Visual Disability Research Articles

Investigating the effect of eye drops based on iodine nanoparticles in the treatment of corneal ulcers in rabbit eyes

BackgroundVarious organisms, such as bacteria, viruses, and fungi, can cause corneal ulcers. One of the leading causes of vision loss and disability worldwide is corneal ulceration. Practical, accessible, and affordable treatment for this disease seems essential.Materials and methodsFifteen New Zealand rabbits infected with Staphylococcus aureus (ATCC 25923) corneal ulcers were randomly divided into three groups of five for the present study. (I, II, and III). Group I was used as the control group (without treatment). The second group received an iodine solution (1.25%) without a nanoparticle structure (betadine). The third group received an iodine solution with a nanoparticle structure used as eye drops. Drops in the corneal ulcer group were used five times daily for 14 days.Microbial counts and disease severity scores were measured on the first, second, fifth, and fourteenth days and compared between groups separately for each disease.ResultsThe results showed that the changes in microbial load were significant in the group that received betadine and nanoparticles. The microbial load was further reduced when using iodine nanoparticles than betadine. The betadine and nano-iodine groups significantly reduced the severity of the disease in rabbits with corneal ulcers (p < 0.05). The average changes in disease severity score were 4.8 ± 1.3, -2.6 ± 0.89, and -2.22 ± 1.22 in the untreated, nano iodine, and betadine groups, respectively. However, a significant increase in disease severity was observed in the untreated group (p = 0.001). It shows a significant difference (p < 0.001) between the nano iodine, betadine, and untreated groups. However, the difference in disease severity changes between nano iodine and non-nano iodine groups was insignificant.ConclusionNanoparticle iodine is more effective than non-nanoparticle iodine in reducing bacterial load. In reducing the severity of the disease, both types of iodine were superior to no treatment. But there was no apparent difference between the two groups treated with iodine.

Trends in Geographic Distribution of Visual Disability – United States, 2010-2019

ABSTRACT Purpose We aimed to describe changes in the geographic distribution of self-reported visual impairment (VI) over the last decade (2010–2019) in the U.S. Methods Our study was an analysis of publicly available data collected between 2010 and 2019 from the Census Bureau American Community Survey. Results The mean overall prevalence of self-reported VI from 2010 to 2019 was 2.31% in the United States, and there was a significant increase in VI over the past decade from 2.25% in 2010–2014 to 2.37% in 2015–2019 (p < .001). VI was significantly higher in rural counties (3.58%), compared to urban (3.10%) or metropolitan counties (2.18%) (p < .001). In terms of geographic region, the South of the United States had the highest rate of VI (2.63%) (p < .001). For age groups > 17-years-old in the 2010–2019 data, women had higher rates of VI compared to men. Conclusions Prevalence of self-reported visual impairment has risen and disproportionately affects certain communities. This includes individuals living in the South, in rural counties, and women.

The Transfer Patterns of Vulnerable Populations with Acute Cardio-Cerebrovascular Diseases

Abstract Background In Korea, cardio-cerebrovascular diseases (CCDs) are the second leading cause of death. As providing appropriate treatment within the golden hour is crucial for managing acute onset CCDs, health outcomes vary depending on the accessibility of hospital. This study aimed to investigate the healthcare accessibility of vulnerable populations based on the transfer patterns with acute CCDs. Methods We analyzed the transfer times to final treatment hospital using the Korean National Health Insurance claim database from 2016 to 2021. We used multivariate logistic regression analysis on whether patients were transferred between hospitals after adjusting for age, gender, income level, and residence. Results The risk of transfer between hospitals was lower in socially vulnerable groups (elderly, low-income groups, and people with disabilities) compared to other groups (adjusted Odds Ratio [aOR]=0.65; 95% Confidence Interval [CI] 0.64-0.67 for people with disabilities vs people without disabilities), while it was higher in geographically vulnerable groups (rural) compared to other groups (aOR=2.05; [CI] 2.01-2.09 for rural vs metropolitan). Additionally, people with mild disabilities and those with visual, hearing, language, or physical disabilities showed higher transfer risk compared to other groups. Conclusions The risk of transfer showed opposite patterns between the two vulnerable groups with high mortality rates. The geographically vulnerable group had a higher risk due to absence treatable hospitals, while the socially vulnerable group might not have transferred even when it was necessary due to economic and physical constraints. The possibility of transfer was higher among the high-income group, which was assumed to be transferred to hospitals with better medical services. In fact, among patients hospitalized at teaching hospitals, 40% belong to the top 20% of income level. Efforts to improve accessibility for all in medical services should be continued. Key messages • The risk of being transferred between hospitals showed opposite patterns between socially vulnerable and geographically vulnerable groups with high mortality rates. • Measures are needed to improve access to quality hospitals, and monitoring is necessary for situations where necessary transfers are not carried out.

