Mathematically aggregating experts' predictions of possible futures.

Structured protocols offer a transparent and systematic way to elicit and combine/aggregate, probabilistic predictions from multiple experts. These judgements can be aggregated behaviourally or mathematically to derive a final group prediction. Mathematical rules (e.g., weighted linear combinations of judgments) provide an objective approach to aggregation. The quality of this aggregation can be defined in terms of accuracy, calibration and informativeness. These measures can be used to compare different aggregation approaches and help decide on which aggregation produces the "best" final prediction. When experts' performance can be scored on similar questions ahead of time, these scores can be translated into performance-based weights, and a performance-based weighted aggregation can then be used. When this is not possible though, several other aggregation methods, informed by measurable proxies for good performance, can be formulated and compared. Here, we develop a suite of aggregation methods, informed by previous experience and the available literature. We differentially weight our experts' estimates by measures of reasoning, engagement, openness to changing their mind, informativeness, prior knowledge, and extremity, asymmetry or granularity of estimates. Next, we investigate the relative performance of these aggregation methods using three datasets. The main goal of this research is to explore how measures of knowledge and behaviour of individuals can be leveraged to produce a better performing combined group judgment. Although the accuracy, calibration, and informativeness of the majority of methods are very similar, a couple of the aggregation methods consistently distinguish themselves as among the best or worst. Moreover, the majority of methods outperform the usual benchmarks provided by the simple average or the median of estimates.

Orthogonal astigmatic axes in Chinese and Caucasian infants.

Caucasian infants are known to have a high incidence of astigmatism. The axis of greatest power is usually in the orientation orthogonal to the most common type found in Caucasian adults, with-the-rule astigmatism. We now find that Chinese infants also have a high incidence of astigmatism relative to adults, but its orientation is orthogonal to that of Caucasian infants. The source of this racial difference is not clear. It is unlikely to be due to the most obvious difference, the structure of the eyelids.

Myopic children show insufficient accommodative response to blur.

PURPOSE: The study was performed to establish the relationship between the slope of the accommodative response function and refractive error in children. METHODS: Using an autorefractor, accommodative responses were measured in children under the following conditions. The subjects wore their best subjective refraction to view targets (a 3 x 3 array of 20/100 letters) displayed at seven distances (4.0 to 0.25 m). They viewed letters placed at 4.0 m through a series of negative lenses and letters placed at 0.25 m through a series of positive lenses. RESULTS: Myopic children accommodate significantly less than emmetropic children for real targets at near distances. Compared with emmetropic subjects, myopic children use blur poorly to increase accommodation, as shown by shallow slopes of the accommodative response functions for negative lenses. However, with positive lenses, requiring relaxation of accommodation, there is no significant difference in slope between myopic and emmetropic children. CONCLUSIONS: Blur is not an effective stimulus for accommodation in myopic children.

The development of eye alignment, convergence, and sensory binocularity in young infants.

PURPOSE: To measure and compare the development of ocular alignment, sensory binocularity, and convergence in infants during the first 5 months of life. METHODS: Healthy infants were tested between 2 and 21 weeks of age. Ocular alignment was measured by the Hirschberg test; convergence was determined by visual examination as an illuminated toy approached an infant's face; and sensory binocularity was measured by preferential looking for fusible versus rivalrous gratings. In experiment 1 we compared the proportion of infants at different ages demonstrating orthotropic ocular alignment with those showing convergence. In experiment 2, we compared the age of onset of convergence to that of sensory binocularity. RESULTS: Experiment 1: Most infants were orthotropic during the first month, and almost all of the others showed small amounts of exotropia. None of the infants showed accurate convergence until 6 weeks of age. By 4 months of age virtually all were orthotropic and had good convergence. Experiment 2: The onset of sensory binocular fusion occurred at 12.8 +/- 3.3 weeks. Full convergence did not occur until 13.7 +/- 3.2 weeks, although the first signs of convergence occurred slightly earlier. For individual infants there was a high correlation between the age of onset of sensory binocularity and convergence, and both onsets occurred earlier in girls than in boys. CONCLUSIONS: Ocular alignment did not require the development of binocularity mechanisms, and the development of binocularity mechanisms did not await the onset of good ocular alignment. The relatively sudden onset of binocularity, both sensory (preference for fusion and stereopsis) and motor (convergence) at about 3 months of age and the high correlation between these measures indicate a common causal mechanism that probably involves refinements in striate cortex circuitry.

