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1.
Indian J Ophthalmol ; 68(7): 1306-1311, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32587155

RESUMO

The severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic has disrupted our society on an unprecedented scale since its inception in December 2019. As the health-care system is finally re-organizing to mitigate the impact of the pandemic, it was necessary to re-structure primary eye care (PEC) activities as well on the same lines. A consensus meeting was held with leading eye-care experts on 2nd May 2020 to prepare a roadmap for PEC in the days to come. Guidelines are needed for PEC activities like vision testing, refraction, optical dispensing, counseling, etc., Some of the activities at vision centers (VCs) may be postponed or modified in light of the current pandemic situation. PEC workers need to strictly follow social distancing norms (minimum 3 feet) for minimizing risk of exposure and need access to appropriate personal protective equipment (PPE), like gloves, masks and shields while examining beneficiaries. For optometrists, sterilization of instruments and encouraging the people to remain silent during the examination is recommended. Because conjunctivitis may be an early sign which can present at VCs, extra precautions in the form of PPE has to be ensured while examining such patients. This is also an opportunity to start running telemedicine clinics for all emergent cases that cannot be managed at the primary level. The guidelines also need to be updated based on the context of the working environment and changes in government directives from time to time.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Transtornos da Visão/diagnóstico , Infecções por Coronavirus/transmissão , Humanos , Índia/epidemiologia , Oftalmologia/normas , Pneumonia Viral/transmissão , Saúde Pública , Transtornos da Visão/terapia
2.
Br J Hosp Med (Lond) ; 81(6): 1-10, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32589541

RESUMO

Ocular complications in critical care patients are common. There has been a surge in intensive care admissions following the COVID-19 outbreak. The management of COVID-19 exposes patients to a number of specific risk factors for developing ocular complications, which include non-invasive ventilation, mechanical ventilation and prone positioning. Consequently, it is likely that there will be an increase in the number of ocular complications secondary to the management of COVID-19 patients in the intensive care unit setting, and these complications could lead to permanent visual loss and blindness. Increased awareness of eye care in the intensive care unit setting is therefore vital to help prevent visual loss and maintain quality of life for patients recovering from COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Oftalmopatias/terapia , Unidades de Terapia Intensiva , Oftalmologia , Pneumonia Viral/terapia , Encaminhamento e Consulta , Doença Aguda , Betacoronavirus , Doenças da Túnica Conjuntiva/prevenção & controle , Doenças da Túnica Conjuntiva/terapia , Conjuntivite/prevenção & controle , Conjuntivite/terapia , Doenças da Córnea/prevenção & controle , Doenças da Córnea/terapia , Lesões da Córnea/prevenção & controle , Lesões da Córnea/terapia , Cuidados Críticos , Estado Terminal , Edema/prevenção & controle , Edema/terapia , Endoftalmite/prevenção & controle , Endoftalmite/terapia , Oftalmopatias/prevenção & controle , Glaucoma/diagnóstico , Glaucoma/terapia , Humanos , Ceratite/prevenção & controle , Ceratite/terapia , Lubrificantes/uso terapêutico , Pomadas/uso terapêutico , Pandemias , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia
3.
Strabismus ; 28(1): 7-12, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32301677

