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Biomedical subjects

M J Moseley

Publications and source records attributed to M J Moseley.

At least 19 recordsLinked to original sources
PubMed1992

Preferential looking--clinical lessons.

Preferential looking-based tests of acuity have been available for over a decade. The authors discuss their use in clinical practice, particularly in three groups in whom acuity could not be quantified by traditional means: normal infants, and young children who are either mentally retarded, or who have visual disorders. Preferential looking (PL) testing has increased our understanding of the natural history of visual pathway disorders and has revealed certain patterns of acuity development. Early acuity development may be normal, delayed, or stationary, while in later infancy and childhood the following abnormal patterns have been identified: asymptotic, parallel, catch-up, or regressing. While this information has introduced a degree of complexity hitherto unknown which, if misunderstood, can lead to test misinterpretation, it offers the clinician invaluable information to improve patient care, and may also offer clues to the fundamental mechanisms of visual development.

Child, Preschool↗
PubMed1992

Light and retinopathy of prematurity: does retinal location offer a clue?

Nursery illumination has been implicated in the pathogenesis of retinopathy of prematurity (ROP), although the results of recent studies are conflicting. The data base for this article is a prospective ROP study on 607 infants of birth weight less than or equal to 1700 g including 35 larger siblings from multiple births when 1 infant fulfilled the birth weight criteria. Retinopathy commences preferentially in the nasal retina of the most immature neonate and is less likely to develop, or its onset is delayed, in the superior and inferior regions. These findings cannot be fully accounted for by regional vascular and neuroanatomical variations. Radiometric and physiological evidence suggests that the very immature neonate, most at risk of developing severe ROP, receives the greatest retinal irradiance. Furthermore, ROP commences in the areas of the retina receiving the highest light dose, and its onset is either retarded or inhibited in the darker retinal regions. Further studies are required to determine whether early exposure to light is a factor in the development of ROP. If a causal relationship is proven, here at least is one modality that can easily and immediately be controlled.

Cohort Studies↗
PubMed1992

Thrombolytic therapy: a case study.

Nursing care for Mr J evolved around his actual and potential problems. The actual problems were: an alteration in comfort (chest pain) related to myocardial ischemia, decreased cardiac output related to reperfusion dysrhythmias, and knowledge deficit regarding treatment with thrombolytic therapy. The potential problems were: fluid volume deficit related to lysis of clots in the cerebral vasculature, and alteration in myocardial tissue perfusion related to reocclusion of the coronary artery. Objectives focused on relief of chest pain, prompt initiation of thrombolytic therapy, maintenance of hemodynamics and cardiac output with early interventions, prevention of bleeding and initiation of patient education.

Electrocardiography↗
PubMed1991

Visual acuity and contrast sensitivity in cataract: summation and inhibition of visual performance.

Patients exhibiting uniocular cataract often report an improvement in vision on closing their cataractous eye. Such qualitative evidence suggests the presence of binocular inhibition--the converse of binocular summation (that is the normal superiority of binocular over monocular vision). To quantify the extent of inhibition in cataract, binocular and monocular visual acuity and contrast sensitivity were measured in 28 patients. Twelve patients showed binocular inhibition for visual acuity whilst 11 showed inhibition for contrast sensitivity measured at four cycles per degree (c.deg-1). Contrast sensitivity for 8 c.deg-1 targets was further recorded in a subset of 14 patients in whom seven showed inhibition. In patients who demonstrated inhibition, the mean decrement in performance for visual acuity was 13%. For contrast sensitivity at 4 and 8 c.deg-1 the mean decrement was 25% and 32% respectively. The clinical significance of these findings is discussed with respect to the assessment of visual function and management of the cataract patient.

Adult↗
PubMed1991

Light transmission measurements and phototherapy eyepatches.

The transmission characteristics of phototherapy eyeshields have been measured under conditions that mimic the clinical situation. Peak transmission (less than 10%) was detected at 700 nm for the poorest patch tested and less than 2% for either of the other patches examined. The optics of measurement systems are considered with reference both to this and previous studies of light transmission through eyepatches. The simplicity and effectiveness with which eyepatches can be secured may be as important as their transmission characteristics.

Evaluation Studies as Topic↗
PubMed1991

Fluid volume dynamics.

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Education, Nursing, Continuing↗
PubMed1990

Mother-child interaction with preschool language-delayed children: structuring conversations.

The discourse skills of mothers and their language-delayed children were examined to determine how participants opened and responded to each other in conversation. Four language-delayed children were matched to four normal children on mean length of utterance. Videotapes were made of the children and their mothers during 15 minutes of play. The types of utterances used to open and respond were similar; however, the flow of dialogue was different for the two groups in the use of invitations, initiations, sustaining, and non-sustaining responses. In the language-delayed child-mother dyads the flow of information through dialogue was interrupted by the necessity to clarify and the lack of definitive control of the turn-taking structure. Conclusions were that there was less shared context between mothers and their language-delayed children. These differences could be explained by the linguistic, semantic, and pragmatic ability of the children.

