Subjects with CVI required extra time prior to starting the movement (as shown by longer onset time) and this was probably needed to localise the object and to perceive its dimensions. They spent more time after maximum grip aperture, indicating a need for a longer time to grasp the object. A possible reason is that visually impaired patients need to use more tactile information than normal subjects in order to fully execute grasping of the object. CVI that was of <10 years in duration affected more indices compared to CVI that was of long standing and may suggest adaptation to the visual impairment for this task.

Reducing the FOV to 11 degrees (an absence of peripheral vision) affects the planning and execution of the reach and the grasp component of the movement. Restricting the FOV to 23 degrees of central vision (with some peripheral cues present) affects only the planning of the reach and grasp component of the movement. Peripheral visual cues are therefore more important for the on-line control than for the planning of the movement. The findings of this study have important clinical implications in patients who suffer from ocular diseases in which peripheral vision gradually decreases.

PurposeUncorrected refractive error remains a leading cause of visual impairment (VI) across the globe with Mozambique being no exception. The establishment of an optometry profession in Mozambique that is integrated into the public health system denotes significant progress with refractive services becoming available to the population. As the foundations of a comprehensive refractive service have now been established, this article seeks to understand what barriers may limit their uptake by the general population and inform decision making on improved service delivery.MethodsA community-based cross-sectional study using two-stage cluster sampling was conducted. Participants with VI were asked to identify barriers that were reflective of their experiences and perceptions of accessing refractive services. A total of 4601 participants were enumerated from 76 clusters in Nampula, Mozambique.ResultsA total of 1087 visually impaired participants were identified (884 with near and 203 with distance impairment). Cost was the most frequently cited barrier, identified by more than one in every two participants (53%). Other barriers identified included lack of felt need (20%), distance to travel (15%), and lack of awareness (13%). In general, no significant influence of sex or type of VI on barrier selection was found. Location had a significant impact on the selection of several barriers. Pearson χ2 analysis indicated that participants from rural areas were found to feel disadvantaged regarding the distance to services (p ≤ 0.001) and adequacy of hospital services (p = 0.001).ConclusionsFor a comprehensive public sector refractive service to be successful in Mozambique, those planning its implementation must consider cost and affordability. A clear strategy for overcoming lack of felt need will also be needed, possibly in the form of improved advocacy and health promotion. The delivery of refractive services in more remote rural areas merits careful and comprehensive consideration.

Subjects with VI took longer to initiate and to complete the movement. Maximum velocity and grip aperture were not different suggesting that once the target was "seen" by subjects with VI performance was similar to normal subjects. Time after maximum grip aperture was longer in subjects with VI indicating the need for "online" modifications in these subjects. Contrast sensitivity was significantly correlated to more indices than visual acuity.

Reaching and grasping behavior is compromised in subjects with VI due to macular disorders compared with normals, and crowding affected performance for both normal subjects and those with VI. Flankers placed half an object diameter away showed greater deterioration than those placed further away.