Pub Date : 2019-03-29DOI: 10.31707/vdr2019.5.1.p31
J. Richman, Lieutenant Stephen
Background Neuropsychological tests have been used for years to determine impairments in cognitive and motor functions. There have been increases in impairment related to the abuse of alcohol and/or drugs related to driving. Recently, there has been an increased use of the Smartphone/Tablet applications for neurocognitive impairment testing. The DRUID® test is intended to identify and measure impairment from alcohol and various drugs by measuring changes in divided attention, decision making, reaction time, motor tracking, and balance movements control. We investigated the application of The DRUID® test as a potential rapid screening for cognitive and psychomotor impairment as a function of specific levels of alcohol that are known to have an effect on driving and job performance. Methods There were 48 volunteer drinkers, (Mean age 30[5.36])19 females -29 males who were administered a two minute DRUID® test pre and post drinking alcohol in a controlled dosage setting. Breath testing for alcohol was performed confirming absence of alcohol (Pre DRUDI®) and the when dosing exceeded the legal intoxication level for alcohol in Massachusetts (Blood Alcohol Content BAC 0.08%). Results DRUID® post drinking scores were significantly higher (worse) than DRUID® pre drinking. Higher scores on the BAC and DRUID® correspond to higher intoxication and associated impairment. There were no significant differences by gender for any of the central variables. A repeated measures t-test comparing DRUID® pre and post alcohol BAC scores revealed a highly significant (t(47) = 34.5, p < .0001), difference in pre- and post DRUID® scores (t(47) = 8.68, p < .0001). Conclusions The DRUID® test is a compelling and useful Smartphone/Tablet based candidate as a rapid screening test for identifying cognitive and psychomotor impairment associated with the intoxication level of alcohol and effects on driving.
多年来，神经心理学测试一直被用来确定认知和运动功能的损伤。与驾驶相关的酒精和/或药物滥用有关的损害有所增加。最近，越来越多的人使用智能手机/平板电脑应用程序进行神经认知障碍测试。DRUID®测试旨在通过测量分散注意力、决策、反应时间、运动跟踪和平衡运动控制的变化来识别和测量酒精和各种药物的损害。我们研究了DRUID®测试的应用，作为认知和精神运动障碍的潜在快速筛查，作为特定酒精水平的功能，已知对驾驶和工作表现有影响。方法48名饮酒者志愿者(平均年龄30岁[5.36])，19名女性-29名男性，在控制剂量的情况下，在饮酒前后进行2分钟的DRUID®测试。进行酒精呼气测试，确认没有酒精(Pre DRUDI®)，以及当剂量超过马萨诸塞州酒精的法定中毒水平(血液酒精含量BAC 0.08%)时。结果德鲁伊®饮酒后评分明显高于(低于)饮酒前评分。BAC和DRUID的分数越高，中毒和相关损伤就越严重。任何中心变量的性别差异都不显著。重复测量t检验比较DRUID®前后酒精BAC评分显示高度显著(t(47) = 34.5, p < 0.0001)，德鲁id®前后评分差异(t(47) = 8.68, p < 0.0001)。DRUID®测试是一种令人信服且有用的基于智能手机/平板电脑的候选快速筛选测试，用于识别与酒精中毒水平和驾驶影响相关的认知和精神运动障碍。
{"title":"An Investigation of the Druid® Smartphone/Tablet App as a Rapid Screening Assessment for Cognitive and Psychomotor Impairment Associated with Alcohol Intoxication","authors":"J. Richman, Lieutenant Stephen","doi":"10.31707/vdr2019.5.1.p31","DOIUrl":"https://doi.org/10.31707/vdr2019.5.1.p31","url":null,"abstract":"Background\u0000Neuropsychological tests have been used for years to determine impairments in cognitive and motor functions. There have been increases in impairment related to the abuse of alcohol and/or drugs related to driving. Recently, there has been an increased use of the Smartphone/Tablet applications for neurocognitive impairment testing. The DRUID® test is intended to identify and measure impairment from alcohol and various drugs by measuring changes in divided attention, decision making, reaction time, motor tracking, and balance movements control.