Vision Assessment Research Articles

Building Consensus about the Functional Vision Assessment Process: A Delphi Study

Introduction: Within the field of visual impairment, there is no set of standards that guide teachers of students with visual impairments as they conduct, report, and share functional vision assessment (FVA) results with other educational team members, and university instructors vary in how they teach the assessment process to preservice teachers. Methods: In parallel, a group of teachers of students with visual impairments and a group of university instructors completed three rounds of a Delphi study. After providing background information in Round 1, they rated 84 statements about the FVA process. The level for consensus was set at 80%. Results: Of the 84 statements, consensus was reached for 45 statements regarding the level of importance by both groups. Participants rated 11 of 22 visual skills (e.g., near acuity, distance acuity) as extremely important to include in the FVA process. Discussion: There continues to be a need to build consensus on when FVAs should be conducted, what visual skills should be included when conducting them, what should be included in reports, and with whom assessment information should be shared. The importance of conducting such assessments for all students, including students under the age of 5 years and those with additional disabilities, needs to be recognized by the field of visual impairment. Implications for practitioners: University personnel need to work together to develop consistent curricula that focuses on the FVA process. Future studies that examine the FVA practices of individual teachers are necessary.

Testing a Popular Smartphone Application for Colour Vision Assessment in Healthy Volunteer Subjects

ABSTRACT We aimed to compare the Ishihara pseudoisochromatic colour vision test with a colour vision test from a popular smartphone application (EyeHandBook [EHB]) using digital image processing to simulate colour vision deficiencies. Three digital versions of the Ishihara and EHB slides were created: full colour; 32 bit- greyscale (removing all colour information); and blue channel (to simulate red-green colour vision deficiencies). Twenty healthy volunteers were shown each colour-edited plate. The answers they reported were compared with what would be expected for that colour-simulation scenario based on the answer key provided in the Ishihara booklet (“expected” answer). There were nine plates that had comparable patterns between the EHB and Ishihara test. We found no significant difference in the overall proportion of “expected” answers for the full colour (p = .35), 32 bit-greyscale (p = .39) and blue channel (p = .22) conditions. There were significant differences between the proportion of “expected” answers among six individual colour- edited plates (p < .05 for each). Colour vision assessment from the EHB is distinct from comparable Ishihara plates. Clinical scenarios that require serial assessment of colour vision may benefit from using the same modality consistently rather than exchanging between the two tests with the assumption of equivalence. Refinement of digital colour editing techniques beyond 32-bit greyscale and RGB channel splitting is necessary in order to accurately simulate colour vision deficiency.

BYNOCS®1 – A Cloud-Based Indigenous Tele-Health Vision Therapy Software for the Assessment and Management of Binocular Vision Disorders

Background: Binocular vision assessment is an integral part of an eye and vision care practice. With the need for a user friendly, simplified, and comprehensive tool especially in this digital era, we propose a new indigenous cloudbased software, Bynocs.® This manuscript describes the technical details, the functioning of this indigenous software, and a case series demonstrating the application and efficacy of Bynocs® as a tele-health vision therapy tool. All the three cases were handled remotely through the Bynocs tele-health vision therapy platform. Case Reports: Case 1: This is a case of symptomatic convergence insufficiency who had prior compliance issues with a conventional vision therapy approach. With 10 sessions of Bynocs vision therapy focused on improving convergence amplitudes, the patient showed significant improvements in both subjective and objective parameters. Case 2: This case is of a 12 year old child with residual anisometropic amblyopia who had excellent compliance with patching therapy for 3 years but visual acuity had plateaued over the last 6 months. After 20 sessions of Dichoptic amblyopia therapy, best-corrected visual acuity (BCVA) improved by 3 log MAR lines, with improvements in stereoacuity to 100 sec of arc. Case 3: This case of a 10 year old child with residual exophoria after strabismus surgery was referred for managing the residual deviation and associated visual complaints. The child had 20/20 visual acuity in both eyes and 10 prism diopters of residual exophoria at distance and near. After 30 sessions of vision therapy, improvements in fusional vergence amplitudes was achieved along with the deviation restoring to orthophoria at both distance and near, with further improvements in stereoacuity from 400 sec of arc to 120 sec of arc. Conclusions: As tele-health is finding favor across the globe, Bynocs® can be a valuable tele-health vision therapy tool for in the management of binocular vision anomalies and amblyopia with the functionality for remote diagnosis and therapy.

