Acuity Chart Research Articles

Vision Screening and Detection of Ocular Abnormalities in School Children by Teachers in Jordan.

To evaluate the accuracy of vision screening and detection of ocular abnormalities conducted by teachers in school children in Jordan compared with vision testing by optometrists and ocular disease identification by ophthalmologists. A non-random, purposive sampling strategy where 6-year-old and 15-year-old school children from three schools in Amman, Jordan were included. Twenty-two teachers were trained to conduct visual acuity screening using the 0.2 logMAR line of the distance visual acuity (DVA) chart at 10 feet and near visual acuity (NVA) chart at 16 inches, in addition to detecting ocular abnormalities. An optometrist assessed the visual acuity and conducted objective and subjective refraction, while an ophthalmologist examined the ocular health of all children. A total of 542 children (51% female) were included in the study, of which 47% were 6 years old and 53% were 15 years old. Teacher screening had sensitivities of 76.92% for DVA, 68% for NVA, and 37.50% for abnormality detection. The specificities of DVA, NVA, and ocular abnormalities were 98.22%, 98.48%, and 99.24%, respectively. The positive predictive value for DVA, NVA, and ocular abnormalities were 83.33%, 99.00%, and 60%, respectively. The negative predictive value for each procedure was 98.22% for DVA, 98.48% for NVA, and 98.12% for ocular abnormalities. Teachers were able to conduct vision screening with a high level of accuracy compared to the gold standard of testing by optometrists, which would be useful for the early detection and referral of refractive errors in school children. However, they were unable to detect ocular abnormalities compared with the gold standard for disease identification by ophthalmologists. Further training and monitoring, or different training approaches should be implemented to enable teachers to identify ocular abnormalities at acceptable levels.

Commentary on: MNREAD acuity charts in regional languages.

Commentary on: MNREAD acuity charts in regional languages.

Foveal crowding in children with developmental dyslexia.

Excessive crowding in the visual periphery has been demonstrated in children with developmental dyslexia (DD). However, less is known about crowding in the fovea, even though foveal crowding is at least equally important, as reading is mostly accomplished through foveal vision. Here we used a special set of digitstimuli (Pelli fonts) to measure foveal crowding in DD and DD + ADHD children, and compared it to that in TD (typically developing) and ADHD children. We also used the Chinese reading acuity charts (C-READ) to assess the maximum reading speed and reading acuity, along with tests to evaluate cognitive attributes including phonological awareness, rapid automatized naming, morphological awareness, and orthographic knowledge. The results indicate significantly stronger foveal crowding in the DD and DD + ADHD groups, as well as in the ADHD group, than in the TD group. Furthermore, the DD and DD + ADHD groups exhibited poorer maximum reading speed and reading acuity compared to the ADHD and TD groups.Within the two DD groups, theslower maximum reading speed and higher reading acuitycan be predicted bystronger foveal crowding. In addition, the DD and DD + ADHD groups performed the worst in four cognitive skills, with the DD group showing negative correlations between foveal crowding and performances across all these skills. Our findings thus move beyond previously well-documented peripheral crowding in dyslexia, and the easy administration of the Pelli-font-based crowding test may be useful for early diagnosis of developmental dyslexia in young children.

Prevalence, sociodemographic risk factors, and coverage of myopia correction among adolescent students in the central region of Portugal