\u0000 \u0000We investigated the application of The DRUID® test as a potential rapid screening for\u0000cognitive and psychomotor impairment as a function of specific levels of alcohol that are known to have an effect on driving and job performance.\u0000\u0000Methods\u0000There were 48 volunteer drinkers, (Mean age 30[5.36])19 females -29 males who were\u0000administered a two minute DRUID® test pre and post drinking alcohol in a controlled\u0000dosage setting. Breath testing for alcohol was performed confirming absence of alcohol\u0000(Pre DRUDI®) and the when dosing exceeded the legal intoxication level for alcohol in\u0000Massachusetts (Blood Alcohol Content BAC 0.08%).\u0000\u0000Results\u0000DRUID® post drinking scores were significantly higher (worse) than DRUID® pre drinking. Higher scores on the BAC and DRUID® correspond to higher intoxication\u0000and associated impairment. There were no significant differences by gender for any of the central variables. A repeated measures t-test comparing DRUID® pre and post alcohol BAC scores revealed a highly significant (t(47) = 34.5, p < .0001), difference in pre- and post DRUID® scores (t(47) = 8.68, p < .0001).\u0000\u0000Conclusions \u0000The DRUID® test is a compelling and useful Smartphone/Tablet based candidate as\u0000a rapid screening test for identifying cognitive and psychomotor impairment associated with the intoxication level of alcohol and effects on driving.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76144431","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 : 2019-03-29DOI: 10.31707/vdr2019.5.1.p43
D. Ratra, Archayeeta Rakshit, V. Ratra
Background Teleophthalmology is widely used for screening and diagnosis of many eye disorders. But its role in low vision rehabilitation is unexplored. The purpose of this study was to explore the feasibility of teleophthalmology for visual rehabilitation. Methods We prospectively enrolled 15 patients (age range 12-30 years, mean 16±3.2 years) with heredomacular degeneration with reduced central vision but healthy paracentral retina. We used visual stimulation and biofeedback with video game play. After the baseline investigations, the patients were given a compact disc with the video game and were trained to play the game. Subsequently, they did 40 hours of the visual training at home which was monitored using teleophthalmology by us at our tertiary institute. We used video chat and screen sharing software to guide the patients and monitor compliance. The primary outcome was feasibility of monitoring visual training remotely and secondary outcome was improvement in visual function. Results Seven patients returned for follow up after completing the training. The visual acuity improved from 0.74±0.29 to 0.66±0.32 logMAR (p=0.043). There was significant improvement in contrast sensitivity (p=0.023) and fixation stability (p=0.018). The vision related quality of life questionnaire showed improved scores. The ease of communication, patient comfort were high. The office visits were limited to two. Conclusions Our study showed preliminary evidence of benefit of teleophthalmology in visual rehabilitation and monitoring. The reduced visits would likely promote compliance and reduce economic burden of the rehabilitatory training.
