ABSTRACT
Although accommodative adaptation has been studied extensively in young adult populations, there has been little consideration of this function in children. Accordingly, we examined accommodative adaptation by comparing pre- and post-task measurements of dark accommodation (DA) in children and young adults. DA was assessed objectively before and immediately after a 5-min near-vision task (viewing distance = 20 cm) using an open-field, infrared optometer (Canon Autoref R-1). The study was performed on 15 visually normal children (mean age = 10.1 years) and 10 visually normal young adults (mean age = 25.2 years). No significant difference was observed between the mean values of pre-task DA for the two age groups (children = 1.01 D, adults = 0.88 D). Both groups showed equivalent degrees of accommodative adaptation (approximately 1.0 D), and the rate of regression of post-task DA to the pre-task level was similar for each group. We found a significant positive correlation between the magnitude of adaptation and pre-task DA in children, which was not found in the young adult population. The results indicate that pre-task DA and accommodative adaptation (both in terms of magnitude and rate of decay) are similar in adults and children. This would not support the proposal that the development of nearwork-induced myopia in children is related to short-term variations in accommodative adaptation when compared with young adults.
Subject(s)
Accommodation, Ocular/physiology , Dark Adaptation/physiology , Adolescent , Adult , Child , Child, Preschool , HumansABSTRACT
The purpose of this study was to examine the intraocular pressure (IOP) in a pediatric population without general anesthesia, and compare it to the IOP in a normal adult population. Little information is available on the normal IOP in a pediatric population. IOP was measured in a sample of 212 eyes (111 patients) using the Keeler Pulsair Hand Held Non-Contact Tonometer to determine the range of IOP in this population. Patients ranged in age from 7 months to 5 years, 10 months. The mean IOP of each eye was based on three readings. These IOP values were grouped by the chronological age of the children. The results support the conclusion that infant/toddler patients have lower mean IOP than adults and that as age increases, IOP increases.
Subject(s)
Intraocular Pressure/physiology , Adult , Child , Child, Preschool , Humans , Infant , Reference Values , Tonometry, Ocular/instrumentationABSTRACT
Early screening for refractive errors is highly desirable. Techniques for doing this must be usable with noninstructable subjects (infants), noninvasive, and relatively easy to use. Photorefraction has been used to examine infants' refractive status. However, unless cycloplegia is used, the results can be difficult to evaluate, inasmuch as the subject's plane of focus is not known. This paper describes a photorefraction system that is being used for routine screening of young infants, without cycloplegia and without using highly skilled personnel. The major innovation is the systematic presentation of attractive targets at distances that present a range of demands to accommodation. Changes in the fundal reflections, seen in the photographs taken as the infant views the different targets, can be interpreted unequivocally to identify severe myopia and hyperopia, anisometropia, heterotropia, and anisocoria. The results can also be quantified and are compared with retinoscopic refractions.
Subject(s)
Refraction, Ocular/methods , Refractive Errors/diagnosis , Vision Screening , Clinical Protocols , Humans , Infant , Photography , Refraction, Ocular/instrumentationABSTRACT
The presence of significant refractive error and/or anisometropia can produce an irreversible decrease in visual function if not detected and treated at an early age. The general consensus is that the earlier a problem is detected, the easier the process of remediation. The authors have examined photoretinoscopy as a means of screening infant/toddlers and/or nonverbal persons for refractive anomalies. Fifty adults and fifty infants/toddlers/children were photographed and the estimated refractive error from review of the pictures was compared to the refractive error obtained from retinoscopy. The results indicate that photoretinoscopy is an effective screening procedure for the detection of significant refractive error and is extremely sensitive to anisometropia.
Subject(s)
Mass Screening/methods , Photography , Refractive Errors/diagnosis , Retina/pathology , Adolescent , Adult , Aged , Child , Child, Preschool , False Positive Reactions , Humans , Infant , Middle Aged , Referral and ConsultationABSTRACT
This paper presents a survey of the literature on management of the various forms of exotropia. Criteria for success of treatment are examined. A table summarizing the results of 11 studies is given.