The “Cristo Re” hospital experience on telerehabilitation for treatment post thyroidectomy neck pain

Abstract Background Thyroidectomies are one of the most frequently performed endocrine surgical procedures and are mostly consequent to thyroid cancers with about 80% of patients develop neck pain and stiffness. For better management in a public health setting, Cristo Re Hospital in Rome has designed specific physiotherapy based on selective stretching and strengthening of neck muscles combined with breathing. Methods The study enrolled 26 patients with a mean age of 51.2 years: 20 were treated with total thyroidectomy and 6 with thyroid lobectomy. Follow-up was performed at 1 day, 1 week and 1 month after surgery. We used for assessment: Visual Analog Scale (VAS), Neck Pain and Disability Scale-I (NPDS-I), Short Form-12 (SF12), Disability of the Arm, Shoulder and Hand (DASH), Neck Disability Index Questionnaire (NDI). The patients performed 10 therapeutic sessions: the first in the hospital on the first post-surgery day, the others in telerehabilitation 3 times a week (40 min. each) for 3 weeks. A nonparametric Friedmann test was analyzed the differences between the scale averages at T0/T1 and T2. Using case-control analysis the effects of treatment duration (&amp;lt;vs&amp;gt;90 min.) were assessed with the U-Mann-Whitney test. Results A statistically significant improvement was shown in the Physical Component Summary- SF12 at 1 week and 1 month after treatment (+3 pts at T1, +13.2 at T2 p &amp;lt; 0.001), while no significant changes in the Mental Component Summary. The averages of NPDS-I, NDI and DASH also decreased at T1 and T2 demonstrating the effectiveness of the protocol (-37.7 median points,-18.3 mp,-34.5 mp,-35 mp, respectively p &amp;lt; 0.001). No significant change in VAS scale at T1 and T2 and in patients treated for more or less than 90 minutes. Conclusions This protocol is useful for reducing neck pain and improving quality of life and can be recommended as a therapy after thyroidectomy with a strong reduction in cost and morbidity, being able to treat patients even in telerehabilitation. Key messages • Therapy after thyroidectomy that, by being able to treat patients even in telerehabilitation, reduces hospitalization rates, costs, and morbidity due to neck pain, with increased quality of life. • New low-cost methodology for neck physiotherapy after thyroidectomy, also performed in telerehabilitation, which improves quality of life and ability of movement while greatly reducing pain.

