Diagnosis of retinopathy in children younger than 12 years of age:implications for the diabetic eye screening guidelines in the UK

Aim: To assess whether the current starting age of 12 is suitable for diabetic retinopathy (DR) screening and whether diabetes duration should be taken into account when deciding at what age to start screening patients. Materials and methods: A retrospective analysis of 143 patients aged 12 years or younger who attended diabetic eye screening for the first time in the Birmingham, Solihull and Black Country Diabetic Eye Screening Programme was performed. Results: The mean age of the patients was 10.7 (7-12) years with 73 out of 143 aged below 12 years and 70 were 12 years of age. 98% had type 1 diabetes and mean diabetes duration was 5 (1 month-11 years) years. For those younger than 12 years, 7/73 (9.6%) had background DR (BDR), of these mean diabetes duration was 7 years (6-8). The youngest patient to present with DR was aged 8 years. In those aged 12 years, 5/70 (7.1%) had BDR; of these mean diabetes duration was 8 years (6-11). No patient developed DR before 6 years duration in either group. Conclusions: The results show that no patient younger than the age of 12 had sight-threatening DR (STDR), but BDR was identified. Based on the current mission statement of the Diabetic Eye Screening Programme to identify STDR, 12 years of age is confirmed as the right age to start screening, but if it is important to diabetic management to identify first development of DR, then screening should begin after 6 years of diabetes diagnosis.

Eye-related photophobia

This article provides an overview of the various eye-related causes of photophobia and the likely mechanisms responsible. Photophobia is an experience of discomfort affecting the eyes due to exposure to light. It has a variety of causes including the result of eye or brain disease, or it can be a side effect of various drugs or laser surgery. Photophobia can also be a symptom of a more serious disorder such as meningitis and therefore, requires appropriate investigation, diagnosis, and treatment. Trauma or disease affecting several structures of the eye are a common cause of photophobia and can be associated with: (1) the ocular adnexia, such as blepharitis and blepharospasm, (2) the cornea, including abrasion, ulcerative keratitis, and corneal dystrophy, (3) problems in eye development, such as aniridia, buphthalmos, coloboma, and aphakia, (4) various eye inflammations, including uveitis, and (5) retinal disorders, such as achromatopsia, retinal detachment, and retinal dystrophy. There may be two main explanations for eye-related photophobia: (1) direct stimulation of the trigeminal nerve due to damage, disease, or excessive light entering the eye and (2) overstimulation of the retina including a specific population of light-sensitive ganglion cells.

The influence of variations in eating disorder-related symptoms on processing of emotional faces in a non-clinical female sample:an eye-tracking study

This study aimed to: i) determine if the attention bias towards angry faces reported in eating disorders generalises to a non-clinical sample varying in eating disorder-related symptoms; ii) examine if the bias occurs during initial orientation or later strategic processing; and iii) confirm previous findings of impaired facial emotion recognition in non-clinical disordered eating. Fifty-two females viewed a series of face-pairs (happy or angry paired with neutral) whilst their attentional deployment was continuously monitored using an eye-tracker. They subsequently identified the emotion portrayed in a separate series of faces. The highest (n=18) and lowest scorers (n=17) on the Eating Disorders Inventory (EDI) were compared on the attention and facial emotion recognition tasks. Those with relatively high scores exhibited impaired facial emotion recognition, confirming previous findings in similar non-clinical samples. They also displayed biased attention away from emotional faces during later strategic processing, which is consistent with previously observed impairments in clinical samples. These differences were related to drive-for-thinness. Although we found no evidence of a bias towards angry faces, it is plausible that the observed impairments in emotion recognition and avoidance of emotional faces could disrupt social functioning and act as a risk factor for the development of eating disorders.

