BACKGROUND: Cortical visual impairment (CVI) is a verifiable visual dysfunction that cannot be attributed to disorders of the anterior visual pathways or any potentially co-occurring ocular impairment. Given the limited knowledge on the most effective interventions for visual impairment resulting from CVI, this case report provides valuable insights into an example of successful implementation of anti-amblyopia therapy in a patient with CVI.
METHODS: This case report presents a 5-year-old girl with CVI secondary to hypoxic-ischemic injury, resulting in visual impairment, dyspraxia, and abnormal visual evoked potential testing. The girl did not suffer from amblyopia, there was no evidence of relevant refractive errors or strabismus, so visual pathway damage was the cause of her visual deficit. Nevertheless, the patient underwent anti-amblyopia therapy and showed significant improvement in visual acuity after 12 months of treatment. The improvement, resulting from visual stimulation, was due to a good functional recovery by a better usage of the damaged visual pathways. The therapy included prescribing corrective glasses and implementing secondary occlusion of the better eye for 4 months, which was protracted for another 4 months, leading to further improvements in visual acuity.
CONCLUSIONS: The case report shows that addressing even minor refractive errors and implementing anti-amblyopia therapy can significantly improve vision in children with CVI, even without co-existing amblyopia. It also highlights the importance of early intervention and multidisciplinary rehabilitation in children with CVI, focusing on motor and cognitive skills. Additionally, it emphasizes the need for further research to establish evidence-based practice standards for improving vision in children with CVI.

Understanding longitudinal changes in why individuals frequent low-vision clinics is crucial for ensuring that patient care keeps current with changing technology and changing lifestyles. Among other findings, our results suggest that reading remains a prevailing patient complaint, with shifting priorities toward technology-related topics.
This study aimed to understand changes in patient priorities and patient care in low vision over the past decade.
We conducted a retrospective study of examination records (2009 to 2019, 3470 examinations) from two U.S. low-vision clinics. Automated word searches summarized two properties of the records: topics discussed during the case history and types of rehabilitative devices assessed. Logistic regression was used to model the effects of examination year, patient age, patient sex, and level of visual impairment.
Collapsing across all years, the most common topic discussed was reading (78%), followed by light-related topics (71%) and technology (59%). Whereas the odds of discussing reading trended downward over the decade (odds ratio, 0.57; P = .03), technology, social interaction, mobility, and driving trended upward (odds ratios, 4.53, 3.31, 2.71, and 1.95; all P \'s < 0.001). The most frequently assessed devices were tinted lenses (95%). Over time, video magnifier and spectacle assessments trended downward (odds ratios, 0.64 and 0.72; P = .004, 0.04), whereas assessments of other optical aids increased. The data indicate several consistent differences among patient demographics.
Reading is likely to remain a prevailing patient complaint, but an increase in technology-related topics suggests shifting priorities, particularly in younger demographics. \"Low-tech\" optical aids have remained prominent in low-vision care even as \"high-tech\" assistive devices in the marketplace continue to advance.

BACKGROUND: Fractures are common extremity injuries in pediatric orthopedic practice. The aim of this study is to determine the relationship between pediatric extremity fractures and visual impairments.
METHODS: Thirty pediatric patients who were admitted to the emergency and orthopedics and traumatology clinic due to an extremity fracture after a fall were included in the study. Following fracture treatment, the patients were evaluated in terms of ocu-lar findings before discharge from the hospital. Thirty age- and sex-matched healthy children who presented to the ophthalmology department for routine care were also recruited as the control group. All participants underwent a comprehensive ophthalmologic examination, including cycloplegic refraction, visual acuity levels, and near stereoacuity measurement.
RESULTS: The number of male participants was higher in both groups. There was no significant difference between the groups in terms of age and gender distribution. The most common upper extremity fractures were observed to be distal radius (52%) and distal humerus fractures (28%). The number of patients who had a refractive error that required spectacles was significantly higher in the fracture group (p=0.039). When the visual acuity levels of the better eye were evaluated, the mean visual acuity was significantly lower in the fracture group (p=0.016). The mean stereoacuity was also significantly lower in the study group (<0.001). In the binary logistic regression analysis model, low stereopsis levels were associated with the risk of pediatric extremity fractures (95% CI: 1.056-1.385; p=0.006).
CONCLUSIONS: Our study showed that low-energy pediatric extremity fractures are more common in children with visual im-pairments that require treatment, and low stereopsis is a risk factor for fractures. Consequently, regular eye examinations and early treatment of visual impairments in children may help to prevent fall-related injuries.

A 25-year-old longsighted woman presented with a history of spectacle and contact lens induced exacerbation of Tourette syndrome symptoms. Preoperatively, she had very poor unaided vision (6/60), achieving good (6/9) vision in both eyes with spectacle correction. The patient underwent bilateral simultaneous implantation of phakic implantable collamer lens (ICL) implants (STAAR, USA) which sit in front of the natural lens. Postoperatively, her uncorrected visual acuity was markedly improved as were her manifestations of Tourette syndrome. She achieved her full potential of unaided vision (6/9). This is the first documented case of Tourette syndrome triggered by glasses and contact lenses in which bilateral phakic toric lens implants were effective in improving vision and controlling motor symptoms. Phakic toric ICL implantation is a reversible technique for the correction of visually significant ametropia in selected patients and has improved this patient\'s quality of life.

