PURPOSE: To describe the 14-year incidence of age-related maculopathy (ARM) lesions and the related visual loss. DESIGN: Population-based cohort study. PARTICIPANTS: Nine hundred forty-six residents (age range, 60-80 years) of Copenhagen participated in the study from 1986 through 1988. Excluding participants who had died since baseline, 359 persons (97.3% of survivors) were reexamined from 2000 through 2002. METHODS: Participants underwent extensive ophthalmologic examinations. Age-related maculopathy lesions were determined by grading color fundus photographs from the examinations using a modified Wisconsin Age-Related Maculopathy Grading System. MAIN OUTCOME MEASURES: Incidence of drusen type and size, pigmentary abnormalities, pure geographic atrophy, exudative ARM, visual impairment, and blindness. RESULTS: The 14-year incidences of early and late ARM were 31.5% and 14.8%, respectively. Individuals 75 to 80 years of age at baseline had significantly (P or =125 microm; 34.2% vs. 12.8%, respectively), soft drusen (45.2% vs. 21.4%), pigmentary abnormalities (31.4% vs. 17.0%), pure geographic atrophy (17.4% vs. 1.0%), and exudative ARM (23.3% vs. 5.7%). Severe drusen type, large drusen, and retinal pigmentary abnormalities at baseline were important predictors of incident late ARM. The 14-year incidences of visual impairment (20/200) or legal blindness from late ARM were 6.0% and 3.4%, respectively. Late ARM caused 35.7% of all visual impairment and 66.7% of all blindness. CONCLUSIONS: There is a high incidence of ARM lesions in this elderly white population. Severe drusen type and size or a combination of drusen and pigmentary abnormalities significantly increases the risk of developing late ARM, the most frequent cause of legal blindness in this population.
A retrospective analysis of adults with strabismus was done to examine the potential risks and the possible benefits of surgical treatment and to describe the types of adult strabismus.
Eight hundred ninety-two patients were analyzed. Age at time of surgery ranged from 9 years to 89 years. The average follow up was 34 months. Major types of strabismus were grouped by their original diagnoses. The group of patients with horizontal strabismus, which usually had an onset before 9, was termed the before visual maturity (BVM) group. The group of patients with paretic or restrictive strabismus usually had the onset of strabismus after age 9 and was termed the after visual maturity (AVM) group.
Patients with adult strabismus can gain restoration of alignment, as well as binocular function. At the last postoperative visit, 74% of the BVM group were aligned within 15 prism diopters. Not only was restoration of alignment accomplished, many of them gained some degree of sensory fusion as measured by the Worth 4-Dot (W4D) or Titmus stereoacuity. Twenty-nine percent of patients with congenital esotropia had some sensory fusion. The other subtypes in the BVM group had even higher percentages of patients with postoperative stereoacuity. In the AVM group, 92% had fusion at the last postoperative visit.
The outcomes of adult strabismics in our study show that certain benefits can be gained from correction of ocular alignment. Restoration of alignment, elimination of diplopia and sensory fusion are functional benefits that can be obtained through strabismus surgery in the adult patient. It is clear that adult strabismus is more than just a cosmetic problem and treatment is worthwhile.
A case of rare genetic disease rod monochromasia which is often called total congenital cone dysfunction (syn. congenital cone dystrophy, congenital achromatopsia) is presented. Symptoms and signs of the disease are described in details and methods for improvement of patient's condition are indicated.
To describe the causes, sites, and types of eye anomaly and associated handicaps in children identified in the last 30 years with ocular visual impairment of 20/200 (6/60) or worse in the better eye with correction.
Children in British Columbia younger than 19 years with visual loss diagnosed between January 1960 and December 1989 who were referred for multidisciplinary assessment.
The incidence of acquired ocular visual impairment has decreased from 0.6 to less than 0.2 per 10,000 people aged 19 years or younger during the last 30 years. The most common cause was a genetic cause, followed by tumor, injury, infection and autoimmune disorders. Optic nerve atrophy and retinal disorders together resulted in more than 90% of all ocular lesions. Gender distribution revealed more males than females to be affected. Sixty-six percent of children had enough sight to read. The percentage of affected children with neurologic disabilities has increased overall in the last 30 years because more children with profound brain damage have survived.
Acquired ocular visual impairment is rare. The incidence of such impairment has been reduced by two thirds in the last 30 years. This decline has had little impact, however, because most cases of blindness are due to congenital conditions. The number of cases of acquired blindness is only one fourth that of congenital blindness, which has begun to increase again owing to the reemergence of retinopathy of prematurity.
A population-based study of active epilepsy was conducted in 6-13-year-old mentally retarded children born between 1975 and 1986. The population at risk comprised 48,873 children. Ninety-eight children were identified, 35 mildly and 63 severely retarded. The prevalence was 2.0 per 1000; 0.7 per 1000 for mildly and 1.3 per 1000 for severely retarded children. Sixty-nine children had at least one additional neuroimpairment. Cerebral palsy was found in 42 children with a majority of spastic/dystonic tetraplegias; visual impairment was present in 24 and autism in 24. Thirty-three children had only a mild or no gross motor disability and mild mental retardation, while 23 had IQs