Relationship between vision impairment and ability to perform activities of daily living

Purpose: To determine the relationship between clinical measures of vision impairment and the ability to perform activities of daily living (ADLs).

Methods: One hundred and twenty subjects with low vision from a variety of causes participated in the study. Vision impairment was assessed under binocular conditions by measuring distance visual acuity, near word acuity, Melbourne Edge Test contrast sensitivity, Pelli–Robson Chart contrast sensitivity and visual fields. The ADL performance was assessed using the Melbourne Low Vision ADL Index (MLVAI), which is in part an observed performance assessment of instrumental ADLs and in part a self-report assessment of basic self-care ADLs.

Results: All vision measures had a high, statistically significant correlation with MLVAI total score. Near word acuity, had the strongest correlation (rs=−0.86, p < 0.001), followed by Melbourne Edge Test contrast sensitivity (rs=0.80, p < 0.001). Visual field had the weakest correlation (rs=0.56, p < 0.001). Together, age, near word acuity, Melbourne Edge Test contrast sensitivity and visual field accounted for 82.2% (adjusted R2, p < 0.001) of the variance in MLVAI total score. All correlations obtained were higher for the observed performance assessment of instrumental ADLs than for the self-report assessment of basic self-care ADLs.

Conclusions: Clinical vision impairment measures are highly correlated with capacity to perform ADLs, as measured by the MLVAI.

Preliminary investigation of the responsiveness of the Melbourne low vision ADL index to low-vision rehabilitation

Purpose. To conduct a preliminary investigation on the ability of the Melbourne Low Vision ADL Index to detect changes in functional ability as a result of low-vision rehabilitation.

Methods. Twenty two subjects with age-related macular degeneration (ARMD) who were newly referred to the Kooyong Low Vision Clinic were recruited. The Melbourne Low Vision ADL Index was administered prerehabilitation and postrehabilitation. Changes in scores and effect size statistics were analyzed.

Results. The median total score for the subjects prerehabilitation was 67, and the median total score postrehabilitation was 76. The difference in prerehabilitation and postrehabilitation scores was statistically significant (Wilcoxon signed rank test = 248.5, p < 0.001). The mean change score for the total Melbourne Low Vision ADL Index was 9.3 (SD, 5.6). Thus the overall effect size statistic (mean change score divided by SD of prerehabilitation score) was 0.78.

Conclusions. This preliminary investigation indicates that the Melbourne Low Vision ADL Index is responsive to a rehabilitation program for patients with ARMD. It has potential to be used as a measure of low-vision rehabilitation outcomes.

A weighted version of the Melbourne low-vision ADL index : a measure of disability impact

Objective. To develop a version of the Melbourne Low-Vision ADL Index that measures the personal impact of disability in activities of daily living (ADL's). Also, to determine the relationship between clinical measures of vision impairment and disability impact.

Methods. The Melbourne Low-Vision ADL Index (MLVAI) is a desk-based clinical assessment of disability in ADL's. Ability to perform each item is rated on a five-level descriptive scale from zero to four. In this study, the original version of the MLVAI was modified to measure disability impact. The simple modification involved weighting each item by the importance of that item to the person being tested. Importance was also rated on a five-level scale from zero to four. The validity and reliability of the Weighted Melbourne Low-Vision ADL Index (MLVAIW) was determined for 97 vision-impaired subjects in a cross-sectional study.

Results. Cronbach's alpha coefficient indicated an internal reliability of 0.94, and an intraclass correlation coefficient indicated an overall reliability of 0.88. The standard error of measurement was 24.7 points (out of a possible score of 400). There was a statistically significant difference in test scores between normal subjects and vision-impaired subjects. All vision measures had a high, statistically significant correlation with MLVAIW score. Near-word acuity had the strongest correlation (rs = 0.78, p < 0.001), followed by Melbourne Edge Test contrast sensitivity (rs = -0.72, p < 0.001). Visual field had the weakest correlation (rs = -0.52, p < 0.001). The best predictive model of MLVAIW score incorporated the variables age, near-word acuity, and visual field. Together, these variables accounted for 65.1% of the variance in MLVAIW score.

