Thesis (M.S.)--New England College of Optometry, 2009. / Includes bibliographical references (p. 79-84).

Photorefraction is a technique that has been used in the past two decades for pediatric vision screening. The technique uses a digital or photographic camera to capture the examinee‟s retinal reflex from a light source that is located near the camera‟s lens. It has the advantages of being objective, binocular and low cost, which make it a good candidate for pediatric screening when compared to other methods. Although many children have been screened using this technique in the U.S., its sensitivity and other disadvantages make it unacceptable for continued use. The Adaptive Photorefraction system (APS) was developed at the Center for Laser Applications (CLA) at the University of Tennessee Space Institute (UTSI) to correct the problems in the existing PS devices. APS was designed to determine quantitatively binocular refractive errors and strabismus and to accomplish these tasks objectively, without the need of medical professionals, and it is capable of performing these objectives and reporting the digitally recorded results within one- to-two minutes. In this dissertation, two APS prototypes were constructed, and measurements were performed using both an artificial eye and human subjects. Binocular measurements of refractive error were determined, and the effects of the variation of pupil-size and gaze angle were determined. After initial corrections for ocular scattering effects, measurement of the binocular refractive error of forty human subjects was achieved, and in the myopic region with uncertainty of the method was 0.6 diopter. Ocular alignment determinations were achieved, and using a novel cover-uncover test, strabismus detection was demonstrated.

Vision impairment is recognized as a global public health problem. Children are the most susceptible population to many of the vision diseases. Knowledge of the causes and prevalence of common types of visual impairments is important for planning of preventive health care services to ensure that the children receive proper eye care in a timely manner. The purpose of this thesis is to describe the prevalence of visual impairment and to identify associated risk factors among the prekindergarten children in Georgia. During August 2005 to May 2006, there were 30,115 prekindergarten children enrolled in the Prevent Blindness Georgia Children Vision Screening Program, and a total of 25,543 (84.8%) children received vision screening. A total of 1,345 (5.27%) children had visual impairments and were referred to take an eye exam. Over 80% of the children who were referred and received eye exams were found to have vision problems. Timely screening is one of the effective ways for early detection of vision problems among these children. This study showed there were significant differences in the screening rate between the children with high socioeconomic status and those with low socioeconomic status. Educational and promotion programs should focus on improving the knowledge of vision diseases and use of available preventive service, particularly by the community of low socioeconomic status.

No description available.

No description available.

Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 4 uppsatser.

INTRODUCTION: Children in inpatient settings are in an unfamiliar environment that does not facilitate engagement in typical occupations. Children report multiple concerns with the hospital environment and experience including physical pain, loss of independence, loss of meaningful activities, lack of routine, and loss of control. Occupational therapists play a distinct role in improving the hospitalization experience for children by addressing these concerns. By improving the evaluation and treatment of visual deficits for children in inpatients settings, occupational therapists can increase children’s function and independence in meaningful activities and maximize psychological well-being. THEORETICAL PERSPECTIVE AND EVIDENCE: Self-determination theory posits that humans have three innate psychological needs – competence, autonomy, and relatedness. These needs are not being met for children in inpatient settings as shown by multiple qualitative studies, however occupational therapy can aid in meeting these needs through proper intervention. DESCRIPTION OF PROJECT: Resources were developed to improve the evaluation and treatment of visual deficits in children in inpatient settings including a vision screening tool, treatment protocol, referral protocol, and functional implications of visual deficits chart. METHODS: The vision screening tool and protocols were used on a small sample of patients (n=6) to identify and treat visual deficits. A survey was provided to occupational therapists to determine feasibility, usefulness, and effectiveness of the resources. CONCLUSION: The resources are useful and feasible for evaluating and treating visual deficits in children in the inpatient setting.

