Comparison of Reading Test Parameters from the Print and Tablet Application Forms of the Minnesota Low Vision Reading Test.

Objectives: To compare reading parameters measured with the Turkish version of the Minnesota Low Vision Reading Test (MNREAD-TR) printed acuity chart and the tablet application version of the same test for both normally sighted and low-vision individuals. Materials and Methods: A total of 116 individuals (92 normally sighted and 24 low-vision) were included in the study. All participants were tested with both the print version of the MNREAD-TR chart (method 1) and the tablet application version (method 2). Reading acuity (RA), critical print size (CPS), maximum reading speed (MRS), and reading accessibility index (ACC) were compared statistically. Results: No statistically significant difference was found in RA and CPS between the two methods for the normally sighted individuals (p=0.083 and p=0.075, respectively). There was no statistically significant difference in RA and ACC between the two methods for the patients with low vision (p=0.159 and p=0.103, respectively). The mean MRS was 233.1±34.7 words per minute (wpm) with method 1 and 169.3±23.4 wpm with method 2 in the normally sighted group (p<0.001) and 93.2±50.2 wpm with method 1 and 68.2±34.7 wpm with method 2 in the low-vision group (p<0.001). Conclusion: In our study, it was found that the parameters RA and CPS in the normally sighted individuals and RA and ACC in the low vision individuals provided similar results in both forms of the MNREAD. The tablet application method can be preferred to eliminate evaluators' bias of scoring the printed chart. In addition, applications have other advantages such as being faster and more practical and providing automatic analysis of parameters, especially in low-vision rehabilitation.

Fixation Stability and Preferred Retinal Locus in Advanced Age-Related Macular Degeneration

Objectives: To evaluate fixation stability and characteristics of the preferred retinal locus (PRL) in patients with advanced age-related macular degeneration (AMD). Materials and Methods: Sixty-three eyes of 63 patients with AMD who presented to the low vision unit were included in this prospective study. Sociodemographic characteristics, eye examination findings, and reading performance results with the Minnesota Low Vision Reading test were evaluated. Microperimetry was used to evaluate fixation stability and PRL characteristics. Results: There was unstable fixation in 68% of the eyes, relative stable fixation in 27%, and stable fixation in 5%. The mean PRL-foveal distance was 5.15°±3.31° (range 0.75°-14.2°). PRL-foveal distance was greater in cases with unstable fixation than cases with stable fixation (p=0.023). Distance of the PRL from the lesion margin was not associated with absolute scotoma size or fixation stability (p=0.315, p=0.095, respectively). PRLs were most frequently located in the nasal quadrant (31%), followed by the superior quadrant (26%) of the retina. There was no significant relationship between PRL location and fixation stability (p=0.088). Fixation stability was significantly associated with reading speed (p=0.003). Conclusion: In advanced AMD, PRL-foveal distance is an important factor in fixation stability. Knowing the factors that affect fixation stability may be important in determining low vision rehabilitation strategies for these patients because of the strong association between fixation stability and reading speed.

Comparison of Quality of Life Questionnaires in Patients with Low Vision

Objectives: To compare the quality of life assessed by the Low Vision Quality of Life Questionnaire (LVQOL) and National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in patients with low vision. Materials and Methods: A total of 64 consecutive patients who presented to the Ankara University Low Vision Rehabilitation Department for the first time were included in the study. Patients aged 18 or older who had a best-corrected visual acuity of less than 20/60 or a visual field of equal to or less than 20° from the fixation point in the better eye were included. After examination, the patients were asked to complete the LVQOL and NEI VFQ-25 questionnaires. Results: A very strong correlation was found between the total scores of the two questionnaires. A strong correlation was found between the "distance vision" subscale score of LVQOL and "distance activities" subscale score of NEI VFQ-25. There was also a strong correlation between the "reading and fine work" subscale score of LVQOL and "near activities" subscale score of NEI VFQ-25. There was a weak correlation between the LVQOL total score and visual acuity. There were moderate negative correlations between age at disease onset and the total scores of the two questionnaires. Conclusion: Both the LVQOL and NEI VFQ-25 are able to quantify the quality of life of individuals with low vision and it is possible to compare the studies carried out with these two questionnaires which are validated in Turkish.

Ophthalmologic approach to babies with cerebral visual impairment.

BACKGROUND: Cerebral visual impairment (CVI) is an increasingly common type of visual disturbance in infants and children. The increased incidence is associated with improved neonatal intensive care services and survival of premature infants, especially in developed countries and our country. For accurate ophthalmological evaluation, it is important to know the behavioral responses to visual stimuli that are unique to CVI such as color preference, need for movement, visual latency, visual field preference, and difficulty in visual complexity. METHODS: This review is prepared to draw attention to the subject within the scope of Ankara University Vision, Artificial Vision and Low Vision Rehabilitation training programs. RESULTS: The most common causes are hypoxia and perinatal ischemia. Ocular structures are generally normal or are not sufficient to explain the visual impairment. Diagnosis and habilitation methods differ from visual impairment of ocular origin. As a result, early diagnosis of CVI in infants and toddlers and an effective visual habilitation with a multidisciplinary approach where ophthalmologists and pediatricians lead the team is very valuable. CONCLUSIONS: Early diagnosis and early visual habilitation will increase the quality of life of babies and will provide important gains for families and therefore the whole society. Pediatricians should be familiar with this group of disturbances and the available resources, as they are best placed to refer the child for evaluation and rehabilitation and encourage the family for follow-up.

Current Approaches to Low Vision (Re)Habilitation

With increased life expectancy at birth and especially the rising incidence of age-related macular degeneration, low vision (re)habilitation is becoming more important today. Important factors to consider when presenting rehabilitation and treatment options to patients presenting to low vision centers include the diagnosis of the underlying disease, the patient's age, their existing visual functions (especially distance and near visual acuity), whether visual loss is central or peripheral, whether their disease is progressive or not, the patient's education level, and their expectations from us. Low vision patients must be guided to the right centers at the appropriate age, with appropriate indications, and with realistic expectations, and the rehabilitation process must be carried out as a multidisciplinary collaboration.