Conclusions. The MLVAI is highly valid and reliable when weighted by a scale that reflects the personal importance of ADL's. The MLVAIW can provide information over and above that obtained with the usual clinical vision measures and may be used to assess low-vision patients and to measure low-vision rehabilitation outcomes. It is suggested that the assessment of disability using the original MLVAI and the assessment of the impact of disability using the MLVAIW should be kept separate to facilitate the clear interpretation of the outcomes of low-vision rehabilitation.

Mobility of people with retinitis pigmentosa as a function of vision and psychological variables

We investigated the mobility performance of subjects with retinitis pigmentosa (RP) as a function of clinical measures of residual vision and psychological variables. We found a highly significant correlation between clinical measures of residual vision and mobility. Pelli-Robson contrast sensitivity and residual visual field together explained 64% of the variance in mobility performance in an indoor shopping mall. We suggest a simple new clinical method of scoring the visual field for predicting mobility performance, the RP Concentric Field Rating. The RP Concentric Field Rating alone explained 60% of the variance in mobility performance. In spite of expectations derived from reading the recent literature, we did not find a significant correlation between psychological variables and mobility performance in a group of subjects with RP.

Comparison of functional mobility performance with clinical vision measures in simulated Retinitis Pigmentosa

Simulations of retinitis pigmentosa (RP) under various conditions of retinal illuminance were designed and investigated in order that they might be used in the mobility training of clients with early RP. Goggles incorporating a 2.5 neutral density (ND) filter with a 0.5-mm diameter pinhole were found to be a potentially useful simulation device for this purpose. This investigation also compared mobility performance with clinical vision measures under photopic, mesopic, and scotopic conditions of retinal illuminance. Although none of the clinical vision measures we used was entirely predictive of mobility performance, some measures were better predictors than others. For a severe constriction of the visual field and decreasing retinal illuminance, both edge contrast sensitivity and visual acuity, measured outdoors, accounted for a greater proportion of the variance in mobility performance than did low contrast visual acuity measured under the same circumstances. The same clinical vision measures, taken in-doors, were of no value in predicting outdoor mobility performance.

Monumental vision : a confrontation with the image of the Eternal Return

"Monumental Vision” is a nuanced summary of Nietzschean nihilism and the Eternal Return as rite of passage for free subjects and as condensed image of speculative intelligence proper. Utilizing Gerhard Richter’s “Sheet 692” from Atlas, a series of photographs of the mountains and lake at Sils Maria, Switzerland, as summary judgment of the limit imposed by this condition on all systems of representation, this form of vision discloses the chiasmus embedded in consciousness itself. In constantly revisiting Sils, the very location where Nietzsche “suffered” the vision of the Eternal Return, Richter has engaged repeatedly this origin for what has come into his work via Nietzsche – that is, an elective veil that refuses all compromises with transcendence until such is merged with immanence.

As situated amidst modernist “ideology as intellection”, and subsequent nascent forms of anti-modernism, the Eternal Return as image also signals the return of the Kantian “aesthetic-teleological” synthesis in non-discursive or purely visual agency. As an elective form of aesthetic vision, and as image of time insofar as it registers an overwhelming externality (Other) that nominally swallows and empowers the subject at once, this excoriating sense of universal praxis underwrites artistic and architectural production of the highest order, renegotiating concepts of the paradigmatic.

Utilizing Georg Simmel’s late work on Rembrandt (1916) and his encounter with Schopenhauer and Nietzsche (1907), the essay suggests that by the 1920s the avant-garde premises of modernism had already come under attack by an ahistorical and synoptic vision here denoted “monumental vision,” which also contains the imprint of eschatological time (invoking a schism present in rationality as such). The two readings of this image perpetrated by Karl Löwith in Nietzsche’s Philosophy of the Eternal Recurrence of the Same (Nietzsches Philosophie der ewigen Wiederkehr des Gleichen, 1935), or the cosmological and the ethical, while considered irreconcilable by Löwith, have since the 1960s been recalibrated through the figure of the event to pose possible scenarios out of the stalemate of the confrontation between Self and Other (ipseity and alterity) buried within this image as limit. In this manner, the image of the Eternal Return stands at the boundary between two forms of time (or two worlds) and signals the irreducible confrontation present in speculative thought and the necessity of closure through an aesthetic vision that produces a unitary field for all creative acts.

