Estrategias para el manejo pedagógico, del niño con deficiencias en la: visión binocular, acomodación, y en los movimientos oculares relacionadas con dificultades en la escritura.

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Is there any evidence for the validity of diagnostic criteria used for accommodative and nonstrabismic binocular dysfunctions?

Purpose: To analyze the diagnostic criteria used in the scientific literature published in the past 25 years for accommodative and nonstrabismic binocular dysfunctions and to explore if the epidemiological analysis of diagnostic validity has been used to propose which clinical criteria should be used for diagnostic purposes. Methods: We carried out a systematic review of papers on accommodative and non-strabic binocular disorders published from 1986 to 2012 analysing the MEDLINE, CINAHL, PsycINFO and FRANCIS databases. We admitted original articles about diagnosis of these anomalies in any population. We identified 839 articles and 12 studies were included. The quality of included articles was assessed using the QUADAS-2 tool. Results: The review shows a wide range of clinical signs and cut-off points between authors. Only 3 studies (regarding accommodative anomalies) assessed diagnostic accuracy of clinical signs. Their results suggest using the accommodative amplitude and monocular accommodative facility for diagnosing accommodative insufficiency and a high positive relative accommodation for accommodative excess. The remaining 9 articles did not analyze diagnostic accuracy, assessing a diagnosis with the criteria the authors considered. We also found differences between studies in the way of considering patients’ symptomatology. 3 studies of 12 analyzed, performed a validation of a symptom survey used for convergence insufficiency. Conclusions: Scientific literature reveals differences between authors according to diagnostic criteria for accommodative and nonstrabismic binocular dysfunctions. Diagnostic accuracy studies show that there is only certain evidence for accommodative conditions. For binocular anomalies there is only evidence about a validated questionnaire for convergence insufficiency with no data of diagnostic accuracy.

Diseño y test VHDL de un cambiador de formato para ver TV3D en un televisor convencional

La difusión de TV3D actual utiliza formatos como el Side-by-Side o Top-and-Bottom, en los que cada par de imágenes, correspondiente a las vistas de los ojos derecho e izquierdo, se encapsula con la mitad de la resolución espacial en una sola imagen. Estas imágenes se muestran de manera casi simultánea de forma que el ojo humano compone una imagen con profundidad que se asemeja a la visión binocular natural. Desde hace un par de años las principales plataformas de televisión han empezado a crear canales con contenido 3D. La televisión 3D (TV3D) se ha introducido en los hogares gracias a los televisores estereoscópicos. Estos televisores, que son compatibles con los formatos antes mencionados, extraen de cada imagen sus dos vistas, recuperan la resolución original y presentan cada vista alternativamente en la pantalla, generando al mismo tiempo una señal de sincronismo para las gafas activas, creando de esta forma la sensación tridimensional de las imágenes. En este PFC se pretende realizar el diseño VHDL de un cambiador de formato que genere en tiempo real la secuencia de imágenes correspondiente a los ojos derecho e izquierdo, con resolución completa, a partir de una secuencia codificada en formato tipo Top-and-Bottom y el banco de test para su prueba. Este circuito se implementará como un periférico del procesador NIOS II de Altera. El diseño podría utilizarse como parte de un sistema que permita la visualización de las actuales emisiones de televisión 3D en un televisor convencional. La tecnología de referencia que se utilizará serán las FPGAs, más concretamente la tarjeta Cyclone III FPGA Starter Kit (EP3C25 FPGA) de Altera, junto a una tarjeta de ampliación de Microtronix con entrada y salida HDMI para video y audio. Además se pretende crear la documentación necesaria para el desarrollo de futuros trabajos relacionados con la televisión 3D. ABSTRACT Current TV3D broadcasting uses formats as Side-by-Side or Top-and-Bottom, where every single pair of images, corresponding to left and right eyes views, are encapsulated with half spatial resolution in one single image. These images are almost simultaneously displayed so that the human eye forms an image with depth resembling naturally binocular vision. From a couple of years the major TV platforms have begun to create 3D content channels. 3D Television (3DTV) has been introduced in homes through stereoscopic televisions. These televisions, which are compatible with the above formats, each image is extracted from the two views, and recover the original resolution and displays alternately each view in screen, while generating a synchronization signal for active glasses, thereby creating the three-dimensional sensation of the images. The main objective in this PFC is to make the design of an exchanger VHDL format in real time to generate the image sequence corresponding to the right and left eyes, with full resolution from an encoded sequence type format Top-and-Bottom and test bench for testing. This circuit is implemented as a Altera NIOS II processor peripheral.The design could be used as part of a system enabling the display of current television broadcasts 3D on a conventional television. The reference technology that will be use are FPGAs, more specifically Cyclone III FPGA Starter Card Kit (EP3C25 FPGA) Altera, along with an expansion card Microtronix with HDMI input and output video and audio. It also aims to create documentation for the development of future works related to 3D TV.

