Pub Date : 2019-09-27DOI: 10.31707/vdr2019.5.3.p187
K. Ciuffreda, B. Tannen, D. Ludlam, M. Han
Detection and diagnosis of concussion/mild traumatic brain injury (C/mTBI) has a multitude of general vocational and avocational, as well as public health and educational, implications. A relatively short, focused, updated, highyield set of subjective and objective clinical vision tests are proposed that we and others have found to be assistive in the process. These vision tests are of a sensory, motor, and/or perceptual nature, many of which are relatively easy to implement in the standard, clinical environment.
{"title":"Vision-Based Concussion/Mild Traumatic Brain Injury Diagnostic Tests/Biomarkers: An Update and Reappraisal","authors":"K. Ciuffreda, B. Tannen, D. Ludlam, M. Han","doi":"10.31707/vdr2019.5.3.p187","DOIUrl":"https://doi.org/10.31707/vdr2019.5.3.p187","url":null,"abstract":"Detection and diagnosis of concussion/mild traumatic brain injury (C/mTBI) has a multitude\u0000of general vocational and avocational, as well as public health and educational, implications. A relatively short, focused, updated, highyield set of subjective and objective clinical vision tests are proposed that we and others have found to be assistive in the process. These vision tests are of a sensory, motor, and/or perceptual nature, many of which are relatively easy to implement in the standard, clinical environment.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89955622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-27DOI: 10.31707/vdr2019.5.3.p195
Background: Autism spectrum disorder is characterized in part by atypical behavior in the communication, social, and visual domains. Success in vision therapy is judged not only by changes in optometric findings, but through improvement in quality of life involving communication, social behavior and visual behavior. It would therefore be beneficial to have a validated questionnaire to assess parent reported quality of life pre and post vision therapy specific to patients with autism spectrum disorder. To our knowledge, a questionnaire of this nature has not been previously published in the literature. Methods: Questionnaire items were generated through surveying medical literature based on symptoms in three different categories: visual behavior, social behavior and communication. A pool of 34 questions was developed initially and then with thorough discussion with other experts, a 20-point questionnaire was developed with each item reflected in the construct concept. A draft of 20 questions was then sent to 10 subject experts with clinical experience in the field for more than 20 years, to review the pooled items. Validity and reliability was established prior to assessing the psychometric properties of the ASD/QOL-VT. Prospective observational study was conducted for a duration of 18 months. The study included individuals undergoing vision therapy in the age range of 3 to 15 years who had been diagnosed with ASD. The questionnaire was administered to parents of these children prior to the start of vision therapy. All subjects completed a minimum of 60 vision therapy sessions. The questionnaire was readministered after completing 60 sessions of vision therapy. Results: Cronbach’s alpha value for this questionnaire was 0.93, which reflected very good internal consistency. Factorial analysis yielded four factors with an Eigen value exceeding 1.0 which accounted for 68% variation in the model. The Cronbach alpha value for subscales identified by factorial analysis is 0.97 indicating excellent internal reliability. The mean pre vision therapy social behavior, communication and visual behavior score was 12.0±3.21, 17.07±4.57 and 26.97±6.41 respectively. The mean post vision therapy scores for social behavior, communication and visual behavior was 8.27±4.16, 11.33±5.27 and 17.93±6.52 respectively. On paired t test, the mean difference in score was statistically significant with P<0.001 in all three subcategories. Conclusions: Our study presents the development of a valid and reliable parent questionnaire, the ASD/QOL-VT, that judges communication, social behavior, and visual behavior in autism. Results of the study conducted indicate that vision therapy can result in significant improvements in the quality of life of patients with ASD as judged by their parents. This is evidenced by statistically significant changes in psychometric properties of the ASD/QOL-VT in social behavior, communication and visual behavior.