The eye of the beholder: The impact of a district implementation plan of state mandates as perceived by the implementers

The purpose of this inquiry was to investigate the impact of a large, urban school district's experience in implementing a mandated school improvement plan and to examine how that plan was perceived, interpreted, and executed by those charged with the task. The research addressed the following questions: First, by whom was the district implementation plan designed, and what factors were considered in its construction? Second, what impact did the district implementation plan have on those charged with its implementation? Third, what impact did the district plan have on the teaching and learning practices of a particular school? Fourth, what aspects of the implemention plan were perceived as most and least helpful by school personnel in achieving stated goals? Last, what were the intended and unintended consequences of an externally mandated and directed plan for improving student achievement? The implementation process was measured against Fullan's model as expounded upon in The Meaning of Educational Change (1982) and The New Meaning of Educational Change (1990). The Banya implementation model (1993), because it added a dimension not adequately addressed by Fullan, was also considered.^ A case study was used as the methodological framework of this qualitative study. Sources of data used in this inquiry included document analysis, participant observations in situ, follow-up interviews, the "long" interview, and triangulation. The study was conducted over a twelve-month period. Findings were obtained from the content analysis of interview transcripts of multiple participants. Results were described and interpreted using the Fullan and Banya models as the descriptive framework. A cross-case comparison of the multiple perspectives of the same phenomena by various participants was constructed.^ The study concluded that the school district's implementation plan to improve student achievement was closely aligned to Fullan's model, although not intentionally. The research also showed that where there was common understanding at all levels of the organization as to the expectations for teachers, level of support to be provided, and availability of resources, successful implementation occured. The areas where successful implementation did not occur were those where the complexity of the changes were underestimated and processes for dealing with unintended consequences were not considered or adequately addressed. The unique perspectives of the various participants, from the superintendent to the classroom teacher, are described. Finally, recommendations for enhancement of implementation are offered and possible topics for further research studies are postulated. ^

Signal processing and information fusing algorithms for the synthesis of an alternative electromyogram/eye gaze tracking computer cursor control system

This research pursued the conceptualization and real-time verification of a system that allows a computer user to control the cursor of a computer interface without using his/her hands. The target user groups for this system are individuals who are unable to use their hands due to spinal dysfunction or other afflictions, and individuals who must use their hands for higher priority tasks while still requiring interaction with a computer. ^ The system receives two forms of input from the user: Electromyogram (EMG) signals from muscles in the face and point-of-gaze coordinates produced by an Eye Gaze Tracking (EGT) system. In order to produce reliable cursor control from the two forms of user input, the development of this EMG/EGT system addressed three key requirements: an algorithm was created to accurately translate EMG signals due to facial movements into cursor actions, a separate algorithm was created that recognized an eye gaze fixation and provided an estimate of the associated eye gaze position, and an information fusion protocol was devised to efficiently integrate the outputs of these algorithms. ^ Experiments were conducted to compare the performance of EMG/EGT cursor control to EGT-only control and mouse control. These experiments took the form of two different types of point-and-click trials. The data produced by these experiments were evaluated using statistical analysis, Fitts' Law analysis and target re-entry (TRE) analysis. ^ The experimental results revealed that though EMG/EGT control was slower than EGT-only and mouse control, it provided effective hands-free control of the cursor without a spatial accuracy limitation, and it also facilitated a reliable click operation. This combination of qualities is not possessed by either EGT-only or mouse control, making EMG/EGT cursor control a unique and practical alternative for a user's cursor control needs. ^

A practical system for hands-off computer interaction based on electromyogram (EMG)/eye gaze tracking (EGT)

Effective interaction with personal computers is a basic requirement for many of the functions that are performed in our daily lives. With the rapid emergence of the Internet and the World Wide Web, computers have become one of the premier means of communication in our society. Unfortunately, these advances have not become equally accessible to physically handicapped individuals. In reality, a significant number of individuals with severe motor disabilities, due to a variety of causes such as Spinal Cord Injury (SCI), Amyothrophic Lateral Sclerosis (ALS), etc., may not be able to utilize the computer mouse as a vital input device for computer interaction. The purpose of this research was to further develop and improve an existing alternative input device for computer cursor control to be used by individuals with severe motor disabilities. This thesis describes the development and the underlying principle for a practical hands-off human-computer interface based on Electromyogram (EMG) signals and Eye Gaze Tracking (EGT) technology compatible with the Microsoft Windows operating system (OS). Results of the software developed in this thesis show a significant improvement in the performance and usability of the EMG/EGT cursor control HCI.

