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Clinical & Experimental Optometry Sep 2021: Refracting low vision patients require special procedures and strategies. A device-taking the reduced visual acuity and higher blur tolerance into account-is designed...
: Refracting low vision patients require special procedures and strategies. A device-taking the reduced visual acuity and higher blur tolerance into account-is designed to measure refraction in this group.: Instant Vision Assessment Device (IVAD) is a stenopaeic slit refraction system in a binocular telescopic optometer calibrated to measure refraction. This study aims to validate IVAD in measuring refraction of low vision patients.: Refractions were measured with IVAD on the right eyes of 35 normal subjects (ages nine to 69) and on the better eyes of 20 low vision subjects (ages 60 to 90) and compared with subjective refraction (SR). The visual acuities were compared in the low vision group. Paired Student t-test and Bland-Altman analysis were used to test the significance of difference and limits of agreement between methods, respectively.: In normal subjects, mean spherical equivalent refraction (M) measured by IVAD and SR was -2.88 ± 2.51 D and -2.72 ± 2.29 D, respectively, and the difference of -0.16 ± 0.47 D was not statistically significant (p = 0.05, t = 2.03). In low vision subjects, M measured by IVAD and SR was-0.66 ± 2.64 D and -0.55 ± 2.61 D, respectively, and the difference of -0.11 ± 0.59 D was also not statistically significant (p = 0.43, t = 2.09). Only the astigmatism J0 in the normal subject group of -0.03 ± 0.24 D by IVAD and 0.07 ± 0.17 D by SR showed a statistically significant difference of -0.10 ± 0.25 D (p = 0.04, t = 2.03). In low vision subjects, mean visual acuities with refraction from IVAD and SR were 0.52 ± 0.32 logMAR and 0.53 ± 0.32 logMAR, respectively, and the difference of 0.01 ± 0.07 logMAR was not statistically significant (p = 0.51, t = 2.09). At least 80% of the IVAD measure of refraction components (M, J0, J45) were within ±0.50 D of SR measure.: IVAD is a practical and valid refraction method for low vision patients.
Topics: Aged; Aged, 80 and over; Humans; Middle Aged; Refraction, Ocular; Reproducibility of Results; Vision Tests; Vision, Low; Visual Acuity
PubMed: 33689633
DOI: 10.1080/08164622.2021.1878825 -
Scientific Reports May 2023According to World Health Organization (WHO), currently, 2.2 billion people are living with visual impairment worldwide, of which almost half could have been prevented....
According to World Health Organization (WHO), currently, 2.2 billion people are living with visual impairment worldwide, of which almost half could have been prevented. There are both modifiable and unmodifiable factors leading to visual disability and, ultimately, blindness. Several population-based studies in different parts of Iran have tried to determine these factors concerning their specific population and environment-related characteristics. AZAR Eye and Vision cohort is the second-largest cohort study in the whole country. AZAR Eye and Vision cohort is the ophthalmologic branch of AZAR cohort which is the largest eye cohort study in the country, which is trying to determine the prevalence and incidence of visual impairment, blindness, and other major ophthalmologic conditions and their associated risk factors in East Azerbaijan province located in Iran, a middle eastern country. A recently emerging phenomenon is the drying of the ultra-salty lake of Urmia located in the West Azerbaijan province which is a direct neighbor of our studied population and has caused recurrent salt storms in the immediate near areas. This phenomenon could adversely affect visual health via different conditions which our study will elucidate. The enrollment phase took place between 2014 and 2017 and 11,208 participants were enrolled out of 15,000 participants in the primary cohort. The resurvey phase will begin five years after the enrollment phase. In this phase, 30% of the participants are randomly selected to be reexamined and complete questionnaires. The participants showing any issues such as diabetes and being a glaucoma suspect will be included in the resurvey phase, too. Data categories gathered include demographics, lifestyle factors, past medical and drug histories, and a diet quality and quantity questionnaire including 130 edible items. Urine, hair, nail, and 25-ml blood samples, were collected from the participants. Then they were referred to an optometrist to complete an ophthalmologic questionnaire and undergo eye examination and lensometry. Then they underwent slit-lamp examinations and pictures were taken of the lens and fundus. People with suspected visual impairment were referred to an ophthalmology clinic. The data are processed and a four-level quality check is performed on each block. The most common visual impairment is cataracts. This study's most important aim is to evaluate the effect of local environmental and ethnic factors on eye diseases in this specific population.
