SING IMT in pseudophakic eyes: Results of the first experiences.

Purpose: To evaluate the feasibility and outcomes of implanting the Smaller-Incision New-Generation Implantable Miniature Telescope (SING IMT) in pseudophakic patients affected by late-stage dry AMD. Subjects: Five pseudophakic patients' eyes with stable dry AMD were suitable for SING IMT implantation. Four eyes were excluded because of previous YAG laser capsulotomy. Patients underwent preoperative assessments, including visual acuity measurements and OCT scans. Methods: Surgical procedures were performed under peribulbar anesthesia, with careful IOL removal and SING IMT implantation. Postoperative follow-up was conducted at regular intervals to monitor visual acuity, device positioning and complications. Results: Postoperative outcomes demonstrated improvements in visual acuity for most patients with an average gain in CDVA (Corrected Distance Visual Acuity) and CNVA (Corrected Near Visual Acuity) of 16,8 ± 10,2 and 13,8 ± 7,4 ETDRS letters, respectively. Limited complications have been observed. In one case, we observed dislocation of the device into the vitreous chamber, which we managed through vitrectomy and scleral fixation of the SING IMT using GoreTex suture. Conclusions: Despite being traditionally contraindicated for pseudophakic patients, SING IMT implantation in selected cases yielded favorable outcomes, indicating potential benefits for this population. Further research with larger sample sizes and longer follow-up periods is warranted to refine patient selection criteria and optimize surgical techniques.

The multiple mediating effects of vision-specific factors and depression on the association between visual impairment severity and fatigue: a path analysis study.

BACKGROUND: Severe fatigue is a common symptom for people with visual impairment, with a detrimental effect on emotional functioning, cognition, work capacity and activities of daily living. A previous study found that depression was one of the most important determinants of fatigue, but less is known about disease-specific factors in this patient population. This study aimed to explore the association between visual impairment severity and fatigue in adults with low vision, both directly and indirectly, with vision-specific factors and depression as potential mediators. METHODS: Cross-sectional data were collected from 220 Dutch low vision service patients by telephone interviews. Fatigue was defined as a latent variable by severity and impact on daily life. Potential mediators included vision-related symptoms, adaptation to vision loss and depression. Hypothesized structural equation models were constructed in Mplus to test (in)direct effects of visual impairment severity (mild/moderate, severe, blindness) on fatigue through above mentioned variables. RESULTS: The final model explained 60% of fatigue variance and revealed a significant total effect of visual impairment severity on fatigue. Patients with severe visual impairment (reference group) had significantly higher fatigue symptoms compared to those with mild/moderate visual impairment (ß = -0.50, 95% bias-corrected confidence interval [BC CI] [-0.86, -0.16]) and those with blindness (ß = -0.44, 95% BC CI [-0.80, -0.07]). Eye strain & light disturbance, depression and vision-related mobility mediated the fatigue difference between the severe and mild/moderate visual impairment categories. The fatigue difference between the severe visual impairment and blindness categories was solely explained by eye strain & light disturbance. Moreover, depressive symptoms (ß = 0.65, p < 0.001) and eye strain & light disturbance (ß = 0.19, p = 0.023) were directly associated with fatigue independent of visual impairment severity. CONCLUSIONS: Our findings indicate an inverted-U shaped relationship between visual impairment severity and fatigue in patients with low vision. The complexity of this relationship is likely explained by the consequences of visual impairment, in particular by strained eyes and depressive mood, rather than by severity of the disability itself.

Accessible Point-and-Tap Interaction for Acquiring Detailed Information about Tactile Graphics and 3D Models.

We have devised a novel "Point-and-Tap" interface that enables people who are blind or visually impaired (BVI) to easily acquire multiple levels of information about tactile graphics and 3D models. The interface uses an iPhone's depth and color cameras to track the user's hands while they interact with a model. When the user points to a feature of interest on the model with their index finger, the system reads aloud basic information about that feature. For additional information, the user lifts their index finger and taps the feature again. This process can be repeated multiple times to access additional levels of information. For instance, tapping once on a region in a tactile map could trigger the name of the region, with subsequent taps eliciting the population, area, climate, etc. No audio labels are triggered unless the user makes a pointing gesture, which allows the user to explore the model freely with one or both hands. Multiple taps can be used to skip through information levels quickly, with each tap interrupting the current utterance. This allows users to reach the desired level of information more quickly than listening to all levels in sequence. Experiments with six BVI participants demonstrate that the approach is practical, easy to learn and effective.