Love comes in at the eye

LOVE COMES IN AT THE EYE relates the story of Marshall Craig, a Midwesterner transplanted to South Florida who turns 35 in the course of the book. Marshall is an assistant curator for a Miami art museum, a man who has been obsessed with--as he calls it--a greed for seeing from a young age. His fascination with the surface of appearance of things is exacerbated by his precocious studies in art and its histories. Marshall views himself as marked by his red hair and freckled skin, as someone whose chances of attracting a partner into a meaningful relationship have been diminished by his looks. He is colored by his image of himself as unattractive and most importantly, convinced that his romantic life would be more successful, more vibrant, if he'd been graced with the face and figure of, say, a Velazquez. When Marshall meets a Cuban-born man from Atlanta, he is transfixed by the conviction that this is the man the universe has selected for him. The thrust of the story goes beyond boy-meets/loses/gets-boy to an exploration of said boy coming to terms with his definition of self. In a pivotal span of six months, the book explores Marshall's obsessions with seeing and how they define his vision of reality, the emphasis placed on beauty in gay culture, the tentative beginnings of a relationship as it takes root and grows, and finally, the inexplicable, magical forces that direct our romantic destinies.

On-screen pre-deblurring of digital images using the wavefront aberration function of the human eye to improve computer access for the visually impaired

Traditional Optics has provided ways to compensate some common visual limitations (up to second order visual impairments) through spectacles or contact lenses. Recent developments in wavefront science make it possible to obtain an accurate model of the Point Spread Function (PSF) of the human eye. Through what is known as the "Wavefront Aberration Function" of the human eye, exact knowledge of the optical aberration of the human eye is possible, allowing a mathematical model of the PSF to be obtained. This model could be used to pre-compensate (inverse-filter) the images displayed on computer screens in order to counter the distortion in the user's eye. This project takes advantage of the fact that the wavefront aberration function, commonly expressed as a Zernike polynomial, can be generated from the ophthalmic prescription used to fit spectacles to a person. This allows the pre-compensation, or onscreen deblurring, to be done for various visual impairments, up to second order (commonly known as myopia, hyperopia, or astigmatism). The technique proposed towards that goal and results obtained using a lens, for which the PSF is known, that is introduced into the visual path of subjects without visual impairment will be presented. In addition to substituting the effect of spectacles or contact lenses in correcting the loworder visual limitations of the viewer, the significance of this approach is that it has the potential to address higher-order abnormalities in the eye, currently not correctable by simple means.

Analisi della sicurezza dei percorsi ciclabili mediante Mobile Eye Detector

La tesi tratta l'analisi della sicurezza delle piste ciclabili di Bologna, mediante tecnologie innovative quali Mobile Eye e Video V-Box. Si trattano due percorsi: "Sabotino" e "Sant'Orsola", comprendenti ciascuno due itinerari alternativi, uno ciclabile e uno no. In prima fase, si sono somministrati dei questionari di gradimento ad un campione composto da 50 utenti per percorso. I questionari sono composti da una parte generale e da una specifica dell'itinerario. Dall'analisi dei risultati delle interviste, eseguita esclusivamente per il percorso "Sabotino", è stato possibile evidenziare le criticità segnalate dai ciclisti. Sono state poi condotte, esclusivamente nel tratto Nord-Ovest della tangenziale delle biciclette, indagini sperimentali con Mobile Eye, con lo scopo di conoscere quali elementi stradali sono maggiormente guardati e considerati dall'utente e con Video V-Box, in grado di fornire posizione, velocità puntuale e accelerazione. A tali sperimentazioni hanno partecipato 17 utenti, ignari dello scopo del test. Ottenuti i dati, sono stati analizzati i risultati provenienti da V-Box quindi analizzate le velocità in prossimità delle intersezioni significative. Dal confronto dei risultati provenienti dai questionari e dai test sperimentali è stato possibili giundere a delle conclusioni.

“Doctor my eyes” : A natural experiment on the demand for eye care services

This paper is dedicated to our friend Divine Ikenwilo, who passed away on the 27th November 2015. Divine was a gifted researcher who was taken from us too early and will be sorely missed by everyone in the team. Our thoughts are with his family. This research was funded by a research grant (CGZ/2/533) from the Chief Scientist Office of the Scottish Government. The Health Economics Research Unit is funded by the Scottish Government Health and Social Care Directorate. The usual disclaimer applies.

Use of NeuroEyeCoach™ to Improve Eye Movement Efficacy in Patients with Homonymous Visual Field Loss

Acknowledgements: We would like to thank Sigrid Kenkel, Susanne Muller, Valentina Varalta, Cristina Fonte, Venecia Alb and Cristina Racasan who have contributed to data collection. Declaration of Interest: AS is Chief Science Officer of NovaVision Inc. NS has no conflict of interest. JZ is a member of the Scientific Advisory Board of NovaVision Inc. This study was supported by a NovaVision Inc. research grant to AS.

