Efficacy of low-vision devices in elderly population with age-related macular degeneration

Purpose: Age?related macular degeneration (AMD) is a common cause of blindness, residual damage to macular area in spite of treatment necessitates visual rehabilitation by means of low?vision aids (LVAs). Methods: Thirty patients suffering from different stages of AMD requiring LVAs were included in this prospective study. Patients with nonprogressive, adequately treated AMD were enrolled over a 12?month period, prescribed requisite LVAs and followed?up for a minimum 1?month period. Before and after provision of LVAs, near work efficiencies were evaluated by calculating reading speed as words per minute (wpm) under both photopic and mesopic light conditions, and impact of poor vision on activities of daily living (ADL) was quantified by modified standard questionnaire based on Nhung X et al. questionnaire. Results: Of the 30 patients mean studied with mean age of 68 ± 10 years, 20 patients (66.7%) had dry AMD in better eye and 10 (33.3%) had wet AMD. Post?LVA, near visual acuity improved significantly and all cases were able to read some letters on near vision chart with an average improvement of 2.4 ± 0.96 lines. The different LVAs prescribed were high plus reading spectacles (up to 10 D) in 23.3%, hand?held magnifiers in 53.3%, base in prisms in 10%, stand held magnifiers in 6.7%, and bar and dome magnifiers in 3.3%. Conclusion: LVAs are effective in visual rehabilitation in patients with AMD. Self?reported reduction in visual dependency and improvement in vision?related quality of life post use of aids corroborated perceived benefit.

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.

Factors related to reduction and visual acuity recovery after minimally invasive extrascleral compression for retinal detachment with single aperture / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the factors affecting reduction and vision recovery after minimally invasive scleral compression with RRD detachment.<p>METHODS: From December 2014 to October 2017, 296 cases(296 eyes)of incipient RRD patients in our hospital were selected as the research objects. All patients underwent minimally invasive scleral compression, the postoperative retinal reduction rate and BCVA were observed, and the factors that may affect the retinal reduction and visual recovery were analyzed.<p>RESULTS: A total of 272 eyes(91.9%)were successfully restored after minimally invasive postoperative scleral compression for the first time. Perioperative factors affecting retinal reduction include the number of holes, retinal detachment range and grade C1 PVR. At the follow-up of 6mo, 196 eyes(66.2%)had BCVA ≥0.4, and 100 eyes(33.8%)had BCVA <0.4. Duration of disease, preoperative BCVA, retinal detachment, and macular involvement were risk factors for postoperative BCVA(all <i>P</i><0.05), while preoperative BCVA was an independent risk factor for postoperative BCVA recovery(<i>P</i>< 0.05).<p>CONCLUSION: Minimally invasive scleral extrascleral compression is effective in the treatment of retinal detachment due to simple aperture, with a high postoperative reduction rate. Early detection and early treatment are required for RRD patients.

Research progress of visual function remodeling after optic nerve injury / 国际眼科杂志(Guoji Yanke Zazhi)

@#Optic neuron injury caused by glaucoma and other factors commonly considered as irreversible. However, some evidences demonstrate considerable neuroplasticity in the nervous system. In this review, we try to illuminate the mechanism of neuroplasticity, and reactivate the “silent” cell and neural transmission visual experience, alternating current stimulation, eye yoga, and anti-stress program, and so on. Predict visual change after intervention using self-organizing maps.

Experiencia de la Atención Primaria de Salud en el proceso de rehabilitación visual en la provincia de Santi Spíritus / Experience of the Primary Health Care in the visual rehabilitation process in Sancti Spíritus province

