Establishing Normative Values for Amplitude of Accommodation and Accommodative Facility among University Students in Malawi

The study aimed to examine the distribution of Accommodative Facility (AF) and Amplitude of Accommodation (AA) and compare the findings with established guidelines.Place and Duration of Study: Mzuzu University, Malawi. Between May and July 2022.Methods: This cross-sectional study was conducted among students at Mzuzu university in Malawi. We recruited 77 students using a stratified random sampling technique. The participants' age ranged from 16 to 35 years of age. We measured AA using the push-up method while AF was measured using +/- 1.50 Diopters (D) flippers. Both techniques utilized black reading material on white background held at 40 centimeters (cm). Next, we measured the accommodation facility by counting the number of Cycles per Minute (c/m). We utilized the Pearson correlation test and the One-way ANOVA where appropriate. The value of p< 0.05 was considered statistically significant. Results: The participants comprised 44 (57.1%) males and 33 (42.9%) females. Monocular AA was 10.04D (SD=2.71) and Binocular AA was 10.51 (3.641). The difference was statistically significant (p=0.04). While Monocular AF and Binocular AF were 9 c/m (SD= SD=1.84) and 8.96 (SD=1.539) respectively but the difference was non-significant (p=0.868). AF and AA were not significantly different between males and females. All the parameters decreased with age. The measured AA was significantly higher than using Hofstetter’s formula.Conclusion: The study provides a cut-off value for practitioners diagnosing Accommodation anomalies. However, indices in the study differ from the well-established guidelines hence practitioners should endeavor to perform the clinical assessment instead of relying on equations.

Cambios del estado oculomotor en pacientes de 18 a 25 años diagnosticados con insuficiencia de convergencia (IC) de la Universidad El Bosque, tras el tratamiento sugerido de ortóptica durante tres meses, 2013 / Oculomotor status changes in patients 18 to 25 years diagnosed with convergence insufficiency (CI) of the universidad el bosque, after orthoptics suggested treatment for three months, 2013

Estudio de casos prospectivo longitudinal, cuyo propósito es valorar los cambios de las condiciones binoculares, en pacientes diagnosticados con insuficiencia de convergencia, tras el tratamiento sugerido de ortóptica durante tres meses, con el fin de establecer el porcentaje de mejoría. Durante el desarrollo de esta investigación, se establecieron como criterios de inclusión: exoforia (X´) en visión próxima <20 Dioptrías prismáticas (Dpt), reservas fusiónales positivas (RFP) <15 Dpt, amplitud de acomodación baja (AA), punto próximo de convergencia (PPC) ≥6cm, acomodación relativa positiva (ARP) <2.50 y edades entre 18-25 años. Un total de 7 pacientes fueron incluidos; quienes firmaron el consentimiento informado. Inicialmente se valoró el estado oculomotor de cada paciente y respondieron la encuesta de síntomas pre-tratamiento; posteriormente fueron instruidos para realizar ejerciciosy/o terapia visual diarios en casa por 30 minutos. Una vez, finalizado el tratamiento, se tomaron medidas, las cuales evidenciaron cambios significativos en el PPC con luz ruptura/ recuperación (p = 0.0022) / (p = 0.0017); PPC con objeto real ruptura/ recuperación (p = 0.0040) / (p= 0.0017); reservas fusiónales positivas en visión próxima ruptura/ recobro (p = 0.0017) / (p = 0.0027). El 100% de los pacientes presentaron una ruptura ≤6cm y una recuperación de 7 ±3,6 cm en el PPC con luz; con objeto real el 71,4% presento una ruptura ≤ 6cm y una recuperación de 9 ±1,2 cm; las RFP incrementaron en el 85,7% siendo esta ≥15Δ en ruptura y una recuperación ≥15Δ en el 71,4% y en la encuesta el 48% de los pacientes reportaron mejoría de sus síntomas. Con lo anterior, se puede concluir que el tratamiento sugerido de ortoptica, presentó cambios y mejoras significativas de los signos clínicos los cuales se acompañan de una reducción de síntomas, los que permiten mejoras en la calidad de vida de los jóvenes universitarios y el restablecimiento de las condiciones binoculares.