Blue flicker modifies the subfoveal choroidal blood flow in the human eye

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Clinical characteristics and benefit of cataract intervention amongst UK domiciliary eye care recipients

Purpose: Given the ageing UK population and the high prevalence of activity-limiting illness and disability in the over 65s, the demand for domiciliary eye care services is set to grow significantly. Over 400,000 NHS domiciliary eye examinations are conducted each year, yet minimal research attention has been directed to this mode of practice or patient needs amongst this group. The study aimed to compare clinical characteristics and benefits of cataract surgery between conventional in-practice patients and domiciliary service users. Methods: Clinical characteristics were compared between patients in North-West England receiving NHS domiciliary eye care services (n = 197; median age 76.5 years), and an age-matched group of conventional in-practice patients (n = 107; median age 74.6 years). Data including reason for visit; logMAR uncorrected and best corrected distance (UDVA and CDVA) and near acuities (UNVA and CNVA); presence of ocular pathology and examination outcome were documented retrospectively. To compare the benefit of cataract surgery in terms of functional capacity between the patient groups, individuals undergoing routine referral for first-eye surgery completed the VF-14 questionnaire pre-operatively, and at 6 weeks post-operatively. Results: UDVA was similar between the two groups (median 0.48 and 0.50 logMAR in the domiciliary and practice groups, P = 0.916); CDVA was significantly worse in the domiciliary group (median 0.18 vs 0.08 logMAR, P<0.001), who were more likely to have clinically-significant cataract. Both groups showed similar improvements in VF-14 scores following cataract surgery (mean gains 24.4 ± 11.7, and 31.5 ± 14.7 points in the in-practice and domiciliary groups, respectively. P = 0.312). Conclusions: Patients receiving domiciliary eye care services are more likely to have poorer corrected vision than in-practice patients of a similar age, partly due to a higher prevalence of significant cataract. Despite limitations in their activities due to illness and disability, domiciliary patients experience similar gains in self-reported functional capacity following cataract surgery

Parsing mathematical constructs:results from a preliminary eye tracking study

The semantic model described in this paper is based on ones developed for arithmetic (e.g. McCloskey et al. 1985, Cohene and Dehaene 1995), natural language processing (Fodor 1975, Chomsky 1981) and work by the author on how learners parse mathematical structures. The semantic model highlights the importance of the parsing process and the relationship between this process and the mathematical lexicon/grammar. It concludes by demonstrating that for a learner to become an efficient, competent mathematician a process of top-down parsing is essential.

Exploring business models to provide a foundation for enhanced eye care services in high street optometric practice

High street optometric practices are for-profit businesses. They mostly provide sight testing and eye examination services and sell optical products, such as spectacles and contact lenses. The sight testing services are often sold at a vastly reduced price and profits are generated primarily through high margin spectacle sales, in a loss leading strategy. Published literature highlights weaknesses in this strategy as it forms a barrier to widening the scope of services provided within optometric practices. This includes specialist non-refraction based services, such as shared care. In addition this business strategy discourages investment in advanced diagnostic equipment and higher professional qualifications. The aim of this thesis was to develop a greater understanding of the traditional loss-leading strategy. The thesis also aimed to assess the plausibility of alternative business models to support the development of specialist non-refraction services within high street optometric practice. This research was based on a single independent optometric practice that specialises in advanced retinal imaging and offers a broad range of shared care services. Specialist non-refraction based services were found to be poor generators of spectacle sales likely due to patient needs and presenting concerns. Alternative business strategies to support these services included charging more realistic professional fees via cost-based pricing and monthly payment plans. These strategies enabled specialist services to be more self-sustainable with less reliance on cross-subsidy from spectacle sales. Furthermore, improving operational efficiency can increase stand-alone profits for specialist services.Practice managers may be reluctant to increase professional fees due to market pressures and confidence. However, this thesis found that patients were accepting of increased professional fees. Practice managers can implement alternative business models to enhance eye care provision in high street optometric practices. These alternative business models also improve revenues and profits generated via clinical services and improve patient loyalty.