An innovative visual acuity chart for urgent and primary care settings: validation of the Runge near vision card.

OBJECTIVE: We evaluated the Runge card, a near-vision eye chart designed for ease of use, by testing agreement in visual acuity results between it and the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart. As a clinical reference point, we compared the Runge card and an electronic Snellen chart with respect to agreement with ETDRS results. METHODS: Participants consisted of adult eye clinic patient volunteers who underwent a protocol refraction, followed by testing with a Runge card, ETDRS chart, and Snellen chart. Mean logMAR visual acuities were calculated for each method. Agreement levels among the tests were assessed for the group overall and for subjects with good (ETDRS logMAR < 0.6; better than 20/80 Snellen equivalent) and poor (logMAR ≥ 0.6) acuity. RESULTS: One hundred and thirty-eight participants completed testing. The mean ( ± standard deviation) logMAR visual acuities (Snellen equivalent) with Runge, ETDRS, and Snellen, respectively, were 0.66 ± 0.50 (20/91, n = 138), 0.59 ± 0.51 (20/78, n = 138), and 0.67 ± 0.62 (20/94, n = 137). Runge testing agreed similarly with ETDRS and Snellen testing, with CCC 0.92 between Runge and ETDRS, and 0.87 between Runge and Snellen (p = 0.14). Runge agreed better with ETDRS than Snellen agreed with ETDRS in participants with poor acuity (CCC = 0.79 vs. 0.63, respectively, p = 0.001) but not in those with good acuity (CCC = 0.70 vs. 0.87, respectively, p = 0.005). CONCLUSION: Visual acuity measurements with the Runge near card agreed with measurements from the ETDRS to approximately the same degree as did the Snellen chart, suggesting potential utility of the Runge near card, particularly given its user-friendly characteristics and ease of use.

Spontaneous Resolution of Acute Corneal Hydrops in a Patient With Post-LASIK Ectasia.

PURPOSE: To describe a case of acute corneal hydrops in a patient with corneal ectasia after laser in situ keratomileusis (LASIK). METHODS: An observational study presenting clinical, slit-lamp, and optical coherence tomographic findings. RESULTS: A 66-year-old man with a history of moderate myopic astigmatism presented with a sudden loss of vision in his left eye 11 years after undergoing LASIK. He underwent a single enhancement in his left eye and was subsequently diagnosed with ectasia 9 years later. Slit-lamp examination demonstrated a small tear in the Descemet membrane with a large fluid-filled cleft separating the LASIK flap and extending to the flap edge. Because no aqueous humor leakage was detected, the patient was managed conservatively with eventual resolution of the fluid-filled cleft and return of 20/30 visual acuity. CONCLUSIONS: Acute corneal hydrops is a rare complication of post-LASIK corneal ectasia. In the absence of flap dehiscence and wound leak, such patients may be managed with simple observation.