-
JAMA Ophthalmology May 2022Visual acuity (VA) is one of the most important clinical data points in ophthalmology. However, few options for validated at-home VA assessments are currently available. (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Visual acuity (VA) is one of the most important clinical data points in ophthalmology. However, few options for validated at-home VA assessments are currently available.
OBJECTIVE
To validate 3 at-home visual acuity tests in comparison with in-office visual acuity.
DESIGN, SETTING, AND PARTICIPANTS
Between July 2020 and April 2021, eligible participants with VA of 20/200 or better were recruited from 4 university-based ophthalmology clinics (comprehensive, cornea, glaucoma, and retina clinics). Participants were prospectively randomized to self-administer 2 of 3 at-home VA tests (printed chart, mobile phone app, and website) within 3 days before their standard-of-care clinic visit. Participants completed a survey assessing usability of the at-home tests. At the clinic visit, best-corrected Snellen distance acuity was measured as the reference standard.
MAIN OUTCOMES AND MEASURES
The at-home VA test results were compared with the in-office VA test results using paired and unpaired t tests, Pearson correlation coefficients, analysis of variance, χ2 tests, and Cohen κ agreement. The sensitivity, specificity, positive predictive value, and negative predictive value of each at-home test were calculated to detect significant VA changes (≥0.2 logMAR) from the in-office baseline.
RESULTS
A total of 121 participants with a mean (SD) age of 63.8 (13.0) years completed the study. The mean in-office VA was 0.11 logMAR (Snellen equivalent 20/25) with similar numbers of participants from the 4 clinics. Mean difference (logMAR) between the at-home test and in-office acuity was -0.07 (95% CI, -0.10 to -0.04) for the printed chart, -0.12 (95% CI, -0.15 to -0.09) for the mobile phone app, and -0.13 (95% CI, -0.16 to -0.10) for the website test. The Pearson correlation coefficient for the printed chart was 0.72 (95% CI, 0.62-0.79), mobile phone app was 0.58 (95% CI, 0.46-0.69), and website test was 0.64 (95% CI, 0.53-0.73).
CONCLUSIONS AND RELEVANCE
The 3 at-home VA test results (printed chart, mobile phone app, and website) appeared comparable within 1 line to in-office VA measurements. Older participants were more likely to have limited access to digital tools. Further development and validation of at-home VA testing modalities is needed with the expansion of teleophthalmology care.
Topics: COVID-19; Humans; Middle Aged; Ophthalmology; Telemedicine; Vision Tests; Visual Acuity
PubMed: 35357405
DOI: 10.1001/jamaophthalmol.2022.0396 -
Romanian Journal of Ophthalmology 2020This study was performed to determine achromatic contrast sensitivity and color vision in lead and zinc mine workers. A total of 230 male workers, who had been working...
This study was performed to determine achromatic contrast sensitivity and color vision in lead and zinc mine workers. A total of 230 male workers, who had been working in mine and had been in contact with minerals for at least 1 year, were considered as the case group, and the age of 90 years matched men who have not been in contact with minerals, being regarded as the control group. Contrast sensitivity was assessed using the Freiburg test at three frequencies of 1, 5 and 15 cycles of degree and under low mesopic light condition by two gratings and Landolt C stimuli. Color vision was assessed using the Farnsworth D-15 test under high mesopic light condition. Both tests were carried out monocularly. Data were analyzed using version 22 SPSS software. There was a significant difference between studied groups with Landolt C stimulus in all three frequencies 1, 5 and 15 cycles per degree (p=0.009, p=0.016 and p=0.003). With Grating stimulus, there was a significant difference between the two groups in frequencies of 1 and 15 cycles per degree but at frequency of 5 cycles per degree, there was a border difference (p<0.0001, p=0.051 and p=0.008). A significant difference was observed between color confusion indexes of the two groups (p<0.0001). Chronic exposure to mineral in lead and zinc mine may cause color vision deficiency and decrease in contrast sensitivity. It is recommended that Farnsworth D-15 and Freiburg contrast sensitivity tests would be involved in the early diagnosis of neurodegenerative and visual disorders in workers exposed to minerals.
Topics: Adult; Color Perception Tests; Color Vision; Color Vision Defects; Contrast Sensitivity; Cross-Sectional Studies; Humans; Lead; Male; Middle Aged; Miners; Occupational Diseases; Occupational Exposure; Romania; Young Adult; Zinc
PubMed: 32292857
DOI: No ID Found -
Optometry and Vision Science : Official... Jan 2021Quality refractive error care is essential for reducing vision impairment. Quality indicators and standardized approaches for assessing the quality of refractive error...