RESUMO

Objective: Acute acquired concomitant esotropia (AACE) is a distinct subtype of esotropia. The purpose of this retrospective study was to describe the clinical characteristics and discuss the diagnostic and therapeutic management, and evaluate the effect of prism treatment.Methods: The records of 30 patients who presented with acute-onset diplopia at the General Hospital of Central Theater Command from August 2015 to November 2018 were reviewed. All patients underwent a complete medical history, ophthalmological and orthoptic examinations, and brain and orbital imaging. The patients were followed up between 2 and 8 months (mean 3.9 ± 1.2). Angle of strabismus, refractive error, stereopsis, and results of treatment with prisms were analyzed. Level of stereopsis was assessed before and after prismatic correction. Patient satisfaction was assessed with a telephone follow-up survey.Results: The mean age of the 30 patients was 29.7 ± 10.3 years (range 14-52). All patients complained about uncrossed diplopia, only at distance. The esophoria was concomitant in all cases ranging from 12 to 60 prism diopters (PD) at distance (mean 35.80 ± 14.17) and from 10 to 46 PD at near (mean 26.23 ± 11.46) (t = 6.51, P <.001). Cycloplegic spherical-equivalent refraction averaged -5.25 ± 1.67 D (range -0.50 to -8.13), 28 patients were myopic and 2 were emmetropic, all did not wear glasses for near work. All patients received brain and orbital computed tomography scans and magnetic resonance imaging and, in some cases, neurological examinations were performed. All of these examinations were normal. In 27 out of 30 patients treated with prisms, the diplopia resolved, whereas three patients were not satisfied with prismatic correction and underwent surgery. With prisms the esophoria was concomitant, ranging from 6 to 23 PD at distance fixation and from 4 to 18 PD at near fixation. Out of 30 patients, 23 patients were satisfied, 3 patients were not satisfied because their vision remained uncomfortable and 4 patients had an intermediate score.Conclusion: AACE was characterized by a sudden onset of concomitant non-accommodative esotropia with diplopia or visual confusion. In most cases, prismatic correction had a favorable effect with a resolution of diplopia. It offers a good treatment alternative in the early stage, when the angle of strabismus is unstable and surgery is not without risk.


Assuntos
Diplopia/terapia , Esotropia/terapia , Óculos , Transtornos da Visão/terapia , Doença Aguda , Adolescente , Adulto , Percepção de Profundidade/fisiologia , Diplopia/fisiopatologia , Esotropia/fisiopatologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Retrospectivos , Transtornos da Visão/fisiopatologia , Testes Visuais , Acuidade Visual/fisiologia , Adulto Jovem
4.
Am J Case Rep ; 21: e918488, 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31929495

RESUMO

BACKGROUND Cerebral venous sinus obstruction associated with leptomeningeal carcinomatosis is an extremely rare complication of advanced non-small-cell lung cancer. There is little information available on the efficacy of therapeutic options because of its rarity and extremely poor prognosis. CASE REPORT A 57-year-old man presented with severe headache, vomiting, and visual loss for 1 month. Head magnetic resonance venography (MRV) showed occlusion of the left transverse sinus. Gd-enhanced MRI showed no abnormal enhancement. Lumbar puncture intracranial pressure was higher than 40 cmH2O. Positive cerebrospinal fluid tumor cytology confirmed the diagnosis of leptomeningeal carcinomatosis (LC). The headache was relieved by repeated lumbar punctures, and ventriculo-peritoneal shunt was performed. Cerebral angiography showed severe stenosis of the left transverse sinus without thrombosis, and significant delay of cerebral circulation. The transverse sinus stenosis was judged to be contributing to raised intracranial pressure, and the patient underwent left transverse sinus stent placement. After the procedure, his visual acuity improved, the visual field was enlarged, and his headache could be controlled by medication. Follow-up Gd-enhanced MRI showed dural enhancement and spinal dissemination. Because molecular biology of the surgical specimen showed epidermal growth factor receptor (EGFR)-activating mutations, he was treated with osimertinib for 2 months. He survived for 8 months following the diagnosis of LC and left transverse sinus stenosis. CONCLUSIONS Venous sinus stenting can offer an effective palliative interventional option for symptom relief of severe headache and visual symptoms, even in the end stage of malignancy.


Assuntos
Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Carcinomatose Meníngea/diagnóstico , Carcinomatose Meníngea/secundário , Stents , Seios Transversos/patologia , Acrilamidas/administração & dosagem , Compostos de Anilina/administração & dosagem , Antineoplásicos/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/patologia , Angiografia Cerebral , Receptores ErbB/genética , Cefaleia/terapia , Humanos , Hipertensão Intracraniana/terapia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Masculino , Carcinomatose Meníngea/líquido cefalorraquidiano , Pessoa de Meia-Idade , Mutação/genética , Cuidados Paliativos , Flebografia , Inibidores de Proteínas Quinases/administração & dosagem , Punção Espinal , Derivação Ventriculoperitoneal , Transtornos da Visão/terapia , Acuidade Visual
5.
Cell Mol Life Sci ; 77(5): 779-780, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31897540