Perception of the quality of medical care in patients from the LGBT+ community

Abstract Background Mexico does not have comprehensive care services for members of the LGBT+ community, who also still suffer from a social context that still develops between traditions of inequality and lack of inclusion. Objective: To determine the factors associated with the perception of good quality of medical care in patients from the LGBT+ community Methods A cross-sectional, observational, prospective and analytical study was carried out between November and April 2023. Members of the LGBT+ community of Veracruz, Mexico were included; Subjects with visual or hearing disabilities or some psychological disorder that affects the perception of behavior were excluded. Data collection was done through Google Forms. The SPSS v22 program was used, X2 test, Odds Ratio (OR) and confidence interval (CI95%). Results 489 subjects were included, 295 (60.6%) use the public medical system, 155 (31.7%) consider a medical specialty is necessary to care for the LGBT+ community and 150 (30.7 %) indicates that the specialty should only be for care of patients with gender change; 297 (60.7%) perceive that they receive good quality medical care and 69 (14.1%) have perceived that they have been denied consultation because they belong to the LGBT+ community. The factors associated (OR/CI95%) to the perception of good medical care is the lack of: a family doctor (0.4/0.3-0.6), discomfort on physical examination (13.1/6.9-24.0), verbal abuse (13.3 /6.7-26.0), sexual harassment (5.1/2.7-9.5), physical harassment (11.5/4.7-28.0), discomfort of the doctor during the consultation (10/6.0-19.2), breach of confidentiality (7.2/3.7-14.1), denying care (12.7/6.3-25.6) (p &amp;lt; 0.05). Conclusions The factors associated with the perception of a good quality of care in patients from the LGBT+ community are similar to those reported in the literature within any community, which invites health institutions to reinforce their inclusion programs, to reduce acts of discrimination. Key messages • Health systems need to consider care for the LGBT+ community from specialists who can make a comprehensive assessment that favors adequate medical care. • Discrimination is still present within the medical care of patients from the LGBT+ community, so it is essential that the doctor is trained and sensitized in the processes of inclusion.

Altered Oculomotor and Vestibulo-ocular Function in Children and Adolescents Postconcussion.

To document (1) oculomotor (OM) and vestibulo-ocular (VO) function in children with concussion who were symptomatic at the time of assessment and to compare it with that in children with concussion who were clinically recovered (asymptomatic) and in children with no concussive injury, and (2) the extent to which OM and VO function relates to postconcussion symptom severity in injured children. Participants were recruited from a concussion clinic or the community. A total of 108 youth with concussion (72 symptomatic; 36 recovered) and 79 healthy youth (aged 9-18 years). Youth with concussion were included if aged 9 to 18 years, had no previous concussion within the last 12 months, less than 90 days since injury, and no known existing visual disorders or learning disabilities. A prospective cross-sectional study. All participants were tested for OM and VO function with a commercial virtual reality (VR) eye-tracking system (Neuroflex ® , Montreal,Québec, Canada). Participants in the concussion group who completed the postconcussion symptoms were scored with the Post-Concussion Symptom Inventory. There was a significant group effect for vergence during smooth pursuit ( F2,176 = 10.90; P < .05), mean latency during saccades ( F2,171 = 5.99; P = .003), and mean response delay during antisaccades ( F2,177 = 9.07; P < .05), where children with symptomatic concussion showed poorer performance than clinically recovered and healthy children. Similar results were found in VO for average vestibular ocular reflex gain in the horizontal leftward ( F2,168 = 7; P = .001) and rightward directions ( F2,163 = 13.08; P < .05) and vertical upward ( F2,147 = 7.60; P = .001) and downward directions ( F2,144 = 13.70; P < .05). Mean saccade error was positively correlated to total Post-Concussion Symptom Inventory scores in younger clinically recovered children. VR eye tracking may be an effective tool for identifying OM and VO deficits in the subacute phase (<90 days) postconcussion.

Screen-Reader Based Contextual Exploration of Mathematical Formulas in Brazilian Portuguese: Design, User Evaluation and Teaching Scenario in the Context of Numerical Analysis

Although screen readers have made significant technological advancements, mathematics remains a challenging subject for people with visual disabilities. Due to its complex notations and abstract nature, mathematics presents difficulties in understanding through means other than visual. Consequently, reading mathematical content with screen readers poses challenges such as ambiguity, comprehension of long formulas, and identification of specific elements. Furthermore, even with reading difficulties, few screen readers support reading this type of content in Portuguese. This study presents an extension of a previous study which described the development and evaluation of an add-on for NVDA, which enables contextual exploration and navigation of mathematical formulas. The add-on, called Access8Math-NavMatBR, allows for internal exploration of formulas by providing contextual delineations of mathematical elements with support for the Brazilian variant of the Portuguese language. Based on the open-source Access8Math add-on, the new version was developed and evaluated in usability tests with six people with visual disabilities. Results showed that the new system improved understanding of formulas and provided better access to specific elements through formulas abstraction. The evaluation identified 52 issues, such as problems with commands and interaction approaches, verbalization by the screen reader, and platform structure. This extended version extends the analysis by presenting a teaching scenario in the context of numerical analysis and how the contextual exploration can be applied to aid in the understanding of complex elements. The paper presents design implications for systems for reading mathematical formulas in the Brazilian context and considerations for exploring patterns used by Brazilian users when reading and browsing mathematical formulas, dialoguing with the practical example presented.