{"title":"Development and Validation of a Questionnaire to Assess Parent Reported Quality of Life Pre and Post Vision Therapy in a Population with Autism Spectrum Disorder","authors":"","doi":"10.31707/vdr2019.5.3.p195","DOIUrl":"https://doi.org/10.31707/vdr2019.5.3.p195","url":null,"abstract":"Background: Autism spectrum disorder is characterized in part by atypical behavior in the communication, social, and visual domains. Success in vision therapy is judged not only by changes in optometric findings, but through improvement in quality of life involving communication, social behavior and visual behavior. It would therefore be beneficial to have a validated questionnaire to assess parent reported quality of life pre and post vision therapy specific to patients with autism spectrum disorder. To our\u0000knowledge, a questionnaire of this nature has not been previously published in the literature.\u0000\u0000Methods: Questionnaire items were generated through surveying medical literature based on symptoms in three different categories: visual behavior, social behavior and communication. A pool of 34 questions was developed initially and then with thorough discussion with other experts, a 20-point questionnaire was developed with each item reflected in the construct concept. A draft of 20 questions was then sent to 10 subject\u0000experts with clinical experience in the field for more than 20 years, to review the pooled items. Validity and reliability was established prior to assessing the psychometric properties of the ASD/QOL-VT. \u0000\u0000Prospective observational study was conducted for a duration of 18 months. The study\u0000included individuals undergoing vision therapy in the age range of 3 to 15 years who had\u0000been diagnosed with ASD. The questionnaire was administered to parents of these children prior to the start of vision therapy. All subjects completed a minimum of 60 vision therapy sessions. The questionnaire was readministered after completing 60 sessions of vision therapy.\u0000\u0000Results: Cronbach’s alpha value for this questionnaire was 0.93, which reflected very good internal consistency. Factorial analysis yielded four factors with an Eigen value exceeding 1.0 which accounted for 68% variation in the model. The Cronbach alpha value for subscales identified by factorial analysis is 0.97 indicating excellent internal reliability. The mean pre vision therapy social behavior, communication and visual behavior score was 12.0±3.21, 17.07±4.57 and 26.97±6.41 respectively. The mean post vision therapy scores for social behavior, communication and visual behavior was 8.27±4.16, 11.33±5.27 and 17.93±6.52 respectively. On paired t test, the mean difference in score was statistically significant with P<0.001 in all three subcategories.\u0000\u0000Conclusions: Our study presents the development of a valid and reliable parent questionnaire, the ASD/QOL-VT, that judges communication, social behavior, and visual behavior in autism. Results of the study conducted indicate that vision therapy can result in significant improvements in the quality of life of patients with ASD as judged by their parents. This is evidenced by statistically significant changes in psychometric\u0000properties of the ASD/QOL-VT in social behavior, communication and visual behavior.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84266047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-27DOI: 10.31707/vdr2019.5.3.p155
R. Sanet, Fcovd, Pilar Vergara Giménez, L. Press
Our goal in this perspective piece is to provide a framework of support for a paradigm shift in the approach to treatment of amblyopia. Older paradigms essentially conceived of amblyopia as a monocular phenomenon. The National Eye Institute of the National Institute of Health in the United States (NEI/NIH) characterizes amblyopia as “a medical term used when the vision in one of the eyes is reduced because the eye and the brain are not working together properly.
{"title":"A Paradigm Shift in the Treatment of Amblyopia","authors":"R. Sanet, Fcovd, Pilar Vergara Giménez, L. Press","doi":"10.31707/vdr2019.5.3.p155","DOIUrl":"https://doi.org/10.31707/vdr2019.5.3.p155","url":null,"abstract":"Our goal in this perspective piece is to provide a framework of support for a paradigm\u0000shift in the approach to treatment of amblyopia. Older paradigms essentially conceived of amblyopia as a monocular phenomenon. The National Eye Institute of the National Institute of Health in the United States (NEI/NIH) characterizes amblyopia as “a medical term used when the vision in one of the eyes is reduced because the eye and the brain are not working together properly.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77733487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-27DOI: 10.31707/vdr2019.5.3.p158
A. Mitchell
Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder caused by a dopamine deficiency that presents with motor symptoms. Visual disorders can occur concomitantly but are frequently overlooked. Deep brain stimulation (DBS) has been an effective treatment to improve tremors, stiffness and overall mobility, but little is known about its effects on the visual system. Case Report: A 75-year-old Caucasian male with PD presented with longstanding binocular diplopia. On baseline examination, the best-corrected visual acuity was 20/25 in each eye. On observation, he had noticeable tremors with an unsteady gait. Distance alternating cover test showed exophoria with a right hyperphoria. Near alternating cover test revealed a significantly larger exophoria accompanied by a reduced near point of convergence. Additional testing with a 24-2 Humphrey visual field and optical coherence tomography (OCT) of the nerve and macula were unremarkable. The patient underwent DBS implantation five weeks after initial examination, and the device was activated four weeks thereafter. At follow up, the patient still complained of intermittent diplopia. There was no significant change in the manifest refraction or prism correction. On observation, the patient had remarkably improved tremors with a steady gait. All parameters measured were unchanged. The patient was evaluated again seven months after device activation. Although vergence ranges at all distances were improved, the patient was still symptomatic for intermittent diplopia. OCT scans of the optic nerve showed borderline but symmetric thinning in each eye. All other parameters measured were unchanged. Conclusion: The case found no significant changes on ophthalmic examination after DBS implantation and activation in a patient with PD. To the best of the authors’ knowledge, there are no other cases in the literature that investigated the effects of DBS on the visual system pathway in a patient with PD before and after DBS implantation and activation.