Cross - cultural adaptation of the Low Vision Quality of life scale.

INTRODUCTION: The quality of life related to visual function is a multidimensional construct that complements the functional assessment of patients with low vision. It shows the individual's perception of the course of ocular disease and its treatment within the framework of a value system and a sociocultural context. This clinical-epidemiological outcome is recognized as objective and valuable. METHODOLOGY: A content validation study was conducted, which involved translating and back-translating the scale to evaluate semantic, idiomatic, conceptual, and experiential equivalence in the resulting version. The study included the participation of 21 individuals, and a quantitative evaluation was performed using Aiken's V coefficient to analyze the scores assigned in the categories of relevance and experiential capacity. RESULTS: The questionnaire presentation was reorganized. The examples were expanded, and some optical aids were mentioned. Additionally, terms were changed to improve comprehension and reduce rudeness. Out of the 25 items, 11 had an Aiken V coefficient of less than 1.0. CONCLUSIONS: The obtained version is comparable to the original questionnaire. However, the idiomatic twists specific to the local context emphasize the need for content validation to ensure correct interpretation and contribute to the updating of the scale.

Essential Occupational Therapy Competencies for Low Vision and Blindness.

Background. The prevalence of low vision and blindness in persons across the lifespan means that occupational therapists will encounter these conditions across all areas of practice. Practitioners must be equipped with competencies necessary to recognize and respond to vision loss-related concerns. Purpose. This study sought to identify essential occupational therapy competencies when providing services to people with low vision and blindness. Method. The study employed a three-phase modified Delphi methodology administered through online surveys and focus group. Respondents included people with low vision or blindness, professionals with special expertise in low vision/blindness, and occupational therapists in other practice areas. Data were analyzed using an iterative, consensus-generating strategy involving quantitative analysis of competencies, qualitative input, and expert panel review. Findings. The process yielded a 51-item competency framework organized into six domains. Implications. The framework provides the foundation for a common curriculum for Canadian occupational therapy programs and for the creation of educational resources.

Clinical features of a novel compound heterozygous genotype of the BBS2 gene: a case report.

Bardet-Biedl syndrome is a rare autosomal recessive genetic disorder with heterogenous clinical manifestations. The present study reports the clinical features of a novel compound heterozygous genotype of the BBS2 gene in a 14-year-old girl and her 6-year-old sister who had complaints of early-onset low vision. Fundus images revealed retinitis pigmentosa-like changes, and full-field electroretinograms showed no amplitude for the rod or cone response in both patients. Interestingly, nystagmus was observed in the older sister. On physical examination, the sisters had moderate obesity without polydactyly, hypogonadism, or intellectual disability. Exome sequencing revealed a novel compound heterozygous genotype of BBS2 in the sisters, namely the paternally inherited NM_031885.5:c.534 + 1G > T variant and the maternally inherited NM_031885.5:c.700C > T (p.Arg234Ter) variant. Both variants were classified as pathogenic according to the American College of Medical Genetics and Genomics guidelines. This study provides useful information on the genotype-phenotype relationships of the BBS2 gene for genetic counseling and diagnosis.

Smart speakers and skill use: what do we know?

Personal smart technologies are becoming increasingly interwoven into everyday life, yet the usability and usefulness for some of these off-the-shelf technologies for persons with disabilities has yet to be determined. Smart speakers with both their native and downloadable functionalities (skills) have great potential to support individuals with disabilities through communication functionalities, smart home integrations, and more. However, the potential for usefulness does not always translate to how something is actually perceived or used in the real-world. Therefore, the objective of this qualitative study was to gather insight from individuals with disabilities on their experiences with smart speakers and smart speaker skills. Participant feedback highlighted several primary themes: (1) external factors that might influence extent of, and advancement in smart speaker use, (2) Smart speaker use barriers, (3) Smart speaker use facilitators, and (4) Smart speaker uses specific to individuals with disabilities. Continued research and development is needed to help ensure that commercially available technologies are designed with universal design principles that will ensure accessibility for all potential users.