COVID-19’S IMPACT ON THE HIGHER EDUCATION SYSTEM IN JORDAN: ADVANTAGES, CHALLENGES, AND SUGGESTIONS

Purpose of the study: The present study surveys the reactions of university-level faculty members in Jordan towards their experience with COVID-19's emergency online learning model. It primarily investigates the advantages of switching to online learning, challenges faced, and suggestions for improving the teaching-learning process.&#x0D; Methodology: The study is based on empirical data compiled from the responses of 432 instructors in six Jordanian public and private universities. The data collection instrument consists of a structured open-ended questionnaire, which comprises three constructs: challenges, advantages, and suggestions for improvement. Similar responses were combined in thematic categories and were calculated to obtain frequencies and percentages.&#x0D; Main Findings: Concerning the advantages, e-learning enabled instructors to use new effective teaching tools and acquire new skills. The challenges were mainly related to technology and the Internet, assessment, interaction, and lack of clear vision and regulations by policymakers. Instructors suggested providing better technical support; blending online with traditional learning; offering more training, and improving the assessment tools and designing new ones.&#x0D; Applications of this study: This study is useful for educational leaders and policymakers providing guidance and insights on how higher education institutions have responded to this global health emergency, and how they managed to meet the evolving needs of students and staff. Consequently, the higher education sector should be prepared to operate more efficiently and effectively for any future emergencies.&#x0D; Novelty/Originality of this study: While different studies have investigated the impact of COVID-19 on the education sector globally, little attention has been given to developing countries in the Middle East. To this end, the present study focuses on how COVID-19 has been effective in reshaping and revolutionizing the higher education paradigm in Jordan through highlighting the advantages, challenges, and subsequent suggestions for improvement.

Application of the Modified Вagolini Test in the Diagnosis of Binocular Vision Disorders

The work is devoted to one of the most actual problems of current strabismology — the development of effective ways to study binocular vision.The purpose — to study the effectiveness of the developed modification of the Bagolini test in the diagnostics of binocular disorders.Patients and methods. 240 patients with non-paralytic strabismus aged from 6 to 17 (on average 10.8 ± 0.24) years were observed. There were 190 patients with converging strabismus and 50 patients with diverging strabismus. The control group consisted of 180 children aged also from 6 to 17 (on average 10.9 ± 0.3) years without ophthalmopathology. All children were examined for the character of vision using a Worth-test, the classic Bagolini test (CTB), and the developed modified Bagolini test (MTB). If the patient has a strabismus angle, the study was performed in two variants: without prismatic deviation compensation (under the subjective angle of strabismus — SU) and under full prismatic compensation (under the objective angle of strabismus — OU). For qualitative assessment of binocular vision with MTB, static presentation of the test image was used, for quantitative assessment — alternating (alternate presentation of details corresponding to the right and left eyes).Results. The qualitative evaluation data obtained with the help of MTB made it possible to differentiate patients with non-permanent regional functional scotoma of suppression (FSP) and patients with stable bifoveal fusion among children with binocular vision by color test, and to distinguish patients with regional stable FSP and total FSP among children with monocular vision by color test. In the study under SU, the sensitivity of the method was 97.8 % and specificity 96.2 %, under OU — 96.6 % and 92.7 %, correspondingly. Using quantitative evaluation, it was found that the minimum duration of monocular phases required to eliminate functional inhibition in children with total FSP is twice as long as in children with regional FSP (z = 6,303, df 52, p &lt; 0.001 according to the Mann — Whitney criterion).Conclusion. Thus, the modified Bagolini test developed by us is an effective way of qualitative and quantitative assessment of the state of binocular vision. The method has a high sensitivity and specificity, combines the capabilities of anaglyphic and phase haploscopy, and can be used for a personalized approach to the selection of conditions and modes of functional correction of binocular disorders, as well as for monitoring binocular vision during treatment.