RESUMO

Prolonged life expectancies contribute to the increasing prevalence of age-related macular degeneration (AMD) that is already the leading cause of severe vision loss among the elderly in developed countries. In dry AMD, the disease culminates into vast retinal atrophy, whereas the wet form is characterized by retinal edema and sudden vision loss due to neovascularization originating from the choroid beneath the Bruch's membrane. There is no treatment for dry AMD and despite intravitreal injections of anti-vascular endothelial growth factor (VEGF) that suppress the neovessel formation, also wet AMD needs new therapies to prevent the disease progression and to serve patients lacking of positive response to current medicines. Knowledge on disease mechanisms is a prerequisite for the drug development, which is hindered by the multifactorial nature of AMD. Numerous distinguished publications have revealed AMD mechanisms at the cellular and molecular level and in this multi-author review, we take a bit broader look at the topic with some novel aspects.


Assuntos
Degeneração Macular/patologia , Retina/patologia , Transtornos da Visão/patologia , Idoso de 80 Anos ou mais , Humanos , Degeneração Macular/diagnóstico , Degeneração Macular/terapia , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia
6.
Cell Mol Life Sci ; 77(5): 819-833, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31893312

RESUMO

Understanding the mechanisms that underlie age-related macular degeneration (AMD) has led to the identification of key molecules. Hypoxia-inducible transcription factors (HIFs) have been associated with choroidal neovascularization and the progression of AMD into the neovascular clinical phenotype (nAMD). HIFs regulate the expression of multiple growth factors and cytokines involved in angiogenesis and inflammation, hallmarks of nAMD. This knowledge has propelled the development of a new group of therapeutic strategies focused on gene therapy. The present review provides an update on current gene therapies in ocular angiogenesis, particularly nAMD, from both basic and clinical perspectives.


Assuntos
Proteínas Reguladoras de Apoptose/metabolismo , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Terapia Genética/métodos , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Degeneração Macular/genética , Degeneração Macular/terapia , Proteínas Repressoras/metabolismo , Proteínas Reguladoras de Apoptose/antagonistas & inibidores , Proteínas Reguladoras de Apoptose/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/antagonistas & inibidores , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Neovascularização de Coroide/genética , Neovascularização de Coroide/patologia , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/antagonistas & inibidores , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Degeneração Macular/patologia , Proteínas Repressoras/antagonistas & inibidores , Proteínas Repressoras/genética , Transtornos da Visão/genética , Transtornos da Visão/patologia , Transtornos da Visão/terapia
7.
PLoS One ; 15(1): e0227677, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995568

RESUMO

Prosthetic vision is being applied to partially recover the retinal stimulation of visually impaired people. However, the phosphenic images produced by the implants have very limited information bandwidth due to the poor resolution and lack of color or contrast. The ability of object recognition and scene understanding in real environments is severely restricted for prosthetic users. Computer vision can play a key role to overcome the limitations and to optimize the visual information in the prosthetic vision, improving the amount of information that is presented. We present a new approach to build a schematic representation of indoor environments for simulated phosphene images. The proposed method combines a variety of convolutional neural networks for extracting and conveying relevant information about the scene such as structural informative edges of the environment and silhouettes of segmented objects. Experiments were conducted with normal sighted subjects with a Simulated Prosthetic Vision system. The results show good accuracy for object recognition and room identification tasks for indoor scenes using the proposed approach, compared to other image processing methods.


