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AIM: To investigate the role of visual perception training on the recovery of visual function at all levels and the improvement of perceptual eye position in children with intermittent exotropia(IXT).METHODS: Prospective clinical study. A total of 74 patients with IXT who received corrective surgery for strabismus in the Ophthalmology Department of the First People's Hospital of Lanzhou City from January to June 2022 were collected and followed up for 3mo. The patients were randomly divided into 2 groups at 1d after surgery: 35 patients in the training group received binocular visual perception training, and 39 patients in the control group did not receive visual training. The changes of visual function and perceived eye position at all levels were observed at 1d and 3mo after operation.RESULTS: There were 24 patients(69%)with simultaneous perception in the training group at 1d after surgery and 34 patients(97%)with recovered visual function at 3mo after surgery, which was significantly higher than 1d after surgery(P=0.002). Furthermore, there were 22 cases(56%)of fusion function in the control group at 3mo after surgery, 13 cases(33%)of far stereopsis, 20 cases(51%)of dynamic stereopsis and 17 cases(44%)of static fine stereopsis. In the training group, there were 31 cases(89%)of fusion function, 25 cases(71%)of far stereopsis, 30 cases(86%)of dynamic stereopsis and 27 cases(77%)of static fine stereopsis, which were significantly higher than those in the control group(all P<0.05). The degree of perceived eye displacement in the training group decreased more significantly than that in the control group(all P<0.05).CONCLUSION: Postoperative visual perceptual training in children with IXT can promote recovery of visual function at all levels, improve perceptual eye position and enhance the control of eye position at the perceptual level of the brain.
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@#AIM: To investigate the effect of rigid contact lenses with multifocal design on binocular visual function in myopic patients. <p>METHODS: A self-control study before and after. Fifteen myopic students of North Sichuan Medical College were recruited as test persons between July and August 2020. The subjects first wore framed glasses for binocular visual function examination, then wore single vision and multifocal rigid contact lenses(1wk apart), and binocular visual function examination was performed after wearing each lens for 2wk. One-way analysis of variance was used to compare the binocular visual function of multifocal rigid contact lens, single vision rigid contact lens and frame glasses.<p>RESULTS: There were no significant differences among the three lenses in stereopsis, far horizontal phoria, far positive fusional vergence, far negative fusional vergence, near negative fusional vergence, convergence and dispersion flexibility, convergence near point, adjustment magnitude, adjustment flexibility and negative relative adjustment(<i>P</i>>0.05). Compared with frame glasses, multifocal rigid contact lenses had significant difference in near horizontal phoria, near positive fusional vergence, accommodation lag, positive relative accommodation increased and AC/A decreased(<i>P=</i>0.023,0.048,0.001,0.013,0.046); Compared with single vision rigid contact lenses, multifocal rigid contact lenses had significant difference in near horizontal phoria, accommodation lag, positive relative accommodation increased and AC/A decreased(<i>P</i>=0.014,<0.001,0.001,0.009).<p>CONCLUSION:Wearing multifocal rigid contact lenses can lead to near horizontal phoria, accommodation lag, positive relative accommodation increase and AC/A decrease, which may have some influence on proximal use of eyes. These expected changes should be considered in clinical application in order to evaluate and manage patients correctly.
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@#AIM:To observe curative effect and safety of slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia.<p>METHODS:This study included 29 patients who underwent slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia in our hospital between October 2017 and November 2019 with a follow-up of 6mo, the deviation, the surgical success rate, the binocular vision function and the complications were observed.<p>RESULTS:In our study, the mean near deviations, the mean distance deviations and the near-distance deviation differences reduced from -41.72±3.35PD, -23.28±9.75PD and 16.90±2.47PD before surgery to -5.97±4.85PD, -2.66±4.78PD, 3.28±1.10PD 6mo after surgery, the surgical success rate was 76%. The Grades I and Ⅱ binocular vision function improved 6mo after surgery(<i>P</i><0.05), the distance stereopsis and the near stereopsis were not statistically significant(<i>P</i>>0.05). None of the patients developed A-V pattern, limitation of eye movement, restrictive strabismus, vertical strabismus, and rotated diplopia, some patients had transient horizontal diplopia, which disappeared within 2-3wk after surgery.<p>CONCLUSION:Slanted bilateral lateral rectus recession may successfully reduce the near exodeviations, the distance exodeviations and the near-distance deviations difference without obvious complications, proved to be a safe and effective procedure for the treatment of convergence insufficiency-type intermittent exotropia.
