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2.
J. optom. (Internet) ; 15(4)October - December 2022. tab
Artigo em Inglês | IBECS | ID: ibc-210184

RESUMO

Convergence insufficiency (CI) is a common binocular vision (BV) disorder characterized by difficulty in maintaining motor fusion at near, which affects approximately 7.5 percent of the population. Diagnostic criteria for the disorder are inconsistent, ranging from one to many clinical signs. Methodology for clinical tests is inconsistent in measurement technique, visual targets, required repetitions, and normative values.This manuscript demonstrates the inconsistencies amongst published studies, and highlights the importance of consistent clinical diagnostic signs, measurement techniques, visual targets, and cut-off criteria. For each clinical sign, the recommended methodology for the procedure is described. Several studies do not take age into account when diagnosing CI in their cohorts. As such, the review emphasizes changes in diagnostic signs with age.This manuscript highlights the need for consistent and clear procedures and diagnostic criteria amongst clinicians and provides the basis for future studies in terms of diagnostic testing required for CI of varying age groups. (AU)


Assuntos
Humanos , Acomodação Ocular , Convergência Ocular , Transtornos da Motilidade Ocular/diagnóstico , Transtornos da Motilidade Ocular/epidemiologia , Transtornos da Visão/diagnóstico , Visão Binocular
3.
J. optom. (Internet) ; 15(4)October - December 2022. tab, graf
Artigo em Inglês | IBECS | ID: ibc-210185

RESUMO

Background: Several studies have suggested that accommodative and non-strabismic binocular dysfunctions are commonly encountered in optometric practice. This study aims to verify whether these findings apply to a Portuguese clinical population.MethodsThis study included consecutive nonpresbyopic subjects that came to two Portuguese optometric clinics over a period of six months. A complete visual exam was conducted and included the measurement of visual acuity (VA), refraction, near point of convergence (NPC), distance and near phoria, near and distance fusional vergences, amplitude of accommodation (AA), monocular accommodative facility (MAF), relative accommodation and lag of accommodation.Results156 subjects with a mean age of 24.9 ± 5.3 years (from 18 to 35 years old) participated in the study. Of all subjects, 32 % presented binocular vision and/or accommodative disorders accompanied or not by refractive errors. Moreover, 21.1 % had accommodative disorders, and 10.9 % had a binocular vision dysfunction. Accommodative insufficiency (11.5 %) was the most prevalent disorder, followed by convergence insufficiency (7.1 %) and accommodative infacility (5. 8 %).ConclusionsClinicians should be aware that about one third of the optometric clinical population could have accommodative and/or non-strabismic binocular disorders. Accommodative insufficiency was the most prevalent dysfunction presented in the studied population, followed by accommodative infacility and convergence insufficiency. (AU)


Assuntos
Humanos , Adolescente , Adulto Jovem , Adulto , Acomodação Ocular , Transtornos da Motilidade Ocular , Presbiopia , Transtornos da Visão/epidemiologia , Testes Visuais , Visão Binocular , Portugal
4.
J. optom. (Internet) ; 15(3)Jul-Sep.2022. graf, ilus
Artigo em Inglês | IBECS | ID: ibc-204703

RESUMO

Objective: The main objective of this study was to obtain percentile curves of stereoacuity in arc seconds for a Spanish population aged between three and twelve years of age.Materials and methods: A descriptive, observational and transversal study was conducted, which included children aged between three and twelve years of age who did not present with any known ocular and/or systemic diseases. The convenience sampling method was used to select the sample from three schools and one hospital in the Community of Madrid. The Bueno-Matilla Vision Unit's random dot test was used to measure stereoacuity. A descriptive statistic was performed with the stereoacuity values that were obtained for the 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles.Results: The stereoacuity values of 1300 children were analysed. In the 50th percentile curve, it was determined that stereoacuity values close to 40 sec/arc were present from four years of age, and at four years and nine months, stereoacuity values close to 28 sec/arc were already being observed within said percentile, with values that were similar to those expected in the adult population. A progressive increase was observed, reaching 19 sec/arc before six years of age, with this stereoacuity value becoming more established in children from seven years of age.Conclusion: Although given the specific type of sampling that was performed it was not possible to generalise the results to the entire population, these percentile curves may aid paediatric professionals in their assessment of the development of this visual ability, which is indicative of the degree of development of binocular vision. (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Testes Visuais , Visão Ocular , Visão Binocular , Percepção de Profundidade , Acuidade Visual , Estudos Transversais , Epidemiologia Descritiva
5.
J. optom. (Internet) ; 15(3)Jul-Sep.2022. tab, graf
Artigo em Inglês | IBECS | ID: ibc-204707

RESUMO

Purpose: This study aimed to investigate the correlation between convergence insufficiency symptom survey (CISS) score and the signs of convergence insufficiency (CI) and to evaluate the sensitivity and specificity of the CISS to predict CI and ametropia among young adult university students.Method: This prospective cross-sectional clinic-based study included 300 first year university students (mean age = 21.58 (SD ± 2.2) years) who consecutively reported for eye examination. Participants were administered the CISS questionnaire and investigated for the signs of CI. Diagnosis of CI was based on presence of three or four signs. The correlation between the CISS score and the signs of CI were determined and Receiver Operation Characteristics (ROC) curves were used to evaluate sensitivity and specificity.Results: There were significant correlations between CISS score and the clinical signs of CI namely NPC break (rs = 0.622, p = 0.0001), NPC recovery (rs = 0.620, p = 0.0001), near exophoria (rs = 0.434, p = 0.0001), near PFV blur (rs = -0.359, p = 0.0001), near PFV break (-0.306, p = 0.0001), near PFV recovery (rs = -0.326, p = 0.0001) and gradient AC/A ratio (rs = -0.290, p = 0.0001). There was a significant positive correlation between CISS score and the number of clinical signs of CI (rs = 0.575, p-value = 0.0001). The CISS had good sensitivity (AOC = 0.882) to predict CI and poor sensitivity (AOC = 0.642) to predict ametropia.Conclusion: The CISS score is correlated with the severity and number of signs of CI in young adult Ghanaian university students. Its use in addition to clinical investigative testing may give a definitive diagnosis of symptomatic CI. (AU)


