Blindly Research Articles

Vision-related quality of life in low-vision patients who underwent epiretinal membrane surgery

Aims: To evaluate the vision-related quality of life (VR-QOL) in patients with low vision, who underwent epiretinal membrane (ERM) surgery with pars plana vitrectomy. Methods: Twenty subjects with unilateral ERM and 20 healthy subjects as CG were included in the study. The National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) was used. In ERM cases, the two-step 23 G vitrectomy was performed with a similar technique by the same experienced vitreoretinal surgeon. The relationship between the composite score and visual acuity was evaluated. Reliability analysis was performed. Flexible discriminant analysis was performed to group individuals according to the NEI VFQ-25 results. Results: The preoperative best corrected visual acuity (BCVA) in ERM group was 1.04±0.41. Postoperative visual improvement reached statistical significance (p<0.001) and postoperative 6th month BCVA was 0.61±0.41. The composite score was significantly lower in patients with ERM than in CG (p=0.017). The subscale scores were significantly lower in the patients with ERM than in the CG in general vision, ocular pain, near activities and distance activities (p<0.001, p=0.005, p<0.001, p=0.003, respectively). There was a statistically significant correlation between the composite score and visual acuity (R2=0.19, p=0.004). The scale has high reliability (Cronbach's alpha=0.8743). The accuracy of the flexible discriminant function was found to be 100%. Conclusion: The NEI VFQ-25 questionnaire may help to define the effects of ERM surgery since visual acuity does not fully reflect VR-QOL. Impaired binocular vision may be associated with the deterioration of VR-QOL in patients with ERM in the postoperative period.

Developing a Statewide Peer Support Network for Individuals Who Are Blind or Low Vision

Abstract This article looks at experiences of setting up and maintaining peer support groups in two states with long-standing peer support networks for seniors who are blind or low vision (B/LV).

Visual experience shapes bodily representation of emotion.

Philosophers and experimentalists have long debated whether bodily representation of emotion is grounded in our sensory experience. Indeed, we are used to observe emotional reactions expressed through the bodies of others, yet it is still unknown whether this observation influences how we experience affective states in our own bodies. To delve into this question, we developed a naturalistic haptic task and asked a group of early (n = 20) and late (n = 20) blind, as well as sighted individuals (n = 20) to indicate where in the body they perceive changes associated with affective states. Our results show that visual experience shapes bodily representation of emotion. Blind and sighted individuals attribute different importance to body regions in relation to specific emotional states, as sighted people focus more on visceral sensations, while blind report as more relevant the mouth and the hand areas. We also observe differences in the coherence of bodily maps of specific emotions, such as aggressiveness, for which early and late blind are homogenous in reporting the mouth, while sighted subjects demonstrate a scattered pattern of activation across the body. Finally, our findings show that blind people rely on a different organization of affect, as only sighted categorize bodily maps of emotion through the valence and arousal dimensions. In summary, we demonstrate that sensory experience impacts the bodily representation of affect by modulating the relevance that different body parts have in emotional reactions, modifying the weights attributed to interoceptive and exteroceptive signals, and changing how emotions are conceptualized in the body. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Accessible scientific conferences for blind and low vision professionals and researchers: a necessary step for achieving STEMM equity

Scientific conferences and meetings are an integral part of careers in research, medicine, education, and many other professional arenas. Such meetings allow professionals and researchers to share their findings, support expansion of professional networks, enhance professional development, and foster new collaborations. However, barriers throughout the conference experience lead to the exclusion of experts with disabilities, deepening existing inequities in the STEMM (science, technology, engineering, mathematics, and medicine) workforce. This is especially problematic for STEMM experts with blindness or low vision, who remain significantly under-represented throughout the health and science ecosystem.

Research progress of retinal neuroprotective drugs for glaucoma

Glaucoma is a neural degenerative disease characterized by progressive loss of retinal ganglion cells, resulting in irreversible visual field loss, low vision, and total blindness. Despite the fact that the pathological elevation of intraocular pressure is a major risk factor for glaucoma, it is imperative to develop therapies that can prevent and block retinal ganglion cell injury and apoptosis in addition to reducing intraocular pressure. Drug therapy is the primary treatment for glaucoma in most clinical cases. This article provides reference information for the clinical treatment of glaucoma by summarizing and analyzing the medications that have direct optic nerve protection in clinical or preclinical trials, based on the most recent research results from both domestic and international studies.

Integration of auditory and visual cues in spatial navigation under normal and impaired viewing conditions.

