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PubMed2002

[Adamantiades-Behcet's syndrome and pregnancy: a case report].

Is introducing a case study on a 20 year old female first time pregnant who presents with rare case of Adamantiadis-Bechet syndrome. These symptoms first appeared at the age of 9. The patient refers that from this age she has suffered from recurrent relapses of ulcerations of the mouth and genital organs, vescicular exanthema of the upper and lower extremities and severe headaches that would not subside with analgetic therapy. The patient upon the first trimester presented with a relapse of the disease and significant improvement during the remainder of the pregnancy. She delivered on the 39th week of her pregnancy a neonate male, alive and weighing 3640 gr. The Apgar--score 9 and 10 the 1st and 5th minute. Mother and neonate were discharged from the clinic on the 3rd postpartum day in good health. This case is also being discussed in international bibliography. Adamantiadis-Behcet syndrome constitutes systemic angiitis of unknown etiology that is characterized mainly by recurrent ulcers of the mouth and genital organs, serum negative arthritis, central nervous system disorders as well as ulcerations of the epidermis, nodular erythema, thrombophlebitis and vision disorders. It usually affects people in early adulthood, more often those in their 30s. Geographically it is seen more often in Japan, Korea, Turkey, Israel and other Mediterranean countries. Familial prevalence is also common.

Adult↗
PubMed2002

[Acquired disorders of color vision].

This article is a general view of acquired disorders of color vision. The revision of the best known methods and of the etiopathogenic classification is not very important in ophthalmology but on the other hand, the detection of the blue defect advertise and associated ocular pathology. There is a major interest in serious diseases as multiple sclerosis, AIDS, diabetes melitus, when the first ocular sign can be a defect in the color vision.

Color Perception Tests↗
PubMed1985

Clinical management of nearpoint stress-induced vision problems.

Functional vision problems caused by or associated with nearpoint vision stress include: accommodative disorders (insufficiency, ill-sustained, infacility); abnormal heterophorias (esophoria, high exophoria); and vergence disorders. These vision disorders cause problems with acuity, comfort, and performance (efficiency). A combination of lens prescribing, vision therapy, and work/study visual hygiene recommendations can eliminate or greatly reduce nearpoint stress-induced vision problems.

Eyeglasses↗
PubMed1996

Liability for pediatric care.

Liability claims involving eye care for pediatric patients may constitute as much as 20% of claims against optometrists, with the most common sources of litigation being failure to detect tumors affecting the visual system, improper diagnosis and management of binocular vision disorders, and injuries from shattered spectacle lenses. Claims for pediatric patients tend to allege large damages, partially because of the significant effect exerted by lifelong vision impairment or loss of vision.

Child↗
PubMed2002

A survey of treatment modalities for convergence insufficiency.

BACKGROUND: Convergence insufficiency (CI) is a common and distinct binocular vision disorder. However, there is a lack of consensus regarding the treatment most appropriate for Cl. Possible treatment modalities include base-in prism, pencil pushup therapy (PPT), reading glasses, home-based vision therapy/orthoptics (HBVT), and office-based vision therapy/orthoptics (OBVT). The purpose of this study was to investigate the care process for Cl by surveying eyecare professionals regarding the most common treatment modalities used by both optometrists and ophthalmologists across the United States. METHODS: Surveys requesting doctors to indicate which treatment(s) they prescribed and believed to be most effective for symptomatic CI patients were mailed to 863 optometrists and 863 ophthalmologists in the United States. RESULTS: Fifty-eight percent of the optometrists responded to the survey; the most common treatment prescribed was PPT (36%) followed by HBVT (22%) and OBVT (16%). For the ophthalmologists (who had a 23% response rate), the most common treatment prescribed was PPT (50%) followed by HBVT (21 %) and base-in prism (10%). CONCLUSIONS: This survey suggests that most eyecare practitioners prescribe PPT as the initial treatment for CI.

Data Collection↗
PubMed2002

[Psychogenic paralysis in childhood and adolescence].

OBJECTIVES: This article presents the characteristics of psychogenic paralysis in children and adolescents. The overview covers the changes in its diagnostic classification from ICD-6 to ICD-10. METHODS: Characteristics of this diagnostic entity are presented and epidemiological data discussed on the basis of clinical studies from the literature. Among the dissociative disorders in children and adolescents, psychogenic paralysis shows a characteristic distribution according to sex and age. Furthermore the literature indicates a better prognosis for patients with this symptomatology than for children and adolescents with pseudoseizures and psychogenic vision disorders. RESULTS: Iatrogenic invasive diagnostic and therapeutic procedures, somatic injuries, infections and a model for the symptoms play an important role in the pathogenesis of gait disorders.