{"title":"Exploring the Role of Telemedicine in Low Vision Rehabilitation in Patients with Heredomacular Degeneration – A Novel Concept","authors":"D. Ratra, Archayeeta Rakshit, V. Ratra","doi":"10.31707/vdr2019.5.1.p43","DOIUrl":"https://doi.org/10.31707/vdr2019.5.1.p43","url":null,"abstract":"Background\u0000Teleophthalmology is widely used for screening and diagnosis of many eye disorders. But its role in low vision rehabilitation is unexplored. The purpose of this study was to explore the feasibility of teleophthalmology for visual rehabilitation.\u0000\u0000Methods\u0000We prospectively enrolled 15 patients (age range 12-30 years, mean 16±3.2 years) with\u0000heredomacular degeneration with reduced central vision but healthy paracentral retina.\u0000We used visual stimulation and biofeedback with video game play. After the baseline\u0000investigations, the patients were given a compact disc with the video game and were\u0000trained to play the game. Subsequently, they did 40 hours of the visual training at home\u0000which was monitored using teleophthalmology by us at our tertiary institute. We used video chat and screen sharing software to guide the patients and monitor compliance. The primary outcome was feasibility of monitoring visual training remotely and secondary outcome was improvement in visual function.\u0000\u0000Results\u0000Seven patients returned for follow up after completing the training. The visual acuity\u0000improved from 0.74±0.29 to 0.66±0.32 logMAR (p=0.043). There was significant improvement in contrast sensitivity (p=0.023) and fixation stability (p=0.018). The vision related quality of life questionnaire showed improved scores. The ease of communication, patient comfort were high. The office visits were limited to two.\u0000\u0000Conclusions \u0000Our study showed preliminary evidence of benefit of teleophthalmology in visual\u0000rehabilitation and monitoring. The reduced visits would likely promote compliance and\u0000reduce economic burden of the rehabilitatory training.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81416361","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 : 2019-01-01DOI: 10.31707/vdr2019.5.2.p119
Nancy Sorrell, S. Schmiedecke, Kara Tison
Background: Albinism refers to a group of hereditary conditions, present at birth, that are characterized by gene mutations resulting in hypopigmentation of the skin, hair, and ocular structures. There are two categories of albinism distinguished by the mode of inheritance as well as the body structures affected: Oculocutaneous Albinism and Ocular Albinism. Case Report A 10 year old Caucasian-Hispanic female was referred to the Low Vision Clinic withvision impairment secondary to albinism, a diagnosis confirmed by the Electrophysiology Department two years prior. Ancillary testing supporting albinism included Visual Evoked Potentials (VEPs) demonstrating abnormal optic nerve fiber decussation and optical coherence tomography (OCT) revealing foveal hypoplasia. Clinical findings consistent with albinism included strabismus with reduced stereopsis, mild but diffuse iris transillumination defects and blonde fundi. The patient had physical characteristics of fair skin, light brown hair, and had normal color vision, moderately reduced visual acuity, and absence of nystagmus, suggesting a mild phenotypic variation of albinism. At her low vision evaluation, the patient appreciated improvement in visual function with the following devices: a dome magnifier for magnification at near, a handheld telescope for magnification at distance, and a light grey tint to reduce photophobia indoors. Additional accommodations were recommended to the school system to employ while in the classroom setting. Conclusion: Clinicians should consider the diagnosis of albinism in patients with reduced vision even when they demonstrate mostly normal skin and ocular pigmentation. Clinical cases associated with a better acuity in albinism patients include some presence of stereoacuity, mild strabismus, absence of nystagmus and near normal levels of iris pigmentation, like the patient described in the case report. Despite the level of visual impairment, the standard of care for patients with decreased vision or visual symptoms should always be a low vision evaluation in order to maximize functional vision.
{"title":"A Phenotypically Variable Presentation of Albinism: A Case Report","authors":"Nancy Sorrell, S. Schmiedecke, Kara Tison","doi":"10.31707/vdr2019.5.2.p119","DOIUrl":"https://doi.org/10.31707/vdr2019.5.2.p119","url":null,"abstract":"Background: Albinism refers to a group of hereditary conditions, present at birth, that are characterized by gene mutations resulting in hypopigmentation of the skin, hair, and ocular structures. There are two categories of albinism distinguished by the mode of inheritance as well as the body structures affected: Oculocutaneous Albinism and Ocular Albinism. Case Report A 10 year old Caucasian-Hispanic female was referred to the Low Vision Clinic withvision impairment secondary to albinism, a diagnosis confirmed by the Electrophysiology Department two years prior. Ancillary testing supporting albinism included Visual Evoked Potentials (VEPs) demonstrating abnormal optic nerve fiber decussation and optical coherence tomography (OCT) revealing foveal hypoplasia. Clinical findings consistent with albinism included strabismus with reduced stereopsis, mild but diffuse iris transillumination defects and blonde fundi. The patient had physical characteristics of fair skin, light brown hair, and had normal color vision, moderately reduced visual acuity, and absence of nystagmus, suggesting a mild phenotypic variation of albinism. At her low vision evaluation, the patient appreciated improvement in visual function with the following devices: a dome magnifier for magnification at near, a handheld telescope for magnification at distance, and a light grey tint to reduce photophobia indoors. Additional accommodations were recommended to the school system to employ while in the classroom setting. Conclusion: Clinicians should consider the diagnosis of albinism in patients with reduced vision even when they demonstrate mostly normal skin and ocular pigmentation. Clinical cases associated with a better acuity in albinism patients include some presence of stereoacuity, mild strabismus, absence of nystagmus and near normal levels of iris pigmentation, like the patient described in the case report. Despite the level of visual impairment, the standard of care for patients with decreased vision or visual symptoms should always be a low vision evaluation in order to maximize functional vision.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81308867","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 : 2018-12-20DOI: 10.31707/vdr2018.4.4.p186
