Asthenopia: Diagnosis, Tatalaksana, Terapi

Asthenopia (kelelahan mata) merupakan sekumpulan gejala berupa permasalahan pada penglihatan (visual), mata (okular), dan muskuloskeletal yang umumnya terjadi hilang timbul. Keluhan ini sering muncul akibat pengaruh penggunaan perangkat digital dalam waktu yang lama terutama lebih dari 6 jam perhari. Penderita asthenopia secara global mencapai 60 juta orang yang didominasi usia muda. Gejala asthenopia yang paling sering dirasakan adalah keluhan mata kering, kesulitan dalam memfokuskan objek, mata tegang, mata lelah, dan sakit kepala. Diagnosis asthenopia dapat dilakukan secara subjektif dengan menggunakan kuesioner standar ataupun secara objektif dengan pemeriksaan lanjutan. Pemeriksaan yang dapat dilakukan berupa pengukuran Critical Flicker-fusion Frequency (CFF), pengukuran frekuensi berkedip, kemampuan akomodasi, serta refleks cahaya dan ukuran pupil yang dapat memberikan gambaran lebih jelas ke arah asthenopia. Tatalaksana dan terapi pada asthenopia diberikan untuk meredakan gejala dan mengatasi penyebabnya seperti terapi untuk mengatasi mata kering, koreksi gangguan refraksi, terapi gangguan akomodasi dan vergensi, dan penggunaan kacamata filter cahaya biru. Walaupun asthenopia terjadi secara hilang timbul, penyakit ini dapat menjadi menetap dan berkembang menimbulkan keluhan permanen. Artikel ini ditulis berdasarkan hasil literature review dari penelitian terkait diagnosis, tatalaksana, dan terapi asthenopia yang sudah dipublikasi. Penulisan artikel ini diharapkan dapat dijadikan acuan dalam menindaklanjuti kasus asthenopia sehingga prevalensi dan insidensinya dapat ditekan.

Acquisition of a Learned Operant and Critical Flicker-Fusion Rate in the Tuatara (Sphenodon spp.)

<p>Scientific investigation of the sensory world and behavior of the tuatara is limited. This study incorporates both ecological and psychological perspectives to test learning and visual perception using a novel operant technique and flicker-fusion rates to measure visual discrimination in tuatara. We posed four main questions: (1) can a reliable method examine learning and visual perception in tuatara?, (2) what is the critical flicker-fusion (CFF) rates for tuatara and how does it relate to motion detection ability?, (3) can stimulus control be transferred to a Y-maze from an open field arena?, and (4) what are the implications for behavioral ecology, conservation, and species welfare? Tuatara (Sphenodon punctatus) were trained using an operant conditioning procedure with food reinforcement to respond to discriminative stimuli (S+) of various flicker-fusion rates, and ignore a non-discriminative stimulus (S-). Tuatara discriminated CFF rates between 2.65-45.61 Hz, but not at 65.09 Hz. The upper threshold between 45.61-65.09 Hz is comparable to other mammalian, avian, and herpetological species. Tuatara demonstrated a learning capacity for acquisition of an operant task as well as cognitive development for learning and memory strategies. Visual discrimination is important to tuatara and may facilitate behavioral responses to many context-dependent ecological processes (i.e., predator/prey/kin recognition, mate selection, environmental discrimination, optimal foraging strategies, and communication). By understanding the importance of visual stimuli, the study provides a better perspective of the tuatara natural sensory world. Additionally, a reliable method was established that can be used for more comprehensive psychophysical experiments to further access visual perception and learning in all reptiles, with the potential to examine other sensory mechanisms such as audition, chemoreception, and tactility.</p>

Acquisition of a Learned Operant and Critical Flicker-Fusion Rate in the Tuatara (Sphenodon spp.)

<p>Scientific investigation of the sensory world and behavior of the tuatara is limited. This study incorporates both ecological and psychological perspectives to test learning and visual perception using a novel operant technique and flicker-fusion rates to measure visual discrimination in tuatara. We posed four main questions: (1) can a reliable method examine learning and visual perception in tuatara?, (2) what is the critical flicker-fusion (CFF) rates for tuatara and how does it relate to motion detection ability?, (3) can stimulus control be transferred to a Y-maze from an open field arena?, and (4) what are the implications for behavioral ecology, conservation, and species welfare? Tuatara (Sphenodon punctatus) were trained using an operant conditioning procedure with food reinforcement to respond to discriminative stimuli (S+) of various flicker-fusion rates, and ignore a non-discriminative stimulus (S-). Tuatara discriminated CFF rates between 2.65-45.61 Hz, but not at 65.09 Hz. The upper threshold between 45.61-65.09 Hz is comparable to other mammalian, avian, and herpetological species. Tuatara demonstrated a learning capacity for acquisition of an operant task as well as cognitive development for learning and memory strategies. Visual discrimination is important to tuatara and may facilitate behavioral responses to many context-dependent ecological processes (i.e., predator/prey/kin recognition, mate selection, environmental discrimination, optimal foraging strategies, and communication). By understanding the importance of visual stimuli, the study provides a better perspective of the tuatara natural sensory world. Additionally, a reliable method was established that can be used for more comprehensive psychophysical experiments to further access visual perception and learning in all reptiles, with the potential to examine other sensory mechanisms such as audition, chemoreception, and tactility.</p>

