Comparing the Visual Skills of a Trinidadian Cricket Team

This study attempted to determine if there is a correlation between visual skills and physical sporting performance by comparing the members within a Trinidadian cricket team based on their ranked visual skills, as well, as their ranked playing ability for batting, fielding and bowling. Visual skills measured were; hand-eye dominiance, static visual acuity, dynamic visual acuity, steropsis, contrast sensitivity, accommodative facility, central and peripheral awareness and eye movement. SPSS Analysis of data showed that there was a weak correlation between the visual ranking and physical ranking. This can be attributed to the many different factors that contribute to remarkable athleticism. One of which is the percetual-cognitive skill that allows athletes to use visual information in the process of decision making and to execute accurate and rapid anticipatory movements. Performance in sports may possess an interdependency of both the hardware (quality of system) and software (knowledge based system) elements, and thus, futher study must be done into the integration of both systems as a unit.

Visual acuity screening of patients who are institutionalized and suffering from mental disorders

OBJECTIVE: Visual problems in persons who are institutionalized suffering from mental disorders are overwhelmingly under-recognized. The aim of this study was therefore to screen for visual acuity among 285 patients at the St. Ann’s Psychiatric Hospital (SAH) and 27 at the Arima Rehabilitation Centre (ARC). The projected number of patients to be screened was 427 persons. However, only 312 inpatients were included to participate in the study. The study evaluated the patients who were chosen to assess their visual acuity. The project was conducted from August to December, 2011. DESIGN AND METHODS: A total of 312 inpatients admitted to the hospital and rehabilitation centre with mental disorders were evaluated using either the Snellen or Lea Charts by trained technicians from the Lions Club of Trinidad and Tobago. The evaluations were conducted for four months on 25 wards and at the Arima Rehabilitation Centre. A Stereo Optical Vision Tester was used for the evaluation of patients using a Snellen Chart and/or a Lea Chart. Analysis was done using SPSS version 20.0. RESULTS: One hundred and twenty-five (125) patients were found to have visual acuity problems and recommended for further evaluation by an ophthalmologist. This represents 40.1% of the sample tested. CONCLUSIONS: Our findings coincided with the existing literature that visual impairment appears to be an area of physical health which is under-recognized, under-diagnosed and under-treated in people with severe mental health problems, even though certain psychiatric medications are known to cause visual problems as a side effect.

New protocol of early preventative screening of children in coorporation with the island health services [abstract]

The protocol "Early Preventive Visual Screening of Children" has been developed in mutual Cooperation with both the Islands Ophthalmologic Society and the Department of Youth Preventitive Medicine of the Island Health Service. The aim is to periodically screen for function of the visual system in children starting at a very young age and going up to age 15 years. This means that at an early stage, dysfunctional problems can be detected and appropriately dealth with. This protocol has two parts. The first one is about the visual examination and the second part has to do with the visual acuity measurement in children. (AU)

Nutritional amblyopia in a 32-year-ld male [abstract]

A 32-year-old Caucasian man presented with a 6 month history of gradual visual loss. He lived alone and consumed large quantities of alcohol. In addition, he smoked heavily and had only one meal per day. Examination revealed poor visual acuities bilaterally, with normal looking optic discs and retina. An MRI brain scan was normal. Visual evoked potentials showed small P100 responses. His mean corpuscular volume was elevated as was the gammaglutamyl transpeptidase. The patient was started on high dose vitamin B. His visual acuities are improving. (AU)

Update on phakic intraocular lenses: two-year results

Since July 21, 1998, twenty-seven eyes have been implanted with angle-supported OII phakic intraocular lenses (IOL) in the Eastern Caribbean. Present visual acuity ranges from 20/20 (78 percent), 20/25 (14 percent), 20/30 (4 percent), 20/40 (4 percent); intraocular pressures range from 14 to 21 mmHg. There have been no inflammatory complications or cataract formation to date. All information is included in an FDA study on phakic - IOLs.(AU)

Extraadrenal retroperitoneal paraganglioma causing malignant hypertension and permanent visual loss in an eleven-year-old-girl