Assuntos
Inteligência Artificial , Próteses Visuais , Adulto , Inteligência Artificial/estatística & dados numéricos , Simulação por Computador , Feminino , Voluntários Saudáveis , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Fosfenos/fisiologia , Estimulação Luminosa/métodos , Psicofísica , Semântica , Transtornos da Visão/fisiopatologia , Transtornos da Visão/psicologia , Transtornos da Visão/terapia , Percepção Visual , Próteses Visuais/estatística & dados numéricos , Adulto Jovem
9.
Ophthalmology ; 127(1): 27-37, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31543351

RESUMO

PURPOSE: To compare wear of standard, adjustable, and ready-made glasses among children. DESIGN: Randomized, controlled, open-label, noninferiority trial. PARTICIPANTS: Students aged 11 to 16 years with presenting visual acuity (VA) ≤6/12 in both eyes, correctable to ≥6/7.5, subjective spherical equivalent refractive error (SER) ≤-1.0 diopters (D), astigmatism and anisometropia both <2.00 D, and no other ocular abnormalities. METHODS: Participants were randomly allocated (1:1:1) to standard glasses, ready-made glasses, or adjustable glasses based on self-refraction. We recorded glasses wear on twice-weekly covert evaluation by head teachers (primary outcome), self-reported and investigator-observed wear, best-corrected visual acuity (BCVA) (not prespecified), children's satisfaction, and value attributed to glasses. MAIN OUTCOME MEASURE: Proportion of glasses wear on twice-weekly covert evaluation by head teachers over 2 months. RESULTS: Among 379 eligible participants, 127 were allocated to standard glasses (mean age, 13.7 years; standard deviation [SD], 1.0 years; 54.3% were male), 125 to ready-made (mean age, 13.6; SD, 0.83; 45.6%), and 127 to adjustable (mean age, 13.4 years; SD, 0.85; 54.3%). Mean wear proportion of adjustable glasses was significantly lower than for standard glasses (45% vs. 58%; P = 0.01), although the adjusted difference (90% confidence interval [CI], -19.0% to -3.0%) did not meet the prespecified inferiority threshold of 20%. Self-reported (90.2% vs. 84.8%, P = 0.64) and investigator-observed (44.1% vs. 33.9%, P = 0.89) wear did not differ between standard and adjustable glasses, nor did satisfaction with (P = 0.97) or value attributed to study glasses (P = 0.55) or increase in quality of life (5.53 [SD, 4.47] vs. 5.68 [SD, 4.34] on a 100-point scale, P > 0.30). Best-corrected visual acuity with adjustable glasses was better (P < 0.001) than with standard glasses. Change in power of study lenses at the end of the study (adjustable: 0.65 D, 95% CI, 0.52-0.79; standard, 0.01 D; 95% CI, -0.006 to 0.03, P < 0.001) was greater for adjustable glasses, although interobserver variation in power measurements may explain this. Lens scratches and frame damage were more common with adjustable glasses, whereas lens breakage was less common than for standard glasses. CONCLUSIONS: Proportion of wear was lower with adjustable glasses, although VA was better and measures of satisfaction and quality of life were not inferior to standard glasses.


Assuntos
Óculos , Manufaturas , Refração Ocular/fisiologia , Erros de Refração/terapia , Transtornos da Visão/terapia , Adolescente , Grupo com Ancestrais do Continente Asiático/etnologia , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cooperação do Paciente , Satisfação do Paciente , Desenho de Prótese , Erros de Refração/etnologia , Erros de Refração/fisiopatologia , Inquéritos e Questionários , Transtornos da Visão/etnologia , Transtornos da Visão/fisiopatologia , Seleção Visual , Acuidade Visual/fisiologia
10.
Int J Health Geogr ; 18(1): 29, 2019 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-31829212

RESUMO

BACKGROUND: Considerable number of indoor navigation systems has been proposed to augment people with visual impairments (VI) about their surroundings. These systems leverage several technologies, such as computer-vision, Bluetooth low energy (BLE), and other techniques to estimate the position of a user in indoor areas. Computer-vision based systems use several techniques including matching pictures, classifying captured images, recognizing visual objects or visual markers. BLE based system utilizes BLE beacons attached in the indoor areas as the source of the radio frequency signal to localize the position of the user. METHODS: In this paper, we examine the performance and usability of two computer-vision based systems and BLE-based system. The first system is computer-vision based system, called CamNav that uses a trained deep learning model to recognize locations, and the second system, called QRNav, that utilizes visual markers (QR codes) to determine locations. A field test with 10 blindfolded users has been conducted while using the three navigation systems. RESULTS: The obtained results from navigation experiment and feedback from blindfolded users show that QRNav and CamNav system is more efficient than BLE based system in terms of accuracy and usability. The error occurred in BLE based application is more than 30% compared to computer vision based systems including CamNav and QRNav. CONCLUSIONS: The developed navigation systems are able to provide reliable assistance for the participants during real time experiments. Some of the participants took minimal external assistance while moving through the junctions in the corridor areas. Computer vision technology demonstrated its superiority over BLE technology in assistive systems for people with visual impairments.


