Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-08-19T13:05:28Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO - Desempenho de crianças e adolescentes com baixa visao na eep -Agda.pdf: 2124116 bytes, checksum: a8994023ce55797add4330e1c5b7d7e7 (MD5) / Made available in DSpace on 2016-08-19T13:05:28Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO - Desempenho de crianças e adolescentes com baixa visao na eep -Agda.pdf: 2124116 bytes, checksum: a8994023ce55797add4330e1c5b7d7e7 (MD5) Previous issue date: 2016-02-29 / CAPEs / Deficiência visual pode implicar em comprometimento de atividades básicas relativas ao movimento, como o equilíbrio. É importante mensurar esse comprometimento de acordo com a idade, para averiguar e posteriormente acompanhar o desenvolvimento motor das crianças e adolescentes. O objetivo desse estudo foi investigar o desempenho de crianças e adolescentes com baixa visão na Escala de Equilíbrio Pediátrica (EEP), bem como, avaliar a relação do escore alcançado na EEP com a percepção dos pais quanto à qualidade de vida dos seus filhos e à assistência especializada por eles recebida. A EEP foi administrada em 41 sujeitos, entre cinco e 14 anos de idade, com baixa visão e sem comprometimento motor ou cognitivo associado, em população do agreste de Pernambuco e Recife. A EEP foi desenvolvida como medida de funcionalidade de equilíbrio, adaptada da Escala de Equilíbrio de Berg e proposta para crianças na faixa etária de cinco a 15 anos. É uma escala de alta confiabilidade para teste-reteste e relativamente simples e de fácil administração. O teste utilizado para avaliação da percepção dos pais quanto à qualidade de vida das crianças/adolescentes foi o PedsQLTM Generic Core Scale 4.0 e os dados sobre a deficiência visual foram obtidos através do cadastro dos indivíduos no centro de referência onde se realizou a coleta. Utilizou-se a estatística descritiva para o cálculo de tendência central (medianas), dispersão (quartis) e frequência simples. O coeficiente de correlação de Spearman foi utilizado para verificar a correlação entre a idade e a pontuação obtida na escala e também para a relação deste com os escores da escala de qualidade de vida. O teste de Mann-Whitney foi utilizado para calcular a associação entre o escore alcançado na EEP e o tipo de assistência especilizada recebida. Houve uma correlação de 0,52, com Intervalo de Confiança (95%) de 0,24-0,74, entre a pontuação obtida na EEP e a idade. A variação de pontuação foi maior em crianças entre cinco a sete anos de idade e mínima em grupos etários mais velhos. A pontuação máxima foi obtida em seis itens da escala por todas as crianças e adolescentes. Não houve correlação significante entre o questionário de qualidade de vida aplicado aos pais e responsáveis com o desempenho das crianças e adolescentes na EEP, bem como a associação entre este e a assistência especializada recebida. A EEP mostrou-se como um instrumento de triagem de fácil aplicação em crianças e adolescentes com baixa visão, sendo mais adequada para crianças de cinco a sete anos de idade, porém sem discriminar déficit de equilíbrio, com efeito teto para crianças e adolescentes mais velhos. / Visual impairment can have implications that hinder basic activities related to body movement such as balance. It is important to measure such hindrance, according to age, for baseline assessment and for later tracking of the motor development of those children and adolescents. The objective of this study was to investigate the performance of children and adolescents with low vision on the Pediatric Balance Scale (PBS) as well as evaluate the relationship of a PBS score to the parents’ perception of their children’s quality of life and the specialized assistance which they receive. The PBS was administered to 41 subjects between the ages of five and 14 with low vision but no associated motor, nor cognitive impairment, in the interior of Pernambuco and in Recife. The PBS was developed to measure functional balance, adapted from Berg Balance Scale, and intended for children from five to fifteen years old. It is a scale of high reliability for testing and retesting and is relatively simple and easy to apply. The test used to evaluate the parents’ perception of their children’s/adolescents’ quality of life was the PedsQLTM Generic Core Scale 4.0 and the data related to visual deficiency were collected from the participants’ registration records in a top performance health center. Descriptive statistics was used to calculate central tendencies (median), dispersion (quartiles), and simple frequency. Spearman’s correlation coefficient was used to verify the correlation between age and the score obtained on the scale and subsequently, to verify the relationship of the PBS score to the scores from the quality of life scale. Mann-Whitney’s test was used to calculate the association between the score reached on the PBS and the type of specialized assistance received. There was a 0.52 correlation, with a confidence interval (95%) of 0.24 - 0.74, between the scores achieved on the PBS and the subject’s age. The score variation was greater in children between the ages of five and seven and minimal in older age groups. All children and adolescents reached the maximum score in six items of the scale. There was no significant correlation between the quality of life questionnaire, administered to the parents and legal guardians, to the performance of the children and adolescents on the PBS, nor there was association of the same and the specialized assistance received. The PBS proved to be a triage instrument that is easy to use on children and adolescents with low vision, being more appropriate for children of ages five to seven and, without discrimination of balance deficit, having a ceiling effect for older children and adolescents.