Objetivo: describir la implementación del proceso de rehabilitación visual extendido a la Atención Primaria de Salud en el período 2011-2012. Métodos: se realizó una investigación con diseño experimental en 246 pacientes del Hospital General Camilo Cienfuegos, de la provincia de Sancti Spíritus, desde el año 2011 al 2012. Se implementó el proceso de rehabilitación visual en la Atención Primaria de Salud. Su efectividad se midió a través de indicadores como agudeza visual mejor corregida de cerca y continuidad con el uso de ayudas ópticas. Resultados: se alcanzó el 91,9 por ciento de pacientes rehabilitados y ninguno de ellos abandonó el proceso. La agudeza visual mejor corregida de cerca mejoró en relación con el inicio y los pacientes rehabilitados continuaron usando sus ayudas ópticas al asistir a la consulta evolutiva. Conclusiones: el número de pacientes con baja visión continúa en ascenso y la rehabilitación visual es el proceder que les permite reinsertarse a la sociedad. La implementación de este proceso en la Atención Primaria de Salud permite mejorar la agudeza visual mejor corregida de cerca en todos sus rangos(AU)

Objective: to describe the implementation of the extended visual rehabilitation process in the primary health care in the period of 2011 through 2012. Methods: an experimental research study was carried out in 246 patients from Camilo Cienfuegos General Hospital in Sancti Spíritus province from 2011 to 2012. The visual rehabilitation process was implemented in the primary health care and its effectiveness was measured with indicators such as best corrected near visual acuity and use of optical aids. Results: in this group, 91.9 percent of patients were rehabilitated and none of them quit the process. The best corrected near visual acuity improved when compared to that of the beginning of the process and the rehabilitated patients continued using their optic aids when going to the specialist's to see their progress. Conclusions : the number of patients with low vision is on the rise and visual rehabilitation is the procedure that allows them to be reincorporated into society. The implementation of this process in the primary health care allowed improving all the ranges of the best corrected near visual acuity(AU)

Características clínicas en niños con baja visión. Sancti Spíritus 2001-2012 / Clinical characteristics in children with low vision. Sancti Spíritus 2001-2012

Fundamento: Las consecuencias del aumento creciente de la discapacidad visual afecta a los diferentes grupos etarios. En el niño limita el conocimiento del mundo y con ello sus avances académicos, el desarrollo sicomotor y la formación de su personalidad. Objetivo: Determinar las características clínicas en niños con baja visión en la provincia Sancti Spíritus desde el 2001 hasta el 2012. Metodología: Se realizó un estudio descriptivo, en el período de enero 2001 hasta diciembre 2012, en la consulta de baja visión del Hospital General Camilo Cienfuegos a los 87 niños entre 0 y 18 años, atendidos en intervención precoz y estudiantes de la escuela especial Miguel Ángel Echemendía. Resultados: Hubo un predominio del sexo masculino, en el grupo de pacientes atendidos en la consulta de intervención precoz, el motivo fundamental fue la retinopatía de la prematuridad y las principales causas de discapacidad en edad escolar fueron las anomalías congénitas, con 96,4 % de rehabilitación visual. Conclusiones: La estimulación visual en niños constituye un factor importante para contribuir al desarrollo de su visión. Se ofrece una atención diferenciada a este grupo etario para garantizar su inserción a la sociedad(AU)

Sustentos teóricos acerca de los problemas clínicos de la baja visión y la rehabilitación visual / Theoretical basis on the clinical problems of low vision and visual rehabilitation

Se realizó una búsqueda en la literatura digital. Se revisaron artículos en español y en inglés que resultaron significativos de la temática en estudio, con el propósito de identificar los referentes teóricos acerca de baja visión y la rehabilitación visual. La baja visión es una condición que deriva en una reducción importante de la visión de la persona y en este contexto representa un reto mundial. Las principales causas son el glaucoma, la maculopatía miópica, la degeneración macular relacionada con la edad y la retinopatía diabética. La rehabilitación visual implica un conjunto de procesos encaminados a obtener el máximo aprovechamiento visual de un paciente con baja visión, en aras de lograr su reincorporación a la sociedad. Las causas que provocan la baja visión son múltiples. En Sancti Spíritus las más frecuentes son el glaucoma, la maculopatía miópica, la degeneración macular relacionada con la edad y la retinopatía diabética. Se teoriza el proceso de rehabilitación visual, que garantiza el uso del resto útil de la visión que conserva el paciente, con el empleo de las ayudas ópticas y no ópticas(AU)