Child, Preschool↗
PubMed1990

Illuminance of neonatal units.

We have measured the illuminance (brightness) of seven neonatal units during both the day and the night. When the units were lit solely by fluorescent tubes the mean illuminance was 348 lux (range 192-690). During the day the mean illuminance was 470 lux (range 236-905). The high dependency regions in four of the seven units were significantly brighter than the corresponding low dependency nurseries at all times. In two of these units there is a policy of reducing the amount of artificial light in the low dependency areas at night, and in these the normal mean illuminance was 50 lux. We have measured the general levels of illumination to which a neonate might be exposed; the ocular exposure to light of a neonate depends, however, on both physical and biological factors and more research is required before an accurate estimate can be made.

Humans↗
PubMed1989

Comparison of a new non-contact tonometer with Goldmann applanation.

A comparison of a new non-contact tonometer (Keeler Pulsair: Keeler UK Ltd) with the Goldmann applanation tonometer is reported. Measurements of intraocular pressure were obtained from 182 eyes of 94 patients. At low pressures (less than 10 mmHg) the candidate tonometer tended to overestimate pressures obtained with the Goldmann tonometer whilst at high pressures (greater than 19 mmHg) those obtained by Goldmann applanation were underestimated. Between 10 and 19 mmHg there was no significant difference between readings obtained with either method. Up to 71% of averaged Pulsair measurements fell within +/- 3 mmHg of those obtained with the Goldmann tonometer increasing to 78% if pressures greater than or equal to 30 mmHg obtained with the Pulsair tonometer were excluded. Adopting a screening criterion of greater than or equal to 21 mmHg (Goldmann) resulted in a sensitivity of 85% and a specificity of 95%. Some evidence that serial Pulsair readings are influenced by the ocular pulse is presented. It is concluded that the Pulsair tonometer can provide clinically useful measurements of intraocular pressure.

Evaluation Studies as Topic↗
PubMed1989

Eyelid opening in preterm neonates.

The frequency and patterns of eyelid opening were examined in a group of neonates (gestational age 24-35 weeks). Observations were spread over the 24 hour period to obtain a complete pattern of events. Mean eyelid closure was 74%. When babies were grouped by gestational age, however, differences became apparent, babies of less than 26 weeks having their eyes shut for only 55% of observations compared with 93% at 28 weeks. Trend analysis confirmed that eyelid closure reached a peak at 28 weeks. Neonates exposed to a day/night regimen, opened their eyes significantly more than those exposed to continuous illumination. We suggest that frequency of eyelid opening may be related both to the infant's developmental state (postmenstrual age) and the illumination of the neonatal unit. Frequency of eyelid opening should therefore be considered when calculating the ocular light exposure of preterm neonates.

Aging↗
PubMed1988

Effects of nursery illumination on frequency of eyelid opening and state in preterm neonates.

The behaviour of a group of premature neonates was observed under three conditions of ambient illumination defined as either DARK, LIGHT or BRIGHT (mean intensities: 0.9, 109 and 1370 lux). Trends in the data suggested that increasing the level of illumination resulted in a reduction in the proportion of time spent with eyelids open and of the amount of time spent in awake states. However, these effects were small and in most cases failed to attain statistical significance. Sudden offset of light did however produce a transitory increase in eyelid opening for a period of approximately 60 s that appeared to be unaccompanied by any change of state (P less than 0.001). Irrespective of illumination condition, the infants' behaviour was characterized by prolonged periods of eyelid closure which were significantly greater for the lower eye (in mattress contact, mean lid closure = 96.2%) compared to the upper eye (no mattress contact, mean lid closure = 88.25%). The prolonged occurrences of eyelid closure are discussed in relation to visual development and phototoxicity.

Arousal↗
PubMed1988

Light transmission through the human eyelid: in vivo measurement.

We describe an in vivo measurement technique for determining the transmission of light through the human eyelid and present data from three human subjects. The relevance of the transmission measurements are discussed in relation to (1) clinical electrophysiology and (2) the effects of light on the developing visual system.

Adult↗
PubMed1988

Grating and recognition acuities of young amblyopes.

The visual acuities of 36 young amblyopes were determined by (a) conventional recognition tests (near and distance) and (b) an adapted grating acuity card procedure. Considerable agreement between the estimates of acuity obtained with each method was demonstrated, which was generally less than, or equal to, the mean difference between adjacent Snellen lines (4.5 c deg-1). Estimates of grating acuity obtained with vertical gratings did not differ significantly from those obtained with horizontal gratings. There was no difference between the subjects' ability to detect the grating (acuity) and accurately to discriminate target orientation (horizontal or vertical). The results of the experiment are discussed in relation to previous findings of a discrepancy between grating and recognition acuities in amblyopia, and the clinical use of the acuity card procedure.

Amblyopia↗