Adolescent↗
PubMed2001

A clinical evaluation of random dot stereoacuity cards in infants.

PURPOSE: To clinically evaluate the random dot stereoacuity cards developed by Birch and Salomao on a population of infants within the first 12 months of life and to generate baseline normative data. METHODS: Random dot stereoacuity cards were constructed using vectographic vertical bar stimuli with cross disparities ranging from 45 to 1735 seconds of arc (1.65 to 3.2 log seconds of arc). Wearing polarising goggles, infants were assessed using a two-alternative forced choice preferential looking staircase procedure. Success rate and stereoacuity values for performance as a function of age were evaluated. RESULTS: One hundred and seventy-seven tests were completed on 41 infants with ages ranging from 5 to 56 weeks. The random dot stereoacuity procedure was successful in 128 (72.3%) infants, success being dependent upon age. At 0-8 weeks of age, none of the infants produced a fixation preferance towards even the coarsest stereogram. The success rate increased to 50% at 9-16 weeks, 97% at 17-24 weeks, 93% at 25-36 weeks, dropping to 69% at 37-56 weeks due to increasing intolerance to the goggles. Stereopsis was not demonstrable in infants under 8 weeks of age. By 9-16 weeks the mean stereoacuity level was 2.91 log seconds of arc, further increasing to 2.53 at 17-24 weeks, reducing slightly to 2.65 at 25-36 weeks. At 37-56 weeks the mean stereoacuity value was recorded as 2.53 log seconds of arc. CONCLUSION: Our results indicate that the infant random dot stereoacuity cards provide a simple, quick and portable test for the clinical assessment of stereopsis in infants aged between 17 and 36 weeks, and should prove to be a useful clinical tool to monitor infants at risk of binocular vision disorders.

Age Factors↗
PubMed1977

The office retinal electrophysiology laboratory.

The "Visual Retinal Profile" can be obtained in the complete office evaluation of patients with night vision disorders, unexplained poor visual acuity, or undiagnosed retinal and/or choroidal diseases. This profile allows later follow-up evaluations and comparisons of previous tests to document improvement or progression of disease. The profile consists of the usual ophthalmologic evaluation plus color vision testing Amsler grid, stereoacuity, visual fields, electroretinogram (ERG), and electrooculogram (EOG). This entire set of tests, though time consuming, can be performed in the office by an ophthalmic assistant and greatly add to the ophthalmologists ability to evaluate and diagnose subtle retinal and/or choroidal diseases. A portable ERG/EOG and light source will be described that can be used in the office, clinic, nursing home, or operating room by trained office personnel.

Choroid↗
PubMed1991

The Charles F. Prentice Award Lecture 1990: specific tests and specific blindnesses: keys, locks, and parallel processing.

Classical color vision theory incorporates the concepts of hard-wired parallel independent processing and of hard-wired opponent-processing. These two powerful concepts can be applied more generally in visual psychophysics. The concept of parallel independent processing can help to understand two extremes of visual performance: disordered vision in patients and the extraordinary visual abilities of athletes and aviators. Three illustrations of this thesis are discussed. First, evidence for dissociations of spatial vision for low-contrast and high-contrast objects. Second, evidence that a binocular system for motion in depth runs in parallel with the classical disparity-driven binocular system for relative position in depth. Third, evidence that a visual system for motion-defined form parallels the well known system for contrast-defined form. However, in principle these two concepts have limited value because they do not incorporate the possibility that the functional organization of the visual pathway could be modified by descending task-dependent signals.

Awards and Prizes↗
PubMedDate not supplied

[Neuro-ophthalmological examinations in craniopharyngiomas in childhood].