Background Coincidence-anticipation timing (CAT) responses require individuals to determine the time at which an approaching object will arrive at (time to collision) or pass by (time to passage) the observer and to then make a response coincident with this time. Previous studies suggest that under some conditions time to collision estimates are more accurate when binocular and monocular cues are combined. The purpose of this study was to compare binocular and monocular coincidence anticipation timing responses with the Bassin Anticipation Timer, a device for testing and training CAT responses. Methods: Useable data were obtained from 20 participants. Coincidence-anticipation timing responses were determined using a Bassin Anticipation Timer over a range of approaching stimulus linear velocities of 5 to 40mph. Participants stood to the left side of the Bassin Anticipation track. The track was below eye height. The participants’ task was to push a button to coincide with arrival of the approaching stimulus at a location immediately adjacent to the participant. CAT responses were made under three randomized conditions: binocular viewing, monocular dominant eye viewing, and monocular non-dominant eye viewing. Results: Signed (constant), unsigned (absolute), and variable (standard deviation) CAT response errors were determined and compared across viewing conditions at each stimulus velocity. There were no significant differences in CAT errors between the conditions at any stimulus velocity, although the differences in signed and unsigned errors approached significance at 40mph. Conclusions: The addition of binocular cues did not result in a reduction in coincidence anticipation timing response errors compared to the monocular viewing conditions. There were no differences in CAT response errors between the monocular dominant eye viewing and monocular non-dominant eye viewing conditions.
{"title":"Binocular and Monocular Coincidence-Anticipation Timing Responses","authors":"","doi":"10.31707/vdr2018.4.4.p186","DOIUrl":"https://doi.org/10.31707/vdr2018.4.4.p186","url":null,"abstract":"Background\u0000Coincidence-anticipation timing (CAT) responses require individuals to determine the time at which an approaching object will arrive at (time to collision) or pass by (time to passage) the observer and to then make a response coincident with this time. Previous studies suggest that under some conditions time to collision estimates are more accurate when binocular and monocular cues are combined. The purpose of this study was to compare binocular and monocular coincidence anticipation timing responses with the Bassin Anticipation Timer, a device for testing and training CAT responses.\u0000\u0000Methods: Useable data were obtained from 20 participants. Coincidence-anticipation timing responses were determined using a Bassin Anticipation Timer over a range of approaching stimulus linear velocities of 5 to 40mph. Participants stood to the left side of the Bassin Anticipation track. The track was below eye height. The participants’ task was to push a button to coincide with arrival of the approaching stimulus at a location immediately adjacent to the participant. CAT responses were made under three randomized conditions: binocular viewing, monocular dominant eye viewing, and\u0000monocular non-dominant eye viewing.\u0000\u0000Results: Signed (constant), unsigned (absolute), and variable (standard deviation) CAT response errors were determined and compared across viewing conditions at each\u0000stimulus velocity. There were no significant differences in CAT errors between the\u0000conditions at any stimulus velocity, although the differences in signed and unsigned\u0000errors approached significance at 40mph. \u0000\u0000Conclusions: The addition of binocular cues did not result in a reduction in coincidence anticipation timing response errors compared to the monocular viewing conditions. There were no differences in CAT response errors between the monocular dominant eye viewing and monocular non-dominant eye viewing conditions.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81483665","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 : 2018-09-24DOI: 10.31707/vdr2018.4.3.p128
Executive Summary “Screen time” has become a topic of discussion amongst the scientific and medical communities in recent years with the marked increase of electronic devices in American homes. Electronic devices have not only become commonplace for the average adult both in the workplace and recreation, but they have also become a staple in the lives of children in communication with friends/family, education, and recreation. In optometry, this has led to many questions pertaining to the manner in which these devices affect a child’s development of refractive error, attention and learning skills, and ocular health. This review article summarizes some of the most recent research in the area of screen time as it pertains to the practicing optometrist examining children, offering recommendations on how to manage these patients and educate their parents on this current issue.