Assuntos
Humanos , Adulto , Correlação de Dados , Convergência Ocular , Acomodação Ocular , Gana , Erros de Refração , Transtornos da Motilidade Ocular , Visão Binocular , Estudos Transversais , Estudos Prospectivos , Inquéritos e Questionários
6.
J. optom. (Internet) ; 15(1): 1-32, January-March 2022. tab
Artigo em Inglês | IBECS | ID: ibc-204377

RESUMO

The purpose of our work is to do an update of recent investigations about amblyopia treatment based on perceptual learning, dichoptic training and videogames. Therefore, we conducted a search of the studies published about this subject in the last six years. The review shows that the investigations during that period have used several kinds of treatments regarding their design (e.g., type of stimulus and context used, duration of the training), and in a wider range of age that also include adults. Most of the studies have found an improvement in some mono and binocular visual functions, such as visual acuity, contrast sensitivity and stereopsis, which for now, it seems advisable that these processes could be used, as an alternative or a complement of the traditional passive therapy. Nevertheless, it would be plausible to conduct additional, controlled and random, clinical trials in order to discover in a more deeply way which perceptive learning method of treatment is more effective for the improvement of visual functions and for how long the effects of the treatment could persist. (AU)


Assuntos
Humanos , Adulto , Ambliopia/terapia , Sensibilidades de Contraste , Percepção de Profundidade , Visão Binocular , Acuidade Visual , Literatura de Revisão como Assunto
7.
J. optom. (Internet) ; 15(1): 1-9, January-March 2022. tab, graf
Artigo em Inglês | IBECS | ID: ibc-204382

RESUMO

Purpose: The main objective of this study is to obtain percentile curves of monocular and binocular visual acuity on a decimal scale in a Spanish population aged between 3 and 12 years old.Materials and method: Descriptive, observational and transversal study which included children between 3 and 12 years old without any known eye and/or systemic diseases. The selection of the sample was made by means of a convenience sampling method carried out in three schools and a hospital of the Community of Madrid. Far monocular and binocular visual acuity was measured using the Bueno Matilla vision unit on a decimal scale, both for monocular and binocular tests. The test used was the symmetrical letters test included with this unit. A descriptive statistic was performed and the visual acuity percentile values obtained were 5, 10, 25, 50, 75, 90 and 95. Results: The visual acuity of 1300 children was evaluated and analysed. In all the percentile curves obtained, an increase in age-related visual acuity has been observed, reaching a value close to the unit for the 50th percentile, around five years and three months of age, under monocular conditions and somewhat earlier in binocular conditions. Conclusion: Although the type of sampling performed does not allow a generalization to the entire population, these percentile curves may help the paediatric professional to decide the referral of the relevant child to the eyecare professional, so that certain conditions, like amblyopia or the early stages of school myopia may be early detected. (AU)


Assuntos
Pré-Escolar , Criança , Optometria , Ambliopia/diagnóstico , Miopia/diagnóstico , Visão Monocular , Visão Ocular , Visão Binocular , Acuidade Visual , Epidemiologia Descritiva , Estudos Transversais
8.
J. optom. (Internet) ; 14(3): 227-228, July - September 2021.
Artigo em Inglês | IBECS | ID: ibc-208999
9.
J. optom. (Internet) ; 14(3): 229-239, July - September 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-209000

RESUMO

Introduction: Symptoms experienced when using digital devices are known as digital eyestrain (DES) or computer vision syndrome. They can be categorised as either external (associated with dry eye) or internal (related to refractive, accommodative or binocular vision anomalies). In a large cohort of adults with DES, we investigate the prevalence of binocular and accommodative anomalies, contrasting different diagnostic approaches, to evaluate potential mechanisms for the benefit from +0.75D addition lens that has been previously reported. Methods: Participants (20−40y) were selected using the Computer Vision Syndrome Questionnaire (CVS-Q) tool as suffering with DES. A comprehensive eye examination was given to each participant, and this paper concentrates on “internal factors”, detected with a refraction and comprehensive testing of binocular and accommodative functions. The effects of low-powered addition lenses (+0.50D, +0.75D, +1.25D; and plano controls) were assessed by double-masked testing with the Wilkins Rate of Reading Test (WRRT) and by subjective preference. Results: As previously reported, most participants showed a subjective preference for one of the three convex lenses we used, with +0.75D chosen most frequently. Performance at the WRRT was significantly improved with +0.50D and +0.75D, but not +1.25D. Using a variety of diagnostic criteria, there were no strong associations between WRRT results or CVS-Q scores and any binocular or accommodation functions. The one finding of significance is that a disproportionate number of participants who benefited from adds had an eso-fixation disparity on the near Mallett unit, although this only affected 5% of the population. Conclusions: DES is a collection of diverse symptoms that have a multifactorial aetiology. In the sample described here, binocular and accommodative anomalies do not seem to be a major cause of DES. (AU)


