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An iPod treatment of amblyopia: an updated binocular approach. iPod治疗弱视:一种更新的双目方法。
Pub Date : 2012-02-15
Robert F Hess, B Thompson, J M Black, G Machara, P Zhang, W R Bobier, J Cooperstock

We describe the successful translation of computerized and space-consuming laboratory equipment for the treatment of suppression to a small handheld iPod device (Apple iPod; Apple Inc., Cupertino, California). A portable and easily obtainable Apple iPod display, using current video technology offers an ideal solution for the clinical treatment of suppression. The following is a description of the iPod device and illustrates how a video game has been adapted to provide the appropriate stimulation to implement our recent antisuppression treatment protocol. One to 2 hours per day of video game playing under controlled conditions for 1 to 3 weeks can improve acuity and restore binocular function, including stereopsis in adults, well beyond the age at which traditional patching is used. This handheld platform provides a convenient and effective platform for implementing the newly proposed binocular treatment of amblyopia in the clinic, home, or elsewhere.

我们描述了计算机化和空间消耗实验室设备的成功翻译,用于治疗抑制的小型手持iPod设备(苹果iPod;苹果公司(Apple Inc., Cupertino, California)。一个便携式和易于获得的苹果iPod显示器,使用当前的视频技术为临床治疗抑制提供了理想的解决方案。以下是对iPod设备的描述,并说明如何通过电子游戏提供适当的刺激来执行我们最近的抗抑制治疗方案。在控制条件下每天玩一到两个小时的电子游戏,持续1到3周,可以提高视力,恢复双眼功能,包括成年人的立体视觉,远远超过使用传统贴片的年龄。这种手持式平台为在诊所、家庭或其他地方实施新提出的双眼弱视治疗提供了一个方便有效的平台。
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引用次数: 0
Central toxic keratopathy: a case study and literature review. 中毒性角膜病变一例及文献回顾。
Pub Date : 2012-02-15
Linda A Morgan

Background: Central toxic keratopathy (CTK) is a rare, non-inflammatory corneal opacity that can occur after corneal laser refractive surgery. It is characterized by the absence of inflammatory cells within the cornea or anterior chamber, central stromal necrosis, and corneal opacification, with an onset of 3 to 9 days after refractive surgery;

Case study: This case report reviews the clinical findings, differential diagnosis, possible etiologies, and management of CTK;

Conclusion: Though listed in the literature under numerous names, including diffuse lamellar keratitis (DLK) Stage IV, central lamellar keratitis (CLK), central flap necrosis (CFN), flap necrosis syndrome (FNS), and keratocyte-induced corneal microedema (KME), the conditions share characteristics with CTK, including clinical findings and treatment modalities. Treatment for CTK is controversial, though studies show best practices include close monitoring for possible corneal melt, avoiding topical corticosteroids, and possible enhancements for resultant hyperopia.

背景:中毒性角膜病变(CTK)是一种罕见的非炎症性角膜混浊,可在角膜激光屈光手术后发生。其特征是角膜或前房内无炎症细胞,中央间质坏死,角膜混浊,在屈光手术后3 - 9天发病。病例研究:本病例报告回顾了CTK的临床表现,鉴别诊断,可能的病因和治疗。虽然在文献中以许多名称列出,包括弥漫性板层角膜炎(DLK) IV期,中央板层角膜炎(CLK),中央皮瓣坏死(CFN),皮瓣坏死综合征(FNS)和角化细胞诱导的角膜微水肿(KME),但这些疾病与CTK具有共同的特征,包括临床表现和治疗方式。CTK的治疗是有争议的,尽管研究表明,最佳做法包括密切监测可能的角膜融化,避免局部使用皮质类固醇,以及可能的增强治疗由此产生的远视。
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引用次数: 0
Chiari I malformation presenting as downbeat nystagmus: clinical presentation, diagnosis, and management. 表现为下拍性眼球震颤的Chiari I畸形:临床表现、诊断和治疗。
Pub Date : 2012-02-15
Denise Goodwin, Ami R Halvorson

Introduction: Chiari I malformation is a congenital, neurological condition that is characterized by defects of the skull base resulting in herniation of the cerebellum through the foramen magnum into the cervical spinal canal. Because the condition can result in visual symptoms, patients will often search for answers from their eye care providers;

Case report: A 28-year-old Hispanic diabetic male with a 10-year history of nystagmus was referred to the neuro-ophthalmic disease clinic following the initiation of oscillopsia 1 year previous. Downbeat nystagmus, which worsened in right and down gaze, was evident. Cranial nerve testing was unremarkable, but the patient did report trouble with choking on food and drink. Neuroimaging revealed Chiari I malformation. The patient underwent a suboccipital craniectomy which resulted in lessened nystagmus and improved symptoms;