{"title":"Screen Time in the Pediatric Population: A Review of Its Effects on Refractive Error, Attention and Learning, and Ocular Health","authors":"","doi":"10.31707/vdr2018.4.3.p128","DOIUrl":"https://doi.org/10.31707/vdr2018.4.3.p128","url":null,"abstract":"Executive Summary\u0000“Screen time” has become a topic of discussion amongst the scientific and medical\u0000communities in recent years with the marked increase of electronic devices in American\u0000homes. Electronic devices have not only become commonplace for the average adult\u0000both in the workplace and recreation, but they have also become a staple in the lives of\u0000children in communication with friends/family, education, and recreation. In optometry, this has led to many questions pertaining to the manner in which these devices affect a child’s development of refractive error, attention and learning skills, and ocular health. This review article summarizes some of the most recent research in the area of screen time as it pertains to the practicing optometrist examining children, offering recommendations on how to manage these patients and educate their parents on this current issue.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"66 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72497142","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 : 2018-09-24DOI: 10.31707/vdr2018.4.3.p121
Background: A significant part of successful athletic performance is the use of peripheral vision. A divide visual attention task with a central and peripheral target was used to assess athletes with and without a history of concussion. The research suggests that both groups had the same response accuracy in the task performance. The purpose of this research was to determine if peripheral visual attention is impacted in ice hockey players who have had a history of one or more self reported concussion. Methods: Orientation discrimination accuracy of a pair of Landolt type block “C” targets was measured using a divided covert attention task on 22 collegiate level men’s ice hockey players. Stimuli were presented simultaneously at central fixation and at one of 40 peripheral locations against a bright white background for two stimulus durations (150ms and 15ms). Block “C” targets were presented at one of 4 orientations (up, down, left and right) and randomized for central and peripheral locations. Results: Overall there was a statistically significant difference in the performance at 150ms and 15ms stimuli durations; athletes had a larger area of correct responses with the 150ms stimulus duration. Athletes performed better in the horizontal meridian compared to the vertical meridian for both stimulus durations. Conclusion: The divided visual attention test results for a cohort of university level men’s ice hockey players shows a decline in area of correct responses with shorter stimulus durations. There was no difference in response accuracy between those with a history of a concussion compared to those without a previous concussion.
{"title":"Divided Visual Attention Performance of Ice Hockey Players with History of Concussion","authors":"","doi":"10.31707/vdr2018.4.3.p121","DOIUrl":"https://doi.org/10.31707/vdr2018.4.3.p121","url":null,"abstract":"Background: A significant part of successful athletic performance is the use of peripheral vision. A divide visual attention task with a central and peripheral target was used to assess athletes with and without a history of concussion. The research suggests that both groups had the same response accuracy in the task performance. The purpose of this research was to determine if peripheral visual attention is impacted in ice hockey players who have had a history of one or more self reported concussion.\u0000\u0000Methods: Orientation discrimination accuracy of a pair of Landolt type block “C” targets was measured using a divided covert attention task on 22 collegiate level men’s ice hockey players. Stimuli were presented simultaneously at central fixation and at one of 40 peripheral locations against a bright white background for two stimulus durations (150ms and 15ms). Block “C” targets were presented at one of 4 orientations (up, down, left and right) and randomized for central and peripheral locations.\u0000\u0000Results: Overall there was a statistically significant difference in the performance at\u0000150ms and 15ms stimuli durations; athletes had a larger area of correct responses with the 150ms stimulus duration. Athletes performed better in the horizontal meridian compared to the vertical meridian for both stimulus durations.\u0000\u0000Conclusion: The divided visual attention test results for a cohort of university level men’s\u0000ice hockey players shows a decline in area of correct responses with shorter stimulus\u0000durations. There was no difference in response accuracy between those with a history of a concussion compared to those without a previous concussion.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72855472","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 : 2018-09-24DOI: 10.31707/vdr2018.4.3.p110
Primary Objectives: By extending the scope of knowledge of the primary care optometrist, the brain injury population will have expanded access to entry level neurooptometric care by optometric providers who have a basic understanding of their neurovisual problems, be able to provide some treatment and know when to refer to their colleagues who have advanced training in neuro-optometric rehabilitation.