Assuntos
Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Acomodação Ocular , Astenopia/etiologia , Leitura , Testes Visuais , Visão Binocular
10.
J. optom. (Internet) ; 14(3): 247-253, July - September 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-209002

RESUMO

Introduction: We evaluated the effectiveness of office-based vergence/accommodative therapy with home reinforcement for intermittent exotropia in a private practice environment. Methods: This was a retrospective chart review study. Patients who received office-based vision therapy for intermittent exotropia in a private optometric clinic were reviewed. Patients with intermittent exotropia treated with and without strabismus surgery were both included. The pre-therapy baseline data were compared to the re-evaluation data obtained at the last therapy session. All patients received office-based vergence/accommodative therapy administered by a trained therapist during a 60 min office visit every one to two weeks, combined with home reinforcement for a minimum of 15 min, five times per week. The primary outcome measure in this study was the change in the Office Control Score from the pre-therapy visit to the post-therapy visit. The hypothesis was that office-based vergence/accommodative therapy would significantly improve the Office Control Score. Results: Forty patients aged from 5 to 22 years old fulfilled the inclusion criteria. Eight of them were postoperative patients. After treatment, there was a change of −1.1 ± 1.6 (p < 0.001, z = 3.73, effect size: 0.42) and −1.1 ± 1.4 (p < 0.001, z = 4.26, effect size: 0.48) in distance and near Office Control Score, respectively. In the subgroup analysis, significant improvements in the Office Control Score were observed in both the operated and unoperated intermittent exotropes at distance and near. Conclusion: This study showed that office-based vergence/accommodative therapy with home reinforcement significantly improved the distance and near control of exodeviation in both operated and unoperated intermittent exotropia patients in a private practice environment. (AU)


Assuntos
Humanos , Masculino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Acomodação Ocular , Exotropia/cirurgia , Músculos Oculomotores/cirurgia , Visão Binocular , Estudos Retrospectivos
11.
J. optom. (Internet) ; 14(3): 263-274, July - September 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-209004

RESUMO

Purpose : Phoria measurements form a routine part of the examination of binocular vision. Various studies have compared different methods of phoria measurement and their repeatability between sessions. However, no studies have accounted for within-session repeatability, and few norms have been available to date. Our aims were to assess the short-term within-session repeatability, the agreement and the comparisons between three phoria tests and the delineation of normative data.Method: The participants comprised 315 refractive corrected participants with a normal binocular vision, with ages between 20 and 80 years. Phoria was measured using three methods: von Graefe (VG), modified Thorington (MT) and Thorighton (TH) procedures. Each measurement was taken 3 consecutive times at far and near.Results: The repeatability between measurements was high (0.87 to 0.96), but the relationship between tests was medium (0.407 to 0.682). About the mean bias, VG show more exo values (0.02 to 0.14 at far and 0.07 to 0.14 at near) and MT and TH similar values (−0.04 to 0.08 at far and −0.1 to 0.03 at near). The best agreement between tests was for TH and MT (LoA = 2.33 at far and LoA = 4.44 at near). Normative data for non-presbyopic were provided.Conclusion : Overall, there is a high agreement between MT and TH. Conversely, VG shows more exo values at near and shows large limits of agreement. We recommend that subjective measurements of phoria can best be quantified once using the MT or TH techniques in free space and the values compared with updated norms. (AU)


Assuntos
Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estrabismo/diagnóstico , Testes Visuais , Visão Binocular
12.
J. optom. (Internet) ; 14(3)July - September 2021. tab
Artigo em Inglês | IBECS | ID: ibc-209005

RESUMO

Purpose: Convergence insufficiency, the most common binocular vision anomaly, is characterised by a receded near point of convergence and an exophoria which is at least 4 prism dioptres (Δ) larger at near than at distance. However, the repeatability of standard heterophoria measures are poorly understood. This study assessed the ability of four common heterophoria tests to detect differences of 4Δ by evaluating the inter- and intra-examiner variability of the selected techniques. Methods: Distance and near horizontal heterophorias of 20 visually-normal adults were measured with the alternating prism cover test, von Graefe prism dissociation, Howell Card and Maddox Rod by two examiners at two separate visits using standardised instructions and techniques. We investigated inter- and intra-examiner variability using repeatability and reproducibility indices, as well as Bland-Altman analysis with acceptable limits of agreement defined as ±2Δ. Results: The Howell card test had the lowest intra-examiner variability at both distance and near, as well as the best 95% limits of agreement (±1.6Δ for distance and ±3.7Δ for near). Inter-examiner reproducibility results were similar, although at near the alternating prism cover test had better repeatability (1.1Δ, 95% confidence intervals −1.1Δ to 4.0Δ) than the Howell card (1.4Δ, 95% confidence intervals −1.9Δ to 5.9Δ). Conclusion: The low repeatability of many standard clinical heterophoria tests limits the ability to reliably detect a 4Δ difference. The Howell Card provided the most repeatable and reproducible results indicating that this technique should be used to detect small changes in heterophoria magnitude and direction. (AU)


Assuntos
Humanos , Acomodação Ocular , Estrabismo/diagnóstico , Testes Visuais , Visão Binocular , Reprodutibilidade dos Testes
13.
J. optom. (Internet) ; 14(2): 142-155, April-June 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-208526