SIGNIFICANCE
Quality refractive error care is essential for reducing vision impairment. Quality indicators and standardized approaches for assessing the quality of refractive error care need to be established.
PURPOSE
This study aimed to develop a set of indicators for assessing the quality of refractive error care and test their applicability in a real-world setting using unannounced standardized patients (USPs).
METHODS
Patient outcomes and three quality of refractive error care (Q.REC) indicators (1, optimally prescribed spectacles; 2, adequately prescribed spectacles; 3, vector dioptric distance) were developed using existing literature, refraction training standards, and consulting educators. Twenty-one USPs with various refractive errors were trained to visit optical stores across Vietnam to have a refraction, observe techniques, and order spectacles. Spectacles were assessed against each Q.REC indicator and tested for associations with vision and comfort.
RESULTS
Overall, 44.1% (184/417) of spectacles provided good vision and comfort. Of the spectacles that met Q.REC indicators 1 and 2, 62.5 and 54.9%, respectively, provided both good vision and comfort. Optimally prescribed spectacles (indicator 1) were significantly more likely to provide good vision and comfort independently compared with spectacles that did not meet any indicator (good vision: 94.6 vs. 85.0%, P = .01; comfortable: 66.1 vs. 36.3%, P < .01). Adequately prescribed spectacles (indicator 2) were more likely to provide good comfort compared with spectacles not meeting any indicator (57.7 vs. 36.3%, P < .01); however, vision outcomes were not significantly different (85.9 vs. 85.0%, P = .90). Good vision was associated with a lower mean vector dioptric distance (P < .01) but not with comfort (P = .52).
CONCLUSIONS
The optimally prescribed spectacles indicator is a promising approach for assessing the quality of refractive error care without additional assessments of vision and comfort. Using USPs is a practical approach and could be used as a standardized method for evaluating the quality of refractive error care.
Topics: Adult; Delivery of Health Care; Eyeglasses; Female; Humans; Male; Middle Aged; Prescriptions; Quality Indicators, Health Care; Refraction, Ocular; Refractive Errors; Standard of Care; Vietnam; Vision Tests; Visual Acuity; Young Adult
PubMed: 33394928
DOI: 10.1097/OPX.0000000000001629 -
Translational Vision Science &... Mar 2023To propose new methods for eye selection in presbyopic monovision corrections.
PURPOSE
To propose new methods for eye selection in presbyopic monovision corrections.
METHODS
Twenty subjects with presbyopia performed two standard methods of binary eye dominance identification (sensory with +1.50 diopters [D ]and +0.50 D and sighting with "hole-in-the-card") and two psychophysical methods of perceived visual quality: (1) the Preferential test, 26 natural images were judged with the near addition in one eye or in the other in a 2-interval forced-choice task, and the Eye Dominance Strength (EDS) defined as the proportion of trials where one monovision is preferred over the other; (2) the Multifocal Acceptance Score (MAS-2EV) test, the perceived quality of a natural images set (for 2 luminance levels and distances) was scored and EDS defined as the score difference between monovision in one eye or the other. Left-eye and right-eye dominance are indicated with negative and positive values, respectively. Tests were performed using a Simultaneous Vision Simulator, which allows rapid changes between corrections.
RESULTS
Standard sensory and sighting dominances matched in only 55% of subjects. The Preferential EDS (ranging from -0.7 to +0.9) and MAS-2EV EDS (ranging from -0.6 to +0.4) were highly correlated. Selecting the eye for far in monovision with the MAS-2EV, sensory, or sighting tests would have resulted in 79%, 64%, and 43% success considering the Preferential test as the gold standard.
CONCLUSIONS
Tests based on perceptual preference allow selection of the preferred monovision correction and measurement of dominance strength.
TRANSLATIONAL RELEVANCE
The binocular visual simulator allows efficient implementation of eye preference tests for monovision in clinical use.
Topics: Humans; Vision, Monocular; Visual Acuity; Dominance, Ocular; Vision, Ocular; Vision Tests
PubMed: 36939712
DOI: 10.1167/tvst.12.3.18 -
Endocrinology, Diabetes & Metabolism Jan 2023The aim of this study was to investigate the effects of hypothyroidism on visual functions such as visual acuity, refractive errors, colour vision, and contrast...
INTRODUCTION
The aim of this study was to investigate the effects of hypothyroidism on visual functions such as visual acuity, refractive errors, colour vision, and contrast sensitivity, among hypothyroid adults.
METHODS
Forty-three patients with clinical hypothyroidism along with 43 age- and sex-matched healthy individuals underwent visual examinations, including visual acuity, refractive errors, eye deviations with the cover test, colour vision with the D15 test, and contrast sensitivity with Pelli-Robson test.
