Simulated hyperopic anisometropia and reading, visual information processing, and reading-related eye movement performance in children

Purpose: This study investigated the impact of simulated hyperopic anisometropia and sustained near work on performance of academic-related measures in children. Methods: Participants included 16 children (mean age: 11.1 ± 0.8 years) with minimal refractive error. Academic-related outcome measures included a reading test (Neale Analysis of Reading Ability), visual information processing tests (Coding and Symbol Search subtests from the Wechsler Intelligence Scale for Children) and a reading-related eye movement test (Developmental Eye Movement test). Performance was assessed with and without 0.75 D of imposed monocular hyperopic defocus (administered in a randomised order), before and after 20 minutes of sustained near work. Unilateral hyperopic defocus was systematically assigned to either the dominant or non-dominant sighting eye to evaluate the impact of ocular dominance on any performance decrements. Results: Simulated hyperopic anisometropia and sustained near work both independently reduced performance on all of the outcome measures (p<0.001). A significant interaction was also observed between simulated anisometropia and near work (p<0.05), with the greatest decrement in performance observed during simulated anisometropia in combination with sustained near work. Laterality of the refractive error simulation (ocular dominance) did not significantly influence the outcome measures (p>0.05). A reduction of up to 12% in performance was observed across the range of academic-related measures following sustained near work undertaken during the anisometropic simulation. Conclusion: Simulated hyperopic anisometropia significantly impaired academic–related performance, particularly in combination with sustained near work. The impact of uncorrected habitual anisometropia on academic-related performance in children requires further investigation.

The driving visual field and a history of motor vehicle collision involvement in older drivers: A population-based examination

Purpose We designed a visual field test focused on the field utilized while driving to examine associations between field impairment and motor vehicle collision involvement in 2,000 drivers ≥70 years old. Methods The "driving visual field test" involved measuring light sensitivity for 20 targets in each eye, extending 15° superiorly, 30° inferiorly, 60° temporally and 30° nasally. The target locations were selected on the basis that they fell within the field region utilized when viewing through the windshield of a vehicle or viewing the dashboard while driving. Monocular fields were combined into a binocular field based on the more sensitive point from each eye. Severe impairment in the overall field or a region was defined as average sensitivity in the lowest quartile of sensitivity. At-fault collision involvement for five years prior to enrollment was obtained from state records. Poisson regression was used to calculate crude and adjusted rate ratios examining the association between field impairment and at-fault collision involvement. Results Drivers with severe binocular field impairment in the overall driving visual field had a 40% increased rate of at-fault collision involvement (RR 1.40, 95%CI 1.07-1.83). Impairment in the lower and left fields was associated with elevated collision rates (RR 1.40 95%CI 1.07-1.82 and RR 1.49, 95%CI 1.15-1.92, respectively), whereas impairment in the upper and right field regions was not. Conclusions Results suggest that older drivers with severe impairment in the lower or left region of the driving visual field are more likely to have a history of at-fault collision involvement.

Development of the OnTrack Diabetes program

Background: Type 2 diabetes affects an estimated 347 million people worldwide and often leads to serious complications including blindness, kidney disease, and limb amputation. Comorbid dysphoria is common and is an independent risk factor for poor glycaemic control. Professional support for diabetes self-management and dysphoria has limited availability and involves high costs, especially after regular hours, and in rural and remote areas. Web-based cognitive behavior therapy offers highly accessible, acceptable, and cost-effective support for people with diabetes. This paper describes the development of OnTrack Diabetes, a self-guided, Web-based program to promote improved physical and emotional self-management in people with Type 2 diabetes. Objective: The objective of the study is to describe the development of the OnTrack Diabetes program, which is a self-guided, Web-based program aimed to promote euthymia and improved disease self-management in people with Type 2 diabetes. Methods: Semistructured interviews with 12 general practitioners and 13 patients with Type 2 diabetes identified enablers of and barriers to effective diabetes self-management, requirements for additional support, and potential program elements. Existing resources and research data informed the development of content, and consultants from relevant disciplines provided feedback on draft segments and reviewed the program before release. Using a self-guided delivery format contained costs, in addition to adapting program features and modules from an existing OnTrack program. Results: A separate paper describes the protocol for a randomized controlled trial to provide this required evaluation. Conclusions: Development of the OnTrack Diabetes program demonstrates strategies that help ensure that a program is acceptable to users. The next stages involve testing users’ experiences and examining the program’s effectiveness and cost-effectiveness in randomized controlled trials.