Orientadores: Newton Kara-Jose, Edmea Rita Temporini Nastari / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T18:24:24Z (GMT). No. of bitstreams: 1 Arruda_SoniaMariaChadidePaula_D.pdf: 28329860 bytes, checksum: 108e9cf52621bc75cdf2e5f223f9638a (MD5) Previous issue date: 2006 / Resumo: Com o objetivo de estudar percepções de auto-eficácia e condutas de estudantes com deficiência visual, em relação às atividades de vida diária (AVD), realizou-se um "survey" analítico, tipo transversal. Criaram-se escores para analisar percepções de auto-eficácia e condutas nos domínios: higiene e cuidado pessoal, vestuário, alimentação, atividades domésticas e sociais, e escolares. Foi construído questionário estruturado, aplicado por entrevista, em amostra composta por 109 estudantes de Campinas e outros municípios do Estado de São Paulo. Os estudantes apresentaram as seguintes características: 52,3% do sexo masculino e 47,7% do sexo feminino; média de idade 23,37 anos; 84,4% solteiros. Declararam não enxergar 56,9% e enxergar pouco 43,1%, a maioria (57,8%) referiu deficiência visual congênita; 89,9% mencionaram mais de uma causa como responsável pela deficiência visual. Manifestaram preocupação de piorar e perder a visão 38,2%. Os estudantes declararam ter percepção de auto-eficácia e conduta na maioria dos domínios estudados Maior grau de percepção de auto-eficácia foi declarado para atividades de higiene e cuidado pessoal (x = 88,95 e s= 15,21) e menor grau nas atividades escolares (x = 53,78 e 5= 17,73). A deficiência visual foi considerada principal dificuldade para a realização das AVD. Observaram-se diferenças significativas no domínio higiene e cuidado pessoal, entre os grupos com menos de 20 anos e com 20 anos e mais, em relação à percepção de auto-eficácia (p<0,001) e conduta (p<0,001) Entre os grupos que declararam não enxergar e os que declararam enxergar pouco houve diferença significativa no domínio alimentação em relação à gradação de capacidade (p=0,004), e no domínio atividades domésticas e sociais em relação à auto-eficácia (p=0,018), gradação de capacidade (p<0,001) e conduta (p=0,020). Entre os grupos que se declararam pouco ou nada satisfeitos e os satisfeitos ou muito satisfeitos houve diferença significativa no domínio vestuário em relação à auto-eficácia (p=0,007), na gradação de capacidade (p=0,005) e conduta (p=0,003); no domínio alimentação em relação à auto-eficácia (p=0,014), gradação de capacidade (p=0,003) e conduta (p=0,010). Entre os dependentes e os independentes evidenciaram-se diferenças significativas em todos os domínios. Dos 77 estudantes que tinham feito ou estavam em processo de reabilitação, 61,0% declararam julgar-se capazes de agir sozinho. A maioria relatou aprendizagem das AVD por si próprio, apesar de ter-se submetido a processo de reabilitação. Na percepção dos entrevistados, foram observadas dificuldades mais freqüentes nas atividades domésticas e sociais. A percepção de auto-eficácia foi preponderante nos domínios pesquisados, e houve relação entre essa percepção e a conduta declarada. A reabilitação favoreceu a percepção de auto-eficácia e de satisfação com a própria capacidade, o que sugere percepção de melhor qualidade de vida / Abstract: With the purpose of assessing perceptions of self-efficacy and performance in daily life-activities of visually impaired students a cross-sectional analytical survey was carried out Scores were created to analyze self-efficacy, degree of perceived capability, performance and cause of difficulty in performing ADL in the following domains: hygiene and personal care, dressing, feeding, household, social and school activities. A semi-structured questionnaire was constructed after an exploratory study, and personal interviews were conducted with 109 students from Campinas and other São Paulo State municipalities Student characteristics were: 52.3% male and 47.7% female; mean age 23.37 years; 84.4% single. Of the respondents 56.9% declared themselves as blind and 43.1% declared low vision, most declared that the cause for their visual impairment was congenital (57.8%), and 89.9% mentioned more than one cause as responsible for their visual impairment. Concern about further deterioration or loss of vision was expressed by 38 2%. The students declared perceived self-efficacy and performance in most of the researched domains. The greatest perceived self-efficacy level was assessed for the hygiene and personal care domain (x = 88,95 e s= 15,21) and the least for school activities (x = 53,78 e s= 17,73). Visual impairment was considered the main cause of difficulty in the performance of ADL Significant differences were detected between the students under 20 years old and those aged 20 or more in the hygiene and personal care domain in perceived self-efficacy (p<0,001) and performance (p<0,001) Among those that declared themselves as blind and the ones that declared low vision, significant differences were detected in the feeding domain for perceived capability (p=0,004); in the household and social