People with age-related macular disease frequently experience reading difficulty that could be attributed to poor acuity, elevated crowding or unstable fixation associated with peripheral visual field dependence. We examine how the size, location, spacing and instability of retinal images affect the visibility of letters and words at different eccentricities. Fixation instability was simulated in normally sighted observers by randomly jittering single or crowded letters or words along a circular arc of fixed eccentricity. Visual performance was assessed at different levels of instability with forced choice measurements of acuity, crowding and reading speed in a rapid serial visual presentation paradigm. In the periphery: (1) acuity declined; (2) crowding increased for acuity- and eccentricity-corrected targets; and (3), the rate of reading fell with acuity-, crowding- and eccentricity-corrected targets. Acuity and crowding were unaffected by even high levels of image instability. However, reading speed decreased with image instability, even though the visibility of the component letters was unaffected. The results show that reading performance cannot be standardised across the visual field by correcting the size, spacing and eccentricity of letters or words. The results suggest that unstable fixation may contribute to reading difficulties in people with low vision and therefore that rehabilitation may benefit from fixation training.
PurposeAmong computer workers, visual complaints, and neck pain are highly prevalent. This study explores how occupational simulated stressors during computer work, like glare and psychosocial stress, affect physiological responses in young females with normal vision.MethodsThe study was a within-subject laboratory experiment with a counterbalanced, repeated design. Forty-three females performed four 10-min computer-work sessions with different stress exposures: (1) minimal stress; (2) visual stress (direct glare); (3) psychological stress; and (4) combined visual and psychological stress. Muscle activity and muscle blood flow in trapezius, muscle blood flow in orbicularis oculi, heart rate, blood pressure, blink rate and postural angles were continuously recorded. Immediately after each computer-work session, fixation disparity was measured and a questionnaire regarding perceived workstation lighting and stress was completed.ResultsExposure to direct glare resulted in increased trapezius muscle blood flow, increased blink rate, and forward bending of the head. Psychological stress induced a transient increase in trapezius muscle activity and a more forward-bent posture. Bending forward towards the computer screen was correlated with higher productivity (reading speed), indicating a concentration or stress response. Forward bent posture was also associated with changes in fixation disparity. Furthermore, during computer work per se, trapezius muscle activity and blood flow, orbicularis oculi muscle blood flow, and heart rate were increased compared to rest.ConclusionsExposure to glare and psychological stress during computer work were shown to influence the trapezius muscle, posture, and blink rate in young, healthy females with normal binocular vision, but in different ways. Accordingly, both visual and psychological factors must be taken into account when optimizing computer workstations to reduce physiological responses that may cause excessive eyestrain and musculoskeletal load.
The development of sensitivity to radial optic flow discrimination was investigated by measuring motion coherence thresholds (MCTs) in school-aged children at two speeds. A total of 119 child observers aged 6-16years and 24 young adult observers (23.66+/-2.74years) participated. In a 2AFC task observers identified the direction of motion of a 5° radial (expanding vs. contracting) optic flow pattern containing 100 dots with 75% Michelson contrast moving at 1.6°/s and 5.5°/s and. The direction of each dot was drawn from a Gaussian distribution whose standard deviation was either low (similar directions) or high (different directions). Adult observers also identified the direction of motion for translational (rightward vs. leftward) and rotational (clockwise vs. anticlockwise) patterns. Motion coherence thresholds to radial optic flow improved gradually with age (linear regression, p<0.05), with different rates of development at the two speeds. Even at 16years MCTs were higher than that for adults (independent t-tests, p<0.05). Both children and adults had higher sensitivity at 5.5°/s compared to 1.6°/s (paired t-tests, p<0.05). Sensitivity to radial optic flow is still immature at 16years of age, indicating late maturation of higher cortical areas. Differences in sensitivity and rate of development of radial optic flow at the different speeds, suggest that different motion processing mechanisms are involved in processing slow and fast speeds.
Motion-sensitivity losses with age, eccentricity, and POAG can arise from higher levels of internal noise and lower sampling efficiency. The central and peripheral glaucomatous neuropathy is mostly attributable to a reduction in sampling efficiency, suggesting that RGCs are nonfunctional rather than dysfunctional in this condition.
Background Undetected vision problems is an important cause of reduced academic achievement, performance in everyday life and self-esteem. This receives little attention in national health care services in Norway even though most of these vision problems are easily correctable. There are no published data on how many Norwegian schoolchildren are affected by correctable vision problems . This study aims to determine the vision status in primary and secondary schoolchildren referred from vision screening during the 10 year period of 2003–2013. Methods Of the 1126 children (15%) aged 7–15 years referred to the university eye clinic by the school screening program, all 782 who attended the eye clinic were included in the study. Patient records were retrospectively reviewed with regard to symptoms, refractive error, best corrected visual acuity (BCVA) of logMAR, binocular vision, ocular health and management outcomes. Results Previously undetected vision problems were confirmed in 650 (83%) of the children. The most frequent outcomes were glasses (346) or follow-up (209), but types of treatment modalities varied with age. Mean refractive errors were hyperopic for all age groups but reduced with age (ANOVA, p < 0.001). Overall, 51% were hyperopic, 32% emmetropic and 17% myopic. Refractive errors did not change across the decade (linear regression, all p > 0.05). Mean logMAR BCVAs were better than 0.0 and improved with age (ANOVA, p < 0.001) . The most prevalent symptoms were headaches (171), near vision problems (149) and reduced distance vision (107). Conclusions The vision screening identified children with previously undetected visual problems. This study shows that the types of visual problems varied with age and that most problems could be solved with glasses. Our results stress the importance of regular eye examinations and that vision examinations should be included in primary health care services. Furthermore, there is a need for raised awareness among parents and teaching staff regarding vision problems in children.
