PURPOSE: We intended to analyze the characteristics of a pediatric low vision population. METHODS: Among 430 patients who visited our low vision clinic from May 1995 to April 2000, 137 patients(31.9%) aged 15 years or less were reviewed to study epidemiologic characteristics, prescribed aids and required magnification. RESULTS: The percentage of pediatric low vision patients was higher than that of developed countries. Male predominance was found. Optic atrophy(41.6%), congenital cataract(12.4%), macular degeneration and dystrophy(9.5%) were the major causes of low vision in this population. The most commonly prescribed low vision aid was a telescope. For near task, light-gathering magnifiers were prescribed most commonly. The visual acuity was improved significantly at near and far distance after correction with low vision aid. The mean required magnification was 3.5 xand this means that a low magnification was sufficient in the majority of cases. CONCLUSIONS: Early rehabilitation and long-range planning for the low vision child are required because of profound effect of childhood visual impairment.
Child ; Developed Countries ; Humans ; Macular Degeneration ; Male ; Optic Atrophy ; Rehabilitation ; Telescopes ; Vision Disorders ; Vision, Low* ; Visual Acuity

The number of low vision patients and the demand for low vision rehabilitation are increasing as the life expectancy and visual impairment due to largely untreatable ocular conditions are.It is therefore, imperative to recognize the importance of low vision aids, which have recently been developed actively.To evaluate the efficacy of low vision aids for low vision rehabilitation, we reviewed the clinical records of 350 patients who had visited our low vision clinic more than twice and had been prescribed with low vision aids. According to the data analysed, optic nerve atrophy, macular degeneration and retinitis pigmentosa were the leading causes of visual impairment in those patients.The purposes to visit our low vision clinic were to read books, read letters on the black board, identify a person at a distance, etc.Hand-held magnifiers, aspheric doublet lens and telemicroscope with plus cap were commonly used for near vision, while Keplerian and Galilean telescope were popular aids for distant vision.Visual acuity after prescription was improved when it was compared with that before prescription.Majority of the patients benefited from attending low vision clinic.These results suggest that the optical low vision aids were required to rehabilitate the visually impaired patients.
Atrophy ; Humans ; Life Expectancy ; Macular Degeneration ; Optic Nerve ; Prescriptions ; Rehabilitation ; Retinitis Pigmentosa ; Telescopes ; Vision Disorders ; Vision, Low*

BACKGROUNDPrimary open angle glaucoma (POAG) is a common cause of irreversible blindness. The variable etiology of POAG poses significant challenges for treatment and rehabilitation. We analyzed a large POAG patient cohort during treatment to reveal possible causes of vision disorder, assess vision-related quality of life (VRQL), and to evaluate the efficacy of rehabilitative treatments.

METHODSWe analyzed the visional disturbances in 500 POAG patients (890 eyes) by regular ophthalmic examination and visual field examination using Humphrey 30° perimetry. Appropriate rehabilitative treatments for POAG were prescribed based on results of clinical examination and included correction of ametropia, health education, counseling, and the fitting of typoscopes. VRQL was assessed before and after treatment by a VRQL self-assessment questionnaire.

RESULTSScores on the VRQL self-assessment were significantly lower compared to healthy controls. The primary cause of the vision disturbances was ametropia (97.99%), and 51.61% of the ametropia eyes had not received appropriate correction. The secondary causes of visual impairment were glaucomatous neurodegeneration (26.29%), complicated cataract, or other accompanying eye diseases. The causes of the clinical low vision (44 patients) were glaucomatous neurodegeneration (32 eyes), fundus diseases (23 eyes), keratopathy (11 eyes), and other eye diseases (10 eyes). The VRQL scores of patients improved significantly after rehabilitation and the correction of ametropia (P < 0.01). Twenty-five patients with low vision were provided with typoscopes, and 21 (84%) experienced significant functional recovery, while the remaining low vision patients could see letter lines two or more levels lower (smaller) on visual charts in a near vision test.

CONCLUSIONSVision disorders in POAG patients are common and severe. Appropriate rehabilitation, especially the correction of ametropia, can significantly improve VRQL as revealed by the self-assessment of POAG patients.

Adult ; Aged ; Female ; Glaucoma, Open-Angle ; complications ; rehabilitation ; Humans ; Male ; Middle Aged ; Quality of Life ; Surveys and Questionnaires ; Vision Disorders ; etiology ; rehabilitation

INTRODUCTIONUsing artificial means to treat extreme vision impairment has come closer to reality during the past few decades. The goal of this research has been to create an implantable medical device that provides useful vision for those patients who are left with no alternatives. Analogous to the cochlear implants for some forms of hearing loss, these devices could restore useful vision by converting visual information into patterns of electrical stimulation that excite the remaining viable inner retinal neurons in patients with retinitis pigmentosa or age-related macular degeneration.

