To demonstrate differences in foveal constrast sensitivity (CS) between glaucomatous and nonglaucomatous eyes using a simple, rapid computerized test. Methods: This study included consecutive patients with glaucoma (35 eyes) and age-matched control participants (23 eyes) with visual acuity of 20/30 or better. Patients with any other ocular disease, including cataract, were excluded. All participants underwent a comprehensive ocular examination, perimetry, and CS. Contrast sensitivity was examined by means of 2 computerized psychophysical tests. The transient method included the presentation of a target in a temporal, 2-alternative, forced-choice procedure, and the static method involved 4 forced-choice procedures. The targets were Gabor patches with spatial frequencies of 1.5 to 9.0 cycles per degree. The tests were conducted under photopic and mesopic conditions. Results: Significantly lower foveal CS was found in glaucomatous eyes under photopic and mesopic conditions for all spatial frequencies (PϽ.01). The transient and static methods yielded similar results and were significantly correlated (PϽ.001). All transient photopic and mesopic CSs were significantly correlated with cup to disc ratio (PϽ.05). The static photopic spacial frequency of 6 cycles per degree was significantly correlated with the severity of the glaucomatous damage. Conclusions: The results indicate that foveal CS is impaired in glaucoma despite good visual acuity, suggesting that central visual function damage occurs in glaucoma. The similarity between the 2 methods of testing implies that the static method, being the shorter and easier one, may be used in future research. Further research is necessary to establish a CS testing role in the screening and monitoring of glaucoma.

We examined the feasibility of a low-bandwidth, Internet-based tele-ophthalmology system for consultation in an ophthalmic emergency room. Forty-nine patients (98 eyes) with complicated cases were seen during night shifts in the ophthalmic emergency room. Ocular images were taken using a slit-lamp connected to a video camera, processed and transmitted to a senior physician by email. A telephone was used for real-time audio communication. Each case was re-examined by the same senior physician the following day. The time needed to capture and to process the images was 5 min (SD 2). Each case was given a feasibility score (0-100%), which was defined as the contribution made by the transmitted images in presenting clinical details which could not have been described verbally. High feasibility scores (mean scores ranging from 85 to 90) were found for the following images: ocular surface, anterior chamber, anterior chamber angle, pupils, lens, optic nerve and macula. In contrast, images of vitreous and peripheral retina received low feasibility scores (mean score 65). There was 100% agreement between the diagnosis made during consultation and the on-site examination made by the senior ophthalmologist later on. Ninety-eight percent of the patients stated that they would prefer being examined under the telemedicine system on their next emergency room visit, rather than the traditional resident on-site examination.

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Our results confirm the strong association between overweight and IIH. The recurrence rate seemed to be influenced by the obstetrical history and the severity of visual field defects at presentation. In contrast to some previous studies, we have found an interrelation between the CSF opening pressure, grade of papilledema and depression of the visual field sensitivity.

The Tono-Pen tonometer appeared to be less affected than the GAT by the relative flattening, thinning, and anterior stromal decreased rigidity of the central cornea that occur following PRK. Post-PRK steroid-induced IOP elevation may be masked by the artifactual decrease in GAT IOP.

The HRR 4th edition test proved to be superior to the Ishihara test in detecting acquired dyschromatopsia due to optic neuropathy. We recommend using the HRR 4th edition test as a screening method for detection of color-vision defects in patients with optic neuropathy.

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