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PubMed2004

[Preserving vision in the elderly: a survey to start a quality development program in general practice].

The study examined the rate of patients, who do not follow recommendations for routine screening, do not visit physicians for eye-symptoms and when suffering from diabetes or glaucoma do not adhere to follow-up. To what extent can primary care physicians impact on these deficits of ophthalmologic care? 4918 consecutive, > or = 40 old patients of 107 primary care physicians of 9 networks participated. Of these patients 15% had never, 43% not within the last 3 years, consulted an ophthalmologist. 16% were diabetics, 7% had glaucoma and 46% had observed subjective eye symptoms. A quarter of these patients turn to their primary care physician, when having eye problems. Primary care physicians do not frequently suggest routine ophthalmologic controls nor do they use diagnostic tools like the Amsler-grid or the Swinging-Flash-Light Test.

Adult↗

PubMed2004

Visual function tests on the Internet--sense or nonsense?

BACKGROUND: The quantitative capability of the visual system can be tested using graphic presentations with defined size, form and color. For presentations, a chart projector or monitor can be used. Today, the number of visual function tests on the Internet is increasing constantly. Options and limitations of visual function tests using the METHODS: Internet and the authors' own test results are described. RESULTS: Several visual function tests, such as visual acuity tests, the Amsler-Grid, stereo and color vision tests, can already be given via Internet. The variability of the tests ranges from the simple presentation of graphic elements to the laboriously programmed interactive input by the user to specify the test result. Under standardized examination conditions, there was a very high correspondence between the results of the authors' own web-based color vision test and those of luminescence color test plates and conventional pigment color plates. CONCLUSIONS: However, the interpretation of the test results is difficult due to the absence of controls during the test as well as the heterogeneity of the hardware. In order to obtain comparable test results, differences in size and resolution as well as in brightness, contrast and color of computer monitors must be taken into consideration. Due to the deficits described in the tests, the value of visual function tests on the Internet is rather limited. Currently, the data of test distributers with respect to the test conditions are all still insufficient. Standards need to be defined for Internet-based visual function tests. However, visual function tests on the Internet can achieve test results comparable to those of conventional visual function tests under standardized examination conditions in clinical practice. Further studies are needed to check the accuracy of web-based screening examinations in ophthalmology.

Color Perception Tests↗

PubMed1988

The flight of colours test. Its value as an indicator of dysfunction of the visual pathways.

The flight of colours (FOC) test was compared with visual evoked potentials (VEPs) in 135 patients in a 2 year prospective study, to determine whether the FOC test is a sensitive and reliable alternative. We obtained an 80% overall agreement between the tests, confirming the levels of agreement reported by Rolak (87%) and Swart and Millac (92%). Abnormal VEPs, however, were more closely associated with cases of clinically definite multiple sclerosis (MS) while abnormal FOCs were more frequent in cases of non-demyelinating disease and cases without clinically evident optic nerve or other ocular disorder. We cannot explain this result by any demonstrated superiority of the FOC test over VEPs in non-demyelinating visual disturbances, whether clinically evident or not. Thus the study does not confirm the earlier expectation that the FOC test would be a reliable alternative to the study of VEPs in the differential diagnosis of MS.

Adolescent↗

PubMed1993

[A study of para-foveal color vision in normal-tension and primary open angle glaucoma eyes].

A perimetric color vision test developed by Iijima et al. for evaluating parafoveal color vision provides information regarding local retinal function which can not be evaluated by other color vision tests. Using this method, we investigated para-foveal color sensitivity in normal-tension glaucoma (NTG) and primary open angle glaucoma (POAG) eyes whose glaucomatous visual field change determined with the central 30-2 program of the Humphrey visual field analyzer was confined to either the upper or the lower hemifield. The examined eyes had no abnormalities in ocular media with best corrected visual acuity of 1.0 or higher, and age, refraction, mean deviation, and extent of visual field loss were matched between NTG and POAG eyes. In the para-foveal area of the spared hemifield, acquired blue-yellow dyschromatopsia was detected in 52.3% of the POAG eyes and in 11.3% of the NTG eyes (p < 0.02, chi 2-test), and in damaged hemifield, it was found in 76.1% of the POAG eyes and 80.7% of the NTG eyes. We suggest that visual function is more diffusely damaged in POAG than in NTG and that the perimetric color vision test is useful for detecting glaucomatous damage which cannot be detected with conventional light threshold measurements.