Yes / Purpose: To determine presenting visual acuity levels and explore the factors associated with failing vision screening in a multi-ethnic population of UK children aged 4–5 years. Methods: Visual acuity (VA) using the logMAR Crowded Test was measured in 16,541 children in a population-based vision screening programme. Referral for cycloplegic examination was based on national recommendations (>0.20logMAR in one or both eyes). Presenting visual impairment (PVI) was defined as VA >0.3logMAR in the better eye. Multivariable logistic regression was used to assess the association of ethnicity, maternal, and early-life factors with failing vision screening and PVI in participants of the Born in Bradford birth cohort. Results: In total, 2467/16,541 (15%) failed vision screening, 732 (4.4%) had PVI. Children of Pakistani (OR: 2.49; 95% CI: 1.74–3.60) and other ethnicities (OR: 2.00; 95% CI: 1.28–3.12) showed increased odds of PVI compared to white children. Children born to older mothers (OR: 1.63; 95% CI: 1.19–2.24) and of low birth weight (OR: 1.52; 95% CI: 1.00–2.34) also showed increased odds. Follow-up results were available for 1068 (43.3%) children, 993 (93%) were true positives; 932 (94%) of these had significant refractive error. Astigmatism (>1DC) (44%) was more common in children of Pakistani ethnicity and hypermetropia (>3.0DS) (27%) in white children (Fisher’s exact, p < 0.001). Conclusions: A high prevalence of PVI is reported. Failing vision screening and PVI were highly associated with ethnicity. The positive predictive value of the vision screening programme was good, with only 7% of children followed up confirmed as false positives. / National Institute for Health Research Post-Doctoral Fellowship Award (PDF-2013-06-050); The Born in Bradford study presents independent research commissioned by the National Institute for Health Research Collaboration for Applied Health Research and Care (NIHR CLAHRC) and the Programme Grants for Applied Research funding scheme (RP-PG-0407-10044).

