Susceptibility of the Cowpea Aphid (Hemiptera: Aphididae) to Widely Used Insecticides in Australia.

Globally, 27 aphid species have evolved resistance to almost 100 insecticide active ingredients. A proactive approach to resistance management in pest aphids is needed; this should include risk analysis, followed by regular baseline susceptibility assays for species deemed at high risk of evolving resistance. The cowpea aphid (Aphis craccivora Koch) has evolved insecticide resistance to multiple insecticides outside Australia and was recently identified as a high-risk species in Australia. In this study, we generated toxicity data against four insecticides (representing four unique chemical Mode of Action groups) for populations of A. craccivora collected across Australia. Alpha-cypermethrin was the most toxic chemical to A. craccivora in leaf-dip laboratory bioassays with an average LC50 value across nine populations of 0.008 mg a.i./L, which was significantly lower than dimethoate (1.17 mg a.i./L) and pirimicarb (0.89 mg a.i./L). Small, but significant, differences in sensitivity were detected in some populations against pirimicarb and dimethoate, whereas responses to alpha-cypermethrin and imidacloprid were not significantly different across all aphid populations examined in this study. For all insecticides, the field rate controlled 100% of individuals tested. The data generated will be important for future monitoring of insecticide responses of A. craccivora. Proactive management, including increased reliance on non-chemical pest management approaches and routine insecticide baseline sensitivity studies, is recommended for A. craccivora.

Veterans Affairs Multicenter Low Vision Enhancement System (LVES) study: clinical results. Report 1: effects of manual-focus LVES on visual acuity and contrast sensitivity.

PURPOSE: The Department of Veterans Affairs LVES Study is a multicenter study to determine the effectiveness of the Low Vision Enhancement System (LVES) as a visual rehabilitation device. The purpose of this study was to explore the efficacy of the Beta 1 manual-focus LVES for improving visual acuity and contrast sensitivity. METHODS: Patients whose visual acuity was 20/80 or worse in the better eye from any disease, who did not have significant visual field loss, who had previous low vision experience and were capable of working with the LVES were enrolled in a comprehensive prospective multicenter clinical evaluation. Initially, corrected spectacle visual acuities were measured using a standardized ETDRS chart. Contrast sensitivities were also measured with spectacle correction using a standardized Peli-Robson chart. These results were then compared to the acuities and contrast sensitivity obtained with the LVES at optimal magnification. Also, visual acuities were measured using an Eschenbach 3x spectacle-mounted binocular telescope, then compared to the acuities obtained using the LVES set at the lowest magnification (3x). RESULTS: All patients who completed the study demonstrated an improvement in visual acuity, with a median improvement of six lines of Snellen equivalent acuity using the LVES. Improvement in visual acuity was the same in both ARMD and non-ARMD causes of vision loss. Mean contrast sensitivity improved in 52 of 58 patients tested, with a mean improvement of 0.49 log units. CONCLUSION: The LVES significantly improves both visual acuity and contrast sensitivity in visually impaired patients who fall within the study criteria. Up to 10-fold improvement in visual acuity and up to 1.80 log units improvement in contrast sensitivity were noted in the study group when the LVES was used.

National survey of the impact of low vision device use among veterans.

BACKGROUND: This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through he Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs. METHODS: Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Factor analyses were used to describe prescription and use patterns. RESULTS: Most (85.4%) of the devices were still in use. Having a helper in the home was a demographic variable related to continued use. Neither age, acuity, nor etiology were related to continued use. Strong prescription and use patterns emerged. Most veterans reported receiving > 20 h of training and > 20 h of practice in the use of their LVDs. CONCLUSIONS: Most veterans who receive LVDs through the service delivery system of the Department of Veterans Affairs appear to use them for a wide variety of daily tasks and reported that they obtain a great deal of benefit from their use.

Veterans' use of low vision devices for reading.

BACKGROUND: This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through the Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs. METHODS: Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Because most devices were used for reading, an exploratory data analysis was completed to further investigate successful use of LVDs for this task. Relationships of 21 variables with a definition of highly successful use, use and nonuse of LVDs for reading were evaluated. RESULTS: Only visual acuity provided a statistically significant predictor of use of LVDs for reading. LVDs in the lowest visual acuity grouping tend to be used either highly successfully, or fall into the nonuse category. The highly successful LVDs are primarily video magnifiers; the nonused LVDs tended to be spectacle magnifiers. CONCLUSIONS: This population is using devices extensively for reading, reporting frequencies of use of several times per day.

Visual deficits and mobility. Evaluation and management.