BackgroundKnowing the prevalence of myopia at school age is essential to implement preventive measures and appropriate interventions, ensure access to vision care, promote a healthier educational environment and improve academic performance. The purpose of this study was to determine the prevalence of myopia and its associated sociodemographic risk factors, as well as to estimate the coverage of myopia correction among adolescents in center of Portugal.MethodsThis cross-sectional study evaluated 1115 adolescents from the 5th to the 9th year of school, with an average of 12.9 years (SD = 1.5) ranging from 10.0 to 18.0 years. Optometric evaluations were carried out in a school environment and consisted of the evaluation of distance visual acuity, assessed using a logarithmic visual acuity chart (ETDRS charts 1 and 2) at 4 m, and measured by refractive error with a pediatric autorefractometer (Plusoptix), by non-cycloplegic. Myopia was defined as spherical equivalent (SE ≤ -0.50 diopter (D)) and uncorrected visual acuity (UVA ≤ 95VAR). Adjusted logistic regression analysis was applied to investigate risk factors.ResultsWe found a myopia rate of 21.5% and a high myopia rate of 1.4%. Higher school level and attendance at urban schools were associated with myopia, but no association was found with age or sex. Only 34.6% of myopic adolescents use the best optical correction and 26.4% do not use any type of optical correction.ConclusionsData on the prevalence of refractive problems in Portugal are scarce and heterogeneous. This study, although regional, provides a valuable contribution with a clear and reproducible methodology, following international guidelines and filling gaps in the existing literature. The results show that the rate of myopia in this age group is similar to reports from other European studies. The high rate of adolescents with uncorrected or under-corrected myopia in Portugal is a problem that deserves attention.

Atypical mycobacterial keratitis: Clinical outcome in nonrefractive surgery cases.

To identify the predisposing factors, clinico-microbiological profiles, and treatment responses in patients with atypical mycobacterial keratitis. The study retrospectively analyzed patients who presented at a tertiary eyecare center in eastern India with atypical mycobacterial keratitis between 2008 and 2021. The diagnostic criteria included cases positive for acid-fast bacilli on Ziehl-Nielsen stain or culture. The antibiotic susceptibility pattern was observed, and treatment was initiated accordingly. Out of the 29 cases, ocular predisposing factors were present in 62.1% with an antecedent history of trauma, and vegetative matter was the most common risk factor. There was no predisposing association with systemic conditions in any case. A long lag time was observed between the onset of corneal infection and presentation in 79.3% of cases, with the average time being 43.7 days. Clinical signs mimicked fungal keratitis in most cases. Typical cracked windshield appearance was only observed in two cases. Two patients presented with clinical pictures like peripheral ulcerative keratitis. Topical amikacin was used as treatment in 28 cases. Based on disk diffusion assay, 28 (96.5%) isolates were sensitive to amikacin. Twelve (41.3%) were sensitive to vancomycin, six (20.6%) to gatifloxacin, six (20.6%) to ciprofloxacin, and four (13.7%) to moxifloxacin. Twelve participants showed good final visual acuity posttreatment, which improved to over two lines of Snellen's visual acuity chart (44.5%). Atypical mycobacteria keratitis may not present with classically described clinical features. The duration of presentation, clinical presentation, special microbiological stains, targeted therapy, and antibiotic susceptibility patterns are the key to successfully managing these intractable infections and obtaining favorable outcomes.

Prevalence and associated factors of myopia among adolescents aged 12–15 in Shandong Province, China: a cross-sectional study

Myopia is a growing concern worldwide, especially among adolescents. This study aimed to investigate the prevalence and associated factors of myopia in adolescents aged 12–15 in Shandong Province, China. This cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and involved stratified random cluster sampling of 128,678 students from 186 middle schools across 17 cities in Shandong Province. Data collection was conducted from March to April 2024. We excluded students with organic eye diseases, abnormal binocular vision functions, or a history of eye injuries or surgeries. Myopia was assessed using the standard logarithmic visual acuity chart and autorefractor without inducing ciliary muscle paralysis. A comprehensive questionnaire survey was conducted to gather demographic characteristics and daily life behaviors. With the chi-squared test for univariable analysis and multivariable logistic regression for identifying significant factors. This study included 126,375 participants, with a gender distribution of 51.02% male and 48.98% female. The overall prevalence of myopia was 71.34%. Higher prevalence was observed in girls (72.26%) compared to boys (70.45%), and the prevalence increased with age, peaking at 73.12% in 15-year-olds. Urban residents had a higher prevalence (71.86%) than rural (70.39%). Factors such as increased frequency of eye usage while lying down or leaning forward, frequent use of eyes while walking or riding in a car, prolonged screen time, and extended homework duration were associated with higher odds of developing myopia. Conversely, higher frequency of outdoor exercise, maintaining proper posture during reading and writing, greater distance from eyes to screen, and longer sleep duration were associated with lower odds. Additionally, female gender, older age, urban residence, and parental history of myopia increased the risk. The high prevalence of myopia among adolescents in Shandong Province was influenced by a combination of demographic, behavioral, and environmental factors. The study highlighted the importance of lifestyle modifications, such as increasing outdoor activities and maintaining proper visual habits, limiting the duration of screen exposure and homework sessions, and extending sleep duration, to mitigate the risk of developing myopia. These findings underscored the need for targeted public health interventions and educational campaigns to address this significant public health issue.