Digital literature review was made to review Spanish and English articles that were significant in the study subject, with the objective of identifying the theoretical referents on low vision and visual rehabilitation. Low vision is a condition that results in significant reduction of a person´s vision and thus it represents a challenge worldwide. The main causes are glaucoma, myopic maculopathy, age-related macular degeneration and diabetic retinopathy. Visual rehabilitation involves a set of processes aimed at obtaining the maximum visual utilization from a patient with low vision, with a view to achieving his/her re-incorporation into the society. The causes of low vision are varied. The most common ones in Santi Spiritus province are glaucoma, myopic maculopathy, age-related macular degeneration and diabetic retinopathy. The article theorized about the visual rehabilitation process that assures the use of the remaining useful vision that a patient preserves, by using optical and non-optical aids(AU)

Research on the Perceptions of Low Vision Rehabilitation

PURPOSE: To evaluate the understanding of low vision and awareness of low vision rehabilitation of non-health care providers and health care providers using a survey. METHODS: The present survey included 304 individuals; 137 non-health care providers (25 low vision patients, 38 non-low vision patients, and 74 normal controls) and 167 health care providers (51 ophthalmologists, 56 non-ophthalmic physicians, 24 nurses, and 36 medical technicians). The questionnaire used in the survey consisted of 10 items pertaining to the definition of low vision (3 items), assistance of low vision patients (3 items), awareness of the difficulties of low vision patients in daily life (3 items), and the understanding of low vision aids (1 item). RESULTS: The majority of participants, except ophthalmologists, were unaware of low vision rehabilitation. The perceptions of low vision rehabilitation between non-health care providers and health care providers except ophthalmologists were not different. The ophthalmologists showed a better understanding of low vision and awareness of low vision rehabilitation than other health care provider groups. However, no difference was found in the degree of understanding regarding low vision aids. Low vision patients showed the lowest rate of satisfaction with the environment around them and most experienced the greatest difficulties in public transportation and outside activities. CONCLUSIONS: Although ophthalmologists showed a better understanding of low vision rehabilitation, their understanding of low vision aids was poor. Thus, there should be an effort to improve the ophthalmologists' understanding regarding low vision care. To enhance low vision rehabilitation awareness, promotion of low vision services and education campaigns is necessary and a strategy concerning social welfare to improve the environment for low vision patients should be implemented.

Enfermedad de Vogt-Koyanagi-Harada y rehabilitación visual / Vogt-Koyanagi-Harada disease and visual rehabilitation

La enfermedad de Vogt-Koyanagi-Harada es una entidad infrecuente, multisistémica, de etiología desconocida, presuntamente autoinmune, caracterizada por panuveítis granulomatosa crónica bilateral y difusa, acompañada de participación tegumentaria, neurológica y auditiva, que afecta con mayor frecuencia la raza no caucasiana y, por lo general, a mujeres. Se presenta generalmente entre los 20-50 años de edad. Su incidencia varía geográficamente. Se estima que el 25 por ciento de los pacientes con esta enfermedad son ciegos legales; que el 25 por ciento puede presentar baja visión y el 50 por ciento agudeza visual mayor de 20/50. Se presenta una paciente de 50 años de edad con antecedentes de enfermedad de Vogt-Koyanagi-Harada, de 8 años de evolución, quien ha llevado tratamiento con antinflamatorios esteroideos sistémicos e inmunosupresores, así como terapia de apoyo con antinflamatorios esteroideos tópicos y ciclopléjicos. Acudió a la consulta de baja visión y se le realizó examen oftalmológico completo, estudios complementarios y se rehabilitó mediante el uso de ayudas ópticas y no ópticas para lograr el mayor aprovechamiento de su resto visual(AU)

