Utility of retinoscopy to examine peripheral refraction

Purpose: This study explored whether retinoscopy (RET) provides comparable results of relative peripheral refraction (RPR) to open–field autorefractometry (AR) in myopic subjects.Methods: Peripheral refraction was measured in 20 myopic and 20 control adult subjects. Both central and peripheral refraction (20° nasal and temporal eccentricity) were measured using RET and open-field AR. Differences in the median central spherical equivalent (SE), median RPR, and median J45/J180 power vectors between the RET and AR techniques were analyzed. Moreover, Bland – Altman plots were used to assess the agreement between RET and AR methods for RPR measurements in MG. Results: For MG, the median RPR values were positive (hyperopic shift), and no significant differences were observed between the RET and AR techniques with respect to RPR measurement. In addition, we did not observe any significant differences in the RPR values between the nasal and temporal eccentricities for either the RET or AR technique for myopic subjects. There was also a significant correlation and agreement between the RET and AR technique for RPR measurements. With respect to central refraction, the median SE was slightly more positive for the RET than for the AR technique. Inside the CG, we also found significant correlation between the RET and AR technique for RPR measurements, and we observed a myopic shift in peripheral eccentricities. Conclusion: Our results show that retinoscopy may be a useful tool for objective measurements of RPR in myopic subjects and may be used interchangeably with the open-field AR method in everyday clinical practice. (AU)

Utility of retinoscopy to examine peripheral refraction.

PURPOSE: This study explored whether retinoscopy (RET) provides comparable results of relative peripheral refraction (RPR) to open-field autorefractometry (AR) in myopic subjects. METHODS: Peripheral refraction was measured in 20 myopic and 20 control adult subjects. Both central and peripheral refraction (20° nasal and temporal eccentricity) were measured using RET and open-field AR. Differences in the median central spherical equivalent (SE), median RPR, and median J45/J180 power vectors between the RET and AR techniques were analyzed. Moreover, Bland - Altman plots were used to assess the agreement between RET and AR methods for RPR measurements in MG. RESULTS: For MG, the median RPR values were positive (hyperopic shift), and no significant differences were observed between the RET and AR techniques with respect to RPR measurement. In addition, we did not observe any significant differences in the RPR values between the nasal and temporal eccentricities for either the RET or AR technique for myopic subjects. There was also a significant correlation and agreement between the RET and AR technique for RPR measurements. With respect to central refraction, the median SE was slightly more positive for the RET than for the AR technique. Inside the CG, we also found significant correlation between the RET and AR technique for RPR measurements, and we observed a myopic shift in peripheral eccentricities. CONCLUSION: Our results show that retinoscopy may be a useful tool for objective measurements of RPR in myopic subjects and may be used interchangeably with the open-field AR method in everyday clinical practice.

The Combination of Neural Tracking and Alpha Power Lateralization for Auditory Attention Detection.

Purpose The acoustic source that is attended to by the listener in a mixture can be identified with a certain accuracy on the basis of their neural response recorded during listening, and various phenomena may be used to detect attention. For example, neural tracking (NT) and alpha power lateralization (APL) may be utilized in order to obtain information concerning attention. However, these methods of auditory attention detection (AAD) are typically tested in different experimental setups, which makes it impossible to compare their accuracy. The aim of this study is to compare the accuracy of AAD based on NT, APL, and their combination for a dichotic natural speech listening task. Method Thirteen adult listeners were presented with dichotic speech stimuli and instructed to attend to one of them. Electroencephalogram of the subjects was continuously recorded during the experiment using a set of 32 active electrodes. The accuracy of AAD was evaluated for trial lengths of 50, 25, and 12.5 s. AAD was tested for various parameters of NT- and APL-based modules. Results The obtained results suggest that NT of natural running speech provides similar accuracy to APL. The statistically significant improvement of the accuracy of AAD using a combined method has been observed not only for the longest duration of test samples (50 s, p = .005) but also for shorter ones (25 s, p = .011). Conclusions It seems that the combination of standard NT and APL significantly increases the effectiveness of accurate identification of the traced signal perceived by a listener under dichotic conditions. It has been demonstrated that, under certain conditions, the combination of NT and APL may provide a benefit for AAD in cocktail party scenarios.