The results of ophthalmologic examinations of 50 children with craniopharyngiomas are analyzed. The condition was diagnosed on the basis of clinical examinations, roentgenography, angiography, brain scintigraphy, and computer-aided tomography. In 48 cases the diagnosis was confirmed by histologic findings. The mean age of the patients was 9 years 6 months, both boys and girls were included in the study group. Vision acuity deterioration was detected in 69.6% of children, optic disk edema in 22% and atrophic changes of the disk in 52% of the examinees. Vision field defects were revealed in 67.7%, nystagmus in 4 cases, oculomotor nerve paresis in 6 cases. The authors emphasize timely employment of conventional and present-day x-ray examinations, that are highly informative in such conditions, in all the patients with vision disorders of unknown origin and with suspected compression of the visual routes.

Adolescent↗
PubMed1997

Distribution of astigmatism among Sioux Indians in South Dakota.

BACKGROUND: Previous studies have reported a greater prevalence of high astigmatism and vision disorders among Native Americans than occurs in the general U.S. population. The majority of these studies, however, have focused on Native American schoolchildren. This study assessed the distribution of astigmatism in a general clinic population at the Rosebud Indian Reservation in South Dakota. METHODS: From examination of 174 patients, demographic information, visual acuities, refractive error, binocular vision status, and eye health were recorded. RESULTS: The data showed more high astigmatism than would be expected in a general U.S. population. Three or more diopters of astigmatism were found in 9.2% of the right eyes and 10.8% of the left eyes in the study population. High astigmatism was noted less frequently among those ages 40 years and older (3.3% right eyes, 6.3% left eyes). Most of the astigmatism was with-the-rule, but a shift toward against-the-rule and oblique astigmatism was found in older individuals. No significant gender differences were noted. CONCLUSIONS: The results suggest an ethnic difference in astigmatism and emphasize thee need for continued and expanded vision services for Native American populations.

Adolescent↗
PubMed2007

Children unable to perform screening tests in vision in preschoolers study: proportion with ocular conditions and impact on measures of test accuracy.

PURPOSE: To examine the relative prevalence of ocular conditions among children who are unable to perform preschool vision screening tests and the impact on measures of screening test performance. METHODS: Trained nurse and lay screeners each administered a Lea Symbols visual acuity (VA) test (Good-Lite, Inc., Steamwood, IL), Stereo Smile II test (Stereo Optical, Inc., Chicago, IL), and Retinomax Autorefractor (Right Manufacturing, Virginia Beach, VA), and SureSight Vision Screener (Welch Allyn, Inc., Skaneateles Falls, NY) examinations to 1475 children who later received a comprehensive eye examination to identify amblyopia, strabismus, significant refractive error, and unexplained reduced VA. The outcomes of the examination for children for whom screeners were unable to obtain results (Unables) were compared to the outcomes of children who passed and children who failed each screening test. When estimating sensitivity, specificity, and positive and negative predictive values (PPV and NPV), Unables were classified as either screening failures or screening passers. RESULTS: Less than 2% of children were classified as Unables for each test. The percentage with an ocular condition was at least two times higher for Unables than for screening passers for six of the eight modes of screening (P < 0.05). Considering Unables as screening failures, rather than screening passers, increased the estimate of sensitivity by 1% to 3% (depending on test) and decreased the estimate of specificity by 0% to 2%; PPV decreased by 0% to 4% for most tests, whereas NPV increased by <1%. CONCLUSIONS: Preschool children who are unable to perform VIP screening tests are more likely to have vision disorders than are children who pass the tests. Because < or =2% of children were unable to do each test, referring these children for an eye examination had little impact on the PPV and NPV of the tests, as administered in VIP.

Allied Health Personnel↗
PubMed2000

[Strabismus, hemianopsia and the sundial of Mawas and Franceschetti].

UNLABELLED: THE ARTIFACT: The artifact is a light rectangular slate of black cardboard showing two white lines at 40 degrees angle. It provokes physiological diplopia in lateral vision. BACKGROUND: In normal subjects, the right oblique line stimulates the right nasal hemiretina, perceived as an oblique line, and the left temporal hemiretina, perceived as a vertical line, both lines being on the right hand side. Likewise, the left oblique line is seen as two lines on the left hand side. The 4 lines form and M and a W combined. The strabismus subject sees 3 lines for he neutralizes one; the alternating squint sees only 2; the heterophoric sees 4 lines, two of which blurred, and the hemianopic sees only part of the dial. RESULTS: The subject must select the image he sees from an array of possibilities shown on the back of the dial. From 5 years of age on, normal subjects select the [symbol: see text] or the "butterfly"; hemianopic subjects correctly describe the loss of either the left or right field. CONCLUSIONS: The sundial facilitates both the screening and the treatment of binocular vision disorders. Bangerter's hemifilter will be used in association with exercises for physiological diplopia at home under monthly orthoptic control. All this made it possible to obtain useful peripheral fusion in early onset strabismus.