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@#AIM: To evaluate the clinical efficacy and safety of oral propranolol for treatment of vision function-threaten infantile ocular hemangioma. <p>METHODS: This is a prospective observational study. A total of 54 infants with huge ocular hemangioma were treated with oral propranolol. The changes of tumor appearance, tumor size evaluated by color ultrasound or MRI were examined before treatment, 1mo, 3mo, 6mo and 1a after treatment. In addition, the astigmatism degree of hemangioma eyes were measured with cycloplegic refraction before treatment and at the stage of drug withdrawal, the local and general adverse reactions were recorded during the treatment. <p>RESULTS: One week after treatment, all of the cases had different degrees of tumor color or texture changes gradually. 1mo, 3mo and 6mo after treatment, the effective rates were 88%, 96% and 98%, the cure rates were 25%, 35% and 67% respectively. The patients with ocular dysfunction such as ptosis, ocular motility disorder or exophthalmos became better gradually during the treatment, and were fully recovered finally as the hemangioma shrinking. At the stage of drug withdrawal, the <i>M</i>(<i>P</i>25, <i>P</i>75)of the hemangioma average volume were 150.00(0.00, 378.00)mm3 which decreased from 3254.00(2016.00, 7600.00)mm3 before treatment; and the <i>M</i>(<i>P</i>25, <i>P</i>75)of astigmatism values were 0.75(0.50, 1.44)D compared with 2.25(1.00, 3.50)D measured pre-treatment. The difference of hemangioma volume and astigmatism values before and after treatment was statistically significant(<i>P</i><0.001). <p>CONCLUSION: With the detailed assessment of the general condition of patients, oral propranolol of recommended dosage for treatment of vision function-threaten infantile ocular hemangioma was a safe and effective regimen.
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@#AIM: To observe the curative effect of vision therapy on children with functional visual loss.<p>METHODS: Totally 22 children with functional vision loss were enrolled in our department between January 2018 and June 2018, including 12 males and 10 females, the mean age 7.5±0.8 years old. All patients had routine eye examinations, refraction and binocular visual function examinations. Children with or without astigmatism whose diopter spherical mirror was between±1.00D and were accompanied by astigmatism less than ±1.00D participated in personalized vision therapy. Paired <i>t</i> test was used to analyze the binocular visual function before and after vision therapy.<p>RESULTS: The average visual acuity of the 22 children were improved, but the diopters before and after vision therapy were -0.011±0.573D and -0.057 ±0.338D drespectively, without statistical significance(<i>P</i>=0.633). The average of the distant level phoria(DLP)before and after vision therapy were -3△ ±2.97△ and -1.18△ ±1.6△, which was not statistically significant(<i>P</i>=0.089). The near level phoria(NLP)were -6.27△ ±4.56△ and -2.82△ ±2.56△; the near point of convergene(NPC)were 7.73±2.15 and 3.05±0.69cm; the accommodation convergence/accommodation(AC/A)were 2.00±1.55, 3.64±0.5 before and after the training respectively(<i>P</i><0.05); The negative relative accommodation(NRA)and positive relative accommodation(PRA)before vision therapy were 1.61±0.41 and -1.98±0.71D; after training they were 2.09±0.23 and -3.89±0.71D respectively; binocular crossed-cylinder(BCC)was 0.09±0.38D, which improved to 0.39±0.13D after therapy; the average of amplitude of accommodation(AMP)were 9.55±2.54 and 11.55±1.13D; binocular accommodation facility(BAF)were 3.36±2.73 and 9.64±1.5cpm respectively before and after therapy.<p>CONCLUSION:It is necessary to perform binocular visual function examination base on the refractive examination for children with functional vision loss. Visual therapy can improve visual acuity and binocular vision function.