METHODSData for this review were selected through a comprehensive literature search.

RESULTSAdvances in microtechnology have facilitated the development of a variety of prostheses that can be implanted in the visual cortex, around the optic nerve, or in the eye. Some of these approaches have shown the promise of providing useful visual input to patients with visual impairments.

CONCLUSIONWhile the development of various retinal prostheses have shown promise in limited clinical trials, there are distinct advantages and disadvantages for each type of prosthesis. This review will focus primarily on the Epiretinal Intraocular Retinal Prosthesis, studied by our group, but will also briefly review other modalities: the subretinal prosthesis, cortical prosthesis, and optic nerve prosthesis.

Electric Stimulation Therapy ; Electrodes, Implanted ; Humans ; Macular Degeneration ; complications ; Prosthesis Implantation ; Retinitis Pigmentosa ; complications ; Vision Disorders ; etiology ; rehabilitation

OBJECTIVE: To investigate the neurodevelopmental outcomes in children with developmental disorder according to visual evoked potential (VEP) results. METHODS: We retrospectively analyzed children who visited our Department of Pediatric Rehabilitation Medicine with a chief complaint of developmental disability from January 2001 to July 2015. Of the 549 medical records reviewed, 322 children younger than 42 months who underwent both Bayley Scales of Infant and Toddler Development second edition (BSID-II) and VEP studies were enrolled. We compared the development of 182 children with normal VEP latency and 140 children with delayed VEP latency results using the BSID-II results. The Mann-Whitney U-test was used to analyze the differences between the two groups. RESULTS: There were no significant differences in baseline characteristics between the two groups. The delayed VEP latency group showed a significant delay in BSID-II index scores and developmental quotients compared with the normal VEP latency group. In addition, a comparative analysis of developmental quotients of mental and psychomotor domains according to age (younger than 12 months, 12–23 months, and 24–42 months) revealed significantly lower values in children with delayed VEP latency compared to children with normal VEP latency, younger than 12 months and from 12 to 23 months. CONCLUSION: Children with delayed VEP latency showed more developmental delay than children with normal VEP latency. It is suggested that VEP can be easily applied to children with suspected developmental delay when physicians have concerns about visual impairment. Furthermore, it is proposed that VEP results could provide an insight into children's development and serve as early indicators for consultation with an ophthalmologist for the existing problem.
Child* ; Developmental Disabilities ; Evoked Potentials, Visual* ; Humans ; Infant ; Medical Records ; Rehabilitation ; Retrospective Studies ; Vision Disorders ; Weights and Measures

PURPOSE: Patients with brain damage suffer from limitations in performing the activities of daily living (ADL) because of their motor function and visual perception impairment. The aim of this study was to help improve the motor function and visual perception ability of patients with brain damage by providing them with virtual reality-based contents. The usability results of the patients and specialists group were also evaluated. METHODS: The ADL contents consisted of living room, kitchen, veranda, and convenience store, similar to a real home environment, and these were organized by a rehabilitation specialist (e.g., neurologist, physiotherapist, and occupational therapist). The contents consisted of tasks, such as turning on the living room lights, organizing the drawers, organizing the kitchen, watering the plants on the veranda, and buying products at convenience stores. To evaluate the usability of the virtual reality-based visual cognitive rehabilitation service, general elderly subjects (n=11), stroke patients (n=7), stroke patients with visual impairment (n=4), and rehabilitation specialists (n=11) were selected. The questionnaires were distributed to the subjects who were using the service, and the subjective satisfaction of individual users was obtained as data. The data were analyzed using SPSS 21.0 software. The general characteristics of the users and the evaluation scores of the experts were analyzed using descriptive statistics. RESULTS: The usability test result of this study showed that the mean value of the questionnaire related to content understanding and difficulty was high, between 4–5 points. CONCLUSION: The virtual reality rehabilitation service of this study is an efficient service that can improve the function, interest, and motivation of stroke patients.
Activities of Daily Living ; Aged ; Brain ; Cognitive Therapy ; Humans ; Motivation ; Physical Therapists ; Rehabilitation ; Specialization ; Stroke ; Vision Disorders ; Visual Perception ; Water