Assuntos
Inteligência Artificial/tendências , Navegação Espacial/fisiologia , Transtornos da Visão/terapia , Tecnologia sem Fio/tendências , Aprendizado Profundo/tendências , Humanos , Reconhecimento Automatizado de Padrão/métodos , Reconhecimento Automatizado de Padrão/tendências , Estimulação Luminosa/métodos , Transtornos da Visão/fisiopatologia , Tecnologia sem Fio/instrumentação
12.
Neurochirurgie ; 65(5): 310-317, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31574284

RESUMO

INTRODUCTION: In published series, a large proportion of patients with craniosynostosis show impaired vision. MATERIALS AND METHODS: A literature review was performed, using the PubMed and Google Scholar databases, to identify original and review articles on the consequences of craniosynostosis on the eyes and visual pathways, and on the ophthalmological management of craniosynostosis. RESULTS AND DISCUSSION: Many ophthalmic, potentially sight-threatening, complications, can occur in patients with craniosynostosis, especially when syndromic. Optic neuropathy, mostly resulting from the papilledema-optic atrophy sequence, secondary to raised intracranial pressure (ICP), should be diagnosed early, in order to promptly lower the ICP. Cyclovertical and horizontal strabismus and refractive errors are frequent in unicoronal synostosis (anterior plagiocephaly) and syndromic craniosynostosis. Exorbitism, encountered in some cases of syndromic craniofacial synostosis, leads to exposure keratopathy, which requires aggressive management to avoid severe irremediable corneal complications. Amblyopia can result from optic neuropathy, corneal opacities, strabismus, or refractive errors. If undiagnosed and untreated at a young age, it results in permanent visual impairment. CONCLUSION: Children with craniosynostosis require a multidisciplinary care network including a pediatric ophthalmologist. Systematic ophthalmological follow-up enables papilledema to be diagnosed and amblyopia to be diagnosed and treated, in order to avoid visual impairment.


Assuntos
Craniossinostoses/complicações , Craniossinostoses/terapia , Oftalmopatias Hereditárias/etiologia , Oftalmopatias Hereditárias/terapia , Transtornos da Visão/etiologia , Transtornos da Visão/terapia , Adolescente , Criança , Pré-Escolar , Craniossinostoses/patologia , Humanos , Lactente , Vias Visuais/patologia
14.
Continuum (Minneap Minn) ; 25(5): 1310-1328, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31584539

RESUMO

PURPOSE OF REVIEW: This article reviews the anatomy, symptoms, examination findings, and causes of diseases affecting the optic chiasm, optic tracts, optic radiations, and occipital lobes. RECENT FINDINGS: Modern ophthalmic imaging can be used to monitor the effects of diseases of the optic chiasm and tract on the retinal ganglion cells. It can also be used to visualize transsynaptic degeneration of the anterior visual pathway in the setting of acquired retrogeniculate lesions. Visual prostheses that directly stimulate the occipital lobe are a potential strategy for rehabilitation that is in active clinical trials. SUMMARY: Detecting and characterizing visual deficits due to optic chiasm and retrochiasmal disease are important for the diagnosis, localization, and monitoring of neurologic disease; identifying patient disability; and guiding rehabilitation.