activities domain for self-efficacy (p=0,018), perceived capability (p<0,0001) and performance (p=0,020). Among those satisfied or very satisfied and those that were not satisfied or little satisfied with their perceived capability the significant differences were - in the clothing domain, for self-efficacy (p=0,007), perceived capability (p=0,005) and performance (p=0,003); and in the feeding domain, for self-efficacy (p=0,014), perceived capability (p=0,003) and performance (p=0,010). There were significant differences in all domains among those that declared themselves independent and those that declared themselves dependent. A significant statistical association was detected between perceived self-efficacy and self-reported performance with age, visual ability, independence, and satisfaction. Of the 77 students that had been or were going through a rehabilitation process, 61% found themselves capable of acting on their own. Most of them reported that they learned to perform these activities by themselves, even though they had been through the rehabilitation process. Self-efficacy was preponderant in the investigated domains, and there was a significant statistical association between perceived self-efficacy and self-reported performance. The respondents perceived more frequent difficulties in the performance of domestic and social activities Rehabilitation reinforced self-efficacy perceptions and satisfaction with one's own capability, which suggests perceptions of improved quality of life / Doutorado / Ciencias Biomedicas / Doutor em Ciências Médicas

Orientador: Edmea Rita Temporini Nastari / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T13:33:44Z (GMT). No. of bitstreams: 1 Monteiro_GelseBeatrizMartins_D.pdf: 955089 bytes, checksum: 395ca3d7ca998e85560e652896ab7f93 (MD5) Previous issue date: 2010 / Resumo: A presente pesquisa teve os objetivos de verificar a viabilidade do uso de internet para transmissão de informações e orientações a professores, a respeito do uso de auxílios ópticos no ambiente escolar; descrever e discutir percepções e condutas de professores em relação ao uso de internet; verificar opiniões sobre apresentação e conteúdo do site "Auxílios Ópticos"; e identificar fatores que influem na receptividade a orientações, divulgadas por internet, sobre o uso de auxílios ópticos para baixa visão. O método consistiu em pesquisa com enfoques quantitativo e qualitativo. A pesquisa quantitativa caracterizou-se como estudo transversal analítico, com aplicação de questionário estruturado disponibilizado on-line. A abordagem qualitativa referiu-se a estudo descritivo-exploratório, com aplicação de técnica de grupo focal. A população foi constituída por 58 professores do sistema estadual de ensino de Campinas. Para análise dos resultados foram avaliados aspectos estatísticos e aplicada a técnica de análise do discurso do sujeito coletivo, respectivamente. A pesquisa foi realizada a partir de informações fornecidas por site na internet, sob o domínio www.auxiliosopticos.fcm.unicamp.br, construído especificamente para orientação sobre o uso de auxílios ópticos utilizados por pessoas com baixa visão, e dirigido especialmente a professores, alunos e funcionários de escolas. Os dados estatísticos mostraram que os sujeitos consideraram fácil acessar a internet (96,4%) e encontrar informações no site (64,9%); opinaram que o site despertou muito interesse sobre o assunto (77,6%). O fato de o professor lecionar para alunos com deficiência visual não influiu no recebimento de explicações sobre o uso de auxílios ópticos (p=0,829) e na periodicidade do uso de internet na prática educativa (p=0,574) ou na facilidade de acesso à internet (p=0,122). Os resultados qualitativos permitiram perceber que os sujeitos acessam a internet usualmente na busca de informações, embora tenham declarado encontrar restrições de acesso nas escolas; foi reconhecida a necessidade de informações sobre deficiência visual. Observadas as limitações tecnológicas existentes nas escolas incluídas neste estudo, pode-se concluir ter sido considerado viável o uso de internet em programa de disseminação de informações a respeito do uso de auxílios ópticos para baixa visão / Abstract: The aim of this study was to verify the viability of using the Internet to inform and guide teachers regarding the use of optical aids into the school environment; to describe and discuss teachers' perceptions and behaviors related to the use of the Internet; to verify opinions about presentation and content of the site "Optical Aids"; and to identify factors that affect receptivity to orientations spread across the Internet concerning the use of optical aids for low vision. The method consisted of a research with quantitative and qualitative approaches. The quantitative research characterized as an analytical transversal study in which a structured online questionnaire was applied. The qualitative approach referred to a descriptive-exploratory study in which the focus group technique was applied. The population