Epistemological lens : birth, death and ecology of documentary practices

This paper considers the epistemological life cycle of the camera lens in documentary practices. The 19th century industrial economies that manufactured and commercialised the camera lens have engendered political and economic contingencies on documentary practices to sustain a hegemonic and singular interpretive epistemology. Colonial documentary practices are considered from the viewpoint of manipulative hegemonic practices - all of which use the interpretive epistemology of the camera lens to capitalise a viewpoint which is singular and possesses the power to sustain its own status and economic privilege. I suggest that decolonising documentary practices can be nurtured in what Boaventura de Sousa Santos proposes as an 'ecology of knowledges' (Andreotti, Ahenakew, & Cooper 2011) - a way of including the epistemologies of cultures beyond the 'abyssal' (Santos), outside the limits of epistemological dominance. If an 'epistemicide' (Santos) of indigenous knowledges in the dominant limits has occurred then in an ecology of knowledges the limits become limitless and what were once invisible knowledges, come into their own ontological and epistemological being: as free agents and on their own terms. In an ecology of knowledges, ignorance and blindness may still exist but are not privileged. The decolonisation of documentary practices inevitably destabilises prevailing historicities and initiates ways for equal privilege to exist between multiple epistemologies.

Frequency of convergence and accommodative disorders in a clinical population of Mashhad, Iran

Purpose To investigate the frequency of convergence and accommodation anomalies in an optometric clinical setting in Mashhad, Iran, and to determine tests with highest accuracy in diagnosing these anomalies. Methods From 261 patients who came to the optometric clinics of Mashhad University of Medical Sciences during a month, 83 of them were included in the study based on the inclusion criteria. Near point of convergence (NPC), near and distance heterophoria, monocular and binocular accommodative facility (MAF and BAF, respectively), lag of accommodation, positive and negative fusional vergences (PFV and NFV, respectively), AC/A ratio, relative accommodation, and amplitude of accommodation (AA) were measured to diagnose the convergence and accommodation anomalies. The results were also compared between symptomatic and asymptomatic patients. The accuracy of these tests was explored using sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR−). Results Mean age of the patients was 21.3 ± 3.5 years and 14.5% of them had specific binocular and accommodative symptoms. Convergence and accommodative anomalies were found in 19.3% of the patients; accommodative excess (4.8%) and convergence insufficiency (3.6%) were the most common accommodative and convergence disorders, respectively. Symptomatic patients showed lower values for BAF (p = .003), MAF (p = .001), as well as AA (p = .001) compared with asymptomatic patients. Moreover, BAF (S = 75%, Sp = 62%) and MAF (S = 62%, Sp = 89%) were the most accurate tests for detecting accommodative and convergence disorders in terms of both sensitivity and specificity. Conclusions Convergence and accommodative anomalies are the most common binocular disorders in optometric patients. Including tests of monocular and binocular accommodative facility in routine eye examinations as accurate tests to diagnose these anomalies requires further investigation.

The short-term accommodation response to aniso-accommodative stimuli in isometropia

Purpose There have been only a limited number of studies examining the accommodative response that occurs when the two eyes are provided with disparate accommodative stimuli, and the results from these studies to date have been equivocal. In this study, we therefore aimed to examine the capacity of the visual system to aniso-accommodate by objectively measuring the interocular difference in the accommodation response between fellow dominant and non-dominant eyes under controlled monocular and binocular viewing conditions during short-term exposure to aniso-accommodative stimuli. Methods The accommodative response of each eye of sixteen young isometropic adults (mean age 22 ± 2 years) with normal binocular vision was measured using an open-field autorefractor during a range of testing conditions; monocularly (accommodative demands ranging from 1.32 to 4.55 D) and binocularly while altering the accommodation demand for each eye (aniso-accommodative stimuli ranging from 0.24 to 2.05 D). Results Under monocular viewing conditions, the dominant and non-dominant eyes displayed a highly symmetric accommodative response; mean interocular difference in spherical equivalent 0.01 ± 0.06 D (relative) and 0.22 ± 0.06 D (absolute) (p>0.05). During binocular viewing, the dominant eye displayed a greater accommodative response (0.11 ± 0.34 D relative and 0.24 ± 0.26 D absolute) irrespective of whether the demand of the dominant or non-dominant eye was altered (p = 0.01). Astigmatic power vectors J0 and J45 did not vary between eyes or with increasing accommodation demands under monocular or binocular viewing conditions (p>0.05). Conclusion The dominant and non-dominant eyes of young isometropic individuals display a similar consensual lag of accommodation under both monocular and binocular viewing conditions, with the dominant eye showing a small but significantly greater (by 0.12 to 0.25 D) accommodative response. Evidence of short-term aniso-accommodation in response to asymmetric accommodation demands was not observed.