Application of Blue Filters Increases the Usefulness of Moreland Test in Anomaloscopic Color Vision Assessment for Blue-Green Color Range.

The effect of blue light filters on the anomaloscopic examination was analyzed. Thirty subjects (18-43 y, 20 female, 10 male) without color vision disorders were examined in 4 filter conditions: no filter (F-0), Blue Control Hoya (F-BC), Med-1 JZO (F-Med1) and 450 Eschenbach (F-450). Both Rayleigh test (red-green axis) and Moreland test (blue-green axis) were performed. Application of F-BC filter shows negligible effect on color vision perception in both tests. Contrary to this, the application of strong F-450 filter causes significant shift in Moreland test towards tritanopy and the decrease in correlations of Moreland parameters with Rayleigh test parameters. The application of medium strong F-Med1 filter causes the slight shift in Moreland test towards the center of the Moreland scale and increases the Spearman correlations between Moreland and Rayleigh test parameters. This observation suggests that the about 15-40% reduction of blue diode intensity in the Moreland test may be beneficial in detecting mild changes in color vision perception in the blue-green axis and may improve its usefulness in evaluating the color vision perception disorders accompanying different illnesses, such as diabetes, glaucoma, neuritis optica, or cataract. The discussion concerning the modifications of Moreland test construction is also presented.

Variability of Rayleigh and Moreland test results using anomaloscope in young adults without color vision disorders.

AIM: To validate the reference ranges proposed by the manufacturer of the Oculus HMC Anomaloscope MR for Rayleigh and Moreland tests in healthy young adults. METHOD: The manual Rayleigh (red-green) and the Moreland (blue-green) anomaloscope tests were performed on 90 healthy subjects (54 female, 36 male, 178 eyes) residing in Poland, aged between 18-45 years, and without color vision disorders (assessed with HRR test). The analyzed parameters for both the Rayleigh and the Moreland tests were as follows: the lower (R1/M1) and the upper (R2/M2) limits; the center (RC/MC) and the width (RW/MW) of the matching ranges. RESULTS: The results of the Rayleigh test were similar to the values proposed in the anomaloscope user's manual, however, with a small shift of RC and R2 towards the red color. The double-peak distribution of R2 with a small second peak (approximately at R2 = 52) was mainly due to the measurements in male subjects (nmale = 8, nfemale = 2), which suggests that this group might be diagnosed with subtle protanomaly. The results of the Moreland test showed a high MW which did not correspond to the reference range described in the anomaloscope user's manual. The observed significant correlations between R1 and M1 suggest that the M1 parameter seems to be the best indicator of blue vision quality. CONCLUSIONS: Oculus HMC Anomaloscope MR is a sensitive tool for detection of prot-deuteranomalies but the reference ranges for young adults require a certain adjustment towards the red color. The parameters obtained for the Moreland test varied significantly between the subjects and therefore the test should not be used as is to diagnose color vision deficits in the green-blue area (tritanomaly).

Computerised dynamic posturography for postural control assessment in subjects wearing multifocal contact lenses dedicated for myopia control.