Smart speaker skills are being used for smart home management by persons with disabilities, but these functionalities are not without barriers.Persons with various disabilities should be involved in the development and translation of smart speaker functions that are intended to, or that could, support the needs of this population.

Evaluation of Depression Levels in Patients With Primary Open-Angle Glaucoma Using the Geriatric Depression Scale.

Introduction Glaucoma is a chronic disease that can lead to severe visual impairment and blindness. Methods The study included 91 primary open-angle glaucoma patients aged 60 years and older (group 1) and 83 healthy controls (group 2) with similar age and gender distribution. The duration of the disease, the number of anti-glaucomatous drops used daily, and visual field parameters were recorded. All participants then underwent a comprehensive mental status examination by a psychiatrist and were administered the Geriatric Depression Scale (GDS). Results In Group 1, the mean duration of glaucoma was 10.2±6.0 years, and the mean number of drops used per day was 2.91±1.47 drops/day. According to visual field (24-2) data, the mean mean deviation (MD) was -7.76±4.78 dB and the mean pattern standard deviation (PSD) was 5.14±2.60 dB. According to the classification based on MD, 33 (36.3%) patients were in the early stage, 36 (39.5%) in the intermediate stage, and 22 (24.2%) in the advanced stage. The mean best-corrected visual acuity (BCVA) was 0.85±0.38 logMAR in group 1 and 0.34±0.19 logMAR in group 2. The mean GDS scores were 13.7±7.23 points in group 1 and 3.61±1.71 points in group 2. There were statistically significant differences between the groups in terms of BCVA and GDS scores (p=0.039 and p<0.001, respectively). Conclusion In conclusion, it is important that ophthalmologists provide adequate information about glaucoma to prevent the development of depression in patients with glaucoma. This information may protect patients from uncertainty. A multidisciplinary approach in the management of glaucoma, a chronic and vision-threatening disease, can positively affect patients' compliance with follow-up and treatment, increase the quality of healthcare, and improve treatment responses.

The impact of using reverse polarity text for children with vision impairment assessed using light-adapted flicker electroretinogram.

CLINICAL RELEVANCE: Children with vision impairment can have difficulty accessing classroom reading material and knowledge of which students are likely to have improved performance reading performance with reverse polarity would be of value to educators. BACKGROUND: Printed material is typically presented as black text on a white background; however, reversing the polarity to white text on a black background may improve the reading speed for children with vision impairment. This study sought to identify the visual function or pathological features of children with vision impairment where reversing the polarity of text would improve their reading performance. METHODS: Forty-eight vision-impaired participants (27 male), aged 5-18 years with binocular visual acuities between 0.18-1.52 logMAR, were included. Reading performance was assessed by changes in Critical Print Size (ΔCPS), Maximum Reading Speed (ΔMRS) in normal and reverse polarity digital print, and numeric reading speed (ΔNRS) with normal and reverse polarity fonts. Correlations were made with 30 Hz flicker electroretinogram amplitude and high/low contrast acuity. Paired nonparametric tests evaluated significance in pathological condition groups. RESULTS: Significant negative correlations were only found between the 30 Hz flicker amplitude and ΔMRS (r = -.42, p = .028) and ΔNRS (r = -.46, p = .027). Follow-up pairwise comparisons based on pathology group only showed a significant effect of the retinal dystrophy group and CPS (n = 12, z = -2.24, p = .025). All other pairwise comparisons based on group were non-significant (p > .05). CONCLUSIONS: This study did not identify a specific pathological group or visual functional measure that could be used as a clinical marker to predict the impact of reversing polarity. However, significant improvements could be made in reading performance for some children and so a reading performance assessment is recommended for all children with vision impairment.

Personalized Citizen Assistance for Social Participation (APIC) adapted for older adults with visual impairment: results from a mixed study.