Auditory landmarks can contribute to spatial updating during navigation with vision. Whereas large inter-individual differences have been identified in how navigators combine auditory and visual landmarks, it is still unclear under what circumstances audition is used. Further, whether or not individuals optimally combine auditory cues with visual cues to decrease the amount of perceptual uncertainty, or variability, has not been well-documented. Here, we test audiovisual integration during spatial updating in a virtual navigation task. In Experiment 1, 24 individuals with normal sensory acuity completed a triangular homing task with either visual landmarks, auditory landmarks, or both. In addition, participants experienced a fourth condition with a covert spatial conflict where auditory landmarks were rotated relative to visual landmarks. Participants generally relied more on visual landmarks than auditory landmarks and were no more accurate with multisensory cues than with vision alone. In Experiment 2, a new group of 24 individuals completed the same task, but with simulated low vision in the form of a blur filter to increase visual uncertainty. Again, participants relied more on visual landmarks than auditory ones and no multisensory benefit occurred. Participants navigating with blur did not rely more on their hearing compared with the group that navigated with normal vision. These results support previous research showing that one sensory modality at a time may be sufficient for spatial updating, even under impaired viewing conditions. Future research could investigate task- and participant-specific factors that lead to different strategies of multisensory cue combination with auditory and visual cues.

Bridging the Past, or Breaking From It? Leader Continuity Rhetoric and Nontarget Employee Diversity Initiative Support

Organizations launch diversity initiatives to promote diversity within their ranks, improve the work experiences of underrepresented groups, and satisfy growing demands for diversity in workplace settings. While typically welcomed by the target group, diversity initiatives can be compromised when employees who are not the initiative’s targets—for example, men in the case of gender diversity initiatives—withhold their support. Particularly organizations that are mostly composed of nontargets may thus struggle with a lack of support for their diversity initiatives. To understand how organizations can successfully implement diversity initiatives while preserving nontarget support, we take an uncertainty management perspective and examine the interactive effects of diversity practice type (identity-conscious vs. identity-blind) and leader continuity rhetoric (high vs. low vision of continuity) on nontarget support. In Study 1, using data from a 2 × 2 between-person field experiment in a firefighter organization, we find that framing the initiative under a vision of high (vs. low) continuity preserves nontargets’ anticipatory distributive justice in the face of identity-conscious (vs. identity-blind) practices and thereby promotes initiative support. Study 2, a vignette experiment, replicates our findings and shows that other justice dimensions above and beyond distributive justice appear secondary in this context. Our work has important implications for managing the initiation phase of diversity initiatives in organizations primarily composed of nontargets in a way that fosters nontargets’ perceived justice and support.

Pharmacological Advances in Glaucoma Management

Glaucoma is the leading cause of global irreversible blindness, with clinical diagnosis related to population-based low vision standards and subsequently to diminished vision-related quality of life. The main objective of the present study is to review the updates regarding pharmacological advances in glaucoma management. Pharmacological management to reduce intraocular pressure and inflammation and improve retinal ganglion cell survival has a significant impact on the overall management of glaucoma. The changes in the therapeutic pipelines include the targeting of both traditional and novel molecules. New medications in the offing either improve the already established targets or focus on newer avenues to confer better anti-glaucomatous effects with minimal side effects.

Changes in Vitreous and Retina in Pathological Myopia

Myopia is the leading cause of visual impairment and its prevalence continues to increase significantly. Pathological myopia affects 1-3% of the general population and is one of the main causes of low vision and blindness worldwide. Myopic vitreopathy associated with pathological myopia essentially represents fibrous vitreous liquefaction, resulting from both hereditary and degenerative processes. In addition, myopic retinopathy, in which axial elongation plays an important role in pathogenesis, has many unique pathologies. In this review, changes in the vitreous and retina in patients with pathological myopia are discussed.

Changes in Lens Structure in Pathological Myopia, Cataract Surgery and Special Situations

Pathological myopia is a major cause of low vision and blindness worldwide. In patients with pathological myopia, there are changes such as thinning of the lens and increase in equatorial diameter. In various population and clinic-based cohort, case-control and cross-sectional studies, it has been reported that myopic patients have a higher risk of posterior subcapsular cataract, cortical and nuclear cataract. It is known that the modern technique of phacoemulsification and intraocular lens implantation is effective in highly myopic eyes and provides significant improvement in visual acuity. However, complications related to phacoemulsification such as posterior capsule rupture, retinal detachment, progression of existing maculopathy, capsular phimosis, late lens dislocation and transient intraocular pressure elevation occur more frequently in highly myopic patients. As a result, it is extremely important that cataract surgeries of these patients are performed by experienced surgeons and that attention is paid to perioperative and postoperative complications.