PURPOSE: To measure body balance using computerised dynamic posturography in young adults wearing multifocal contact lenses (MFCL) with high addition powers designed for myopia control. METHODS: Twenty-four young adults (mean age: 24 years) wearing distance-centred soft MFCL (SwissLens Orbis Relax) with two different central zones (3 and 4.5 mm), two addition powers (+2 D, +4 D) and single vision control lenses. Body balance was measured on a moving platform under three viewing conditions: (1) eyes open when fixating on letters at 3 m or (2) at 40 cm, as well as (3) with the eyes closed. Parameters of body stabilisation were analysed: the rate of body stabilisation (τrelax ), the stabilisation time (Tmax ) and the number of oscillations (Nosc ). RESULTS: The MFCLs did not produce a significant difference in the mean values of the analysed parameters (p > 0.05 for τrelax, Tmax, Nosc ). However, a positive correlation was found between pupil size and Nosc and Tmax (p < 0.01), suggesting an effect of the +4 D add with the 3 mm central zone on the posturographic parameters. As was expected, dynamic body stabilisation was better with eyes open versus eyes closed (p < 0.005). CONCLUSIONS: Distance-centred MFCLs with a medium addition (+2 D) do not disturb body stabilisation in young adults. However, high additions (+4 D) with a small central zone may affect body balance control in subjects with large pupil size.

Frontal brain areas are more involved during motor imagery than during motor execution/preparation of a response sequence.

Results of several neuroimaging studies support the functional equivalence model, which states that motor imagery (MI) and motor execution (ME) involve the same processes, except for the final execution component. In contrast, the motor-cognitive model implies that MI additionally involves frontal executive control processes. However, according to some authors MI may actually be more comparable to motor preparation (MP). In the current electroencephalographic study, a version of the discrete sequence production paradigm was employed in which human participants initially had to prepare a sequence of five finger movements that subsequently had to be executed, imagined, or withheld. MI, ME, and MP were compared by computing event-related (de)-synchronization in the theta, alpha/mu, and beta bands. Results revealed a major increase in frontal theta power during MI as compared to ME and MP. At the end of the examined intervals, a posterior reduction in alpha power was present during ME and MP, but not during MI. Finally, above sensorimotor areas a decrease in beta power was observed that was most pronounced in the case of ME. The increase of frontal theta activity during MI may reflect increased effort, while the absence of a reduction in posterior alpha power suggests no major involvement of visuospatial attention and/or visual imagery. The present findings favor the motor-cognitive model, as it predicts extra involvement of frontal executive processes during MI.

Contrast sensitivity and visual acuity in subjects wearing multifocal contact lenses with high additions designed for myopia progression control.

OBJECTIVES: To assess the visual performance of multifocal contact lenses (MFCLs) with high addition powers designed for myopia control. METHODS: Twenty-four non-presbyopic adults (mean age 24 years, range 18-36 years) were fitted with soft MFCLs with add powers of +2.0 D (Add2) and +4.0 D (Add4) (RELAX, SwissLens) and single vision lenses (SVCL; Add0) in a counterbalanced order. In this double-masked study, half of the participants were randomly fitted with 3 mm-distance central zone MFCLs while the other half received 4.5 mm-distance central zone MFCLs. Visual acuity was measured at distance (3.0 m) and at near (0.4 m). Central and peripheral contrast sensitivity was evaluated at distance using the Gabor patch test. The area under the logarithmic contrast sensitivity function curve (ALCSF) was calculated and compared between the groups (i.e. different additions powers used). RESULTS: Near and distance visual acuities were not affected by the lenses, neither Add2 nor Add4, when compared to Add0, however, CZ3 significantly reduced distance visual acuity with Add4 when compared to CZ4.5 (-0.08 logMAR vs. for CZ3 and -0.18 logMAR for CZ4.5, p = 0.013). MFCLs impaired central ALCSF only when Add2 was used (15.99 logCS for Add2 and 16.36 logCS for SVCLs, p = 0.021). Peripheral ALCSF was statistically lower for both addition powers of the MFCLs when compared to SVCLs (12.70 for Add2 and Add4, 13.73 for SVCLs, p = 0.009). The above effects were the same for both central zones used. CONCLUSIONS: MFCLs with CZ3 diameter and high add power (Add4) slightly reduced distance visual acuity when compared to CZ4.5 but no reduction in this parameter was found with medium add power (Add2). Central contrast sensitivity was impaired only by MFCLs with the lower add power (Add2). Both add powers in the MFCLs reduced peripheral contrast sensitivity to a similar extent.