Dynamic & static visual acuity chart – past, present & future: A brief review

Dynamic & static visual acuity chart – past, present & future: A brief review

Investigating the impact of asymmetric macular sensitivity on visual acuity chart reading in choroideremia.

Degeneration in choroideremia, unlike typical centripetal photoreceptor degenerations, is centred temporal to the fovea. Once the fovea is affected, the nasal visual field (temporal retina) is relatively spared, and the preferred retinal locus shifts temporally. Therefore, when reading left to right, only the right eye reads into a scotoma. We investigate how this unique property affects the ability to read an eye chart. Standard- and low-luminance visual acuity (VA) for right and left eyes were measured with the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart. Letters in each line were labelled by column position. The numbers of letter errors for each position across the whole chart were summed to produce total column error scores for each participant. Macular sensitivity was assessed using microperimetry. Central sensitivity asymmetry was determined by the temporal-versus-nasal central macular difference and subsequently correlated to a weighted ETDRS column error score. Healthy volunteers and participants with X-linked retinitis pigmentosa GTPase regulator associated retinitis pigmentosa (RPGR-RP) were used as controls. Thirty-nine choroideremia participants (median age 44.9 years [IQR 35.7-53.5]), 23 RPGR-RP participants (median age 30.8 years [IQR 26.5-40.5]) and 35 healthy controls (median age 23.8 years [IQR 20.3-29.0]) were examined. In choroideremia, standard VA in the right eye showed significantly greater ETDRS column errors on the temporal side compared with the nasal side (p = 0.002). This significantly correlated with greater asymmetry in temporal-versus-nasal central macular sensitivity (p = 0.04). No significant patterns in ETDRS column errors or central macular sensitivity were seen in the choroideremia left eyes, nor in RPGR-RP and control eyes. Difficulty in tracking across lines during ETDRS VA testing may cause excess errors independent of true VA. VA assessment with single-letter optotype systems may be more suitable, particularly for patients with choroideremia, and potentially other retinal diseases with asymmetric central macular sensitivity or large central scotomas including geographic atrophy.

Development and validation of the Thai version of MNREAD acuity charts.

To develop and validate MNREAD acuity charts in the Thai language (MNREAD-TH). In total, 180 Thai sentences were generated using words specific to the primary 1-3 students. Each sentence contained 60 characters divided into three lines with even left and right margins and was evaluated by instructors in the education program in Thai. The selected 118 sentences were tested in 20 adults and 20 children by measuring reading time and recording the errors. Sentences with extremely high or low mean reading speeds were excluded. The remaining sentences were selected for contributing to the MNREAD-TH charts. For validation, the charts were tested in another 20 normal-sighted adult groups. In total, 118 sentences were tested on 20 adults (range: 23-58 years) and 20 primary school students (age: 8-9 years). The mean (SD) reading speeds in adult and children's groups were 134.09 (12.45) and 71.33 (10.77) words/min (wpm), respectively. After removing the sentences that deviated by ±1 SD from the mean reading speed, repeatedly had difficulty words, and had low subjective scoring, 60 matched sentences between the groups were selected to develop three versions of the MNREAD-TH chart. The intraclass correlation coefficients between charts were 0.85 for reading acuity, 0.94 for maximum reading speed, and 0.79 for critical print size. The MNREAD-TH charts can be reliably used for evaluating reading performance in Thai people for both children and adults with either normal sight or low vision. These charts are standardized and helpful in clinical trials involving reading.

