Biomedical subjects

Andrew Carkeet

Publications and source records attributed to Andrew Carkeet.

9 recordsLinked to original sources

PubMed2003

Relationship between goblet cell density and tear function tests.

AIM: The objective of this study was to find a relationship between goblet cell density (GCD) and other diagnostic tests of dry eye in a group of normal healthy Chinese subjects. The capability of using GCD as a tear function test was assessed. METHOD: A total of 42 optometry students with no contact lens wear history were recruited. Subjects were required to fill in a dry eye questionnaire. The non-invasive tear break-up time (NITBUT) of each subject was measured, followed by phenol red thread test (PRTT) and tear break-up time (TBUT) tests. Conjunctival epithelial cells from the inferior nasal bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS (Periodic Acid Schiff)-haematoxylin. The goblet cells and the conjunctival epithelial cells were counted under a light microscope of 100x magnification. Spearman's rho (rho) correlation test was used to analyse the relationship between GCD and the other tear function tests. RESULTS: With a probability level of 0.0051 (corrected for a cumulative familywise error rate of p = 0.05), GCD was found to have no correlation with NITBUT (rho = -0.193, p = 0.222), McMonnies Dry Eye Scores (MCDES) (rho = -0.052, p = 0.742), PRTT (rho = - 0.188, p = 0.234) and TBUT (rho = 0.246, p = 0.117). CONCLUSION: There was no correlation between GCD and MCDES, NITBUT, PRTT and TBUT. The GCD alone is not a useful diagnostic test for tear film instability in normal eyes although it is a good indicator in the diagnosis of ocular surface diseases.

Adult↗

PubMed2003

Modulation transfer functions in children: pupil size dependence and meridional anisotropy.

PURPOSE: This study quantified preschool children's optical quality in terms of their aberrations and modulation transfer function (MTF), and examined the dependence of MTF on pupil size and grating orientation. METHODS: Aberrometry was used to measure Zernike coefficients in 34 Chinese preschool children (18 males, 16 females; aged 4.95-6.89 years; mean, 5.91 +/- 0.56). For each subject, after mathematical correction for refractive error, these wavefront errors were used to calculate MTF (lambda = 550 nm) for pupil sizes from 1 to 5 mm and for gratings at orientations in 15 degrees intervals. RESULTS: Aberrations were correlated between right and left eyes, for wavefront RMS and some Zernike coefficients. Average aberrometry results showed that third-order terms predominated, in addition to some positive spherical aberration with an average higher order root mean square (RMS) of 0.20 micro m over a 5-mm pupil. Average MTFs were optimal for 3-mm pupil sizes at lower spatial frequencies (<69 cyc/deg) and slightly better than those found by similar techniques in young adults. Heights of MTFs were significantly related to higher order RMS (Spearman rho = -0.926). MTFs showed a small meridional anisotropy for 3-mm pupils, with average MTF for vertical gratings (horizontal modulation) being slightly, but significantly better than for horizontal gratings (vertical modulation). There was no evidence of an oblique effect in the optics of these children. CONCLUSIONS: In these children, ocular optical quality is pupil dependent, shows slight meridional anisotropy and is slightly better than that for young adults.

Anisotropy↗

PubMed2002

Refractive error and monochromatic aberrations in Singaporean children.

Higher order optical aberrations were measured in 273 cyclopleged Singaporean school children using a Bausch and Lomb Zywave aberrometer, with 268 of these subjects also undergoing corneal topography measurements (Tomey TMS 2 system). Subjects with low myopia (> -3.00 to -0.50 D) showed slightly, but significantly, less positive levels of spherical aberration than other refractive error groups. Chinese subjects also showed significantly higher amounts of aberrations than Malay subjects, particularly for vertical coma, but also for horizontal coma and spherical aberration. Anterior corneal spherical aberration (calculated from topography) was significantly correlated with whole eye spherical aberration, but did not vary significantly with refractive error or racial background. Residual spherical aberration (i.e. of posterior cornea and crystalline lens) did vary significantly with refractive error and race. Our results do not provide any evidence for aberration-driven form-deprivation as a major mechanism of myopia development.

Child↗

PubMed2002

Component dependent risk factors for ocular parameters in Singapore Chinese children.