Vogt-Koyanagi-Harada (VKH) is a rare, multisystemic, allegedly autoimmune disease of unknown etiology. It is characterized by chronic bilateral granulomatous and diffuse panuveitis, accompanied by tegumentary, neurological and hearing impairments that often affect the non-Caucasians and usually women. It usually occurs in the 20-25 years age group and its incidence varies with the geographic location. It is estimated that 25 percent of the patients with this disease are legally blind, the other 25 percent may have low vision and 50% present with visual acuity over 20/50. There is a 50 years-old patient with a history of Vogt - Koyanagi - Harada disease for 8 years. He had been treated with systemic steroid anti-inflammatory drugs and immunosuppressive therapy as well as supporting therapy with topical and cycloplegic steroid anti-inflammatories. The patient had gone to the low vision service looking for rehabilitation. He was performed a complete eye examination, supplementary studies and he was finally rehabilitated through the use of optical and non-optical aids in order to maximize his remaining vision(AU)

Capacidad funcional y calidad de vida en los ancianos con degeneración macular y baja visión / Functional capacity and quality of life in elderly patients with macular degeneration and low vision

OBJETIVO: caracterizar la capacidad funcional y la calidad de vida en los ancianos con degeneración macular y baja visión, atendidos en el Instituto Cubano de Oftalmología “Ramón Pando Ferrer” en el período comprendido de enero a junio de 2013. MÉTODOS: se realizó un estudio descriptivo, de corte transversal. Fueron estudiadas las siguientes variables: edad, sexo, color de la piel, agudeza visual mejor corregida de cerca con cartilla Zeiss, antes y después de la rehabilitación visual, discapacidad visual, capacidad funcional para las actividades de la vida diaria, tipo clínico de degeneración macular, factores de riesgo de la enfermedad, motivación para la rehabilitación visual y ayudas ópticas y no ópticas prescritas. RESULTADOS: existió un predominio de la enfermedad en las mujeres (55,2 %), entre los 75-79 años de edad y en el color de la piel blanca. La discapacidad visual que prevaleció fue la baja visión ligera a moderada; la capacidad funcional mayormente encontrada fue la independencia con alguna limitación. La degeneración macular seca se presentó en el 82,7 % de los casos; el factor de riesgo más frecuente fue el tabaquismo (82,7 %); la lectoescritura fue la motivación principal y el mayor número de pacientes mejoró la agudeza visual después de la rehabilitación visual. Las ayudas ópticas y no ópticas que más se prescribieron fueron los microscopios y la iluminación. CONCLUSIONES: el grupo de edades entre 75 y 79 años, el sexo femenino y la piel blanca o caucasiana son los factores que aportan un mayor número de casos de degeneración macular y baja visión. La discapacidad visual que prevalece es la de los clasificados como baja visión ligera a moderada. La degeneración macular seca se presenta en casi la totalidad de los casos. Los factores de riesgo más frecuentes son el tabaquismo, la herencia y las enfermedades cardiovasculares. El mayor número de pacientes mejora después de la rehabilitación visual.

OBJECTIVE: to characterize the functional capacity and the quality of life of the elderly people with macular degeneration and low vision who were seen at "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from January to June 2013. METHODS: cross-sectional and descriptive study that included the following variables: age, sex, race, best corrected near visual acuity using Zeiss chart before and after visual rehabilitation, visual disability, functional capacity for daily life activities, clinical type of macular degeneration, risk factors for the disease, reason for visual rehabilitation and prescribed optical and non-optical aids. RESULTS: the disease prevailed in females (55,2 %), 75-79 years-old age group and Caucasians. Predominant visual disability was mild to moderate low vision; the mostly found functional capacity was independence with some limitations. Dry macular degeneration was present in 82,7 % of cases; the most frequent risk factor was smoking (82,7 %); reading and writing was the main motivation and a large number of patients improved their visual acuity after rehabilitation. The optical and non-optical aids that were mostly prescribed included microscopes and lighting. CONCLUSIONS: females, 75-79 years-old age group and Caucasians are the risk factors that cause the highest number of cases with macular degeneration and low vision. Visual disability prevailed among those classified as mild to moderate low vision patients. Dry macular degeneration was present in almost all the cases. The most frequent risk factors were smoking, heredity and cardiovascular diseases. Most of the patients improved their condition after visual rehabilitation.