Desarrollo de tecnologías de telemanipulación con alto grado de escalado orientadas a la interacción hombre-robot en entornos nucleares

Esta tesis se centra en desarrollo de tecnologías para la interacción hombre-robot en entornos nucleares de fusión. La problemática principal del sector de fusión nuclear radica en las condiciones ambientales tan extremas que hay en el interior del reactor, y la necesidad de que los equipos cumplan requisitos muy restrictivos para poder aguantar esos niveles de radiación, magnetismo, ultravacío, temperatura... Como no es viable la ejecución de tareas directamente por parte de humanos, habrá que utilizar dispositivos de manipulación remota para llevar a cabo los procesos de operación y mantenimiento. En las instalaciones de ITER es obligatorio tener un entorno controlado de extrema seguridad, que necesita de estándares validados. La definición y uso de protocolos es indispensable para regir su buen funcionamiento. Si nos centramos en la telemanipulación con algo grado de escalado, surge la necesidad de definir protocolos para sistemas abiertos que permitan la interacción entre equipos y dispositivos de diversa índole. En este contexto se plantea la definición del Protocolo de Teleoperación que permita la interconexión entre dispositivos maestros y esclavos de distinta tipología, pudiéndose comunicar bilateralmente entre sí y utilizar distintos algoritmos de control según la tarea a desempeñar. Este protocolo y su interconectividad se han puesto a prueba en la Plataforma Abierta de Teleoperación (P.A.T.) que se ha desarrollado e integrado en la ETSII UPM como una herramienta que permita probar, validar y realizar experimentos de telerrobótica. Actualmente, este Protocolo de Teleoperación se ha propuesto a través de AENOR al grupo ISO de Telerobotics como una solución válida al problema existente y se encuentra bajo revisión. Con el diseño de dicho protocolo se ha conseguido enlazar maestro y esclavo, sin embargo con los niveles de radiación tan altos que hay en ITER la electrónica del controlador no puede entrar dentro del tokamak. Por ello se propone que a través de una mínima electrónica convenientemente protegida se puedan multiplexar las señales de control que van a través del cableado umbilical desde el controlador hasta la base del robot. En este ejercicio teórico se demuestra la utilidad y viabilidad de utilizar este tipo de solución para reducir el volumen y peso del cableado umbilical en cifras aproximadas de un 90%, para ello hay que desarrollar una electrónica específica y con certificación RadHard para soportar los enormes niveles de radiación de ITER. Para este manipulador de tipo genérico y con ayuda de la Plataforma Abierta de Teleoperación, se ha desarrollado un algoritmo que mediante un sensor de fuerza/par y una IMU colocados en la muñeca del robot, y convenientemente protegidos ante la radiación, permiten calcular las fuerzas e inercias que produce la carga, esto es necesario para poder transmitirle al operador unas fuerzas escaladas, y que pueda sentir la carga que manipula, y no otras fuerzas que puedan influir en el esclavo remoto, como ocurre con otras técnicas de estimación de fuerzas. Como el blindaje de los sensores no debe ser grande ni pesado, habrá que destinar este tipo de tecnología a las tareas de mantenimiento de las paradas programadas de ITER, que es cuando los niveles de radiación están en sus valores mínimos. Por otro lado para que el operador sienta lo más fielmente posible la fuerza de carga se ha desarrollado una electrónica que mediante el control en corriente de los motores permita realizar un control en fuerza a partir de la caracterización de los motores del maestro. Además para aumentar la percepción del operador se han realizado unos experimentos que demuestran que al aplicar estímulos multimodales (visuales, auditivos y hápticos) aumenta su inmersión y el rendimiento en la consecución de la tarea puesto que influyen directamente en su capacidad de respuesta. Finalmente, y en referencia a la realimentación visual del operador, en ITER se trabaja con cámaras situadas en localizaciones estratégicas, si bien el humano cuando manipula objetos hace uso de su visión binocular cambiando constantemente el punto de vista adecuándose a las necesidades visuales de cada momento durante el desarrollo de la tarea. Por ello, se ha realizado una reconstrucción tridimensional del espacio de la tarea a partir de una cámara-sensor RGB-D, lo cual nos permite obtener un punto de vista binocular virtual móvil a partir de una cámara situada en un punto fijo que se puede proyectar en un dispositivo de visualización 3D para que el operador pueda variar el punto de vista estereoscópico según sus