Assuntos
Encefalopatias , Lobo Occipital , Quiasma Óptico , Doenças do Nervo Óptico , Transtornos da Visão , Vias Visuais , Adulto , Encefalopatias/diagnóstico , Encefalopatias/patologia , Encefalopatias/fisiopatologia , Encefalopatias/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Lobo Occipital/patologia , Lobo Occipital/fisiopatologia , Quiasma Óptico/patologia , Quiasma Óptico/fisiopatologia , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/patologia , Doenças do Nervo Óptico/fisiopatologia , Doenças do Nervo Óptico/terapia , Transtornos da Visão/diagnóstico , Transtornos da Visão/patologia , Transtornos da Visão/fisiopatologia , Transtornos da Visão/terapia , Vias Visuais/patologia , Vias Visuais/fisiopatologia
15.
Tidsskr Nor Laegeforen ; 139(11)2019 Aug 20.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-31429247
16.
PLoS One ; 14(8): e0220480, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31369627

RESUMO

OBJECTIVES: To determine whether implementation of comprehensive in-school eyecare results in measurable benefits for children and young people in terms of visual status, classroom behaviours and how well their visual needs are met. DESIGN: School-based observational study. PARTICIPANTS & METHODS: 200 pupils [mean age 10 years 9 months, 70% male, majority moderate (40%) or severe (35%) learning difficulty] of a special education school in the UK. A sector-agreed in-school eyecare framework including full eye examination and cycloplegic refraction, dispensing of spectacles (as appropriate) and written reporting of outcomes to parents/teachers was applied. Classroom behaviours were observed and recorded prior to, and after, the in-school eyecare. Surveys were employed to obtain visual histories from parents/teachers. School records and statutory documents were reviewed for diagnostic and learning disability classifications. Visual function and ocular health were profiled at baseline and significant visual deficits identified. Where such deficits were previously unrecognised, untreated or not compensated for (e.g. correction of refractive error, enlargement of educational material) they were recorded as 'unmet visual need'. At follow-up, 2-5 months after initial (baseline) measures, eye examinations, parent/teacher surveys and behaviour observations were repeated. Follow-up measures were used to determine if measurable improvements were evident in visual function, ocular health, the level of unmet need and classroom behaviour following implementation of in-school eyecare. RESULTS: 199 participants completed baseline and follow-up measures. 122 (61%) participants presented with at least one significant visual or ocular health deficit and 90 (45%) participants had at least one unmet visual need. Younger pupils and those with no previous history of eyecare were more likely to demonstrate unmet visual needs at baseline (OR 1.12 95% CI 1.03 to 1.21) p = 0.012; (OR 4.44 95% CI 1.38 to 14.29 p = 0.007 respectively). On follow-up, the number of pupils with unmet visual needs dropped significantly to 36 (18%) (McNemar's test p<0.001). Visual and behavioural metrics of participants without significant visual deficits or whose visual needs were adequately addressed at baseline remained relatively unchanged between baseline and follow-up (Wilcoxon signed rank p>0.05). Where significant refractive deficits were corrected at follow-up, near visual acuity improved significantly (Wilcoxon signed rank p = 0.013), however, poor spectacle compliance was a persistent cause of unmet visual need. Off-task behaviour reduced significantly after actions to address unmet visual needs were communicated to parents and teachers (Wilcoxon signed rank p = 0.035). CONCLUSIONS: The present study demonstrates for the first time measurable visual and behaviour benefits to children in special education settings when they receive comprehensive in-school eye examinations, on-site spectacle dispensing and jargon-free reporting of outcomes to teachers and parents.


Assuntos
Comportamento Infantil , Educação Especial , Serviços de Saúde Escolar , Seleção Visual/métodos , Visão Ocular , Criança , Feminino , Humanos , Deficiências da Aprendizagem/complicações , Deficiências da Aprendizagem/psicologia , Masculino , Transtornos da Visão/complicações , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia
18.
Rheumatol Int ; 39(10): 1789-1796, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31440812