RESUMO

Aim: The aim of this study was to explore associations among clinical measures of accommodation and vergences with symptoms, which could facilitate the validation of the Convergence Insufficiency Symptoms Survey to screen for deficient clinical measures.MethodsUsing a multi-stage random cluster sampling, 1211 high school students (481 males and 730 females) between 13 and 18 years of age were selected and examined. Visual acuity, stereoacuity and suppression, refractive errors, near point of convergence, heterophoria and fusional vergences, as well as, amplitude of accommodation, accommodative response, facility and relative accommodation were evaluated. The validity of the Convergence Insufficiency Symptoms Survey to distinguish between children with and those without anomalies in the clinical measures were characterized using the Receiver Operation Curve, sensitivity and specificity of the tests.ResultsThe overall mean and standard deviation for symptoms score was 27.38 ± 11.04. Deficient accommodative measures revealed worse symptoms scores than did deficient vergence measures and children with deficient clinical measures had significantly higher mean symptoms scores. (p = 0.001) However, the correlations between defective clinical measures and symptoms were significant but relatively weak. The Receiver Operation Curve showed that the clinical measures with the highest sensitivities using the CISS (≥16) were: reduced amplitude of accommodation 0.63, 95% Confidence interval, 0.59−0.68%) accommodative facility 0.62 (95% Confidence interval, 0.58−0.67) and near point of convergence 0.60 (95% Confidence interval, 0.53−0.67).ConclusionDeficient clinical measures and symptoms of asthenopia are prevalent and correlated in the sample of school children studied. Overall, findings suggest that high school children with deficient clinical measures may be symptomatic when they perform intense near task compared to those without deficiencies. (AU)


Assuntos
Humanos , Adolescente , Medições dos Movimentos Oculares , Acomodação Ocular , Convergência Ocular , Transtornos da Motilidade Ocular/diagnóstico , Erros de Refração , Visão Binocular , Acuidade Visual , Amostragem Aleatória e Sistemática , Amostragem por Conglomerados
14.
J. optom. (Internet) ; 14(2): 156-165, April-June 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-208527

RESUMO

Background: Stereopsis is a valuable feature of human visual perception which is critically impaired in amblyopia, but can be improved through perceptual learning (PL). This article aims to determine the variables affecting the outcomes and intensity of a stereoacuity stimulation program.MethodsRe-analysis of a previous study in stereodeficient subjects with a history of amblyopia. Sixteen subjects (12 females, 4 males) aged between 7 and 14 received stereopsis stimulation through a PL program at home. A correlation analysis evaluated whether treatment intensity or percentage improvement were related to age or baseline stereoacuity measurements. Further analysis was performed to assess whether the type of amblyopia conditioned the PL treatment (Fischer Statistical Test).ResultsNo significant correlation was found between age and percentage improvement (rho=−0.08, p=0.749), nor was age correlated with treatment intensity (rho=0.170, p=0.544). However, a correlation did exist between baseline stereoacuity levels and treatment intensity (rho=0.734, p=0.001). Baseline stereoacuity and percentage improvement had a negative correlation (rho=−0.748, p=0.005), while treatment intensity showed only a weak association with the type of amblyopia (p=0.064).ConclusionsPresent results suggest that perceptual learning in stereodeficient subjects is not influenced by either the subject's age or the type of amblyopia. Baseline stereoacuity, on the other hand, seems to be a predicting factor for perceptual learning outcomes. According to our study, subjects with poor basal stereoacuity needed more sessions to improve and their percentage improvement was lower. However, due to the reduced size of the sample, the results should be considered with caution. (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Ambliopia , Percepção de Profundidade , Visão Binocular , Acuidade Visual , Percepção Visual
15.
Arch. Soc. Esp. Oftalmol ; 96(1): 3-9, ene. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-200179

RESUMO

OBJETIVO: Estudiar la eficacia a largo plazo y las complicaciones de varios tipos de transposición en el tratamiento del síndrome de Duane: la transposición muscular de rectos verticales total o parcial, la transposición sin desinserción muscular y la transposición del recto superior. MATERIAL Y MÉTODOS: Estudio retrospectivo de los pacientes diagnosticados de síndrome de Duane con esotropía operados con cualquier tipo de transposición muscular asociada o no al debilitamiento del recto medio con seguimiento mayor de 12 meses. Se consideró un buen resultado una desviación ≤ 10 dioptrías prismáticas (dp) en posición primaria de la mirada, tortícolis < 10° con mejoría de la abducción y sin diplopía. RESULTADOS: Un total de 7 casos fueron incluidos (6 mujeres, 6 unilaterales), con una edad media de 37,71 años. La esotropía inicial en posición primaria de la mirada de 28 ± 11,68dp disminuyó a 6 ± 4,62dp al final del seguimiento (p = 0,009). El tortícolis mejoró en 6, y la abducción mejoró un grado en todos (media: -3,14 a -2,14). En 4 casos apareció una desviación vertical ≤ 8dp. Ningún paciente tuvo diplopía final. El porcentaje de reintervenciones fue del 71,42%; solo un 28,57% obtuvo un buen resultado con una cirugía y ascendió a un 71,42% al final del seguimiento con cirugías adicionales. El tiempo de evolución medio fue de 52 ± 31,65 meses. CONCLUSIONES: Las transposiciones en el síndrome de Duane con signos clínicos moderados o severos han sido solo eficaces en una pequeña proporción de los casos. La mayoría requirió una segunda cirugía para corregir las complicaciones o las hipocorrecciones


