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Impairment of visual functions
Published in Ramar Sabapathi Vinayagam, Integrated Evaluation of Disability, 2019
The Snellen chart assesses the acuity of vision within 6 meters (20 feet). The evaluator assesses each eye separately with a pinhole occluder and current spectacles. The person reads the multi-letter, or “E,” or “C” Snellen chart with proper illumination. The line with the smallest letters that the person could read refers to a fraction, for example, 6/60 where numerator 6 denotes the test distance in meters at which the person could recognize the symbol and denominator 60 indicates the distance in meters at which the person with normal vision could recognize the symbol. The evaluator ascertains if the person could not read the largest letter on the Snellen chart at 6 m whether he/she could read at 5 m from the chart (5/60). If the person could not read the letters at 5 m, the evaluator assess whether he/she could read at 4 m (4/60), 3 m (3/60), 2 m (2/60). If the person could not read even at a 1-meter distance (1/60), the evaluator further ascertains whether he/she could count the fingers at less than one-meter distance, and, if it is not possible, whether he/she could recognize hand movement. Finally, the evaluator examines whether he/she could perceive the light splashed on his/her eye (6).
Population-based assessment of prevalence of spectacle use and effective spectacle coverage for distance vision in Andhra Pradesh, India – Akividu Visual Impairment Study
Published in Clinical and Experimental Optometry, 2022
Srinivas Marmamula, Saptak Banerjee, Vijay Kumar Yelagondula, Rohit C Khanna, Rajesh Challa, Ratnakar Yellapragada, Jill Keeffe
After the interview, clinical examination was carried out as described in our previous publications.4,12 In brief, distance visual acuity was measured using the standard Snellen chart with tumbling E optotypes at a distance of six metres outdoors in ambient lighting conditions. Near vision was also recorded using N-notation chart at a fixed distance of 40 cm. Unaided VA was recorded first for all the participants followed by aided VA among those who reported using spectacles. If unaided VA was worse than 6/12, then VA was re-assessed using a multiple pinhole occluder. Among non-spectacles users, unaided VA was considered as presenting VA whereas, aided VA was considered as presenting VA among current spectacle users. If presenting VA was worse than 6/12, the VA was recorded using a multiple pinhole occluder. External eye examination was performed using a torchlight. The lens status was assessed using distant direct ophthalmoscopy in semi-dark conditions as described in our previous publications.12,13 Fundus images were taken for all the participants in dim illumination inside the households using a non-mydriatic fundus camera (Visuscout 100 Handheld Fundus Camera, Carl Zeiss Meditec, Inc. USA).
Population Based Assessment of Prevalence and Causes of Vision Impairment in the North-eastern State of Tripura, India – The Tripura Eye Survey
Published in Ophthalmic Epidemiology, 2020
Srinivas Marmamula, Shashank Yellapragada, Rohit C Khanna
The eye examination protocols are reported in our previous publications.5,6 In short, distance visual acuity (VA) was assessed outdoors and in shade on bright and sunny days using a standard Snellen chart with tumbling E optotypes at a distance of 6 m. Due precautions were taken to avoid reflections and glare on the chart. If a subject was unable to identify letters on the first line of the chart, then the distance between the chart and the subject was reduced to 3 m and then to 1 m and VA assessment was attempted. Unaided VA was recorded on all subjects. Aided VA was recorded if subjects reported the use of spectacles. Among those that had no spectacles, unaided VA was considered as presenting VA and among those who had spectacles, aided VA was considered as presenting VA. If presenting VA was worse than 6/12, the VA was recorded using a multiple pinhole occluder. External eye examination was performed using torchlight and oblique flashlight test. The crystalline lens was assessed under semi-dark lighting condition using distant direct ophthalmoscopy and the lens were graded as Normal, Obvious lens opacity, Aphakia or Pseudophakia. If the lens could not be examined due to conditions such as corneal opacities, phthisis or absent globe, these were fully documented. Fundus was examined with a direct ophthalmoscope through undilated pupils.
Late-onset Etanercept-associated Ocular Sarcoidosis with Profound Vision Loss
Published in Ocular Immunology and Inflammation, 2022
Murtaza Saifee, Alok Bansal, Gregory J. Bever, Jay M. Stewart
At the patient’s last follow-up 8 months after initial presentation, the patient was off systemic prednisone and continued on subcutaneous methotrexate 20 mg weekly. Her visual acuity was 20/40 in the right eye and 20/25, with improvement using a pinhole occluder to 20/20, in the left eye, with tonometry at 21 mmHg in the right eye and 14 mmHg in the left eye. Her exam showed no evidence of anterior chamber inflammation or vitritis, with trace resolving optic disc edema in both eyes, and no serous retinal detachments (Figure 1). Macular optical coherence tomography showed a new epiretinal membrane with mild traction and mild intraretinal fluid in the right eye (felt to be unrelated to ocular inflammation), and no macular edema in the left eye (Figure 2).