Notably, Nietzsche’s startling vision from Zarathustra suggests that the limit imposed by the Eternal Return is also a mask for an austere condition within subjectivity closely resembling the conundrum of Fichte’s I facing I, or thought turned toward thought itself (absolute subjectivity as cipher for Being). In Alenka Zupančič’s reading, in The Shortest Shadow: Nietzsche’s Philosophy of the Two (2003), the Eternal Return effectively contains a secret formal function that grinds all “error” to dust – a highly suggestive interpretation that also neutralizes the schism introduced by Löwith between the cosmological and the ethical.

Modeling of a stereo vision system using a genetic algorithm based fuzzy linear regression

In this paper a fuzzy linear regression (FLR) model integrated with a genetic algorithm (GA) is proposed. The proposed GA-FLR model is applied to modeling of a stereo vision system. A set of empirical data from stereo vision object measurement is collected based on the full factorial design technique. Three regression models, namely ordinary least-squares regression (OLS), FLR, and GA-FLR, are developed, and with their performances compared. The results show that the proposed GA-FLR model performs better than OLS and FLR in modeling of a stereo vision system.

Instrumental vision

This chapter interrogates stereo-immersive ‘virtual reality’ (VR), the technology that enables a perceiver to experience what it is like to be immersed in a simulated environment. While the simulation is powered by the “geometry engine” (Cutting, 1997: 31) associated with high-end computer imaging technology, the visual experience itself is powered by ordinary human vision: the vision system’s innate capacity to see “in 3D”. To understand and critically appraise stereo-immersive VR, we should study not its purported ‘virtuality’, but its specific visuality, because the ‘reality’ of a so-called ‘virtual environment’ is afforded by the stereoacuity of binocular vision itself. By way of such a critique of the visuality of stereo-immersive VR, this chapter suggests that we think about the ‘practice’ of vision, and consider on what basis vision can have its own ‘materiality’. Pictorial perception is proposed as an exemplary visual mode in which the possibilities of perception might emerge. Against the ‘possibilities’ of vision associated with pictures, the visuality of stereo-immersive VR emerges as a harnessing, or ‘instrumentalisation’ of vision’s innate capabilities. James J. Gibson’s ‘ecological’ approach to vision studies is referenced to show the degree to which developers of VR have sought — and succeeded — to mimic the ‘realness’ of ordinary perceptual reality. This raises a question concerning whether the success of stereo-immersive VR is simultaneously the source of its own perceptual redundancy: for to bring into being the perceptual basis of ordinary ‘real’ reality, is to return the perceiver to what is already familiar and known.

Next generation robotic counter IED technology : A step change in capability

Improvised Explosive Devices (IEDs) are reported as the number one cause of injury and death for allied troops in the current theater of operation. Deakin University’s Centre for Intelligent Systems Research (CISR) is working on next-generation technology to combat the threat. In 2006 CISR was awarded funding through the Capability and Technology Demonstrator (CTD) Program managed by the Australian Defence Force. The objective was to investigate the use of haptics or force feedback technology for Counter-IED (CIED) tasks. Over the past six years, engineers from CISR have worked alongside Defence stakeholders to develop a series of robotic platforms designed to immerse a soldier in the remote environment. Utilising a natural user interface, haptic force feedback and stereovision, the technology has undergone initial trials in Sydney, Canberra, Woomera and at the CISR testing facility in Geelong, Australia. The technology has proved popular among operators allowing them increased fidelity and manipulation speed while significantly reducing required training. CISR has a history of rapidly delivering technology to meet the needs of police and law enforcement in Australia. The OzBot™ series of robots developed in conjunction with the Victorian Police is currently in service and used extensively for hostage negotiation and first responder roles. The CISR robotics group works on technologies that reduce operator fatigue, minimise training liability and maintenance. Over 55 engineers develop simulation environments for increased training availability and continuous improvement to the current range of mobile platforms, including communications range, payload, manipulator reach and capability. This paper describes a number of the technologies, methods and systems developed by CISR for IED neutralisation, with the aim to increasing military awareness of Australian capability.