comprised 58 teachers of the state teaching system in the city of Campinas. The analysis included statistical aspects and the collective subject discourse technique. The research was performed from information provided by the Internet site, under the domain name www.auxiliosopticos.fcm.unicamp.br, specifically built for orientation about the use of optical aids by low vision people and especially directed to teachers, students and school employees. The statistical data showed that the subjects considered easy the access to the Internet (96.4%) and to find information on the site (64.9%); others said that the site aroused interest on the subject (77.6%). The fact that the teacher teaches students with visual impairments did not affect the acceptance of explanations about the use of optical aids (p=0.829) and the period of Internet usage in the educative practice (p=0.574) or the easy access to the Internet (p=0.122). The qualitative results allowed to observe that the subjects usually access the Internet in search of information, although they declared having found restrictions in the access to the Internet in schools; it was recognized the need for information regarding visual impairments. After observing the technological limitations of the schools included in this study, we could conclude that the use of the Internet was considered viable in the program for the dissemination of the information concerning the use of optical aids for low vision / Doutorado / Ciencias Biomedicas / Doutor em Ciências Médicas

Visual conditions such as retinitis pigmentosa and Usher syndrome can gradually cause tunnel vision. Patients with these conditions usually face difficulties with navigation, avoiding obstacles, and performing visual search. Loss of mobility can affect patients' independence and quality of life. One of the rehabilitation strategies for patients with tunnel vision is the use of optical aids to enhance mobility performance. The main method used to evaluate the usefulness of optical aids is the patient’s subjective report after extended wear. In order to evaluate optical aid effectiveness in the clinic, a new test based on the visual search paradigm was designed to assess the patient's visual awareness. This was named the assessment of visual awareness (AVA) test. The main aim of this study was to develop the AVA test, establish its sensitivity, validity and repeatability, and then use it to investigate the efficacy of optical aids in this group of people. The AVA test consists of 32 peripheral targets presented at four different locations: 1st annulus (at 5° from the central fixation), 2nd annulus (10°), 3rd annulus (20°) and 4th annulus (30°)). In this study, the peripheral targets were presented singly against a spatial noise background in a presentation area of 81° H × 62° V. Participants were allowed to use head and eye movements and were asked to search for and locate each target. The detection time (DT) was recorded. A new, sensitive and easy to set up indoor mobility course was also designed and validated prior to its use in validating the AVA test. A total of 50 normally sighted participants with simulated tunnel vision (TV) (5° to 20°, in 5° steps) and 20 patients with TV (retained field 4° to 21°) were tested. The AVA test was found to be responsive to the change in field of view (FoV) and to the target locations in both groups of participants. In the simulated group, a significant relationship was found between FoV and DT at each annulus (r ranging from -0.55 to -0.77, p < 0.0001). A significant relationship was found between target location and DT within each FoV size (20°, 15°, 10° and 5°) (r ranging from 0.53 to 0.84, p < 0.0001). In the TV patients, a statistically significant relationship was found between FoV and DT at each annulus (r range from -0.40 to -0.60, p < 0.05). The target location was shown to have a significant relationship with the DT within each FoV size (r ranging from 0.50 to 0.60, p < 0.05). Finally, the AVA test was found to be significantly related to the simulated TV participants' performance on the indoor mobility course. The AVA test was used to assess the efficacy of three optical aids: the partial aperture prism (10 patients), the Tri-field prism (10 patients) and the reverse telescope (4 patients). The AVA test showed no significant improvement in DT with either of the prisms and the participants did not find these aids helpful. DT with the reverse telescope improved, but none of the participants were willing to use these on extended trial. The AVA test gave clear indications of the efficacy of each aid, a result which could affirm the importance of the AVA test. In conclusion, the AVA test was found to be sensitive, valid and repeatable. DT did not improve in either of the optical aids which were found to be unsuccessful, suggesting that the AVA could be a promising clinical test. However the aids which showed improved DT were not evaluated over the longer term, and therefore did not allow full evaluation of the AVA test.