Efectividad de la biometría de inmersión para el cálculo del poder dióptrico de la lente intraocular / Effectiveness of immersion biometry for the calculation of intraocular lens dioptric power

OBJETIVO: determinar la efectividad de la biometría de inmersión para el cálculo del lente intraocular. MÉTODOS: se realizó un estudio observacional descriptivo, prospectivo. El universo estuvo constituido por los pacientes operados de catarata en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", entre enero y septiembre de 2011. La muestra estuvo conformada por 39 ojos de 34 pacientes que cumplieron con los criterios de inclusión establecidos para la investigación y fueron operados por la técnica de facoemulsificación con previo cálculo del lente intraocular por biometría de inmersión e interferometría de coherencia óptica. RESULTADOS: el promedio de edad fue de 72,33 años, con un predominio del sexo femenino. La diferencia de longitud axial promedio entre los pacientes calculados por inmersión y los de IOL Máster fue de 0,09 mm, mientras que la diferencia de profundidad de la cámara anterior fue de 0,19 mm. Se obtuvo una diferencia de 0,13 D y no existió diferencia significativa en cuanto al cálculo del poder del lente intraocular entre ambos métodos. CONCLUSIONES: los valores de longitud axial y de profundidad de cámara anterior obtenidos mediante biometría de inmersión pueden ser utilizados para calcular con efectividad el poder del lente intraocular de los pacientes que serán sometidos a cirugía de cataratas, lo que demuestra ser una alternativa en ausencia del IOL Máster.

OBJECTIVE: to characterize the functional capacity and the quality of life of the elderly people with macular degeneration and low vision who were seen at "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from January to June 2013. METHODS: Cross-sectional and descriptive study that included the following variables: age, sex, race, best corrected near visual acuity using Zeiss chart before and after visual rehabilitation, visual disability, functional capacity for daily life activities, clinical type of macular degeneration, risk factors for the disease, reason for visual rehabilitation and prescribed optical and non-optical aids. RESULTS: the disease prevailed in females (55,2 %), 75-79 years-old age group and Caucasians. Predominant visual disability was mild to moderate low vision; the mostly found functional capacity was independence with some limitations. Dry macular degeneration was present in 82,7 % of cases; the most frequent risk factor was smoking (82,7 %); reading and writing was the main motivation and a large number of patients improved their visual acuity after rehabilitation. The optical and non-optical aids that were mostly prescribed included microscopes and lighting. CONCLUSIONS: females, 75-79 years-old age group and Caucasians are the risk factors that cause the highest number of cases with macular degeneration and low vision. Visual disability prevailed among those classified as mild to moderate low vision patients. Dry macular degeneration .

Caracterización clinicoepidemiológica de la baja visión en el adulto mayor y su rehabilitación visual / Clinical and epidemiolotical characterization of the low vision in the older adult and their visual rehabilitation

OBJETIVO: caracterizar clínica y epidemiológicamente a los pacientes con diagnóstico de baja visión, así como su rehabilitación. MÉTODOS: se realizó un estudio descriptivo, prospectivo, en 628 pacientes atendidos en el Servicio de Baja Visión en el período de 2011 a 2012 en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Se recogieron los datos generales, los antecedentes generales y oculares, el defecto refractivo, la causa de la baja visión, la motivación, la ayuda óptica y la evaluación de la rehabilitación visual. La información obtenida se plasmó en una base de datos; posteriormente se procesaron y analizaron para dar salida a los objetivos del estudio. RESULTADOS: predominaron el sexo femenino, la raza blanca y el grupo de edad entre 70 y 79 años. La mayor parte de los pacientes no presentaron enfermedad sistémica y sí estuvo presente en la mayoría de los pacientes con predominio del glaucoma, lo que constituyó la primera causa ocular de discapacidad visual en estos. La ayuda óptica estuvo en correspondencia con la motivación expresada por ellos, donde la principal fue la lectoescritura. En la mayoría de los casos se logró una adecuada rehabilitación. CONCLUSIONES: en los casos de baja visión, la rehabilitación presenta relación estadística con el sexo, los antecedentes patológicos generales, la motivación y la ayuda óptica, algunas sin explicación clínica.