8034 Putting the Pieces Together: Carney Complex, A Hyper-Rare Congenital Neoplastic Syndrome

Abstract Disclosure: G. Fontanazza: None. A.R. Conforti: None. K. Bird: None. M. Caplan: None. Intro: Carney complex (CNC) is an autosomal dominant disorder characterized by multisystem neoplasia that primarily affects the thyroid, pituitary, and adrenal glands. Its prevalence is not well established, as only 750 cases have been reported worldwide. This condition arises when an inactivating PRKAR1A gene mutation results in dysregulated cell proliferation and tumorigenesis. Complications include the potential for malignant transformation and systemic manifestations, necessitating comprehensive management and ongoing surveillance of disease progression. Case: The patient is a 58-year-old woman who initially presented as a teenager with complaints of hirsutism, truncal obesity, and violaceous abdominal striae. Initial workup revealed a low-dose dexamethasone suppression test that resulted in a non-suppressed cortisol levels. She also had undetectable adrenocorticotropic hormone (ACTH) levels. Imaging revealed no pituitary masses and demonstrated slight bilateral adrenal enlargement without adenomas. Despite these results, she was empirically treated for presumed pituitary-dependent Cushing's disease and received external beam radiation. Despite treatment, she continued to have episodes of hypercortisolism that were apparent clinically and biochemically. Over time, she developed a cardiac myxoma with six cerebrovascular accidents and multiple benign tumors. As an adult, she underwent extensive endocrine evaluation, which revealed urine cortisol excretion that paradoxically rose in response to dexamethasone. ACTH levels were always undetectable, even when she was significantly hypercortisolemic. Genetic testing revealed a homozygous mutation in the melanocortin-2 receptor (MC2R). Accordingly, she elected to have a bilateral adrenalectomy and was started on hydrocortisone and fludrocortisone. Discussion: The patient exhibited ACTH-independent micronodular adrenal hyperplasia and its most frequent variant, primary pigmented nodular adrenocortical disease. Bilateral pigmented nodular hyperplasia is a finding which can occur in association with CNC and cause episodic hypercortisolism. These patients have been shown to respond to dexamethasone with a paradoxical increase in glucocorticoid excretion. While management requires ongoing surveillance, this patient had not been diagnosed until later in life and did not have regular screening. When speculating on the late detection, her story reflects the parable of the blind men and the elephant: endocrinology managed Cushing's disease, cardiology managed atrial myxoma, and oncology managed osteochondromyxomas. Limited perspective with specialized management and an inability to see the whole picture led to prolonged diagnosis with unfortunate sequelae. This report encourages physicians to develop perspective awareness and to consider the entire picture when treating patients. Presentation: 6/2/2024

A spatial data model of blind outdoor navigation for path optimization

Current navigational aids for blind people do not provide spatial information that meets the requirements of blind and visually impaired people (BVIP) for travel, and traditional map-based navigation services cannot be used directly for navigation. The purpose of this paper is to establish a spatial data model that aligns with their outdoor travel requirements to assist them in accessing spatial information. In alignment with the analysis of spatial information requirements for blind people during outdoor travel, the proposed data model divides the outdoor space into the path layer, the functional layer, the obstacle layer, and the transport and weather layer. Areas such as schools and sports fields, which fulfill certain requirements for them, are categorized as functional features. Essential public transportation stations for outdoor travel are included in transport station features, while obstacles that pose threats to their safety constitute obstacle features. Various features in space are spatially connected through different paths. The proposed semantic information properties enhance the information content representation of the features. The geometry of the features and the topological relationships between them are recorded and used for path planning and navigation in combination with the path layer. Finally, the eastern campus of Jiangxi University of Science and Technology served as an experimental area for the development of a prototype system based on the data model, and a case analysis was provided.

Seeing clearly: A novel model for low vision screening and evaluation in hospitalized older adults.

Seeing clearly: A novel model for low vision screening and evaluation in hospitalized older adults.