The prevalence of severe visual impairment increases with age. Additionally, visually impaired elders are much more likely to have mobility restrictions than their normal-sighted peers. Specifically, individuals with visual impairment between 65 and 74 years of age are three to four times more likely to have difficulty walking, going outside, and getting in and out of bed. This article reviews the eye and vision problems associated with aging and discusses management options.

Preventing transmission of infectious diseases including the human immunodeficiency virus in the practice of optometry.

The risks of acquisition of infectious diseases including the human immunodeficiency virus--1 (HIV) to practitioners and patients in the practice of optometry is discussed. Measures that reduce the risk of contracting or transmitting HIV and other infectious diseases in optometry are presented. Effective disinfection including that for HIV are discussed.

Cytomegalovirus retinitis complicated by optic neuropathy: a longitudinal study.

Two cases of suspected cytomegalovirus (CMV) retinitis treated with ganciclovir and followed for 18 and 5 months are presented. Each patient developed optic neuropathy and experienced reduced vision despite effective control of their retinitis. In addition to objective ocular findings, subjective visual function changes (perimetry, contrast sensitivity and accommodation) in long term follow up of AIDS patients are reported for the first time. A discussion of CMV, its treatment and complications follows.

Optometric findings in the fragile X syndrome.

Fragile X syndrome (fra X) is one of the most significant discoveries in the area of mental retardation in the past 2 decades. Although hundreds of articles and two text-books have been written on the subject, only two studies have been published in the ophthalmic literature. This paper provides a brief review of the syndrome and reports on the ocular findings of 30 subjects with this genetic abnormality. We found that 30% of the subjects exhibited strabismus. Of those with strabismus, 70% were esotropes. Fifty-nine percent of the eyes evaluated (N = 58) showed hyperopia of +1.00 D or greater, 17% myopia of -1.00 D or greater, and 22% had at least 1.00 D of astigmatism. Major ocular health abnormalities were not identified in any of our subjects. The optometrist, as the primary eye care provider, should diagnose and treat these oculo-visual dysfunctions.

Primary and secondary iris cysts.

Primary cysts of the iris usually arise from the pigment epithelial layers and are almost always benign, stationary lesions which require no treatment. Those cysts which are secondary to such agents as trauma or inflammation are, however, characterized by progressive enlargement and visual complications. The major clinical significance of iris cysts lies in their similarity to iris melanomas. Cysts should be monitored for enlargement and/or other complications such as inflammation or secondary glaucoma.

The BITA telescope: a first impression.

The Bilevel Telemicroscope Apparatus (BITA) is a new galilean telescope designed to offer improved cosmesis, weight, field of view and spatial orientation over more traditional spectacle-mounted telescopic systems. This paper describes the characteristics of the new telescope and presents two cases where the BITA was successfully prescribed.

Mental retardation syndromes with associated ocular defects.

The mentally handicapped represent up to six million individuals who require the eye and vision care the optometrist can provide. Few of these individuals, however, ever receive this care. This paper reviews the pertinent aspects of each of these syndromes and briefly describes the associated oculo-visual anomalies that are frequently seen. The optometric clinician should actively participate in the primary health care needs of children and adults diagnosed as having mental retardation.

Ocular anomalies in fragile X syndrome.

Fragile X (fra[X]) syndrome is a newly discovered, but relatively common, genetic disorder with an estimated frequency of 1:1000. Several ocular dysfunctions may be associated with this syndrome, but there are few articles that fully report on these. A review of this genetic disorder is provided, as well as a discussion of a case review of a family with three siblings with fragile X syndrome. Since this disorder is the most common familial cause of mental retardation, is second only to Down's syndrome as a genetic cause for mental retardation, and may play a significant role in learning disabilities, the eye care practitioner should be aware of its importance.

Community hospital administration of intravenous tissue plasminogen activator in acute myocardial infarction: improved timing, thrombolytic efficacy and ventricular function.

As an investigational fibrinolytic agent for acute myocardial infarction, intravenous recombinant tissue-type plasminogen activator (rt-PA) has been administered primarily in tertiary care and university centers. To determine the value of early initiation of such therapy, two satellite community hospital emergency rooms were established for use of rt-PA and the experience was compared among 142 consecutive patients who were transferred to a regional center for acute cardiac catheterization after intravenous rt-PA therapy. In Group I (n = 19), patients received rt-PA after interhospital transport to the regional center, but before cardiac catheterization. In Group II (n = 70), rt-PA therapy was initiated by the helicopter physician and nurse team after their arrival at the local community hospital emergency room. Group III patients (n = 53) had rt-PA administered in the local community hospital by the emergency room physician. Group III patients had earlier initiation of therapy (2.1 +/- 0.8 hours in Group III versus 3.8 +/- 1.2 hours in combined Groups I and II, p less than 0.001) and an increased rate of infarct vessel recanalization on the 90 minute coronary angiogram (81 in Group III versus 67% in combined Groups I and II, p = 0.057). The patients in Group III had a higher acute left ventricular ejection fraction (54 +/- 8% versus 50 +/- 9.5% in combined Groups I and II, p less than 0.01) and a trend toward an increased 7 day ejection fraction (55.5 +/- 9% versus 51.7 +/- 9.5%, respectively, p = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)

Family participation during resuscitation: an option.