RESULTS
It was indicated that visual acuity, refractive errors, phoria, and colour vision had no significant difference between the hypothyroid and control groups. Contrast sensitivity decreased in hypothyroid subjects as compared with controls. The mean values of binocular contrast sensitivity were 1.85 ± 0.09 log in the hypothyroid group and 1.93 ± 0.09 log in controls, which showed a statistically significant difference (p = .03).
CONCLUSIONS
Our findings illustrated a reduced contrast sensitivity in adult hypothyroidism. Since CS is related to functioning and quality of life, a comprehensive and detailed eye examination may be beneficial for hypothyroidism patients.
Topics: Humans; Adult; Iran; Vision Tests; Quality of Life; Refractive Errors; Hypothyroidism
PubMed: 36519206
DOI: 10.1002/edm2.393 -
Graefe's Archive For Clinical and... Sep 2021Stereopsis is a fundamental skill in human vision and visual actions. There are many ways to test and quantify stereoacuity: traditional paper and new digital...
PURPOSE
Stereopsis is a fundamental skill in human vision and visual actions. There are many ways to test and quantify stereoacuity: traditional paper and new digital applications are both valid ways to test the stereoacuity. The aim of this study is to compare the results obtained using standard tests and the new Stereoacuity Test App developed by the University of Bergamo.
METHODS
A group of 497 children (272 males), aged between 6 and 11 years old, were tested using different tests for the quantification of stereopsis at near. These tests were TNO, Weiss EKW, and the new developed Stereoacuity Test App.
RESULTS
A one-way repeated measure ANOVA showed that the three tests give different thresholds of stereoacuity (p < 0.0001). Post hoc analyses with Bonferroni correction showed that all tests showed different thresholds (p < 0.0001). The lower threshold was obtained by Titmus Stereo Test followed by Stereoacuity App, Weiss MKW, and TNO.
CONCLUSION
The stereoacuity based on global stereopsis showed that the better values were obtained in order by Stereoacuity Test App, TNO, and Weiss EKW. However, the clinical significance of their values is similar. The new digital test showed a greater compliance by the child, showing itself in tune with the digital characteristics of today's children.
Topics: Child; Depth Perception; Humans; Male; Mobile Applications; Vision Tests; Vision, Binocular; Visual Acuity
PubMed: 33907883
DOI: 10.1007/s00417-021-05195-z -
Journal of Optometry 2022Several studies have suggested that accommodative and non-strabismic binocular dysfunctions are commonly encountered in optometric practice. This study aims to verify...
BACKGROUND
Several studies have suggested that accommodative and non-strabismic binocular dysfunctions are commonly encountered in optometric practice. This study aims to verify whether these findings apply to a Portuguese clinical population.
METHODS
This study included consecutive nonpresbyopic subjects that came to two Portuguese optometric clinics over a period of six months. A complete visual exam was conducted and included the measurement of visual acuity (VA), refraction, near point of convergence (NPC), distance and near phoria, near and distance fusional vergences, amplitude of accommodation (AA), monocular accommodative facility (MAF), relative accommodation and lag of accommodation.
RESULTS
156 subjects with a mean age of 24.9 ± 5.3 years (from 18 to 35 years old) participated in the study. Of all subjects, 32 % presented binocular vision and/or accommodative disorders accompanied or not by refractive errors. Moreover, 21.1 % had accommodative disorders, and 10.9 % had a binocular vision dysfunction. Accommodative insufficiency (11.5 %) was the most prevalent disorder, followed by convergence insufficiency (7.1 %) and accommodative infacility (5. 8 %).
CONCLUSIONS
Clinicians should be aware that about one third of the optometric clinical population could have accommodative and/or non-strabismic binocular disorders. Accommodative insufficiency was the most prevalent dysfunction presented in the studied population, followed by accommodative infacility and convergence insufficiency.
Topics: Accommodation, Ocular; Adolescent; Adult; Humans; Ocular Motility Disorders; Portugal; Presbyopia; Vision Disorders; Vision Tests; Vision, Binocular; Young Adult
PubMed: 34852966
DOI: 10.1016/j.optom.2021.10.002 -
Documenta Ophthalmologica. Advances in... Feb 2024The full-field stimulus test (FST) is a psychophysical technique designed for the measurement of visual function in low vision. The method involves the use of a ganzfeld...
