Thesis (M.A.)--Boston University / Procedures to reshape the cornea to correct refractive errors have been a longstanding and fast-evolving area of interest for centuries. As recent advances in excimer laser technology allow keratorefractive treatments to deliver precise treatments with fewer associated risks and complications, the popularity of modern refractive procedures continues to grow at unprecedented rates. For this reason, it is imperative to continue correlating patient characteristics to outcomes so that refractive surgeons can more accurately foresee the results of the selected procedure. This study examined the outcomes of refractive surgeries at a full-scope ophthalmology clinic from January 2011 to November 2011. The main objectives of th is study were to determine the differences between the outcomes of LASIK vs. LASEK, Custom vs. Traditional treatment plans, myopic vs. hyperopic patients and MMC exposure vs. no MMC exposure (LASEK only). More importantly, the data was scrutinized to determine whether or not any of these treatments and/or patient characteristics correlated with poor visual outcomes or the need for an enhancement. Of the 590 myopic eyes treated with Custom LASIK, 90.85% (n=536 eyes) had UDVA of 20/20 or better, 96.10% (n=567 eyes) had UDVA of 20/25 or better and 99.32% (n=586 eyes) had UDVA of 20/40 or better. Of the 170 myopic eyes treated with Custom LASEK, 70.59% (n=120 eyes) had a UDVA of 20/20 or better, 82.94% (n=141 eyes) had a UDVA of 20/25 or better and 96.47% (n=164 eyes) had a UDVA of 20/40 or better. Of the 45 hyperopic eyes that were treated with Traditional LASIK, 44.44% (n=20 eyes) had postoperative UDVA of 20/20 or better, 62.22% (n=28 eyes) had postoperative UDVA of 20/25 or better and 82.22% (n=37 eyes) had postoperative UDVA of 20/40 or better. Of the 536 eyes receiving LASIK, 91.42% (n=490 eyes) had an UDVA of 20/20 or better, 96.46% (n=517 eyes) had an UDVA of 20/25 or better and 99.44% (n=533 eyes) had an UDVA of 20/40 or better. Of the 146 low or moderately myopic eyes receiving Custom LASEK, 74.65% (n=106 eyes) had an UDVA of 20/20 or better, 86.62% (n=123 eyes) had an UDVA of 20/25 or better and 96.48% (n=137 eyes) had an UDVA of 20/40 or better. Of the 54 highly myopic eyes treated with Custom LASIK, 85.19% (n=46 eyes) had an UDVA of 20/20 or better, 92.59% (n=50 eyes) had an UDVA of 20/25 or better, and 98.15% (n=53 eyes) had an UDVA of 20/40 or better. Of the 28 highly myopic eyes treated with Custom LASEK, 53.57% (n=15 eyes) had an UDVA of 20/20 or better, 64.29% (n=18 eyes) had an UDVA of 20/25 or better, and 96.43% (n=27 eyes) had an UDVA of 20/40 or better. An analysis of these data yields significantly greater percentages of myopic (low, moderate and high) eyes achieving 20/20 or better after treatment by Custom LASIK versus Custom LASEK. The data suggested no correlations between poor visual outcomes and/or the need for an enhancement treatment and intraoperative complications, magnitude of ametropia, pupil size, age, treatment type, and treatment plan. All of the LASEK patients who underwent an enhancement treatment were exposed to MMC during their original procedure. Hyperopic patients displayed significantly reduced visual outcomes than comparable myopic treatments. Future studies should investigate similar preoperative characteristics and attempt to correlate them to results to improve predictability and, thus, visual outcomes.