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A falta de conhecimento por parte das mÃes acerca da saÃde ocular dos seus filhos à um denominador comum encontrado quando sÃo abordadas sobre essa temÃtica, principalmente relacionado à estimulaÃÃo visual, componente de valor significativo na saÃde ocular dos recÃm-nascidos. Nesse intuito, objetivamos aplicar um manual com Ãnfase na estimulaÃÃo visual para mÃes de crianÃas com risco para alteraÃÃes visuais e validar material e mÃtodo para educaÃÃo e saÃde aplicado à estimulaÃÃo visual de crianÃas prematuras e/ou com riscos para alteraÃÃes visuais. A coleta de dados foi realizada de abril a junho de 2005 em trÃs momentos metodolÃgicos. No primeiro momento, o manual foi avaliado por trÃs especialistas; no segundo, foi reformulado a partir das suas sugestÃes; e no terceiro, o manual foi aplicado com as mÃes internadas na enfermaria mÃe-canguru, sendo realizadas entrevistas gravadas, as quais abordaram itens de avaliaÃÃo apÃs a leitura do manual. Os dados foram organizados segundo Bardin (1977) e analisados conforme Nietshe (2000). As sugestÃes, de acordo com indicaÃÃo dos especialistas, contemplaram a contracapa, com a identificaÃÃo completa das autoras; acrÃscimo de um item sobre a histÃria obstÃtrica e outro sobre sinais e sintomas de alteraÃÃes visuais; modificaÃÃo de um desenho sobreposto ao texto que dificultava a leitura; Ãnfase ao tÃpico sobre a participaÃÃo dos pais na promoÃÃo à saÃde ocular dos seus filhos; atualizaÃÃo da literatura; e ampliaÃÃo do material criado para todas as crianÃas com riscos para alteraÃÃes visuais, nÃo apenas para os prematuros. Em seguida foi promovido o segundo momento, com a inserÃÃo do conteÃdo sugerido pelos especialistas. ApÃs a anÃlise temÃtica das 12 entrevistas, identificamos quatro temas, a saber: PercepÃÃo do manual, Conhecimento das mÃes acerca da saÃde ocular, Estrutura do manual e PromoÃÃo à saÃde ocular. ConcluÃmos que o manual facilitou a aprendizagem sobre a estimulaÃÃo visual, como tambÃm facilitarà a identificaÃÃo de alteraÃÃes visuais durante a convivÃncia familiar, alÃm de proporcionar incentivo à continuidade da estimulaÃÃo no domicÃlio como fator indispensÃvel para o desenvolvimento da crianÃa, seja ela prematura ou nÃo. Ao mencionar os componentes contemplados pela tecnologia emancipatÃria, como o exercÃcio da consciÃncia crÃtica, a cidadania, a liberdade e a autonomia, afirmamos que cada um deles esteve presente na aplicaÃÃo do manual, inserindo-o na prÃtica junto Ãs mÃes como tecnologia emancipatÃria. / The lack of knowledge on the part of mothers about their childrenâs ocular health is a common denominator found when they are asked about this theme, mainly concerning the visual stimulation, which is a component of significant value to the newborn babiesâ ocular health. Thus, one aimed to apply a handbook highlighting the visual stimulation for mothers of children with risk to visual alterations and to validate material and method for education and health applied to visual stimulation of premature children and/or with risks to visual alterations. Data collection was carried out from April to June, 2005 in three methodological moments. On the first moment, the handbook was analyzed by three experts, on the second one, the handbook was reformulated starting from the suggestions and on the third moment the handbook was applied to the mothers admitted to the kangaroo-mother ward, with record of interviews where the items of evaluation were approached after the reading of the handbook. The data were described according to Bardin (1977) and Nietsche(2000). Referring to the first moment, one suggested changes in the handbookâs back page, with the complete identification of the authors, addition of an item about the obstetric history and another about signs and symptoms of visual alterations; change of a drawing that was over the text making it difficult to read; emphasis on the topic about the participation of parents on the promotion of ocular health to their children; update on the literature; and enlargement of the material created for all the children with risks to visual alterations, not only the premature ones. Next, one carried out the second methodological moment, with the corrections suggested by the experts, being all obeyed. After the thematic analysis of the 12 interviews, one identified four themes: Perception of the handbook, Knowledge of mothers about ocular health, Handbookâs structure and Promotion of the ocular health. We concluded that the handbook facilitated the learning about visual stimulation, as well as it will make that the visual deficit, in case it appears, is noticed as precocious as possible, in the family life. Besides encouraging the stimulation at home as an indispensable factor to the development of the child, be it premature or not. By mentioning the components contemplated by the emancipatory technology, to know: the exercise of critical conscience, citizenship, freedom and autonomy; we affirm that each one of them was present at the application of the handbook about visual stimulation, what makes the handbook, as well as the practice together with the mothers as emancipatory technology.

To determine the test-retest reliability of the Randot stereoacuity test when used as part of vision screening in schools. METHODS: Randot stereoacuity (graded-circles) and logMAR visual acuity measures were gathered in an unselected sample of 139 children (aged 4-12, mean 8.1+/-2.1 years) in two schools. Randot testing was repeated on two occasions (average interval between successive tests 8 days, range: 1-21 days). Three Randot scores were obtained in 97.8% of children. RESULTS: Randot stereoacuity improved by an average of one plate (ie, one test level) on repeat testing but was little changed when tested on the third occasion. Within-subject variability was up to three test levels on repeat testing. When stereoacuity was categorised as 'fine', 'intermediate' or 'coarse', the greatest variability was found among younger children who exhibited 'intermediate' or 'coarse'/nil stereopsis on initial testing. Whereas 90.8% of children with 'fine' stereopsis (</=50 arc-seconds) on the first test exhibited 'fine' stereopsis on both subsequent tests, only approximately 16% of children with 'intermediate' (>50 but </=140 arc-seconds) or 'coarse'/nil (>/=200 arc-seconds) stereoacuity on initial testing exhibited stable test results on repeat testing. CONCLUSIONS: Children exhibiting abnormal stereoacuity on initial testing are very likely to exhibit a normal result when retested. The value of a single, abnormal Randot graded-circles stereoacuity measure from school screening is therefore questionable.