Adult↗

PubMed2003

Loss of cone function in age-related maculopathy.

PURPOSE: To evaluate cone visual function of subjects with age-related maculopathy (ARM). METHODS: Cone thresholds in 16 patients with ARM and 14 age-matched control subjects were compared. All subjects had visual acuity of 6/12 or better in the studied eye. A range of contrast thresholds were measured to evaluate diverse aspects of cone visual function under steady state conditions (spatiotemporal, color and luminance, and photopic sensitivity) or after bleaching (adaptation dynamics). RESULTS: ARM produced a diffuse loss across all cone steady state visual functions in 31% to 44% of subjects. The adaptation time constant of cone recovery was significantly prolonged in most (69%) ARM eyes. A cross-correlational analysis found adaptational kinetics to be independent of other steady state losses, with cone photopigment regeneration being the most affected visual function in ARM (chi(2) = 4.03, P < 0.05). CONCLUSIONS: The results show that cone-adaptational kinetics are affected in ARM more so than are steady state thresholds. Given that cone recovery is easy to examine in a clinical setting, this test may provide a useful index of photopic function in patients with ARM.

Adaptation, Ocular↗

PubMed1991

Automated analysis of the McKenzie test through color slide digitization and processing.

The McKenzie test is performed to compare the antiinflammatory activity of topical corticosteroids. Each drug induces a local whiteness of the skin called blanching. The blanchings are classically evaluated on the basis of visual score. This paper proposes a new blanching index and a methodology for designing such an index by digitizing and processing color slides. Several indices derived from classical color models are proposed and compared to the visual scores. This work demonstrates the significant improvement of quantitation derived from digitized images with respect to the observer assessment. The difference of chromatic green between the blanching patch and the surrounded healthy skin is proposed for analysis of the McKenzie test.

Administration, Topical↗

PubMed1998

Daylight simulators and colour vision tests.

Our previous studies have shown that the influence of the illuminating source used for colour vision examination on the intended function of the test is very test dependent, some being relatively unaffected by source characteristics while others can be significantly affected. The effects can even differ between the plates of one pseudo-isochromatic plate test set. In addition, in previous studies we have considered a large range of sources on one test at a time. For this study the emphasis is on four fluorescent tube sources, all of which meet the requirements of the CIE method for assessing the quality of daylight simulators. The colour vision tests include sorting tests (the D-15 tests [Standard, Lanthony Desat and Adams Desat]), the Lanthony New Colour Test and the FM100 Hue Test, pseudo-isochromatic plate tests (Ishihara, Standard Pseudo-isochromatic Plates Volume 1, Hahn New Colour Test and Lanthony Tritan Album) and a matching test (TCU Test). Two examples are quoted here. The tests were assessed on the basis of alignment of the colours of the tests to protanopic and deuteranopic confusion axes and, where appropriate, to the tritanopic confusion axis. The data and analysis indicate that the four fluorescent tubes are essentially equivalent.

Color Perception Tests↗

PubMed1988

Low-contrast letter charts to detect subtle optic [corrected] neuropathies.

We performed visual contrast sensitivity testing with Regan's low-contrast letter charts on 30 patients with optic neuropathies and good Snellen visual acuity. Results of this testing were compared with color vision and the presence of an afferent pupillary defect. Regan's low-contrast letter charts were found to be 93% sensitive for detecting subtle optic neuropathies, with the apparent false-negative findings being readily explainable. Color vision testing was abnormal in only 49% of eyes with known optic neuropathies.

Adolescent↗

PubMed1996

Color vision in patients with a silicone intraocular lens.