We began to question the fairness of a policy to exclude close family members from the treatment room during attempted resuscitation of cardiac arrest victims in 1982 after 13 of 18 surviving relatives (72%) who were surveyed about their experiences during the attempted resuscitation of a family member responded that they would have liked to have been present during the resuscitation. We report the results of a program instituted at that time that allowed selected family members to be present during resuscitation efforts. Family members were asked by a chaplain or nurse if they wished to be present in the resuscitation room, and those accepting were accompanied by a supporting emergency staff member who explained the milieu of the code room. None of the participants interfered with resuscitation efforts. Seventy persons who participated were later contacted by one of the chaplains and asked to complete a survey form. Forty-four of 47 respondents (94%) who had been present during resuscitation believed that they would participate again. Thirty-six (76%) thought that adjustment to the death or grieving was facilitated by their witnessing the resuscitation; 30 (64%) felt that their presence was beneficial to the dying family member. We conclude that lay person may wish to be with family members who may be dying even though resuscitation efforts are being made, and that it is reasonable to inquire about this wish. This experience has assisted the grieving process for many and has not interrupted or adversely affected medical efforts at resuscitation.

Veterans Administration residency programs: an overview.

At present, there are 33 Veterans Administration (VA) Medical Centers providing 1-year COE (Council on Optometric Education) accredited residency training programs for 46 recent graduates. This paper describes the types of programs available, discusses the staffing of the clinics, and details the clinical experience.

Residency training at the Kansas City Veterans Administration Medical Center: the first 10 years.

Hospital residency training is relatively new to optometry. At the present time, 48 residents are in training at 30 VA Medical Centers and approximately 17 residents are in training elsewhere. This paper reviews the initial 10 years (1975-1985) of the first Council on Optometric Education accredited VA residency program at Kansas City, and describes the program and future plans.

NoIRs and low vision.

Records of three hundred and eighteen low vision patients from three low vision centers were reviewed to determine patient preferences for NoIR light filters based on ocular disease and visual acuity. Eighty-nine percent chose the #101 and #102 filters. Patients with dry macular degeneration, chronic open angle glaucoma, and retinitis pigmentosa showed a greater preference for the #101 NoIRs. When visual acuity dropped below 20/400, no patients selected the darker filters (#108 & #109).

Eccentricity perception in the periphery of normal observers and those with retinitis pigmentosa.

The perception of the eccentricity of a suprathreshold light flash (III/4e) presented in a Goldmann perimeter was measured in four ophthalmologically normal observers and three young observers with retinitis pigmentosa (RP). The task was to indicate the perceived distance from central fixation of each light flash by making a mark on a 180-mm line drawn on a sheet of paper. In the center of the line was a hash mark. Observers were instructed that the hash mark should correspond to fixation and the ends of the line to the limits of the visual field. The vertical, horizontal, and both 45 degree oblique meridians were tested. The results showed that: 1. The extent of the field along the tested meridian determined perceived eccentricity, i.e., eccentricity of 45 degrees in the temporal field of normals was perceived as equally eccentric as 30 degrees in the superior field. 2. The central 20 degrees were taken to represent more of the perceptual field than any other 20 degrees. 3. Along a meridian, the eccentricity which extends from fixation to 16% of the way to the field limit along the meridian is perceived as extending to 25% of the field by normal observers. 4. On the other hand, observers with RP reported that along a meridian the eccentricity extending from fixation to 8% of the field limit is perceived as extending to 25% of the field. Kinetic primary with the II/4 target showed no evidence of field constriction in observers with RP. However, losses in sensitivity are evident starting at about 10 degrees. Full field single flash electroretinograms were unrecordable in the observers with RP.(ABSTRACT TRUNCATED AT 250 WORDS)

Treatment of low vision in fundus flavimaculatus.

Twenty-eight patients with fundus flavimaculatus were evaluated retrospectively after they had undergone examination for and treatment of low vision. Despite poor distance acuity, 27 (96%) of the patients could read 1M (20/50 reduced Snellen) or smaller print with a spectacle lens, and all patients could read standard-sized print (1M text) with some optical aid. Because such uniform improvement is uncommon among patients with low vision, we recommend examination for and trial of low-vision aids for those patients with this disorder who are having visual difficulties.