Exposure to additional environmental stress during computer work, such as visual and psychological demands, is associated with increased eye and neck discomfort, altered moods, and reduced well-being. The aim of this study is to elucidate further how subjective responses in healthy, young females with normal binocular vision are affected by glare and psychological stress during computer work, and to investigate possible associations between trapezius muscle blood flow and neck pain development. Methods Forty-three females participated in a laboratory experiment with a within-subject design. Four ten-minute computer work conditions with exposure to different stressors were performed at an ergonomically optimal workstation, under the following series of conditions: no additional stress, visual stress (induced as direct glare from a large glare source), psychological stress, and combined visual and psychological stress. Before and immediately after each computer work condition, questionnaires regarding different visual and eye symptoms, neck and shoulder symptoms, positive and negative state moods, perceived task difficulty, and perceived ambient lighting were completed. Associations between neck pain and trapezius muscle blood flow were also investigated. Results Exposure to direct glare induced greater development of visual/eye symptoms and discomfort, while psychological stress exposure made participants feel more negative and stressed. The perception of work lighting during glare exposure was closely related to perceived stress, and associations between visual discomfort and eyestrain, and neck pain were observed in all conditions. Furthermore, participants with high trapezius muscle blood flow overall reported more neck pain, independent of exposure. Conclusions Exposure to visual and psychological stresses during computer work affects the development of symptoms and negative moods in healthy, young females with normal binocular vision, but in different ways. The results also demonstrate the complex interactions involved in symptom development and lighting appraisal during computer work. When optimizing computer workstations, the complexity of the field must be taken into account, and several factors, including visual conditions, must be considered carefully.
Neck pain and headache are leading causes of years lived with disability globally, and the prevalence is gradually increasing from school age to early adulthood. These symptoms have been linked to the use of digital devices. However, there is little knowledge related to this topic in adolescents, who spend increasingly more time using digital media. The aim of the study was to investigate eyestrain, headache, and musculoskeletal symptoms in relation to the use of tablets and smartphones in healthy adolescents with normal vision. Fifty healthy adolescents aged 11 – 13 years (mean = 12.1 (SD = 0.53)) with normal vision and development participated. A vision examination was performed by an authorised optometrist and an interview questionnaire measuring eyestrain, headache, and musculoskeletal symptoms in relation to screen use was filled out. In addition, screen time, ergonomics, participation in sports, and outdoor time were obtained. Forty-nine (98%) of the 50 children used a smartphone and 17 (34%) used a tablet. Overall, 12% to 41% experienced symptoms of headache, neck pain, tiredness and/or tired eyes while using smartphones and tablets. Nine (18%) experienced at least one symptom often or always while using their device. Musculoskeletal pain and headache were significantly associated with vision and eyestrain. Tablet use was associated with increased symptom scores compared to smartphone use. Increased screen time and shorter viewing distance were associated with eyestrain, headache, and neck pain. Children with neck- shoulder- and back pain were significantly (2.1 hours) less physically active than children without these symptoms. Most adolescents with good health and vision had no symptoms while using smartphones and tablets. However, a significant proportion still experienced symptoms of headache, neck pain, tiredness and tired eyes, and these symptoms were associated. Symptoms increased with screen time, shorter viewing distance and reduced participation in sports. This suggests that even healthy children with good vision may develop vision symptoms and musculoskeletal pain. Awareness should be raised among parents, teachers, eye care- and health care personnel, of the importance of good visual ergonomics and physical activity to promote health in adolescents.
Background: Visual impairments (VIs) have a negative impact on life and affect up to 60% of stroke survivors. Despite this, VIs are often overlooked. This paper explores how persons with VIs experience vision care within stroke health services and how VIs impact everyday life the first 3 months post stroke. Methods: Individual semi-structured interviews were conducted with 10 stroke survivors 3 months post stroke, and analyzed using qualitative content analysis. Results: The main theme, "Invisible" visual impairments, represents how participants experience VIs as an unknown and difficult symptom of stroke and that the lack of attention and appropriate visual care leads to uncertainty about the future. VIs were highlighted as a main factor hindering the participants living life as before. The lack of acknowledgement, information, and systematic vision rehabilitation leads to feelings of being unsupported in the process of coping with VIs. Conclusion: VIs are unknown symptoms pre stroke and sequelas after stroke that significantly affect everyday life. VIs and vision rehabilitation needs more attention through all phases of stroke health services. We request a greater awareness of VIs as a presenting symptom of stroke, and that visual symptoms should be included in stroke awareness campaigns. Further, we suggest increased competence and standardized evidence-based clinical pathways for VIs to advance all stroke health services including rehabilitation in order to improve outcomes and adaptation to future life for stroke survivors with VIs.
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