Topics: Humans; Visually Impaired Persons; Cohort Studies; Visual Acuity; Blindness; Vision, Low; Eye Diseases; Ocular Hypertension; Prevalence; Vision Disorders
PubMed: 37198199
DOI: 10.1038/s41598-023-30212-y -
Clinical & Experimental Optometry Nov 2020Vision impairment can have a significant impact on the wellbeing and quality of life of an individual. Vision rehabilitation has the potential to improve these areas;... (Review)
Review
Vision impairment can have a significant impact on the wellbeing and quality of life of an individual. Vision rehabilitation has the potential to improve these areas; however, four in five patients with vision impairment are not being referred to the appropriate services. Barriers to on-referral include, but are not limited to: (1) misunderstandings by both practitioners and patients alike regarding which individuals with vision impairment might benefit or qualify for low vision services; (2) lack of awareness of available services; (3) unfamiliarity with practice guidelines; (4) miscommunication between practitioners and patients; (5) required patient travel or limitations in access; and (6) the perceived costs of goods and services. Further, current referral patterns do not represent a holistic patient-centric approach. Vision-related quality of life questionnaires are tools which can assist health professionals in providing optimal individualised care. This review explores current evidence regarding low vision service delivery within Australia and globally, the impact of vision impairment on activities of daily living, the instruments used for the assessment of vision-related quality of life (VRQOL), competing priorities of individual needs in low vision services and rehabilitation, and provides recommendations for a more patient-centred model of care.
Topics: Activities of Daily Living; Health Services Accessibility; Humans; Quality of Life; Surveys and Questionnaires; Vision, Low
PubMed: 32128871
DOI: 10.1111/cxo.13054 -
The Cochrane Database of Systematic... Aug 2015Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive... (Review)
Review
BACKGROUND
Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits at rehabilitation clinics. These people may be able to overcome barriers to care through remote, Internet-based consultation (i.e., telerehabilitation).
OBJECTIVES
To compare the effects of telerehabilitation with face-to-face (e.g., in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and reading speed in people with visual function loss due to any ocular condition. Secondary objectives are to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for visual assistive equipment devices, and patient satisfaction ratings.
SEARCH METHODS
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2015 Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1980 to June 2015), EMBASE (January 1980 to June 2015), PubMed (1980 to June 2015), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the Internet was not introduced to the public until 1982. We last searched the electronic databases on 15 June 2015.
SELECTION CRITERIA
We planned to include randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants were diagnosed with low vision and were undergoing low vision rehabilitation using an Internet, web-based technology compared with an approach based on in-person consultations.
DATA COLLECTION AND ANALYSIS
Two authors independently screened titles and abstracts, and then full-text articles against the eligibility criteria. We planned to have two authors independently abstract data from included studies. We resolved discrepancies by discussion.
MAIN RESULTS
We did not find any study that met the inclusion criteria for this review and, hence, we did not conduct a quantitative analysis. As a part of the background, we discussed review articles on telemedicine for facilitating communication with elderly individuals or for providing remote ophthalmological care.
AUTHORS' CONCLUSIONS
We did not find any evidence on whether the use of telerehabilitation is feasible or a potentially viable means to remotely deliver rehabilitation services to individuals with low vision. Given the disease burden and the growing interest in telemedicine, there is a need for future pilot studies and subsequent clinical trials to explore the potential for telerehabilitation as a platform for providing services to people with low vision.
Topics: Humans; Telerehabilitation; Vision, Low
PubMed: 26329308
DOI: 10.1002/14651858.CD011019.pub2 -
Indian Journal of Ophthalmology Mar 2016Oculodentodigital dysplasia is a rare, autosomal dominant disorder with high penetrance and variable expressivity, caused by mutations in the connexin 43 or gap junction...