The goal of my study is to develop a mobile application to enable all visitors, including blind and low-vision visitors, to autonomously gather and share information about interpretations of art and to have a fully independent museum-going experience. With an application, blind visitors have more access to opportunities and tools in the museum, which empowers their museum experience. My study used a qualitative, mixed-methods approach to research how blind and low vision museum visitors might increase their independence in the museum space and discover ways to equalize their access without relying on museum educators. In carrying out my study, I conducted interviews and collected data based on observations and transcribed and analyzed them using a grounded theory approach. I used Freire's theory of pedagogy of the oppressed and hooks' theory of education as the practice of freedom to frame my study.

No description available.

Le présent travail s’inscrit dans une perspective descriptive analytique des comportements des pianistes aveugles et déficients visuels durant la mise en mémoire et la restitution au piano de diverses tâches présentées à l’oreille ou sur un support écrit adapté au handicap visuel de ceux-ci. Cette adaptation qui consiste à transcrire en braille pour les aveugles ou à imprimer en gros caractères pour les malvoyants des partitions ordinaires, se révèle lourde de conséquences. Ainsi, deux conditions font qu’un travail mental d’intégration et de synthèse très coûteux s’impose à ces musiciens : d’un côté la complexité du braille musical due à un degré d’abstraction très élevé et à une linéarité spatiale permanente, de l’autre la non-conformité de la technique d’agrandissement des textes ordinaires avec une lecture synthétique et avec un champ visuel très réduit. De telles circonstances invitent à s’interroger sur les effets de la structure de ces notations musicales et des représentations mentales qu’elles génèrent sur la conduite de mémorisation en l’absence totale ou partielle de la vision. L’objectif principal est de relever la spécificité des processus qui sous-tendent l’assimilation des données inscrites sur le matériau de la lecture. Pour ce faire, j’ai mené une étude de cas portant sur des jeunes pianistes aveugles et malvoyants non professionnels utilisant des procédures de déchiffrage diverses. / The present work involves an analytical description of the behaviors of blind and visually impaired pianists when memorizing and rendering on the piano various tasks presented to the ear or on written material adapted to their visual disability. This adaptation, which consists in transcribing ordinary music scores in braille, for the blind, or in large print, for the visually impaired, entails important consequences. Two conditions result in those musicians having to perform a very difficult integrating and synthesizing task: on the one hand, musical braille is complex, being highly abstract and characterized by permanent spatial linearity; on the other hand, the technique for enlarging ordinary texts is not compatible with synthetic reading and a very restricted visual field. Those circumstances lead us to investigate how those musical notations and the mental representations they generate affect the memorizing process when vision is totally or partially lacking. The main objective is to pinpoint the specific processes underlying the assimilation of the data inscribed on the reading material. To this end, I have carried out a case study involving young non-professional blind and visually impaired pianists using diverse reading procedures.