Validation of selected tablet apps for determining visual acuity

Purpose. The aim of the study is to investigate whether applications for mobile devices are suitable for the professional determination of visual acuity. Material and Methods. The best-corrected logMAR was determined in 25 healthy subjects (age: 25.7 ± 6.7; Vcc ≥ 1.0) using the Konan Acuity and the Snellen chart applications with letters (B) and with Landolt rings at 4 orientations (L) both without an additional lens (0) and with additional spherical lenses +0.50 D (0.5) or +1.00 D (1.0), and compared with the logMAR determined on the corresponding ETDRS charts. Furthermore, the best-corrected logMAR was investigated for 6 of the 25 participants on the tablet at three different screen brightnesses (80, 200 and 370 cd/m²). Results. For the Konan Acuity app, the following mean values and significant logMAR differences to the ETDRS charts were determined: B0: −0.20; ∆ = −0.03 (p = 0.045); B0.5: −0.13; ∆ = −0.04; (p < 0.001); B1.0: 0.06; ∆ = −0.08 (p < 0.001); L0: −0.20; ∆ = −0.06 (p < 0.001); L0.5: −0,13; ∆ = −0.09 (p < 0.001); L1.0: 0.08; ∆ = −0.11 (p < 0.001). For the Snellen chart app, the following mean values and significant logMAR differences to the ETDRS charts were determined: B0: −0.22; ∆ = −0.05 (p < 0.001); B0.5: −0.16; ∆ = −0.07 (p < 0.001); B1.0: 0.05; ∆ = −0.09 (p < 0.001); L0: −0.23; ∆ = −0.08 (p < 0.001); L0.5: −0.17; ∆ = −0.12 (p < 0.001); L1.0: 0.08; ∆ = −0.11 (p < 0.001). The median logMAR differences between the different screen brightnesses were 0.02 (80 – 200 cd/m²) and 0.00 (370 – 200 cd/m²). Conclusion. At ideal screen brightness, both applications show significant differences to the ETDRS charts. However, these can be regarded as tolerable in clinical practice, at least in young, healthy eyes. The measurements with deviating screen brightness show only minor differences. With the right app, tablets are suitable for determining visual acuity in everyday clinical practice, but are unsuitable for scientific or expert purposes. Keywords Visual acuity, ETDRS chart, Konan acuity chart, Snellen chart

Combination of 2 test methods, single-picture optotype visual acuity chart and spot™ vision screener, in the eye health screening program for 3-year-old children in Tokyo: A retrospective, observational study.