Oculodentodigital dysplasia is a rare, autosomal dominant disorder with high penetrance and variable expressivity, caused by mutations in the connexin 43 or gap junction protein alpha-1 gene. It has been diagnosed in fewer than 300 people worldwide with an incidence of around 1 in 10 million. It affects many parts of the body, particularly eyes (oculo), teeth (dento), and fingers and/or toes (digital). The common clinical features include facial dysmorphism with thin nose, microphthalmia, syndactyly, tooth anomalies such as enamel hypoplasia, anodontia, microdontia, early tooth loss and conductive deafness. Other less common features are abnormalities of the skin and its appendages, such as brittle nails, sparse hair, and neurological abnormalities. To prevent this syndrome from being overlooked, awareness of possible symptoms is necessary. Early recognition can prevent blindness, dental problems and learning disabilities. Described here is the case of a 21-year-old male who presented to the ophthalmology outpatient department with a complaint of bilateral progressive loss of vision since childhood.
Topics: Abnormalities, Multiple; Craniofacial Abnormalities; Eye Abnormalities; Foot Deformities, Congenital; Humans; Male; Microphthalmos; Syndactyly; Tooth Abnormalities; Vision, Low; Visual Acuity; Young Adult
PubMed: 27146935
DOI: 10.4103/0301-4738.180191 -
Ophthalmic & Physiological Optics : the... Mar 2021Non-urgent face-to-face outpatient ophthalmology appointments were suspended in the United Kingdom in March 2020, due to the COVID-19 outbreak. In common with other...
PURPOSE
Non-urgent face-to-face outpatient ophthalmology appointments were suspended in the United Kingdom in March 2020, due to the COVID-19 outbreak. In common with other centres, Moorfields Eye Hospital NHS Foundation Trust (London) offered modified telephone consultations to new and follow-up patients in the low vision clinic. Here we assess the success of this telephone service.
METHODS
Data were collected for 500 consecutive telephone low vision appointments. Successful completion of the assessment and clinical outcomes (low vision aids prescribed, onward referral) were recorded.
RESULTS
Telephone assessments were completed for 364 people (72.8%). The most common reasons for non-completion were either no answer to the telephone call (75 people, 15%), or the patient declining assessment (20 people, 4%). There was no association between age and the likelihood of an assessment being completed. 131 new low vision aids were dispensed, 77 internal referrals were made and 15 people were referred to outside services. More than 80% of the low vision aids prescribed were useful.
CONCLUSIONS
Telephone low vision assessments were completed in about three-quarters of cases. About one-quarter of consultations resulted in new low vision aids being dispensed, which were generally found useful. Telephone low vision assessments can be used successfully in a large low vision clinic, but have many limitations when compared to face-to-face assessments.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; COVID-19; Communicable Disease Control; Comorbidity; Disease Transmission, Infectious; Female; Humans; Male; Middle Aged; Quarantine; Referral and Consultation; SARS-CoV-2; Telemedicine; Telephone; United Kingdom; Vision, Low; Young Adult
PubMed: 33529405
DOI: 10.1111/opo.12789 -
Indian Journal of Ophthalmology 2012Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered... (Review)
Review
Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered visually impaired because they do not have access to corrective treatment. Refractive errors, if uncorrected, results in an impaired quality of life for millions of people worldwide, irrespective of their age, sex and ethnicity. Over the past decade, a series of studies using a survey methodology, referred to as Refractive Error Study in Children (RESC), were performed in populations with different ethnic origins and cultural settings. These studies confirmed that the prevalence of uncorrected refractive errors is considerably high for children in low-and-middle-income countries. Furthermore, uncorrected refractive error has been noted to have extensive social and economic impacts, such as limiting educational and employment opportunities of economically active persons, healthy individuals and communities. The key public health challenges presented by uncorrected refractive errors, the leading cause of vision impairment across the world, require urgent attention. To address these issues, it is critical to focus on the development of human resources and sustainable methods of service delivery. This paper discusses three core pillars to addressing the challenges posed by uncorrected refractive errors: Human Resource (HR) Development, Service Development and Social Entrepreneurship.
Topics: Global Health; Humans; Prevalence; Public Health; Refraction, Ocular; Refractive Errors; Vision, Low
PubMed: 22944755
DOI: 10.4103/0301-4738.100543 -
The Cochrane Database of Systematic... Jun 2015Recent technological developments, such as the near universal spread of mobile phones and portable computers and improvements in the accessibility features of these... (Review)
Review
BACKGROUND
Recent technological developments, such as the near universal spread of mobile phones and portable computers and improvements in the accessibility features of these devices, give children and young people with low vision greater independent access to information. Some electronic technologies, such as closed circuit TV, are well established low vision aids and newer versions, such as electronic readers or off-the shelf tablet computers, may offer similar functionalities with easier portability and at lower cost.