{"title":"Providing Care of Mild Traumatic Brain Injury by the Family Practice/Primary Care Optometrist","authors":"","doi":"10.31707/vdr2018.4.3.p110","DOIUrl":"https://doi.org/10.31707/vdr2018.4.3.p110","url":null,"abstract":"Primary Objectives: By extending the scope of knowledge of the primary care optometrist, the brain injury population will have expanded access to entry level neurooptometric care by optometric providers who have a basic understanding of their neurovisual problems, be able to provide some treatment and know when to refer to their colleagues who have advanced training in neuro-optometric rehabilitation.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84996987","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 : 2018-06-27DOI: 10.31707/vdr2018.4.2.p87
Background: Binasal Occlusion (BNO) is a clinical technique used by many neurorehabilitative optometrists in patients with mild traumatic brain injury (mTBI) and increased visual motion sensitivity (VMS) or visual vertigo. BNO is a technique in which partial occluders are added to the spectacle lenses to suppress the abnormal peripheral visual motion information. This technique helps in reducing VMS symptoms (i.e., nausea, dizziness, balance difficulty, visual confusion). Case Report: A 44-year-old AA female presented for a routine eye exam with a history of mTBI approximately 33 years ago. She was suffering from severe dizziness for the last two years that was adversely impacting her ADLs. The dizziness occurred in all body positions and all environments throughout the day. She was diagnosed with vestibular hypofunction and had undergone vestibular therapy but reported little improvement. Neurological exam revealed dizziness with both OKN drum and hand movement, especially in the left visual field. BNO technique resulted in immediate relief of her dizziness symptoms. Conclusion: To our knowledge, this is the first case that illustrates how the BNO technique in isolation can be beneficial for patients with mTBI and vestibular hypofunction. It demonstrates the success that BNO has in filtering abnormal peripheral visual motion in these patients.
{"title":"Case Report: Management of a Patient with mTBI and Vestibular Hypofunction with the Binasal Occlusion Technique","authors":"","doi":"10.31707/vdr2018.4.2.p87","DOIUrl":"https://doi.org/10.31707/vdr2018.4.2.p87","url":null,"abstract":"Background: Binasal Occlusion (BNO) is a clinical technique used by many neurorehabilitative optometrists in patients with mild traumatic brain injury (mTBI) and\u0000increased visual motion sensitivity (VMS) or visual vertigo. BNO is a technique in which\u0000partial occluders are added to the spectacle lenses to suppress the abnormal peripheral visual motion information. This technique helps in reducing VMS symptoms (i.e., nausea, dizziness, balance difficulty, visual confusion). \u0000\u0000Case Report: A 44-year-old AA female presented for a routine eye exam with a history\u0000of mTBI approximately 33 years ago. She was suffering from severe dizziness for the last two years that was adversely impacting her ADLs. The dizziness occurred in all body positions and all environments throughout the day. She was diagnosed with vestibular hypofunction and had undergone vestibular therapy but reported little improvement. Neurological exam revealed dizziness with both OKN drum and hand movement, especially in the left visual field. BNO technique resulted in immediate relief of her dizziness symptoms. \u0000\u0000Conclusion: To our knowledge, this is the first case that illustrates how the BNO technique in isolation can be beneficial for patients with mTBI and vestibular hypofunction. It demonstrates the success that BNO has in filtering abnormal peripheral visual motion in these patients.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78582467","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 : 2018-06-27DOI: 10.31707/vdr2018.4.2.p78
Background: H.J. Haase developed a set of tests for measuring associated phoria and stereopsis using a variety of different targets for each. This study investigates the test-retest repeatability of the distance and near stereopsis tests for the MKH-Haase charts. Methods: MKH-Haase contour (Line Test) and randomdot (Steps Test) stereopsis tests were measured at distance and near for 34 symptomatic and 40 asymptomatic participants on two different sessions. The MKH-Haase protocol requires the stereoacuity to be measured twice within a session; once for crossed and once for uncrossed disparities. Results: Direct comparison within sessions did not reveal any significant differences in MKHHaase stereoacuity tests between symptomatic and asymptomatic groups; hence, the two groups were pooled for further analysis. The within and between-sessions repeatability of most MKH-Haase stereoacuity tests results was good at both distance and near. However, there were a few exceptions to this general finding. Crossed disparity thresholds were significantly lower than uncrossed disparities within the first session at distance for both Line and Steps tests. The differences between sessions for both disparities were not significant for all stereoacuity tests except the Steps test at distance. Conclusions: MKH-Haase stereoacuity charts are considered reliable tests for measuring local and global stereothreshold at both distance and near.