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· AIM:To discuss the effect of mental image network training on binocular visual function recovery in children with concomitant strabismus.· METHODS:Totally 100 children with concomitant strabismus were selected from March 2013 to March 2017 in our Hospital.According to the random distribution,they were divided into mental group and control group,50 cases in each group.Mental group was given the mental image network training,control group was given no training.The visual function of the two groups of binocular vision,the near stereoscopic visual acuity and the eye position of the two groups were compared.· RESULTS:The proportion of patients with vision function by synoptophore at Ⅰ,Ⅱ,Ⅲ after treatment of mental group and control group were significantly higher than those before treatment,the after treatment of mental group was significantly higher than that of control group,the difference was statistically significant (P＜0.05).In the aspect of rate of ceses without stereovision by Titmus near stereoacuity,that after treatment of mental group and control group were significantly lower than those of the before treatment,that after treatment of mental group was significantly lower than control group;in the aspect of central fovea,macular hole,peripheral stereoscopic vision,those after treatment of mental group and control group were significantly higher than those of the before treatment,those after treatment of mental group was significantly higher than that of control group,the difference was statistically significant (P＜ 0.05).During the follow-up for 6mo,the ocular position maintenance rate of mental group was significantly higher than that of control group,the difference was statistically significant (P＜0.05).· CONCLUSION:Mental image network training can effectively promote the recovery of visual function in children after concomitant strabismus surgery.It is beneficial to maintain the position of the eye of children.
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AIM:To study and compare the outcomes of coaxial 2. 2 mm phacoemulsiflcation with conventional coaxial 3 mm small-incision cataract surgery. METHODS: A randomized prospective study was conducted on 100 patients with age - related cataract:coaxial 2. 2 mm micro - incision cataract surgery was performed in 50 cases (50 eyes), and coaxial 3 mm small incision cataract surgery was performed in 50 cases ( 50 eyes) . Statistical analysis was takenwith the data of the two groups. Visual acuity, VF and QOL were compared at intervals of 1wk and 3mo after surgery. In addition, surgically induced astigmatism ( SIA ) was analyzed. Statistic analysis was taken by Student's t-test and Chi-square test. RESULTS:There was no significant difference on BCVA (t=-1. 366, -1. 688; P=0. 148, 0. 107) between these two groups. One week and 3mo after the surgery, SIA was (0. 46±0.29)D, (0. 43±0. 26)D in the 2. 2 group; and (1. 55±0. 59) D, (0. 89±0. 28) D, in 3. 0 group. The differences between these two groups were statistically significant ( t=-7. 348, -3. 788; P = 0. 000, 0. 000 ) There were no statistically significant differences on VF scores between two group, while it's got a better score in 2. 2 groups on vision adaptation. (t=-3. 348, P CONCLUSION:Coaxial 2. 2mm micro-incision cataract surgery could significantly reduce SIA and obtain morestable status of VF and QOL. This suggests that the coaxial 2. 2 phacoemulsification surgery implanted AkreosMI60 intraocular lens could get earliervisual rehabilitation postoperation.
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Purpose: To evaluate the impact of initial topical medical therapy on newly diagnosed glaucoma patients using the Indian Vision Function Questionnaire (IND-VFQ33). Patients and Methods: The IND-VFQ33 was used to evaluate the quality of life (QoL) in 62 newly diagnosed patients with moderate to severe primary glaucoma and 60 healthy controls. IND-VFQ33 is a 33 item QoL assessment tool with three domains: General functioning, psychosocial impact and visual symptoms. The glaucoma patients were started on medical therapy and the QoL assessment was repeated after 3 months. Results: Glaucoma patients (mean age: 55.6 ± 9.6 years, range 40–77 years) and controls (mean age: 54.9 ± 6.7 years, 42–73 years) were matched with respect to age (P = 0.72), gender (P = 0.91) and literacy (P = 0.18). Glaucoma patients had significantly worse QoL as compared to controls at baseline across all the three domains (P < 0.001). 3 months after initiation of treatment, the overall QoL life significantly worsened from baseline with a decrease in general functioning (P < 0.001) and psychosocial impact (P = 0.041). Visual acuity in better eye significantly co-related to poor QoL at baseline (P < 0.001) and at 3 months (P = 0.04). In addition, the use of >2 topical medications significantly co-related to poor QoL at 3 months (P = 0.01). Conclusions: Evaluation using the IND-VFQ33 revealed that newly diagnosed glaucoma patients have a significant worsening of QoL after initiation of topical ocular hypotensive therapy. This should be an important consideration when educating patients about the disease and its therapy.