Discussion: The majority of patients with Chiari I malformation have an onset of symptoms in the second or third decade of life. Most commonly, a suboccipital headache that worsens with Valsalva maneuver is present. Visual symptoms include retro-orbital pain, flashing lights or floaters, blurred vision, photophobia, diplopia, transient vision loss, and peripheral vision loss. Objective evidence is often lacking in these patients; however, horizontal or vertical nystagmus is present in up to 45% of those with Chiari I malformation. Surgery has proven to be an effective and safe method to treat symptomatic Chiari I malformation.

简介:Chiari I型畸形是一种先天性神经系统疾病,其特征是颅底缺陷导致小脑通过枕骨大孔疝入颈椎管。病例报告:一名28岁的西班牙裔男性糖尿病患者,有10年眼球震颤病史,因1年前出现眼球震颤症而被转介至神经眼科诊所。向下眼震在右、向下凝视时明显加重。脑神经测试没有异常,但病人确实报告了食物和饮料窒息的问题。神经影像学显示Chiari I型畸形。该患者接受了枕下颅骨切除术,眼球震颤减轻,症状改善。讨论:大多数Chiari I型畸形患者在生命的第二或第三个十年出现症状。最常见的是枕下头痛,在Valsalva手法时加重。视觉症状包括眼眶后疼痛、闪光或飞物、视力模糊、畏光、复视、短暂性视力丧失和周围视力丧失。这些患者往往缺乏客观证据;然而,高达45%的Chiari I型畸形患者会出现水平或垂直性眼球震颤。手术已被证明是一种有效和安全的方法来治疗症状性Chiari I畸形。
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引用次数: 0
1971 - 2011: Forty year history of scope expansion into medical eye care. 1971年至2011年:四十年的历史范围扩大到医疗眼科护理。
Pub Date : 2012-02-15
Sherry L Cooper

The focus of this paper is to provide a historical timeline for many of the well over 180 incremental scope of practice expansion and amplification legislative successes achieved in the United States (U.S.) during the 40-year period 1971 - 2011 that cumulatively expanded optometry into medical eye care. This paper also serves to update the historical timeline of scope of practice amplification legislation enacted after the year 1999, which was so comprehensively described up to that point by Dr. Melvin D. Wolfberg.

本文的重点是为1971年至2011年40年间在美国(美国)取得的180多个实践扩展和放大立法成功提供一个历史时间表,这些成功累积将验光扩展到医疗眼科护理中。本文还对1999年以后制定的实践范围扩大立法的历史时间线进行了更新,Melvin D. Wolfberg博士对此进行了非常全面的描述。
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引用次数: 0
Ninety is the new...ninety! 九十是新的……九十!
Pub Date : 2012-02-15
Paul B Freeman
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引用次数: 0
A survey of optometry leadership: Participation in disaster response 验光领导力调查:参与救灾
Pub Date : 2012-01-01 DOI: 10.1016/j.optm.2011.06.012
Walter J. Psoter D.D.S., Ph.D. , David L. Glotzer D.D.S. , Kera Fay Weiserbs Ph.D. , Linda S. Baek , Rajiv Karloopia D.D.S.

Background

A study was completed to assess the academic and state-level professional optometry leadership views regarding optometry professionals as surge responders in the event of a catastrophic event.

Methods

A cross-sectional survey was conducted using a 21-question, self-administered, structured questionnaire. All U.S. optometry school deans and state optometric association presidents were mailed a questionnaire and instructions to return it by mail on completion; 2 repeated mailings were made. Descriptive statistics were produced and differences between deans and association presidents were tested by Fisher exact test.

Results

The questionnaire response rate was 50% (25 returned/50 sent) for the state association presidents and 65% (11/17) for the deans. There were no statistically significant differences between the leadership groups for any survey questions. All agreed that optometrists have the skills, are ethically obligated to help, and that optometrists should receive additional training for participation in disaster response. There was general agreement that optometrists should provide first-aid, obtain medical histories, triage, maintain infection control, manage a point of distribution, prescribe medications, and counsel the “worried well.” Starting intravenous lines, interpreting radiographs, and suturing were less favorably supported. There was some response variability between the 2 leadership groups regarding potential sources for training.

Conclusions

The overall opinion of optometry professional leadership is that with additional training, optometrists can and should provide an important reserve pool of catastrophic event responders.