OBJECTIVE: with the objective of characterizing clinical epidemically to the patients with diagnostic of low vision as well as its rehabilitation. METHODS: was carried out a descriptive study, prospective in 628 patients assisted in the service of Low Vision in the period from the 2011 to the 2012 in the ICO "Ramón Pando Ferrer". the general data were picked up, the general and ocular antecedents, refractive defect, causes of the drop vision, motivation, helps optics and evaluation of the visual rehabilitation. The obtained Information was captured in a database, later on they were processed and they analyzed to give exit to the objectives of the study. RESULTS: it prevailed the feminine sex, the white race and the age group between 70 and 79 years. Most of the patients didn't present systemic illness. I didn't seize in the ocular pathological antecedents that it was present in most of the patients with prevalence of the glaucoma, constituting the first ocular cause of visual discapacidad in these. The optic help was in correspondence with the motivationexpressed by the same ones, where the lecture-write was the main one, in most of the cases an appropriate rehabilitation was achieved. CONCLUSIONS: the rehabilitation was evaluated meeting statistical relationship with the sex, the general pathological antecedents, the motivation and the optic help, some without clinical explanation.

Rehabilitación visual en el niño ambliope / Visual rehabilitation in amblyopic child

Se realizó un estudio observacional, descriptivo y longitudinal, desde septiembre de 2007 hasta junio de 2009, de 33 escolares con ambliopía, pertenecientes a la escuela especial "Josué País García" de Santiago de Cuba, para describir los resultados del tratamiento rehabilitador. Estos niños fueron clasificados según el grado de la agudeza visual con corrección y la causa de la enfermedad. Se les realizó visuscopia antes y después del tratamiento, además de potencial evocado visual cortical. En la casuística prevalecieron el grupo etario de 4-6 años, el sexo femenino y la ambliopía estrábica. La agudeza visual mejoró significativamente después del tratamiento rehabilitador y hubo 9,0 % de pacientes irrecuperados. Se recomienda diseñar un programa de salud dirigido al personal médico de la atención primaria acerca de la prevención y tratamiento de estos pacientes, así como realizar acciones educativas con los padres sobre tan importante tema de salud.

An observational, descriptive and longitudinal study was carried out from September 2007 to June 2009 in 33 schoolchildren with amblyopia, belonging to "Josué País García" special school of Santiago de Cuba, in order to describe the results of the rehabilitation treatment. These children were classified according to the degree of corrected visual acuity and cause of the disease. Visuscopy was performed in them before and after treatment, besides cortical visual evoked potential. Age group of 4-6 years, the female sex and strabic amblyopia prevailed in the case material. Visual acuity improved significantly after rehabilitation treatment and 9.0% of patients did not recover. It is recommended to design a health program aimed at medical staff of primary care for prevention and treatment of these patients, and to conduct educational activities with parents on this important health issue.

Rehabilitación en pacientes con trauma ocular / Rehabilitation of ocular trauma patients

La rehabilitación en oftalmología tiene como función fundamental lograr el máximo aprovechamiento posible del resto visual. El traumatismo ocular es considerado una de las entidades nosológicas frecuentes que conllevan a una rehabilitación visual. Las causas que provocan este tipo de trauma son variadas y dentro de estas, las agresiones con intención de provocar daños con secuelas son muy frecuentes. Es objetivo de esta revisión puntualizar la importancia de la rehabilitación en pacientes con traumatismo ocular e incentivar el buen accionar de todos los oftalmólogos en cuanto a su atención.

The main goal of rehabilitation in ophthalmology is to use as much as possible the residual vision. Ocular trauma is considered one of the common diseases that imply visual rehabilitation. The causes of eye injuries are varied; among them assaults with intent to cause damage are the most common. The objective of this article was to point out the importance of rehabilitation in patients with ocular trauma and to encourage all the ophthalmologists to act accordingly.