The full-field stimulus test (FST) is a psychophysical technique designed for the measurement of visual function in low vision. The method involves the use of a ganzfeld stimulator, as used in routine full-field electroretinography, to deliver full-field flashes of light. This guideline was developed jointly by the International Society for Clinical Electrophysiology of Vision (ISCEV) and Imaging and Perimetry Society (IPS) in order to provide technical information, promote consistency of testing and reporting, and encourage convergence of methods for FST. It is intended to aid practitioners and guide the formulation of FST protocols, with a view to future standardisation.
Topics: Electroretinography; Visual Field Tests; Societies, Medical; Photic Stimulation; Vision, Ocular
PubMed: 38238632
DOI: 10.1007/s10633-023-09962-7 -
Translational Vision Science &... Mar 2023To describe two new stereoacuity tests: the eRDS v6 stereotest, a global dynamic random dot stereogram (dRDS) test, and the Vivid Vision Stereo Test version 2 (VV), a...
PURPOSE
To describe two new stereoacuity tests: the eRDS v6 stereotest, a global dynamic random dot stereogram (dRDS) test, and the Vivid Vision Stereo Test version 2 (VV), a local or "contour" stereotest for virtual reality (VR) headsets; and to evaluate the tests' reliability, validity compared to a dRDS standard, and learning effects.
METHODS
Sixty-four subjects passed a battery of stereotests, including perceiving depth from RDS. Validity was evaluated relative to a tablet-based dRDS reference test, ASTEROID. Reliability and learning effects were assessed over six sessions.
RESULTS
eRDS v6 was effective at measuring small thresholds (<10 arcsec) and had a moderate correlation (0.48) with ASTEROID. Across the six sessions, test-retest reliability was good, varying from 0.84 to 0.91, but learning occurred across the first three sessions. VV did not measure stereoacuities below 15 arcsec. It had a weak correlation with ASTEROID (0.27), and test-retest reliability was poor to moderate, varying from 0.35 to 0.74; however, no learning occurred between sessions.
CONCLUSIONS
eRDS v6 is precise and reliable but shows learning effects. If repeated three times at baseline, this test is well suited as an outcome measure for testing interventions. VV is less precise, but it is easy and rapid and shows no learning. It may be useful for testing interventions in patients who have no global stereopsis.
TRANSLATIONAL RELEVANCE
eRDS v6 is well suited as an outcome measure to evaluate treatments that improve adult stereodepth perception. VV can be considered for screening patient with compromised stereovision.
Topics: Adult; Humans; Reproducibility of Results; Vision Tests; Depth Perception; Dystonic Disorders
PubMed: 36857068
DOI: 10.1167/tvst.12.3.1 -
Indian Journal of Ophthalmology May 2022To profile the presentation of ocular conditions among school children aged 6 to 17 years from the south Indian state of Tamil Nadu.
PURPOSE
To profile the presentation of ocular conditions among school children aged 6 to 17 years from the south Indian state of Tamil Nadu.
METHODS
The study was conducted as part of a school eye health program in Kanchipuram district, Tamil Nadu that aimed to address the refractive needs of children (6-17 years) between July 2016 and June 2019. The study followed a three-phase protocol, which included visual acuity test, modified clinical test, color vision test, binocular vision assessment, objective and subjective refraction, dispensing spectacles, posterior segment evaluation using direct ophthalmoscopy, and referral to the base hospital. The demographics, clinical details, and ocular conditions (classified under 16 categories) were analyzed. Profiling and association of ocular conditions among different locations, types of schools, class grades, and gender were presented.
RESULTS
Data of 2,45,565 children were analyzed from 1,047 schools, of which 4,816 (1.96%) children were identified with ocular conditions other than refractive errors. The common reasons for referral were high myopia 901 (0.37%), strabismus 819 (0.33%), and amblyopia 691 (0.28%). Retinal problems (odds ratio [OR]: 1.65, 95% confidence interval [CI]: 1.22-2.22, P = 0.001) and strabismus (OR: 1.41, 95% CI: 1.21-1.65, P < 0.001) were the conditions prevalent in the rural location. Cataract and related conditions (OR: 5.73, 95% CI: 4.10-8.01, P < 0.001) and retinal problems (OR: 4.76, 95% CI: 3.37-6.72, P < 0.001) were common in children studying in public schools. Of the 16 categories, 13 conditions were seen among primary school children. Vernal keratoconjunctivitis (OR: 3.64 95% CI: 2.12-6.23 P < 0.001) was common among males.
CONCLUSION
The study profiled ocular conditions among school children. Most ocular conditions warrant prolonged care and specialty eye care services. Ensuring the availability of such services and follow-up after school eye screening would safeguard the visual development of these children.
Topics: Child; Female; Humans; India; Male; Myopia; Prevalence; Strabismus; Visual Acuity
PubMed: 35502067
DOI: 10.4103/ijo.IJO_2569_21