PURPOSE: To investigate the general clinical features of congenital cataracts and to determine their relationship to visual prognosis and surgical complications according to age at operation and surgical procedure adopted. METHOD: We retrospectively evaluated 92 eyes in 61 patients with congenital cataracts who underwent cataract surgery between January 1996 and December 2006. The demographic data, surgical technique, post-operative complications, and final visual prognosis were evaluated. RESULTS: The average age at surgery was 3.17 years (range 1 month to 11 years), and the mean follow-up was 40.02 months (range 6 to 46 months). Of the 56 eyes that could be checked for visual acuity after cataract extraction, 29 (51.7%) had a BCVA of > or =0.5 at last visit. Unilateral congenital cataracts (p=0.025) and congenital cataracts with strabismus (p=0.019) showed significantly poorer visual outcomes. Patients with nystagmus also experienced a poor visual outcome; 6 patients (67%) had a BCVA of <0.1. Posterior cataracts had the worst visual prognosis (p=0.004). No statistically significant differences in posterior capsular opacity (p=0.901) or synechia formation (p=0.449) were observed between surgical techniques, but children younger than one year showed a higher tendency for PCO and synechia formation. CONCLUSIONS: Anterior vitrectomy did not reduce postoperative complications. Higher rates of complications (PCO, posterior synechia) developed in children younger than one year of age.
Capsulorhexis/methods ; Cataract/classification/*congenital ; Cataract Extraction/*methods ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; *Lens Implantation, Intraocular ; Male ; Nystagmus, Pathologic/complications ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Strabismus/complications ; Vision Disorders/rehabilitation ; Visual Acuity/physiology ; Vitrectomy

Cortical visual prosthesis, optic nerve visual prosthesis and vision substitution devices are alternative ways for repairing the visual impairment in case of optic nerve injury, retina lose or blindness without fully developed central visual system. This article is a state-of-art review of the principles, technical details and the limitations of different types of prostheses beyond the retinal prosthesis.
Animals ; Artificial Intelligence ; Electric Stimulation Therapy ; instrumentation ; methods ; Humans ; Optic Nerve ; physiopathology ; Prosthesis Design ; Prosthesis Implantation ; methods ; trends ; Retinal Ganglion Cells ; physiology ; Vision Disorders ; rehabilitation ; Visual Cortex ; physiopathology ; Visual Pathways ; physiopathology

BACKGROUND: Comprehensive geriatric assessment is identified as a dynamic process responsive to the changes on health status that occurs over time in the context of extremely increasing trend in the numbers of the elderly people, their office visit, and the medical cost universally. We completed the comprehensive geriatric assessment and applied it to the Korean elderly through the multi-center trials. METHODS: We performed studies variables using questionnaires, with interviewing, physical examination to the number of total 312 elderly people who visited the department of family medicine or physical medicine and rehabilitation of the 11 university hospital or general hospital in Korea from July 1, 1999 through October 31, 1999. We, the geriatrician, met and discussed 3 times to complete the comprehensive geriatric assessment through the consensus panel. RESULTS: We found the sex ratio of 312 subjects was 1 to 2 (104 males and 208 females) and the average age was 73.2 years old. The orders of more frequency of self-reported health status of the respondents were hypertension, arthritis, cataract, gastrointestinal disturbance, diabetes mellitus, urinary/fecal incontinence, depression, cerebrovascular accident, anemia, and heart disease. Nearly 15% of those showed depression, 41.6% of those were in the status of socially isolation. We found 43.1% of those showed hypertension, 3.7% isolated systolic hypertension, and 20.2% orthostatic hypotension. Of those, cognitive impairment were measured in 37.1%, gait disturbance 13.0%, and the risk of malnutrition 39.6%. Geriatrician spent 21.1 minutes per person during the process of comprehensive geriatric assessment. CONCLUSION: We realized we could diagnose and intervene effectively certain hidden conditions/diseases, particularly urinary incontinence, falls, visual impairment, hearing impairment, pain, depression, social isolation, cognitive impairment, and orthostatic hypotension, with using the comprehensive geriatric assessment. These results reflected the fact that the comprehensive geriatric assessment might be necessary for the care of the elderly.
Aged* ; Anemia ; Arthritis ; Cataract ; Consensus ; Surveys and Questionnaires ; Depression ; Diabetes Mellitus ; Gait ; Geriatric Assessment* ; Hearing Loss ; Heart Diseases ; Hospitals, General ; Humans ; Hypertension ; Hypotension, Orthostatic ; Korea ; Male ; Malnutrition ; Office Visits ; Physical and Rehabilitation Medicine ; Physical Examination ; Sex Ratio ; Social Isolation ; Stroke ; Urinary Incontinence ; Vision Disorders