Visual search problems are often reported in children with Cerebral Visual Impairment (CVI). To tackle the clinical challenge of objectively differentiating CVI from other neurodevelopmental ...disorders, we developed a novel test battery. Visual search tasks were coupled with verbal and gaze-based measurements. Two search tasks were performed by children with CVI (n: 22; mean age (SD): 9.63 (.46) years) ADHD (n: 32; mean age (SD): 10.51 (.25) years), dyslexia (n: 28; mean age (SD): 10.29 (.20) years) and neurotypical development (n: 44; mean age (SD): 9.30 (.30) years). Children with CVI had more impaired search performance compared to all other groups, especially in crowded and unstructured displays and even when they had normal visual acuity. In-depth gaze-based analyses revealed that this group searched in overall larger areas and needed more time to recognize a target, particularly after their initial fixation on the target. Our gaze-based approach to visual search offers new insights into the distinct search patterns and behaviours of children with CVI. Their tendency to overlook targets whilst fixating on it, point towards higher-order visual function (HOVF) deficits. The novel method is feasible, valid, and promising for clinical differential-diagnostic evaluation between CVI, ADHD and dyslexia, and for informing individualized training.
•Impaired visual search performance was found in CVI, but not in ADHD or dyslexia.•Unstructured and crowded displays are detrimental for children with CVI.•Visual selective attention deficits seem to underlie impaired visual search in CVI.•Gaze-based parameters offer new insights in visual search strategies and patterns.•This valid approach is promising for non-verbal and non-motor assessments.
Though micronutrient deficiency is recognized to cause visual system dysfunction, avoidant/restrictive food intake disorder (ARFID) has been poorly described in relation to this. Review of 18 ...previously published similar cases highlights the importance of identifying other micronutrient deficiencies, even when vitamin A deficiency accounts for the presenting features. We present four patients with permanent visual loss as a result of highly restricted diets due to avoidant/restrictive food intake disorder (ARFID), and with autistic spectrum disorder (ASD). The four cases reported here make a total of 22 reported cases of visual impairment due to ARFID-like restricted diets in boys with ASD. The severity of ASD varied widely across the 22 cases, but all had extremely restricted diets, in some cases tolerating only one or two food items. The most avoided food groups in children with ASD and food selectivity have been reported from the USA as vegetables, fruit, dairy and protein, with the most preferred food items being bread, chicken, cereal and yoghurt. In the 22 cases reviewed or reported here, tolerated foods tended to be predominately carbohydrate based, with dry or crunchy textures and beige or pale colouring, i.e. French fries, potato waffles, potato chips (crisps), rice, white bread, bagels, biscuits or cookies. This case series and review highlights the need for heightened vigilance for visual problems in individuals with ASD-related ARFID and early and complete assessment of micronutrient deficiency.
The inconsistency in terminology for Cortical Visual Impairment or Cerebral Visual Impairment presents challenges: (1) different levels of changes in visual pathway and other cerebral areas do not ...allow discrimination; (2) different visual and oculomotor aspects are not adequately considered. We open a debate to consider a more appropriate diagnosis.
The symptoms that characterize children with cerebral visual impairments (CVI) are diverse, ranging from extensive behavioral or physical disabilities to subtle changes that can easily be missed. A ...correct diagnosis of CVI is therefore difficult to make, but having a wide variety of tests available can be helpful. This study aims to determine if the developmental eye movement test (DEM) can be one of those tests. In this test, a fixed set of numbers has to be read aloud, first in vertical columns and then in horizontal lines. In order to measure differences between children with CVI compared to normally sighted age-matched controls and children with a visual impairment (VI), we determined DEM times, crowding intensities and the reaction time to a large visual stimulus for all three groups. We found that children with CVI or VI need significantly more time to read the DEM numbers than age-matched controls. Additionally, children with CVI need more time than children with VI to read the horizontal DEM, but not the vertical DEM. We also found a significant difference between the children with CVI and the other two groups in the relationship between horizontal DEM performance and crowding intensity. However, for the relationship between DEM performance and visual detection time, no group-differences were found. We conclude that the DEM can be a useful addition in the diagnosis of CVI, especially in combination with information about crowding.