Bases teóricas de la microperimetría en la rehabilitación visual de pacientes con baja visión / Theoretical basis of microperimetry in visual rehabilitation of low visión patients

Las enfermedades maculares constituyen una causa importante de discapacidad visual a nivel mundial. La mejor comprensión de la relación existente entre estructura y función a nivel macular ha permitido el desarrollo de nuevas tecnologías capaces de relacionar estos parámetros. Esto permite la rehabilitación de áreas retinianas con mejor función, convirtiéndolas en nuevos puntos de fijación de la mirada. Con el objetivo de sintetizar los conocimientos actuales sobre rehabilitación visual utilizando el microperímetro MP1, se realizó una búsqueda en la literatura digital contenida en MEDLINE, Academic Search Premier y MedicLatina a través de la plataforma EBSCO con acceso al texto completo del artículo por HINARI, cuando no estuvo disponible en la interfase inicial. Se utilizaron los términos de búsqueda: microperímetro, microperimetría, rehabilitación visual y plasticidad neuronal. Se revisaron artículos en idioma español, inglés y francés, publicados entre enero 2005 y mayo 2011 que resultaron más significativos de la temática en estudio.

Macular diseases are an important cause of visual disability all over the world. Better comprehension of structure- function relationship at macular level has allowed developing new technologies capable to relate these parameters. This permits rehabilitation of retinal areas with better function, transforming them into new preferred retinal locus for sight fixation. A search in the digital literature contained in MEDLINE, Academic Search Premier and MedicLatina through the EBSCO platform with access to the full text article through HINARI, when not available in the initial interface, was carried out with the objective of synthesizing the current knowledge on visual rehabilitation using the MP1 microperimeter, The search terms used were: microperimeter, microperimetry, visual rehabilitation and neuronal plasticity. Those articles in Spanish, English and French languages, published from January 2005 and May 2011, were considered as the most significant on this topic and were reviewed.

Individualización de pacientes con baja visión en el Centro Oftalmológico del Hospital General Docente Dr Juan Bruno Zayas Alfonso / Individualization of low vision patients in Dr Juan Bruno Zayas Alfonso Teaching General Hospital Ophthalmologic Center

Se efectuó un estudio descriptivo y transversal de 73 pacientes con baja visión, que asistieron a la consulta del Centro Oftalmológico del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, desde julio hasta diciembre del 2009, a fin de describir algunas características clínicas y demográficas. La degeneración macular asociada a la edad primó en más de 25,0 por ciento de los integrantes de la casuística, seguida por el glaucoma crónico simple y la miopía degenerativa y, según lugar de procedencia, los pertenecientes al municipio de Santiago de Cuba representaron 73,0 por ciento del total. Se logró rehabilitar a 89,0 por cientode los pacientes examinados y tratados

A descriptive and cross sectional study of 73 patients with low vision who visited the Ophthalmologic Center at Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba was carried out from July to December 2009 in order to describe some clinical and demographic characteristics. Macular degeneration associated with age prevailed in more than the 25,0 per cent of the case material, followed by simple chronic glaucoma and degenerative myopia and, according to origin place, those belonging to Santiago de Cuba municipality represented 73,0 per cent of the total. It was possible to rehabilitate the 89,0 per cent of the examined and treated patients

The rehabilitating effect of hyperbaric oxygen on visual pathway lesions / 中华物理医学与康复杂志

Objective To evaluate the rehabilitating effect of hyperbaric oxygen on visual pathway lesions with blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI). Methods Sixteen patients with visual pathway lesions (the study group) and twelve healthy volunteers (the control group) were assessed using BOLD-fMRI and DTI. After hyperbaric oxygen therapy, the patients in the study group were again assessed using BOLD-fMRI and DTI. The activated regions of the BOLD-fMRI scan and the fractional anisotropy (FA) value determined from the DTI were calculated. Results Before hyperbaric oxygen treatment, there were significant differences between control and study groups in their BOLD-fMRI activated regions and the FA values of their radiation optics (P≤0.01). After hyperbaric oxygen treatment, there were no significant differences. Conclusion Combining BOLD-fMRI with DT1 could be used to evaluate the rehabilitation effect of hy-perbaric oxygen treatment in patients with visual pathway lesions.