We report a secretory paraganglioma in an eleven-year-old Trinidadian girl of East Indian descent who presented with malignant hypertension, proteinuria and modest elevation of urinary vanillylmandelic acid levels. The extraadrenal mass was surgically removed without complications. The patient has been normotensive without evidence of recurrence of disease but with persistent visual sequel two years later. This case reinforces the observation that extraadrenal retroperitoneal paragangliomas can be functionally very active and early computed tomography or other imaging procedure is necessary for rapid noninvasive evaluation, timely surgery and prevention of permanent morbidity.(Au)

Health status of the elderly in the Marigot Health District, Dominica

The health status and the prevalence of hypertension, diabetes mellitus, glaucoma and visual disorders of 123 elderly people (56 men, 67 women) in the Marigot Health District, Dominica, were assessed by means of four questionnaires: collection of data from their medical records; physical examination, measurement of blood pressure, visual acuity and intra-ocular pressure (IOP); and testing for glucosuria. The overall health status was good, but 20 percent were dependent on care. 74 percent were independent in the activities in daily life, with only moderate limitations in activities. The health status decreased considerably in those over 75 years of age. There were slight perceived differences in health status between men and women. About 40 percent of the study population were known to be hypertensive, and another 13 percent had an elevated blood pressure on examination. Diabetes mellitus was present in 15 percent. 20 percent had a visual acuity of 0.1 or below, and 10 percent had an elevated IOP. During the study, a considerable number of new cases of hypertension, diabetes mellitus and elevated IOP were diagnosed. 50 percent of the study population who were on medication used this more than as prescribed. This study indicates a high prevalence of the secondary complications of hypertension, diabetes mellitus, cataract, glaucoma and osteo-arthritis that cause disability and dependency in the elderly population. Education, diagnosis at an early stage and appropriate treatment of these disorders may prevent or delay their development. We suggest the development of a programme oriented approach of primary health care for the elderly to support this.(AU)

Visual symptoms, visual impairment and use of eye care among people with diabetes in Trinidad and Tobago

We carried out a survey of 2,117 subjects with clinical diabetes attending government health centres in Trinidad and Tobago. Measurements included self-reported difficulty with eyesight, visual acuity (VA) measured using the Hooks test, the SF36 questionnaire (as a measure of health related quality of life), and self-reported attendance at an eye specialist. Overall 1,241 (59 percent) subjects complained of difficulty with eyesight. The odds of difficulty with eyesight were higher in women, and increased with age and increasing duration of diabetes. Vision in the better eye was reduced to light perception only or blindness in 49 (2 percent), visual acuity was less than 6/60 in 329 (16 percent), and was measured as 6/60 in a further 395 (19 percent). Among those >75 years, 36 percent had severe visual impairment (VA<6/60) or blindness, compared with 5 percent of those <45 years. Subjects with impaired vision showed evidence of impaired physical and social functioning on the SF36 questionnaire. Among subjects with difficulty with eyesight 494, (40 percent) had never seen an eye specialist. Among subjects with visual acuity <6/60 or blind, 133 (35 percent) had never seen an eye specialist. We conclude that persons with diabetes in Trinidad and Tobago often have visual symptoms and visual impairment which cause significant disability. These subjects may have difficulty gaining access to effective eye care. These results point to a need to implement measures to prevent diabetic eye disease by improving blood glucose control, and to ensure early detection and effective treatment of diabetic retinopathy.(AU)

