PURPOSE: To compare the classification and severity of congenital color vision deficiency using a Nagel anomaloscope and Farnsworth Munsel 100-hue Test (FM 100-hue).METHODS: A total of 394 eyes of 197 patients diagnosed with congenital color vision deficiency were included. Examinations using a Nagel anomaloscope and FM 100-hue were performed, and color vision abnormalities were classified as a protan color defect or deutan color defect by each test, and the degrees of color vision abnormalities were compared.RESULTS: The tests showed 64.3% (p < 0.001) agreement in the classification of color vision deficiencies. The Nagel anomaloscope was able to classify all cases, whereas 143 eyes (36.3%) could not be classified using the FM 100-hue test. In the case of the same type of color vision abnormality in both eyes, 196 cases (99.5%) using the Nagel anomaloscope and 111 cases (56.3%) using the FM 100-hue were observed. Regarding the degree of color defect, there was a moderate positive correlation between the two tests (r = 0.43; p < 0.001). There were no significant differences in the total error scores between mild anomalous trichromacy and severe anomalous trichromacy as assessed using FM 100-hue (p = 0.087).CONCLUSIONS: The Nagel anomaloscope was a more appropriate test for discerning the degree of color defect and binocular classification. In severity assessments, there was a moderate positive correlation between the two test methods. However, there were no significant differences in the total error scores between mild anomalous trichromacy and severe anomalous trichromacy as assessed using FM 100-hue. Therefore, it was difficult to perform severity classification using the Nagel anomaloscope based on the total error score of the FM 100-hue test.
Classification ; Color Vision Defects ; Color Vision ; Humans ; Telescopes

PURPOSE: We sought factors affecting amblyopia recurrence after successful treatment.METHODS: We included 117 patients with amblyopia. Patients were divided into recurrence and non-recurrence groups. We analyzed sex, age, amblyopia type, treatment duration, visual acuity, and binocular status.RESULTS: Of the 117 patients, 25 (21.4%) experienced recurrences. In that group, 60.0% of patients (compared to 14.1% of the no-recurrence group) exhibited high-frequency strabismus (p < 0.001). The recurrence group were younger than the no-recurrence group at both the beginning and end of treatment (p < 0.05). None of visual acuity at treatment commencement or end, stereoacuity, or suppression affected amblyopia recurrence.CONCLUSIONS: Recurrent amblyopia is frequent after initial successful treatment if the patient exhibits strabismus or is young.
Amblyopia ; Humans ; Recurrence ; Risk Factors ; Strabismus ; Telescopes ; Visual Acuity

BACKGROUND: To objectively investigate accommodative response to various refractive stimuli in subjects with normal accommodation. METHODS: This prospective, non-randomized clinical trial included 64 eyes of 32 subjects with a mean spherical equivalent −1.4 diopters (D). We evaluated changes in accommodative power, pupil diameter, astigmatic value, and axis when visual stimuli were applied to binocular, monocular (dominant eye, non-dominant eye, ipsilateral, and contralateral), and pinhole conditions. Visual stimuli were given at 0.25 D (4 m), 2 D (50 cm), 3 D (33 cm), and 4 D (25 cm) and accommodative response was evaluated using open view binocular autorefractor/keratometer. RESULTS: The accommodative response to binocular stimulus was 90.9% of the actual refractive stimulus, while that of the monocular stimulus was 84.6%. The binocular stimulus induced a smaller pupil diameter than did the monocular stimulus. There was no difference in accommodative response between the dominant eye and non-dominant eye or between ipsilateral and contralateral stimuli. As the refractive stimuli became stronger, the absolute astigmatic value increased and the direction of the astigmatism axis became more horizontal. Pinhole glasses required 10%–15% less accommodative power compared with the monocular condition. CONCLUSION: Binocular stimuli enable more precise and effective accommodation than do monocular stimuli. Accommodative response is composed of 90% true accommodation and 10% pseudo-accommodation, and the refractive stimulus in one eye affects the contralateral eye to the same extent. This should be taken into account when developing guidelines for wearing smart glasses while driving, as visual stimulation is applied to only one eye, but far distance attention is constantly needed. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03557346
Astigmatism ; Eyeglasses ; Glass ; Non-Randomized Controlled Trials as Topic ; Photic Stimulation ; Prospective Studies ; Pupil ; Telescopes*