preferencias. La correcta integración de estas tecnologías para la interacción hombre-robot en la P.A.T. ha permitido validar mediante pruebas y experimentos para verificar su utilidad en la aplicación práctica de la telemanipulación con alto grado de escalado en entornos nucleares de fusión. Abstract This thesis focuses on developing technologies for human-robot interaction in nuclear fusion environments. The main problem of nuclear fusion sector resides in such extreme environmental conditions existing in the hot-cell, leading to very restrictive requirements for equipment in order to deal with these high levels of radiation, magnetism, ultravacuum, temperature... Since it is not feasible to carry out tasks directly by humans, we must use remote handling devices for accomplishing operation and maintenance processes. In ITER facilities it is mandatory to have a controlled environment of extreme safety and security with validated standards. The definition and use of protocols is essential to govern its operation. Focusing on Remote Handling with some degree of escalation, protocols must be defined for open systems to allow interaction among different kind of equipment and several multifunctional devices. In this context, a Teleoperation Protocol definition enables interconnection between master and slave devices from different typologies, being able to communicate bilaterally one each other and using different control algorithms depending on the task to perform. This protocol and its interconnectivity have been tested in the Teleoperation Open Platform (T.O.P.) that has been developed and integrated in the ETSII UPM as a tool to test, validate and conduct experiments in Telerobotics. Currently, this protocol has been proposed for Teleoperation through AENOR to the ISO Telerobotics group as a valid solution to the existing problem, and it is under review. Master and slave connection has been achieved with this protocol design, however with such high radiation levels in ITER, the controller electronics cannot enter inside the tokamak. Therefore it is proposed a multiplexed electronic board, that through suitable and RadHard protection processes, to transmit control signals through an umbilical cable from the controller to the robot base. In this theoretical exercise the utility and feasibility of using this type of solution reduce the volume and weight of the umbilical wiring approximate 90% less, although it is necessary to develop specific electronic hardware and validate in RadHard qualifications in order to handle huge levels of ITER radiation. Using generic manipulators does not allow to implement regular sensors for force feedback in ITER conditions. In this line of research, an algorithm to calculate the forces and inertia produced by the load has been developed using a force/torque sensor and IMU, both conveniently protected against radiation and placed on the robot wrist. Scaled forces should be transmitted to the operator, feeling load forces but not other undesirable forces in slave system as those resulting from other force estimation techniques. Since shielding of the sensors should not be large and heavy, it will be necessary to allocate this type of technology for programmed maintenance periods of ITER, when radiation levels are at their lowest levels. Moreover, the operator perception needs to feel load forces as accurate as possible, so some current control electronics were developed to perform a force control of master joint motors going through a correct motor characterization. In addition to increase the perception of the operator, some experiments were conducted to demonstrate applying multimodal stimuli (visual, auditory and haptic) increases immersion and performance in achieving the task since it is directly correlated with response time. Finally, referring to the visual feedback to the operator in ITER, it is usual to work with 2D cameras in strategic locations, while humans use binocular vision in direct object manipulation, constantly changing the point of view adapting it to the visual needs for performing manipulation during task procedures. In this line a three-dimensional reconstruction of non-structured scenarios has been developed using RGB-D sensor instead of cameras in the remote environment. Thus a mobile virtual binocular point of view could be generated from a camera at a fixed point, projecting stereoscopic images in 3D display device according to operator preferences. The successful integration of these technologies for human-robot interaction in the T.O.P., and validating them through tests and experiments, verify its usefulness in practical application of high scaling remote handling at nuclear fusion environments.