Prevalence of lens opacities in the Barbados Eye Study

OBJECTIVE: To present population-based data on type and extent of age-related lens opacities in the predominantly black population of the Barbados Eye Study. DESIGN: Prevalence study. SETTING AND PARTICIPANTS: The Barbados Eye Study included 4709 participants (84 percent of those eligible), who were identified from a random sample of Barbadian-born citizens aged 40 to 84 years. DATA COLLECTION: Lens gradings at the slit lamp, obtained with the use of the Lens Opacities Classification System II. MAIN OUTCOME MEASURE: Prevalence of posterior subcapsular, nuclear, and cortical opacities (defined as a grade > or = 2 in either eye), as well as prevalence of any lens changes (including history of previous cataract surgery and/or cataract too advanced to grade). RESULTS: Overall, 41 percent of the Barbados Eye Study population had any lens change, including 3 percent with aphakia or an intraocular lens. Among the population of African descent, cortical opacities (34 percent) were most prevalent, followed by nuclear (19 percent) and posterior subcapsular (4 percent) opacities. Prevalence of all opacity types increased with age (P < .001). Cortical and nuclear opacities were more frequent in women than men. When prevalence of a single kind of opacity was considered, 21 percent of participants had cortical only, 6 percent had nuclear only, and 0.4 percent and posterior subcapsular only; 13 percent had mixed opacities. Visual acuity loss to worse than 20/40 in the more affected eye was present in 48 percent, 26 percent, and 18 percent of nuclear only, posterior subcapsular only, and cortical only types, respectively, and in 53 percent of mixed opacities. CONCLUSIONS: The Barbados Eye Study provides the first prevalence data on different types of lens opacities in a large, predominantly black population. Whereas nuclear opacities are most common in white populations, cortical opacities were the most frequent type in the Barbados Eye Study, a finding of possible etiologic relevance. Other results highlight a higher frequency of opacities in women than men and a high prevalence of visual acuity loss in affected eyes.(AU)

Screening for opthalmic manifestations of sickle cell disease in the United Kingdom

There are marked variations in the manifestations of sickle cell disease in different populations. The occular complications of this condition amongst the Afro-Caribbeans living in the United Kingdom have not previously been reported. We present the preliminary results of an opthalmic screening programme at King's College Hospital, London. One hundred eyes of 50 patients with sickle cell disease were assessed. Full ocular examination was performed including fundus fluorescein angiography. We have looked at the haemotological and clinical profile of the patients involved as well as the number of days spent in the hospital during the year preceding the examination. The incidence of Grade 11 retinopathy was found to be significantly higher than grade 1 in SC disease. This concurs with the results of the Jamaican screening and confirms that the patients are at higher risk of visual impairment than those wuth the SS disease. Our results also agrees with the Jamaican experience which suggests that visual morbidity is mostly due to complications of proliferative sickle cell retinopathy (PSR). However, the findings in patients without proliferative changes are different; in particular, angloid streaks leading to disciforms are an important cause of visual loss in Jamaica, but were not seen in any of the 98 eyes examined in this study. No correlation was found between the grade of retinopathy and age, sex, systemic complications and various haematological parameters except for the percentage of haemoglobin F, which was significantly higher in patients with grade I (7.6) compared with grade II (4.2) retinopathy (p=0.0127)(AU)

Distribution of refractive errors in patients from Dominica, West Indies

A total of 779 consecutive private patients requiring spectacles for correction of refractive errors were categorized according to age, sex, occupation and type of refractive error. Virtually all patients (97.1 percent) were black. The relationship between age, sex, occupation and refractive error was determined and showed that refractive errors were approximately equally distribibuted between the sexes, but myopia was more common among those with near-point occupations. Data also showed that more of the elderly were hyperopic than myopic in contrast to the younger patients who were more often myopic.(AU)

Posterior lip sclerectomy vs trabeculectomy in West Indian Blacks

Surgical treatment in a West Indian black population with primary open angle glaucoma was randomized to full-thickness posterior lip sclerectomies or partial thickness trabeculectomies. Forty-five posterior lip sclerectomies and 35 trabeculectomies were performed. With a mean follow-up period of 28.3 months, the eyes with posterior lip sclerectomies had lower intraocular pressures, reduced glaucoma medication requirements, and less failures. Decline of visual acuity did not differ significantly between the two groups, but early visual acuity loss due to accelerated cataract formation was noted more frequently with posterior lip sclerectomies. The incidence of flat anterior chambers also did not differ significantly, but shallow anterior chambers were more frequent and persisted for a longer time with posterior lip sclerectomies. Other complications were more frequent with posterior lip sclerectomies. (AU)

Diabetic maculopathy in a Jamaican population

Maculopathy is the commonest cause of severe visual loss diabetic retinopathy in Jamaica [5]. Ophthalmic assessment of 158 black Jamaican maturity onset diabetics referred randomly from the primary and secondary health centres, demonstrated maculopathy in 48 percent of patients. Duration of diabetes was a strong risk factor for maculopathy (p less than 0.0010). Poor compliance with diabetic and hypertensive therapy may infleunce the prevalence of maculopathy (AU)

Sickle cell retinopathy in Jamaican children: further observations from a cohort study

