Low Vision Devices for Age-Related Macular Degeneration: a Systematic Review
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Vision Rehabi I Itation for Patients with Age Related Macular Degeneration
Vision rehabi I itation for GARY S. RUBIN patients with age related macular degeneration Epidemiology of low vision The over-representation of macular degeneration patients in the low-vision clinic is The epidemiology of vision impairment is dealt reflected in the chief complaints of those with in detail elsewhere.1 However, there is one referred for rehabilitation. A study of 1000 particularly salient factor that bears emphasis. consecutive patients seen at the Wilmer Low The prevalence of vision impairment increases Vision clinic indicated that 64% listed 'reading' dramatically with advancing age. Statistics as their chief complaint, while other activities compiled in the UK by the Royal National were identified by fewer than 8% of patients. Institute for the Blind2 indicate that there were Undoubtedly the bias towards reading approximately 1.1 million blind or partially problems results partly from the nature of the sighted persons in 1996, of whom 82% were 65 low-vision services offered. Those served by a years of age or older. Thus it is not surprising to community-based programme that includes learn that the major causes of vision impairment home visits might be more likely to report are age-related eye diseases. Fig. 1 illustrates the problems with activities of daily living, while a distribution of causes of vision impairment blind rehabilitation centre would be more likely 5 from three recent studies?- Approximately to address mobility issues. Nevertheless, most equal percentages are attributed to macular macular degeneration patients are referred to degeneration and cataract, with smaller hospital or optometry clinic services, and as percentages for glaucoma, diabetic retinopathy their overwhelming concern is with reading, and optic neuropathies. -
Symptoms of Age Related Macular Degeneration
WHAT IS MACULAR DEGENERATION? wavy or crooked, visual distortions, doorway and the choroid are interrupted causing waste or street signs seem bowed, or objects may deposits to form. Lacking proper nutrients, the light- Age related macular degeneration (AMD) is appear smaller or farther away than they sensitive cells of the macula become damaged. a disease that may either suddenly or gradually should, decrease in or loss of central vision, and The damaged cells can no longer send normal destroy the macula’s ability to maintain sharp, a central blurry spot. signals from the macula through the optic nerve to central vision. Interestingly, one’s peripheral or DRY: Progression with dry AMD is typically slower your brain, and consequently your vision becomes side vision remains unaffected. AMD is the leading de-gradation of central vision: need for increasingly blurred cause of “legal blindness” in the United States for bright illumination for reading or near work, diffi culty In either form of AMD, your vision may remain fi ne persons over 65 years of age. AMD is present in adapting to low levels of illumination, worsening blur in one eye up to several years even while the other approximately 10 percent of the population over of printed words, decreased intensity or brightness of eye’s vision has degraded. Most patients don’t the age of 52 and in up to 33 percent of individuals colors, diffi culty recognizing faces, gradual increase realize that one eye’s vision has been severely older than 75. The macula allows alone gives us the in the haziness of overall vision, and a profound drop reduced because your brain compensates the bad ability to have: sharp vision, clear vision, color vision, in your central vision acuity. -
Macular Degeneration
DRIVEWELL Driving When You Have Macular Degeneration You have been a safe driver for years. For you, driving means freedom and control. As you get older, changes in your physical and mental health can affect how safely you drive. Macular degeneration (also known as age-related macular degeneration) damages the macula, a spot near the center of the retina (light-sensitive inner lining of the eyeball). It is a common eye problem among older drivers that makes it hard to drive safely. Age-related macular degeneration is the leading cause of new cases of blindness in people 65 and older. If you have macular degeneration, you may not notice any signs in the early stages. You may not know you have this condition until you lose your peripheral vision (what you see out of the corner of your eyes). In time it will affect your central vision, causing a dark or empty area in the center of your vision. How Can Macular Degeneration Affect the Way I Drive? • Your central vision may be dull and blurry. This can lead to loss of sharp vision. • You may not see the road, street signs, lane markers, and even people and bicyclists in the road. • You may need more bright light to see up close. • Colors may look less vivid or bright. • You may have trouble when you go from bright light to low light. • You may not be able to recognize people’s faces. What Should I Do if I Have Any of These Signs? As soon as you notice any of these warning signs: • Tell your family or someone close to you, especially if you have a family history of macular degeneration or have changes in your central vision. -
Visual Performance of Scleral Lenses and Their Impact on Quality of Life In