Parameters of the crossing points between center of pressure and center of mass signals are potential markers of postural control efficiency.

Posturographic signals were recorded for 384 subjects of different ages and with old persons with gait disturbances. Four conditions were used: Eyes Open/Closed vs. Head Normal/Bent Back. 'Center of Pressure' (CoP) signals were decomposed into 'Center of Mass' (CoM) and the remaining difference between Center of Pressure and Center of Mass (CoPM). The Zero-Crossing points in which the Center of Mass and Center of Pressure paths cross each other have been extracted. Velocity of CoM, velocity of CoPM and acceleration of CoPM in Zero-Crossing points were analyzed to be potential markers of balance efficiency. Three factors causing the deterioration of balance quality were analyzed: closing eyes, bending the head back and patient age. The influence of the given factors was measured using the significance p of the t-Student test and Cohen's d effect size and applied to differences for the logarithms of three of the mentioned above variables measured without and with the given deteriorating factor. In the majority of comparisons, the proposed new parameters of balance quality possessed higher statistical power to detect deteriorated balance quality than the standard parameters: standard deviation of the signal and ellipse area covering 90% of the signal envelope. Most valuable are the velocity and acceleration of CoPM for the medio-lateral direction. Logarithms of the analyzed parameters are proposed to be used in analyses because they possess normal or close to normal distribution and they are less sensitive to single high values occurring often in measurements.

Deficient vergence prism adaptation in subjects with decompensated heterophoria.

Vergence prism adaptability was evaluated in subjects with high symptomatic and asymptomatic heterophoria and compared to individuals with a heterophoria within normal range (the control group). A computer haploscope was used to measure phoria values and changes in the eye position after introducing 6 prism diopters base out in front of the right eye. Phoria values were measured with a nonius paradigm every minute for a period of 10 minutes during adaptation. The results showed that subjects with symptomatic heterophoria are characterized by a lower rate of prism adaptation and adapted to a smaller extent with respect to the control group. The group with high but asymptomatic heterophoria showed prolonged adaptation time but after several minutes of binocular viewing the subjects were able to adapt to the prism to a level similar to the control group. These findings suggest that an impairment in the slow vergence control system may be responsible for the inability to fully reduce vergence effort, which results in poor vergence ranges and asthenopic symptoms during prolonged viewing.

The engagement of cortical areas preceding exogenous vergence eye movements.

Source analyses on event related potentials (ERPs) derived from the electroencephalogram (EEG) were performed to examine the respective roles of cortical areas preceding exogenously triggered saccades, combined convergences, and combined divergences. All eye movements were triggered by the offset of a central fixation light emitting diode (LED) and the onset of a lateral LED at various depths in an otherwise fully darkened room. Our analyses revealed that three source pairs, two located in the frontal lobe-the frontal eye fields (FEF) and an anterior frontal area-, and one located within the occipital cortex, can account for 99.2% of the observed ERPs. Overall, the comparison between source activities revealed the largest activity in the occipital cortex, while no difference in activity between FEF and the anterior frontal area was obtained. For all sources, increased activity was observed for combined vergences, especially combined convergences, relative to saccades. Behavioral results revealed that onset latencies were longest for combined convergences, intermediate for combined divergences, and the shortest for saccades. Together, these findings fit within a perspective in which both occipital and frontal areas play an important role in retinal disparity detection. In the case of saccades and combined divergences stimulus-locked activity was larger than response-locked activity, while no difference between stimulus- and response-locked activity was observed for combined convergences. These findings seem to imply that the electrophysiological activity preceding exogenous eye movements consists of a sensory-related part that is under cortical control, while subcortical structures may be held responsible for final execution.

On understanding creative language: The late positive complex and novel metaphor comprehension.