{"title":"Visual Effects of Deep Brain Stimulation in a Patient with Parkinson’s Disease","authors":"A. Mitchell","doi":"10.31707/vdr2019.5.3.p158","DOIUrl":"https://doi.org/10.31707/vdr2019.5.3.p158","url":null,"abstract":"Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder caused by a dopamine deficiency that presents with motor symptoms. Visual disorders can occur concomitantly but are frequently overlooked. Deep brain stimulation (DBS) has been an effective treatment to improve tremors, stiffness and overall mobility, but little is known about its effects on the visual system.\u0000\u0000Case Report: A 75-year-old Caucasian male with PD presented with longstanding binocular diplopia. On baseline examination, the best-corrected visual acuity was 20/25 in each eye. On observation, he had noticeable tremors with an unsteady gait. Distance\u0000alternating cover test showed exophoria with a right hyperphoria. Near alternating cover\u0000test revealed a significantly larger exophoria accompanied by a reduced near point of\u0000convergence. Additional testing with a 24-2 Humphrey visual field and optical coherence\u0000tomography (OCT) of the nerve and macula were unremarkable. The patient underwent\u0000DBS implantation five weeks after initial examination, and the device was activated\u0000four weeks thereafter. At follow up, the patient still complained of intermittent diplopia. There was no significant change in the manifest refraction or prism correction. On observation, the patient had remarkably improved tremors with a steady gait. All parameters measured were unchanged. The patient was evaluated again seven months after device activation. Although vergence ranges at all distances were improved, the patient was still symptomatic for intermittent diplopia. OCT scans of the optic nerve showed borderline but symmetric thinning in each eye. All other parameters measured were unchanged.\u0000\u0000Conclusion: The case found no significant changes on ophthalmic examination after DBS implantation and activation in a patient with PD. To the best of the authors’ knowledge, there are no other cases in the literature that investigated the effects of DBS on the visual system pathway in a patient with PD before and after DBS implantation and activation.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85861376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-28DOI: 10.31707/vdr2019.5.2.p84
Rachel Coulter, A. Bade, E. Jenewein, Y. Tea, L. Woodmansee, Alicia Andrade Groce, Cassandria Warr, Marina Abdalla
Background Double-blind studies have reported improvements in posture, spatial awareness, and behavior in Autism Spectrum Disorder (ASD) individuals wearing yoked prism lenses. The Kaplan Nonverbal Battery (KNB) is a performance-based test used to evaluate yoked prism lenses. To date, only Kaplan has reported KNB results. This study investigates inter-examiner and intra-examiner agreement obtained in scoring the KNB in nonverbal/ minimally verbal ASD subjects. Methods Ten nonverbal/minimally verbal ASD subjects between 9 and 17 years old enrolled and completed an eye examination. All subjects adapted to spectacles, wearing refractive correction for four weeks. Subjects completed two study visits that were videotaped. At each visit, subjects completed the KNB wearing habitual spectacle correction and then wearing yoked prism lenses of five-prism diopters base up or down. Two examiners scored the KNB live and two other examiners scored the KNB via videorecording. Examiners were masked to the base direction of the yoked prism lenses and to the other examiners’ responses. Agreement between and within examiners was computed using the weighted version of Cohen’s kappa. Results Nine subjects completed both study visits. Both inter-examiner and intra-examiner agreement were markedly better when examiners scored via video. When scored by live presentation, inter-examiner agreement by the weighted Cohen’s kappa coefficient was 0.674, 0.364, 0.726 and 0.357. When scored via video, inter-examiner agreement was 0.634, 0.620,0.702 and 0.678. Intra-examiner agreement for live presentation was 0.451 and 0.579, but increased for video scoring to 0.861 and 0.875. Conclusions Examiners assessing the KNB to evaluate yoked prism lenses for nonverbal or minimally verbal ASD children consistently showed good inter-examiner and intra-examiner agreement when evaluating by video, but not by live presentation. Clinicians may improve reliability by incorporating scoring of the KNB by video presentation.