OBJECTIVE: To study the long-term efficacy and the complications of several transposition techniques for the treatment of Duane syndrome. These included, full vertical rectus transposition, partial vertical rectus transposition, transposition without muscle disinsertion, and superior rectus transposition. MATERIAL AND METHODS: A retrospective study of the patients diagnosed with Duane syndrome, and who underwent any of the different transposition techniques associated or not to the medial rectus recession with a follow-up longer than 12 months. A good result was considered a final deviation ≤ 10 prism dioptres (pd) in primary position, anomalous head posture < 10°, and an improvement of the abduction without diplopia. RESULTS: Seven cases were included (6 women, 6 unilateral), and a mean age of 37.71 years. Pre-operative central gaze esotropia of 28 ± 11.68 pd decreased to 6 ± 4.62 pd at the final visit (P = .009). The anomalous head posture decreased in 6 patients, and the abduction improved one degree from -3.14 to -2.14 (mean). An induced vertical deviation ≤ 8pd was observed in 4 cases. None experienced diplopia at the final visit. The percentage of reoperations was 71.42%. Only 28.57% had a favourable outcome with a single surgery, which increased to 71.42% with further surgeries at the final follow-up. Mean evolution time was 52 ± 31.65 months. CONCLUSIONS: Vertical rectus transpositions in Duane syndrome with moderate or severe clinical signs have only been effective in a small percentage of the cases. Most of them required further surgeries to resolve the complications or the under-corrections


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Síndrome da Retração Ocular/complicações , Esotropia/etiologia , Esotropia/cirurgia , Músculos Oculomotores/transplante , Resultado da Gravidez , Síndrome da Retração Ocular/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Síndrome da Retração Ocular/diagnóstico , Movimentos Oculares/fisiologia , Visão Binocular/fisiologia
16.
J. optom. (Internet) ; 13(1): 59-68, ene.-mar. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-195309

RESUMO

PURPOSE: To determine the significance of changes and and inter-relationships between three markers of binocular function (aniseikonia, distance and near stereoacuity) following unremarkable LASIK at 3 and 6 months postoperatively. METHODS: All patients underwent LASIK using the Schwind Amaris 750S and the flaps were created using Intralase 150 kHz. Patients were I, monocular myopes II, binocular myopes III, binocular hyperopes IV, binocular astigmats V, anisometropes and VI, matched age and gender control (n = 20 in each group except III where n = 18). Aniseikonia (Awaya test), distance and near stereoacuity (Randot tests) were measured before surgery, and at 3 and 6 months after surgery. At all times data were collected under constant conditions and analyzed using appropriate non-parametric statistical tests. RESULTS: The following statistically significant changes were found after applying the Bonferroni correction (p ≤ 0.001); aniseikonia reduced (groups I, III, IV, V), stereoacuity improved at distance (groups I, III-V) and near (groups I, V). Inter-group differences in aniseikonia distance and near stereoacuity were significant preoperatively, but not postoperatively. In groups I, IV and V, the changes in aniseikonia and stereoacuity (near and distance) were significantly correlated with the preoperative value. Aniseikonia was significantly correlated with distance and near stereoacuity preoperatively but not postoperatively. CONCLUSION: Binocular function improved in all groups after LASIK except in binocular myopes. In general, binocular function was still low compared with the control group at six months postoperatively. It is unclear why binocular function improved in the binocular astigmats


OBJETIVO: Determinar la significancia de cualquier cambio, así como las interrelaciones entre tres marcadores de la función binocular (aniseiconía, estereoagudeza de lejos y de cerca) tras LASIK sin complicaciones a los 3 y 6 meses postoperatorios. MÉTODOS: A todos los pacientes se les realizó cirugía LASIK con el laser Schwind Amaris 750S, creándose los flaps con Intralase 150 kHz. Los grupos de pacientes fueron: I miopes monoculares, II miopes binoculares, III hipermétropes binoculares, IV astígmatas binoculares, V anisométropes y VI controles equivalentes en edad y género (n = 20 en cada grupo, exceptuando III donde n = 18). Se midió la aniseiconía (prueba de Awaya), la estereoagudeza de lejos y de cerca (pruebas Randot) durante el preoperatorio, y a los 3 y 6 meses posteriores a la cirugía. En todo momento se recabaron los datos en condiciones constantes, analizándose los mismos con pruebas estadísticas no paramétricas adecuadas. RESULTADOS: Se encontraron los siguientes cambios estadísticamente significativos tras aplicar la corrección de Bonferroni (p ≤ 0,001); se redujo la aniseiconía (grupos I, III, IV, V), y mejoró la estereoagudeza de lejos (grupos I, III-V) y de cerca (grupos I, V). Las diferencias inter-grupo en cuanto a aniseiconía de lejos y de cerca y la estereoagudeza de cerca fueron significativas en el preoperatorio, pero no en el postoperatorio. En los grupos I, IV y V, los cambios en cuanto a aniseiconía y estereoagudeza (de cerca y de lejos) guardaron una correlación significativa con el valor preoperatorio. La aniseiconía guardó una correlación significativa con la estereoagudeza de lejos y de cerca en el preoperatorio, pero no el postoperatorio. CONCLUSIÓN: La función binocular mejoró en todos los grupos tras la cirugía LASIK, excepto en la miopía binocular. En general, la función binocular fue aún baja al compararse con el grupo control a los seis meses postoperatorios. No queda claro por qué la función binocular mejoró en el astigmatismo binocular