BACKGROUND: Diabetic patients are known to have unusually high mean intraocular pressure (IOP); attributable to autonomic dysfunction and genetic factors. A recent study reported that diabetic complications occur in not only diabetes but also prediabetes. We performed this study to analyze the relationship between glycated hemoglobin A1c (HbA1c) levels and IOP in non-diabetics using electronic medical records at the health screening center of Soon Chun Hyang University Seoul Hospital.METHODS: We considered 16,643 individuals who visited the health screening center of Soon Chun Hyang University Seoul Hospital between November 2015 and September 2017. In total, 3,029 subjects were included in the study. Exclusion criteria included a history of hypertension, diabetes, stroke, cardiovascular disease, hepatitis (A-C), cancer, other disease, fasting blood glucose of 126 mg/dL or higher, HbA1c of 6.5% or higher, and individuals whose binocular IOP could not be measured. We categorized subjects into two groups; those with HbA1c less than or equal to 5.6%, and those with HbA1c greater than 5.6% and less than 6.5%. The mean IOP of each group was compared by gender.RESULTS: After adjusting for factors affecting IOP, analysis of variance was performed to analyze the relationship between HbA1c and IOP. There was no statistically significant difference between the HbA1c groups in males. However, there was a significant difference in IOP between females in the the higher and lower HbA1c groups.CONCLUSION: There was a statistically significant relationship between mean IOP and HbA1c in females without diabetes. Further research is needed with prospective and extensive data collection.
Blood Glucose ; Data Collection ; Diabetes Complications ; Diabetes Mellitus ; Electronic Health Records ; Fasting ; Female ; Health Promotion ; Hemoglobin A, Glycosylated ; Hepatitis ; Humans ; Hypertension ; Intraocular Pressure ; Male ; Mass Screening ; Myocardial Infarction ; Prediabetic State ; Prospective Studies ; Seoul ; Telescopes

A 49-year-old male presented with horizontal binocular diplopia without facial pain or skin lesion. Limitation of medial gaze in the left eye was revealed on neurological examination, which is accompanied by peripheral facial nerve palsy ipsilaterally. The diagnosis had been made based on the diffusion restriction lesion of left pontine tegmentum. We may denominate a “seven-and-a-half syndrome” and clinician should maintain a high level of awareness of the various syndromes associated with pontine lesions.
Diagnosis ; Diffusion ; Diplopia ; Facial Nerve ; Facial Pain ; Facial Paralysis ; Humans ; Male ; Middle Aged ; Neurologic Examination ; Ocular Motility Disorders ; Paralysis ; Pontine Tegmentum ; Skin ; Telescopes

PURPOSE: We report two patients diagnosed with a sinus thrombosis with papillary edema. CASE SUMMARY: Case 1 was a 27-year-old male who presented with complaints of headache and vomiting for 2 months and blurred vision in both eyes. The best-corrected visual acuity (BCVA) was 1.0 in the right eye and 1.0 in the left eye. A visual field (VF) examination revealed a binocular peripheral VF defect and optical coherence tomography (OCT) and a fundus examination indicated optic disc swelling in both eyes. Brain magnetic resonance imaging (MRI) showed no specific finding but magnetic resonance venography revealed filling defect signs in the transverse sinus and a cerebrospinal fluid examination indicated elevated intracranial pressure (ICP). Case 2 was a 54-year-old female who came to our hospital with suspicion of bilateral optic disc swelling. The BCVA was 0.9 in the right eye and 1.0 in the left eye. A VF examination revealed an inferior-temporal VF defect and blind spot enlargement in the right eye. OCT and a fundus examination showed optic disc swelling in both eyes. Brain MRI showed no specific finding but magnetic resonance venography revealed a decrease in blood flow in the transverse sinus, sigmoid sinus. A cerebrospinal fluid examination indicated elevated ICP. CONCLUSIONS: In the case of optic disc swelling in both eyes, a secondary cause of ICP elevation and the possibility of optic disc swelling due to sinus thrombosis should be considered, and brain MRI and venography are needed to distinguish these possibilities.
Adult ; Brain ; Cerebrospinal Fluid ; Colon, Sigmoid ; Edema ; Female ; Headache ; Humans ; Intracranial Hypertension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Optic Disk ; Optic Nerve Diseases ; Papilledema ; Phlebography ; Sinus Thrombosis, Intracranial ; Telescopes ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields ; Vomiting

PURPOSE: To evaluate the interocular symmetry of microvascular parameters measured by optical coherence tomography angiography (OCTA) in normal eyes of Korean adults. METHODS: We retrospectively reviewed the retinal microvascular structure of 91 healthy Korean subjects (182 eyes). We used OCTA to measure the area of the foveal avascular zone (FAZ), vessel density (VD), and perfusion density (PD) in both eyes. Intraclass correlation coefficients (ICCs), coefficients of variation (CVs), and Pearson correlation coefficients were calculated to evaluate the extent of agreement and correlations between binocular OCTA measurements. RESULTS: Both eyes had similar microvascular characteristics: FAZ area (right eye: 0.31 ± 0.11 mm², left eye: 0.30 ± 0.10 mm², p = 0.98), FAZ perimeter (right eye: 2.35 ± 0.45 mm, left eye: 2.36 ± 0.39 mm, p = 0.86). VD 1-mm center (right eye: 9.42 ± 2.75, left eye: 9.14 ± 2.96, p = 0.163), full area (right eye: 19.94 ± 1.65, left eye: 19.72 ± 1.76, p = 0.285), and PD 1-mm center (right eye: 0.16 ± 0.05, left eye: 0.16 ± 0.05, p = 0.151), full area (right eye: 0.36 ± 0.03, left eye: 0.36 ± 0.04, p = 0.716). All ICC values were above 0.8 and all CVs below 10%. CONCLUSIONS: The microvascular structure, as represented by the VD, PD, and FAZ area measured via OCTA, was bilaterally symmetric in normal eyes of Korean adults.
Adult ; Angiography ; Humans ; Perfusion ; Retinaldehyde ; Retrospective Studies ; Telescopes ; Tomography, Optical Coherence