To evaluate the usefulness of the Tokyo Metropolitan Government's Eye Health Screening Program for 3-year-old children, which combines the Single-Picture Optotype Visual Acuity Chart (SPVAC) and Spot™ Vision Screener (SVS) tests. This was a retrospective, observational, matched study. Patients who underwent the eye health screening program and had abnormalities were classified into 3 groups according to the outcomes of the SPVAC (SPVAC-passed, SPVAC-P; SPVAC-failed, SPVAC-F) and SVS (SVS-passed, SVS-P; SVS-failed, SVS-F) tests as follows: SPVAC-P/SVS-F, SPVAC-F/SVS-P, and SPVAC-F/SVS-F. We evaluated the age at examination, SPVAC and SVS test success rates, and SVS refractive power. Additionally, the rates of refractive error, amblyopia, and strabismus were compared among the 3 groups. The SPVAC-P/SVS-F, SPVAC-F/SVS-P, and SPVAC-F/SVS-F groups comprised 158, 28, and 74 eyes, respectively. The mean age was 37.4 months. The success rates of the SPVAC and SVS tests were 69.8% and 96.2%, respectively. The mean SVS hyperopia value in the SPVAC-F/SVS-F group (2.71 ± 1.50 D) was significantly higher than that of the SPVAC-P/SVS-F group. The mean SVS astigmatism and myopia values were -2.21 diopter (D) ± 1.09 D and -3.40 ± 1.82 D, respectively; they did not differ significantly from that of the SPVAC-P/SVS-F group. Significant differences were observed in the refractive error, amblyopia, and strabismus rates among the 3 groups. Regarding disease determination, no significant difference was observed among participants who passed and failed the SPVAC test, regardless of the outcome of the other test. However, a significant difference was observed between those passing and failing the SVS tests. The SPVAC method used to screen 3-year-old children should be modified to commence at 42 months of age or be replaced with a single Landolt C test. The SVS test is useful for screening younger patients. Furthermore, the SVS test showed that the degree of hyperopia was higher in patients who did not pass the SPVAC test.

Age and Gender Strongly Influence Visual Impairment in Schoolchildren

Background: Blurred vision caused by refractive errors, which result from an imbalance between the axial length and optical power of the eye, is prevalent worldwide. This condition, if undiagnosed in school-aged children, can significantly affect learning and development. Specific background: In Basra City, the prevalence of refractive errors and their impact on students' academic performance remains underexplored. Knowledge gap: There is limited data on the correlation between visual acuity and academic levels in elementary school pupils in this region, especially concerning demographic factors such as age and gender. Aims: This study aimed to determine the prevalence of visual impairment (VI), evaluate the visual acuity of elementary school pupils, and describe the characteristics of visually impaired students. Additionally, it sought to assess the relationship between visual acuity, age, gender, and academic performance. Results: A cross-sectional study was conducted on 200 students from Basra primary schools using a Snellen visual acuity chart. The results revealed that 24% had poor grades, 37% had moderate grades, and 39% had good grades. No significant relationship was found between visual acuity and academic performance, but a strong correlation was observed between visual acuity and both age and gender. Novelty: The study emphasizes the need for early detection of refractive errors in elementary school students and the significant correlation between visual acuity and demographic factors, especially age and gender. Implications: These findings suggest the need for regular vision screenings in schools to ensure early intervention and reduce the long-term impact of visual impairments on children’s educational and social development. Highlights: Prevalence: High rates of visual impairment found among Basra elementary students. Correlation: Visual acuity strongly linked to age and gender, not academic performance. Recommendation: School vision screenings are vital for early detection and intervention. Keywords: Refractive errors, Visual acuity, Elementary students, Basra City, Vision screening

Self-assessment of Visual Acuity Using a Smartphone Application

Purpose: We evaluated the accuracy and usefulness of self-assessment of visual acuity (VA) using a smartphone application for Korean users and explored its potential application in screening eye diseases.Methods: In total, 52 participants aged ≥ 20 years were included in the study. Of these participants, 31 used Jin Yong-Han’s VA chart and the smartphone application to measure their distant visual acuity (DVA), whereas 21 used Han Chun-Seok’s near visual acuity chart and the application to measure their near visual acuity (NVA). The results and time required for VA measurement using both methods were compared. VA was converted to logarithm of the minimum angle of resolution (logMAR) for analysis. The voice recognition rate of the application for numbers 2-9 was assessed.Results: The mean NVA was 0.29 ± 0.28 using Han’s chart and 0.30 ± 0.43 using the application with no significant difference (<i>p</i> = 1.00). The mean DVA was 0.19 ± 5.89 using Jin's chart and 0.20 ± 0.27 using the application with no significant difference (<i>p</i> = 0.19). The average time spent for measuring NVA and DVA was 19 seconds (s) using Han’s and Jin's charts, whereas it was 42 and 38 s for measuring NVA and DVA using the application. The voice recognition rate of the application was 87% on average for numbers 2-9, with the highest rate for number 7 (79%) and the lowest rate for number 4 (91%).Conclusions: Self-assessment of VA using a smartphone application exhibited similar results to conventional VA measurement methods. Although the measurement time varied, DVA and NVA could be measured at home using a smartphone, and would be particularly useful for those who have difficulty visiting a hospital.

