Rating the Impact of Visual Impairment

2011 ◽  
Vol 16 (6) ◽  
pp. 1-6
Author(s):  
August Colenbrander
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Impairment ◽  
Low Vision ◽  
Scientific Progress ◽  
Visual Field Loss ◽  
Statistical Estimates ◽  
Organ Systems ◽  
Visual Acuity Loss ◽  
The Impact

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) used the Snell Visual Efficiency Scale (1925). Following scientific progress, the Vision chapter in the fifth and sixth editions of the AMA Guides began using the Functional Vision Score (FVS) that is endorsed by the International Council of Ophthalmology and the International Society for Low Vision Research and Rehabilitation. Use of the FVS provided an opportunity to correct many inconsistencies in the VES system and also is better integrated with modern measurement methods and the ratings used for other organ systems. The FVS score is obtained by combining the Functional Acuity Score and the Functional Field Score; if any adjustments are introduced in this combination, they must be completely justified and cannot be based on subjective arguments. The disability is rated on the basis of functional considerations and is not influenced by nonfunctional factors. Combining visual acuity loss and visual field loss into a single number is attractive for administrative and legal purposes, but this step is meaningless in the context of rehabilitation because rehabilitation for visual acuity loss is entirely different from rehabilitation for visual field loss. The FVS system provides internationally endorsed statistical estimates of the effects of visual impairment on the ability to perform activities of daily living.

scholarly journals A Prospective Profile of Visual Field Loss following Stroke: Prevalence, Type, Rehabilitation, and Outcome

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Fiona J. Rowe ◽  
David Wright ◽  
Darren Brand ◽  
Carole Jackson ◽  
Shirley Harrison ◽  
...  
Keyword(s):  
Visual Field ◽  
Visual Impairment ◽  
Parietal Lobe ◽  
Low Vision ◽  
Treatment Options ◽  
Visual Awareness ◽  
Visual Field Loss ◽  
Blurred Vision ◽  
Stroke Prevalence ◽  
Search Training

Aims. To profile site of stroke/cerebrovascular accident, type and extent of field loss, treatment options, and outcome.Methods. Prospective multicentre cohort trial. Standardised referral and investigation protocol of visual parameters.Results. 915 patients were recruited with a mean age of 69 years (SD 14). 479 patients (52%) had visual field loss. 51 patients (10%) had no visual symptoms. Almost half of symptomatic patients (n=226) complained only of visual field loss: almost half (n=226) also had reading difficulty, blurred vision, diplopia, and perceptual difficulties. 31% (n=151) had visual field loss as their only visual impairment: 69% (n=328) had low vision, eye movement deficits, or visual perceptual difficulties. Occipital and parietal lobe strokes most commonly caused visual field loss. Treatment options included visual search training, visual awareness, typoscopes, substitutive prisms, low vision aids, refraction, and occlusive patches. At followup 15 patients (7.5%) had full recovery, 78 (39%) had improvement, and 104 (52%) had no recovery. Two patients (1%) had further decline of visual field. Patients with visual field loss had lower quality of life scores than stroke patients without visual impairment.Conclusions. Stroke survivors with visual field loss require assessment to accurately define type and extent of loss, diagnose coexistent visual impairments, and offer targeted treatment.

scholarly journals Epidemiological Findings of Refractive Errors and Amblyopia among the Schoolchildren in Hatta Region of the United Arab Emirates

2021 ◽  
pp. 1-7
Author(s):  
Salam Chettian Kandi ◽  
Hayat Ahmad Khan
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
United Arab Emirates ◽  
Refractive Error ◽  
Screening Program ◽  
Low Vision ◽  
Refractive Errors ◽  
Vision Screening ◽  
Screening Programs ◽  
School Based