RESUMO

Permanent vision loss is one of the most serious complications of giant cell arteritis (GCA) and therefore prompt diagnosis is paramount. However, diagnosis of GCA remains challenging due to its frequently non-specific presentation. Our aim was to identify differences in the characteristics of GCA patients with, and without, current visual symptoms. A cross-sectional survey was mailed to patients with a GCA Read code entered in their GP electronic medical record. Responders were categorised as those currently reporting a visual symptom or not. We compared general and GCA-specific characteristics in these two groups. The association of diagnostic delay with subsequent experience of visual symptoms was examined using unadjusted and adjusted linear regression analysis. 318 GCA patients responded to the survey (59.6%). Responders were predominantly female (69.8%), with a mean age of 73.7 years (SD 8.2). 28% reported current visual symptoms. There was no statistically significant difference in the general characteristics between those with and without visual symptoms. Of GCA-specific characteristics, pre-GCA diagnosis of diplopia (p = 0.018), temporary (p ≤ 0.001) or permanent visual problems (p = 0.001) and hoarseness (p = 0.004) were more common among those reporting current visual symptoms. There was no association between the extent of diagnostic delay and reporting of current visual symptoms. Though we found few characteristics to distinguish between GCA patients with or without current visual symptoms, diagnostic delay was not associated with current visual symptoms. Our findings highlighted the continued difficulty for clinicians to identify GCA patients at the highest risk of visual complications.


Assuntos
Arterite de Células Gigantes/diagnóstico , Transtornos da Visão/diagnóstico , Visão Ocular , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diagnóstico Tardio , Progressão da Doença , Diagnóstico Precoce , Inglaterra/epidemiologia , Feminino , Arterite de Células Gigantes/epidemiologia , Arterite de Células Gigantes/terapia , Inquéritos Epidemiológicos , Humanos , Masculino , Valor Preditivo dos Testes , Prevalência , Prognóstico , Fatores de Risco , Autorrelato , Transtornos da Visão/epidemiologia , Transtornos da Visão/fisiopatologia , Transtornos da Visão/terapia
19.
Indian J Med Ethics ; 4(2): 154-156, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31271368

RESUMO

February 9, 2017. The alarm on my phone was set to a pre-dawn hour. We were to leave for a holiday in the hills, a long drive that I had planned for days, eager for hours of camaraderie with the steering wheel. But the waking was a shock. The walls and ceiling of the room were swirling, my body felt as if strapped to a rotating carnival wheel. Sitting, standing, walking, nothing eased it. I threw up from the nausea. Maybe it will slow, maybe it will stop, maybe it is nothing. It is vertigo, said my cousin (a doctor) on the phone, and prescribed an over-the-counter medication. The world steadied. I made the drive, the vacation, but the condition was now with me, for several hours each day.


Assuntos
Gerenciamento Clínico , Medicina Ayurvédica , Transtornos da Visão/terapia , Adulto , Vertigem Posicional Paroxística Benigna/terapia , Doença Crônica/terapia , Feminino , Humanos , Índia
20.
Zhonghua Yan Ke Za Zhi ; 55(6): 469-474, 2019 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-31189277

RESUMO

With the rapid development of global perinatal medicine and neonatal medicine, the survival rate of high-risk neonates (premature, and those who suffer neurologic lesion during or shortly after birth, et al.) improved significantly, however the incidence of cerebral visual impairment (CVI) also rose, which has become the most common cause of visual impairment in children in developed countries. Studies found that visual abnormalities of patients with CVI can be various. Since children's cognition and motor development are inseparable from visual functions, children with CVI are usually characterized by abnormalities in sensory perception, cognition and even movement, other than visual impairment itself. Due to the characteristics of CVI, such as early onset, complex etiology, difficulty in diagnosis and treatment, and involvement with ophthalmology, pediatrics, rehabilitation medicine, genetic epidemiology and other multi-disciplinary content, current domestic research on CVI is limited. From the perspective of ophthalmologist, this paper reviews the progress of ophthalmology diagnosis and treatment in children with CVI in recent years, aiming to have better early recognition and individualized intervention, so as to help pediatrician and rehabilitation physicians to improve survival skills for CVI children and their quality of life. (Chin J Ophthalmol, 2019, 55:469-474).


Assuntos
Oftalmologia , Transtornos da Visão , Baixa Visão , Criança , Pré-Escolar , Humanos , Incidência , Lactente , Recém-Nascido , Oftalmologia/tendências , Qualidade de Vida , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia
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