PURPOSE: To explore the effects of the Personalized Citizen Assistance for Social Participation (APIC), an intervention adapted here for visual impairment, involving weekly stimulation sessions over six to twelve months, provided by trained and supervised attendants, on seven outcomes (social participation, leisure, independence, mobility, quality of life, health-related quality of life, and empowerment) in older adults with visual impairment, and to document its facilitators and barriers. METHODS: A mixed-method design, which included a pre-experimental and an exploratory qualitative clinical research component, was used on 8 older adults (7 women) with visual impairment aged 70-86, and 8 attendants (5 women) aged 20-74. Before the intervention, directly after, and four months later, older adults completed questionnaires on the 7 outcomes. During the intervention, attendants completed diaries and participated in monthly meetings. Semi-structured interviews were administered to all participants after the intervention. RESULTS: Social participation, leisure, mobility, quality of life and empowerment had increased immediately after the APIC. These improvements were still generally observed four months later. Participants reported that the APIC improved older adults' capabilities, social participation, and social environment. CONCLUSIONS: The APIC is a promising intervention which helps older adults with visual impairment to deal with social restrictions.

In older adults, visual impairment has important consequences on active and healthy aging.Personalized citizen assistance for social participation (APIC) is an intervention that aims to foster the social participation.This study shows that APIC adapted to visual impairment influences social participation, leisure, mobility, quality of life and empowerment of older adults with visual impairment.Participants also reported improvements in their capabilities, social participation, and social environment.

Transitioning vision rehabilitation patients from over-the-counter magnifiers to prescribed aids.

PURPOSE: We determined over-the-counter magnifier usage rates by patients who newly presented for vision rehabilitation services, and sought to elucidate whether patients' ratings of over-the-counter magnifiers were associated with vision rehabilitation management strategies. METHODS: Retrospective records reviews of 274 new vision rehabilitation patients seen between 2021-2023 were completed by three optometric providers at an ophthalmic academic center, college of optometry, and private practice. RESULTS: Over half (58%) of patients tried an over-the-counter magnifier. Older age was significantly associated with trying over-the-counter magnifiers (OR:1.04; p < 0.001). Patients who tried an over-the-counter magnifier had significantly greater odds of the provider recommending and/or dispensing a prescribed hand-held optical illuminated magnifier (P< =0.04) or recommending a CCTV electronic magnifier (p = 0.049). The majority indicated over-the-counter magnifiers were somewhat (46%) or not helpful (38%). There was a significantly greater odds of rating the over-the-counter magnifier as not helpful when the provider subsequently recommended a CCTV (OR:4.8; p = 0.01) or higher spectacle-based near add power (OR: 2.0; p = 0.02). CONCLUSIONS: Since most new patients were unsatisfied with over-the-counter magnifiers, it is encouraging that previous over-the-counter magnifier use often led to upgrades with hand-held optical illuminated magnifiers prescribed by vision rehabilitation providers, or patients were transitioned to CCTV electronic magnifiers or spectacle-based high add powers for near reading. These findings support that older adults who have previously experienced that over-the-counter magnifiers were either helpful or unhelpful are ideal candidates to receive vision rehabilitation by optometric providers who can transition them to a prescribed magnification device to better support their visual functioning needs for near reading.

Over-the-counter magnifiers were deemed helpful by only a small proportion of visually-impaired patients who were newly seeking vision rehabilitation services; but there other are viable options for them, since optometric vision rehabilitation providers prescribed alternative magnification devices, such as spectacle-based high near add powers or electronic visual aids for patients.Patients who have previously tried an over-the-counter magnifier were often recommended and received a different magnification device from vision rehabilitation providers who should be encouraged to evaluate other aids in-office to determine if they are more acceptable and/or better suited to meet patients' needs.For patients and their families who have not yet pursued vision rehabilitation, our findings indicate that they should not give up on magnifiers and remain open to the possibility of using other types of magnification that could be helpful, such as a different optical magnifier, prescription for strong near reading glasses, electronic video magnification, or visual assistive apps for smartphones or tablets.

Prevalence of dry eye disease in the low vision population at the University of Colorado