La disparidad de fijación: concepto y manejo clínico

La diferencia de alineación de los ejes visuales en la Disparidad de Fijación en la gran mayoría de situaciones se produce como un efecto fisiológico no produciendo sintomatología al paciente. Sin embargo, existen ciertas situaciones en las que la Disparidad de Fijación sí que produce sintomatología al paciente, produciéndose como consecuencia del estrés de los sistemas de vergencia y acomodativo con el objetivo de mantener la visión binocular. Existen además evidencias científicas de que determinados hábitos de lectura, patologías como las migrañas y pacientes disléxicos con problemas de lectura y de aprendizaje pueden observar un incremento significativo de la Disparidad de Fijación, estando asociados a Disparidades de Fijación anormales. Debido a la información que proporciona la medida de la Disparidad de Fijación resulta de especial interés la cuantificación de la misma en la práctica clínica, existiendo en la actualidad diferentes tests y dispositivos clínicos que se utilizan comúnmente para la medida de la Disparidad de Fijación, como la Curva de Vergencias Forzadas, el Disparómetro de Sheedy, la Unidad de Mallet y la Carta de Wesson entre otros.

Aprendizaje perceptivo en sujetos estereodeficientes con historial de ambliopía

Tesis inédita presentada en la Universidad Europea de Madrid. Facultad de Ciencias de la Salud. Programa de Doctorado en Ciencias de la Visión

Do we really know the prevalence of accomodative and nonstrabismic binocular dysfunctions?

Purpose: To determine the scientific evidence about the prevalence of accommodative and nonstrabismic binocular anomalies. Methods: We carried out a systematic review of studies published between 1986 and 2009, analysing the MEDLINE, CINAHL, FRANCIS and PsycINFO databases. We considered admitting those papers related to prevalence in paediatric and adult populations. We identified 660 articles and 10 papers met the inclusion criteria. Results: There is a wide range of prevalence, particularly for accommodative insufficiency (2 %-61.7 %) and convergence insufficiency (2.25 %-33 %). More studies are available for children (7) compared with adults (3). Most of studies examine clinical population (5 studies) with 3 assessed at schools and 1 at University with samples that vary from 65 to 2048 patients. There is great variability regarding the number of diagnostic signs ranging from 1 to 5 clinical signs. We found a relation between the number of clinical signs used and prevalence values for convergence insufficiency although this relationship cannot be confirmed for other conditions. Conclusion: There is a lack of proper epidemiological studies about the prevalence of accommodative and nonstrabismic binocular anomalies. Studies reviewed examine consecutive or selected patients in clinical settings and schools but in any case they are randomized and representative of their populations with no data for general population. The wide discrepancies in prevalence figures are due to both sample population and the lack of uniformity in diagnostic criteria so that it makes difficult to compile results. Biases and limitations of reports determine that prevalence rates offered are only estimations from selected populations.

A high-resolution binocular video-oculography system: assessment of pupillary light reflex and detection of an early incomplete blink and an upward eye movement

Background: The pupillary light reflex characterizes the direct and consensual response of the eye to the perceived brightness of a stimulus. It has been used as indicator of both neurological and optic nerve pathologies. As with other eye reflexes, this reflex constitutes an almost instantaneous movement and is linked to activation of the same midbrain area. The latency of the pupillary light reflex is around 200 ms, although the literature also indicates that the fastest eye reflexes last 20 ms. Therefore, a system with sufficiently high spatial and temporal resolutions is required for accurate assessment. In this study, we analyzed the pupillary light reflex to determine whether any small discrepancy exists between the direct and consensual responses, and to ascertain whether any other eye reflex occurs before the pupillary light reflex. Methods: We constructed a binocular video-oculography system two high-speed cameras that simultaneously focused on both eyes. This was then employed to assess the direct and consensual responses of each eye using our own algorithm based on Circular Hough Transform to detect and track the pupil. Time parameters describing the pupillary light reflex were obtained from the radius time-variation. Eight healthy subjects (4 women, 4 men, aged 24–45) participated in this experiment. Results: Our system, which has a resolution of 15 microns and 4 ms, obtained time parameters describing the pupillary light reflex that were similar to those reported in previous studies, with no significant differences between direct and consensual reflexes. Moreover, it revealed an incomplete reflex blink and an upward eye movement at around 100 ms that may correspond to Bell’s phenomenon. Conclusions: Direct and consensual pupillary responses do not any significant temporal differences. The system and method described here could prove useful for further assessment of pupillary and blink reflexes. The resolution obtained revealed the existence reported here of an early incomplete blink and an upward eye movement.