Novel metaphoric sentences have repeatedly evoked larger N400 amplitudes than literal sentences, while investigations of the late positive complex (LPC) have brought inconsistent results, with reports of both increased and reduced amplitudes. In two experiments, we examined novel metaphor comprehension in Polish, using the same set of literal, novel metaphoric, and anomalous sentences. The first aim of the study was to test whether novel metaphors would evoke larger or smaller late positivity complex (LPC) amplitudes compared to literal and anomalous sentences. Some earlier studies have shown that whether increased LPC amplitudes are observed or not may be related to the task participants are asked to perform, with explicit acceptability judgments being more likely to evoke the LPC effect. The second aim of the study was, thus, to test whether the observed LPC pattern would be the same across two tasks, the semantic decision task (Experiment 1) and the reading task (Experiment 2). Our results replicated the N400 effect observed in earlier studies on metaphor in both experiments. Most importantly, a reduction in late positivity to novel metaphors relative to anomalous sentences was found in both experiments. Additionally, this difference was broadly distributed over parietal sites in Experiment 1, and clearly left-lateralized in Experiment 2, which might imply differences in the involvement of recollection and semantic processes. Overall, these results seem to indicate that both conventionality and task demands modulate the LPC pattern.

Unstable Binocular Fixation Affects Reaction Times But Not Implicit Motor Learning in Dyslexia.

Purpose: Individuals with developmental dyslexia suffer not only from reading problems as more general motor deficits can also be observed in this patient group. Both psychometric clinical tests and objective eyetracking methods suggest that unstable binocular fixation may contribute to reading problems. Because binocular instability may cause poor eye-hand coordination and impair motor control, the primary aim of this study was to explore in dyslexic subjects the influence of unstable binocular fixation on reaction times (RTs) and implicit motor learning (IML), which is one of the fundamental cerebellar functions. Methods: Fixation disparity (FD) and instability of FD were assessed subjectively using the Wesson card and a modified Mallett test. A modified version of the Serial Reaction Time Task (SRTT) was used to measure the RTs and IML skills. The results for the dyslexic group (DG), which included 29 adult subjects (15 were tested binocularly, DGbin; 14 were tested monocularly, DGmono), were compared with data from the control group (CG), which consisted of 30 age-matched nondyslexic subjects (15 tested binocularly, CGbin; and the other 15 tested monocularly, CGmono). Results: The results indicated that the DG showed poorer binocular stability and longer RTs in the groups tested binocularly (RTs: 534 vs. 411 ms for DGbin and CGbin, respectively; P < 0.001) as compared with the groups examined monocularly (RTs: 431 vs. 424 ms for DGmono and CGmono, respectively; P = 0.996). The DG also exhibited impaired IML when compared with the CG (EFIML: 25 vs. 50 ms for DG and CG, respectively; P = 0.012). Conclusions: Unstable binocularity in dyslexia may affect RTs but was not related to poor IML skills. Impaired IML in dyslexia was independent of the viewing conditions (monocular versus binocular) and may be related to cerebellar deficits.

How effector-specific is the effect of sequence learning by motor execution and motor imagery?

The aim of the present study was twofold. First, we wanted to examine how effector specific the effect of sequence learning by motor execution is, and second, we wanted to compare this effect with learning by motor imagery. We employed a Go/NoGo discrete sequence production task in which in each trial a spatial sequence of five stimuli was presented. After a Go signal the corresponding spatial response sequence had to be executed, while after a NoGo signal, the response sequence had to be mentally imagined. For the training phase, participants were divided into two groups. In the index finger group, participants had to respond (physically or mentally) with the left or right index finger, while in the hand group they had to respond with four fingers of the left or right hand. In a final test phase both execution modes were compared and all trials had to be executed. Response times and the percentage of correct responses were determined to establish learning effects. Results showed that sequence learning effects as assessed in the test phase were independent of the effector used during the training phase. Results revealed the presence of aspecific learning effects in the case of learning a required motor task with an index finger, but sequence-specific learning effects, both due to motor execution and to motor imagery, were not effector specific.