Purpose: To evaluate the prevalence of diagnosed dry eye syndrome, meibomian gland dysfunction, and blepharitis amongst the low vision population. Methods: A retrospective analysis was conducted on patients seen in the University of Colorado Low Vision Rehabilitation Service between the dates of 12/1/2017 and 12/1/2022. 74 ICD-10 codes were used to identify patients as having dry eye syndrome or not having dry eye syndrome. Data was further analyzed to determine the prevalence of blepharitis and meibomian gland dysfunction using 29 blepharitis and 9 meibomian gland dysfunction ICD-10 codes. Data were also analyzed to determine the age and sex of the patients with diagnosed dry eye syndrome. Results: The percentage of patients with a diagnosis of dry eye syndrome by an eyecare provider was 38.02 %. The prevalence of dry eye syndrome by age group was 3.57 % for 0–19 years, 14.35 % for 20–39 years, 29.07 % for 40–59 years, 43.79 % for 60–79 years, and 46.21 % for 80 and above. The prevalence of meibomian gland dysfunction and blepharitis was 11.90 % and 9.1 % respectively. Dry eye syndrome prevalence amongst males was 31.59 % and 42.47 % for females. Conclusion: This study demonstrates that dry eye syndrome in the low vision population is a significant co-morbidity occurring in over a third of patients in the University of Colorado Low Vision Rehabilitation Service. These findings are meaningful as ocular comfort should not be overlooked while managing complex visual needs. (AU)

Assessment of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah.

BACKGROUND AND AIM: Refractive errors, amblyopia, strabismus, and low vision are more common among children with hearing impairments in comparison with their hearing peers. Neglecting visual disorders can pose educational and social problems for these children. The present study aimed to assess the prevalence of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah. MATERIALS AND METHODS: A total of 79 deaf and hearing impaired students within the age range of 7-20 years (mean age of 15.01 ± 2.72) underwent optometric examinations, including autorefractometry, retinoscopy, ophthalmoscopy, slit lamp, visual acuity measurement, and cover-uncover test. Those who needed further evaluation were referred to the Ophthalmology Clinic of Imam Khomeini Hospital. RESULTS: Regarding the prevalence of refractive errors, 32 (40.5%) subjects had one or a combination of refractive errors, the most common of which was astigmatism (36.7%), followed by amblyopia (15.1%). The most common type of strabismus was latent strabismus (heterophoria) (88.6%), followed by exophoria (81%). Moreover, 3 (3.7%) cases had nystagmus. A significant difference was observed between the prevalence of amblyopia and the degree of hearing loss (P = 0.026), and no significant difference was detected in other cases. CONCLUSION: As evidenced by the obtained results, refractive errors, amblyopia, strabismus, and low vision are more prevalent among deaf and hearing-impaired children compared to normal children because deaf and hearing-impaired children are not able to convey their vision problems and need to compensate for their poor hearing with an enhanced sense of sight, inattention to these disorders can present these children with serious educational and social problems. Therefore, eye screening examinations are of paramount importance in deaf and hearing-impaired children.

Low vision aids provision in an urban setting in Germany between 2014 and 2017: a regional population based study with healthcare claims data.

PURPOSE: Little is known about the utilization of low vision services (LVS) in Germany. To understand which persons and how often these services would be utilized, this study aimed to investigate low vision aids (LVAs) provision in an urban setting and to describe user characteristics and trends in their characteristics. METHODS: A retrospective study based on a population-based healthcare claims database in Cologne (N = ~ 500,000), Germany. The study population comprised individuals, who were continuously insured at four large statutory health insurers and who redeemed a prescription for visual aids or aids for blindness between January 2014 and December 2017. We examined their socio-demographic and clinical characteristics. Trends in characteristics were examined with logistic and linear regression models over time. RESULTS: Out of ~ 500,000 persons, 781 unique individuals (~ 0.2%) redeemed an LVA prescription. They were mainly female (68.7%), 60 years or older (75.3%) and had macular degeneration (50.6%) and/or glaucoma (25.9%). In the working-age subgroup, 33.8% were employed. Visual aids were most often prescribed (74.1%) and of all types of LVAs, individuals most commonly redeemed a prescription for magnifiers (35.8%), screen readers (34.3%) and/or canes (17.1%). Of the entire study population, 75.4% received their prescription from an ophthalmologist, 5.3% from a general practitioner and 7.1% from other medical specialists. Significant trends in characteristics of individuals who redeemed an LVA prescription were not found. CONCLUSIONS: Between 2014 and 2017, 781 individuals in Cologne redeemed an LVA prescription. They had characteristics which mostly can be explained by the epidemiology of VI. Results indicate that individuals that redeemed LVAs have a magnification requirement of ≥ 1.5-fold and ≥ 6-fold. Furthermore, next to ophthalmologists, general practitioners and other medical specialists seem to play a role in LVA provision as well, which should be taken into account by policy makers when planning interventions for increasing LVS provision. Our findings provide a starting point to examine LVS provision in Germany.