{"title":"Prescribing Yoked Prism in Patients with Autism Spectrum Disorder (ASD): A Study of Inter- and Intraexaminer Agreement Using the Kaplan Nonverbal Battery","authors":"Rachel Coulter, A. Bade, E. Jenewein, Y. Tea, L. Woodmansee, Alicia Andrade Groce, Cassandria Warr, Marina Abdalla","doi":"10.31707/vdr2019.5.2.p84","DOIUrl":"https://doi.org/10.31707/vdr2019.5.2.p84","url":null,"abstract":"Background\u0000Double-blind studies have reported improvements\u0000in posture, spatial awareness, and\u0000behavior in Autism Spectrum Disorder (ASD)\u0000individuals wearing yoked prism lenses.\u0000The Kaplan Nonverbal Battery (KNB) is a\u0000performance-based test used to evaluate\u0000yoked prism lenses. To date, only Kaplan has\u0000reported KNB results. This study investigates\u0000inter-examiner and intra-examiner agreement\u0000obtained in scoring the KNB in nonverbal/\u0000minimally verbal ASD subjects.\u0000\u0000Methods\u0000Ten nonverbal/minimally verbal ASD subjects\u0000between 9 and 17 years old enrolled and\u0000completed an eye examination. All subjects\u0000adapted to spectacles, wearing refractive\u0000correction for four weeks. Subjects completed\u0000two study visits that were videotaped. At each\u0000visit, subjects completed the KNB wearing\u0000habitual spectacle correction and then wearing\u0000yoked prism lenses of five-prism diopters base\u0000up or down. Two examiners scored the KNB\u0000live and two other examiners scored the KNB\u0000via videorecording. Examiners were masked\u0000to the base direction of the yoked prism\u0000lenses and to the other examiners’ responses.\u0000Agreement between and within examiners\u0000was computed using the weighted version of\u0000Cohen’s kappa.\u0000\u0000Results\u0000Nine subjects completed both study visits. Both\u0000inter-examiner and intra-examiner agreement\u0000were markedly better when examiners scored\u0000via video. When scored by live presentation,\u0000inter-examiner agreement by the weighted\u0000Cohen’s kappa coefficient was 0.674, 0.364,\u00000.726 and 0.357. When scored via video,\u0000inter-examiner agreement was 0.634, 0.620,0.702 and 0.678. Intra-examiner agreement\u0000for live presentation was 0.451 and 0.579, but\u0000increased for video scoring to 0.861 and 0.875.\u0000\u0000Conclusions\u0000Examiners assessing the KNB to evaluate\u0000yoked prism lenses for nonverbal or minimally\u0000verbal ASD children consistently showed good\u0000inter-examiner and intra-examiner agreement\u0000when evaluating by video, but not by live\u0000presentation. Clinicians may improve reliability\u0000by incorporating scoring of the KNB by video\u0000presentation.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88612009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-28DOI: 10.31707/vdr2019.5.1.p19
A range of visual deficits and related visual symptoms are common in those afflicted with mild traumatic brain injury (mTBI/concussion). Several basic neuro-optometric, diagnostic test protocols have been proposed over the past decade. However, none have specifically addressed and focused upon an advanced level of care. Thus, a comprehensive set of advanced, diagnostic vision tests of a sensory and motor nature is proposed, with all having a clinical and scientific rationale. These tests have been used by the authors for many years, with good success and providing important clinical insights into this population.