本研究旨在评估学术界和国家级专业视光领导对视光专业人员在灾难性事件中作为快速反应者的看法。方法采用21个问题的自填结构化问卷进行横断面调查。所有美国验光学院院长和州验光协会主席都被邮寄了一份问卷,并指示他们在完成后邮寄回去;重复发了两封邮件。采用描述性统计方法对院长和会长之间的差异进行Fisher精确检验。结果州协会会长的问卷回复率为50%(回复率为25 /发送率为50),院长的问卷回复率为65%(11/17)。在任何调查问题上,领导小组之间没有统计学上的显著差异。所有人都同意验光师有技能,在道德上有义务提供帮助,验光师应该接受额外的培训,以参与灾难应对。人们普遍认为验光师应该提供急救、获取病史、分诊、保持感染控制、管理分发点、开药以及为“担心的人”提供咨询。开始静脉注射、解读x线片和缝合的支持度较低。对于潜在的培训资源,两组领导之间的反应存在差异。结论验光专业领导的总体观点是,通过额外的培训,验光师可以而且应该提供一个重要的储备库,以应对灾难性事件。
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引用次数: 0
Letter
Pub Date : 2012-01-01 DOI: 10.1016/j.optm.2011.11.001
Jerome Sherman O.D., Samantha Slotnick O.D.
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引用次数: 7
Remote treatment of intermittent central suppression improves quality-of-life measures 间歇性中枢抑制的远程治疗可改善生活质量
Pub Date : 2012-01-01 DOI: 10.1016/j.optm.2011.05.009
Eric S. Hussey O.D.

Background

Intermittent central suppression (ICS) is a repetitive intermittent (“on-and-off”) loss of central visual sensation without strabismus or amblyopia. These repetitive seconds-long suppressions have been suggested to create visual confusion and instability that would cause vision symptoms, contribute to reading complaints, and even impair reading.

Methods

Teacher-identified Job Corps students were diagnosed with ICS and then treated with 5-Hz electronic liquid crystal shutter alternate occlusion.

Results

Twenty-six young adult students (19.7 ± 1.6 y) had their ICS treated over 5.9 ± 3.7 months. Suppression periods decreased in length (P < 0.0001) and “binocular” nonsuppressed periods increased in length (P < 0.0001). Overall, College of Optometrists in Vision Development (COVD) quality-of-life (QOL) scores improved (P < 0.0001), 16 reading behavior COVD QOL questions improved (P < 0.0001), and individual QOL questions improved. Posttherapy reading scores (N = 18) improved 3.7 (± 2.6) years (P < 0.0001).

Conclusions

Treating ICS with electronic alternate occlusion reduced suppression periods, increased binocular periods, and improved symptoms as measured in the COVD QOL questionnaire. Positive changes also occurred in reading scores. These data suggest ICS should be considered a probable cause for symptoms of reading problems.

背景间歇性中枢性抑制(ICS)是一种重复性的间歇性(“开-关”)中枢性视觉感觉丧失,无斜视或弱视。这些持续数秒的重复抑制被认为会造成视觉混乱和不稳定,从而导致视力症状,导致阅读抱怨,甚至损害阅读。方法对经教师鉴定的就业团学生进行ICS诊断,并采用5 hz电子液晶快门交替闭塞治疗。结果26例青年学生(19.7±1.6 y)治疗ICS超过5.9±3.7个月。抑制期长度减小(P <0.0001),“双眼”非抑制期长度增加(P <0.0001)。总体而言,视光师学院视力发展(COVD)生活质量(QOL)评分改善(P <0.0001), 16个阅读行为COVD QOL问题得到改善(P <0.0001),个人生活质量问题得到改善。治疗后阅读评分(N = 18)提高3.7(±2.6)年(P <0.0001)。结论通过COVD QOL问卷测量,电子交替闭塞治疗ICS减少了抑制期,增加了双眼期,改善了症状。阅读成绩也出现了积极的变化。这些数据表明,ICS应该被认为是阅读问题症状的可能原因。
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引用次数: 7
The Florida Heiken Children's Vision Program 佛罗里达海肯儿童视力项目
Pub Date : 2012-01-01 DOI: 10.1016/j.optm.2011.10.002
Virginia A. Jacko, Alan P. Levitt O.D., Steven E. Marcus Ed.D., Alfred A. Rosenbloom O.D., D.O.S.
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引用次数: 0
Response 响应
Pub Date : 2012-01-01 DOI: 10.1016/j.optm.2011.11.002
Christopher Suhr O.D.
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引用次数: 0
期刊
Optometry
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