PURPOSE: To test color vision in eyes with a silicone intraocular lens (IOL) and compare it with that in normal phakic eyes. SETTING: University Eye Clinic of Kuopio, Finland. METHODS: Color vision in 33 patients from 50 to 69 years old with a silicone IOL was evaluated with the Farnsworth-Munsell 100 hue test (FM 100) and the Color Vision Meter 712 (CVM) anomaloscope. In the FM 100 test, 37 normal phakic eyes served as controls; 21 were 50 to 59 years old and 16, 60 to 69 years old. In the CVM, 46 normal phakic eyes served as controls; 21 were 50 to 59 years old and 25, 60 to 69 years old. Nine of the 33 patients had a silicone IOL in one eye and a poly(methyl methacrylate) (PMMA) IOL in the other; the color vision in the two eyes was compared. RESULTS: The FM 100 results showed no significant difference between the silicone IOL and control eyes. In the CVM examination, the blue equation showed a significantly greater shift to the green side (patient sees more blue) in the silicone IOL group than in the control group. Other CVM results were similar between groups. No significant difference was found in any test between the 9 PMMA IOL eyes and the contralateral silicone IOL eyes. CONCLUSION: Eyes with a silicone IOL had color discrimination ability similar to that of normal phakic eyes. In the blue color sensitivity test, the silicone IOL eyes had significantly better results. There were no significant differences between eyes with a silicone IOL and contralateral eyes with a PMMA IOL.

Aged↗

PubMed1990

Clinical measures of central differential sensitivity in glaucoma.

To verify whether central threshold testing with a common automated perimeter could detect glaucomatous damage, we selected 40 eyes with primary open-angle glaucoma and 43 eyes of age-matched normal subjects. The glaucomatous eyes were free from visual field defects within the central 5 degrees. They underwent the Macula Threshold Test of the Humphrey perimeter, using white and blue targets. Differential sensitivities to both white and blue were significantly depressed in the glaucoma group (p less than 0.001). Blue thresholds of glaucomatous subjects and normal subjects were distributed in two quite separate domains, with a mean difference of 4.51 dB. Sensitivities to blue stimuli were related to age in the normal group (r = 0.62; p less than 0.001), while in the glaucoma group they were related to horizontal cup/disc ratios (r = 0.63; p less than 0.001). These results suggest that threshold testing with an automated perimeter and its built-in colour filters can be of help in detecting early central functional disturbances from glaucoma.

Color Perception Tests↗

PubMed1991

Threshold Amsler grid testing in diabetic retinopathy.

The Amsler grid is a suprathreshold target used to assess the central 10 degrees of the visual field; thus, it may fail to detect relative central scotomas. Low luminance conditions can be created by viewing the white grid on a black background through two cross-polarizing filters that vary light transmission and change the procedure to a threshold Amsler grid (TAG) test, thereby increasing its sensitivity. A total of 26 patients with diabetic retinopathy were tested by standard Amsler grid, TAG, and tangent screen. Four scotomas were detected by Amsler grid testing; each of these scotomas expanded in size on retesting with the TAG. TAG testing revealed 22 scotomas more than five times the number seen with conventional Amsler grid testing; tangent-screen examination confirmed 9 of these defects. In many cases, fundus photography and fluorescein angiography revealed pathology that correlated with the scotomas detected only by TAG testing. It thus appears that the TAG test is a rapid, high-yield, and sensitive means of assessing the central visual field in patients with diabetic retinopathy.

Adult↗

PubMed2004

Screening for sight-threatening diabetic retinopathy: comparison of fundus photography with automated color contrast threshold test.

PURPOSE: To compare tritan contrast threshold (TCT) with fundus photography in screening for sight-threatening diabetic retinopathy (STDR), before significant visual loss. DESIGN: Prospective, comparative study. METHODS: A total of 510 consenting diabetic patients attending a hospital-based photographic screening clinic were recruited over a 2-year period. Exclusion criteria included visual acuity of worse than 6/9, previous photocoagulation, and a history of previous eye disease known to affect color vision. The automated TCT test was performed using a computerized cathode ray tube-based technique. Retinal photography was performed using a Polaroid mydriatic fundus camera with a 45 degrees field. Grading of diabetic retinopathy was carried out by an ophthalmologist using slit-lamp biomicroscopy and a 78-diopters lens. Assessments of sensitivity, specificity, and predictive values for both fundus photography and the TCT test were made. RESULTS: Both the fundus photography and TCT test correlated significantly with the presence of STDR (P <.0001, chi(2) test). The TCT test yielded a sensitivity of 94% (95% confidence interval [CI], 73%- 100%) and a specificity of 95% (95% CI, 92%- 96%) for detection of STDR compared with a sensitivity of 88% (95% CI, 66%-97%) and a specificity of 95% (95% CI, 93%-97%) with fundus photography. Combined modality improved overall screening performance. CONCLUSION: The TCT assessment is an effective and clinically viable technique, in comparison with fundus photography, to screen for STDR among a diabetic population. Additionally, our results also showed that combining the TCT test with fundus photography greatly increases the performance of screening for STDR.