The influence of motor imagery on the learning of a fine hand motor skill.

Motor imagery has been argued to affect the acquisition of motor skills. The present study examined the specificity of motor imagery on the learning of a fine hand motor skill by employing a modified discrete sequence production task: the Go/NoGo DSP task. After an informative cue, a response sequence had either to be executed, imagined, or withheld. To establish learning effects, the experiment was divided into a practice phase and a test phase. In the latter phase, we compared mean response times and accuracy during the execution of unfamiliar sequences, familiar imagined sequences, and familiar executed sequences. The electroencephalogram was measured in the practice phase to compare activity between motor imagery, motor execution, and a control condition in which responses should be withheld. Event-related potentials (ERPs) and event-related lateralizations (ERLs) showed strong similarities above cortical motor areas on trials requiring motor imagery and motor execution, while a major difference was found with trials on which the response sequence should be withheld. Behavioral results from the test phase showed that response times and accuracy improved after physical and mental practice relative to unfamiliar sequences (so-called sequence-specific learning effects), although the effect of motor learning by motor imagery was smaller than the effect of physical practice. These findings confirm that motor imagery also resembles motor execution in the case of a fine hand motor skill.

To What Extent Can Motor Imagery Replace Motor Execution While Learning a Fine Motor Skill?

Motor imagery is generally thought to share common mechanisms with motor execution. In the present study, we examined to what extent learning a fine motor skill by motor imagery may substitute physical practice. Learning effects were assessed by manipulating the proportion of motor execution and motor imagery trials. Additionally, learning effects were compared between participants with an explicit motor imagery instruction and a control group. A Go/NoGo discrete sequence production (DSP) task was employed, wherein a five-stimulus sequence presented on each trial indicated the required sequence of finger movements after a Go signal. In the case of a NoGo signal, participants either had to imagine carrying out the response sequence (the motor imagery group), or the response sequence had to be withheld (the control group). Two practice days were followed by a final test day on which all sequences had to be executed. Learning effects were assessed by computing response times (RTs) and the percentages of correct responses (PCs). The electroencephalogram (EEG ) was additionally measured on this test day to examine whether motor preparation and the involvement of visual short term memory (VST M) depended on the amount of physical/mental practice. Accuracy data indicated strong learning effects. However, a substantial amount of physical practice was required to reach an optimal speed. EEG results suggest the involvement of VST M for sequences that had less or no physical practice in both groups. The absence of differences between the motor imagery and the control group underlines the possibility that motor preparation may actually resemble motor imagery.

The amblyopic eye in subjects with anisometropia show increased saccadic latency in the delayed saccade task.

The term amblyopia is used to describe reduced visual function in one eye (or both eyes, though not so often) which cannot be fully improved by refractive correction and explained by the organic cause observed during regular eye examination. Amblyopia is associated with abnormal visual experience (e.g., anisometropia) during infancy or early childhood. Several studies have shown prolongation of saccadic latency time in amblyopic eye. In our opinion, study of saccadic latency in the context of central vision deficits assessment, should be based on central retina stimulation. For this reason, we proposed saccade delayed task. It requires inhibitory processing for maintaining fixation on the central target until it disappears-what constitutes the GO signal for saccade. The experiment consisted of 100 trials for each eye and was performed under two viewing conditions: monocular amblyopic/non-dominant eye and monocular dominant eye. We examined saccadic latency in 16 subjects (mean age 30 ± 11 years) with anisometropic amblyopia (two subjects had also microtropia) and in 17 control subjects (mean age 28 ± 8 years). Participants were instructed to look at central (fixation) target and when it disappears, to make the saccade toward the periphery (10°) as fast as possible, either left or the right target. The study results have proved the significant difference in saccadic latency between the amblyopic (mean 262 ± 48 ms) and dominant (mean 237 ± 45 ms) eye, in anisometropic group. In the control group, the saccadic latency for dominant (mean 226 ± 32 ms) and non-dominant (mean 230 ± 29 ms) eye was not significantly different. By the use of LATER (Linear Approach to the Threshold with Ergodic Rate) decision model we interpret our findings as a decrease in accumulation of visual information acquired by means of central retina in subjects with anisometropic amblyopia.