Comparative study between JAWS® And NVDA® in academic performance of students with visual impairment

Assistive technology (AT) plays a significant role in improving academic activities of visually impaired students. Through these ATs, visually impaired students can be empowered to engage actively in academic activities. To investigate the impact of JAWS® (job access with speech) and NVDA® (nonvisual desktop access) on the academic performance of visually impaired students. This study employed a prospective analytical design. Age-matched groups of severely visually impaired students were enrolled and divided into two groups: Group A ( N = 25) received NVDA® and Group B ( N = 25) received JAWS®. The MNREAD acuity chart was used to measure the reading acuity, maximum reading speed, and critical print size. In addition, a self-designed questionnaire was employed to gather qualitative data on the features of the software and the students’ experiences while using it. Statistical Package for Social Science (SPSS) was used for data tabulation and analysis. An independent samples t-test was conducted to analyze the differences between variables. Furthermore, a qualitative assessment was performed using Pearson’s chi-square association test to determine the association between software usage and student experience. Statistical significance was set at p < .05. The results revealed that NVDA® exhibited better outcomes than JAWS® in terms of improved academic activity among visually impaired students. These findings contribute to the existing literature on AT and underscore the potential of NVDA® in supporting the educational experiences of visually impaired students. Use of screen reader software not only enhanced the reading and learning experience but also promoted independence in the classroom. NVDA is the superior choice for several reasons. It caters to the individual needs of students, effectively supports their learning processes, and demonstrates a high level of appreciation among the users.

Evaluation of Keratoconus Patients Refractive Status Before and after Corneal Collagen Cross-linking

Background: Corneal Collagen Cross Linking (CXL) incorporated with riboflavin solution activated by UV (Ultraviolet) irradiation is a modern promising treatment protocol for keratoconus. Evaluation of the clinical effect of CXL treatment on keratoconus patients was the aim of this study. Methods: This Quasi Experimental (before-and-after) study was comprised with 50 patients, having progressive keratoconus (progression was documented by Corneal Topography), reported to Cornea Clinic, CMH Dhaka, from February 2022 to January 2023. Before and after the CXL procedure; un-corrected and best-corrected visual acuity of study population was documented using Snellen visual acuity chart. Auto-refractometry readings were also noted. Results: Among the 50 study subjects; 26 (52%) were men and 24 (48%) were female, age was 24.14 ± 5.07 (mean+SD) years and age range was 18-35 years. Mean preoperative spherical power was −1.84 ± 0.82 Diopter (D) and mean cylindrical power was −3.66 ± 0.97 D. Postoperatively, mean spherical power was found −1.15 ± 0.55 D and mean cylindrical power was −2.87 ± 0.99 D. After CXL treatment; significant vision improvement found in 15 (30%) patients (p<0.05). Conclusion: Despite strengthening the corneal stromal collagen bond and halting the keratoconus progression, CXL treatment stabilize the refractive status of keratoconus patient and also in some extent, it improves vision. Bangladesh Armed Forces Med J Vol 56 No (2) December 2023, pp 45-50

Omnidirectional Virtual Visual Acuity: A User-Centric Visual Clarity Metric for Virtual Reality Head-Mounted Displays and Environments.

