Objectives To assess the efficacy and cost effectiveness of a home safety programme and a home exercise programme to reduce falls and injuries in older people with low vision. Design Randomised controlled trial. Setting Dunedin and Auckland, New Zealand. Participants 391 women and men aged ≥ 75 with visual acuity of 6/24 or worse who were living in the community; 92% (361 of 391) completed one year of follow-up. Interventions Participants received a home safety assessment and modification programme delivered by an occupational therapist (n = 100), an exercise programme prescribed at home by a physiotherapist plus vitamin D supplementation (n = 97), both interventions (n = 98), or social visits (n = 96). Main outcome measures Numbers of falls and injuries resulting from falls, costs of implementing the home safety programme. Results Fewer falls occurred in the group randomised to the home safety programme but not in the exercise programme (incidence rate ratios 0.59 (95% confidence interval 0.42 to 0.83) and 1.15 (0.82 to 1.61), respectively). However, within the exercise programme, stricter adherence was associated with fewer falls (P = 0.001). A conservative analysis showed neither intervention was effective in reducing injuries from falls. Delivering the home safety programme cost $NZ650 (£234, 344 euros, $US432) (at 2004 prices) per fall prevented. Conclusion The home safety programme reduced falls and was more cost effective than an exercise programme in this group of elderly people with poor vision. The Otago exercise programme with vitamin D supplementation was not effective in reducing falls or injuries in this group, possibly due to low levels of adherence. Trial registration number ISRCTN15342873.

In the absence of astigmatism and disease, a pseudophakic eye with -0.75 D of myopia can expect to achieve 20/30 uncorrected distance acuity and read N5 unaided if the pupil is approximately 2.5 mm.

Summary Children from a population sample whose cycloplegic refractive errors included myopia, pre‐myopia and hypermetropia were compared on measures of IQ and reading with a group of children without significance refractive errors. At age 11 both those with myopia and with pre‐myopia had increased verbal and performance IQ, while those with hypermetropia had slightly reduced verbal and performance IQ, in comparison with the children without refractive errors. The differences in verbal IQ were not attributable simply to earlier differences, but the differences in performance IQ were attributable to earlier differences. No significant differences in reading scores were found at either age. It is concluded that differing abilities of myopic and other children at age 11 are not fully explained by differences in family background or in pre‐existing ability. RÉSUMÉ Défaut de réfraction, QI et capacité de lecture: étude longitudinale de sept à 11 ans Des enfants provenant d'un échantillon dont les défauts de réfraction cycloplégiques incluaient la myopie, la pré‐myopie et I'hypermétropie ont été comparés en termes de QI et d'efficience de lecture avec un groupe d'enfants sans troubles significatifs de réfraction. A l'age de 11 ans, les QI verbaux et de performance étaient élevés chez les enfants porteurs de myopie et de pré‐myopie, légèrement inférieurs chez les hypermétropes, par comparaison avec les enfants sans défauts de réfraction. Les différences dans les QI verbaux n'étaient pas attribuables seulement aux différences antérieures, au contraire des différences pour le QI de performance. Aucune différence significative dans les scores d'efficience de lecture n'a été notée à aucun age. Les auteurs concluent que la différence d'aptitude chez les enfants myopes et autres à 11 ans ne sont pas totalement explicables par des différences de milieu social ou de capacités antérieurs. ZUSAMMENFASSUNG Refraktionsfehler, IQ und Leseleistung: eine Langzeitstudie von sieben bis 11 Jahren Eine Gruppe von Kindern, deren cycloplegische Refraktionsfehler Myopie, Prämyopie und Hypermetropie beinhalteten, wurden anhand des IQ und der Leseleistung mit einer Gruppe von Kindern ohne signifikante Refraktionsfehler verglichen. Im Alter von 11 Jahren hatten die mit Myopie und mit Prämyopie erhöhte Verbal und Performance IQs, während die mit Hypermetropie leicht erniedrigte Verbal und Performance IQs im Vergleich zu den Kindern ohne Refraktionsfehler hatten. Die Unterschiede beim Verbal IQ waren nicht nur früiheren Unterschieden zuzuordnen, aber die Unterschiede beim Performance IQ waren früheren Unterschieden zuzuordnen. Die Lesescores wiesen in keiner Altersstufe signifikante Unterschiede auf. Die Autoren sind der Meinung, daß abweichende Leistungen bei myopischen und anderen Kindern nicht ausreichend durch Unterschiede des familiären Hintergrunds oder von bereits vorhandenen Fähigkeiten erklärt sind. RESUMEN Error de refraccion, CI y habilidad para la lectura: estudio longitudinal de los siete a los 11 añRos de edad Niños de una muestra d...

Aims Pressure phosphene tonometry is said to assess intraocular pressure by inducing a pressure phosphene. This study compared the results of this relatively new technique with Goldmann applanation tonometry. Methods A total of 100 patients (196 readings) in a general ophthalmology clinic at Dunedin Hospital who consented to take part in this study were randomised to receive by different examiners either pressure phosphene tonometry by a Proview TM eye pressure monitor (Bausch & Lomb Inc., Tampa, FL, USA) or Goldmann tonometry first. There was no communication between the examiners regarding results. Results Of the 196 attempted readings, pressure phosphene tonometer readings were only able to be obtained for 136 eyes (69%) compared to all 196 (100%) eyes with the Goldmann tonometer. The mean IOPs were 18.5 mmHg using the pressure phosphene tonometer and 16.0 mmHg using the Goldmann tonometer. The mean difference was þ 2.43 mmHg (95% confidence interval: 10.37 mmHg below to 15.22 mmHg above Goldmann readings). Conclusion This study found that 31% of patients could not perceive a pressure phosphene using the Proview TM eye pressure monitor. Data obtained from those who could perceive the phosphene indicated that large discrepancies between pressure phosphene tonometry and Goldmann tonometry were common.

Combining the VEP and Psyc thresholds appeared to improve diagnostic power. Canonical correlation analysis indicated that they measured statistically independent aspects of glaucoma possibly related to disease severity. Adding the 20-s psychophysical test to a VEP test produced a significant benefit for a small time cost.