<b><i>Introduction:</i></b> Uncorrected refractive errors and amblyopia pose a major problem affecting schoolchildren. We had previously observed that many schoolchildren in the Hatta region presented to the ophthalmology clinic with uncorrected refractive errors and amblyopia, which led us to undertake this research. As per the WHO, the term “visual impairment” can be “low vision” or “blindness.” Based on the presenting vision, “low vision” is defined for children who have vision of &#x3c;6/18 to 3/60 or having visual field loss to &#x3c;20° in the better-seeing eye. Children defined to have “blindness” have presenting vision of &#x3c;3/60 or corresponding visual field of &#x3c;10°. <b><i>Purpose:</i></b> To estimate the magnitude of uncorrected refractive errors and amblyopia among the schoolchildren aged 6–19 years and to assess the efficacy of school-based refractive error screening programs in the Hatta region of the United Arab Emirates. <b><i>Methods:</i></b> An epidemiological, cross-sectional, descriptive study was conducted on the entire student population studying in the government schools of the region. Those who failed the Snellen visual acuity chart test and those who were wearing spectacles were evaluated comprehensively by the researcher in the Department of Ophthalmology of the Hatta Hospital. Data were entered in the Refractive Error Study in School Children (RESC) eye examination form recommended by the WHO, and were later transferred to Excel sheets and analyzed by SPSS. <b><i>Results:</i></b> 1,591 students were screened and evaluated from the end of 2016 to mid-2017. About 21.37% (<i>n</i> = 340) had impaired vision with 20.9% (<i>n</i> = 333) refractive errors, of which 58% were uncorrected. Among the refractive error group, 19% (64 subjects) had amblyopia (4% of total students). The incidence of low vision was 9.5% and blindness was 0.38%. Low vision was found to be 9.5% and blindness 0.38%, taking in to account presenting visual acuity rather than best-corrected visual acuity for defining low vision and blindness. <b><i>Conclusion:</i></b> A significant number of students were detected to have uncorrected refractive errors among the vision impaired group (59%, <i>n</i> = 197) despite a school-based vision screening program in place. Seventy-eight percent of the amblyopia cases (<i>n</i> = 50) were found to be in the 11–19 years age group. Noncompliance with optical corrections was the reason for the high number of cases. A rigorous vision screening program and refractive services, complimented with awareness among parents and teachers, are recommended.

scholarly journals Neuroplasticity in visual impairments

2018 ◽  
Vol 10 (4) ◽  
Author(s):  
Paulo Ramiler Silva ◽  
Tiago Farias ◽  
Fernando Cascio ◽  
Levi Dos Santos ◽  
Vinícius Peixoto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Visual Impairment ◽  
Visual Impairments ◽  
Cortical Reorganization ◽  
Pubmed Database ◽  
Visual Areas ◽  
Visual Acuity Loss ◽  
The Brain

The visual acuity loss enables the brain to access new pathways in the quest to overcome the visual limitation and this is wellknown as neuroplasticity which have mechanisms to cortical reorganization. In this review, we related the evidences about the neuroplasticity as well as cortical anatomical differences and functional repercussions in visual impairments. We performed a systematic review of PUBMED database, without date or status publication restrictions. The findings demonstrate that the visual impairment produce a compensatory sensorial effect, in which non-visual areas are related to both cross (visual congenital) and multimodal (late blind) neuroplasticity.

scholarly journals Implications of a Remote Study of Children With Cerebral Visual Impairment for Conducting Virtual Pediatric Eye Care Research: Virtual Assessment Is Possible for Children With CVI

2021 ◽  
Vol 15 ◽  
Author(s):  
Reem Almagati ◽  
Barry S. Kran
Keyword(s):  
Visual Acuity ◽  
Visual Impairment ◽  
Low Vision ◽  
Typically Developing ◽  
Typically Developing Children ◽  
Parent Questionnaire ◽  
Low Vision Clinic ◽  
Age Range ◽  
Vision Function ◽  
E Mail

The Pandemic of 2020 impacted conducting in-person research. Our proposed project already had an asynchronous online component but was later morphed to add a synchronous online component, thereby eliminating the need for in-person assessment. The project compares the results of various tests between a group of children with Cerebral Visual Impairments (CVI) (N = 4) and an age-matched sample of children without CVI (N = 3) from a pediatric low vision clinic. This model was trialed with a small convenient sample of typically developing children in the same age range (N = 4). Given the positive feedback, recruitment for the larger study was done via encrypted e-mail rather than through traditional mailing. The asynchronous components included recruitment, pre-assessment information, the Flemish CVI questionnaire, Vineland-3 comprehensive parent questionnaire for assessment of age equivalent, and vision function tests, such as contrast sensitivity. The synchronous components were administered via Zoom telehealth provided by necoeyecare.org and included assessment of visual acuity via the Freiburg Visual Acuity and Contrast Test (FrACT) electronic software and assessment of visual perceptual batteries via the Children’s Visual Impairment Test for developmental ages 3–6-years (CVIT 3–6). Our virtual testing protocol was successful in the seven participants tested. This paper reviews and critiques the model that we utilized and discusses ways in which this model can be improved. Aside from public health considerations during the pandemic, this approach is more convenient for many families. In a broader perspective, this approach can be scaled for larger N studies of rare conditions, such as CVI without being confined by proximity to the researcher.