Cirurgia de catarata: características e opiniões de pacientes com visão mono versus binocular

OBJETIVO: Verificar em dois grupos de pacientes com visão monocular (grupo 1) e com visão binocular (grupo 2), a serem submetidos à cirurgia de catarata num hospital universitário, opiniões em relação ao problema ocular, à qualidade da visão e à cirurgia de catarata. MÉTODOS: Foi realizado estudo transversal e comparativo, de forma consecutiva, por meio de questionário estruturado, aplicado por entrevista a pacientes, elaborado a partir de estudo exploratório e medidas acuidade visual e causa da perda visual. RESULTADOS: A amostra foi constituída por 96 indivíduos do grupo 1 (50,0% homens; 50,0% mulheres, com idade entre 41 e 91 anos, média 69,3 anos ± 10,4 anos) e 110, do grupo 2 (40,9% homens; 59,1% mulheres, com idade entre 40 e 89 anos, média 68,2 anos ± 10,2 anos). A maioria dos indivíduos de ambos os grupos apresentava baixa escolaridade. Não houve diferença estatisticamente significante entre os grupos em relação ao sexo (p=0,191), à idade (p=0,702) e à escolaridade (p=0,245). Não exerciam atividade laboral 95,8% dos indivíduos do grupo 1 e 83,6%, do grupo 2 (p=0,005) e 30,4% do grupo 1 mencionaram não ter possibilidade de trabalhar por causa da deficiência visual. Observou-se acuidade visual do olho a ser operado menor que 0,05 em 40,6% (grupo 1) e 33,6% (grupo 2), entre 0,25 e 0,05. Quase a totalidade dos indivíduos de ambos os grupos afirmou ter dificuldade para realização das atividades de vida diária e qualificou como insuficiente a respectiva acuidade visual; 71,9% dos entrevistados do grupo 1 e 71,6%, do grupo 2 mencionaram saber a causa da visão fraca; desses, 87,1% do grupo 1 e 83,3% do grupo 2 referiram a catarata como causa da baixa acuidade visual. CONCLUSÃO: Os indivíduos de ambos os grupos tiveram acesso à cirurgia de catarata com acuidade visual menor do que a idealmente indicada; os pacientes com visão monocular apresentaram acuidade visual significativamente menor em relação aos com visão binocular; a maioria dos entrevistados de ambos os grupos referiu dificuldades para realizar atividades cotidianas como consequência da baixa visão; muitos indivíduos de ambos os grupos desconheciam a causa da dificuldade visual ou a atribuíram a outra causa que não a catarata.

How configurations of binocular disparity determine whether stereoscopic slant or stereoscopic occlusion is seen

A partially occluded contour and a slanted contour may generate identical binocular horizontal disparities. We investigated conditions promoting an occlusion resolution indicated by an illusory contour in depth along the aligned ends of horizontally disparate line sets. For a set of identical oblique lines with a constant width added to one eye's view, strength, depth, and stability of the illusory contour were poor, whereas for oblique lines of alternating orientations the illusory contours were strong, indicating a reliance on vertical size disparities rather than vertical positional disparities in generating perceived occlusion. For horizontal lines, occlusion was seen when the lines were of different lengths and absolute width disparity was invariant across the set. In all line configurations, when the additional length was on the wrong eye to be attributed to differential occlusion, lines appeared slanted consistent with their individual horizontal disparities. This rules out monocular illusory contours as the determining factor.