OBJECTIVE: To examine the risk factors for variations in ocular biometry parameters in Singapore Chinese children, a population with a known high prevalence rate of myopia at an early age. DESIGN: Cross-sectional study. PARTICIPANTS: Children aged 7 to 9 years (n = 1453) from three schools in Singapore. METHODS: The children underwent A scan biometry and cycloplegic autorefraction measurements. Questions were asked regarding number of books read per week, night lighting, and parental myopia. MAIN OUTCOME MEASURES: Axial length, vitreous chamber depth, lens thickness, anterior chamber depth, refraction, and corneal curvature radius measurements were made. RESULTS: After controlling for several factors, the axial lengths were found to be longer and vitreous chambers deeper in children who were older, male, read more than two books per week, or taller, and those who had at least one parent who was myopic. In these models, children who read more than two books per week had axial lengths that were 0.17 mm longer and vitreous chambers that were 0.15 mm deeper compared with children who read two or fewer books per week. Anterior chambers were deeper in males and taller children, whereas corneal curvature was steeper in female, older, and shorter children. CONCLUSIONS: Increases of axial length and vitreous cavity depth were associated with older age, being male, reading more than two books per week, increased height, and parental history of myopia. Of these risk factors, however, neither reading nor parental myopia history were associated with values for anterior chamber depth, corneal curvature, or lens thickness. These findings confirm that conventional risk factors for myopia associated with the vitreous cavity, but suggest that anterior segment parameters such as corneal curvature and lens thickness may be subject to unrelated postnatal growth control mechanisms.

Age Distribution↗

PubMed2002

Prevalence rates and epidemiological risk factors for astigmatism in Singapore school children.

PURPOSE: This study examined the prevalence rate of astigmatism and its epidemiological risk factors in Singapore school children. METHODS: In a study of school children aged 7 to 9 years old in two schools in Singapore in 1999, a detailed questionnaire was administered to parents regarding reading or close-work habits, past history of close-work, family history, and socioeconomic factors. Cycloplegic refraction was performed five times in each eye. Defining astigmatism as worse than or equal to 0.5, 0.75, and 1 D cylinder in the right eye, the prevalence of astigmatism was calculated. RESULTS: The study population consisted of 1028 children. The prevalence rate of astigmatism (worse than or equal to 1 D cylinder) was 19.2% (95% confidence interval, 16.8 to 21.6). This was not different between genders, ethnic groups, or age (p > 0.05). With-the-rule astigmatism was more common than against-the-rule astigmatism. The prevalence of astigmatism and myopia was 9.8% (95% confidence interval, 8.0 to 11.6). A high AC/A ratio was associated (p = 0.003) with astigmatism, even after exclusion of myopic children. On vectorial analysis, J0 and J45 were associated with the number of hours of playing video games, whereas J45 was also associated with computer use. Only J45 was associated to male gender, a high AC/A ratio, and a family history of myopia. CONCLUSIONS: The prevalence rate of astigmatism (> or = 1 D) was 19%. Playing video games and computer use may be associated with astigmatism severity, although the presence of astigmatism (> or = 1 D) was not associated with any nearwork factors. A family history of myopia was associated with oblique astigmatism severity. A high AC/A ratio is associated with astigmatism, and this requires further investigation.

Astigmatism↗

PubMed2002

Sensitivity and specificity of visual acuity screening for refractive errors in school children.

PURPOSE: To examine the optimal cutoff point for the use of the visual acuity test to screen for refractive errors in schoolchildren. METHODS: In a sample of schoolchildren between 7 and 9 years old, visual acuity testing was performed using modified ETDRS charts monocularly without optical aids by trained personnel. Cycloplegic autorefraction was performed in each eye. The screening efficacy of using various cutoff points for referring children for further optometric/ ophthalmic assessment was studied. Myopia was defined as a spherical equivalent of at least -0.5 D, hyperopia a spherical equivalent of at least +2.0 D, and astigmatism a cylinder of at least -1.0 D in at least one eye. The sensitivity, specificity, and predictive values were calculated using each patient as a case; a receiver operator curve was plotted. RESULTS: A total of 1,028 children were tested. A satisfactory sensitivity/specificity profile was obtained using a referral criterion of visual acuity worse than or equal to 0.28 logarithm of the minimum angle of resolution in at least one eye. In this scenario, the sensitivity and specificity of this screening test were 72% (95% confidence interval [CI], 68 to 76) and 97% (95%CI, 95 to 98), respectively. The positive and negative predictive values were 96% (95%CI, 93 to 98) and 78% (95%CI, 75 to 82), respectively. CONCLUSIONS: The modified ETDRS visual acuity chart can be used to predict refractive errors in schoolchildren in Singapore in a sensitive and specific manner using a referral criterion of worse than or equal to 0.28 logarithm of the minimum angle of resolution.