A RQUIVOS B RASILEIROS DE ORIGINAL ARTICLE Visual performance of scleral lenses and their impact on quality of life in patients with irregular corneas Desempenho visual das lentes esclerais e seu impacto na qualidade de vida de pacientes com córneas irregulares Dilay Ozek1, Ozlem Evren Kemer1, Pinar Altiaylik2 1. Department of Ophthalmology, Ankara Numune Education and Research Hospital, Ankara, Turkey. 2. Department of Ophthalmology, Ufuk University Faculty of Medicine, Ankara, Turkey. ABSTRACT | Purpose: We aimed to evaluate the visual quality CCS with scleral contact lenses were 0.97 ± 0.12 (0.30-1.65), 1.16 performance of scleral contact lenses in patients with kerato- ± 0.51 (0.30-1.80), and 1.51 ± 0.25 (0.90-1.80), respectively. conus, pellucid marginal degeneration, and post-keratoplasty Significantly higher contrast sensitivity levels were recorded astigmatism, and their impact on quality of life. Methods: with scleral contact lenses compared with those recorded with We included 40 patients (58 eyes) with keratoconus, pellucid uncorrected contrast sensitivity and spectacle-corrected contrast marginal degeneration, and post-keratoplasty astigmatism who sensitivity (p<0.05). We found the National Eye Institute Visual were examined between October 2014 and June 2017 and Functioning Questionnaire overall score for patients with scleral fitted with scleral contact lenses in this study. Before fitting contact lens treatment to be significantly higher compared with scleral contact lenses, we noted refraction, uncorrected dis- that for patients with uncorrected sight (p<0.05). Conclusion: tance visual acuity, spectacle-corrected distance visual acuity, Scleral contact lenses are an effective alternative visual correction uncorrected contrast sensitivity, and spectacle-corrected contrast method for keratoconus, pellucid marginal degeneration, and sensitivity. -
Detached and Torn Retina Retinal Detachments Occur in 1 out of 10,000 Americans Each Year
Detached and Torn Retina Retinal Detachments Occur in 1 Out of 10,000 Americans Each Year A retinal detachment is not as common as other eye conditions such as glaucoma or macular degeneration, however… it is just as serious and it is a vision threatening condition which should be treated as an emergency. Dr. Randy Katz, Florida Eye’s Diabetic Retinopathy, Retinal Detachment & Macular Degeneration Specialist says that the sooner a retinal tear or detachment is treated the better the chances of saving the vision in the eye. What Is a Retinal Detachment? The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. When the retina detaches, it is lifted or pulled from its normal position. When this occurs, if not promptly treated, retinal detachment can cause permanent vision loss. In some cases there may be small areas of the retina that are torn. These areas, called retinal tears or retinal breaks, can lead to a retinal detachment. Vitreous gel, the clear material that fills the eyeball, is attached to the retina in the back of the eye. As we get older, the vitreous may change shape, pulling away from the retina. If the vitreous pulls a piece of the retina with it, it causes a retinal tear. Once a retinal tear occurs, vitreous fluid may seep through and lift the retina off the back wall of the eye, causing the retina to detach or pull away. 2 Are You At Risk for a Torn or Detached Retina? A retinal detachment can occur at any age, but it is more common in people over age 40. -
Fact Sheet: Refractive Errors
Fact Sheet: Refractive Errors More than 11 million Americans have common vision problems that can be corrected with the use of prescriptive eyewear such as glasses or contact lenses.1 These conditions are known as refractive errors and they occur when the eye doesn’t correctly bend, or ―refract,‖ light as it enters the eye. Common refractive errors include the following: o Nearsightedness (also called myopia)—A condition where objects up close appear clearly, while objects far away appear blurry. With nearsightedness, light comes to focus in front of the retina instead of on the retina. o Farsightedness (also called hyperopia)—A common type of refractive error where distant objects may be seen more clearly than objects that are near. However, people experience farsightedness differently. Some people may not notice any problems with their vision, especially when they are young. For people with significant farsightedness, vision can be blurry for objects at any distance, near or far. o Astigmatism—A condition in which the eye does not focus light evenly onto the retina, the light-sensitive tissue at the back of the eye. This can cause images to appear blurry and stretched out. o Presbyopia—An age-related condition in which the ability to focus up close becomes more difficult. As the eye ages, the lens can no longer change shape enough to allow the eye to focus close objects clearly. Refractive errors are one of the most common—and correctable—causes of visual impairment in the United States. According to a recent study led by the National Eye Institute (NEI), approximately half of all American adults don’t have the 20/20 vision physicians consider optimal due to refractive errors.2 Women experience refractive error more frequently than men: Twenty-six percent more women aged 12 and older have uncorrected visual impairment due to refractive error compared with men aged 12 and older. -
Visual Impairment 101: What Do Administrators Need to Know?
