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Biomedical subjects

N N Chiu

Publications and source records attributed to N N Chiu.

4 recordsLinked to original sources

Effect of contralateral fog during refractive error assessment.

BACKGROUND: When assessing refractive error using static retinoscopy, it is conventional to fog the contralateral eye by approximately 2.00 D to prevent a blur-driven accommodative response stimulating consensual accommodation in the tested eye. However, the effect of higher amounts of contralateral fog (e.g., in a moderate-to-high uncorrected myopic individual) during refractive error assessment is unclear. METHODS: We assessed the refractive state in 16 visually normal myopic subjects while fogging the contralateral eye between zero and 6.00 D, in 1.00 D increments. Retinoscopy was simulated by shining a streak retinoscope light into the right eye, while simultaneously measuring the refractive state of this eye objectively. RESULTS: No significant change in mean refractive state was observed for up to 5.00 D of contralateral fog. But, 6.00 D of contralateral fog produced a significant mean increase in the myopic direction of 0.13 D. Also, in three subjects, a myopic shift of approximately 0.60 D was recorded after the introduction of 6.00 D of contralateral fog. Nevertheless, the magnitude of these largest shifts in refractive error are still smaller than the previously reported degree of repeatability of static retinoscopy. CONCLUSIONS: Since large amounts of contralateral fog produced only small and clinically insignificant changes in the refractive state, the practitioner merely needs to ensure that the nontested eye is indeed fogged. The magnitude of fog present will have only a minimal effect on the final result.

Adult

Repeatability of subjective and objective refraction.

Although several studies have examined the repeatability of objective refraction, data concerning the repeatability of subjective refraction under masked conditions, i.e., where the examiner is unaware of the refractive results, are limited. Accordingly, the present study compared the variability of both subjective and objective refractive techniques. Refractive error was measured in 12 subjects on 5 separate occasions. Conventional subjective procedures were used, with the exception that the sphere power scale on the phoropter was covered so that the examiner was unaware of the final result. Objective measurements were obtained using a Canon Autoref R-1 infrared autorefractor. The standard deviation (SD) of the five examinations was calculated for each individual and the mean values for the population sample determined. The mean SD's for the subjective and objective techniques were +/- 0.14 and +/- 0.18 D, indicating 95% confidence limits of +/- 0.27 and +/- 0.35 D, respectively. It is concluded that with either assessment technique, a change in refractive error of at least +/- 0.50 D should be adopted as the minimum significant shift in refractive status.

Adult

Accommodative adaptation in children.

Although accommodative adaptation has been studied extensively in young adult populations, there has been little consideration of this function in children. Accordingly, we examined accommodative adaptation by comparing pre- and post-task measurements of dark accommodation (DA) in children and young adults. DA was assessed objectively before and immediately after a 5-min near-vision task (viewing distance = 20 cm) using an open-field, infrared optometer (Canon Autoref R-1). The study was performed on 15 visually normal children (mean age = 10.1 years) and 10 visually normal young adults (mean age = 25.2 years). No significant difference was observed between the mean values of pre-task DA for the two age groups (children = 1.01 D, adults = 0.88 D). Both groups showed equivalent degrees of accommodative adaptation (approximately 1.0 D), and the rate of regression of post-task DA to the pre-task level was similar for each group. We found a significant positive correlation between the magnitude of adaptation and pre-task DA in children, which was not found in the young adult population. The results indicate that pre-task DA and accommodative adaptation (both in terms of magnitude and rate of decay) are similar in adults and children. This would not support the proposal that the development of nearwork-induced myopia in children is related to short-term variations in accommodative adaptation when compared with young adults.

Accommodation, Ocular

Tonic accommodation, tonic vergence and surround propinquity.

Previous studies have typically assessed tonic accommodation (TA) and tonic vergence (TV) by placing subjects in total darkness. However, a recent investigation demonstrated that even under such apparently stimulus-free conditions, subjects' awareness of the proximity of the adjacent surroundings and overall room topography (i.e. surround propinquity) may still influence the accommodative response. Accordingly, the aim of the present study was to measure TA and TV while subjects (n = 34) viewed an illuminated distant target (viewing distance = 6 m) to minimize this propinquity effect. TA was measured using an objective, open-field, infrared optometer under two conditions: first, while viewing the distant target monocularly through a 0.5 mm pinhole, and second in total darkness. Additionally, TV was assessed by determining the heterophoria subjectively while subjects viewed the distant target biocularly through 0.5 mm pinholes. The mean level of TA using the pinhole technique (mean = 0.28 D) was significantly lower than that observed in total darkness (mean = 0.60 D). Furthermore, a significant positive correlation (r = 0.86) was found when comparing the difference between the two TA measurements with the level obtained in total darkness. Those subjects having apparently high levels of TA in darkness exhibited the largest propinquity effect. Thus measurements of accommodation recorded in total darkness are likely to have overestimated both the magnitude and normal range of TA. The mean level of TV was 0.58 metre angle. No significant correlation was observed between TV and either of the two TA measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Accommodation, Ocular