Abstract PR09: Field application of digital technologies for health assessment in the 10,000 Families Study

Abstract The 10,000 Families Study (10KFS) is a Minnesota-based cohort study designed to study longitudinal changes in health. Here we report our efforts from a pilot study of 10KFS. During health fairs hosted by the study, we measured anthropometrics, blood pressure, and grip strength; collected biospecimens; performed vision and hearing assessments; and measured lung function and cognitive function. We describe the field deployment of digital applications for measurement of cognitive function, lung function, and hearing assessment in 10KFS. We measure cognitive function using the Digital Clock Drawing (dDCT) test (Cognition Technologies Inc.), a multidimensional task that evaluates spatial skills, semantic knowledge, planning, and motor functioning. We perform spirometry to assess lung function using an Air Smart Spirometer (Pond Healthcare Innovation) that uses a spirometry app (NuvoAir) to estimate forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF). We measure hearing using an iPad-enabled audiometry device (Shoebox, Inc.) that allows us to estimate air conduction and bone conduction over a range of tones from 500-8000 Hertz. These digital devices are low cost and the measurements are readily implemented with minimal training of study staff (training time 2-3 hours). To date, we have performed these measurements on 139 10KFS participants (age range: 5 years–100 years) during an in-person clinic visit. A vast majority (88%; n=123) of eligible 10KFS participants successfully completed all these measurements; participants across the age spectrum were comfortable using these digital technologies during their clinic visit. The Digital Clock Drawing test was administered only to adults &amp;gt;40 years old and completion rates were 92% (n=34) for participants between 41-64 years old and 95% (n=35) for those over 65 years old. The Air Smart Spirometer was administered to participants over 4 years old without a contraindication and completion rates were 96% (n=22) for children 5-17 years old, 98% (n=64) for adults 18-64 years old, and 100% (n=36) for adults over the age of 65 years. The audiometry test was administered to participants &amp;gt;3 years old and completion rates were 87% (n=20) for children 4-17 years old, 100% (n=67) for adults 18-64 years old, and 100% (n=37) for adults over the age of 65 years. As compared to traditional methods for collecting information on cognitive function, lung function, and hearing, these devices allow for real-time monitoring of quality-control measures and allow deployment of standardized methods of data collection in a variety of settings that do not require specialized equipment or have space constraints. In the future we anticipate deploying these methods to a broader range of data collection venues that may include in-home visits, remote assessments, and clinic visits. This abstract is also being presented as Poster A28. Citation Format: Bharat Thyagarajan, Lazovich DeAnn, Nelson H. Heather, Poynter Jen, Prizment Anna, Roesler Michelle, Cassidy Erin, Putnam Sara, Reilly Cavan, Spector Logan. Field application of digital technologies for health assessment in the 10,000 Families Study [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr PR09.

Can Psychophysics Be Fun? Exploring the Feasibility of a Gamified Contrast Sensitivity Function Measure in Amblyopic Children Aged 4-9 Years.

Routine assessments of the Contrast Sensitivity Function [CSF] could be useful for the diagnosis and monitoring of amblyopia. However, current CSF measures are not clinically practical, as they are too slow, too boring, and too uncomfortable to sustain a young child's interest. Here we assess the feasibility of a more gamified approach to CSF testing, in which a maximum likelihood psychophysical algorithm (QUEST+) is combined with a largely unconstrained user interface (no fixation target, head restraints, or discrete trials). Twenty-five amblyopes (strabismic, anisometropic, or mixed) aged 4.0–9.2 years performed the gamified CSF assessment monocularly (once per eye). The test required the child to “pop” (press) grating stimuli as they “bounced” around a tablet screen. Head tracking via the tablet's front-facing camera was used to adjust for variations in viewing distance post hoc. CSFs were fitted for each eye, and Area Under the CSF (AUCSF) computed as a summary measure of sensitivity. The results showed that AUCSF measurements were able to separate moderately and severely amblyopic eyes from fellow eyes (case-control effect), and to distinguish individuals with varying degrees of vision loss (dose effect). Even the youngest children exhibited no difficulties completing the test or comprehending what to do, and most children appeared to find the test genuinely enjoyable. Informal feedback from a focus group of older children was also positive, although potential shortcomings with the present design were identified. This feasibility study indicates that gamified, child-friendly vision assessments have promise as a future means of pediatric clinical assessment. Such measures could be particularly valuable for assessing children outside of conventional eye-care facilities (e.g., home-monitoring, school screening).

