal limits of monocular and binocular spatial vision under photopic and mesopic conditions.
PURPOSE
To establish age-related, normal limits of monocular and binocular spatial vision under photopic and mesopic conditions.
METHODS
Photopic and mesopic visual acuity (VA) and contrast thresholds (CTs) were measured with both positive and negative contrast optotypes under binocular and monocular viewing conditions using the Acuity-Plus (AP) test. The experiments were carried out on participants (age range from 10 to 86 years), who met pre-established, normal sight criteria. Mean and ± 2.5σ limits were calculated within each 5-year subgroup. A biologically meaningful model was then fitted to predict mean values and upper and lower threshold limits for VA and CT as a function of age. The best-fit model parameters describe normal aging of spatial vision for each of the 16 experimental conditions investigated.
RESULTS
Out of the 382 participants recruited for this study, 285 participants passed the selection criteria for normal aging. Log transforms were applied to ensure approximate normal distributions. Outliers were also removed for each of the 16 stimulus conditions investigated based on the ±2.5σ limit criterion. VA, CTs and the overall variability were found to be age-invariant up to ~50 years in the photopic condition. A lower, age-invariant limit of ~30 years was more appropriate for the mesopic range with a gradual, but accelerating increase in both mean thresholds and intersubject variability above this age. Binocular thresholds were smaller and much less variable when compared to the thresholds measured in either eye. Results with negative contrast optotypes were significantly better than the corresponding results measured with positive contrast (p < 0.004).
CONCLUSIONS
This project has established the expected age limits of spatial vision for monocular and binocular viewing under photopic and high mesopic lighting with both positive and negative contrast optotypes using a single test, which can be implemented either in the clinic or in an occupational setting.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Color Vision; Contrast Sensitivity; Humans; Lighting; Middle Aged; Vision, Binocular; Visual Acuity; Young Adult
PubMed: 35979702
DOI: 10.1111/opo.13037 -
Journal of AAPOS : the Official... Apr 2022To evaluate a newly developed, web-based system for at-home pediatric visual acuity testing and to compare results with standard in-office visual acuity test results.
PURPOSE
To evaluate a newly developed, web-based system for at-home pediatric visual acuity testing and to compare results with standard in-office visual acuity test results.
METHODS
Children aged 3-12 years with and without visual deficits were enrolled (N = 65; 130 eyes). Monocular visual acuity was tested in-office using the ATS-HOTV (ages 3-6) or E-ETDRS (ages 7-12) protocol. Each child's family was emailed a link to a web-based version of the same visual acuity test for at-home testing. Equivalence was evaluated by using a linear mixed model to estimate the mean difference between in-office and at-home visual acuity test results and the corresponding two-sided 95% confidence interval.
RESULTS
For children tested with the ATS-HOTV protocol, the mean difference between in-office and at-home visual acuity test results was 0.01 log MAR (95% CI, -0.06 to 0.09). For children tested with the E-ETDRS protocol, the mean difference was 0.04 log MAR (95% CI, -0.06 to 0.14).
CONCLUSIONS
At-home, web-based ATS-HOTV and E-ETDRS visual acuity test results had excellent concordance with in-office visual acuity testing. If the burden of travel is significant, at-home testing of children's visual acuity may provide the information needed to continue care when it might otherwise be discontinued or delayed.
Topics: Child; Humans; Internet; Reproducibility of Results; Vision Tests; Visual Acuity
PubMed: 34920136
DOI: 10.1016/j.jaapos.2021.11.007 -
Journal of Optometry 2022Why myopia develops, why it is reaching epidemic proportions and what is its cause are questions that puzzle many people. There is an answer to these questions and it is... (Review)
Review
Why myopia develops, why it is reaching epidemic proportions and what is its cause are questions that puzzle many people. There is an answer to these questions and it is a simple one. This paper makes the connection between ametropic and in particular myopic development and theory to come with a summary of what we know about myopia and its governing equation. Key experiments, involving myopia and the effect of lenses in humans and animals have been done with unmistakable results. The observed effect of lenses implies a feedback mechanism. Feedback theory explains those results with mathematical precision. Disruption of emmetropization, is the mechanism behind ametropia and particularly myopia. Feedback theory for emmetropization was derived by observation of the input and output of the emmetropization feedback system in many patients. We show that it has the same equation as it is derived here independently from simple homeostasis principles. Classical observations and recent clinical studies have shown the association of many variables with myopia. They include near work, atropine, lenses, blur and outdoors versus indoors activities. We propose that human refractive development is controlled by homeostasis and based on that alone we derive the equation for the calculation of refraction for any patient and the effect of lenses. We provide software to calculate the refraction of any individual at any time. The editor of this journal makes the following statement: "This manuscript is intended for scientific discussion rather than clinical application. The present work does not intend to promote clinical under correction or no correction of myopia. Instead, clinicians should follow current clinical myopia management guidelines."
Topics: Animals; Humans; Myopia; Refraction, Ocular; Refractive Errors; Vision Tests
PubMed: 34600857
DOI: 10.1016/j.optom.2021.08.001 -
Seminars in Pediatric Neurology Oct 2019The complete assessment of vision-related abilities should consider visual function (the performance of components of the visual system) and functional vision (visual... (Review)
Review
The complete assessment of vision-related abilities should consider visual function (the performance of components of the visual system) and functional vision (visual task-related ability). Assessment methods are highly dependent upon individual characteristics (eg, the presence and type of visual impairment). Typical visual function tests assess factors such as visual acuity, contrast sensitivity, color, depth, and motion perception. These properties each represent an aspect of visual function and may impact an individual's level of functional vision. The goal of any functional vision assessment should be to measure the visual task-related ability under real-world scenarios. Recent technological advancements such as virtual reality can provide new opportunities to improve traditional vision assessments by providing novel objective and ecologically valid measurements of performance, and allowing for the investigation of their neural basis. In this review, visual function and functional vision evaluation approaches are discussed in the context of traditional and novel acquisition methods.
Topics: Behavior; Brain Mapping; Contrast Sensitivity; Humans; Vision Disorders; Vision Tests; Visual Acuity
PubMed: 31548022
DOI: 10.1016/j.spen.2019.05.006