Various researchers highlight the role of neuro-motor and visual motor integration problems on learning-related barriers (Mutti et al., 1998; Goldstein & Britt, 1994; Kulp, 1999; Lotz et al., 2005; Van Roon et al., 2010). Visual motor integration and neuro-motor problems, that include perceptual, gross- and fine motor problems further relates to writing, reading, spelling and mathematical problems (Cheatum & Hammond, 2000). The visual system plays an important role in visual motor integration and researchers found ocular-motor control to correlate with learning-related problems and are therefore investigated (Vaughn et al., 2006). The aim of the study was twofold. The first aim was to determine the nature of neuro-motor problems that are present in 7- to 8-year old children with learning-related problems (writing, reading, spelling and mathematical problems). The second aim was to determine the nature of ocular-motor control and visual-motor integration that are present in 7- to 8-year old children with learning-related problems (writing, reading, spelling and mathematical problems). Sixty-eight learners (45 boys and 23 girls) with and without learning-related problems took part in the study. The group with learning-related problems (n=31) consisted of learners that received remedial intervention in Grade 1 and were in Grade 2 during the data collection. The control group (n=37) represented the study group for age and gender with a mean age of 7.5 years (SD=0.43) and had no learning-related problems. The Quick Neurological Screening Test II (QNST-II) and the Sensory Input Systems Screening Test (SISM) were used to determine the state of neuro-motor development and the visual and ocular-motor control status of learners. The Developmental Test of Visual-Motor Integration - 4th ed. (VMI-4) were used to evaluate the visual-motor integration of learners. The Statistica for Windows 2011 computer program was used to do the data processing (StatSoft, 2011). Differences between learners with and without learning-related problems were determined by an independent t-test. A multi-dimensional representation of learners with learning-related problems were established by means of a correspondence analysis of twoway variance tables with respect to reading, writing, spelling and mathematical problems. Results indicate that statistical as well as practical significant differences were found between learners with and without learning-related problems with respect to neuro-motor, visual-motor integration as well as ocular-motor problems. Neuro-motor problems were found between the two groups in visual, auditory, and tactile perception as well as different gross motor skills and were associated with reading, writing, spelling and mathematical problems. Regarding ocularmotor control and visual-motor integration, statistical- (p≤0,01) as well as practical (d≥0,8) significant differences were found between learners with and without learning related problems in visual-motor integration as well as 10 of the 11 sub-items of the SISM which include the following: fixation with both eyes, fixation with right eye, fixation with left eye, ocular alignment with right eye, ocular alignment with left eye, tracking with both eyes, tracking with right eye, tracking with left eye, vertical tracking and horizontal tracking. It can be concluded from the results that a significant correlation could be found between neuro-motor problems, that includes ocular-motor control as well as visual-motor integration and learning-related problems (reading, writing, spelling and mathematical problems). Neuromotor skills as well as visual-motor integration should therefore be incorporated in intervention of children with learning-related problems. / Thesis (MA (Kinderkinetics))--North-West University, Potchefstroom Campus, 2013.

Various researchers highlight the role of neuro-motor and visual motor integration problems on learning-related barriers (Mutti et al., 1998; Goldstein & Britt, 1994; Kulp, 1999; Lotz et al., 2005; Van Roon et al., 2010). Visual motor integration and neuro-motor problems, that include perceptual, gross- and fine motor problems further relates to writing, reading, spelling and mathematical problems (Cheatum & Hammond, 2000). The visual system plays an important role in visual motor integration and researchers found ocular-motor control to correlate with learning-related problems and are therefore investigated (Vaughn et al., 2006). The aim of the study was twofold. The first aim was to determine the nature of neuro-motor problems that are present in 7- to 8-year old children with learning-related problems (writing, reading, spelling and mathematical problems). The second aim was to determine the nature of ocular-motor control and visual-motor integration that are present in 7- to 8-year old children with learning-related problems (writing, reading, spelling and mathematical problems). Sixty-eight learners (45 boys and 23 girls) with and without learning-related problems took part in the study. The group with learning-related problems (n=31) consisted of learners that received remedial intervention in Grade 1 and were in Grade 2 during the data collection. The control group (n=37) represented the study group for age and gender with a mean age of 7.5 years (SD=0.43) and had no learning-related problems. The Quick Neurological Screening Test II (QNST-II) and the Sensory Input Systems Screening Test (SISM) were used to determine the state of neuro-motor development and the visual and ocular-motor control status of learners. The Developmental Test of Visual-Motor Integration - 4th ed. (VMI-4) were used to evaluate the visual-motor integration of learners. The Statistica for Windows 2011 computer program was used to do the data processing (StatSoft, 2011). Differences between learners with and without learning-related problems were determined by an independent t-test. A multi-dimensional representation of learners with learning-related problems were established by means of a correspondence analysis of twoway variance tables with respect to reading, writing, spelling and mathematical problems. Results indicate that statistical as well as practical significant differences were found between learners with and without learning-related problems with respect to neuro-motor, visual-motor integration as well as ocular-motor problems. Neuro-motor problems were found between the two groups in visual, auditory, and tactile perception as well as different gross motor skills and were associated with reading, writing, spelling and mathematical problems. Regarding ocularmotor control and visual-motor integration, statistical- (p≤0,01) as well as practical (d≥0,8) significant differences were found between learners with and without learning related problems in visual-motor integration as well as 10 of the 11 sub-items of the SISM which include the following: fixation with both eyes, fixation with right eye, fixation with left eye, ocular alignment with right eye, ocular alignment with left eye, tracking with both eyes, tracking with right eye, tracking with left eye, vertical tracking and horizontal tracking. It can be concluded from the results that a significant correlation could be found between neuro-motor problems, that includes ocular-motor control as well as visual-motor integration and learning-related problems (reading, writing, spelling and mathematical problems). Neuromotor skills as well as visual-motor integration should therefore be incorporated in intervention of children with learning-related problems. / Thesis (MA (Kinderkinetics))--North-West University, Potchefstroom Campus, 2013.