Development of Gazi Functional Vision Assessment Instrument

<p style="text-align: justify;">This study aimed to develop a valid and reliable instrument that measures the functional vision of students with low vision. Thus, an assessment tool and performance activities were developed for three vision skill groups (near vision skills, distance vision skills, and visual field) that include functional vision skills. The universe was 1485 students studying in various primary and middle schools (from 2nd to 7th grades) affiliated to the Ministry of National Education, and simple random sampling was used to select 310 students. The data were collected using the Gazi Functional Vision Assessment Instrument developed by the researchers. Many-facet Rasch model and generalizability theory were used for the rater reliability of the measurements obtained from the instrument, while discriminant analysis was used for the validity of the measurements. The analysis showed that the measurements were reliable, and the inferences based on these measurements were valid. Thus, this instrument can be used to identify and assess the functional vision status of students with low vision.</p>

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.

An ERG and OCT study of neuronal ceroid lipofuscinosis CLN2 Battens retinopathy

Background Late infantile neuronal ceroid lipofuscinosis (CLN2 Batten disease) is a rare, progressive neurodegenerative disease of childhood. The natural history of motor and language regression is used to monitor the efficacy of CNS treatments. Less is known about CLN2 retinopathy. Our aim is to elaborate the nature, age of onset, and symmetry of CLN2 retinopathy using visual electrophysiology and ophthalmic imaging. Subjects and methods We reviewed 22 patients with genetically confirmed CLN2 disease; seventeen showing classical and five atypical disease. Flash electroretinograms (ERGs), flash and pattern reversal visual evoked potentials (VEPs), recorded from awake children were collated. Available fundus images were graded, optical coherence tomography (OCT) central subfoveal thickness (CST) measured, and genotype, age, clinical vision assessment and motor language grades assembled. Results ERGs show cone/rod system dysfunction preceded by localised macular ellipsoid zone disruption on OCT from 4.8 years. Electroencephalogram (EEG) time-locked spikes confounded both pattern 6/17 (35%) and flash VEPs 12/16 (75%). Paired right eye (RE) and left eye (LE) ERG amplitudes did not differ significantly for each flash stimulus at the p 0.001 level, Wilcoxon ranked signed test. Cone ERGs show a functional deficit before CST thinning in classical disease. Optomap hyper fundus autofluorescence (FAF) at the fovea was noted in three patients with normal ERGs. The oldest patient showed an ovoid aggregate above the external limiting membrane at the fovea, which did not affect the PERG. Conclusion ERG findings in CLN2 retinopathy show symmetrical cone-rod dysfunction, from 4y10m in this series, but a broad range of ages when ERG function is preserved.

Cytomegalovirus (CMV) Infection in Infants: Two Case Reports and Review of Literature

Cytomegalovirus (CMV) is a virus under the Herpesviridae family. We describe two case reports on different manifestations of infants with CMV infection presented with neonatal jaundice, small for gestational age (SGA) and congenital cataract. Congenital CMV (cCMV) was diagnosed in a neonate presented with jaundice and SGA. cCMV cannot be excluded in another case as no CMV PCR done within 3 weeks of life. Only one cCMV infection was treated with 6 weeks of ganciclovir anti-viral therapy, which presented with neonatal jaundice, SGA with a very high CMV viral load. All cases were under multidisciplinary follow[1]up, including pediatric for developmental assessments, audiologist for hearing assessment, and ophthalmology for vision assessment. These case reports describe the importance of thorough clinical examination and early screening of CMV infection in infants to rule out cCMV as CMV is the commonest congenital treatable viral infection in Malaysia. Early treatment and intervention can be planned for child wellbeing.

Rare case of Terson’s syndrome and viral retinitis due to dengue haemorrhagic fever in an infant

Dengue haemorrhagic fever with consequent thrombocytopaenia can lead to intracranial haemorrhage and Terson’s syndrome that can lead to visual problems. Simultaneously, the dengue virus can cause typical viral retinitis like picture in the eye. Early funduscopy and vision assessment is desirable in all dengue patients. In our case, an infant with dengue haemorrhagic fever and intracranial haemorrhage developed not only simultaneous bilateral vitreous and subinternal limiting membrane haemorrhage due to Terson’s syndrome from the indirect effect of thrombocytopaenia but also typical chorioretinitis possibly due to the direct effect of the virus on the retina. The vitreoretinal surgical outcome was satisfactory in this case.

Vision loss, vision difficulty and psychological distress in South Africa: results from SANHANES-1

Background Psychological distress in vision impairments and blindness is a complex issue and a major public health concern. Sudden adjustments in routine lifestyle and career aspirations in such persons culminate in and/or aggravate their level of stress. Yet, psychological distress in persons with visual difficulties and vision loss in South Africa is poorly understood. We investigated the association between psychological distress and self-reported vision difficulties as well as clinician-assessed vision loss using data from the South African National Health and Nutrition Examination Survey (SANHANES-1). Methods Data was analysed on participants aged ≥ 15 years who participated in the SANHANES-1 clinical examinations and interviews. Data on demographic, socio-economic, and health status variables were gathered using a structured questionnaire. Psychological distress was assessed using the Kessler psychological distress scale (K10). Vision assessment was conducted by clinicians adhering to standard protocols as well as by participants’ subjective response to vision-related questions. Vision loss was defined as presenting visual acuity worse than Snellen 6/12 in the better eye. Bivariate and multiple logistic regressions were used to examine the association between vision parameters and psychological distress. Results The analytic sample comprised 6859 participants with mean age of 38.4 years (60.8% females). The prevalence of psychological distress was 19.9%. After adjusting for demographics, socioeconomic, health risk and eye care variables, self-reported myopia (mild adjusted odds ratio [AOR] = 1.9, 95% CI 1.3–2.7; moderate AOR = 2.4, 95% CI 1.6–3.7; severe AOR = 3.6, 95% CI 1.8–7.3) and self-reported hyperopia (mild AOR = 1.7, 95% CI 1.2–2.5; moderate AOR = 2.4, 95% CI 1.5–3.8; severe AOR = 3.5, 95% CI 1.8–6.8) were significantly associated with psychological distress. While psychological distress was higher in patients with clinician assessed vision loss than those with normal vision, the association was not statistically significant after adjusting for confounders (AOR: 1.0, 95% CI 0.7–1.4). Conclusions Persons who self-reported vision difficulty experienced a higher prevalence of psychological distress. Therefore, comprehensive psychological care is needed for patients with eye disease or vision difficulties as part of a governmental strategy to provide mental health care for all South Africans.