Visual Impairment 101: What do Administrators Need to Know? Stephanie Walker, ESC Region 11 Mary Shore, TSBVI Outreach Visual Impairment 101 What do administrators need to know? Presented by: Stephanie Walker, M.Ed. Lead for the State Leadership Services for the Blind and Visually Impaired (SLSBVI) Network Mary Shore, COMS Professional Preperation Coordinator TSBVI Outreach Handouts and Additional Resources Texas School for the Blind and Visually Impaired - Administrator’s Toolbox Statewide Leadership Services for the Blind and Visually Impaired Simulation Activities What is a visual impairment? §300.8 (c)(13) Visual impairment including blindness means an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness. §89.1040 (c)(12) (A) A student with a visual impairment is one who has been determined to meet the criteria for visual impairment as stated in 34 CFR, §300.8(c)(13). The visual loss should be stated in exact measures of visual field and corrected visual acuity at a distance and at close range in each eye in a report by a licensed ophthalmologist or optometrist. The report should also include prognosis whenever possible. If exact measures cannot be obtained, the eye specialist must so state and provide best estimates. What types of vision does this include? Legally Blind Central vision acuity in the better eye of 20/200 or worse after the best correction possible, or a field of vision of 20 degrees or less. Low Vision/Partial sight Visual acuity better than 20/200 after correction in the better eye. -
Color Blindness
. assessment report Color Blindness .......... Betsy J. Case, Ph.D. February 2003 (Revision 2, November 2003) Copyright © 2003 by Pearson Education, Inc. or its affiliate(s). All rights reserved. Pearson and the Pearson logo are trademarks of Pearson Education, Inc. or its affiliate(s). ASSESSMENT REPORT . Color Blindness . Color Blindness Acknowledgements Pearson Inc. (Pearson) gratefully acknowledges the following individuals for providing expertise and references to empirical research on this topic. Furthermore, several of these individuals reviewed all Stanford Achievement Test Series, Tenth Edition (Stanford 10) materials to ensure that the color choices provided effective color contrast for students with color blindness. Dr. Carol Allman, formerly with the Florida Department of Education, currently with the American Printing House for the Blind, Inc., Louisville, KY. Multiple personal contacts from 1997 – present. Dawn Dunleavy, The Psychological Corporation. Barbara Henderson, Research Group, American Printing House for the Blind, Inc., Louisville, KY. Multiple personal contacts from 2001 – present. Diane Spence, Director, Braille Services Unit, Region IV Education Service Cooperative, Houston, Texas. Multiple personal contacts from 1997 – present. Dr. Sandra Thompson, Senior Researcher, National Center on Educational Outcomes, University of Minnesota, Minneapolis. Critical nexus with the Minnesota Laboratory for Low-Vision Research by Gordon E. Legge. Multiple personal contacts from 1993 – present. Debra Willis, American Printing House for the Blind, Inc. Personal communications from 1996 – present. Color Vision Color vision is determined by the discrimination of three qualities of color: hue (such as red vs. green), saturation (that is, pure vs. blended colors), and brightness (that is, vibrant vs. dull reflection of light) (Arditi, 1999a). The essential difference between the color blind and most people is that hues that appear different to most people look the same to a color blind person. -
Analysis of Three Genes in Leber Congenital Amaurosis in Indonesian Patients
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Vision Research 43 (2003) 3087–3093 www.elsevier.com/locate/visres Analysis of three genes in Leber congenital amaurosis in Indonesian patients Rita S. Sitorus a,b,*, Birgit Lorenz a, Markus N. Preising a a Department of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, Klinikum, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany b Department of Ophthalmology, School of Medicine, University of Indonesia, Salemba 6, Jakarta 10430, Indonesia Received 23 June 2003 Abstract Purpose. To assess the frequency, the pattern of disease causing mutations, and phenotypic variations in patients with Leber congenital amaurosis (LCA) from Indonesia. Patients and methods. Twenty-one unrelated index cases with a clinical diagnosis of LCA were screened for mutations in the coding sequence of RetGC1, RPE65 and AIPL1 gene with single strand conformation polymorphism analysis followed by direct sequencing and restriction enzyme digestion. Results. Four novel disease causing mutations were identified: Three in the RPE65 gene (106del9bp, G32V and Y435C) in two of 21 index cases and one in the AIPL1 (K14E). Two of them were homozygous and one was compound-heterozygous. No disease causing mutation was identified in RetGC1. Conclusions. The four novel disease causing mutations identified in this study confirmed the diagnosis of LCA which has not been recognized before in Indonesia. The frequency of RPE65 mutations was 9.5%; and of AIPL1 mutations 4.8%. This was in general accordance with previous studies reported from other countries. Unlike in those studies, no disease causing RetGC1 mutations could be identified in our patients. -
