Quality of life of low-vision patients and the impact of low-vision services.

PURPOSE: To investigate the functional status and quality of life of patients at a low-vision clinic and to evaluate the impact of low-vision services. METHODS: Interviews, including the Medical Outcomes Study 36-Item Short Form (SF-36), the Visual Function-14 (VF-14), and the 51-item Field Test Version of the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ), were administered to 156 consecutive patients 1 week before and 3 months after their low-vision clinic visit. RESULTS: Low-vision patients scored lower (P < .001) in physical functioning and role limitations caused by physical and emotional health problems than published SF-36 scores of the age-appropriate United States normal population, patients with congestive heart failure, and clinically depressed patients. Low-vision services were associated with improvement in the subjective functional status of 150 patients (98.7%) and were rated "very useful" by 82 (53.9%) patients. The SF-36 scores did not change significantly after low-vision services. The VF-14 mean score improved from 35.8 to 41.2 (P < .001). Four NEI-VFQ subscale scores improved significantly (P < .001): general vision, near activities, distance activities, and peripheral vision. CONCLUSIONS: The SF-36, VF-14, and NEI-VFQ demonstrate that low-vision clinic patients perceive marked impairment of functional status and quality of life. Low-vision services are associated with high patient satisfaction. Vision-targeted questionnaires are more sensitive than general health-related quality of life questionnaires to changes in functional status and quality of life after low-vision services, and they may help elucidate the outcomes of low-vision services.

Degradation of parathion methyl on field-sprayed apples and stored apples.

Residue levels of parathion methyl on field-sprayed Granny-Smith apples were studied. The pesticide was applied according to producer recommendations. Apples received a single spraying at a rate of 40 g active ingredient/100 L. Residues were determined with a simple gas chromatographic method. Recovery of parathion methyl was 88-108%, and the limit of determination was 0.002 mg/kg. Decomposition of parathion methyl was studied in apples remaining on trees after spraying and in apples harvested and stored under ambient-temperature, refrigerated-room, and controlled-atmosphere conditions. During post harvest storage, parathion methyl degrades more slowly than on apples remaining on the trees. Best-fit curves were determined, and kinetic equations, rate constants, and half-lives were calculated. Half-lives found were 8 days for apples on trees, 45 days for apples stored at ambient conditions, 68 days for apples stored in controlled-atmosphere room, and 62 days for apples stored in a refrigerated room. Under storage conditions, levels of parathion methyl residues need a long time to become lower than the legal limit (0.2 mg/kg).

Long-term results of compression treatment for lymphedema.

Although numerous operations have been devised for lymphedema, most surgeons manage this vexing condition by nonsurgical means. Previous studies by us showed that high-pressure (90 to 100 torr) sequential external pneumatic compression (SEP) reduced both limb girth and volume in a lymphedematous extremity. To assess the long-term effects of a program entailing (1) SEP, (2) elastic compression stockings to maintain the post-SEP girth, and (3) daily skin care, we reviewed the long-term courses of 49 patients managed by one surgeon. Limb girths measured at nine levels on the limb were obtained serially in follow-up (mean 25 months) by an independent observer to provide an objective response to therapy. The relative reduction in lymphedematous tissue was determined by the difference between the pretreatment, postacute treatment, and long-term treatment girths at nine points in the limb. In long-term follow-up, 26 of the patients maintained a full response (reduction at > 3 levels), whereas 10 maintained a partial response (reduction at < or = 3 levels). At late follow-up, calf and ankle girths were reduced by an absolute value of 5.37 +/- 1.01 and 4.63 +/- 0.88 cm in the full-response group and 5.43 +/- 1.58 and 3.98 +/- 1.18 cm in the partial-response group over pretreatment measurements. The degree of subcutaneous fibrosis in relationship to the duration of the edema appeared to influence results greatly. The treatment of lymphedema with SEP and compression stockings is associated with long-term maintenance of reduced limb girth in 90% of patients.

Is the Autorefractor reading closest to manifest refraction? A comparison of the patient's previous spectacles and the 6600 Autorefractor reading.

In a study of 56 patients, the old glasses of a previously refracted individual were as close to the final subjective refraction as the reading obtained with a 6600 Autorefractor. Therefore, the previous spectacle correction might logically be used for the starting point of a subjective refraction, with retinoscopy or automatic refractor results being used for this purpose in patients whose previous spectacle refraction is unknown or in the first refraction of an aphakic patients.

Clinical evaluation of the 6600 Autorefractor.

The 6600 Autorefractor was evaluated on 200 patients undergoing refraction. The automatic refractor showed a high degree of accuracy in determining the needed refractive correction, but the errors are sufficient that the automatic refractor alone without subjective refinement cannot be substituted for conventional complete refracting methods with subjective refinement. However, for aphakic patients and for patients with clear media and cylindric corrections over 0.50 diopters, the automatic refractor can be used as a substitute for retinoscopy in determining the starting point for a subjective refraction.