Journal of the American Optometric Association最新文献

Background: Cocaine is an alkaloid prepared from the leaves of the Erythroxylon coca plant. It is widely recognized as one of the most dangerous illicit drugs in use today. The U.S. Substance Abuse and Mental Health Services Administration estimates that 23.5 million Americans have used cocaine at some time in their life. Corneal defects from crack cocaine were first described in 1989 and later named crack eye syndrome in 1993.

Case report: A 40-year-old man reported to the eye clinic reporting vigorous eye rubbing after repeated exposure to and use of crack cocaine. A corneal infiltrate with an overlying epithelial defect developed and the man was treated with ciprofloxacin, homatropine, and diclofenac. This case presents background information concerning the systemic and ocular manifestations of cocaine, as well as the clinical presentations of crack eye syndrome, with recommendations on treatment.

Conclusions: A thorough social history should be elicited when patients who have unilateral or bilateral corneal defects of unknown origin are examined, or when treating persons with no other known risk factors for corneal disruption. Prompt recognition and treatment are the main factors in successful management of crack eye syndrome.

Background: The techniques of speed reading are widely used and generally accepted, but few studies have investigated whether- and how-speed reading actually improves reading ability in the typical reader.

Methods: Using the Ober2, an infrared monitoring device that accurately tracks eye movements, we measured the eye movements of 59 students. The Ober2 calculates reading speed, number of fixations per 100 words, number of words seen in each fixation, number of regressions per 100 words, and duration of fixation. Comprehension was assessed with ten detailed true or false questions.

Results: One group of the students (n = 25) participated in a speed reading class; the other group (n = 34) did not. After completion of the course, all 59 were re-measured on the Ober2. The speed-reading group improved significantly in five of the six aspects tested. Comprehension for the speed reading group showed an insignificant decrease.

Conclusions: We conclude that measurable changes in reading eye movements accompany successful completion of a speed-reading course.

Purpose: Dry eye is more prevalent among women than men. To examine whether gender influences the ocular surface, conjunctival goblet-cell density was monitored for a 30-day period. Changes in goblet-cell density are a sensitive marker for ocular surface disease.

Methods: Six men and twelve women who were free from ocular surface disease were sampled by impression cytology on the inferior bulbar conjunctiva every other day for 30 days. Samples were analyzed for goblet-cell content. The mean age of the subjects was 24 years for the men and 25.4 years for the women. A minimum of 200 epithelial cells were scored per microscopic field examined.

Results: There is a statistically significant difference in goblet-cell count between men and women over the 30-day test period. The mean goblet-cell count measured for men was 3.75% +/- 1.04%, while the mean count for women was 2.545% +/- 0.8%. When the data on women were replotted with reference to the menstrual cycle, the largest and longest depression of goblet-cell count occurs midcycle, around the time of ovulation. A significant difference in goblet-cell count was also noted when subjects using oral contraceptives (3.065% +/- 0.98%) are compared with those not using oral contraceptives (2.28% +/- 0.92%).

Conclusion: It appears there may be a reproductive hormonal influence on conjunctival goblet-cell count.

Background: Optometrists and Ophthalmologists have a history of difficult professional relationships. This paper discusses common issues both professions face while working under managed care.

Conclusions: Managed care initiatives may help to improve the ability of Optomotrists and Ophthalmologists to work together to treat the patient's eye problems.

Background: Many LASIK patients are early and mid-presbyopes. Monovision is commonly targeted for these patients because of demographics. Considerations are reduced stereopsis, reduced acuity, night driving, and liability.

Case reports: Case studies are used to illustrate contact lens and alternative trials for presbyopic and prepresbopic monovision LASIK patients.

Conclusion: A preoperative monovision contact lens trial can be used to demonstrate monovision effects to the candidate for refractive surgery. Selection of add power, selection of distance and near eye, residual astigmatism, management, and gradual transistioning with regards to adaptation are discussed.

Background: Accommodative infacility, as commonly measured by accommodative flippers, has been implicated as a factor in academic underperformance. This study compares four areas of academics (reading, writing, math and gym) to accommodative flexibility scores.

Methods: Seventy-six elementary school children with a mean age was 8 years, 8 months were tested monocularly and binocularly with traditional accommodative flexibility flipper testing and with a new accommodative flexibility apparatus that allows control of visual acuteness, minification/magnification, and reaction time. These scores were then compared with academic scores using a number of failure criteria. The academic ratings were based on teacher responses for each student.

Results: Our data did not show any clear correlation or relationship between evaluations by reading, writing, math, or gym teachers and accommodative flexibility by either the traditional or new testing methods.

Conclusion: Accommodative function, free of contaminating variables, does not appear to predict academic function any better than the traditional.

Background: The use of anti-reflection coatings (AR) for spectacle lenses is steadily increasing. These ultra-thin coatings reduce reflections in lenses, increasing light transmittance about 8% (from 91% to 99%). Patient reports of crisper detail and brighter environment indicate that this perceived increase in visual function would probably be of benefit to many, including highway patrolmen who must make daily judgments on the basis of fine visual detail.

Methods: Nineteen presbyopic Missouri State Highway Patrolmen (MSHP) participated in this crossover study. Subjects randomly wore Varilux Comfort progressive addition lenses in CR-39 that were uncoated or AR-coated. The AR coating was Crizal. Subjects wore each lens for 1 month, then compared the lenses directly for 1 week. Data were collected for lens scoring (both general and job specific) and lens preferences.

Results: The AR-coated lens was found to be significantly better in most categories. Reduction in glare and reflections during the day, night, indoors, and in the patrol vehicle--as well as improvement in overall night vision--were highly significant. Eighty-nine percent of the subjects chose the Crizal-coated lenses as their overall preferred lens.

Conclusions: The results of this study appear to demonstrate a noticeable subjective preference for AR-coated lenses when used by a group engaged in a visually demanding occupation.