OBJECTIVES
To assess the effect of electronic assistive technologies on reading, educational outcomes and quality of life in children and young people with low vision.
SEARCH METHODS
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2014), EMBASE (January 1980 to October 2014), the Health Technology Assessment Programme (HTA) (www.hta.ac.uk/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 30 October 2014.
SELECTION CRITERIA
We intended to include randomised controlled trials (RCTs) and quasi-RCTs in this review. We planned to include trials involving children between the ages of 5 and 16 years with low vision as defined by, or equivalent to, the WHO 1992 definition of low vision. We planned to include studies that explore the use of assistive technologies (ATs). These could include all types of closed circuit television/electronic vision enhancement systems (CCTV/EVES), computer technology including tablet computers and adaptive technologies such as screen readers, screen magnification and optical character recognition (OCR). We intended to compare the use of ATs with standard optical aids, which include distance refractive correction (with appropriate near addition for aphakic (no lens)/pseudophakic (with lens implant) patients) and monocular/binoculars for distance and brightfield magnifiers for near. We also planned to include studies that compare different types of ATs with each other, without or in addition to conventional optical aids, and those that compare ATs given with or without instructions for use.
DATA COLLECTION AND ANALYSIS
Independently, two review authors reviewed titles and abstracts for eligibility. They divided studies into categories to 'definitely include', 'definitely exclude' and 'possibly include', and the same two authors made final judgements about inclusion/exclusion by obtaining full-text copies of the studies in the 'possibly include' category.
MAIN RESULTS
We did not identify any randomised controlled trials in this subject area.
AUTHORS' CONCLUSIONS
High-quality evidence about the usefulness of electronic AT for children and young people with visual impairment is needed to inform the choice healthcare and education providers and family have to make when selecting a technology. Randomised controlled trials are needed to assess the impact of AT. Research protocols should carefully select outcomes relevant not only to the scientific community, but more importantly to families and teachers. Functional outcomes such as reading accuracy, comprehension and speed should be recorded, as well as the impact of AT on independent learning and quality of life.
Topics: Adolescent; Child; Child, Preschool; Humans; Self-Help Devices; Vision, Low
PubMed: 26086876
DOI: 10.1002/14651858.CD011350.pub2 -
Clinical & Experimental Optometry Sep 2017Ocular pathology that manifests at an early age has the potential to alter the vision-dependent emmetropisation mechanism, which co-ordinates ocular growth throughout... (Review)
Review
Ocular pathology that manifests at an early age has the potential to alter the vision-dependent emmetropisation mechanism, which co-ordinates ocular growth throughout childhood. The disruption of this feedback mechanism in children with congenital or early-onset visual impairment often results in the development of significant ametropia, including high levels of spherical refractive error, astigmatism and anisometropia. This review examines the use of contact lenses as a refractive correction, low vision aid and therapeutic intervention in the rehabilitation of patients with bilateral, irreversible visual loss due to congenital ocular disease. The advantages and disadvantages of the use of contact lenses for increased magnification (telescopes and microscopes) or field expansion (reverse telescopes) are discussed, along with the benefits and practical considerations for the correction of pathological high myopia. The historical and present use of therapeutic tinted contact lenses to reduce photosensitivity and nystagmus in achromatopsia, albinism and aniridia are also presented, including clinical considerations for the contact lens practitioner. In addition to the known optical benefits in comparison to spectacles for high levels of ametropia (an improved field of view for myopes and fewer inherent oblique aberrations), contact lenses may be of significant psycho-social benefit for patients with low vision, due to enhanced cosmesis and reduced conspicuity and potential related effects of improved self-esteem and peer acceptance. The contact lens correction of patients with congenital vision impairment can be challenging for both practitioner and patient but should be considered as a potential optical or therapeutic solution in modern low vision rehabilitation.
Topics: Contact Lenses; Humans; Optics and Photonics; Refractive Errors; Vision, Low
PubMed: 28664572
DOI: 10.1111/cxo.12562 -
Indian Journal of Ophthalmology May 2013
Topics: Audiovisual Aids; Equipment Design; Humans; Vision, Low; Visual Acuity
PubMed: 23760451
DOI: 10.4103/0301-4738.113314