Compensatory eye movements during active head rotation for near targets: effects of imagination, rapid head oscillation and vergence.

Because the center of natural head rotation lies some distance behind the centers of eye rotation, the VOR has to operate with a gain substantially above 1 for there to be stable fixation of targets lying near the head. In humans, VOR gain was increased inversely proportional to fixation distance and changed with the angle of the head for very near targets. These effects were also evident when the subject imagined the target. However, this "high-gain" VOR was found to deteriorate substantially at frequencies beyond ca 2.5 Hz. In conditions without visual feedback, the VOR gain enhancement due to near fixation was disrupted by monocular viewing. When the subjects wore lenses to relax or increase accommodation, the lenses were found to have no effect on VOR gain. On the other hand, prisms of equivalent power to the lenses had a large effect whereby gain was adjusted according to the vergence state of the eyes. This suggests that VOR gain modulation is under the direct control of convergence.

A dynamic relationship between myopia and blur-driven accommodation in school-aged children.

Previously we reported that recently myopic children accommodated insufficiently to blur induced by negative lenses. The purpose of the present study was to relate changes in blur-driven accommodation to myopia development in children. Refractive errors and the accommodation response function (ARF) were measured in 23 myopic and 40 emmetropic children on two occasions separated by periods ranging from 6 to 12 months. Repeated measures of accommodation were made with a Canon R-1 autorefractor while negative lenses of increasing power were placed in front of the child's right eye viewing 20/100 letters at 4 m. Concomitant changes in refractive error and in accommodative function over periods of 6-12 months were found to be highly correlated in myopes (r = 0.77) but not in emmetropes (r = 0.09).

Astigmatism and the development of myopia in children.

While it is now established that astigmatism is more prevalent in infants and young children than in the adult population, little is known about the functional significance of this astigmatism, especially its role, if any, in emmetropization and the development of myopia. Manifest refractions (mean of 16 per subject) were obtained from 245 subjects starting in the first year, with 6-23 years of regular follow-up. Results showed that infantile astigmatism is associated with increased astigmatism and myopia during the school years. Two possible mechanisms underlying this association are discussed: (1) infantile astigmatism disrupts focusing mechanisms; and (2) ocular growth induces astigmatism and myopia.

Consensual accommodation.

Consensual accommodation, like other consensual responses, may be a useful diagnostic indicator. The consensual interocular lag (direct accommodative response minus consensual accommodative response) was measured under a variety of accommodative conditions in four normal subjects, one of whom later underwent cryosurgery for a retinal tear. There was no consensual interocular lag when subjects were orthophoric , but when slightly exophoric at near distances a small lag does occur. A subject with large exophorias at near showed a more complex accommodative pattern. The consensual interocular lag proved to be the most sensitive measure of accommodative loss and subsequent recovery after retinal cryosurgery.

High myopia does not affect contrast sensitivity.

The axial elongation of high myopia is known to induce tangential stretching forces on the retina. Such forces might be expected to compromise retinal circuitry and thus affect the temporal and spatial contrast sensitivity function. In fact, we find that simple high myopes have normal contrast sensitivity for stationary gratings, moving gratings, and uniform field flicker. This suggests that, unlike many other retinal disease processes, the high myope's retina retains its normal integrity until the outer retina is compromised.

Prevalence of pterygium and cataract in indigenous populations of the Brazilian Amazon rain forest.