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Musculoskeletal pain and headache are leading causes of years lived with disability, and an escalating problem in school children. Children spend increasingly more time reading and using digital screens, and increased near tasks intensify the workload on the precise coordination of the visual and head-stabilizing systems. Even minor vision problems can provoke headache and neck- and shoulder (pericranial) pain. This study investigated the association between headaches, pericranial tenderness, vision problems, and the need for glasses in children. An eye and physical examination was performed in twenty 10-15 year old children presenting to the school health nurse with headache and pericranial pain (pain group), and twenty age-and-gender matched classmates (control group). The results showed that twice as many children in the pain group had uncorrected vision and needed glasses. Most children were hyperopic, and glasses were recommended mainly for near work. Headache and pericranial tenderness were significantly correlated to reduced binocular vision, reduced distance vision, and the need for new glasses. That uncorrected vision problems are related to upper body musculoskeletal symptoms and headache, indicate that all children with these symptoms should have a full eye examination to promote health and academic performance.

CONCLUSIONS: The options that can help patients with congenital color vision defect, to a better professional and leisure adaptation, are very limited. Different haploscopic lenses can be considered, and their effects need to be investigated in patients with different defects.
OBJECTIVE: The purpose of this study was to present and discuss the effect of a pair of asymmetric long-pass filters fitted for deuteranopia, with the result of a 60% improvement in distinguishing red-green plates when compared with baseline.
METHODS: We report the case of a 51-year-old man with congenital deuteranopia fitted with haploscopic ChromaGen filters. During the 2-month follow-up, we observed a decrease in left-eye logMAR visual acuity and contrast sensitivity with an increased ability to discriminate the plates of different color vision tests (Ishihara, Farnsworth, and Hardy-Rand-Rittler). The visual outcomes are discussed considering the spectral sensitivity curves of each filter, measured with a spectrophotometric device.
CONCLUSIONS: This report describes an improvement in the ability to resolve color vision plates after using asymmetric haploscopic filters showing a left-eye decrease in logMAR visual acuity and contrast sensitivity function. Subjects with a history of color vision deficiency might benefit from using haploscopic filters that selectively minimize the transmittance within a specific bandwidth to improve the color discrimination in deutan color vision deficiency. The simultaneous analysis of the color vision outcomes and transmittance spectrum of the haploscopic filters might contribute to a better understanding of the mechanisms behind the claimed efficacy of these devices.

BACKGROUND: Persistent hyperplastic primary vitreous (PHPV) is a rare congenital developmental ocular disorder caused by incomplete regression of the embryonic hyaloid vasculature. Here we report a case of nonsurgical unilateral anterior PHPV that was managed by amblyopia treatment and resulted in an improvement of visual acuity and regression of the fetal vasculature.
METHODS: A three-year-old girl was diagnosed with unilateral anterior PHPV in the left eye, manifested with posterior pole cataract, posterior capsule opacification, tunica vasculosa lentis, and a floating hyaloid artery connected to the retrolental mass. The plaque was not large enough to fill the pupil, and conservative management along with amblyopia treatment was conducted. Nineteen months later, the visual acuity in the affected eye improved from 20/100 to 20/50 with correction, and the fetal vasculature regressed gradually and finally into a nonperfusion ghost vessel.
CONCLUSIONS: In PHPV-affected children, regression of the fetal vasculature may be observed, and conservative management and amblyopia treatment may be helpful for visual improvement.

This case report demonstrates a novel approach of using the optical principle of vergence amplification to correct for a visually impaired patient\'s ametropia while using a telescope system. This approach is easy to apply clinically.
The purpose of this study was to present a novel approach of correcting high myopia for a patient with visual impairment using a spectacle-mounted telescope.
A 51-year-old man desired improved distance vision for television viewing and facial recognition. His refractive error was -18.00 diopter sphere in each eye with best-corrected acuities of 5/225 (20/900 Snellen equivalent) for the right eye and 10/225 (20/450) for the left eye. Over the years, multiple attempts at contact lens use were unsuccessful, and the patient used spectacle prescription. After evaluating telescope systems, the patient was successful with a 7 × 30 Beecher Mirage Keplerian telescope system. This system cannot be worn over glasses. To correct his ametropia, a -0.25-diopter minus lens cap was applied in front of the objective lens of the telescope, capitalizing on the property of vergence amplification. In addition, the tube length was adjusted. Adding lenses in front of the telescope and focusing the telescope can both affect the angular magnification of the system. Depending on the lenses used, type of telescope, and refractive error, there can be an increase or decrease in angular magnification. In this case, the minus lens at the front of the telescope decreased the power of the objective lens, and the focusing for the remaining uncorrected myopia increased the power of the ocular lens. Both of these factors contributed to increased resultant angular magnification for this patient. The patient achieved 10/30 (20/60) vision and reported success with his distance vision.
Minus-powered lens caps over the objective lens are a viable option for highly myopic individuals who wish to use premanufactured spectacle-mounted telescopes.

BACKGROUND: To report a patient who presented with bluish scleral discoloration, keratoconus, and progressive high myopia.
METHODS: A 6-year-old Chinese female patient presented with a significant bluish discoloration of the sclera in both eyes and extreme corneal thinning with anterior corneal protrusion. General pediatric physical examination was normal for all systems and no genetic disorders known were observed.
CONCLUSIONS: We aim to highlight the importance of diagnosis and treatment of patients suffering from Brittle cornea syndrome. Timely diagnosis and early provision of protective glasses seem to be the most important step in treating BCS. To our knowledge, this is the first case of BCS being reported in the Asia area.