Demographic Assessment of Low Vision in Niger State, Nigeria

Purpose: The study was conducted to assess the demographic distribution of low vision in Niger State, Nigeria.&#x0D; Methods: The retrospective cross-sectional study design was adopted. The study sample consisted of 306 low vision patients selected from a total of 12,960 clinical records of patients seen over a 5-year period (2012-2016) in three selected public hospitals in Niger State. Diagnostic criterion for low vision was based on World Health Organization (WHO) definition. Data were analyzed using the Statistical Package for the Social Sciences (SPPS) version 21.0.&#x0D; Results: The prevalence rate of low vision was 2.36%. There were more males (184; 60.1%) than females (122; 33.9%). The males had a higher proportion of the middle-aged (36-55 years; 33.7%) while the females had more of older adults/elderly (≥ 56 years; 33.6%). Low vision was most prevalent among students (39.2%). Glaucoma (118; 38.6%) was the leading cause of low vision. Albinism accounted for more than half (16/31) of low vision cases amongst children while glaucoma (37/91) and cataract (38/91) accounted for 82.5% of low vision cases among older adults/elderly. The majority (115; 37.6%) of patients had severe low vision (VA &lt; 6/60 to 3/60). The uptake of low vision devices was high (217; 70.9%) and the spectacle magnifier (70; 22.9%) was mostly dispensed.&#x0D; Conclusion: The study has provided baseline information on the demographics of low vision in NigerState, Nigeria which could be the basis for the planning of low vision services in the State.&#x0D; Keywords: Demographic, assessment, low vision, Niger State, Nigeria.

Visual Binocular Disorders and Their Relationship with Baropodometric Parameters: A Cross-Association Study.

The aim of this study was to establish a relationship between nonstrabismic binocular dysfunction and baropodometric parameters. A total of 106 participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges, and vergence facility. Posturography was measured using the FreeMED baropodometric platform. Among the variables that the software calculates are foot surface, foot load, and foot pressure. Our results showed that in the participants with positive fusional vergence (PFV) (near) blur and recovery values outside the norm, there are statistically significant differences between the total foot area (p < 0.05), forefoot area (p < 0.05), forefoot load (p < 0.05), and rearfoot load (p < 0.05), in all of the cases of left foot vs. right foot. In the group of subjects who did not meet Sheard's criterion (distance), that is, those with unstable binocular vision, there was a statistically significant difference (p < 0.01) between maximum left and right foot pressure. In conclusion, our results establish a relationship between nonstrabismic binocular dysfunctions and some baropodometric parameters.

Elderly Fall and Glaucoma: Vision Assessment in Geriatrics

Elderly Fall and Glaucoma: Vision Assessment in Geriatrics

Prevalence of Non-Strabismic Binocular Vision Dysfunction in A Hospital based Population

This study was aimed towards finding the prevalence of non strabismic binocular vision dysfunctions (NSBVD) in the Indian population presenting with different symptoms pertaining to binocular vision disorders. Method: This retrospective study included one hundred and sixty one patients who presented to the out- patient department with symptoms of binocular vision dysfunction, during a period of one year. Patients were in the age group of 18 ±6.93, with 71 males and 90 females. Their binocular vision dysfunction was assessed via several diagnostic modules/tools designed for binocular vision assessment. Results: Results indicate that the most common binocular vision anomalies in this studied population are fusional vergence dysfunction with accommodative infacility (40.38%), convergence insufficiency with accommodative infacility (24.36%), Fusional vergence dysfunction (7.05%). Convergence Insufficiency and Accommodative infacility showed the same prevalence of 7.7%. Discussion: Accommodative and non strabismic binocular vision dysfunctions are commonly underdiagnosed/undiagnosed in clinical practice. These disorders affect academic performance, sports activities and general quality of life. An appropriate detailed orthoptic examination and accurate diagnosis is necessary to manage these binocular vision dysfunctions.