Prerequisites defining the trajectory of creative thinking

Introduction. The modern, rapidly changing world needs specialists with creative thinking skills, who are able to show rapidity, flexibility and originality in solving complex and extraordinary problems. When a specialist finds himself in such a situation where he faces extraordinary problems, he does not know how to solve them and is at a loss. It is impossible to acquire creative thinking skills without preparation. Therefore, a student, a future specialist, must be taught these skills. However, the difficulty lies in the fact that without developing students' skills such as analysis, synthesis, abstract, associative and combinatorial thinking, selective comparison, generalisation of information, system vision, assessment of ideas, the ability to ask right questions, to visualise and to draw conclusions, it will be difficult to further develop creative thinking in students.Aim. The aim of the study is to discover the relationship between various types of thinking and creative thinking, to determine the types of thought operations and the list of prerequisites that precede creative thinking, which will contribute to the formation of creative thinking in students.Methodology and research methods. General logical reasoning methods and some scientific research methods were applied. The phenomenological method was employed to understand the process of creative thinking. Based on the determination of the main parameters and properties of each type of thinking, it became possible to model the process of creative thinking activity, to investigate this mental process and draw certain conclusions. The use of the explanatory method also makes it possible to substantiate the need for the following prerequisites for the formation of creative thinking.Results and scientific novelty. Based on the analysis, it was discovered that various types of thinking are related to creative thinking, the types of thought operations were determined and a list of prerequisites was proposed. The list of prerequisites includes the following types of thinking: positive, synergetic, associative, abstract, visual, algorithmic, divergent, lateral, Janusian, questioning style, combinatorial, intuitive, systemic, and critical. The research results show the importance and necessity of prerequisites for creative thinking and also determine the trajectory of creative thinking activity.Practical significance. The research results can be useful for teachers of higher educational institutions with the aim of applying them in the learning process.

A study on selected morbidities among mining workers in Goa

Background: Given the complexity of the underground work system, the accidents at mining site and associated occupational diseases are dysfunctions that reduce the efficiency, productivity and profitability of workers. The present study provides a profile of selected morbidities among mining workers in Goa.Methods: Data was obtained from the records of a Occupational Health Service (OHS) centre in Ponda, Goa that conducted periodic health check ups of mining workers employed in 4 open cast iron ore mines from 4 Talukas, 2 each from North and South districts of Goa. Patient records of 199 workers representing different categories of work were obtained and analyzed. Data primarily focussed on visual acuity, audiometry findings, spirometry reports, ECG and basic laboratory blood investigations.Results: Upon analysis of data, it was observed that a high proportion of workers (43.21%) had defective vision. Assessment of audiometry reports revealed that 22.61% of workers had some form of hearing loss. As much as 19 (9.5%) workers were hypertensive, 26 (13.06%) were diabetic and 26 (13.06%) were dyslipidaemic. As high as 40 (20.1%) workers had ECG changes while 5 (2.51%) had pulmonary function impairment.Conclusions: Mining workers suffer from various health problems, notably, hearing loss, visual impairment, pulmonary function abnormalities and non-communicable diseases. This study emphasizes the importance of pre-employment and periodic medical check-ups in the mining industry for timely detection and appropriate treatment of these health conditions among the mining workers.

Knowledge, attitude and practice of Ethiopian pediatricians concerning childhood eye diseases

Background Eye examination and vision assessment are vital for the detection of conditions that result in blindness. Childhood blindness seriously impacts the development, education, and future employment opportunities of affected children. Pediatricians’ knowledge of eye diseases is critical for the prevention of blindness through early diagnosis, allowing proper treatment and identification of conditions requiring referral to an ophthalmologist to preserve or restore vision. This study aimed to assess the knowledge, attitude, and practice of Ethiopian pediatricians concerning childhood eye diseases. Methods We carried out a cross-sectional descriptive study of pediatricians working in various hospitals and clinics in Ethiopia. Participants were selected via a convenient sampling technique. Data were collected using both closed and open-ended semi-structured questionnaires. Responses were entered into EpiData 3.1 and transferred to SPSS version 21.0 software for analysis. Results A total of 79 pediatricians participated in the study. Our findings showed that the attitude of all but 2 participants towards improving the management of childhood eye diseases was positive, even though this was not reflected in actual knowledge or practice. Even though attitudes were positive, knowledge was often poor and practice inadequate owing to barriers such as inadequate undergraduate training, lack of ophthalmology options during pediatric residency, and unavailability of ophthalmic equipment. Conclusions Participants’ attitudes towards improving treatment for childhood eye diseases are positive, but their insufficient knowledge of eye diseases makes their practice poor in this respect.