A Chlamydia trachomatis strain with a chemically generated amino acid substitution (P370L) in the cthtrA gene shows reduced elementary body production

Background Chlamydia (C.) trachomatis is the most prevalent bacterial sexually transmitted infection worldwide and the leading cause of preventable blindness. Genetic approaches to investigate C. trachomatis have been only recently developed due to the organism’s intracellular developmental cycle. HtrA is a critical stress response serine protease and chaperone for many bacteria and in C. trachomatis has been previously shown to be important for heat stress and the replicative phase of development using a chemical inhibitor of the CtHtrA activity. In this study, chemically-induced SNVs in the cthtrA gene that resulted in amino acid substitutions (A240V, G475E, and P370L) were identified and characterized. Methods SNVs were initially biochemically characterized in vitro using recombinant protein techniques to confirm a functional impact on proteolysis. The C. trachomatis strains containing the SNVs with marked reductions in proteolysis were investigated in cell culture to identify phenotypes that could be linked to CtHtrA function. Results The strain harboring the SNV with the most marked impact on proteolysis (cthtrAP370L) was detected to have a significant reduction in the production of infectious elementary bodies. Conclusions This provides genetic evidence that CtHtrA is critical for the C. trachomatis developmental cycle.

Genome-wide association study for sight-threatening diabetic retinopathy reveals association with genetic variation near the GRB2 gene

Aims/hypothesis Diabetic retinopathy is a serious complication of diabetes mellitus and can lead to blindness. A genetic component, in addition to traditional risk factors, has been well described although strong genetic factors have not yet been identified. Here, we aimed to identify novel genetic risk factors for sight-threatening diabetic retinopathy using a genome-wide association study. Methods Retinopathy was assessed in white Australians with type 2 diabetes mellitus. Genome-wide association analysis was conducted for comparison of cases of sight-threatening diabetic retinopathy (n = 336) with diabetic controls with no retinopathy (n = 508). Top ranking single nucleotide polymorphisms were typed in a type 2 diabetes replication cohort, a type 1 diabetes cohort and an Indian type 2 cohort. A mouse model of proliferative retinopathy was used to assess differential expression of the nearby candidate gene GRB2 by immunohistochemistry and quantitative western blot. Results The top ranked variant was rs3805931 with p = 2.66 × 10−7, but no association was found in the replication cohort. Only rs9896052 (p = 6.55 × 10−5) was associated with sight-threatening diabetic retinopathy in both the type 2 (p = 0.035) and the type 1 (p = 0.041) replication cohorts, as well as in the Indian cohort (p = 0.016). The study-wide meta-analysis reached genome-wide significance (p = 4.15 × 10−8). The GRB2 gene is located downstream of this variant and a mouse model of retinopathy showed increased GRB2 expression in the retina. Conclusions/interpretation Genetic variation near GRB2 on chromosome 17q25.1 is associated with sight-threatening diabetic retinopathy. Several genes in this region are promising candidates and in particular GRB2 is upregulated during retinal stress and neovascularisation.

Genome-wide association study identifies susceptibility loci for open angle glaucoma at TMCO1 and CDKN2B-AS1

We report a genome-wide association study for open-angle glaucoma (OAG) blindness using a discovery cohort of 590 individuals with severe visual field loss (cases) and 3,956 controls. We identified associated loci at TMCO1 (rs4656461[G] odds ratio (OR) = 1.68, P = 6.1 × 10-10) and CDKN2B-AS1 (rs4977756[A] OR = 1.50, P = 4.7 × 10-9). We replicated these associations in an independent cohort of cases with advanced OAG (rs4656461 P = 0.010; rs4977756 P = 0.042) and two additional cohorts of less severe OAG (rs4656461 combined discovery and replication P = 6.00 × 10-14, OR = 1.51, 95% CI 1.35-1.68; rs4977756 combined P = 1.35 × 10-14, OR = 1.39, 95% CI 1.28-1.51). We show retinal expression of genes at both loci in human ocular tissues. We also show that CDKN2A and CDKN2B are upregulated in the retina of a rat model of glaucoma. © 2011 Nature America, Inc. All rights reserved.