Low vision AIDS provision for visually impaired Egyptian patients - a clinical outcome

Purpose: To evaluate a low vision rehabilitation service implemented for heterogeneously diverse group of Egyptian patients with vision loss in terms of improving their visual performance and fulfilling their visual needs. Methods: Fifty patients with low vision were included in a prospective study. History taking; ophthalmic examination and evaluation of the visual functions were performed for all patients. The required magnification was calculated; and subsequently a low vision aid was chosen after counseling with patients. Low vision aids were tried in office; followedby a period of training before patients received their own low vision aids. Follow up was done for 6 months. Results: All patients who were referred to the low vision unit were not satisfied with their current spectacles or low vision aids. After training and prescription of suitable LVAs; the improvement in distance and near visual acuity wasstatistically significant (p0.001). Fifty-six per cent of the patients (nof the patients (n=27) could discern N8 print size or better. The most commonly used aids were high powered near adds. Despite the complaints about the appearance and use of LVAs; 76of the patients reported being moderately to highly-satisfied with their aids. Conclusions: The significant improvement in the visual performance of patients with low vision after the prescriptionand training on the use of LVAs; associated with patients' satisfaction; confirms the importance of expanding low vision rehabilitative services and increasing the public awareness of its existence and benefits

Avaliação oftalmológica e educacional em escolares com baixa visão / Ophthalmologic and educational assessment in low vision students

O estudo objetivou avaliar a necessidade do uso de recursos ópticos por escolares com baixa visão atendidos no Serviço de Visão Subnormal HC/UNICAMP, na avaliação dos pré-requisitos para alfabetização. Foram avaliados cinco escolares com baixa visão, com idades entre 7 e 8 anos, durante o período de agosto a novembro de 2002. A conduta incluiu a avaliação oftalmológica completa e a pedagógica, utilizando-se o Instrumento de Avaliação do Repertório Básico para Alfabetização (IAR). A acuidade visual variou de 20/30 a 20/400 para longe e, para perto, de 0,8 M a 2,5 M, para quatro alunos foram prescritos os sistemas telescópios para melhorar o desempenho visual para longe; um deles recebeu também a prescrição de óculos esferoprismáticos para melhorar a visão de perto, e outro, correção óptica convencional Em relação ao IAR verificou-se que, de forma geral, os escolares não apresentaram dificuldades visuais para realizar o teste. Para 80 por cento dos escolares avaliados, verificou-se a necessidade do uso de recursos ópticos para melhora do desempenho visual nas atividades de longe e perto. Observou-se que a deficiência visual não interferiu na avaliação dos pré-requisitos para alfabetização. Um dos alunos não precisou usar recursos ópticos, tinha visão muito boa.

To assess the need for using optical resources by low vision students attending the Subnormal Vision Service at HC/FCM/UNICAMP in the assessment of requirements for the alphabetization was the objective of this paper Five low vision students, between 7 and 8 years old, were assessed from August to November, 2002. Procedures included a thorough pedagogic and ophthalmologic assessment, through the use of the Instrument for Basic Repertoire for Alphabetization Assessment (IAP). Visual acuity ranged from 20/30 to 20/400 for long distances, and from 0.8 M to 2.5 M for short distances; for four students telescopic systems were prescribed to improve visual performance for long distances, one of them also received a prescription for spheroprismatic glasses to improve short distance vision and another one a prescription for conventional optical correction. As for the IAR it was observed that the students did not show any visual difficulty to perform the test. For 80' o of assessed students it was observed that the students needed optical resources to improve their visual performance for long and for short distances. It was noted that visual deficiency did not have any effect on the assessment of requirements for alphabetization. One of the students did not have to use optical resources since he had a very good vision.