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Aniseiconia/fisiopatologia , Astigmatismo/cirurgia , Percepção de Profundidade/fisiologia , Hiperopia/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Astigmatismo/fisiopatologia , Hiperopia/fisiopatologia , Miopia/fisiopatologia , Estudos Prospectivos , Visão Binocular/fisiologia , Acuidade Visual/fisiologia
17.
J. optom. (Internet) ; 12(4): 222-231, oct.-dic. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-188251

RESUMO

BACKGROUND: Various instruments have been developed to measure aligning prism, the prism that eliminates a fixation disparity (associated heterophoria). This includes the established Mallett near vision unit and recently developed Thomson Vision Toolbox on the iPad. With no previous research investigating the agreement between these instruments, practitioners may question if they can be used interchangeably. METHODS: 80 participants underwent near vision testing with the Mallett unit and iPad fixation disparity test. Data were analysed in four ways to investigate the agreement of the two instruments. RESULTS: Many participants reported no fixation disparity (horizontally 46.25%, vertically 82.5%), or non-significant aligning prism (horizontally 70%, vertically 97.5%), on both instruments. The iPad revealed a larger range of aligning prism results horizontally, 6∆ base out to 15∆ base in; the Mallett unit produced a larger range of results vertically, 1∆ base up to 3.5∆ base down. More participants required a significant aligning prism on the Mallett unit horizontally and vertically. Wilcoxon signed rank analysis found that the difference in aligning prism was not statistically significant (p = 0.357 horizontally, p = 0.236 vertically), but 95% limits of agreement revealed clinically significant differences between the instruments. CONCLUSION: Although the measured differences between the instruments are not significant in a Wilcoxon analysis, a Bland & Altman approach shows them to be in some cases clinically unacceptable, therefore the instruments should not be used interchangeably. Previous research indicates that the Mallett unit performs reasonably well at detecting symptomatic individuals and determining a prismatic correction that is likely to be helpful. Further research is required to determine the performance of the iPad test in these functions and to assess the reproducibility of both instruments


ANTECEDENTES: Se han desarrollado diversos instrumentos para medir el prisma de alineamiento, que es el prisma que elimina la disparidad de fijación (heteroforia asociada). Entre estos instrumentos se incluyen la unidad de visión de cerca de Mallett y la recientemente desarrollada Thomson Vision Toolbox en el iPad. Como no existe investigación previa acerca del acuerdo entre estos instrumentos, los clínicos pueden cuestionarse si pueden usarse ambos tests de forma intercambiable. MÉTODOS: Se realizó una prueba de visión de cerca a 80 participantes, utilizando la unidad de Mallett y la prueba iPad de disparidad de fijación. Los datos fueron analizados de cuatro modos, para evaluar el acuerdo entre ambos instrumentos. RESULTADOS: Muchos participantes reportaron ausencia de disparidad de fijación (horizontalmente 46,25%, verticalmente 82,5%), o prisma de alineamiento no significativo (horizontalmente 70%, verticalmente 97,5%), con ambos instrumentos. El iPad reveló un mayor rango de resultados de prisma de alineamiento horizontalmente, 6∆ base externa con respecto a 15∆ base interna, y la unidad de Mallett produjo un rango mayor de resultados verticalmente, 1∆ base superior con respecto a 3,5∆ base inferior. Muchos participantes requirieron un prisma de alineamiento significativo en la unidad de Mallett horizontalmente y verticalmente. La prueba de rango con signo de Wilcoxon encontró que la diferencia en cuanto a prisma de alineamiento no era estadísticamente significativa (p = 0,357 horizontalmente, p = 0,236 verticalmente), pero el 95% de los límites de acuerdo revelaron diferencias clínicamente significativas entre los dos instrumentos. CONCLUSIÓN: Aunque las diferencias de las mediciones entre ambos instrumentos no son significativas con el analisis de Wilcoxon, los analisis con Bland & Altman muestran algunas casos clinicamente significativos, y por tanto los instrumentos no deberían usarse de manera intercambiable. La investigación previa indica que la unidad de Mallett tiene un rendimiento razonablemente bueno para detectar los individuos sintomáticos, y determinar una corrección prismática que pueda resultar útil. Es necesaria más investigación para determinar el rendimiento de la prueba iPad en estas funciones y para analizar la reproducibilidad de ambos instrumentos


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Computadores de Mão , Fixação Ocular/fisiologia , Estrabismo/diagnóstico , Disparidade Visual/fisiologia , Testes Visuais/métodos , Estrabismo/fisiopatologia , Visão Binocular/fisiologia , Acuidade Visual/fisiologia
18.
J. optom. (Internet) ; 12(4): 240-247, oct.-dic. 2019. graf
Artigo em Inglês | IBECS | ID: ibc-188253

RESUMO

PURPOSE: To investigate immediate and short-term visual recovery in a large cohort of 2093 myopic eyes (with or without astigmatism) treated with SmartSurfACE procedure, a combination of Transepithelial Photo Refractive Keratectomy (PRK) and Smart Pulse Technology (SPT, SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). METHODS: In this retrospective case series, post-operative outcomes were evaluated immediately after the surgery (Day 0), at day 1 and 3 months postoperatively, after myopic SmartSurfACE treatment with mean pre-operative spherical equivalent -4.65 ± 2.53 D and range from -16.13D to- 0.13D. In all cases, pre and postoperative standard examinations were performed. The analysis evaluated preoperative Corrected and Uncorrected Distance Visual Acuity (CDVA and UDVA, respectively), and postoperative UDVA, monocularly and binocularly, immediately after the surgery, at day 1 and 3 month follow up. RESULTS: Sixty-two percent eyes achieved monocular UDVA 20/40 or better immediately after the surgery, while 82% patients achieved binocular UDVA 20/32 or better immediately after the surgery. At 3-month postoperatively, monocular UDVA 20/25 or better was achieved in 94% eyes. Treated eyes achieved immediately after the surgery or by the next day mean UDVA 20/41 ± 8. UDVA improved significantly from Day 1 to 3-months follow up (p < 0.0001 for both OS and OD) to mean UDVA 20/21 ± 5 (equal to preoperative CDVA 20/21 ± 8). CONCLUSION: Immediate and short-term visual recovery after SmartSurfACE PRK in our large cohort was rapid, providing functional binocular UDVA immediately after the surgery