PURPOSE: To compare the postoperative clinical outcomes after cataract surgery with implantation of bifocal intraocular lenses (IOLs) and extended depth of focus (EDOF) IOLs. METHODS: A total of 60 patients were divided into three groups, and each group included 20 patients of 40 eyes: group A with a +3.25 D bifocal IOL in both eyes, group B with an EDOF IOL in both eyes, and group C with a +3.25 D bifocal in one eye and an EDOF IOL in the other eye. We retrospectively reviewed the patients' medical charts to analyze their binocular uncorrected visual acuities (UCVAs; distant, intermediate, and near) and refraction at postoperative 3 months. RESULTS: The binocular distant UCVAs were 0.04 ± 0.01, 0.05 ± 0.02, and 0.04 ± 0.01 in groups A, B, and C, respectively, and there were no differences between the groups (p > 0.05). The intermediate UCVAs were 0.16 ± 0.01, 0.10 ± 0.01, and 0.10 ± 0.01, respectively, and group A was the lowest (A–B, p = 0.031; A–C, p = 0.018; B–C, p = 1.000). The near UCVAs were 0.05 ± 0.01, 0.24 ± 0.01, and 0.13 ± 0.01, respectively, and there were significant differences between the groups (A–B, p < 0.001, A–C: p = 0.009; B–C, p = 0.003). CONCLUSIONS: There were no significant differences among the three groups in binocular distant UCVA, and groups B and C showed better intermediate UCVAs than group A. Near UCVA was ranked in the order of groups A, C, B.
Cataract ; Humans ; Lenses, Intraocular ; Retrospective Studies ; Telescopes ; Visual Acuity

BACKGROUND: To evaluate binocular summation ratio using contrast sensitivity (CS) testing and correlation between binocular summation and stereoacuity, and control scale in intermittent exotropia (IXT). METHODS: We conducted a prospective case-control study. Thirty-seven IXT and 41 controls were evaluated with both monocular and binocular CS testing. We compared the binocular summation ratio of IXT to that of controls. Near and distance stereoacuity was assessed and office-based control scale was evaluated. We investigated correlation between binocular CS summation ratio and stereoacuity, and control scale in IXT, respectively. RESULTS: IXT had lower binocular CS summation ratio than controls at 1.5 and 3.0 cycles/degree (1.01 ± 1.02 vs. 1.62 ± 1.88 and 1.17 ± 0.96 vs. 1.86 ± 1.75, Both P < 0.05). We found significant correlation between binocular CS summation ratio at 3.0 cycles/degree and both near and distance stereoacuity (r = −0.411, P = 0.012 and r = −0.624, P = 0.005), and ratio at 1.5 cycles/degree also correlated significantly with distance stereoacuity (r = −0.397, P = 0.034) in the IXT. Binocular CS summation ratio was correlated to control scale at 1.5 and 3.0 cycles/degree (r = −0.327, P = 0.041 and r = −0.418, P = 0.028), and the ratio significantly differed in control scale groupings analysis at the same frequencies (Both P < 0.05). CONCLUSION: Our findings of subnormal binocular CS summation ratio in IXT had correlation with stereoacuity and control scale suggest that binocular CS testing may be a useful method in assessing binocular visual function in IXT.
Case-Control Studies ; Contrast Sensitivity* ; Exotropia* ; Humans ; Methods ; Prospective Studies ; Telescopes*

BACKGROUND: We compared the efficacy between trifocal and bifocal diffractive intraocular lens (IOL) implantation. METHODS: Through PubMed, MEDLINE, EMBASE, and CENTRAL, we searched potentially relevant articles published from 1990 to 2018. Defocus curves, visual acuities (VAs) were measured as primary outcomes. Spectacle dependence, postoperative refraction, contrast sensitivity (CS), glare, and higher-order aberrations (HOAs) were measured as secondary outcomes. Effects were pooled using random-effects method. RESULTS: We included 11 clinical trials, with a total of 787 eyes (395 subjects). The trifocal IOL group showed better binocular distance VA corrected with defocus levels of −0.5, −1.0, −1.5, and −2.5 diopter than the bifocal IOL group (All P ≤ 0.004). The trifocal IOL group showed better monocular uncorrected distance and intermediate VAs (mean difference [MD], −0.04 logarithm of the minimum angle of resolution [logMAR]; 95% confidence interval [CI], −0.07, −0.01; P = 0.006 and MD, −0.07 logMAR; 95% CI, −0.13, −0.01; P = 0.03, respectively). Postoperative refraction, glare, CS, and HOAs were not significantly different from each other. CONCLUSION: The overall findings indicate that trifocal diffractive IOL implantation is better than the bifocal diffractive IOL in intermediate VA, and provides similar or better in distance and near VAs without any major deterioration in the visual quality.
Cataract* ; Contrast Sensitivity ; Glare ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Methods ; Telescopes ; Visual Acuity