Feasibility of telerehabilitation to address the orientation and mobility needs of individuals with visual impairment: perspectives of current guide dog users.

OBJECTIVE: To assess guide dog users' perspectives on the feasibility of telerehabilitation for their O&M needs. METHOD: An online survey gathered insights from 56 guide dog (GD) users (Mean age = 59, Mean GD used = 4, Mean duration of use = 22 years). Thirteen GD users further participated in interviews or focus groups to explore survey responses. Data were analyzed using content analysis. FINDINGS: Most (40) were blind, and 16 had low vision, with intermediate (25) and advanced (25) communication technology proficiency. Most GD users (46) underwent residential training, and 10 received one-on-one visits. Qualitative analysis revealed acceptance of telerehabilitation services, citing accessibility as an advantage. However, GD users expressed concerns about safety, potential loss of behavioral observation, and social contact loss. Success depended on the type of technology, service type, and personal attributes. CONCLUSION: While feasible, telerehabilitation services may not be universally suitable for all training stages. Flexibility and applicability in service design are necessary to accommodate individual preferences and experience levels.

Telerehabilitation of Orientation & Mobility (O&M) services for individuals that are blind or have low vision potentially offers a hybrid service delivery mode, reducing wait time and travel costs.A remote O&M service offer could allow rehabilitation professionals to provide services across borders, to rural and remote regions, and reach a broader client base.Rehabilitation professionals should collaborate with technology companies to improve remote rehabilitation service delivery and address clients' concerns.Rehabilitation professionals should ensure that their approach to utilizing this telerehabilitation services is flexible and patient-centered, accommodating the client's need for in-person services.

Access to low vision rehabilitation services in Australia: practitioner perspective.

CLINICAL RELEVANCE: The burden of vision loss is both personal and economic. Having reduced vision can restrict access to education, job opportunities, and other activities, and patients can require substantial government funds for treatment and rehabilitation. An in-depth investigation of barriers and enablers is required to improve access to low vision rehabilitation services. BACKGROUND: Several clinical trials have demonstrated the effectiveness of low vision rehabilitation services, leading to improved clinical and functional abilities. However not all patients make use of these resources. METHODS: A purposive sample of primary eyecare practitioners (optometrists and orthoptists who held a variety of roles in clinical practice, academia and low vision specific organisations) were invited to participate in focus groups that were audio-recorded and transcribed verbatim. The resulting data were de-identified, cleaned, independently coded by two researchers and compared. Data were analysed using an interpretative phenomenological approach that included inductive thematic analysis. RESULTS: Of the 21 practitioners attending the five focus groups, 67% were female and 33% were male. The participants were optometrists and orthoptists with a wide range (4 to 20+ years) of clinical experience in eyecare service delivery. Four major themes emerged from the analysis: three themes focus on identifying barriers, while one theme highlighted potential enablers. These themes encompassed barriers impacting referral frequency, practitioner knowledge, patient experience, and enablers that suggest improvement options for enhancing low vision services. CONCLUSION: Miscommunication between service providers, miscommunication between patients and clinicians, late referral, cost of services and social stigma were major barriers preventing patients from receiving low vision services. Most practitioners admitted limited knowledge of the scope of services provided by low vision organisations, suggesting there is a need for enablers such as professional development, improved communication between service providers, enhanced referral guidelines and increased public awareness.

The FreiBurger: a new optotype for P300-based acuity estimation.