Responsible Practices for Crowdsourced Transcription and Accessibility for Web‐based Library, Archive, and Museum Content

ABSTRACTHundreds of Libraries, Archives, and Museums (LAMs) around the world run crowdsourced transcription projects in order to engage users with their collections. Some LAMs explicitly use crowdsourcing projects to make non‐machine‐readable images of documents, such as manuscripts, discoverable to people who are blind or have low vision. We present findings from Crowdsourced Data: Accuracy, Accessibility, Authority (CDAAA), a 3‐year Institute of Museum and Library Services (IMLS) grant project that investigates whether and how LAMs integrate crowdsourced transcriptions into their discovery systems, and whether these efforts result in accessible web‐content for blind people and those with low vision who use assistive technology to navigate the web. We share research findings as well as practical suggestions for those in charge of crowdsourcing projects, the resulting transcription data, or similar web‐based textual content such as scholarly editions. These research and practice‐oriented findings are relevant to any national or local context where inaccessible images are transcribed, and are especially timely in the US context given recent Federal rule‐making to ensure that all web and app‐based content provided by US State and local governments is accessible, including tools, resources, and content created in‐house, through contracts or by license (2024).

An Evaluation of the Precision of Ocular Trauma Score and Factors for Poor Visual Outcomes in Open Globe Injury: A Retrospective Analysis of Resourcelimited Hospital Settings

Objective: To evaluate the accuracy and validity of ocular trauma scores (OTS) among patients with open globe injury (OGI) in rural hospital settings and to identify the determinants predicting poor visual outcomes. Materials and Methods: A single-center retrospective cohort study was conducted through a chart review of OGI patients between July 2018 and June 2023 at Bueng Kan Hospital. Demographic and preoperative factors affecting the final visual outcome were evaluated. OTS score for each patient was calculated and categorized. Final VA after 6 months was compared to the predicted VA from OTS study. Poor visual outcome was defined as legal blindness after 6 months of treatment. Results: Thirty-nine eyes from patients with a mean age of 44.05 years were evaluated. Most subjects were male (94.87%), and workplace injuries were the most common (78.38%). Compared to the OTS study, patients in OTS category 2 achieved a significantly higher percentage of better final VA, while categories 3 and 4 showed similar outcomes. OTS category 1 patients had a lower proportion of no light perception (NLP) outcomes, though the difference was not significant. Poor visual outcomes were predicted by initial VA (OR=4.64), wound extension ≥10 mm (OR=20.66), and lens injury (OR=7.44). Conclusion: OTS is beneficial for predicting final vision in patients with OGI, particularly with less severe trauma. Severe cases often lead to better visual outcomes, emphasizing the need for cautious management and counseling by ophthalmologists. Factors that estimate poor visual outcomes involve poor initial VA, wound extension  10 mm, and lens damage.

Three-Year Clinical Outcomes in Geographic Atrophy: An Analysis of 18,712 Patient Eyes

Methods: Retrospective analysis of 18,712 eyes with GA using the CorEvitas Vestrum Health Retina Database. Results: Mean age at index was 78.6 years (SD = 7.9) and mean visual acuity (VA) was 67.5 letters (SD = 13.0, Snellen equivalent 20/45). 18.9% of eyes developed nAMD within 36 months. Eyes with fellow-eye nAMD developed nAMD at over twice the rate of eyes with fellow-eye GA (relative risk 2.34, 95% CI [2.20, 2.49]). Mean VA of eyes that did not develop nAMD declined by 12.4 letters (95% CI [12.0, 12.9]) within 36 months. Older age and moderate baseline visual impairment (VA < 20/40 to 20/100) independently correlated with accelerated rate of decline. Eyes of patients in the oldest quartile with moderate visual impairment experienced the worst outcomes, losing an average of 19.7 letters over 36 months (95% CI [18.1, 21.3]). By 36 months, 70% of eyes had vision below threshold for driving (VA ≤ 20/40), 42% had low vision (VA ≤ 20/70), and 23% were legally blind (VA ≤ 20/200). Conclusions: GA is associated with significant disease burden. Eyes with GA lose an average of two to three lines of VA within 36 months of follow up. Older age and moderate baseline visual impairment independently correlate with poorer visual outcomes. Presence of nAMD in the fellow eye is associated with twofold higher risk of exudative conversion within 36 months.