Diplopia↗
PubMed1999

Prevalence of chief complaints in a pediatric clinic population.

PURPOSE: To determine the type and frequency of chief complaints reported by parents of pediatric patients younger than 8 years of age in an optometry clinic. There have been many reports on prevalence of pediatric eye and vision disorders; however, the frequency of presenting complaints has not been carefully investigated. METHODS: 578 patient charts were retrospectively evaluated to determine the entering chief complaint, representing a 28-month time period between January 1993 and April 1995. The subjects were classified by age, and the chief complaint was placed in one of eight categories. RESULTS: The most frequently reported (30.1%) entering complaint for all subjects was the need for a routine vision examination. Each age category, however, had a unique distribution of complaints. Infants (1 to 11 months of age, n = 24) and young school age children (6 to 7-11 years of age, N = 233) most frequently reported complaints in the "other" category, at rates of 37.5% and 38.2%, respectively. Toddlers (12 to 36 months of age, N = 61) most commonly presented with complaints of an observed eye turn (39.3%), and preschoolers (3 to 5-11 years of age, N = 260) presented mainly for routine vision examinations (48.9%). CONCLUSIONS: There was a large percentage of patients presenting for routine vision care, which may represent an encouraging trend in public education efforts concerning children's vision care needs. The relative frequency of chief complaints in each age category prepares the eye care practitioner to address common parental concerns. This information can help to improve vision care education and services for the pediatric population.

Age Distribution↗
PubMed1986

Computer analysis of Farnsworth-Munsell 100-hue test.

Color vision abnormalities indicated by the Farnsworth-Munsell 100-hue Color Vision Tests (FM-100) were analyzed by computer to better characterize and group congenital and acquired color vision disorders and to help establish statistically significant diagnostic criteria. Standard evaluation of the FM-100 is by axis and error score calculations. A method has been established for computer-averaging many tests from patients with the same color abnormalities determined by history, standard FM-100 and Nagel anomaloscope. The computer calculated an average error score and standard deviation for each of the 85 color caps. Every time a new patient was evaluated for color vision abnormality, his score was compared with averaged tests with common diagnoses, by calculating distance scores. The averaged test with the lowest distance score consistently tended to coincide with the diagnosis. An analysis of 130 FM-100 color tests found technician-calculated error scores to be incorrect, although usually minor, in 40% of the tests. The computer-calculated axes agreed well with the technician's estimates. The distance scores predicted the diagnosis accurately 89% of the time. Many errors were due to the small number of protanopes averaged and inability to distinguish trichromats from dichromats.

Color Perception Tests↗
PubMedDate not supplied

Neuropsychological features of rapidly progressive dementia in a patient with an atypical presentation of Creutzfeldt-Jakob Disease.

BACKGROUND: Creutzfeldt-Jakob Disease (CJD) is a degenerative disease of the brain, characterized by rapid and irreversible decline, with dementia, ataxia, myoclonus, and other neurological and neurobehavioral disorders associated with rapidly progressive spongiform encephalopathy. The mode of transmission and basic pathomechanism remain unclear. The clinical picture of CJD is highly diverse, producing a number of variants. MATERIAL AND METHODS: The patient to be described is a 68-year-old Polish female, JR, clinically diagnosed with CJD. The article presents the case history in detail, with particular emphasis on neuropsychological testing, which was initiated when the patient was still lucid and capable of cooperation. The first presenting symptom was agraphia, followed by hemianopsia and other vision disorders, culminating in visual hallucinations. As the progress of the disease accelerated there was rapidly progressive dementia, aphasia developing to organic mutism, myoclonus, hyperkinesia, ultimately loss of all verbal contact or voluntary movement. RESULTS: JR's neuropsychological parameters declined in a period of less than 3 months from near normal to levels characteristic of severe dementia. CONCLUSIONS: The clinical picture here presented is consistent with that of the Heidenhain variant of CJD, with spongiform encephalopathy beginning in the right occipital lobe. Several features of the case remain atypical, however, including the absence of the most common genetic mutation and the patient's long survival after onset.

Aged↗