Prospective longitudinal study of cases, the purpose is evaluate the changes in binocular conditions, in patients diagnosed with convergence insufficiency after orthoptic suggested treatment for three months, with the objective of determine the percentage of improvement. During the development of this investigation, were established as inclusion criteria: exophoria (X) in near vision <20 prism diopters (DPT), positive fusional reserves (RFP) <15 Dpt, low amplitude accommodation (AA), next point Convergence (CPP) ≥6cm, positive relative accommodation (PRA) low and ages 18-25 years. A total of 7 patients were included; They signed the informed consent. Initially the oculomotor status of each patient were evaluated and respondents survey of pretreatment symptoms; then they were instructed to perform exercises and / or vision therapy daily at home for 30 minutes.. Once treatment is completed, measures were taken, which showed significant changes in the PPC with break light / recovery (p = 0.0022) / (p = 0.0017); PPC real object breakdown / recovery (p = 0.0040) / (p = 0.0017); positive fusional reserves near sighted ness breakdown / recovery (p = 0.0017) / (p = 0.0027). 100% of patients had a breakdown and recovery ≤6cm 7 ± 3.6 cm in the PPC with light; real object with 71.4% showed a break ≤ 6cm and a recovery of 9 ± 1.2 cm; RFPs increased by 85.7% this being ≥15Δ in breaking ≥15Δ recovery and 71.4% in the survey and 48% of patients reported improvement in their symptoms. With this, one can conclude that the treatment suggested orthotopic, introduced significant changes and improvements in the clinical signs which are accompanied by a reduction in symptoms, which allow improvements in the quality of life in college students and restoring binocular conditions.

Investigation of visual impairment and its rehabilitation following stroke / 中华老年医学杂志

Objective To investigate the visual impairment and its rehabilitation after stroke.Methods After diagnosis of stroke by the neurologists, the patients received examinations of ocular pathology and visual function, especially in vision correction and rehabilitation. Results Five hundred and forty-seven stroke patients were recruited. 47.0% of the patients had eye alignment/movement impairment, 34.0% had visual field impairment, 19. 0% had visual perceptual difficulties and 19.9% had low vision blind. After using telescope, 35.7% blind patient's distance vision was ≥0.05; 58.2% low vision patient's distance vision was ≥0.3. After refraction (average vision:0.36±0.34 vs. 0.48 ±0.36,t =- 3.949,P=0.03) or using telescope(average vision of patients had low vision:0. 13±0. 07 vs. 0. 46±0.26,t=-5. 208,P=0.01 ;average vision of blind patients:0. 01 ±0.01 vs. 0. 06±0. 05,t = -3. 628, P= 0. 05), the improvement of vision for patients was significant.Conclusions The 72% of stroke patients has some kinds of visual impairment, which will affect not only the patients' independent living but also the clinical rehabilitation. Refraction and using telescope are effective for vision rehabilitation. Doctors should pay much attention to the visual therapy and rehabilitation for the stroke patients.

The effects of two-suppression therapy compared for school-age children with monocular amblyopia / 中国医师进修杂志

Objective To compare the effectiveness of two-suppression therapy with over-plus hyperopia lens and atropine mydriasis for school-age chihtren with monocular amblyopia. Method One hundred and sixty-seven cases of children with monocular amblyopia in the age of 7-12 years old were observed, who were randomly divided into two groups, using over-plus hyperopia lens or atropine mydriasis to suppress the normal eye, and the amblyopia eye was comprehensive trained, followed-up of 3 years. Results The effect rate was similar between over-plus hyperopia lens and atropine mydriasis [90.7%(78/86) and 91.4%(74/81), respectively]. There was no significant difference (P>0.05). Conclusions For school-age children with monocular amblyopia, you can use over-plus hyperopia lens inhibit the normal eye sight, its effect is similar with the atropine mydriasis.