Association between glaucoma and at–fault motor vehicle collision involvement among older drivers

Objective To examine the association between glaucoma and motor vehicle collision (MVC) involvement among older drivers, including the role of visual field impairment that may underlie any association found. Design A retrospective population-based study Participants A sample of 2,000 licensed drivers aged 70 years and older who reside in north central Alabama. Methods At-fault MVC involvement for five years prior to enrollment was obtained from state records. Three aspects of visual function were measured: habitual binocular distance visual acuity, binocular contrast sensitivity and the binocular driving visual field constructed from combining the monocular visual fields of each eye. Poisson regression was used to calculate crude and adjusted rate ratios (RR) and 95% confidence intervals (CI). Main Outcomes Measures At-fault MVC involvement for five years prior to enrollment. Results Drivers with glaucoma (n = 206) had a 1.65 (95% confidence interval [CI] 1.20-2.28, p = 0.002) times higher MVC rate compared to those without glaucoma after adjusting for age, gender and mental status. Among those with glaucoma, drivers with severe visual field loss had higher MVC rates (RR = 2.11, 95% CI 1.09-4.09, p = 0.027), whereas no significant association was found among those with impaired visual acuity and contrast sensitivity. When the visual field was sub-divided into six regions (upper, lower, left, and right visual fields; horizontal and vertical meridians), we found that impairment in the left, upper or lower visual field was associated with higher MVC rates, and an impaired left visual field showed the highest RR (RR = 3.16, p = 0.001) compared to other regions. However, no significant association was found in deficits in the right side or along the horizontal or vertical meridian. Conclusions A population-based study suggests that older drivers with glaucoma are more likely to have a history of at-fault MVC involvement than those without glaucoma. Impairment in the driving visual field in drivers with glaucoma appears to have an independent association with at-fault MVC involvement, whereas visual acuity and contrast sensitivity impairments do not.

Closed-form solutions for low-rank non-rigid reconstruction

Recovering the motion of a non-rigid body from a set of monocular images permits the analysis of dynamic scenes in uncontrolled environments. However, the extension of factorisation algorithms for rigid structure from motion to the low-rank non-rigid case has proved challenging. This stems from the comparatively hard problem of finding a linear “corrective transform” which recovers the projection and structure matrices from an ambiguous factorisation. We elucidate that this greater difficulty is due to the need to find multiple solutions to a non-trivial problem, casting a number of previous approaches as alleviating this issue by either a) introducing constraints on the basis, making the problems nonidentical, or b) incorporating heuristics to encourage a diverse set of solutions, making the problems inter-dependent. While it has previously been recognised that finding a single solution to this problem is sufficient to estimate cameras, we show that it is possible to bootstrap this partial solution to find the complete transform in closed-form. However, we acknowledge that our method minimises an algebraic error and is thus inherently sensitive to deviation from the low-rank model. We compare our closed-form solution for non-rigid structure with known cameras to the closed-form solution of Dai et al. [1], which we find to produce only coplanar reconstructions. We therefore make the recommendation that 3D reconstruction error always be measured relative to a trivial reconstruction such as a planar one.

Differences in the accommodation stimulus response curves of adult myopes and emmetropes: A summary and update

Purpose To provide a summary of the classic paper "Differences in the accommodation stimulus response curves of adult myopes and emmetropes" published in Ophthalmic and Physiological Optics in 1998 and to provide an update on the topic of accommodation errors in myopia. Summary The accommodation responses of 33 participants (10 emmetropes, 11 early onset myopes and 12 late onset myopes) aged 18-31 years were measured using the Canon Autoref R-1 free space autorefractor using three methods to vary the accommodation demand: decreasing distance (4 m to 0.25 cm), negative lenses (0 to -4 D at 4 m) and positive lenses (+4 to 0 D at 0.25 m). We observed that the greatest accommodation errors occurred for the negative lens method whereas minimal errors were observed using positive lenses. Adult progressing myopes had greater lags of accommodation than stable myopes at higher demands induced by negative lenses. Progressing myopes had shallower response gradients than the emmetropes and stable myopes; however the reduced gradient was much less than that observed in children using similar methods. Recent Findings This paper has been often cited as evidence that accommodation responses at near may be primarily reduced in adults with progressing myopia and not in stable myopes and/or that challenging accommodation stimuli (negative lenses with monocular viewing) are required to generate larger accommodation errors. As an analogy, animals reared with hyperopic errors develop axial elongation and myopia. Retinal defocus signals are presumably passed to the retinal pigment epithelium and choroid and then ultimately the sclera to modify eye length. A number of lens treatments that act to slow myopia progression may partially work through reducing accommodation errors.