REPAIR CAPABILITIES OF ALLOGENIC STEM CELLS IN DISEASES OF THE ANTERIOR SEGMENT OF THE EYEBALL

Corneal diseases are one of the leading causes of low vision and blindness throughout the world, which serves to increase visual disability among the young and working-age population. The low effectiveness of therapeutic treatment, lack of donor material and frequent rejection reactions after transplantation prompt the search for more effective methods of treating corneal diseases, both inflammatory and dystrophic.

Access to primary healthcare services by people with disabilities

Objective: to analyze the access of people with hearing, physical, and visual disabilities to primary healthcare services. Methods: a cross-sectional study was conducted with 250 participants, and data collection was implemented in three stages: contact with the health department, locating the residences of persons with disabilities within the coverage area of the primary healthcare unit, and analysis of integrated data. Results: there was a predominance of older individuals, individuals of non-white race/ethnicity, males, and those who were either married or in a consensual union. Self-transportation, including cars, motorcycles, or bicycles, was the primary means of access to services, followed by walking. Most individuals sought health services within six months, followed by those who sought care between six months and one year, mainly because of chronic or worsening conditions. Conclusions: impaired access was identified, as evidenced by multiple barriers, including transportation, architectural, and communication barriers. Contributions to practice: it is important to consider the disparities, vulnerabilities, and health status of the disabled population in health care.

Study of ocular manifestations of COVID-19 patients in a tertiary care hospital of Rural North Maharashtra

Objectives: The purpose of the study is to understand profile of ocular manifestations in recovered post COVID 19 patients and to suggest recommendations based on observations. Materials and Methods: It was a prospective hospital-based case analysis study done at tertiary care hospital of rural North Maharashtra from April 2020 to June2021 and included 104 patients with recent history of COVID 19 infection and various ocular symptom Results: Diabetes mellitus is most common associated factor observed. Viral conjunctivitis was observed in 52 cases .2 cases reported subconjunctival hemorrhage. Retinal vein occlusions were seen in 3 cases. Total ophthalmoplegia was seen in 23 cases. Orbital cellulitis with mucormycosis was documented in 12 cases. Orbital apex syndrome with an impending intracranial spread in 4 case required orbital exenteration. Peribulbar Amphotericin B was given in 3 cases and intravenous and oral antifungals also given simultaneously Conclusion: COVID 19 infection can lead to various ocular symptoms even in the recovery period. Early diagnosis by high degree of suspicion and prompt treatment with multidisciplinary approach is required for prevention of visual disability.

Study protocol of OmegaROP-2 prospective study: expression of placental fatty acid receptors in preterm newborns with retinopathy of prematurity

BackgroundIncomplete vascularization of the retina in preterm infants carries a risk of retinopathy of prematurity (ROP). Progress in neonatal resuscitation in developing countries has led to the survival of an increasing number of premature infants, resulting in an increased rate of ROP and consequently in visual disability. Strategies to reduce ROP involve optimizing oxygen saturation, nutrition, and normalizing factors such as insulin-like growth factor 1 and n-3 long-chain polyunsaturated fatty acids (LC-PUFA). Our previous study, OmegaROP, showed that there is an accumulation or retention of docosahexaenoic acid (DHA) in mothers of infants developing ROP, suggesting abnormalities in the LC-PUFA placental transfer via fatty acid transporting proteins. The present study aims to better understand the LC-PUFA transport dysfunction in the fetoplacental unit during pregnancy and to find a novel target for the prevention of ROP development.MethodsThe study protocol is designed to evaluate the correlation between the expression level of placental fatty acid receptors and ROP occurrence. This ongoing study will include 100 mother-infant dyads: mother-infant dyads born before 29 weeks of gestational age (GA) and mother-infant dyads with full-term pregnancies. Recruitment is planned over a period of 46 months. Maternal and cord blood samples as well as placental tissue samples will be taken following delivery. ROP screening will be performed using wide-field camera imaging according to the International Classification of ROP consensus statement.DiscussionThe results of this study will have a tangible impact on public health. Indeed, if we show a correlation between the expression level of placental omega-3 receptors and the occurrence of ROP, it would be an essential step in discovering novel pathophysiological mechanisms involved in this retinopathy.Trial registrationNCT04819893.