PURPOSE: Accurate objective assessment of visual acuity is crucial, particularly in cases of suspected malingering, or when the patient's inability to cooperate makes standard psychophysical acuity tests unreliable. The P300 component of the event-related potentials offers a potential solution and even allows for the use of standard optotypes like the Landolt C. However, low-vision patients with large eccentric visual field defects often struggle to locate the Landolt C gap quickly enough for a P300 to be reliably produced. METHODS: Addressing this challenge, we introduce a novel optotype (the "FreiBurger") with a critical detail that extends through the optotype's center. Two experiments, with 16 and 12 participants, respectively, were conducted. In the first, psychophysical acuity estimates were obtained with both the FreiBurger and the Landolt C. In the second, we tested the performance of the FreiBurger, relative to the Landolt C, in eliciting a P300 with undegraded vision, simulated low vision, and in a simulated combination of low vision and visual field constriction. RESULTS: Comparable psychophysical acuity values (average difference 0.03 logMAR) were obtained for both optotypes. In the P300 recordings, both optotypes produced similar P300 responses under conditions of undegraded vision and low vision. However, with the combination of low vision and constricted visual field, the P300 could only be reliably obtained with the FreiBurger, while the amplitude was drastically reduced with the Landolt C (9.1 µV vs. 2.2 µV; p < 0.0005). CONCLUSION: The new optotype extends the applicability of P300-based acuity estimation to the frequently encountered combination of low vision and constricted visual field, where Landolt C optotypes fail. Although impairments were simulated in the present study, we assume that the advantages of the new optotype will also manifest in patients with such impairments. We furthermore expect the advantages to apply to time-sensitive psychophysical examinations as well.

Efficacy of a wearable night-vision aid in patients with concentric peripheral visual field loss: a randomized, crossover trial.

PURPOSE: To investigate the efficacy of our wearable night-vision aid in patients with concentric peripheral visual field loss. STUDY DESIGN: Prospective, single blind, three-group, and three-period crossover clinical study. METHODS: The study included patients with concentric peripheral visual field loss, a best-corrected visual acuity (decimal visual acuity) of 0.1 or higher in the better eye, and the presence of a central visual field. HOYA MW10 HiKARI® (HOYA Corporation), our original wearable night-vision aid, was used as the test device with three types of camera lenses (standard-, middle-, and wide-angle lenses). Under both bright and dark conditions, the angle of the horizontal visual field was measured using each of the three lens types for each group. The baseline angle was measured when each participant wore the night-vision aid (powered off). RESULTS: The study included 21 participants. Under bright condition, the perceived horizontal visual field was significantly wider than the baseline setup when using the standard-angle lens ("the standard lens"); the middle-angle lens ("the middle lens") was significantly wider than both the baseline setup and the standard lens; and the wide-angle lens ("the wide lens") was significantly wider than the other lenses. Under dark condition, the perceived horizontal visual field was again significantly wider when using the middle lens than the baseline setup and the standard lens, and when using the wide lens, the perceived horizontal visual field was again wider than when using the other lenses. The control in the bright condition was significantly wider (p < 0.001) than when used in the dark condition, while the standard-angle lens in the dark condition was significantly wider (p = 0.05) than when used in the bright condition. In regards to the middle and wide lenses, there was no statistically significant result emerging from either of the illumination conditions. CONCLUSION: Our wearable night-vision aid with a middle-angle or wide-angle lens appears to provide wider visual field images in patients with concentric peripheral visual field loss, regardless of whether the illumination conditions are bright or dark.

Confidence in low vision rehabilitation and attitudes towards further learning: A survey of UK optometrists.

PURPOSE: Optometrists are well positioned to help expand low vision (LV) services and improve their availability and accessibility. Determinants of participation in LV service provision must be well understood to facilitate successful service expansion. This survey aimed to investigate optometrists' professional confidence in the delivery of LV services and attitudes towards further learning. METHODS: An online survey was emailed to a sample of College of Optometrists members. Respondents rated their confidence in different areas of core optometric practice; confidence in LV was compared with confidence in other areas. Respondents also rated their confidence in undertaking multiple tasks involved in LV service delivery and in routine optometric practice; confidence was compared between optometrists who do and do not work in a LV service. Attitudes towards learning more about assessing and supporting patients with a vision impairment (VI) were recorded. RESULTS: The survey received 451 recorded responses (15.1% response rate). Optometrists who do not work in a LV service reported significantly lower confidence in LV than in other areas of core optometric practice, whereas optometrists who work in a LV service reported significantly higher confidence in LV than in other areas. Additionally, optometrists who do not work in a LV service reported significantly lower confidence in all tasks involved in LV service delivery than optometrists who work in a LV service (p < 0.001 for all tasks). Approximately 80% of respondents were interested in learning more about assessing and supporting patients with a VI. CONCLUSIONS: Optometrists who do not work in a LV service have relatively low confidence in LV, which could contribute to low motivation to participate in LV service provision. There is sizeable interest in learning more about assessing and supporting patients with a VI, which could help to increase motivation to participate in LV service provision.