PURPOSE: To compare the prevalence of pterygium and cataract in four indigenous populations of the Brazilian Amazonian rain forest (Arawak, Tukano, Maku, and Yanomami) with different ethnic and social behaviour backgrounds. METHODS: A cross-sectional pterygium and cataract survey was performed in 624 adult Indians of the Brazilian rain forest belonging to four different ethnic groups. The Indians were classified according to their social behaviour in two groups: Arawak and Tukano (group 1) and Maku and Yanomami (group 2). Slit-lamp biomicroscopy was employed to examine the entire sample. All subjects were classified as 1 or 0 according to the presence or absence pterygium and cataract. Sex and age were also recorded. RESULTS: chi(2)-tests revealed that the prevalence of pterygium and cataract differed significantly between groups 1 and 2. For pterygia: 36.6% (97/265) and 5.0% (18/359), respectively (chi(2)=101.2, P<0.0001), and for cataracts: 24.5% (65/265) and 13.7% (49/359) respectively (chi(2)=12.09, P=0.0005). Gender was not associated with pterygium (P=0.1326) and cataract (P=0.2263) in both groups. Elderly subjects showed a significantly higher prevalence of cataract (P<0.0001). The prevalence of pterygia did not increase with age (P=0.8079) in both groups. CONCLUSION: Indians of group 1 have higher prevalence of pterygia and cataract than Indians of group 2. Social behaviour, especially the rate of sun exposure, appears to be the main factor for the different rates of pterygium and cataract displayed by these indigenous people of the Brazilian rain forest.

Development of refraction and strabismus.

Research on the etiology and causes of refractive errors has become a very active field of study during the past few years. Most of this research has focused on myopia. But hyperopia and astigmatism are also being examined both in comparison to myopia and in their own right. Animal models have also been developed for the study of experimentally induced myopia and hyperopia. These studies demonstrate the chain of neural and molecular events that occurs in induced myopia and hyperopia with increasing precision. In the future, these results may elucidate the mechanisms that underlie the refractive errors seen in human populations. Research into the development of strabismus has not progressed with the same vigor. The links among hyperopia, accommodative convergence, and strabismus are well established. Numerous neural, oculomotor, and subjective correlates of strabismus are now well established, but there has been a failure to develop the experimental paradigms needed to demonstrate the causal relations among these different factors.

Effects of dioptric blur on the Vistech contrast sensitivity test.

We studied the effect of dioptric blur on contrast sensitivity using the Vistech Vision Contrast System Chart. One diopter of blur affected the Vistech gratings by an amount consistent with expectations; sensitivity loss was greatest with higher spatial frequencies. However, a second diopter of blur induced an equal sensitivity loss for all spatial frequencies. A third diopter induced the greatest loss at the lowest frequency and an actual increase in sensitivity at the highest frequencies. This surprising finding is due to an interaction between "spuriously resolved" gratings and the border of the grating disc which resulted in the finest grating discs appearing to contain low frequency borders aligned with the fine gratings. Actually the fine gratings in the disc were invisible. When performing scanning photometry on the Vistech chart, we found that the contrasts of the unblurred gratings with higher contrast levels are 2.7 to 5.4 times higher than those stated by the manufacturer. The presence of this aliasing artifact indicates that the Vistech Vision Contrast System may produce erroneous results when used under conditions of high dioptric blur.

Progressive addition lenses for deaf lip readers and signers.

Deaf patients depend on intermediate vision for interpersonal communication. Deaf presbyopes are at a particular disadvantage since they are usually corrected for near and far vision with bifocals without consideration of their intermediate vision. Progressive addition lenses were used in this study to provide an intermediate correction for a group of deaf presbyopes. The patients' communication ability was tested through Varilux II lenses and habitual bifocals on a series of standardized lip reading and sign language tests. The patients showed better visual communication skills with the progressive adds, a preference for the progressive adds, and the impression of better vision through the progressive addition lens as opposed to their habitual bifocals.

Development of refraction and strabismus.

The goal of current research on the development of refraction is not to establish whether refraction is either genetically programmed or environmentally influenced, but to assess how heredity and environment interact in the genesis of refractive error. The continuing problem in strabismus research is one of cause and effect. Do binocular deficiencies induce strabismus, or is it the other way around? The papers highlighted in this article address these critical issues. The new findings have the potential to influence the treatment and clinical care of patients with refractive errors and strabismus.