scholarly journals Impact of low vision services on the quality of life of low vision patients in Ghana

2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Godwin O. Ovenseri-Ogbomo ◽  
Harriette Osafo-Agyei ◽  
Ralph E.U. Akpalaba ◽  
James Addy ◽  
Elizabeth O. Ovenseri
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Positive Impact ◽  
Low Vision ◽  
Care Quality ◽  
Eastern Region ◽  
Post Intervention ◽  
Low Vision Clinic ◽  
The Impact

Patients’ perspectives on the impact of clinical interventions have been recognised as critical elements in patient care. Quality-of-life instruments are designed to measure these perspectives. We used the National Eye Institute’s 25-item Visual Function Questionnaire (NEI VFQ) to measure the impact of optical low vision devices on the quality of life of 22 low vision patients who obtained and were using low vision devices from a secondary low vision clinic in the Eastern Region, Ghana. The study employed a pre- and post-intervention technique. We found statistically significant improvements in measured visual acuity and NEI VFQ scores in 8 of the 10 domains evaluated. We conclude that optical low vision devices have a positive impact on the quality of life of low vision patients in Ghana.Keywords: low vision; quality of life; visual acuity; visual impairment; Ghana

Charles Bonnet syndrome as first manifestation of occipital infarction

2022 ◽  
pp. 112067212110697
Author(s):  
Marta Isabel Martínez-Sánchez ◽  
Gema Bolívar
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Field Tests ◽  
Visual Field Loss ◽  
Visual Hallucinations ◽  
Correct Treatment ◽  
Cerebral Magnetic Resonance Imaging ◽  
Full Field ◽  
Charles Bonnet Syndrome ◽  
The Right

Purpose To describe a case of Charles Bonnet syndrome as the first manifestation of occipital infarction in a patient with preserved visual acuity. Observations We report a 78-year-old man followed in our department with a two-month-long history of visual hallucinations based on the vision of flowers and fruits intermittently, being perceived as unreal images. Best-corrected visual acuity was stable in the follow-up time being 20/20 in the right eye and 20/25 in the left eye. Extraocular muscle function testing, pupillary reflexes, biomicroscopy, fundus and optical coherence tomography examinations did not reveal any interesting findings. In order to rule out occipital pathology, orbital-cerebral magnetic resonance imaging was performed, showing an image compatible with the chronic ischemic right occipital lesion. The patient was diagnosed with Charles Bonnet syndrome secondary to occipital infarction and neurology decided that no treatment was required. 24-2 and 10-2 visual field tests showed no remarkable alterations and Full-field 120 point screening test showed nonspecific peripheral defects. Hallucinations improved over the months, being described as not annoying and increasingly infrequent. Conclusions and Importance Charles Bonnet syndrome is a condition characterized by the presence of recurrent and complex visual hallucinations in patients with visual pathway pathologic defects. Visual acuity or visual field loss is not a requirement for diagnosis. Charles Bonnet syndrome should be suspected in all patients with non-disturbing visual hallucinations, even though they present good visual acuteness. It will be essential to perform complementary explorations to identify the underlying pathology that allows the starting of a correct treatment option.

Vision in context

2014 ◽  
pp. 903-920
Author(s):  
Alastair K.O. Denniston ◽  
Philip I. Murray
Keyword(s):  
Visual Impairment ◽  
Low Vision ◽  
Professional Standards ◽  
Support Strategies ◽  
The Impact

‘Vision in context’ helps the reader to address the whole patient, to consider the impact of visual impairment on their life and to think more broadly about how they may be supported. It includes issues around the assessment of low vision, registration, support strategies, driving standards and professional standards.