Serial retinal examinations were performed in children aged 5 years and older and fluorescein angiography/angioscopy in children 6 years and older participating in a cohort study of sickle cell disease. There were 1229 patient years of observation among 389 children aged 5 - 13 years. Peripheral retinal vessel closure was present in approximately 50 percent of children with SS and SC genotypes at age 6 years and increased to affect 90 percent of children by age 12 years. A matched pair analysis, comparing groups with minimal and complete closure, indicated that complete closure was associated with significantly lower total haemoglobin and fetal haemoglobin levels and significantly lower weight in SS disease, whereas in SC disease the risk factors appeared to be high mean cell volume and low platelet count. Proliferative retinopathy was rare, occurring only once in an 8-year-old boy with SC disease, despite 592 patient years of observation in children over this age. (AU)

Recurrent visual loss in homozygous sickle cell disease

In sickle cell retinopathy vascular involvement is most frequently recognised at the retinal periphery but obstruction of perimacular arterioles and of major retinal vessels may also occur. This report describes a patient with homozygous sickle cell (SS) disease with recurrent occlusion of major retinal vessels associated with recurring transient impairment of visual function. (Summary)

Macular vasculature, visual acuity, and irreversibly sickled cells in homozygous sickle cell disease

Observations of visual acuity and the conjunctival, macular, and perimacular vascularity have been assessed in patients with homozygous sickle cell (SS) disease. There were 17 matched pairs, each consisting of one patient with a high count (>15 percent) and one with a low count (<5 percent) of irreversibly sickled cell (ISCs). The macular vascular bed was assessed by measurements of the foveal avascular zone (FAZ), perimacular zones, and counts of perimacular vascular abnormalities (perimacular counts). Small foveal avascular zones and high perimacular counts were commoner in younger than older patients and there was a significant inverse correlation between size of the FAZ and the perimacular count. These observations were compatible with the hypothesis that perimacular vessel anomalies represent the early vaso-occlusive phase which progresses to ischaemia and the formation and enlargement of avascular areas. Visual acuity was assessed by Snell's test type and by measuring contrast sensitvity. There was no obvious relationship between acuity measured by the 2 methods and no relationship between acuity and observations of mascular vascularity. High ISC counts were significantly related to abnormalities of conjunctival vasculature, but no relationship was noted with abnormalities of the macular vasculature or with visual acuity (AU)

Ocular findings in elderly cases of homozygous sickle-cell disease in Jamaica

The ocular findings in 60 patients with homozygous sickle-cell disease over the age of 40 years have been described. Peripheral retinal vessel disease was common and appeared to increase with age. Retinitis proliferans was common among older patients in the group. Angioid streaks occurred in 13 (22 percent) patients. (Summary)

Photocoagulation and diathermy in the treatment of proliferative sickle retinopathy

The O'Malley Log II portable photocoagulator was used to treat the worse eye of 36 patients with proliferative sickle cell retinopathy flat on the retinal surface. The technique involved direct coagulation of the feeder arterioles before treatment of the new vessels themselves. The photocoagulator was most successful in treating the lesions and 131 of 137 retinitis proliferans (RP) lesions were occluded. In only one RP lesion did the photocoagulator have insufficient power to occlude the lesion. Vitreous haemorrhage occurred in only one patient and small round localized retinal haemorrhages in five. The Manchester portable diathermy machine successfully occluded all 29 raised RP lesions and fifty feeder arterioles in thirteen patients. Anterior segment ischaemia occurred in only one patient who had advanced traction retinopathy involving 360 degrees of arc of the retinal circumference before treatment. No recurrence of retinopathy over a 2-year follow-up period was seen in seven patients and in the remainder there was no recurrence in the 2 months after treatment. (Summary)

Unusual chorioretinal degeneration in sickle cell disease. Possible sequelae of posterior ciliary vessel occlusion

The vascular occlusive process characteristic of sickle cell disease may affect the retinal circulation and the resulting pathological changes, from peripheral vessel obstructions to a proliferative retinpathy, are well recognized. In the present report, three cases of sickle cell disease are described with an unusual chorioretinopathy. It is suggested that these change may have resulted from the vascular occlusive process affecting the posterior ciliary vessels. (Summary)