The unusually large number of oculomotor and/or automaticity problems found in this normal PT population using a test based on U.S. norms highlights the need for PT-specific guidelines. It appears that DEM scores may be affected by differences in language, educational systems, and/or cultural systems. Therefore, clinicians should be aware of these findings when using the DEM test on children in countries with differing languages and cultures.
Goldmann applanation tonometry (GAT) is considered the gold standard technique for tonometry. It is a procedure involving administration of topical anaesthetic (a drug which could have several side effects). This prevents a large number of vision care practitioners from using GAT, due to legal restrictions regarding the use of these ophthalmic drugs. The purpose of this study was to establish whether the discomfort experienced during non-anaesthetic Goldmann Applanation Tonometry (NAGAT) would be acceptable to subjects. The intensity of pain inflicted by GAT, NAGAT, Non-Contact Tonometry (NCT) and Schirmer test was assessed on thirty-one subjects enrolled in the study using the Numerical Rating Scale (NRS) to assess pain. The GAT was performed on one eye and the other three procedures were carried out in random order on the fellow eye. Initially, each subject was asked to score their Maximum Pain Without Complaint (MPWC). The MPWC and the Schirmer test were used as references to grade the pain levels. The scores for the five procedures were registered using the NRS (0-10) and compared using a non-parametric statistical analysis (Friedman test and a post-hoc analysis). In addition, IOP results for GAT and NAGAT were also compared using the t-test. The scores obtained on the NRS ranged from 0-4, 0-5, 0-8, 0-7 and 3-8 with a median of 1, 1, 2, 2, and 5, respectively for NCT, GAT, NAGAT, Schirmer and MPWC. A statistically significant difference (p = 0.01) was found between the MPWC and the four clinical tests but no difference was found between the clinical tests. There was no statistically significant difference (p = 0.71) between the IOP results for GAT and NAGAT, 14.0 ± 2.0 mmHg and 13.8 ± 2.0 mmHg (mean ± 1S.D.) respectively. The Goldmann Applanation Tonometry without anaesthetic (NAGAT) can be performed with an acceptable level of discomfort for the majority of subjects and should be performed identically to a traditional GAT, informing the subjects about the possibility of feeling a small discomfort.
The topic of ophthalmic use of cocaine in clinical practice has a long history; nevertheless, the possible influence and pathways of action of inhaled cocaine in the human eye remain unknown. This study evaluates the effect of snorted cocaine in the eye tear of 22 occasional cocaine users using the Schirmer Test I (ST1). The tear amount without the subjects being under the effect of cocaine was (mean +/- standard deviation) 22.50 +/- 12.85 mm ranging from 5-55 mm. Under the effect of cocaine, 17 in 22 eyes had a decrease in the tear amount, averaging 16.52 +/- 10.13 mm ranging from 1-38 mm, representing a statistical significant decrease (paired t-test, one-tailed p = 0.0024) of about 27% between the previous conditions. The large majority of the subjects under the effect of cocaine present a decrease in ST1 determining a global statistical significant decrease in ST1. That suggests a relationship between snorted cocaine and a reduction in tear amount. The identification of the tear cocaine effect and the pathway of action cannot be overlooked in the research for a comprehensive characterization of inhaled cocaine action in the central and peripheral nervous system.
Purpose. The photostress recovery time test (PSRT) has been widely reported as a helpful screening clinical tool. However, the poor standardization of its measurement technique remains to be a limitation among clinicians. The purpose of this study is to apply a recommended clinical technique to measure the PSRT in some of the most commons eye diseases to ascertain whether these diseases affect the PSRT values.Methods. One hundred and one controls and 105 patients, with diagnosed diabetes (without visible signs of diabetic retinopathy), primary open angle glaucoma (POAG) or cataracts underwent photostress testing. The test was performed with a direct ophthalmoscope for illuminating the macula for 30 seconds. Participants belonged to three age classes: A, B and C; and were divided into four groups: control, diabetic, POAG and cataract. The age range for A, B and C classes were respectively 43-54, 55-64 and 65-74 years. The groups were also further compared within each age class. In addition, the influence of age on PSRT was evaluated using the control group.Results. Results demonstrate that PSRT changes with age (p<0.02). In class A, diabetic group had a faster PSRT than control group, (mean ± standard deviation) 20.22±7.51 and 26.14±8.34 seconds. The difference between these groups was statistical significant (t-test, p=0.012). Cataract and POAG groups did not affect the PSRT significantly.Conclusions. The technique used for the Photostress showed that diabetics, younger than 54 years, may have faster PSRT and that, aging delays PSRT.
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