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Near Vision (near + vision)

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Medical Sciences	100%

Selected Abstracts

Significant improvements in near vision, reading speed, central visual field and related quality of life after ranibizumab treatment of wet age-related macular degeneration

ACTA OPHTHALMOLOGICA, Issue 4 2010
Christina Frennesson
Abstract. Purpose:, To investigate the effects on near visual acuity, reading speed, central visual field and related quality of life of ranibizumab treatment of wet age-related macular degeneration (AMD). Methods:, The study was a prospective, non-comparative consecutive case series, followed for 3 months and investigator-driven. Thirty eyes of 30 patients with wet AMD were included, mean age 75 years (range 69,95 years). In addition to a full ophthalmological examination , including best-corrected visual acuity (BCVA; Early Treatment Diabetic Research Study chart), fundus biomicroscopy, fundus photography, fluorescein angiography, indocyanine green angiography (occult cases) and ocular coherence tomography , near visual acuity, reading speed, central visual field and quality of life for related activities were also investigated at baseline and at 3 months after ranibizumab treatment. Results:, Mean BCVA increased from 62 ± 11 to 66 ± 14 letters at 3 months (7%; p = 0.018). Near vision improved from 9 ± 5 to 6 ± 3 points (33%; p = 0.0006) and reading speed increased from 59 ± 40 to 85 ± 50 words/min (44%; p < 0.0001). The mean deviation from normal of the visual field improved from ,9 ± 7 to ,6 ± 5 dB (33%; p < 0.0001). Quality of life improved for distance activities from 54 ± 28 to 63 ± 28 points (17%; p < 0.0001) but significantly (p = 0.024) more for near activities, from 49 ± 26 to 63 ± 26 points (29%; p < 0.0001). Reading newspaper text in the group in which the better eye was treated showed the highest increase in quality of life score of all: 116%. Conclusion:, The increase in BCVA after ranibizumab treatment is well established. The present study also showed significant improvements in other important visual qualities, such as near visual acuity, reading speed, central visual field and several activities influencing quality of life. The improvement was greater for near activities than for distance activities. Therefore, the beneficial effects of ranibizumab treatment shown here are more extensive than those reported previously. [source]

Reduced accommodative function in dyskinetic cerebral palsy: a novel management strategy

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2000
Linda M Ross MBCh B MRCP MRCPCH
A9-year-old boy with dyskinetic cerebral palsy secondary to neonatal encephalopathy is described. He presented with blurring of near vision which had begun to impact on his school work. Objective assessment of accommodation showed that very little was present, although convergence was almost normal. The near-vision symptoms were completely removed and reading dramatically improved with the provision of varifocal spectacles. Varifocal lenses provide an optimal correction for far, intermediate (i.e. for computer screens), and near distances (i.e. for reading). Managing this type of patient with varifocal spectacles has not been previously reported. It is clearly very important to prescribe an optimal spectacle correction to provide clear vision to optimize learning. [source]

The Mallett Fixation Disparity Test: influence of test instructions and relationship with symptoms

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 5 2006
Rajula Karania
Abstract Fixation disparity is a minute ocular misalignment under conditions of binocular single vision and is typically detected in primary eye care practices in the UK using the Mallett Unit Fixation Disparity Test. This instrument creates natural viewing conditions, when the patient's binocular system is fused using both central and peripheral fusion locks. This allows the examiner to determine the minimum prism power that eliminates the fixation disparity: the associated phoria or aligning prism. The spherical power that eliminates the fixation disparity, the aligning sphere, can also be determined. The near Mallett Unit Fixation Disparity Test has been shown to have good sensitivity and specificity for detecting symptomatic heterophoria. Cases of decompensated heterophoria tend to have a fixation disparity and the aligning prism or aligning sphere is a good indicator of the correction that will render the heterophoria compensated. The purpose of this study was, for the first time, to investigate the effect of test instructions on the results of the Mallett Unit Fixation Disparity Test. In study 1, we surveyed and observed practitioners to determine the instructions that are typically used. In study 2, we compared results obtained with this ,standard' method of questioning with a more ,specific' form of questioning that has been suggested in the literature. The participants for study 2 were 105 patients aged 7,70 years who were randomly selected from those attending a community optometric practice. Significantly different results were obtained with the two sets of instructions. The specific form of questioning revealed more cases of fixation disparity and the results with this method showed a better correlation with symptoms. This only held for near vision: for distance vision, symptoms were not significantly correlated with the presence of fixation disparity. This agrees with previous work with the Mallett unit, which showed a significant relationship with symptoms only at near. We also found that patients with more severe symptoms had greater degrees of aligning prism. Our study supports previous work indicating that the Mallett unit is a useful tool for detecting symptomatic heterophoria at near. However, we found that the testing method is important: patients need to be asked not just whether the nonius strips are aligned but also whether one or both of the strips ever moves. More research is needed to investigate the significance of precise test instructions in other optometric and orthoptic tests. [source]

Significant improvements in near vision, reading speed, central visual field and related quality of life after ranibizumab treatment of wet age-related macular degeneration

Clinical application of the multifocal visual evoked potential

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 3 2004
David P. Crewther PhD
Background: Measures of visual function thresholds such as visual acuity and visual fields are generally dependent on subjective responses and assume maintenance of fixation, attention and motivation. In the young, elderly, cognitively impaired or malingering populations, such measures may be inaccurate or difficult to obtain. The Visual Evoked Response Imaging System (VERIS) has been claimed to give more objective topographic recordings of retinal and cortical function. This paper aims to explore the adequacy of this technique in four unusual, unrelated, clinically difficult cases. Methods: Multifocal visual evoked potentials (mfVEPs) recorded on the VERIS System 3.01 are used to assess visual function in four cases with contradictory clinical findings or unreliable subjective responses. Results: Patient 1 had sustained a head injury and had normal ocular and pupil examination but light perception in the right eye and 6/5 acuity in the left. Multifocal VEPs showed a marked depression of the right visual field with little macular response. Patient 2 had sustained a head injury, had a left field hemianopia, possible macular sparing and loss of much of the right field, reduced but variable visual acuities, good near vision and normal ocular fundi. Multifocal VEPs showed a severe depression in both visual fields (L more than R) with little macular response. Patient 3 had a left optic nerve meningioma and experienced great difficulty with visual field assessment. mfVEPs showed a bilateral depression in the superior field particularly the left field, with a larger deficit in the left eye. Patient 4 had unexplained visual acuity and peripheral field deficits. mfVEP results were inconclusive in this case. Discussion: Where there is difficulty performing traditional techniques or conflicting clinical findings, mfVEPs may provide additional objective information to aid in the assessment of patients. [source]