Ocular Morbidity Pattern and Presentation among Residence of a Semi-Urban Community in Rivers State, Nigeria

Background: Ocular diseases vary in different parts of the world and are influenced by racial, geographic, socioeconomic and cultural factors. The common ocular diseases worldwide are cataract, glaucoma, conjunctivitis, corneal ulcers, uveitis, refractive errors, pterygium.&#x0D; Methods: This was a community-based cross-sectional descriptive study carried out in Rumuokwuta community in Rivers state. Socio-demographic and clinical presentation information was obtained from an interviewer-administered questionnaire. Distant visual acuity was assessed at 6 m with the Snellen’s chart while near vision assessment was at 33 cm with a Sussex vision R near vision chart. External eye examination was with pen touch while fundoscopy was with direct Ophthalmoscope. Data were analyzed with the Statistical Package for Social Sciences (SPSS) v20. Using descriptive statistics, categorical variables were presented in the form of frequencies and percentages (%) and summary statistics in means and standard deviations (SD). Using inferential statistics, the Chi-Square (X2) test of significance was used to associate categorical variables and a p-value ≤ 0.05 was considered statistically significant.&#x0D; Results: A total of 114 subjects were examined.The mean age was 41.41± 15.49 years. The male to female ratio was 2:3. About 70.5% and 76.2% respectively in Right Eye and Left Eye had normal vision better than 6/18, while 27.1% and 21.9% respectively in Right Eye and Left Eye had a low vision (VA between 6/18 and 6/60). About 2.6% in either eye were blind. The three most common ocular conditions were Glaucoma (13.95%), Refractive error (13.02%) and Presbyopia (12.56%).&#x0D; Conclusion: The commonest cause of Ocular morbidity in this study are glaucoma, refractive error and presbyopia. The age distribution of a study area was a significantly associated factor in the frequency of visual impairment and blindness.

DESENVOLVIMENTO DO PROTOCOLO DA AVALIAÇÃO DA VISÃO FUNCIONAL INFANTIL (AVFI) PARA CRIANÇAS COM DEFICIÊNCIA VISUAL

The vision system, as the most sophisticated sensory system has been arousing interest of researchers in several countries in the study of functional vision for children. In Brazil, there are some evaluations, but these are not based on psychophysical and psychosensory studies. Therefore, the present study sought to develop an adequate functional vision assessment using &nbsp; scientific criteria. The evaluation consists of 12 procedures, the instruments being developed: checkered racket, face racket, checkered cubes and striped strip. The application distance varies from 30 to 50cm, the environment should be free of visual clusters and distractors, and the presentation interval between stimuli is approximately 30 seconds. The child's positioning varies with age, and the evaluator should remain outside the child's functional visual field. This functional visual assessment protocol has significant differences compared to national and international protocols available in the literature. The presence of evidence-based stimuli and a protocol for the presentation and recording of systematic results is a method with less subjective influence both in the conduction of evaluations and in the recording of visual functionalities present. This protocol for assessing children's functional vision covers important issues of visual development correlated with the child's neuropsychomotor development.

Assessment of color vision among health science students

The synergistic and harmonic functions of retina, optic nerve, part of thalamus and visual cortex are essential for the perception of color: human color vision is trichromatic i.e. the mixture of red, green and blue lights. The present cross-sectional study was conducted in August to October 2018. The ethical approval was obtained from Institutional Review Committee (IRC) of Nepal Medical College. After obtaining consent from the participants, the study was carried out among health science students of age group 18-25 years at Jorpati, Kathmandu, Nepal. The number (n) of sample size was 300; (male, n=150, female, n=150). The assessment of color blindness was done with the help of Ishihara Chart (“Ishihara Type Tests for Color Blindness”-38 plates (2002) Eye Care- Ludhiana, India). Among the study group (male, n=150, female, n=150), the color deficiency were found in male participants only; n=7, which is 2.33% of total participants (n=300). None of the female participants were found to be color blind/weak. Among the color deficient (n=7), protanomaly detected in 1, deuteranomaly in 2 and deuteranopia in 4. Hence, the present students of health stream are future health workers, whose observation apt to clinical examination is instrumental to treat patients; therefore, they must be aware and circumspect of their color vision to discharge their duties to the patients in a better way.