A partir da constatação do limitado investimento no design de produtos de auxílio à visão subnormal no Brasil e de sua crescente demanda, esta tese teve por objetivo analisar o estado da arte dos produtos existentes no mundo, particularmente dos que oferecem ampliação eletrônica da imagem, propor um projeto de equipamento inovador que agrega videomagnificação a uma prancha de leitura, e analisar alguns casos pioneiros de design para a saúde no Brasil, inclusive oftalmológico. Como método foram realizadas entrevistas, pesquisas bibliográficas, por internet e observação de pacientes para embasar a proposta de projeto de prancha de leitura acoplada a câmera de videomagnificação para deficientes visuais. A proposta resultante tem como base comum o produto prancha de leitura acoplada a lupa já disponível no mercado em que no lugar da lupa será colocada uma câmera de vídeomagnificação para leitura de perto. Nesta prancha de base o usuário poderá ler de modo estável comandando por sua mão o movimento do anel em volta da câmera que por sua vez excursionará horizontalmente num trilho para manter a linha e o foco de leitura constantes. Evidenciam-se os elementos indicadores de que o design inovador deste equipamento apresenta vantagens em relação aos equipamentos atualmente existentes e que poderão contribuir para facilitar a leitura dos portadores de baixa visão. Por meio do design com responsabilidade social, este trabalho pretende dar uma contribuição para a inclusão do deficiente visual no Brasil. / Low investment in design for low vision and growing demand for low vision products in Brazil were the reason for proposing the goals of this thesis: analysis of the state of the art of low vision products in the world, particularly those with video magnification; proposal of a product that aggregates video-magnification to a reading stand in an innovative product; analysis of representative cases of design for health in Brazil, including ophthalmic design. As method, interviews, bibliographic and internet search along with patient observation were performed in order to support the project of a reading stand with a sliding video-magnification camera for low vision people. The resulting project has as common platform the commercially available product: a reading stand with a sliding magnifier in which the magnifier is replaced by a near reading video-magnification camera. This reading stand allows the user to read on a steady basis as the hand moves the ring around the camera to the right or to the left on a rail, maintaining the reading line and focus constant. Indicative elements are shown that the innovative design of this equipment presents advantages which may contribute favorably for the reading of low vision people, comparing with the equipment currently in the market. Through the socially responsible design, this thesis is meant to contribute to social inclusion of low vision people in Brazil.

Um dos problemas para desenvolvimento de trabalhos multicêntricos é a falta de protocolos padronizados compatíveis às políticas de saúde, que sejam de fácil entendimento e inserção de dados confiáveis, mesmo por pesquisadores não envolvidos no desenvolvimento do projeto. Por outro lado, algumas políticas de saúde pública não estão sintonizadas às necessidades populacionais nem aos programas de especialização, necessitando, portanto, da criação de cursos de treinamentos objetivos que garantam qualidade de entendimento dos assuntos abordados pelos protocolos. O Brasil possui grande número de portadores de deficiência visual. A reabilitação para portadores de baixa visão é pouco conhecida e praticada pela classe oftalmológica. No país, existe falta de programas de capacitação em Baixa Visão durante a residência médica e não existe sistematização do uso de protocolo multicêntrico para coletar dados confiáveis que permitam o levantamento do perfil nacional da baixa visão. A padronização, registro e intercâmbio dos dados multicêntricos necessários para estudos podem ser obtidos pela utilização de um protocolo para formação de um banco de dados nacional com grande valor para o desenvolvimento de programas em saúde pública. Este estudo teve como objetivo desenvolver e estruturar um protocolo multicêntrico para trabalhos em Baixa Visão, baseado no protocolo adotado pela OMS, com lançamento dos dados via Internet, mantendo a qualidade da informação inserida na ficha de pesquisa. Material e Método: Adequação do protocolo da OMS para a necessidade brasileira, integrado na Web. Desenvolvimento do curso básico de baixa visão, utilizando recursos de teleducação interativa. O protocolo foi preenchido por dois grupos de residentes, mas apenas um deles (grupo B) teve acesso prévio ao curso disponível na Web. O preenchimento dos protocolos foi avaliado por quatro especialistas. Para cada item da ficha de pesquisa foi atribuída uma nota segundo o grau de concordância do preenchimento com o padrão-ouro. Resultado: Foi criado um protocolo simplificado e implementado na Web que pôde ser aplicado em pacientes adultos