Adolescent↗

PubMed1997

Closure and acuity in pseudoisochromatic color tests.

While visual acuity was related to performance on several pseudoisochromatic color tests for 73 male college students, no evidence was found that perceptual closure also affected performance. No scores were correlated for the 69 undergraduate women.

Age Factors↗

PubMed1985

Association of hue discrimination loss and diabetic retinopathy.

The results of Farnsworth-Munsell 100-hue, visual acuity, and visual field testing were compared with the severity of retinopathy in a group of 90 diabetic patients. The patients showed significantly higher than expected Farnsworth-Munsell 100-hue scores, with a tritanlike axis, compared with published age norms for nondiabetic individuals. The magnitude of the acquired blue-yellow hue discrimination defect correlated significantly and to a similar extent with both the severity of overall diabetic retinopathy and the severity of macular edema and hard exudate formation. Visual acuity loss correlated somewhat more significantly with macular edema than with overall retinopathy, whereas the converse was true for visual fields. For all visual function tests, the correlations were more significant for fluorescein leakage in the macula than for capillary nonperfusion in the macula. Abnormal hue discrimination was found in 65% (32/49) of eyes with proliferative diabetic retinopathy, suggesting a potential role for this test in screening for proliferative diabetic retinopathy in primary care facilities. Also, because the ability of diabetic patients with color vision deficiency to perform color-dependent tests for urinary and blood glucose may be impaired, such patients should be made aware of this potential problem.

Adult↗

PubMed1978

Acquired color vision defects in retrobulbar neuritis.

We used the Farnsworth-Munsell 100 Hue Test to study the incidence of acquired color vision defects in 16 patients with unilateral and and seven patients with bilateral retrobulbar optic neuritis whose visual acuity had recovered to 6/12 (20/40) or better. We recorded the visual-evoked response to a pattern stimulus on the same day. All 30 affected eyes showed an excessive number of errors on Farnsworth-Munsell 100 Hue testing. The number of errors increased with greater residual optic nerve damage. One false-positive and two false-negative visual-evoked responses were found.

Adult↗

PubMed1991

Visual performance at video display terminals--effects of screen color and illuminant type.

A limited set of illuminants and phosphor colors are commonly used in video display terminal (VDT) working environments. This study attempts to identify any combinations of such conditions that influence performance on a visually demanding counting task. Experiments were performed to test whether the phosphor color, ambient lighting spectrum, or temporal frequency characteristics of the display and ambient lighting could alter performance. Under conditions where potentially contaminating variables such as reflectance level and screen glare patterns were equalized, no significant differences in performance were produced by the particular sets of stimulus conditions tested. The results suggest that displays and illuminant types that are in common use allow substantially equivalent visual performance.

Adult↗

PubMed1987

F-M 100-Hue total error scores have discrete values.

A proof is presented which shows that the total error scores derived from the Farnsworth-Munsell 100-Hue test are an integer multiple of 4. The one proviso for this relates to the way in which the first and last caps in a box are handled.

Color Perception Tests↗

PubMed1982

An inherited central retinal pigment epithelial dystrophy.

This report describes three generations of one family in which a mother and three of her children were affected by an unusual bilateral symmetrical atrophy of the retinal pigment epithelium in the macular area. All members of the family underwent complete eye examinations, stereoscopic color fundus photography and fluorescein angiography. The mother and four of her children underwent Goldmann visual fields, electroretinography, electro-oculography, Farnsworth-Munsell 100-Hue test, 24-hour quantitative urine analysis for amino acids, serum lipid profile, plasma vitamin E and zinc levels, whole blood selenium and glutathione peroxidase levels, and red blood cell fragility testing. Except for the mother all members of this family were asymptomatic, had good visual acuity and had normal electrophysiologic findings. The mother had bilateral disciform scars resulting in loss of vision. There was no evidence of aminoaciduria or of abnormalities in systemic factors tested which may be associated with protection against lipoprotein peroxidation. This condition appears to be similar to central areolar retinal pigment epithelial dystrophy reported by Fetkenhour et al. (1976).

Adult↗