Child↗

PubMedDate not supplied

Motion perception in glaucoma patients: a review.

Most of the histopathological and psychophysical studies in glaucoma reveal a preferential damage to the magnocellular (M) pathway although a few of them support a damage to the parvocellular (P) pathway as well. In glaucoma, the visual fields are usually evaluated by conventional perimetry. However, it has been demonstrated that 20-40% of ganglion cells are lost before field defects are detected using conventional perimetry. Therefore, new psychophysical tests have recently been designed in order to specifically isolate and evaluate the visual mechanisms that are impaired at the early stages of glaucoma. In this context, several authors have addressed the issue of motion perception under the hypothesis of a predominant damage of the M pathway in glaucoma, and that motion perception is mediated mainly by M pathway. The results of these studies depict a large variation in the percentage of patients showing anomalous motion perception. Overall, motion thresholds are elevated in both glaucoma and ocular hypertensive patients as compared to control subjects, irrespective of the stimulus size and eccentricity. The test which discriminates best between patients and normal subjects is motion perimetry. The visual field defects in glaucoma patients identified by conventional perimetry and motion perimetry are similar, but the sizes of the defects are usually larger with motion perimetry. However, motion tests in central vision have no correlation with visual field defect on conventional perimetry. In glaucoma, loss of performance on motion perception tests does not necessarily support the existence of a specific deficit in the M pathway, because some behavioral studies suggest that the P pathway can also mediate motion perception. It is also difficult to conclude that motion perception is specifically affected in glaucoma because most of these studies do not yield a comparison with other visual functions. Despite these difficulties, localized motion perception tests at eccentricities of more than 15 degrees can be considered as a promising diagnostic tool.

Glaucoma, Open-Angle↗

PubMedDate not supplied

Field restriction and vignetting in contact lenses with opaque peripheries.

BACKGROUND: Some previous researchers have shown empirically that visual fields can be restricted by contact lenses with opaque and semi-opaque peripheral zones. However, there has been no formal statement of the optical theory behind such restriction. METHODS: Calculations are made of fields of view with opaque periphery contact lenses, based on paraxial theory and meridional finite ray tracing in the Gullstrand-Emsley schematic eye. RESULTS: This analysis shows that paraxial theory is adequate for predicting 'half fields of full illumination' for ocular pupil diameters smaller than six millimetres, although paraxial estimates of 'half total field' can substantially underestimate those obtained by finite ray tracing for a wide range of ocular pupil sizes. Therefore finite ray tracing may be a more appropriate method of calculating half total field. 'Total field' will be smaller with smaller ocular pupils and smaller contact lens apertures. A clinical method is suggested for assessing total field with such contact lenses in situ. The analysis applied to opaque periphery contact lenses is extended to the semi-opaque periphery contact lenses used for cosmetic alteration of eye appearance. CONCLUSION: Semi-opaque periphery contact lenses will decrease retinal illuminance most at regions outside those tested by previous empirical static perimetry studies.

Journal Article↗

PubMedDate not supplied

Higher order ocular aberrations after cycloplegic and non-cycloplegic pupil dilation.

PURPOSE: Clinical aberrometry is commonly undertaken with the use of mydriatic agents, however there is no literature available on whether aberrometry results obtained under cycloplegia differ from those obtained without cycloplegia. METHODS: Higher order aberrations were measured over a 6-mm pupil with a Bausch and Lomb Technolas Zywave Aberrometer on the right eyes of 31 young subjects (average age 19.7 +/- 1.7 years; 5 females, 16 males). Two measurement conditions were used for each subject: 1) topical installation of 3 drops 1% cyclopentolate hydrochloride; and 2) topical installation of 1 drop 2.5% phenylephrine hydrochloride, prior to aberrometry measurements. RESULTS: For higher order aberrations (3rd to 5th order), average root mean square (RMS) after phenylephrine measurement (0.3852 microm) was significantly lower than after cyclopentolate (0.4259 microm). A small but statistically significant difference was found between the two conditions for average vertical and horizontal coma and, to a lesser extent, horizontal 5th order aberrations. Repeatability RMS, a measure of test-retest measurement repeatability, was similar for the two conditions at 0.15 microm, and significantly lower than the average RMS for the difference between the two conditions (residual RMS) of 0.22 microm. CONCLUSIONS: The difference between cycloplegic and non-cycloplegic aberration measurements has implications for surgical correction of higher order aberrations.

Administration, Topical↗