{"title":"Advanced Neuro-Optometric Diagnostic Tests for Mild Traumatic Brain Injury/Concussion: A Narrative Review, Proposed Techniques and Protocols","authors":"","doi":"10.31707/vdr2019.5.1.p19","DOIUrl":"https://doi.org/10.31707/vdr2019.5.1.p19","url":null,"abstract":"A range of visual deficits and related visual symptoms are common in those afflicted with\u0000mild traumatic brain injury (mTBI/concussion). Several basic neuro-optometric, diagnostic\u0000test protocols have been proposed over the past decade. However, none have specifically addressed and focused upon an advanced level of care. Thus, a comprehensive set of advanced, diagnostic vision tests of a sensory and motor nature is proposed, with all having a clinical and scientific rationale. These tests have been used by the authors for many years, with good success and providing important clinical insights into this population.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87282652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-28DOI: 10.31707/vdr2019.5.2.p113
Background Suppression is associated with binocular vision conditions such as amblyopia and strabismus. Commercial methods of testing fusion often only measure central fusion or suppression at near. The purpose of this pilot study was to assess a new iPad picture fusion test that assesses foveal and central fusion at near. Methods Participants aged 5 years and older presenting for eye examination at The Ohio State University College of Optometry were enrolled. Results from visual acuity, dry and wet refraction/retinoscopy, stereopsis and cover testing were recorded from the patient chart. The iPad picture fusion test, Worth four-dot, Worth type test with foveal letter targets, and Polarized four-dot were performed by one examiner in a randomized order at 40 cm. Testing was repeated with the anaglyphic filters reversed. Crosstabulation and McNemar chi-square analysis were used to compare the results between fusion testing devices. Results Of the fifty participants (mean age = 17.5), twelve reported suppression and one reported diplopia. Testability was excellent for all tests (98% to 100%). There were no significant differences between tests in reported results (P ≥ 0.22 for all comparisons). No difference in reported fusion or suppression status was observed with change in orientation of the anaglyphic filters. Six participants reported foveal suppression alone at near which was not identified with Worth four-dot at near. Conclusion The iPad picture fusion test provided excellent testability and agreement with commonly used tests of fusion and allowed testing of both central and foveal fusion at near. Nearly half (46%) of participants with suppression reported foveal suppression, supporting the importance of testing for foveal suppression.
{"title":"Evaluation of a New Clinical Test of Fusion Status: A Pilot Study","authors":"","doi":"10.31707/vdr2019.5.2.p113","DOIUrl":"https://doi.org/10.31707/vdr2019.5.2.p113","url":null,"abstract":"Background\u0000Suppression is associated with binocular\u0000vision\u0000conditions such as amblyopia and strabismus.\u0000Commercial\u0000methods of testing fusion often\u0000only measure central fusion or suppression\u0000at near. The purpose of this pilot study was\u0000to assess a new iPad picture fusion test that\u0000assesses foveal and central fusion at near.\u0000\u0000Methods\u0000Participants aged 5 years and older presenting\u0000for eye examination at The Ohio State University\u0000College of Optometry were enrolled. Results\u0000from visual acuity, dry and wet refraction/retinoscopy, stereopsis and cover testing were\u0000recorded from the patient chart. The iPad\u0000picture fusion test, Worth four-dot, Worth type\u0000test with foveal letter targets, and Polarized\u0000four-dot were performed by one examiner\u0000in a randomized order at 40 cm. Testing was\u0000repeated with the anaglyphic filters reversed.\u0000Crosstabulation and McNemar chi-square\u0000analysis were used to compare the results\u0000between fusion testing devices.\u0000\u0000Results\u0000Of the fifty participants (mean age = 17.5),\u0000twelve reported suppression and one reported\u0000diplopia. Testability was excellent for all tests\u0000(98% to 100%). There were no significant\u0000differences between tests in reported results\u0000(P ≥ 0.22 for all comparisons). No difference\u0000in reported fusion or suppression status was\u0000observed with change in orientation of the\u0000anaglyphic filters. Six participants reported\u0000foveal suppression alone at near which was\u0000not identified with Worth four-dot at near.\u0000\u0000Conclusion\u0000The iPad picture fusion test provided excellent\u0000testability and agreement with commonly\u0000used tests of fusion and allowed testing of\u0000both central and foveal fusion at near. Nearly\u0000half (46%) of participants with suppression\u0000reported foveal suppression, supporting the\u0000importance of testing for foveal suppression.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89983313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-28DOI: 10.31707/vdr2019.5.2.p100