Subject(s)
Biofeedback, Psychology/standards , Exotropia/therapy , Strabismus/therapy , Vision Disorders/therapy , Eyeglasses , Humans , Visual PerceptionABSTRACT
There has been an abundance of data collected on the high prevalence of visual anomalies in cerebral palsy. Relatively little has been written about remediation. This article discusses the problems encountered in the CP population, and therapy programs which can be utilized to deal with them. Heavy emphasis is placed on ocular motility and accommodation because deficits in these two visual skills are encountered very frequently, are most amenable to therapy, and show the greatest improvement as a result of vision therapy.
Subject(s)
Cerebral Palsy/complications , Vision Disorders/therapy , Accommodation, Ocular , Adolescent , Child , Exercise Therapy , Eyeglasses , Humans , Intellectual Disability/complications , Movement Disorders/etiology , Oculomotor Muscles , Optometry/methods , Saccades , Vision Disorders/etiology , Visual Perception/physiologyABSTRACT
Accommodation function, in a population of severely involved cerebral palsied children, is significantly lowered or absent. This observation suggests that lowered amplitudes and accommodation facility could be part of the cerebral palsy syndrome and untrainable . This paper looks at the accommodative function and the results of vision training on such a population.
Subject(s)
Accommodation, Ocular , Cerebral Palsy/physiopathology , Optometry , Adolescent , Age Factors , Cerebral Palsy/rehabilitation , Child , Child, Preschool , Female , Humans , Male , Vision, OcularABSTRACT
The forced preferential looking (FPL) technique has been used clinically, to assess visual acuity in infants for the past decade. It is generally accepted that the effectiveness of the procedure extends to the upper limit of 10 months of age. The authors discuss clinical observations on the viability of FPL as an effective technique in the measurement of visual acuity in an older population of neurologically impaired children.
Subject(s)
Intellectual Disability/physiopathology , Vision Tests/methods , Visual Acuity , Age Factors , Child, Preschool , Down Syndrome/physiopathology , Humans , Infant , Infant, Newborn , Television , Vision Tests/instrumentationABSTRACT
For years, researchers have recognized the very high incidence of visual anomalies in the population of children with cerebral palsy. However, little if anything has been attempted to remediate these problems. This article describes an experimental program of visual training, applied on a daily basis, to a population of inpatient, cerebral palsied children. After one year, the results were evaluated and the findings are discussed.
Subject(s)
Cerebral Palsy/therapy , Learning Disabilities/therapy , Vision Disorders/therapy , Cerebral Palsy/complications , Child , Esotropia/complications , Eye Movements , Female , Humans , Learning Disabilities/complications , Male , Orthoptics , Strabismus/complications , Vision Disorders/complicationsABSTRACT
The purpose of this paper will be to carefully examine the effectiveness of orthoptics as a viable treatment modality for strabismus. It will be necessary to first examine the scope of this problem and the significance of functional cure. A short discussion of perceptual and psychological effects will be included. A review of pertinent literature and an analysis of the data will be presented. Any commonalities or generalizations which can be identified will then be discussed and analyzed. Finally, the training of the optometrist in orthoptics and associated subjects will be examined to demonstrate the qualification of the optometrist to administer orthoptics in the treatment of visual anomalies.
Subject(s)
Orthoptics , Strabismus/therapy , Adolescent , Adult , Child , Curriculum , Education, Medical, Undergraduate , Evaluation Studies as Topic , Humans , Orthoptics/educationABSTRACT
Ocular dominance, as measured in sighting tests, involves a temporary suppression of the input from the non-dominant eye in order to avoid diplopia. Amblyopia ex anopsia may be viewed as a long term suppression of the input from one eye for the same reason. In the absence of anisometropia, paralysis of extra ocular muscles, or other factors which would tend to determine which eye would manifest suppression, the non-dominant sighting eye should be more likely to develop amblyopia given the presence of strabismus. A sample of 258 amblyopes supports this prediction based on the population norms for sighting dominance.