OBJETIVO: Investigar la recuperación visual inmediata y a corto plazo en una amplia cohorte de 2.093 ojos miópicos (con o sin astigmatismo) tratados con el procedimiento SmartSurfACE, una combinación de Queratectomía Fotorrefractiva Transepitelial (PRK) y SPT (Smart Pulse Technology, SCHWIND eye-tech-solutions GmbH, Kleinostheim, Alemania). MÉTODOS: En esta serie de casos retrospectivos, se evaluaron los resultados post-operatorios inmediatamente tras la cirugía (Día 0), al día siguiente a la misma, y a los tres meses de la intervención, tras el tratamiento de la miopía con SmartSurfACE, con un equivalente esférico preoperatorio medio -4,65 ± 2,53D y rango desde -16,13D a -0,13D. En todos los casos se realizaron exámenes estándar preoperatorios y postoperatorios. El análisis evaluó preoperatoriamente la agudeza visual de lejos corregida y no corregida (CDVA y UDVA), y postoperatoriamente UDVA, monocular y binocular, inmediatamente tras la cirugía, al día siguiente, y a los tres meses de seguimiento. RESULTADOS: El 62% de los ojos logró UDVA monocular 20/40 o un valor mejor inmediatamente tras la cirugía, y el 82% de los pacientes logró UDVA binocular 20/32 o un mejor valor inmediatamente tras la cirugía. A los tres meses de la intervención, se logró UDVA monocular 20/25 o un valor mejor en el 94% de los ojos. Los ojos tratados lograron inmediatamente tras la cirugía o al día siguiente UDVA 20/41 ± 8. UDVA mejoró significativamente entre el día siguiente y los tres meses de seguimiento (p < 0,0001 para ambos ojos) a un valor medio de 20/21 ± 5 (igual a CDVA preoperatoria de 20/21 ± 8). CONCLUSIÓN: La recuperación visual inmediata y a corto plazo tras PRK con SmartSurfACE en nuestra amplia cohorte fue rápida, logrando una UDVA binocular funcional inmediatamente tras la cirugía


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Ceratectomia Fotorrefrativa/métodos , Recuperação de Função Fisiológica/fisiologia , Topografia da Córnea , Miopia/fisiopatologia , Refração Ocular/fisiologia , Estudos Retrospectivos , Visão Binocular/fisiologia
19.
J. optom. (Internet) ; 12(3): 143-160, jul.-sept. 2019. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-185364

RESUMO

Aim: To determine normative values for stereoacuity, accommodative and vergence measures for high school populations. Methods: Using a multi-stage random cluster sampling, 1211 children (481 males and 730 females) between 13 and 18 years of age, with a median age of 16 years, were selected. Visual acuity, stereoacuity and suppression, refractive errors, near point of convergence, heterophoria and fusional vergences, as well as, amplitude of accommodation, accommodative response, facility and relative accommodation were evaluated. Results: Most data did not have a normal distribution. The range of normality for the vergence measures were: near point of convergence break, 5-10 cm, recovery, 6-13 cm, near lateral phoria, 2.5-6 prism dioptre (pd) (nasal), near vertical, orthophoria to 0.50 pd, negative fusional vergence break, 12-23pd, recovery, 8-17 pd, positive fusional vergence break, 16-35 and recovery 11-24 pd. For accommodative measures, the range of normality for accommodative measures was: amplitude of accommodation, 12-18 pd, accommodative response, plano to + 0.75 D, binocular accommodative facility, 5-12 cycles per minute (cpm), negative relative accommodation, 1.75-2.50 DS, positive relative accommodation, -2.0 to -3.0 DS and 17-69 s arc for stereoacuity. Conclusion: This study provides norms for clinical measures which could be used to classify accommodative and vergence parameters for children aged 13-18 years in this population or beyond. Findings should be applied in the context of the measurement techniques and the associated limitations outlined in this report


