Effectiveness of low vision aids in vision rehabilitation and improvement of reading speed in people with age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To assess the effectiveness of low vision devices in visual rehabilitation of people with age-related macular degeneration(AMD).<p>METHODS: Forty-four consecutive people with AMD were assessed in low vision clinic. Data about uncorrected and best corrected visual acuity, refractive errors, types of low vision aids(LVAs)and reading speed prior and with low vision devices were collected and analyzed.<p>RESULTS: Among 44 people with mean age 73±10.8 years suffering from AMD, 36(82%)were male. 29(67%)participants had distance visual acuity(DVA)of 1.0-1.6 LogMAR in the better-seeing eyes while 36(82%)had near visual acuity(NVA)less than 3.2 m. Mean improvement in DVA with low vision devices was 0.67±0.27 LogMAR(<i>P</i>=0.000). With LVAs 42(95%)participants achieved NVA of 1 m or better whereas only two(4.5%)participants had NVA of 1 m without LVAs. With the provision of adequate LVAs, mean reading speed was improved from 2.9±4.78 words per minute(wpm)to 71.31±29.96 wpm among the group of participants who could read(<i>P</i><0.001). Monocular telescopes were prescribed to 15 participants for distance vision and high plus monocular lenses in spectacle were the most common aid for reading.<p>CONCLUSION: LVAs can play an effective role in vision rehabilitation of people with AMD and in improvement of reading abilities. Referral to low vision care services must be considered for people with AMD.

Causes of visual impairment in children with low vision

To determine the main causes of visual impairment in children with low vision. To assess the need of spectacles and low vision devices [LVDs] in children and to evaluate visual outcome after using their LVDs for far and near distance. Observational study. Khyber Institute of Ophthalmic Medical Sciences, Peshawar, Pakistan, from June 2006 to December 2007. The clinical record of 270 children with low vision age 4-16 years attending the Low Vision Clinic were included. All those children, aged 4-16 years, who had corrected visual acuity [VA] less than 6/18 in the better eye after medical or surgical treatment, were included in the study. WHO low vision criteria were used to classify into visually impaired, severe visually impaired and blind. Results were described as percentage frequencies. One hundred and eighty nine [70%] were males and 81 [30%] were females. The male to female ratio was 2.3:1. The main causes of visual impairment included nystagmus [15%], Stargardt's disease [14%], maculopathies [13%], myopic macular degeneration [11%] and oculocutaneous albinism [7%]. The percentages of visually impaired, severe visually impaired and blind were 33.8%, 27.2% and 39.0% respectively. Spectacles were prescribed to 146 patients and telescopes were prescribed to 75 patients. Spectacles and telescope both were prescribed to 179 patients while Ocutech telescope was prescribed to 4 patients. Retinal diseases nystagmus and macular conditions were mainly responsible for low vision in children. Visually impaired children especially with hereditary /congenital ocular anomalies benefit from refraction and low vision services which facilitate vision enhancement and inclusive education

Visual rehabilitation of patients with Stargardt's disease

To assess the role of low vision devices in visual rehabilitation of patients with Stargardt`s disease. Descriptive study. The Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar, Pakistan, from June 2003 to June 2005. Patients diagnosed as having Stargardt`s disease and confirmed by two senior ophthalmologists clinically and after fluorescein fundus angiography and Electro-Retinogram [ERG] when needed, were included in the study. Patients with fundus pathologies other than Stargardt`s disease were excluded. Each subject underwent an ophthalmic examination. Visual acuity was tested with a logarithm of the minimum angle of resolution chart; Feinbloom chart and Snellen type. Low vision assessment was performed on all individuals. SPSS version 10 was used for analysis of the data regarding the severity of visual impairment, visual acuity and devices used for aiding vision. Chi-square test was used for comparison of proportions. Of this cohort of 64 patients, 72% were aged between 7 to 15 years and 28% were 16 to 32 years. Using WHO low vision criteria, the percentage of visually impaired, severe visually impaired and blind [at the time of presentation] were 56.3%; 31.3% and 9.4% respectively. Among those patients, 3.1% had distance visual acuity of 6/18 or better in the better eye and 53% had normal near visual acuity of 1M [0.8 print size]. Telescopes were prescribed to 53% patients for enhancement of distance visual acuity to meet their needs. Stargardt's patients respond well to magnification. Simple bifocal glasses may be used in the early stages. Visual rehabilitation can help Stargardt's patients to learn independence in their activities of daily living

Clinical profile of amblyopia in Pakistani children agy 3 to 14 years

To study the clinical profile of amblyopia in children age 3 to 14 years. A cohort study. The study was conducted over a period of two years from June 2001 to June 2003 at Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar, Pakistan. This study included 316 children. Visual acuity was tested with Snellen type and Lea symbols chart according to the level of cooperation of the children. Cycloplegic refraction and orthoptic assessment was performed on all children. One hundred and eighty-two children were between 3 to 8 years age and 134 were between 8 to 14 years. Mean age was 8 years. One hundred and twenty children had strabismic amblyopia, 136 children had anisometropic amblyopia, while 60 children had combined mechanism amblyopia [strabismus and anisometropia both]. The results indicate the importance of screening school-going children for refractive error and amblyopia and the importance of a future prospective study on the magnitude, cause and treatment of amblyopia at more treatable age