GABAB Receptor antagonist CGP46381 inhibits form-deprivation myopia development in guinea pigs

The aim was to investigate the effects of the GABAB receptor antagonist, CGP46381, on form-deprivation myopia (FDM) in guinea pigs. Twenty-four guinea pigs had monocular visual deprivation induced using a diffuser for 11 days (day 14 to 25). The deprived eyes were treated with daily subconjunctival injections (100 μl) of either 2% CGP46381, 0.2% CGP46381, or saline or received no injection. The fellow eyes were left untreated. Another six animals received no treatment. At the start and end of the treatment period, ocular refractions were measured using retinoscopy and vitreous chamber depth (VCD) and axial length (AL) using A-scan ultrasound. All of the deprived eyes developed relative myopia (treated versus untreated eyes, P < 0.05). The amount of myopia was significantly affected by the drug treatment (one-way ANOVA, P < 0.0001). The highest dose tested, 2% CGP46381, significantly inhibited myopia development compared to saline (2% CGP46381: -1.08 ± 0.40 D, saline: -4.33 ± 0.67 D, P < 0.01). The majority of these effects were due to less AL (2% CGP46381: 0.03 ± 0.01 mm, saline: 0.13 ± 0.02 mm, P < 0.01) and VCD (2% CGP46381: 0.02 ± 0.01 mm, saline: 0.08 ± 0.01 mm, P < 0.01) elongation. The lower dose tested, 0.2% CGP46381, did not significantly inhibit FDM (P > 0.05). Subconjunctival injections of CGP46381 inhibit FDM development in guinea pigs in a dose-dependent manner.

Half-occlusion processing in stereoscopic vision

This study investigated questions related to half-occlusion processing in human stereoscopic vision: (1) How does the depth location of a half-occluding figure affect the depth localization of adjacent monocular objects? (2) Is three-dimensional slant around vertical axis (geometric effect) affected by half-occlusion constraints? and (3) How the half-occlusion constraints and surface formation processes are manifested in stereoscopic capture? Our results showed that the depth localization of binocular objects affects the depth localization of discrete monocular objects. We also showed that the visual system has a preference for a frontoparallel surface interpretation if the half-occlusion configuration allows multiple interpretation alternatives. When the surface formation was constrained by textures, our results showed that a process of rematching spreading determines the resulting perception and that the spreading can be limited by illusory contours that support the presence of binocularly unmatched figures. The unmatched figures could be present, if the inducing figures producing the illusory surface contained binocular image differences that provided cues for quantitative da Vinci stereopsis. These findings provide evidence of the significant role of half-occlusions in stereoscopic processing.

A head-mounted display as a personal viewing device: Dimensions of subjective experiences

The use of head-mounted displays (HMDs) can produce both positive and negative experiences. In an effort increase positive experiences and avoid negative ones, researchers have identified a number of variables that may cause sickness and eyestrain, although the exact nature of the relationship to HMDs may vary, depending on the tasks and the environments. Other non-sickness-related aspects of HMDs, such as users opinions and future decisions associated with task enjoyment and interest, have attracted little attention in the research community. In this thesis, user experiences associated with the use of monocular and bi-ocular HMDs were studied. These include eyestrain and sickness caused by current HMDs, the advantages and disadvantages of adjustable HMDs, HMDs as accessories for small multimedia devices, and the impact of individual characteristics and evaluated experiences on reported outcomes and opinions. The results indicate that today s commercial HMDs do not induce serious sickness or eyestrain. Reported adverse symptoms have some influence on HMD-related opinions, but the nature of the impact depends on the tasks and the devices used. As an accessory to handheld devices and as a personal viewing device, HMDs may increase use duration and enable users to perform tasks not suitable for small screens. Well-designed and functional, adjustable HMDs, especially monocular HMDs, increase viewing comfort and usability, which in turn may have a positive effect on product-related satisfaction. The role of individual characteristics in understanding HMD-related experiences has not changed significantly. Explaining other HMD-related experiences, especially forward-looking interests, also requires understanding more stable individual traits and motivations.