Users' perceived image quality of virtual reality head-mounted displays (VR HMDs) is determined by multiple factors, including the HMD's structure, optical system, display and render resolution, and users' visual acuity (VA). Existing metrics such as pixels per degree (PPD) have limitations that prevent accurate comparison of different VR HMDs. One of the main limitations is that not all VR HMD manufacturers released the official PPD or details of their HMDs' optical systems. Without these details, developers and users cannot know the precise PPD or calculate it for a given HMD. The other issue is that the visual clarity varies with the VR environment. Our work has identified a gap in having a feasible metric that can measure the visual clarity of VR HMDs. To address this gap, we present an end-to-end and user-centric visual clarity metric, omnidirectional virtual visual acuity (OVVA), for VR HMDs. OVVA extends the physical visual acuity chart into a virtual format to measure the virtual visual acuity of an HMD's central focal area and its degradation in its noncentral area. OVVA provides a new perspective to measure visual clarity and can serve as an intuitive and accurate reference for VR applications sensitive to visual accuracy. Our results show that OVVA is a simple yet effective metric for comparing VR HMDs and environments.

Demographic distribution of allergic conjunctivitis in selected schools in Ovia North East Local Government Area, Benin City, Edo State

Background: The burden of allergic diseases and conjunctivitis has been on the increase, especially in developing countries, prompting several studies across varying populations to investigate the causes and prevalence of these conditions. Epidemiological studies have been concerned largely with the prevalence of allergic conjunctivitis in the adult population and little is known about its prevalence in the paediatric population. The purpose of this study was to determine the prevalence of allergic conjunctivitis among school children in Ovia North East Local government Area, Benin City. Materials and Methods: A cross-sectional study was conducted using a sample size of 300 children aged 5 to 17 years from selected schools. Case history was taken through a structured questionnaire after which the children were screened. Visual acuity was measured using the Snellen Acuity chart. Internal and external eye examinations were done using a direct ophthalmoscope, magnifying loupe and penlight respectively. Data obtained was presented in percentages and tables. Chi square test was utilized to test for association between variables. Results: A total of 190 participants were examined: 78 males and 112 females (12.9± 2.39 years). The study revealed that allergic conjunctivitis was present in 48.4% (92) of the participants, with itching being the most commonly experienced symptom. There was no association between allergic conjunctivitis and either age or gender (p<0.05). Conclusion: Allergic conjunctivitis was prevalent among children in the southern part of the country, stating the need for enlightenment among parents/guardians, use of relief methods, and recommendation of further research.

Primary intraorbital inflammatory lumpy lesion: A rare case report.

Eosinophilic angiocentric fibrosis (EAF) is considered to be a kind of benign IgG4-related disease, and it is more often found in the nasal cavity. We present a pretty rare case of orbital EAF that is unlike any other reported case for this case is an IgG4 negative orbital EAF and successfully treated by the fronto orbitozygomatic approach surgery. This is a 68-year-old man from a rural area of Inner Mongolia Autonomous Region, went to our hospital for a 2-month history of vision loss with a local hospital orbital computer tomography which showed that there was a lesion in his left orbit. The inspection of the patient revealed that the patient left eye was protruding outward and the left eyelid unable to complete open or close. And his left eyeball movement had difficulty in all directions. Postoperative pathology diagnosed that this was a case of IgG4-negative EAF case. Orbital EAF. Surgical radical resection and postoperative glucocorticoid therapy. After surgery, the left eye vision of this patient increased to 0.6 tested in the standard logarithmic visual acuity chart. And his left eyeball movement dysfunction and eyeball outward protruding get a partially relief. EAF occurring in the orbit is a very rare disease and immunohistochemical results of EAF can be IgG4 negative.

Subjective Straylight Index: A Visual Test for Retinal Contrast Assessment as a Function of Veiling Glare.