Outcomes of Multidisciplinary Low-Vision Rehabilitation Using Two Questionnaires and the International Classification of Functioning, Disability, and Health

Objective: To evaluate the effectiveness of a low-vision service by using three tools and to identify the specific outcomes obtained from each instrument. Materials and Methods: Patients consecutively visiting the low-vision clinic at Siriraj Hospital, Bangkok, Thailand, were enrolled. The impact of the prescribed rehabilitation on patient quality of life was measured using three tools: the Low-Vision Quality-Of-Life Questionnaire (LVQOL); the generic EuroQol Five-Dimensional Questionnaire (EQ-5D); and the World Health Organization International Classification of Functioning, Disability, and Health (WHO-ICF). Results: Out of the 104 patients recruited, 76 patients (mean age, 53 ± 16.2 years) completed the questionnaires before and after rehabilitation, which was assessed after 5.8 ± 2.0 months. Post-rehabilitation, the time of follow-up, patients had significant improvements in the mean scores of both the LVQOL scores and mean EQ-5D scores compared to before rehabilitation (P < 0.001), with Cohen’s effect sizes of 0.85 and 0.67, respectively. Subgroup analyses by age, severity, and cause of visual impairment also showed significant improvements in the LVQOL (P < 0.05), but not the EQ-5D score in the blindness severity subgroup. The ICF scores also showed significant improvement in most domains, including seeing functions, mobility across different locations, transportation use, meal preparation, economic self-sufficiency, community life, and recreational activities (P < 0.01). Conclusion: Patients with low vision experienced significant improvements following vision rehabilitation, especially in terms of seeing functions and mobility. Evaluation by different questionnaire types could provide additional information. The WHO-ICF was effective in assessing each domain related to activity performance and participation.

Assessment of visual impairment and need of rehabilitation services for children attending schools for blind in an urban city of North India

ABSTRACT Background/Aims: By understanding the prevalence and causes of childhood blindness, stakeholders can work toward comprehensive strategies that encompass prevention, treatment, rehabilitation, and support, ultimately improving the quality of life for affected children. The information about the pattern and causes of childhood blindness in Northern Indian states is limited, it highlights the need for further research and data collection to better understand and address the specific challenges in this region. Therefore, the present cross-sectional study was planned to ascertain the different causes and patterns of childhood blindness and to understand the barriers to the use of LVAs and its compliance among the students attending schools for the blind in a North Indian State. Study Design and Setting: Students from two schools for blind were examined in Chandigarh and its vicinity in North India. The different causes of severe visual impairment/blindness were classified as per the World Health Organization/Prevention of Blindness standard recording form. Results: A total of 89 students attending schools for the blind were examined. The mean age was 13.10 years (range = 4–16 years). Male, female ratio was 3.3:1. The major causes of blindness were congenital anomalies (whole globe anomalies 37.08%), followed by retinal conditions (16.7 = 8%), undetermined/other (12.3), and lenticular conditions (112%). More than one-third of children (34.8%) were blind due to avoidable causes of blindness. Conclusion: The current study data append on the existing national available data about childhood blindness in India. Though the sample size of the current is comparatively low, observed different results as compared to previously published reports from other regions, emphasize the strengthening of pediatric ophthalmology services as well as of low vision services in this particular region of North India.

LoVi App: Android Application-based Image Classification for Low Vision

In Indonesia, many people with visual impairments are drawing public attention to their rights as fellow humans. One of the limitations that individuals with low vision face is their ability to recognize objects and navigate their surroundings due to difficulties in visual perception. In this modern era, deep learning technologies, especially in image classification, can help people with low vision overcome these challenges. In this paper, we discuss a deep learning system that optimizes image classification on users' smartphones to enhance visual support for individuals with low vision. We present an Android-based app, LoVi, designed to assist users with low vision. Powered by core systems within Sherpa models (TrotoarNet, IndoorNet, and CurrencyNet), LoVi has three modes: outdoor, indoor, and currency. The LoVi application provides over 80% accuracy for navigation on sidewalks, indoor object recognition, and currency identification. TrotoarNet aids in sidewalk navigation, IndoorNet assists with indoor object identification, and CurrencyNet recognizes Rupiah banknotes. Additionally, low-vision users can receive voice feedback for further accessibility.

시각장애인의 박물관 관람을 위한 감상 보조 방법 적용 연구

The purpose of this study is to evaluate appreciation assistance methods of 3D model printouts and audio explanations of four historical relics for blind people. As a result, five participants with visual disabilities recognized the main elements through appreciating 3D model printouts and audio explanations of historical relics. The participants responded that they were satisfied with being able to directly appreciate tactile objects from the historical relics. Also, they were satisfied that they learned about the parts of the 3D model printouts and historical backgrounds with audio explanations. Otherwise they could not know them with only tactile method. Through this study, we presented suggestions to address when providing assistance methods to appreciate historical relics for people with visual disabilities in museums. Future research is needed to make guidelines that take into account various factors that arise when museums provide appreciation assistance methods for those with visual disabilities.