e crianças, sua utilização não interferiu na rotina do atendimento ambulatorial. O curso foi executado pelo grupo B entre 2 e 3 dias. O nível de melhoria da qualidade das informações inseridas foi medido pela análise comparativa do preenchimento entre os dois grupos. O grupo B apresentou superioridade no preenchimento da ficha de pesquisa. Discussão: A elaboração do protocolo multicêntrico pode ser o ponto inicial para integração e intercâmbio das informações. O lançamento dos dados via Internet possibilita a formação do banco de dados que pode ser incrementado por diversos centros. A construção do programa de teleducação via Internet para a formação objetiva em Baixa Visão é uma ferramenta para difusão dos conhecimentos básicos desta especialidade, garantindo a melhoria das informações inseridas na ficha de pesquisa. A análise dos dados pode favorecer o delineamento do perfil da deficiência visual e estabelecimento de estratégias nacionais de atenção primária. Conclusão: É viável a construção de um protocolo de pesquisa multicêntrica, com dados relevantes sobre deficiência visual, orientado pela necessidade de desenvolver estratégia de política de saúde compatível com o protocolo Internacional. A utilização da Internet para lançamento dos dados possibilitou a formação do banco de dados que pode ser incrementado por diferentes centros oftalmológicos, passando a ter abrangência nacional. A construção do curso de teleducação proporcionou aumento da qualidade da inserção de dados. / One of the problems in the development of multicentric projects is the lack of standardized protocols compatible with health policies, which are easy to understand and to use in recording reliable data even by researchers not involved in developing the project. On the other hand, some public health policies are not in tune wit h the needs of the population or with specialization programs, and require the creation of objective training courses that guarantee the quality of understanding of the topics covered by the protocols. Brazil has a great number of visual impaired individuals. Rehabilitation for Low Vision patients is not well known or widely practiced by ophthalmologists. Besides a lack of professional qualification training programs in Low Vision during medical residency, there is no systematization of use of the multicentric protocol to collect reliable data in order to map out a national profile of Low Vision. Standardization, register, and interchange of the multicentric data necessary for studies can be obtained by the use of a protocol to construct a national data base that would be vital for the development of Public Health programs. This study has the objective of developing and structuring a multicentric protocol for Low Vision projects, based on the protocol adopted by the World Health Organization -WHO, with data entered via the Internet, maintaining the quality of the information inserted on the research form. Material and Method: Adaptation of the Web-integrated WHO protocol to the needs of Brazil, and development of a basic course in Low Vision using interactive Tele-Education resources. The protocol form was completed by two groups of medical residents, but only one of them (Group B) had had prior access to the course available on the Web. The answers to the protocol questions were evaluated by four specialists. For each item on the research form, a grade was attributed according to the degree of agreement with the gold standard. Result: A simplified Web-implemented protocol was developed which could be applied to adult and child patients, and its application did not interfere in the out-patient routine of patient care. The course was taken by Group B for 2 to 3 days. The level of improvement in quality of the information entered was measured by a comparative analysis between the two groups. Group B showed superiority in terms of the answers given on the research form. Discussion: The preparation of a multicentric protocol may be the starting point for the integration and exchange of information. Data insertion via the Internet enables the construction of a data bank that can be incremented by several centers. The Internet-based Tele-Education program for objective professional qualification training in Low Vision is a tool for divulging basic knowledge in this specialty, guaranteeing an improvement in the information entered on the research forms. Analysis of the data may outline the profile of visual deficiency and enable the establishment of national primary care strategies. Conclusion: the construction of a multicentric research protocol with relevant data on visual deficiency is viable, guided by the need to develop a strategy of health care policies compatible with the international protocol. The use of the Internet for data insertion has made it possible to form a data base that can receive information from different ophthalmology centers, thus presenting a national scope. The preparation of the Tele-Education course led to an improvement in the quality of data inserted.