Background Unilateral functional amblyopia due to anisometropia is a common cause of vision loss in children. There has been a significant amount of research recently to determine the most effective management strategies for such cases, and it is important for clinicians to determine how to apply these findings clinically. Case Report A 6-year-old female presented for her first comprehensive eye exam after failing a school vision screening. She was diagnosed with significant anisometropia with anisometropic amblyopia in her left eye. She was treated with spectacle correction initially, and was eventuallyfit with soft contact lenses to achieve optimal vision and binocularity. Part-time occlusion therapy was also initiated, which was modified throughout the treatment period based on clinical findings. She was also treated with 19 sessions of office-based vision therapy in order to maximize the success of amblyopia treatment. At the completion of the treatment, this patient showed significant improvement in her visual acuity and other non-acuity factors, including contrast sensitivity and binocularity. Conclusions The successful treatment of this patient with anisometropic amblyopia was achieved by the combination of active vision therapy with evidence-based management strategies, consisting of optical correction and occlusion therapy
{"title":"Management of Anisometropic Amblyopia: A Case Report and Brief Review","authors":"","doi":"10.31707/vdr2019.5.2.p100","DOIUrl":"https://doi.org/10.31707/vdr2019.5.2.p100","url":null,"abstract":"Background\u0000Unilateral functional amblyopia due\u0000to anisometropia is a common cause\u0000of vision loss in children. There has been a\u0000significant amount of research recently to\u0000determine the most effective management\u0000strategies for such cases, and it is important\u0000for clinicians to determine how to apply these\u0000findings clinically.\u0000\u0000Case Report\u0000A 6-year-old female presented for her first\u0000comprehensive eye exam after failing a school\u0000vision screening. She was diagnosed with\u0000significant anisometropia with anisometropic\u0000amblyopia in her left eye. She was treated with\u0000spectacle correction initially, and was eventuallyfit with soft contact lenses to achieve optimal\u0000vision and binocularity. Part-time occlusion\u0000therapy was also initiated, which was modified\u0000throughout the treatment period based on\u0000clinical findings. She was also treated with\u000019 sessions of office-based vision therapy in\u0000order to maximize the success of amblyopia\u0000treatment. At the completion of the treatment,\u0000this patient showed significant improvement in\u0000her visual acuity and other non-acuity factors,\u0000including contrast sensitivity and binocularity.\u0000\u0000Conclusions\u0000The successful treatment of this patient with\u0000anisometropic amblyopia was achieved by\u0000the combination of active vision therapy with\u0000evidence-based management strategies,\u0000consisting of optical correction and occlusion\u0000therapy","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82271763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-28DOI: 10.31707/vdr2019.5.2.p75
Visual snow syndrome (VSS) is a relatively new diagnosis in optometry and in medicine. VSS represents a constellation of visual and non-visual problems, with the hallmark symptom being the perception of visual snow (VS) appearing in a single plane in front of and throughout the visual field. Individuals with VS describe seeing “snow”, dots, pixelated fuzz, bubbles, and “static” as found on a poorly-tuned television. In this paper, the evolving area of VSS is briefly reviewed, a VSS symptom survey is proposed, several cases and related information are presented, and current neuro-optometric therapeutic interventions are discussed.
{"title":"Visual Snow Syndrome (VSS): An Evolving Neuro-Optometric Clinical Perspective","authors":"","doi":"10.31707/vdr2019.5.2.p75","DOIUrl":"https://doi.org/10.31707/vdr2019.5.2.p75","url":null,"abstract":"Visual snow syndrome (VSS) is a relatively new diagnosis in optometry and in medicine. VSS represents a constellation of visual and non-visual problems, with the hallmark symptom being the perception of visual snow (VS) appearing in a single plane in front of and throughout the visual field. Individuals with VS describe seeing “snow”, dots, pixelated fuzz, bubbles, and “static” as found on a poorly-tuned television. In this paper, the evolving area of VSS is briefly reviewed, a VSS symptom survey is proposed, several cases and related information are presented, and current neuro-optometric therapeutic interventions are discussed.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90584032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-28DOI: 10.31707/vdr2019.5.2.p130
Orlando Monteiro da Silva, Teresa da Silva
The proprioceptive system has an extensive influence on the maintenance of human health. When the proprioceptive system is dysfunctional, the central nervous system does not recognize the correct status of tonicity of the muscles at rest or in movement, does not integrate correctly the information that comes from sensory receptors, and has difficulty in modulating multisensorial integration, with consequences in motor behavior and cognitive functions. This results in a wide range of proprioceptive abnormalities which are clinically related, are treated together, and are termed as Postural Deficiency Syndrome (PDS) or more recently Proprioceptive Dysfunction Syndrome. The author has personally observed more than 40,000 patients suffering from this condition during the last 40 years and devised an active prism therapeutic protocol that is based on the knowledge that small modifications of the muscular tonus of the oculomotor muscles can change the tonus of the axial paravertebral muscles. This paper describes PDS diagnosis and provides explanation of the updated active prism protocol aimed toward vision professionals.
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