Loss of vision

2018 ◽  
Author(s):  
Susan Mollan ◽  
Alastair Denniston
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Low Vision ◽  
Visual Field Loss ◽  
Age Related Macular Degeneration ◽  
World Health ◽  
Clinical Approach ◽  
Loss Of Vision ◽  
P Loss ◽  
Age Related

Loss of vision describes a reduction in vision that cannot be corrected by glasses or contact lenses. Patients who complain of changes in their vision may have loss of visual acuity, distorted vision, or visual field loss. The World Health Organization classifies visual impairment as blindness or low vision. Blindness is defined as visual acuity of less than 3/60 in the better eye. Low vision is present when the visual acuity is less than 6/18 but equal to or better than 3/60, in the better eye. The etiology of permanent visual loss is diverse and depends on the region studied. In the UK, the leading causes are age-related macular degeneration, glaucoma, diabetic retinopathy, optic atrophy, and cataract. This chapter describes the clinical approach to the patient with loss of vision.

scholarly journals Novel Pathogenic Sequence Variants in NR2E3 and Clinical Findings in Three Patients

Genes ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 1288
Author(s):  
Saoud Al-khuzaei ◽  
Suzanne Broadgate ◽  
Stephanie Halford ◽  
Jasleen K. Jolly ◽  
Morag Shanks ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Fields ◽  
Visual Field Loss ◽  
Clinical Findings ◽  
Sequence Variants ◽  
Childhood Onset ◽  
Distinctive Features ◽  
Targeted Ngs ◽  
Clinical Records

A retrospective review of the clinical records of patients seen at the Oxford Eye Hospital identified as having NR2E3 mutations was performed. The data included symptoms, best-corrected visual acuity, multimodal retinal imaging, visual fields and electrophysiology testing. Three participants were identified with biallelic NR2E3 pathogenic sequence variants detected using a targeted NGS gene panel, two of which were novel. Participant I was a Nepalese male aged 68 years, and participants II and III were white Caucasian females aged 69 and 10 years old, respectively. All three had childhood onset nyctalopia, a progressive decrease in central vision, and visual field loss. Patients I and III had photopsia, patient II had photosensitivity and patient III also had photophobia. Visual acuities in patients I and II were preserved even into the seventh decade, with the worst visual acuity measured at 6/36. Visual field constriction was severe in participant I, less so in II, and fields were full to bright targets targets in participant III. Electrophysiology testing in all three demonstrated loss of rod function. The three patients share some of the typical distinctive features of NR2E3 retinopathies, as well as a novel clinical observation of foveal ellipsoid thickening.

Sickle cell maculopathy: prevalence, associations and impact on visual acuity

2020 ◽  
Author(s):  
Haroen Sahak ◽  
Mohammed Saqalain ◽  
Pooi Lott ◽  
Martin Mckibbin
Keyword(s):  
Visual Acuity ◽  
Sickle Cell Disease ◽  
Visual Impairment ◽  
Sickle Cell ◽  
Consecutive Series ◽  
High Contrast ◽  
Cell Disease ◽  
Spectral Domain Oct ◽  
Frequent Finding ◽  
The Impact

Aims: To investigate the prevalence of sickle cell maculopathy (SCM), associations with age, sex, genotype and proliferative sickle cell retinopathy (PSR) stage and the impact on visual acuity Methods: Age, sex and visual acuity were recorded and spectral domain OCT and ultra-widefield images of the macula and retina were reviewed for a consecutive series of 74 adults with sickle cell disease Results: The median age was 37 years (range 19-73 years) and 36 cases (48.6%) were male. SCM was present in at least one eye of 40 cases (54.1%) or in 67 of all eyes (42.3%). SCM prevalence was 54.8%, 62.5% and 25% for HbSS, HbSC and HbS/BThal or other genotypes respectively. SCM was observed in 41 (39.4%) of the eyes with PSR stages 0,1,2 and 21 (51.2%) of the eyes with PSR stages 3,4,5. Mild visual impairment or worse was present in 3 eyes (4.8%) with SCM but this was secondary to other pathology. Conclusion: SCM is a frequent finding in eyes of adults with sickle cell disease. The prevalence is similar for both HbSS and HbSC genotypes and is not related to the PSR stage. High-contrast distance visual acuity is typically preserved.

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