Frequency of Low Vision Patient and Their Causes Presenting in Madinah Teaching Hospital, Pakistan
Advances in Ophthalmology & Visual System Research Article Open Access Frequency of low vision patient and their causes presenting in Madinah Teaching Hospital, Pakistan Abstract Volume 9 Issue 6 - 2019 Aim: The aim of our study to determine the frequency of low vision patient and their causes presenting in Madinah Teaching Hospital. Fatima Iqbal,1 Iqra Khalil,1 Hafiza Ayesha Khalil,2 Mariam Sadiq,3 Hafiza Azka Noor,3 Methods: 400 patients were screened in the duration of five month from JAN to MAY Mawra Zahid 2019.80 subjects were taken as a low vision patient according to WHO, whose visual 1 acuity was less than 6/18 with correction. The main causes of low vision were observed Lecturer in School of Optometry, University of Faisalabad, Pakistan high refractive errors, retinitis pigmentosa, cataract, glaucoma and diabetic retinopathy all 2Optometrist, Fred Hollow Foundation, Pakistan patients presenting in ophthalmology department with either gender and age ranging from 3Optometrist, LRBT Toba Tek Singh, Pakistan 10-80 years. Uncooperative and mentally retarded persons were excluded in our study. 4Demonstrator, University of Lahore, Pakistan After complete history, we examined the all individual’s visual acuity with log-mar chart, color vision with ishihara and contrast sensitivity with Pelli-robson chart. Data was entered Correspondence: Fatima Iqbal, Lecturer in School of in to SPSS latest version and analyzed by descriptive analysis. Optometry, University of Faisalabad, Pakistan, Tel 03315538865, Email [email protected] Results: -
Refractive Error Is a Disease of the Eye, and We Should Treat It
Refractive error is a disease of the eye, and we should treat it. believe that refractive error is a disease of the eye— no different from glaucoma, dry eye disease, and other issues for which we readily offer treatment. In the world of modern cataract and refractive surgery, we have the capability to correct visual Iacuity that is compromised due to astigmatism and other types refractive error, so why shouldn't we treat astigmatism during cataract surgery? A large percentage of our cataract patients, about 75%, have at least 0.50 D of astigmatism. Even this small amount of astigmatism can and often does create issues visually for patients. The higher the My Philosophy of level of astigmatism, the more it can affect vision. My philosophy is, why not try to help these people? Correcting their astigmatism will help them to achieve better visual acuity, and this is even more crucial in patients who elect a multifocal, extended depth of focus, or other premium IOL. It is important to educate patients about their astigmatism and to relay to them what we can do ASTIGMATISM to correct it. The level of care and attention to detail affects everything, from our surgical outcomes, to the practice’s reputation, to future referral patterns. THRESHOLDS AND BEST PRACTICES My threshold for astigmatism treatment is about 0.75 D. Above that, the patient can lose contrast and can have functional visual acuity issues if the astig- MANAGEMENT matism is not addressed. I believe that correction of low astigmatism, especially, is low-hanging fruit, as it provides surgeons with an additional opportunity to improve their practices. -
Impact of Presbyopia and Its Correction in Its Correction and of Presbyopia Impact Copyright © 2018 Asia-Pacific Academy of Ophthalmology
REVIEW ARTICLE Impact of Presbyopia and Its Correction in Low- and Middle-Income Countries Ving Fai Chan, MSc, PhD,* Graeme E. MacKenzie, DPhil,† Jordan Kassalow, OD, MPH,‡§ Ella Gudwin, MA,‡ and Nathan Congdon, MD, MPH¶ǁ** 10,11 07/24/2019 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3XLe684GKHSUkTaSrkQQMT2tZTRYsAPrCn1WjGM14MXk= by https://journals.lww.com/apjoo from Downloaded Abstract: Presbyopia affects more than 1 billion people worldwide, of presbyopic correction with glasses are as low as 10%. The prevalence of presbyopia in LMICs ranges from 43.8% Downloaded and the number is growing rapidly due to the aging global population. 10,12–39 Uncorrected presbyopia is the world’s leading cause of vision impair- to 93.4%. However, most of these studies are of somewhat limited value in understanding the burden of presbyopia, as they from ment, and as with other causes. The burden falls unfairly on low- and https://journals.lww.com/apjoo middle-income countries (LMICs), in which rates of presbyopic correc- largely focus on distance vision, few were population-based, and tion are as low as 10%. The importance of presbyopia as a cause of vision definitions of disease and age group cut-offs also vary. impairment is further underscored by the fact that it strikes at the heart The definition of presbyopia is also potentially problematic. 10,16–19,40,41 of the productive working years, although it can be safely and effectively Many studies define NVI as uncorrected bilateral near treated with a pair of inexpensive glasses. To galvanize action for pro- visual acuity (NVA) worse than N6 or N8 at 40 cm (the 40 cm by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3XLe684GKHSUkTaSrkQQMT2tZTRYsAPrCn1WjGM14MXk= grams to address uncorrected presbyopia in the workplace and beyond equivalent of less than or equal to 6/12 and 6/15, respectively).