Binocular rivalry and the cerebral hemispheres with a note on the correlates and constitution of visual consciousness

In addressing the scientific study of consciousness, Crick and Koch state, "It is probable that at any moment some active neuronal processes in your head correlate with consciousness, while others do not: what is the difference between them?" (1998, p. 97). Evidence from electrophysiological and brain-imaging studies of binocular rivalry supports the premise of this statement and answers to some extent, the question posed. I discuss these recent developments and outline the rationale and experimental evidence for the interhemispheric switch hypothesis of perceptual rivalry. According to this model, the perceptual alternations of rivalry reflect hemispheric alternations, suggesting that visual consciousness of rivalling stimuli may be unihemispheric at any one time (Miller et al., 2000). However, in this paper, I suggest that interhemispheric switching could involve alternating unihemispheric attentional selection of neuronal processes for access to visual consciousness. On this view, visual consciousness during rivalry could be bihemispheric because the processes constitutive of attentional selection may be distinct from those constitutive of visual consciousness. This is a special case of the important distinction between the neuronal correlates and constitution of visual consciousness.

Monocular and binocular distance cues: insights from visual form agnosia I (of III)

The human nervous system constructs a Euclidean representation of near (personal) space by combining multiple sources of information (cues). We investigated the cues used for the representation of personal space in a patient with visual form agnosia (DF). Our results indicated that DF relies predominantly on binocular vergence information when determining the distance of a target despite the presence of other (retinal) cues. Notably, DF was able to construct an Euclidean representation of personal space from vergence alone. This finding supports previous assertions that vergence provides the nervous system with veridical information for the construction of personal space. The results from the current study, together with those of others, suggest that: (i) the ventral stream is responsible for extracting depth and distance information from monocular retinal cues (i.e. from shading, texture, perspective) and (ii) the dorsal stream has access to binocular information (from horizontal image disparities and vergence). These results also indicate that DF was not able to use size information to gauge target distance, suggesting that intact temporal cortex is necessary for learned size to influence distance processing. Our findings further suggest that in neurologically intact humans, object information extracted in the ventral pathway is combined with the products of dorsal stream processing for guiding prehension. Finally, we studied the size-distance paradox in visual form agnosia in order to explore the cognitive use of size information. The results of this experiment were consistent with a previous suggestion that the paradox is a cognitive phenomenon.

Avaliação da visão binocular e da secreção lacrimal nos técnicos de farmácia em contexto de produção de nutrição parentérica

A astenopia e a fadiga visual constituem-se como queixas frequentes e podem ser desencadeadas pelo uso contínuo dos olhos em actividades prolongadas a uma distância de perto (cerca de 33cm). Os técnicos de farmácia realizam, em contexto hospitalar, a preparação de bolsas de nutrição parentérica num ambiente controlado por uma câmara de fluxo de ar laminar horizontal que emite ar de forma unidireccional e constante na direcção do utilizador. Esta actividade exige um elevado desempenho visual, devido ao contínuo uso do sistema ocular de perto, conduzindo a fadiga visual, entre outras complicações. A exigência visual de uma tarefa provoca diminuição da frequência do pestanejo e aumento da exposição da superfície ocular. O constante fluxo de ar dirigido ao utilizador provoca aumento do ritmo de evaporação lacrimal, podendo assim surgir sintomas característicos de olho seco. Será que existem alterações da visão binocular e da secreção lacrimal, queixas astenópicas e de olho seco nos técnicos de farmácia que produzem nutrição parentérica?

Importância da visão binocular no desempenho da leitura em crianças

Objectivos do estudo: 1) identificar os movimentos oculares envolvidos na leitura e (2) descrever a influência das anomalias da visão binocular no desempenho da leitura em crianças. Metodologia: estudo descritivo baseado numa revisão de literatura. Foi efetuada uma pesquisa de referências publicadas até 2011, acessíveis através da PubMed, da Science Direct e de outras fontes adicionais. Os seguintes termos foram utilizados na pesquisa: binocular vision AND reading; ocular movements AND reading. Quanto à elegibilidade, as referências foram analisadas com base na leitura seletiva do título, resumo e texto integral.