Quality of Life and its Predictors among Persons with Visual Disabilities in Sri Lanka: Development of a New Measure

Quality of Life and its Predictors among Persons with Visual Disabilities in Sri Lanka: Development of a New Measure

Abnormal network connections to early visual cortex in posterior cortical atrophy

IntroductionPosterior Cortical Atrophy (PCA), a visual variant of Alzheimer's disease, initially manifests with higher-order visual disorders and parieto/temporo-occipital atrophy. Recent studies have shown remote functional impairment in both distant brain networks and along the calcarine sulcus (V1). Functional alteration in the calcarine differs along its length, reflecting center to periphery visual space differences. Herein, we aim to connect between these two sets of findings by looking at the retinotopic patterns of functional connectivity between large-scale brain networks and V1, comparing patients with normally sighted subjects. MethodsResting state functional magnetic resonance imaging (fMRI) and T1 anatomical scans were obtained from 11 PCA patients and 17 age-matched healthy volunteers. Default mode network (DMN) and fronto parietal network (FPN) were defined and differences between the networks in patients and healthy controls were evaluated at the whole brain level, specifically their connectivity to V1. ResultsConnectivity patterns within the DMN and the FPN were similar between the groups, although differences were found in regions within and beyond the networks. Focusing on V1, in the control group we identified the expected pattern of a distributed connectivity along eccentricity, with foveal regions showing stronger connectivity to the FPN and peripheral regions showing stronger connectivity to the DMN. However, in PCA patients we could not identify a clear difference in connectivity along the eccentricities. ConclusionLost specialization of function along the calcarine in PCA patients may have further implications on large-scale networks or vice versa. This impairment, distant from the core pathology, might explain patients' visual disabilities.

Discrimination against people with mental, physical or visual disabilities in the French rental housing market: field experiment

We implement correspondence testing to detect and assess the extent of discrimination against people with disabilities in the French rental housing market. By sending 1,750 emails in a matched-pair procedure, we provide evidence of significant and extensive discrimination against blind people with a guide dog, individuals with mental disabilities, and individuals with motor impairments in the process of rented housing allocation. However, the primary cause of discrimination against blind individuals appears to stem from the presence of the guide dog, rather than the disability itself. Our results are also consistent with the presence of statistical discrimination (particularly based on financial means). We find that absolute discrimination against disabled applicants increases in accordance with the level of rent, while real estate agents discriminate significantly less against disabled applicants than private landlords.

The average life expectancy of persons with disabilities in China

The average life expectancy (ALE) of persons with disabilities (PWDs) is much shorter than that of the total population in many countries. However, there have been relatively few empirical studies on the ALE of PWDs in China. This study estimates the ALE and compiles the life tables of PWDs in China using data on 1,359,812 PWDs registered in the Special Surveys of Basic Services and Needs of the Disabled (SSBSND) in K Province in China from 2015 to 2017. The ALE of PWDs at age 20 is 45.2 years (95% CI: 44.7–45.8) for men and 48.1 years (95% CI: 47.6–48.6) for women, which is 15.0 years (men) and 16.5 years (women) lower than that of the entire population. The ALE of those with the most severe disability is only 33.7 years (95% CI: 32.2–45.1) for men and 37.1 years (95% CI: 35.3–38.8) for women. The ALE is relatively short for persons with intellectual and physical disabilities; moderate for those with hearing, speech, and mental disabilities; and relatively long for those with visual and multiple disabilities. Of the PWDs participating in basic old-age insurance (BOI), more than 30% do not live long enough to receive their pensions. As such, because a large proportion of PWDs die before 60 years old, social policies for PWDs should be specially designed.

