[One-year longitudinal change in parameters of myopic school children trained by a new accommodative training device--uncorrected visual acuity, refraction, axial length, accommodation, and pupil reaction].

PURPOSE: School children with myopia were trained using a visual stimulation device that generated an isolated blur stimulus on a visual target, with a constant retinal image size and constant brightness. Uncorrected visual acuity, cycloplegic refraction, axial length, dynamic accommodation and papillary reaction were measured to investigate the effectiveness of the training. SUBJECTS AND METHODS: There were 45 school children with myopia without any other ophthalmic diseases. The mean age of the children was 8.9 +/- 2.0 years (age range; 6-16)and the mean refraction was -1.56 +/- 0.58 D (mean +/- standard deviation). As a visual stimulus, a white ring on a black background with a constant ratio of visual target size to retinal image size, irrespective of the distance, was displayed on a liquid crystal display (LCD), and the LCD was quickly moved from a proximal to a distal position to produce an isolated blur stimulus. Training with this visual stimulus was carried out in the relaxation phase of accommodation. Uncorrected visual acuity, cycloplegic refraction, axial length, dynamic accommodation and pupillary reaction were investigated before training and every 3 months during the training. RESULTS: Of the 45 subjects, 42 (93%) could be trained for 3 consecutive months, 33 (73%) for 6 months, 23 (51%) for 9 months, and 21 (47%) for 12 months. The mean refraction decreased by 0.83 +/- 0.56 D (mean +/- standard deviation) and the mean axial length increased by 0.47 +/- 0.16 mm at 1 year, showing that the training bad some effect in improving the visual acuity. In the tests of the dynamic accommodative responses, the latency of the accommodative-phase decreased from 0.4 +/- 0.2 sec to 0.3 +/- 0.1 sec at 1 year, the gain of the accommodative-phase improved from 69.0 +/- 27.0% to 93.3 +/- 13.4%, the maximum speed of the accommodative-phase increased from 5.1 +/- 2.2 D/sec to 6.8 +/- 2.2 D/sec and the gain of the relaxation-phase significantly improved from 52.1 +/- 26.0% to 72.7 +/- 13.7% (corresponding t-test, p < 0.005). No significant changes were observed in the pupillary reaction. CONCLUSION: The training device was useful for improving the accommodative functions and accommodative excess, suggesting that it may be able to suppress the progression of low myopia, development of which is known to be strongly influenced by environmental factors.

[Influence of accommodative response and visual symptoms on visual display terminal adult operators with asthenopia through adequately corrected refractive errors].

PURPOSE: Application of adequate correction of refractory errors for the treatment of asthenopia of young visual display terminal (VDT) workers was evaluated from subjective complaints and the effect on accommodation dynamics (step response) before and after 6 months. METHODS: Young VDT workers who visited the clinic because of eye strain were consecutively selected. Fifteen workers who were under-corrected for myopia and three workers who were over-corrected for myopia were treated by "adequate correction of refractory errors" with spectacles or soft contact lenses. The adequate correction was defined as minimum convex lenses which could obtain visual acuity of 1.2 or better, similar to daily life conditions, without cyclopegia or fogging. The workers were in their 20's. Accommodative responses to step stimuli were recorded by infrared optometer, and questionnaires were filled out by the VDT workers concerning the severity (a severity rating in percent in five steps) of subjective symptoms (headache, dry eye, eye strain, and eye irritation). Spectacles or disposable contact lenses were prescribed for the workers for "adequate correction". Six months later, accommodative responses and subjective symptoms were evaluated and compared with under-or over-corrected conditions and adequate correction. RESULTS: In under-corrected workers, the adequate correction significantly improved complains i.e. headache, eye strain, eye tiredness (p < 0.005). Accommodative responses also improved in gain (%), maximum velocity (D/sec), and time of accommodation and relaxation (p < 0.05). Three over-corrected workers showed improvement of complains and also accommodative response in gain, maximum velocity, and time of accommodation and relaxation. CONCLUSIONS: Application of "adequate correction" to young VDT workers with asthenopia by using adequately corrected spectacles or soft contact lenses improved the asthenopia and accommodative dynamics.

Correlations between allergen-specific IgE serum levels in patients with allergic conjunctivitis in spring.

PURPOSE: The purpose of this study was to evaluate the relation between various specific class E immunoglobulins (IgE) in serum and allergic conjunctivitis in spring. METHODS: Forty patients with allergic conjunctivitis and fifty healthy volunteers were selected for this trial. Total IgE and specific IgE to twelve inhalant allergens were measured using the CAP system. RESULTS: Specific IgE levels caused by cedar and cypress pollen, house dust, Dermatophagoides pteronyssinus, acarus, and moth allergens were higher in the allergy group than in the control group. No correlation was proven between the specific IgE levels and the total IgE level. The highest positivity rate for a specific allergen in patients with allergic conjunctivitis was 52.5% for cedar pollen, followed by cypress pollen at 37.5%. CONCLUSIONS: These results suggest that cypress pollen was the largest cause of allergic conjunctivitis and that the total IgE level had no correlation with each specific IgE.

Underestimation of intraocular pressure in eyes after laser in situ keratomileusis.

PURPOSE: Retrospectively, we reviewed the records of 65 patients (115 eyes) regarding the intraocular pressure (IOP) after laser in situ keratomileusis (LASIK). METHODS: The mean patient age was 31.2 +/- 10.5 years. The average preoperative spherical equivalent was -6.85 +/- 2.54 diopters. A noncontact pneumatic tonometer and a Goldmann applanation tonometer were used in measuring the IOP. RESULTS: The IOP after LASIK was significantly lower than that before surgery (Mann-Whitney U-test). The IOP correlated significantly with the corrected diopter value, corneal thickness, and corneal curvature (Spearman rank correlation). CONCLUSIONS: The postoperative IOP can be underestimated due to decreased corneal thickness and curvature. When evaluating IOP after LASIK surgery, this possibility should be carefully investigated.