{"title":"Clinical Evaluation of the MKH-HAASE Stereoacuity Tests","authors":"","doi":"10.31707/vdr2018.4.2.p78","DOIUrl":"https://doi.org/10.31707/vdr2018.4.2.p78","url":null,"abstract":"Background: H.J. Haase developed a set of tests for measuring associated phoria and\u0000stereopsis using a variety of different targets for each. This study investigates the test-retest repeatability of the distance and near stereopsis tests for the MKH-Haase charts.\u0000\u0000Methods: MKH-Haase contour (Line Test) and randomdot (Steps Test) stereopsis\u0000tests were measured at distance and near for 34 symptomatic and 40 asymptomatic\u0000participants on two different sessions. The MKH-Haase protocol requires the stereoacuity to be measured twice within a session; once for crossed and once for uncrossed disparities. \u0000\u0000Results: Direct comparison within sessions did not reveal any significant differences in MKHHaase stereoacuity tests between symptomatic and asymptomatic groups; hence, the two groups were pooled for further analysis. The within and between-sessions repeatability of most MKH-Haase stereoacuity tests results was good at both distance and near. However, there were a few exceptions to this general finding. Crossed disparity thresholds were significantly lower than uncrossed disparities within the first session at distance for both Line and Steps tests. The differences between sessions for both disparities were not significant for all stereoacuity tests except the Steps test at distance.\u0000\u0000Conclusions: MKH-Haase stereoacuity charts are considered reliable tests for measuring local and global stereothreshold at both distance and near.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75059457","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 : 2018-01-01DOI: 10.31707/vdr2018.4.4.p157
K. Ciuffreda, B. Tannen, D. Ludlam
Vision problems are common in individuals with mild traumatic brain injury (mTBI)/concussion. However, a global conceptualization of the diagnostic process remains incomplete and practitioner dependent. Thus, a comprehensive diagnostic test battery is proposed to assist in the management of these patients. This battery includes a range of basic clinical tests of a sensory and motor nature, with all having a clinical and scientific rationale. These tests have been used by the authors for many years, with good success, and furthermore they have been found to be clinically useful and insightful.
{"title":"Basic Neuro-Optometric Diagnostic Tests for Mild Traumatic Brain Injury/Concussion: A Narrative Review, Perspective, Proposed Techniques and Protocols","authors":"K. Ciuffreda, B. Tannen, D. Ludlam","doi":"10.31707/vdr2018.4.4.p157","DOIUrl":"https://doi.org/10.31707/vdr2018.4.4.p157","url":null,"abstract":"Vision problems are common in individuals with mild traumatic brain injury (mTBI)/concussion. However, a global conceptualization of the diagnostic process remains incomplete and practitioner dependent. Thus, a comprehensive diagnostic test battery is proposed to assist in the management of these patients. This battery includes a range of basic clinical tests of a sensory and motor nature, with all having a clinical and scientific rationale. These tests have been used by the authors for many years, with good success, and furthermore they have been found to be clinically useful and insightful.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89256118","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}
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