Spatial aspects of visual performance are usually evaluated through visual acuity charts and contrast sensitivity (CS) tests. CS tests are generated by vanishing the contrast level of the visual charts. However, the quality of retinal images can be affected by both ocular aberrations and scattering effects and none of those factors are incorporated as parameters in visual tests in clinical practice. We propose a new computational methodology to generate visual acuity charts affected by ocular scattering effects. The generation of glare effects on the visual tests is reached by combining an ocular straylight meter methodology with the Commission Internationale de l'Eclairage's (CIE) general disability glare formula. A new function for retinal contrast assessment is proposed, the subjective straylight function (SSF), which provides the maximum tolerance to the perception of straylight in an observed visual acuity test. Once the SSF is obtained, the subjective straylight index (SSI) is defined as the area under the SSF curve. Results report the normal values of the SSI in a population of 30 young healthy subjects (19 ± 1 years old), a peak centered at SSI = 0.46 of a normal distribution was found. SSI was also evaluated as a function of both spatial and temporal aspects of vision. Ocular wavefront measures revealed a statistical correlation of the SSI with defocus and trefoil terms. In addition, the time recovery (TR) after induced total disability glare and the SSI were related; in particular, the higher the RT, the greater the SSI value for high- and mid-contrast levels of the visual test. No relationships were found for low contrast visual targets. To conclude, a new computational method for retinal contrast assessment as a function of ocular straylight was proposed as a complementary subjective test for visual function performance.

Development and Evaluation of a New Self-Administered Near Visual Acuity Chart: Accuracy and Feasibility of Usage.

Background: Visual acuity (VA) assessments are crucial in ophthalmology but traditionally rely on in-clinic evaluations. The emergence of telemedicine has spurred interest in creating dependable self-administered VA tests for use beyond standard clinical environments. This study evaluated the practicality and validity of a self-administered near VA card test against traditional Snellen and Rosenbaum Pocket Vision Screener (RPVS) methods for home monitoring and enhancing clinical workflow. Methods: In a cross-sectional study, a near VA card (Hadassah Self-Visual Acuity Screener (HSVA)) was developed with written and videotaped instructions for self-use. Patients with a minimal best-corrected VA (BCVA) of 1.0 LogMAR in at least one eye were recruited from ophthalmology and optometry clinics. Outcomes included the mean BCVA difference between the self-administered values and those obtained by the examiner, and correlations between BCVA values obtained by the Snellen, RPVS, HSVA, and previous distance BCVA methods according to the patients' electronic medical records. Results: A total of 275 participants (mean age: 42.5 ± 19.4 years; range: 18-89 years; 47% female) were included. Test-retest reliability analysis of the HSVA demonstrated a very good correlation and repeatability (n = 38 patients; Rs = 1.0; p < 0.001). Accuracy analysis revealed the mean LogMAR BCVA values of an additional 237 patients obtained by the Snellen, RPVS, and HSVA methods were similar (p = 0.10). The self-test BCVA results obtained by the HSVA agreed with the masked examiner-tested VA results (n = 67 patients; p = 0.17; Rs = 0.87; ICC = 0.96). Similar results were obtained when stratification by median age (42 years) was performed. Bland-Altman analysis of the HSVA and RPVS methods demonstrated a good agreement. To assess whether the HSVA could predict the VA results in the clinically used charts, multivariate analysis was used and revealed that the HSVA predicted the RPVS results (β = 0.91; p = 0.001; R2 = 0.88), and the self-test HSVA predicted the Snellen VA results within two lines (β = 0.93; p = 0.01; R2 = 0.36). Conclusions: The home-based HSVA assessment exhibited high test-retest reliability, accuracy, and alignment with clinical-standard VA tests. Its efficacy in self-testing mirrored examiner-conducted VA assessments and accurately predicted Snellen VA outcomes, indicating the HSVA's suitability for self-monitoring in chronic ocular conditions or when access to conventional examinations is limited. The utility of self-administered VA tests may extend beyond ophthalmology and optometry, potentially benefiting primary care, emergency medicine, and neurology. Further research is needed to explore and validate the practical applications of remote VA testing.