The practise of paediatric optometry in a low‐resource environment

BackgroundThe role of optometrists in paediatric visual assessment must compliment the role of other eye‐care practitioners at all levels of care. This study was undertaken to determine if optometrists in Ghana screen, diagnose and manage paediatric ocular conditions (for example, strabismus, amblyopia), and further assessed if optometrists in Ghana have the requisite paediatric instrumentation in their practices.MethodsThis was a cross‐sectional descriptive survey involving optometrists in both public and private eye‐care sectors in Ghana. A paediatric visual assessment questionnaire was sent to all registered optometrists in Ghana. The contents of the questionnaire evaluated areas of vision assessment, refraction, and previous diagnosis and management, which were matched with practice characteristics such as location, type of practice and type of employment. Chi‐squared statistic was used to test associations between variables.ResultsResponses were obtained from 140 optometrists out of the 326 registered optometrists, representing a response rate of 46 per cent. Overall, less than half of respondents (64 which represents 46 per cent) assessed themselves as practising full‐scope paediatric eye care. These self‐assessment views were more common among optometrists at the regional level (111: 79.3 per cent), followed by the district (20: 14.3 per cent) and sub‐district levels (nine: 6.4 per cent) (χ2 = 4.774, p < 0.05), but was not influenced by type of employment, type of practice and level of training (p > 0.05). In addition, the study revealed that many respondents were more likely to assess pre‐schoolers' visual acuity (VA) (121: 96.0 per cent), do refraction (109: 88.6 per cent) and perform binocular vision (BV) assessment (93: 76.9 per cent) compared to the toddlers' VA (72: 55.4 per cent), refraction (57: 46 per cent) and BV assessment (68: 56.2 per cent).ConclusionFull‐scope paediatric eye care services among optometrists in Ghana is limited.

Vision impairment and cognitive function among urban-dwelling malaysians aged 55 years and over from the Malaysian Elders Longitudinal Research (MELoR) study

IntroductionPublished literature on vision impairment and cognitive function amongst older Malaysians remains scarce. This study investigates the association between vision impairment and cognitive function in an older Malaysian population. MethodsSubjects aged 55 years and above from the Malaysian Elders Longitudinal Research (MELoR) study with available information on vision and Montreal Cognitive Assessment (MoCA) scores were included. Data were obtained through a home-based interview and hospital-based health check by trained researchers. Visual acuity (VA) was assessed with logMAR score with vision impairment defined as VA 6/18 or worse in the better-seeing eye. Cognition was evaluated using the MoCA-Blind scoring procedure. Those with a MoCA-Blind score of <19/22 were considered to have cognitive impairment. ResultsData was available for 1144 participants, mean (SD) age = 68.57 (±7.23) years. Vision impairment was present in 143 (12.5 %) and 758 (66.3 %) had MoCA-Blind score of <19. Subjects with vision impairment were less likely to have a MoCA-Blind score of ≥19 (16.8 % vs 36.2 %, p < 0.001). Vision impairment was associated with poorer MoCA-Blind scores after adjustments for age, gender, and ethnicity (β = 2.064; 95 % CI, −1.282 to 3.320; P = 0.003). In those who had > 6 years of education attainment, vision impairment was associated with a significant reduction of cognitive function and remained so after adjustment for age and gender (β = 1.863; 95 % CI, 1.081–3.209; P = 0.025). ConclusionOur results suggest that vision impairment correlates with cognitive decline. Therefore, maintaining good vision is an important interventional strategy for preventing cognitive decline in older adults.

Supraorbital Neuralgia Associated With Thyroid Eye Disease.