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Aim: To study long term outcome of bilateral congenital and developmental cataract surgery. Subjects: 258 pediatric cataract operated eyes of 129 children. Materials and Methods: Children who underwent pediatric cataract surgery in 2004‑8 were traced and examined prospectively in 2010‑11. Demographic and clinical factors were noted from retrospective chart readings. All children underwent visual acuity estimation and comprehensive ocular examination in a standardized manner. L. V. Prasad Child Vision Function scores (LVP‑CVF) were noted for before and after surgery. Statistics: Statistical analysis was done with SPSS version 16 including multi‑variate analysis. Results: Children aged 9.1 years (std dev 4.6, range 7 weeks‑15 years) at the time of surgery. 74/129 (57.4%) were boys. The average duration of follow‑up was 4.4 years (stddev 1.6, range 3‑8 years). 177 (68.6%) eyes had vision <3/60 before surgery, while 109 (42.2%) had best corrected visual acuity (BCVA) >6/18 and 157 (60.9%) had BCVA >6/60 3‑8 years after surgery. 48 (37.2%) had binocular stereoacuity <480 sec of arc by TNO test. Visual outcome depended on type of cataract (P = 0.004), type of cataract surgery (P < 0.001), type of intra‑ocular lens (P = 0.05), age at surgery (P = 0.004), absence of post‑operative uveitis (P = 0.01) and pre‑operative vision (P < 0.001), but did not depend on delay (0.612) between diagnosis and surgery. There was a statistically significant improvement for all the 20 questions of the LVP‑CVF scale (P < 0.001). Conclusion: Pediatric cataract surgery improved the children’s visual acuity, stereo acuity and vision function. Developmental cataract, use of phacoemulsification, older children and those with better pre‑operative vision had betterlong‑termoutcomes.
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Objective:To evaluate the clinical significance of pattern visual evoked potential (P-VEP) parameters on amblyopic patients with normal-vision atfer pleoptic therapy. Methods:We investigated 60 amblyopic children (8-12 years old) who gained normal-vision atfer pleoptic therapy. hTese patients were assigned to a unilateral amblyopia group (40 patients)and a bilateral amblyopia group (20 patients). Another 20 healthy children served as a control group. All patients underwent a full initial ophthalmologic and orthoptic evaluation. P-VEP test was performed in all. Amplitude and latencies were analyzed and compared among groups. The latencies of P100 waves in the amblyopic eyes were used to generate a multiple linear regression formula from sex, ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Results:hTere was no signiifcant difference in the mean levels of best-corrected visual acuity among groups (P>0.05). A signiifcant prolongation of the latency and a decrease of amplitude of P100 waves were observed in the unilateral amblyopia group and the bilateral amblyopia group compared with the healthy control group (P<0.05). Amplitude and latencies of the fellow eyes in the unilateral amblyopia group were abnormal compared with the healthy control group (P<0.05). Multiple linear regression analysis revealed that the latencies of P100 waves were signiifcantly correlated with the ifrst treatment age, baseline visual acuity, and cycloplegic refraction (R2=0.52, P<0.05). Conclusion:Deifcits exist in the fellow eyes and in normal-vision eyes atfer pleoptic therapy. hTe delayed P100 latency is affected by the ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Traditional amblyopic therapy may be not enough for vision function recovery.