Les travaux de cette thèse sont menés dans le cadre d’un projet porté par le centre de recherche LGI2P, (IMT Mines Ales). L’objectif final de ce projet vise à permettre le retour à l’emploi et à améliorer le quotidien des personnes malvoyantes atteintes de rétinite pigmentaire et de glaucome. Le dispositif final est conçu pour aider les personnes dans leurs activités en mobilité : détection d’obstacles, recherche d’indices visuels, en adressant les problèmes liés à l’éblouissement et à l’héméralopie dont souffrent ces utilisateurs potentiels.La contribution de cette thèse au projet se situe sur plusieurs plans. Tout d’abord, il était demandé de définir les paramètres caractérisant la vision résiduelle de chaque utilisateur. En effet, chaque patient a ses propres conditions de confort lumineux, qui dépendent en particulier de l’état d’avancement de sa pathologie : à chaque étape de l’évolution de leur maladie, les patients ont des limites spécifiques de luminosité minimale en dessous de laquelle ils ne perçoivent plus les détails dans une scène, et aussi de la luminosité maximale au-dessus de laquelle ils ressentent gêne et douleur. La définition de ces limitations en luminosité va permettre de paramétrer le dispositif et l’adapter à chaque utilisateur. Mais il n’existe pas de méthode pour mesurer ces niveaux de luminance limite. Nous avons donc participé à la conception et au développement de tests dédiés, et à la réalisation d’essais sur des sujets déficients visuels, dans le cadre d’un essai clinique piloté par le CHU de Nîmes et l’ARAMAV (institut spécialisé dans la rééducation fonctionnelle basse vision), pour l’aspect médical. Nous avons également proposé un nouveau test pour mesurer la sensibilité au contraste chromatique, toujours dans le but de mieux adapter les images affichées à la vision des utilisateurs.Nous avons ensuite travaillé sur la mise au point d’un prototype du dispositif (caméras et visiocasque de réalité virtuelle). Pour cela, nous avons dû choisir les équipements de capture et d’affichage d’images. Un travail de calibration colorimétrique sur ces équipements nous permet de relier grandeurs numériques (code RGB) et grandeurs physiques (luminance et chrominance). Cette étape est nécessaire pour réaliser les tests précités dans des conditions physiquement connues. Elle nous permet également de définir les caractéristiques physiques que devront posséder les équipements qui seront choisis pour réaliser le produit final, s’ils sont différents de ceux utilisés pendant nos travaux.Enfin, nous avons abordé la question des traitements à appliquer au signal capturé par la caméra. Nous avons proposé des traitements en temps réel sur la luminosité dans le but d’augmenter la luminosité dans les zones sombres de l’image et de baisser la luminosité dans les zones qui éblouissent le patient. Nous avons montré les limitations de l’imagerie classique et la nécessité de travailler sur des images HDR (high dynamic range) Nous avons comparé plusieurs méthodes pour permettre l’affichage de ces images HDR sur les écrans de plus faible dynamique, en recherchant les caractéristiques de l’image que ces méthodes doivent préserver au mieux, et en prenant en compte les performances visuelles des utilisateurs potentiels. Nous avons aussi proposé des traitements sur la couleur en augmentant le contraste et la saturation pour rendre les images mieux perceptibles par les patients qui souffrent de troubles de vision des couleurs. / This thesis is part of a project conducted by the LGI2P research center (IMT Mines Ales). The project's final aim is to help people with vision disorders suffering from retinitis pigmentosa and glaucoma get back to work and improve their daily lives. The final device is designed to help people in their mobility activities: detecting obstacles, searching for visual signals, by addressing problems related to dazzling and haemeralopia affecting these potential users.The research of this thesis has several contributions to the project. First of all, parameters characterizing the residual vision of each user had to be defined. Indeed, each patient has his own light comfort conditions, which depend in particular on his pathology's progress: at each stage of the evolution of their disease, patients have specific minimum luminosity limits below which they no longer perceive the details in a scene, and also on the maximum luminosity above which they feel discomfort and pain. The definition of these limitations in luminosity will make it possible to parameterize the device and adapt it to each user. But there is no method to measure these limiting luminance levels. We have therefore participated in the design and development of specialized tests, and in the conduct of trials on visually impaired subjects, as part of a clinical trial led by the Nîmes University Hospital and the ARAMAV (institute specializing in low vision functional rehabilitation), for medical research. We have also proposed a new test to measure sensitivity to chromatic contrast, always with the aim of better adjusting the images displayed to users' vision.Then, we developed a prototype of the device (cameras and virtual reality video headset). In order to achieve these results, we had to choose the image capture and display equipment. A colorimetric calibration work on these equipments allowed us to link digital quantities (RGB code) and physical quantities (luminance and chrominance). This stage is required to perform the above tests under physically known conditions. It also allowed us to define the physical characteristics of the equipment that would be selected to produce the final product, whether they are different from those required during our work.Finally, we discussed the processing to be applied to the signal captured by the camera. We have proposed real-time brightness treatments to increase brightness in dark areas of the image and decrease brightness in areas that dazzle the patient. We have presented the limitations of conventional imaging and the necessity to work on HDR (high dynamic range) images. We have compared several methods to allow the display of these HDR images on screens with lower dynamic range, looking for the image characteristics that these methods should better preserve, and taking into consideration the visual performance of potential users. We have also suggested color treatments by increasing contrast and saturation to make images more perceptible to patients with color vision disorders.