Impaired body balance control in adults with strabismus.

Previous studies revealed that people with binocular vision disorders have poor postural stability. However, most of the research was performed only on children and under binocular viewing condition, that could negatively affect the results. The aim of the current study was to investigate the influence of extra-ocular proprioceptive signals on postural stability in young adults with binocular vision disorders. Moreover, additional mental task was introduced to detect any postural compensation which could possibly hide the real influence of afferent extra-ocular signals. 21 Subjects, aged 18-45 yrs, with horizontal strabismus, were qualified to binocular vision disorders (BVD) group. 41 subjects, aged 19-45 yrs, with no strabismus formed the normal binocular vision (NBV) group. Posturography data were collected in 2 separate parts: (1) quiet standing (Single-Task), and (2) performance of a mental task while standing (Dual-Task). Each part consisted of three 60-s viewing conditions, with: (1) dominant/fellow eye (DE), (2) non-dominant/strabismic eye (NDE), and with (3) both eyes closed (EC). Subjects were looking at X located at the distance of 150 cm. Generally, BVD group showed elevated body balance during quiet stance compared to NBV group. Interestingly, better stabilization in BVD group occurred under NDE viewing. Surprisingly, additional mental task improved the postural stability in BVD group almost to the level of NBV group. These findings emphasize the role of the eye-muscle signals in postural control and suggest that suitable vision therapy can be the appropriate way to improve body balance/motor functions in people with binocular vision disorders.

The filtering of the posturographic signals shows the age related features.

OBJECTIVE: Lower frequencies of slow oscillations of the posturographic signals can be removed using high-pass filtering. This procedure releases postural reflexes possessing higher frequencies and lower amplitude range. Mutual dependence between the x and y components of posturographic signals was analyzed using principal component analysis (PCA). The posturographic signals of old patients with idiopathic gait disturbance were compared with the control group of similar age and with younger patients. There was also the analysis of the influence of the eyes state (open versus closed) and the head position (normal or bent back). The statistically significant differences in the mutual dependence between x and y components between the groups of patients were analyzed using MANOVA. The significant differences were observed mainly in the range of filter frequencies f = 0.1-1.5 Hz and f = 2.2-5.5 Hz with a maximum effect at approximately 4-5 Hz. A detailed post-hoc analysis is also presented. The differences in the higher frequency range suggest the main disturbance to be connected with the spinal reflexes. Visual and vestibular support appear insufficient for postural stability control in the idiopathic gait disturbance group. The results suggest that idiopathic gait disturbance is the final stage of the aging process of postural system.

Change in ocular refraction after tropicamide cycloplegia in preschool children.

PURPOSE: The aim of the study was to evaluate changes in ocular refraction after 1% tropicamide and its efficacy in diagnosing refractive errors in preschool children. MATERIAL AND METHODS: 116 children (232 eyes) at the age of 5 to 6 years participated in the study. An objective examination of refraction using autorefractor before and after 1% tropicamide cycloplegia (2 x 1 drop of the agent instilled 5 min apart) was performed in the study. RESULTS: After the instillation of tropicamide, the spherical component of the refractive error significantly increased by +0.78 D, while the cylindrical component (i.e. its power and axis) remained unaltered. In examining the refractive error, the mean value of the spherical component in children at the age of 5 to 6 years amounted to +1.55 D, in the cylindrical component mean value was -0.51 D, and the axis was 102 degrees. CONCLUSIONS: 1% Tropicamide appears an effective cycloplegic agent in preschool children, excluding children with high hyperopia, anisometropia, or strabismus.