Objetivo: Determinar los valores normativos para la estereoagudeza, y las mediciones de acomodación y vergencia para poblaciones de estudiantes de secundaria. Métodos: Utilizando un muestreo de grupo aleatorio de etapas múltiples, se seleccionaron 1.211 chicos (481 varones y 730 mujeres) de edades comprendidas entre 13 y 18 años, con una edad media de 16 años. Se evaluaron la agudeza visual, estereoagudeza y supresión, errores refractivos, punto próximo de convergencia, heteroforia y vergencias fusionales, así como amplitud de acomodación, respuesta acomodativa, flexibilidad de acomodación y acomodación relativa. Resultados: Muchos datos no reflejaron una distribución normal. El rango de normalidad para las mediciones de vergencia fue: punto próximo de rotura de convergencia, de 5 a 10 cm, recobro, de 6 a 13 cm, foria lateral de cerca, de 2,5 a 6 dioptrías prismáticas (pd) (nasal), vertical de cerca, ortoforia 0,5 pd, rotura de vergencia fusional negativa, 12-23 pd, recobro, 8-17 pd, rotura de vergencia fusional positiva, 16-35 y recobro 11-24 pd. Para las mediciones de la acomodación, el rango de normalidad para mediciones acomodativas fue: amplitud de acomodación, de 12 a 18 pd, respuesta acomodativa, de plano a + 0,75 D, flexibilidad acomodativa binocular, de 5 a 12 ciclos por minuto (cpm), acomodación relativa negativa, de 1,75 a 2,5 DS, acomodación relativa positiva, de -2 a -3 DS y 17-69 s arc para estereoagudeza. Conclusión: Este estudio aporta normas para mediciones clínicas que podrían utilizarse para clasificar los parámetros de acomodación y vergencia medidos en niños de edades comprendidas entre 13 y 18 años en esta población, o con edades superiores. Deberán aplicarse los hallazgos en el contexto de las técnicas de medición y las limitaciones asociadas destacadas en este estudio


Assuntos
Humanos , Masculino , Feminino , Adolescente , Visão Binocular/fisiologia , Vias Visuais/fisiologia , Acomodação Ocular/fisiologia , Convergência Ocular/fisiologia , Acuidade Visual/fisiologia , África Austral
20.
J. optom. (Internet) ; 12(3): 161-167, jul.-sept. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185365

RESUMO

Purpose: To determine the prevalence of accommodative insufficiency (AI) and its relation with age, gender, and refractive errors in a college-age student population in Iran. Methods: The present study was conducted cross-sectionally in 2017. All students had optometric tests including measurement of visual acuity, objective and subjective refraction, as well as binocular vision and accommodative examinations. Amplitude of accommodation was measured with the Donders¡' push-up method using the Royal Air Force (RAF) rule. Monocular accommodative facility was measured with ±2.00 diopter flipper lenses. The accommodative response was tested using dynamic retinoscopy with the monocular estimation method (MEM). Results: The prevalence of AI in the studied population was 4.07% (95% CI: 2.61-5.52). The rate was 6.04% (95% CI: 3.58-8.50) in females and 2.01% (95% CI: 0.53-3.48) in males, and logistic regression showed a significantly higher odds of AI in females (OR = 3.14, 95% CI: 1.33-7.45, p-value = 0.009). The prevalence of AI was 2.59% (95% CI: 0.55-7.56) in the 18-19-year-old age group and 4.08% (95% CI: 0.09-8.07) in the 24-25-year-old group (p-value = 0.848). The prevalence of AI among emmetropic, myopic, and hyperopic individuals was 3.74% (95% CI: 1.88-5.61), 4.44% (95% CI: 2.07-6.81), and 5.26% (95% CI: 4.79-16.32), respectively (p-value = 0.869). In the multiple regression model, only gender showed significant relationship with AI (Odds ratio = 3.14, 95% CI: 1.33-7.45; p-values = 0.009). Conclusion: The prevalence of AI in the present study is lower than the most prevalence rates reported in previous studies. In the present study, gender and AI showed a strong association, such that AI prevalence was significantly higher in females than males


Objetivo: Determinar la prevalencia de la insuficiencia acomodativa (IA) y su relación con la edad, sexo, y errores refractivos en una población universitaria de Irán. Métodos: El presente estudio se realizó de forma transversal en 2017. Se realizaron pruebas optométricas a todos los estudiantes, incluyendo medición de la agudeza visual, refracción objetiva y subjetiva, visión binocular y pruebas de acomodación. La amplitud de acomodación se midió con el método de Donders (push-up) utilizando la regla de la RAF (Royal Air Force). La flexibilidad acomodativa monocular se midió con flippers de ± 2 dioptrías. La respuesta acomodativa se evaluó mediante retinoscopía dinámica utilizando el método de estimación monocular (MEM). Resultados: La prevalencia de IA en la población de estudiantes fue de 4,07% (95%ICI: 2,61-5,52). La tasa fue de 6,04% (95%IC: 3,58-8,5) en mujeres y 2,01% (95%IC: 0,53-3,48) en varones, y la regresión logística reflejó un odds ratio significativamente superior de IA en mujeres (OR= 3,14, 95%IC: 1,33-7,45, valor p = 0,009). La prevalencia de IA fue de 2,59% (95%IC: 0,55-7,56) en el grupo de edad de 18-19 años, y de 4,08% (95%IC: 0,09-8,07) en el grupo de 24-25 años (valor p = 0,848). La prevalencia de IA entre los individuos emetrópicos, miopes e hipermétropes fue de 3,74% (95%IC: 1,88-5,61), 4,44% (95%IC: 2,07-6,81), y 5,26% (95%IC: 4,79-16,32), respectivamente (valor p=0,869). En el modelo de regresión múltiple, únicamente el sexo reflejó una relación con IA (Odds ratio = 3,14 95%IC: 1,33-7,45; valor p= 0,009). Conclusión: La prevalencia de IA en el presente estudio es inferior a la mayoría de las tasas de prevalencia reportadas en estudios previos. En el presente estudio, sexo e IA reflejaron una fuerte asociación, en el sentido de que la prevalencia de IA fue significativamente superior en las mujeres con respecto a los varones


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Acomodação Ocular/fisiologia , Transtornos da Visão/epidemiologia , Estudos Transversais , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Erros de Refração/epidemiologia , Fatores Sexuais , Transtornos da Visão/fisiopatologia , Visão Binocular/fisiologia
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