To identify the relationship between thyroid eye disease (TED) and supraorbital neuralgia (SON) and establish a reliable approach to the diagnosis and management of TED-associated SON. This retrospective study included 1,126 patients. Demographics, active and inactive phase status and duration, and reactivation rate were noted. TED clinical activity was determined using the vision, inflammation, strabismus, and appearance assessment system, and TED severity was classified using the European Group of Graves' Orbitopathy system. Subtypes of periorbital pain were identified, and suspected SON was confirmed by supraorbital nerve block. Of the study's 1,126 patients, 935 (83%) were deemed "active" at some point during the follow up and 34 (3%) remained "active" at the study's conclusion. Of the 2,251 eyes studied, 1,193 (53%) underwent orbital decompression. Of the 1,126 patients, 946 (84%) reported a retrobulbar "pressure" or "aching," but a distinct, more debilitating pain suggestive of SON was reported in 91 (8%). All 91 patients were given a supraorbital nerve block, and all had complete pain resolution lasting from hours to weeks. Eighty-eight (97%) of the 91 patients with SON-type pain underwent orbital decompression compared to 496 (48%) of the 1,035 without SON-type pain (p < 0.00001). A difference was found in the rate of TED reactivation between those with SON-type symptoms (8%) as compared to those without (2%), p = 0.01. SON of uncertain etiology appears to be a previously underreported but significant pain associated with TED. Paradoxically, although the SON does not appear to be related to the type or severity of TED on standard rating scales, the presence of SON was found to be associated with increased likelihood of both orbital decompression and TED reactivation.

Clash of Visions: Analysing Practices of Politicizing the Future

Clashes between visions of the future politicize the future of urgent societal transformations. In the political economy, visions and their promises become resources and their implementation turns into capacities that serve to increase value. Our paper argues that visions as political-economic means influence the transformation processes responding to grand challenges, guide them in certain directions, promote or even hinder them. To shed light on this correlation, we adopt the vision assessment approach of technology assessment (TA), and substantiate and suggest modifications of its analytical perspective to make it suitable for analysing interactions between multiple visions as formative elements in societal transformations on the one hand and as political-economic resources and capacities on the other. Our hypothesis is that the relationship between visions, political economies and transformation can only be examined by looking at power constellations that change through clashes and interactions of multiple and competing visionary practices.

Multi-focus image fusion method based on two stage of convolutional neural network

This paper proposes a two-stage convolutional neural network (CNN) fusion method that can obtain accurate decision map and deal with the problem of unclear fusion boundaries. In the first stage, an improved densenet is trained to classify whether the image patch is in focus or defocus, and then the corresponding fusion rule is utilized to acquire a perfect decision map. In addition, a multi-version blurred dataset is designed to improve the generalization ability of the network. In the second stage, edge-deblurring generative adversarial networks (EDGAN) is introduced to process the boundary. Furthermore, five different loss functions are applied to generate approving boundary deblurred images. At the same time, natural images are selected from the COCO dataset for special processing to simulate the boundary blurring situation to create the second-stage dataset. After two stages of processing, an image with rich details and decent fusion boundaries are attained. Experimental results demonstrate that the proposed algorithm is superior to other fusion algorithms in subjective vision and objective assessment.

The use of electronic devices by students, parents and teachers before and after the transition to distance learning

Transition to distance education in spring 2020 led to the overuse of information and communication technologies by the participants of the educational process. The aim of this study was to characterize the patterns of using electronic devices in high school students, their parents, and teachers in the settings of traditional brick-and-mortar education and distance learning. We created online questionnaires that were used to survey 200 high school students, 389 teachers and 251 parents before the transition to distance learning and also 658 teachers and 500 parents after the transition. Statistical analysis was conducted using Student’s t test, χ2, and Pearson’s contingency coefficient; relative risks were calculated using fourfold contingency tables. Differences were considered significant at p ≤ 0,05. After the transition to distance learning, the number of electronic devices used by each student increased for 96.6% of the surveyed students; the average screen time also increased. About 80% of the surveyed parents reported that their children had more health complaints; of them, 60% reported symptoms typical of computer vision syndrome. We established a correlation between the readiness to cut down on screen time and the subjective assessment of vision as perfect or good by the respondents (Pearson’s contingency coefficient 0.3; p ≤ 0.05). Our study confirms the relative risk for subjectively assessing one’s vision as satisfactory or poor in individuals who use ED on a daily basis; the risk is 1.13 for students, 1.41 for parents, and 1.27 for teachers (p ≤ 0.05). The study proves that eliminating screen time from daily activities for at least one day per week is an effective measure for preventing vision disorders.