Trends in the prevalence of common ocular conditions and comparison of ophthalmic outpatient utilisation related to these conditions in children with and without various types of disabilities: analysis of nationwide population-based data from Taiwan, 2014–2019

ObjectiveThe study objectives were to investigate trends in the prevalence of common ocular conditions among children with and without disabilities; to compare the prevalence of these conditions in children with...

Ophthalmologic Emergencies: Assessment and Management.

There are an estimated 2-3 million emergency department (ED) visits in the United States for eye complaints. Although most patients who present to the ED have nontraumatic eye complaints, many seek treatment for eye trauma, which is a leading cause of unilateral blindness and vison impairment. Given the prevalence of eye-related emergencies, it is imperative that emergency care providers understand how to recognize and treat eye complaints to prevent permanent vision loss and disability. This article covers basic eye anatomy and physiology, discusses a systematic approach to the eye examination, and presents the evidence-based treatment of selected, common nonemergent and emergent eye complaints. For each complaint, essential history questions, examination techniques, differentials, and emergency management have been presented.

Assistive technology for people with visual disability: Future prospects through a technology foresight exercise

BACKGROUND: In recent years, with ever-improving technology, considerable progress has been made in the approaches available to develop mobility assistive technology systems. OBJECTIVE: This paper aims to anticipate the future of assistive technologies of navigation and mobility for people with severe visual disabilities in the next twenty years (2021–2041). METHODS: We conducted a technology foresight exercise by identifying promising technologies and invited over 20,000 researchers worldwide to share their views on the future of assistive technologies for people with visual impairment. The technologies and respondents were identified from specialized journals indexed on Web of Science. RESULTS: Most respondents believe computer vision will be the most important assistive technology group for mobility and navigation for visually impaired people, especially with haptic feedback. They also believe that voice and vibrotactile are the most relevant feedback and that glasses and smartphones will be the most important tools for visual impairment support. CONCLUSIONS: While costs and lack of user training may hamper the development and use of these new technologies, they represent the future of assistive technology for people with visual impairments.

Developing a training program in reading and writing Braille symbols in English language for students with visual disability in low elementary grades and measuring its effectiveness

The objective of this study is to identify the impact of a training program in Reading and Writing Braille symbols in English language for students with visual disability in the elementary stage in Jordan. Participants are 60 students with visual disability, from Grades 1–6, studying at the blind school in Abdoun. Members were divided into two groups: control and experimental. In order to evaluate the efficacy of the training program, the researcher developed a scale to measure pre- and post-ability to read and write Braille symbols in English language. Means and standard deviations were calculated for both groups. Analysis was carried out using two-way analysis of variance. The results indicate statistically significant differences on reading and writing dimensions and on the total score, as well as on the post training results in favor of the experimental group indicating significant impact of the training program. The results did not show any significant differences between blind and partial visual disability in the experimental group on reading and writing scores and on the total score. Findings demonstrated the efficacy of the training program, which introduced reading and writing in a simple and interesting way according to certain levels ranging in difficulty, in addition to using different forms of reinforcement to motivate students. As for the implications for practitioners, teachers in inclusive schools of schools of visually disabled students can use the training program to teach both blind and partially sighted students reading and writing English Braille using both the hands.

The Use Of Flat Structure Puzzles To Improve Fine Motor Ability In Students With Visual Disabilities

This study aims to determine the process of learning mathematics in students with visual disabilities. Researchers use the experimental method, where the experimental method is part of the quantitative method. Data collection uses a questionnaire to find out the results of learning mathematics in students with visual disabilities. The subject of this study was one of the 3rd-grade students at special education school SDLB Purwosari Kudus who has special needs and is visually impaired. The results of the study show that in the process of teaching activities, the teacher only provides material and the teacher does not provide examples of learning media to students. Students with visual disabilities have difficulties in mathematics lessons, where the teacher only explains the material to students in the process of teaching and learning activities, but students have a high curiosity and enthusiasm for the material being taught. Meanwhile, the limitations of learning media and school facilities are inhibiting factors in teaching and learning mathematics for students with visual disabilities. Seeing these conditions, the researcher chose the Flat Puzzle learning media.