Summary Glaucoma is a heterogeneous group of diseases characterised by cupping of the optic nerve head and visual-field damage. It is the most frequent cause of irreversible blindness worldwide. ...Progression usually stops if the intraocular pressure is lowered by 30–50% from baseline. Its worldwide age-standardised prevalence in the population aged 40 years or older is about 3·5%. Chronic forms of glaucoma are painless and symptomatic visual-field defects occur late. Early detection by ophthalmological examination is mandatory. Risk factors for primary open-angle glaucoma—the most common form of glaucoma—include older age, elevated intraocular pressure, sub-Saharan African ethnic origin, positive family history, and high myopia. Older age, hyperopia, and east Asian ethnic origin are the main risk factors for primary angle-closure glaucoma. Glaucoma is diagnosed using ophthalmoscopy, tonometry, and perimetry. Treatment to lower intraocular pressure is based on topical drugs, laser therapy, and surgical intervention if other therapeutic modalities fail to prevent progression.
The purpose of this study was to measure alterations of inner retinal microvascular density and outer retinal sublayer thicknesses in pathological myopia, and to correlate the measured parameters ...with best corrected visual acuity (BCVA).
Optical coherence tomography (OCT) and OCT angiography (OCTA) images of 21 control, 48 simple high myopia, and 22 pathological myopia eyes were analyzed to quantify the thicknesses of the outer retinal sublayers and the density of the inner retinal microvascular network that includes the superficial retinal capillary plexus (SRCP) and deep retinal capillary plexus (DRCP). Retinal sublayer thicknesses and microvascular densities were compared among the three groups, and correlations of sublayer thicknesses and microvascular densities with BCVA were determined.
In pathological myopia, density of the DRCP, thicknesses of myoid and ellipsoid zone (MEZ), interdigitation zone and retinal pigment epithelium/Bruch complex (IZ + RPE), and choroid were lower than in simple high myopia (P < 0.05). The decreased DRCP density was correlated with thinner MEZ and IZ+RPE in pathological myopia (P < 0.05), but not in simple high myopia (P > 0.05). Simple linear regression showed that axial length, female, thicknesses of outer plexiform layer (OPL), MEZ, IZ + RPE, choroid, and density of the SRCP and DRCP were correlated with BCVA. In multiple regression analysis, worse BCVA was associated only with thinner MEZ, thinner choroid, and decreased DRCP (P < 0.05).
Alteration of inner retinal microvascular density and outer retinal sublayer thicknesses occurred in pathological myopia, especially decreased DRCP and thinner MEZ, which were significantly associated with worse BCVA.
Simulation of visual impairment in healthy eyes has multiple applications in students' training, research and product development. However, due to the absence of an existing standard protocol, the ...method of simulation was left to the discretion of the researcher. This review aimed to outline the various methods of simulating visual impairment and categorising them. A scoping review of the relevant publications was conducted. Of the 1593 articles originally retrieved from the databases, 103 were included in the review. The characteristics of the participants, the method for simulation of the visual impairment in persons with normal vision and the level or type of visual impairment that was simulated were extracted from the papers. None of the methods of simulation can be judged as being superior to the others. However, electronic displays produced the most consistent form of visual impairment simulation.
This paper reports on a study that helps visually impaired people to steer uncountable confidently. The study hypothesizes that a Wise Cane that alerts visually impaired people about obstacles before ...might facilitate them in walking with less accident. The white cane, because of its primitive vogue, is unable to produce the blind and visually impaired level of independence that is possible with stylish technology. The aim of the paper is to handle the event work of a cane, which is able to communicate with the users through sound alert, and vibration, that is mentioned as ‘Wise/Smart Cane’. The event work involves writing and physical installation. A series of test unit is distributed on the wise cane and the results are mentioned. This study found that the Wise Cane functions well as meaning, in alerting users about the obstacles before.
A 28 year old man had longstanding tearing, irritation, and marked photophobia in both eyes since childhood, and had experienced blurred vision in the past three months.
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