Critical Flicker Fusion Frequency: A Narrative Review

This review presents the current knowledge of the usage of critical flicker fusion frequency (CFF) in human and animal model studies. CFF has a wide application in different fields, especially as an indicator of cortical arousal and visual processing. In medicine, CFF may be helpful for diagnostic purposes, for example in epilepsy or minimal hepatic encephalopathy. Given the environmental studies and a limited number of other methods, it is applicable in diving and hyperbaric medicine. Current research also shows the relationship between CFF and other electrophysiological methods, such as electroencephalography. The human eye can detect flicker at 50–90 Hz but reports are showing the possibility to distinguish between steady and modulated light up to 500 Hz. Future research with the use of CFF is needed to better understand its utility and application.

Assessment of Alertness and Cognitive Performance of Closed Circuit Rebreather Divers With the Critical Flicker Fusion Frequency Test in Arctic Diving Conditions

Introduction: Cold water imposes many risks to the diver. These risks include decompression illness, physical and cognitive impairment, and hypothermia. Cognitive impairment can be estimated using a critical flicker fusion frequency (CFFF) test, but this method has only been used in a few studies conducted in an open water environment. We studied the effect of the cold and a helium-containing mixed breathing gas on the cognition of closed circuit rebreather (CCR) divers.Materials and Methods: Twenty-three divers performed an identical dive with controlled trimix gas with a CCR device in an ice-covered quarry. They assessed their thermal comfort at four time points during the dive. In addition, their skin temperature was measured at 5-min intervals throughout the dive. The divers performed the CFFF test before the dive, at target depth, and after the dive.Results: A statistically significant increase of 111.7% in CFFF values was recorded during the dive compared to the pre-dive values (p &lt; 0.0001). The values returned to the baseline after surfacing. There was a significant drop in the divers’ skin temperature of 0.48°C every 10 min during the dive (p &lt; 0.001). The divers’ subjectively assessed thermal comfort also decreased during the dive (p = 0.01).Conclusion: Our findings showed that neither extreme cold water nor helium-containing mixed breathing gas had any influence on the general CFFF profile described in the previous studies from warmer water and where divers used other breathing gases. We hypothesize that cold-water diving and helium-containing breathing gases do not in these diving conditions cause clinically relevant cerebral impairment. Therefore, we conclude that CCR diving in these conditions is safe from the perspective of alertness and cognitive performance.

Effect of abacus training on critical flicker fusion frequency threshold among primary schoolchildren

Objectives: The concept of neuronal plasticity has been considerably studied to know how long-lasting changes are associated with brain’s capacity to be shaped or sculptured by experience. Potential cognitive benefits of abacus training have been proved by various studies indicating it to be a promising tool in improving cognitive abilities including arithmetic abilities, visuospatial and working memory. Critical flicker fusion happens when the individual can no longer differentiate between changing visual stimuli. It can be modulated by behavioural or psychophysical techniques. The objectives of the study were to evaluate the effects of abacus training on critical flicker fusion frequency (CFFF) threshold. Materials and Methods: CFFF threshold (CFFFT) was measured in 60 school students studying third and fourth standard (30 trained in abacus and 30 not trained in abacus) using portable software-based apparatus. Results: The mean scores of abacus trained individuals were significantly higher compared to those who were not trained. Conclusion: Since higher CFFFTs can absorb more visual information, increasing their threshold might lead to cognitive improvement and better academic performance. Abacus trained individuals showed significantly higher critical fusion frequency threshold.

Visuo-motor integration, vision perception and attention in mTBI patients. Preliminary findings

Patients with mild traumatic brain injuries (mTBI) often report difficulties in motor coordination and visuo-spatial attention. However, the consequences of mTBI on fine motor and visuo-motor coordination are still not well understood. We aimed to evaluate whether mTBI had a concomitant effect on fine motor ability and visuo-motor integration and whether this is related to visual perception and visuo-spatial attention impairments, including patients at different symptoms stage. Eleven mTBI patients (mean age 22.8 years) and ten healthy controls participated in the study. Visuo-motor integration of fine motor abilities and form recognition were measured with the Beery-Buktenica Developmental Test of Visual-Motor Integration test, motion perception was evaluated with motion coherence test, critical flicker fusion was measured with Pocket CFF tester. Visuo-spatial was assessed with the Ruff 2 & 7 Selection Attention Test. mTBI patients showed reduced visuo-motor integration, form recognition, and motor deficits as well as visuo-spatial attention impairment, while motion perception and critical flicker fusion were not impaired. These preliminary findings suggest that the temporary brain insults deriving from mTBI compromise fine motor skills, visuomotor integration, form recognition, and visuo-spatial attention. The impairment in visuo-motor coordination was associated with speed in visuo-attention and correlated with symptoms severity while motor ability was correlated with time since concussion. Given the strong correlation between visuomotor coordination and symptom severity, further investigation with a larger sample seems warranted. Since there appeared to be differences in motor skills with respect to symptom stage, further research is needed to investigate symptom profiles associated with visuomotor coordination and fine motor deficits in mTBI patients.