Approximately one in ten students aged 6 to 16 in Ontario (Canada) school boards have an individual education plan (IEP) in place due to various learning disabilities, many of which are specific to reading difficulties. The relationship between reading (specifically objectively determined reading speed and eye movement data), refractive error, and binocular vision related clinical measurements remain elusive.
One hundred patients were examined in this study (50 IEP and 50 controls, age range 6 to 16 years). IEP patients were referred by three local school boards, with controls being recruited from the routine clinic population (non-IEP patients in the same age group). A comprehensive eye examination was performed on all subjects, in addition to a full binocular vision work-up and cycloplegic refraction. In addition to the cycloplegic refractive error, the following binocular vision related data was also acquired: vergence facility, vergence amplitudes, accommodative facility, accommodative amplitudes, near point of convergence, stereopsis, and a standardized symptom scoring scale. Both the IEP and control groups were also examined using the Visagraph III system, which permits recording of the following reading parameters objectively: (i) reading speed, both raw values and values compared to grade normative data, and (ii) the number of eye movements made per 100 words read. Comprehension was assessed via a questionnaire administered at the end of the reading task, with each subject requiring 80% or greater comprehension.
The IEP group had significantly greater hyperopia compared to the control group on cycloplegic examination. Vergence facility was significantly correlated to (i) reading speed, (ii) number of eye movements made when reading, and (iii) a standardized symptom scoring system. Vergence facility was also significantly reduced in the IEP group versus controls. Significant differences in several other binocular vision related scores were also found.
This research indicates there are significant associations between reading speed, refractive error, and in particular vergence facility. It appears sensible that students being considered for reading specific IEP status should have a full eye examination (including cycloplegia), in addition to a comprehensive binocular vision evaluation.
Endovascular therapy has had a major effect on vascular surgery; surgeons perform tasks in three dimensions (3D) while viewing two-dimensional (2D) displays. This fundamental change in how surgeons perform operations has educational implications related to learning curves and patient safety. We studied the effects of experience, training, and visual-spatial ability on 3D perception of 2D angiographic images of abdominal aortic aneurysms (AAA).
A novel computer-based method was developed to produce 3D depth maps based on subjects' interpretations of 2D images. Seven experts (certified vascular surgeons) and 20 novices (medical or surgical trainees) were presented with a 2D AAA angiographic image. With software specifically designed for this study, a depth map representing each subject's 3D interpretation of the 2D angiogram was produced. The novices were then randomized into a control group and a treatment group, who received a 5-minute AAA anatomy educational session. All subjects repeated the exercise on a second AAA image. Finally, all novices were given tests of visual-spatial ability, including the Surface Development Test and the Mental Rotations Test. Comparisons between experts and novices were made with depth map comparison, a subject's perception of overall object contour.
The depth maps were significantly different (depth map comparison, P
INTRODUCTION: Prematurely born children have an increased risk of ophthalmologic problems. There is still no consensus on how they should be followed. The purpose of this study was to evaluate predictive factors for problems in premature children at ten years of age and to discuss follow-up recommendations. MATERIALS AND METHODS: One hundred ninety-nine children with a birth weight of 1500 g or less were screened for retinopathy of prematurity (ROP) in the neonatal period and thereafter ophthalmologically examined at 6 months, 1.5, 2.5, 3.5, and 10 years of age. "Visual dysfunction" at ten years of age was defined as visual acuity > or =0.1 logMAR and/or strabismus and/or subnormal contrast sensitivity. Multiple regression analyses were used to evaluate risk factors at an early age, which could predict problems at ten years of age. RESULTS: Twenty-five percent of the cohort had visual dysfunction at ten years of age. Neurological complications, cryotreated ROP, anisometropia, and astigmatism were risk factors. The sensitivity was 75.5%, and the specificity 80.7% for the detection of visual dysfunction at ten years of age when all children with neurological complications, cryotreated ROP, strabismus, anisometropia > or =1 diopters (D) at 2.5 years, and astigmatism > or =2 D at 2.5 years were included in further follow-up. CONCLUSIONS: Repeated ophthalmologic follow-up of prematurely born children should be performed in those with treated ROP and/or neurological conditions. For a third group without such problems, at least one follow-up is recommended. Such an examination also provides a good opportunity to identify neurological problems that warrant further ophthalmologic follow-up.
Eighty-six nine-year-old dyslexic children were matched to control children with regard to age, sex, class in school, and intelligence. Orthoptic and eye movement analysis were performed on all children. It was concluded that the dyslexic pupils did not differ significantly from control children in terms of strabismus, accommodation, stereo acuity, vergence function or ocular dominance. Eye movement recordings did not show any qualitative differences between the groups in vergence dynamics during synoptophore investigations.
The purpose of this study is to examine the referrals made to a pediatric ophthalmology practice in south Western Ontario. Timing of initiating a referral for children presenting with esotropia and the management offered prior to referral will be examined to identify room for improvement.
Retrospective chart review of 326 children diagnosed with esotropia with an age of onset
PURPOSE: To evaluate the effectiveness of the Lang II stereo card as a screening test for amblyopia and/or strabismus. METHODS: A total of 1046 children aged 12-13 years were examined in a field study in the Göteborg area, Sweden. In addition to the Lang II stereo card, the examination included visual acuity, cover testing, cycloplegic refraction, and inspection of the optical media and posterior pole. RESULTS: If every incorrect subject response was considered a reason for referral, the Lang II test would have correctly identified 82% (23 subjects) of the 28 children with manifest strabismus and 38% (11 subjects) of the 29 children with amblyopia. The test failed to refer 45% (21 subjects). Of all subjects referred, 44 (63%) were found to be ophthalmologically normal. CONCLUSIONS: The Lang II stereo card is neither a reliable nor an efficient method of screening for amblyopia and/or strabismus.